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Sample records for facet joint injections

  1. 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.

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

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    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.

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

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    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.

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

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    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.

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

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    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.

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

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    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

  7. 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.

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

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    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

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

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    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.)

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

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    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.

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

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    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.

  12. 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.

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

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    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

  14. 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.)

  15. 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).

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

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    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.

  17. [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.

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

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    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

  19. 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.

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

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    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.

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

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    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.

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

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    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.

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

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    Manchikanti L; Cash KA; McManus CD; Pampati V

    2012-01-01

    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 ...

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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

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

    Science.gov (United States)

    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.

  12. Steroid injections - tendon, bursa, joint

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007678.htm Steroid injections - tendon, bursa, joint To use the sharing features on ... painful. It can be injected into a joint, tendon, or bursa. Description Your health care provider inserts ...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  14. Three-dimensional evaluation of the facet joints

    Science.gov (United States)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Science.gov (United States)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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

  20. 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.)

  1. 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.

  2. 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

  3. 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.

  4. 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....

  5. 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....

  6. 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

  7. 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...

  8. 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...

  9. 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.

  10. 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.

  11. 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.

  12. 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.)

  13. 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.)

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. [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.

  17. 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.

  18. 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.)

  19. 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.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. A cadaveric study on sacroiliac joint injection.

    Science.gov (United States)

    Zou, Yu-Cong; Li, Yi-Kai; Yu, Cheng-Fu; Yang, Xian-Wen; Chen, Run-Qi

    2015-02-01

    The scope of this study was to explore the possibility as well as the feasibility of sacroiliac joint injection following simple X-ray clip location. For the cadaveric study, 10 fixed sacroiliac joint (SIJ) sectional specimens, 4 dried cadaveric pelvises and 21 embalmed adult cadaveric pelvises were dissected, followed by an injection of contrast agent into the joint. The irrigation of the agent was observed through CT scanning. For the radiologic study, 188 CT scans of ankylosing spondylitis patients (143 male, 45 female) were collected from 2010 to 2012, in Nanfang Hospital. What was measured was (1) Distance between the posterior midline and sagittal synovium; (2) Length of the sagittal synovium; (3) Distance between the midpoint of the sagittal synovium and posterior superior iliac spine; and (4) Distance between the superficial skin vertical to the sagittal synovium point were measured. For the practice-based study: 20 patients (17 males and 3 females) with early ankylosing spondylitis, from Nanfang Hospital affiliated with Southern Medical University were recruited, and sacroiliac joint unguided injections were done on the basis of the cadaveric and radiologic study. Only the inferior 1/3(rd) portion parallel to the posterior midline could be injected into since the superior 2/3(rd) portion were filled with interosseous ligaments. Thirteen of the 20 patients received successful injections as identified by CT scan using the contrast agent. Sacroiliac joint injection following simple X-ray clip location is possible and feasible if the operation is performed by trained physicians familiar with the sacroiliac joint and its surrounding anatomic structures.

  6. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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.

  9. 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.

  10. 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.

  11. [Temporomandibular joint arthropathy in situ steroid injection].

    Science.gov (United States)

    Gagé, J; Gallucci, A; Arnaud, M; Chossegros, C; Foletti, J M

    2016-09-01

    Temporomandibular disorders (TMDs) affect the masticatory muscles and the temporomandibular joints (TMJs). TMDs most often result from occlusal and/or muscular disorders and are then called primary or idiopathic TMDs. Less frequently, TMDs are related to local (trauma, infection) or general (rheumatoid arthritis) causes and are then called secondary TMDs. A little known iatrogenic cause of secondary TDM is the osteoarthritis that may be induced by intra-articular cortisone injections. We report one case of condylar lysis that occurred after one single intra-articular cortisone injection. A 62-years-old woman consulted for a long-lasting TMD on the left side manifesting itself through pain and noise. She benefited one year before from an intra-articular injection of cortisone by her rheumatologist for repeated closed lock of her left TMJ. Physical examination showed limited mouth opening with deviation on the left side. Lateral movements on the right side were impossible. The panoramic X-ray showed a condylar lysis on the left side that was on the CT scan. MRI additionally showed an anteriorly displaced and severely reshaped disc and an articular inflammation without intra-articular effusion. TMJ osteoarthritis secondary to unique or repeated intra-articular steroid injections are little-known. They are clinically expressed as typical TMDs and characterized on X-rays by condylar lysis and inflammation. Intra-articular injections of steroids are not totally harmless and other treatments must be preferred. Copyright © 2016. Published by Elsevier Masson SAS.

  12. 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.

  13. 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.)

  14. 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.

  15. Ultrasound-guided sacroiliac joint injection technique.

    LENUS (Irish Health Repository)

    Harmon, Dominic

    2008-07-01

    We describe a case report and technique for using a portable ultrasound scanner and a curvilinear transducer (4-5MHz) (SonoSite Micromaxx SonoSite, Inc. 21919 30th Drive SE Bothwell W. A.) to guide sacroiliac joint (SIJ) injection. A 42-year-old male presented with chronic lower back pain centered on his left SIJ. His pain averaged 7 out of 10 (numerical rating scale). For the ultrasound-guided SIJ injection the patient was placed in the prone position. The ultrasound transducer was oriented in a transverse orientation at the level of the sacral hiatus. Here the sacral cornuae were identified. Moving the transducer laterally from here, the lateral edge of the sacrum was identified. This bony edge was followed in a cephalad direction with the transducer maintained in a transverse orientation. A second bony contour, the ileum, was identified. The cleft between both bony contours represented the sacroiliac joint. This was found at 4.5 cm depth. Real-time imaging was used to direct a 22G spinal needle into the SIJ, where solution was injected under direct vision. The patient\\'s pain intensity decreased to a 2 out of 10 (numerical rating scale). Function improved and the patient was able to return to work. These improvements were maintained at 16 weeks. Ultrasound guidance does not expose patients and personnel to radiation and is readily accessible. Ultrasound-guided SIJ injections may have particular applications in the management of chronic lower back pain in certain clinical scenarios (e.g. pregnancy). Future studies to demonstrate efficacy and reproducibility are needed.

  16. 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

  17. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  19. 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.

  20. Design and validation of a simulator for equine joint injections.

    Science.gov (United States)

    Fox, Victoria; Sinclair, Charlotte; Bolt, David M; Lowe, John; Weller, Renate

    2013-01-01

    Joint injections are commonly used in equine practice for diagnosis and treatment of joint disorders. Performing joint injections is hence an essential skill for equine practitioners. However, opportunities for veterinary students to practice this skill are often scarce in veterinary curricula. The aim of this study was to design and validate an equine joint injection simulator. We hypothesized that the simulator will enhance student ability and confidence in performing joint injections. The simulator was constructed around an equine forelimb skeleton with soft tissues rebuilt using building foam and rubber bands. An electrical circuit including a buzzer, a battery, wire wool in the joints, and a hypodermic needle at the end of the cable was incorporated. If the students placed the needle into the joint correctly, instant auditory feedback was provided by the buzzer. To validate the simulator, 45 veterinary students were allocated to three groups: cadaver limb, textbook, or simulator. Students' ability to perform joint injections was tested and students' opinions were evaluated with a questionnaire. The proportion of students performing a metacarpophalangeal (MCP) joint injection correctly was significantly higher in the cadaver (93%) and simulator (76%) groups compared to the textbook group (50%). There was no significant difference between groups for performing a distal interphalangeal (DIP) joint injection correctly. Students rated the learning experience with the cadaver and simulator group high and with the textbook group low. The joint injection simulator represents an affordable teaching aid that allows students to repeatedly practice this skill in their own time with immediate feedback.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. Accuracy of Posterior Subtalar Joint Injection Without Fluoroscopy

    Science.gov (United States)

    Kirk, Kevin L.; Campbell, John T.; Guyton, Gregory P.

    2008-01-01

    Injection into the posterior subtalar joint has not been validated for accuracy using radiographic end points. We asked whether needle placement into a normal posterior subtalar joint could be performed accurately and selectively by experienced surgeons without fluoroscopic guidance. Three fellowship-trained orthopaedic foot and ankle surgeons each injected the posterior subtalar joint of 20 cadaveric specimens using an anterolateral approach. Fluoroscopic images were obtained by an independent investigator and blinded. A separate fellowship-trained foot and ankle surgeon interpreted the images. Of 60 injections, 58 were accurate and two were extraarticular based on interpretation by an independent foot and ankle surgeon. Extravasation into the ankle occurred in 14 samples and into the peroneal sheath in two samples. Experienced surgeons can place intraarticular injections into a radiographically normal posterior subtalar joint without fluoroscopy with a high degree of accuracy. However, extravasation into the ankle or peroneal tendon sheath occurred in an unpredictable fashion, suggesting selectivity of injection placement is relatively limited without the use of fluoroscopy. Fluoroscopy may not be necessary for injections used solely for therapeutic purposes. However, if the injection is intended for diagnostic purposes or to assist in surgical decision-making or if the joint is abnormal, we recommend fluoroscopy to ensure the subtalar joint is the only anatomic structure impacted by the injection. PMID:18404293

  9. 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.

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  12. 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.

  13. 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...

  14. 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.

  15. Injection in temporomandibular joint of rats. Description of technical protocol.

    Science.gov (United States)

    Fuentes, R; Veuthey, C; Arias, A; Saravia, D; Ottone, N E

    2017-03-01

    The development of animal models for research has been very diffused. Osteoarthritis is a joint degenerative pathology that induces cartilage erosion, chondrocyte proliferation and osteophyte formation. The aim of this paper is to present a technical procedure to perform the injection of monosodium iodine acetate in the temporomandibular joints of rats to generate osteoarthritis and to contribute to future research analysis related to pathology progression and proper treatment performance. The use of rat models may be a complex process because of their size, but they can be compared to the human temporomandibular joint due to the similar characteristics and the possibility of performing diagnosis and treatment protocols in order to detect this pathology.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. Symptomatic Lumbar Facet Synovial Cysts: Clinical Outcomes Following Percutaneous CT-Guided Cyst Rupture with Intra-articular Steroid Injection.

    Science.gov (United States)

    Haider, Steffen J; Na, Nu R; Eskey, Clifford J; Fried, Jessica G; Ring, Natalie Y; Bao, Mike H; Pastel, David A

    2017-08-01

    To evaluate clinical outcomes following percutaneous rupture of symptomatic lumbar facet synovial cysts (LFSCs) with intra-articular steroid injection. In this retrospective review, 44 consecutive patients with symptomatic LFSCs received primary treatment with CT-guided synovial cyst rupture with intra-articular steroid injection. Outcomes questionnaires were obtained before and 1, 4, 26, and 52 weeks after LFSC rupture. Assessment included pain medication use and numeric rating scale (NRS), Oswestry Disability Index (ODI), and 12-item short form health survey (SF-12) physical and mental composite scores (PCS and MCS). Clinical endpoint was 52-week survey response or surgery. LFSC rupture was technically successful in 84% (37/44) of cases. Clinical endpoint was reached in 68% (30/44) of patients with 82% overall 1-year follow-up. Lumbar spine surgery was performed in 25% (11/44) of patients within 1 year after procedure. Mean NRS, ODI, and SF-12 PCS demonstrated significant improvement at all follow-up time points (P < .001). At 52-week follow-up, NRS decreased from 8.1 to 3.7 (P < .001), ODI improved from 35 to 24 (P = .006), and SF-12 PCS improved from 31 to 42 (P < .001). Daily pain medication decreased from 71% (31/44) of patients before procedure to 29% (9/26) at 52-week follow-up (P = .012). History of prior lumbar intervention was associated with poorer LFSC rupture success (P = .025) and ODI (P = .047). NRS, ODI, and SF-12 PCS indices improved and pain medication use decreased significantly at all time points over 1-year follow-up after percutaneous rupture of symptomatic LFSCs with intra-articular steroid injection. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  5. 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.

  6. 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.

  7. Clinical study evaluating the accuracy of injecting the distal tarsal joints in the horse.

    Science.gov (United States)

    Seabaugh, K A; Selberg, K T; Mueller, P O E; Eggleston, R B; Peroni, J F; Claunch, K M; Markwell, H J; Baxter, G M

    2017-09-01

    Osteoarthritis (OA) of the centrodistal (CD) and tarsometatarsal (TMT) joints is a common cause of lameness in horses. Intra-articular diagnostic anaesthesia and/or therapeutic injection are relied upon to help diagnose and treat many horses with OA of these joints. The objective of this study was to determine the accuracy of arthrocentesis of the CD and TMT joints using a sample population of equine surgeons and surgery residents. Randomised experimental study. Six operators each injected four CD and four TMT joints in 12 sedated horses. The operators were randomly assigned to inject either the left CD and right TMT or the right CD and left TMT on four randomly assigned horses. The joints were injected with a 4 ml solution of contrast medium (2 ml), sterile saline (1.5 ml) and amikacin (0.5 ml). A minimum of two radiographs of each joint was obtained to evaluate the presence of contrast medium within the target joint. The TMT joint was successfully injected in 23/24 joints (96% accuracy). The CD joint was successfully injected in 10/24 joints (42% accuracy). Communication between the TMT and CD joints was visible in 26% of successful TMT injections. Communication between the CD and TMT joints was visible in 20% of successful CD injections. Despite specific requests to do so, we were unable to standardise the injection technique across all operators. The accuracy of injecting the TMT and CD joints of sedated horses was 96 and 42%, respectively. The CD joint was frequently missed with contrast medium being placed in the periarticular tissues. These data support the clinical impression of the difficulty of injecting the CD joint and suggests that practitioners should utilise ancillary methods, such as radiographs, to ensure proper needle placement. © 2017 EVJ Ltd.

  8. Evidence-based radiology (part 1): Is there sufficient research to support the use of therapeutic injections for the spine and sacroiliac joints?

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Cynthia; Hodler, Juerg [Orthopaedic University Hospital of Balgrist, Radiology, Zuerich (Switzerland)

    2010-01-15

    This review article addresses the best evidence currently available for therapeutic injection therapy for conditions targeting the spine and sacroiliac joints. The article is presented by spinal region. Controversies and areas of interest for further studies are identified. There is conclusive evidence supporting the effectiveness of the caudal approach for the administration of epidural steroid injections for patients with low back pain from a variety of causes. In general, there is moderate-to-strong evidence supporting the use of transforaminal therapeutic epidural injections for lumbar nerve-root compression and facet injections for joint pain arising from these joints in the cervical, thoracic and lumbar spine, but further subgroup analysis is needed to help predict which specific patients may receive the most benefit from these procedures. No randomized controlled trials, meta-analyses or systematic reviews addressing the effectiveness of therapeutic sacroiliac joint injections have been found. For some injections, corticosteroids may not provide better outcomes compared to local anesthetic injections alone. (orig.)

  9. Long-Acting Diclofenac Ester Prodrugs for Joint Injection

    DEFF Research Database (Denmark)

    Mertz, Nina; Larsen, Susan Weng; Kristensen, Jesper

    2016-01-01

    A prodrug approach for local and sustained diclofenac action after injection into joints based on ester prodrugs having a pH-dependent solubility is presented. Inherent ester prodrug properties influencing the duration of action include their pH-dependent solubility and charge state, as well...... as susceptibility to undergo esterase facilitated hydrolysis. In this study, physicochemical properties and pH rate profiles of 3 diclofenac ester prodrugs differing with respect to the spacer carbon chain length between the drug and the imidazole-based promoiety were determined and a rate equation for prodrug...... degradation in aqueous solution in the pH range 1-10 was derived. In the pH range 6-10, the prodrugs were subject to parallel degradation to yield diclofenac and an indolinone derivative. The prodrug degradation was found to be about 6-fold faster in 80% (vol/vol) human plasma as compared to 80% (vol...

  10. 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.

  11. 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.)

  12. 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.

  13. Investigation of Using Injection-Locked Fabry-Pérot Laser Diode With 10% Front-Facet Reflectivity for Short-Reach to Long-Reach Upstream PON Access

    National Research Council Canada - National Science Library

    Hsing-Yu Chen; Chien-Hung Yeh; Chi-Wai Chow; Jiun-Yu Sung; Yen-Liang Liu; Jeyhong Chen

    2013-01-01

    In this paper, we propose and investigate an injection-locked Fabry-Pérot laser diode (FP-LD) with 10% front-facet reflectivity by using orthogonal frequency-division multiplexing-quadrature amplitude modulation...

  14. Combined pre-injection wrist and ankle MRI protocol and steroid joint injections in juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H. [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Graham, T.B. [Monroe Carell Jr. Children' s Hospital at Vanderbilt, Department of Pediatric Rheumatology, Nashville, TN (United States)

    2011-10-15

    Precise localization of affected compartments of the wrist and ankle in children with an established diagnosis of juvenile idiopathic arthritis (JIA) is clinically challenging. The purpose of this paper is to describe our experience utilizing a pre-injection MRI protocol of the wrist and ankle for localizing disease activity followed by fluoroscopically guided joint injections in children with JIA. (orig.)

  15. 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.

  16. 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

  17. Feasibility and accuracy of ultrasound-guided sacroiliac joint injection in dogs.

    Science.gov (United States)

    Jones, Jeryl C; Gonzalez, Luis M; Larson, Martha M; Freeman, Larry E; Werre, Stephen R

    2012-01-01

    Frozen cadaver specimens from three dogs were used to create a sectional anatomic atlas of the sacroiliac region. Frozen/thawed cadaver specimens from 12 dogs were used to develop an ultrasound-guided sacroiliac joint injection technique. Accuracy of the technique was tested in 15 additional canine cadaver specimens, using injectate containing blue dye and iodinated contrast medium. Sonoanatomic landmarks for consistently identifying a caudodorsal window into the canine sacroiliac joint space included the L7-S1 articular process joints, ilial wing, sacral wing, sacral lamina, and median sacral crest. Accuracy of ultrasound-guided sacroiliac joint injection was not significantly affected by operator, but was affected by the tissue location targeted and the reference standard used for calculations. Accuracy of the technique was good for placing injectate into either the synchondrosis component, dorsal sacroiliac ligament or ventral sacroiliac ligament; fair to poor for placing injectate into the synovial component; and poor for placing injectate into all four sacroiliac soft tissue structures. Concurrent placement of injectate into extraarticular tissues occurred frequently. We conclude that ultrasound-guided sacroiliac joint injection is feasible for evaluation as a treatment method for lumbosacral region pain in dogs, but is not sufficiently accurate for localizing pain to the sacroiliac joint alone.

  18. Mycobacterium avium-intracellulare cellulitis occurring with septic arthritis after joint injection: a case report

    Directory of Open Access Journals (Sweden)

    Murdoch David M

    2007-02-01

    Full Text Available Abstract Background Cellulitis caused by Mycobacterium avium-intracellulare has rarely been described. Mycobacterium avium-intracellulare is a rare cause of septic arthritis after intra-articular injection, though the causative role of injection is difficult to ascertain in such cases. Case presentation A 57-year-old with rheumatoid arthritis treated with prednisone and azathioprine developed bilateral painful degenerative shoulder arthritis. After corticosteroid injections into both acromioclavicular joints, he developed bilateral cellulitis centered over the injection sites. Skin biopsy showed non-caseating granulomas, and culture grew Mycobacterium avium-intracellulare. Joint aspiration also revealed Mycobacterium avium-intracellulare infection. Conclusion Although rare, skin and joint infections caused by Mycobacterium avium-intracellulare should be considered in any immunocompromised host, particularly after intra-articular injection. Stains for acid-fast bacilli may be negative in pathologic samples even in the presence of infection; cultures of tissue specimens should always be obtained.

  19. Transverse morphology of the sacroiliac joint: effect of angulation and implications for fluoroscopically guided sacroiliac joint injection

    Energy Technology Data Exchange (ETDEWEB)

    Ling, B.C.; Lee, J.W.; Man, H.S.J.; Grace, M.G.A.; Lambert, R.G.W. [Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton (Canada); Jhangri, G.S. [Department of Public Health Sciences, University of Alberta Hospital, Edmonton (Canada)

    2006-11-15

    Effects of angulation of computed tomography (CT) reconstruction plane on sacroiliac (SI) joint morphology were studied, and factors influencing the approach to fluoroscopically guided SI joint injection were assessed. CT scans of pelvises were reformatted on 41 subjects, aged 51.7 ({+-}15.1) years. Transverse images were reconstructed at the caudal 3 cm of the SI joint tilting plane of reconstruction from -30 to +30 at 15 increments. Anteroposterior diameter of joint (depth), angle from sagittal plane (orientation angle), and distance from skin were measured. Joint contour was classified, and presence of bone blocking access to the joint was recorded. Comparison between angles were analysed by t-test. Relationships between variables were assessed by a Pearson correlation test. Depth was shorter with angulation in the inferior direction (P<0.01). Orientation angle increased with superior angulation (P<0.01). Distance from skin increased (P<0.01) with angulation in either direction. Joint contour was significantly different from baseline at each angle (P<0.001) but highly variable. Inferior angulation resulted in interposition of ilium between skin and SI joint, and superior angulation caused bone block due to the lower sacrum. None of these features was identified without tilting of the reconstruction plane, and effects were more pronounced with steeper angulation.

  20. 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.

  1. Fluoroscopy-Guided Sacroiliac Intraarticular Injection via the Middle Portion of the Joint.

    Science.gov (United States)

    Kurosawa, Daisuke; Murakami, Eiichi; Aizawa, Toshimi

    2016-12-30

    OBJECTIVE : Sacroiliac intraarticular injection is necessary to confirm sacroiliac joint (SIJ) pain and is usually performed via the caudal one-third portion of the joint. However, this is occasionally impossible for anatomical reasons, and the success rate is low in clinical settings. We describe a technique via the middle portion of the joint. DESIGN : Observational study. SUBJECTS : Enrolled were 69 consecutive patients (27 men and 42 women, with an average age of 53 years) in whom the middle portion of 100 joints was targeted.

  2. 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

  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. 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

  5. Conservative treatment of temporomandibular joint osteoarthrosis: intra-articular injection of sodium hyaluronate.

    Science.gov (United States)

    Guarda-Nardini, L; Masiero, S; Marioni, G

    2005-10-01

    Promising short-term results in the treatment of temporomandibular joint osteoarthrosis with intra-articular injections of sodium hyaluronate (SH) have been reported in preliminary studies. The present prospective study compared long-term outcomes of temporomandibular joint SH injections with those of a conventional non-surgical treatment (bite-plane). Data from three groups of 20 patients with degenerative temporomandibular joint disease were considered. Group A underwent one cycle of five injections of 1 mL SH. Group B underwent a bite-plane treatment for at least 6 months. We considered a control group of 20 patients who refused any treatments. The description of the outcomes was based on objective and subjective parameters after a 6-month follow-up. Sodium hyaluronate and bite-plane treatments significantly improved patients conditions in all considered parameters. No significant differences in outcomes were confirmed by the statistical analysis. The tolerability of SH treatment resulted to be significantly higher. The analysis of results of serial controls in the SH treated group disclosed a significant worsening in pain at rest by comparing 1 and 6 months follow-up. Sodium hyaluronate infiltration resulted a valid non-surgical treatment for temporomandibular joint degenerative disease. Five well-tolerated intra-articular SH injections achieved equivalent results to those of a 6 months bite-plane treatment. We did not diagnose any complications of SH intra-articular injections. Longer time follow-up is necessary to determine the stability of SH properties.

  6. Accuracy of non assisted glenohumeral joint injection in the office setting

    Energy Technology Data Exchange (ETDEWEB)

    Sidon, Eliezer, E-mail: eli.sidon@gmail.com [Department of Orthopedics, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Velkes, Steven, E-mail: velkes@yahoo.com [Department of Orthopedics, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Shemesh, Shai, E-mail: shai.shemesh@gmail.com [Department of Orthopedics, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Levy, Jakob, E-mail: Jlevy@clalit.org.il [Department of Imaging, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Glaser, Ernesto, E-mail: glaser.ernesto@gmail.com [Department of Imaging, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Kosashvili, Yona, E-mail: yonasofi@gmail.com [Department of Orthopedics, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel)

    2013-12-01

    Purpose: The diagnostic and therapeutic success of shoulder joint injection depends on its accuracy. Two recent studies reported high success (93–96%) for non-imaging-assisted anterior injection in anesthetized patients. This study examined the accuracy of anterior shoulder injection in awake patients under conditions similar to the office setting. Methods: The study group consisted of 166 consecutive patients with shoulder pain who underwent diagnostic magnetic resonance arthrography at a tertiary medical center in 2011–2012. As part of the examination, contrast material was injected into the glenohumeral joint via an anterior approach by a certified musculoskeletal radiologist without any image assistance. Success was defined as contrast material limited to the intra-articular joint on the scan, without scatter to the periauricular tissue. Results: A successful injection was verified by magnetic resonance arthography in 163 patients (98.2%). Conclusions: Non-assisted anterior shoulder injection is highly accurate (98.2%) in the hands of an experienced radiologist, even in awake patients.

  7. Relaxation phenomena and jointing in ore bodies under explosive injection treatment

    Science.gov (United States)

    Shevchenko, YuS

    2017-02-01

    Under analysis are relaxation phenomena in ore bodies under leaching. It is shown that liquid and gas–liquid phases make these phenomena last longer, thus it is recommended to apply synergetically interconnected processes of explosive fracture of an ore block and simultaneous injection of active leaching solutions in the generated system of joints.

  8. Autologous blood injection to the temporomandibular joint: magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Candirili, Celal; Yuece, Serdar; Cavus, Umut Yuecel; Akin, Kayihan; Cakir, Banu [Fatih University Hospital, Ankara (Turkmenistan)

    2012-03-15

    The aim of this study was to investigate the effect of the autologous blood injection (ABI) for chronic recurrent temporomandibular joint (TMJ) dislocation using magnetic resonance imaging (MRI). ABI was applied to 14 patients who had chronic recurrent TMJ dislocation. MRIs of the patients were taken and compared before and one month after the injection. All of the patients had no dislocations of their TMJs on clinical examination one month after the injection. In the pre-injection, unilateral or bilateral TMJ dislocations were observed on MRIs in all patients. One month after the injection, TMJ dislocations were not observed in MRI evaluation of any patients. A significant structural change that caused by ABI was not observed. The procedure was easy to perform and it caused no foreign body reaction. However, it was unclear how the procedure prevented the dislocation.

  9. Evaluation of a caudolateral approach for arthrocentesis and injection of the equine elbow joint.

    Science.gov (United States)

    Bodaan, C J; Riley, C B; Engeli, E

    2016-08-13

    The objectives of this study were to evaluate the likelihood of successful arthrocentesis of the equine elbow joint using the caudolateral approach and to determine if the deep branch of the radial nerve (DBRN) varies in its proximity to the site of centesis. Methylene blue (MB) was injected into 71 elbow joint specimens immediately caudal to the lateral collateral ligament using a 3.8-cm needle advanced to its hub. The elbow joints were dissected, staining of the synovial structures assessed and the proximity of DBRN to the site of centesis evaluated. The articular cartilage of all 71 joints was stained with MB. The location of DBRN did not vary substantially among the specimens and did not course close to the site of centesis. Direct communication was found between the bursa of the tendon of the ulnaris lateralis muscle and the elbow joint in 41 of 71 specimens (57.8 per cent). The caudolateral approach for centesis of the equine elbow joint, performed by inserting a needle 3.8-cm, was found to be reliable. Radial nerve paralysis reported to be caused by injection of local anaesthetic solution using the caudolateral approach may be due to diffusion of the solution from the dorsal pouch rather than from leakage at the site of centesis.

  10. 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...

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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...

  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. 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.

