Cell wall canals formed upon growth of Candida maltosa in the presence of hexadecane are associated with polyphosphates.

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Zvonarev, Anton N; Crowley, David E; Ryazanova, Lubov P; Lichko, Lydia P; Rusakova, Tatiana G; Kulakovskaya, Tatiana V; Dmitriev, Vladimir V

2017-05-01

Canals are supramolecular complexes observed in the cell wall of Candida maltosa grown in the presence of hexadecane as a sole carbon source. Such structures were not observed in glucose-grown cells. Microscopic observations of cells stained with diaminobenzidine revealed the presence of oxidative enzymes in the canals. 4΄,6΄-diamino-2-phenylindole staining revealed that a substantial part of cellular polyphosphate was present in the cell wall of cells grown on hexadecane in condition of phosphate limitation. The content and chain length of polyphosphates were higher in hexadecane-grown cells than in glucose grown ones. The treatment of cells with yeast polyphosphatase PPX1 resulted in the decrease of the canal size. These data clearly indicated that polyphosphates are constituents of canals; they might play an important role in the canal structure and functioning. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Increased Dickkopf-1 expression accelerates bone cell apoptosis in femoral head osteonecrosis.

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Ko, Jih-Yang; Wang, Feng-Sheng; Wang, Ching-Jen; Wong, To; Chou, Wen-Yi; Tseng, Shin-Ling

2010-03-01

Intensive bone cell apoptosis contributes to osteonecrosis of femoral head (ONFH). Dickkopf-1 (DKK1) reportedly mediates various types of skeletal disorders. This study investigated whether DKK1 was linked to the occurrence of ONFH. Thirty-nine patients with various stages of ONFH were recruited. Bone specimens were harvested from 34 ONFH patients underwent hip arthroplasty, and from 10 femoral neck fracture patients. Bad, Bcl2 TNFalpha, DKK1, Wnt3a, LRP5, and Axin1 expressions were analyzed by quantitative RT-PCR and ELISA. Apoptotic cells were assayed using terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end-labelling (TUNEL). Primary bone-marrow mesenchymal cells were treated with DKK1 RNA interference and recombinant DKK1 protein. ONFH patients with the histories of being administrated corticosteroids and excessive alcohol consumption had significantly higher Bad and DKK1 mRNA expressions in bone tissue and DKK1 abundances in serum than femoral neck fracture patients. Bone cells adjacent to osteonecrotic bone displayed strong DKK1 immunoreactivity and TUNEL staining. Increased DKK1 expression in bone tissue and serum correlated with Bad expression and TUNEL staining. Serum DKK1 abundance correlated with the severity of ONFH. The DKK1 RNA interference and recombinant DKK1 protein regulated Bad expression and apoptosis of primary bone-marrow mesenchymal cells. Knock down of DKK1 reduced dexamethasone-induced apoptosis of mesenchymal cells. Taken together, promoted DKK1 expression was associated with bone cell apoptosis in the occurrence of ONFH patients with the histories of corticosteroid and alcohol intake and progression of ONFH. DKK1 expression in injured tissue provides new insight into ONFH pathogenesis.

Necrosis of the femoral head after /sup 60/Co radiation therapy

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Maruno, H; Kawai, K [Kobe Univ. (Japan). School of Medicine

1978-10-01

A patient (50-year-old woman) received 10500 rad of skin dose and 630 rad of tumor dose for treatment of cervical cancer 15 years ago. The depth dose at the hip-joint was 3590 rad at the right hip-joint and 4315 rad at the left. Hip-joint pain occurred about 15 years after the irradiation, and one more year later she could not walk because of severe pain. X-ray films revealed great bone destruction at the both hip-joints as well as necrosis of the femoral head and arthropathy. The same findings were seen at the ilium, ischium, and pubis. Histologically, the synovial membrane was highly thick, fibrotic, and cicatricial. Obstructive changes were observed also in the small arteries. A severe narrowing or obstruction was observed in the Harversian canal at the bone cortex. The femoral head at the whole area was necrotic. The trabeculae were entirely thinned and were partially thickened by appositional bone formation. This new bone was also necrotic. Edematous fibrous-fatty tissues predominated the bone marrow. There was no proliferation of fibrous cell or new bone formation at the sites other than the margin.

Healing of experimental femoral defects in rats after implantation of collagen-calcium phosphate biocomposites

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O. V. Korenkov

2017-06-01

Full Text Available The aim of this study was to investigate the healing process of experimental defects of the femoral shaft diaphysis of rats after implantation of osteoplastic material Collapan into its cavity. In experi-mental animals, a perforated defect with diameter of 2.5 mm was created in the medullary canal of the femoral shaft and filled with osteoplastic material Collapan. In control rats, the defect was left un-filled. The bone fragments were examined on the 15th and 30th day by light microscopy morphometry and scanning electron microscopy. It was found that application of osteoplastic material Collapan in the femoral diaphysis defect optimised reparative osteogenesis, showed high biocompatibility, osteo-conductive properties, resorption ability and good integration with tissue-specific structures of the regenerate

Satisfactory Results of the Exeter Revision Femoral Stem Used for Primary Total Hip Arthroplasty.

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Desy, Nicholas M; Johnson, Joshua D; Sierra, Rafael J

2017-02-01

The Exeter cemented femoral stem has demonstrated excellent clinical and radiographic outcomes as well as long-term survivorship free from aseptic loosening. A shorter revision stem (125 mm) with a 44 offset became available for the purpose of cement-in-cement revision situations. In certain cases, this shorter revision stem may be used for various primary total hip arthroplasties (THAs) where the standard length stem would require distally reaming the femoral canal. We sought to report on the early to midterm results of this specific stem when used for primary THA regarding (1) clinical and radiographic outcomes, (2) complications, and (3) survivorship. Twenty-nine patients (33 hips) underwent a hybrid THA using the smaller revision Exeter cemented femoral stem. Twenty-five patients (28 hips) had at least 2 years of follow-up and were assessed for clinical and radiographic outcomes. All 33 hips were included in the analysis of complications and survivorship. The Kaplan-Meier survivorship was performed using revision for all causes and for aseptic loosening as the end points. The average clinical follow-up was 4 years (range, 2-7). Harris Hip Scores improved from a mean preoperative value of 56 (range, 23-96) to 90 (range, 51-100) at the latest follow-up. All patients demonstrated superior cement mantles with no signs of loosening. One patient suffered a B2 periprosthetic fracture and 1 patient experienced 2 episodes of instability. The 5-year Kaplan-Meier survivorship was 96.7% for all causes of revision and was 100% using aseptic loosening as the end point. The shorter Exeter revision cemented femoral stem has favorable early to midterm clinical and radiographic outcomes when used for primary THA with a low complication rate and is a viable option in patients with narrow femoral canals where uncemented stem fixation is not desired. Copyright © 2016 Elsevier Inc. All rights reserved.

Functional recovery of anterior semicircular canal afferents following hair cell regeneration in birds

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Boyle, Richard; Highstein, Stephen M.; Carey, John P.; Xu, Jinping

2002-01-01

Streptomycin sulfate (1.2 g/kg i.m.) was administered for 5 consecutive days to 5-7-day-old white Leghorn chicks; this causes damage to semicircular canal hair cells that ultimately regenerate to reform the sensory epithelium. During the recovery period, electrophysiological recordings were taken sequentially from anterior semicircular canal primary afferents using an indentation stimulus of the canal that has been shown to mimic rotational stimulation. Chicks were assigned to an early (14-18 days; n = 8), intermediate (28-34 days; n = 5), and late (38-58 days; n = 4) period based on days after treatment. Seven untreated chicks, 15-67 days old, provided control data. An absence of background and indent-induced discharge was the prominent feature of afferents in the early period: only "silent" afferents were encountered in 5/8 experiments. In several of these chicks, fascicles of afferent fibers were seen extending up to the epithelium that was void of hair cells, and intra- and extracellular biocytin labeling revealed afferent processes penetrating into the supporting cell layer of the crista. In 3/8 chicks 74 afferents could be characterized, and they significantly differed from controls (n = 130) by having a lower discharge rate and a negligible response to canal stimulation. In the intermediate period there was considerable variability in discharge properties of 121 afferents, but as a whole the number of "silent" fibers in the canal nerve diminished, the background rate increased, and a response to canal stimulation detected. Individually biocytin-labeled afferents had normal-appearing terminal specializations in the sensory epithelium by 28 days poststreptomycin. In the late period, afferents (n = 58) remained significantly different from controls in background discharge properties and response gain. The evidence suggests that a considerable amount of variability exists between chicks in the return of vestibular afferent function following ototoxic injury and

Prevention of excessive postoperative sliding of the short femoral nail in femoral trochanteric fractures.

Science.gov (United States)

Ito, Juji; Takakubo, Yuya; Sasaki, Kan; Sasaki, Junya; Owashi, Kazuya; Takagi, Michiaki

2015-05-01

Lag screw cut-out is one of the major postoperative complications on femoral trochanteric fractures. However, precise analyses of excessive sliding and lag screw cut-out were limited. The purpose of this study was to investigate the factors that induce this unfavorable event. From April 2010 to April 2013, 226 patients were operated in our institute using a short femoral nail. Among them, 177 patients (29 males and 148 females) with a mean age of 84 years (60-97 years), who were followed up >3 months, were included in this study. The postoperative sliding distance, fracture type (AO/OTA classification), tip-apex distance (TAD), reduction pattern in the postoperative X-ray (antero-posterior and lateral views), bone quality (canal flare and cortical indices), walking ability at the time of pre-injury and final follow-up, and complications were investigated retrospectively. The mean sliding distance was 3.7 mm, and one cut-out case (0.6 %) was observed. The sliding distance of the AO/OTA 31-A2 fractures was significantly longer than that of the A1 fractures (p fractures, an accurate reduction in the lateral view at surgery is important, particularly in unstable fractures.

Early Squamous Cell Carcinoma of the Anal Canal Resected by Endoscopic Submucosal Dissection

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Yuzuru Tamaru

2015-04-01

Full Text Available The standard treatment approach for squamous cell carcinoma (SCC of the anal canal includes abdominoperineal resection and chemoradiotherapy. However, there are currently very few reports of early SCC of the anal canal resected by endoscopic submucosal dissection (ESD. We report 2 rare cases of SCC of the anal canal resected by ESD. In case 1, a 66-year-old woman underwent a colonoscopy due to blood in her stool, and an elevated lesion, 15 mm in size, was identified from the rectum to the dentate line of the anal canal on internal hemorrhoids. The lesion was diagnosed as an early SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. In case 2, a 71-year-old woman underwent a colonoscopy due to constipation, and an elevated lesion, 25 mm in size, was identified from the dentate line to the anal canal. The lesion was diagnosed as early-stage SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. No complications or recurrence after ESD occurred in either case.

Sedentary lifestyle related exosomal release of Hotair from gluteal-femoral fat promotes intestinal cell proliferation.

Science.gov (United States)

Lu, Xiaozhao; Bai, Danna; Liu, Xiangwei; Zhou, Chen; Yang, Guodong

2017-03-31

Pioneering epidemiological work has established strong association of sedentary lifestyle and obesity with the risk of colorectal cancer, while the detailed underlying mechanism remains unknown. Here we show that Hotair (HOX transcript antisense RNA) is a pro-adipogenic long non-coding RNA highly expressed in gluteal-femoral fat over other fat depots. Hotair knockout in adipose tissue results in gluteal-femoral fat defect. Squeeze of the gluteal-femoral fat induces intestinal proliferation in wildtype mice, while not in Hotair knockout mice. Mechanistically, squeeze of the gluteal-femoral fat induces exosomal Hotair secretion mainly by transcriptional upregulation of Hotair via NFκB. And increased exosomal Hotair in turn circulates in the blood and is partially endocytosed by the intestine, finally promoting the stemness and proliferation of intestinal stem/progenitor cells via Wnt activation. Clinically, obese subjects with sedentary lifestyle have much higher exosomal HOTAIR expression in the serum. These findings establish that sedentary lifestyle promotes exosomal Hotair release from the gluteal-femoral fat, which in turn facilitates intestinal stem and/or progenitor proliferation, raising a possible link between sedentary lifestyle with colorectal tumorigenesis.

Tratamento da Osteonecrose da Cabeça Femoral com celulas progenitoras autólogas em anemia falciforme Femoral Head Necrosis treatment with autologous stem cells in sickle cell disease

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Gildásio Cerqueira Daltro

2008-01-01

Full Text Available OBJETIVO: Avaliação da segurança e eficácia do uso de células progenitoras autólogas da medula óssea (CMMO no tratamento da Osteonecrose da Cabeça Femoral (OCF de pacientes portadores de anemia falciforme. MÉTODOS: Foram estudados 8 pacientes portadores de anemia falciforme, com OCF nos estágios I e II (classificação de Ficat e Arlet. As CMMO retiradas da crista ilíaca posterior foram concentradas e reinfundidas na área central da osteonecrose. Os principais parâmetros avaliados foram segurança, sintomas clínicos e progressão da doença, através da avaliação clínica (Harris Hip Score e radiológica. RESULTADOS: A maior parte dos pacientes (7 em 8 referiu melhora dos sintomas após o tratamento. Não houve complicações durante o procedimento anestésico e cirúrgico. A medida do escore (Harris Hip Score no pré-operatório foi 78,5 +/- 6,2 pontos, com aumento significativo destes valores no pós-operatório (98,3 +/- 2,5 pontos (pPURPOSE: To assess the efficacy and safety of autologous bone-marrow mononuclear cells (BMMC implantation in necrotic lesions of the femoral head in patients with sickle cell disease. METHODS: We studied eight patients with stage-I or -II femoral head osteonecrosis according to the system by Ficat and Arlet. BMMCs were harvested and re-infused into the necrotic zone. The primary endpoints studied were safety, clinical symptoms and disease progression, these being assessed according to the Harris hip score (HHS and to X-ray studies. RESULTS: After eight months, seven of the eight patients reported improvement from symptoms. There were no complications during anesthetic and surgery procedures. There was a significant postoperative increase in the HHS (98.3 +/- 2.5 points compared to preoperative HHS (78.5 +/- 6.2 points (p< 0.001. X-ray evaluation and cell parameters were found to be favorable. CONCLUSION: The autologous bone-marrow mononuclear cells implantation seems to be a safe and effective

The effects of intraoperative positioning on patients undergoing early definitive care for femoral shaft fractures.

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Apostle, K L; Lefaivre, K A; Guy, P; Broekhuyse, H M; Blachut, P A; O'Brien, P J; Meek, R N

2009-10-01

To determine if there is a difference in morbidity and mortality in orthopaedic trauma patients with femoral shaft fractures undergoing early definitive care with intramedullary (IM) nails in the supine versus the lateral position. Retrospective cohort study, single centered. One level 1 trauma center. Nine hundred eighty-eight patients representing 1027 femoral shaft fractures treated with IM nails were identified through a prospectively gathered database between 1987 and 2006. Antegrade IM nail insertion with reaming of the femoral canal in either the supine or lateral position. Mortality was the primary outcome. Admission to intensive care unit (ICU) was the secondary outcome measure and a surrogate measure of morbidity. Literature review was performed to identify factors shown to contribute to morbidity and mortality in orthopaedic trauma patients. Intraoperative position in either the supine or lateral position was added to this list. Logistic regression analysis was performed to determine the magnitude and effect of the independent variables on each of the study end points. To determine if a more significant trend toward less favorable outcomes was observed with increasing severity of injury, particularly injuries of the chest and thorax, subgroup analysis was performed for all those with a femur fracture and an Injury Severity Score > or =18 and all those with a femur fracture and an Abbreviated Injury Score chest > or =3. Intraoperative position in either the supine or lateral position was not a significant predictor of mortality or ICU admission for the original cohort or the subgroup of Injury Severity Score > or =18. However, for the subgroup of Abbreviated Injury Score chest > or =3, intraoperative positioning in the lateral position had a statistically significant protective effect against ICU admission (P = 0.044). For polytrauma patients with femoral shaft fractures, surgical stabilization using IM nails inserted with reaming of the femoral canal in

The threshold force required for femoral impaction grafting in revision hip surgery.

LENUS (Irish Health Repository)

Flannery, Olivia M

2010-06-01

BACKGROUND AND PURPOSE: Femoral impaction grafting requires vigorous impaction to obtain adequate stability without risk of fracture, but the force of impaction has not been determined. We determined this threshold force in a preliminary study using animal femurs. METHODS: Adult sow femurs were used because of their morphological similarity to human femurs in revision hip arthroplasty. 35 sow femurs were impacted with morselized bone chips and an increasing force was applied until the femur fractured. This allowed a threshold force to be established. 5 other femurs were impacted to this force and an Exeter stem was cemented into the neomedullary canal. A 28-mm Exeter head was attached and loaded by direct contact with a hydraulic testing machine. Axial cyclic loading was performed and the position sensor of the hydraulic testing machine measured the prosthetic head subsidence. RESULTS: 29 tests were completed successfully. The threshold force was found to be 4 kN. There was no statistically significant correlation between the load at fracture and the cortex-to-canal ratio or the bone mineral density. Following impaction with a maximum force of 4 kN, the average axial subsidence was 0.28 mm. INTERPRETATION: We achieved a stable construct without fracture. Further studies using human cadaveric femurs should be done to determine the threshold force required for femoral impaction grafting in revision hip surgery.

The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

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Oblak Irena

2016-03-01

Full Text Available Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal.

Semicircular canals circumvent Brownian Motion overload of mechanoreceptor hair cells

DEFF Research Database (Denmark)

Muller, Mees; Heeck, Kier; Elemans, Coen P H

2016-01-01

Vertebrate semicircular canals (SCC) first appeared in the vertebrates (i.e. ancestral fish) over 600 million years ago. In SCC the principal mechanoreceptors are hair cells, which as compared to cochlear hair cells are distinctly longer (70 vs. 7 μm), 10 times more compliant to bending (44 vs. 500...... nN/m), and have a 100-fold higher tip displacement threshold (hair cells where the bundle is approximated as a stiff, cylindrical elastic rod subject to friction and thermal agitation. Our models suggest that the above...... differences aid SCC hair cells in circumventing the masking effects of Brownian motion noise of about 70 nm, and thereby permit transduction of very low frequency (

Performance and safety of femoral central venous catheters in pediatric autologous peripheral blood stem cell collection.

Science.gov (United States)

Cooling, Laura; Hoffmann, Sandra; Webb, Dawn; Yamada, Chisa; Davenport, Robertson; Choi, Sung Won

2017-12-01

Autologous peripheral blood hematopoietic progenitor cell collection (A-HPCC) in children typically requires placement of a central venous catheter (CVC) for venous access. There is scant published data regarding the performance and safety of femoral CVCs in pediatric A-HPCC. Seven-year, retrospective study of A-HPCC in pediatric patients collected between 2009 and January 2017. Inclusion criteria were an age ≤ 21 years and A-HPCC using a femoral CVC for venous access. Femoral CVC performance was examined by CD34 collection rate, inlet rate, collection efficiency (MNC-FE, CD34-FE), bleeding, flow-related adverse events (AE), CVC removal, and product sterility testing. Statistical analysis and graphing were performed with commercial software. A total of 75/119 (63%) pediatric patients (median age 3 years) met study criteria. Only 16% of children required a CVC for ≥ 3 days. The CD34 collect rate and CD34-FE was stable over time whereas MNC-FE decreased after day 4 in 80% of patients. CD34-FE and MNC-FE showed inter- and intra-patient variability over time and appeared sensitive to plerixafor administration. Femoral CVC showed fewer flow-related AE compared to thoracic CVC, especially in pediatric patients (6.7% vs. 37%, P = 0.0005; OR = 0.12 (95%CI: 0.03-0.45). CVC removal was uneventful in 73/75 (97%) patients with hemostasis achieved after 20-30 min of pressure. In a 10-year period, there were no instances of product contamination associated with femoral CVC colonization. Femoral CVC are safe and effective for A-HPCC in young pediatric patients. Femoral CVC performance was maintained over several days with few flow-related alarms when compared to thoracic CVCs. © 2017 Wiley Periodicals, Inc.

Effect of copper nanoparticles administered in ovo on the activity of proliferating cells and on the resistance of femoral bones in broiler chickens

DEFF Research Database (Denmark)

Mroczek-Sosnowska, Natalia; Lukasiewicz, Monika; Adamek, Dobrochna

2017-01-01

The objective of this study was to evaluate bone resistance after in ovo administration of copper nanoparticles (NanoCu) and to determine the number of cells positive for proliferating cell nuclear antigen (PCNA) in the femoral bones of broiler chickens (n = 12 per group). The study demonstrated...... that femoral bones from the NanoCu group were characterised by a higher weight and volume and by significantly greater resistance to fractures compared to the Control group. NanoCu promoted the proliferation of PCNA-positive cells in the long bones of chickens. A significantly higher number of PCNA......-positive cells in the bones of birds in the NanoCu group compared with the Control group (137 and 122, respectively) indicate a stimulatory effect during embryogenesis. Considering the improvement in bone resistance to fractures and the effect of NanoCu on the number of PCNA-positive cells in femoral bones, Nano...

The tridimensional geometry of the proximal femur should determine the design of cementless femoral stem in total hip arthroplasty.

Science.gov (United States)

Wegrzyn, Julien; Roux, Jean-Paul; Loriau, Charlotte; Bonin, Nicolas; Pibarot, Vincent

2018-02-22

Using a cementless femoral stem in total hip arthroplasty (THA), optimal filling of the proximal femoral metaphyseal volume (PFMV) and restoration of the extramedullary proximal femoral (PF) parameters (i.e., femoral offset (FO), neck length (FNL), and head height (FHH)) constitute key goals for optimal hip biomechanics, functional outcome, and THA survivorship. However, almost 30% of mismatch between the PF anatomy and implant geometry of the most widely implanted non-modular cementless femoral stem has been demonstrated in a computed tomography scan (CT scan) study. Therefore, this anatomic study aimed to evaluate the relationship between the intra- and extramedullary PF parameters using tridimensional CT scan reconstructions. One hundred fifty-one CT scans of adult healthy hips were obtained from 151 male Caucasian patients (mean age = 66 ± 11 years) undergoing lower limb CT scan arteriography. Tridimensional PF reconstructions and parameter measurements were performed using a corrected PF coronal plane-defined by the femoral neck and diaphyseal canal longitudinal axes-to avoid influence of PF helitorsion and femoral neck version on extramedullary PF parameters. Independently of the femoral neck-shaft angle, the PFMV was significantly and positively correlated with the FO, FNL, and FHH (r = 0.407 to 0.420; p < 0.0001). This study emphasized that the tridimensional PF geometry measurement in the corrected coronal plane of the femoral neck can be useful to determine and optimize the design of a non-modular cementless femoral stem. Particularly, continuous homothetic size progression of the intra- and extramedullary PF parameters should be achieved to assure stem fixation and restore anatomic hip biomechanics.

Evaluation of the delivery of mesenchymal stem cells into the root canal space of necrotic immature teeth after clinical regenerative endodontic procedure.

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Lovelace, Tyler W; Henry, Michael A; Hargreaves, Kenneth M; Diogenes, Anibal

2011-02-01

Immature teeth with open apices treated with conventional nonsurgical root canal treatment often have a poor prognosis as a result of the increased risk of fracture and susceptibility to recontamination. Regenerative endodontics represents a new treatment modality that focuses on reestablishment of pulp vitality and continued root development. This clinical procedure relies on the intracanal delivery of a blood clot (scaffold), growth factors (possibly from platelets and dentin), and stem cells. However, to date, the clinical presence of stem cells in the canal space after this procedure has not been demonstrated. The purpose of this clinical study was to evaluate whether regenerative endodontic procedures are able to deliver stem cells into the canal space of immature teeth in young patients and to identify the possible tissue origin for these cells. After informed consent, the first appointment consisted of NaOCl irrigation and treatment with a triple antibiotic paste. One month later, the root canal space was irrigated with sterile saline, and bleeding was evoked with collection of samples on paper points. Real-time reverse-transcription polymerase chain reaction and immunocytochemistry were conducted to compare the gene transcripts and proteins found in the root canal sample with levels found in the systemic circulation. Molecular analyses of blood collected from the canal system indicated the significant accumulation of transcripts for the stem cell markers CD73 and CD105 (up to 600-fold), compared with levels found in the systemic blood. Furthermore, this effect was selective because there was no change in expression of the differentiation markers ALK-P, DSPP, ZBTB16, and CD14. Histologic analyses demonstrated that the delivered cells expressed both CD105 and STRO-1, markers for a subpopulation of mesenchymal stem cells. Collectively, these findings demonstrate that the evoked-bleeding step in regenerative procedures triggers the significant accumulation of

Cotransplantation of bone marrow mononuclear cells and umbilical cord mesenchymal stem cells in avascular necrosis of the femoral head.

Science.gov (United States)

Cai, J; Wu, Z; Huang, L; Chen, J; Wu, C; Wang, S; Deng, Z; Wu, W; Luo, F; Tan, J

2014-01-01

We sought to investigate the therapeutic effects of cotransplantation of autologous bone marrow mononuclear cells (BMMNCs) and allogeneic umbilical cord mesenchymal stem cells (UC-MSCs) on avascular necrosis of the femoral head (ANFH). In all, 30 patients (49 hips; 24 males and 6 females) with ANFH were enrolled. According to the system of the Association Research Circulation Osseous, there were 24 hips in phase II and 25 hips in phase Ⅲ. Blood supply to the femoral head was evaluated by using digital subtraction angiography. Generally, 60 to 80 mL of autologous BMMNCs and 30 to 50 mL of UC-MSCs were infused into the femoral head artery. Harris scores including pain and joint function were used to evaluate the effects before and 3, 6, 9, and 12 months after transplantation. Computed tomography and radiographs were performed before and 12 months after the treatment. Clinical symptoms of pain and claudication were gradually improved. After the treatment, 93.3% (28/30), 86.7% (26/30), and 86.7% (26/30) of patients showed relief of hip pain, improvement of joint function, and extended walking distances, respectively. The Harris scores were increased significantly at 3, 6, and 12 months posttransplant compared with those pretransplant. In addition, the bone lesions in 89.7% of hips (44/49) were improved as showed on computed tomography after transplantation. Cotransplantation of autologous BMMNCs and allogeneic UC-MSCs showed therapeutic effect on ANFH without severe adverse effects. Copyright © 2014 Elsevier Inc. All rights reserved.

Nodular Fasciitis of External Auditory Canal

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Jihyun Ahn

2016-09-01

Full Text Available Nodular fasciitis is a pseudosarcomatous reactive process composed of fibroblasts and myofibroblasts, and it is most common in the upper extremities. Nodular fasciitis of the external auditory canal is rare. To the best of our knowledge, less than 20 cases have been reported to date. We present a case of nodular fasciitis arising in the cartilaginous part of the external auditory canal. A 19-year-old man complained of an auricular mass with pruritus. Computed tomography showed a 1.7 cm sized soft tissue mass in the right external auditory canal, and total excision was performed. Histologic examination revealed spindle or stellate cells proliferation in a fascicular and storiform pattern. Lymphoid cells and erythrocytes were intermixed with tumor cells. The stroma was myxoid to hyalinized with a few microcysts. The tumor cells were immunoreactive for smooth muscle actin, but not for desmin, caldesmon, CD34, S-100, anaplastic lymphoma kinase, and cytokeratin. The patient has been doing well during the 1 year follow-up period.

Clinical study on 44 cases of femoral hernia

International Nuclear Information System (INIS)

Yamamoto, Ryo; Shinozaki, Hiroharu; Kase, Kenichi; Kobayashi, Kenji; Sasaki, Junichi

2012-01-01

Femoral hernia is a surgical disease that is frequently associated with incarceration and necessitates emergency surgery. However, there are only a few studies referred which have compared emergency and elective surgery for femoral hernias. We retrospectively reviewed the clinical characteristics of patients diagnosed as having femoral hernia between 2005 and 2009 in our institution. The clinical features of emergency repairs were compared with those of elective ones, and diagnostic values of preoperative diagnostic modalities were studied. The mean age of the patients was 73±12 years. Females comprised 68% of the cases, and right femoral hernias comprised 70% of the cases. Incarceration was associated with 66% of the cases (29 patients), and emergency surgery was performed in 52% of the patients (23 patients). Bowel resection was performed in 32% of the cases (14 patients). The mean age, body temperature, white blood cell (WBC) count, and LDH value were higher in the emergency repairs than in the elective one, and most of the hernias were repaired with McVay's procedure. CT scans had a high diagnostic value in detecting femoral hernias (44%) and incarceration (88%). It was confirmed that femoral hernias were frequently associated with incarceration and CT scan has a high diagnostic value in femoral hernias. (author)

Fully automatic segmentation of femurs with medullary canal definition in high and in low resolution CT scans.

Science.gov (United States)

Almeida, Diogo F; Ruben, Rui B; Folgado, João; Fernandes, Paulo R; Audenaert, Emmanuel; Verhegghe, Benedict; De Beule, Matthieu

2016-12-01

Femur segmentation can be an important tool in orthopedic surgical planning. However, in order to overcome the need of an experienced user with extensive knowledge on the techniques, segmentation should be fully automatic. In this paper a new fully automatic femur segmentation method for CT images is presented. This method is also able to define automatically the medullary canal and performs well even in low resolution CT scans. Fully automatic femoral segmentation was performed adapting a template mesh of the femoral volume to medical images. In order to achieve this, an adaptation of the active shape model (ASM) technique based on the statistical shape model (SSM) and local appearance model (LAM) of the femur with a novel initialization method was used, to drive the template mesh deformation in order to fit the in-image femoral shape in a time effective approach. With the proposed method a 98% convergence rate was achieved. For high resolution CT images group the average error is less than 1mm. For the low resolution image group the results are also accurate and the average error is less than 1.5mm. The proposed segmentation pipeline is accurate, robust and completely user free. The method is robust to patient orientation, image artifacts and poorly defined edges. The results excelled even in CT images with a significant slice thickness, i.e., above 5mm. Medullary canal segmentation increases the geometric information that can be used in orthopedic surgical planning or in finite element analysis. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

Radiographic femoral varus measurement is affected unpredictably by femoral rotation

DEFF Research Database (Denmark)

Miles, James Edward

Radiographic measurements of femoral varus are used to determine if intervention to correct femoral deformity is required, and to calculate the required correction. The varus angle is defined as the angle between the proximal femoral long axis (PFLA) and an axis tangential to the distal femoral...... and externally by 5° and 10° using plastic wedges. Accuracy of rotation was within +1°. Digital radiographs were obtained at each position. Varus angles were measured using ImageJ, employing two definitions of PFLA. Mean varus angles increased with 10° of either internal or external rotation with both PFLA...... rotation angles. The effect of rotation on varus angle measurements in these femoral specimens contradicts a previous report using CT. The most probable explanation is the difference in femoral positioning: the CT study used a slightly elevated position compared to that in this study, resulting in better...

Functional and regenerative effects of local administration of autologous mononuclear bone marrow cells combined with silicone conduit on transected femoral nerve of rabbits.

Science.gov (United States)

Trindade, Anelise Bonilla; Schestatsky, Pedro; Torres, Vítor Félix; Gomes, Cristiano; Gianotti, Giordano Cabral; Paz, Ana Helena da Rosa; Terraciano, Paula Barros; Marques, Janete Maria Volpato; Guimarães, Karina Magano; Graça, Dominguita Lühers; Cirne-Lima, Elizabeth Obino; Contesini, Emerson Antonio

2015-10-01

The inoculation of cells into injury sites can accelerate and improve the quality of nerve regeneration. This study aimed to evaluate the functional and regenerative effects of mononuclear autologous bone marrow cells (MABMC) combined with silicon conduit grafting in rabbit femoral nerves. Twenty-eight animals were allocated to one of two groups: treatment group (TG) or control group (CG), divided according to the time of evaluation, at either 50 or 75 days. After neurotmesis of the femoral nerve, surgical repair was performed with nerve autografts in silicon conduits, leaving a 5mm gap in both groups. The TG received MABMC in silicon conduits, and CG received a sham saline inoculum. Histological, clinical and electrophysiological analyses detected no differences between groups, but analysis of leg diameter showed that TG diameters were larger. This cell therapy did not improve regeneration of the femoral nerve, but there was a tendency for better functional recovery. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pravastatin Protects Against Avascular Necrosis of Femoral Head via Autophagy.

Science.gov (United States)

Liao, Yun; Zhang, Ping; Yuan, Bo; Li, Ling; Bao, Shisan

2018-01-01

Autophagy serves as a stress response and may contribute to the pathogenesis of avascular necrosis of the femoral head induced by steroids. Statins promote angiogenesis and ameliorate endothelial functions through apoptosis inhibition and necrosis of endothelial progenitor cells, however the process used by statins to modulate autophagy in avascular necrosis of the femoral head remains unclear. This manuscript determines whether pravastatin protects against dexamethasone-induced avascular necrosis of the femoral head by activating endothelial progenitor cell autophagy. Pravastatin was observed to enhance the autophagy activity in endothelial progenitor cells, specifically by upregulating LC3-II/Beclin-1 (autophagy related proteins), and autophagosome formation in vivo and in vitro . An autophagy inhibitor, 3-MA, reduced pravastatin protection in endothelial progenitor cells exposed to dexamethasone by attenuating pravastatin-induced autophagy. Adenosine monophosphate-activated protein kinase (AMPK) is a key autophagy regulator by sensing cellular energy changes, and indirectly suppressing activation of the mammalian target of rapamycin (mTOR). We found that phosphorylation of AMPK was upregulated however phosphorylation of mTOR was downregulated in pravastatin-treated endothelial progenitor cells, which was attenuated by AMPK inhibitor compound C. Furthermore, liver kinase B1 (a phosphorylase of AMPK) knockdown eliminated pravastatin regulated autophagy protein LC3-II in endothelial progenitor cells in vitro . We therefore demonstrated pravastatin rescued endothelial progenitor cells from dexamethasone-induced autophagy dysfunction through the AMPK-mTOR signaling pathway in a liver kinase B1-dependent manner. Our results provide useful information for the development of novel therapeutics for management of glucocorticoids-induced avascular necrosis of the femoral head.

Osmolarity and root canal antiseptics.

Science.gov (United States)

Rossi-Fedele, G; Guastalli, A R

2014-04-01

Antiseptics used in endodontics for disinfection purposes include root canal dressings and irrigants. Osmotic shock is known to cause the alteration of microbial cell viability and might have a role in the mechanism of action of root canal antiseptics. The aim of this review was to determine the role of osmolarity on the performance of antiseptics in root canal treatment. A literature search using the Medline electronic database was conducted up to 30 May 2013 using the following search terms and combinations: 'osmolarity AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; osmolality AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; osmotic AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; osmosis AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; sodium chloride AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm'. Publications were included if the effects of osmolarity on the clinical performance of antiseptics in root canal treatment were stated, if preparations with different osmolarities values were compared and if they were published in English. A hand search of articles published online, 'in press' and 'early view', and in the reference list of the included papers was carried out following the same criteria. A total of 3274 publications were identified using the database, and three were included in the review. The evidence available in endodontics suggests a possible role for hyperosmotic root canal medicaments as disinfectants, and that there is no influence of osmolarity on the tissue dissolution capacity of sodium hypochlorite. There are insufficient data to obtain a sound conclusion regarding the role of hypo-osmosis in root canal disinfection, or osmosis in any further desirable

Posterior Femoral Single Limb Osteotomy for the Removal of Well-Fixed Modular Femoral Neck Components

Directory of Open Access Journals (Sweden)

Keith A Fehring

2017-07-01

Full Text Available Modular neck femoral components were introduced to optimize femoral neck anteversion, leg length, offset, and stability in total hip arthroplasty. However, concerns have been raised in recent years regarding early failure of these implants due to corrosion, pseudotumor, as well as fracture of the modular neck. Removing modular neck femoral implants is challenging as removal of the modular femoral neck leaves a proximally coated femoral stem level with the proximal bone of the femoral neck. We describe a posterior femoral single limb osteotomy  (posterior cut of an extended trochanteric osteotomy for the removal of a modular neck femoral component.

The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin.

Science.gov (United States)

Oblak, Irena; Cesnjevar, Monika; Anzic, Mitja; Hadzic, Jasna But; Ermenc, Ajra Secerov; Anderluh, Franc; Velenik, Vaneja; Jeromen, Ana; Korosec, Peter

2016-03-01

Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal. One hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190-0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375-9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167-4.264, p = 0.015). The pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer.

The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

International Nuclear Information System (INIS)

Oblak, Irena; Cesnjevar, Monika; Anzic, Mitja; Hadzic, Jasna But; Ermenc, Ajra Secerov; Anderluh, Franc; Velenik, Vaneja; Jeromen, Ana; Korosec, Peter

2016-01-01

Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal. One hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190–0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375–9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167–4.264, p = 0.015). The pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer

Femoral intertrochanteric nail (fitn): a new short version design with an anterior curvature and a geometric match study using post-operative radiographs.

Science.gov (United States)

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

2018-02-01

Femoral intertrochanteric fractures are usually fixed with short, straight cephalomedullary nails. However, mismatches between the nail and the femur frequently occur, such as tip impingement and tail protrusion. The authors designed a new type of short femoral intertrochanteric nail (fitn) with an anterior curvature (length=19.5cm, r=120cm) and herein report the geometric match study for the first of 50 cases. A prospective case series of 50 geriatric patients suffering from unstable intertrochanteric fractures (AO/OTA 31 A2/3) were treated. There were 15 males and 35 females, with an average age of 82.3 years. Post-operatively, the nail entry point position in the sagittal greater trochanter (in three categories, anterior, central and posterior), the nail-tip position in the medullary canal (in 5-grade scale) and the nail-tail level to the greater trochanter (in 3-grade scale) were measured using X-ray films. For the nail entry point measurement, 5 cases were anterior (10%), 38 cases were central (76%), and 7 cases were posterior (14%). For the distal nail-tip position, 32 cases (64%) were located along the central canal axis, 13 cases (26%) were located anteriorly but did not contact the anterior inner cortex, 2 cases (4%) showed less than one-third anterior cortex thickness contact, and 3 cases (6%) were located posteriorly with no contact. For the proximal nail-tail level, there were no protrusions over the greater trochanter in 15 cases (30%), protrusion of less than 5mm in 29 cases (58%), and protrusion of more than 5mm in 6 cases (12%). The fitness was very high, as 96% cases showed no tip-cortex contact, and 88% cases showed less than 5mm proximal tail protrusion. The newly designed femoral intertrochanteric nail has a good geometric match with the femur medullary canal and the proximal length in the Chinese population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Macroscopic and microscopic findings in avascular necrosis of the femoral head.

Science.gov (United States)

Kamal, Diana; Alexandru, D O; Kamal, C K; Streba, C T; Grecu, D; Mogoantă, L

2012-01-01

The avascular necrosis of the femoral head is an illness induced by the cutoff of blood flow to the femoral head and it affects mostly young adults between the ages of 30 and 50 years, raising therapeutic and diagnostic issues. Many risk factors are incriminated in the development of avascular necrosis of the femoral head like: trauma, chronic alcohol consumption, smoking, administration of corticosteroid drugs, most of the cases are considered to be idiopathic. The main goal of our paper is to describe the macroscopic and microscopic variations of the bone structure, which occur in patients with avascular necrosis of the femoral head. The biological material needed for our study was obtained following hip arthroplasty surgery in 26 patients between the ages of 29 and 59 years, which previously were diagnosed with avascular necrosis of the femoral head and admitted in the Orthopedics Department of the Emergency County Hospital of Craiova (Romania) between 2010 and 2011. From a macroscopic point of view, we found well defined areas of necrosis, most of which were neatly demarcated of the adjacent viable tissue by hyperemic areas, loss of shape and contour of the femoral head and transformations of the articular cartilage above the area of necrosis. When examined under the microscope, we found vast areas of fibrosis, narrow bone trabeculae, obstructed blood vessels or blood vessels with clots inside, hypertrophic fat cells, bone sequestration but also small cells and pyknotic nuclei. The microscopic and macroscopic findings on the femoral head sections varied with the patients and the stage of the disease.

Femoral nerve damage (image)

Science.gov (United States)

The femoral nerve is located in the leg and supplies the muscles that assist help straighten the leg. It supplies sensation ... leg. One risk of damage to the femoral nerve is pelvic fracture. Symptoms of femoral nerve damage ...

Femoral rotation unpredictably affects radiographic anatomical lateral distal femoral angle measurements

DEFF Research Database (Denmark)

Miles, James Edward

2016-01-01

Objective: To describe the effects of internal and external femoral rotation on radiographic measurements of the anatomical lateral distal femoral angle (a-LDFA) using two methods for defining the anatomical proximal femoral axis (a-PFA). Methods: Digital radiographs were obtained of 14 right...... femora at five degree intervals from 10° external rotation to 10° internal rotation. Using freely available software, a-LDFA measurements were made using two different a-PFA by a single observer on one occasion. Results: Mean a-LDFA was significantly greater at 10° external rotation than at any other...... rotation. The response of individual femora to rotation was unpredictable, although fairly stable within ±5° of zero rotation. Mean a-LDFA for the two a-PFA methods differed by 1.5°, but were otherwise similarly affected by femoral rotation. Clinical significance: If zero femoral elevation can be achieved...

Anal canal plasmacytoma - An uncommon presentation site

International Nuclear Information System (INIS)

Antunes, M. I.; Bujor, L.; Grillo, I. M.

2011-01-01

Background: Extramedullary plasmacytomas (EMP) are rare plasma cell tumors that arise outside the bone marrow. They are most often located in the head and neck region, but may also occur in the other locations. The lower gastrointestinal EMP represents less than 5% of all cases, and location in the anal canal is exceedingly rare. Aim: We present an exceedingly rare case of anal canal plasmacytoma, aiming to achieve a better understanding of this rare entity. Methods: We report a case of a 61-year-old man with a bulky mass in the anal canal. The lesion measured about 6 cm and invaded in all layers of the anal canal wall. The biopsy was performed and revealed a round and plasmocitoid cell population with a solid growth pattern and necrosis. The tumoral cells have express CD79a and CD138 with lambda chains. There was no evidence of disease in other locations and these features were consistent with the diagnosis of an extra-osseous plasmacytoma. The patient was submitted to conformal radiotherapy 50.4 Gy total dose, 1.8 Gy per fraction. After 24 months, the patient is asymptomatic and the lesion has completely disappeared. Conclusions: EMP accounts for approximately 3% of plasma cell malignancies. The median age is about 60 years, and the majority of patients are male. The treatment of choice for extramedullary plasmacytoma is radiation therapy in a dosage of about 50 Gy. Patients should be followed-up for life with repeated bone marrow aspiration and protein studies to detect the development of multiple myeloma. (authors)

Squamous cell carcinoma of the external auditory canal: computed tomography findings in six cases; Carcinoma espinocelular do conduto auditivo externo: estudo por tomografia computadorizada de seis casos

Energy Technology Data Exchange (ETDEWEB)

Gonzalez, Fabio Mota; Paes Junior, Ademar Jose de Oliveira; Tornin, Olger de Souza [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil). Servico de Diagnostico por Imagem]. E-mail: fmg961@yahoo.com.br; Souza, Ricardo Pires de [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil). Programa de Residencia Medica em Radiologia e Diagnostico por Imagem

2005-05-15

Objective: to evaluate the role of computed tomography in the assessment of deep extension of squamous cell carcinoma of the external auditory canal. Materials and methods: in the period between May 1995 and December 2003 six patients with squamous cell carcinoma of the external auditory canal were submitted to computed tomography scan at 'Hospital Heliopolis', Sao Paulo, SP, Brazil, including axial and coronal slices with soft tissue and bone algorithms. Results: thickening of the soft tissue of the external auditory canal was seen in all patients, bone erosion and invasion of the middle ear in five (83.3%), invasion of the mastoid and parotid gland in four (66.7%), invasion of the temporomandibular joint in three (50%), and invasion of the middle cranial fossa, carotid canal and cervical lymph node enlargement in two (33.3%) patients. Conclusion: assessment of deep extension of squamous cell carcinoma of the external auditory canal using computed tomography is useful for clinical staging of the disease allowing better therapeutic planning for these patients. (author)

Viperous fangs: development and evolution of the venom canal.

Science.gov (United States)

Zahradnicek, Oldrich; Horacek, Ivan; Tucker, Abigail S

2008-01-01

Fangs are specialised long teeth that contain either a superficial groove (Gila monster, Beaded lizard, some colubrid snakes), along which the venom runs, or an enclosed canal (viperid, elapid and atractaspid), down which the venom flows inside the tooth. The fangs of viperid snakes are the most effective venom-delivery structures among vertebrates and have been the focus of scientific interests for more than 200 years. Despite this interest the questions of how the canal at the centre of the fang forms remains unresolved. Two different hypotheses have been suggested. The mainstream hypothesis claims that the venom-conducting canal develops by the invagination of the epithelial wall of the developing tooth germ. The sides of this invagination make contact and finally fuse to form the enclosed canal. The second hypothesis, known as the "brick chimney", claims the venom-conducting canal develops directly by successive dentine deposition as the tooth develops. The fang is thus built up from the tip to the base, without any folding of the tooth surface. In an attempt to cast further light on this subject the early development of the fangs was followed in a pit viper, Trimeresurus albolabris, using the expression of Sonic hedgehog (Shh). We demonstrate that the canal is indeed formed by an early folding event, resulting from an invagination of epithelial cells into the dental mesenchyme. The epithelial cells proliferate to enlarge the canal and then the cells die by apoptosis, forming an empty tube through which the poison runs. The entrance and discharge orifices at either end of the canal develop by a similar invagination but the initial width of the invagination is very different from that in the middle of the tooth, and is associated with higher proliferation. The two sides of the invaginating epithelium never come into contact, leaving the orifice open. The mechanism by which the orifices form can be likened to that observed in reptiles with an open groove along

99mTc-MDP scintigraphy of femoral head necrosis following femoral neck fracture

International Nuclear Information System (INIS)

Lee, Soon Jin; Lee, Jun Hyung; Kim, Eun Kyung; Lee, Sun Wha; Kim, Soon Yong

1985-01-01

Secondary ischemic necrosis of femoral head due to loss of blood supply following to femoral neck fracture is well known. The regional distribution of bone-seeking radiopharmaceuricals in the skeleton can depend on a number of factors, but bone blood flow is a major physiological determinant of regional skeletal uptake of Tc-99m polyphosphate and bone imaging may thus be used for the evaluation of vascularity of the femoral head. The authors made a comparative study of scintigraphic findings and operative findings of 28 cases of femoral neck fracture treated at Kyung Hee University Hospital from April 1980 to May 1984. The results were as follows: 1. In 16 cases of proven avascular necorsis of femoral head, scintigraphy showed absent or decreased activity in 14 cases (87.5%), while radiography showed increased density in 10 cases (62.5%). 2. In 12 cases of proven vital femoral head, scintigraphy showed increased activity in 9 cases (75%) and radiography showed decreased density in 9 cases (75%). 3. 99mTc-MDP scintigraphy was an excellent and useful method for assessing bone vitality of femoral head

ALIMENTARY CANAL ANATOMY AND HISTOLOGY OF THE WORKER TERMITE NEOTERMES BOSEI

Directory of Open Access Journals (Sweden)

LEKSONO EKOPURANTO HARIPRABOWO

2006-01-01

Full Text Available As social insects, termites live in a colony that consist of reproductive (drone and queen, and non-reproductive (soldiers and workers castes. Workers obtain their food directly from wood, humus, and other substances that contain cellulose. The objective of this study was to examine the alimentary canal of the Neotermes bosei workers. Observations of gut transverse section were carried out through the length, perimeter, and area of each alimentary canal region. The results showed that total length of N. bosei alimentary canal was 13.71+1.28 mm. The canal was divided into fore-, mid-, and hindgut which were 24, 28, and 48%, respectively of the gut total length. Two types of alimentary canal epithelial cells were found, i.e. the squamous and transitional cells. Areas covered with thick muscular tissues were crop, proventriculus, and rectum. Proventriculus was characterized with six large dentitions. There was no gastric caeca in N. bosei midgut, which commonly occurred in chewing insect. Secretory cells .wer e observed at proventriculus and ventriculus regions. Cardiac valve was found at the anterior end of ventriculus. Area with the largest outer perimeter was the rectum pouch. Enteric valve had three internal folds.

Stability of guest molecules in urea canal complexes by canal polymerization

International Nuclear Information System (INIS)

Yoshii, Fumio; Makuuchi, Keizo

1995-01-01

It was found that various organic materials are attracted into urea canal by hexanediol diacrylate (HDDA) and long chain compounds. This means that materials which does not form complex by itself are induced in canal by HDDA and long chain compounds. To include with stability perfumes, insecticides, attractants and repellents in urea canal, leaf alcohol was used as a model compound for guest molecules in the canal. The leaf alcohol from the canal released gradually over many days and the release was inhibited for 15 days by long chain compounds and for 30 days by polymerized HDDA after irradiation. After releasing, the leaf alcohol in the canal remained 25 % stable for long chain compounds and 40 % for polymerized HDDA. The dose required for stabilization of leaf alcohol in the urea canal by canal polymerization of HDDA was 30 kGy. (author)

Root canal irrigants

OpenAIRE

Kandaswamy, Deivanayagam; Venkateshbabu, Nagendrababu

2010-01-01

Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are...

[Experimental study on vascular bundle implantation combined with cellular transplantation in treating rabbit femoral head necrosis].

Science.gov (United States)

Chen, Shuang-Tao; Zhang, Wei-Ping; Liu, Chang-An; Wang, Jun-Jiang; Song, Heng-Yi; Chai, Zhi-wen

2013-03-01

To discuss the feasibility of vascular bundle implantation combined with allogeneic bone marrow stromal cells (BMSCs) transplantation in treating rabbit femoral head osteonecrosis and bone defect, in order to explore a new method for the treatment of femoral head necrosis. Thirty-six New Zealand rabbits were randomly divided into three groups,with 12 rabbits in each group. Bilateral femoral heads of the rabbits were studied in the experiment. The models were made by liquid nitrogen frozen, and the femoral heads were drilled to cause bone defect. Group A was the control group,group B was stem cells transplantaion group of allograft marrow stromal,and group C was stem cells transplantation group of allograft marrow stromal combined with vascular bundle implantation. Three rabbits of each group were sacrificed respectively at 2, 4, 8, 12 weeks after operation. All specimens of the femoral heads were sliced for HE staining. Furthermore ,vascular density and the percentage of new bone trabecula of femoral head coronary section in defect area were measured and analyzed statistically. In group C,new bone trabecula and original micrangium formed at the 2nd week after operation; new bone trabecula was lamellar and interlaced with abundant micrangium at the 8th week;at the 12th week,the broadened,coarsened bone trabecula lined up regularly,and the mature bone trabecula and new marrow were visible. At the 2nd week after operation,there was no statistical significance in the percentage of new bone trabecula of femoral head coronary section in defect area between group B and C. While at 4, 8, 12 week after operation, vascular density and the percentage of new bone trabecula of femoral head coronary section in defect area of group C was higher than that of group B. Allogeneic bone marrow stromal cells cultured in vivo can form new bone trabecula, and can be applied to allotransplant. Vascular bundle implanted into the bone defect area of femoral head necrosis could improve blood

Temperature dependency of cupular mechanics and hair cell frequency selectivity in the fish canal lateral line organ

NARCIS (Netherlands)

Wiersinga-Post, JEC; van Netten, SM

2000-01-01

The mechanical frequency selectivity of the cupula located in the supraorbital lateral line canal and the frequency selectivity of the hair cells driven by the cupula were measured simultaneously in vivo. Laser interferometry was used to measure cupular mechanics and extracellular receptor

Evaluation of perfusion of the femoral head after femoral neck fracture using bone scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Yamaguchi, Satoshi; Ishido, Yasuhiro [Saiseikai Sendai Hospital, Kagoshima (Japan); Okano, Toshihiro [Ibusuki National Hospital, Kagoshima (Japan); Komiya, Setsuro [Kagoshima Univ. (Japan). Faculty of Medicine

2002-09-01

We treated 13 patients for femoral neck fracture. They consisted of 2 males and 11 females, and were classified according to Garden stage classification; Stage I, 3 cases; Stage II, 2 cases; Stage III, 2 cases; Stage IV, 4 cases. Two trochanteric fracture cases were used by control. We evaluated perfusion of the femoral head after femoral neck fracture using bone scintigraphy, which is considered useful for evaluation of perfusion of the femoral neck before operation. (author)

Evaluation of perfusion of the femoral head after femoral neck fracture using bone scintigraphy

International Nuclear Information System (INIS)

Yamaguchi, Satoshi; Ishido, Yasuhiro; Okano, Toshihiro; Komiya, Setsuro

2002-01-01

We treated 13 patients for femoral neck fracture. They consisted of 2 males and 11 females, and were classified according to Garden stage classification; Stage I, 3 cases; Stage II, 2 cases; Stage III, 2 cases; Stage IV, 4 cases. Two trochanteric fracture cases were used by control. We evaluated perfusion of the femoral head after femoral neck fracture using bone scintigraphy, which is considered useful for evaluation of perfusion of the femoral neck before operation. (author)

Vascular endothelial growth factor/bone morphogenetic protein-2 bone marrow combined modification of the mesenchymal stem cells to repair the avascular necrosis of the femoral head

Science.gov (United States)

Ma, Xiao-Wei; Cui, Da-Ping; Zhao, De-Wei

2015-01-01

Vascular endothelial cell growth factor (VEGF) combined with bone morphogenetic protein (BMP) was used to repair avascular necrosis of the femoral head, which can maintain the osteogenic phenotype of seed cells, and effectively secrete VEGF and BMP-2, and effectively promote blood vessel regeneration and contribute to formation and revascularization of tissue engineered bone tissues. To observe the therapeutic effect on the treatment of avascular necrosis of the femoral head by using bone marrow mesenchymal stem cells (BMSCs) modified by VEGF-165 and BMP-2 in vitro. The models were avascular necrosis of femoral head of rabbits on right leg. There groups were single core decompression group, core decompression + BMSCs group, core decompression + VEGF-165/BMP-2 transfect BMSCs group. Necrotic bone was cleared out under arthroscope. Arthroscopic observation demonstrated that necrotic bone was cleared out in each group, and fresh blood flowed out. Histomorphology determination showed that blood vessel number and new bone area in the repair region were significantly greater at various time points following transplantation in the core decompression + VEGF-165/BMP-2 transfect BMSCs group compared with single core decompression group and core decompression + BMSCs group (P < 0.05). These suggested that VEGF-165/BMP-2 gene transfection strengthened osteogenic effects of BMSCs, elevated number and quality of new bones and accelerated the repair of osteonecrosis of the femoral head. PMID:26629044

{sup 99m}Tc-MDP scintigraphy of femoral head necrosis following femoral neck fracture

Energy Technology Data Exchange (ETDEWEB)

Lee, Soon Jin; Lee, Jun Hyung; Kim, Eun Kyung; Lee, Sun Wha; Kim, Soon Yong [Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

1985-02-15

Secondary ischemic necrosis of femoral head due to loss of blood supply following to femoral neck fracture is well known. The regional distribution of bone-seeking radiopharmaceuricals in the skeleton can depend on a number of factors, but bone blood flow is a major physiological determinant of regional skeletal uptake of Tc-99m polyphosphate and bone imaging may thus be used for the evaluation of vascularity of the femoral head. The authors made a comparative study of scintigraphic findings and operative findings of 28 cases of femoral neck fracture treated at Kyung Hee University Hospital from April 1980 to May 1984. The results were as follows: 1. In 16 cases of proven avascular necorsis of femoral head, scintigraphy showed absent or decreased activity in 14 cases (87.5%), while radiography showed increased density in 10 cases (62.5%). 2. In 12 cases of proven vital femoral head, scintigraphy showed increased activity in 9 cases (75%) and radiography showed decreased density in 9 cases (75%). 3. 99mTc-MDP scintigraphy was an excellent and useful method for assessing bone vitality of femoral head.