  19. ROLE OF PRP AND STEM CELL INJECTIONS IN OSTEOARTHRITIC PATIENTS OF KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Srinivas

    2015-07-01

    stem cells injections in to the osteoarthritic knees , produces good results and safe . I f the patient is not opting for surgical procedures and this is the only better treatment modality for controlling the pain and improvement of joint function. Hence use of PRP and stem cells injections in osteoarthritic patients is great value in preventing the further damage of the cartilage . By repairing the damaged cartilage with the PRP and stem cells , pain is greatly reduced , increase in the function of joint and patients will have better quality of life.

  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. [Arthrocentesis of the temporomandibular joint and intra-articular injections : An update].

    Science.gov (United States)

    Marty, P; Louvrier, A; Weber, E; Dubreuil, P-A; Chatelain, B; Meyer, C

    2016-09-01

    Arthocentesis of the temporomandibular joint combined with intra-articular washout and, more recently, intra-articular injection of pharmacological agents has been developed from the 1990s and is nowadays extensively in use for the treatment of temporomandibular dysfunctions (TMDs). The goal of our work was to answer 3 questions: 1. Is intra-articular washout effective for the treatment of TMDs ? 2. What kind of pharmacological agents may nowadays be injected in addition to washout and are these injections useful ? 3. What is the place of these treatments in the treatment strategies of TMDs ? A bibliographic research has been carried out in the PubMed database using following keywords arthrocentesis, temporomandibular joint. The 27 articles published between 1991 and 2016, indicating patient's inclusion criterions and objectively evaluating the clinical results (mouth opening, intra-articular noises, pain) were selected. Pharmacological agents were noticed when used. 1. All authors concluded to the efficacy of intra-articular washout. No prognostic factor for arthrocentesis efficacy could be identified. 2. Main pharmacological agents used were steroids, hyaluronic acid, morphine-based drugs and platelet rich plasma. Superiority of ith-injection protocols failed to win unanimous support. All authors who compared with- and without-injection protocols concluded to the superiority of with-injection protocols, whatever the agent. Numerous studies have proven the efficacy of intra-articular washout for the treatment of TMDs resistant to noninvasive treatments. The advantage of any kind of pharmacological agent is not clear. Mechanisms of action are not all elucidated. No pharmacological agent showed any superiority over another. Study methodologies are often defective: imprecise inclusion criterions, short follow-up, confounding variables not taken into account, few comparison between pharmacological agents. Copyright © 2016 Elsevier Masson SAS. All rights

  2. Fluoroscopy-Guided Sacroiliac Joint Injection: Description of a Modified Technique.

    Science.gov (United States)

    Kasliwal, Prasad Jaychand; Kasliwal, Sapana

    2016-02-01

    Sacroiliac joint (SIJ) pathology is a common etiologic cause for 10 - 27% of cases of mechanical low back pain (LBP) below the L5 level. In the absence of definite clinical or radiologic diagnostic criteria, controlled blocks of the SIJ have become the choice assessment method for making the diagnosis of SIJ pain. The SI joint is most often characterized as a large, auricular-shaped, diarthrodial synovial joint. In reality, its synovial characteristic is limited only to the distal third and anterior third. In SIJ interventions, the lateral view has been underutilized. In our technique, we used the lateral view to create a three-dimensional view of the SIJ to aid in gauging the accurateness of the contrast spread and to obtain a precise block. After obtaining appropriate fluoroscopic images, a curved tip spinal needle was directed into the inferior aspect of the SIJ using a posterior approach. As the needle contacts firm tissues on the posterior aspect of the joint, position of the needle tip is checked using lateral fluoroscopy. In the lateral view, the needle tip position is manipulated to keep it in the anterior third of the SIJ and contrast is injected. Our criteria for accurate SIJ block, in posteroanterior (PA) view, is the injection of the contrast medium should outline the joint space and the contrast medium should be seen to travel cephalad along the joint line. In the lateral view, the contrast medium most densely outlines the parameter of the joint. We have utilized this method with good effect in approximately 30 cases over one year. Out of 30 cases, needle position and contrast spread was satisfactory in 28 and 27 cases, respectively. So satisfactory needle placement and contrast spread was in 93% and 87% cases. Pain relief of 80% or more after intra-articular injection of local anesthetic was seen in 50% (15 of 30) patients; pain relief of 50 - 79% was witnessed in 30% (9 of 30) patients. Thus, pain decreased 50% or more in 80% (24 of 30) of the joints

  3. 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...

  4. Intra-articular injection of tenoxicam following temporomandibular joint arthrocentesis: a pilot study.

    Science.gov (United States)

    Aktas, I; Yalcin, S; Sencer, S

    2010-05-01

    This study examined the clinical and radiological effects of intra-articular tenoxicam injection following arthrocentesis and compared them with arthrocentesis alone in patients with disc displacement without reduction (DDwoR). 24 temporomandibular joints (TMJs) in 21 patients with DDwoR were studied. Patients were divided randomly into Group A in which only arthrocentesis was performed (14 TMJs in 14 patients) and Group AT which received arthrocentesis plus intra-articular injection of tenoxicam (10 TMJs in 7 patients). Patients were evaluated before the procedure, on postoperative day 7, then 2, 3, 4 weeks, and 2, 3, 4, 5, 6 months postoperatively. Intensity of joint pain was assessed using a visual analog scale. Maximum mouth opening was recorded at each follow-up. TMJ sounds and palpation scores were noted as positive or negative. Magnetic resonance imaging (MRI) was performed before and 6 months after treatment in both groups. Disc form, disc location during neutral position, reduction with movement, joint effusion, structures of the articular surfaces, and bone marrow anomalies were evaluated all in MRIs. Both treatments succesfully increased maximum mouth opening and reduced TMJ pain; there were no complications. Difference between the groups was not statistically significant and a larger controlled study is necessary to clarify this use of tenoxicam.

  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. Comparative study on the effectiveness of corticosteroid injections between trigger fingers with and without proximal interphalangeal joint flexion contracture.

    Science.gov (United States)

    Shinomiya, R; Sunagawa, T; Nakashima, Y; Kawanishi, Y; Masuda, T; Ochi, M

    2016-02-01

    Trigger fingers with proximal interphalangeal joint flexion contracture are suggested to have a poorer response to corticosteroid injection than those without contracture, though this has not been proven scientifically. We compared the clinical response to corticosteroid injection between trigger fingers with and without proximal interphalangeal joint contracture, and investigated the influence of the injection on the A1 pulley and flexor digitorum tendons using ultrasonography. One month after injection, pain was significantly reduced in the no contracture group, and 56% of trigger fingers with proximal interphalangeal joint contracture resolved. Before injection, relative thickening of the A1 pulley and flexor digitorum tendons, and a partial hypoechoic lesion of the flexor digitorum superficialis tendon were observed in the contracture group. One month after injection, the thickening of the tendons and the A1 pulley was reduced, but the partial hypoechoic lesion was still observed in significant numbers. We have demonstrated that the presence of a proximal interphalangeal joint contracture was associated with a reduced clinical response to corticosteroid injection, and we suggest that the pathologic change in the flexor digitorum superficialis tendon, represented by the partial hypoechoic lesion, contributed to corticosteroid injection resistance. IV. © The Author(s) 2015.

  7. 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.

  8. Spine epidural and sacroiliac joints injections – when and how to perform

    Energy Technology Data Exchange (ETDEWEB)

    D’Orazio, Federico, E-mail: federico.dorazio@gmail.com; Gregori, Lorenzo Maria, E-mail: lollog@hotmail.it; Gallucci, Massimo, E-mail: massimo.gallucci@cc.univaq.it

    2015-05-15

    Highlights: • Image guided interventions focused to administer drugs inside the epidural space are effective in reducing the perceived spinal pain, but their efficacy seems to be limited in time. • To treat spinal pain with image guided interventions is safe and repeatable. • Sacroiliac dysfunction is a common cause of sciatica-like pain which can be treated with CT-guided interventions (both steroids and pulsed RF denervation). - Abstract: Objectives: To review the state-of-the-art of image – guided techniques used to treat painful syndromes of the lower back, their indications, how they should be performed, their related risks and the expected results. Methods: We describe the actual standards about image-guided infiltrative therapies both on spine and on sacroiliac joints. Results: Both spinal epidural and sacroiliac injections appear useful in a large percentage of treated patients to get control of the perceived pain. Performing these therapies under CT or fluoroscopic guidance is the best and safest way to obtain satisfactory results because it is possible to target the use of drugs directly to the involved painful structures. Conclusions: Image-guided injections of the epidural space and of the sacroiliac joints are effective techniques for the treatment of pain; their effectiveness is sometimes not lasting for long periods of time but considering the low associated risk when performed by trained personnel, they can be easily repeated.

  9. Local steroid injection accompanied by ultrasonographic imaging in the treatment of

    Directory of Open Access Journals (Sweden)

    Murat Karkucak

    2014-03-01

    Full Text Available Ultrasonography (USG is becoming increasingly important in visualizing the musculoskeletal system. It is used as a diagnostic guide and in local injection procedures but is less frequently applied in visualizing deep joints and injections. The purpose of this study is to describe the results of USG-guided facet joint injection in a 19-year-old male patient with low back pain for the preceding year and a preliminary diagnosis of facet syndrome, together with a review of the literature. J Clin Exp Invest 2014; 5 (1: 126-128

  10. 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

  11. Predictive factors of hyaluronic acid injections short-term effectiveness for TMJ degenerative joint disease.

    Science.gov (United States)

    Guarda-Nardini, L; Ferronato, G; Favero, L; Manfredini, D

    2011-05-01

    This study attempted to identify baseline predictors of positive outcome of arthrocenteses plus hyaluronic acid injections in degenerative temporomandibular joint disease (TMJ DJD). Ninety (n=90) consecutive patients with Research Diagnostic Criteria for Temporomandibular Disorders TMJ osteoarthritis (RDC/TMD 1.0 Axis I Group IIIb) underwent a cycle of five arthrocenteses with injections of 1mL hyaluronic acid and were followed up for 3months. Eight potential predictors of positive treatment outcome (sex, age, pain duration, baseline pain at chewing, presence of uni- or bilateral arthritis, presence of other concurrent RDC/TMD diagnoses, type of intervention and tolerability of treatment) were included in a logistic regression model to identify baseline predictors of treatment effectiveness. At follow-up, 85·6% of patients improved with respect to baseline VAS values, and 64·4% had a 50% or more decrease (positive outcomes). Correlation with positive outcomes existed only for unilateral osteoarthritis, and the logistic regression identified the side of arthritis (unilateral/bilateral) as the only predictor of positive treatment outcome (P=0·032). The achievement of any treatment improvement was predicted by high baseline pain levels (P=0·016). The regression models explained only 7·7-15% of the variance in the outcome variable. The attempts to find predictors of positive treatment outcome with HA injections for TMJ degenerative joint disease have been successful only in part. The search for other outcome predictors is likely to benefit from the assessment of psychosocial features associated with TMJ disorders.

  12. 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

  13. Glucosamine oral administration as an adjunct to hyaluronic acid injection in treating temporomandibular joint osteoarthritis.

    Science.gov (United States)

    Cen, Xiao; Liu, Yan; Wang, Shasha; Yang, Xianrui; Shi, Zongdao; Liang, Xinhua

    2017-09-01

    To investigate the therapeutic effect of oral glucosamine (GS) as an adjunct to hyaluronic acid (HA) injection on patients with temporomandibular joint osteoarthritis (TMJ OA). In this clinical trial, 136 participants, diagnosed as TMJ OA clinically and radiographically, were enrolled and randomized into two groups (Group GS+HA: oral GS+HA injection; Group placebo+HA: oral placebo+HA injection). Pain, maximum inter-incisal mouth opening (MMO), the levels of IL-1β, IL-6, and TGF-β in TMJ synovial were defined as the outcome measurements and conducted before operation, and at 1-month, 1-year follow-up. In both groups, pain scores were decreased and MMOs were increased at 1-month and 1-year follow-up, the changes at 1-year follow-up showed statistically significant intergroup differences. At 1-month follow-up, only IL-6 concentration was lower in group GS+HA than that in group placebo+HA. One year later, TGF-β concentration was higher, IL-6 and IL-1β concentrations were lower in group GS+HA than those in group placebo+HA. Both strategies alleviated symptoms in short term, but the patients treated with GS benefited more than those with placebo in long term, which may be due to the suppression of IL-1β and IL-6 and the stimulation of TGF-β. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. 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

  15. INJECTION MOLDING AND STRUCTURAL ANALYSIS IN METAL TO PLASTIC CONVERSION OF BOLTED FLANGE JOINT BY CAE

    Directory of Open Access Journals (Sweden)

    Marian Blaško

    2014-12-01

    Full Text Available Many metal parts in various applications are being replaced by plastic parts. There are several reasons for that depending on actual application - minimize part cost, enhance corrosion resistance, integrating more components into one part etc. Most important steps of metal to plastic conversion are material selection and design of plastic part. Plastic part has to withstand the same load as metal part. To fulfill this requirement fiber reinforced engineering plastics are often used. Also it is convenient to substitute heavy wall sections with ribbed structure to increase load-carrying ability of part and decrease cycle time, eliminate voids, sink marks etc. Mechanical properties of such part could be highly affected by fiber orientation. Results of fiber orientation from injection molding filling analysis can be used in stress analysis for better prediction of part response to mechanical load. Such coupled analysis is performed here in this case study on bolted flange joint.

  16. 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

  17. 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.

  18. 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.

  19. Measurement and analysis of internal loss and injection efficiency for continuous-wave blue semipolar ( 20 2 ¯ 1 ¯ ) III-nitride laser diodes with chemically assisted ion beam etched facets

    Science.gov (United States)

    Becerra, Daniel L.; Kuritzky, Leah Y.; Nedy, Joseph; Saud Abbas, Arwa; Pourhashemi, Arash; Farrell, Robert M.; Cohen, Daniel A.; DenBaars, Steven P.; Speck, James S.; Nakamura, Shuji

    2016-02-01

    Continuous-wave blue semipolar ( 20 2 ¯ 1 ¯ ) III-nitride laser diodes were fabricated with highly vertical, smooth, and uniform mirror facets produced by chemically assisted ion beam etching. Uniform mirror facets are a requirement for accurate experimental determination of internal laser parameters, including internal loss and injection efficiency, which were determined to be 9 cm-1 and 73%, respectively, using the cavity length dependent method. The cavity length of the uncoated devices was varied from 900 μm to 1800 μm, with threshold current densities ranging from 3 kA/cm2 to 9 kA/cm2 and threshold voltages ranging from 5.5 V to 7 V. The experimentally determined internal loss was found to be in good agreement with a calculated value of 9.5 cm-1 using a 1D mode solver. The loss in each layer was calculated and in light of the analysis several modifications to the laser design are proposed.

  20. A randomized, double-blind, controlled study of ultrasound-guided corticosteroid injection into the joint of patients with inflammatory arthritis.

    LENUS (Irish Health Repository)

    Cunnington, Joanna

    2010-07-01

    Most corticosteroid injections into the joint are guided by the clinical examination (CE), but up to 70% are inaccurately placed, which may contribute to an inadequate response. The aim of this study was to investigate whether ultrasound (US) guidance improves the accuracy and clinical outcome of joint injections as compared with CE guidance in patients with inflammatory arthritis.

  1. Intra-articular distribution pattern after ultrasound-guided injections in wrist joints of patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Boesen, Mikael [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark)], E-mail: parker@frh.regioh.dk; Jensen, Karl Erik [State Hospital, Department of Radiology, MRI Division, Copenhagen (Denmark)], E-mail: karl.erik.Jensen@rh.regionh.dk; Torp-Pedersen, Soren [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark); Cimmino, Marco A. [Rheumatologic Clinic, Department of Internal Medicine, University of Genoa (Italy)], E-mail: cimmino@unige.it; Danneskiold-Samsoe, Bente; Bliddal, Henning [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark)

    2009-02-15

    Objective: To investigate the distribution of an ultrasound-guided intra-articular (IA) injection in the wrist joint of patients with rheumatoid arthritis (RA). Methods: An ultrasound-guided IA drug injection into the wrist joint was performed in 17 patients with 1 ml methylprednisolone (40 mg/ml), 0.5 ml Lidocaine (5 mg/ml) and 0.15 ml gadolinium (Omniscan 0.5 mmol/ml). The drug solution was placed in the central proximal part of the wrist between the distal radius and the lunate bone. Coronal and axial MRI sequences were performed after the injection to visualize the distribution. Carpal distribution (radio-carpal, inter-carpal, and carpo-metacarpal) as well as radio-ulnar distribution was recorded. Full distribution in one compartment was given the value 1, partial distribution 0.5 and no distribution 0. A sum of the total distribution for all four compartments was calculated and correlated to the clinical parameters and the MRI OMERACT scores. Results: No uniform pattern was seen in the distribution of the contrast. Only two patients had full contrast distribution to all four compartments, and the mean distribution count for all patients was 2.4 (range 0.5-4). The distribution count correlated with the MRI OMERACT synovitis score (r = 0.60, p = 0.014), but not with the erosions, bonemarrow oedema scores or any clinical parameters. Conclusion: The distribution of contrast on MRI showed patient specific and random patterns after IA injections in active RA wrist joints. The degree of distribution increased with the MRI synovitis score, while no association was found with the erosion- and bonemarrow oedema score. These results indicate that a single injection into a standard injection site in the proximal part of the wrist cannot be assumed to distribute - and treat - the whole joint.

  2. 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.

  3. 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

  4. 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

  5. Fluoroscopy-guided intra-articular steroid injection for sternoclavicular joint arthritis secondary to limited cutaneous systemic sclerosis: a case report

    Science.gov (United States)

    Güler, Emel; Cüce, Isa; Erol, Kemal

    2017-01-01

    We report a case of fluoroscopy-guided intraarticular steroid injection for sternoclavicular joint (SCJ) arthritis caused by limited cutaneous systemic sclerosis (SSc). A 50-year-old woman diagnosed with limited cutaneous SSc presented with swelling and pain in the right SCJ. MRI revealed signs of inflammation consistent with right-sided sternoclavicular joint arthritis. After the failure of oral medications, we performed fluoroscopy-guided injection in this region. She reported complete resolution of her symptoms at 4 and 12-week follow-ups. This outcome suggests that a fluoroscopy-guided SCJ injection might be a safe and successful treatment option for sternoclavicular joint arthritis. PMID:28119772

  6. 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.

  7. Radiation dose reduction in CT-guided sacroiliac joint injections to levels of pulsed fluoroscopy: a comparative study with technical considerations

    Directory of Open Access Journals (Sweden)

    Artner J

    2012-08-01

    Full Text Available Juraj Artner, Balkan Cakir, Heiko Reichel, Friederike LattigDepartment of Orthopaedic Surgery, University of Ulm, RKU, GermanyBackground: The sacroiliac (SI joint is frequently the primary source of low back pain. Over the past decades, a number of different SI injection techniques have been used in its diagnosis and therapy. Despite the concerns regarding exposure to radiation, image-guided injection techniques are the preferred method to achieve safe and precise intra-articular needle placement. The following study presents a comparison of radiation doses, calculated for fluoroscopy and CT-guided SI joint injections in standard and low-dose protocol and presents the technical possibility of CT-guidance with maximum radiation dose reduction to levels of fluoroscopic-guidance for a precise intra-articular injection technique.Objective: To evaluate the possibility of dose reduction in CT-guided sacroiliac joint injections to pulsed-fluoroscopy-guidance levels and to compare the doses of pulsed-fluoroscopy-, CT-guidance, and low-dose CT-guidance for intra-articular SI joint injections.Study design: Comparative study with technical considerations.Methods: A total of 30 CT-guided intra-articular SI joint injections were performed in January 2012 in a developed low-dose mode and the radiation doses were calculated. They were compared to 30 pulsed-fluoroscopy-guided SI joint injections, which were performed in the month before, and to five injections, performed in standard CT-guided biopsy mode for spinal interventions. The statistical significance was calculated with the SPSS software using the Mann–Whitney U-Test. Technical details and anatomical considerations were provided.Results: A significant dose reduction of average 94.01% was achieved using the low-dose protocol for CT-guided SI joint injections. The radiation dose could be approximated to pulsed-fluoroscopy-guidance levels.Conclusion: Radiation dose of CT-guided SI joint injections can be

  8. 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.

  9. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies.

    LENUS (Irish Health Repository)

    Mandl, Peter

    2012-01-01

    To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR).

  10. 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.

  11. 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.

  12. Accuracy of ultrasound-guided injections of thoracolumbar articular process joints in horses

    DEFF Research Database (Denmark)

    Fuglbjerg, Vibeke; Nielsen, J.V.; Thomsen, Preben Dybdahl

    2010-01-01

    in the literature. Objectives: To evaluate factors of affecting the accuracy of intra-articular injections of the APJs in the caudal thoracolumbar region. Method: One-hundred-and-fifty-four injections with blue dye were performed on APJs including the T14-L6 region in 12 horses subjected to euthanasia for reasons...

  13. 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.

  14. 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.

  15. Prolonged naproxen joint residence time after intra-articular injection of lipophilic solutions comprising a naproxen glycolamide ester prodrug in the rat

    DEFF Research Database (Denmark)

    Thing, Mette; Lu, Yi; Agårdh, Li

    2013-01-01

    ,N-diethyl glycolamide ester prodrug of naproxen (16mg/ml) were injected into the rat knee joint by dosing 6μl formulation per 100g body weight. The sustained release properties were compared to those of intra-articularly injected aqueous and oil solutions of naproxen by monitoring the naproxen serum concentrations over...

  16. 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。

  17. 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.

  18. ULTRASOUND-GUIDED INJECTIONS IN HORSES WITH CRANIOVENTRAL DISTENSION OF THE COXOFEMORAL JOINT CAPSULE: FEASIBILITY FOR A CRANIOVENTRAL APPROACH.

    Science.gov (United States)

    Whitcomb, Mary Beth; Vaughan, Betsy; Katzman, Scott; Hersman, Jake

    2016-01-01

    Intrasynovial access to the equine coxofemoral joint (CFJ) is inherently challenging. Blind injection techniques rely upon inconsistently palpable landmarks, and ultrasound guidance requires expertise for needle placement into the coxofemoral articulation. Aspiration is recommended to confirm intrasynovial placement and avoid sciatic nerve anesthesia. The aim of this observational, descriptive, retrospective study was to evaluate the feasibility for an alternative ultrasound-guided approach in horses with cranioventral distention of the CFJ identified during pelvic ultrasound. Thirteen horses with cranioventral CFJ distention, including 12 with severe pathology, were recruited from 2009 to 2014. Seven were excluded as they were not injected or underwent ultrasound-guided injection using a dorsal approach. The remaining six horses underwent a total of nine injections into the cranioventral recess. With the exception of one foal, all were aged horses (15-29 years) of varying breeds and uses, with prominent lameness due to subluxation (three), luxation (two), and severe osteoarthritis (one). The cranioventral recess was imaged adjacent to the proximal femur using a low-frequency curvilinear transducer placed ventral to the cranial joint margins. Using aseptic technique, spinal needles were placed cranial to the transducer and advanced caudomedially into the distended cranioventral recess. Synovial fluid was retrieved in all cases with one needle placement. Findings indicated that, when distended, ultrasound-guided access to the cranioventral CFJ recess is a feasible alternative approach and may reduce the potential for extra-synovial placement. Distention in this sample of horses was accompanied by severe pathology, also supporting the use of this approach for therapeutic interventions.

  19. The effect of a therapy protocol for increasing correction of severely contracted proximal interphalangeal joints caused by dupuytren disease and treated with collagenase injection.

    Science.gov (United States)

    Skirven, Terri M; Bachoura, Abdo; Jacoby, Sidney M; Culp, Randall W; Osterman, A Lee

    2013-04-01

    To determine the effect of a specific orthotic intervention and therapy protocol on proximal interphalangeal (PIP) joint contractures of greater than 40° caused by Dupuytren disease and treated with collagenase injections. All patients with PIP joints contracted at least 40° by Dupuytren disease were prospectively invited to participate in the study. Following standard collagenase injection and cord rupture by a hand surgeon, a certified hand therapist evaluated and treated each patient based on a defined treatment protocol that consisted of orthotic intervention to address residual PIP joint contracture. In addition, exercises were initiated emphasizing reverse blocking for PIP joint extension and distal interphalangeal joint flexion exercises with the PIP joint held in extension to lengthen a frequently shortened oblique retinacular ligament. Patients were assessed before injection, immediately after injection, and 1 and 4 weeks later. There were 22 fingers in 21 patients. The mean age at treatment was 63 years (range, 37-80 y). The mean baseline passive PIP joint contracture was 56° (range, 40° to 80°). At cord rupture, the mean PIP joint contracture became 22° (range, 0° to 55°). One week after cord rupture and therapy, the contracture decreased further to a mean of 12° (range, 0° to 36°). By 4 weeks, the mean contracture was 7° (range, 0° to 35°). The differences in PIP joint contracture were statistically significant at all time points except when comparing the means at 1 week and 4 weeks. The results represent an 88% improvement of the PIP joint contracture. In the short term, it appears that severe PIP joint contractures benefit from specific, postinjection orthotic intervention and targeted exercises. Therapeutic IV. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  20. Evidence-based radiology (part 2): Is there sufficient research to support the use of therapeutic injections into the peripheral joints?

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Cynthia; Hodler, Juerg [Orthopaedic University Hospital of Balgrist, Radiology, Zuerich (Switzerland)

    2010-01-15

    This review article addresses the best evidence currently available for the effectiveness of injection therapy for musculoskeletal conditions involving the peripheral joints. The research is presented by anatomical region and areas of controversy and the need for additional research are identified. Randomized controlled trials, meta-analyses and systematic reviews are lacking that address the effectiveness of therapeutic injections to the sternoclavicular, acromioclavicular, ankle and foot joints. No research studies of any kind have been reported for therapeutic injections of the sternoclavicular joint. With the exception of the knee, possibly the hip and patients with inflammatory arthropathies, research does not unequivocally support the use of therapeutic joint injections for most of the peripheral joints, including the shoulder. Additionally, controversy exists in some areas as to whether or not corticosteroids provide better outcomes compared to local anesthetic injections alone. When viscosupplementation injections are compared to corticosteroids in patients with osteoarthritis of the knee, the evidence supports the use of viscosupplementation for more prolonged improvement in outcomes, with corticosteroids being good for short-term relief. (orig.)

  1. 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.

  2. Pre-injection of hyaluronic acid does not affect the systemic effects of intra-articular depot betamethasone injection at the knee joint.

    Science.gov (United States)

    Habib, George; Khatib, Muhamad; Sakas, Fahed; Artul, Suheil; Jabaly-Habib, Haneen

    2017-01-01

    Intra-articular injection (IAI) of both hyaluronic acid (HA) and depot-steroid preparations had the advantage of quick and prolonged favorable effects on pain relief among patients with symptomatic osteoarthritis of the knee (OAK). The effect of IAI of HA on the systemic effects of the intra-articular steroids had not been investigated. Non-selected patients attending the rheumatology clinic with symptomatic OAK who failed NSAIDS and physical therapy were offered an IAI of HA at the knee joint followed 20 min later by an IAI of 1 ml of Celestone Chronodose at the same joint (group 1). Morning serum levels of cortisol were obtained just prior to the IAI and 1, 2 and 8 days later. Demographic, clinical, and laboratory parameters were obtained also from all the patients. Age- and sex-matched group of patients from the same clinic were recruited as a control group (group 2). Mean baseline serum cortisol levels in group 1 was 381 ± 154 mmol/l vs. 376 ± 119 in group 2 (p = 0.954). Morning serum cortisol levels at day 1 and day 2 were 24 ± 6 and 22 ± 6 mmol/l, respectively, in group 1 patients vs. 27 ± 5.8 (p = 0.214) and 25 ± 5.6 mmol/l (p = 0.200), respectively, in group 2. These levels were significantly lower than baseline levels in each group. Morning serum cortisol levels at day 8 in group 1 and group 2 were 349 ± 128 and 314 ± 99 mmol/l, respectively (p = 0.419). Pre-injection of HA at the knee joint did not affect the systemic effect on the hypothalamic-pituitary-adrenal axis of IAI of Celestone Chronodose.

  3. Joint inversion of time-lapse VSP data for monitoring CO2 injection at the Farnsworth EOR field in Texas

    Science.gov (United States)

    Zhang, M.; Gao, K.; Balch, R. S.; Huang, L.

    2016-12-01

    During the Development Phase (Phase III) of the U.S. Southwest Regional Partnership on Carbon Sequestration (SWP), time-lapse 3D vertical seismic profiling (VSP) data were acquired to monitor CO2 injection/migration at the Farnsworth Enhanced Oil Recovery (EOR) field, in partnership with the industrial partner Chaparral Energy. The project is to inject a million tons of carbon dioxide into the target formation, the deep oil-bearing Morrow Formation in the Farnsworth Unit EOR field. Quantitative time-lapse seismic monitoring has the potential to track CO2 movement in geologic carbon storage sites. Los Alamos National Laboratory (LANL) has recently developed new full-waveform inversion methods to jointly invert time-lapse seismic data for changes in elastic and anisotropic parameters in target monitoring regions such as a CO2 reservoir. We apply our new joint inversion methods to time-lapse VSP data acquired at the Farnsworth EOR filed, and present some preliminary results showing geophysical properties changes in the reservoir.

  4. Sensitivity Analysis for Residual Stress on DVI (Direct Vessel Injection) Nozzle Welded Joint

    Energy Technology Data Exchange (ETDEWEB)

    Noh, Byeong Wook; Chung, Sung Ho; Lee, Jung Hun; Kim, Oak Sug [DOOSAN Heavy Industries and Construction Co. LTD, Reactor Design Team, 555 Guygok-dong Changwon (Korea, Republic of)

    2008-07-01

    Generally, any welding process produces high compressive or tensile residual stresses in the heat affected zone depending on the method, shape and procedures of the weldment. In particular, the tensile residual stresses have a considerable effect on the material strength, fatigue strength and corrosion cracking. For this reason, it is important that some knowledge of the internal stress state be deduced either from measurements or from modeling predictions. In this study, the residual stresses after a multi-pass welding process for DVI nozzle welding joint were evaluated by a numerical simulation method. The welding joint considered three weld joint angles of 40 deg., 6 deg. and 2 deg. Computations were made using a 2-D finite element model based on the simulation of cooling from the heat treatment temperature to room temperature with two cooling conditions at the inside surface. In these results, it is shown that the residual stress increased at the inner surface, when water cooling was applied to the inner surface, and axial compressive residual stress increased at the inner surface when the joint angle was decreased. (authors)

  5. Progression of cartilage degradation, bone resorption and pain in rat temporomandibular joint osteoarthritis induced by injection of iodoacetate.

    Directory of Open Access Journals (Sweden)

    Xue-Dong Wang

    Full Text Available BACKGROUND: Osteoarthritis (OA is an important subtype of temporomandibular disorders. A simple and reproducible animal model that mimics the histopathologic changes, both in the cartilage and subchondral bone, and clinical symptoms of temporomandibular joint osteoarthritis (TMJOA would help in our understanding of its process and underlying mechanism. OBJECTIVE: To explore whether injection of monosodium iodoacetate (MIA into the upper compartment of rat TMJ could induce OA-like lesions. METHODS: Female rats were injected with varied doses of MIA into the upper compartment and observed for up to 12 weeks. Histologic, radiographic, behavioral, and molecular changes in the TMJ were evaluated by light and electron microscopy, MicroCT scanning, head withdrawal threshold test, real-time PCR, immunohistochemistry, and TUNEL assay. RESULTS: The intermediate zone of the disc loosened by 1 day post-MIA injection and thinned thereafter. Injection of an MIA dose of 0.5 mg or higher induced typical OA-like lesions in the TMJ within 4 weeks. Condylar destruction presented in a time-dependent manner, including chondrocyte apoptosis in the early stages, subsequent cartilage matrix disorganization and subchondral bone erosion, fibrosis, subchondral bone sclerosis, and osteophyte formation in the late stages. Nociceptive responses increased in the early stages, corresponding to severe synovitis. Furthermore, chondrocyte apoptosis and an imbalance between anabolism and catabolism of cartilage and subchondral bone might account for the condylar destruction. CONCLUSIONS: Multi-level data demonstrated a reliable and convenient rat model of TMJOA could be induced by MIA injection into the upper compartment. The model might facilitate TMJOA related researches.

  6. Progression of Cartilage Degradation, Bone Resorption and Pain in Rat Temporomandibular Joint Osteoarthritis Induced by Injection of Iodoacetate

    Science.gov (United States)

    Wang, Xue-Dong; Kou, Xiao-Xing; He, Dan-Qing; Zeng, Min-Min; Meng, Zhen; Bi, Rui-Yun; Liu, Yan; Zhang, Jie-Ni; Gan, Ye-Hua; Zhou, Yan-Heng

    2012-01-01

    Background Osteoarthritis (OA) is an important subtype of temporomandibular disorders. A simple and reproducible animal model that mimics the histopathologic changes, both in the cartilage and subchondral bone, and clinical symptoms of temporomandibular joint osteoarthritis (TMJOA) would help in our understanding of its process and underlying mechanism. Objective To explore whether injection of monosodium iodoacetate (MIA) into the upper compartment of rat TMJ could induce OA-like lesions. Methods Female rats were injected with varied doses of MIA into the upper compartment and observed for up to 12 weeks. Histologic, radiographic, behavioral, and molecular changes in the TMJ were evaluated by light and electron microscopy, MicroCT scanning, head withdrawal threshold test, real-time PCR, immunohistochemistry, and TUNEL assay. Results The intermediate zone of the disc loosened by 1 day post-MIA injection and thinned thereafter. Injection of an MIA dose of 0.5 mg or higher induced typical OA-like lesions in the TMJ within 4 weeks. Condylar destruction presented in a time-dependent manner, including chondrocyte apoptosis in the early stages, subsequent cartilage matrix disorganization and subchondral bone erosion, fibrosis, subchondral bone sclerosis, and osteophyte formation in the late stages. Nociceptive responses increased in the early stages, corresponding to severe synovitis. Furthermore, chondrocyte apoptosis and an imbalance between anabolism and catabolism of cartilage and subchondral bone might account for the condylar destruction. Conclusions Multi-level data demonstrated a reliable and convenient rat model of TMJOA could be induced by MIA injection into the upper compartment. The model might facilitate TMJOA related researches. PMID:22984604

  7. Accurate intra-articular knee joint injection in the obese? 'Fat Chance!'-A clinical lesson and recommendations for secondary referral.

    LENUS (Irish Health Repository)

    McGarry, James G

    2011-04-12

    Abstract Corticosteroid joint injections are perceived as being an effective treatment for symptomatic knee osteoarthritis, with a very low risk of complications. While the procedure is often performed in secondary care by orthopaedic surgeons and rheumatologists (and trainees in either specialty), the role of general practitioners (GPs) in chronic disease management has long existed with joint injections also frequently performed in primary care. The perception that serious complications from corticosteroid knee joint injections are rare and that their benefits in treating symptomatic knee osteoarthritis significantly outweigh the risks has not been well addressed. We present a case of a 71-year-old obese female who presented to her general practitioner (GP) with worsening left knee pain and radiographic changes consistent with osteoarthritis. She was administered a corticosteroid joint injection, which gave minimal relief, and over the next few days resulted in worsening severe pain, erythema and swelling. She returned to the GP who commenced oral antibiotics and referred her to casualty. A large knee abscess was diagnosed and intravenous antibiotics were commenced. The patient was admitted under the orthopaedic surgeons with her treatment consisting of multiple surgical procedures over a prolonged duration. Although lengthy, her postoperative recovery was unremarkable. Based on this case report and our review of the literature, we highlight the potential complications associated with corticosteroid knee joint injections and suggest certain patients for whom we would recommend secondary referral before any intervention in primary care.

  8. Glenohumeral joint injection: a comparative study of ultrasound and fluoroscopically guided techniques before MR arthrography.

    NARCIS (Netherlands)

    Rutten, M.J.; Collins, J.M.; Maresch, B.J.; Smeets, J.H.R.; Janssen, C.M.; Kiemeney, L.A.L.M.; Jager, G.J.

    2009-01-01

    To assess the variability in accuracy of contrast media introduction, leakage, required time and patient discomfort in four different centres, each using a different image-guided glenohumeral injection technique. Each centre included 25 consecutive patients. The ultrasound-guided anterior (USa) and

  9. Intra-articular distribution pattern after ultrasound-guided injections in wrist joints of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Boesen, Mikael; Jensen, Karl Erik; Torp-Pedersen, Søren

    2007-01-01

    /ml), 0.5 ml Lidocaine (5mg/ml) and 0.15 ml gadolinium (Omniscan 0.5 mmol/ml). The drug solution was placed in the central proximal part of the wrist between the distal radius and the lunate bone. Coronal and axial MRI sequences were performed after the injection to visualize the distribution. Carpal...... to the clinical parameters and the MRI OMERACT scores. RESULTS: No uniform pattern was seen in the distribution of the contrast. Only two patients had full contrast distribution to all four compartments, and the mean distribution count for all patients was 2.4 (range 0.5-4). The distribution count correlated...... with the MRI synovitis score, while no association was found with the erosion- and bonemarrow oedema score. These results indicate that a single injection into a standard injection site in the proximal part of the wrist cannot be assumed to distribute--and treat--the whole joint Udgivelsesdato: 2009/2...

  10. [Intra-articular injections of hyaluronic acid for anterior disc displacement of temporomandibular joint].

    Science.gov (United States)

    Long, X

    2017-03-09

    Anterior disc displacement (ADD) of temporomandibular joint (TMJ) is regarded as one of the major findings in temporomandibular disorders (TMD). It is related to joint noise, pain, mandibular dysfunction, degenerative change and osteoarthritis. In the mean time, the pathological changes were found in synovial membrane and synovial fluid. Hyaluronic acid is a principal component of the synovial fluid which plays an important role in nutrition, lubrication, anti-inflammation and cartilage repair. The synthesis, molecule weight, and concentration of hyaluronic acid are decreased during TMD and cause TMJ degenerative changes. The clinical conditions, pathological changes, the mechanism of action for hyaluronic acid and the treatment of anterior disc displacement of TMJ are discussed in this article.

  11. Preventing effects of joint contracture by high molecular weight hyaluronan injections in a rat immobilized knee model.

    Science.gov (United States)

    Kanazawa, Kenji; Hagiwara, Yoshihiro; Tsuchiya, Masahiro; Yabe, Yutaka; Sonofuchi, Kazuaki; Koide, Masashi; Sekiguchi, Takuya; Itaya, Nobuyuki; Ando, Akira; Saijo, Yoshifumi; Itoi, Eiji

    2015-01-01

    To elucidate preventive effects of high molecular weight hyaluronan (HMWHA) on the joint capsule of immobilized knees in rats. Unilateral knee joints of rats were immobilized with an internal fixator. Either 50 μl of HMWHA (Im-HA group) or 50 μl of saline (control group) was administered intra-articularly once a week after surgery. Sagittal sections were prepared from the medial midcondylar region of the knee joints and assessed by histological, histomorphometric, and immunohistochemical methods. Gene expressions related to inflammation, fibrotic conditions, and hypoxia were evaluated by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Tissue elasticity of the capsule from both groups was examined using a scanning acoustic microscope (SAM). CD68 positive cells decreased in adhesion areas of the synovial membrane after 1 week in both groups. The length of the superficial layer in the synovial membrane of the Im-HA group was significantly longer than those in the control group over a period of 4 to 8 weeks with significantly small numbers of CD68 positive cells. The gene expressions of IL-6, IL-1β, TGF-β, CTGF, COL1a1, COL3a1, SPARC, and HIF1-α were significantly lower in the Im-HA group compared to those in the control group. The sound speed of the anterior and posterior synovial membrane increased significantly (a reduction in elasticity) in the control group compared to those in the Im-HA group during weeks 1 to 4. This study demonstrated that HMWHA injections suppressed inflammatory, fibrotic, and hypoxic conditions observed in the immobilized joint capsule.

  12. Predictors of response to intra-articular steroid injections in patients with osteoarthritis of the knee joint.

    Science.gov (United States)

    Fatimah, Nibah; Salim, Babur; Raja, Ejaz-Ul-Haq; Nasim, Amjad

    2016-10-01

    This study aimed to determine the factors associated with response to intra-articular steroid injection (IASI) in patients with knee joint osteoarthritis. One hundred seventy-four female patients, age ranging from 30 to 80 years, diagnosed to have osteoarthritis of the knee joint, were given IASI. Response to IASI was assessed by using WOMAC and VAS at 2 weeks, 4 weeks and 3 months. At 3 months, the subjects were categorized as responders, partial responders and non-responders to treatment by IASI. Various factors were narrowed down to see their effect on response, namely age, BMI, smoking habits, comorbidities, presence of clinical effusion, radiographic score, local knee tenderness, range of movement and socioeconomic status. One hundred twenty-four patients completed the study. 16.1 % showed 50 % or more improvement in WOMAC score at 3 months post IASI therapy, whereas 38.7 % of OA patients had more than 50 % improvement in VAS score. Out of all factors, range of movement, local knee tenderness and radiographic score of the affected joint are the three parameters which can predict the improvement in WOMAC score after 3 months of IASI therapy (P = 0.013, P = 0.045 and P = 0.000, respectively). Age of the patient can predict improvement in VAS at 3 months post IASI (P = 0.027). We conclude that age, range of movement, local knee tenderness and radiographic score of the affected joint can predict response to IASI after 3 months of IASI therapy.

  13. Cefotaxime Injection

    Science.gov (United States)

    Cefotaxime injection is used to treat certain infections caused by bacteria including pneumonia and other lower respiratory ... skin, blood, bone, joint, and urinary tract infections. Cefotaxime injection may also be used before surgery, and ...

  14. 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

  15. Auto-aggressive metallic mercury injection around the knee joint: a case report

    Directory of Open Access Journals (Sweden)

    Friesenbichler Joerg

    2011-11-01

    Full Text Available Abstract Background Accidental or intentional subcutaneous and/or intramuscular injection of metallic mercury is an uncommon form of poisoning. Although it does not carry the same risk as mercury vapour inhalation, it may cause destructive early and late reactions. Case Presentation Herein we present the case of a 29-year-old male patient who developed an obsessive-compulsive disorder causing auto-aggressive behaviour with injection of elemental mercury and several other foreign bodies into the soft tissues around the left knee about 15 years before initial presentation. For clinical examination X-rays and a CT-scan of the affected area were performed. Furthermore, blood was taken to determine the mercury concentration in the blood, which showed a concentration 17-fold higher than recommended. As a consequence, the mercury depots and several foreign bodies were resected marginally. Conclusion Blood levels of mercury will decrease rapidly following surgery, especially in combination with chelating therapy. In case of subcutaneous and intramuscular injection of metallic mercury we recommend marginal or wide excision of all contaminated tissue to prevent migration of mercury and chronic inflammation. Nevertheless, prolonged clinical and biochemical monitoring should be performed for several years to screen for chronic intoxication.

  16. 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...

  17. Long-Acting Diclofenac Ester Prodrugs for Joint Injection: Kinetics, Mechanism of Degradation, and In Vitro Release From Prodrug Suspension

    DEFF Research Database (Denmark)

    Mertz, Nina

    2016-01-01

    A prodrug approach for local and sustained diclofenac action after injection into joints based on ester prodrugs having a pH-dependent solubility is presented. Inherent ester prodrug properties influencing the duration of action include their pH-dependent solubility and charge state, as well...... as susceptibility to undergo esterase facilitated hydrolysis. In this study, physicochemical properties and pH rate profiles of 3 diclofenac ester prodrugs differing with respect to the spacer carbon chain length between the drug and the imidazole-based promoiety were determined and a rate equation for prodrug...... degradation in aqueous solution in the pH range 1-10 was derived. In the pH range 6-10, the prodrugs were subject to parallel degradation to yield diclofenac and an indolinone derivative. The prodrug degradation was found to be about 6-fold faster in 80% (vol/vol) human plasma as compared to 80% (vol...

  18. 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…

  19. Injectable Collagenase Versus Percutaneous Needle Fasciotomy for Dupuytren Contracture in Proximal Interphalangeal Joints: A Randomized Controlled Trial.

    Science.gov (United States)

    Skov, Simon Toftgaard; Bisgaard, Therkel; Søndergaard, Per; Lange, Jeppe

    2017-05-01

    Collagenase Clostridium histolyticum (CCH) injection was introduced commercially as a treatment for Dupuytren contracture following initial phase-3 investigations in 2009 with promising results. However, the efficacy of CCH has not been prospectively investigated in a direct comparison to other active treatments of Dupuytren contracture with more than 1-year follow-up, despite a wide and increasing clinical use. In this prospective, independent, open-label, randomized controlled trial, (Clinicaltrials.gov; NCT 01538017), percutaneous needle fasciotomy (PNF) was directly compared with CCH. Fifty patients with primary isolated proximal interphalangeal joint Dupuytren contractures were enrolled and followed for 2 years. The primary outcome was clinical improvement defined as a reduction in contracture by 50% or more relative to baseline. Secondary outcomes included change in contracture, recurrence, adverse events, complications, and Disabilities of the Arm, Shoulder, and Hand questionnaire score. Clinical improvement at 2 years was maintained in 7% of CCH patients (2 of 29) and 29% of PNF patients (6 of 21). Collagenase Clostridium histolyticum led to more, mainly transient, complications, in 93% of patients versus 24% of the patients treated with PNF. No other differences were observed. This study provides evidence that CCH is not superior to PNF in the treatment of isolated proximal interphalangeal joint Dupuytren contracture regarding clinical outcome, and it led to more complications than PNF. Therapeutic I. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  20. A Prodrug Approach Involving In Situ Depot Formation to Achieve Localized and Sustained Action of Diclofenac After Joint Injection

    DEFF Research Database (Denmark)

    Thing, Mette; Agårdh, Li; Larsen, Susan

    2014-01-01

    Long-acting nonsteroidal anti-inflammatory drug formulations for intra-articular injection might be effective in the management of joint pain and inflammation associated sports injuries and osteoarthritis. In this study, a prodrug-based delivery system was evaluated. The synthesized diclofenac...... ester prodrug, a weak base (pKa 7.52), has relatively high solubility at low pH (6.5 mg mL(-1) at pH 4) and much lower solubility at physiological pH (4.5 μg mL(-1) at pH 7.4) at 37°C. In biological media including 80% (v/v) human synovial fluid (SF), the prodrug was cleaved to diclofenac mediated...... cell model, a slightly acidic prodrug solution was added to the donor cell containing 80% SF resulting in a continuous appearance of diclofenac in the acceptor phase for more than 43 h after an initial lag period of 8 h. Detectable amounts of prodrug were found in the rat joint up to 8 days after knee...

  1. Intra-articular injections with corticosteroids and sodium hyaluronate for treating temporomandibular joint disorders: a systematic review

    Directory of Open Access Journals (Sweden)

    Eduardo Machado

    2013-10-01

    Full Text Available INTRODUCTION: In some cases, conservative treatment of internal derangements of the Temporomandibular Joint (TMJ is considered little responsive. Thus, it is necessary to accomplish treatments that aim at reducing pain and improve patients' functions who present arthrogenic temporomandibular disorders. OBJECTIVE: This study, by means of a systematic review of the literature, aimed to analyze the effectiveness of intra-articular injections with corticosteroids and sodium hyaluronate for treating internal derangements of the TMJ. METHODS: Carry out a research in the following databases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs, and BBO, considering publications issued between 1966 and October of 2010, focusing on randomized or quasi-randomized controlled clinical trials, single or double-blind. RESULTS: After applying the inclusion criteria we collected 9 articles, 7 of which were randomized controlled double-blind clinical trials and 2 randomized controlled single-blind clinical trials. CONCLUSION: After analyzing the literature, it was found that intra-articular injection with corticosteroids and sodium hyaluronate seems to be an effective method for treating internal derangements of the TMJ. However, further randomized controlled clinical trials, with representative samples and longer follow-up time must be carried out in order to assess the real effectiveness of this technique.

  2. Can combined use of low-level lasers and hyaluronic acid injections prolong the longevity of degenerative knee joints?

    Directory of Open Access Journals (Sweden)

    Ip D

    2015-08-01

    Full Text Available David Ip, Nga Yue FuAsia Medical Pain Centre, Grand Plaza, Mong Kok, Hong KongBackground: This study evaluated whether half-yearly hyaluronic acid injection together with low-level laser therapy in addition to standard conventional physical therapy can successfully postpone the need for joint replacement surgery in elderly patients with bilateral symptomatic tricompartmental knee arthritis.Methods: In this prospective, double-blind, placebo-controlled study, 70 consecutive unselected elderly patients with bilateral tricompartmental knee arthritis were assigned at random to either one of two conservative treatment protocols to either one of the painful knees. Protocol A consisted of conventional physical therapy plus a sham light source plus saline injection, and protocol B consisted of protocol A with addition of half-yearly hyaluronic acid injection as well as low-level laser treatment instead of using saline and a sham light source. Treatment failure was defined as breakthrough pain necessitating joint replacement.Results: Among the 140 painful knees treated with either protocol A or protocol B, only one of the 70 painful knees treated by protocol B required joint replacement, whereas 15 of the 70 painful knees treated by protocol A needed joint replacement surgery (P<0.05.Conclusion: We conclude that half-yearly hyaluronic acid injections together with low-level laser therapy should be incorporated into the standard conservative treatment protocol for symptomatic knee arthritis, because it may prolong the longevity of the knee joint without the need for joint replacement.Keywords: knee osteoarthritis, hyaluronic acid injection, low-level laser, outcome

  3. 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

  4. Delayed Gadolinium-Enhanced Magnetic Resonance Imaging (dGEMRIC) of Hip Joint Cartilage: Better Cartilage Delineation after Intra-Articular than Intravenous Gadolinium Injection

    DEFF Research Database (Denmark)

    Boesen, M.; Jensen, K.E.; Quistgaard, E.;

    2006-01-01

    PURPOSE: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. MATERIAL AND METHODS: In 10 patients (50% males, mean age 58...

  5. Temporomandibular joint disorders treated with articular injection: the effectiveness of plasma rich in growth factors-Endoret.

    Science.gov (United States)

    Giacomello, Maurizio; Giacomello, Alberto; Mortellaro, Carmen; Gallesio, Giorgia; Mozzati, Marco

    2015-05-01

    The objective of this study was to evaluate the effectiveness of the temporomandibular joint (TMJ) osteoarthritis treatment through articular injections of plasma rich in growth factors (PGRF)-Endoret. Thirteen patients (median age, 47.64 y; SD, 7.51; range, 40-64 y; male-female ratio, 2:11) with osteoarthritis of TMJ associated to chronic pain have been selected. They were treated with articular injections of PRGF-Endoret, measuring the maximum mouth opening and pain level before the first injection (t0), 30 days after just before the second (t1), and after 6 months (t2). Data were analyzed using the paired Student's t-test data. The visual analogue scale score at t0 is 7.69 (range, 4-10; SD, 1.9), whereas that at t1 is 1.54 (range, 0-5; SD, 1.74) and that at t2 is 0.23 (range, 0-2; SD, 0.65). These differences in the results are statistically highly significant (P < 0.0001 comparison t0-t1 and t0-t2 and P < 0.01 comparison t1-t2). In terms of maximum mouth opening, it reduced from 30.15 mm at t0 (range, 26-40 mm; SD, 4.44) to 37.54 mm at t1 (range, 31-51 mm; SD, 5.10), with an increase of 7.38 mm (range, 4-11 mm; SD, 2.02) and a highly significant difference (P < 0.0001). At t2, it was 39.54 mm (range, 34-51; SD, 4.55) with an increase of 9.38 mm (range, 5-12 mm; SD, 2.21) compared with t0 and that of 2.00 mm compared with t1. Both differences in the results are statistically significant (P < 0.0001 and P < 0.01, respectively). The articular injections of PRGF-Endoret represent a very efficient method to control pain and to improve the TMJ mobility.

  6. 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...

  7. Evaluation of MR imaging guided steroid injection of the sacroiliac joints for the treatment of children with refractory enthesitis-related arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, J. [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Eberhard-Karls-University Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany); Tzaribachev, N. [Eberhard-Karls-University Tuebingen, Department of Hematology, Oncology and General Pediatrics, University Children' s Hospital, Tuebingen (Germany); Klinikum Bad Bramstedt, Department of Pediatric Rheumatology, Bad Bramstedt (Germany); Thomas, C.; Claussen, C.D. [Eberhard-Karls-University Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany); Carrino, J.A.; Lewin, J.S. [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Pereira, P.L. [Eberhard-Karls-University Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany); SLK-Kliniken Heilbronn, Department of Radiology, Minimally Invasive Therapies and Nuclearmedicine, Heilbronn (Germany)

    2011-05-15

    To test the hypothesis that MR imaging guided triamcinolone acetonide injection into the sacroiliac joints of children with enthesitis-related arthritis is feasible, accurate and safe; and effectively reduces sacroiliac inflammation and disease progression. A retrospective analysis of 14 children (6/14 [43%] female, 8/14 (57%) male; mean age, 13.2 years; range, 6-16 years) who received MR imaging guided sacroiliac joint injections at 0.2 Tesla or 1.5 Tesla for enthesitis-related arthritis and acute sacroilitis refractory to medical therapy was performed. 20 mg triamcinolone acetonide were injected. Assessed were intra-articular drug delivery; image quality, duration, and complications. Success of therapy was defined by change of sacroiliac inflammation. Remission time and erosions were assessed by follow-up MRI (range, 10-22 months). Twenty four procedures resulted in intra-articular injection. Image quality was sufficient. No complications occurred. Procedure time was 40 min. Sedation time was 22 min. Success of therapy was achieved in 11/14 (79%) children. Sacroiliac inflammation decreased significantly (-59%). Median remission time was 13.7 months. No erosions occurred. MR imaging guided steroid injection of the sacroiliac joints is feasible, accurate, and safe and can effectively reduce sacroiliac inflammatory activity and may therefore aid in the prevention of disease progression. (orig.)

  8. Prolonged naproxen joint residence time after intra-articular injection of lipophilic solutions comprising a naproxen glycolamide ester prodrug in the rat

    DEFF Research Database (Denmark)

    Thing, Mette; Lu, Yi; Agårdh, Li;

    2013-01-01

    Intra-articular injection of oil solutions of lipophilic prodrugs that rapidly degrade to their parent compound in synovial fluid may constitute a feasible approach to increase the joint residence time of non-steroidal anti-inflammatory drugs. In this in vivo study, oil solutions of the N......,N-diethyl glycolamide ester prodrug of naproxen (16mg/ml) were injected into the rat knee joint by dosing 6μl formulation per 100g body weight. The sustained release properties were compared to those of intra-articularly injected aqueous and oil solutions of naproxen by monitoring the naproxen serum concentrations over...... time. Two oils, medium-chain triglycerides and castor oil, differing with respect to viscosity were tested. After intra-articular administration of oil prodrug solutions, a significant increase in the time to maximum naproxen serum concentration from around 40 to 245min, an increase in the MRTj from...