Sedentary lifestyle related exosomal release of Hotair from gluteal-femoral fat promotes intestinal cell proliferation

OpenAIRE

Xiaozhao Lu; Danna Bai; Xiangwei Liu; Chen Zhou; Guodong Yang

2017-01-01

Pioneering epidemiological work has established strong association of sedentary lifestyle and obesity with the risk of colorectal cancer, while the detailed underlying mechanism remains unknown. Here we show that Hotair (HOX transcript antisense RNA) is a pro-adipogenic long non-coding RNA highly expressed in gluteal-femoral fat over other fat depots. Hotair knockout in adipose tissue results in gluteal-femoral fat defect. Squeeze of the gluteal-femoral fat induces intestinal proliferation in...

Balloon cell melanoma of the anal canal: A wolf in sheep′s clothing?

Directory of Open Access Journals (Sweden)

Munita Meenu Bal

2013-01-01

Full Text Available Balloon cell melanoma (BCM is a rare histologic variant of cutaneous malignant melanoma with exceptional reports of occurrences at non-cutaneous sites. Herein we present a case of primary amelanotic BCM of anal canal, a heretofore undescribed location. Histologically, the tumor was characterized by sheets of pale cells that bore striking resemblance to foamy macrophages. Presence of rare atypical mitoses confirmed the malignant nature of the cells. Neoplastic cells were immunoreactive for S100, Melan-A, and focally for HMB-45 while were negative for myogenic, gastrointestinal stromal tumor, epithelial and neuroendocrine markers. Resemblance to foamy macrophages, bland cytology and absence of pigment imparts this tumor a deceptively benign histological appearance making it prone to diagnostic pitfalls. Awareness of this rare entity and judicious employment of immunohistochemistry is imperative in segregating it from its diverse mimics.

[Femoral osteolytic lesions with soft tissue tumors and hypercalcemia as presentation form of a B-cell lymphoma].

Science.gov (United States)

Hernández Hernández, J L; Olmos Martínez, J M; Figols Ladrón de Guevara, J; Riancho Moral, J A; González Macías, J

2000-05-01

Hypercalcemia associated with haematological neoplasms account for 15 to 20% of hipercalcemia in malignancy, and occurs usually in patients with multiple myeloma. However, its incidence in patients with linfoma is low, and it is observed usually in T-cell linfomas. Bone affectation is also uncommon in patients with non-Hodgkin linfoma. It usually is seen as a late manifestation of the disease, and its occurrence as the form of presentation is exceptional. We hereby report a patient with a B-cell non-Hodgkin linfoma presenting with hypercalcemia and femoral osteolytic lesions.

Cytotoxicity of 5% Tamarindus indica extract and 3% hydrogen peroxide as root canal irrigation

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Erawati Wulandari

2008-09-01

Full Text Available Background: Preparation of root canal is an important stage in endodontic treatment. During conducting preparation, it is always be followed with root canal irrigation that has aim to clean root canal from necrotic tissue remains, grind down dentin powder, micro organism, wet the root canal to make preparation process of root canal easier, and solute root canal content at area that can not be reached by equipment. Flesh of Tamarindus indica (pulpa tamarindorum is used as traditional medicine and it contains vitamin C (antioxidant, protein, fat, glucose, etc. Previous research shows that 5% tamarindus indica extract can clean smear layer but it is more cytotoxicity to cell line BHK–21 than sterilized aquabides. Purpose: This research is to compare cytotoxicity between 5% Tamarindus indica extract with 3% H2O2 as root canal irrigation material. Method: Four teen culture cell line BHK 21 divides into 2 groups. Group 1 is treated with 3% H2O2 and Group 2 is treated with 5% Tamarindus indica extract, for about 2.5 minutes in every group. Then, living and death cell percentage is measured. Data is analyzed with independent t test with significant level of 0.05%. Result: The research showed that death cell in group 1 was 29.3% and in group 2 was 21.1%. There was a significant different (p < 0.05 between group 1 and group 2. Conclusion: Cytotoxicity of 5% Tamarindus indica extract to the cell line BHK–21 is lower than 3% H2O2.

Osteonecrosis of the femoral head in sickle cell disease: prevalence, comorbidities, and surgical outcomes in California

OpenAIRE

Adesina, Oyebimpe; Brunson, Ann; Keegan, Theresa H. M.; Wun, Ted

2017-01-01

Osteonecrosis of the femoral head (ONFH) is a prevalent complication of sickle cell disease (SCD) that has not been well described in population-based cohort studies. Using California's Office of Statewide Planning and Development discharge databases (1991-2013), we estimated the cumulative incidence of ONFH after accounting for the competing risk of death and used a multivariable Cox proportional hazards regression to identify factors associated with ONFH diagnosis. We also calculated rates ...

Young's modulus of elasticity of Schlemm's canal endothelial cells.

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Zeng, Dehong; Juzkiw, Taras; Read, A Thomas; Chan, Darren W-H; Glucksberg, Matthew R; Ethier, C Ross; Johnson, Mark

2010-02-01

Schlemm's canal (SC) endothelial cells are likely important in the physiology and pathophysiology of the aqueous drainage system of the eye, particularly in glaucoma. The mechanical stiffness of these cells determines, in part, the extent to which they can support a pressure gradient and thus can be used to place limits on the flow resistance that this layer can generate in the eye. However, little is known about the biomechanical properties of SC endothelial cells. Our goal in this study was to estimate the effective Young's modulus of elasticity of normal SC cells. To do so, we combined magnetic pulling cytometry of isolated cultured human SC cells with finite element modeling of the mechanical response of the cell to traction forces applied by adherent beads. Preliminary work showed that the immersion angles of beads attached to the SC cells had a major influence on bead response; therefore, we also measured bead immersion angle by confocal microscopy, using an empirical technique to correct for axial distortion of the confocal images. Our results showed that the upper bound for the effective Young's modulus of elasticity of the cultured SC cells examined in this study, in central, non-nuclear regions, ranged between 1,007 and 3,053 Pa, which is similar to, although somewhat larger than values that have been measured for other endothelial cell types. We compared these values to estimates of the modulus of primate SC cells in vivo, based on images of these cells under pressure loading, and found good agreement at low intraocular pressure (8-15 mm Hg). However, increasing intraocular pressure (22-30 mm Hg) appeared to cause a significant increase in the modulus of these cells. These moduli can be used to estimate the extent to which SC cells deform in response to the pressure drop across the inner wall endothelium and thereby estimate the extent to which they can generate outflow resistance.

Correlation of ultrasound appearance, gross anatomy, and histology of the femoral nerve at the femoral triangle.

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Lonchena, Tiffany K; McFadden, Kathryn; Orebaugh, Steven L

2016-01-01

Correlation between ultrasound appearance, gross anatomic characteristics, and histologic structure of the femoral nerve (FN) is lacking. Utilizing cadavers, we sought to characterize the anatomy of the FN, and provide a quantitative measure of its branching. We hypothesize that at the femoral crease, the FN exists as a group of nerve branches, rather than a single nerve structure, and secondarily, that this transition into many branches is apparent on ultrasonography. Nineteen preserved cadavers were investigated. Ultrasonography was sufficient to evaluate the femoral nerve in nine specimens; gross dissection was utilized in all 19. Anatomic characteristics were recorded, including distances from the inguinal ligament to femoral crease, first nerve branch, and complete arborization of the nerve. The nerves from nine specimens were excised for histologic analysis. On ultrasound, the nerve became more flattened, widened, and less discrete as it coursed distally. Branching of the nerve was apparent in 12 of 18 images, with mean distance from inguinal ligament of 3.9 (1.0) cm. However, upon dissection, major branching of the femoral nerve occurred at 3.1 (1.0) cm distal to the inguinal ligament, well proximal to the femoral crease. Histologic analysis was consistent with findings at dissection. The femoral nerve arborizes into multiple branches between the inguinal ligament and the femoral crease. Initial branching is often high in the femoral triangle. As hypothesized, the FN exists as a closely associated group of nerve branches at the level of the femoral crease; however, the termination of the nerve into multiple branches is not consistently apparent on ultrasonography.

External fixation of femoral defects in athymic rats: Applications for human stem cell implantation and bone regeneration

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Terasa Foo

2013-01-01

Full Text Available An appropriate animal model is critical for the research of stem/progenitor cell therapy and tissue engineering for bone regeneration in vivo. This study reports the design of an external fixator and its application to critical-sized femoral defects in athymic rats. The external fixator consists of clamps and screws that are readily available from hardware stores as well as Kirschner wires. A total of 35 rats underwent application of the external fixator with creation of a 6-mm bone defect in one femur of each animal. This model had been used in several separate studies, including implantation of collagen gel, umbilical cord blood mesenchymal stem cells, endothelial progenitor cells, or bone morphogenetic protein-2. One rat developed fracture at the proximal pin site and two rats developed deep tissue infection. Pin loosening was found in nine rats, but it only led to the failure of external fixation in two animals. In 8 to 10 weeks, various degrees of bone growth in the femoral defects were observed in different study groups, from full repair of the bone defect with bone morphogenetic protein-2 implantation to fibrous nonunion with collagen gel implantation. The external fixator used in these studies provided sufficient mechanical stability to the bone defects and had a comparable complication rate in athymic rats as in immunocompetent rats. The external fixator does not interfere with the natural environment of a bone defect. This model is particularly valuable for investigation of osteogenesis of human stem/progenitor cells in vivo.

Treatment of neglected femoral neck fracture

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Anil K Jain

2015-01-01

Full Text Available Intra-capsular femoral neck fractures are seen commonly in elderly people following a low energy trauma. Femoral neck fracture has a devastating effect on the blood supply of the femoral head, which is directly proportional to the severity of trauma and displacement of the fracture. Various authors have described a wide array of options for treatment of neglected/nonunion (NU femoral neck fracture. There is lack of consensus in general, regarding the best option. This Instructional course article is an analysis of available treatment options used for neglected femoral neck fracture in the literature and attempt to suggest treatment guides for neglected femoral neck fracture. We conducted the "Pubmed" search with the keywords "NU femoral neck fracture and/or neglected femoral neck fracture, muscle-pedicle bone graft in femoral neck fracture, fibular graft in femoral neck fracture and valgus osteotomy in femoral neck fracture." A total of 203 print articles were obtained as the search result. Thirty three articles were included in the analysis and were categorized into four subgroups based on treatment options. (a treated by muscle-pedicle bone grafting (MPBG, (b closed/open reduction internal fixation and fibular grafting (c open reduction and internal fixation with valgus osteotomy, (d miscellaneous procedures. The data was pooled from all groups for mean neglect, the type of study (prospective or retrospective, classification used, procedure performed, mean followup available, outcome, complications, and reoperation if any. The outcome of neglected femoral neck fracture depends on the duration of neglect, as the changes occurring in the fracture area and fracture fragments decides the need and type of biological stimulus required for fracture union. In stage I and stage II (Sandhu′s staging neglected femoral neck fracture osteosynthesis with open reduction and bone grafting with MPBG or Valgus Osteotomy achieves fracture union in almost 90

Subtrochanteric femoral fracture during trochanteric nailing for the treatment of femoral shaft fracture.

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Yun, Ho Hyun; Oh, Chi Hun; Yi, Ju Won

2013-09-01

We report on three cases of subtrochanteric femoral fractures during trochanteric intramedullary nailing for the treatment of femoral shaft fractures. Trochanteric intramedullary nails, which have a proximal lateral bend, are specifically designed for trochanteric insertion. When combined with the modified insertion technique, trochanteric intramedullary nails reduce iatrogenic fracture comminution and varus malalignment. We herein describe technical aspects of trochanteric intramedullary nailing for femoral shaft fractures to improve its application and prevent implant-derived complications.

Exposure to non-ionizing electromagnetic fields emitted from mobile phones induced DNA damage in human ear canal hair follicle cells.

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Akdag, Mehmet; Dasdag, Suleyman; Canturk, Fazile; Akdag, Mehmet Zulkuf

2018-01-01

The aim of this study was to investigate effect of radiofrequency radiation (RFR) emitted from mobile phones on DNA damage in follicle cells of hair in the ear canal. The study was carried out on 56 men (age range: 30-60 years old)in four treatment groups with n = 14 in each group. The groups were defined as follows: people who did not use a mobile phone (Control), people use mobile phones for 0-30 min/day (second group), people use mobile phones for 30-60 min/day (third group) and people use mobile phones for more than 60 min/day (fourth group). Ear canal hair follicle cells taken from the subjects were analyzed by the Comet Assay to determine DNA damages. The Comet Assay parameters measured were head length, tail length, comet length, percentage of head DNA, tail DNA percentage, tail moment, and Olive tail moment. Results of the study showed that DNA damage indicators were higher in the RFR exposure groups than in the control subjects. In addition, DNA damage increased with the daily duration of exposure. In conclusion, RFR emitted from mobile phones has a potential to produce DNA damage in follicle cells of hair in the ear canal. Therefore, mobile phone users have to pay more attention when using wireless phones.

Ca(2+) currents and voltage responses in Type I and Type II hair cells of the chick embryo semicircular canal.

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Masetto, Sergio; Zampini, Valeria; Zucca, Giampiero; Valli, Paolo

2005-11-01

Type I and Type II hair cells, and Type II hair cells located in different zones of the semicircular canal crista, express different patterns of voltage-dependent K channels, each one specifically shaping the hair cell receptor potential. We report here that, close to hatching, chicken embryo semicircular canal Type I and Type II hair cells express a similar voltage-dependent L-type calcium current (I(Ca)), whose main features are: activation above -60 mV, fast activation kinetics, and scarce inactivation. I(Ca) should be already active at rest in Zone 1 Type II hair cells, whose resting membrane potential was on average slightly less negative than -60 mV. Conversely, I(Ca) would not be active at rest in Type II hair cells from Zone 2 and 3, nor in Type I hair cells, since their resting membrane potential was significantly more negative than -60 mV. However, even small depolarising currents would activate I(Ca) steadily in Zone 2 and 3 Type II hair cells, but not in Type I hair cells because of the robust repolarising action of their specific array of K(+) currents. The implications of the present findings in the afferent discharge are discussed.

Cancer of the external auditory canal

DEFF Research Database (Denmark)

Nyrop, Mette; Grøntved, Aksel

2002-01-01

OBJECTIVE: To evaluate the outcome of surgery for cancer of the external auditory canal and relate this to the Pittsburgh staging system used both on squamous cell carcinoma and non-squamous cell carcinoma. DESIGN: Retrospective case series of all patients who had surgery between 1979 and 2000....... Median follow-up was 47 months (range, 2-148 months). Data on age, sex, symptoms, TNM status, histopathological diagnosis, surgery, adjunctive therapy, sequelae, recurrence, and status at follow-up were obtained. SETTING: An ear, nose, and throat department in an ambulatory and hospitalized care center....... PATIENTS: Ten women and 10 men with previously untreated primary cancer. Median age at diagnosis was 67 years (range, 31-87 years). Survival data included 18 patients with at least 2 years of follow-up or recurrence. INTERVENTION: Local canal resection or partial temporal bone resection. MAIN OUTCOME...

Idiopathic avascular necrosis of the femoral heads in five members of a Moroccan family.

Science.gov (United States)

Sekkat, Jihane; Rachidi, Ouafaa; Janani, Saadia; Mkinsi, Ouafaa

2012-10-01

Avascular necrosis (AVN) is idiopathic in about 40% of cases. The pathophysiology of avascular necrosis remains incompletely elucidated. Here, we report a case that underlines the role for inherited factors in AVN of the femoral heads. Idiopathic AVN of the femoral heads occurred in five members of the same family (a woman, her two paternal aunts, her male paternal cousin and her female paternal cousin) at a mean age of 42.4 years (range, 33-58 years). Standard pelvic radiographs showed Arlet and Ficat stage 4 AVN in three patients and stage 3 in two patients. None of the patients had a history of glucocorticoid therapy, alcohol abuse, or trauma. All five patients underwent investigations for a cause, including blood cell counts, a lipid profile, coagulation tests, testing for antinuclear antibodies, hemoglobin electrophoresis, ultrasonography of the abdomen, and standard radiographs of the long limb bones. The results were normal or negative, ruling out known hereditary causes of AVN such as sickle cell anemia and Gaucher disease. Many cases of familial AVN of the femoral head have been described in patients with sickle cell anemia or Gaucher disease. However, only five families with idiopathic familial AVN of the femoral heads have been reported (three in the US and two in Taiwan). All the patients in these families had isolated bilateral AVN of the femoral heads without AVN at other sites. Copyright © 2012. Published by Elsevier SAS.

Self-designed femoral neck guide pin locator for femoral neck fractures.

Science.gov (United States)

Xia, Shengli; Wang, Ziping; Wang, Minghui; Wu, Zuming; Wang, Xiuhui

2014-01-01

Closed reduction and fixation with 3 cannulated screws is a widely accepted surgery for the treatment of femoral neck fractures. However, how to obtain optimal screw placement remains unclear. In the current study, the authors designed a guide pin positioning system for femoral neck fracture cannulated screw fixation and examined its application value by comparing it with freehand guide needle positioning and with general guide pin locator positioning provided by equipment manufacturers. The screw reset rate, screw parallelism, triangle area formed by the link line of the entry point of 3 guide pins, and maximum vertical load bearing of the femoral neck after internal fixation were recorded. As expected, the triangle area was largest in the self-designed positioning group, followed by the general positioning group and the freehand positioning group. The difference among the 3 groups was statistically significant (P.05). The authors’ self-designed guide pin positioning system has the potential to accurately insert cannulated screws in femoral neck fractures and may reduce bone loss and unnecessary radiation.

Canal shaping of different single-file systems in curved root canals

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Maurizio D'Amario

2017-12-01

Full Text Available Background/Purpose: This study compared maintenance of canal anatomy, occurrence of apical transportation, and working time observed after instrumentation with One Shape New Generation rotary system (Micro-Mega, with those observed after instrumentation with Reciproc (VDW and WaveOne (Dentsply-Maillefer reciprocating systems. Materials and methods: The mesial canals of 45 mandibular molars (curvature angles between 35° and 45° were selected. Specimens were randomly divided into three groups, and canal preparations were performed using One Shape, Reciproc, or WaveOne systems (size #25. A digital double radiographic technique was used to determine apical transportation and change in angle of curvature. Also, working time and instrument failures were recorded. Data were statistically analyzed. Results: During preparation, no file fractured. No statistically significant differences were found among groups. No system showed a significantly faster preparation time than others (P>0.05. All instruments maintained the original canal curvature well and were safe to use. Conclusion: Both continuous rotary instrument and reciprocating systems did not have any influence on the presence of apical transportation or caused an alteration in angle of canal curvature. Keywords: canal curvature, canal straightening, endodontics, reciprocating motion, single file instrumentation

Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention.

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Koshy, Linda M; Aberle, Laura H; Krucoff, Mitchell W; Hess, Connie N; Mazzaferri, Ernest; Jolly, Sanjit S; Jacobs, Alice; Gibson, C Michael; Mehran, Roxana; Gilchrist, Ian C; Rao, Sunil V

2018-01-01

This study was conducted to determine the association between radial access, guided femoral access, and non-guided femoral access on postprocedural bleeding and vascular complications after percutaneous coronary intervention (PCI). Bleeding events and major vascular complications after PCI are associated with increased morbidity, mortality, and cost. While the radial approach has been shown to be superior to the femoral approach in reducing bleeding and vascular complications, whether the use of micropuncture, fluoroscopy, or ultrasound mitigates these differences is unknown. We conducted a post hoc analysis of women in the SAFE-PCI for Women trial who underwent PCI and had the access method identified (n = 643). The primary endpoint of postprocedure bleeding or vascular complications occurring within 72 hours or at discharge was adjudicated by an independent clinical events committee and was compared based on three categories of access technique: radial, guided femoral (fluoroscopy, micropuncture, ultrasound), or non-guided femoral (none of the aforementioned). Differences between the groups were determined using multivariate logistic regression using radial access as the reference. Of the PCI population, 330 underwent radial access, 228 underwent guided femoral access, and 85 underwent non-guided femoral access. There was a statistically significant lower incidence of the primary endpoint with radial access vs non-guided femoral access; however, there was no significant difference between radial approach and femoral access guided by fluoroscopy, micropuncture, or ultrasound. This post hoc analysis demonstrates that while radial access is safer than non-guided femoral access, guided femoral access appears to be associated with similar bleeding events or vascular complications as radial access.

Bacterial action of carbon dioxide laser radiation in experimental dental root canals

International Nuclear Information System (INIS)

Zakariasen, K.L.; Dederich, D.N.; Tulip, John; DeCoste, Sandra; Jensen, S.E.; Pickard, M.A.

1986-01-01

The ability of a carbon dioxide laser to sterilize the root canal of human teeth has been investigated. Three oral bacteria, Streptococcus sanguis, Streptococcus mutans, and Actinomyces viscosus, and three other bacteria, Bacillus cereus, Staphyloccus aureus, and Pseudomonoas aeruginosa were used as experimental organisms. Exposure of cells on glass slides to laser radiation showed there was little difference in the exposure required to kill these six organisms. Complete recovery of bacteria from the root canal was initially a problem and was only achieved when bacterial manipulations and removal were carried out in rapid succession, within 5 min of inoculation. However, the geometry of the instrumented canal and the laser alignment were major factors in achieving consistent cell death of oral bacteria in the root canals. Using sets of 10 teeth, four repeated exposures of 10 W for 1 s was found to sterilize 4 or more of the teeth

[Hernia surgery in urology: part 1: inguinal, femoral and umbilical hernias - fundamentals of clinical diagnostics and treatment].

Science.gov (United States)

Franz, T; Schwalenberg, T; Dietrich, A; Müller, J; Stolzenburg, J-U

2013-05-01

Hernias are a common occurrence with correspondingly huge clinical and economic impacts on the healthcare system. The most common forms of hernia which need to be diagnosed and treated in routine urological work are inguinal and umbilical hernias. With the objective of reconstructing and stabilizing the inguinal canal there are the possibilities of open and minimally invasive surgery and both methods can be performed with suture or mesh repair. Indications for surgery of umbilical hernias are infrequent although this is possible with little effort under local anesthesia. This article presents an overview of the epidemiology, pathogenesis, clinical symptoms, diagnostics and therapy of inguinal, femoral and umbilical hernias.

Evaluation of a pig femoral head osteonecrosis model

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Kim Harry

2010-03-01

Full Text Available Abstract Background A major cause of osteonecrosis of the femoral head is interruption of a blood supply to the proximal femur. In order to evaluate blood circulation and pathogenetic alterations, a pig femoral head osteonecrosis model was examined to address whether ligature of the femoral neck (vasculature deprivation induces a reduction of blood circulation in the femoral head, and whether transphyseal vessels exist for communications between the epiphysis and the metaphysis. We also tested the hypothesis that the vessels surrounding the femoral neck and the ligamentum teres represent the primary source of blood flow to the femoral head. Methods Avascular osteonecrosis of the femoral head was induced in Yorkshire pigs by transecting the ligamentum teres and placing two ligatures around the femoral neck. After heparinized saline infusion and microfil perfusion via the abdominal aorta, blood circulation in the femoral head was evaluated by optical and CT imaging. Results An angiogram of the microfil casted sample allowed identification of the major blood vessels to the proximal femur including the iliac, common femoral, superficial femoral, deep femoral and circumflex arteries. Optical imaging in the femoral neck showed that a microfil stained vessel network was visible in control sections but less noticeable in necrotic sections. CT images showed a lack of microfil staining in the epiphysis. Furthermore, no transphyseal vessels were observed to link the epiphysis to the metaphysis. Conclusion Optical and CT imaging analyses revealed that in this present pig model the ligatures around the femoral neck were the primary cause of induction of avascular osteonecrosis. Since the vessels surrounding the femoral neck are comprised of the branches of the medial and the lateral femoral circumflex vessels, together with the extracapsular arterial ring and the lateral epiphyseal arteries, augmentation of blood circulation in those arteries will improve

[Root canal treatment of mandibular first premolar with 4 root canals: a case report].

Science.gov (United States)

Liu, Xin-yang; Zhan, Fu-Liang

2015-10-01

The mandibular first premolar can be considered one of the most challenging teeth to treat, due to the complexity of its root canal morphology and increased incidence of multiple canals. A case of endodontic treatment of a mandibular first premolar exhibiting a total of 4 distinct root canals and 4 apical foramina was described. Anatomic variation of root canal morphology should be considered in endodontic treatment to ensure a favorable healing outcome, and its identification could be enhanced by careful examination using a dental operating microscope. Obturation of root canals using a warm vertical compaction technique with a highly-radiopaque root canal sealer, such as AH Plus, after careful ultrasonic activated irrigation might allow the flow of sealer into the narrowed but unprepared part of the canal, thereby facilitating optimum chemo-mechanical debridement of the root canal system.

Avascular necrosis of the femoral head in HIV infected patients

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Marcos Almeida Matos

Full Text Available Avascular necrosis (AVN of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipidemia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.

MULTIPLE SPINAL CANAL MENINGIOMAS

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Nandigama Pratap Kumar

2016-10-01

Full Text Available BACKGROUND Meningiomas of the spinal canal are common tumours with the incidence of 25 percent of all spinal cord tumours. But multiple spinal canal meningiomas are rare in compare to solitary lesions and account for 2 to 3.5% of all spinal meningiomas. Most of the reported cases are both intra cranial and spinal. Exclusive involvement of the spinal canal by multiple meningiomas are very rare. We could find only sixteen cases in the literature to the best of our knowledge. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for single lesion. We analysed the literature, with illustration of our case. MATERIALS AND METHODS In September 2016, we performed a literature search for multiple spinal canal meningiomas involving exclusively the spinal canal with no limitation for language and publication date. The search was conducted through http://pubmed.com, a wellknown worldwide internet medical address. To the best of our knowledge, we could find only sixteen cases of multiple meningiomas exclusively confined to the spinal canal. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for solitary intradural extra medullary spinal canal meningioma at D4-D6 level, again presented with spastic quadriparesis of two years duration and MRI whole spine demonstrated multiple intradural extra medullary lesions, which were excised completely and the histopathological diagnosis was transitional meningioma. RESULTS Patient recovered from his weakness and sensory symptoms gradually and bladder and bowel symptoms improved gradually over a period of two to three weeks. CONCLUSION Multiple

Endometriosis-associated hydrocele of the canal of Nuck with immunohistochemical confirmation: a case report.

Science.gov (United States)

Okoshi, Kae; Mizumoto, Masaki; Kinoshita, Koichi

2017-12-21

The canal of Nuck is an embryological vestige of the processus vaginalis, and presents a potential site for endometriosis seeding. Hydroceles in this region are a rare cause of inguinal swelling in females. In addition, endometriosis localized to the canal of Nuck is exceedingly rare. A 44-year-old Japanese woman presented with a painful mass overlying her right pubis. She underwent surgery to completely excise the mass. During surgery, division of the external oblique aponeurosis revealed a cyst that occupied the inguinal canal and it adhered to the transverse fascia, inguinal ligament, and pubic bone. The cyst was dissected from the round ligament, and the defect in the internal inguinal ring was repaired and reinforced with mesh. On macroscopic examination, the cyst had a heterogeneous fibrous aspect with dark brown inclusions. Microscopic examination revealed that the cyst was tortuous, lined by mesothelial-like cells, and accompanied by partial subcapsular hemorrhage. Endometrium-like tissue was observed in the cystic wall. Immunohistochemical staining for podoplanin confirmed the mesothelial origin of the cyst-lining cells. The epithelial cells and stromal cells were positive for estrogen receptors. In this case of an endometriosis-associated hydrocele of the canal of Nuck, the mesothelial origin of the cyst-lining cells and endometriosis were confirmed by positive immunohistochemical staining for podoplanin and estrogen receptors, respectively. We determined that hydrocele resection and reinforcement of the anterior inguinal canal wall (if necessary) are appropriate treatments for this condition.

Nerve canals at the fundus of the internal auditory canal on high-resolution temporal bone CT

International Nuclear Information System (INIS)

Ji, Yoon Ha; Youn, Eun Kyung; Kim, Seung Chul

2001-01-01

To identify and evaluate the normal anatomy of nerve canals in the fundus of the internal auditory canal which can be visualized on high-resolution temporal bone CT. We retrospectively reviewed high-resolution (1 mm thickness and interval contiguous scan) temporal bone CT images of 253 ears in 150 patients who had not suffered trauma or undergone surgery. Those with a history of uncomplicated inflammatory disease were included, but those with symptoms of vertigo, sensorineural hearing loss, or facial nerve palsy were excluded. Three radiologists determined the detectability and location of canals for the labyrinthine segment of the facial, superior vestibular and cochlear nerve, and the saccular branch and posterior ampullary nerve of the inferior vestibular nerve. Five bony canals in the fundus of the internal auditory canal were identified as nerve canals. Four canals were identified on axial CT images in 100% of cases; the so-called singular canal was identified in only 68%. On coronal CT images, canals for the labyrinthine segment of the facial and superior vestibular nerve were seen in 100% of cases, but those for the cochlear nerve, the saccular branch of the inferior vestibular nerve, and the singular canal were seen in 90.1%, 87.4% and 78% of cases, respectiveIy. In all detectable cases, the canal for the labyrinthine segment of the facial nerve was revealed as one which traversed anterolateralIy, from the anterosuperior portion of the fundus of the internal auditory canal. The canal for the cochlear nerve was located just below that for the labyrinthine segment of the facial nerve, while that canal for the superior vestibular nerve was seen at the posterior aspect of these two canals. The canal for the saccular branch of the inferior vestibular nerve was located just below the canal for the superior vestibular nerve, and that for the posterior ampullary nerve, the so-called singular canal, ran laterally or posteolateralIy from the posteroinferior aspect of

Nerve canals at the fundus of the internal auditory canal on high-resolution temporal bone CT

Energy Technology Data Exchange (ETDEWEB)

Ji, Yoon Ha; Youn, Eun Kyung; Kim, Seung Chul [Sungkyunkwan Univ., School of Medicine, Seoul (Korea, Republic of)

2001-12-01

To identify and evaluate the normal anatomy of nerve canals in the fundus of the internal auditory canal which can be visualized on high-resolution temporal bone CT. We retrospectively reviewed high-resolution (1 mm thickness and interval contiguous scan) temporal bone CT images of 253 ears in 150 patients who had not suffered trauma or undergone surgery. Those with a history of uncomplicated inflammatory disease were included, but those with symptoms of vertigo, sensorineural hearing loss, or facial nerve palsy were excluded. Three radiologists determined the detectability and location of canals for the labyrinthine segment of the facial, superior vestibular and cochlear nerve, and the saccular branch and posterior ampullary nerve of the inferior vestibular nerve. Five bony canals in the fundus of the internal auditory canal were identified as nerve canals. Four canals were identified on axial CT images in 100% of cases; the so-called singular canal was identified in only 68%. On coronal CT images, canals for the labyrinthine segment of the facial and superior vestibular nerve were seen in 100% of cases, but those for the cochlear nerve, the saccular branch of the inferior vestibular nerve, and the singular canal were seen in 90.1%, 87.4% and 78% of cases, respectiveIy. In all detectable cases, the canal for the labyrinthine segment of the facial nerve was revealed as one which traversed anterolateralIy, from the anterosuperior portion of the fundus of the internal auditory canal. The canal for the cochlear nerve was located just below that for the labyrinthine segment of the facial nerve, while that canal for the superior vestibular nerve was seen at the posterior aspect of these two canals. The canal for the saccular branch of the inferior vestibular nerve was located just below the canal for the superior vestibular nerve, and that for the posterior ampullary nerve, the so-called singular canal, ran laterally or posteolateralIy from the posteroinferior aspect of

Varus femoral osteotomy improves sphericity of the femoral head in older children with severe form of Legg-Calvé-Perthes disease.

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Terjesen, Terje; Wiig, Ola; Svenningsen, Svein

2012-09-01

In the Norwegian prospective study on Legg-Calvé-Perthes disease (LCPD), we found varus femoral osteotomy gave better femoral head sphericity at a mean of 5 years postoperative than physiotherapy in children older than 6.0 years at diagnosis with femoral head necrosis of more than 50%. That study did not include separate analyses for hips with 100% necrosis and those with a percentage of necrosis between 50% and 100%. We asked whether (1) femoral osteotomy improves femoral head sphericity at followup in all patients with more than 50% femoral head necrosis or in selected groups only and (2) there is a critical age between 6.0 and 10.0 years over which femoral osteotomy does not improve the prognosis. We treated 70 patients with unilateral LCPD, age at diagnosis of more than 6.0 years, and femoral head necrosis of more than 50% with varus femoral osteotomy between 1996 and 2000. We classified necrosis using the Catterall classification. We established a control group of 51 similar children who received physiotherapy. At the 5-year followup visit, the hips were graded according to femoral head shape: spherical, ovoid, or flat. At 5-year followup, there was no difference between the treatment groups in radiographic outcome in Catterall Group 3 hips. In Catterall Group 4 hips, femoral head sphericity was better in the osteotomy group, with flat femoral heads in 14% compared to 75% after physiotherapy. The same trend toward better head sphericity occurred when the lateral pillar classification was used. In children aged 6.0 to 10.0 years, in whom the whole femoral head is affected, femoral head sphericity 5 years after femoral osteotomy was better than that after physiotherapy.

Preoperative virtual reduction reduces femoral malrotation in the treatment of bilateral femoral shaft fractures.

Science.gov (United States)

Omar, Mohamed; Suero, Eduardo M; Hawi, Nael; Decker, Sebastian; Krettek, Christian; Citak, Musa

2015-10-01

In bilateral femoral shaft fractures, significant malrotation (>15°) occurs in about 40 % of cases after intramedullary nailing. Most of the methods that provide rotational control during surgery are based on a comparison to the intact femur and, thus, not applicable for bilateral fractures. In this study, we evaluated if preoperative virtual reduction can help improving rotational alignment in patients with bilateral femoral shaft fractures. Seven patients with bilateral femoral shaft fractures were initially treated with external fixation of both femurs. After obtaining a CT scan of both legs, the fractures were reduced virtually using the software program VoXim®, and the amount and direction of rotational correction were calculated. Subsequently, the patients were treated by antegrade femoral nailing and rotation was corrected to the preoperatively calculated amount. After external fixation, the mean rotational difference between both legs was 15.0° ± 10.2°. Four out of seven patients had a significant malrotation over 15°. Following virtual reduction, the mean rotational difference between both legs was 2.1° ± 1.2°. After intramedullary nailing, no case of malrotation occurred and the mean rotational difference was 6.1° ± 2.8°. Preoperative virtual reduction allows determining the pretraumatic femoral antetorsion and provided useful information for the definitive treatment of bilateral femoral shaft fractures. We believe that this procedure is worth being implemented in the clinical workflow to avoid malrotation after intramedullary nailing.

[Trochanteric femoral fractures].

Science.gov (United States)

Douša, P; Čech, O; Weissinger, M; Džupa, V

2013-01-01

At the present time proximal femoral fractures account for 30% of all fractures referred to hospitals for treatment. Our population is ageing, the proportion of patients with post-menopausal or senile osteoporosis is increasing and therefore the number of proximal femoral fractures requiring urgent treatment is growing too. In the age category of 50 years and older, the incidence of these fractures has increased exponentially. Our department serves as a trauma centre for half of Prague and part of the Central Bohemia Region with a population of 1 150 000. Prague in particular has a high number of elderly citizens. Our experience is based on extensive clinical data obtained from the Register of Proximal Femoral Fractures established in 1997. During 14 years, 4280 patients, 3112 women and 1168 men, were admitted to our department for treatment of proximal femoral fractures. All patients were followed up until healing or development of complications. In the group under study, 82% were patients older than 70 years; 72% of those requiring surgery were in their seventies and eighties. Men were significantly younger than women (pfractures were 2.3-times more frequent in women than in men. In the category under 60 years, men significantly outnumbered women (pfractures were, on the average, eight years older than the patients with intertrochanteric fractures, which is a significant difference (pTrochanteric fractures accounted for 54.7% and femoral neck fractures for 45.3% of all fractures. The inter-annual increase was 5.9%, with more trochanteric than femoral neck fractures. There was a non-significant decrease in intertrochanteric (AO 31-A3) fractures. On the other hand, the number of pertrochanteric (AO 31-A1+2) fractures increased significantly (pfractures were treated with a proximal femoral nail; a short nail was used in 1260 and a long nail in 134 of them. A dynamic hip screw (DHS) was employed to treat 947 fractures. Distinguishing between pertrochanteric (21-A1

Effects of Focused Extracorporeal Shock Waves on Bone Marrow Mesenchymal Stem Cells in Patients with Avascular Necrosis of the Femoral Head.

Science.gov (United States)

Zhai, Lei; Sun, Nan; Zhang, Bo; Liu, Shui-Tao; Zhao, Zhe; Jin, Hai-Chao; Ma, Xin-Long; Xing, Geng-Yan

2016-03-01

To observe the effect of extracorporeal shock waves (ESWs) on bone marrow mesenchymal stem cells (MSCs) in patients with avascular necrosis of the femoral head, we collected bone marrow donated by patients and then cultivated and passaged MSCs in vitro using density gradient centrifugation combined with adherence screening methods. The P3 generation MSCs were divided into the ESW group and the control group. The cell counting kit for MSCs detected some proliferation differences. Cytochemistry, alkaline phosphatase staining and Alizarin red staining were used to determine alkaline phosphatase content. Simultaneously, real-time polymerase factor α1, osteocalcin and peroxisome proliferator-activated receptor γ. Together, the results of our study first indicate that moderate ESW intensity, which is instrumental in enhancing MSC proliferation, inducing conversion of MSCs into osteoblasts, and inhibiting differentiation of MSCs into adipocytes from MSCs, is one of the effective mechanisms for treating avascular necrosis of the femoral head. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Scanning electron microscopy investigation of canal cleaning after canal preparation with nickel titanium files

Directory of Open Access Journals (Sweden)

Živković Slavoljub

2010-01-01

Full Text Available Introduction. Root canal preparation is the most important phase of endodontic procedure and it consists of adequate canal space cleaning and shaping. In recent years, rotary instruments and techniques have gained importance because of the great efficacy, speed and safety of the preparation procedure. Objective. The aim of this research was to investigate the influence of different NiTi files on the canal wall cleaning quality, residual dentine debris and smear layer. Methods. The research was conducted on extracted human teeth in vitro conditions. Teeth were divided in 7 main groups depending on the kind of instruments used for root canal preparation: ProTaper, GT, ProFile, K-3, FlexMaster, hand ProTaper and hand GT. Root canal preparation was accomplished by crown-down technique. Prepared samples were assessed on scanning electron microscopy JEOL, JSM-6460 LV. The evaluation of dentine debris was done with 500x magnification, and the evaluation of smear layer with 1,000 times magnification. Quantitive assessment of dentine debris and smear layer was done according to the criteria of Hulsmann. Results. The least amount of debris and smear layer has been found in canals shaped with ProFile instruments, and the largest amount in canals shaped with FlexMaster instruments. Canal cleaning efficacy of hand GT and ProTaper files has been similar to cleaning efficacy of rotary NiTi files. Statistic analysis has shown a significant difference in amount of dentine debris and smear layer on the canal walls between sample groups shaped with different instruments. Conclusion. Completely clean canals have not been found in any tested group of instruments. The largest amount of debris and smear layer has been found in the apical third of all canals. The design and the type of endodontic instruments influence the efficacy of the canal cleaning.

Curved canals: Ancestral files revisited

Directory of Open Access Journals (Sweden)

Jain Nidhi

2008-01-01

Full Text Available The aim of this article is to provide an insight into different techniques of cleaning and shaping of curved root canals with hand instruments. Although a plethora of root canal instruments like ProFile, ProTaper, LightSpeed ® etc dominate the current scenario, the inexpensive conventional root canal hand files such as K-files and flexible files can be used to get optimum results when handled meticulously. Special emphasis has been put on the modifications in biomechanical canal preparation in a variety of curved canal cases. This article compiles a series of clinical cases of root canals with curvatures in the middle and apical third and with S-shaped curvatures that were successfully completed by employing only conventional root canal hand instruments.

Drug eruption (erythema multiforme type) following chemoradiotherapy with mitomycin C and 5-fluorouracil administration for squamous cell carcinoma of the anal canal

International Nuclear Information System (INIS)

Arikawa, Shunji; Uchida, Masafumi; Ogoh, Etsuyo

2010-01-01

We report a case of drug eruption (erythema multiforme type) in a 54-year-old woman, following concurrent chemoradiotherapy for squamous cell carcinoma of the anal canal. Chemotherapy comprised one cycle of mitomycin C 10 mg/m 2 /day (intravenous bolus injection) on day 1 and 5-fluorouracil (5-FU) 1, 000 mg/m 2 /day (continuous intravenous infusion) on days 1-4 of radiotherapy. External irradiation of the pelvic space was performed, using daily fractions of 1.5 Gy (total dose, 33 Gy). From day 4 after chemoradiotherapy, erythema appeared proximal to the forearm site used for drug administration. On day 6, erythema was noted on the trunk, hip and thigh. We suspected erythema multiforme based on the appearance of wheals and target lesions of the skin and a patient history of chemoradiotherapy. Steroids were administered orally, which resolved systemic eruption at week 2. The patient also experienced grade 3 leukocytopenia, neutropenia, thrombopenia, diarrhea, and anorexia. Although we could not provide sufficient chemotherapy and radiation therapy due to severe side effects, squamous cell carcinoma of the anal canal responded extremely well with a marked decrease in complete response. We surmise that the drug eruption was associated with 5-FU. Concurrent chemoradiotherapy is safe and effective for squamous cell carcinoma of the anal canal, but care is required to prevent drug eruption during treatment. (author)

Vertically transmitted HPV-dependent squamous cell carcinoma of the external auditory canal. Case report of a child

International Nuclear Information System (INIS)

Snietura, Miroslaw; Pakulo, Slawomir; Kopec, Agnieszka; Piglowski, Wojciech; Stanek-Widera, Agata; Chelmecka-Wiktorczyk, Liliana; Drabik, Grazyna; Kosowski, Bogdan; Wyrobek, Lukasz; Balwierz, Walentyna

2017-01-01

There is much evidence that high-risk human papillomavirus (HPV) plays a causative role in a subset of head and neck squamous cell cancer (HNSCC) in adults. HPV-positive tumors behave differently even in their response to treatment and are therefore a distinct subset. Both HPV-positive and HPV-negative tumors of the head and neck region are usually in the domain of adults and cases in children are rare; thus when a 2-year-old child was diagnosed with this cancer in the external auditory canal, an in-depth assessment of the tumor was considered necessary. A 2-year-old girl was born to a HPV-positive mother who was diagnosed with cervical cancer during pregnancy. The child was delivered by caesarean section and the mother died of her cancer 7 months after delivery. After the diagnosis of locally invasive HPV-positive squamous cell cancer of the external auditory canal, the child was treated surgically, and with chemotherapy and radiotherapy. Full remission was obtained lasting up to 325 weeks since treatment was started, resulting in over 6 years of disease-free survival. This is the first case of advanced, HPV-related HNSCC in a 2-year-old child, in whom the tumor was located in the external auditory canal and who made a dramatic recovery after treatment with nonradical surgery, chemotherapy and radiotherapy. The child has currently been disease free for 6 years. This case supports the observation that HPV-related HNSCC tumors appear to respond favorably to treatment despite the patient's young age and the clinically advanced stage of the tumor. (orig.) [de

Endogenous neural stem cells in central canal of adult rats acquired limited ability to differentiate into neurons following mild spinal cord injury

Science.gov (United States)

Liu, Yuan; Tan, Botao; Wang, Li; Long, Zaiyun; Li, Yingyu; Liao, Weihong; Wu, Yamin

2015-01-01

Endogenous neural stem cells in central canal of adult mammalian spinal cord exhibit stem cell properties following injury. In the present study, the endogenous neural stem cells were labeled with Dil to track the differentiation of cells after mild spinal cord injury (SCI). Compared with 1 and 14 days post mild injury, the number of endogenous neural stem cells significantly increased at the injured site of spinal cord on 3 and 7 days post-injury. Dil-labeled βIII-tublin and GFAP expressing cells could be detected on 7 days post-injury, which indicated that the endogenous neural stem cells in central canal of spinal cord differentiated into different type of neural cells, but there were more differentiated astrocytes than the neurons after injury. Furthermore, after injury the expression of inhibitory Notch1 and Hes1 mRNA began to increase at 6 hours and was evident at 12 and 24 hours, which maintained high levels up to 7 days post-injury. These results indicated that a mild SCI in rat is sufficient to induce endogenous neural stem cells proliferation and differentiation. However, the ability to differentiate into neurons is limited, which may be, at least in part, due to high expression of inhibitory Notch1 and Hes1 genes after injury. PMID:26097566

To study the role of dynamic magnetic resonance imaging in assessing the femoral head vascularity in intracapsular femoral neck fractures

Energy Technology Data Exchange (ETDEWEB)

Kaushik, Abhishek, E-mail: abhiortho27@gmail.co [Department of Orthopedics, 513, Thermal Colony, Sector-22, Faridabad 121005, Haryana (India); Sankaran, Balu; Varghese, Mathew [Department of Orthopedics, St Stephen' s Hospital, Tis hazari, Delhi, New Delhi 110054 (India)

2010-09-15

Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity after femoral neck fracture are 87%, 88% and 87%, respectively. Type A or Type B curve pattern is a positive factor to successful osteosynthesis with p value <0.0001 (Chi-square test). This is a statistically significant value. From this finding it can be suggested that the reliability of dynamic curves A and B in predicting maintained vascularity of femoral head is high. This investigation can be used to predict the vascularity of femoral head after intracapsular femoral neck fractures. There was a good correlation between the outcomes of fractures and dynamic MRI curves done within 48 h of injury. This signifies the role of dynamic MRI in predicting the vascularity of femoral head as early as 48 h. A treatment algorithm can be suggested on the basis of dynamic MRI curves. The fractures with Type C dynamic curve should be considered as fractures with poor vascularity of femoral head and measures to enhance the vascularity of femoral head along with rigid internal fixation should be undertaken to promote

To study the role of dynamic magnetic resonance imaging in assessing the femoral head vascularity in intracapsular femoral neck fractures

International Nuclear Information System (INIS)

Kaushik, Abhishek; Sankaran, Balu; Varghese, Mathew

2010-01-01

Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity after femoral neck fracture are 87%, 88% and 87%, respectively. Type A or Type B curve pattern is a positive factor to successful osteosynthesis with p value <0.0001 (Chi-square test). This is a statistically significant value. From this finding it can be suggested that the reliability of dynamic curves A and B in predicting maintained vascularity of femoral head is high. This investigation can be used to predict the vascularity of femoral head after intracapsular femoral neck fractures. There was a good correlation between the outcomes of fractures and dynamic MRI curves done within 48 h of injury. This signifies the role of dynamic MRI in predicting the vascularity of femoral head as early as 48 h. A treatment algorithm can be suggested on the basis of dynamic MRI curves. The fractures with Type C dynamic curve should be considered as fractures with poor vascularity of femoral head and measures to enhance the vascularity of femoral head along with rigid internal fixation should be undertaken to promote

Femoral head avascular necrosis

International Nuclear Information System (INIS)

Chrysikopoulos, H.; Sartoris, D.J.; Resnick, D.L.; Ashburn, W.; Pretorius, T.

1988-01-01

MR imaging has been shown to be more sensitive and specific than planar scintigraphy for avascular necrosis (AVN) of the femoral head. However, experience with single photon emission CT (SPECT) is limited. The authors retrospectively compared 1.5-T MR imaging with SPECT in 14 patients with suspected femoral head AVN. Agreement between MR imaging and SPECT was present in 24 femurs, 14 normal and ten with AVN. MR imaging showed changes of AVN in the remaining four femoral heads. Of these, one was normal and the other three inconclusive for AVN by SPECT. The authors conclude that MR imaging is superior to SPECT for the evaluation of AVN of the hip

Femoral revision with impaction allografting and an uncemented femoral component

DEFF Research Database (Denmark)

Nickelsen, T N; Erenbjerg, M; Retpen, J B

2008-01-01

A technique for uncemented revision of the femoral component which combines impaction allografting and the use of a long-stemmed proximally coated titanium prostheses (Bimetric, Biomet Inc.) is described. The results after a mean follow-up of 112 months are reported. From 1991 to 1995 femoral...... implants 88% had no pain, 10% had slight pain and only 2% had severe pain. Thirty-eight patients had radiographic signs of remodelling of the graft and/or cortical repair. In cases with a successful outcome, the results have been encouraging in relation to clinical performance, regeneration of bone...

Avascular Necrosis of the Femoral Head: Are Any Genes Involved?

Science.gov (United States)

Pouya, Farzaneh; Kerachian, Mohammad Amin

2015-01-01

Avascular necrosis of the femoral head (ANFH) is a pathologic process that results from interruption of blood supply to the femur bone resulting in the death of bone cells and collapse of the femoral head. Nontraumatic ANFH continues to be a significant challenge to orthopedic surgeons. While the exact mechanisms remain elusive, many new insights have emerged from research in the last decade that has given us a clearer picture of the pathogenesis of nontraumatic ANFH. Progression to the end stage of ANFH appears to be related to five main mechanisms: hypercoagulable conditions, angiogenesis suppressions, hyperadipogenesis, heritable states, and switching the bone remodelling into bone resorption. Researchers have been examining the pathogenic mechanisms of ANFH but none of these theories have been firmly confirmed although some appear more plausible than the others. All of these factors can switch bone remodelling into bone resorption, which can further lead to ANFH progression ending up to femoral head collapse. PMID:26213697

[Ex vivo microCT analysis of possible microfractures of the femoral head during implantation of a cementless hip resurfacing femoral component].

Science.gov (United States)

Lerch, M; Olender, G; von der Höh, N; Thorey, F; von Lewinski, G; Meyer-Lindenberg, A; Windhagen, H; Hurschler, C

2009-01-01

Microfractures of the femoral head during implantation of the femoral components are suspected to be a cause of fractures at the implant/neck junction which represent a common failure mode in hip resurfacing arthroplasty. Callus formation observed in femoral head retrievals suggests the occurrence of microfractures inside the femoral head, which might be inadvertently caused by the surgeon during implantation. The aim of this biomechanical study was to analyse whether or not the implantation of a cementless femoral component hip resurfacing system causes microfractures in the femoral head. After the preparation of 20 paired human cadaveric femoral heads, the cementless femoral component ESKA Typ BS (ESKA Implants GmbH & Co., Lübeck) was implanted on 9 specimens with an impaction device that generates 4.5 kN impaction force. On 9 specimens the femoral component was implanted by hand. One head was used as a fracture model, 1 specimen served as control without manipulation. The femoral component used for impaction was equipped with hinges to enable its removal without further interfering with the bone stock. Specimens were scanned with a microCT device before and after impaction and the microCT datasets before and after impaction were compared to identify possible microfractures. Twenty strikes per hand or with the impaction device provided sufficient implant seating. Neither the macroscopic examination nor the 2-dimensional microCT analysis revealed any fractures of the femoral heads after impaction. At least macroscopically and in the 2-dimensional microCT analysis, implantation of the cementless hip resurfacing femoral component ESKA Typ BS with 4.5 kN or by hand does not seem to cause fractures of the femoral head. Georg Thieme Verlag KG Stuttgart, New York.

Endoscopic root canal treatment.

Science.gov (United States)

Moshonov, Joshua; Michaeli, Eli; Nahlieli, Oded

2009-10-01

To describe an innovative endoscopic technique for root canal treatment. Root canal treatment was performed on 12 patients (15 teeth), using a newly developed endoscope (Sialotechnology), which combines an endoscope, irrigation, and a surgical microinstrument channel. Endoscopic root canal treatment of all 15 teeth was successful with complete resolution of all symptoms (6-month follow-up). The novel endoscope used in this study accurately identified all microstructures and simplified root canal treatment. The endoscope may be considered for use not only for preoperative observation and diagnosis but also for active endodontic treatment.

A Morphological Insight of the Femoral Vein

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Ferreira AH

2015-10-01

Full Text Available A total of 13 cadavers (12 men and 1 women of different age group were used for the study with the purpose to determine the prevalence of femoral vein duplication. Lower limb regions (26 sides were carefully dissected as per the standard dissection procedure. Femoral vein (unitruncular was found in 96.15% of specimen. Bitruncular configurations (total bifidity was found in a male cadaver of 75 years of age (3.85%. In the right lower limb, 6.5 cms below the inguinal ligament the femoral vein - lateral ramus received the lateral circumflex femoral vein, and the medial circumflex femoral vein, and the lateral and medial ramii formed a common venous trunk. Knowledge of the truncular venous variations is important to recognize and avoid potential errors in diagnosis of deep venous thrombosis of the femoral vein, in the case of an occluded duplicated trunk.

A tissue engineering strategy for the treatment of avascular necrosis of the femoral head.

Science.gov (United States)

Aarvold, A; Smith, J O; Tayton, E R; Jones, A M H; Dawson, J I; Lanham, S; Briscoe, A; Dunlop, D G; Oreffo, R O C

2013-12-01

Skeletal stem cells (SSCs) and impaction bone grafting (IBG) can be combined to produce a mechanically stable living bone composite. This novel strategy has been translated to the treatment of avascular necrosis of the femoral head. Surgical technique, clinical follow-up and retrieval analysis data of this translational case series is presented. SSCs and milled allograft were impacted into necrotic bone in five femoral heads of four patients. Cell viability was confirmed by parallel in vitro culture of the cell-graft constructs. Patient follow-up was by serial clinical and radiological examination. Tissue engineered bone was retrieved from two retrieved femoral heads and was analysed by histology, microcomputed tomography (μCT) and mechanical testing. Three patients remain asymptomatic at 22- to 44-month follow-up. One patient (both hips) required total hip replacement due to widespread residual necrosis. Retrieved tissue engineered bone demonstrated a mature trabecular micro-architecture histologically and on μCT. Bone density and axial compression strength were comparable to trabecular bone. Clinical follow-up shows this to be an effective new treatment for focal early stage avascular necrosis of the femoral head. Unique retrieval analysis of clinically translated tissue engineered bone has demonstrated regeneration of tissue that is both structurally and functionally analogous to normal trabecular bone. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Decreased levels of matrix metalloproteinase-2 in root-canal exudates during root canal treatment.

Science.gov (United States)

Pattamapun, Kassara; Handagoon, Sira; Sastraruji, Thanapat; Gutmann, James L; Pavasant, Prasit; Krisanaprakornkit, Suttichai

2017-10-01

To determine the matrix metalloproteinase-2 (MMP-2) levels in root-canal exudates from teeth undergoing root-canal treatment. The root-canal exudates from six teeth with normal pulp and periradicular tissues that required intentional root canal treatment for prosthodontic reasons and from twelve teeth with pulp necrosis and asymptomatic apical periodontitis (AAP) were sampled with paper points for bacterial culture and aspirated for the detection of proMMP-2 and active MMP-2 by gelatin zymography and the quantification of MMP-2 levels by ELISA. By gelatin zymography, both proMMP-2 and active MMP-2 were detected in the first collection of root-canal exudates from teeth with pulp necrosis and AAP, but not from teeth with normal pulp, and their levels gradually decreased and disappeared at the last collection. Consistently, ELISA demonstrated a significant decrease in MMP-2 levels in the root-canal exudates of teeth with pulp necrosis and AAP following root canal procedures (papical lesions, similar to the clinical application of MMP-8 as a biomarker. Copyright © 2017 Elsevier Ltd. All rights reserved.

Subtrochanteric Femoral Fracture during Trochanteric Nailing for the Treatment of Femoral Shaft Fracture

OpenAIRE

Yun, Ho Hyun; Oh, Chi Hun; Yi, Ju Won

2013-01-01

We report on three cases of subtrochanteric femoral fractures during trochanteric intramedullary nailing for the treatment of femoral shaft fractures. Trochanteric intramedullary nails, which have a proximal lateral bend, are specifically designed for trochanteric insertion. When combined with the modified insertion technique, trochanteric intramedullary nails reduce iatrogenic fracture comminution and varus malalignment. We herein describe technical aspects of trochanteric intramedullary nai...