  9. 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.

  10. Intra-articular injection of parathyroid hormone in the temporomandibular joint as a novel therapy for mandibular asymmetry.

    Science.gov (United States)

    Wan, Qilong; Li, Zu-Bing

    2010-04-01

    Mandibular asymmetry (MA) is one of the most common craniofacial malformations. However, there is no optimal technique for this malformation nowadays. A novel technique for both children and adults with less disadvantages is a must. Parathyroid hormone (PTH) is a straight-chain polypeptide secreted by the parathyroid gland that regulates calcium metabolism. PTH has both anabolic and catabolic effects on bone formation, depending on its mode of administration. Furthermore, the mandible is characterized by the most delayed growth and the most postnatal growth of all the facial bones. The condyle, the major growth site of mandible, grows by proliferation of cartilage in the condylar head and endochondral bone formation. Condylar cartilage is present throughout postnatal life, taking part in endochondral ossification and having a special multidirectional capacity for growth potential and remodeling throughout life. Based on the double effects of PTH on bone formation and characters of mandibular development and growth, it is hypothesized that intermittent or/and continuous intra-articular injection of PTH in the temporomandibular joint be a novel therapy for mandibular asymmetry for both children and adults. It can achieve early treatment of MA to avoid many secondary deformities and keep away from many complications resulting from current techniques or systematic administration of PTH.

  11. Prolonged naproxen joint residence time after intra-articular injection of lipophilic solutions comprising a naproxen glycolamide ester prodrug in the rat

    DEFF Research Database (Denmark)

    Thing, Mette; Lu, Yi; Agårdh, Li

    2013-01-01

    Intra-articular injection of oil solutions of lipophilic prodrugs that rapidly degrade to their parent compound in synovial fluid may constitute a feasible approach to increase the joint residence time of non-steroidal anti-inflammatory drugs. In this in vivo study, oil solutions of the N...... around 0.11 to 3.3h and a 30% reduction in the maximum serum concentration were observed compared to that of the parent naproxen. The similar serum profiles obtained using the two oils indicate that the release was not affected by the oil viscosity. A prolonged naproxen joint residence time in rats...

  12. Are joint and soft tissue injections painful? Results of a national French cross-sectional study of procedural pain in rheumatological practice

    Directory of Open Access Journals (Sweden)

    Poncet Coralie

    2010-01-01

    Full Text Available Abstract Background Joint, spinal and soft tissue injections are commonly performed by rheumatologists in their daily practice. Contrary to other procedures, e.g. performed in pediatric care, little is known about the frequency, the intensity and the management of procedural pain observed in osteo-articular injections in daily practice. Methods This observational, prospective, national study was carried out among a French national representative database of primary rheumatologists to evaluate the prevalence and intensity of pain caused by intra-and peri-articular injections, synovial fluid aspirations, soft tissue injections, and spinal injections. For each physician, data were collected over 1 month, for up to 40 consecutive patients (>18-years-old for whom a synovial fluid aspiration, an intra or peri-articular injection or a spinal injection were carried out during consultations. Statistical analysis was carried out in order to compare patients who had suffered from pain whilst undergoing the procedure to those who had not. Explanatory analyses were conducted by stepwise logistic regression with the characteristics of the patients to explain the existence of pain. Results Data were analysed for 8446 patients (64% female, mean age 62 ± 14 years recruited by 240 physicians. The predominant sites injected were the knee (45.5% and spine (19.1%. Over 80% of patients experienced procedural pain which was most common in the small joints (42% and spine (32% Pain was severe in 5.3% of patients, moderate in 26.6%, mild in 49.8%, and absent in 18.3%. Pain was significantly more intense in patients with severe pain linked to their underlying pathology and for procedures performed in small joints. Preventative or post-procedure analgesia was rarely given, only to 5.7% and 36.3% of patients, respectively. Preventative analgesia was more frequently prescribed in patients with more severe procedural pain. Conclusion Most patients undergoing intra-or peri

  13. Joint Injection/Aspiration

    Science.gov (United States)

    ... Cryopyrin-Associated Autoinflammatory Syndrome (CAPS) (Juvenile) Dermatomyositis (Juvenile) Familial Mediterranean Fever (Juvenile) Fibromyalgia Giant Cell Arteritis Glucocorticoid-induced Osteoperosis ...

  14. Joint Injection/Aspiration

    Science.gov (United States)

    ... Pharyngitis, Adenitis Syndrome (Juvenile) Polymyalgia Rheumatica Psoriatic Arthritis Raynaud's Phenomenon Reactive Arthritis Rheumatoid Arthritis Scleroderma Sjogren's Syndrome Spinal Stenosis Spondyloarthritis Systemic Lupus Erythematosus (Juvenile) Takayasu's ...

  15. Cationic PLGA/Eudragit RL nanoparticles for increasing retention time in synovial cavity after intra-articular injection in knee joint.

    Science.gov (United States)

    Kim, Sung Rae; Ho, Myoung Jin; Lee, Eugene; Lee, Joon Woo; Choi, Young Wook; Kang, Myung Joo

    2015-01-01

    Positively surface-charged poly(lactide-co-glycolide) (PLGA)/Eudragit RL nanoparticles (NPs) were designed to increase retention time and sustain release profile in joints after intra-articular injection, by forming micrometer-sized electrostatic aggregates with hyaluronic acid, an endogenous anionic polysaccharide found in high amounts in synovial fluid. The cationic NPs consisting of PLGA, Eudragit RL, and polyvinyl alcohol were fabricated by solvent evaporation technique. The NPs were 170.1 nm in size, with a zeta potential of 21.3 mV in phosphate-buffered saline. Hyperspectral imaging (CytoViva(®)) revealed the formation of the micrometer-sized filamentous aggregates upon admixing, due to electrostatic interaction between NPs and the polysaccharides. NPs loaded with a fluorescent probe (1,1'-dioctadecyl-3,3,3',3' tetramethylindotricarbocyanine iodide, DiR) displayed a significantly improved retention time in the knee joint, with over 50% preservation of the fluorescent signal 28 days after injection. When DiR solution was injected intra-articularly, the fluorescence levels rapidly decreased to 30% of the initial concentration within 3 days in mice. From these findings, we suggest that PLGA-based cationic NPs could be a promising tool for prolonged delivery of therapeutic agents in joints selectively.

  16. 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…

  17. 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.

  18. Ceftazidime Injection

    Science.gov (United States)

    ... skin, blood, bone, joint, female genital tract, and urinary tract infections. Ceftazidime injection is in a class of medications ... to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( ...

  19. Radiation dose and intra-articular access: comparison of the lateral mortise and anterior midline approaches to fluoroscopically guided tibiotalar joint injections

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Ambrose J.; Torriani, Martin; Bredella, Miriam A.; Chang, Connie Y.; Simeone, Frank J.; Palmer, William E. [Massachusetts General Hospital, Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Boston, MA (United States); Balza, Rene [Centro Medico de Occidente, Department of Radiology, Maracaibo (Venezuela, Bolivarian Republic of)

    2016-03-15

    To compare the lateral mortise and anterior midline approaches to fluoroscopically guided tibiotalar joint injections with respect to successful intra-articular needle placement, fluoroscopy time, radiation dose, and dose area product (DAP). This retrospective study was IRB-approved and HIPAA-compliant. 498 fluoroscopically guided tibiotalar joint injections were performed or supervised by one of nine staff radiologists from 11/1/2010-12/31/2013. The injection approach was determined by operator preference. Images were reviewed on a PACS workstation to determine the injection approach (lateral mortise versus anterior midline) and to confirm intra-articular needle placement. Fluoroscopy time (minutes), radiation dose (mGy), and DAP (μGy-m{sup 2}) were recorded and compared using the student's t-test (fluoroscopy time) or the Wilcoxon rank sum test (radiation dose and DAP). There were 246 lateral mortise injections and 252 anterior midline injections. Two lateral mortise injections were excluded from further analysis because no contrast was administered. Intra-articular location of the needle tip was documented in 242/244 lateral mortise injections and 252/252 anterior midline injections. Mean fluoroscopy time was shorter for the lateral mortise group than the anterior midline group (0.7 ± 0.5 min versus 1.2 ± 0.8 min, P < 0.0001). Mean radiation dose and DAP were less for the lateral mortise group than the anterior midline group (2.1 ± 3.7 mGy versus 2.5 ± 3.5 mGy, P = 0.04; 11.5 ± 15.3 μGy-m{sup 2} versus 13.5 ± 17.3 μGy-m{sup 2}, P = 0.006). Both injection approaches resulted in nearly 100 % rates of intra-articular needle placement, but the lateral mortise approach used approximately 40 % less fluoroscopy time and delivered 15 % lower radiation dose and DAP to the patient. (orig.)

  20. 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.

  1. Cationic PLGA/Eudragit RL nanoparticles for increasing retention time in synovial cavity after intra-articular injection in knee joint

    Directory of Open Access Journals (Sweden)

    Kim SR

    2015-08-01

    Full Text Available Sung Rae Kim,1 Myoung Jin Ho,2 Eugene Lee,3 Joon Woo Lee,3 Young Wook Choi,1 Myung Joo Kang21College of Pharmacy, Chung-Ang University, Dongjak-gu, Seoul, 2College of Pharmacy, Dankook University, Dongnam-gu, Cheonan, Chungnam, 3Department of Radiology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, Gyeonggi-do, South KoreaAbstract: Positively surface-charged poly(lactide-co-glycolide (PLGA/Eudragit RL nanoparticles (NPs were designed to increase retention time and sustain release profile in joints after intra-articular injection, by forming micrometer-sized electrostatic aggregates with hyaluronic acid, an endogenous anionic polysaccharide found in high amounts in synovial fluid. The cationic NPs consisting of PLGA, Eudragit RL, and polyvinyl alcohol were fabricated by solvent evaporation technique. The NPs were 170.1 nm in size, with a zeta potential of 21.3 mV in phosphate-buffered saline. Hyperspectral imaging (CytoViva® revealed the formation of the micrometer-sized filamentous aggregates upon admixing, due to electrostatic interaction between NPs and the polysaccharides. NPs loaded with a fluorescent probe (1,1'-dioctadecyl-3,3,3',3' tetramethylindotricarbocyanine iodide, DiR displayed a significantly improved retention time in the knee joint, with over 50% preservation of the fluorescent signal 28 days after injection. When DiR solution was injected intra-articularly, the fluorescence levels rapidly decreased to 30% of the initial concentration within 3 days in mice. From these findings, we suggest that PLGA-based cationic NPs could be a promising tool for prolonged delivery of therapeutic agents in joints selectively.Keywords: PLGA, Eudragit RL, hyaluronic acid, cationic nanoparticles, intra-articular injection, electrostatic interaction

  2. Reducing invasiveness, duration, and cost of magnetic resonance imaging in rheumatoid arthritis by omitting intravenous contrast injection -- Does it change the assessment of inflammatory and destructive joint changes by the OMERACT RAMRIS?

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Ostergaard, Mikkel; Conaghan, Philip G;

    2009-01-01

    OBJECTIVE: Gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) provides highly sensitive assessment of inflammatory and destructive changes in rheumatoid arthritis (RA) joints, but intravenous (IV) Gd injection prolongs examination time and increases cost, invasiveness, and patient discomfo......: Omitting IV contrast injection did not change scores of bone erosions and bone edema, but decreased the reliability of synovitis scores. However, this disadvantage may for some purposes be outweighed by the possibility to assess more joints and/or greater feasibility....

  3. 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

  4. 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

  5. Percutaneous injection of autologous, culture-expanded mesenchymal stem cells into carpometacarpal hand joints: a case series with an untreated comparison group.

    Science.gov (United States)

    Centeno, Christopher J; Freeman, Michael D

    2014-03-01

    In the present study, we describe six patients who received autologous mesenchymal stem cell (MSC) therapy for symptomatic carpometacarpal (CMC) joint and hand osteoarthritis (OA). Six patients who received injections of adult autologous culture expanded MSCs in their thumb CMC joints were followed for 1 year posttreatment, and matched with four procedure candidates who remained untreated. We observed positive outcomes in the treatment group for both symptoms and function related to the OA, compared with a reported worsening among the untreated controls. While these results should be interpreted with caution because of the small number of treated subjects and lack of placebo control and randomization, we find sufficient evidence for further investigation of MSC therapy as an alternative to more invasive surgery in patients with OA of the hand.

  6. 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.

  7. Delayed Gadolinium-Enhanced Magnetic Resonance Imaging (dGEMRIC) of Hip Joint Cartilage: Better Cartilage Delineation after Intra-Articular than Intravenous Gadolinium Injection

    Energy Technology Data Exchange (ETDEWEB)

    Boesen, M.; Jensen, K. E.; Qvistgaard, E.; Danneskiold-Samsoe, B.; Thomsen, C.; Oestergaard, M.; Bliddal, H. [Frederiksberg Hospital, Copenhagen (Denmark). Parker Inst.

    2006-07-15

    Purpose: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. Material and Methods: In 10 patients (50% males, mean age 58 years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II-III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90-180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90-180 min after ultrasound-guided i.a. injection of a 4 mmol/l Gd-DTPA solution. Coronal STIR, coronal T1 fat-saturated spin-echo, and a cartilage-sensitive gradient-echo sequence (3D T1 SPGR) in the sagittal plane were applied. Results: Both the post-i.v. and post-i.a. Gd-DTPA images showed significantly higher signal-to-noise (SNR) and contrast-to-noise (CNR) in the joint cartilage compared to the non-enhanced images ( P <0.002). I.a. Gd-DTPA provided significantly higher SNR and CNR compared to i.v. Gd-DTPA ( P <0.01). Furthermore, a better delineation of the cartilage in the synovial/cartilage zone and of the chondral/subchondral border was observed. Conclusion: The dGEMRIC MRI method markedly improved delineation of hip joint cartilage compared to non-enhanced MRI. The i.a. Gd-DTPA provided the best cartilage delineation. dGEMRIC is a clinically applicable MRI method that may improve identification of early subtle cartilage damage and the accuracy of volume measurements of hip joint cartilage.

  8. Microstructure of Temporomandibular Joint Cartilage after Intra-Articular Betamethasone Sodium Phosphate/Betamethasone Dipropionate Injection during the Early Stage of Experimental Osteoarthrosis

    Directory of Open Access Journals (Sweden)

    Irina N. Kostina

    2014-06-01

    Full Text Available Objective: to study the morphological changes in cartilage after a single intra-articular betamethasone sodium phosphate (BSP/betamethasone dipropionate (BDP injection during the early stage of experimental osteoarthrosis (OA of the temporomandibular joint (TMJ. Material and Methods: The experiment was performed on 18 male rabbits aged 6 months .The first group consisted of 9 healthy rabbits. The second group included 9 rabbits with mechanically induced TMJ OA. For 5 days, 3 hours daily, a load (with a force of 200N on the TMJ was imposed. In the left TMJ of the second group of rabbits, betamethasone was injected intra-articularly in different doses: 0.1 ml (n=3, 0.3 ml (n=3, and 0.5 ml (n=3. The right TMJ was used for comparison. A combined anesthesia was applied each experimental day. Rabbits of both groups were sacrificed on days 7, 14, and 30 with introductory combined anesthesia and intravenous injection of Zoletil 100® 20 mg/kg to stop their breathing. Results: Betamethasone caused destruction of the chondrocytes, fragmentation of collagen fibers, deficit of proteoglycans (PGs and glycosaminoglycans (GAGs, thinning of the cartilage, and contributed to the progression of TMJ OA. Conclusion: The optimal dose of BSP/BDP for intra-articular injection in the early stages of TMJ OA must be within the range of 0.1-0.3 ml|0.7-1.5 mg.

  9. Does Immediate Pain Relief After an Injection into the Sacroiliac Joint with Anesthetic and Corticosteroid Predict Subsequent Pain Relief?

    Science.gov (United States)

    Schneider, Byron J; Huynh, Lisa; Levin, Josh; Rinkaekan, Pranathip; Kordi, Ramin; Kennedy, David J

    2017-05-17

    To determine if immediate pain response following an injection with local anesthetic and corticosteroid predicts subsequent relief.  Prospective observational cohort.  An institutional review board-approved prospective study from a single academic medical center.  Patients with clinical diagnosis of sacroiliac (SIJ) pain and referred for SIJ injection were enrolled; 1 cc of 2% lidocaine and 1 cc of triamcinolone 40 mg/mL were injected into the SIJ. Pain score on 0-10 numeric rating scale (NRS) during provocation maneuvers was recorded immediately before injection, immediately after injection, and at two and four weeks of follow-up. Oswestry Disability Index (ODI) was also recorded.  Various cutoffs were identified to establish positive anesthetic response and successful outcomes at follow-up. These were used to calculated likelihood ratios. Of those with 100% anesthetic response, six of 11 (54.5%, 95% confidence interval [CI]+/-29.4%, +LR 2.6, 95% CI = 1.1-5.9) demonstrated 50% or greater pain relief at follow-up, and four of 11 (36.5%, 95% CI+/-28.4%, +LR 3.00, 95% CI = 1.4-5.1) had 100% relief at two to four weeks. Fourteen of 14 (100%, 95% CI+/-21.5%, -LR 0.0, 95% CI = 0.0-2.1) with an initial negative block failed to achieve 100% relief at follow-up.  Patients who fail to achieve initial relief after SIJ injection with anesthetic and steroid are very unlikely to achieve significant pain relief at follow-up; negative likelihood ratios (LR) in this study, based on how success is defined, range between 0 and 0.9. Clinically significant positive likelihood ratios of anesthetic response to SIJ injection are more limited and less robust, but are valuable in predicting 50% relief or 100% relief at two to four weeks.

  10. Joint Replacement (Finger and Wrist Joints)

    Science.gov (United States)

    ... artificial joint Damage to vessels, nerves or other structures in the region of the surgery Alternatives Some alternate procedures for treating arthritis include: Joint injections Oral medications such as aspirin or anti-inflammatory medicines Hand therapy exercises and ...

  11. CT-guided corticosteroid injection of the sacroiliac joints: quality assurance and standardized prospective evaluation of long-term effectiveness over six months.

    Science.gov (United States)

    Althoff, Christian E; Bollow, Matthias; Feist, Eugen; Marticorena-Garcia, Stephan R; Eshed, Iris; Diekhoff, Torsten; Hamm, Bernd; Hermann, Kay Geert A

    2015-06-01

    Steroid injection of the sacroiliac joints is widely used for the management of active sacroiliitis in patients with spondyloarthritis (SpA). The aims of this study were to prospectively investigate the effectiveness of corticosteroid injection of the sacroiliac joints and to identify factors determining positive and negative outcome. Twenty-nine patients (18 female, 11 male) suffering from sacroiliitis were treated by computed tomography (CT)-guided administration of 40 or 60 mg triamcinolone acetonide per joint. Clinical outcome of the intervention was determined using a visual analog scale from days 1 to 7 as well as after 1, 3, and 6 months. Patients were grouped according to intra-articular (n = 22) and peri-articular positions (n = 7) of the tip of the puncture needle. In patients with intra-articular needle position (76 %), the mean pain score decreased significantly from 7.3 (±1.9) to 3.9 (±3.4) at day 7 and to 3.9 (±3.4) after 1 month, 4.2 (±3.3) after 3 months, and 5.2 (±2.9) after 6 months. The group with peri-articular needle position (24 %) did not show a statistically significant pain reduction throughout the entire 6-month follow-up period. A substantial reduction of inflammatory back pain (reduction of at least 4 visual analog scale (VAS) points) was reported by 55 % of patients after 3 months and 45 % of patients after 6 months. Our results demonstrate that intra-articular CT-guided steroid instillation can achieve sufficient pain and symptom control for 6 months in patients suffering from active sacroiliitis. It is therefore recommended to perform this intervention under appropriate image guidance to ensure proper positioning of the needle tip.

  12. 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.

  13. /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

  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. 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.

  17. 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...

  18. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies

    DEFF Research Database (Denmark)

    Mandl, Peter; Naredo, Esperanza; Conaghan, Philip G

    2012-01-01

    Objectives. To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR). Methods. An English-language questionnaire, containing questions on demographics......, clinical and practical aspects of UGAJ, training options in UGAJ for rheumatologists, UGAJ education in the rheumatology training curriculum and other structured education programmes in UGAJ was sent to three different groups: (i) all national rheumatology societies of EULAR; (ii) all national societies...... of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB); and (iii) 22 senior rheumatologists involved in EULAR musculoskeletal US training from 14 European countries, who were also asked to circulate the questionnaire among relevant colleagues. Results. Thirty-three (75%) of 44...

  19. 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.

  20. Lanreotide Injection

    Science.gov (United States)

    Lanreotide injection is used to treat people with acromegaly (condition in which the body produces too much growth hormone, causing enlargement of the hands, feet, and facial features; joint pain; and other symptoms) who have not successfully, or cannot be treated ...

  1. Peroneal spastic flatfoot in adolescents with accessory talar facet impingement: a preliminary report.

    Science.gov (United States)

    Niki, Hisateru; Aoki, Haruhito; Hirano, Takaaki; Akiyama, Yui; Fujiya, Hiroto

    2015-07-01

    This study analyzed imaging, arthroscopic findings, and treatment responses for peroneal spastic flatfoot (PSFF) caused by talocalcaneal impingement at the accessory anterolateral talar facet (AALTF) (accessory talar facet impingement) in 13 adolescents without histories of trauma and tarsal coalition. The AALTF was determined with computed tomography and MRI. Focal abutting bone marrow edema (FABME) on MRI around the AALTF was confirmed. In seven patients who underwent AALTF resection, subtalar arthroscopy was performed. All experienced alleviation PSFF after treatment; reduction in FABME was observed. AALTF resection alone is beneficial for PSFF caused by accessory talar facet impingement when peroneal spasms are restored by an injection of local anesthesia.

  2. 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

  3. 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.

  4. Intra-articular corticosteroid injections to the temporomandibular joints are safe and appear to be effective therapy in children with juvenile idiopathic arthritis.

    Science.gov (United States)

    Stoll, Matthew L; Good, Jennifer; Sharpe, Tyler; Beukelman, Timothy; Young, Daniel; Waite, Peter D; Cron, Randy Q

    2012-08-01

    The purpose of this study was to evaluate the safety and efficacy of intra-articular corticosteroid injections (IACIs) of the temporomandibular joint (TMJ) in children with juvenile idiopathic arthritis (JIA) when administered by an oral and maxillofacial surgeon without imaging guidance. This was a retrospective study of children with JIA, seen at a single center, who were selected based on having received IACIs of the TMJ. All subjects received the intervention, which consisted of referral to a single oral and maxillofacial surgeon for TMJ IACI with 5 to 10 mg triamcinolone hexacetonide, under general anesthesia. Primary outcomes assessed in all subjects were the safety of the procedure and efficacy as determined by the change in maximal incisal opening (MIO). In addition, a subset of 31 subjects underwent repeat magnetic resonance imaging of the TMJ, permitting analysis of the change in the acute and chronic findings of arthritis in those patients. Sixty-three patients (68% female) received 137 IACIs. The mean age for diagnosis of JIA was 8.5 years, and the mean age at presentation for TMJ injections was 10 years. The injections were well tolerated: only 1 patient developed the steroid complication of hypopigmentation, and none developed degeneration or ankylosis. In terms of efficacy, the mean MIO increased from 40.8 ± 0.93 to 43.5 ± 0.90 mm (P = .001); in addition, changing the unit of analysis to individual joints, in patients who underwent repeat magnetic resonance imaging examination, 51% of TMJs showed magnetic resonance imaging evidence of improvement of arthritic changes, of whom 18% had complete resolution of TMJ arthritis. The results indicate that IACI of the TMJ can be safely performed by experienced oral and maxillofacial surgeons without a requirement for computed tomographic guidance. In addition, these results show that IACI may be effective in the management of TMJ arthritis, although further studies are required. Copyright © 2012 American

  5. Interrelationship between temporomandibular joint osteoarthritis (OA) and cervical spine pain: Effects of intra-articular injection with hyaluronic acid.

    Science.gov (United States)

    Guarda-Nardini, Luca; Cadorin, Cristina; Frizziero, Antonio; Masiero, Stefano; Manfredini, Daniele

    2017-09-01

    The aim of this study was to evaluate cervical spine pain and function after five sessions of viscosupplementation with hyaluronic acid (HA) in patients with temporomandibular joint (TMJ) osteoarthritis. Forty-nine patients, (79% females, aged between 43-81 years), affected by TMJ osteoarthritis and concurrent cervical spine pain and limited function were recruited. All patients underwent a cycle of five weekly arthrocenteses and viscosupplementation with 1 ml of medium molecular weight HA according to the single-needle arthrocentesis technique. Outcome variables were TMJ pain (VAS), cervical active ranges of motion, cervical disability (NPDS), and presence of painful palpation sites. Assessments were carried out at baseline and at one, three and six months after the end of treatment protocol. A significant reduction over time was shown both in TMJ pain levels and in NPDS values with respect to baseline (p < 0.001). Most parameters of active cervical range of motion showed an improvement with time. Benefits remained stable throughout six months after the viscosupplementation protocol. A protocol of TMJ intra articular arthrocentesis and viscosupplementation improved cervical function and reduced disability in patients with concurrent cervical spine pain. These findings add to the complex amount of literature on the relationship between temporomandibular disorders and cervical spine disorders.

  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. The effect of intra-articular injection of ultracain in the temporomandibular joint in patients with preauricular pain - A randomized prospective double-blind placebo-controlled crossover study

    NARCIS (Netherlands)

    Tjakkes, Geerten-Has E.; TenVergert, Elisabeth M.; de Bont, Lambert G. M.; Stegenga, Boudewijn

    2007-01-01

    Objectives: To evaluate the distinguishing ability of intraarticular anesthesia from placebo in orofacial pain patients with pain located in the temporomandibular joint (TMJ) region, aiming at a validation of intra-articular anesthesia injection as a diagnostic test of pain in the TMJ region. Materi

  9. 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.

  10. Common injections in musculoskeletal medicine.

    Science.gov (United States)

    Monseau, Aaron J; Nizran, Parminder Singh

    2013-12-01

    Musculoskeletal injections are a common procedure in primary care and sports medicine but can be intimidating for some clinicians. This article addresses current evidence for corticosteroid injections, and common injection indications and techniques, namely knee, subacromial bursa, glenohumeral joint, lateral epicondyle, de Quervain tenosynovitis, and greater trochanteric bursa injections. Preparation for injections and some evidence for ultrasound guidance are also reviewed.

  11. 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

  12. 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.

  13. 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...

  14. GaAs-based self-aligned stripe superluminescent diodes processed normal to the cleaved facet

    Science.gov (United States)

    Ghazal, O. M. S.; Lei, D.; Childs, D. T.; Stevens, B. J.; Babazadeh, N.; Hogg, R. A.; Groom, K. M.

    2016-03-01

    We demonstrate GaAs-based superluminescent diodes (SLDs) incorporating a window-like back facet in a self-aligned stripe. SLDs are realised with low spectral modulation depth (SMD) at high power spectral density, without application of anti-reflection coatings. Such application of a window-like facet reduces effective facet reflectivity in a broadband manner. We demonstrate 30mW output power in a narrow bandwidth with only 5% SMD, outline the design criteria for high power and low SMD, and describe the deviation from a linear dependence of SMD on output power as a result of Joule heating in SLDs under continuous wave current injection. Furthermore, SLDs processed normal to the facet demonstrate output powers as high as 20mW, offering improvements in beam quality, ease of packaging and use of real estate.

  15. Fluoroscopic lumbar interlaminar epidural injections in managing chronic lumbar axial or discogenic pain.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Cash, Kimberly A; McManus, Carla D; Pampati, Vidyasagar; Benyamin, Ramsin

    2012-01-01

    Among the multiple causes of chronic low back pain, axial and discogenic pain are common. Various modalities of treatments are utilized in managing discogenic and axial low back pain including epidural injections. However, there is a paucity of evidence regarding the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. In an interventional pain management practice in the US, a randomized, double-blind, active control trial was conducted. The objective was to assess the effectiveness of lumbar interlaminar epidural injections of local anesthetic with or without steroids for managing chronic low back pain of discogenic origin. However, disc herniation, radiculitis, facet joint pain, or sacroiliac joint pain were excluded. Two groups of patients were studied, with 60 patients in each group receiving either local anesthetic only or local anesthetic mixed with non-particulate betamethasone. Primary outcome measures included the pain relief-assessed by numeric rating scale of pain and functional status assessed by the, Oswestry Disability Index, Secondary outcome measurements included employment status, and opioid intake. Significant improvement or success was defined as at least a 50% decrease in pain and disability. Significant improvement was seen in 77% of the patients in Group I and 67% of the patients in Group II. In the successful groups (those with at least 3 weeks of relief with the first two procedures), the improvement was 84% in Group I and 71% in Group II. For those with chronic function-limiting low back pain refractory to conservative management, it is concluded that lumbar interlaminar epidural injections of local anesthetic with or without steroids may be an effective modality for managing chronic axial or discogenic pain. This treatment appears to be effective for those who have had facet joints as well as sacroiliac joints eliminated as the pain source.

  16. 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

  17. 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...

  18. 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...

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. Joint and Soft Tissue Injections

    Science.gov (United States)

    ... A Treatment for ArrhythmiaRead Article >>Cardioverter-Defibrillator: A Treatment for ArrhythmiaAugust 2017April 1999Procedures & Devicesfamilydoctor.org editorial staffUnderstanding Abnormal Cervical Cancer Screening ResultsRead Article >>Understanding Abnormal Cervical Cancer Screening ...

  6. 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.

  7. 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.

  8. 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.

  9. Intradiscal and intra-articular facet infiltrations with plasma rich in growth factors reduce pain in patients with chronic low back pain

    Science.gov (United States)

    Kirchner, Fernando; Anitua, Eduardo

    2016-01-01

    Context: Low back pain (LBP) is a complex and disabling condition, and its treatment becomes a challenge. Aims: The aim of our study was to assess the clinical outcome of plasma rich in growth factors (PRGF-Endoret) infiltrations (one intradiscal, one intra-articular facet, and one transforaminal epidural injection) under fluoroscopic guidance-control in patients with chronic LBP. PRGF-Endoret which has been shown to be an efficient treatment to reduce joint pain. Settings and Design: The study was designed as an observational retrospective pilot study. Eighty-six patients with a history of chronic LBP and degenerative disease of the lumbar spine who met inclusion and exclusion criteria were recruited between December 2010 and January 2012. Subjects and Methods: One intradiscal, one intra-articular facet, and one transforaminal epidural injection of PRGF-Endoret under fluoroscopic guidance-control were carried out in 86 patients with chronic LBP in the operating theater setting. Statistical Analysis Used: Descriptive statistics were performed using absolute and relative frequency distributions for qualitative variables and mean values and standard deviations for quantitative variables. The nonparametric Friedman statistical test was used to determine the possible differences between baseline and different follow-up time points on pain reduction after treatment. Results: Pain assessment was determined using a visual analog scale (VAS) at the first visit before (baseline) and after the procedure at 1, 3, and 6 months. The pain reduction after the PRGF-Endoret injections showed a statistically significant drop from 8.4 ± 1.1 before the treatment to 4 ± 2.6, 1.7 ± 2.3, and 0.8 ± 1.7 at 1, 3, and 6 months after the treatment, respectively, with respect to all the time evaluations (P < 0.0001) except for the pain reduction between the 3rd and 6th month whose signification was lower (P < 0.05). The analysis of the VAS over time showed that at the end point of the

  10. 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

  11. 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

  12. Research Progress of Articular Cavity Injection in the Treatment of Knee Joint Osteoarthritis%关节腔注射治疗膝关节骨性关节炎研究进展

    Institute of Scientific and Technical Information of China (English)

    汤晓清

    2011-01-01

    Knee joint osseous arthritis( KOA ), a degenerative disease of the knee joint, is a common, frequently-occurring disease in orthopedics. The treatment methods are mainly oral drug therapy, intra-articular injection,physiotherapy and surgical operation etc. ; intra-articular injection of medications have rapid onset of action,local high effective concentration, so it is widely used by clinicians. Western medicine intra-articular injection drugs mainly are sodium hyaluronate,glucocorticoid,ozone,etc. ; traditional Chinese medicine and the extract of intra-articular injection are ligustrazine,salvia miltiorrhiza,deer polypeptide melon, etc.. It is also not rare to see traditional Chinese and western medicine combined in intra-articular injection. Here is to make a review on KOA traditional Chinese and western medicine combined therapy in articular cavity injection in recent years.%膝关节骨性关节炎(KOA)是一种膝关节退行性疾病,是骨科常见病、多发病.其治疗方法主要有口服药物、关节腔注射、物理治疗及手术等,关节腔注射起效快,局部有效浓度高,被临床医师广泛应用.西药关节腔注射治疗药物主要有玻璃酸钠、糖皮质激素、臭氧等,中药及中药提取物关节腔注射主要有川芎嗪、丹参、鹿瓜多肽等,中西药物联合注射治疗亦不少见.现就近年来有关KOA中西药物关节腔注射治疗予以综述.

  13. Fixed-point Injection with Joint Mobilization in the Treatment of Shoulder Periarthritis%定点注射联合关节松动术治疗肩周炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    王蒙; 姜益常

    2013-01-01

    Objective:To observe the effect of fixed -point injection and joint mobilization in the treatment of shoulder periarthritis .Methods:60 patients met the criteria for shoulder periarthritis cases were randomly divid-ed into two groups with 30 patients in each group , the treatment group was used by fixed -point injection and joint mobilization ,and the control group was used with the simple fixed -point injection therapy .The curative effect was evaluated according to the clinical curative effect of shoulder pain and shoulder function activity quan -tification score between pre and post treatment .Results:The shoulder pain and shoulder function activity quan-tification score of the two groups after the treatment were significantly reduced .The treatment group was superior to the control group , and there was a significant difference between the two groups ( P<0 .05 ) .Conclusion:Fixed-point injection with joint mobilization in the treatment of shoulder periarthritis can effectively relieve pain and improve the range of shoulder activity .Fixed-point injection with joint mobilization in the treatment of shoulder periarthritis is superior to the simple fixed -point injection therapy .%目的:观察定点注射与关节松动术联合治疗肩周炎的疗效。方法:将符合纳入标准的60例肩周炎患者随机分为两组各30例,治疗组采用定点注射与关节松动术联合治疗;对照组采用单纯定点注射治疗。治疗前后根据肩关节疼痛及活动度的评分进行疗效评定。结果:两组患者经治疗后肩关节疼痛程度及活动度评分均明显降低,同时治疗组优于对照组,具有统计学意义( P<0.05)。结论:定点注射与关节松动术联合治疗肩周炎有显著的疗效,能够有效地止痛和改善肩关节活动范围,且定点注射与关节松动术联合治疗肩周炎的疗效优于单纯定点注射治疗。

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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...

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. [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

  8. 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)].

  9. Efficacy of intra-articular injection with sodium hyaluronate for knee joint osteoarthritis%玻璃酸钠关节腔内注射治疗膝关节骨关节炎的疗效

    Institute of Scientific and Technical Information of China (English)

    黄越

    2012-01-01

    Objective To observe the therapeutic effect of intra-articular injection with sodium hyaluronate for knee joint osteoarthritis. Methods 123 cases of knee joint osteoarthritis patients, total 159 gonitis were treated with sodium hyaluronate,once a week,5 times a course. The patients were evaluated with HSS' Scale before and after treatment, following up for 6 months. Results The joint function of 146 knee improved. The total effective rate was 91. 9% ,the signs and symptoms of most patients were improved obviously. Conclusion Sodium hyaluronate can alleviate the symptom effectively,and improve the joint's function for knee joint osteoarthritis.%目的 观察玻璃酸钠关节腔内注射治疗膝关节骨关节炎的临床疗效.方法 对123例膝关节骨关节炎患者(159个膝关节)腔内注射玻璃酸钠,每周注射1次,连续5次为1个疗程,采用HSS膝关节评分标准,分别于治疗前、治疗后进行评分,随访半年.结果 146个膝关节功能改善,症状减轻,总有效率达91.9%,半年随访,大部分患者膝关节症状、体征明显改善.结论 玻璃酸钠关节腔内注射治疗膝关节骨关节炎,能有效缓解疼痛,改善关节功能.

  10. 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.

  11. 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.

  12. Perturbative studies of toroidal momentum transport using neutral beam injection modulation in the Joint European Torus: Experimental results, analysis methodology, and first principles modeling

    DEFF Research Database (Denmark)

    Mantica, P.; Tala, T.; Ferreira, J.S.

    2010-01-01

    Perturbative experiments have been carried out in the Joint European Torus [Fusion Sci. Technol. 53(4) (2008)] in order to identify the diffusive and convective components of toroidal momentum transport. The torque source was modulated either by modulating tangential neutral beam power or by modu...

  13. Treatment of temporomandibular joint disc perforation with injection of hyaluronic acid or disc repair%颞下颌关节盘穿孔两种治疗方法的疗效分析

    Institute of Scientific and Technical Information of China (English)

    陆金标; 龙星; 邓末宏; 程勇; 李波

    2014-01-01

    Objective To assess the efficacy of injection of sodium hyaluronate in the treatment of patients with disc perforation by using cone-beam computed tomography (CBCT) and temporomandibular joint (TMJ) function.Methods Twenty-eight patients (38 joints) with disc perforation observed through arthrography who received injection of sodium hyaluronate and other 20 patients (29 joints) who received disc repair were included in this study.Pain (visual analog scale,scores 0 to 100),maximal mouth opening,modified Helkimo's clinical dysfunction index and TMJ examinations with CBCT were obtained before and 3,9 months after treatment.Results A statistically significant increase (P<0.05) in TMJ clinical outcome was observed at each follow-up.The maximal mouth opening (MMO) increased 5.89 mm and 7.64 mm at 3 and 9 months follow-up in the hyaluronic acid (HA) group,and the MMO increased 2.75 mm and 6.10 mm at 3 and 9 months follow-up in the operation group.Osseous remodeling occurred in 66% (25 of 38 joints) of patients after HA injection and 55%(16 of 29 joints) of patients appeared bone remodeling after disc repair.Conclusions Both injection of hyaluronic acid and disc repair are effective for treatment of temporomandibular joint disc perforation.%目的 分析透明质酸(hyaluronic acid,HA)关节腔注射及关节盘修补术两种方法治疗颞下颌关节盘穿孔的效果.方法 随访分别采用透明质酸注射治疗的28例(38侧,HA组)及关节盘修补术治疗的20例(29侧,手术组)颞下颌关节盘穿孔患者,比较治疗前及治疗后3、9个月时最大开口度、疼痛及髁突骨质变化.结果 两组患者治疗后3及9个月开口度均较治疗前显著增大,HA组开口度增大平均5.89、7.64 mm;手术组增大2.75、6.10 mm,同时疼痛缓解,临床症状减轻,差异均有统计学意义(P<0.05).髁突有骨质修复性改建:HA组66%(25/38),手术组55%(16/29).结论 透明质酸注射及关节盘修补术均能有效缓解关节盘穿孔患者的临床症状.

  14. 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...

  15. 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.

  16. 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

  17. Stabilization of the sacroiliac joint.

    Science.gov (United States)

    Shaffrey, Christopher I; Smith, Justin S

    2013-07-01

    Lower back pain and pain involving the area of the posterior iliac spine are extremely common. Degeneration of the sacroiliac joint (SIJ) is one potential cause for lower back pain and pain radiating into the groin or buttocks. Degenerative changes to the lumbar spine and sacroiliac joints are common. A recent study evaluating SIJ abnormalities in a primary low back pain population demonstrated 31.7% of patients demonstrated SI joint abnormalities. (4) As is the case for the evaluation and management of isolated lower back pain, the evaluation, management, and role for surgical intervention in SIJ pain is very controversial. Many patients have degenerative changes of the disc, facet joints, and SIJs. A recent systematic review performed to determine the diagnostic accuracy of tests available to clinicians to identify the disc, facet joint, or SIJ as the source of low back pain concluded that tests do exist that change the probability of the disc or SIJ (but not the facet joint) as the source of low back pain. (3) It was also concluded that the usefulness of these tests in clinical practice, particularly for guiding treatment selection, remains unclear. (3) Although there is general agreement that SIJ pathological changes are a potential cause of pain, there is far less agreement about the optimal management of these conditions. A variety of conditions can cause SIJ dysfunction including degenerative and inflammatory arthritis, trauma, prior lumbosacral fusion, hip arthritis, limb length inequality, infections, and neoplasia. (8) There is increasing evidence that image intensifier-guided single periarticular injection can correctly localize pain to the SIJ but the optimal management strategy remains controversial. Recent publications have compared surgical versus injection treatments and fusion versus denervation procedures. (1 , 8) A systematic review found improvement regardless of the treatment, with most studies reporting over 40% improvement in pain as measured

  18. EFFICACY OF TRANSFORAMINAL EPIDURAL STEROID INJECTION IN LUMBOSACRAL RADICULOPATHY

    Directory of Open Access Journals (Sweden)

    Saheel

    2016-02-01

    Full Text Available BACKGROUND Lumbosacral radiculopathy is a common medical and socioeconomic problem with a lifetime prevalence estimated to be around 40%-60%. In 1930, Evans reported that sciatica could be treated by epidural injection. The use of epidural corticosteroid injection for the treatment of axial and radicular back pain was first reported in 1953. Lumbar Transforminal Epidural Steroid Injections (TFESIs are performed to provide symptomatic relief in patients with radicular pain. A transforaminal epidural steroid injection (TFESI using a small volume of local anaesthetic will anaesthetize the spinal nerve and also partially anaesthetize the dura, the posterior longitudinal ligament, the intervertebral disc and facet joint. For these reasons, fluoroscopy-guided TFESI has become the preferred approach to epidural space. AIMS AND OBJECTIVES To study the role of transforaminal epidural steroid injection in management of radiculopathy. SETTINGS AND DESIGN This prospective study was conducted in the Department of Orthopaedics, SKIMS Medical College and Hospital, Bemina, Srinagar, J and K, India, for a 2-year period from November 2012 to October 2014; 110 cases, both male and female in the age group of 20-60 years having back pain with radiculopathy of varied types and duration without neurodeficit were enrolled in the study. MATERIALS AND METHODS After selecting a patient for giving transforaminal block, we used a local anaesthetic (2% Xylocaine. Contrast media, e.g. Iohexol was used to demarcate the correct positioning of the needle. A spinal needle (20-25 gauge and 5mL syringe were used to deliver the drug. CONCLUSION Transforaminal epidural steroid injections with long acting anaesthetic is an excellent form of conservative treatment in management of low back ache with radicular pain. It is relatively safe, simple, economical and shortens the time of recovery from severe pain, avoids risks and complications of surgery and also avoids long periods of bed

  19. 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...

  20. Therapeutic effect of intra-articular injection of ribbon-type decoy oligonucleotides for hypoxia inducible factor-1 on joint contracture in an immobilized knee animal model.

    Science.gov (United States)

    Sotobayashi, Daisuke; Kawahata, Hirohisa; Anada, Natsuki; Ogihara, Toshio; Morishita, Ryuichi; Aoki, Motokuni

    2016-08-01

    Limited range of motion (ROM) as a result of joint contracture in treatment associated with joint immobilization or motor paralysis is a critical issue. However, its molecular mechanism has not been fully clarified and a therapeutic approach is not yet established. In the present study, we investigated its molecular mechanism, focusing on the role of a transcription factor, hypoxia inducible factor-1 (HIF-1), which regulates the expression of connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF), and evaluated the possibility of molecular therapy to inhibit HIF-1 activation by ribbon-type decoy oligonucleotides (ODNs) for HIF-1 using immobilized knee animal models. In a mouse model, ROM of the immobilized knee significantly decreased in a time-dependent manner, accompanied by synovial hypertrophy. Immunohistochemical studies suggested that CTGF and VEGF are implicated in synovial hypertrophy with fibrosis. CTGF and VEGF were up-regulated at both the mRNA and protein levels at 1 and 2 weeks after immobilization, subsequent to up-regulation of HIF-1 mRNA and transcriptional activation of HIF-1. Of importance, intra-articular transfection of decoy ODNs for HIF-1 in a rat model successfully inhibited transcriptional activation of HIF-1, followed by suppression of expression of CTGF and VEGF, resulting in attenuation of restricted ROM, whereas transfection of scrambled decoy ODNs did not. The present study demonstrates the important role of HIF-1 in the initial progression of immobilization-induced joint contracture, and indicates the possibility of molecular treatment to prevent the progression of joint contracture prior to intervention with physical therapy. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Fluoroscopic lumbar interlaminar epidural injections in managing chronic lumbar axial or discogenic pain

    Directory of Open Access Journals (Sweden)

    Manchikanti L

    2012-08-01

    Full Text Available Laxmaiah Manchikanti,1,2 Kimberly A Cash,1 Carla D McManus,1 Vidyasagar Pampati,1 Ramsin Benyamin3,41Pain Management Center of Paducah, Paducah, KY; 2University of Louisville, Louisville, KY; 3Millennium Pain Center, Bloomington, IL; 4University of Illinois, Urbana-Champaign, IL, USAAbstract: Among the multiple causes of chronic low back pain, axial and discogenic pain are common. Various modalities of treatments are utilized in managing discogenic and axial low back pain including epidural injections. However, there is a paucity of evidence regarding the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. In an interventional pain management practice in the US, a randomized, double-blind, active control trial was conducted. The objective was to assess the effectiveness of lumbar interlaminar epidural injections of local anesthetic with or without steroids for managing chronic low back pain of discogenic origin. However, disc herniation, radiculitis, facet joint pain, or sacroiliac joint pain were excluded. Two groups of patients were studied, with 60 patients in each group receiving either local anesthetic only or local anesthetic mixed with non-particulate betamethasone. Primary outcome measures included the pain relief-assessed by numeric rating scale of pain and functional status assessed by the, Oswestry Disability Index, Secondary outcome measurements included employment status, and opioid intake. Significant improvement or success was defined as at least a 50% decrease in pain and disability. Significant improvement was seen in 77% of the patients in Group I and 67% of the patients in Group II. In the successful groups (those with at least 3 weeks of relief with the first two procedures, the improvement was 84% in Group I and 71% in Group II. For those with chronic function-limiting low back pain refractory to conservative management

  2. Cervical foraminal steroid injections under CT guidance: retrospective study of in situ contrast aspects in a serial of 248 cases

    Energy Technology Data Exchange (ETDEWEB)

    Pottecher, Pierre; Krause, Denis; Di Marco, Lucy; Loffroy, Romaric; Estivalet, Louis [CHU Dijon Bocage Central, Departement de Radiologie et Imagerie Diagnostique et Interventionnelle, Dijon (France); Duhal, Romain; Demondion, Xavier [CHRU de Lille, Service de Radiologie Musculosquelettique, CCIAL, Laboratoire d' Anatomie, Faculte de Medecine de Lille, Hopital Roger Salengro, Lille (France)

    2015-01-15

    To describe all the CT findings after in situ contrast injection just before steroid injection and to recognize the abnormal aspects associated with intravascular contamination. We retrospectively evaluated 248 cervical transforaminal steroid injections done at the university hospital in Dijon, France, in 2008-2012, to treat cervicobrachial neuralgia inadequately improved by optimal medical treatment for at least 3 weeks. Features describing the opacification patterns were recorded. Five main nonvascular opacification patterns were identified: clumps of contrast agent outside the foramen (16 %), a crab claw pattern surrounding the ganglion (13 %), a ''French'' circumflex accent pattern (15 %), reflux along the needle (7 %), and facet joint capsule opacification (22 %). Concerning the situations requiring a change in needle position, intravenous injection occurred in 26 % of the patients, with a crab claw pattern in half the cases and a clump pattern in half the cases. Intraarteriolar injection was noted in two patients. CT after in situ contrast injection ensures proper needle positioning outside the blood vessels before steroid injection. Penetration of the needle tip into a vein is very common, whereas arteriolar puncture is extremely rare. (orig.)

  3. 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.

  4. 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...

  5. /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

  6. Efficacy of medical ozone intra-articular injection for the treatment of patients with knee joint meniscus injury%医用三氧膝关节腔内注射治疗半月板损伤的疗效

    Institute of Scientific and Technical Information of China (English)

    董俊球; 黎小雅

    2015-01-01

    目的 探讨膝关节腔内注射医用三氧治疗半月板损伤的疗效.方法 半月板损伤患者64例,以随机法分为三氧组和理疗组,每组32例.三氧组采用膝关节腔内医用三氧注射治疗;理疗组采用中西结合物理治疗,两组均配合股四头肌功能训练.于治疗后1个月时行AKS评分及临床疗效评定.结果 治疗后三氧组患者AKS各分项及总评分均高于理疗组,优良率三氧组94%(30/32例)高于理疗组56%(18/32例),差异均有统计学意义(P<0.05).结论 膝关节腔内医用三氧注射治疗半月板损伤疗效良好.%Objective To observe the efficacy of medical ozone intra-articular injection in the treatment of patients with knee joint meniscus injury.Methods Sixty-four patients with knee joint meniscus injury were randomly divided into two groups,32 cases in each group.Patients in ozone group were received intraarticular injection of ozone,while physiotherapy group were received combination of traditional Chinese and Western physical therapy.All of the patients were combined with functional training of quadratus femoris muscle.AKS and clinical effects were evaluated at 1 month after the treatment.Results The total score of AKS and its each item were significantly higher in ozone group than those in physiotherapy group (P < 0.05).The excellent and good rate in ozone group (94%,30/32 cases) was significantly higher than that in physiotherapy group (56%,18/32 cases) (P < 0.05).Conclusion Medical ozone intra-articular injection is effective in the treatment of knee joint meniscus injury.

  7. 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.

  8. What is the Role of Epidural Injections in the Treatment of Lumbar Discogenic Pain: A Systematic Review of Comparative Analysis with Fusion

    Science.gov (United States)

    Staats, Peter S.; Nampiaparampil, Devi E.; Hirsch, Joshua A.

    2015-01-01

    Background Lumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery. Methods A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. Results Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. Conclusions The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments. PMID:25852828

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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...

  15. SEMICONDUCTOR DEVICES Thermal analysis of the cavity facet for an 808 nm semiconductor laser by using near-field scanning optical microscopy

    Science.gov (United States)

    Lan, Rao; Guofeng, Song; Lianghui, Chen

    2010-10-01

    In order to analyze the thermal characteristics of the cavity facet of a semiconductor laser, a home-built near-field scanning optical microscopy (NSOM) is employed to probe the topography of the facet. By comparing the topographic images of two samples under different DC current injections, we can find that the thermal characteristic is related to its lifetime. We show that it is possible to predict the lifetime of the semiconductor laser diode with non-destructive tests.

  16. Influence of patterned TiO2/SiO2 dielectric multilayers for back and front mirror facets on GaN-based laser diodes

    Institute of Scientific and Technical Information of China (English)

    Chen Wei-Hua; Hu Xiao-Dong; Dai Tao; Li Rui; Ye Xue-Min; Zhao Tai-Ping; Du Wei-Min; Yang Zhi-Jian; Zhang Guo-Yi

    2008-01-01

    Ridge InGaN multi-quantum-well-structure(MQW)edge-emitting laser diodes(LDs)were grown on(0001)sapphire substrates by low-pressure metal-organic chemical vapour deposition(MOCVD).The dielectric TiO2/SiO2 front and back facet coatings as cavity mirror facets of the LDs have been deposited with electron-beam evaporation method.The reflectivity of the designed front coating is about 50% and that of the back high reflective coating is as high as 99.9%.Under pulsed current injection at room temperature,the influences of the dielectric facets were discussed.The threshold current of the ridge GaN-based LDs was decreased after the deposition of the back high reflective dielectric mirrors and decreased again after the front facets were deposited.Above the threshold,the slope efficiency of the LDs with both reflective facets was larger than those with only back facets and without any reflective facets.It is important to design the reflectivity of the front facets for improving the performance of GaN-based LDs.

  17. 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.

  18. 仰卧位关节腔注射治疗膝骨性关节炎疗效观察及护理%Curative Effect Observation and Nursing Care of Supine Joint Cavity Injection Knee Osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    曾亚华; 翟亚玲; 孙光华

    2012-01-01

    Objective:Observe clinical effect and explore nursing programs of supine joint cavity injecting treat knee osteoarthritis(knee OA).Methods:116 patients with knee OA which met the diagnostic criteria were injected with Sodium Hyaluronatc Injection through supine patella outer edge into joint cavity.One time per week,consecutive five weeks as a course of treatment,nursing and rehabilitation guidance were given before and after injection.And visual analogue scale(VAS) scores、WOMAC osteoarthritis index,swelling and tenderness index were used to valuate the curative effect.Result:There were significant pre-/post-treatment differences in the VAS pain scores and WOMAC osteoarthritis index,swelling,tenderness index(P0.05).After treatment,2 cases in clinical control(1.72%),26 cases excellent(22.41%),76 cases effective(65.52%),12 cases none-effective(10.35%).Conclusion:Supine joint cavity injection with nursing and rehabilitation can improve the clinical symptoms of knee OA significantly,and the clinical operations are safe and convenient.%目的:观察仰卧位关节腔注射治疗膝骨性关节炎(osteoarthritis,以下简称膝OA)的临床疗效并探讨护理方案.方法:选取116例符合诊断标准的膝OA患者,所有患者采用仰卧位髌骨外缘入路关节腔注射玻璃酸钠注射液,1次/周,连续5周为一个疗程,并于注射前后给予护理及康复指导.治疗前及治疗后应用视觉模拟评分(visual ana-log scale,VAS)、WOMAC骨关节炎指数、肿胀、压痛积分进行评分,以评价疗效.结果:治疗前后VAS疼痛评分、WOMAC骨性关节炎指数、肿胀、压痛指数均有显著性意义(P〈0.05).经治疗后,临床控制2例(1.72%),显效26例(22.41%),有效76例(65.52%),无效12例(10.35%).结论:仰卧位关节腔注射治疗并配合护理康复能明显改善膝OA临床症状,且临床操作安全、方便.

  19. 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...