Femoral shaft fractures

International Nuclear Information System (INIS)

Bender, C.E.; Campbell, D.C. II

1985-01-01

The femur is the longest, largest, and strongest bone in the body. Because of its length, width, and role as primary weight-bearing bone, it must tolerate the extremes of axial loading and angulatory stresses. Massive musculature envelopes the femur. This masculature provides abundant blood supply to the bone, which also allows great potential for healing. Thus, the most significant problem relating to femoral shaft fractures is not healing, but restoration of bone length and alignment so that the femoral shaft will tolerate the functional stresses demanded of it

Functional morphology of femoral glands in the Tegu lizard, Tupinambis merianae.

Science.gov (United States)

Chamut, Silvia; Valdez, Valeria García; Manes, Mario E

2009-04-01

Several lizards have femoral glands, which have an influence in various reproductive behaviors. In this paper we describe the morphological organization of the femoral glands in the Tegu, Tupinambis merianae, by means of light and electron microscopy. Even though these glands are present in both genders, secretions during the reproductive period can only be found in males. The glandular parenchyma, which is organized in numerous secretory units, consists of keratinocyte-like cells and granular cells. The holocrine secretion is constituted from both cells, which lose their integrity and become a semi-amorphous material, reinforced by keratin sheets. The discharges of each unit merge together into a solid cylinder of secretion, surrounded by epithelial cells, that is extruded to the exterior. The keratin sheets and epithelial layers that surround both the complete and partial secretions form a sort of structural support suitable for the type of territorial demarcation characteristic of the species. The granular cells, supposedly the producers of pheromones, are characterized by the presence of electron-dense granules and multilaminar membranous bodies that show ultrastructural changes of unknown function. The free granules in the secretion cylinder may act as pheromone deposits.

Predicting the Effects of Man-Made Fishing Canals on Floodplain Inundation - A Modelling Study

Science.gov (United States)

Shastry, A. R.; Durand, M. T.; Neal, J. C.; Fernandez, A.; Hamilton, I.; Kari, S.; Laborde, S.; Mark, B. G.; Arabi, M.; Moritz, M.; Phang, S. C.

2016-12-01

The Logone floodplain in northern Cameroon is an excellent example of coupled human-natural systems because of strong couplings between the social, ecological and hydrologic systems. Overbank flow from the Logone River in September and October is essential for agriculture and fishing livelihoods. Fishers dig canals to catch fish during the flood's recession to the river in November and December by installing nets at the intersection of canals and the river. Fishing canals connect the river to natural depressions in the terrain and may serve as a man-made extension of the river drainage network. In the last four decades, there has been an exponential increase in the number of canals which may affect flood hydraulics and the fishery. The goal of this study is to characterize the relationship between the fishing canals and flood dynamics in the Logone floodplain, specifically, parameters of flooding and recession timings and the duration of inundation. To do so, we model the Bara region ( 30 km2) of the floodplain using LISFLOOD-FP, a two-dimensional hydrodynamic model with sub-grid parameterizations of canals. We use a simplified version of the hydraulic system at a grid-cell size of 30-m, using synthetic topography, parameterized fishing canals, and representing fishnets as a combination of weir and mesh screens. The inflow at Bara is obtained from a separate, lower resolution (1-km grid-cell) model forced by daily discharge records obtained from Katoa, located 25-km upstream of Bara. Preliminary results show more canals lead to early recession of flood and a shorter duration of flood inundation. A shorter duration of flood inundation reduces the period of fish growth and will affect fisher catch returns. Understanding the couplings within the system is important for predicting long-term dynamics and the impact of building more fishing canals.

Closed retrograde retrieval of the distal broken segment of femoral cannulated intramedullary nail using a ball-tipped guide wire.

Science.gov (United States)

Metikala, Sreenivasulu; Mohammed, Riazuddin

2011-07-01

Extracting broken segments of intramedullay nails from long bones can be an operative challenge, particularly from the distal end. We report a case series where a simple and reproducible technique of extracting broken femoral cannulated nails using a ball-tipped guide wire is described. This closed technique involves no additional equipment or instruments. Eight patients who underwent the described method were included in the study. The technique involves using a standard plain guide wire passed through the cannulated distal broken nail segment after extraction of the proximal nail fragment. The plain guide wire is then advanced distally into the knee joint carefully under fluoroscopy imaging. Over this wire, a 5-millimeter (mm) cannulated large drill bit is used to create a track up to the distal broken nail segment. Through the small knee wound, a ball-tipped guide wire is passed, smooth end first, till the ball engages the end of the nail. The guide wire is then extracted along with the broken nail through the proximal wound. The method was successfully used in all eight patients for removal of broken cannulated intramedullary nail from the femoral canal without any complications. All patients underwent exchange nailing with successful bone union in six months. None of the patients had any problems at the knee joint at the final follow-up. We report a technique for successful extraction of the distal fragment of broken femoral intramedullary nails without additional surgical approaches.

Subchondral insufficiency fractures of the femoral head

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Davies, M.; Cassar-Pullicino, V.N. [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom); Darby, A.J. [Department of Pathology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom)

2004-02-01

The aim of this study was to increase awareness of, and to show the variable clinical and radiological features of, subchondral insufficiency fractures of the femoral head. The clinical and radiological findings in 7 patients with subchondral insufficiency fractures of the femoral head were reviewed retrospectively. The diagnosis was confirmed histologically in 4 patients. Radiographs were performed in all patients, MRI in 5 and scintigraphy in 4 patients. Radiographs showed varying degrees of femoral head collapse in 4 patients. In the remaining 3 patients radiographs showed a normal femoral head, regional osteoporosis and focal sclerosis, respectively. Magnetic resonance imaging showed a low-signal band on T1- and T2-weighted images in the subchondral bone adjacent or parallel to the articular surface associated with bone marrow oedema. Scintigraphy showed increased uptake in the femoral head. Insufficiency fractures of the femoral head are easily overlooked or confused with avascular necrosis and, when there is significant joint destruction, osteoarthritis. Unsuspected insufficiency fracture of the femoral head can lead to significant and rapid loss of bone stock in osteoporotic patients waiting for arthroplasty for osteoarthritis. Increased awareness of this condition will hopefully lead to earlier diagnosis and a successful outcome of conservative treatment. (orig.)

Effectiveness of EDTA as the irrigation solution to remove smear layer in root canal

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Kurniasri Amas Achiar

2009-07-01

Full Text Available One of the objectives of successful endodontic treatment is the hermetic obturation of the root canal system. To achieve this, the root canal filling must seal the canal space both apically and coronally to prevent the ingress of microorganisms or tissue fluids into the canal space. Apical leakage is reported a common reason for the clinical failure of endodontic therapy. Leakage through an obturated root canal is expected to take place at interfaces between sealer and dentin or sealer and gutta-percha, or through voids within the sealer. Hence, the sealing quality of root canal filling depends much on the sealing ability of the sealer. Therefore, anything that may influence the adaptation of the root filling to the canal wall is can determine the degree and the extent of leakage, and ultimately the prognosis of the endodontic therapy. In endodontic therapy, the smear layer formation results from root canal preparation and may influence the effective seal of the root canal system. The smear layer formation is mainly composed of inorganic components (dentin debris and organic materials, such as pulp tissue remnant, bacteria, and blood cells. Removal of the smear layer from the root canal walls before the obturation can reduce the leakage of root canal sealer. To remove the smear layer use 10 ml 17% EDTA followed by 10 ml of 5.25% NaOCl as irrigating solution. This paper discribe about how the effectivity of EDTA as irigating solution to remove the smear layer especially in the apical root canal with many lateral canal to reduce the apical leakage.

Design of canals

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Swamee, P K

2015-01-01

The book presents firsthand material from the authors on design of hydraulic canals. The book discusses elements of design based on principles of hydraulic flow through canals. It covers optimization of design based on usage requirements and economic constraints. The book includes explicit design equations and design procedures along with design examples for varied cases. With its comprehensive coverage of the principles of hydraulic canal design, this book will prove useful to students, researchers, and practicing engineers. End-of-chapter pedagogical elements make it ideal for use in graduate courses on hydraulic structures offered by most civil engineering departments across the world.

Case report: AVN of the femoral head five year follow-up of the combination of ipsilateral femoral neck and sub-trochanteric fracture.

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Zhang, Wei; Zhu, Feng; Dong, Hanqing; Xu, Yaozeng

2016-04-01

To our knowledge, the type of combination of ipsilateral femoral neck and sub-trochanteric fracture is rare. And the long term follow-up is seldom been reported. A 60 year old woman suffered from a traffic accident. We gave her the intramedullary nail treatment for the combination of ipsilateral femoral neck and sub-trochanteric fracture, and the fracture indeed cured after one year and there is no clue of necrosis of the femoral head, but after 5 years, there is an evidence of necrosis of the femoral head. Combination of ipsilateral femoral neck and sub-trochanteric fracture should be kept in mind. Patients with this unusual fracture should be kept under surveillance for longer than might be thought currently to be necessary for there is a possibility of necrosis of the femoral head, even a nondisplaced femoral neck fracture.

Fracturing of revision of a cobalt-chrome femoral head after fracturing of a ceramic femoral head, with diffuse metallosis. Case report

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Pedro Miguel Dantas Costa Marques

2013-04-01

Full Text Available We presente a case of a fracture of a cobalt-chrome femoral head after revision of a hip total prosthesis with ceramic femoral head fracture. During surgery we found the cobalt-chrome femoral head fracture, wear of the polyethylene and massive metallosis in muscular and cartilaginous tissue. Both femoral stem and acetabular cup were stable and without apparent wearing. After surgical debridement, we promoted the substitution of the femoral head and the acetabular polyethylene by similar ones. After 12 months of follow-up, the patient has no pain complaints, function limit or systemic signs associated with malign metallosis

The circulation of the cerebrospinal fluid (CSF) in the spinal canal

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Sanchez, Antonio L.; Martinez-Bazan, Carlos; Lasheras, Juan C.

2016-11-01

Cerebrospinal Fluid (CSF) is secreted in the choroid plexus in the lateral sinuses of the brain and fills the subarachnoid space bathing the external surfaces of the brain and the spinal canal. Absence of CSF circulation has been shown to impede its physiological function that includes, among others, supplying nutrients to neuronal and glial cells and removing the waste products of cellular metabolism. Radionuclide scanning images published by Di Chiro in 1964 showed upward migration of particle tracers from the lumbar region of the spinal canal, thereby suggesting the presence of an active bulk circulation responsible for bringing fresh CSF into the spinal canal and returning a portion of it to the cranial vault. However, the existence of this slow moving bulk circulation in the spinal canal has been a subject of dispute for the last 50 years. To date, there has been no physical explanation for the mechanism responsible for the establishment of such a bulk motion. We present a perturbation analysis of the flow in an idealized model of the spinal canal and show how steady streaming could be responsible for the establishment of such a circulation. The results of this analysis are compared to flow measurements conducted on in-vitro models of the spinal canal of adult humans.

An unusual and spectacular case of spindle cell lipoma of the posterior neck invading the spinal cervical canal and posterior cranial fossa.

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Petit, Damien; Menei, Philippe; Fournier, Henri-Dominique

2011-11-01

The authors describe the first case of spindle cell lipoma of the posterior neck invading the upper cervical spinal canal and the posterior cranial fossa. Spindle cell lipoma is an extremely rare variant of benign lipoma. It usually occurs as a solitary subcutaneous well-circumscribed lesion in the posterior neck or shoulders of adult men. Local aggressiveness is unusual. This 61-year-old man presented with an increased left cerebellar syndrome and headaches. He also had a posterior neck tumefaction, which had been known about for a long time. Computed tomography and MR imaging studies revealed a voluminous mass extending to the upper cervical canal and posterior cranial fossa and eroding the neighboring bones. The lesion was well delimited, and contrast enhancement was intense and heterogeneous. The tumor, which had initially developed under the muscles of the posterior neck, was totally resected. Histological assessment revealed numerous fat cells with spindle cells secreting collagen. The large size of the tumor and the submuscular location, bone erosion, and compression of the CNS were unusual in this rare subtype of benign adipose tumor. Its presentation could simulate a sarcoma.

An evaluation of canal curvature at the apical one third in type II mesial canals of mandibular molars

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Hye-Rim Yun

2012-05-01

Full Text Available Objectives The purpose of this study was to evaluate the buccolingual curvature at the apical one third in type II mesial canals of mandibular molars using the radius and angle of curvature. Materials and Methods Total 100 mandibular molars were selected. Following an endodontic access in the teeth, their distal roots were removed. #15 H- or K-files (Dentsply Maillefer were inserted into the mesiobuccal and mesiolingual canals of the teeth. Radiographs of the teeth were taken for the proximal view. Among them, type II canals were selected and divided into two subgroups, IIa and IIb. In type IIa, two separate canals merged into one canal before reaching the apex and in type IIb, two separate canals merged into one canal within the apical foramen. The radius and angle of curvature of specimens were examined. Results In type II, mean radius of curvature in mesiolingual and mesiobuccal canals were 2.82 mm and 3.58 mm, respectively. The radius of the curvature of mesiolingual canals were significantly smaller than that of mesiobuccal canals in type II, and especially in type IIa. However, there were no statistically significant differences in radius of curvature between mesiobuccal and mesiolingual canals in type IIb and there were no significant differences in angle of curvature between type IIa and IIb. Conclusion In this study, type II mesial canals of mandibular molars showed severe curvature in the proximal view. Especially, mesiolingual canals of type IIa had more abrupt curvature than mesiobuccal canals at the apical one third.

Femoral shaft bowing in the coronal plane has more significant effect on the coronal alignment of TKA than proximal or distal variations of femoral shape.

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Kim, Jong-Min; Hong, Soo-Heon; Kim, Jong-Min; Lee, Bum-Sik; Kim, Dong-Eun; Kim, Kyung-Ah; Bin, Seong-Il

2015-07-01

The aim of this study was to determine (1) variations in the shape of the proximal, middle, and distal femur in a series of Korean patients who had undergone total knee arthroplasty (TKA), (2) the preoperative relationship between these three parameters and the distal valgus cutting angle referenced off the femoral intramedullary guide, and (3) whether there was any relationship between femoral bowing and variations in the shape of the proximal or distal femur in the coronal plane. The preoperative long-standing anteroposterior radiographs of 316 consecutive osteoarthritis patients who underwent primary TKA from 2009 to 2011 were examined. The femoral neck shaft angle, the femoral shaft bowing angle, and the mechanical lateral distal femoral angle were measured to assess the shape of the proximal, middle, and distal femur, respectively. The valgus cutting angle of the femur was defined as the angle between the distal anatomical and mechanical axes of the femur. The study population showed large variations in femoral shape. The mean femoral intramedullary guide angle was 6.5° ± 1.3° (range: 4°-13°). The femoral shaft bowing angle was the factor that showed the strongest correlation with this angle (P shaft angle showed no correlation (n.s.). The femoral shaft bowing angle showed a weak correlation with the mechanical lateral distal femoral angle (P = 0.001), but was not significantly correlated with the femoral neck shaft angle (n.s.). Apparent femoral bowing (>3° of lateral or medial bowing) was found in 42 (13.3 %) of cases (37 cases of lateral bowing and five of medial bowing). Cases with lateral apparent femoral bowing >3° had a distal cutting angle of 8.6° ± 2.2° relative to the femoral intramedullary guide. The femoral intramedullary guide angle was mainly influenced by femoral shaft bowing among femoral deformities in the coronal plane. Therefore, to increase the accuracy of distal femoral cut during TKA, it is necessary to confirm femoral

Slipped capital femoral epiphysis: A modern treatment protocol

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Slavković Nemanja

2009-01-01

Full Text Available The treatment of a patient with slipped capital femoral epiphysis begins with an early diagnosis and accurate classification. On the basis of symptom duration, clinical findings and radiographs, slipped capital femoral epiphysis is classified as pre-slip, acute, acute-on-chronic and chronic. The long-term outcome of slipped capital femoral epiphysis is directly related to severity and the presence or absence of avascular necrosis and/or chondrolysis. Therefore, the first priority in the treatment of slipped capital femoral epiphysis is to avoid complications while securing the epiphysis from further slippage. Medical treatment of patients with acute and acute-on-chronic slipped capital femoral epiphysis, as well as those presented in pre-slip stage, is the safest, although time-consuming. Manipulations, especially forced and repeated, are not recommended due to higher avascular necrosis risk. The use of intraoperative fluoroscopy to assist in the placement of internal fixation devices has markedly increased the success of surgical treatment. Controversy remains as to whether the proximal femoral epiphysis in severe, chronic slipped capital femoral epiphysis should be realigned by extracapsular osteotomies or just fixed in situ. The management protocol for slipped capital femoral epiphysis depends on the experience of the surgeon, motivation of the patient and technical facilities.

Frequency of ipsilateral femoral neck fractures in patients with ...

African Journals Online (AJOL)

Background: Ipsilateral associated femoral neck and shaft fractures are reported to occur in 2.5-6% of all femoral shaft fractures. Objective: To establish the frequency of ipsilateral femoral neck fractures amongst all patients presenting with femoral shaft fractures in Mulago Hospital. Methodology: This was a descriptive ...

[Continuous observation of canal aberrations in S-shaped simulated root canal prepared by hand-used ProTaper files].

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Xia, Ling-yun; Leng, Wei-dong; Mao, Min; Yang, Guo-biao; Xiang, Yong-gang; Chen, Xin-mei

2009-08-01

To observe the formation of canal aberrations in S-shaped root canals prepared by every file of hand-used ProTaper. Fifteen S-shaped simulated resin root canals were selected. Each root canal was prepared by every file of hand-used ProTaper following the manufacturer instruction. The images of canals prepared by S1, S2, F1, F2 and F3 were taken and stored, which were divided into group S1, S2, F1, F2 and F3. One image of canal unprepared was superposed with the images of the same root canal in these five groups respectively to observe the types and number of canal aberrations, which included unprepared area, danger zone, ledge, elbow, zip and perforation. SPSS12.0 software pakage was used for Fisher's exact probabilities in 2x2 table. Unprepared area decreased following preparation by every file of ProTaper, but it still existed when the canal preparation was finished. The incidence of danger zone, elbow and zip in group F1 was 15/15, 11/15, 4/15, respectively, which was significantly higher than that in group S2(2/15,0,0) (PProTaper.The presence of unprepared area suggests that it is essential to rinse canal abundantly during complicated canal preparation and canal antisepsis after preparation.

Anatomic study on mental canal and incisive nerve canal in interforaminal region in Chinese population.

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Xu, Yun; Suo, Ning; Tian, Xiufen; Li, Fei; Zhong, Guangxin; Liu, Xiaoran; Bao, Yongxing; Song, Tao; Tian, Hua

2015-08-01

This study was aimed to detect the positions of mental canal and incisive nerve canal as well as the prolongation of mandibular canal in interforaminal region in Chinese population to supply the reference data of the surgical safe zone in chin for clinicians. A total of 80 formalin-fixed semi-mandibles of Chinese adult cadavers were dissected, the positions and courses of mental canal and incisive nerve canal as well as the prolongation of mandibular canal in interforaminal region were measured. The mental foramina were present in all cases (100 %), and most of them were located below 2nd premolar (58.75 %). Accessory mental foramina were observed in 5 %. The anterior end of mandibular canal, extending along the course of 7.37 ± 1.10 mm above the lower border of mandible to interforaminal region about 3.54 ± 0.70 mm medial to the mental foramen, most often ended below between the two premolars (73.75 %), where it continued as the incisive nerve canal (100 %) and the mental canal (96.25 %). Mental canal, with the wall formed by compact bone, being 2.60 ± 0.60 mm in diameter and 4.01 ± 1.20 mm in length, opened into mental foramen. Incisive nerve canal, with the wall formed by thin compact bone and/or partly or completely by spongy bone, being 1.76 ± 0.27 mm in diameter and 24.87 ± 2.23 mm in length, extended to the incisor region along the course of 9.53 ± 1.43 mm above the lower border of mandible, and most often ended below the lateral incisor (70.00 %). This research recommended for chin operations in Chinese population: the surgical safe zone could be set in the region about over 4 mm anterior to the mental foramen, and over 12 mm above inferior border of mandible for anterior alveolar surgery, or within 9 mm above inferior border of mandible for genioplasty.

Experimental and clinical stuties on microcirculation disturbance in the hormonal avascular necrosis of femoral head

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Shen Xiaowen

2007-01-01

Objective: To find the correlation factors with microcirculation disturbance by animal and clinic exprements; making clear of the pathogenetic mechanism; and providing theoritical evidence for prevention and treatment of the disease. Methods: The rabbits femoral head avascular necrosis models were induced and created by corticoid steroids. The microcirculation including capillary blood flow rate, blood viscosity, blood ingredients and histopathologic change were studied comparatively between the experimental and the control groups in order to explore the correlative factors of the incidence and proper clinical treatment. Results: The expremental group showed intracappillary blood cells aggregation, obviously slow down of blood flow, increase of serum cholesterol and protein, together with decrease of femoral head capillary vasculation. The effective rate for hormone induced femoral head avaseular necrosis through anticoagulation and promotion of microvascular circulation reached 93.75%. Conclusion: Hormone induced femoral head avascular necrosis is a kind of microcirculation disturbance disease. (authors)

Periapical repair after root canal filling with different root canal sealers.

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Tanomaru-Filho, Mário; Tanomaru, Juliane Maria Guerreiro; Leonardo, Mario Roberto; da Silva, Lea Assed Bezerra

2009-01-01

The aim of this study was to evaluate periapical repair after root canal filling with different endodontic sealers. Sixty-four root canals from dog s teeth were filled, divided into 4 groups (n=16). Root canals were instrumented with K-type files and irrigated with 1% sodium hypochlorite solution. Root canals were filled in the same session by active lateral condensation of the cones and sealers: Intrafill, AH Plus, Roeko Seal and Resilon/Epiphany System. After 90 days, the animals were euthanized and the tissues to be evaluated were processed and stained with hematoxylin and eosin. For histopathological analysis, the following parameters were evaluated: inflammatory process, mineralized tissue resorption, and apical mineralized tissue deposition. Histopathological analysis demonstrated that Intrafill had less favorable results in terms of apical and periapical repair, compared to the other sealers (p0.05). In conclusion, AH Plus and the materials Roeko Seal and Epiphany are good options for clinical use in Endodontics.

A comparative evaluation of the increase in root canal surface area and canal transportation in curved root canals by three rotary systems: A cone-beam computed tomographic study

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Prasanthi, Nalam NVD; Rambabu, Tanikonda; Sajjan, Girija S; Varma, K Madhu; Satish, R Kalyan; Padmaja, M

2016-01-01

Aim: The aim of this study was to measure the increase in root canal surface area and canal transportation after biomechanical preparation at 1, 3, and 5 mm short of the apex with three different rotary systems in both continuous rotary and reciprocating rotary motions. Materials and Methods: Sixty freshly extracted human mandibular molars with mesial root canal curvatures between 20° and 30° were included in the study. Teeth were randomly distributed into three groups (n = 20). Biomechanical preparations were done in all the mesial canals. In Group 1, instrumentation was done with ProTaper universal rotary files, Group 2, with K3XF rotary files, and Group 3, with LSX rotary files. Each group was further subdivided into subgroups A and B (n = 10) where instrumentation was done by continuous rotary and reciprocating rotary techniques, respectively. Increase in root canal surface area and canal transportation was measured using the preoperative and postoperative cone-beam computed tomography scans. Statistical Analysis: The data were analyzed by one-way ANOVA followed by Tukey pairwise multiple comparison tests. Results: Increase in root canal surface area was significantly more (P 0.05) in increase of root canal surface area and canal transportation between continuous rotary and reciprocating rotary techniques for ProTaper Universal, K3XF and LSX groups. Conclusion: LSX rotary system showed minimal increase of root canal surface area and minimal canal transportation when compared to ProTaper and K3XF rotary systems. PMID:27656062

Femoral neck-shaft angle in extra-capsular proximal femoral fracture fixation; does it make a TAD of difference?

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Walton, N P; Wynn-Jones, H; Ward, M S; Wimhurst, J A

2005-11-01

The effect of femoral neck-shaft angle and implant type on the accuracy of lag screw placement in extra-capsular proximal femoral fracture fixation was investigated. Radiographs of all extra-capsular proximal femoral fractures seen in one unit over 18 months were reviewed. Of 399 cases, 307 (237 female, 70 male) were included in the study as they had no contra-lateral proximal femoral metal work. Femoral neck-shaft angle (NSA) of the uninjured hip and magnification adjusted tip-apex distance (TAD) of femoral head lag screw were measured. Type of fixation implant was 135 degrees classic hip screw (CHS) (n=144) or 130 degrees intra-medullary hip screw (IMHS) (n=163). Mean contra-lateral NSA was 130.2 degrees (112.9--148 degrees ) and 64 patients (58 female, 6 male) had a NSA TAD was 18.7 mm (5.8--43.8mm) and 88.9% of cases had a TAD of less than 25 mm. TAD values were significantly greater using an IMHS if NSA was 125 degrees (p=0.028). This was not the case with the CHS. The use of the 130 degrees -IMHS in patients with a NSA 125 degrees and caution is advocated when using this device in such cases.

Posterior semicircular canal dehiscence: a morphologic cause of vertigo similar to superior semicircular canal dehiscence

International Nuclear Information System (INIS)

Krombach, G.A.; Schmitz-Rode, T.; Haage, P.; Guenther, R.W.; DiMartino, E.; Prescher, A.; Kinzel, S.

2003-01-01

Heading Abstract.The aim of this study was to assess imaging findings of posterior semicircular dehiscence on computed tomography and to evaluate incidence of posterior and superior semicircular canal dehiscence in patients presenting with vertigo, sensorineuronal hearing loss or in a control group without symptoms related to the inner ear. Computed tomography was performed in 507 patients presenting either with vertigo (n=128; 23 of these patients suffered also from sensorineuronal hearing loss), other symptoms related to the inner ear, such as hearing loss or tinnitus (n=183) or symptoms unrelated to the labyrinth (n=196). All images were reviewed for presence of dehiscence of the bone, overlying the semicircular canals. Twenty-nine patients had superior semicircular canal dehiscence. Of these patients, 83% presented with vertigo, 10% with hearing loss or tinnitus and the remaining 7% with symptoms unrelated to the inner ear. In 23 patients dehiscence of the posterior semicircular canal was encountered. Of these patients, 86% presented with vertigo, 9% with hearing loss or tinnitus and 5% with symptoms unrelated to the inner ear. Defects of the bony overly are found at the posterior semicircular canal, in addition to the recently introduced superior canal dehiscence syndrome. Significant prevalence of vertigo in these patients suggests that posterior semicircular canal dehiscence can cause vertigo, similar to superior semicircular canal dehiscence. (orig.)

Posterior semicircular canal dehiscence: a morphologic cause of vertigo similar to superior semicircular canal dehiscence

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Krombach, G A; Schmitz-Rode, T; Haage, P; Guenther, R W [Department of Diagnostic Radiology, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); DiMartino, E [Department of Otorhinolaryngology, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); Prescher, A [Department of Anatomy, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); Kinzel, S [Department of Experimental Veterinarian Medicine, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany)

2003-06-01

Heading Abstract.The aim of this study was to assess imaging findings of posterior semicircular dehiscence on computed tomography and to evaluate incidence of posterior and superior semicircular canal dehiscence in patients presenting with vertigo, sensorineuronal hearing loss or in a control group without symptoms related to the inner ear. Computed tomography was performed in 507 patients presenting either with vertigo (n=128; 23 of these patients suffered also from sensorineuronal hearing loss), other symptoms related to the inner ear, such as hearing loss or tinnitus (n=183) or symptoms unrelated to the labyrinth (n=196). All images were reviewed for presence of dehiscence of the bone, overlying the semicircular canals. Twenty-nine patients had superior semicircular canal dehiscence. Of these patients, 83% presented with vertigo, 10% with hearing loss or tinnitus and the remaining 7% with symptoms unrelated to the inner ear. In 23 patients dehiscence of the posterior semicircular canal was encountered. Of these patients, 86% presented with vertigo, 9% with hearing loss or tinnitus and 5% with symptoms unrelated to the inner ear. Defects of the bony overly are found at the posterior semicircular canal, in addition to the recently introduced superior canal dehiscence syndrome. Significant prevalence of vertigo in these patients suggests that posterior semicircular canal dehiscence can cause vertigo, similar to superior semicircular canal dehiscence. (orig.)

Unpredictable Root Canal Morphology: Expect the Unexpected

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Sohez J Makani

2015-01-01

Full Text Available Background: A maxillary first molar with more than four canals is an interesting example of anatomic variations, especially when two of these canals are detected, with separate apical foramen in the distal root. The inability to locate the unexpected canals of various anatomical configuration and subsequently treat them , may lead to therapeutic failures. Endodontic retreatment is usually the modality of choice in such cases. This report describes a case of a maxillary first molar with five canals (two mesial canals in mesial root, two distal canals in two distal roots and a palatal canal in palatal root. Additionally it shows a rare anatomic configuration and emphasizes the importance of identifying additional canals.

Incidence of Avascular Necrosis of the Femoral Head After Intramedullary Nailing of Femoral Shaft Fractures

Science.gov (United States)

Kim, Ji Wan; Oh, Jong-Keon; Byun, Young-Soo; Shon, Oog-Jin; Park, Jai Hyung; Oh, Hyoung Keun; Shon, Hyun Chul; Park, Ki Chul; Kim, Jung Jae; Lim, Seung-Jae

2016-01-01

Abstract The goal of this study was to determine the incidence of avascular necrosis of the femoral head (AVNFH) after intramedullary nailing of femoral shaft fractures and to identify risk factors for developing AVNFH. We retrospectively reviewed all patients with femoral shaft fractures treated with antegrade intramedullary nailing at 10 institutions. Among the 703 patients enrolled, 161 patients were excluded leaving 542 patients in the study. Average age was 42.1 years with average follow-up of 26.3 months. Patient characteristics and fracture patterns as well as entry point of femoral nails were identified and the incidence of AVNFH was investigated. Patients were divided into 2 groups according to open versus closed physis, open versus closed fractures, and age (<20 versus ≥20 years). Overall incidence of AVNFH was 0.2% (1 of 542): the patient was 15-year-old boy. Of 25 patients with open physis, the incidence of AVNFH was 4%, whereas none of 517 patients with closed physis developed AVNFH (P < 0.001). The incidence of AVNFH in patients aged < 20 versus ≥20 years was 1.1% (1 of 93) and 0.0% (0 of 449), respectively (P = 0.172), which meant that the incidence of AVNFH was 0% in adult with femur shaft fracture. Of 61 patients with open fractures, the incidence of AVNFH was 0%. The number of cases with entry point at the trochanteric fossa or tip of the greater trochanter (GT) was 324 and 218, respectively, and the incidence of AVNFH was 0.3% and 0.0%, respectively (P = 0.412). In patients aged ≥20 years with isolated femoral shaft fracture, there was no case of AVNFH following antegrade intramedullary nailing regardless of the entry point. Therefore, our findings suggest that the risk of AVNFH following antegrade femoral nailing is extremely low in adult patients. PMID:26844518

Avascular necrosis of the femoral head after osteosynthesis of femoral neck fracture.

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Min, Byung-Woo; Kim, Sung-Jin

2011-05-18

The reported incidence of avascular necrosis after femoral neck fracture fixation varies widely, and there is no consensus regarding its risk factors. We evaluated the incidence of avascular necrosis of the femoral head with the use of contemporary techniques for femoral neck fracture fixation. We then sought to determine what potential risk factors influenced the development of avascular necrosis.Between 1990 and 2005, one hundred sixty-three intracapsular femoral neck fractures in 163 patients were treated with internal fixation at our level-I trauma center. All patients were monitored until conversion to total hip arthroplasty or for a minimum of 2 years postoperatively. Ten patients (10 hips) died and 7 patients (7 hips) were lost to follow-up. The remaining 146 patients (146 hips) had a mean 5.2 years of follow-up (range, 3 months to 17 years). The incidence of avascular necrosis was 25.3% (37 hips). The average time to diagnosis of avascular necrosis was 18.8 months (range, 3-47 months). Patient sex, age, interval from injury to surgery, and mechanism of injury were statistically not associated with the development of avascular necrosis. The quality of fracture reduction, adequacy of fixation, degree of displacement, and comminution of the posterior cortex were significantly associated. After we controlled for patient and radiographic characteristics, multivariate analyses indicated that the important predictors for avascular necrosis are poor reduction (odds ratio=13.889) and initial displacement of the fracture (odds ratio=4.693). Copyright 2011, SLACK Incorporated.

Biomechanical comparisons between a new avascular necrosis of femaral head stem based on Chinese patients with avascular necrosis and two other designs.

Science.gov (United States)

Zhang, Qiang; Cheng, Cheng-Kung; Wei, Hung-Wen; Dong, Xiang; Chen, Yi-Ting; Lai, Yu-Shu; Wang, Yan

2013-01-01

There is a relatively high failure rate of the femoral component in patients with avascular necrosis at the intermediate-term follow-up. Improving the geometrical fit of the femoral stem against the medullary canal may help to provide long-term survivorship of the hip replacement for patients with avascular necrosis. We designed a specific stem, based on morphometric studies of proximal femoral canals in Chinese avascular necrosis patients and evaluated the stem by finite element analyses, comparing the novel stem with two commercially available and commonly used stems. The morphometric data from avascular necrosis patients showed specific geometric differences in the proximal femoral canal, including profile curves in both the sagittal and coronary planes than the patients with femoral neck fracture. The shorter stemmed prostheses (Fitmore(®) and our stem) performed better than the longer stemmed prosthesis (VerSys(®)). This is the first study to investigate the femoral geometries of Chinese avascular necrosis patients. Our stem provides better stability and is theoretically beneficial to bone ingrowth, which may increase the long-term stability and fixation of the implant.

Femoral neck buttressing: a radiographic and histologic analysis

International Nuclear Information System (INIS)

Dixon, T.; Benjamin, J.; Lund, P.; Graham, A.; Krupinski, E.

2000-01-01

Objective. To examine the incidence, radiographic and histologic findings of medial femoral neck buttressing in a consecutive group of patients undergoing total hip arthroplasty.Design. Biomechanical parameters were evaluated on standard anteroposterior pelvic radiographs of 113 patients prior to hip replacement surgery. Demographic information on all patients was reviewed and histologic evaluation was performed on specimens obtained at the time of surgery.Results. The incidence of medial femoral neck buttressing was found to be 50% in a consecutive series of patients undergoing total hip arthroplasty. The incidence was slightly higher in women (56% vs 41%). Patients with buttressing had increased neck-shaft angles and smaller femoral neck diameters than were seen in patients without buttressing. Histologic evaluation demonstrated that the buttress resulted from deposition bone by the periosteum on the femoral neck in the absence of any evidence of femoral neck fracture.Conclusion. It would appear that femoral neck buttressing occurs in response to increased joint reactive forces seen at the hip being transmitted through the femoral neck. The increased joint reactive force can be related to the increased neck shaft angle seen in patients with buttressing. (orig.)

Angiographic analysis of avascular necrosis of a femoral head -selective angiography of medial femoral circumflex artery-

Energy Technology Data Exchange (ETDEWEB)

Ryu, Kyung Nam; Yoon, Yup; Lee, Sun Wha; Lim, Jae Hoon [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1991-07-15

The degree of anatomical revascularization of a necrotic femoral head and traumatic hip would provide information about treatment and prognosis. The authors analyzed the vascular changes of femoral head among unilateral avascular necrosis, bilateral avascular necrosis, and traumatic hips. Forty - four patients with avascular necrosis and 19 patients with traumatic hips were examined by selective angiography of the medial femoral circumflex artery. In the traumatic hip cases, 12 (63%) showed occlusion, 2 (11%) hypertrophy of the capsular branches, and 5 ( 26 % ) were normal . In the avascular necrosis cases, 15 (25%) showed occlusion, 39 (67%) had hypertrophy of the capsular branches, and 4 (7%) had normal findings. Hypertrophy of the superior capsular branch of the medial femoral circumflex artery is more frequently observed in avascular necrosis than in traumatic hip. Bilateral avascular necrosis reveals more frequent incidences than unilateral cases. Selective angiography could help in the therapy plan and also provide information about the contralateral side.

Angiographic analysis of avascular necrosis of a femoral head -selective angiography of medial femoral circumflex artery-

International Nuclear Information System (INIS)

Ryu, Kyung Nam; Yoon, Yup; Lee, Sun Wha; Lim, Jae Hoon

1991-01-01

The degree of anatomical revascularization of a necrotic femoral head and traumatic hip would provide information about treatment and prognosis. The authors analyzed the vascular changes of femoral head among unilateral avascular necrosis, bilateral avascular necrosis, and traumatic hips. Forty - four patients with avascular necrosis and 19 patients with traumatic hips were examined by selective angiography of the medial femoral circumflex artery. In the traumatic hip cases, 12 (63%) showed occlusion, 2 (11%) hypertrophy of the capsular branches, and 5 ( 26 % ) were normal . In the avascular necrosis cases, 15 (25%) showed occlusion, 39 (67%) had hypertrophy of the capsular branches, and 4 (7%) had normal findings. Hypertrophy of the superior capsular branch of the medial femoral circumflex artery is more frequently observed in avascular necrosis than in traumatic hip. Bilateral avascular necrosis reveals more frequent incidences than unilateral cases. Selective angiography could help in the therapy plan and also provide information about the contralateral side

Risk stratification for avascular necrosis of the femoral head after internal fixation of femoral neck fractures by post-operative SPECT/CT

Energy Technology Data Exchange (ETDEWEB)

Han, Sang Won; Oh, Min Young; Yoon, Seok Ho; Kim, Jin Soo; Chang, Jae Suk; Ryu, Jin Sook [Asan Medical CenterUniversity of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Ji Wan [Dept. of Orthopedic Surgery, Haeundae Paik Hospital, Inje University, Busan (Korea, Republic of)

2017-03-15

Avascular necrosis (AVN) of the femoral head is a major complication after internal fixation of a femoral neck fracture and determines the functional prognosis. We investigated postoperative bone single-photon emission computed tomography/computed tomography (SPECT/CT) for assessing the risk of femoral head AVN. We retrospectively reviewed 53 consecutive patients who underwent bone SPECT/CT within 2 weeks of internal fixation of a femoral neck fracture and follow-up serial hip radiographs over at least 12 months. Nine patients developed femoral head AVN. In 15 patients who showed normal uptake on immediate postoperative SPECT/CT, no AVN occurred, whereas 9 of 38 patients who showed cold defects of the femoral head later developed AVN. The negative predictive value of immediate postoperative SPECT/CT for AVN was 100 %, whereas the positive predictive value was 24 %. Among 38 patients with cold defects, 1 developed AVN 3 months postoperatively. A follow-up bone SPECT/CT was performed in the other 37 patients at 2–10 months postoperatively. The follow-up bone SPECT/CT revealed completely normalized femoral head uptake in 27, partially normalized uptake in 8, and persistent cold defects in 2 patients. AVN developed in 3.7 % (1/27), 62.5 % (5/8), and 100 % (2/2) of each group, respectively. According to the time point of imaging, radiotracer uptake patterns of the femoral head on postoperative bone SPECT/CT indicate the risk of AVN after internal fixation of femoral neck fractures differently. Postoperative bone SPECT/CT may help orthopedic surgeons determine the appropriate follow-up of these patients.

Risk stratification for avascular necrosis of the femoral head after internal fixation of femoral neck fractures by post-operative SPECT/CT

International Nuclear Information System (INIS)

Han, Sang Won; Oh, Min Young; Yoon, Seok Ho; Kim, Jin Soo; Chang, Jae Suk; Ryu, Jin Sook; Kim, Ji Wan

2017-01-01

Avascular necrosis (AVN) of the femoral head is a major complication after internal fixation of a femoral neck fracture and determines the functional prognosis. We investigated postoperative bone single-photon emission computed tomography/computed tomography (SPECT/CT) for assessing the risk of femoral head AVN. We retrospectively reviewed 53 consecutive patients who underwent bone SPECT/CT within 2 weeks of internal fixation of a femoral neck fracture and follow-up serial hip radiographs over at least 12 months. Nine patients developed femoral head AVN. In 15 patients who showed normal uptake on immediate postoperative SPECT/CT, no AVN occurred, whereas 9 of 38 patients who showed cold defects of the femoral head later developed AVN. The negative predictive value of immediate postoperative SPECT/CT for AVN was 100 %, whereas the positive predictive value was 24 %. Among 38 patients with cold defects, 1 developed AVN 3 months postoperatively. A follow-up bone SPECT/CT was performed in the other 37 patients at 2–10 months postoperatively. The follow-up bone SPECT/CT revealed completely normalized femoral head uptake in 27, partially normalized uptake in 8, and persistent cold defects in 2 patients. AVN developed in 3.7 % (1/27), 62.5 % (5/8), and 100 % (2/2) of each group, respectively. According to the time point of imaging, radiotracer uptake patterns of the femoral head on postoperative bone SPECT/CT indicate the risk of AVN after internal fixation of femoral neck fractures differently. Postoperative bone SPECT/CT may help orthopedic surgeons determine the appropriate follow-up of these patients

Ipsilateral femoral neck and shaft fractures: An overlooked association

International Nuclear Information System (INIS)

Daffner, R.H.; Riemer, B.L.; Butterfield, S.L.

1991-01-01

A total of 304 patients with injuries to the femoral shaft and ipsilateral hip presented between 1984 and 1990. Some 253 of them suffered fractures of the femoral shaft and dislocated hips or fractures of the acetabulum, and 51 of these sustained fractures of the femoral shaft and neck or trochanteric region. All of the trochanteric injuries were demonstrated on the initial radiographs. However, in 11 of the patients with combined femoral shaft and neck fractures, the diagnosis was delayed by as much as 4 weeks. This delay related to the fact that these fractures tended not to separate in the initial evaluation period and that there was external rotation of the proximal femoral fragment due to the femoral shaft fracture. (orig./GDG)

Ipsilateral femoral neck and shaft fractures: An overlooked association

Energy Technology Data Exchange (ETDEWEB)

Daffner, R.H. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (USA) Medical Coll. of Pennsylvania, Pittsburgh, PA (USA)); Riemer, B.L.; Butterfield, S.L. (Dept. of Orthopedic Surgery, Allegheny General Hospital, Pittsburgh, PA (USA) Medical Coll. of Pennsylvania, Pittsburgh, PA (USA))

1991-05-01

A total of 304 patients with injuries to the femoral shaft and ipsilateral hip presented between 1984 and 1990. Some 253 of them suffered fractures of the femoral shaft and dislocated hips or fractures of the acetabulum, and 51 of these sustained fractures of the femoral shaft and neck or trochanteric region. All of the trochanteric injuries were demonstrated on the initial radiographs. However, in 11 of the patients with combined femoral shaft and neck fractures, the diagnosis was delayed by as much as 4 weeks. This delay related to the fact that these fractures tended not to separate in the initial evaluation period and that there was external rotation of the proximal femoral fragment due to the femoral shaft fracture. (orig./GDG).

Pneumocystis jirovecii infection of the external auditory canal

African Journals Online (AJOL)

nonspecific symptoms of otorrhoea, otalgia, hearing loss, vertigo and tinnitus. Clinical findings include a mass in the external auditory canal and occasional otitis media. Destruction of the ossicles and sclerosis of the mastoid air cells, extensive bony erosion, and extension into the middle cranial fossa are rare complications.

Femoral component rotation in patellofemoral joint replacement.

Science.gov (United States)

van Jonbergen, Hans-Peter W; Westerbeek, Robin E

2018-06-01

Clinical outcomes in patellofemoral joint replacement may be related to femoral component rotation. Assessment of rotational alignment is however difficult as patients with isolated patellofemoral osteoarthritis often have trochlear dysplasia. The use of the medial malleolus as a landmark to guide rotation has been suggested. The purpose of our study was to evaluate this technique with regard to femoral component rotation, and to correlate rotation with clinical outcomes at one-year follow-up. Forty-one knees in 39 patients had patellofemoral joint replacement using the Zimmer Gender-Solutions patellofemoral prosthesis. Intraoperatively, we determined femoral component rotational alignment using an extramedullary rod aimed at the inferior tip of the medial malleolus. Postoperatively, we measured the angle between the femoral component and the anatomical transepicondylar axis using CT. The amount of rotation was correlated with clinical outcomes at one-year follow-up. Forty knees in 38 patients were available for one-year follow-up. Mean femoral component rotation relative to the anatomical transepicondylar axis was 1.4° external rotation (range, -3.8 to 5.7°). We found no statistically significant correlation between femoral component rotation and change from baseline KOOS subscales at one-year follow-up. Our findings show that when using the medial malleolus as a landmark to guide rotation, the femoral component of the patellofemoral prosthesis was oriented in external rotation relative to the anatomical transepicondylar axis in 80% of knees. Our study did not show a relation between the amount of external rotation and clinical outcomes. Level III. Copyright © 2018 Elsevier B.V. All rights reserved.

Mandibular second premolar with three canals: Re-treatment of a case with unusual root canal anatomy

Directory of Open Access Journals (Sweden)

Niranjan Desai

2011-01-01

Full Text Available A thorough knowledge of root canal anatomy along with the anatomical variations that may be present is essential for success of endodontic therapy. Unusual presentations in the number of the roots or the canals should be expected in every tooth. Mandibular second premolars are thought of as having a single root and canal. Studies have stated that the prevalence of three canals with three orifices in this tooth is 0.4%. The mandibular second premolar is particularly difficult to treat owing to the fact that a wide variation in the number, location and curvature of the roots and canals exist. Added to this is the fact that the access opening is restricted and location of the lingually placed orifices is difficult. This case report details the re-treatment of a mandibular second premolar with three canals and three separate orifices using the surgical microscope.

MR evaluation of femoral neck version and tibial torsion

Energy Technology Data Exchange (ETDEWEB)

Koenig, James Karl; Dwek, Jerry R. [University of California, San Diego, Children' s Hospital and Health Center, Department of Radiology, San Diego, CA (United States); Pring, Maya E. [Rady Children' s Hospital, Department of Pediatric Orthopedic Surgery, San Diego, CA (United States)

2012-01-15

Abnormalities of femoral neck version have been associated with a number of hip abnormalities in children, including slipped capital femoral epiphysis, proximal femoral focal deficiency, coxa vara, a deep acetabulum and, rarely, developmental dysplasia of the hip. Orthopedic surgeons also are interested in quantifying the femoral neck anteversion or retroversion in children especially to plan derotational osteotomies. Historically, the angle of femoral version and tibial torsion has been measured with the use of radiography and later by CT. Both methods carry with them the risks associated with ionizing radiation. Techniques that utilize MR are used less often because of the associated lengthy imaging times. This article describes a technique using MRI to determine femoral neck version and tibial torsion with total scan times of approximately 10 min. (orig.)

Correlation between baseline femoral neck marrow status and the development of femoral head osteonecrosis in corticosteroid-treated patients: A longitudinal study by MR imaging

International Nuclear Information System (INIS)

Vande Berg, Bruno C.; Gilon, Raphael; Malghem, Jacques; Lecouvet, Frederic; Depresseux, Genevieve; Houssiau, Frederic A.

2006-01-01

Objective: To test the hypothesis that the development of corticosteroid (CS)-associated femoral head osteonecrosis (ON) is influenced by baseline femoral neck marrow status. Patients and methods: The population consisted of 20 untreated patients with a newly diagnosed rheumatic disease in whom a standardized CS regimen was planned. Before CS treatment, baseline femoral neck marrow status was determined by magnetic resonance (MR) imaging on T1-weighted images (proportion of surface area of femoral neck and intertrochanteric area occupied by fatty marrow; index of marrow conversion [IMC]) and on a quantitative MR sequence (bulk T1 values of femoral head and neck). The presence of ON was assessed by coronal T1-weighted MR images of the hips at 6 and 12 months. Results: None of the patients suffered from ON at baseline. Four patients (20%) developed bilateral femoral head ON at 6 months. The mean percentage of fat marrow in the femoral neck before treatment was significantly higher in ON-positive than in ON-negative patients (p = 0.0025). The mean baseline femoral neck IMC value, which parallels the degree of red to yellow marrow conversion, was higher in ON-positive than in ON-negative patients (p = 0.089). The mean baseline bulk T1 value of the femoral neck (but not of the femoral head), which inversely correlates with the amount of fat marrow, was significantly shorter in ON-positive than in ON-negative patients (p = 0.0298). Conclusion: The development of CS-associated femoral head ON is correlated with a high fat content in the proximal femur before CS therapy

Trochanteric entry femoral nails yield better femoral version and lower revision rates-A large cohort multivariate regression analysis.

Science.gov (United States)

Yoon, Richard S; Gage, Mark J; Galos, David K; Donegan, Derek J; Liporace, Frank A

2017-06-01

Intramedullary nailing (IMN) has become the standard of care for the treatment of most femoral shaft fractures. Different IMN options include trochanteric and piriformis entry as well as retrograde nails, which may result in varying degrees of femoral rotation. The objective of this study was to analyze postoperative femoral version between three types of nails and to delineate any significant differences in femoral version (DFV) and revision rates. Over a 10-year period, 417 patients underwent IMN of a diaphyseal femur fracture (AO/OTA 32A-C). Of these patients, 316 met inclusion criteria and obtained postoperative computed tomography (CT) scanograms to calculate femoral version and were thus included in the study. In this study, our main outcome measure was the difference in femoral version (DFV) between the uninjured limb and the injured limb. The effect of the following variables on DFV and revision rates were determined via univariate, multivariate, and ordinal regression analyses: gender, age, BMI, ethnicity, mechanism of injury, operative side, open fracture, and table type/position. Statistical significance was set at pregression analysis revealed that a lower BMI was significantly associated with a lower DFV (p=0.006). Controlling for possible covariables, multivariate analysis yielded a significantly lower DFV for trochanteric entry nails than piriformis or retrograde nails (7.9±6.10 vs. 9.5±7.4 vs. 9.4±7.8°, pregression analysis. However, this is not to state that the other nail types exhibited abnormal DFV. Translation to the clinical impact of a few degrees of DFV is also unknown. Future studies to more in-depth study the intricacies of femoral version may lead to improved technology in addition to potentially improved clinical outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Bilateral femoral neck fractures following pelvic irradiation

International Nuclear Information System (INIS)

Mitsuda, Kenji; Nishi, Hosei; Oba, Hiroshi

1977-01-01

Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but thickness of the internal membrane and thrombogenesis were not recognized. Treatment should be performed according to degree of displacement of fractures. In this case, artificial joint replacement surgery was performed to the side of fracture of this time, because this case was bilateral femoral neck fractures and the patient had received artificial head replacement surgery in the other side of fracture formerly. (Tsunoda, M.)

[Treatment of avascular necrosis of femoral head after femoral neck fracture with pedicled iliac bone graft].

Science.gov (United States)

Wang, Benjie; Zhao, Dewei; Guo, Lin; Yang, Lei; Li, Zhigang; Cui, Daping; Tian, Fengde; Liu, Baoyi

2011-05-01

To explore the effectiveness of pedicled iliac bone graft transposition for treatment of avascular necrosis of femoral head (ANFH) after femoral neck fracture. Between June 2002 and December 2006, 22 cases (22 hips, 16 left hips and 6 right hips) of ANFH after femoral neck fracture were treated with iliac bone graft pedicled with ascending branch of the lateral femoral circumflex vessels. There were 18 males and 4 females with an age range from 28 to 48 years (mean, 37.5 years). The time from injury to internal fixation was 2-31 days, and all fractures healed within 12 months after internal fixation. The ANFH was diagnosed at 15-40 months (mean, 22 months) after internal fixation. The ANFH duration was 3-11 months (mean, 8 months). According to Association Research Circulation Osseous (ARCO) staging system, 2 hips were classified as stage IIa, 3 hips as stage IIb, 3 hips as stage IIc, 3 hips as stage IIIa, 7 hips as stage IIIb, and 4 hips as stage IIIc. The preoperative Harris hip score (HHS) was 64.10 +/- 5.95. All incisions healed by first intention and the patients had no complication of lung embolism, sciatic nerve injury, lower limb deep venous thrombosis, and numbness and pain of donor site. All patients were followed up 2.5 to 6.3 years (mean, 4.8 years). The fracture healing time was 8-12 months, and no femoral neck fracture recurred. The HHS was 90.20 +/- 5.35 at last follow-up, showing significant difference when compared with the preoperative value (t = -18.447, P = 0.000). The hip function were excellent in 11 hips, good in 10 hips, fair in 1 hip, and the excellent and good rate was 95.5%. Four hips were radiographically progressed in ARCO staging, 18 hips remained stable with a stable rate of 81.8%. Pedicled iliac bone graft transposition is an ideal option for treatment of ANFH after internal fixation of femoral neck fracture for the advantages of femoral head revascularization, sufficient cancellous bone supply, and relatively simple procedure.

Magnetic resonance imaging of the femoral head necrosis

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Narita, Shinya; Asada, Kanji; Yoshida, Kenjiro and others

1986-06-01

Ten patients with avascular femoral head necrosis and four normal adults were examined by magnetic resonance imaging (MRI). In addition, the relationship between MRI and pathophysiology of three operated-on avascular femoral heads was evaluated. The medullary cavities of the normal femoral heads had a strong signal intensity on the saturation recovery (SR) image due to fat marrow, and the T/sub 1/ relaxation time was 160 +- 11 msec. In avascular femoral head necrosis, the necrotic area had a low signal intensity on the SR image and a prolonged T/sub 1/ relaxation time, while the reactive fibrous area had more prolonged T/sub 1/ relaxation time. For these reasons, MRI was found to show the pathological changes of avascular femoral head necrosis and can be expected to be useful for making early diagnoses and operation planning.