  20. Image-guided spinal injection procedures in open high-field MRI with vertical field orientation: feasibility and technical features

    Energy Technology Data Exchange (ETDEWEB)

    Streitparth, F.; Walter, T.; Wonneberger, U.; Wagner, M.; Hermann, K.G.; Hamm, B.; Teichgraeber, U. [Charite, Humboldt-Universitaet zu Berlin, Department of Radiology, Berlin (Germany); Chopra, S. [Charite-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Department of General, Visceral, and Transplantation Surgery, Berlin (Germany); Wichlas, F. [Charite-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Center for Musculoskeletal Surgery, Berlin (Germany)

    2010-02-15

    We prospectively evaluated the feasibility and technical features of MR-guided lumbosacral injection procedures in open high-field MRI at 1.0 T. In a CuSO{sub 4}.5H{sub 2}O phantom and five human cadaveric spines, fluoroscopy sequences (proton-density-weighted turbo spin-echo (PDw TSE), T1w TSE, T2w TSE; balanced steady-state free precession (bSSFP), T1w gradient echo (GE), T2w GE) were evaluated using two MRI-compatible 20-G Chiba-type needles. Artefacts were analysed by varying needle orientation to B{sub 0}, frequency-encoding direction and slice orientation. Image quality was described using the contrast-to-noise ratio (CNR). Subsequently, a total of 183 MR-guided nerve root (107), facet (53) and sacroiliac joint (23) injections were performed in 53 patients. In vitro, PDw TSE sequence yielded the best needle-tissue contrasts (CNR = 45, 18, 15, 9, and 8 for needle vs. fat, muscle, root, bone and sclerosis, respectively) and optimal artefact sizes (width and tip shift less than 5 mm). In vivo, PDw TSE sequence was sufficient in all cases. The acquisition time of 2 s facilitated near-real-time MRI guidance. Drug delivery was technically successful in 100% (107/107), 87% (46/53) and 87% (20/23) of nerve root, facet and sacroiliac joint injections, respectively. No major complications occurred. The mean procedure time was 29 min (range 19-67 min). MR-guided spinal injections in open high-field MRI are feasible and accurate using fast TSE sequence designs. (orig.)

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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...

  7. Medroxyprogesterone Injection

    Science.gov (United States)

    Medroxyprogesterone intramuscular (into a muscle) injection and medroxyprogesterone subcutaneous (under the skin) injection are used to prevent pregnancy. Medroxyprogesterone subcutaneous injection is also used to treat endometriosis (a condition in which ...

  8. Pentamidine Injection

    Science.gov (United States)

    Pentamidine injection is used to treat pneumonia caused by a fungus called Pneumocystis carinii. It is in ... Pentamidine injection comes as powder to be mixed with liquid to be injected intramuscularly (into a muscle) ...

  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. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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...

  3. 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.

  4. 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.

  5. 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...

  6. 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.

  7. 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)

  8. 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.

  9. 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....

  10. 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....

  11. /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

  12. 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.

  13. Evaluation of the relationship of SMT injection and cytokines expression for temporomandibular joint osteoarthrosis%S-甲基异硫脲对兔关节滑液中细胞因子表达的影响

    Institute of Scientific and Technical Information of China (English)

    秦霞南; 麦伟持; 游曼求; 张爱芳

    2008-01-01

    Objeetlve To evaluate the relationship between temporomandibular joint(TMJ)osteoarthrosis (OA)and cytokines.Methods 20 rabbits were enrolled in this study.They were divided into either experiment(n=10)or control group(n=10).The modeh of TMJ osteoarthrosis were formed by injection SMT into upper joint compartment of the TMJ.Cytokines in the aspirated synovial fluid,induding interleukin(IL-1),IL-6,tumor necrosis faetor(TNF-α),were tested before and after SMT iniection.Results The level of IL-1β,IL-6 and TNF-α in experiment group decreased significantly after treatment,there was significance(P<0.05);and the level of IL-1β,IL-6 and TNF-α in control group is lower after treatment,there was no significance(P>0.05).Conclusion The cytokines,including IL-1β,IL-6,TNF-α,decreased significantly by injection SMT into upper joint compartment of the TMJ with OA.%目的 探讨甲基异硫脲(SMT)治疗颞下领关节骨关节病对关节滑液中细胞因子表达的影响.方法 选取20只成年新西兰大白兔,用0.5%胶原酶溶液0.4 ml注射人左侧颞下颌关节,诱导形成骨关节病动物模型;关节上腔注射S-甲基异硫脲0.5 ml,4周后,抽取关节滑液1 ml,进行IL-1β、11-6和TNF-α的检测.结果 实验组SMT治疗前IL-1β、IL-6和TNF-α分别为0.529、46.18、0.865μg/L,治疗后分别为0.283、21.49、0.329μg/L,P<0,05;对照组治疗前IL-1β、IL-6和TNF-α分别为0.512、45.98、0.822μg/L,治疗后分别为0.453、33.91、0.552μhg/L.结论 SMT关节腔注射能够显著减少IL-1β、IL-6、TNF-α等炎性细胞因子的表达.

  14. 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.

  15. 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.

  16. Doripenem Injection

    Science.gov (United States)

    ... injection is in a class of medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such ... if you are allergic to doripenem injection; other carbapenem antibiotics such as imipenem/cilastatin (Primaxin) or meropenem ( ...

  17. Methotrexate Injection

    Science.gov (United States)

    Methotrexate injection is used alone or in combination with other medications to treat gestational trophoblastic tumors (a ... in bones) after surgery to remove the tumor. Methotrexate injection is also used to treat severe psoriasis ( ...

  18. Bendamustine Injection

    Science.gov (United States)

    Bendamustine injection is used to treat chronic lymphocytic leukemia (CLL; a type of cancer of the white ... injection. You should use birth control to prevent pregnancy in yourself or your partner during your treatment ...

  19. Caspofungin Injection

    Science.gov (United States)

    Caspofungin injection is used in adults and children 3 months of age and older to treat yeast ... people with a weakened ability to fight infection. Caspofungin injection is in a class of antifungal medications ...

  20. Temozolomide Injection

    Science.gov (United States)

    Temozolomide is used to treat certain types of brain tumors. Temozolomide is in a class of medications called alkylating ... Temozolomide injection comes as a powder to be added to fluid and injected over 90 minutes intravenously ( ...

  1. Pembrolizumab Injection

    Science.gov (United States)

    Pembrolizumab injection is used to treat melanoma (a type of skin cancer) that cannot be treated with ... who have a specific type of melanoma tumor. Pembrolizumab injection is also used to treat a certain ...

  2. Lacosamide Injection

    Science.gov (United States)

    ... injection is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in ... older (about 1 in 500 people) who took anticonvulsants like lacosamide injection to treat various conditions during ...

  3. Midazolam Injection

    Science.gov (United States)

    ... injection is in a class of medications called benzodiazepines. It works by slowing activity in the brain ... breast-feeding.talk to your doctor about the risks and benefits of receiving midazolam injection if you ...

  4. Doxycycline Injection

    Science.gov (United States)

    Doxycycline injection is used to treat or prevent bacterial infections, including pneumonia and other respiratory tract infections. ... certain skin, genital, intestine, and urinary system infections. Doxycycline injection may be used to treat or prevent ...

  5. Paclitaxel Injection

    Science.gov (United States)

    ... with other medications. Paclitaxel injection manufactured with polyoxyethylated castor oil is used to treat ovarian cancer (cancer that ... cancer, and lung cancer. Paclitaxel injection with polyoxyethylated castor oil is also used to treat Kaposi's sarcoma (a ...

  6. Etanercept Injection

    Science.gov (United States)

    ... will be using the prefilled syringe or automatic injection device, tell your doctor if you or the person who will be injecting the medication for you are allergic to rubber or latex.tell your doctor and pharmacist what ...

  7. Cyclosporine Injection

    Science.gov (United States)

    Cyclosporine injection is used with other medications to prevent transplant rejection (attack of the transplanted organ by ... who have received kidney, liver, and heart transplants. Cyclosporine injection should only be used to treat people ...

  8. Estrogen Injection

    Science.gov (United States)

    The estradiol cypionate and estradiol valerate forms of estrogen injection are used to treat hot flushes (hot ... should consider a different treatment. These forms of estrogen injection are also sometimes used to treat the ...

  9. 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.

  10. 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.

  11. Ustekinumab Injection

    Science.gov (United States)

    ... Do not inject into an area where the skin is tender, bruised, red, or hard or where you have scars or stretch marks.Your doctor or pharmacist will ... injection.you should know that ustekinumab injection may decrease your ability ... new or changing skin lesions, minor infections (such as open cuts or ...

  12. Ranitidine Injection

    Science.gov (United States)

    Ranitidine injection comes as a solution (liquid) to be mixed with another fluid and injected intravenously (into a vein) over 5 to 20 minutes. Ranitidine may also be injected into a muscle. It is usually given every 6 to 8 hours, but may also be given ...

  13. 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.).

  14. 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.

  15. 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...

  16. 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. ...

  17. Sciatic nerve palsy associated with intramuscular quinine injections ...

    African Journals Online (AJOL)

    Key Words: Sciatic nerve palsy, intramuscular injections, children, quinine dil~ ... adverse effects which include ototoxicity resulting .... quinine injection into the gluteal muscles of his right ... to maintain joint movement and avoid damage to.

  18. 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.

  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. Subcutaneous Injections

    DEFF Research Database (Denmark)

    Thomsen, Maria

    This thesis is about visualization and characterization of the tissue-device interaction during subcutaneous injection. The tissue pressure build-up during subcutaneous injections was measured in humans. The insulin pen FlexTouchr (Novo Nordisk A/S) was used for the measurements and the pressure...... build-up was evaluated indirectly from the changes in the flow rate between subcutaneous injections and air injections. This method enabled the tissue counter pressure to be evaluated without a formal clinical study approval. The measurements were coupled to a model for the pressure evolution...

  4. The use of a novel injectable hydrogel nucleus pulposus replacement in restoring the mechanical properties of cyclically fatigued porcine intervertebral discs.

    Science.gov (United States)

    Balkovec, Christian; Vernengo, Jennifer; McGill, Stuart M

    2013-06-01

    Repeated flexion and extension of an intervertebral disc has been shown to affect the angular stiffness of spinal motion segments and is a barometer of the mechanical integrity of the disc. A degenerated disc that loses height causes higher levels of stress on the annulus and facet joints which may increase its level of degeneration; restoring disc height may therefore help to slow this degenerative cascade. Previous research has indicated that nucleus implants have the potential to improve the mechanical characteristics of a disc and an implant that is custom-fit to the intervertebral disc yields the best results with respect to decreasing annular degeneration. Two groups of porcine spinal motion segments were exposed to repeated flexion and extension. One group was then injected with a novel hydrogel while the other group was used as a control. Both groups were then exposed to another round of cyclic flexion and extension to examine the effect that the hydrogel had on restoring the original mechanics to the motion segments. Angular stiffness was restored to the group which received the hydrogel injection in addition to a significant improvement in specimen height. No significant changes were seen in the group which did not receive an injection. It would appear that use of the novel injectable hydrogel is able to restore angular stiffness to cyclically fatigued spinal motion segments. It is also important to note that continued repetition of the event causing specimen fatigue after performing hydrogel injection will result in an eventual return to the same fatigued state.

  5. 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.

  6. [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.

  7. 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

  8. 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

  9. 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

  10. Injection MD

    CERN Document Server

    Bartmann, W; Bracco, C; Drosdal, L; Gianfelice, E; Goddard, B; Kain, V; Papaphilippou, Y; Vanbavinckhove, G

    2012-01-01

    This note summarizes the results obtained at injection during the 2nd MD block and the floating MD block in July. Highlights are presented for injection in the LHC with the Q20 SPS optics, influence of the supercycle and injection with 25 ns bunch spacing. Beams were successfully injected into the LHC using the Q20 optics [1, 3]. Small corrections were needed to steer the beam in the transfer lines. Dispersion measurements were conducted for both beams. The horizontal normalized dispersion in TI2 was a factor 2 smaller for Q20 with respect to Q26, for TI8 on the other hand the opposite was observed. The results for injection loss dependency on super cycle composition show only a small increase in losses for beam 2. The losses observed must therefore mainly come from other sources such as shot-by-shot stability or quality of scraping. For the injection with 25 ns bunch spacing bunches were injected for both beams. For B1 up to the maximum of 288 bunches. For B2 on the other only up to 144 bunches were injected...

  11. Effect of intravenous injection of flurbiprofen axetil jointed with epidural injection of ropivacaine in 0.2 % concentration on uterine contraction pain of the patients in cesarean section under the combined spinal-epidural anaesthesia%静注氟比洛芬酯复合硬膜外注射0.2%罗哌卡因对剖宫产术患者抑制宫缩痛的临床观察

    Institute of Scientific and Technical Information of China (English)

    陈云利; 王金; 金立民

    2013-01-01

    Objective:To discuss the effect of intravenous injection of flurbiprofen axetil jointed with epidural injection of ropivacaine in 0.2% concentration on uterine contraction pain of the patients in cesarean section under the combined spinal-epidural anaesthesia.Methods:80 patients for cesarean section were chosen and randomly divided into the control group (A group,n =40) and the observation group (B group,n =40),and used all the combined spinal-epidural anaesthesia.For the patients in observation group,intravenous injection of 50 mg flurbiprofen axetil after the fetal delivery was conducted and simultaneously the epidural injection of 10 ml 0.2%ropivacaine.For the patients in the control group,not any treatment was taken after the fetal delivery.Results:The difference between the total efficacies for suppressing the uterine contraction pain in the observation group and the control group had statistical significance (P <0.05).Conclusion:The intravenous injection of flurbiprofen axetil jointed with epidural injection of 0.2% ropivacaine can alleviate effectively the uterine contraction pain in cesarean section,which is a safe,inexpensive and effective treatment.%目的:探讨剖宫产手术在腰硬联合阻滞麻醉下,静注氟比洛芬酯复合硬膜外注射一定量浓度为的罗哌卡因对剖宫产手术患者宫缩痛的影响.方法:选择80例剖宫产手术患者随机分为对照组(40例)和观察组(40例),均采用腰硬联合阻滞麻醉,观察组患者于胎儿娩出后静注氟比洛芬酯50 mg,同时硬膜外注射0.2%罗哌卡因10 ml,对照组患者于胎儿娩出后不做处理.结果:观察组抑制宫缩痛的总有效率与对照组比较差异有统计学意义(P<0.05).结论:静注氟比洛芬酯复合硬膜外注射0.2%罗哌卡因可有效减轻甚至消除剖宫产手术的宫缩痛,比较安全,而且费用低,经济有效.

  12. Subcutaneous Injections

    DEFF Research Database (Denmark)

    Thomsen, Maria

    This thesis is about visualization and characterization of the tissue-device interaction during subcutaneous injection. The tissue pressure build-up during subcutaneous injections was measured in humans. The insulin pen FlexTouchr (Novo Nordisk A/S) was used for the measurements and the pressure...... build-up was evaluated indirectly from the changes in the flow rate between subcutaneous injections and air injections. This method enabled the tissue counter pressure to be evaluated without a formal clinical study approval. The measurements were coupled to a model for the pressure evolution...... in subcutaneous tissue, based on mass conservation and flow in a porous medium. From the measurements the flow permeability and bulk modulus of the tissue were determined. In the adipose tissue the drug forms a bolus from where it is absorbed by the blood capillaries. The spatial distribution of the injected...

  13. Denosumab Injection

    Science.gov (United States)

    ... Xgeva) is also used in adults and some adolescents to treat giant cell tumor of bone (GCTB; ... your arms muscle or joint pain nausea diarrhea headache runny nose sore throat Some side effects can ...

  14. Clindamycin Injection

    Science.gov (United States)

    ... the lungs, skin, blood, bones, joints, female reproductive organs, and internal organs. Clindamycin is in a class of medications called ... have or have ever had asthma, allergies, eczema (sensitive skin that often becomes itchy and irritated)colitis ( ...

  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. 氨基葡萄糖联合透明质酸钠治疗颞下颌关节骨关节病的临床观察%Clinical Study on Oral Glucosamine Combined With Sodium Hyaluronate Injection for Osteoarthrosis of Temporoman dibular Joint

    Institute of Scientific and Technical Information of China (English)

    魏明波; 吴燕丽

    2013-01-01

    Objective:To evaluate the clinical effect of oral glucosamine combined with sodium hyaluronate injection into superior space for osteoarthrosis of temporomandibular joint.Methods:54 cases diagnosed as Osteoarthrosis of temporomandibular joint were collected and divided into two equal groups of 27 randomly.Treatment group received oral glucosamine and injection into superior space of temporomandibular joint with sodium hyaluronate,but control group was treated with sodium hyaluronate injection only.Before and after treatment,Fricton's Index (DI) and Pain Index (VAS) were analysed and used to access the clinical results.Results:The clinical effects of all cases were very good in follow-up of 3 months,the temporomandibular joint function was improved obviously after treatment,the clinical effects of treatment group were better than those of the control group.Conclusion:Oral glucosamine combined with sodium hyaluronate injection is more effective for the treatment of osteoarthrosis of temporomandibular joint.%目的:探讨氨基葡萄糖联合透明质酸钠治疗颞下颌关节骨关节病的临床效果.方法:54例颞下颌关节骨关节病患者随机分为治疗组和对照组,各27例,治疗组采用关节上腔注射透明质酸钠,并同时开始口服氨基葡萄糖,对照组则仅行关节上腔注射透明质酸钠.所有患者治疗前及3个月后进行Fricton颞下颌关节紊乱指数和疼痛指数评分,评价患者颞下颌关节功能的变化.结果:经治疗后54名患者的颞下颌关节紊乱指数和疼痛指数明显改善,治疗组疗效优于对照组.结论:口服氨基葡萄糖联合关节上腔注射透明质酸钠治疗颞下颌关节骨关节病有协同作用,临床效果显著.

  17. Identifying and Determining Facets in the Associative Relationships Within and Outside Domain of Islamic Ethics Thesaurus

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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...

  3. 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)

  4. Manufacturing injection-moleded Fresnel lens parquets for point-focus concentrating photovoltaic systems

    Energy Technology Data Exchange (ETDEWEB)

    Peters, E.M.; Masso, J.D. [AOtec, Southbridge, MA (United States)

    1995-10-01

    This project involved the manufacturing of curved-faceted, injection-molded, four-element Fresnel lens parquets for concentrating photovoltaic arrays. Previous efforts showed that high-efficiency (greater than 82%) Fresnel concentrators could be injection molded. This report encompasses the mold design, molding, and physical testing of a four-lens parquet for a solar photovoltaic concentrator system.

  5. CT-guided spinal injection: initial experience with Sprotte tip needles

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore)

    2010-09-15

    The purpose of this paper is to describe our initial experience and to illustrate the potential benefits of using small caliber (25 and 27 G), noncutting pencil point needles (Sprotte) with single puncture coaxial technique in CT-guided spinal intervention (CTSI). From January 2009 to June 2009, Sprotte needles with single puncture coaxial technique were used in a total of ten patients for selective nerve root block (SNRB), facet joint block, and pars block under CT fluoroscopy (total of 16 target structures). All procedures were performed without conscious sedation, and visual analog scale (VAS) scores were recorded to determine pain related to needle placement. Total CT fluoroscopy time and out-of-plane needle deviation were obtained. Final needle position was documented by contrast injection for SNRBs and image capture for joint space cannulation. Sixteen out of the 16 structures were successfully targeted. No increase in VAS scores associated with needle placement was recorded, after infiltration of local anesthesia. Optimal peri-neurograms were obtained in all cases of SNRB, despite the side-hole opening in the Sprotte needles. Mean CT fluoroscopy time was 2 s (range 2-8 s per structure), and there was no case of out-of-plane needle deviation that required adjustment of the CT gantry. The use of small caliber Sprotte needles in CTSI is technically feasible and represents a potential refinement to current techniques in the management of chronic spinal pain. (orig.)

  6. Mepolizumab Injection

    Science.gov (United States)

    ... or do not go away: pain, redness, swelling, warmth, burning, or itching in the place mepolizumab was injected headache dry and itchy skin with or without red, scaly rashes back pain muscle spasms Some side ...

  7. Metoclopramide Injection

    Science.gov (United States)

    ... and feeling of fullness that lasts long after meals. Metoclopramide injection is also used to prevent nausea ... tranylcypromine (Parnate); narcotic medications for pain; sedatives; sleeping pills; tetracycline (Bristacycline, Sumycin); tranquilizers. Your doctor may need ...

  8. Ramucirumab Injection

    Science.gov (United States)

    ... dose of ramucirumab injection. Tell your doctor or nurse if you experience any of the following while you receive ramucirumab: uncontrollable shaking of a part of the body; back pain or spasms; chest pain and tightness; chills; flushing; ...

  9. Alemtuzumab Injection

    Science.gov (United States)

    Alemtuzumab injection is used to treat B-cell chronic lymphocytic leukemia (a slowly developing cancer in which ... of white blood cell accumulate in the body). Alemtuzumab is in a class of medications called monoclonal ...

  10. Ferumoxytol Injection

    Science.gov (United States)

    Ferumoxytol injection is used to treat iron-deficiency anemia (a lower than normal number of red blood ... pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or ...

  11. Fludarabine Injection

    Science.gov (United States)

    Fludarabine injection is used to treat chronic lymphocytic leukemia (CLL; a type of cancer of the white ... a reliable method of birth control to prevent pregnancy during this time. Talk to your doctor for ...

  12. Insulin Injection

    Science.gov (United States)

    ... or buttocks. Do not inject insulin into muscles, scars, or moles. Use a different site for each ... you are using insulin.Alcohol may cause a decrease in blood sugar. Ask your doctor about the ...

  13. Tigecycline Injection

    Science.gov (United States)

    ... in a person who was not in the hospital), skin infections, and infections of the abdomen (area between the ... that developed in people who were in a hospital or foot infections in people who have diabetes. Tigecycline injection is ...

  14. Golimumab Injection

    Science.gov (United States)

    Golimumab injection is used alone or with other medications to relieve the symptoms of certain autoimmune disorders ( ... did not help or could not be tolerated. Golimumab is in a class of medications called tumor ...

  15. Albiglutide Injection

    Science.gov (United States)

    ... will develop tumors of the thyroid gland, including medullary thyroid carcinoma (MTC; a type of thyroid cancer). ... symptoms or those listed in the IMPORTANT WARNING section, stop using albiglutide injection and call your doctor ...

  16. Dexamethasone Injection

    Science.gov (United States)

    ... body tissues,) gastrointestinal disease, and certain types of arthritis. Dexamethasone injection is also used for diagnostic testing. ... effects.tell your doctor if you have a fungal infection (other than on your skin or nails). ...

  17. Hydrocortisone Injection

    Science.gov (United States)

    ... own organs), gastrointestinal disease, and certain types of arthritis. Hydrocortisone injection is also used to treat certain ... effects.tell your doctor if you have a fungal infection (other than on your skin or nails). ...

  18. Methylprednisolone Injection

    Science.gov (United States)

    ... own organs), gastrointestinal disease, and certain types of arthritis. Methylprednisolone injection is also used to treat certain ... effects.tell your doctor if you have a fungal infection (other than on your skin or nails). ...

  19. Glatiramer Injection

    Science.gov (United States)

    ... To inject glatiramer, follow these steps: Remove one blister pack from the carton of glatiramer syringes and place ... paper label and remove the syringe from the blister pack. Check your prefilled syringe to be sure it ...

  20. Dexrazoxane Injection

    Science.gov (United States)

    ... that are used to treat or prevent certain side effects that may be caused by chemotherapy medications. Dexrazoxane injection (Zinecard) is used to prevent or decrease heart damage caused by doxorubicin in women who are ...

  1. Evolocumab Injection

    Science.gov (United States)

    ... autoinjector in hot water, microwave, or place in sunlight.Before you use evolocumab injection, look at the ... chills pain or burning during urination muscle or back pain dizziness stomach pain Some side effects can be ...

  2. Cidofovir Injection

    Science.gov (United States)

    Cidofovir injection is used along with another medication (probenecid) to treat cytomegaloviral retinitis (CMV retinitis) in people with acquired immunodeficiency syndrome (AIDS). Cidofovir is in a class of medications called antivirals. ...

  3. Brivaracetam Injection

    Science.gov (United States)

    ... older. Brivaracetam in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in ... older (about 1 in 500 people) who took anticonvulsants like brivaracetam injection to treat various conditions during ...

  4. Diphenhydramine Injection

    Science.gov (United States)

    ... not to use diphenhydramine injection if you are breastfeeding because of the risk of harm to infants.tell your doctor if you have or have ever had asthma or other types of lung disease; glaucoma (a ...

  5. Cefazolin Injection

    Science.gov (United States)

    ... valve, respiratory tract (including pneumonia), biliary tract, and urinary tract infections. Cefazolin injection also may be used before, during, ... to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( ...

  6. Fluconazole Injection

    Science.gov (United States)

    ... and fungal infections of the eye, prostate (a male reproductive organ), skin and nails. Fluconazole injection is ... Motrin, others) and naproxen (Aleve, Anaprox, Naprelan); oral contraceptives (birth control pills); oral medication for diabetes such ...

  7. Moxifloxacin Injection

    Science.gov (United States)

    ... available.Moxifloxacin injection is in a class of antibiotics called fluoroquinolones. It works by killing the bacteria that cause ... you are allergic to moxifloxacin, other quinolone or fluoroquinolone antibiotics such as ciprofloxacin (Cipro), gatifloxacin (Tequin) (not available ...

  8. Levofloxacin Injection

    Science.gov (United States)

    ... available. Levofloxacin injection is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections. ... severe reaction to levofloxacin; any other quinolone or fluoroquinolone antibiotic such as ciprofloxacin (Cipro), gatifloxacin (Tequin) (not available ...

  9. Ciprofloxacin Injection

    Science.gov (United States)

    ... available. Ciprofloxacin injection is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections. ... reaction to ciprofloxacin or any other quinolone or fluoroquinolone antibiotic such as gatifloxacin (Tequin) (not available in the ...

  10. Alirocumab Injection

    Science.gov (United States)

    ... further decrease the amount of low-density lipoprotein (LDL) cholesterol ('bad cholesterol') in the blood. Alirocumab injection is ... antibodies. It works by blocking the production of LDL cholesterol in the body to decrease the amount of ...

  11. Chloramphenicol Injection

    Science.gov (United States)

    ... an arm or leg sudden changes in vision pain with eye movement Chloramphenicol injection may cause a condition called gray syndrome in premature and newborn infants. There have also been reports of gray ...

  12. 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.

  13. Genetic correlations among facets of type A behavior and personality.

    Science.gov (United States)

    Johnson, Andrew M; Schermer, Julie Aitken; Vernon, Philip A; Jang, Kerry L

    2012-08-01

    The purpose of this study was to examine the phenotypic, genetic, and environmental relationships between multiple dimensions of Type A behavior and personality. Adult twins (N=247 pairs) completed a self-report personality measure and a work style questionnaire that measured six facets of Type A behavior: impatience, anger, work involvement, time urgency, job dissatisfaction, and competitiveness. Univariate results suggest that only the job dissatisfaction facet of Type A behavior was explained by non-genetic (environmental) factors. Multivariate results suggest that all of the genetically determined facets of Type A behavior show some correspondence with at least one of the personality factors found in the study, suggesting that some of the phenotypic (observed) relationships could be due to common genetic factors.

  14. Facets of Parenting a Child with Hypoplastic Left Heart Syndrome

    Directory of Open Access Journals (Sweden)

    Gwen R. Rempel

    2012-01-01

    Full Text Available The purpose of the study was to conceptualize the needs of parents of young children with hypoplastic left heart syndrome (HLHS to provide a theoretical framework to inform the development of future parent interventions. Participants were parents and grandparents (n=53 of 15 young children who had undergone the Sano surgical approach for HLHS. Analysis of recorded and transcribed single interviews with each participant was done as directed by interpretive description methodology. A model of five facets of parenting was conceptualized. These included survival parenting, “hands-off” parenting, expert parenting, uncertain parenting, and supported parenting. The facets of parenting delineated through this study provide a theoretical framework that can be used to guide the development and evaluation of interventions for parents of children with complex congenital heart disease and potentially other life-threatening conditions. Each facet constitutes a critical component for educational or psychosocial intervention for parents.