Magnetic resonance imaging of the femoral head necrosis

International Nuclear Information System (INIS)

Narita, Shinya; Asada, Kanji; Yoshida, Kenjiro

1986-01-01

Ten patients with avascular femoral head necrosis and four normal adults were examined by magnetic resonance imaging (MRI). In addition, the relationship between MRI and pathophysiology of three operated-on avascular femoral heads was evaluated. The medullary cavities of the normal femoral heads had a strong signal intensity on the saturation recovery (SR) image due to fat marrow, and the T 1 relaxation time was 160 ± 11 msec. In avascular femoral head necrosis, the necrotic area had a low signal intensity on the SR image and a prolonged T 1 relaxation time, while the reactive fibrous area had more prolonged T 1 relaxation time. For these reasons, MRI was found to show the pathological changes of avascular femoral head necrosis and can be expected to be useful for making early diagnoses and operation planning. (author)

The enlargement of geniculate fossa of facial nerve canal: a new CT finding of facial nerve canal fracture

International Nuclear Information System (INIS)

Gong Ruozhen; Li Yuhua; Gong Wuxian; Wu Lebin

2006-01-01

Objective: To discuss the value of enlargement of geniculate fossa of facial nerve canal in the diagnosis of facial nerve canal fracture. Methods: Thirty patients with facial nerve canal fracture underwent axial and coronal CT scan. The correlation between the fracture and the enlargement of geniculate fossa of facial nerve canal was analyzed. The ability of showing the fracture and enlargement of geniculate fossa of facial nerve canal in axial and coronal imaging were compared. Results: Fracture of geniculate fossa of facial nerve canal was found in the operation in 30 patients, while the fracture was detected in CT in 18 patients. Enlargement of geniculate ganglion of facial nerve was detected in 30 patients in the operation, while the enlargement of fossa was found in CT in 28 cases. Enlargement and fracture of geniculate fossa of facial nerve canal were both detected in CT images in 18 patients. Only the enlargement of geniculate fossa of facial nerve canal was shown in 12 patients in CT. Conclusion: Enlargement of geniculate fossa of facial nerve canal was a useful finding in the diagnosis of fracture of geniculate fossa in patients with facial paralysis, even no fracture line was shown on CT images. (authors)

Femoral component loosening after hip resurfacing arthroplasty

International Nuclear Information System (INIS)

Zustin, Jozef; Sauter, Guido; Hahn, Michael; Morlock, Michael M.; Ruether, Wolfgang; Amling, Michael

2010-01-01

Before the re-introduction of the current generation of total hip resurfacing arthroplasty, component loosening and osteolysis were of great concern to the orthopaedic community. Early, mid- and long-term clinical results are encouraging, but component loosening still exists. Macroscopic, contact radiographic and histopathological analyses after undecalcified preparation of bone tissue specimens were performed. To investigate the frequency and morphological patterns of the loosening of the femoral component, we analysed a series of 190 retrieved femoral remnants that were revised for aseptic failures. Thirty-five (18.4%) hips were revised for clinical and/or radiographic loosening of the femoral component. Pseudoarthrosis (n = 17; median in situ time: 16 weeks, interquartile range [IQR]: 9 to 34), collapsed osteonecrosis (n = 5; median in situ time: 79 weeks, IQR: 63 to 97), cement-socket debonding (n = 3; median in situ time: 89 weeks, IQR: 54 to 97) and at later follow-up bone-cement loosening (n = 10; median in situ time: 175 weeks; IQR 112 to 198; p =0.005) were distinct patterns of the femoral remnant-implant loosening. Fibrocartilaginous metaplasia of interface bone trabeculae (n = 38; median in situ time: 61 weeks, IQR: 32 to 138) was strongly associated with femoral component loosening (p = 0.009). Both the trabecular hyperosteoidosis (n = 32; median in situ time: 71 weeks, IQR 50 to 129) and excessive intraosseous lymphocyte infiltration (n = 12; median in situ time: 75 weeks, IQR 51 to 98) at the bone-cement interface correlated strongly with fibrocartilaginous metaplasia (p = 0.001 and p = 0.016 respectively) and all three lesions were associated with the female gender (p = 0.021, p = 0.009, and p = 0.051). Femoral component loosening at early follow-up was mostly caused by pathological changes of the femoral remnant bone tissue: pseudoarthrosis and collapsed osteonecrosis. Fibrocartilaginous metaplasia was frequently observed in hips with femoral

Industrial canal waterfronts in The Netherlands : transforming the canal zones of B5

NARCIS (Netherlands)

Curulli, G.I.

2012-01-01

Industrial Canal Waterfronts in The Netherlands provides a comprehensive presentation of the characteristics and challenges of five interconnected and dismissed industrial canal zones located in the Dutch Brabant cities of Eindhoven, Breda, Tilburg, s’-Hertogenbosch and Helmond (B5). Through the

Avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Kokubo, Takeshi; Takatori, Yoshio; Kamogawa, Morihide; Nakamura, Toshitaka; Ninomiya, Setsuo; Yoshikawa, Kohki; Itai, Yuji; Iio, Masahiro; Mitamura, Tadayuki

1990-01-01

T1-weighted MR images of thirty-six hips in 25 patients with avascular necrosis of the femoral head were obtained two to five times during the course of 2 to 26 months. We investigated these MR images in the light of the chronological change and compared them with plain radiographs. MR images changes in 16 femoral head; in general, the abnormal low intensity area in the femoral head reduced in extent and the internal high intensity area became smaller of disappeared. Thirteen femoral heads among them became more flattened on plain radiographs in the same period. It is noted that four different zones are defined in the femoral head after bone necrosis takes place: the dead bone marrow, the dead marrow which still contains fat, the reactive interface and the hyperemic bone marrow. In T1-weighted MR images, the dead bone marrow, the reactive interface and the hyperemic bone marrow are demonstrated as low intensity area, while the dead marrow containing fat may remain high in intensity. On the basis of this knowledge of histopathology and MR images of this disease, we suggest that reduction of the abnormal low intensity area and disappearance of the internal high intensity area on MR images can be regarded as diminution of hyperemia in the living bone marrow and loss of fat in the dead bone marrow, respectively. (author)

Diagnosis and root canal treatment in a mandibular premolar with three canals.

Science.gov (United States)

Soares, Lanuce Rosa; Arruda, Marcos; de Arruda, Marcos Pôrto; Rangel, Andréa Leão; Takano, Edson; de Carvalho Júnior, Jacy Ribeiro; Saquy, Paulo Cesar

2009-01-01

This paper presents a case report of a left mandibular second premolar with three canals and three different apical foramina. A 39-year-old male patient presented to our clinic with pain in the mandibular left second premolar. Initially, pain was caused by cold stimulus and later was spontaneously. The intraoral clinical examination revealed a fractured amalgam restoration with occlusal caries. Percussion and cold (Endo-Frost) tests were positive. The radiographic examination showed the presence of two roots. The probable diagnosis was an acute pulpitis. After access cavity, it was observed remaining roof of the pulp chamber and mild bleeding in the tooth lingual area, indicating the possible presence of a third canal. The endodontic treatment was completed in a single session using Root ZX apex locator and K3 NiTi rotary system with surgical diameter corresponding to a .02/45 file in the three canals and irrigation with 1% sodium hypochlorite. The canals were obtured with gutta-percha cones and Sealer 26 using the lateral condensation technique. After 1 year of follow-up, the tooth was asymptomatic and periapical repair was observed radiographically. Internal alterations should be considered during the endodontic treatment of mandibular second premolars. The correct diagnosis of these alterations by the analysis of preoperative radiographs can help the location of two or more canals, thereby avoiding root therapy failure.

CT study of avascular necrosis of femoral head in adults

International Nuclear Information System (INIS)

Liu Jihua; Du Yuqing; Xu Aide

2000-01-01

Objective: To study the early and new CT signs of avascular necrosis of femoral head in adults. Methods: The CT scans of 127 cases with this condition were analyzed. Results: There were 90 hip joints with femoral head normal in shape, including 67 femoral heads with only high-density sclerosis and 23 ones with high-density and low-density areas. In 111 hip joints, the femoral head was depressed and manifested purely high-density sclerosis in 25 and mixed-density areas in 86. Air-filled cysts appeared in 43 femoral heads. In follow-up cases, the changes in shape and density of femoral head followed some rules. Conclusion: Purely high-density sclerosis is an early sign and is of great diagnostic value combined with its special shape. Air in femoral heads is also a sign of the disease

Femoral Head Bone Loss Following Short and Long-Duration Spaceflight

Science.gov (United States)

Blaber, Elizabeth A.; Cheng-Campbell, Margareth A.; Almeida, Eduardo A. C.

2016-01-01

Exposure to mechanical unloading during spaceflight is known to have significant effects on the musculoskeletal system. Our ongoing studies with the mouse bone model have identified the failure of normal stem cell-based tissue regeneration, in addition to tissue degeneration, as a significant concern for long-duration spaceflight, especially in the mesenchymal and hematopoietic tissue lineages. The 30-day BionM1 and the 37-day Rodent Research 1 (RR1) missions enabled the possibility of studying these effects in long-duration microgravity experiments. We hypothesized that the inhibition of stem cell-based tissue regeneration in short-duration spaceflight would continue during long-duration spaceflight and furthermore would result in significant tissue alterations. MicroCT analysis of BionM1 femurs revealed 31 decrease in bone volume ratio, a 14 decrease in trabecular thickness, and a 20 decrease in trabecular number in the femoral head of space-flown mice. Furthermore, high-resolution MicroCT and immunohistochemical analysis of spaceflight tissues revealed a severe disruption of the epiphyseal boundary, resulting in endochondral ossification of the femoral head and perforation of articular cartilage by bone. This suggests that spaceflight in microgravity may cause rapid induction of an aging-like phenotype with signs of osteoarthritic disease in the hip joint. However, mice from RR1 exhibited significant bone loss in the femoral head but did not exhibit the severe aging and disease-like phenotype observed during BionM1. This may be due to increased physical activity in the RH hardware. Immunohistochemical analysis of the epiphyseal plate and investigation of cellular proliferation and differentiation pathways within the marrow compartment and whole bone tissue is currently being conducted to determine alterations in stem cell-based tissue regeneration between these experiments. Our results show that the observed inhibition of stem cell-based tissue regeneration

Comparative transcriptome analysis of stylar canal cells identifies novel candidate genes implicated in the self-incompatibility response of Citrus clementina

Directory of Open Access Journals (Sweden)

Caruso Marco

2012-02-01

Full Text Available Abstract Background Reproductive biology in citrus is still poorly understood. Although in recent years several efforts have been made to study pollen-pistil interaction and self-incompatibility, little information is available about the molecular mechanisms regulating these processes. Here we report the identification of candidate genes involved in pollen-pistil interaction and self-incompatibility in clementine (Citrus clementina Hort. ex Tan.. These genes have been identified comparing the transcriptomes of laser-microdissected stylar canal cells (SCC isolated from two genotypes differing for self-incompatibility response ('Comune', a self-incompatible cultivar and 'Monreal', a self- compatible mutation of 'Comune'. Results The transcriptome profiling of SCC indicated that the differential regulation of few specific, mostly uncharacterized transcripts is associated with the breakdown of self-incompatibility in 'Monreal'. Among them, a novel F-box gene showed a drastic up-regulation both in laser microdissected stylar canal cells and in self-pollinated whole styles with stigmas of 'Comune' in concomitance with the arrest of pollen tube growth. Moreover, we identify a non-characterized gene family as closely associated to the self-incompatibility genetic program activated in 'Comune'. Three different aspartic-acid rich (Asp-rich protein genes, located in tandem in the clementine genome, were over-represented in the transcriptome of 'Comune'. These genes are tightly linked to a DELLA gene, previously found to be up-regulated in the self-incompatible genotype during pollen-pistil interaction. Conclusion The highly specific transcriptome survey of the stylar canal cells identified novel genes which have not been previously associated with self-pollen rejection in citrus and in other plant species. Bioinformatic and transcriptional analyses suggested that the mutation leading to self-compatibility in 'Monreal' affected the expression of non

Morphometric analysis of rat femoral vessels under a video magnification system

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Rui Sergio Monteiro de Barros

Full Text Available Abstract The right femoral vessels of 80 rats were identified and dissected. External lengths and diameters of femoral arteries and femoral veins were measured using either a microscope or a video magnification system. Findings were correlated to animals’ weights. Mean length was 14.33 mm for both femoral arteries and femoral veins, mean diameter of arteries was 0.65 mm and diameter of veins was 0.81 mm. In our sample, rats’ body weights were only correlated with the diameter of their femoral veins.

Study of the anatomical position of the femoral nerve by magnetic resonance imaging in patients with fractured neck of femur: relevance to femoral nerve block.

LENUS (Irish Health Repository)

Mehmood, Shehzad

2012-01-31

STUDY OBJECTIVE: To determine the anatomical location of the femoral nerve in patients who have sustained fracture of the neck of femur, and its relevance to femoral nerve block technique. DESIGN: Prospective, observational clinical study. SETTING: Orthopedic and Radiology departments of a regional hospital. SUBJECTS: 10 consecutive adult ASA physical status II and III patients (mean age, 78.5 yrs) and 4 adult healthy volunteers. INTERVENTIONS: A T1 magnetic resonance imaging scan was performed of both upper thighs in patients and healthy volunteers successfully. MEASUREMENTS: The distance (mm) between the midpoint of the femoral artery and the midpoint of the femoral nerve, and the distance of the femoral nerve from the skin was measured at the mid-inguinal ligament, the pubic tubercle, and at the mid-inguinal crease. Data are shown as means (SD). Differences between both sides were compared using paired Student\\'s t-tests. P < 0.05 was significant. MAIN RESULTS: In patients the mean distance (mm) between the midpoint of the femoral nerve from the midpoint of femoral artery at the mid-inguinal crease on the fractured and non-fractured sides was 10.7 and 11.0, respectively (P = 0.87). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the mid-inguinal ligament on the fractured and non-fractured sides was 9.64 and 12.5, respectively (P = 0.03). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the pubic tubercle on the fractured and non-fractured sides was 8.74 and 10.49, respectively (P = 0.18). CONCLUSIONS: Blockade of the femoral nerve may be easier to perform at the mid-inguinal crease in patients with fractured neck of femur.

Hydrocele of the canal of Nuck

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Nourah ALSaleh

2018-02-01

Full Text Available Hydrocele of the canal of Nuck is a rare condition in female children caused by a failure of complete obliteration of the canal of Nuck. The canal of Nuck is an abnormal patent pouch of the peritoneum extending anterior to the round ligament of the uterus into the labia majora. Incomplete obliteration of this canal (patent processus vaginalis can result in either an inguinal hernia or a hydrocele. Here, we report two cases of hydrocele of the canal of Nuck presented within a two-month period. In the first case, incarcerated right-sided inguinal hernia was suspected while the second case was clinically diagnosed as encysted hydrocele of canal of Nuck. Both patients underwent surgical exploration. Hydrocelectomy with high ligation was also performed. One month after the surgery, the first patient showed signs of hydrocele on contralateral side, while the other patient showed no sign of contralateral hydrocele or hernia.

Stem cell- and growth factor-based regenerative therapies for avascular necrosis of the femoral head

Science.gov (United States)

2012-01-01

Avascular necrosis (AVN) of the femoral head is a debilitating disease of multifactorial genesis, predominately affects young patients, and often leads to the development of secondary osteoarthritis. The evolving field of regenerative medicine offers promising treatment strategies using cells, biomaterial scaffolds, and bioactive factors, which might improve clinical outcome. Early stages of AVN with preserved structural integrity of the subchondral plate are accessible to retrograde surgical procedures, such as core decompression to reduce the intraosseous pressure and to induce bone remodeling. The additive application of concentrated bone marrow aspirates, ex vivo expanded mesenchymal stem cells, and osteogenic or angiogenic growth factors (or both) holds great potential to improve bone regeneration. In contrast, advanced stages of AVN with collapsed subchondral bone require an osteochondral reconstruction to preserve the physiological joint function. Analogously to strategies for osteochondral reconstruction in the knee, anterograde surgical techniques, such as osteochondral transplantation (mosaicplasty), matrix-based autologous chondrocyte implantation, or the use of acellular scaffolds alone, might preserve joint function and reduce the need for hip replacement. This review summarizes recent experimental accomplishments and initial clinical findings in the field of regenerative medicine which apply cells, growth factors, and matrices to address the clinical problem of AVN. PMID:22356811

Assessment of three root canal preparation techniques on root canal geometry using micro-computed tomography: In vitro study

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Shaikha M Al-Ali

2012-01-01

Full Text Available Aim: To assess the effects of three root canal preparation techniques on canal volume and surface area using three-dimensionally reconstructed root canals in extracted human maxillary molars. Materials and Methods: Thirty extracted Human Maxillary Molars having three separate roots and similar root shape were randomly selected from a pool of extracted teeth for this study and stored in normal saline solution until used. A computed tomography scanner (Philips Brilliance CT 64-slice was used to analyze root canals in extracted maxillary molars. Specimens were scanned before and after canals were prepared using stainless steel K-Files, Ni-Ti rotary ProTaper and rotary SafeSiders instruments. Differences in dentin volume removed, the surface area, the proportion of unchanged area and canal transportation were calculated using specially developed software. Results: Instrumentation of canals increased volume and surface area. Statistical analysis found a statistically significant difference among the 3 groups in total change in volume (P = 0.001 and total change in surface area (P = 0.13. Significant differences were found when testing both groups with group III (SafeSiders. Significant differences in change of volume were noted when grouping was made with respect to canal type (in MB and DB (P < 0.05. Conclusion: The current study used computed tomography, an innovative and non destructive technique, to illustrate changes in canal geometry. Overall, there were few statistically significant differences between the three instrumentation techniques used. SafeSiders stainless steel 40/0.02 instruments exhibit a greater cutting efficiency on dentin than K-Files and ProTaper. CT is a new and valuable tool to study root canal geometry and changes after preparation in great details. Further studies with 3D-techniques are required to fully understand the biomechanical aspects of root canal preparation.

Avascular osteonecrosis of the femoral condyle after arthroscopic surgery; Osteonecrose aseptique du condyle femoral apres meniscectomie par voie arthroscopique

Energy Technology Data Exchange (ETDEWEB)

Al-Kaar, M.; Garcia, J. [Hopital Cantonal Geneve, Geneva (Switzerland); Fritschy, D.; Bonvin, J.C. [Policlinique de Chirurgie, Hopital Cantonal Universitaire, Geneve (Switzerland)

1997-04-01

Avascular osteonecrosis of the femoral condyle after arthroscopic surgery. Retrospective review of 10 patients who presented with avascular necrosis of the ipsilateral femoral condyle following arthroscopic meniscectomy (9 medial, 1 lateral). The bone lesions were evaluated by radiography and MRI, which were repeated for few patients. MRI allows earlier diagnosis of avascular necrosis of the femoral condyle and offers an evaluation of extent of the lesions whose evolution is variable: 3 patients required a knee prosthesis, the other 7 patients were treated medically. (authors). 21 refs.

Effect of Adductor Canal Block Versus Femoral Nerve Block on Quadriceps Strength, Mobilization, and Pain After Total Knee Arthroplasty

DEFF Research Database (Denmark)

Grevstad, Jens Ulrik; Mathiesen, Ole; Valentiner, Laura Risted Staun

2015-01-01

strength. METHODS: We included 50 TKA patients with severe movement-related pain; defined as having visual analog scale pain score of greater than 60 mm during active flexion of the knee. The ACB group received an ACB with ropivacaine 0.2% 30 mL and a femoral nerve block (FNB) with 30 mL saline. The FNB...... group received an ACB with 30 mL saline and an FNB with ropivacaine 0.2% 30 mL. We compared the effect of the ACB versus FNB on maximum voluntary isometric contraction of the quadriceps muscle relative to a postoperative baseline value. Secondary end points were differences between groups in ability...

Carcinoma espinocelular do conduto auditivo externo: estudo por tomografia computadorizada de seis casos Squamous cell carcinoma of the external auditory canal: computed tomography findings in six cases

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Fábio Mota Gonzalez

2005-06-01

Full Text Available OBJETIVO: Analisar a importância da avaliação tomográfica da extensão profunda dos carcinomas espinocelulares do conduto auditivo externo. MATERIAIS E MÉTODOS: Foram realizados exames tomográficos com cortes axiais e coronais com janelas para partes moles e óssea em seis pacientes com carcinoma espinocelular do conduto auditivo externo, com idade variando entre 55 e 71 anos, internados no Hospital Heliópolis, no período entre maio de 1995 e dezembro de 2003. RESULTADOS: Dos seis pacientes, todos apresentavam aumento de partes moles no conduto auditivo externo, cinco (83,3% tinham erosão óssea e invasão da orelha média, quatro (66,7% possuíam comprometimento da mastóide e da glândula parótida, três (50% apresentavam invasão da articulação temporomandibular, dois (33,3% tinham invasão da fossa média, do canal carotídeo e linfonodomegalia júgulo-carotídea alta ipisilateral. CONCLUSÃO: A avaliação da extensão tumoral profunda fornecida pela tomografia computadorizada é importante no estadiamento clínico, possibilitando um planejamento terapêutico mais eficaz.OBJECTIVE: To evaluate the role of computed tomography in the assessment of deep extension of squamous cell carcinoma of the external auditory canal. MATERIALS AND METHODS: In the period between May 1995 and December 2003 six patients with squamous cell carcinoma of the external auditory canal were submitted to computed tomography scan at "Hospital Heliópolis", São Paulo, SP, Brazil, including axial and coronal slices with soft tissue and bone algorithms. RESULTS: Thickening of the soft tissue of the external auditory canal was seen in all patients, bone erosion and invasion of the middle ear in five (83.3%, invasion of the mastoid and parotid gland in four (66.7%, invasion of the temporomandibular joint in three (50%, and invasion of the middle cranial fossa, carotid canal and cervical lymph node enlargement in two (33.3% patients. CONCLUSION: Assessment of

A FUNCTIONAL EVALUATION STUDY OF DISTAL FEMORAL FRACTURES FIXED WITH DISTAL FEMORAL LOCKING PLATE

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Manikumar C. J

2017-04-01

Full Text Available BACKGROUND Fractures of the distal femur present considerable challenges in management. Older patients especially women sustain fractures due to osteoporosis. Supracondylar fractures of femur have a bimodal distribution. They account for 6% of all femur fractures and 31% if hip fractures were excluded. Nearly, 50% of distal femur intra-articular fractures are open fractures. Before 1970, most supracondylar fractures were treated nonoperatively; however, difficulties were often encountered including persistent angulatory deformity, knee joint incongruity, loss of knee motion and delayed mobilisation. The trend of open reduction and internal fixation has become evident in recent years with good results being obtained with AO blade plate, dynamic condylar screw, intramedullary supracondylar nail and locking compression plate. Elderly patients and osteoporosis pose difficulty in treating intra-articular fractures of the lower end of femur. Loss of stable fixation is of great concern in these cases. Hence, locking compression plate use has an advantage in these patients. MATERIALS AND METHODS In this study, 20 patients with closed fracture of distal femur were studied. All the cases were treated at the Department of Orthopaedics, Rangaraya Medical College/Government General Hospital, Kakinada, Andhra Pradesh, between November 2013 and November 2015. The method used for fracture fixation was open reduction and internal fixation with distal femoral locking plate. The duration of follow up ranged from 3 months to 24 months. All the fractures in this series were posttraumatic. The patients were functionally evaluated with Neer’s scoring system. 1 RESULTS Twenty distal femoral fractures were treated with distal femoral locking plates. 15 patients were males and 5 patients were females. The median age was 47 years ranging from 28-70 years. 16 of the fractures were caused by road traffic accidents and 2 were due to fall, 2 were due to assault. 12 patients

21 CFR 872.3810 - Root canal post.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Root canal post. 872.3810 Section 872.3810 Food... DEVICES DENTAL DEVICES Prosthetic Devices § 872.3810 Root canal post. (a) Identification. A root canal... of the platinum group intended to be cemented into the root canal of a tooth to stabilize and support...

Benign aggressive lesions of femoral head and neck: Is salvage possible?

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Yogesh Panchwagh

2018-01-01

Full Text Available Background: Benign aggressive bone lesions of the femoral head and neck are mostly seen in young adults and warrant treatment for pain, impending fracture or established fracture, and disease clearance. It becomes challenging to treat them effectively while attempting salvage of the femoral head and yet achieving long term disease control with minimum complications. We describe our technique and experience in dealing with these lesions which can achieve the above-mentioned goals and can be easily replicated. Materials and Methods: We analyzed 15 cases of surgically treated, biopsy-proven benign, locally aggressive lesions affecting the femoral head and neck in skeletally mature individuals. All cases were treated with extended curettage through anterolateral modified Smith–Petersen approach along with tricortical iliac crest bone graft (combined with fibular graft in some cases reconstruction with or without suitable internal fixation. Results: All, except one, patients were available for follow up. The age ranged from 18 to 43 years and the follow up ranged between 24 and 124 months (average 78 months. These included aneurysmal bone cysts (9, giant cell tumors (4, and fibrous dysplasia (2. The indication was pain (8, with impending (2 or established pathological neck femur fracture (5. In all cases, there was satisfactory healing of lesion and timely rehabilitation. Nonunion, avascular necrosis or local recurrences were not seen. The MSTS functional score was good or excellent in all (range 26–29, average 28. Conclusion: Benign aggressive lesions affecting femoral head and neck in young and middle-aged adults pose a treatment challenge. A sturdy, lasting reconstruct with acceptable functional outcome and minimal recurrence rate can be achieved by salvaging the femoral head and neck using curettage and reconstruction, obviating the need for replacement at such an early age.

Clinical Effects of Novel Nanoscaled Core Decompression Rods Combined with Umbilical Cord Mesenchymal Stem Cells on the Treatment of Early Osteonecrosis of the Femoral Head

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Hongyang Gao

2015-01-01

Full Text Available Osteonecrosis of the femoral head (ONFH is one of the most common diseases in orthopedics. In this study, we investigated the clinical effects of novel nanoscaled core decompression rods combined with mesenchymal stem cells on the treatment of the ONFH. 12 adult patients with early ONFH (at the stage of Ficat II received the treatment using the implantation of novel nanoscaled core decompression rods combined with umbilical cord mesenchymal stem cells. The grade of the patients’ hip was scored by Harris marking system before and after the surgery, and then paired t-test was done. We assessed the curative efficiency based on the change of the patients before and after the surgery. In particular, the survival rate of femoral head was assessed at 12 months after the surgery. The results demonstrated that according to the standard of Harris Scoring, the average grade of hip joint before the surgery was 54.16 ± 4.23 points while average grade of hip joint at 12 months after the surgery was 85.28 ± 3.65 points. So, the implantation of the novel nanoscaled core decompression rods combined with mesenchymal stem cells had satisfactory clinical effects, suggesting that this implantation should be effective to treat early ONFH.

Simultaneous avascular necrosis of both medial and lateral femoral condyles

International Nuclear Information System (INIS)

Mansberg, R.

2002-01-01

Full text: Avascular necrosis (AVN) of a femoral condyle is a common orthopaedic condition. While both medial and lateral femoral condyles may be involved either singly or sequentially the simultaneous occurrence of AVN of both femoral condyles is extremely uncommon. A 57-year-old male is presented who developed the onset of severe left sided knee pain suddenly at rest. Plain and tomographic radiography was unremarkable and a bone scan was performed. Markedly increased vascularity was demonstrated in the left knee with intense osteoblastic activity in the left medial and femoral condyles more marked in the lateral femoral condyle. A diagnosis of AVN of both femoral condyles was made and a MRI exam was performed to confirm this unusual diagnosis. The MRI showed a diffuse increase in intensity bilaterally with subtle bony change in the subarticular bone consistent with AVN more marked in the left lateral femoral condyle. The patients' symptoms resolved with supportive treatment. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Semiconductor laser irradiation improves root canal sealing during routine root canal therapy

Science.gov (United States)

Hu, Xingxue; Wang, Dashan; Cui, Ting; Yao, Ruyong

2017-01-01

Objective To evaluate the effect of semiconductor laser irradiation on root canal sealing after routine root canal therapy (RCT). Methods Sixty freshly extracted single-rooted human teeth were randomly divided into six groups (n = 10). The anatomic crowns were sectioned at the cementoenamel junction and the remaining roots were prepared endodontically with conventional RCT methods. Groups A and B were irradiated with semiconductor laser at 1W for 20 seconds; Groups C and D were ultrasonically rinsed for 60 seconds as positive control groups; Groups E and F without treatment of root canal prior to RCT as negative control groups. Root canal sealing of Groups A, C and E were evaluated by measurements of apical microleakage. The teeth from Groups B, D and F were sectioned, and the micro-structures were examined with scanning electron microscopy (SEM). One way ANOVA and LSD-t test were used for statistical analysis (α = .05). Results The apical sealing of both the laser irradiated group and the ultrasonic irrigated group were significantly different from the control group (pirrigated group (p>0.5). SEM observation showed that most of the dentinal tubules in the laser irradiation group melted, narrowed or closed, while most of the dentinal tubules in the ultrasonic irrigation group were filled with tooth paste. Conclusion The application of semiconductor laser prior to root canal obturation increases the apical sealing of the roots treated. PMID:28957407

Marrow pattern in the proximal femoral metaphysis of patients with osteonecrosis of femoral head and normal subjects: comparison on MR images

International Nuclear Information System (INIS)

Chun, Ho Jong; Park, Jeong Mi; Kim, Jee Young; Lim, Gye Yeon; Yang, Po Song; Kim, Euy Neyong; Kim, Choon Yul; Shinn, Kyung Sub

1996-01-01

To predict early risk of osteonecrosis of the femoral head by comparison of the bone marrow pattern of the proximal femoral metaphysis(PFM) in normal subjects and patients with osteonecrosis of the femoral head on T1-weighted magnetic resonance(MR) images. The authors retrospectively reviewed T1(TR 525/TE 25 msec) weighted coronal MR images of 67 hips with osteonecrosis and 65 normal hips in 39 patients with osteonecrosis of the femoral head and in 27 normal subjects. On the basis of bright signal intensity of fat, the proportion of remaining hematopoietic marrow in PFM was subdivided into 4 grades (0 to 3) by two radiologists. No evidence of remaining hematopoietic marrow was assigned grade 0, and grades 1, 2 and 3 represented scanty, moderate, and prominent hematopoietic marrow, respectively. Grades 0 and 1 were collectively defined as 'predominantly fatty', grades 2 and 3 as 'predominantly hematopoietic'. The frequency of the predominantly fatty marrow in PFM was analyzed in relation to three age groups (<25, 25-50, 50<) and both sexes. The overall frequency of predominantly fatty marrow in PFM was higher in hips with osteonecrosis than in normal hips (p<0.001). Especially in the male population under the age of 50, the frequency was apparently higher in hips with osteonecrosis, compared with normal hips (p<0.0001). However, the male population aged over 50 or female population showed no statistically significant difference in our series. In proximal femoral metaphysis with osteonecrosis of the femoral head, fatty marrow conversion occurs apparently earlier than in normal subject. T1-weighted MR imaging could therefore be useful in predicting early risk of osteonecrosis of the femoral head because of early fatty marrow conversion of the proximal femoral metaphysis

A micro-architectural evaluation of osteoporotic human femoral heads to guide implant placement in proximal femoral fractures.

Science.gov (United States)

Jenkins, Paul J; Ramaesh, Rishikesan; Pankaj, Pankaj; Patton, James T; Howie, Colin R; Goffin, Jérôme M; Merwe, Andrew van der; Wallace, Robert J; Porter, Daniel E; Simpson, A Hamish

2013-10-01

The micro-architecture of bone has been increasingly recognized as an important determinant of bone strength. Successful operative stabilization of fractures depends on bone strength. We evaluated the osseous micro-architecture and strength of the osteoporotic human femoral head. 6 femoral heads, obtained during arthroplasty surgery for femoral neck fracture, underwent micro-computed tomography (microCT) scanning at 30 μm, and bone volume ratio (BV/TV), trabecular thickness, structural model index, connection density, and degree of anisotropy for volumes of interest throughout the head were derived. A further 15 femoral heads underwent mechanical testing of compressive failure stress of cubes of trabecular bone from different regions of the head. The greatest density and trabecular thickness was found in the central core that extended from the medial calcar to the physeal scar. This region also correlated with the greatest degree of anisotropy and proportion of plate-like trabeculae. In the epiphyseal region, the trabeculae were organized radially from the physeal scar. The weakest area was found at the apex and peripheral areas of the head. The strongest region was at the center of the head. The center of the femoral head contained the strongest trabecular bone, with the thickest, most dense trabeculae. The apical region was weaker. From an anatomical and mechanical point of view, implants that achieve fixation in or below this central core may achieve the most stable fixation during fracture healing.

The shape of the human lumbar vertebral canal A forma do canal vertebral lombar humano

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Edmundo Zarzur

1996-09-01

Full Text Available Literature on the anatomy of the human vertebral column characterizes the shape of the lumbar vertebral canal as triangular. The purpose of the present study was to determine the precise shape of the lumbar vertebral canal. Ten lumbar vertebral columns of adult male cadavers were dissected. Two transverse sections were performed in the third lumbar vertebra. One section was performed at the level of the lower border of the ligamenta flava, and the other section was performed at the level of the pedicles. The shape of the lumbar vertebral canal at the level of the pedicles tends to be oval or circular, whereas the shape of the lumbar vertebral canal at the level of the lower border of the ligamenta flava is triangular. Thus, the shape of the human lumbar vertebral canal is not exclusively triangular, as reported in the literature. It is related to the level of the transversal section performed on the lumbar vertebra. This finding should be taken into consideration among factors involved in the spread of solutions introduced into the epidural space.A literatura sobre a anatomia da coluna vertebral descreve como sendo triangular o formato do canal vertebral na região lombar. O objetivo deste estudo é determinar a real forma do canal da coluna vertebral lombar.Dez colunas vertebrais de cadáveres de homens adultos foram dissecadas. Dois cortes transversais foram executados na terceira vértebra lombar. Um corte foi feito no nível das bordas inferiores de dois ligamentos amarelos vizinhos e o outro corte foi transversal, no nível dos pedículos. A forma do canal vertebral variou: no nível dos pedículos ela tende a ser oval ou circular e junto às bordas inferiores dos ligamentos amarelos passa a ser triangular. Portanto, a forma do canal vertebral lombar não é somente triangular; ela depende do nível em que se faz o corte transversal da vértebra. Estes achados devem ser levados em consideração entre os fatores envolvidos na difusão das

One-session root canal treatment with antimicrobial photodynamic therapy (aPDT): an in vivo study.

Science.gov (United States)

Borsatto, M C; Correa-Afonso, A M; Lucisano, M P; Bezerra da Silva, R A; Paula-Silva, F W G; Nelson-Filho, P; Bezerra da Silva, L A

2016-06-01

To evaluate the response of the apical and periapical tissues of dog teeth with apical periodontitis after one-session root canal treatment with and without antimicrobial photodynamic therapy (aPDT) compared with the use of an intracanal dressing. Sixty root canals with an induced periapical lesion were instrumented and assigned to three groups: I, two-session root canal treatment using antibacterial dressing with calcium hydroxide-based paste; II, one-session root canal treatment using aPDT; and III, one-session root canal treatment in which the root canals were filled immediately after biomechanical preparation. The animals were euthanized after a 90-day experimental period. The maxillas and mandibles with teeth were submitted to histotechnical processing and haematoxylin-eosin staining. Descriptive microscopic analysis of the apical and periapical region characteristics was performed, as well as morphometric assessment of the periapical lesion areas in fluorescence microscopy. Quantitative data were analysed statistically by the nonparametric Kruskal-Wallis test and Dunn's post-test (α = 0.05). Group I was characterized by progressive repair, with the presence of fibres, cells and blood vessels. Group II had periodontal ligaments with the presence of collagen fibres and residual inflammatory cells. Group III had a dense inflammatory infiltrate with extensive oedematous areas and fibrillar dissociation, suggesting a persistent inflammatory and resorptive condition. Regarding periapical lesion size, group I had significantly smaller lesions (P session root canal treatment using a calcium hydroxide-based dressing was associated with significantly smaller periapical lesions at 90 days and characterized by progressive repair. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Management of osteonecrosis of the femoral head in children with sickle cell disease: results of conservative and operative treatments at skeletal maturity

OpenAIRE

Mallet, C.; Abitan, A.; Vidal, C.; Holvoet, L.; Mazda, K.; Simon, A.-L.; Ilharreborde, B.

2018-01-01

Abstract Purpose Sickle cell disease (SCD) is the most common cause of femoral head osteonecrosis (ONFH) during childhood with an overall prevalence of 10%. In children, spontaneous revascularization can occur, as in Legg-Calve-Perthes disease. Consequently, the aim of treatment is to restore proper hip containment to prevent joint arthritis. This is the first study reporting long-term results at skeletal maturity of non-operative and surgical treatments for ONFH in SCD children. Methods All ...

The unique organization of filamentous actin in the medullary canal of the medulla oblongata.

Science.gov (United States)

Tan, Bai-Hong; Guo, Chun-Yan; Xiong, Tian-Qing; Chen, Ling-Meng; Li, Yan-Chao

2017-04-01

In the central canal, F-actin is predominantly localized in the apical region, forming a ring-like structure around the circumference of the lumen. However, an exception is found in the medulla oblongata, where the apical F-actin becomes interrupted in the ventral aspect of the canal. To clarify the precise localization of F-actin, the fluorescence signals for F-actin were converted to the peroxidase/DAB reaction products in this study by a phalloidin-based ultrastructural technique, which demonstrated that F-actin is located mainly in the microvilli and terminal webs in the ependymocytes. It is because the ventrally oriented ependymocytes do not possess well-developed microvilli or terminal web that led to a discontinuous labeling of F-actin in the medullary canal. Since spinal motions can change the shape and size of the central canal, we next examined the cytoskeletons in the medullary canal in both rats and monkeys, because these two kinds of animals show different kinematics at the atlanto-occipital articulation. Our results first demonstrated that the apical F-actin in the medullary canal is differently organized in the animals with different head-neck kinemics, which suggests that the mechanic stretching of spinal motions is capable of inducing F-actin reorganization and the subsequent cell-shape changes in the central canal. Copyright © 2017 Elsevier Ltd. All rights reserved.

Surgery for pathological proximal femoral fractures, excluding femoral head and neck fractures: resection vs. stabilisation.

Science.gov (United States)

Zacherl, Max; Gruber, Gerald; Glehr, Mathias; Ofner-Kopeinig, Petra; Radl, Roman; Greitbauer, Manfred; Vecsei, Vilmos; Windhager, Reinhard

2011-10-01

Pathological femoral head and neck fractures are commonly treated by arthroplasty. Treatment options for the trochanteric region or below are not clearly defined. The purpose of this retrospective, comparative, double-centre study was to analyse survival and influences on outcome according to the surgical technique used to treat pathological proximal femoral fractures, excluding fractures of the femoral head and neck. Fifty-nine patients with 64 fractures were operated up on between 1998 and 2004 in two tertiary referral centres and divided into two groups. One group (S, n = 33) consisted of patients who underwent intramedullary nailing alone, and the other group (R, n = 31) consisted of patients treated by metastatic tissue resection and reconstruction by means of different implants. Median survival was 12.6 months with no difference between groups. Surgical complications were higher in the R group (n = 7) vs. the S group (n = 3), with no statistically significant difference. Patients with surgery-related complications had a higher survival rate (p = 0.049), as did patients with mechanical implant failure (p = 0.01). Survival scoring systems did not correlate with actual survival. Resection of metastases in patients with pathological fractures of the proximal femur, excluding femoral head and neck fractures, has no influence on survival. Patients with long postoperative survival prognosis are at risk of implant-related complications.

Femoral head vitality after intracapsular hip fracture

International Nuclear Information System (INIS)

Stroemqvist, B.

1983-01-01

Femoral head vitality before, during and at various intervals from the operation was determined by tetracycline labeling and/or 99 sp (m)Tc-MDP scintimetry. In a three-year follow-up, healing prognosis could be determined by scintimetry 3 weeks from operation; deficient femoral head vitality predicting healing complications and retained vitality predicting uncomplicated healing. A comparison between pre- and postoperative scintimetry indicated that further impairment of the femoral head vitality could be caused by the operative procedure, and as tetracycline labeling prior to and after fracture reduction in 370 fractures proved equivalent, it was concluded that the procedure of osteosynthesis probably was responsible for capsular vessel injury, using a four-flanged nail. The four-flanged nail was compared with a low-traumatic method of osteosynthesis, two hook-pins, in a prospective randomized 14 month study, and the postoperative femoral head vitality was significantly better in the hook-pin group. This was also clearly demonstrated in a one-year follow-up for the fractures included in the study. Parallel to these investigations, the reliability of the methods of vitality determination was found satisfactory in methodologic studies. For clinical purpose, primary atraumatic osteosynthesis, postoperative prognostic scintimetry and early secondary arthroplasty when indicated, was concluded to be the appropriate approach to femoral neck fracture treatment. (Author)

Dorello's Canal for Laymen: A Lego-Like Presentation.

Science.gov (United States)

Ezer, Haim; Banerjee, Anirban Deep; Thakur, Jai Deep; Nanda, Anil

2012-06-01

Objective Dorello's canal was first described by Gruber in 1859, and later by Dorello. Vail also described the anatomy of Dorello's canal. In the preceding century, Dorello's canal was clinically important, in understanding sixth nerve palsy and nowadays it is mostly important for skull base surgery. The understanding of the three dimensional anatomy, of this canal is very difficult to understand, and there is no simple explanation for its anatomy and its relationship with adjacent structures. We present a simple, Lego-like, presentation of Dorello's canal, in a stepwise manner. Materials and Methods Dorello's canal was dissected in five formalin-fixed cadaver specimens (10 sides). The craniotomy was performed, while preserving the neural and vascular structures associated with the canal. A 3D model was created, to explain the canal's anatomy. Results Using the petrous pyramid, the sixth nerve, the cavernous sinus, the trigeminal ganglion, the petorclival ligament and the posterior clinoid, the three-dimensional structure of Dorello's canal was defined. This simple representation aids in understanding the three dimensional relationship of Dorello's canal to its neighboring structures. Conclusion Dorello's canal with its three dimensional structure and relationship to its neighboring anatomical structures could be reconstructed using a few anatomical building blocks. This method simplifies the understanding of this complex anatomical structure, and could be used for teaching purposes for aspiring neurosurgeons, and anatomy students.

Early detection by sup(99m)Tc-Sn-pyrophosphate scintigraphy of femoral head necrosis following medial femoral neck fractures

International Nuclear Information System (INIS)

Greiff, J.; Lanng, S.; Hoeilund-Carlsen, P.F.; Karle, A.K.; Uhrenholdt, A.

1980-01-01

A selected series of 24 patients with displaced medial femoral neck fracture, treated with closed reduction and osteosynthesis with cancellous bone screws (ASIF), were investigated. During an observation period of 6 to 26 months, serial hip joint scintigraphies were performed and compared with serial X-ray examinations. At the first scintigraphic examination performed on average 5-6 weeks after the fracture, two separate investigators found a decreased amount of activity or no activity in the femoral head of 10 and 8 patients, respectively. At the second scintigraphic examination performed on average 11.1 weeks after the fracture both investigators found no activity or a decreased amount of activity in 8 patients. This figure declined to 7 during the following period, because one patient with decreased activity was recorded as having normal activity 15 months after the fracture. These 7 patients all developed radiological signs of femoral head collapse on average 16.3 months after the fracture (range 5-26 months), whereas their scintigrams displayed decreased or absent tracer uptake on average 1.2 months after the fracture (P<0.01). None of the patients with initially normal or increased uptake later showed decreased or absent uptake during the study and none developed radiological collapse. It may be concluded that absent or decreased uptake of sup(99m)Tc-Sn-pyrophosphate in the femoral head following medial femoral neck fracture indicates femoral head necrosis and a high risk of late segmental collapse, whereas normal or increased uptake implying preserved blood supply means that late segmental collapse will probably never develop. (author)

Prosthetic rehabilitation of intentionally malpositioned implants in a patient with squamous cell carcinoma of the external auditory canal: a clinical report.

Science.gov (United States)

Bagherpour, Reza; Mirfazaelian, Ali; Mangoli, Amir A; Alikhasi, Marzieh

2009-08-01

This clinical report describes the rehabilitation of a patient with a compromised temporal bone anatomy caused by resection of bone due to squamous cell carcinoma of external auditory canal. Tumor resection was followed by placement of three implants. The implants were intentionally malpositioned in the anterior-posterior plane due to the lack of temporal bone. Prosthodontic treatment included customized implant bar-supported auricular prosthesis.

Microbiological examination of infected dental root canals.

Science.gov (United States)

Gomes, B P F A; Pinheiro, E T; Gadê-Neto, C R; Sousa, E L R; Ferraz, C C R; Zaia, A A; Teixeira, F B; Souza-Filho, F J

2004-04-01

The aim of this study was to investigate the root canal microbiota of primary and secondary root-infected canals and the association of constituent species with specific endodontic signs and symptoms. Microbial samples were taken from 60 root canals, 41 with necrotic pulp tissues (primary infection) and 19 with failed endodontic treatment (secondary infection). Strict anaerobic techniques were used for serial dilution, plating, incubation and identification. A total of 224 cultivable isolates were recovered belonging to 56 different bacterial species. Individual root canals yielded a maximum of 10 bacterial species. Of the bacterial isolates, 70% were either strict anaerobes or microphilic. The anaerobes most frequently isolated were: Peptostreptococcus micros (35%), Fusobacterium necrophorum (23.3%), Fusobacterium nucleatum (11.7%), Prevotella intermedia/nigrescens (16.7%), Porphyromonas gingivalis (6.7%) and Porphyromonas endodontalis (5%). The root canal microflora of untreated teeth with apical periodontitis was found to be mixed, comprising gram-negative and gram-positive and mostly anaerobic microorganisms and usually containing more than 3 species per canal. On the other hand, facultative anaerobic and gram-positive bacteria predominated in canals with failed endodontic treatment, which harbored 1-2 species per canal. Suggested relationships were found between anaerobes, especially gram-negatives, and the presence or history of pain, tenderness to percussion and swelling (PEubacterium spp. (both Pspp. (Pspp. (Pspp. (Pspp. (Pspp. (Pspp. (Pspp. (Pspp., P. micros, F. necrophorum (P<0.05). Our findings indicate potential complex interactions of species resulting in characteristic clinical pictures which cannot be achieved by individual species alone. They also indicate that the microbiota of primary infected canals with apical periodontitis differs in number and in species from the secondary infected canals by using the culture technique.

External dose conversion factor from canal water

International Nuclear Information System (INIS)

Bhargava, Pradeep; Chitra, S.; Mhatre, Arti S.; Singh, Kapil Deo

2016-01-01

External dose needs to be estimated for the radioactivity discharged into the canal, as it constitutes one of the pathways of exposure to the public. Two activities are considered here: i) a walk along the bank of the canal ii) and the walk on the bridge. A concentration of 1 Bq/l is assumed here for the gross beta activity for the estimation of the dose conversion factor. A canal of width 14.39 m and the depth of 2.5 m is considered for this study. Length of the canal is taken to be infinite. Canal side wall is assumed to be the 25 cm thick concrete. Two points are selected, one on the bank, and the second on a bridge 1 m above the top surface of canal water. Dose Conversion factors for the person moving on the Bridge (at one meter above the water surface) and standing on bank of canal is estimated by using the QAD CG code for 137 Cs. Dose conversion factors for the location mentioned above are found to be 1.11E-10 Sv/hr/(Bq/l) and 1.55 E-11 Sv/hr/(Bq/l) for bridge and bank of canal respectively. (author)

Clinical significance of dental root canal microflora.

Science.gov (United States)

Gomes, B P; Lilley, J D; Drucker, D B

1996-01-01

Previous work by this group has shown that a significant association exists between pain and the presence of either Prevotella or Peptostreptococcus spp. in dental root canals. The aim of this study was to examine a more extensive series of canals microbiologically, to determine whether any other particular endodontic symptoms or clinical signs showed specific associations with individual bacterial species. Seventy root canals were examined microbiologically and clinical data collected to investigate in detail such associations. Of the canals studied, 37 were associated with pain, 49 with tenderness to percussion, 23 with swelling, six with purulent exudate and 57 presented with wet root canals. Anaerobes were isolated from 70.3% of painful canals and from 29.7% of pain-free canals. Significant associations were found between (a) pain and either Prevotella spp. or peptostreptococci, both with P spp. (P Eubacterium spp. (P spp. or Pstr. micros, both with P spp. (each P Eubacterium, Peptostreptococcus, Prevotella or Propionibacterium (each P < 0.05). It was concluded that several different endodontic clinical signs and symptoms are significantly associated with specific bacterial species.

El Canal del Atazar I

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López de Berges y de los Santos, Emilio

1967-03-01

Full Text Available The Atazar Canal helps to supply Madrid with water, from the rivers Lozoya, Jarama and Sorbe. The section which operates at present starts at the Torrelaguna dam and finishes at the El Goloso reservoir. Later a further section will be added, from the Atazar dam, on the Lozoya river, to link up with the control dam at Torrelaguna. The canal capacity is 16 m3/sec, and it is 43.47 km long. It has a slope of 4/10.000. The cross section is similar to that of the Jarama canal, already built. There are interconnections between this canal and the Canal Alto, which previously supplied the high and medium part of Madrid. To overcome the ground unevenness 5 syphons have been built, the most important of which is the Colmenar Goloso syphon, which is 10.88 km in length. Construction commenced on December 10, 1962, and water reached Madrid on June 15th, 1966. The initial budget for this project was 1,500 million pesetas.El canal del Atazar refuerza considerablemente el abastecimiento de aguas a Madrid, procedentes de los ríos Lozoya, Jarama y, en un próximo futuro, del Sorbe. El tramo, actualmente en funcionamiento, empieza en el salto de Torrelaguna y finaliza en los depósitos de El Goloso. Más adelante se completará su trazado mediante un nuevo tramo que partirá del embalse de Atazar, en el Lozoya, para unirse al actual en el depósito regulador de Torrelaguna. Su capacidad es de 16 m3/s; su longitud, 43,471 km, y su pendiente, 4 diezmilésimas. La sección tipo es análoga a la del canal del Jarama, de construcción anterior. Mediante la oportuna obra de transvase se realizan intercambios entre este Canal y el Canal Alto que abastecía anteriormente la parte media y alta de la capital. Para salvar los desniveles del terreno se han construido 5 sifones, siendo el más importante el de Colmenar-Goloso, con una longitud de 10,8S4 km. El comienzo de las obras tuvo lugar el 10 de diciembre de 1962, y el agua llegó a Madrid el 15 de junio de 1966. Su

Detection of Mesiobuccal Canal in Maxillary Molars and Distolingual Canal in Mandibular Molars by Dental CT: A Retrospective Study of 100 Cases

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Sushma Rathi

2010-01-01

Full Text Available Objective. To detect presence of MB2 canal in maxillary molars and distolingual canal in mandibular molars by Dental CT. Material and Methods. A retrospective study of 100 Dental CTs was done. Axial and paraxial images obtained were used to assess the presence of MB2 canal in maxillary molars and distolingual canal in mandibular molars. Results. The youngest patient was of 11 years while the eldest patient was of 77 years. Males were 58 in number and females were 42 in number. MB2 canals were present in 57 patients and distolingual canal was present in 18 patients. Maximum MB2 canals were present in age group between 51 and 60 years, while distolingual canals were present in age group of 21–30 years. Conclusion. Dental CT allows adequate visualization of variation in root canal morphology and can be important diagnostic tool for successful endodontic therapy.

Femoral Head Avascular Necrosis Is Not Caused by Arthroscopic Posterolateral Femoroplasty.

Science.gov (United States)

Rupp, Robert E; Rupp, Sasha N

2016-05-01

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

Selective arteriography in femoral head fractures

Energy Technology Data Exchange (ETDEWEB)

Mannella, P; Galeotti, R; Borrelli, M; Benea, G; Massari, L; Chiarelli, G M

1986-01-01

The choice between conservative and radical operation in case of femoral neck fractures is very important because it is the determining factor for a successfull therapy. In case of epiphysial necrosis, an endoprosthesis as well as an osteosynthesis will be carried out. Selective arteriography of the medical circumflex artery represents the most reliable study to establish, immediately after the fractures, the possible presence of a post-traumatic ischemic necrosis. Angiography, as a reliable diagnostic tool, has to be carried out in the most selective way and needs the image subtraction technique. The authors report their preliminary results on the reliability of angiography in the femoral epiphyseal ischemic necrosis diagnosed by comparing the results of angiography with the wood light test carried out on the surgically removed femoral head. 18 refs.

[Femoral artery pseudoaneurysms encountered in orthopedics and traumatology].

Science.gov (United States)

Raherinantenaina, F; Rajaonanahary, T M A; Rakoto Ratsimba, H N

2015-12-01

Most published articles regarding orthopedic- and trauma-related femoral artery pseudoaneurysms (FAPs) are case reports in English. Reported cases are often associated with a literature review but actually provide little robust data. We wanted to summarize the current knowledge on diagnostic and therapeutic features of these FAPs. A new case of superficial FAP is described followed by a review of the literature. A bibliographic search was performed online (PubMed, ScinceDirect) from 1964 to 2015 using the descriptors "traumatic femoral pseudoaneurysm, orthopedic surgery, osteochondroma". A total of 64 cases of FAPs was analyzed. There were 50 men with an average age of 40.72±26.45 years old. The most common clinical presentation was painful swelling (34%). Arteriography was the commonest radiological investigation used (63%). The main etiologies were orthopedic injuries (47%), surgery of the upper thigh (30%) and femoral osteochondromas (23%). Arterial injuries included superficial femoral (47%) and profunda femoris artery (50%). The treatment was open surgery (56%) or endovascular repair (36%). Deep femoral artery and its branches were embolized (47%) or ligated (38%). Endovascular stenting was performed in 30% of posttraumatic FAPs. All FAPs relating to osteochondromas were repaired surgically. Postoperative courses were uneventful in 95% of patients. Endovascular embolization is preferred in management of postsurgical FAPs which have usually involved the deep femoral artery. Endovascular stenting graft may be proposed for posttraumatic FAPs, for which the superficial femoral trunk is the most often involved vessel. Surgical repair should be performed when endovascular stenting graft is not feasible. Surgical repair is mandatory for all FAPs secondary to traumatic exostoses. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Blue Ear Cyst: A Rare Eccrine Hidrocystoma of the Ear Canal and Successful Endoscopic Excision

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Taha A. Mur

2016-01-01

Full Text Available Aims. Hidrocystomas are benign cystic growths of the apocrine and eccrine sweat glands. These cystic lesions have been well documented on the face, head, and neck, but rarely in the external auditory canal. Presentation of Case. A 67-year-old woman presented with a bluish cystic mass partially occluding the external auditory canal and interfering with hearing aid use. Lesion was excised completely via a transcanal endoscopic approach with excellent cosmetic results, no canal stenosis, and no recurrence at 1-year follow-up. Discussion. We present a rare eccrine hidrocystoma of the external auditory canal and successful excision of this benign lesion. We describe the surgical management using a transcanal endoscopic approach and follow-up results. An eccrine gland cyst that presents as a mass occluding the external auditory canal is quite rare. There are only a few such cases reported in the literature. These masses can be mistaken for basal cell carcinomas or cholesterol granulomas but can be easily differentiated using histopathology. Conclusion. Eccrine hidrocystoma is a cystic lesion of sweat glands, rarely found in the external auditory canal. A characteristic bluish hue aids in diagnosis and surgical excision using ear endoscopy provides excellent control.

Avascular necrosis of the femoral head: MR imaging with histologic correlation

Energy Technology Data Exchange (ETDEWEB)

Lee, Chae Guk; Cha, Seong Sook; Eun, Choong Ki; Yang, Young Il; Choi, Jang Seok [Pusan Paik Hospital, College of Medicine, Inje University, Busan (Korea, Republic of); Park, Dong Woo [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

1995-07-15

To correlate MR findings with histologic findings in avascular necrosis (AVN) of the femoral head. MR findings was performed with 8 femoral head specimens using T1-and proton density weighted coronal SE sequences, and compared with contact radiography and histologic sections. In each specimen, necrotic zone in the superior portion of femoral head, repair zone located inferior to the necrotic zone, and rim adjacent to normal bone marrow could be defined. Necrotic zone showed high signal intensity on both T1-and proton density-weighted images in 3 cases which were composed of necrotic bone and marrow, and low signal intensity on both sequences in 2 cases which were composed of necrotic bone marrow with amorphous cellular debris. Mixed high and low signal intensities were seen in 3 cases. The repair zone showed low signal intensity on T1-weighted image and high signal intensity on proton density weighted image in 5 cases which were composed of thickened trabecular bone and mesenchymal tissue and also showed intermediate signal intensity on T1-weighted image and high signal intensity on proton density weighted image in 3 cases which were composed of osteoid, chondroid and undifferentiated mesenchymal cells. Rim shown as the low signal intensity on T1 weighted image in all cases was corresponded to viable thickened trabecular bone. MR imaging would be the best modality in the diagnosis of avascular necrosis of femoral head and when used in conjunction with degree and location of signal intensity, the prediction of histologic finding may be possible.