  15. Mapping mindfulness facets onto dimensions of anxiety and depression.

    Science.gov (United States)

    Desrosiers, Alethea; Klemanski, David H; Nolen-Hoeksema, Susan

    2013-09-01

    Mindfulness has been associated with anxiety and depression, but the ways in which specific facets of mindfulness relate to symptoms of anxiety and depression remains unclear. The purpose of the current study was to investigate associations between specific facets of mindfulness (e.g., observing, describing, nonjudging, acting with awareness, and nonreactivity) and dimensions of anxiety and depression symptoms (e.g., anxious arousal, general distress-anxiety, general distress-depression, and anhedonic depression) while controlling for shared variance among variables. Participants were 187 treatment-seeking adults. Mindfulness was measured using the Five Facet Mindfulness Questionnaire and symptoms of depression and anxiety were measured using the Mood and Anxiety Symptom Questionnaire. Bivariate correlations showed that all facets of mindfulness were significantly related to all dimensions of anxiety and depression, with two exceptions: describing was unrelated to general distress-anxiety, and observing was unrelated to all symptom clusters. Path analysis was used to simultaneously examine associations between mindfulness facets and depression and anxiety symptoms. Significant and marginally significant pathways were retained to construct a more parsimonious model and model fit indices were examined. The parsimonious model indicated that nonreactivity was significantly inversely associated with general distress anxiety symptoms. Describing was significantly inversely associated with anxious arousal, while observing was significantly positively associated with it. Nonjudging and nonreactivity were significantly inversely related to general distress-depression and anhedonic depression symptomatology. Acting with awareness was not significantly associated with any dimensions of anxiety or depression. Findings support associations between specific facets of mindfulness and dimensions of anxiety and depression and highlight the potential utility of targeting these

  16. Large conservation gains possible for global biodiversity facets

    Science.gov (United States)

    Pollock, Laura J.; Thuiller, Wilfried; Jetz, Walter

    2017-06-01

    Different facets of biodiversity other than species numbers are increasingly appreciated as critical for maintaining the function of ecosystems and their services to humans. While new international policy and assessment processes such as the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) recognize the importance of an increasingly global, quantitative and comprehensive approach to biodiversity protection, most insights are still focused on a single facet of biodiversity—species. Here we broaden the focus and provide an evaluation of how much of the world’s species, functional and phylogenetic diversity of birds and mammals is currently protected and the scope for improvement. We show that the large existing gaps in the coverage for each facet of diversity could be remedied by a slight expansion of protected areas: an additional 5% of the land has the potential to more than triple the protected range of species or phylogenetic or functional units. Further, the same areas are often priorities for multiple diversity facets and for both taxa. However, we find that the choice of conservation strategy has a fundamental effect on outcomes. It is more difficult (that is, requires more land) to maximize basic representation of the global biodiversity pool than to maximize local diversity. Overall, species and phylogenetic priorities are more similar to each other than they are to functional priorities, and priorities for the different bird biodiversity facets are more similar than those of mammals. Our work shows that large gains in biodiversity protection are possible, while also highlighting the need to explicitly link desired conservation objectives and biodiversity metrics. We provide a framework and quantitative tools to advance these goals for multi-faceted biodiversity conservation.

  17. Rhetorical facets of imagination in contemporary poetry

    Directory of Open Access Journals (Sweden)

    Hassan Delbari

    2015-04-01

    Full Text Available Abstract The present article deals with the trend of literary imaginative descriptions in the purview of poetical imaginations which have been regarded greatly in the discourse of rhetoric’s. The different facets of imagination of these imageries are also introduced in this article. Throughout this study poetical demonstrations are dealt with on the basis of their indications, functions and profundity. Meanwhile overcoming superficial and intermediate layers of imagination towards inner and profound thoughts would represent the domination of the poets in depiction of imagery. For this purpose, an introduction of numerous imagery layers with their deep and superficial, positive and subsidiary nature is presented through some examples. The result suggests that the extent of imagery complexity among many poets has a direct relation to their subjectivity in such a way that different levels of imageries are internalized as a unique stylistic feature of any individual poet. He endeavors to ornament his poem through imagery devices. Yousefi says: “any poem in which there is not imagery cannot be regarded as a poem. “The attractiveness of such imagination and the success or failure of the poet in conveying this imagery is a matter of poet’s tendency in using imagery devices. Through this article the contemporary poems are analyzed from the view point of objectivity and subjectivity. Furthermore, the poems are studied on their functions. The analysis has been carried out from two perspectives idiosyncratic features of the poet and the characteristics of the era in which he has lived. The examples presented in this article are selected from among the poets with different linguistic backgrounds and unique ideologies. The reason behind this specific consideration is an indication of a generalizability rather than a representativeness of few poets with their idiosyncratic styles. Therefore, the results indicate the style characteristics of poet

  18. Ceramic joints

    Science.gov (United States)

    Miller, Bradley J.; Patten, Jr., Donald O.

    1991-01-01

    Butt joints between materials having different coefficients of thermal expansion are prepared having a reduced probability of failure of stress facture. This is accomplished by narrowing/tapering the material having the lower coefficient of thermal expansion in a direction away from the joint interface and not joining the narrow-tapered surface to the material having the higher coefficient of thermal expansion.

  19. An Improved Model Facet Method to Support EA Alignment

    Directory of Open Access Journals (Sweden)

    Jonathan Pepin

    2016-12-01

    Full Text Available Information System evolution requires a well-structured Enterprise Architecture and its rigorous management. The alignment of the elements in the architecture according to various abstraction layers may contribute to the management but appropriate tools are needed. We propose improvements to the Facet technique and we develop accompanying tools to master the difficulties of the alignment of the models used to structure an Enterprise Architecture. This technique has been experimented on many real life cases to demonstrate the effectiveness of our EA alignment method. The tools are already integrated in the Eclipse EMF Facet project.

  20. Inclusive Education is a Multi-Faceted Concept

    Directory of Open Access Journals (Sweden)

    David Mitchell

    2015-03-01

    Full Text Available With the impetus of the UN Convention on the Rights of People with Disabilities, inclusive education is an idea whose time has arrived around the world. Its scope goes far beyond learners with disabilities and has now been extended to cover all learners with special educational needs, whatever their origins. It also extends beyond the mere placement of such learners in regular classes to include consideration of multiple facets of education. The present paper examines a model of inclusive education that, in addition to placement, embraces vision, curriculum, assessment, teaching, acceptance, access, support, resources and leadership. For each of these facets, criteria are specified and indicators are suggested.

  1. b-Tree Facets for the Simple Graph Partitioning Polytope

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2000-01-01

    The simple graph partitioning problem is to partition an edge-weighted graph into mutually disjoint subgraphs, each consisting of no more than b nodes, such that the sum of the weights of all edges in the subgraphs is maximal. In this paper we introduce a large class of facet defining inequalities...... for the simple graph partitioning polytopes P_n(b), b >= 3, associated with the complete graph on n nodes. These inequalities are induced by a graph configuration which is built upon trees of cardinality b. We provide a closed-form theorem that states all necessary and sufficient conditions for the facet...

  2. b-tree facets for the simple graph partitioning polytope

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2004-01-01

    The simple graph partitioning problem is to partition an edge-weighted graph into mutually disjoint subgraphs, each consisting of no more than b nodes, such that the sum of the weights of all edges in the subgraphs is maximal. In this paper we introduce a large class of facet defining inequalities...... for the simple graph partitioning polytopes P_n(b), b >= 3, associated with the complete graph on n nodes. These inequalities are induced by a graph configuration which is built upon trees of cardinality b. We provide a closed-form theorem that states all necessary and sufficient conditions for the facet...

  3. 2016 FACET-II Science Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Hogan, Mark J., ed.

    2017-07-19

    The second in a series of FACET-II Science Workshops was held at SLAC National Accelerator Laboratory on October 17-19, 2016 [1]. The workshop drew thirty-five participants from eighteen different institutions including CERN, DESY, Ecole Polytechnique, FNAL, JAI, LBNL, LLNL, Radiabeam, Radiasoft, SLAC, Stony Brook, Strathclyde, Tech-X, Tsinghua, UC Boulder, UCLA and UT Austin. The 2015 workshop [2, 3] helped prioritize research directions for FACET-II. The 2016 workshop was focused on understanding what improvements are needed at the facility to support the next generation of experiments. All presentations are linked to the workshop website as a permanent record.

  4. Temporomandibular Joint, Closed

    Science.gov (United States)

    ... Gallery > Oral Health > The Temporomandibular Joint, Closed The Temporomandibular Joint, Closed Main Content Title: The Temporomandibular Joint, Closed Description: The temporomandibular joint connects the lower ...

  5. Symptomatic manubriosternal joint involvement in rheumatoid arthritis.

    OpenAIRE

    1989-01-01

    The manubriosternal joint is commonly involved in rheumatoid arthritis but rarely gives rise to symptoms. A patient is reported with seropositive, erosive rheumatoid arthritis, who developed symptoms resembling pleuritic pain, arising from synovitis of the manubriosternal joint. Treatment with intra-articular steroid injection resolved these symptoms rapidly.

  6. Symptomatic manubriosternal joint involvement in rheumatoid arthritis.

    Science.gov (United States)

    Doube, A; Clarke, A K

    1989-06-01

    The manubriosternal joint is commonly involved in rheumatoid arthritis but rarely gives rise to symptoms. A patient is reported with seropositive, erosive rheumatoid arthritis, who developed symptoms resembling pleuritic pain, arising from synovitis of the manubriosternal joint. Treatment with intra-articular steroid injection resolved these symptoms rapidly.

  7. C型臂X线机引导下骶髂关节注射臭氧治疗骶髂关节痛的疗效观察%Efficacy of C-arm fluoroscopy guided sacroiliac joint ozone injection for sacroiliac pain

    Institute of Scientific and Technical Information of China (English)

    张瑞芳; 殷慧荣; 李云泽; 罗剑刚; 赵序利

    2014-01-01

    Retrospective analysis was performed for 68 sacroiliac joint pain patients treated at our hospital from June 2007 to March 2012.And 27 patients received sacroiliac joint ozone injection,and others anti-inflammatory and analgesic solution.Both methods can significantly relieve sacroiliac joint pain (P < 0.05).However there was no inter-group difference (P > 0.05).No difference existed in efficacy [(0.51 ±0.03) vs.(0.34 ±0.06) cm],treatment frequency (1.98 ±0.94) vs.(1.82 ±0.88) or hospitalization duration [(14.6 ± 7.0) vs.(14.9 ± 6.4) days] between two groups (P > 0.05).Thus sacroiliac joint ozone injection can significantly relieve sacroiliac joint pain and its effect is similar to anti-inflammatory analgesic injection.%回顾性分析我院自2007年6月至2012年3月收治的68例骶髂关节痛患者临床资料.在C型臂X线机引导下,27例采用骶髂关节内注射臭氧治疗,41例采用骶髂关节内注射消炎镇痛液(复方倍他米松0.5 ml,2%利多卡因2 ml,生理盐水1.5ml)治疗.两种治疗方法均能显著缓解骶髂关节痛患者的症状(均P<0.05),两种治疗间差异无统计学意义(P>0.05);视觉模拟法评估痛疼程度分别为(0.51±0.03)与(0.34 ±0.06) cm,治疗次数分别为(1.98±0.94)和(1.82±0.88)次,住院时间分别为(14.6±7.0)和(14.9 ±6.4)d(均P>0.05).表明骶髂关节内臭氧注射可以改善骶髂关节痛患者的疼痛,与消炎镇痛液注射治疗的效果相当.

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

    OpenAIRE

    Huang JT; Chen HY; Hong CZ; Lin MT; Chou LW; HS; Chen; Tsai CT; Chang WD

    2014-01-01

    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, Chin...

  9. Personality Facets and RIASEC Interests: An Integrated Model

    Science.gov (United States)

    Armstrong, Patrick Ian; Anthoney, Sarah Fetter

    2009-01-01

    Research examining links between personality and interest have typically focused on links between measures of the five factor model and Holland's RIASEC types. However, the five factor model of personality can be divided in to a larger set of narrow domain personality scales measuring facets of the "big five" traits. Research in a number of fields…

  10. Progress of plasma wakefield self-modulation experiments at FACET

    Energy Technology Data Exchange (ETDEWEB)

    Adli, E., E-mail: Erik.Adli@fys.uio.no [Department of Physics, University of Oslo, N-0316 Oslo (Norway); SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, CA 94025 (United States); Berglyd Olsen, V.K.; Lindstrøm, C.A. [Department of Physics, University of Oslo, N-0316 Oslo (Norway); SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, CA 94025 (United States); Muggli, P.; Reimann, O. [Max Planck Institute for Physics, Munich (Germany); Vieira, J.M.; Amorim, L.D. [GoLP/Instituto de Plasmas e Fusão Nuclear, Instituto Superior Téchnico, Universidade de Lisboa, 1049-001 Lisbon (Portugal); Clarke, C.I.; Gessner, S.J.; Green, S.Z.; Hogan, M.J.; Litos, M.D.; O' Shea, B.D.; Yakimenko, V. [SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, CA 94025 (United States); Clayton, C.; Marsh, K.A.; Mori, W.B.; Joshi, C.; Vafaei-Najafabadi, N.; Williams, O. [University of California Los Angeles, Los Angeles, CA 90095 (United States)

    2016-09-01

    Simulations and theory predict that long electron and positron beams may under favorable conditions self-modulate in plasmas. We report on the progress of experiments studying the self-modulation instability in plasma wakefield experiments at FACET. The experimental results obtained so far, while not being fully conclusive, appear to be consistent with the presence of the self-modulation instability.

  11. Transverse oscillations in plasma wakefield experiments at FACET

    Energy Technology Data Exchange (ETDEWEB)

    Adli, E., E-mail: Erik.Adli@fys.uio.no [Department of Physics, University of Oslo, N-0316 Oslo (Norway); SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, CA 94025 (United States); Lindstrøm, C.A. [Department of Physics, University of Oslo, N-0316 Oslo (Norway); SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, CA 94025 (United States); Allen, J.; Clarke, C.I.; Frederico, J.; Gessner, S.J.; Green, S.Z.; Hogan, M.J.; Litos, M.D.; White, G.R.; Yakimenko, V. [SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, CA 94025 (United States); An, W.; Clayton, C.E.; Marsh, K.A.; Mori, W.B.; Joshi, C.; Vafaei-Najafabadi, N. [University of California Los Angeles, Los Angeles, CA 90095 (United States); Corde, S. [LOA, ENSTA ParisTech, CNRS, Ecole Polytechnique, Université Paris-Saclay, 91762 Palaiseau (France); SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, CA 94025 (United States); Lu, W. [Department of Engineering Physics, Tsinghua University, Beijing 100084 (China)

    2016-09-01

    We study transverse effects in a plasma wakefield accelerator. Experimental data from FACET with asymmetry in the beam-plasma system is presented. Energy dependent centroid oscillations are observed on the accelerated part of the charge. The experimental results are compared to PIC simulations and theoretical estimates.

  12. Personality Facets and RIASEC Interests: An Integrated Model

    Science.gov (United States)

    Armstrong, Patrick Ian; Anthoney, Sarah Fetter

    2009-01-01

    Research examining links between personality and interest have typically focused on links between measures of the five factor model and Holland's RIASEC types. However, the five factor model of personality can be divided in to a larger set of narrow domain personality scales measuring facets of the "big five" traits. Research in a number of fields…

  13. Dealing with the three facets of uncertainty in planning: evidences ...

    African Journals Online (AJOL)

    ahavugimana

    perspectives, since they attempt to tackle three facets of uncertainty in planning: ... parameters in complex organizations, this ideal type of planning induced sharp critiques from ... dynamic environment (Fredrickson et Mitchell 1984). Five years later ..... exile with thousands of pupils seeking to continue their studies. Some of.

  14. Lumbar facet stress fracture in a ballet dancer.

    Science.gov (United States)

    Fehlandt, A F; Micheli, L J

    1993-12-01

    A frequent cause of back pain in athletes and dancers is stress injury to the posterior vertebral elements. Stress fractures affect the pars interarticularis and, rarely, other vertebral regions. The authors present their experience with the diagnosis and treatment of a fourth lumbar inferior articular facet stress fracture in a ballerina in this brief report and discuss the literature concerning posterior element stress fractures.

  15. Facet-defining inequalities for the simple graph partitioning polytope

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2007-01-01

    The simple graph partitioning problem is to partition an edge-weighted graph into mutually node-disjoint subgraphs, each containing at most b nodes, such that the sum of the weights of all edges in the subgraphs is maximal. In this paper we provide several classes of facet-defining inequalities...

  16. Longitudinal analysis of semiconductor lasers with low reflectivity facets

    Energy Technology Data Exchange (ETDEWEB)

    Baets, R.; Lagasse, P.E.; Vande Capelle, J.P.

    1985-06-01

    An analysis is made of longitudinal effects in semiconductor lasers with low facet reflectivities. For this purpose, a self-consistent model is used based on the beam propagation method, which takes into account both the lateral and longitudinal dimension. The calculations show that longitudinal effects have a significant influence on the output fields in the laser.

  17. The usability issues of faceted navigation in digital libraries

    Directory of Open Access Journals (Sweden)

    Eliane Blumer

    2014-05-01

    For more than five years, the project ACCEPT, a subproject of a Swiss national project called e-lib.ch, analyzes the usability and usefulness of digital libraries, by using user oriented methods. Experience has shown that filters provided through faceted navigation are considered as positive and very useful by end users. Nevertheless, based on different test results, several returning mistakes have been detected and it turns out that there are some ‘unwritten standards’ concerning e.g. position, labelling or ranking which should be respected to fulfil the aim of a good usability which users do expect of such web services. In this poster we will first give an introduction to faceted navigation, actual design issues and their use in digital libraries and then present testing methods, which can be easily applied in a digital library context. Together with a list of best practices concerning faceted navigation drawn out of different test experiences, the paper should give the reader all important information to evaluate its current faceted navigation and see where improvements could be made.

  18. A Mean-Field Theory for Coarsening Faceted Surfaces

    CERN Document Server

    Norris, Scott A

    2009-01-01

    A mean-field theory is developed for the scale-invariant length distributions observed during the coarsening of one-dimensional faceted surfaces. This theory closely follows the Lifshitz-Slyozov-Wagner theory of Ostwald ripening in two-phase systems [1-3], but the mechanism of coarsening in faceted surfaces requires the addition of convolution terms recalling the work of Smoluchowski [4] and Schumann [5] on coalescence. The model is solved by the exponential distribution, but agreement with experiment is limited by the assumption that neighboring facet lengths are uncorrelated. However, the method concisely describes the essential processes operating in the scaling state, illuminates a clear path for future refinement, and offers a framework for the investigation of faceted surfaces evolving under arbitrary dynamics. [1] I. Lifshitz, V. Slezov, Soviet Physics JETP 38 (1959) 331-339. [2] I. Lifshitz, V. Slyozov, J. Phys. Chem. Solids 19 (1961) 35-50. [3] C. Wagner, Elektrochemie 65 (1961) 581-591. [4] M. von S...

  19. [Multi-facetted clinical presentation of thrombotic thrombocytopenic purpura

    DEFF Research Database (Denmark)

    Niemann, C.U.; Jurlander, J.; Daugaard, G.

    2009-01-01

    smears. Determination of the ADAMTS13-activity is now becoming available as a routine analysis. We present two cases that illustrate the multi-facetted clinical presentation under which TTP occurs. The importance of access to ADAMTS13 measurements is stressed Udgivelsesdato: 2009/1/26...

  20. Hydrothermal synthesis of magnetite particles with uncommon crystal facets

    Directory of Open Access Journals (Sweden)

    Junki Sato

    2014-09-01

    Full Text Available Hydrothermal synthesis of Fe3O4 (magnetite particles was carried out using organic compounds as morphology control agents to obtain magnetite crystals with uncommon facets. It was established that the morphology of Fe3O4 crystals obtained by hydrothermal treatment of an aqueous solution containing Fe2+ and organic compounds depended on the organic compound used. The shape of the Fe3O4 particles obtained when no additives were used was quasi-octahedral. In contrast, the addition of picolinic acid, citric acid or pyridine resulted in the formation of polyhedral crystals, indicating the presence of not only {1 1 1}, {1 0 0} and {1 1 0} facets but also high-index facets including at least {3 1 1} and {3 3 1}. When citric acid was used as an additive, octahedral crystals with {1 1 1} facets also appeared, and their size decreased as the amount of citric acid was increased. Thus, control of Fe3O4 particle morphology was achieved by a simple hydrothermal treatment using additives.

  1. Empirical Identification of the Major Facets of Conscientiousness

    Science.gov (United States)

    MacCann, Carolyn; Duckworth, Angela Lee; Roberts, Richard D.

    2009-01-01

    Conscientiousness is often found to predict academic outcomes, but is defined differently by different models of personality. High school students (N = 291) completed a large number of Conscientiousness items from different models and the Big Five Inventory (BFI). Exploratory and confirmatory factor analysis of the items uncovered eight facets:…

  2. Thickening of spine ligamentum flavum and facet tropism

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Appolonio

    2014-03-01

    Full Text Available OBJECTIVE: This study investigated the thickening of the ligamentum flavum (LF and its correlation with facet tropism and its severity at different levels of the spine. METHOD: This retrospective study was performed with patients with chronic back pain consecutively admitted to a specialized spinal surgery service between January 2012 and January 2013. All patients underwent magnetic resonance imaging (MRI to measure the thickness of the LF and facet tropism severity (severe, moderate or absent according to the spine levels (L3 -L4, L4-L5, L5-S1. The association between the thickness of LF and facet tropism was analyzed. RESULTS: During the study period, 98 consecutive patients were enrolled with a mean age of 53.6 years, most women (59.2%. There was no significant difference between the thicknesses of the ligament and the presence of tropism in different spinal levels (p > 0.05. The thickness of LF was significantly associated with the severity of tropism only in L5-S1 level (p < 0.03. CONCLUSIONS: Our results show that there is a positive relationship between severe facet tropism and increased thickness of the LF in the L5-S1 level.

  3. Beyond Conflict: Functional Facets of the Work-Family Interplay

    Science.gov (United States)

    Wiese, Bettina S.; Seiger, Christine P.; Schmid, Christian M.; Freund, Alexandra M.

    2010-01-01

    The present paper deals with three positive facets of the work-family interplay, i.e., transfer of competencies, transfer of positive mood, and cross-domain compensation. The latter refers to the experience that engagement in one domain helps dealing with failures in the other domain. In two correlational studies (N[subscript 1] = 107 working…

  4. Facets of operational performance in an emergency room (ER)

    NARCIS (Netherlands)

    van der Vaart, Taco; Vastag, Gyula; Wijngaard, Jacob

    2011-01-01

    This paper, using detailed time measurements of patients complemented by interviews with hospital management and staff, examines three facets of an emergency room's (ER) operational performance: (1) effectiveness of the triage system in rationing patient treatment; (2) factors influencing ER's opera

  5. Thoracic costotransverse joint pain patterns: a study in normal volunteers

    Directory of Open Access Journals (Sweden)

    Wainner Robert S

    2008-10-01

    Full Text Available Abstract Background Pain referral patterns of asymptomatic costotransverse joints have not been established. The objective of this study was to determine the pain referral patterns of asymptomatic costotransverse joints via provocative intra-articular injection. Methods Eight asymptomatic male volunteers received a combined total of 21 intra-articular costotransverse joint injections. Fluoroscopic imaging was used to identify and isolate each costotransverse joint and guide placement of a 25 gauge, 2.5 inch spinal needle into the costotransverse joint. Following contrast medium injection, the quality, intensity, and distribution of the resultant pain produced were recorded. Results Of the 21 costotransverse joint injections, 16 (76% were classified as being intra-articular via arthrograms taken at the time of injection, and 14 of these injections produced a pain sensation distinctly different from that of needle placement. Average pain produced was 3.3/10 on a 0–10 verbal pain scale. Pain was described generally as a deep, dull ache, and pressure sensation. Pain patterns were located superficial to the injected joint, with only the right T2 injections showing referred pain 2 segments cranially and caudally. No chest wall, upper extremity or pseudovisceral pains were reported. Conclusion This study provides preliminary data of the pain referral patterns of costotransverse joints. Further research is needed to compare these findings with those elicited from symptomatic subjects.

  6. Mechanisms of surface alloy segregation on faceted core-shell nanowire growth

    Science.gov (United States)

    Zhang, Qian; Voorhees, Peter W.; Davis, Stephen H.

    2017-03-01

    A general two-dimensional faceted model that accounts for capillarity and deposition of an AxB 1-x alloy is developed for the growth of the shell on a hexagonal core. With this model, the surface alloy segregation and morphological evolution in the processes of the faceted core-shell nanowire growth are studied both analytically and numerically. Mechanisms of formation of Al-rich stripes along { 112 } facets and Al-poor quantum dots/wires at the apices of { 112 } facets are identified. More specifically, it is found that diffusion tends to move the atoms from { 112 } facets to { 110 } facets. The formation of Al-rich stripes along the { 112 } facets is due to the large ratios of mobilities of Al atoms and Ga atoms on { 112 } facets, even though Al atoms diffuse slower than Ga on the { 110 } facets. In addition, the difference of interaction parameters in the enthalpy on different facets can also lead to lines of enhanced concentration of Al behind { 112 } facets. If the attachment rates of Al on the { 112 } facets are smaller than that on { 110 } facets, Al-poor dots will grow at the end of the Al-rich stripes because the growth process switches from diffusion dominant to deposition dominant when the size of the nanowire gets large. Moreover, influences of different parameters on the distribution of concentrations of the atoms in the shell are investigated in details.

  7. A study of the motion pivot in the spine——The measurement of the angle between the vertebra body and the inferior articular facet and its application in the spinal manipulation

    Institute of Scientific and Technical Information of China (English)

    WeiYizong

    2004-01-01

    spinal motion pivot, spinal manipulation, the angle of facet joint, force direction, cylinder pivot motion theory The spinal joint consists of a disc and posterior facet joints. It is the biomechanical structure that enables the spine with six (6) freedoms of movements of flexion/extension, side bends and rotations. We identified that the same spinal joints initiate, eliminate and control spinal movement. These four joints are the atlanto-occipital and the atlanto-odontoid joints, C7/T 1, T12/L1 and L5/S1. The word“pivot”is commonly used to describe an important ruruing porint or matter in Chinese language.We define the above four joints as“pivots” in this article.The joints are briefed as“Occipital-vertebral pivot”(atlanto-occipital and atlanto-odontoid joint),“cervicalthoracic pivot” (C7/T1),“thoracic-lumbar pivot” (T12/L1)and“lumbar-sacrum pivot”(L5/S1). After measuring 20 human spinal columns (dry bones), observing the angle between the vertebral body and the inferior articular faeet,reviewing the spinal anatomy and biomechanics and analyzing the Chinese spinal manipulation techniques and theory, the following is our report:

  8. Terahertz Light Source and User Area at FACET

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Z.; Li, S.Z.; Litos, M.; Fisher, A.D.; Hogan, M.J.; /SLAC

    2011-11-08

    FACET at SLAC provides high charge, high peak current, low emittance electron beam that is bunched at THz wavelength scale during its normal operation. A THz light source based coherent transition radiation (CTR) from this beam would potentially be the brightest short-pulse THz source ever constructed. Efforts have been put into building this photon source together with a user area, to provide a platform to utilize this unique THz radiation for novel nonlinear and ultrafast phenomena researches and experiments. Being a long-time underutilized portion of the electromagnetic spectrum, terahertz (100 GHz {approx} 10 THz) spectral range is experiencing a renaissance in recent years, with broad interests from chemical and biological imaging, material science, telecommunication, semiconductor and superconductor research, etc. Nevertheless, the paucity of THz sources especially strong THz radiation hinders both its commercial applications and nonlinear processes research. FACET - Facilities for Accelerator science and Experimental Test beams at SLAC - provides 23 GeV electron beam with peak currents of {approx} 20 kA that can be focused down to 100 {mu}m{sup 2} transversely. Such an intense electron beam, when compressed to sub-picosecond longitudinal bunch length, coherently radiates high intensity EM fields well within THz frequency range that are orders of magnitude stronger than those available from laboratory tabletop THz sources, which will enable a wide variety of THz related research opportunities. Together with a description of the FACET beamline and electron beam parameters, this paper will report FACET THz radiation generation via coherent transition radiation and calculated photon yield and power spectrum. A user table is being set up along the THz radiation extraction sites, and equipped with various signal diagnostics including THz power detector, Michelson interferometer, sample stages, and sets of motorized optical components. This setup will also be

  9. Sarilumab Injection

    Science.gov (United States)

    ... the needle. Do not try to warm the medication by heating it in a microwave, placing it in warm water or in direct sunlight, or through any other method.Before injecting, check the prefilled syringe to be sure that the expiration date printed on the package has not passed. Look ...