Avascular necrosis of the femoral head: MR imaging with histologic correlation

International Nuclear Information System (INIS)

Lee, Chae Guk; Cha, Seong Sook; Eun, Choong Ki; Yang, Young Il; Choi, Jang Seok; Park, Dong Woo

1995-01-01

To correlate MR findings with histologic findings in avascular necrosis (AVN) of the femoral head. MR findings was performed with 8 femoral head specimens using T1-and proton density weighted coronal SE sequences, and compared with contact radiography and histologic sections. In each specimen, necrotic zone in the superior portion of femoral head, repair zone located inferior to the necrotic zone, and rim adjacent to normal bone marrow could be defined. Necrotic zone showed high signal intensity on both T1-and proton density-weighted images in 3 cases which were composed of necrotic bone and marrow, and low signal intensity on both sequences in 2 cases which were composed of necrotic bone marrow with amorphous cellular debris. Mixed high and low signal intensities were seen in 3 cases. The repair zone showed low signal intensity on T1-weighted image and high signal intensity on proton density weighted image in 5 cases which were composed of thickened trabecular bone and mesenchymal tissue and also showed intermediate signal intensity on T1-weighted image and high signal intensity on proton density weighted image in 3 cases which were composed of osteoid, chondroid and undifferentiated mesenchymal cells. Rim shown as the low signal intensity on T1 weighted image in all cases was corresponded to viable thickened trabecular bone. MR imaging would be the best modality in the diagnosis of avascular necrosis of femoral head and when used in conjunction with degree and location of signal intensity, the prediction of histologic finding may be possible

77 FR 42644 - Safety Zone; Canal Fest of the Tonawandas, Erie Canal, Tonawanda, NY

Science.gov (United States)

2012-07-20

.... ACTION: Temporary final rule. SUMMARY: The Coast Guard is establishing a temporary safety zone on the... Canal during the Canal Fest of the Tonawandas Fireworks display. This temporary safety zone is necessary to protect spectators and vessels from the hazards associated with a fireworks display. DATES: This...

Water Environment Evolution along the China Grand Canal

International Nuclear Information System (INIS)

Mao, F; Wu, Y X; Yang, B F; Li, X J

2014-01-01

The China Grand Canal is one of the earliest canals in the world, having lasted for nearly 3000 years. Even its section canals have a rich history, such as the North-South Grand Canal that was established during the Sui Dynasty, whereas the Beijing-Hangzhou Canal was excavated during the Yuan Dynasty and the east line of the South-to-North Water Diversion. As one of the longest in the world, the China Grand Canal's total length is over 3500 kilometers. This length includes the navigable, unnavigable, and underground sections. Making the best use of situations and according to local conditions, the Chinese people harmoniously constructed the Beijing-Hangzhou Canal with nature. Tens of millions of workers took nearly 3000 years to complete the great shipping system. Navigable sections still exist for up to 900 kilometers and the volume of freight traffic is approximately 300 million tons. The canal remains the main logistical channel of the North-to-South Coal Transportation, South-to-North Water Diversion, and resources circulation. To date, China is promoting the success of heritage application. Part of these efforts is the declaration of the China Grand Canal as a World Cultural Heritage by 2014. In addition, the east route of the South-to-North Water Transfer project is planned to be navigable by 2016. The ancient Beijing-Hangzhou Grand Canal will usher in the new ecological civilization and cultural revival along the canal. This paper presents technical methods of water environment evolution research on the river system, river, and water quality along the Beijing-Hangzhou Canal through the integration of historical literature and modern remote sensing image data. The study carried out water environment investigation and analysis along the Beijing-Hangzhou canal by using ETM, SPOT image data, and GPS measurement data. Spatial and temporal evolution characteristics and regulations of the Beijing-Hangzhou Grand Canal regional water environment in the span of

Computed tomography of the facial canal

International Nuclear Information System (INIS)

Kiuchi, Sousuke

1983-01-01

The radiological details of the facial canal was investigated by computed tomography. In the first part of this study, dry skulls were used to delineate the full course of the facial canal by computed tomography. In the second part of this study, the patients with chronic otitis media and secondary cholesteatoma were evaluated. The labyrinthine and tympanic parts of the canal were well demonstrated with the axial scanning, and the mastoid part with the coronal scanning. Moreover, computed tomography showed excellent delineation of the middle ear contents. In patients with secondary cholesteatoma, the destructions of the intratympanic course of the bony facial canal were also assessed preoperatively. (author)

[Midterm follow-up results on Asian femoral intramedullary nail for the treatment of segmental and comminuted femoral fractures].

Science.gov (United States)

Li, Lang; Gao, Feng; Huang, Qi; Li, Qiang; Xie, Lin; Zhang, Bin

2016-06-01

To investigate midterm follow-up results on Asian femoral intramedullary nail in treating segmental and comminuted femoral fractures. Between June 2011 and October 2012,16 patients with segmental and comminuted femoral fractures were treated with minimally invasive reset and Asian femoral intramedullary nail under extension table. Among them, there were 10 males and 6 females aged from 21 to 49 years old with an average of 34.5 years old; the time from injury to operation ranged from 3 to 24 d with an average of 9.1 d. There were 6 cases were type C1,2 cases were type C2 and 8 cases were type C3 according to AO classification. X-ray of femoral segment at 3,6 and 12 months after operation were applied for evaluating fracture healing. Harris score of hip joint and HSS score of knee joint were used to evaluate postoperative function. All patients were followed up from 24 to 36 months with an average of 28.4 months. Operative time was from 88 to 112 min with an average of 90.7 min; blood loss ranged from 150 to 200 ml with an average of 188.75 ml; the time of fracture healing was from 5 to 9 months with an average of 5.4 months. All incision were healed at stage I. No loosening, breakage of internal fixation and displacement of fracture were occurred. There were no significant differences in Harris score of hip joint at 3, 6 and 12 months after operation (F = 0.07, P = 0.893 > 0.05), 10 cases obtained excellent results, 5 good and 1 moderate. There was no obvious meaning in HSS score of knee joint (F = 0.08,P = 0.876 > 0.05), 9 cases obtained excellent results, 6 good and 1 poor. Asian femoral intramedullary nail could treat segmental and comminuted femoral fractures by using variety of less invasive ways,which has advantages of less trauma, quick recovery of function and satisfied midterm following-up results. But long term following-up effects remains to be seen.

Radiation-induced external ear canal cholesteatoma-like disease

Energy Technology Data Exchange (ETDEWEB)

Ishihara, Akiko; Okuno, Hideji; Noguchi, Keisuke; Komatsuzaki, Atsushi [Tokyo Medical and Dental Univ. (Japan). School of Medicine

1999-06-01

Three cases of cholesteatoma-like disease in the ear canals after radiation therapy for head and neck tumor were reported. Effect of irradiation on bone and soft tissue including skin brings about pathological reaction to the external ear canal as well. Two types of disease resembling cholesteatomas have been recognized: keratosis obturans (KO) and external auditory canal cholesteatoma (EACC). KO appears to be derived from disease of canal skin involved with keratinization, creating a widning of the canal. EACC, on the other hand, seems to develop in the disease of bony canal where a localized absorption of its bone with invasion of squamous epithelium takes place. (author)

Computerized tomography in evaluation of decreased acetabular and femoral anteversion

International Nuclear Information System (INIS)

Toennis, D.; Skamel, H.J.

2003-01-01

Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.) [de

Acceleration induced water removal from ear canals.

Science.gov (United States)

Kang, Hosung; Averett, Katelee; Jung, Sunghwan

2017-11-01

Children and adults commonly experience having water trapped in the ear canals after swimming. To remove the water, individuals will shake their head sideways. Since a child's ear canal has a smaller diameter, it requires more acceleration of the head to remove the trapped water. In this study, we theoretically and experimentally investigated the acceleration required to break the surface meniscus of the water in artificial ear canals and hydrophobic-coated glass tubes. In experiments, ear canal models were 3D-printed from a CT-scanned human head. Also, glass tubes were coated with silane to match the hydrophobicity in ear canals. Then, using a linear stage, we measured the acceleration values required to forcefully eject the water from the artificial ear canals and glass tubes. A theoretical model was developed to predict the critical acceleration at a given tube diameter and water volume by using a modified Rayleigh-Taylor instability. Furthermore, this research can shed light on the potential of long-term brain injury and damage by shaking the head to push the water out of the ear canal. This research was supported by National Science Foundation Grant CBET-1604424.

Femoral neck fracture following groin irradiation

Energy Technology Data Exchange (ETDEWEB)

Grigsby, Perry W; Roberts, Heidi L; Perez, Carlos A

1995-04-30

Purpose: The incidence and risk factors are evaluated for femoral neck fracture following groin irradiation for gynecologic malignancies. Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the Mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group, 207 patients were identified who received irradiation to the pelvis and groins with anterposterior-posterior anterior (AP-PA), 18 MV photons. Data were reviewed regarding irradiation dose to the femoral neck and other presumed risk factors including age, primary site, stage, groin node status, menopausal status, estrogen use, cigarette use, alcohol consumption, and osteoporosis. Results: The per-patient incidence of femoral neck fracture was 4.8% (10 out of 207). Four patients developed bilateral fractures. However, the cumulative actuarial incidence of fracture was 11% at 5 years and 15% at 10 years. Cox multivariate analysis of age, weight, and irradiation dose showed that only irradiation dose may be important to developing fracture. Step-wise logistic regression of presumed prognostic factors revealed that only cigarette use and x-ray evidence of osteoporosis prior to irradiation treatment were predictive of fracture. Conclusion: Femoral head fracture is a common complication of groin irradiation for gynecologic malignancies. Fracture in our database appears to be related to irradiation dose, cigarette use, and x-ray evidence of osteoporosis. Special attention should be given in treatment planning (i.e., shielding of femoral head/neck and use of appropriate electron beam energies for a portion of treatment) to reduce the incidence of this complication.

Femoral neck fracture following groin irradiation

International Nuclear Information System (INIS)

Grigsby, Perry W.; Roberts, Heidi L.; Perez, Carlos A.

1995-01-01

Purpose: The incidence and risk factors are evaluated for femoral neck fracture following groin irradiation for gynecologic malignancies. Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the Mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group, 207 patients were identified who received irradiation to the pelvis and groins with anterposterior-posterior anterior (AP-PA), 18 MV photons. Data were reviewed regarding irradiation dose to the femoral neck and other presumed risk factors including age, primary site, stage, groin node status, menopausal status, estrogen use, cigarette use, alcohol consumption, and osteoporosis. Results: The per-patient incidence of femoral neck fracture was 4.8% (10 out of 207). Four patients developed bilateral fractures. However, the cumulative actuarial incidence of fracture was 11% at 5 years and 15% at 10 years. Cox multivariate analysis of age, weight, and irradiation dose showed that only irradiation dose may be important to developing fracture. Step-wise logistic regression of presumed prognostic factors revealed that only cigarette use and x-ray evidence of osteoporosis prior to irradiation treatment were predictive of fracture. Conclusion: Femoral head fracture is a common complication of groin irradiation for gynecologic malignancies. Fracture in our database appears to be related to irradiation dose, cigarette use, and x-ray evidence of osteoporosis. Special attention should be given in treatment planning (i.e., shielding of femoral head/neck and use of appropriate electron beam energies for a portion of treatment) to reduce the incidence of this complication

Hood Canal Steelhead - Hood Canal Steelhead Supplementation Experiment

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Hood Canal Steelhead Project is a 17-year before-after-control-impact experiment that tests the effects of supplementation on natural steelhead populations in...

Estimated carotid-femoral pulse wave velocity has similar predictive value as measured carotid-femoral pulse wave velocity

DEFF Research Database (Denmark)

Greve, Sara V; Blicher, Marie K; Kruger, Ruan

2016-01-01

BACKGROUND: Carotid-femoral pulse wave velocity (cfPWV) adds significantly to traditional cardiovascular risk prediction, but is not widely available. Therefore, it would be helpful if cfPWV could be replaced by an estimated carotid-femoral pulse wave velocity (ePWV) using age and mean blood pres...... that these traditional risk scores have underestimated the complicated impact of age and blood pressure on arterial stiffness and cardiovascular risk....

Canal Centring Ability of ProTaper and Mtwo Rotary Systems in Curved Canals

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Turkaydin Dilek Erbay

2014-07-01

Full Text Available The purpose of this investigation was to compare centring ratio of ProTaper and Mtwo rotary systems. 60 mandibular molar teeth which had 25, 30 and 35 degree curvature in mesio-buccal root canal were used. Group 1 had 25°, Group 2 had 30°, and Group 3 had 35° curvatures. The roots were sectioned horizontally at 2 mm away from the apex. The apical region was then observed under a stereo-microscope. In each group, teeth were instrumented using ProTaper and Mtwo systems. After canal preparation, digital images of apical part of canals were taken. These images were then superimposed by using Adobe Photoshop CS2 programme. The data were analyzed using ANOVA and Student’s t-test.

Femoral Condyle Fracture during Anterior Cruciate Ligament Reconstruction

Directory of Open Access Journals (Sweden)

Selahattin Ozyurek

2015-07-01

Full Text Available Dear Editor,We have greatly enjoyed reading the case report entitled “‘Femoral Condyle Fracture during Revision of Anterior Cruciate Ligament Reconstruction: Case Report and a Review of Literature in the issue of Arch Bone Jt Surg. 2015;3(2 with great interest. We would like to commend the authors for their detailed and valuable work. Although various case reports have described postoperative distal femur fracture at a range of time intervals (1,2 intraoperative intra-articular distal femur fracture is a unique entity.However, we believe that some important additional observations seem necessary to be contributed through this study. In this article, the authors stated that, to the best of their knowledge, there is no other case report in the literature introducing a femoral condyle fracture during arthroscopic ACL reconstruction or revision reconstruction. Nevertheless, we would like to call the attention of the readers to the fact that that the literature contains one additional case report re‌porting on intraoperative distal femoral coronal plane (Hoffa fracture during primary ACL reconstruction (2. Werner BC and Miller MD presented of case report of an intraoperative distal femoral coronal plane (Hoffa fracture that occurred during independent femoral tunnel drilling and dilation in a primary ACL reconstruction. As in the their case, this type of fracture can occur with appropriately placed femoral tunnels, but the risk can increase with larger graft diameters in patients with smaller lateral femoral condyles The patient was treated with open reduction and internal fixation, without compromise of graft stability and with good recovery of function. We believe that tailoring graft size to the size of the patient is important to prevent similar adverse events.

Management of osteonecrosis of the femoral head in children with sickle cell disease: results of conservative and operative treatments at skeletal maturity.

Science.gov (United States)

Mallet, C; Abitan, A; Vidal, C; Holvoet, L; Mazda, K; Simon, A-L; Ilharreborde, B

2018-02-01

Sickle cell disease (SCD) is the most common cause of femoral head osteonecrosis (ONFH) during childhood with an overall prevalence of 10%. In children, spontaneous revascularization can occur, as in Legg-Calve-Perthes disease. Consequently, the aim of treatment is to restore proper hip containment to prevent joint arthritis. This is the first study reporting long-term results at skeletal maturity of non-operative and surgical treatments for ONFH in SCD children. All children with ONFH due to SCD were retrospectively reviewed. At initial evaluation, extension of osteonecrosis was radiographically defined using Catterall, lateral pillar Herring and Ficat classifications. Subluxation of the femoral head with Reimers migration index > 30% required surgical treatment including femoral varus osteotomy and/or pelvic osteotomies. Conservative treatment including non-weight bearing and physiotherapy was performed in the remaining cases. Outcomes were assessed at skeletal maturity using the Harris Hip Score (HHS) and the Stulberg classification. Total hip arthroplasty and Stulberg 5 were defined as failures. A total of 25 hips in 17 patients were included (mean follow-up 7.5 years SD 3.4). Mean age at diagnosis was 11.4 years SD 2.9. In all, 15 hips (60%) were classified Catterall 3 and 4 and Herring B and C. A total of 13 patients (52%) underwent surgical treatment. At skeletal maturity, mean HHS was good (81 SD 17), 12 hips (48%) were classified Stulberg 1 and 2, seven hips (28%) were classified Stulberg 3 and 4. Both treatments led to good functional results with 75% of congruent hips at skeletal maturity. IV.

Effect of canal preparation with TRUShape and Vortex rotary instruments on three-dimensional geometry of oval root canals.

Science.gov (United States)

Arias, Ana; Paqué, Frank; Shyn, Stephanie; Murphy, Sarah; Peters, Ove A

2018-04-01

The purpose of this study was to assess the geometry of non-round root canals after preparation with TRUShape (a novel instrument with s-shaped longitudinal design) in comparison to conventional rotary instrumentation using micro-computed tomography. Twenty distal root canals of mandibular molars were randomly distributed in two groups to be shaped with either TRUShape or Vortex rotaries. Percentages of unprepared surface and volume of dentin removal for the entire canal and for the apical 4 mm were calculated. Canal transportation and the structure model index (SMI) were assessed. Data were compared with Student t-tests. Shaping with both techniques resulted in similar prepared surface and volume of dentin removed, as well as the extent of canal transportation. The SMI shape factor was significantly lower for TRUShape preparations (P = 0.04) suggesting less rounding during rotary preparation. Although both instruments were suitable for the preparation of oval canals, TRUShape appeared to better conform to the original ribbon-shaped anatomy. © 2017 Australian Society of Endodontology Inc.

Radioanatomy of the singular nerve canal

Energy Technology Data Exchange (ETDEWEB)

Muren, C. [Dept. of Diagnostic Radiology, Sabbatsbergs Hospital, Stockholm (Sweden); Wadin, K. [University Hospital, Uppsala (Sweden); Dimopoulos, P. [University Hospital, Uppsala (Sweden)

1991-08-01

The singular canal conveys vestibular nerve fibers from the ampulla of the posterior semicircular canal to the posteroinferior border of the internal auditory meatus. Radiographic identification of this anatomic structure helps to distinguish it from a fracture. It is also a landmark in certain surgical procedures. Computed tomography (CT) examinations of deep-frozen temporal bone specimens were compared with subsequently prepared plastic casts of these bones, showing good correlation between the anatomy and the images. The singular canal and its variable anatomy were studied in CT examinations of 107 patients. The singular canal could be identified, in both the axial and in the coronal planes. Its point of entry into the internal auditory meatus varied considerably. (orig.)

Treatment of the femoral neck peudoarthrosis in childhood: Case report

Directory of Open Access Journals (Sweden)

Vukašinović Zoran

2013-01-01

Full Text Available Introduction. Femoral neck fractures in children and adolescents are rare. However, their complications are frequent - avascular necrosis, femoral neck pseudoarthrosis, premature physeal closure with consequent growth disturbance and coxa vara deformity. Case Outline. A 9.5­year­old boy was injured in a car accident, and femoral neck fracture was diagnosed. Prior to admission at our hospital he was surgically treated several times. He was admitted at our hospital eight months following the accident. On the X­ray transcervical pseudoarthrosis of the femoral neck was found, as well as coxa vara deformity and metaphyseal avascular necrosis. He was operated at our hospital; all previously placed ostefixation material was removed, valgus osteotomy of 30 degrees was done as well as additional local osteoplasty using the commercial osteoindactive agent (Osteovit®. Postoperatively, we applied skin traction, bed rest and physical therapy. At the final follow­up, the patient was recovered completely. He is now painless, the legs are of equal length, range of movements in the left hip is full, life activity is normal. The X­ray shows that the femoral neck pseudoarthrosis is fully healed. Conclusion. This case is presented in order to encourage other colleagues to challenge the problematic situation such as this one. Also, we would like to remind them what one should think about and what should be taken into consideration in the primary treatment of femoral neck fractures in children. Valgus femoral osteotomy, as a part of the primary treatment of femoral neck fracture in children (identically as in the adults can prevent the occurrence of femoral neck pseudoarthrosis.

Femoral neck fractures complicating gaucher disease in children

International Nuclear Information System (INIS)

Goldman, A.B.; Jacobs, B.

1984-01-01

In normal children, fractures of the femoral neck are uncommon and accompany severe trauma and multiple injuries elsewhere in the skeleton. In children with Gaucher disease, a rare hereditary disorder of lipid metabolism, midcervical or basicervical fractures can occur with minor or no trauma and without other injury to the skeleton. Three children with Gaucher disease who developed pathologic fractures of the femoral neck are described. In all three, the fractures occurred between five and nine years of age, and the fracture lines passed through areas of abnormal bone characterized by poorly defined patches of increased and decreased density and cortical thinning along the medial femoral necks. In the affected hips, there was no evidence of avascular necrosis of the femoral heads at the time of injury. One child's fracture was preceeded by multiple bone 'crisis' localized to the proximal femora. (orig.)

Femoral neck fractures complicating gaucher disease in children

Energy Technology Data Exchange (ETDEWEB)

Goldman, A B; Jacobs, B

1984-09-01

In normal children, fractures of the femoral neck are uncommon and accompany severe trauma and multiple injuries elsewhere in the skeleton. In children with Gaucher disease, a rare hereditary disorder of lipid metabolism, midcervical or basicervical fractures can occur with minor or no trauma and without other injury to the skeleton. Three children with Gaucher disease who developed pathologic fractures of the femoral neck are described. In all three, the fractures occurred between five and nine years of age, and the fracture lines passed through areas of abnormal bone characterized by poorly defined patches of increased and decreased density and cortical thinning along the medial femoral necks. In the affected hips, there was no evidence of avascular necrosis of the femoral heads at the time of injury. One child's fracture was preceeded by multiple bone 'crisis' localized to the proximal femora.

Training effect of using Touch Surgery for intramedullary femoral nailing.

Science.gov (United States)

Sugand, Kapil; Mawkin, Mala; Gupte, Chinmay

2016-02-01

Simulation in orthopaedic training is becoming increasingly popular and has been widely used in formal curricula. However, these resources are expensive and not easily accessible to every trainee. Other means of disseminating surgical education through virtual reality (VR) multimedia can act as useful adjunct to traditional methods of teaching. One validated VR platform is Touch Surgery, a cognitive task simulation and rehearsal app. The primary objective of this study was to identify the training effect of Touch Surgery intramedullary femoral nailing (IFN) modules using objective performance metrics over six consecutive attempts. Secondary objectives consisted of validated multiple choice questions (MCQ) testing before the first (pre) and after the sixth (post) attempts. 27 medical undergraduates were recruited to complete the decision-making process six consecutive times for four modules on the procedural steps of IFN. The modules consisted of (i) preparing the patient and equipment, (ii) femoral canal preparation, (iii) nail insertion and proximal locking, and (iv) distal locking and closure. Real-time objective performance metrics were obtained, stored electronically and analysed using the median and Bonett-Price 95% confidence intervals from the participants' attempts to assess training effect. Significance was calculated using the Mann-Whitney U test for independent data whilst the Wilcoxon signed ranked test was used for paired data. Significance was set as 2-tailed p-value <0.05. Median performance scores per attempt for all four modules demonstrated a significant improvement ranging from 58 to 115%. Scoring variability and distribution was reduced and more predictable per attempt. Logarithmic learning curves elicited strong positive correlations between the number of attempts and scoring. Mean scores for pre and post-study MCQs tests significantly improved from 83 to 94% in all modules. IFN modules on Touch Surgery app demonstrated a significant training

frequency of ipsilateral femoral neck fractures in patients

African Journals Online (AJOL)

Background: Ipsilateral associated femoral neck and shaft fractures are reported to occur in 2.5-6% of all femoral shaft ... nailing of the shaft fracture, which makes treatment of the neck ... chest, spine), while the other had maxillofacial injuries.

Proximal femoral fractures

DEFF Research Database (Denmark)

Palm, Henrik; Teixidor, Jordi

2015-01-01

searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

Localized cortical thickening of the femoral diaphysis captured on an X-ray before alendronate therapy in two cases of atypical femoral fracture

Energy Technology Data Exchange (ETDEWEB)

Iizuka, Yoichi [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Shibukawa General Hospital, Department of Orthopedic Surgery, Shibukawa, Gunma (Japan); Takechi, Rumi [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Gunma Cardiovascular Center, Department of Orthopaedic Surgery, Maebashi, Gunma (Japan); Iizuka, Haku; Takagishi, Kenji [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Omodaka, Takuya [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Gunma Central Hospital, Department of Orthopedic Surgery, Maebashi, Gunma (Japan)

2016-10-15

We herein report two cases of atypical femoral fracture (AFF). X-ray examinations at the first visit of these two female patients showed a complete fracture of the femoral diaphysis diagnosed as an atypical femoral fracture (AFF). X-rays of these two cases also showed localized cortical thickening of the femoral diaphysis. Both patients had been taking alendronate for more than 3 years because of postmenopausal osteoporosis. We assumed that both of the fractures were associated with the long-term use of alendronate. However, we retrospectively identified localized cortical thickening of the femoral diaphysis on an X-ray taken before the alendronate therapy in both of these cases. Therefore, we suspected a pathogenesis of AFFs in which preexisting stress or an insufficient fracture unrelated to bisphosphonate (BP) therapy and subsequent suppression of bone turnover due to BP administration led to the occurrence of an AFF. The patient underwent surgery using intramedullary nails in both of these cases, followed by the administration of teriparatide, and they were able to walk without any support at the final follow-up examination. (orig.)

Xenoimplantation of an Extracellular-Matrix-Derived, Biphasic, Cell-Scaffold Construct for Repairing a Large Femoral-Head High-Load-Bearing Osteochondral Defect in a Canine Model

Directory of Open Access Journals (Sweden)

Yang Qiang

2014-01-01

Full Text Available This study was aimed to develop an ECM-derived biphasic scaffold and to investigate its regeneration potential loaded with BM-MSCs in repair of large, high-load-bearing osteochondral defects of the canine femoral head. The scaffolds were fabricated using cartilage and bone ECM as a cartilage and bone layer, respectively. Osteochondral constructs were fabricated using induced BM-MSCs and the scaffold. Osteochondral defects (11 mm diameter × 10 mm depth were created on femoral heads of canine and treated with the constructs. The repaired tissue was evaluated for gross morphology, radiography, histological, biomechanics at 3 and 6 months after implantation. Radiography revealed that femoral heads slightly collapsed at 3 months and severely collapsed at 6 months. Histology revealed that some defects in femoral heads were repaired, but with fibrous tissue or fibrocartilage, and femoral heads with different degrees of collapse. The bone volume fraction was lower for subchondral bone than normal femoral bone at 3 and 6 months. Rigidity was lower in repaired subchondral bone than normal femoral bone at 6 months. The ECM-derived, biphasic scaffold combined with induced BM-MSCs did not successfully repair large, high-load-bearing osteochondral defects of the canine femoral head. However, the experience can help improve the technique of scaffold fabrication and vascularization.

The Effect of Local Anesthetic Volume Within the Adductor Canal on Quadriceps Femoris Function Evaluated by Electromyography

DEFF Research Database (Denmark)

Grevstad, Ulrik; Jæger, Pia; Kløvgaard, Johan

2016-01-01

BACKGROUND: Single-injection adductor canal block (ACB) provides analgesia after knee surgery. Which nerves that are blocked by an ACB and what influence-if any-local anesthetic volume has on the effects remain undetermined. We hypothesized that effects on the nerve to the vastus medialis muscle......, they received a femoral nerve block and a placebo ACB. The effect on the vastus medialis (primary endpoint) and the vastus lateralis was evaluated using noninvasive electromyography (EMG). Quadriceps femoris muscle strength was evaluated using a dynamometer. RESULTS: There was a statistically significant......L was used (P = 0.0001). No statistically significant differences were found between volume and effect on the vastus lateralis (P = 0.81) or in muscle strength (P = 0.15). CONCLUSIONS: For ACB, there is a positive correlation between local anesthetic volume and effect on the vastus medialis muscle. Despite...

Iodixanol in femoral arteriography

International Nuclear Information System (INIS)

Thorstensen, Oe.; Albrechtsson, U.; Calissendorff, B.; Larusdottir, H.; Norgren, L.; Tengvar, M.; Bolstad, B.; Aspelin, P.

1994-01-01

Two contrast media, iodixanol (Visipaque, Nycomed) 270 mg I/ml and iohexol (Omnipaque, Nycomed) 300 mg I/ml, were compared in femoral arteriography, in 147 patients. Both contrast media were diagnostically effective for use in femoral arteriography, without any significant difference. Pain was reported in connection with injection of iohexol by 36% of the patients, after injection of iodixanol none reported pain. Seventy-two percent of the patients in the iodixanol group reported a sensation of warmth in connection with contrast injection versus 90% in the iohexol group. The average intensity of the warmth was greater with iohexol than with iodixanol. Fourteen percent of patients in the iodixanol group and 1% in the iohexol group reported one or more subjective adverse events. (orig.)

Femoral Neck Shaft Angle in Men with Fragility Fractures

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S. P. Tuck

2011-01-01

Full Text Available Introduction. Femoral neck shaft angle (NSA has been reported to be an independent predictor of hip fracture risk in men. We aimed to assess the role of NSA in UK men. Methods. The NSA was measured manually from the DXA scan printout in men with hip (62, 31 femoral neck and 31 trochanteric, symptomatic vertebral (91, and distal forearm (67 fractures and 389 age-matched control subjects. Age, height, weight, and BMD (g/cm2: lumbar spine, femoral neck, and total femur measurements were performed. Results. There was no significant difference in mean NSA between men with femoral neck and trochanteric hip fractures, so all further analyses of hip fractures utilised the combined data. There was no difference in NSA between those with hip fractures and those without (either using the combined data or analysing trochanteric and femoral neck shaft fractures separately, nor between fracture subjects as a whole and controls. Mean NSA was smaller in those with vertebral fractures (129.2° versus 131°: P=0.001, but larger in those with distal forearm fractures (129.8° versus 128.5°: P=0.01. Conclusions. The conflicting results suggest that femoral NSA is not an important determinant of hip fracture risk in UK men.

Logistic regression analysis of factors associated with avascular necrosis of the femoral head following femoral neck fractures in middle-aged and elderly patients.

Science.gov (United States)

Ai, Zi-Sheng; Gao, You-Shui; Sun, Yuan; Liu, Yue; Zhang, Chang-Qing; Jiang, Cheng-Hua

2013-03-01

Risk factors for femoral neck fracture-induced avascular necrosis of the femoral head have not been elucidated clearly in middle-aged and elderly patients. Moreover, the high incidence of screw removal in China and its effect on the fate of the involved femoral head require statistical methods to reflect their intrinsic relationship. Ninety-nine patients older than 45 years with femoral neck fracture were treated by internal fixation between May 1999 and April 2004. Descriptive analysis, interaction analysis between associated factors, single factor logistic regression, multivariate logistic regression, and detailed interaction analysis were employed to explore potential relationships among associated factors. Avascular necrosis of the femoral head was found in 15 cases (15.2 %). Age × the status of implants (removal vs. maintenance) and gender × the timing of reduction were interactive according to two-factor interactive analysis. Age, the displacement of fractures, the quality of reduction, and the status of implants were found to be significant factors in single factor logistic regression analysis. Age, age × the status of implants, and the quality of reduction were found to be significant factors in multivariate logistic regression analysis. In fine interaction analysis after multivariate logistic regression analysis, implant removal was the most important risk factor for avascular necrosis in 56-to-85-year-old patients, with a risk ratio of 26.00 (95 % CI = 3.076-219.747). The middle-aged and elderly have less incidence of avascular necrosis of the femoral head following femoral neck fractures treated by cannulated screws. The removal of cannulated screws can induce a significantly high incidence of avascular necrosis of the femoral head in elderly patients, while a high-quality reduction is helpful to reduce avascular necrosis.

Three distal root canals in mandibular first molar with different canal configurations: Report of two cases and literature review

Directory of Open Access Journals (Sweden)

Parul Bansal

2015-01-01

Full Text Available With the increasing number of reports of aberrant root canal morphology, the clinician needs to be aware of the variable anatomy. Various case reports have been published with the finding of middle mesial canal in mandibular first molar, however finding of three distal canals in distal roots of mandibular first molar is rare. This article reports endodontic management of two mandibular first molars presented with three distal canals present in a single distal root (Sert and Bayirli type XVIII and distal and distolingual root.

Hemoglobin to Hematocrit Ratio: The Strongest Predictor of Femoral Head Osteonecrosis in Children With Sickle Cell Disease.

Science.gov (United States)

Worrall, Douglas; Smith-Whitley, Kim; Wells, Lawrence

2016-03-01

Femoral head osteonecrosis (ON) secondary to sickle cell disease (SCD) often progresses to femoral head collapse, requiring total hip arthroplasty. However, this treatment has a limited durability and patients with SCD have higher rates of complications, requiring multiple revision operations. Identifying risk factors linked to ON in SCD can facilitate earlier precollapse diagnosis and surgical treatment aimed at preservation of the native hip joint. Fifty-nine children treated at our institution between January 2001 and April 2012 with SCD and ON, as diagnosed by magnetic resonance imaging or radiographic imaging, were compared with age-matched and sickle cell phenotype-matched (SS, SC, Sβ, Sβ) controls with no evidence of ON. Two sided t-tests assuming unequal variances determined statistically risk factors and threshold values were assigned to calculate odds ratios. Systolic blood pressure (P=1.2×10, OR=3.68), diastolic blood pressure (P=0.0084, OR=1.41), weight in the SCD-SS population (P=0.04, OR=1.85), and hemoglobin (Hb) in the SCD-SS population (P=0.036, OR=2.56) were elevated in cases. Curiously, dividing the Hb by the hematocrit to serve as a clinical proxy for the mean corpuscular Hb concentration (MCHC) produced an excellent predictor of ON (P=2.06×10, OR=5.17), which was especially pronounced in the SCD-SS subpopulation (P=2.28×10, OR=8.65). Among children with SCD, the overall prevalence of ON was 9% (59/658) and the phenotype with the highest prevalence of ON was Sβ thalassemia with an ON prevalence of 11.1%. There was no observed correlation between ON and height, body mass index, cholesterol, mean corpuscular volume, hematocrit, or glucocorticoid use. These data support a novel clinical marker, the MCHC proxy, as the strongest predictor of ON in children with SCD. High-risk children should receive hip magnetic resonance imaging to diagnose early ON and facilitate interventions focused on hip preservation, forestalling, or possibly preventing

canal24

Data.gov (United States)

California Natural Resource Agency — Canal system center lines in the Central Valley of California and adjacent areas captured from 1:24,000-scale USGS topographic maps. Updates and modifications made...

Combined Radial and Femoral Access Strategy and Radial-Femoral Rendezvous in Patients With Long and Complex Iliac Occlusions.

Science.gov (United States)

Hanna, Elias B; Mogabgab, Owen N; Baydoun, Hassan

2018-01-01

We present cases of complex, calcified iliac occlusive disease revascularized via a combined radial-femoral access strategy. Through a 6-French, 125-cm transradial guiding catheter, antegrade guidewires and catheters are advanced into the iliac occlusion, while retrograde devices are advanced transfemorally. The transradial and transfemoral channels communicate, allowing the devices to cross the occlusion into the true lumen (radial-femoral antegrade-retrograde rendezvous).

The fluid mechanics of root canal irrigation.

Science.gov (United States)

Gulabivala, K; Ng, Y-L; Gilbertson, M; Eames, I

2010-12-01

Root canal treatment is a common dental operation aimed at removing the contents of the geometrically complex canal chambers within teeth; its purpose is to remove diseased or infected tissue. The complex chamber is first enlarged and shaped by instruments to a size sufficient to deliver antibacterial fluids. These irrigants help to dissolve dying tissue, disinfect the canal walls and space and flush out debris. The effectiveness of the procedure is limited by access to the canal terminus. Endodontic research is focused on finding the instruments and clinical procedures that might improve success rates by more effectively reaching the apical anatomy. The individual factors affecting treatment outcome have not been unequivocally deciphered, partly because of the difficulty in isolating them and in making the link between simplified, general experimental models and the complex biological objects that are teeth. Explicitly considering the physical processes within the root canal can contribute to the resolution of these problems. The central problem is one of fluid motion in a confined geometry, which makes the dispersion and mixing of irrigant more difficult because of the absence of turbulence over much of the canal volume. The effects of treatments can be understood through the use of scale models, mathematical modelling and numerical computations. A particular concern in treatment is that caustic irrigant may penetrate beyond the root canal, causing chemical damage to the jawbone. In fact, a stagnation plane exists beyond the needle tip, which the irrigant cannot penetrate. The goal is therefore to shift the stagnation plane apically to be coincident with the canal terminus without extending beyond it. Needle design may solve some of the problems but the best design for irrigant penetration conflicts with that for optimal removal of the bacterial biofilm from the canal wall. Both irrigant penetration and biofilm removal may be improved through canal fluid

The fluid mechanics of root canal irrigation

International Nuclear Information System (INIS)

Gulabivala, K; Ng, Y-L; Gilbertson, M; Eames, I

2010-01-01

Root canal treatment is a common dental operation aimed at removing the contents of the geometrically complex canal chambers within teeth; its purpose is to remove diseased or infected tissue. The complex chamber is first enlarged and shaped by instruments to a size sufficient to deliver antibacterial fluids. These irrigants help to dissolve dying tissue, disinfect the canal walls and space and flush out debris. The effectiveness of the procedure is limited by access to the canal terminus. Endodontic research is focused on finding the instruments and clinical procedures that might improve success rates by more effectively reaching the apical anatomy. The individual factors affecting treatment outcome have not been unequivocally deciphered, partly because of the difficulty in isolating them and in making the link between simplified, general experimental models and the complex biological objects that are teeth. Explicitly considering the physical processes within the root canal can contribute to the resolution of these problems. The central problem is one of fluid motion in a confined geometry, which makes the dispersion and mixing of irrigant more difficult because of the absence of turbulence over much of the canal volume. The effects of treatments can be understood through the use of scale models, mathematical modelling and numerical computations. A particular concern in treatment is that caustic irrigant may penetrate beyond the root canal, causing chemical damage to the jawbone. In fact, a stagnation plane exists beyond the needle tip, which the irrigant cannot penetrate. The goal is therefore to shift the stagnation plane apically to be coincident with the canal terminus without extending beyond it. Needle design may solve some of the problems but the best design for irrigant penetration conflicts with that for optimal removal of the bacterial biofilm from the canal wall. Both irrigant penetration and biofilm removal may be improved through canal fluid

Radioautographic study of two target organs (epididymis and femoral glands) after injection of 3H testosterone in a non-mammalian vertebrate, the viviparous Lizard

International Nuclear Information System (INIS)

Dufaure, J.-P.; Chambon, Monique.

1978-01-01

After 3 H testosterone injection into castrated males of the Lizard Lacerta vivipara, the radioactive compound is detected by radioautography of epididymis, femoral glands, gut and liver. Between 1 hr. 30 min. to 12 hrs. of retention the 3 H material concentrates progressively into nuclei of the glandular cells of epididymis and femoral organs although no particular concentration occurs in gut and liver cells. This submammalian model is consistent with those previously described for mammals [fr

'Femoral head necrosis' in metabolic and hormonal osteopathies

International Nuclear Information System (INIS)

Heuck, F.H.W.; Treugut, H.

1984-01-01

The pathogenesis of bone necrosis is discussed with special attention and with respect to metabolic, hormonal, and vascular factors. The influence of statics and dynamics of the hip joint bones for the development of aseptic necrosis are discussed. 45 patients with ''idiopathic femoral head necroses'' were observed, including 6 cases of renal osteopathy following renal transplantation and immune suppression therapy, 14 cases of long term corticoid therapy, and 11 cases of liver diseases of different genesis. The femoral head necrosis understood as complication of an osteopathy. In our patients there were 31 males and 14 females - which means higher involvement of males. Plain radiological findings and CT-findings of changes of the femoral heat structure in different stages of the disease are described. Early diagnosis of metabolic and hormonal osteopathies is demanded for a joint keeping therapy of the beginning femoral head necrosis. (orig.) [de

Femoral neck fractures complicating gaucher disease in children

Energy Technology Data Exchange (ETDEWEB)

Goldman, A.B.; Jacobs, B.

1984-09-01

In normal children, fractures of the femoral neck are uncommon and accompany severe trauma and multiple injuries elsewhere in the skeleton. In children with Gaucher disease, a rare hereditary disorder of lipid metabolism, midcervical or basicervical fractures can occur with minor or no trauma and without other injury to the skeleton. Three children with Gaucher disease who developed pathologic fractures of the femoral neck are described. In all three, the fractures occurred between five and nine years of age, and the fracture lines passed through areas of abnormal bone characterized by poorly defined patches of increased and decreased density and cortical thinning along the medial femoral necks. In the affected hips, there was no evidence of avascular necrosis of the femoral heads at the time of injury. One child's fracture was preceeded by multiple bone 'crisis' localized to the proximal femora.

Anatomic landmarks of fluoroscopy guided puncture of the pulseless femoral artery

International Nuclear Information System (INIS)

Jeon, Min Hee; Han, Gi Seok; Kim, Sung Jin; Park, Kil Sun; Cha, Sang Hoon; Bae, Il Hun; Lee, Seung Young

2006-01-01

We wanted to improve puncturing the pulseless femoral artery by evaluating the anatomic landmarks that suggest the course of the femoral artery on fluoroscopy. We analyzed 37 hemipelvis spot images that were centered on the arterial sheath after puncture of the femoral artery. The inguinal angles were measured between the inguinal line connecting the anterior superior iliac spine and the symphysis pubis, and the line of the arterial sheath. Inguinal ligament ratios were measured as the distance from the symphysis pubis to the arterial sheath to the length of the inguinal ligament on the inguinal line. The femoral head ratios were measured as the distance from the medial margin of the femur head to the arterial sheath to the transverse length of the femur head. The mean inguinal angle was 66.5 and the mean inguinal ligament ratio was 0.42 (± 0.03). The mean femoral head ratio was 0.08 (± 0.18). In comparing the men and women, there was no significant difference in the inguinal angle and the femoral head ratio, but the inguinal distance ratio was larger in women (men: 0.41 ± 0.033, women: 0.44 ± 0.031, ρ < 0.05). The femoral artery generally courses just lateral to the medial margin of the femur head (femoral head ratio: 0.08) and the medial 40% of the inguinal ligament (inguinal ligament ratio: 0.42). So, consideration of these relations may be helpful for puncturing the pulseless femoral artery

MRI for early diagnosis of avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Kokubo, Takashi; Takatori, Yoshio; Kamogawa, Morihide; Ninomiya, Setsuo; Yoshikawa, Kohki; Itai, Yuji; Iio, Masahiro; Mitamura, Tadayuki

1988-01-01

Magnetic resonance imaging (MRI) was performed in forty patients on long-term oral steroid therapy for early detection of avascular necrosis (AN) of the femoral head. In 13 patients, AN was diagnosed in the unilateral femoral head from abnormal plain radiographs while the contralateral femoral head was normal radiographically. In the other 27 patients, radiographs were normal. A total of 67 femoral heads with normal radiographs is studied in this paper. In 36 of 67 femoral heads (54 %), MRI demonstrated abnormal low intensity area. The abnormal findings on MRI were divided into five patterns: whole type (type A), peripheral type (type B), ring or band type (type C), small change type (type D) and distal type (type E). Type A, B, C, D and E were found in 2, 11, 5, 16 and 2 femoral heads, respectively. In cases to be followed up over 6 months, AN was manifested radiographically in 4 femoral heads of 5 in type C and in one of 14 in type D. Meanwhile, in 6 of 41 femoral heads examined (15 %), bone scintigrams was abnormal. Followed-up study over 6 months revealed that AN was manifested radiographically in one femoral head of 6 with abnormal scintigram. However, in 4 of 30 with normal scintigram, AN was manifested subsequently. MRI was a better diagnostic modality for early AN. Ring or band-like low intensity (type C) on MRI was considered to be characteristic pattern of early AN. (author)

MRI for early diagnosis of avascular necrosis of the femoral head

Energy Technology Data Exchange (ETDEWEB)

Kokubo, Takashi; Takatori, Yoshio; Kamogawa, Morihide; Ninomiya, Setsuo; Yoshikawa, Kohki; Itai, Yuji; Iio, Masahiro; Mitamura, Tadayuki

1988-09-01

Magnetic resonance imaging (MRI) was performed in forty patients on long-term oral steroid therapy for early detection of avascular necrosis (AN) of the femoral head. In 13 patients, AN was diagnosed in the unilateral femoral head from abnormal plain radiographs while the contralateral femoral head was normal radiographically. In the other 27 patients, radiographs were normal. A total of 67 femoral heads with normal radiographs is studied in this paper. In 36 of 67 femoral heads (54 %), MRI demonstrated abnormal low intensity area. The abnormal findings on MRI were divided into five patterns: whole type (type A), peripheral type (type B), ring or band type (type C), small change type (type D) and distal type (type E). Type A, B, C, D and E were found in 2, 11, 5, 16 and 2 femoral heads, respectively. In cases to be followed up over 6 months, AN was manifested radiographically in 4 femoral heads of 5 in type C and in one of 14 in type D. Meanwhile, in 6 of 41 femoral heads examined (15 %), bone scintigrams was abnormal. Followed-up study over 6 months revealed that AN was manifested radiographically in one femoral head of 6 with abnormal scintigram. However, in 4 of 30 with normal scintigram, AN was manifested subsequently. MRI was a better diagnostic modality for early AN. Ring or band-like low intensity (type C) on MRI was considered to be characteristic pattern of early AN.

Some History and Hydrology of the Panama Canal

National Research Council Canada - National Science Library

Pabst, Arthur

2000-01-01

At the request of the Panama Canal Commission (now Panama Canal Authority), the Hydrologic Engineering Center participated in the development of a model to simulate the existing operation of the Panama Canal System...

Urethral dose sparing in squamous cell carcinoma of anal canal using proton therapy matching electrons with prior brachytherapy for prostate cancer: A case study

Energy Technology Data Exchange (ETDEWEB)

Apinorasethkul, Ontida, E-mail: ontida.a@gmail.com [Medical Dosimetry Graduate Program, University of Wisconsin, La Crosse, WI (United States); Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States); Lenards, Nishele; Hunzeker, Ashley [Medical Dosimetry Graduate Program, University of Wisconsin, La Crosse, WI (United States)

2016-10-01

The purpose of this case study is to communicate a technique on treating the re-irradiation of squamous cell carcinoma (SCC) of anal canal with proton fields matched with electron fields to spare prostatic urethra. A 76-year old male presented with a secondary radiation-induced malignancy as a result of prostate brachytherapy seeds irradiation 10 years prior. A rectal examination revealed a bulky tumor at the top of the anal canal involving the left superior-most aspect of the anal canal extending superiorly into the rectum. The inferior extent was palpable approximately 3 cm from the anal verge and the superior extent of the mass measured greater than 5 cm in the superior-inferior dimension. Chemoradiation was suggested since the patient was opposed to abdominoperineal resection (APR) and colostomy. The use of proton therapy matching with electron fields in the re-irradiation setting could help reduce the complications. A 2 lateral proton beams were designed to treat the bulky tumor volume with 2 electron beams treating the nodal volumes. This complication of treatment fields helped spare the prostatic urethra and reduced the risk of urinary obstruction in the future.

Is Contralateral Templating Reliable for Establishing Rotational Alignment During Intramedullary Stabilization of Femoral Shaft Fractures? A Study of Individual Bilateral Differences in Femoral Version.

Science.gov (United States)

Croom, William P; Lorenzana, Daniel J; Auran, Richard L; Cavallero, Matthew J; Heckmann, Nathanael; Lee, Jackson; White, Eric A

2018-02-01

To determine native individual bilateral differences (IBDs) in femoral version in a diverse population. Computed tomography scans with complete imaging of uninjured bilateral femora were used to determine femoral version and IBDs in version. Age, sex, and ethnicity of each subject were also collected. Femoral version and IBDs in version were correlated with demographic variables using univariate and multivariate regression models. One hundred sixty-four subjects were included in the study. The average femoral version was 9.4 degrees (±9.4 degrees). The mean IBD in femoral version was 5.4 degrees (±4.4 degrees, P alignment during intramedullary stabilization of diaphyseal femur fractures. This is also an important consideration when considering malrotation of femur fractures because most studies define malrotation as a greater than 10-15-degree difference compared with the contralateral side. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Proximal Focal Femoral Deficiency in Ibadan a Developing ...

African Journals Online (AJOL)

The cultural aversion to amputation in our environment makes it difficult to employ that option of treatment. Proximal focal femoral deficiency in Ibadan a developing country's perspective and a review of the literature. Keywords: Proximal focal femoral deficiency , congenital malformations , limb malformations , lower limb ...

Root Canal Retreatment menggunakan Kombinasi Kalsium Hidroksida dan Chlorhexidine sebagai Medikamen Intra Kanal Insisivus Sentral Kiri Maksila

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Andina Novita Sari

2014-12-01

retreatment dengan cleaning dan shaping ulang yang baik dengan menggunakan medikasi intrakanal berupa kombinasi kalsium hidroksida dan chlorhexidine 2% diharapkan mempunyai efek antimikroba yang sinergis untuk mencapai kesuksesan root canal retreatment.   Root Canal Retreatment Using Calcium Hydroxide as Intra Canal Medicament On The Maxillary Left Incisor. Enterococcus faecalis bacteria is most abundant in the root canal infection treated endodontically. Chlorhexidine has a broad antibacterial spectrum and has been used as an endodontic irrigant and intracanal medication. Chlorhexidine has a bactericidal and fungicidal effect as chlorhexidine absorbed into the bacterial cell surface and cause damage to the integrity of the cell membrane. Calcium hydroxide is a biocompatible, antimicrobial agents with high pH effects and stimulates hard tissue formation. A mixture of calcium hydroxide and chlorhexidine is used to control bacteria Enterococcus faecalis alternative. The purpose of this case report is to report on the success of root canal treatment in the left maxillary central incisor with acute periapical periodontitis using a combination of calcium hydroxide and chlorhexidine as intracanal A 24 years old female patient presents with left upper central incisor tooth ache since 4 years ago. The tooth was hurt to percussion, but normal to pulpation as well as the mobility. The tooth has a history of previous trauma and broken 6 years ago and has performed endodontic treatment. Radiographic examination showed obturation teeth 21 are not hermetic with periapical radiolucency in diffuse boundaries, widening of the periodontal ligament and the dissolution of the lamina dura. Root canal re-treatment using a combination of calcium hydroxide and chlorhexidine as intracanal medicaments were performed. In conclussion, the root canal cleaning and shaping retreatment can be performed using a combination of calcium hydroxide and chlorhexidine as intracanal

Influence of a glide path on apical extrusion of debris during canal preparation using single-file systems in curved canals.

Science.gov (United States)

Topçuoğlu, H S; Düzgün, S; Akpek, F; Topçuoğlu, G; Aktı, A

2016-06-01

To evaluate the effect of a glide path on the amount of apically extruded debris during canal preparation using single-file systems in curved canals. Ninety extracted mandibular molar teeth were randomly assigned to six groups (n = 15 for each group) for canal instrumentation. Endodontic access cavities were prepared in each tooth. In three of the six groups, a glide path was not created whereas a glide path was created using PathFile instruments on the mesial canals of all teeth in the remaining three groups. The mesial canals of the teeth were then instrumented with the following single-file instrument systems: WaveOne, Reciproc and OneShape. Debris extruded apically during instrumentation was collected into pre-weighed Eppendorf tubes. The tubes were then stored in an incubator at 70 °C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. The data obtained were analysed using one-way analysis of variance (anova) and Tukey's post hoc tests. The OneShape file was associated with less debris extrusion than the Reciproc and WaveOne files when canal instrumentation was performed without a glide path (P files (P > 0.05). There was no significant difference amongst the OneShape, Reciproc and WaveOne files when a glide path was created before canal preparation in curved root canals (P > 0.05). All systems extruded significantly less debris in groups with a glide path than in groups without a glide path (P < 0.05). All instruments were associated with apical extrusion of debris. Creating a glide path prior to canal instrumentation reduced the amount of apically extruded debris in curved canals. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Femoral neck radiography: effect of flexion on visualization

International Nuclear Information System (INIS)

Garry, S.C.; Jhangri, G.S.; Lambert, R.G.W.

2005-01-01

To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15 o and flexion in 10 o increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0 o and 20 o flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation (ρ o internal rotation to 30 o external rotation (ρ o flexion was applied to bones in external rotation, visualization significantly improved at 15 o (ρ o (ρ o ) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg. (author)

Effects of hypoxia on osteogenic differentiation of mesenchymal stromal cells used as a cell therapy for avascular necrosis of the femoral head.

Science.gov (United States)

Ciapetti, Gabriela; Granchi, Donatella; Fotia, Caterina; Savarino, Lucia; Dallari, Dante; Del Piccolo, Nicola; Donati, Davide Maria; Baldini, Nicola

2016-09-01

Avascular necrosis of the femoral head (AVN) occurs as common result of various conditions or develops as a primary entity, with a high freqency in young adults. Because of its tendency toward osteoarthritis requiring total hip arthroplasty, alternative treatments are being advocated, including cell therapy with mesenchymal stromal cells (MSCs). Because osteonecrotic bone is a severely hypoxic tissue, with a 1-3% oxygen tension, the survival and function of multipotent cells is questionable. In this study, the proliferative, immunophenotypic and osteogenic properties of bone marrow (BM)-derived MSCs from a clinical series of patients with AVN were evaluated under in vitro conditions mimicking the hypoxic milieu of AVN to verify the rationale for cell therapy. MSCs retrieved from the iliac crest (BM-MSC) were isolated, expanded and induced to osteogenic differentiation under a 2% pO2 atmosphere (hypoxia) in comparison with the standard 21% pO2 (normoxia) that is routinely used in cell culture assays. Both proliferation and colony-forming ability were significantly enhanced in hypoxia-exposed BM-MSCs compared with BM-MSCs under normoxia. The expression of bone-related genes, including alkaline phosphatase, Type I collagen, and osteocalcin was significantly increased under hypoxia. Moreover, mineral deposition after osteogenic induction was not hampered, but in some cases even enhanced under low oxygen tension. These findings support autologous cell therapy as an effective treatment to stimulate bone healing in the hypoxic microenvironment of AVN. Copyright © 2016 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

Tratamento com radio e quimioterapia do carcinoma epidermóide do canal anal: experiência do hospital Barão de Lucena Radiochemotherapy for squamous cell carcinoma of the anal canal: Barao de Lucena hospital experience

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Maurilio Toscano de Lucena

2010-06-01

Full Text Available Objetivos: Apresentar os resultados e analisar as variáveis implicadas no tratamento e prognóstico do carcinoma epidermóide do canal anal tratado através da radio e quimioterapia no Hospital Barão de Lucena-SUS-PE. Metodologia: Análise dos prontuários de pacientes com diagnóstico de câncer do canal anal submetidos a tratamento radioquimioterápico. O período de acompanhamento foi de junho de 1989 a junho de 2005. Foram incluídos os pacientes com diagnóstico histológico de câncer de canal anal, enquadrados nos estadios I, II, IIIa e IIIb, submetidos a dois ciclos de quimioterapia com 5-fluorouracil (5-FU na dose de 1g/m²/dia em infusão contínua de 96 horas e cisplatino na dose de 100mg/m² administrado em 6 horas no segundo dia de infusão de cada ciclo, administrados na primeira e terceira semanas do esquema de tratamento radioterápico. Resultados: Avaliamos 108 prontuários de pacientes que preencheram os critérios do protocolo. O tempo médio de seguimento foi de 51 meses (1-182 meses. Houve predomínio do gênero feminino (81,5% dos pacientes. A idade variou de 33 a 83 anos (média de 59 anos. O tipo histológico mais freqüente foi o carcinoma de células escamosas (80,6% dos casos. Em 21 pacientes, foi diagnosticado carcinoma basalóide. Quanto ao grau de diferenciação, prevaleceu o tipo moderadamente diferenciado (61% dos pacientes com carcinoma de células escamosas. O índice de resposta inicial completa foi de 89,8%. Onze pacientes persistiram com tumor após o tratamento radio e quimioterápico. O índice de resposta inicial completa foi menor nos estadios IIIa e IIIb em relação aos estadios I e II com significância estatística (pObjectives: To present the results and analyze the variables involved in the treatment and prognosis of squamous cell carcinoma of the anal canal treated by radiotherapy and chemotherapy at the Hospital Barao de Lucena-SUS-PE. Methodology: Analysis of medical records of patients

3001 canal radiological characterization and waste removal report, Oak Ridge National Laboratory, Oak Ridge, Tennessee

International Nuclear Information System (INIS)

Ritchie, M.G.

1996-12-01

An underground steel reinforced concrete transfer and storage canal was built in 1943 and operated as an integral part of the Oak Ridge Graphite Reactor Building (3001) until 1963 when the reactor was shutdown. During operation, the canal was used for under water transfer of irradiated materials and other metals from the reactor in Building 3001 to the Building 3019 hot cell for further processing. After shutdown of the reactor, the canal was used for storage of irradiated materials and fission products until 1990 when the larger materials were removed and stored in the Department of Energy (DOE) approved solid waste management storage facilities. At that time it was discovered that a considerable amount of sludge had accumulated over the intervening years and subsequent analysis showed that the sludge contained Resource Conservation and Recovery Act (RCRA) materials that violated quantities allowed by the RCRA regulations. It was also recognized in 1990 that the canal was losing water to evaporation and the ground at the rate of approximately 400 gallons per day. To maintain water quality; i.e., radionuclide content at or near DOE derived concentration guidelines (DCG), the water in the canal is constantly demineralized using a demineralizer in the Building 3001 and demineralized make up water is supplied from the Building 3004 demineralizer. This report summarizes the 301 Canal Cleanup Task and the solid waste removed from the 3001 Canal in 1996

Quantitative CT assessment of proximal femoral bone density. An experimental study concerning its correlation to breaking load for femoral neck fractures

International Nuclear Information System (INIS)

Buitrago-Tellez, C.H.; Schulze, C.; Gufler, H.; Langer, M.; Bonnaire, F.; Hoenninger, A.; Kuner, E.

1997-01-01

Purpose: In an experimental study, the correlation between the trabecular bone density of the different regions of the proximal femur and the fracture load in the setting of femoral neck fractures was examined. Methods: The bone mineral density 41 random proximal human femora was estimated by single-energy quanitative CT (SE-QCT). The trabecular bone density was measured at the greatest possible extracortical volume at midcapital, midneck and intertrochanteric level and in the 1 cm 3 volumes of the centres of these regions in a standardised 10 mm thick slice in the middle of the femoral neck axis (in mg/ml Ca-hydroxyl apatite). The proximal femora were then isolated and mounted on a compression/bending device under two-legged stand conditions and loaded up to the point when a femoral neck fracture occurred. Results: Statistical analysis revealed a linear correlation between the trabecular bone density and the fracture load for the greater regions, with the highest value in the maximal area of the head (coefficient factor r=0.76). Conclusion: According to our data, the measurement of the trabecular bone by SE-QCT at the femoral head is a more confident adjunct than the neck or trochanteric area to predict a femoral neck fracture. (orig.) [de

Canal of Nuck hernia: a multimodality imaging review

Energy Technology Data Exchange (ETDEWEB)

Rees, Mitchell A. [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Squires, James E. [Children' s Hospital of Pittsburgh of UPMC, Department of Gastroenterology, Pittsburgh, PA (United States); Tadros, Sameh; Squires, Judy H. [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States)

2017-07-15

Canal of Nuck abnormalities are a rare but important cause of morbidity in girls, most often those younger than 5 years of age. The canal of Nuck, which is the female equivalent of the male processus vaginalis, is a protrusion of parietal peritoneum that extends through the inguinal canal and terminates in the labia majora. The canal typically obliterates early in life, but in some cases the canal can partially or completely fail to close, potentially resulting in a hydrocele or hernia of pelvic contents. Recognition of this entity is especially important in cases of ovarian hernia due to the risk of incarceration and torsion. We aim to increase awareness of this condition by reviewing the embryology, anatomy and diagnosis of canal of Nuck disorders with imaging findings on US, CT and MRI using several cases from a single institution. (orig.)

Canal of Nuck hernia: a multimodality imaging review

International Nuclear Information System (INIS)

Rees, Mitchell A.; Squires, James E.; Tadros, Sameh; Squires, Judy H.

2017-01-01

Canal of Nuck abnormalities are a rare but important cause of morbidity in girls, most often those younger than 5 years of age. The canal of Nuck, which is the female equivalent of the male processus vaginalis, is a protrusion of parietal peritoneum that extends through the inguinal canal and terminates in the labia majora. The canal typically obliterates early in life, but in some cases the canal can partially or completely fail to close, potentially resulting in a hydrocele or hernia of pelvic contents. Recognition of this entity is especially important in cases of ovarian hernia due to the risk of incarceration and torsion. We aim to increase awareness of this condition by reviewing the embryology, anatomy and diagnosis of canal of Nuck disorders with imaging findings on US, CT and MRI using several cases from a single institution. (orig.)

Mechanical properties of femoral trabecular bone in dogs

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Nolte Ingo

2005-03-01

Full Text Available Abstract Background Studying mechanical properties of canine trabecular bone is important for a better understanding of fracture mechanics or bone disorders and is also needed for numerical simulation of canine femora. No detailed data about elastic moduli and degrees of anisotropy of canine femoral trabecular bone has been published so far, hence the purpose of this study was to measure the elastic modulus of trabecular bone in canine femoral heads by ultrasound testing and to assess whether assuming isotropy of the cancellous bone in femoral heads in dogs is a valid simplification. Methods From 8 euthanized dogs, both femora were obtained and cubic specimens were cut from the centre of the femoral head which were oriented along the main pressure and tension trajectories. The specimens were tested using a 100 MHz ultrasound transducer in all three orthogonal directions. The directional elastic moduli of trabecular bone tissue and degrees of anisotropy were calculated. Results The elastic modulus along principal bone trajectories was found to be 11.2 GPa ± 0.4, 10.5 ± 2.1 GPa and 10.5 ± 1.8 GPa, respectively. The mean density of the specimens was 1.40 ± 0.09 g/cm3. The degrees of anisotropy revealed a significant inverse relationship with specimen densities. No significant differences were found between the elastic moduli in x, y and z directions, suggesting an effective isotropy of trabecular bone tissue in canine femoral heads. Discussion This study presents detailed data about elastic moduli of trabecular bone tissue obtained from canine femoral heads. Limitations of the study are the relatively small number of animals investigated and the measurement of whole specimen densities instead of trabecular bone densities which might lead to an underestimation of Young's moduli. Publications on elastic moduli of trabecular bone tissue present results that are similar to our data. Conclusion This study provides data about directional elastic

Radionuclide patterns of femoral head disease

Energy Technology Data Exchange (ETDEWEB)

Webber, M M; Wagner, J; Cragin, M D [California Univ., Los Angeles (USA). Dept. of Radiological Sciences

1977-12-01

The pattern of uptake of bone marrow specific radio-sup(99m)Tc sulfur colloid and the pattern of uptake of bone mineral specific radio-sup(99m)Tc pryophosphate may be valuable in assessing bone vascularity in diseases suspected of causing impaired blood supply, or indicate the presence of reactive bone formation. The low energy of the technetium label has been shown to be superior to /sup 18/F and /sup 85/Sr, and leads to greater imaging detail on the scans. Femoral head scanning with mineral and/or marrow specific radionuclides offers the clinician a method of evaluating the status of the femoral head and possibly an early diagnosis of avascular necrosis before roentgenographic changes occur. This study, which reports on a 5-year experience using radionuclide scanning to assess femoral head vascularity, begins with baseline or normal studies followed by variations of the normal pattern. Typical scan patterns of hip pathology described above are also presented.

Radiological assessment of the femoral bowing in Japanese population

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Abdelaal Ahmed Hamed Kassem

2016-01-01

Full Text Available Introduction: Differences in the magnitude of bowing between races are well-known characteristics of the femur. Asian races have an increased magnitude of femoral bowing but most of the orthopedic implants designed for the femur do not match this exaggerated bowing. We calculated the sagittal and coronal femoral bowing in the Japanese population at different levels of the femur and addressed its surgical significance. Material and methods: We calculated the sagittal and coronal bowing of 132 Japanese femora using CT scan of the femur. A mathematical calculation of the radius of curvature at proximal, middle, and distal regions of the femur was used to determine the degree of femoral bowing. Results: Mean sagittal bowing of the femur was 581, 188, and 161 mm for the proximal, middle, and distal thirds of the femur and mean lateral bowing was 528, 5092, and 876 mm, respectively. Mean sagittal and coronal bowing for the whole femur was 175 and 2640 mm, respectively. No correlation was found between age, gender, length of femur, and the degree of bowing. Conclusion: Our study reveals that femoral bowing in the Japanese population is 175 mm in the sagittal plane and 2640 mm in the coronal plane; these values are greater than the femoral bowing in other ethnic groups studied in the literature. This may result in varying degrees of mismatch between the western-manufactured femoral intramedullary implants and the Japanese femur. We recommend that orthopedic surgeons to accurately perform preoperative evaluation of the femoral bowing to avoid potential malalignment, rotation, and abnormal stresses between the femur and implant.

Management of osteonecrosis of the femoral head in children with sickle cell disease: results of conservative and operative treatments at skeletal maturity

Science.gov (United States)

Mallet, C.; Abitan, A.; Vidal, C.; Holvoet, L.; Mazda, K.; Simon, A.-L.; Ilharreborde, B.

2018-01-01

Abstract Purpose Sickle cell disease (SCD) is the most common cause of femoral head osteonecrosis (ONFH) during childhood with an overall prevalence of 10%. In children, spontaneous revascularization can occur, as in Legg-Calve-Perthes disease. Consequently, the aim of treatment is to restore proper hip containment to prevent joint arthritis. This is the first study reporting long-term results at skeletal maturity of non-operative and surgical treatments for ONFH in SCD children. Methods All children with ONFH due to SCD were retrospectively reviewed. At initial evaluation, extension of osteonecrosis was radiographically defined using Catterall, lateral pillar Herring and Ficat classifications. Subluxation of the femoral head with Reimers migration index > 30% required surgical treatment including femoral varus osteotomy and/or pelvic osteotomies. Conservative treatment including non-weight bearing and physiotherapy was performed in the remaining cases. Outcomes were assessed at skeletal maturity using the Harris Hip Score (HHS) and the Stulberg classification. Total hip arthroplasty and Stulberg 5 were defined as failures. Results A total of 25 hips in 17 patients were included (mean follow-up 7.5 years SD 3.4). Mean age at diagnosis was 11.4 years SD 2.9. In all, 15 hips (60%) were classified Catterall 3 and 4 and Herring B and C. A total of 13 patients (52%) underwent surgical treatment. At skeletal maturity, mean HHS was good (81 SD 17), 12 hips (48%) were classified Stulberg 1 and 2, seven hips (28%) were classified Stulberg 3 and 4. Conclusion Both treatments led to good functional results with 75% of congruent hips at skeletal maturity. Level of Evidence IV PMID:29456754

Effects of blood-activating and stasis-removing drugs combined with VEGF gene transfer on angiogenesis in ischemic necrosis of the femoral head.

Science.gov (United States)

Li, Jun-Hui; Wu, Ya-Ling; Ye, Jian-Hong; Ning, Ya-Gong; Yu, Hai-Ying; Peng, Zhong-Jie; Luan, Xiao-Wen

2009-09-01

To observe the promoting effects of blood-activating and stasis-removing Chinese drugs combined with vascular endothelial growth factor (VEGF) gene transfer on angiogenesis in ischemic necrosis of the femoral head. Forty Japanese giant-ear rabbits were randomly divided into a control group, a model group, a Chinese drug group, a gene group, and a combined group. After 8 weeks of treatment, the rate of VEGF positive cell expression in the synovium of the femoral head was measured using the immunohistochemical method, and the number of blood vessels in the femoral head was measured by digital subtraction angiography. The rate of VEGF positive cell expression in the model group was significantly lower than that in the Chinese drug group (P 0.05). Either the blood-activating and stasis-removing Chinese drugs or VEGF gene transfer can promote the angiogenesis and building of collateral circulation for femoral head ischemic necrosis, and the combined therapy with Chinese drugs or VEGF gene transfer may show a better therapeutic effect. The present study provides an experimental basis for clinical application of the combined therapy with the blood-activating and stasis-removing Chinese drugs and VEGF gene transfer.

Individualised distal femoral cut improves femoral component placement and limb alignment during total knee replacement in knees with moderate and severe varus deformity.

Science.gov (United States)

Palanisami, Dhanasekararaja; Iyyampillai, Geethan; Shanmugam, Sivaraj; Natesan, Rajkumar; S, Rajasekaran

2016-10-01

Our aim was to determine the variation in valgus correction angle and the influence of individualised distal femoral cut on femoral component placement and limb alignment during total knee replacement (TKR) in knees with varus deformity. The study was done prospectively in two stages. In the first stage, the valgus correction angle (VCA) was calculated in long-limb radiographs of 227 patients and correlated with pre-operative parameters of femoral bowing, neck-shaft angle and hip-knee-ankle angle. In the second part comprising of 240 knees with varus deformity, 140 (group 1) had the distal femoral cut individualised according to the calculated VCA, while the remaining 100 knees (group 1) were operated with a fixed distal femoral cut of 5°. The outcome of surgery was studied by grouping the knees as varus 15°. Of the 227 limbs analysed in stage I, 70 knees (31 %) had a VCA angle outside 5-7°. Coronal bowing (p shaft angle (p alignment when VCA was individualised in the groups of knees with varus 10-15° (p 0.002) and varus >15° (p 0.002). Valgus correction angle is highly variable and is influenced by femoral bowing, neck-shaft angle and pre-operative deformity. Individualisation of VCA is preferable in patients with moderate and severe varus deformity. Level 2.

Biophysical stimulation in osteonecrosis of the femoral head

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Massari Leo

2009-01-01

Full Text Available Osteonecrosis of the femoral head is the endpoint of a disease process that results from insufficient blood flow and bone-tissue necrosis, leading to joint instability, collapse of the femoral head, arthritis of the joint, and total hip replacement. Pain is the most frequent clinical symptom. Both bone tissue and cartilage suffer when osteonecrosis of the femoral head develops. Stimulation with pulsed electromagnetic fields (PEMFs has been shown to be useful for enhancing bone repair and for exerting a chondroprotective effect on articular cartilage. Two Italian studies on the treatment of avascular necrosis of the femoral head with PEMFs were presented in this review. In the first study, 68 patients suffering from avascular necrosis of the femoral head were treated with PEMFs in combination with core decompression and autologous bone grafts. The second one is a retrospective analysis of the results of treatment with PEMFs of 76 hips in 66 patients with osteonecrosis of the femoral head. In both studies clinical information and diagnostic imaging were collected at the beginning of the treatment and at the time of follow up. Statistical analysis was performed using chi-square test. Both authors hypothesize that the short-term effect of PEMF stimulation may be to protect the articular cartilage from the catabolic effect of inflammation and subchondral bone-marrow edema. The long-term effect of PEMF stimulation may be to promote osteogenic activity at the necrotic area and prevent trabecular fracture and subchondral bone collapse. PEMF stimulation represents an important therapeutic opportunity to resolve the Ficat stage-I or II disease or at least to delay the time until joint replacement becomes necessary.

[Femoral arteriovenous fistula: a late uncommon complication of central venous catheterization].

Science.gov (United States)

Conz, P A; Malagoli, A; Normanno, M; Munaro, D

2007-01-01

A 77-year-old woman was admitted due to AV graft thrombosis; given the technical impossibility of performing other native AV fistulas, we chose to insert a tunnelled central venous catheter. Considering the vascular history of the patient, the central venous catheter could not be placed into the internal jugular vein; it was therefore put into the left femoral vein. Following a 3-month-period of the catheter working properly, the patient was hospitalized due to sudden acute pain in the left thigh. In a few days the patient developed an important haematoma with serious anemization in the left lower limb. Ultrasonography showed the presence of a fistula between the left common femoral artery and the femoral vein, leading to the subsequent successful positioning of a stent into the common femoral artery through right trans-femoral access. Angiography examination showed the femoral vein patency along the proximal stretch with respect to the function of the tunnelled venous catheter.

Type III apical transportation of root canal

Directory of Open Access Journals (Sweden)

Shiv P Mantri

2012-01-01

Full Text Available Procedural accidents leading to complications such as canal transportation have been ascribed to inapt cleaning and shaping concepts. Canal transportation is an undesirable deviation from the natural canal path. Herewith a case of apical transportation of root canal resulting in endodontic retreatment failure and its management is presented. A healthy 21-year-old young male presented discomfort and swelling associated with painful endodontically retreated maxillary incisor. Radiograph revealed periradicular radiolucency involving underfilled 11 and overfilled 12. Insufficiently obturated 11 exhibited apical transportation of canal. This type III transportation was treated by periradicular surgery and repair using white mineral trioxide aggregate (MTA. Comfortable asymptomatic patient presented uneventful healing at third and fourth month recall visits. A decrease in the size of radiolucency in radiograph supported the clinical finding. In the present case, MTA is useful in repairing the transportation defect. The result of these procedures is predictable and successful.

Vitamin C depletion and pressure sores in elderly patients with femoral neck fracture.

Science.gov (United States)

Goode, H. F.; Burns, E.; Walker, B. E.

1992-01-01

OBJECTIVE--To evaluate the contribution of specific nutritional deficiencies (as indicated by zinc; vitamin A, C, and E; albumin; and haemoglobin concentrations) to the risk of pressure sores. DESIGN--Observational cohort study. SETTING--St James's University Hospital, Leeds. SUBJECTS--21 elderly patients presenting consecutively to the orthopaedic unit with femoral neck fracture. MAIN OUTCOME MEASURE--Full thickness epidermal break over a pressure bearing surface. RESULTS--10 patients (48%) developed a pressure sore during their hospital stay. Indices of zinc status and concentrations of albumin, haemoglobin, and vitamins A and E were similar in patients who developed a pressure sore and those who did not. Mean leucocyte vitamin C concentration, however, was 6.3 (SD 2.2) micrograms/10(8) cells in patients who developed a pressure sore as compared with 12.8 (4.6) micrograms/10(8) cells in patients who did not. CONCLUSIONS--Low concentrations of leucocyte vitamin C appear to be associated with subsequent development of pressure sores in elderly patients with femoral neck fractures. PMID:1458073

Avascular osteonecrosis of the femoral condyle after arthroscopic surgery

International Nuclear Information System (INIS)

Al-Kaar, M.; Garcia, J.; Fritschy, D.; Bonvin, J.C.

1997-01-01

Avascular osteonecrosis of the femoral condyle after arthroscopic surgery. Retrospective review of 10 patients who presented with avascular necrosis of the ipsilateral femoral condyle following arthroscopic meniscectomy (9 medial, 1 lateral). The bone lesions were evaluated by radiography and MRI, which were repeated for few patients. MRI allows earlier diagnosis of avascular necrosis of the femoral condyle and offers an evaluation of extent of the lesions whose evolution is variable: 3 patients required a knee prosthesis, the other 7 patients were treated medically. (authors)

Mandibular molar with five root canals.

Science.gov (United States)

Barletta, Fernando Branco; Dotto, Sidney Ricardo; Reis, Magda de Sousa; Ferreira, Ronise; Travassos, Rosana Maria Coelho

2008-12-01

The purpose of this study was to demonstrate the importance of knowledge of the internal anatomy of root canals for the success of endodontic treatment. Lack of knowledge of anatomic variations and their characteristics in different teeth has been pointed out as one of the main causes of endodontic therapy failure. In this report, the authors describe the endodontic treatment of a mandibular first molar with five root canals, evaluate the rate of occurrence of this number of canals, and discuss the importance of their identification and treatment.

Research and advancement of treating avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Wang Kaibing; Bai Bin; Wang Honghui; Sui Hong

2006-01-01

To undertake retrospective analysis of the research and advancement of treating avascular necrosis of the femoral head. After comparing the superiority and inferiority of different treatments and the present therapeutic status many therapeutic methods for avascular necrosis of the femoral head have been performed, commonly according to the staging of necrosis. Conservative therapy is suitable for stage 0-I, interventional therapy is suitable for stage II-III, operation is adapted for stage II-III and femoral head collapse or degenerative changes. Avascular necrosis of the femoral head is a chronic and dysfunctional illness. Comprehensive treatment according to different stage is now the most popular. Interventional therapy is the study focus of the avascular necrosis of the femoral head meanwhile. (authors)

Lumbar Vertebral Canal Diameters in Adult Ugandan Skeletons ...

African Journals Online (AJOL)

Background: Normal values of lumbar vertebral canal diameters are useful in facilitating diagnosis of lumbar vertebral canal stenosis. Various studies have established variation on values between different populations, gender, age, and ethnic groups. Objectives: To determine the lumbar vertebral canal diameters in adult ...

Impact of canal water shortages on groundwater in the Lower Bari Doab Canal system in Pakistan

International Nuclear Information System (INIS)

Shakir, A.S.; Rehman, H.U.; Khan, N.M.; Qazi, A.U.

2011-01-01

This paper presents rigorous analysis of shortage of canal water supplies, crop water requirements, and groundwater use and its quality in the command of Lower Bari Doab Canal, Pakistan. The annual canal water supplies are 36% less than the crop water requirements. This shortage further increases to 56% if actual canal supplies (averaged over last ten years) are compared with the crop water requirement. The groundwater levels are depleting at the rate of 30 to 40 cm per year in most parts of the LBDC command and this tendency of lowering may increase in future due to further increase in crop water requirements. The analysis of data for the last seven years indicate that quality of groundwater in most parts of LBDC command is generally good (64% of the area) or marginally acceptable (28%) for irrigation use. However, declining trends in groundwater quality are visible and can create long term sustain ability problems if proper remedial actions are not taken well in time. (author)

Gender and laterality in semicircular canal dehiscence syndrome.

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Karimnejad, K; Czerny, M S; Lookabaugh, S; Lee, D J; Mikulec, A A

2016-08-01

To determine if there is gender or laterality predilection in patients with semicircular canal dehiscence syndrome. A multi-institutional chart review was performed to identify patients diagnosed with semicircular canal dehiscence between 2000 and 2015. A systematic literature search was conducted using PubMed to further identify patients with semicircular canal dehiscence. Age, gender and laterality data were collected. Statistical analysis was performed to evaluate for gender or laterality preponderance. A total of 682 patients with semicircular canal dehiscence were identified by literature and chart review. Mean age of diagnosis was 49.75 years (standard deviation = 15.33). Semicircular canal dehiscence was associated with a statistically significant female predominance (chi-square = 7.185, p = 0.007); the female-to-male ratio was 1.2 to 1. Left-sided semicircular canal dehiscence was most common, followed by right-sided then bilateral (chi-square = 23.457, p < 0.001). Semicircular canal dehiscence syndrome is most commonly left-sided and exhibits a female predominance. This may be secondary to morphological cerebral hemisphere asymmetries in both sexes and a predilection of women to seek more medical care than men.

3D-Printed Patient-Specific ACL Femoral Tunnel Guide from MRI.

Science.gov (United States)

Rankin, Iain; Rehman, Haroon; Frame, Mark

2018-01-01

Traditional ACL reconstruction with non-anatomic techniques can demonstrate unsatisfactory long-term outcomes with regards instability and the degenerative knee changes observed with these results. Anatomic ACL reconstruction attempts to closely reproduce the patient's individual anatomic characteristics with the aim of restoring knee kinematics, in order to improve patient short and long-term outcomes. We designed an arthroscopic, patient-specific, ACL femoral tunnel guide to aid anatomical placement of the ACL graft within the femoral tunnel. The guide design was based on MRI scan of the subject's uninjured contralateral knee, identifying the femoral footprint and its anatomical position relative to the borders of the femoral articular cartilage. Image processing software was used to create a 3D computer aided design which was subsequently exported to a 3D-printing service. Transparent acrylic based photopolymer, PA220 plastic and 316L stainless steel patient-specific ACL femoral tunnel guides were created; the models produced were accurate with no statistical difference in size and positioning of the center of the ACL femoral footprint guide to MRI ( p =0.344, p =0.189, p =0.233 respectively). The guides aim to provide accurate marking of the starting point of the femoral tunnel in arthroscopic ACL reconstruction. This study serves as a proof of concept for the accurate creation of 3D-printed patient-specific guides for the anatomical placement of the femoral tunnel during ACL reconstruction.

Environmental pollution and shipping feasibility of the Nicaragua Canal

International Nuclear Information System (INIS)

Chen, Jihong; Zeng, Xin; Deng, Yibing

2016-01-01

In recent years, the Nicaraguan government's renewed interest in constructing this interoceanic canal has once again aroused widespread concern, particularly in the global shipping industry. The project's immense ecological risks, coupled with the recent expansions of both the Panama Canal and the Suez Canal, have raised questions among scientists and experts about its viability. Whether the Nicaragua Canal is really feasible for international shipping, given its high marine pollution risks, requires the further study. This paper discusses and analyses the feasibility of the Nicaragua Canal in the context of its environmental impact and value as a shipping service. This paper aims to provide an important information reference to inform strategic decision-making among policymakers and stakeholders. Our research results indicate that the environmental complexity, economic costs and safety risks of building a new transoceanic canal are simply too high to justify the project. - Highlights: • The Nicaragua Canal is a long-standing controversial maritime project. • We develop specific analysis of the high environmental pollution risks of the canal. • The shipping service feasibility of the canal is faced with great uncertainty. • The government and stakeholders are suggested to be discreet to the mega project.

Femoral artery pseudoaneurysm as a complication of angioplasty. How can it be prevented?

Science.gov (United States)

Gupta, Prabha Nini; Salam Basheer, Abdul; Sukumaran, Gireesh Gomaty; Padmajan, Sabin; Praveen, Satheesan; Velappan, Praveen; Nair, Bigesh Unnikrishnan; Nair, Sandeep Govindan; Kunjuraman, Usha Kumari; Madthipat, Unnikrishnan; R, Jayadevan

2013-01-01

Femoral pseudoaneurysm is a common complication of repeated femoral puncture during cardiac catheterisation. We describe here the development of femoral pseudoaneurysms in a patient with Takayasu's arteritis, which healed in response to conservative treatment, and review the literature on the prevention and treatment of femoral pseudoaneurysm. PMID:27326111

The failures of root canal preparation with hand ProTaper.

Science.gov (United States)

Bătăiosu, Marilena; Diaconu, Oana; Moraru, Iren; Dăguci, C; Tuculină, Mihaela; Dăguci, Luminiţa; Gheorghiţă, Lelia

2012-07-01

The failures of root canal preparation are due to some anatomical deviation (canal in "C" or "S") and some technique errors. The technique errors are usually present in canal root cleansing and shaping stage and are the result of endodontic treatment objectives deviation. Our study was made on technique errors while preparing the canal roots with hand ProTaper. Our study was made "in vitro" on 84 extracted teeth (molars, premolars, incisors and canines). The canal root of these teeth were cleansed and shaped with hand ProTaper by crown-down technique and canal irrigation with NaOCl(2,5%). The dental preparation control was made by X-ray. During canal root preparation some failures were observed like: canal root overinstrumentation, zipping and stripping phenomenon, discarded and/or fractured instruments. Hand ProTaper represents a revolutionary progress of endodontic treatment, but a deviation from accepted rules of canal root instrumentation can lead to failures of endodontic treatment.

Femoral head epiphysis growth and development among Chinese children aged 0-5 years.

Science.gov (United States)

Luo, Jiayou; Tang, Jin; Zhou, Libo; Zeng, Rong; Mou, Jinsong; Zhang, Lingli

2009-05-01

The aim of this study was to examine the pattern of femoral head epiphysis growth and development among Chinese children. Between January and December, 2007, we randomly sampled 1,450 healthy Chinese children (0-5 years old) from Hunan Provincial Children's Hospital in Changsha, Hunan, China. The diameter of femoral head epiphysis was measured by pelvic X-ray photography and processed by medical image processing software. The growth of femoral head epiphysis in girls was 2-3 months earlier than that in boys. The diameter of femoral head epiphysis increased with advancing age in both girls and boys, but the diameter of femoral head epiphysis in 2, 3, 4, 6, and 10-month-old girls was significantly larger than that in boys. Cubic regression equations between the diameter of femoral head epiphysis and age were created for boys and girls that could be used to predict the diameter of femoral head epiphysis. In conclusion, there was gender difference in femoral head epiphysis growth and development among Chinese children, and our prediction models will provide the guidance for early diagnosis of diseases related to the growth and development of the femoral head epiphysis.

Preoperative sup(99m)Tc-MDP scintimetry of femoral neck fractures

International Nuclear Information System (INIS)

Holmberg, S.; Thorngren, K.-G.

1984-01-01

Preoperative sup(99m)Tc-MDP-scintimetry was performed in 117 patients with femoral neck fractures. Scintimetry was shown to be superior to visual evaluation. The ratio was calculated of the uptake in the femoral head of the fractured side over that in the unfractured side, with compensation for the increased trochanteric femoral activity found on the fractured side. A ratio above 0.90 correlated well with uneventful healing in both undisplaced and displaced fractures. Preoperative scintimetry is of great value in the choice of primary treatment of femoral neck fractures. (author)

Case report - curved femoral osteotomy for management of medial patellar luxation

DEFF Research Database (Denmark)

Allpass, Maja; Miles, James Edward

2015-01-01

Medial patellaluxation kan forårsages af femoral varus hos hund. Førhen har patienter med excessiv femoralvarus været korrigeret ved en lateralt placeret femoral kile-ostektomi. Her præsenteres en case, hvor en buet osteotomi blev anvendt til behandling af medial patellaluxation.......Medial patellaluxation kan forårsages af femoral varus hos hund. Førhen har patienter med excessiv femoralvarus været korrigeret ved en lateralt placeret femoral kile-ostektomi. Her præsenteres en case, hvor en buet osteotomi blev anvendt til behandling af medial patellaluxation....

The impact of high total cholesterol and high low-density lipoprotein on avascular necrosis of the femoral head in low-energy femoral neck fractures.

Science.gov (United States)

Zeng, Xianshang; Zhan, Ke; Zhang, Lili; Zeng, Dan; Yu, Weiguang; Zhang, Xinchao; Zhao, Mingdong; Lai, Zhicheng; Chen, Runzhen

2017-02-17

Avascular necrosis of the femoral head (AVNFH) typically constitutes 5 to 15% of all complications of low-energy femoral neck fractures, and due to an increasingly ageing population and a rising prevalence of femoral neck fractures, the number of patients who develop AVNFH is increasing. However, there is no consensus regarding the relationship between blood lipid abnormalities and postoperative AVNFH. The purpose of this retrospective study was to investigate the relationship between blood lipid abnormalities and AVNFH following the femoral neck fracture operation among an elderly population. A retrospective, comparative study was performed at our institution. Between June 2005 and November 2009, 653 elderly patients (653 hips) with low-energy femoral neck fractures underwent closed reduction and internal fixation with cancellous screws (Smith and Nephew, Memphis, Tennessee). Follow-up occurred at 1, 6, 12, 18, 24, 30, and 36 months after surgery. Logistic multi-factor regression analysis was used to assess the risk factors of AVNFH and to determine the effect of blood lipid levels on AVNFH development. Inclusion and exclusion criteria were predetermined to focus on isolated freshly closed femoral neck fractures in the elderly population. The primary outcome was the blood lipid levels. The secondary outcome was the logistic multi-factor regression analysis. A total of 325 elderly patients with low-energy femoral neck fractures (AVNFH, n = 160; control, n = 165) were assessed. In the AVNFH group, the average TC, TG, LDL, and Apo-B values were 7.11 ± 3.16 mmol/L, 2.15 ± 0.89 mmol/L, 4.49 ± 1.38 mmol/L, and 79.69 ± 17.29 mg/dL, respectively; all of which were significantly higher than the values in the control group. Logistic multi-factor regression analysis showed that both TC and LDL were the independent factors influencing the postoperative AVNFH within femoral neck fractures. This evidence indicates that AVNFH was significantly

Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases

Directory of Open Access Journals (Sweden)

Korkmaz MF

2014-04-01

Full Text Available Mehmet Fatih Korkmaz,1 Mehmet Nuri Erdem,2 Zeliha Disli,3 Engin Burak Selcuk,4 Mustafa Karakaplan,1 Abdullah Gogus5 1Department of Orthopedics and Traumatology, Inonu University School of Medicine, Malatya, Turkey; 2Department of Orthopedics and Traumatology, Nisantasi University School of Medicine, Istanbul, Turkey; 3Department of Anesthesiology, Malatya Government Hospital, Malatya, Turkey; 4Department of Family Medicine, Inonu University School of Medicine, Malatya, Turkey; 5Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul, Turkey Purpose: In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. Materials and methods: One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF classification and the American Society of Anesthesiologists' (ASA physical status classification (ASA grade. Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. Results: The mean age of the patients was 77.66 years (range: 37–98 years, and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range

Removal action report on the Building 3001 canal at Oak Ridge National Laboratory, Oak Ridge, Tennessee

International Nuclear Information System (INIS)

1997-05-01

Oak Ridge National Laboratory (ORNL) is a federal facility managed by Lockheed Martin C, Energy Research, Inc., for the U.S. Department of Energy (DOE). ORNL on the Oak Ridge Reservation in East Tennessee at the Anderson and Roane County lines, approximately 38 km (24 miles) west of Knoxville, Tennessee, and 18 km (11 miles) southwest of downtown Oak Ridge. The Oak Ridge Graphite Reactor and its storage and transfer canal are located in Bldg. 3001 in the approximate center of Waste Area Grouping I in the ORNL main complex. 4:1 The Bldg. 3001 Storage Canal is an L-shaped, underground, reinforced-concrete structure running from the back and below the Graphite Reactor in Bldg. 3001 to a location beneath a hot cell in the adjacent Bldg. 3019. The Graphite Reactor was built in 1943 to produce small quantities of plutonium and was subsequently used to produce other isotopes for medical research before it was finally shut down in 1963. The associated canal was used to transport, under water, spent fuel slugs and other isotopes from the back of the reactor to the adjacent Bldg. 31319 hot cell for further processing. During its operation and years subsequent to operation, the canal's concrete walls and floor became contaminated with radioisotopes from the water.This report documents the activities involved with replacing the canal water with a solid, controlled, low-strength material (CLSM) in response to a Comprehensive Environmental Response, Compensation, and Liability Act non-time-critical removal action

Is Assessment of Femoral Head Perfusion During Modified Dunn for Unstable Slipped Capital Femoral Epiphysis an Accurate Indicator of Osteonecrosis?

Science.gov (United States)

Novais, Eduardo N; Sink, Ernest L; Kestel, Lauryn A; Carry, Patrick M; Abdo, João C M; Heare, Travis C

2016-08-01

The modified Dunn procedure, which is an open subcapital realignment through a surgical dislocation approach, has gained popularity for the treatment of unstable slipped capital femoral epiphysis (SCFE). Intraoperative monitoring of the femoral head perfusion has been recommended as a method of predicting osteonecrosis; however, the accuracy of this assessment has not been well documented. We asked (1) whether intraoperative assessment of femoral head perfusion would help identify hips at risk of developing osteonecrosis; (2) whether one of the four methods of assessment of femoral head perfusion is more accurate (highest area under the curve) at identifying hips at risk of osteonecrosis; and (3) whether specific clinical features would be associated with osteonecrosis occurrence after a modified Dunn procedure for unstable SCFE. Between 2007 and 2014, we performed 29 modified Dunn procedures for unstable SCFE (16 boys, 11 girls; median age, 13 years; range, 8-17 years); two were lost to followup before 1 year. During this period, six patients with unstable SCFE were treated by other procedures. All patients undergoing modified Dunn underwent assessment of epiphyseal perfusion by the presence of active bleeding and/or by intracranial pressure (ICP) monitoring. In the initial five patients perfusion was recorded once, either before dissection of the retinacular flap or after fixation by one of the two methods. In the remaining 22 patients (81%), perfusion was systematically assessed before dissection of the retinacular flap and after fixation by both methods. Minimum followup was 1 year (median, 2.5 years; range, 1-8 years) because osteonecrosis typically develops within the first year after surgery. Patients were assessed for osteonecrosis by the presence of femoral head collapse at radiographs obtained every 3 months during the first year after surgery. Seven (26%) of the 27 patients developed osteonecrosis. Measures of diagnostic accuracy including sensitivity

Infected Hydrocele of the Canal of Nuck

Directory of Open Access Journals (Sweden)

Parkash Mandhan

2013-01-01

Full Text Available Hydrocele of the canal of Nuck in children is rare. It may present as incarcerated inguinal hernia and necessitates emergency exploration. Risk of infection in hydrocele of the canal of nuck is very rare. We present a case report of a 5-year-old girl who presented with a left tender inguinolabial region swelling with fever, tachycardia, and mild dehydration. The clinical features were suggestive of strangulated left inguinal hernia and further imaging and surgical exploration revealed it to be an infected hydrocele of the canal of Nuck. High ligation and hydrocelectomy were performed. Hydrocele of the canal of Nuck in a female child presenting with an inguinal swelling should be considered in differential diagnosis.

Proximal focal femoral deficiency: evaluation by MR imaging

International Nuclear Information System (INIS)

Biko, David M.; Davidson, Richard; Pena, Andres; Jaramillo, Diego

2012-01-01

Proximal focal femoral deficiency (PFFD) is a rare congenital anomaly characterized by abnormal development of the proximal femur. The most common radiographic classification (Aitken) does not evaluate the cartilaginous and soft-tissue abnormalities. To demonstrate MR findings of PFFD focusing on features not seen with radiographs. Nine MR examinations of the hip and femurs of seven children with PFFD were retrospectively reviewed. Imaging was quantitatively and qualitatively assessed comparing the affected limb to the contralateral limb and age-matched controls. The children were classified via the Aitken classification. All children had at least mild acetabular dysplasia, and one type D patient had no acetabulum. MR demonstrated that 4/6 children had labral hypertrophy with a decreased distance from the greater trochanter to the acetabular rim, suggesting impingement (P < 0.05). The proximal femoral physis was abnormal in all cases. The connection between the femoral head and shaft if present was fibrous or fibrocartilaginous. MRI can help in evaluation of PFFD by defining the anatomy. MR demonstrates features of the acetabulum and cartilaginous femoral epiphysis and depicts ligamentous abnormalities of the knee. (orig.)

Proximal focal femoral deficiency: evaluation by MR imaging

Energy Technology Data Exchange (ETDEWEB)

Biko, David M. [National Naval Medical Center, Department of Radiology, Bethesda, MD (United States); Uniformed Services University of Health Sciences, Department of Radiology and Radiological Sciences, Bethesda, MD (United States); Davidson, Richard [The Children' s Hospital of Philadelphia, Department of Orthopedic Surgery, Philadelphia, PA (United States); Pena, Andres; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

2012-01-15

Proximal focal femoral deficiency (PFFD) is a rare congenital anomaly characterized by abnormal development of the proximal femur. The most common radiographic classification (Aitken) does not evaluate the cartilaginous and soft-tissue abnormalities. To demonstrate MR findings of PFFD focusing on features not seen with radiographs. Nine MR examinations of the hip and femurs of seven children with PFFD were retrospectively reviewed. Imaging was quantitatively and qualitatively assessed comparing the affected limb to the contralateral limb and age-matched controls. The children were classified via the Aitken classification. All children had at least mild acetabular dysplasia, and one type D patient had no acetabulum. MR demonstrated that 4/6 children had labral hypertrophy with a decreased distance from the greater trochanter to the acetabular rim, suggesting impingement (P < 0.05). The proximal femoral physis was abnormal in all cases. The connection between the femoral head and shaft if present was fibrous or fibrocartilaginous. MRI can help in evaluation of PFFD by defining the anatomy. MR demonstrates features of the acetabulum and cartilaginous femoral epiphysis and depicts ligamentous abnormalities of the knee. (orig.)

Incidence and characteristics of mandibular accessory canals: A radiographic investigation.

Science.gov (United States)

Borgonovo, Andrea Enrico; Taschieri, Silvio; Vavassori, Virna; Re, Dino; Francetti, Luca; Corbella, Stefano

2017-11-01

The aim of the present study was to explore, through tridimensional reconstructions of cone-beam computed tomography (CBCT) scans, the presence and the characteristics of mandibular accessory canals. For each included participant, the presence of accessory canals was recorded. The diameter of the canal, as well as the distance between the canal walls and the walls of the mandibular bone (lingual, buccal, cranial and caudal), were measured and recorded. Mandibular accessory canals could be found in 8.8% of participants. Retromolar canals were the most frequently found accessory mandibular canals. Accessory mandibular canals were found in a relatively high number of participants through the examination of CBCT scans and tridimensional reconstruction. The presence of such structures should be considered cautiously when planning and performing surgical interventions in mandibular area. © 2017 John Wiley & Sons Australia, Ltd.

Hybrid micro/nano-topography of a TiO2 nanotube-coated commercial zirconia femoral knee implant promotes bone cell adhesion in vitro.

Science.gov (United States)

Frandsen, Christine J; Noh, Kunbae; Brammer, Karla S; Johnston, Gary; Jin, Sungho

2013-07-01

Various approaches have been studied to engineer the implant surface to enhance bone in-growth properties, particularly using micro- and nano-topography. In this study, the behavior of osteoblast (bone) cells was analyzed in response to a titanium oxide (TiO2) nanotube-coated commercial zirconia femoral knee implant consisting of a combined surface structure of a micro-roughened surface with the nanotube coating. The osteoblast cells demonstrated high degrees of adhesion and integration into the surface of the nanotube-coated implant material, indicating preferential cell behavior on this surface when compared to the bare implant. The results of this brief study provide sufficient evidence to encourage future studies. The development of such hierarchical micro- and nano-topographical features, as demonstrated in this work, can provide insightful designs for advanced bone-inducing material coatings on ceramic orthopedic implant surfaces. Copyright © 2013 Elsevier B.V. All rights reserved.

Reoperation Rates for Laparoscopic vs Open Repair of Femoral Hernias in Denmark

DEFF Research Database (Denmark)

Andresen, Kristoffer; Bisgaard, Thue; Kehlet, Henrik

2014-01-01

IMPORTANCE: In Denmark approximately 10 000 groin hernias are repaired annually, of which 2% to 4% are femoral hernias. Several methods for repair of femoral hernias are used including sutured repair and different types of mesh repair with either open or laparoscopic techniques. The use of many...... laparoscopic vs open femoral hernia repair, analyzing data from a nationwide database. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study was conducted. Data on femoral hernia repairs registered in the Danish Hernia Database from January 1998 until February 2012 were extracted and analyzed. All...... repairs were followed in the database and analyzed for reports of reoperation, which were used as a proxy for recurrence. Femoral hernia recurrence and inguinal hernia occurrence after the index repair were analyzed. EXPOSURE: Repair of a femoral hernia. MAIN OUTCOMES AND MEASURES: Reoperation...

Radiographic anatomy of the proximal femur: femoral neck fracture vs. transtrochanteric fracture

Directory of Open Access Journals (Sweden)

Ana Lecia Carneiro Leão de Araújo Lima

Full Text Available ABSTRACT OBJECTIVE: To evaluate the correlation between radiographic parameters of the proximal femur with femoral neck fractures or transtrochanteric fractures. METHODS: Cervicodiaphyseal angle (CDA, femoral neck width (FNW, hip axis length (HAL, and acetabular tear drop distance (ATD were analyzed in 30 pelvis anteroposterior view X-rays of patients with femoral neck fractures (n = 15 and transtrochanteric fractures (n = 15. The analysis was performed by comparing the results of the X-rays with femoral neck fractures and with transtrochanteric fractures. RESULTS: No statistically significant differences between samples were observed. CONCLUSION: There was no correlation between radiographic parameters evaluated and specific occurrence of femoral neck fractures or transtrochanteric fractures.

Evaluation of femoral head vascularization in slipped capital femoral epiphysis before and after cannulated screw fixation with use of contrast-enhanced MRI: initial results

International Nuclear Information System (INIS)

Staatz, G.; Honnef, D.; Hohl, C.; Schmidt, T.; Guenther, R.W.; Kochs, A.; Roehrig, H.

2007-01-01

In this study we used contrast-enhanced magnetic resonance imaging (MRI) to evaluate the vascularization of the femoral head in children with slipped capital femoral epiphysis (SCFE) before and after cannulated screw fixation. Eleven consecutive children with SCFE, seven boys and four girls, aged 10-15 years were included in the study. There were no preslips; four children had acute, three acute-on-chronic, and four chronic SCFE. The MRI examinations were performed in a 1.5 Tesla MR scanner with use of a coronal STIR sequence, a coronal contrast-enhanced T1-weighted spin-echo sequence, and a sagittal three-dimensional gradient-echo sequence. Morphology, signal intensities, and contrast-enhancement of the femoral head were assessed by two radiologists in consensus. Morphologic distortion of the physis, bone marrow edema within the metaphysis and epiphysis, and joint effusion were the preoperative MRI findings of SCFE in each child. In nine children, the vascularization of the femoral head before and after surgery was normal. In one child, a preoperative avascular zone in the superolateral aspect of the epiphysis revascularized completely after surgery. One child with severe SCFE developed avascular necrosis of the femoral head after open reduction of the slip. We conclude that MRI allows for accurate evaluation of the femoral head vascularization before and after surgery in children with SCFE. (orig.)

Evaluation of femoral head vascularization in slipped capital femoral epiphysis before and after cannulated screw fixation with use of contrast-enhanced MRI: initial results

Energy Technology Data Exchange (ETDEWEB)

Staatz, G. [Friedrich-Alexander-University Erlangen-Nuernberg, Department of Radiology, Division of Pediatric Radiology, Erlangen (Germany); University Hospital of the RWTH Aachen, Department of Diagnostic Radiology, Aachen (Germany); Honnef, D.; Hohl, C.; Schmidt, T.; Guenther, R.W. [University Hospital of the RWTH Aachen, Department of Diagnostic Radiology, Aachen (Germany); Kochs, A.; Roehrig, H. [University Hospital of the RWTH Aachen, Department of Orthopaedic Surgery, Aachen (Germany)

2007-01-15

In this study we used contrast-enhanced magnetic resonance imaging (MRI) to evaluate the vascularization of the femoral head in children with slipped capital femoral epiphysis (SCFE) before and after cannulated screw fixation. Eleven consecutive children with SCFE, seven boys and four girls, aged 10-15 years were included in the study. There were no preslips; four children had acute, three acute-on-chronic, and four chronic SCFE. The MRI examinations were performed in a 1.5 Tesla MR scanner with use of a coronal STIR sequence, a coronal contrast-enhanced T1-weighted spin-echo sequence, and a sagittal three-dimensional gradient-echo sequence. Morphology, signal intensities, and contrast-enhancement of the femoral head were assessed by two radiologists in consensus. Morphologic distortion of the physis, bone marrow edema within the metaphysis and epiphysis, and joint effusion were the preoperative MRI findings of SCFE in each child. In nine children, the vascularization of the femoral head before and after surgery was normal. In one child, a preoperative avascular zone in the superolateral aspect of the epiphysis revascularized completely after surgery. One child with severe SCFE developed avascular necrosis of the femoral head after open reduction of the slip. We conclude that MRI allows for accurate evaluation of the femoral head vascularization before and after surgery in children with SCFE. (orig.)

21 CFR 872.3820 - Root canal filling resin.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Root canal filling resin. 872.3820 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3820 Root canal filling resin. (a) Identification. A root canal filling resin is a device composed of material, such as methylmethacrylate, intended...

Mejoras en el canal de Panamá

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Brandl, Charles McG.

1963-07-01

Full Text Available The Panama Canal, together with the Suez Canal, is an engineering accomplishment which is now regarded as a master work marking the initiation of modern civil engineering. Other projects, also of great magnitude, do not seem to maintain the reputation of the above two, because they cannot continue to serve their function with sustained usefulness in the new circumstances of today. The Panama Canal, with its limited dock capacity, and the narrow, so called Serpent, canal, has had to cope with a continuously increasing volume of shipping traffic; a natural consequence of commercial evolution. In order to keep up with these increasing demands, it has been necessary to carry out an almost uninterrupted series of modifications and improvements, affecting both the method of operation and organisation, and the actual nature of the canal. Thanks to these alterations the Panama Canal has continued to maintain, at least nominally, an adequate standard of functional efficiency. At present the canal is being widened over certain sections to enable the easy passage of ships of great displacement. The work is being done very rapidly, and in order to gain time, it has been distributed to various contractors simultaneously.El canal a través del ismo de Panamá es una obra de ingeniería civil que, junto con el de Suez, empiezan ya a clasificarse como obras maestras que señalan el primer jalón del desarrollo de la ingeniería moderna. Otras obras, también importantes, no conservan, sin embargo, la misma reputación que aquéllas, por no seguir un paralelismo con las exigencias en cada época. El canal de Panamá, con sus exclusas, y angosto paso llamado de la. Culebra, ha tenido que afrontar un tráfico creciente de navíos que siguen la evolución del tiempo. Para conseguir este paralelismo, tanto el material de explotación como la organización, dragados y mejoras, han tenido que conocer una sucesión ininterrumpida de modificaciones que han permitido

Delayed appearance of hypaesthesia and paralysis after femoral nerve block

OpenAIRE

Stefan Landgraeber; Thomas Albrecht; Ulrich Reischuck; Marius von Knoch

2012-01-01

We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yie...

Urethral dose sparing in squamous cell carcinoma of anal canal using proton therapy matching electrons with prior brachytherapy for prostate cancer: A case study.

Science.gov (United States)

Apinorasethkul, Ontida; Lenards, Nishele; Hunzeker, Ashley

2016-01-01

The purpose of this case study is to communicate a technique on treating the re-irradiation of squamous cell carcinoma (SCC) of anal canal with proton fields matched with electron fields to spare prostatic urethra. A 76-year old male presented with a secondary radiation-induced malignancy as a result of prostate brachytherapy seeds irradiation 10 years prior. A rectal examination revealed a bulky tumor at the top of the anal canal involving the left superior-most aspect of the anal canal extending superiorly into the rectum. The inferior extent was palpable approximately 3cm from the anal verge and the superior extent of the mass measured greater than 5cm in the superior-inferior dimension. Chemoradiation was suggested since the patient was opposed to abdominoperineal resection (APR) and colostomy. The use of proton therapy matching with electron fields in the re-irradiation setting could help reduce the complications. A 2 lateral proton beams were designed to treat the bulky tumor volume with 2 electron beams treating the nodal volumes. This complication of treatment fields helped spare the prostatic urethra and reduced the risk of urinary obstruction in the future. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Incidence and survival patterns of rare anal canal neoplasms using the surveillance epidemiology and end results registry.

Science.gov (United States)

Metildi, Cristina; McLemore, Elisabeth C; Tran, Thuy; Chang, David; Cosman, Bard; Ramamoorthy, Sonia L; Saltzstein, Sidney L; Sadler, Georgia Robins

2013-10-01

Small cell, neuroendocrine tumors, and melanoma of the anus are rare. Limited data exist on the incidence and management for these rare tumors. A large, prospective, population-based database was used to determine incidence and survival patterns of rare anal neoplasms. The Surveillance, Epidemiology and End Results registry was queried to identify patients diagnosed with anal canal neoplasms. Incidence and survival patterns were evaluated with respect to age, sex, race, histology, stage, and therapy. We identified 7078 cases of anal canal neoplasms: melanoma (n = 149), neuroendocrine (n = 61), and small cell neuroendocrine (n = 26). Squamous cell carcinoma (SCC) (n = 6842) served as the comparison group. Anal melanoma (AM) demonstrated the lowest survival rate at 2.5 per cent. Neuroendocrine tumors (NETs) demonstrated similar survival as SCC (10-year survival for regional disease of 25 and 22.3%, respectively). Ten-year survival of small cell NETs resembled AM (5.3 vs 2.5%). Age 60 years or older, sex, black race, stage, and surgery were independent predictors of survival. This study presents the largest patient series of rare anal neoplasms. NETs of the anal canal demonstrate similar survival patterns to SCC, whereas small cell NETs more closely resemble AM. Accurate histologic diagnosis is vital to determine treatment and surgical management because survival patterns can differ among rare anal neoplasms.

Comparison of the rheological properties of four root canal sealers

Institute of Scientific and Technical Information of China (English)

Seok Woo Chang; Kwang Shik Bae; Young-Kyu Lee; Qiang Zhu; Won Jun Shon; Woo Cheol Lee; Kee Yeon Kum; Seung Ho Baek; In Bog Lee; Bum-Soon Lim

2015-01-01

The flowability of a root canal sealer is clinically important because it improves the penetration of the sealer into the complex root canal system. The purpose of this study was to compare the flowabilities of four root canal sealers, measured using the simple press method (ISO 6876), and their viscosities, measured using a strain-controlled rheometer. A newly developed, calcium phosphate-based root canal sealer (Capseal) and three commercial root canal sealers (AH Plus, Sealapex and Pulp Canal Sealer EWT) were used in this study. The flowabilities of the four root canal sealers were measured using the simple press method (n55) and their viscosities were measured using a strain-controlled rheometer (n55). The correlation between these two values was statistically analysed using Spearman’s correlation test. The flow diameters and the viscosities of the root canal sealers were strongly negatively correlated (r520.8618). The viscosity of Pulp Canal Sealer EWT was the lowest and increased in the following order:AH Plus,Sealapex,Capseal (P,0.05). All of the tested root canal sealers showed characteristic time-and temperature-dependent changes in their rheological properties. The viscosities measured using the strain-controlled rheometer were more precise than the flowabilities measured using the simple press method, suggesting that the rheometer can accurately measure the rheological properties of root canal sealers.

Management of Acquired Atresia of the External Auditory Canal.

Science.gov (United States)

Bajin, Münir Demir; Yılmaz, Taner; Günaydın, Rıza Önder; Kuşçu, Oğuz; Sözen, Tevfik; Jafarov, Shamkal

2015-08-01

The aim was to evaluate surgical techniques and their relationship to postoperative success rate and hearing outcomes in acquired atresia of the external auditory canal. In this article, 24 patients with acquired atresia of the external auditory canal were retrospectively evaluated regarding their canal status, hearing, and postoperative success. Acquired stenosis occurs more commonly in males with a male: female ratio of 2-3:1; it seems to be a disorder affecting young adults. Previous ear surgery (13 patients, 54.2%) and external ear trauma (11 patients, 45.8%) were the main etiological factors of acquired ear canal stenosis. Mastoidectomy (12/13) and traffic accidents (8/11) comprise the majority of these etiological factors. Endaural incision is performed in 79.2% and postauricular incision for 20.8% of cases during the operation. As types of surgical approach, transcanal (70.8%), transmastoid (20.8%), and combined (8.4%) approaches are chosen. The atretic plate is generally located at the bony-cartilaginous junction (37.5%) and in the cartilaginous canal (33.3%); the bony canal is involved in a few cases only. Preserved healthy canal skin, split- or full-thickness skin grafts, or pre- or postauricular skin flaps are used to line the ear canal, but preserved healthy canal skin is preferred. The results of surgery are generally satisfactory, and complications are few if surgical principles are followed.

Middle mesial canals in mandibular molars: incidence and related factors.

Science.gov (United States)

Nosrat, Ali; Deschenes, Raney J; Tordik, Patricia A; Hicks, M Lamar; Fouad, Ashraf F

2015-01-01

Although the internal anatomy of mandibular molars has been extensively studied, information about middle mesial (MM) canals is limited. The primary aim of this retrospective study was to evaluate the incidence of MM canals in mandibular first and second molars. The secondary aim was to correlate the incidence of MM canals with variables of molar type, sex, age, ethnicity, and presence of a second distal canal. All mature permanent first and second mandibular molars treated from August 2012 to May 2014 were included in the analysis. After completion of root canal instrumentation in all main canals, the clinician inspected the isthmus area of the mesial root using the dental operating microscope. If there was a catch point in this area with a file or explorer, the operator spent more time attempting to negotiate an MM canal. Seventy-five mandibular first and second molars were treated during the specified period. Fifteen (20%) teeth had negotiable MM canals. The incidence of MM canals was 32.1% in patients ≤ 20 years old, 23.8% in patients 21-40 years old, and 3.8% in patients > 40 years. Analysis of data revealed a significant difference in the distribution of MM canals among different age groups (P molar type, and presence of a second distal canal were not significant. The incidence of negotiable MM canals overall and their frequency of identification in younger patients were higher than in previous reports. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

OUTCOME OF INTERTROCHANTERIC FRACTURES TREATED WITH SHORT FEMORAL NAIL

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Yadkikar Shriniwas V, Yadkikar Vishnu S, Patel Mayank, Dhruvilkumar Gandhi, Kunkulol Rahul

2015-07-01

Full Text Available Aim: To study the functional and anatomical outcome of Inter trochanteric fractures of femur treated with Short femoral nail. Method: This was retrospective study carried out in which 60 patients (50 Male & 10 Female of 5th to 8th decade of life who underwent Short femoral nail fixation for both Stable & unstable Inter Trochanteric fractures. From the records each patient data was assessed for time required for mobilization, average fracture healing time, degree and grade of hip range of movements, complications, anatomical reduction achieved using Short femoral nail fixation. Results: 55 cases achieved Anatomical reduction. Good to Excellent Hip range of Motion was in 55 (90 % cases. Fracture union was seen in all cases. No evidence of Z Effect, AVN of femoral head, Implant failure, Fracture of femoral shaft below the Nail tip was seen in any case, However Reverse Z Effect was seen in 4 & shortening of less than 2 cm was seen in 2 cases, External rotation of 10 degree was seen in1 case. Average fracture Union time was 14 weeks. Conclusion: Short femoral nail appears to be better implant for fixation of both Stable & unstable Inter Trochanteric fractures as it fulfills the biomechanical demands being minimally invasive, less blood loss , it prevents excessive varus collapse at fracture site, produces less stress riser effect below the nail tip, Short operative time, Facilitates early mobilization & functional recovery of patients. But Anatomical fracture reduction & optimal implant placement are absolutely must for better results.