  10. Enfuvirtide Injection

    Science.gov (United States)

    ... inject enfuvirtide into any skin that has a tattoo, scar, bruise, mole, a burn site, or has ... Enfuvirtide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: itching, swelling, pain, tingling, discomfort, ...

  11. Fluorouracil Injection

    Science.gov (United States)

    ... of a doctor who is experienced in giving chemotherapy medications for cancer. Treatment with fluorouracil injection may cause serious side effects. ... this medication.If you experience a serious side effect, you or your doctor ... (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/ ...

  12. Paliperidone Injection

    Science.gov (United States)

    ... the body slow movements or shuffling walk painful erection of the penis that lasts for hours cough, chills and/or other signs of infection Paliperidone injection may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.If you experience a ...

  13. Ziprasidone Injection

    Science.gov (United States)

    ... stiffness falling confusion sweating loss of consciousness painful erection of the penis that lasts for hours Ziprasidone injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.If you experience a ...

  14. Risperidone Injection

    Science.gov (United States)

    ... control slow movements or shuffling walk falling painful erection of the penis that lasts for hours Risperidone extended-release injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.If you experience a ...

  15. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: Gout (especially ...

  16. Effects of the Facet Reflectivity of a Laser Diode on Fiber Bragg Grating Semiconductor Lasers

    Institute of Scientific and Technical Information of China (English)

    Honggang; Yu; Chang-Qing; Xu; Na; Li; Zhilin; Peng; Jacek; Wojcik; Peter; Mascher

    2003-01-01

    Effects of facet reflectivity of a laser diode on the performance of fiber Bragg grating semiconductor lasers are studied experimentally. Facet reflectivity of less than 10-4 is necessary to obtain stable oscillation wavelength.

  17. Percutaneous Rupture of Zygapophyseal Joint Synovial Cysts: a Prospective Assessment of Nonsurgical Management.

    Science.gov (United States)

    Lutz, Gregory E; Nicoletti, Michael R; Cyril, George E; Harrison, Julian R; Lutz, Christopher; Solomon, Jennifer L; Cooke, Paul M; Wyss, James F; Herzog, Richard J; Moley, Peter J

    2017-08-07

    Although lumbar zygapophyseal joint synovial cysts are fairly well recognized, they are an uncommon cause of lumbosacral radicular pain. Non-operative treatments include percutaneous aspiration of the cysts under computed tomography or fluoroscopic guidance with a subsequent corticosteroid injection. However, there are mixed results in terms of long-term outcomes and cyst reoccurrence. This study prospectively evaluates percutaneous ruptures of zygapophyseal joint (Z-joint) synovial cysts for the treatment of lumbosacral radicular pain. Primary: To determine if percutaneous rupture of symptomatic Z-joint synovial cysts leads to sustained improvements in radicular pain and function. To assess the rates of cyst recurrence and progression to surgical intervention following percutaneous rupture of symptomatic Z-joint synovial cysts. Prospective cohort study. Outpatient academic spine practice. Adults with primary radicular pain due to a facet synovial cyst. Participants underwent fluoroscopically guided percutaneous Z-joint synovial cyst ruptures under standard-of-care practice. Data on pain, physical function, satisfaction, and progression to surgery were collected at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year post-rupture. An intention-to-treat analysis was utilized for assessment of patient-reported outcome measures. The Numerical Rating Scale, Oswestry Disability Index (ODI), and modified North American Spine Society questionnaires were used to measure pain, function, and satisfaction with the procedure, respectively. Thirty-five participants were included in the study, and data were analyzed by an independent researcher. Statistically significant changes in ODI were reported at 2 weeks, 3 months, and 1 year post-intervention (p=.034, .040, and .039, respectively). A statistically and clinically significant relief of current pain was reported at 2 weeks (p=.025) and 6 weeks (p=.014) with respect to baseline. Patients showed significant improvements for best

  18. Joint-FACET: The Canada-Netherlands initiative to study multi-sensor data fusion systems

    NARCIS (Netherlands)

    Bossee, E.; Theil, A.; Huizing, A.G.; Aartsen, C.S. van

    1998-01-01

    This paper presents the progress of a collaborative effort between Canada and The Netherlands in analyzing multi-sensor data fusion systems, e.g. for potential application to their respective frigates. In view of the overlapping interest in studying and comparing applicability and performance and ad

  19. Quantum correlation in degenerate optical parametric oscillators with mutual injections

    CERN Document Server

    Takata, Kenta

    2015-01-01

    We theoretically and numerically study the quantum dynamics of two degenerate optical parametric oscillators with mutual injections. The cavity mode in the optical coupling path between the two oscillator facets is explicitly considered. Stochastic equations for the oscillators and mutual injection path based on the positive $P$ representation are derived. The system of two gradually pumped oscillators with out-of-phase mutual injections are simulated, and their quantum states are investigated. When the incoherent loss of the oscillators other than the mutual injections is small, the squeezed quadratic amplitudes $\\hat{p}$ in the oscillators are positively correlated near the oscillation threshold. It indicates finite quantum correlation, and the entanglement between the intracavity subharmonic fields. When with a small loss of the injection path, each oscillator around the phase transition point forms macroscopic superposition for a small pump noise. It suggests that the low-loss injection path works as a sq...

  20. Subcutaneous (SQ) injections

    Science.gov (United States)

    SQ injections; Sub-Q injections; Diabetes subcutaneous injection; Insulin subcutaneous injection ... NIH. Giving a subcutaneous injection . Rockville, MD. National ... of Health and Human Services NIH publications; 2015. Available ...

  1. A selective etching phenomenon on {001} faceted anatase titanium dioxide single crystal surfaces by hydrofluoric acid.

    Science.gov (United States)

    Wang, Yun; Zhang, Haimin; Han, Yanhe; Liu, Porun; Yao, Xiangdong; Zhao, Huijun

    2011-03-14

    A selective etching phenomenon on {001} faceted anatase TiO(2) single crystal surfaces by HF and associated etching mechanism are reported. Density functional theory (DFT) calculations reveal that HF stabilizes the grown {001} facets at low concentrations, but selectively destroys the grown {001} facets at high concentrations.

  2. Dioptrics of the facet lenses in the dorsal rim area of the cricket Gryllus bimaculatus

    NARCIS (Netherlands)

    Ukhanov, KY; Leertouwer, HL; Gribakin, FG; Stavenga, DG

    1996-01-01

    1. The optics of the corneal facet lenses from the dorsal rim area (DRA) and from the dorso-lateral areas (DA) of the compound eye of the cricket Gryllus bimaculatus were studied. 2. The DRA of the cricket eye contains quite normally shaped facet lenses. The diameter of the facet lens in the DA is 2

  3. 硫酸氨基葡萄糖结合关节腔内注射透明质酸钠治疗膝骨关节炎的疗效观察%Clinical observation on knee osteoarthritis treated with glucosamine sulfate and sodium hyaluronate injecting into knee joint

    Institute of Scientific and Technical Information of China (English)

    陈静

    2014-01-01

    Objective To observe the clinical effect of knee osteoarthritis treated with glucosamine sulfate and hyaluronate injecting into knee joint. Methods Divided 98 cases of patient with knee osteoarthritis into two groups. 49 cases in each group, treatment group was treated with oral glucosamine sulfate and articular cavity injection of sodium hyaluronate, control group was treated with sodium hyaluronate alone, clinical effects of two groups were observed. Results The clinical effect of treatment group and control group were 93.9%and 81.6%, there was a significant difference between these two groups(P<0.05). Conclusion Combined glucosamine sulfate with sodium hyaluronate injecting into knee joint can improve the clinical effect of knee osteoarthritis.%目的:探讨硫酸氨基葡萄糖结合关节腔内注射透明质酸钠对治疗膝骨关节炎的临床效果。方法膝骨关节炎患者98例,随机分成两组,治疗组和对照组,治疗组49例给予口服硫酸氨基葡萄糖加关节腔内注射透明质酸钠,对照组49例单纯给予关节腔内注射透明质酸钠,观察两组的临床疗效。结果治疗组总有效率93.9%,对照组总有效率81.6%,治疗组高于对照组,差异有统计学意义(P<0.05)。结论硫酸氨基葡萄糖结合关节腔内注射透明质酸钠可以提高膝骨关节炎的疗效。

  4. Assessment of the lateral patellar facet in varus arthritis of the knee.

    Science.gov (United States)

    Waldstein, Wenzel; Jawetz, Shari T; Farshad-Amacker, Nadja A; Merle, Christian; Schmidt-Braekling, Tom; Boettner, Friedrich

    2014-10-01

    Lateral patellar arthritis has been associated with poor outcomes in unicompartmental knee arthroplasty. The current study correlates intraoperative findings with MRI imaging, skyline radiographs and the presence of anterior knee pain. In 92 consecutive knees with varus arthritis, the patellofemoral compartment was assessed during surgery, on skyline radiographs and on MRI. Anterior knee pain was recorded on a visual-analog-scale. Intraoperative assessment was based on the Outerbridge grading scale. Skyline radiographs were evaluated according to the Ahlbäck grading scale; MRIs were assessed according to a modified Outerbridge grading scale. There was an excellent correlation (rs=0.833; p<0.001) in the cartilage assessment of the lateral patellar facet between MRI and surgery. A good correlation (rs=0.664; p<0.001) was seen between Ahlbäck Grades and macroscopic Outerbridge Grades of the lateral patella. Ahlbäck Grades and MRI modified Outerbridge Grades showed a good correlation (rs=0.643; p<0.001) for the lateral patella. Twelve percent of knees (seven out of 60) with Ahlbäck Grade 0 or 1 and mild to moderate anterior knee pain had a macroscopic Outerbridge Grade of 3 on the lateral patella. None of these 60 knees had a full-thickness cartilage defect on MRI. Normal skyline radiographs in patients with mild to moderate anterior knee pain can rule out full-thickness cartilage defects of the lateral patellar facet as observed during surgery and on MRI. The MRI allows for the most accurate assessment of the patellofemoral joint and is warranted in all patients with radiographic abnormalities or severe anterior knee pain. Diagnostic study, Level II. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. The usability issues of faceted navigation in digital libraries

    Directory of Open Access Journals (Sweden)

    Eliane Blumer

    2014-07-01

    Full Text Available The last decade transformed faceted navigation from a “nice-to-have” into a “must-have functionality” for all online web services that contain a search function. The movement has been started by commercial websites, such as online clothing stores, with the purpose of facilitating access to the products.Now, faceted search seems to be more and more well-known within the community of information institutions and their digital services, too, as for example the online catalogue ofthe Library of Congress or Europeana show. In this context, as well, the feature is often sold as an added value to access the content of their sites in a more effective way. Still, experience shows that the use of faceted navigation in a digital library context is more complex than for online clothing stores. For this reason, it is important to focus on the usability of such functionalities and to test it as often as possible during implementation and regular use, as well. Site providers have to be aware of one important fact: a faceted search that has not been implemented correctly or does not work in the way the user expects it, will create frustration and/or not be used at all. This implies in a worst case scenario that users don’t come back to the site anymore, and may even spread their negative experience among the community. To prevent this, usability tests, either with experts or real users, should be conducted regularly.This can be done with common usability tests, using direct human interaction with a system, or with online tests, where test user are free to fill in the test whenever they want. In both cases, test results illuminate a system’s weaknesses and expose dysfunctional issues, which should be improved in order to offer a positive experience to its users.For more than five years, the project ACCEPT, a subproject of a Swiss national project called e-lib.ch, analyzes the usability and usefulness of digital libraries, by using user oriented

  6. Subvertical grooves of interproximal facets in Neandertal posterior teeth.

    Science.gov (United States)

    Villa, G; Giacobini, G

    1995-01-01

    Subvertical grooves, located on the interproximal facets of most Neandertal posterior teeth, are less frequently noted on the teeth of other hominids, including modern humans. These grooves, 0.1-0.5 mm in width, are strictly localized within the facet area. Scanning electron microscopic (SEM) examination of grooves present on Neandertal teeth from Caverna delle Fate (Liguria, Italy) and Genay (Côte d'Or, France) demonstrated that they were produced during the life of these individuals. Characteristics of the groove surface suggest an erosion-abrasion mechanism of formation. These grooves, which developed in parts of the dentition exposed to marked stress, originated in areas characterized by changes in the orientation of enamel prism bundles (i.e., Hunter-Schreger bands). Observations carried out on modern human molars showed a subvertical disposition of these bands near interproximal ridges facilitating subvertical microfractures. Possible correlations between enamel structure, masticatory stress, and interproximal groove formation in Neandertals are discussed.

  7. Recurrent gallstone ileus: beware of the faceted stone.

    Science.gov (United States)

    Gandamihardja, Tasha A K; Kibria, Shah M G

    2014-11-12

    A 73-year-old man with gallstone disease was admitted with right upper quadrant abdominal pain. He was treated for cholecystitis with intravenous antibiotics. Two days later, he reported of new onset left iliac fossa pain, with tenderness and guarding. An abdominal X-ray demonstrated small bowel obstruction, a CT scan demonstrated an impacted gallstone within the proximal ileum. He was treated for a gallstone ileum and underwent an uncomplicated laparotomy, small bowel enterotomy and removal of a faceted gallstone. Three months later, the patient re-presented with generalised abdominal pain, guarding and rebound tenderness. Small bowel obstruction was again demonstrated with an impacted gallstone within the distal ileum seen on CT scan. A second laparotomy revealed two further faceted gallstones, which were removed through an enterotomy. The densely adherent gallbladder to the duodenum precluded a surgical repair of the cholecystoduodenal fistula. He made an uneventful recovery and was subsequently discharged home.

  8. Nonjudging facet of mindfulness predicts enhanced smoking cessation in Hispanics.

    Science.gov (United States)

    Spears, Claire Adams; Houchins, Sean C; Stewart, Diana W; Chen, Minxing; Correa-Fernández, Virmarie; Cano, Miguel Ángel; Heppner, Whitney L; Vidrine, Jennifer I; Wetter, David W

    2015-12-01

    Although most smokers express interest in quitting, actual quit rates are low. Identifying strategies to enhance smoking cessation is critical, particularly among underserved populations, including Hispanics, for whom many of the leading causes of death are related to smoking. Mindfulness (purposeful, nonjudgmental attention to the present moment) has been linked to increased likelihood of cessation. Given that mindfulness is multifaceted, determining which aspects of mindfulness predict cessation could help to inform interventions. This study examined whether facets of mindfulness predict cessation in 199 Spanish-speaking smokers of Mexican heritage (63.3% male, mean age of 39 years, 77.9% with a high school education or less) receiving smoking cessation treatment. Primary outcomes were 7-day abstinence at weeks 3 and 26 postquit (biochemically confirmed and determined using an intent-to-treat approach). Logistic random coefficient regression models were utilized to examine the relationship between mindfulness facets and abstinence over time. Independent variables were subscales of the Five Facet Mindfulness Questionnaire (Observing, Describing, Acting With Awareness, Nonjudging, and Nonreactivity). The Nonjudging subscale (i.e., accepting thoughts and feelings without evaluating them) uniquely predicted better odds of abstinence up to 26 weeks postquit. This is the first known study to examine whether specific facets of mindfulness predict smoking cessation. The ability to experience thoughts, emotions, and withdrawal symptoms without judging them may be critical in the process of quitting smoking. Results indicate potential benefits of mindfulness among smokers of Mexican heritage and suggest that smoking cessation interventions might be enhanced by central focus on the Nonjudging aspect of mindfulness.

  9. Innovative Facet Passivation for High-Brightness Laser Diodes

    Science.gov (United States)

    2016-02-05

    views, opinions and/or findings contained in this report are those of the author(s) and should not contrued as an official Department of the Army...factor bar) desired for military high energy lasers (HELs). COD of the front facet (laser mirror) is the main failure mechanism that constrains scaling...TOTAL: Books Number of Manuscripts: Patents Submitted Patents Awarded Awards Graduate Students Names of Post Doctorates Received Book TOTAL: Received

  10. Optical characterization of the facets of a heliostat

    OpenAIRE

    Avellaner, J.A.

    1980-01-01

    This study is mainly aimed at describing the testing methods for qualifying the heliostat reflector panels (facets) of a central tower type solar power station from an optical point of view, that is, determination of glass surface irregularities (both microscopic and macroscopic), silver deposition methods and shape distorsions, in order to obtain a set of specifiable parameters applicable to both the selecting process of heliostat components and manufacturing procedures.

  11. Use of technetium-99m methylene diphosphonate and gallium-67 citrate scans after intraarticular injection of Staphylococcus aureus into knee joints of rabbits with chronic antigen-induced arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Mahowald, M.L.; Raskind, J.R.; Peterson, L.; Gerding, D.; Raddatz, D.A.; Shafer, R.

    1986-08-01

    Numerous clinical studies have questioned the ability of radionuclide scans to differentiate septic from aseptic joint inflammation. A clinical study may not be able to document an underlying disease process or duration of infection and, thus, may make conclusions about the accuracy of scan interpretations open to debate. In this study, the Dumonde-Glynn model of antigen-induced arthritis in rabbits was used as the experimental model to study technetium and gallium scans in Staphylococcus aureus infection of arthritic and normal joints. Gallium scans were negative in normal rabbits, usually negative in antigen-induced arthritis, but positive in septic arthritis. The bone scan was usually negative in early infection but positive in late septic arthritis, a finding reflecting greater penetration of bacteria into subchondral bone because of the underlying inflammatory process.

  12. Selective Facet Reactivity During Cation Exchange in Cadmium Sulfide Nanorods

    Energy Technology Data Exchange (ETDEWEB)

    Sadtler, Bryce; Demchenko, Denis; Zheng, Haimei; Hughes, Steven; Merkle, Maxwell; Dahmen, Ulrich; Wang, Lin-Wang; Alivisatos, A. Paul

    2008-12-18

    The partial transformation of ionic nanocrystals through cation exchange has been used to synthesize nanocrystal heterostructures. We demonstrate that the selectivity for cation exchange to take place at different facets of the nanocrystal plays an important role in determining the resulting morphology of the binary heterostructure. In the case of copper I (Cu+) cation exchange in cadmium sulfide (CdS) nanorods, the reaction starts preferentially at the ends of the nanorods such that copper sulfide (Cu2S) grows inwards from either end. The resulting morphology is very different from the striped pattern obtained in our previous studies of silver I (Ag+) exchange in CdS nanorods where non-selective nucleation of silver sulfide (Ag2S) occurs. From interface formation energies calculated for several models of epitaxialconnections between CdS and Cu2S or Ag2S, we infer the relative stability of each interface during the nucleation and growth of Cu2S or Ag2S within the CdS nanorods. The epitaxial connections of Cu2S to the end facets of CdS nanorods minimize the formation energy, making these interfaces stable throughout the exchange reaction. However, as the two end facets of wurtzite CdS nanorods are crystallographically nonequivalent, asymmetric heterostructures can be produced.

  13. The Chernyshenko Conscientiousness Scales: A New Facet Measure of Conscientiousness.

    Science.gov (United States)

    Green, Jessica A; O'Connor, Daryl B; Gartland, Nicola; Roberts, Brent W

    2016-06-01

    The current research sought to validate the Chernyshenko Conscientiousness Scales (CCS), a novel measure designed to assess six facets of conscientiousness. Data from 7,569 U.S. participants and 649 U.K. participants were analyzed to assess the internal reliability and factorial structure of the scales. Test-retest reliability, convergent and divergent validity, and criterion-related validity were also evaluated using a separate U.K. sample (n = 118; n = 80 for test-retest). The results showed that those items designed to measure industriousness, order, self-control, traditionalism, and virtue were best represented by a five-factor structure, broadly consistent with the five scales. However, the content and structure of the responsibility scale requires further investigation. Overall, the CCS has the potential to be a useful alternative to the faceted measures of conscientiousness that are currently available. However, future research is required to refine a number of problematic items and to clarify which facets can be better described as interstitial dimensions between conscientiousness and other Big Five domains.

  14. Framework Application for Core Edge Transport Simulation (FACETS)

    Energy Technology Data Exchange (ETDEWEB)

    Krasheninnikov, Sergei; Pigarov, Alexander

    2011-10-15

    The FACETS (Framework Application for Core-Edge Transport Simulations) project of Scientific Discovery through Advanced Computing (SciDAC) Program was aimed at providing a high-fidelity whole-tokamak modeling for the U.S. magnetic fusion energy program and ITER through coupling separate components for each of the core region, edge region, and wall, with realistic plasma particles and power sources and turbulent transport simulation. The project also aimed at developing advanced numerical algorithms, efficient implicit coupling methods, and software tools utilizing the leadership class computing facilities under Advanced Scientific Computing Research (ASCR). The FACETS project was conducted by a multi-discipline, multi-institutional teams, the Lead PI was J.R. Cary (Tech-X Corp.). In the FACETS project, the Applied Plasma Theory Group at the MAE Department of UCSD developed the Wall and Plasma-Surface Interaction (WALLPSI) module, performed its validation against experimental data, and integrated it into the developed framework. WALLPSI is a one-dimensional, coarse grained, reaction/advection/diffusion code applied to each material boundary cell in the common modeling domain for a tokamak. It incorporates an advanced model for plasma particle transport and retention in the solid matter of plasma facing components, simulation of plasma heat power load handling, calculation of erosion/deposition, and simulation of synergistic effects in strong plasma-wall coupling.

  15. Joint purpose?

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene

    2013-01-01

    Starting from Crenshaw´s point that antiracism often fails to interrogate patriarchy and that feminism often reproduces racist practices (1991: 1252), this paper asks: What are the theoretical reasons for believing that feminism and anti-racism can be regarded as fighting for the joint purpose of...

  16. Modeling Integration and Reuse of Heterogeneous Terminologies in Faceted Browsing Systems.

    Science.gov (United States)

    Harris, Daniel R

    2016-07-01

    We integrate heterogeneous terminologies into our category-theoretic model of faceted browsing and show that existing terminologies and vocabularies can be reused as facets in a cohesive, interactive system. Commonly found in online search engines and digital libraries, faceted browsing systems depend upon one or more taxonomies which outline the structure and content of the facets available for user interaction. Controlled vocabularies or terminologies are often externally curated and are available as a reusable resource across systems. We demonstrated previously that category theory can abstractly model faceted browsing in a way that supports the development of interfaces capable of reusing and integrating multiple models of faceted browsing. We extend this model by illustrating that terminologies can be reused and integrated as facets across systems with examples from the biomedical domain.

  17. Modeling Integration and Reuse of Heterogeneous Terminologies in Faceted Browsing Systems

    Science.gov (United States)

    Harris, Daniel R.

    2017-01-01

    We integrate heterogeneous terminologies into our category-theoretic model of faceted browsing and show that existing terminologies and vocabularies can be reused as facets in a cohesive, interactive system. Commonly found in online search engines and digital libraries, faceted browsing systems depend upon one or more taxonomies which outline the structure and content of the facets available for user interaction. Controlled vocabularies or terminologies are often externally curated and are available as a reusable resource across systems. We demonstrated previously that category theory can abstractly model faceted browsing in a way that supports the development of interfaces capable of reusing and integrating multiple models of faceted browsing. We extend this model by illustrating that terminologies can be reused and integrated as facets across systems with examples from the biomedical domain.

  18. Short- and long-term efficacy of intra-articular injections with betamethasone as part of a treat-to-target strategy in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Østergaard, Mikkel; Ejbjerg, Bo;

    2012-01-01

    by Kaplan-Meier plots of the joint injection survival (ie, the time between injection and renewed flare). Potential predictors of joint injection survival were tested.RESULTS: 1373 Unique joints (ankles, elbows, knees, metacarpophalangeal (MCP), metatarsophalangeal, proximal interphalangeal (PIP), shoulders...

  19. Injury bar liniment joint sodium hyaluronate articular cavity injection treatment of knee osteoarthritis clinical analysis%伤筋擦剂联合透明质酸钠关节腔注射治疗膝骨关节炎临床分析

    Institute of Scientific and Technical Information of China (English)

    代跃荣

    2012-01-01

      Objective:To explore wound bar liniment and sodium hyaluronate combined use of knee osteoarthritis clinical therapeutic effect. Methods: Our choice in March 2008 -March 2012 patients of knee osteoarthritis patients in 166 cases, divided into treatment group and control group, each group of each 83 cases. The treatment group used injury bar liniment joint sodium hyaluronate to patients for treatment; Control group using sodium hyaluronate patients of knee joint upper lateral injection. Comparing the two groups of clinical curative effect. Results: Treatment group total effective in 76 cases, accounting for 91.57% of the group; For control group total effective in 65 cases, accounting for 78.31% of the group, two groups of clinical curative effect compared with (X2= 5.70, P<0.05), and the results have a statistics difference. Conclusions: For knee osteoarthritis patients with wound bar liniment joint sodium hyaluronate for knee joint cavity injection, can effectively improve the clinical curative effect of the patients.%  目的探讨伤筋擦剂联和透明质酸钠联合运用对膝骨关节炎的临床治疗效果.方法选择我院2008年3月-2012年3月收治的膝骨关节炎的患者166例,分为治疗组和对照组,每组各83例.治疗组使用伤筋擦剂联合透明质酸钠对患者进行治疗;对照组使用透明质酸钠对患者行膝关节上外侧注射.对比两组的临床疗效.结果治疗组总有效76例,占该组的91.57%;对照组为总有效65例,占该组的78.31%,两组临床疗效相比(X2=5.70,P<0.05),结果具有统计学差异.结论对膝骨关节炎的患者使用伤筋擦剂联合透明质酸钠进行膝关节腔内注射,能有效的提高患者的临床疗效.

  20. Injectable Corticosteroids: Take Precautions and Use Caution.

    Science.gov (United States)

    Freire, Véronique; Bureau, Nathalie J

    2016-11-01

    Corticosteroids are routinely injected into soft tissues, tendon sheaths, bursae, and joints. These anti-inflammatory agents have different potency and solubility, and solubility is inversely correlated with the duration of action. Corticosteroids carry a low risk of complications but commonly cause systemic and local adverse effects. The use of intra-articular corticosteroid injections in the treatment of inflammatory arthritis and osteoarthritis is well established. Evidence also supports the use of injectable corticosteroids in the treatment of inflammatory tenosynovitis and bursitis associated with rheumatic diseases, trigger finger and de Quervain disease, and carpal tunnel syndrome. The role of corticosteroid injections in the management of rotator cuff disease remains unclear. Strong scientific evidence indicates that corticosteroid injections for lateral epicondylosis worsen the long-term outcomes of patients. This review article discusses the considerations related to the use of corticosteroid injections in the management of nonspinal musculoskeletal conditions.