Evaluation of a patient specific femoral alignment guide for hip resurfacing.

Science.gov (United States)

Olsen, Michael; Naudie, Douglas D; Edwards, Max R; Sellan, Michael E; McCalden, Richard W; Schemitsch, Emil H

2014-03-01

A novel alternative to conventional instrumentation for femoral component insertion in hip resurfacing is a patient specific, computed tomography based femoral alignment guide. A benchside study using cadaveric femora was performed comparing a custom alignment guide to conventional instrumentation and computer navigation. A clinical series of twenty-five hip resurfacings utilizing a custom alignment guide was conducted by three surgeons experienced in hip resurfacing. Using cadaveric femora, the custom guide was comparable to conventional instrumentation with computer navigation proving superior to both. Clinical femoral component alignment accuracy was 3.7° and measured within ± 5° of plan in 20 of 24 cases. Patient specific femoral alignment guides provide a satisfactory level of accuracy and may be a better alternative to conventional instrumentation for initial femoral guidewire placement in hip resurfacing. Crown Copyright © 2014. All rights reserved.

MR evaluation of the articular cartilage of the femoral head during traction. Correlation with resected femoral head

Energy Technology Data Exchange (ETDEWEB)

Nakanishi, K. [Osaka Seamens Insurance Hospital (Japan). Dept. of Radiology; Tanaka, H.; Narumi, Y.; Nakamura, H. [Osaka Univ. Medical School (Japan). Dept. of Radiology; Nishii, T.; Masuhara, K. [Osaka Univ. Medical School (Japan). Dept. of Orthopedic Surgery

1999-01-01

Objective: The purpose was to evaluate the articular cartilage of the hip joint with MR during traction and compare the findings with the resected specimen or arthroscopic findings. Material and Methods: Eight healthy volunteers, 5 patients with osteonecrosis, 5 with acetabular dysplasia, and 5 with advanced osteoarthrosis underwent MR imaging to evaluate the articular cartilage of the hip joint. Coronal fat-suppressed 3D spoiled gradient-echo (SPGR) images were obtained during traction. Identical imaging was performed of all the resected femoral heads of the osteonecrosis and advanced osteoarthrosis patients, and was correlated with the macroscopic pathological findings. Results: The traction was effective and the femoral articular cartilage was clearly identified in all 8 control subjects, and in all cases of osteonecrosis and acetabular dysplasia. In 4 cases of osteonecrosis, chondral fracture was identified in the boundary between the necrosis and the normal area. In all cases of advanced osteoarthrosis, cartilage was identified only at the medial side. The MR images of osteonecrosis and advanced osteoarthrosis corresponded well with the MR images of the resected femoral heads and the macroscopic findings. (orig.)

Dynamic gadolinium-enhanced MRI evaluation of porcine femoral head ischemia and reperfusion

Energy Technology Data Exchange (ETDEWEB)

Schneider, T. [Clinic for Orthopaedics and Sports Traumatology, Dreifaltigkeits-Krankenhaus GmbH, Aachener Str. 445-449, 50933 Koeln (Germany); Drescher, W. [Department of Orthopaedics, Christian Albrechts University, Kiel (Germany); Becker, C. [Department of Orthopaedics, Heinrich Heine University, Duesseldorf (Germany); Sangill, R.; Stoedkilde-Joergensen, H. [Institute for Magnetic Resonance Imaging Tomography, University of Aarhus, Skejby Hospital, Aarhus (Denmark); Heydthausen, M. [Computing Center, Heinrich Heine University, Duesseldorf (Germany); Hansen, E.S.; Buenger, C. [Spine Section, Department of Orthopaedics, University of Aarhus (Denmark)

2003-02-01

To examine the potential of gadolinium (Gd)-enhanced dynamic MRI in the detection of early femoral head ischemia. Furthermore, to apply a three-compartment model to achieve a clinically applicable MR index for femoral head perfusion during the steady state and arterial hip joint tamponade.Design and materials In a porcine model femoral head perfusion was measured by radioactive tracer microspheres and by using a dynamic Gd-enhanced MRI protocol. Femoral head perfusion measurements and MRI tests were performed unilaterally before, during and after the experimentally induced ischemia of one of the hip joints. Ischemia was induced by increasing intra-articular pressure to 250 mmHg. All pigs showed ischemia of the femoral head epiphysis under hip joint tamponade followed by reperfusion to the same level as before joint tamponade. In two cases perfusion after removal of tamponade continued to be low. In dynamic MRI measurements increases in signal intensity were seen after intravenous infusion of Gd-DTPA, followed by a slow decrease in signal intensity. The signal-intensity curve during femoral head ischemia had a minor increase. Also the coefficient determined was a helpful indicator of femoral head ischemia. Femoral head blood flow as measured by microspheres fell significantly under joint tamponade. Early detection of this disturbed regional blood flow was possible using a dynamic MRI procedure. A biomathematical model resulted from the evaluation of the intervals of signal intensity over time which allows detection of bone blood flow changes at a very early stage. Using this new method earlier detection of femoral head necrosis may be possible. (orig.)

Aneurysm of the superficial femoral artery in an infant

Energy Technology Data Exchange (ETDEWEB)

Watanabe, M.; Komuro, H.; Matoba, K.; Kaneko, M. [Dept. of Paediatric Surgery, Inst. of Clinical Medicine, Univ. of Tsukuba, Ibaraki (Japan); Niitsu, M.; Itai, Y. [Dept. of Radiology, Inst. of Clinical Medicine, Univ. of Tsukuba, Ibaraki (Japan)

2003-04-01

An isolated arterial aneurysm in childhood is extremely rare. We report a 1-year-old girl with an aneurysm of the right superficial femoral artery, presenting as an asymptomatic mass of the thigh. The aneurysm involved the whole superficial femoral artery (9 cm in length), and surgical treatment would have required replacement of the affected artery. Conservative treatment was chosen, influenced by the patient's rapid growth at that time. Non-invasive, 3-D contrast-enhanced magnetic resonance angiography (MRA) was useful as an alternative to conventional angiography for detailed evaluation of the femoral arteries, including the aneurysm. (orig.)

Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

Directory of Open Access Journals (Sweden)

Yoshihiro Kotoura

2017-01-01

Full Text Available Slipped capital femoral epiphysis (SCFE is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1; however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered.

Radiographic evaluation of the quality of root canal obturation of single-matched cone Gutta-percha root canal filling versus hot lateral technique

Directory of Open Access Journals (Sweden)

Randa Suleiman Obeidat

2014-01-01

Full Text Available Aim: The aim of this study is to evaluate radiographically the quality of root canal filling in mesiodistal and buccolingual view when comparing matched cone condensation and warm lateral Gutta-percha condensation using system B heating instrument in a low-heat warm lateral condensation technique in0 vitro. Materials and Methods: A total of 40 mandibular premolars with straight single canals were divided into two groups with 20 each. The root canals were shaped by hand file and Revo-S rotary files to size (25, 0.06 at the end point, then they filled by Gutta-percha cone and meta-seal sealer. In group A, a single matched cone technique was used to fill the root canals. In group B, a hot lateral condensation using system B instrument at 101°C was performed. Result: The result of this study showed no significant difference in density of Gutta-percha fill in apical and coronal two-third when comparing matched cone root canal filling and hot lateral technique (P > 0.05. The only significant difference (P < 0.05 was in matched cone between buccolingual and mesiodistal view in the coronal two-third. Conclusion: Within the limitation of this study, single matched cone technique has a good density in the apical one-third as that of the hot lateral technique so it may be used for filling narrow canals. In the coronal two-third of the root canal, single matched cone technique showed inferior density of root canal filling which can be improved by using accessory cones Gutta-percha in wide canal.

Compartment Syndrome following Open Femoral Fracture with an Isolated Femoral Vein Injury Treated with Acute Repair

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David Walmsley

2014-01-01

Full Text Available Acute compartment syndrome is a surgical emergency and its diagnosis is more difficult in obtunded or insensate patients. We present the case of a 34-year-old woman who sustained a Gustilo-Anderson grade III open midshaft femur fracture with an isolated femoral vein injury treated with direct repair. She developed lower leg compartment syndrome at 48 hours postoperatively, necessitating fasciotomies. She was subsequently found to have a DVT in her femoral vein at the level of the repair and was started on therapeutic anticoagulation. This case highlights the importance of recognition of isolated venous injuries in a trauma setting as a risk factor for developing compartment syndrome.

Newer Root Canal Irrigants in Horizon: A Review

Directory of Open Access Journals (Sweden)

Sushma Jaju

2011-01-01

Full Text Available Sodium hypochloride is the most commonly used endodontic irrigant, despite limitations. None of the presently available root canal irrigants satisfy the requirements of ideal root canal irrigant. Newer root canal irrigants are studied for potential replacement of sodium hypochloride. This article reviews the potential irrigants with their advantages and limitations with their future in endodontic irrigation.

MR imaging of femoral marrow in treated β-thalassemia major

International Nuclear Information System (INIS)

Shen Jun; Liang Biling; Chen Jianyu; Zhao Jiquan; Xu Honggui; Chen Chun

2006-01-01

Objective: To investigate MR imaging features of femoral marrow in treated β-thalassemia major. Methods: MR imaging of the proximal femoral marrow was performed in 35 cases of β-thalassemia major and 45 age- and sex-matched normal children as control. Coronal images of femoral marrow with the techniques of spin echo and fast field echo (FFE) were obtained. On T 1 -weighted imaging the red and yellow femoral marrow were judged and marrow distribution was classified into five groups. The hemosiderosis of marrow was judged on the basis of signal intensity of marrow on FFE imaging. The marrow distribution classification and the hemosiderosis on MR imaging were correlated with clinical features. Results: On FFE, marrow hemosiderosis occurred in 15 patients with a marked hypo-intensity signal and was related to the age (P=0.032). On T 1 -weighted imaging, the femoral marrow in 35 patients was classified as group III and IV, while the marrow distribution was group I or II in all normal children, there was statistically significant difference (P<0.001). The marrow distribution correlated positively with blood transfusion (P=0.049). Conclusion: The red marrow hyperplasia and hemosiderosis could occur in the femoral marrow of the treated β-thalassemia major. The marrow hyperplasia on MR imaging was related to the blood transfusion, and the hemosiderosis related to the age. (authors)

Osteoarthritis of the patella, lateral femoral condyle and posterior medial femoral condyle correlate with range of motion.

Science.gov (United States)

Suzuki, Takashi; Motojima, Sayaka; Saito, Shu; Ishii, Takao; Ryu, Keinosuke; Ryu, Junnosuke; Tokuhashi, Yasuaki

2013-11-01

The type of osteoarthritis and the degree of severity which causes restriction of knee range of motion (ROM) is still largely unknown. The objective of this study was to analyse the location and the degree of cartilage degeneration that affect knee range of motion and the connection, if any, between femorotibial angle (FTA) and knee ROM restriction. Four hundreds and fifty-six knees in 230 subjects with knee osteoarthritis undergoing knee arthroplasty were included. Articular surface was divided into eight sections, and cartilage degeneration was evaluated macroscopically during the operation. Cartilage degeneration was classified into four grades based on the degree of exposure of subchondral bone. A Pearson correlation was conducted between FTA and knee flexion angle to determine whether high a degree of FTA caused knee flexion restriction. A logistic regression analysis was also conducted to detect the locations and levels of cartilage degeneration causing knee flexion restriction. No correlation was found between FTA and flexion angle (r = -0.08). Flexion angle was not restricted with increasing FTA. Logistic regression analysis showed significant correlation between restricted knee ROM and levels of knee cartilage degeneration in the patella (odds ratio (OR) = 1.77; P = 0.01), the lateral femoral condyle (OR = 1.62; P = 0.03) and the posterior medial femoral condyle (OR = 1.80; P = 0.03). For clinical relevance, soft tissue release and osteophyte resection around the patella, lateral femoral condyle and posterior medial femoral condyle might be indicated to obtain a higher degree of knee flexion angle.

Femoral neck fractures: A prospective assessment of the pattern ...

African Journals Online (AJOL)

OBJECTIVE: To review the pattern of femoral neck fractures, complications and outcome following fixation with Austin-Moore endoprosthesis. METHOD: A two year prospective study in patients who had fracture of the femoral neck based on strict inclusion criteria. All the patients were treated by Austin-Moore ...

21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral (hemi-hip...

21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femoral (hemi-knee) metallic uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3570 Knee joint femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral (hemi-knee...

Structural and functional studies of bioobjects prepared from femoral heads

Energy Technology Data Exchange (ETDEWEB)

Kirilova, I. A., E-mail: IKirilova@niito.ru; Podorozhnaya, V. T., E-mail: VPodorognaya@niito.ru [Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan, 17, Frunze, Novosibirsk, 630091 (Russian Federation); Sharkeev, Yu. P., E-mail: sharkeev@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4, pr. Akademicheskii, Tomsk, 634021 (Russian Federation); National Research Tomsk Polytechnic University, 30, Lenin Avenue, Tomsk, 634050 (Russian Federation); Popova, K. S., E-mail: kseniya@ispms.tsc.ru; Uvarkin, P. V., E-mail: uvarkin@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4, pr. Akademicheskii, Tomsk, 634021 (Russian Federation)

2015-11-17

Results of examination of physicomechanical characteristics of samples of medial femoral head cuts are presented. The samples of medial femoral head cuts resected in 6 patients with coxarthrosis in primary endoprosthetic replacement of a coxofemoral joint have been tested for micro- and nanohardness. Young’s modulus and elemental composition of bone tissue have been investigated. To estimate the architectonics of cancellous tissue of the femoral head, adjacent cuts of the same patient have been analyzed. The porosity of bone tissue was estimated from macroscopic images obtained using macrophotography. The total porosity is calculated as the ratio of the total length of straight line segments overlapping pores to the total length of secants. A three-point bending test of the samples has shown that their strength changed from 0.187 to 1.650 MPa and their elasticity modulus changes from 1.69 to 8.15 MPa. The microhardness of the samples changes in the range 220–265 MPa and the average microhardness of medial femoral head cuts is 240 MPa. The elemental composition of medial femoral head cuts is represented by basic Ca, P, O, Na and Mg elements as well as by Sn, S, Fe, Cr, and C in microamounts. The atomic Ca to P ratio for bone tissue is 1.55. It is revealed that pores of the upper part of the femoral head have a more regular shape and in the lower part they are more elongated along the cut and occupy a larger volume. The lower part of the femoral head has a higher porosity (39 and 33%) than the upper part (34 and 30%). The total porosity of all samples does not exceed 37%.

Management of Post-Traumatic Phlegmasia Cerulea Dolens via Right-to-Left Femoral Vein to Femoral Vein Bypass (Palma Procedure).

Science.gov (United States)

Dua, Anahita; Heller, Jennifer; Lee, Cheong

2017-11-01

Phlegmasia cerulea dolens (PCD) is a rare condition resulting from venous occlusion that impairs arterial flow. We report a rare case of post-traumatic PCD after ligation of the iliac vein with successful treatment by right-to-left femoral vein to femoral vein bypass using left great saphenous vein (Palma procedure). The clinical presentation, diagnostic process, and approach to management along with a literature review on the operative management of PCD are presented in this case report.

Transvenous liver biopsy via the femoral vein

International Nuclear Information System (INIS)

Khosa, F.; McNulty, J.G.; Hickey, N.; O'Brien, P.; Tobin, A.; Noonan, N.; Ryan, B.; Keeling, P.W.N.; Kelleher, D.P.; McDonald, G.S.A.

2003-01-01

AIM: To study the safety, effectiveness and diagnostic value of transvenous forceps biopsy of the liver in 54 patients with coagulopathy, gross ascites or morbid obesity and suspected liver disease in whom percutaneous liver biopsy was contraindicated. MATERIAL AND METHODS: Forceps biopsy of the liver via the femoral vein was attempted in 54 adult patients with advanced liver disease of unknown aetiology who had coagulation disorders (41 cases), gross ascites (11 cases) or morbid obesity (two cases). In each patient two to six biopsies (average four) were taken using a radial jaw forceps inserted via the right or left femoral vein. RESULTS: The procedure was successful in 53 cases. Hepatic vein catheterization failed in one patient. Adequate liver tissue for diagnosis was obtained in 84% of cases. One patient developed delayed haemorrhage at 12 h from a capsular leak that was undetected during the biopsy procedure. This patient required blood transfusions and laparotomy to control bleeding. There were no deaths in the 53 patients studied. Transient minor chest and shoulder pain was encountered during sheath insertion into a hepatic vein in 23 patients. Three patients developed a femoral vein haematoma, which resolved with conservative treatment. CONCLUSION: Transvenous liver biopsy via the femoral vein is another safe, effective, simple alternative technique of biopsy when the percutaneous route is contraindicated

Neuronal hyperplasia in the anal canal

DEFF Research Database (Denmark)

Fenger, C; Schrøder, H D

1990-01-01

In a consecutive series of minor surgical specimens from the anal canal, neuronal hyperplasia was found in nine of 56 haemorrhoidectomy specimens and in four of 23 fibrous polyps. In an additional series of 14 resections of the anal canal, neuronal hyperplasia was present in six cases, of which f...

Hip dislocation following the treatment of femoral neck fracture: Case report

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Vukašinović Zoran

2010-01-01

Full Text Available Introduction. Femoral neck fractures are very rare in young patients and are frequently complicated by femoral head osteonecrosis and femoral neck nonunion. Case Outline. A 19-year-old girl with hip dislocation following the treatment of the femoral neck fracture is presented. The femoral neck fracture was initially treated by open reduction and three-screw fixation. After detecting the nonunion of femoral neck, valgus osteotomy was done. Secondary, iatrogenic, hip dislocation appeared. The patient had pains, and in clinical findings a shorter leg and limited range of motion in the hip - altogether 40 degrees. She was then successfully treated by open reduction, together with Chiari pelvic osteotomy and joint transfixation. Transfixation pin was removed three weeks following the operation. After that, the patient was put into the abduction device and physical therapy was started. The mentioned regimen lasted four months after the surgery, then the abduction device was removed and walking started. Full weight bearing was allowed eight months after surgery. Conclusion. As we have not found the literature data concerning the above mentioned problem, we solved it in the way that we usually do for the treatment of developmental dislocation of the hip in adolescence.

THE BUSINESS OF THE CANAL: THE ECONOMICS AND POLITICS OF THE CARTER ADMINISTRATION’S PANAMA CANAL ZONE INITIATIVE, 1978

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Mary C. Swilling

2004-01-01

Full Text Available The Carter-Torrijos Treaty of 1978, the initiative to relinquish controi of the Panama Canal Zone to the Republic of Panama, allowed Panama for the first time in its short history to become an autonomous nation and to take control of its destiny as a global trading crossroads. Conservatives rallied against President Carter and accused him of jeopardizing U. S. security and hegemony. Fears were that Panama did not have the economic or technical resources to maintain Canal operations, lacked the administrative knowledge and resources to manage the business of the Canal, lacked the military presence to insure security of the Canal, and did not have the political and social will to maintain the environmental integrity of the region. In short, disastrous results were predicted. Carter prevailed. December 31, 1999 saw the surrender of the Canal Zone, and all its facilities, to Panama. This paper discusses events that precipitated Carter’s decision, economic and political arguments presented during the 1977-78 debate, implementation of the treaty, and an evaluation of the ‘business of the Canal’ today.

Hydrology and environmental aspects of Erie Canal (1817-99)

Science.gov (United States)

Langbein, Walter Basil

1976-01-01

As the first major water project in the United States, the old Erie Canal provides an example of the hydrological and environmental consequences of water development. The available record shows that the project aroused environmental fears that the canal might be impaired by the adverse hydrologic effects of land development induced by the canal. Water requirements proved greater than anticipated, and problems of floods and hydraulic inefficiencies beset navigation throughout its history. The Erie Canal proved the practicality of major hydraulic works to the extent that operations and maintenance could cope with the burdens of deficiencies in design. The weight of prior experience that upland streams, such as the Potomac and Mohawk Rivers, had proved unsatisfactory for dependable navigation, led to a decision to build an independent canal which freed the location from the constraints of river channels and made possible a cross-country water route directly to Lake Erie. The decision on dimensioning the canal prism--chiefly width and depth-involved balance between a fear of building too small and thus not achieving the economic potentials, and a fear of building too expensively. The constraints proved effective, and for the first part of its history the revenues collected were sufficient to repay all costs. So great was the economic advantage of the canal that the rising trend in traffic soon induced an enlargement of the canal cross section, based upon a new but riskier objective-build as large as the projected trend in toll revenues would finance. The increased revenues did not materialize. Water supplies were a primary concern for both the planners and the operators of the canal. Water required for lockage, although the most obvious to the planners, proved to be a relatively minor item compared with the amounts of water that were required to compensate for leakage through the bed and banks of the canal. Leakage amounted to about 8 inches of depth per day. The total

Estimated carotid-femoral pulse wave velocity has similar predictive value as measured carotid-femoral pulse wave velocity

DEFF Research Database (Denmark)

Olsen, Michael; Greve, Sara; Blicher, Marie

2016-01-01

OBJECTIVE: Carotid-femoral pulse wave velocity (cfPWV) adds significantly to traditional cardiovascular (CV) risk prediction, but is not widely available. Therefore, it would be helpful if cfPWV could be replaced by an estimated carotid-femoral pulse wave velocity (ePWV) using age and mean blood...... pressure and previously published equations. The aim of this study was to investigate whether ePWV could predict CV events independently of traditional cardiovascular risk factors and/or cfPWV. DESIGN AND METHOD: cfPWV was measured and ePWV calculated in 2366 apparently healthy subjects from four age...

Central canal ependymal cells proliferate extensively in response to traumatic spinal cord injury but not demyelinating lesions.

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Steve Lacroix

Full Text Available The adult mammalian spinal cord has limited regenerative capacity in settings such as spinal cord injury (SCI and multiple sclerosis (MS. Recent studies have revealed that ependymal cells lining the central canal possess latent neural stem cell potential, undergoing proliferation and multi-lineage differentiation following experimental SCI. To determine whether reactive ependymal cells are a realistic endogenous cell population to target in order to promote spinal cord repair, we assessed the spatiotemporal dynamics of ependymal cell proliferation for up to 35 days in three models of spinal pathologies: contusion SCI using the Infinite Horizon impactor, focal demyelination by intraspinal injection of lysophosphatidylcholine (LPC, and autoimmune-mediated multi-focal demyelination using the active experimental autoimmune encephalomyelitis (EAE model of MS. Contusion SCI at the T9-10 thoracic level stimulated a robust, long-lasting and long-distance wave of ependymal proliferation that peaked at 3 days in the lesion segment, 14 days in the rostral segment, and was still detectable at the cervical level, where it peaked at 21 days. This proliferative wave was suppressed distal to the contusion. Unlike SCI, neither chemical- nor autoimmune-mediated demyelination triggered ependymal cell proliferation at any time point, despite the occurrence of demyelination (LPC and EAE, remyelination (LPC and significant locomotor defects (EAE. Thus, traumatic SCI induces widespread and enduring activation of reactive ependymal cells, identifying them as a robust cell population to target for therapeutic manipulation after contusion; conversely, neither demyelination, remyelination nor autoimmunity appears sufficient to trigger proliferation of quiescent ependymal cells in models of MS-like demyelinating diseases.

The treatment of nonisthmal femoral shaft nonunions with im nail exchange versus augmentation plating.

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Park, Jin; Kim, Sul Gee; Yoon, Han Kook; Yang, Kyu Hyun

2010-02-01

The purpose of this study was to compare the results between exchange nailing (EN) and augmentation plating (AP) with a nail left in situ for nonisthmal femoral shaft nonunion after femoral nailing. : Retrospective data analysis, November 1996-March 2006. A level I trauma center. Eighteen patients with 18 nonisthmal femoral nonunions. Seven patients with 7 fractures treated for nonisthmal femoral shaft nonunions after femoral nailing with EN and 11 patients with 11 fractures treated for nonisthmal femoral shaft nonunions after nailing with AP combined with bone grafting. Union and complications. Five nonunions in the EN group failed to achieve union (72% failure rate), whereas all 11 pseudarthroses in the AP group obtained osseous union. Fisher exact test showed a higher nonunion rate of EN compared with AP for nonisthmal femoral shaft nonunion (odds ratio, 6.5; P = 0.002). AP with autogenous bone grafting may be a better option than EN for nonisthmal femoral nonunions.

Single-rooted maxillary first molar with a single canal: endodontic retreatment.

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de la Torre, Francisco; Cisneros-Cabello, Rafael; Aranguren, José Luis; Estévez, Roberto; Velasco-Ortega, Eugenio; Segura-Egea, Juan José

2008-12-01

This case report presents an unusual root canal system in a maxillary first molar tooth: a single canal in a single root. The endodontic access cavity displayed only 1 canal orifice. This case demonstrated that: 1) clinicians must have adequate knowledge about root canal morphology and its variations; 2) the location and morphology of root canals should be identified radiologically before the root canal treatment; and 3) careful examination of radiographs and the internal anatomy of teeth is essential.

Current indications for open Kuntscher nailing of femoral shaft ...

African Journals Online (AJOL)

Current indications for open Kuntscher nailing of femoral shaft fractures. A S Bajwa FCS(SA)ORTH. E Schnaid FCS(SA)ORTH. M E B Sweet MD PhD(rned). University of Witwatersrand, Johannesburg, South Africa. Key Words: Kuntscher nail, intramedullary nail, femoral fracture. We retrospectively reviewed 32 patients with.

A comparison of three rotary systems and hand instrumentation technique for the elimination of Enterococcus faecalis from the root canal.

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Gorduysus, Melahat; Nagas, Emre; Torun, Ozgur Yildirim; Gorduysus, Omer

2011-12-01

The aim of this study was to compare the in vitro reduction of a bacterial population in a root canal by mechanical instrumentation using three rotary systems and hand instrumentation technique. The root canals contaminated with a suspension of Enterococcus faecalis were instrumented using ProTaper, K3, HeroShaper and K-file hand instrumentation technique. Later the root canals were sampled. After serial dilutions, samples were incubated in culture media for 24 h. Bacterial colonies were counted and the results were given as number of colony-forming units per millilitre. The results showed that all the canal instrumentation systems reduced the number of bacterial cells in the root canals. Statistically, ProTaper instruments were more effective in reducing the number of bacteria than the other rotary files or hand instruments. © 2010 The Authors. Australian Endodontic Journal © 2010 Australian Society of Endodontology.

The failures of root canal preparation with hand ProTaper

OpenAIRE

Bătăiosu, Marilena; Diaconu, Oana; Moraru, Iren; Dăguci, C.; Ţuculină, Mihaela; Dăguci, Luminiţa; Gheorghiţă, Lelia

2012-01-01

The failures of root canal preparation are due to some anatomical deviation (canal in “C” or “S”) and some technique errors. The technique errors are usually present in canal root cleansing and shaping stage and are the result of endodontic treatment objectives deviation. Objectives: Our study was made on technique errors while preparing the canal roots with hand ProTaper. Methodology: Our study was made “in vitro” on 84 extracted teeth (molars, premolars, incisors and canines). The canal roo...

Root canal treatment of mandibular second premolar tooth with taurodontism

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Vujašković Mirjana

2008-01-01

Full Text Available INTRODUCTION Taurodontism is a morphoanatomical change in the shape of a tooth. An enlarged body of a tooth with smaller than usual roots is a characteristic feature. Internal tooth anatomy correlates with this appearance, which means that a taurodontal tooth has a large pulp chamber and apically positioned furcations. This dental anomaly may be associated with different syndromes and congenital discoders. CASE OUTLINE The case report presents the patient of a rare case of taurodontism in the mandibular second premolar with chronic periodontitis. Endodontic treatment was performed after dental history and clinical examination. Special care is required in all segments of endodontic treatment of a taurodontal tooth from the identification orifice, canal exploration, determining working length, cleaning and shaping and obturation of the root canal. Precurved K-file was used for canal exploration and location of the furcation. One mesial and one distal canal with the buccal position were identified in the apical third of the root canal. The working lengths of two canals were determined by radiographic interpretation with two K-files in each canal and verified with the apex locator. During canal instrumentation, the third canal was located in the disto-lingual position. The working length of the third canal was established using the apex locator. CONCLUSION Thorough knowledge of tooth anatomy and its variations can lead to lower percentage of endodontic failure. Each clinical case involving these teeth should be investigated carefully, clinically and radiographically to detect additional root canals. High quality radiographs from different angles and proper instrumentarium improve the quality of endodontic procedure.

Image features of herniation pit of the femoral neck

International Nuclear Information System (INIS)

Zhang Xuezhe; Li Guangming; Wang Cunli; Wang Guimin

2008-01-01

Objective: To evaluate imaging appearances of herniation pit of the femoral neck. Methods: We retrospectively analyzed the X-ray, CT and MRI findings of 9 patients with herniation pit of the femoral neck. All nine patients were male with the age ranging from 21 to 73 years. They had pain in the hip from two months to two years duration. Results: The bilateral hips were affected in six patients, the right hips in the other 3 patients. Of the nine patients, X-ray plain films (2 cases), CT scanning(6 cases), and MR scanning (5 cases ) were performed. The size of the lesions ranged from 0.5 cm x 0.6 cm to 1.0 cm x 1.5 cm, located in the anterosuperior portion of the femoral neck (n=7) or anteroinferior portion (n=2). X-ray plain films showed an osteolytic lesion surrounded by a sclerotic rim. CT scanning showed the lesion just below the cortex of the femoral neck surrounded by a rim of sclerosis or associated with a small cortical break in two patients. MR scanning showed low signal intensity in five patients on T 1 WI and high signal intensity surrounded by a rim of low signal intensity (n=3) or low signal intensity (n=2) on T 2 WI, and high signal intensity on fat suppression MR image. A small joint effusion was observed in two cases on T 2 WI. Conclusion: The CT and MRI findings of herniation pit of the femoral neck are characteristic, it is useful in defining the diagnosis of the herniation pit of the femoral neck. (authors)

[Upper lateral incisor with 2 canals].

Science.gov (United States)

Fabra Campos, H

1991-01-01

Clinical case summary of the patient with an upper lateral incisor with two root canals. The suspicion that there might be an anatomic anomaly in the root that includes a complex root canal system was made when an advanced radicular groove was detected in the lingual surface or an excessively enlarged cingulum.

Transtrochanteric rotational osteotomy for avascular necrosis of the femoral head after unstable slipped capital femoral epiphysis: 10-year clinical results.

Science.gov (United States)

Nakashima, Yasuharu; Yamamoto, Takuaki; Fukushi, Jun-Ichi; Motomura, Goro; Hamai, Satoshi; Kohno, Yusuke; Iwamoto, Yukihide

2016-11-01

Avascular necrosis of the femoral head (AVN) is the most serious complication after unstable slipped capital femoral epiphysis (SCFE), and is often unsalvageable. We report a minimum 10 years of clinical results for transtrochanteric rotational osteotomy of the femoral head (TRO) for AVN. This study included 7 patients (7 hips) with a mean age at surgery of 13.3 years, and the follow-up period was 15.8 years. All patients had prior treatment via closed reduction and pinning of the unstable SCFE, and showed severely collapsed femoral heads. The direction of rotation was anterior in 3 hips and posterior in 4. The Merle d'Aubigné-Postel score (MDPS) was used for clinical assessment, and joint degeneration was assessed with the Kellgren and Lawrence classification (KL-grade). The spherical intact area of the femoral head was moved to the weight-bearing portion, and subluxation was corrected via rotation combined with intentional varus positioning. The mean MDPS improved from 10.3 points to 15.6 points at 5 years, and it was maintained at 15.0 points by 10 years; 3 hips were excellent, 1 was good, 2 were fair, and 1 showed poor outcomes. No patient experienced re-collapse after TRO or required conversion to hip replacement or arthrodesis. After 10 years, degenerative changes became evident over time, and 2 hips progressed to KL-4 with a decreased MDPS. Although some joint degeneration is inevitable in the long-term, TRO is an effective salvage procedure for treating AVN after unstable SCFE. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Environmental pollution and shipping feasibility of the Nicaragua Canal.

Science.gov (United States)

Chen, Jihong; Zeng, Xin; Deng, Yibing

2016-12-15

In recent years, the Nicaraguan government's renewed interest in constructing this interoceanic canal has once again aroused widespread concern, particularly in the global shipping industry. The project's immense ecological risks, coupled with the recent expansions of both the Panama Canal and the Suez Canal, have raised questions among scientists and experts about its viability. Whether the Nicaragua Canal is really feasible for international shipping, given its high marine pollution risks, requires the further study. This paper discusses and analyses the feasibility of the Nicaragua Canal in the context of its environmental impact and value as a shipping service. This paper aims to provide an important information reference to inform strategic decision-making among policymakers and stakeholders. Our research results indicate that the environmental complexity, economic costs and safety risks of building a new transoceanic canal are simply too high to justify the project. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessment of femoral head vascularity by technetium-99m antimony colloid bone marrow imaging within 24 hours of subcapital fracture: a prospective study of 30 patients followed for 2 years

International Nuclear Information System (INIS)

Turner, J.H.

1982-01-01

The rationale of preoperative imaging of bone marrow was based upon the demonstration of histochemical abnormalities secondary to ischaemia which first become apparent in marrow cells of the femoral head following interruption of the blood supply by subcapital fracture. These marrow abnormalities predate changes in bone cells by several days and may explain the absence of abnormality on conventional bone scans performed on avascular femoral heads within 24 hours of subcapital fracture. The use of an endoprosthesis for fresh femoral neck fractures in unselected patients results in high mortality, high infection rate, high incidence of thromboembolic disease and poor long term results. The successful prediction of avascular necrosis in 92% of 28 patients with active bone marrow in the femoral head in this study is sufficiently accurate to allow appropriate selection of patients for internal fixation or primary prosthetic replacement on the basis of preoperative Tc-99m antimony colloid imaging

Assessment of periapical health, quality of root canal filling, and ...

African Journals Online (AJOL)

Sixty three teeth were found to have short root canal fillings, whereas 74 teeth had adequate root canal fillings, and the remaining 10 teeth had over extended root canal filling. A significant correlation was observed between the length of root filling and apical periodontitis (P = 0,023). Inadequately dense root canal filling was ...

Endodontic management of a permanent mandibular first molar with six canals

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Mohammad Ahmad Alenezi

2016-01-01

Full Text Available An excellent knowledge of root canal anatomy of teeth is a golden standard for the successful clinical outcome of root canal therapy. Several anatomic variations may occur in a permanent mandibular first molar. Usually, three to four root canals are found, but six to eight canals have been reported. A 22-year-old Bangladeshi woman was referred for endodontic treatment of mandibular right first molar. Rigorous clinical examination revealed the presence of three canals in mesial root and three canals in distal root as well. The dentists should expect any variation in root canal system and use the diagnostic tools to manage the cases.

MRI diagnosis of intraspinal dermoid ruptured into central spinal canal

International Nuclear Information System (INIS)

Zhang Yong; Cheng Jingliang; Wang Juan; Li Huali; Ren Cuiping; Zhang Yan; Gao Xuemei

2009-01-01

Objective: To evaluate the appearances of intraspinal dermoid ruptured into the central spinal canal, as well as the MRI diagnosis and differential diagnosis. Methods: Eleven cases of intraspinal dermoid ruptured into the central spinal canal were reviewed. Six cases underwent whole spine MRI scan, 2 cases with thoracic and lumbar spine MRI, as well as 3 cases only with lumbar spine MRI. Results: Free fat droplets within spinal cord central canal demonstrated high signal intensity on T 1 WI, slight declined signal intensity on T 2 WI, and extremely low signal on fat suppression sequence. Of the 11 cases, 2 cases broke into neighboring central spinal canal of the dermoid, 3 cases scattered within thoracic spinal cord central canal, 4 cases discontinuously distributed in the whole spinal cord central canal, 2 cases showed continuous distribution. Conclusion: Intraspinal dermoid ruptured in the central spinal canal had specific appearance on MRI, when a dermoid tumor is suspected, MRI of the entire spine were recommended to detect possible leakage of' fat within central spinal canal. (authors)

Exosomes secreted from mutant-HIF-1α-modified bone-marrow-derived mesenchymal stem cells attenuate early steroid-induced avascular necrosis of femoral head in rabbit.

Science.gov (United States)

Li, Haile; Liu, Danping; Li, Chen; Zhou, Shanjian; Tian, Dachuan; Xiao, Dawei; Zhang, Huan; Gao, Feng; Huang, Jianhua

2017-12-01

Mesenchymal stem cells (MSCs)-derived exosomes exhibit protective effects on damaged or diseased tissues. Hypoxia-inducible factor 1α (HIF-1α) plays a critical role in bone development. However, HIF-1α is easily biodegradable under normoxic conditions. The bone-marrow-derived mesenchymal stem cells (BMSCs) were transfected with adenovirus carrying triple point-mutations (amino acids 402, 564, and 803) in the HIF-1α coding sequence (CDS). The mutant HIF-1α can efficiently express functional proteins under normoxic conditions. To date, no study has reported the role of exosomes secreted by mutant HIF-1α modified BMSCs in the recovery of the early steroid-induced avascular necrosis of femoral head (SANFH). In this study, we firstly analyzed exosomes derived from BMSCs modified by mutant (BMSC-Exos MU ) or wild-type HIF-1α (BMSC-Exos WT ). In vitro, we investigated the osteogenic differentiation capacity of BMSCs modified by BMSC-Exos MU or BMSC-Exos WT , and the angiogenesis effects of BMSC-Exos MU and BMSC-Exos WT on human umbilical vein endothelial cells (HUVECs). Besides, the healing of the femoral head was also assessed in vivo. We found that the potential of osteogenic differentiation of BMSCs treated with BMSC-Exos MU was higher than the wild-type group in vitro. In addition, BMSC-Exos MU stimulated the proliferation, migration, and tube formation of HUVECs in a dose-dependent manner. Compared with the BMSC-Exos WT or PBS control group, the injection of BMSC-Exos MU into the necrosis region markedly accelerated the bone regeneration and angiogenesis, which were indicated by the increased trabecular reconstruction and microvascular density. Taken together, our data suggest that BMSC-Exos MU facilitates the repair of SANFH by enhancing osteogenesis and angiogenesis. © 2017 International Federation for Cell Biology.

The Incidence of Atypical Femoral Fractures in Patients with Rheumatic Disease: Yamagata Prefectural Committee of Atypical Femoral Fractures (YamaCAFe) Study.

Science.gov (United States)

Takakubo, Yuya; Ohta, Daichi; Ishi, Masaji; Ito, Juji; Oki, Hiroharu; Naganuma, Yasushi; Uno, Tomohiro; Sasaki, Akiko; Akabane, Takeru; Dairaku, Katsuyuki; Goto, Shinichi; Goto, Yasuo; Kanauchi, Yumiko; Kobayashi, Shinji; Nakajima, Taku; Masuda, Keiji; Matsuda, Michiharu; Mura, Nariyuki; Takenouchi, Kenji; Tsuchida, Hiroyuki; Onuma, Yasushi; Shibuya, Junichirou; Seino, Mitsuyoshi; Yamaguchi, Osamu; Hiragami, Ken; Urayama, Yasuhiro; Furukawa, Takashi; Okuda, Shouta; Ogura, Ken; Nakamura, Takeshi; Sasaki, Kan; Konta, Tsuneo; Takagi, Michiaki

2017-08-01

Atypical femoral fractures (AFFs) have been reported to occur with minimal or spontaneous subtrochanteric and femoral shaft fractures with a characteristic transverse pattern, compared with typical femoral fractures in young patients with high-energy trauma. AFFs are related to long-term use of bisphosphonates (BPs), glucocorticoids and rheumatic diseases. We have estimated a blind analysis of AFFs in rheumatic patients receiving BPs and glucocorticoids ordinary over a long time in all Yamagata prefectural area through radiographic examination. The 123 AFFs including suspected cases over six years were collected and reviewed by two independent orthopedic surgeons. We found 86 patients with a total of 99 AFFs between 2009 and 2014 (1.43 cases/100,000 person/year). Of these 99 AFFs, 11 were in 8 rheumatic patients including three patients with bilateral AFFs. The incidence of AFFs in rheumatic patients had trend to increase from 2012. The mean age of all 8 patients was 54.9 years. All 8 patients received BPs and 7/8 received prednisolone (PSL). The mean dose of PSL was 14 mg/day. Compared to patients with unilateral AFFs, those with bilateral AFFs in rheumatic patients were on a higher dose of PSL (20 mg/day vs. 7 mg/day) and had less femoral neck-shaft angle (129° vs. 136°, p rheumatic patients showed a trend to increase from 2012 to 2014 in Yamagata prefecture. Careful management of AFFs is of particular importance in rheumatic patients who have taken high doses of PSL and have small femoral neck-shaft angle.

Three root canals in the maxillary second premolar

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de Almeida-Gomes Fabio

2009-01-01

Full Text Available In this study, we report an endodontic treatment of the maxillary second premolar with three root canals and distinct foramens. The possibility of three root canals in this tooth is quite small; however, it must be taken into account in clinical and radiographic evaluation during endodontic treatment. Many times, their presence is noticed only after canal treatment due to continuing post-operative discomfort.

The crazy project – Canal Istanbul

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Seda Kundak

2011-10-01

Full Text Available It was late April 2011 when “the Crazy Project - Canal Istanbul” was proposed by the Prime Minister of Turkey, during his election campaign.  Although the idea of an artificial canal is not new, since it is initiated without any consensus between the people and institutions in Istanbul, the project immediately set a large number of debates. These vary from the legitimacy of decentralization of governance, to potential impacts of the canal on international politics, economy, environment and urban life.  Regarding past infrastructure projects in Istanbul, such large scale investments have caused extensive acceleration in construction sector in one hand and social and economic shifts on the other.  In this paper, the Canal Istanbul Project is evaluated according to basic motivations and claims of the PM, multi-perspective view through challenges and limitation that the project is likely to face with and speculations on implementation approach. The final discussion on the project is based on benefits/losses of Istanbul once the project will be implemented.

Development of a method for measuring femoral torsion using real-time ultrasound

International Nuclear Information System (INIS)

Hafiz, Eliza; Hiller, Claire E; Nightingale, E Jean; Eisenhuth, John P; Refshauge, Kathryn M; Nicholson, Leslie L; Clarke, Jillian L; Grimaldi, Alison

2014-01-01

Excessive femoral torsion has been associated with various musculoskeletal and neurological problems. To explore this relationship, it is essential to be able to measure femoral torsion in the clinic accurately. Computerized tomography (CT) and magnetic resonance imaging (MRI) are thought to provide the most accurate measurements but CT involves significant radiation exposure and MRI is expensive. The aim of this study was to design a method for measuring femoral torsion in the clinic, and to determine the reliability of this method. Details of design process, including construction of a jig, the protocol developed and the reliability of the method are presented. The protocol developed used ultrasound to image a ridge on the greater trochanter, and a customized jig placed on the femoral condyles as reference points. An inclinometer attached to the customized jig allowed quantification of the degree of femoral torsion. Measurements taken with this protocol had excellent intra- and inter-rater reliability (ICC 2,1  = 0.98 and 0.97, respectively). This method of measuring femoral torsion also permitted measurement of femoral torsion with a high degree of accuracy. This method is applicable to the research setting and, with minor adjustments, will be applicable to the clinical setting. (paper)

Perfluoroalkyl substances in waters along the Grand Canal, China.

Science.gov (United States)

Piao, H T; Jiao, X C; Gai, N; Chen, S; Lu, G H; Yin, X C; Yamazaki, E; Yamashita, N; Tan, K Y; Yang, Y L; Pan, J

2017-07-01

The Grand Canal, also known as the Beijing-Hangzhou Grand Canal, is a UNESCO World Heritage Site and the longest canal in the world. It is an important trunk line of the South-to-North Water Diversion Project in China. The contamination status and spatial distributions of perfluoroalky substances (PFASs) in waters of the Grand Canal were investigated. The total concentrations of PFASs (∑PFASs) range from 7.8 ng/L to 218.0 ng/L, with high ∑PFASs occurring in the southern part of the Grand Canal which is located in a highly urbanized and economically developed region. The dominance of PFOA showed a decreasing trend toward north while shorter chain homologue proportions increased in the northern part of the Canal which mainly traverses underdeveloped and rural areas in Eastern China. Positive correlations were observed between ∑PFASs and the population density as well as GDP per capita. Intersection with large rivers may affect the contamination levels and composition of PFASs in the water of the Grand Canal near the intersection sites. Copyright © 2017 Elsevier Ltd. All rights reserved.

A STUDY OF ROOT CANAL MORPHOLOGY OF Cebus apella TEETH ESTUDO ANATÔMICO DO CANAL RADICULAR DE DENTES DE Cebus apella

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Priscilla Rocha Afonso

2008-12-01

Full Text Available Realizou-se um estudo anatômico em dentes do Cebus apella, para análise da anatomia interna do canal radicular dessa espécie, normatizando seu uso como modelo experimental. Utilizaram-se doze animais adultos. Após a remoção do tecido orgânico, os dentes foram removidos, seccionados e fotografados, sendo analisados com um estereomicroscópio. Os resultados mostraram que os dentes apresentaram características semelhantes às dos seres humanos, mas com algumas peculiaridades, tais como: a anatomia do canal radicular variou de oval para circular; nos caninos inferiores, os canais são semelhantes a um rim, o que reflete o contorno externo da raiz; nos molares superiores, os canais mesiobucal e distobucal são ovais, seguindo o contorno geral do dente. Os autores concluem que esta espécie pode ser utilizada como modelo em pesquisas odontológicas, principalmente em estudos do tratamento do sistema de canal radicular.

PALAVRAS-CHAVES: Anatomia, dentes, Cebus apella. An anatomic study of Cebus apella root teeth was performed to analyze the internal anatomy of permanent dentition, normalizing its use as experimental model endodontic research. Twelve adult animals were used in this study. After the removal of the organic tissue, the all teeth were removed, sectioned, analyzed and photographed with a stereomicroscope. The results showed that the anatomy of root canal of this species are similar to human dental anatomy, considering the shape, pathway and number of canals, but with some peculiarities, such as: the root canal anatomy varied from oval to circular; in the lower canines, the canals are resembled a kidney, reflecting the outside contour of the root; in the upper molars, the mesiobuccal and distobuccal canals are oval, following the general contour of the tooth. The authors conclude that this primate can be applied as models for study of root canal treatment in human beings, in special the upper central and lateral incisors

Evaluation of femoral head viability via bone scintigraphy in the postoperative pediatric patient

International Nuclear Information System (INIS)

Parikh, Ashishkumar K.; Washington, Eleby R.; Spottswood, Stephanie E.; Bobbey, Adam J.

2018-01-01

Evaluating postoperative patients with hardware is challenging following surgical intervention for hip maladies such as femoral neck fractures and slipped capital femoral epiphysis (SCFE). These children are at increased risk of developing avascular necrosis, and imaging may be requested to confirm or exclude this diagnosis. Children with Legg-Calve-Perthes disease can be monitored for restoration of blood flow to the capital femoral epiphysis to guide management and help with prognosis. Although MRI is sensitive for detecting early avascular necrosis, the presence of hardware degrades image quality. This report examines the utility of bone scans for evaluating femoral head perfusion in children who have undergone surgery for femoral neck fractures, SCFE or Legg-Calve-Perthes disease. A retrospective review of 20 patients (22 scans) after fixation for femoral neck fracture, SCFE or Legg-Calve-Perthes disease from 2012 to 2015 was performed. The bone scan findings were correlated with the intraoperative findings or clinical follow-up. Twenty-one of the 22 (95%) bone scans in 19 of the 20 (95%) patients demonstrated findings consistent with clinical outcomes and/or the intraoperative appearance of the femoral head. Four of 20 patients (20%) had bone scan features of avascular necrosis, defined as ''absent'' or ''moderately diminished'' femoral head activity, which were confirmed intraoperatively and resulted in poor outcomes. Radionuclide imaging of hips in the postoperative setting is a valuable modality for assessing the risk of avascular necrosis, a complication of femoral neck fractures and SCFE and for evaluating the restoration of flow to the capital femoral epiphyses of children with Legg-Calve-Perthes disease. (orig.)

Computed tomography in lumbar canal stenosis

International Nuclear Information System (INIS)

Ohta, Shu; Baba, Itsushi; Ishida, Akihisa; Sumida, Tadayuki; Sasaki, Seishu

1984-01-01

Preoperative CT was done in 39 patients with lumbar canal stenosis. Marked symmetrical narrowing of the whole vertebral canal was seen in the group with nervous symptoms in the cauda equina. Deformed bilateral intervertebral joints were seen in the group with both nervous symptoms in the cauda equina and radicular sciatica. The lateral recess on the affected side was markedly narrowed by the projection of the upper and lower joints and herniation. In the group with radicular sciatica, the vertebral canal itself was not so narrowed, but the unilateral intervertebral joint was extremely deformed, causing a narrowing of the lateral recess. There were large differences in the angle of the left and right intervertebral joints. (Namekawa, K)

Symmetric visualization of the femoral heads in reticuloendothelial bone marrow scanning in adults

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Munz, D L; Hoer, G

1983-03-01

Two hundred and twenty seven consecutive patients of either sex aged 15-84 suffering from various benign and malignant disorders were studied by sup(99m)Tc-HSA-MM reticuloendothelial bone marrow scintigraphy. In all patients, symmetric findings concerning visualization or nonvisualization of the femoral heads could be seen. Femoral heads were clearly visualized in 48%, nonvisualized in 43%, and equivocally visualized in 9%. In patients with clearly visualized femoral heads, the bone marrow showed peripheral extension in 81%, whereas in patients with nonvisualized femoral heads, bone marrow extension was observed in only 42%. There was a correlation between the degree of bone marrow extension and the ability to visualize femoral heads. There was no obvious difference between males and females, nor patients with various diseases or treatments, amongst nor between different age groups. Two hypotheses are suggested to explain the correspondence between presence of bone marrow tissue in the femoral heads and peripheral extension of the bone marrow organ. Nonvisualization of the femoral heads alone is insufficient to establish the diagnosis of avascular necrosis.

Cytotoxicity evaluation of a copaiba oil-based root canal sealer compared to three commonly used sealers in endodontics

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Angela Delfina Bittencourt Garrido

2015-01-01

Full Text Available Background: The constant development of new root canal sealers has allowed the solution of a large number of clinical cases in endodontics, however, cytotoxicity of such sealers must be tested before their validation as filling materials. The aim of this study was to evaluate the cytotoxic effect of a new Copaiba oil-based root canal sealer (Biosealer [BS] on osteoblast-like Osteo-1 cells. Materials and Methods: The experimental groups were formed according to the culture medium conditioned with the tested sealers, as follows: Control group (CG (culture medium without conditioning; Sealer 26 (S26 - culture medium + S26; Endofill (EF - culture medium + EF; AH Plus (AHP - culture medium + AHP; and BS - culture medium + BS (Copaiba oil-based sealer. The conditioned culture medium was placed in contact with 2 × 10 4 cells cultivated on 60 mm diameter Petri dishes for 24 h. Then, hemocytometer count was performed to evaluate cellular viability, using Trypan Blue assay. The normal distribution of data was tested by the Kolmogorov-Smirnov test and the values obtained for cellular viability were statistically analyzed (1-way ANOVA, Tukey′s test - P 0.05. Conclusion: The Copaiba oil-based root canal sealer presented promising results in terms of cytotoxicity which indicated its usefulness as a root canal sealer.

Cytotoxicity evaluation of a copaiba oil-based root canal sealer compared to three commonly used sealers in endodontics

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Garrido, Angela Delfina Bittencourt; de Cara, Sueli Patricia Harumi Miyagi; Marques, Marcia Martins; Sponchiado, Emílio Carlos; Garcia, Lucas da Fonseca Roberti; de Sousa-Neto, Manoel Damião

2015-01-01

Background: The constant development of new root canal sealers has allowed the solution of a large number of clinical cases in endodontics, however, cytotoxicity of such sealers must be tested before their validation as filling materials. The aim of this study was to evaluate the cytotoxic effect of a new Copaiba oil-based root canal sealer (Biosealer [BS]) on osteoblast-like Osteo-1 cells. Materials and Methods: The experimental groups were formed according to the culture medium conditioned with the tested sealers, as follows: Control group (CG) (culture medium without conditioning); Sealer 26 (S26) - culture medium + S26; Endofill (EF) - culture medium + EF; AH Plus (AHP) - culture medium + AHP; and BS - culture medium + BS (Copaiba oil-based sealer). The conditioned culture medium was placed in contact with 2 × 104 cells cultivated on 60 mm diameter Petri dishes for 24 h. Then, hemocytometer count was performed to evaluate cellular viability, using Trypan Blue assay. The normal distribution of data was tested by the Kolmogorov-Smirnov test and the values obtained for cellular viability were statistically analyzed (1-way ANOVA, Tukey's test - P 0.05). Conclusion: The Copaiba oil-based root canal sealer presented promising results in terms of cytotoxicity which indicated its usefulness as a root canal sealer. PMID:25878676

A biomechanical comparison of proximal femoral nails and locking proximal anatomic femoral plates in femoral fracture fixation A study on synthetic bones

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Korhan Ozkan

2015-01-01

Conclusion: The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of unstable intertrochanteric fractures of the femur. Clinicians should be cautious for early weight bearing with locking plate for unstable intertrochanteric femur fractures.

Canal switch after canalith repositioning procedure for benign paroxysmal positional vertigo.

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Lin, Giant C; Basura, Gregory J; Wong, Hiu Tung; Heidenreich, Katherine D

2012-09-01

Canal switch is a complication following canalith repositioning procedure (CRP) for posterior canal benign paroxysmal positional vertigo (BPPV). Instead of being returned to the utricle, the loose otoconia migrate into the superior or horizontal semicircular canal. Patients remain symptomatic, and treatment can be ineffective unless the switch is recognized and additional repositioning maneuvers directed toward the appropriate semicircular canal are performed. This report provides the first videographic documentation of canal switch involving conversion of unilateral posterior semicircular canal BPPV to geotropic horizontal canalithiasis. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Osteonecrosis of femoral head: Treatment by core decompression and vascular pedicle grafting

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Babhulkar Sudhir

2009-01-01

grafting reduces the intraosseous tension to achieve early revascularization of ischemic femoral head. The high percentage of marrow and osteogenic cells survive within a vascularized pedicle graft, which helps in early vascularization and we have been able to achieve good outcome.

Release of Growth Factors into Root Canal by Irrigations in Regenerative Endodontics.

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Zeng, Qian; Nguyen, Sean; Zhang, Hongming; Chebrolu, Hari Priya; Alzebdeh, Dalia; Badi, Mustafa A; Kim, Jong Ryul; Ling, Junqi; Yang, Maobin

2016-12-01

The aim of this study was to investigate the release of growth factors into root canal space after the irrigation procedure of regenerative endodontic procedure. Sixty standardized root segments were prepared from extracted single-root teeth. Nail varnish was applied to all surfaces except the root canal surface. Root segments were irrigated with 1.5% NaOCl + 17% EDTA, 2.5% NaOCl + 17% EDTA, 17% EDTA, or deionized water. The profile of growth factors that were released after irrigation was studied by growth factor array. Enzyme-linked immunosorbent assay was used to validate the release of transforming growth factor (TGF)-β1 and basic fibroblast growth factor (bFGF) at 4 hours, 1 day, and 3 days after irrigation. The final concentrations were calculated on the basis of the root canal volume measured by cone-beam computed tomography. Dental pulp stem cell migration on growth factors released from root segments was measured by using Transwell assay. Total of 11 of 41 growth factors were detected by growth factors array. Enzyme-linked immunosorbent assay showed that TGF-β1 was released in all irrigation groups. Compared with the group with 17% EDTA (6.92 ± 4.49 ng/mL), the groups with 1.5% NaOCl + 17% EDTA and 2.5% NaOCl + 17% EDTA had significantly higher release of TGF-β1 (69.04 ± 30.41 ng/mL and 59.26 ± 3.37 ng/mL, respectively), with a peak release at day 1. The release of bFGF was detected at a low level in all groups (0 ng/mL to 0.43 ± 0.22 ng/mL). Migration assay showed the growth factors released from root segments induced dental pulp stem cell migration. The root segment model in present study simulated clinical scenario and indicated that the current irrigation protocol released a significant amount of TGF-β1 but not bFGF. The growth factors released into root canal space induced dental pulp stem cell migration. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

C-shaped root canal in a maxillary first molar: a case report.

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Yilmaz, Z; Tuncel, B; Serper, A; Calt, S

2006-02-01

This case report presents an unusual C-shaped root canal system in a maxillary first molar tooth. Although C-shaped root canals are most frequently seen in the mandibular second molar, they may also appear in maxillary molars. A literature search revealed only a few case reports of C-shaped root canal systems in maxillary molars. The present case describes a C-shaped canal in the buccal root of a maxillary first molar. The endodontic access cavity displayed two canal orifices, one leading to the canal system in the buccal root, the other into the palatal root canal system. In the buccal root, what appeared to be the mesial and distal canals joined to form a single C-shaped canal. --Careful examination of radiographs and the internal anatomy of teeth is essential.-- The location and morphology of root canals should be identified at high magnification under the microscope.

Comparison among manual instruments and PathFile and Mtwo rotary instruments to create a glide path in the root canal preparation of curved canals.

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Alves, Vanessa de Oliveira; Bueno, Carlos Eduardo da Silveira; Cunha, Rodrigo Sanches; Pinheiro, Sérgio Luiz; Fontana, Carlos Eduardo; de Martin, Alexandre Sigrist

2012-01-01

Nickel-titanium rotary instruments reduce procedural errors and the time required to finish root canal preparation. The goal of this study was to evaluate the occurrences of apical transportation and canal aberrations produced with different instruments used to create a glide path in the preparation of curved root canals, namely manual K-files (Dentsply Maillefer, Ballaigues, Switzerland) and PathFile (Dentsply Maillefer) and Mtwo (Sweden and Martina, Padua, Italy) nickel-titanium rotary files. The mesial canals of 45 mandibular first and second molars (with curvature angles between 25° and 35°) were selected for this study. The specimens were divided randomly into 3 groups with 15 canals each, and canal preparation was performed by an endodontist using #10-15-20 K-type stainless steel manual files (group M), #13-16-19 PathFile rotary instruments (group PF), and #10-15-20 Mtwo rotary instruments (group MT). The double digital radiograph technique was used, pre- and postinstrumentation, to assess whether apical transportation and/or aberration in root canal morphology occurred. The initial and final images of the central axis of the canals were compared by superimposition through computerized analysis and with the aid of magnification. The specimens were analyzed by 3 evaluators, whose calibration was checked using the Kendall agreement test. No apical transportation or aberration in root canal morphology occurred in any of the teeth; therefore, no statistical analysis was conducted. Neither the manual instruments nor the PathFile or Mtwo rotary instruments used to create a glide path had any influence on the occurrence of apical transportation or produced any canal aberration. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Femoral bifurcation with ipsilateral tibia hemimelia: Early outcome of ...

African Journals Online (AJOL)

Hereby, we present a case report of a 2-year-old boy who first presented in our orthopedic clinic as a 12-day-old neonate, with a grossly deformed right lower limb from a combination of complete tibia hemimelia and ipsilateral femoral bifurcation. Excision of femoral exostosis, knee disarticulation and prosthetic fitting gives ...

Fractional-order mathematical model of an irrigation main canal pool

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Shlomi N. Calderon-Valdez

2015-09-01

Full Text Available In this paper a fractional order model for an irrigation main canal is proposed. It is based on the experiments developed in a laboratory prototype of a hydraulic canal and the application of a direct system identification methodology. The hydraulic processes that take place in this canal are equivalent to those that occur in real main irrigation canals and the results obtained here can therefore be easily extended to real canals. The accuracy of the proposed fractional order model is compared by deriving two other integer-order models of the canal of a complexity similar to that proposed here. The parameters of these three mathematical models have been identified by minimizing the Integral Square Error (ISE performance index existing between the models and the real-time experimental data obtained from the canal prototype. A comparison of the performances of these three models shows that the fractional-order model has the lowest error and therefore the higher accuracy. Experiments showed that our model outperformed the accuracy of the integer-order models by about 25%, which is a significant improvement as regards to capturing the canal dynamics.

Bone scintigraphy in idiopathic aseptic femoral head necrosis (IAFHN)

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Dodig, D; Ugarkovic, B; Orlic, D

1983-01-01

Idiopathic aseptic femoral head necrosis (IAFHN) is a disease of unknown aetiology most commonly affecting adults, producing functional impairment of the hip joint and immobility. Characteristic macroscopic, microscopic and radiologic features include: (1) changes in joint cartilage, (2) subchondral necrotic area, (3) changes in fibrous tissue, and (4) osteosclerosis and vascular proliferation. The diagnosis is based on clinical and X-ray examinations. More recently scintigraphy has been used in diagnosing IAFHN. It is a very sensitive, but non-specific method. Nineteen patients aged 25-57 years were included in our study. Scintigrams were divided in four groups: (1) normal, (2) uniformly increased activity in the femoral head, (3) non-uniformly increased activity in the femoral head, and (4) a photon deficient area in the femoral head. A comparison of scintigraphy and radiological examination suggests that a photon deficient area corresponds with stage III of radiological classification, non-uniformly increased activity with stage II, and uniformly increased activity with stage I. These results indicate that scintigraphy can be used for staging of disease.

Management of avascular necrosis of femoral head at pre-collapse stage

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Sen Ramesh

2009-01-01

Full Text Available In osteonecrosis the success of interventions that forestall or prevent femoral head collapse and maintain hip function would represent a substantial achievement in the treatment of this disease. A review of recent literature regarding bisphosphonate, anticoagulant, and vasodilators and biophysical modalities have demonstrated efficacy in reducing pain and delaying disease progression in early stage osteonecrosis. Though it has been considered still insufficient, to support their routine use in the treatment or prevention of osteonecrosis of the hip. Core decompression with modification of technique is still one of the safest and most commonly employed procedures with evidence based success in the pre-collapse stage of AVN of femoral head. The additional use of bone morphogenic protein, and bone marrow stem cells may provide the opportunity to enhance the results of core decompression. At present, the use of large vascularised cortical grafts, the other surgical procedure with high success rate is still not common due to technical difficulty in surgery. Likewise osteotomies are also not getting common as arthroplasty is getting more acceptable, so is awaited without any intermediate big surgical interventions.

Radiographic evaluation of the course and visibility of the mandibular canal

International Nuclear Information System (INIS)

Jung, Yun Hoa; Cho, Bong Hae

2014-01-01

This study was performed to investigate the course of the mandibular canal on panoramic radiography and the visibility of this canal on both panoramic radiography and cone-beam computed tomography (CBCT). The study consisted of panoramic radiographs and CBCT images from 262 patients. The course of the mandibular canal, as seen in panoramic radiographs, was classified into four types: linear, elliptical, spoon-shaped, and turning curves. The visibility of this canal from the first to the third molar region was evaluated by visually determining whether the mandibular canal was clearly visible, probably visible, or invisible. The visibility of the canal on panoramic radiographs was compared with that on CBCT images. Elliptical curves were most frequently observed along the course of the mandibular canal. The percentage of clearly visible mandibular canals was the highest among the spoon-shaped curves and the lowest among the linear curves. On panoramic radiographs, invisible mandibular canals were found in 22.7% of the examined sites in the first molar region, 11.8% in the second molar region, and 1.3% in the third molar region. On CBCT cross-sectional images, the mandibular canal was invisible in 8.2% of the examined sites in the first molar region, 5.7% in the second molar region, and 0.2% in the third molar region. The visibility of this canal was lower in the first molar region than in the third molar region. The mandibular canal presented better visibility on CBCT images than on panoramic radiographs.

About ecological aspects of "Eurasia" canal construction

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G. M. Abdurakhmanov

2010-01-01

Full Text Available Ecological aspects of "Eurasia" canal construction are considered here. The fact that can negatively affect natural area preservation (preserves, reserves, located in Kumo-Manych depression, along where the canal construction will take place, is shown in this article.

[SURGICAL HIP DISLOCATION APPROACH FOR TREATMENT OF FEMORAL HEAD FRACTURE].

Science.gov (United States)

Tang, Yanfeng; Liu, Youwen; Zhu, Yingjie; Li, Jianming; Li, Wuyin; Li, Qiyi; Jia, Yudong

2015-11-01

To discuss the value of surgical hip dislocation approach in the treatment of femoral head fracture. A retrospectively analysis was made on the clinical data of 15 patients with femoral head fractures treated through surgical hip dislocation approach between January 2010 and February 2013. There were 11 men and 4 women with an average age of 30.8 years (range, 15-63 years). The causes included traffic accident injury in 9 cases, falling injury from height in 5 cases, and sports injury in 1 case. According to Pipkin typing, 2 cases were rated as type I, 7 cases as type II, 1 case as type III, and 5 cases as type IV. The interval of injury and operation was 2-10 days (mean, 4.1 days). Reduction was performed in 10 patients within 6 hours after injury, and then bone traction was given for 4-6 weeks except 5 patients who received reduction in the other hospital. Primary healing of incision was obtained in all patients after surgery without complications of dislocation and lower limbs deep venous thrombosis. The mean follow-up time was 29.9 months (range, 25-36 months). During follow-up, there was no infection, breakage of internal fixation, or nonunion of femoral greater trochanter fracture. In 3 patients having necrosis of the femoral head, 2 had no obvious symptoms [staging as IIa and IIb respectively according to Association Research Circulation Osseous (ARCO) staging system], and 1 (stage IIIb) had nonunion of the femoral neck fracture, who underwent total hip arthroplasty (THA). In 4 patients having myositis ossificans (2 cases of grade I, 1 case of grade II, and 1 case of grade III based on Brooker grading), no treatment was given in 3 cases and the focus was removed during THA in 1 case. According to the Thompson-Epstein scale at last follow-up, the results were excellent in 9 cases, good in 3 cases, fair in 1 case, and poor in 2 cases, and the excellent and good rate was 80%. Surgical hip dislocation approach can not only protect the residual vessels of the

Multiple bony lesions other than femoral heads on 99mTc-MDP bone scan in patients with avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Choi, Yun Young; Yang, Seoung Oh; Moon, Dae Hyuk; Ryu, Jin Sook; Weon, Young Cheol; Shin, Myung Jin; Lee, Soo Ho; Lee, Hee Kyung; Chun, Hae Kyung

1997-01-01

To evaluate the clinical significance of the multiple increased uptake lesions other than in femoral heads as seen on whole body bone scan in patients with avascular necrosis of femoral heads. One hundred and seventy three patients with clinical diagnosis of avascular necrosis of the emoral head underwent a bone scan using Tc-99m MDP. Increased uptake lesions other than in femoral heads were evaluated, including frequency and common sites of in volvement, and correlated with clinical information and plain radiographic findings. Two hundred patients without AVN, who had undergone a bone scan, were included as a control group. Increased uptake lesions in extrafemoral head locations were found in 36 of 173 patients(20.8%;the location of 79 lesions was other than the femoral head, This result is statistically different from patients without avascular necrosis of femoral head(p<0.0001). The most common site of involvement was the knee joint area(62.5%). Other lesions were located in the mid-shafts of the long bones of the lower extremities, calcaneus, proximal humerus, etc., in order of decreasing frequency. Plain radiographs of 17 lesions were nonspecific, except for three lesions showing definite changes associated with avascular necrosis. The risk factors included alcoholism, the prolonged use of steroids, renal transplantation, herbal medication and working as a working as deep-sea diver. Most patients did not complain of pain, except for two with irreversible osteonecrotic changes as seen on plain radiograph. in patients with avascular necrosis of the femur, increased uptake lesions other than in the femoral head as seen on bone scan, may represent the early stage of osteonecrosis, which shows a characteristic appearance on bone scan. In order to aveid possible misdiagnoses of multiple extrafemoral lesions as bony metastasis or traumatic lesions, in patients with avascular necrosis of the femur these should be carefully evaluated

Homosexuality via canalized sexual development: a testing protocol for a new epigenetic model.

Science.gov (United States)

Rice, William R; Friberg, Urban; Gavrilets, Sergey

2013-09-01

We recently synthesized and reinterpreted published studies to advance an epigenetic model for the development of homosexuality (HS). The model is based on epigenetic marks laid down in response to the XX vs. XY karyotype in embryonic stem cells. These marks boost sensitivity to testosterone in XY fetuses and lower it in XX fetuses, thereby canalizing sexual development. Our model predicts that a subset of these canalizing epigenetic marks stochastically carry over across generations and lead to mosaicism for sexual development in opposite-sex offspring--the homosexual phenotype being one such outcome. Here, we begin by outlining why HS has been under-appreciated as a commonplace phenomenon in nature, and how this trend is currently being reversed in the field of neurobiology. We next briefly describe our epigenetic model of HS, develop a set of predictions, and describe how epigenetic profiles of human stem cells can provide for a strong test of the model. © 2013 The Authors. Bioessays published by WILEY Periodicals, Inc.

'Femoral head necrosis' in metabolic and hormonal osteopathies

Energy Technology Data Exchange (ETDEWEB)

Heuck, F.H.W.; Treugut, H.

1984-07-01

The pathogenesis of bone necrosis is discussed with special attention and with respect to metabolic, hormonal, and vascular factors. The influence of statics and dynamics of the hip joint bones for the development of aseptic necrosis are discussed. 45 patients with ''idiopathic femoral head necroses'' were observed, including 6 cases of renal osteopathy following renal transplantation and immune suppression therapy, 14 cases of long term corticoid therapy, and 11 cases of liver diseases of different genesis. The femoral head necrosis understood as complication of an osteopathy. In our patients there were 31 males and 14 females - which means higher involvement of males. Plain radiological findings and CT-findings of changes of the femoral heat structure in different stages of the disease are described. Early diagnosis of metabolic and hormonal osteopathies is demanded for a joint keeping therapy of the beginning femoral head necrosis. 90 refs.

Discharge Estimation in a Lined Canal Using Information Entropy

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Yen-Chang Chen

2014-03-01

Full Text Available This study applies a new method and technology to measure the discharge in a lined canal in Taiwan. An Acoustic Digital Current Meter mounted on a measurement platform is used to measure the velocities over the full cross-section for establishing the measurement method. The proposed method primarily employs Chiu’s Equation which is based on entropy to establish a constant ratio the relation between the maximum and mean velocities in an irrigation canal, and compute the maximum velocity by the observed velocity profile. In consequence, the mean velocity of the lined canal can be rapidly determined by the maximum velocity and the constant ratio. The cross-sectional area of the artificial irrigation canal can be calculated for the water stage. Finally, the discharge in the lined canal can be efficiently determined by the estimated mean velocity and the cross-sectional area. Using the data of discharges and stages collected in the Wan-Dan Canal, the correlation of stage and discharge is also developed for remote real-time monitoring and estimating discharge from the pumping station. Overall, Chiu’s Equation is demonstrated to reliably and accurately measure discharge in a lined canal, and can serve as reference for future calibration for a stage-discharge rating curve.

Morpho-functional study of ionizing radiation effects on the rabbits` femoral vein; Avaliacao morfofuncional do efeito da radiacao ionizante sobre a veia femoral. Estudo experimental em coelhos

Energy Technology Data Exchange (ETDEWEB)

Sakiyama, Mauro Yoshimitsu

1995-12-31

In this study we evaluate the effects of the ionizing radiation on the rabbits femoral vein. The samples of femoral vein were obtained from 56 New Zealand rabbits, male with ageing from 90 to 120 days, that were divided into 4 groups of 14 animals: one control group non-irradiated and three animal groups sacrificed 2 days, 14 days and 90 days after irradiation. In the three irradiated rabbits groups, each animal received the total dose 4000 cGy (rads) divided in 10 sessions of 400 cGy, a dose equivalent that utilized on clinical therapeutic. A morpho functional study of vein samples was carried out with: light microscopy: stained by hematoxin - eosin, Masson`s tricromic, and Verhoeff. Immunohistochemical: reactions of immunoperoxidase with monoclonal mouse anti-human endothelial cell factor CD-31 and anti-human Von Willebrand factor (factor VIII), to study the vein endothelium. Histomorphometry of elastic fiber system stained by Weigert`s resorcin-fuchsin with and without prior oxidation with oxone; for the study of mature, elaunin or pre-mature and oxytalan or young elastic fibers. Electronic microscopy: transmission and scanning. With the methodology utilized we observe changes in the femoral vein of the animals submitted to irradiation in relation to the control group, thus described: there is formation of vacuoles between the endothelium and the basal membrane, called sub endothelial vacuoles, in focal areas. The factor VIII and CD-31 endothelial antigens are preserved with no changes in their functions. Focal alterations are present in the endothelial surface with disorder in the setting and orientation of the endothelial cells. there is degeneration of the elastic fibers with significant decrease in their quantity in the stage, 2 days and 14 days after irradiation. There is increase in the quantity of elastic fibers in the late stage, 90 days after irradiation, tending to normality. In this present study, the changes described are not accompanied by venous

Morpho-functional study of ionizing radiation effects on the rabbits` femoral vein; Avaliacao morfofuncional do efeito da radiacao ionizante sobre a veia femoral. Estudo experimental em coelhos

Energy Technology Data Exchange (ETDEWEB)

Sakiyama, Mauro Yoshimitsu

1996-12-31

In this study we evaluate the effects of the ionizing radiation on the rabbits femoral vein. The samples of femoral vein were obtained from 56 New Zealand rabbits, male with ageing from 90 to 120 days, that were divided into 4 groups of 14 animals: one control group non-irradiated and three animal groups sacrificed 2 days, 14 days and 90 days after irradiation. In the three irradiated rabbits groups, each animal received the total dose 4000 cGy (rads) divided in 10 sessions of 400 cGy, a dose equivalent that utilized on clinical therapeutic. A morpho functional study of vein samples was carried out with: light microscopy: stained by hematoxin - eosin, Masson`s tricromic, and Verhoeff. Immunohistochemical: reactions of immunoperoxidase with monoclonal mouse anti-human endothelial cell factor CD-31 and anti-human Von Willebrand factor (factor VIII), to study the vein endothelium. Histomorphometry of elastic fiber system stained by Weigert`s resorcin-fuchsin with and without prior oxidation with oxone; for the study of mature, elaunin or pre-mature and oxytalan or young elastic fibers. Electronic microscopy: transmission and scanning. With the methodology utilized we observe changes in the femoral vein of the animals submitted to irradiation in relation to the control group, thus described: there is formation of vacuoles between the endothelium and the basal membrane, called sub endothelial vacuoles, in focal areas. The factor VIII and CD-31 endothelial antigens are preserved with no changes in their functions. Focal alterations are present in the endothelial surface with disorder in the setting and orientation of the endothelial cells. there is degeneration of the elastic fibers with significant decrease in their quantity in the stage, 2 days and 14 days after irradiation. There is increase in the quantity of elastic fibers in the late stage, 90 days after irradiation, tending to normality. In this present study, the changes described are not accompanied by venous

Otolith and canal reflexes in human standing

Science.gov (United States)

Cathers, Ian; Day, Brian L; Fitzpatrick, Richard C

2005-01-01

We used galvanic vestibular stimulation (GVS) to identify human balance reflexes of the semicircular canals and otolith organs. The experiment used a model of vestibular signals arising from GVS modulation of the net signal from vestibular afferents. With the head upright, the model predicts that the GVS-evoked canal signal indicates lateral head rotation while the otolith signal indicates lateral tilt or acceleration. Both signify body sway transverse to the head. With the head bent forward, the model predicts that the canal signal indicates body spin about a vertical axis but the otolith signal still signifies lateral body motion. Thus, we compared electromyograms (EMG) in the leg muscles and body sway evoked by GVS when subjects stood with the head upright or bent forward. With the head upright, GVS evoked a large sway in the direction of the anodal electrode. This response was abolished with the head bent forward leaving only small, oppositely directed, transient responses at the start and end of the stimulus. With the head upright, GVS evoked short-latency (60–70 ms), followed by medium-latency (120 ms) EMG responses, of opposite polarity. Bending the head forward abolished the medium-latency but preserved the short-latency response. This is compatible with GVS evoking separate otolithic and canal reflexes, indicating that balance is controlled by independent canal and otolith reflexes, probably through different pathways. We propose that the short-latency reflex and small transient sway are driven by the otolith organs and the medium-latency response and the large sway are driven by the semicircular canals. PMID:15618274

ROOT CANAL IRRIGANTS AND IRRIGATION TECHNIQUES: A REVIEW

OpenAIRE

Aniketh; Mohamed; Geeta; Nandakishore; Gourav Kumar; Patrick Timothy; Jayson Mathew; Sahle Abdul

2015-01-01

Root canal irrigation is not much emphasised in endodontic therapy. Most articles discussed are on root canal shaping and obturation not much emphasis is given for irrigation. There are many irrigation solutions which are introduced into market. The primary objective of root canal therapy is the ret ention of the pulpless or pulpally involved tooth with its associated periapical tissues in a healthy state. Achievement of this objective requires that the pulpal spaces and con...

Mechanical Characterization of Femoral Cartilage Under Unicompartimental Osteoarthritis

OpenAIRE

Vidal-Lesso, A.; Ledesma-Orozco, E.; Daza-Benítez, L.; Lesso-Arroyo, R.

2014-01-01

The aim of this study was to determine the mechanical properties and thickness of articular cartilage in the unaffected femoral regions in cases of unicompartimental osteoarthritis on the knees. The specimens were tested using a 3mm plane-ended cylindrical indenter and a displacement of 0.5mm was applied at specific points in seven femoral knee cartilages with unicompartimental osteoarthritis. The thickness, stiffness, elastic modulus, shear modulus and bulk modulus were obtained. These prope...

The use of osteochondral allograft with bone marrow-derived mesenchymal cells and hinge joint distraction in the treatment of post-collapse stage of osteonecrosis of the femoral head.

Science.gov (United States)

Gagala, J; Tarczynska, M; Gaweda, K; Matuszewski, L

2014-09-01

Osteonecrosis of the femoral head is an entity which occurs mainly in young and active patients aged between 20 and 50. The success of hip joint preserving treatments ranges from 15% to 50% depending on the stage and amount of osteonecrotic lesion. Total hip replacement is indicated in late post-collapse hips but it has unsatisfactory survival because of the wear and osteolysis in young and active patients. Osteochondral allografts have been reported in the treatment of large articular lesions with defects in underlying bone in knee, talus and shoulder. By combining osteoconductive properties of osteochondral allograft with osteogenic abilities of bone marrow-derived mesenchymal cells it has a potential to be an alternative to an autologous graft. The adjunct of hinged joint distraction should minimize stresses in subchondral bone to promote creeping substitution and prevent femoral head collapse. Unlike current treatment modalities, it would provide both structural support and allow bony and articular substitution. Copyright © 2014 Elsevier Ltd. All rights reserved.

Maxillary second molar with four roots and five canals

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Xinjia Sha

2018-06-01

Full Text Available In this case report, we present a maxillary second molar variant, which had two palatal roots with two canals and two buccal roots with three canals, including a second mesiobuccal canal. A 44-year-old female patient complained about a tooth crown fracture and severe pain in her right maxillary second molar. A clinical intraoral inspection and radiography were carried out on the tooth, and a diagnosis of chronic apical periodontitis was made. Four roots (two buccal and two palatal and five canals (three buccal and two palatal were found. The anatomical variation of the tooth was further confirmed by cone-beam computed tomography, a cone-fit procedure, and a radiograph with a shifted projection angle. Root-canal treatment was performed under an endodontic microscope.

Femoral head allograft disinfection system using moderate heat

International Nuclear Information System (INIS)

Knaepler, H.; Von Garrel, T.

1999-01-01

The employment of a reliable thermal viral inactivation process, which minimally manipulates tissues, for surgically retrieved femoral head allografts addresses the increased concerns with virus transmissibility while minimizing the loss of biological properties. The newest European and German surgical bone banking guidelines have incorporated the use of independently validated then-nal viral inactivation methods in place of repeat serological testing of donor. Our investigations have shown that heat treatment at 80 degree C for a minimum of 10 minutes provides safe, good quality cancellous bone allografts and increases the cost-effectiveness and simplicity of managing a hospital frozen femoral head bone bank. Human femoral head centers were contaminated with different vegetative bacterial and viral suspensions. A core temperature of 80 degree C for 10 minutes was sufficient to fully inactivate 3 x 106 ml Staphylococcus aureus and Streptococcus faecalis, and >5 loglo steps of cytomeglia (herpes group), polio (enterovirus), and yellow fever (arbovirus) viruses. A one hour treatment in a water bath set at 80 degree sufficient to fully inactivate E. coli, proteus vulgaris, and Pseudomonas aerog. vegetative suspensions; 20 minutes was sufficient to fully inactivate the D antigen (rhesus factor) but had no effect on A or B antigens. Several biomechanical and biological properties of bone following a one hour treatment in a water bath set at 80 degree C were investigated. Employing compression and tension tests, 80 degree C treated human and porcine cancellous bone blocks showed reductions in properties ranging from 8-19% compared to untreated control groups. Osteointegration at 3 months following treatment of explanted and then reimplanted autograft rat diaphyseal segment was 15% less than untreated controls. Subsequently, a thermal disinfection system for femoral heads from living donors (Lobator Marburg Bone Bank System, Telos GmbH, Hungen, Germany) was developed. A

Root canal treatment and special needs patients.

Science.gov (United States)

Yap, E; Parashos, P; Borromeo, G L

2015-04-01

To identify current trends of root canal treatment for patients with special needs. A postal questionnaire was sent to General Dentists in Victoria, Australia and Endodontists and Special Needs Dentists across Australia to determine the extent of root canal treatment performed on special needs patients. Over a four-month period, 1120 questionnaires were distributed with an overall response rate of 63.9% (n = 716). Response rates were 63.2% (n = 655), 68.5% (n = 50) and 100.0% (n = 11) amongst General Dentists, Endodontists and Special Needs Dentists, respectively. Endodontists (95.7%) and Special Needs Dentists (100.0%) performed significantly more root canal treatment on adult patients with special needs compared with 51.2% of General Dentists, (P special needs patients compared with only 29.7% of General Dentists (P special needs patients was more likely to be carried out by specialist dental practitioners who were more likely to utilize a pharmacological approach for behaviour guidance and to perform single-visit root canal treatment compared with General Dentists. A multidisciplinary approach for special needs patients who require root canal treatment provides an opportunity for these patients to retain their dentition. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Femoral intercondylar notch shape and dimensions in ACL-injured patients

NARCIS (Netherlands)

van Eck, Carola F.; Martins, Cesar A. Q.; Vyas, Shail M.; Celentano, Umberto; van Dijk, C. Niek; Fu, Freddie H.

2010-01-01

The femoral intercondylar notch has been an anatomic site of interest as it houses the anterior cruciate ligament (ACL). The objective of this study was to arthroscopically evaluate the femoral notch in patients with known ACL injury. This evaluation included establishing a classification for notch

Tbx20 interacts with smads to confine tbx2 expression to the atrioventricular canal

NARCIS (Netherlands)

Singh, Reena; Horsthuis, Thomas; Farin, Henner F.; Grieskamp, Thomas; Norden, Julia; Petry, Marianne; Wakker, Vincent; Moorman, Antoon F. M.; Christoffels, Vincent M.; Kispert, Andreas

2009-01-01

RATIONALE: T-box transcription factors play critical roles in the coordinated formation of the working chambers and the atrioventricular canal (AVC). Tbx2 patterns embryonic myocardial cells to form the AVC and suppresses their differentiation into chamber myocardium. Tbx20-deficient embryos, which

An endodontic management of mandibular third molar with five root canals

OpenAIRE

Dakshita Joy Sinha; Ashish Amit Sinha

2014-01-01

The existence of several anatomical variations in the root canal system may contribute to failure of the root canal therapy. The planning and performing of endodontic therapy requires knowledge of the internal dental morphology. This paper reports the case of a left mandibular third molar that presented with five root canals; a case of unusual root canal morphology so as to demonstrate the anatomic variations in mandibular third molars. Root canal therapy and case management are described. Th...

Pigmented Villonodular Synovitis Causing Osteonecrosis of the Femoral Head: A Case Report

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Tomohiro Mimura

2013-01-01

Full Text Available We report a case of a 27-year-old man with pigmented villonodular synovitis of the hip joint with coincident osteonecrosis of the femoral head. According to our review of the English-language literature, no detailed report of osteonecrosis of the femoral head complicated with pigmented villonodular synovitis has been published. Preoperative X-ray images showed joint narrowing and severe multiple bone erosions at the acetabulum and femoral neck. Magnetic resonance imaging revealed a low-intensity band attributable to osteonecrosis of the femoral head and massive diffuse pigmented villonodular synovitis lesions. Comparison of a three-dimensional computed tomographic image of this patient with an angiographic image of a normal individual demonstrated proximity of the pigmented villonodular synovitis-induced bone erosions to the medial and lateral femoral circumflex arteries and retinacular arteries, suggesting likely the compromise of the latter by the former. We propose that the massive pigmented villonodular synovitis may have contributed to the pathogenesis of osteonecrosis of the femoral head in this patient. We performed open synovectomy and total hip arthroplasty. No operative complications occurred, and no recurrence of the pigmented villonodular synovitis was detected for 3 years after the operation.

The Effect of Canal Contamination with Saliva on Apical Sealing

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S Sabaghi

2014-08-01

Full Text Available Introduction: Root canal obturation aims at sealing the root canal system to prevent re-contamination of canal and periapical space. Presence of moisture in canal before obturation may posit a negative effect on the quality of canal sealing. Therefore, this study was conducted to investigate the effect of canal contamination with saliva on apical microleakage. Methods: In this laboratory study, 58 human uni-root teeth were cleaned and shaped for obturation with gutta percha and sealer AH26. In the case group, specimens were contaminated with human saliva immediately before obturation, whereas the teeth in the control group were kept dry. All canals were filled by lateral condensation technique. Moreover, the teeth were placed in methylene blue dye for 3 days. Dye penetration was measured using a stereomicrosope. As a matter of fact, the study data were analyzed via utilizing t-test. Results: A significant difference was found between the two groups in regard with the apical leakage(P<0.001. The microleakage mean of dye in the dry group was 3/48mm, whereas it was 6/36mm in the saliva contaminated group. Conclusion: The study findings revealed that complete drying of canal can improve apical sealing.

An endodontic management of mandibular third molar with five root canals

Directory of Open Access Journals (Sweden)

Dakshita Joy Sinha

2014-01-01

Full Text Available The existence of several anatomical variations in the root canal system may contribute to failure of the root canal therapy. The planning and performing of endodontic therapy requires knowledge of the internal dental morphology. This paper reports the case of a left mandibular third molar that presented with five root canals; a case of unusual root canal morphology so as to demonstrate the anatomic variations in mandibular third molars. Root canal therapy and case management are described. This report highlights the importance of looking for additional roots and root canals so as to enable clinicians to treat a case successfully, which might have ended in failure.

Optimizing the chemical aspect of root canal irrigation

OpenAIRE

de Macedo, R.G.

2013-01-01

Root canal treatment is aimed at the removal of inflamed and infected tissue present in the root canal system. It will prevent the entrance of new microorganisms or nutrients in order to maintain or create a healthy environment around the root. There is sufficient evidence that shows that traditional endodontic therapy cannot make the root canal system completely free of bacteria. Moreover, it may not always result in complete healing of apical periodontitis, highlighting the need of optimizi...

Magnetic resonance imaging of the internal auditory canal

International Nuclear Information System (INIS)

Daniels, D.L.; Herfkins, R.; Koehler, P.R.; Millen, S.J.; Shaffer, K.A.; Williams, A.L.; Haughton, V.M.

1984-01-01

Three patients with exclusively or predominantly intracanalicular neuromas and 5 with presumably normal internal auditory canals were examined with prototype 1.4- or 1.5-tesla magnetic resonance (MR) scanners. MR images showed the 7th and 8th cranial nerves in the internal auditory canal. The intracanalicular neuromas had larger diameter and slightly greater signal strength than the nerves. Early results suggest that minimal enlargement of the nerves can be detected even in the internal auditory canal

Quantifying canal leakage rates using a mass-balance approach and heat-based hydraulic conductivity estimates in selected irrigation canals, western Nebraska, 2007 through 2009

Science.gov (United States)

Hobza, Christopher M.; Andersen, Michael J.

2010-01-01

The water supply in areas of the North Platte River Basin in the Nebraska Panhandle has been designated as fully appropriated or overappropriated by the Nebraska Department of Natural Resources (NDNR). Enacted legislation (Legislative Bill 962) requires the North Platte Natural Resources District (NPNRD) and the NDNR to develop an Integrated Management Plan (IMP) to balance groundwater and surface-water supply and demand in the NPNRD. A clear understanding of the groundwater and surface-water systems is critical for the development of a successful IMP. The primary source of groundwater recharge in parts of the NPNRD is from irrigation canal leakage. Because canal leakage constitutes a large part of the hydrologic budget, spatially distributing canal leakage to the groundwater system is important to any management strategy. Surface geophysical data collected along selected reaches of irrigation canals has allowed for the spatial distribution of leakage on a relative basis; however, the actual magnitude of leakage remains poorly defined. To address this need, the U.S. Geological Survey, in cooperation with the NPNRD, established streamflow-gaging stations at upstream and downstream ends from two selected canal reaches to allow a mass-balance approach to be used to calculate daily leakage rates. Water-level and sediment temperature data were collected and simulated at three temperature monitoring sites to allow the use of heat as a tracer to estimate the hydraulic conductivity of canal bed sediment. Canal-leakage rates were estimated by applying Darcy's Law to modeled vertical hydraulic conductivity and either the estimated or measured hydraulic gradient. This approach will improve the understanding of the spatial and temporal variability of canal leakage in varying geologic settings identified in capacitively coupled resistivity surveys. The high-leakage potential study reach of the Tri-State Canal had two streamflow-gaging stations and two temperature monitoring

Maxillary First Molars with 2 Distobuccal Canals: A Case Series.

Science.gov (United States)

Fogel, Howard M; Cunha, Rodrigo Sanches

2017-11-01

An appreciation of the anatomic complexity of the root canal system is essential at every step of endodontic treatment. Endodontic treatment of teeth with unusual root canal anatomy presents a unique challenge. Eight patients underwent nonsurgical root canal treatment of 3-rooted maxillary first molars in a specialty endodontic private practice. Four cases of Weine type II and 4 cases of Weine type III canal configurations in the distobuccal root of maxillary first molars were presented.This article highlighted an uncommon anatomic variation of 2 canals in the distobuccal root of the maxillary first molar. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Three-dimensional measurement of femoral neck anteversion and neck shaft angle.

Science.gov (United States)

Sangeux, Morgan; Pascoe, Jessica; Graham, H Kerr; Ramanauskas, Fiona; Cain, Tim

2015-01-01

We present a three-dimensional measurement technique for femoral neck anteversion and neck shaft angles which do not require alignment of the femoral and scanner axes. Two assessors performed the measurements on 11 patients (22 femurs). Repeatability between assessors was 2.7 degrees for femoral neck anteversion and 4.8 degrees for neck shaft angle. Measurements compared with an alternative single slice method were different by 2 degrees (3 degrees) in average. The method was repeatable and appropriate for clinical practice.

Histopathology of femoral head donations: a retrospective review of 6161 cases.

Science.gov (United States)

Mackie, Katherine E; Zhou, Ziqiang; Robbins, Peter; Bulsara, Max; Zheng, Ming H

2011-08-17

Although total hip arthroplasty is one of the most common orthopaedic surgical procedures, it remains unclear whether histopathological examination of the excised femoral head adds to the quality of patient care. We propose that assessment of femoral heads resected during total hip arthroplasty and donated for allograft use may provide a profile of femoral head pathology that benefits total hip arthroplasty patients and bone donors. We retrospectively analyzed the histological findings reported for 6161 femoral heads donated for allograft use between 1993 and 2006. Specimens obtained during total hip arthroplasty and specimens donated at death were reviewed. Follow-up investigations that resulted from abnormal histopathological findings were also reviewed. The Western Australian Cancer Registry was used to determine whether patients with a suspected neoplasm were subsequently diagnosed with such a disease. A retrospective review of the histopathological findings was conducted to evaluate and reclassify all previous observations of abnormalities. One hundred and five femoral heads demonstrated abnormal or reactive histopathological features not reported prior to surgery and were rejected for allograft use. A reactive lymphocytic infiltrate, most likely due to osteoarthritis, was the most commonly identified feature (forty-five cases). Other features observed in twenty-seven cases were also most likely due to the presence of severe osteoarthritis. Ten femoral heads demonstrated plasmacytosis, which may have been related to osteoarthritis. Two patients were diagnosed with Paget's disease, and two, with rheumatoid arthritis. Nineteen patients had a suspected neoplasm. Of these nineteen, eight cases of non-Hodgkin's lymphoma or chronic lymphocytic leukemia and one case of myelodysplastic syndrome were confirmed on further investigation. One subsequently confirmed malignancy was detected per 770 femoral heads examined. Our findings indicate that, even with a detailed

The therapeutic effect of negative pressure in treating femoral head necrosis in rabbits.

Science.gov (United States)

Zhang, Yin-gang; Wang, Xuezhi; Yang, Zhi; Zhang, Hong; Liu, Miao; Qiu, Yushen; Guo, Xiong

2013-01-01

Because negative pressure can stimulate vascular proliferation, improve blood circulation and promote osteogenic differentiation of bone marrow stromal cells, we investigated the therapeutic effect of negative pressure on femoral head necrosis (FHN) in a rabbit model. Animals were divided into four groups (n = 60/group): [1] model control, [2] core decompression, [3] negative pressure and [4] normal control groups. Histological investigation revealed that at 4 and 8 weeks postoperatively, improvements were observed in trabecular bone shape, empty lacunae and numbers of bone marrow hematopoietic cells and fat cells in the negative pressure group compared to the core decompression group. At week 8, there were no significant differences between the negative pressure and normal control groups. Immunohistochemistry staining revealed higher expression of vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) in the femoral heads in the negative pressure group compared with the core decompression group. Transmission electron microscopy revealed that cell organelles were further developed in the negative pressure group compared with the core decompression group. Microvascular ink staining revealed an increased number of bone marrow ink-stained blood vessels, a thicker vascular lumen and increased microvascular density in the negative pressure group relative to the core decompression group. Real-time polymerase chain reaction revealed that expression levels of both VEGF and BMP-2 were higher in the negative pressure group compared with the core decompression group. In summary, negative pressure has a therapeutic effect on FHN. This effect is superior to core decompression, indicating that negative pressure is a potentially valuable method for treating early FHN.

Delayed appearance of hypaesthesia and paralysis after femoral nerve block

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Stefan Landgraeber

2012-03-01

Full Text Available We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible.

Delayed appearance of hypaesthesia and paralysis after femoral nerve block

Science.gov (United States)

Landgraeber, Stefan; Albrecht, Thomas; Reischuck, Ulrich; von Knoch, Marius

2012-01-01

We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible. PMID:22577509

Assessment of bifid and trified mandicular canals using cone beam computed tomography

Energy Technology Data Exchange (ETDEWEB)

Rashsyren, Oyuntugs [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Mongolian National University Medical Science, Ulaanbaatar (United States); Choi, Jin Woo; Han, Won Jeong; Kim Eun Kyung [Dept. of Oral and Maxillofacial Radiology, Dankook University College of Dentistry, Cheonan (Korea, Republic of)

2014-09-15

To investigate the prevalence of bifid and trifid mandibular canals using cone-beam computed tomography (CBCT) images, and to measure their length, diameter, and angle. CBCT images of 500 patients, involving 755 hemi-mandibles, were used for this study. The presence and type of bifid mandibular canal was evaluated according to a modified classification of Naitoh et al. Prevalence rates were determined according to age group, gender, and type. Further, their diameter, length, and angles were measured using PACSPLUS Viewer and ImageJ 1.46r. Statistical analysis with chi-squared and analysis of variance (ANOVA) tests was performed. Bifid and trifid mandibular canals were found in 22.6% of the 500 patients and 16.2% of the 755 sides. There was no significant difference between genders and among age groups. The retromolar canal type accounted for 71.3% of the identified canals; the dental canal type, 18.8%; the forward canal type, 4.1%; and the trifid canal type, 5.8%. Interestingly, seven cases of the trifid canal type, which has been rarely reported, were observed. The mean diameter of the bifid and trifid mandibular canals was 2.2 mm and that of the main mandibular canal was 4.3 mm. Their mean length was 16.9 mm; the mean superior angle was 149.2 degrees, and the mean inferior angle was 37.7 degrees. Bifid and trifid mandibular canals in the Korean population were observed at a relatively high rate through a CBCT evaluation, and the most common type was the retromolar canal. CBCT is suggested for a detailed evaluation of bifid and trifid mandibular canals before mandibular surgery.

A study of incisive canal using a cone beam computed tomography

International Nuclear Information System (INIS)

Kim, Gyu Tae; Hwang, Eui Hwan; Lee, Sang Rae

2004-01-01

To investigate the anatomical structure of the incisive canal radiographically by a cone beam computed tomography. 38 persons (male 26, female 12) were chosen to take images of maxillary anterior region in dental CT mode using a cone beam computed tomography. The tube voltage were 65, 67, and 70 kVp, the tube current was 7 mA, and the exposure time was 13.3 seconds. The FH plane of each person was parallel to the floor. The images were analysed on the CRT display. The mean length of incisive canal was 15.87 mm ± 2.92. The mean diameter at the side of palate and nasal fossa were 3.49 mm ± 0.76 and 3.89 mm ± 1.06, respectively. In the cross-sectional shape of incisive canal, 50% were round, 34.2% were ovoid, and 15.8% were lobulated. 87% of incisive canal at the side of nasal fossa have one canal, 10.4% have two canals, and 2.6% have three canals, but these canals were merged into one canal in the middle portion of palate. The mean angles of the long axis of incisive canal and central incisor to the FH plane were 110.3 ± 6.96 and 117.45 ± 7.41, respectively. The angles of the long axis of incisive canal and central incisor to the FH plane were least correlated (r 0.258). This experiment suggests that a cone beam computed radiography will be helpful in surgery or implantation on the maxillary incisive area.

A study of incisive canal using a cone beam computed tomography

Energy Technology Data Exchange (ETDEWEB)

Kim, Gyu Tae; Hwang, Eui Hwan; Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

2004-03-15

To investigate the anatomical structure of the incisive canal radiographically by a cone beam computed tomography. 38 persons (male 26, female 12) were chosen to take images of maxillary anterior region in dental CT mode using a cone beam computed tomography. The tube voltage were 65, 67, and 70 kVp, the tube current was 7 mA, and the exposure time was 13.3 seconds. The FH plane of each person was parallel to the floor. The images were analysed on the CRT display. The mean length of incisive canal was 15.87 mm {+-} 2.92. The mean diameter at the side of palate and nasal fossa were 3.49 mm {+-} 0.76 and 3.89 mm {+-} 1.06, respectively. In the cross-sectional shape of incisive canal, 50% were round, 34.2% were ovoid, and 15.8% were lobulated. 87% of incisive canal at the side of nasal fossa have one canal, 10.4% have two canals, and 2.6% have three canals, but these canals were merged into one canal in the middle portion of palate. The mean angles of the long axis of incisive canal and central incisor to the FH plane were 110.3 {+-} 6.96 and 117.45 {+-} 7.41, respectively. The angles of the long axis of incisive canal and central incisor to the FH plane were least correlated (r 0.258). This experiment suggests that a cone beam computed radiography will be helpful in surgery or implantation on the maxillary incisive area.

Bilateral duplication of the internal auditory canal

International Nuclear Information System (INIS)

Weon, Young Cheol; Kim, Jae Hyoung; Choi, Sung Kyu; Koo, Ja-Won

2007-01-01

Duplication of the internal auditory canal is an extremely rare temporal bone anomaly that is believed to result from aplasia or hypoplasia of the vestibulocochlear nerve. We report bilateral duplication of the internal auditory canal in a 28-month-old boy with developmental delay and sensorineural hearing loss. (orig.)

33 CFR 117.769 - Black Rock Canal.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Black Rock Canal. 117.769 Section 117.769 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.769 Black Rock Canal. The draws of the...

Laser scanning dental probe for endodontic root canal treatment

Science.gov (United States)

Blank, Molly A. B.; Friedrich, Michal; Hamilton, Jeffrey D.; Lee, Peggy; Berg, Joel; Seibel, Eric J.

2011-03-01

Complications that arise during endodontic procedures pose serious threats to the long-term integrity and health of the tooth. Potential complexities of root canals include residual pulpal tissue, cracks, mesial-buccal 2 and accessory canals. In the case of a failed root canal, a successful apicoectomy can be jeopardized by isthmuses, accessory canals, and root microfracture. Confirming diagnosis using a small imaging probe would allow proper treatment and prevent retreatment of endodontic procedures. An ultrathin and flexible laser scanning endoscope of 1.2 to 1.6mm outer diameter was used in vitro to image extracted teeth with varied root configurations. Teeth were opened using a conventional bur and high speed drill. Imaging within the opened access cavity clarified the location of the roots where canal filing would initiate. Although radiographs are commonly used to determine the root canal size, position, and shape, the limited 2D image perspective leaves ambiguity that could be clarified if used in conjunction with a direct visual imaging tool. Direct visualization may avoid difficulties in locating the root canal and reduce the number of radiographs needed. A transillumination imaging device with the separated illumination and light collection functions rendered cracks visible in the prepared teeth that were otherwise indiscernible using reflected visible light. Our work demonstrates that a small diameter endoscope with high spatial resolution may significantly increase the efficiency and success of endodontic procedures.

Stress fracture of the femoral neck in a child (stress fracture)

International Nuclear Information System (INIS)

Coldwell, D.; Gross, G.W.; Boal, D.K.

1984-01-01

Femoral neck stress fracture is extremely rare in childhood. We report a case of femoral neck stress fracture in an 11-year-old girl. Differentials diagnosis and a brief review of the literature follow. (orig.)

Aberrant femoral torsion presenting with frog-leg squatting mimicking gluteal muscle contracture.

Science.gov (United States)

Chiang, Chia-Ling; Tsai, Meng-Yuan; Chang, Wei-Ning; Chen, Clement Kuen-Huang

2012-04-01

Patients with frog-leg squatting have restricted internal rotation and adduction of the affected hips during sitting or squatting. In the surgical literature, the cause generally has been presumed to arise from and be pathognomonic for gluteal muscle contracture. However, we have encountered patients with frog-leg squatting but without gluteal muscle contracture. We therefore raised the following questions: What are the imaging features of patients with frog-leg squatting? Do conditions other than gluteal muscle contracture manifest frog-leg squatting? We retrospectively reviewed the MR images of 67 patients presenting with frog-leg squatting from April 1998 to July 2010. There were four females and 63 males; their mean age was 22.2 years (range, 4-50 years). During MRI readout, we observed aberrant axes of some femoral necks and obtained additional CT to measure femoral torsion angles in 59 of the 67 patients. MR images of 27 (40%) patients had signs of gluteal muscle contracture. Twenty-two (33%) patients (40 femora) had aberrant femoral torsion, including diminished anteversion (range, 6°-0°; average, 3.9°) in 11 femora of eight patients and femoral retroversion (range, muscle contracture or aberrant femoral torsion. The observation of aberrant femoral torsion was not anticipated before imaging studies. In addition to gluteal muscle contracture, aberrant femoral torsion can be a cause of frog-leg squatting. Level II, diagnostic study. See the guidelines for Authors for a complete description of levels of evidence.

Does increased femoral antetorsion predispose to cartilage lesions of the patellofemoral joint?

Science.gov (United States)

Oppermann, Johannes; Bredow, Jan; Wissusek, Boris; Spies, Christian Karl; Boese, Christoph Kolja; Chang, Shi-Min; Eysel, Peer; Dargel, Jens

2017-09-01

The purpose of this study was to investigate whether there was a relationship between femoral neck antetorsion and the presence and pattern of osteoarthritis of the patellofemoral joint. It was hypothesized that an increased femoral neck antetorsion (1) correlates with osteoarthritic changes of the lateral facet of the patellofemoral joint and (2) correlates with an increased lateral trochlear height and a decreased sulcus angle. Seventy-eight formalin-embedded cadaveric lower extremities from thirty-nine subjects with a median age of 74 years (range 60-88) were used. Surrounding soft tissues of the lower limb were removed. The femoral neck antetorsion was measured and referenced to the transepicondylar axis and the posterior condylar line. The height of the medial and lateral facet of the trochlea and the sulcus angle was measured. The location and the degree of patellofemoral cartilage degeneration were recorded. A Pearson's correlation analysis was performed to correlate the femoral neck antetorsion with the measured knee parameters. No significant correlation could be found between the femoral antetorsion and cartilage degeneration of the lateral patellofemoral joint (n.s.), the height of the lateral trochlea (n.s.) and the sulcus angle (n.s.). This study could not document that the femoral neck antetorsion and subsequent internal rotation of the distal femur correlated with the degree of degeneration of the lateral facet of the patellofemoral joint. Clinically, femoral internal rotation may play a minor role in the development of lateral patellofemoral joint degeneration.

Widening of the femoral proximal diaphysis--metaphysis angle in fetuses with achondroplasia.

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Khalil, A; Morales-Roselló, J; Morlando, M; Bhide, A; Papageorghiou, A; Thilaganathan, B

2014-07-01

It has recently been reported that fetuses with achondroplasia have a wider than expected femoral proximal diaphysis-metaphysis angle (femoral angle). The aim of this case-control study was to investigate this finding. Cases with confirmed achondroplasia (n = 6), small-for-gestational-age fetuses (n = 70) and a group of normal fetuses (n = 377) were included in this study. The ultrasound image of the femur was examined by two independent experienced observers blinded to the diagnosis, who measured the femoral angle. These values were converted into multiples of the expected median (MoM), after adjustment for gestational age and femur length. Prevalence of various prenatal ultrasound signs of achondroplasia was determined in affected fetuses. Intra- and interobserver agreement of measurement of femoral angle was assessed using 95% limits of agreement and kappa statistics. The femoral angle can be measured accurately by ultrasound, and increases with both increasing gestational age and increasing femur length. The femoral angle-MoM was significantly higher in fetuses with achondroplasia than in the control group (1.36 vs 1.00 MoM, P achondroplasia (83.3%), which was the most consistent finding other than shortening of the long bones. The femoral angle is wider in fetuses with achondroplasia. This new ultrasound sign appears promising as an additional discriminatory marker when clinicians are faced with a case of short long bones in the third trimester. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

Radiographic versus electronic root canal working length determination

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Lumnije Kqiku

2011-01-01

Conclusions: The present ex vivo study showed that electronic root canal working length determination is not superior to radiographic methods. Both methods provided a good performance in determining the root canal working length.

46 CFR 69.7 - Vessels transiting the Panama and Suez Canals.

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2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Vessels transiting the Panama and Suez Canals. 69.7... MEASUREMENT OF VESSELS MEASUREMENT OF VESSELS General § 69.7 Vessels transiting the Panama and Suez Canals. (a... Canal must be measured and certificated under the Arab Republic of Egypt Suez Canal Authority Rules of...

Evaluation of root canal morphology of human mandibular incisors in Yazd

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Tabrizi-zadeh M. Assistant Professor

2003-06-01

Full Text Available Statement of Problem: The main objective of endodontic therapy is chemomechanical cleansing of entire pulp cavity and its complete obturation with an inert material. During this procedure, the failure of detection and inadequate cleaning of a canal will result in failed endodontic therapy. Therefore, the dentist must have enough knowledge of root canal morphology to treat a tooth successfully."nAim: The aim of this study was to determine the number and type of root canals of mandibular incisor teeth."nMaterials and Methods: In order to do this in-vitro, descriptive study, 68 non-carious mandibular incisor teethj collected from different clinics in Yazd, were immersed in indian ink, decalcified and cleared."nResults: It was found that 55.9% of the teeth had two separate canals that in 5.5% of them, the canals"nmerged before' apical foramen. In 4.4% of these samples, two separate canals existed along the whole"nroot."nConclusion: Considering high percentage of two canals in lower mandibular incisors, during access preparation, more attempts in detection of the second canal, is emphasized.

Isolated femoral hypoplasia: an intrauterine differential diagnosis to campomelia

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Koerber, Friederike; Benz-Bohm, Gabriele [University of Cologne, Department of Paediatric Radiology, Cologne (Germany); Schoenau, Eckard [University of Cologne, Department of Paediatrics, Cologne (Germany); Horwitz, A.Eldad [Klinikum Krefeld, Department of Paediatric Radiology, Krefeld (Germany)

2005-06-01

The isolated form of femoral bowing is an important differential diagnosis of campomelia. Therefore, knowledge of isolated anomalies is fundamental for prenatal diagnosis, especially for the differential diagnosis from severe syndromes. Four cases are presented to discuss the differential diagnosis of femoral bowing including a review of the literature. We report four newborn babies with unilateral bowing and shortening of the femur. Three had no further anomaly; one child had additional abnormalities due to coumarin embryopathy. The radiological findings were shortened femora with bowing and varus deformity and cortical thickening on the concave side. All other parts showed normal bone structure. The aetiology of femoral bowing is unknown. Early damage of the cartilaginous model followed by remodelling with thickening on the concave side of the bone similar to the healing of malaligned fractures is suspected. The isolated form of femoral bowing without any other anomalies has to be differentiated from complex and more often severe congenital syndromes such as campomelia. Postpartum radiological examination should be reduced to a single exposure of the affected limb and follow-up should be done by clinical examination. (orig.)

Transfer of obturator nerve for femoral nerve injury: an experiment study in rats.

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Meng, Depeng; Zhou, Jun; Lin, Yaofa; Xie, Zheng; Chen, Huihao; Yu, Ronghua; Lin, Haodong; Hou, Chunlin

2018-07-01

Quadriceps palsy is mainly caused by proximal lesions in the femoral nerve. The obturator nerve has been previously used to repair the femoral nerve, although only a few reports have described the procedure, and the outcomes have varied. In the present study, we aimed to confirm the feasibility and effectiveness of this treatment in a rodent model using the randomized control method. Sixty Sprague-Dawley rats were randomized into two groups: the experimental group, wherein rats underwent femoral neurectomy and obturator nerve transfer to the femoral nerve motor branch; and the control group, wherein rats underwent femoral neurectomy without nerve transfer. Functional outcomes were measured using the BBB score, muscle mass, and histological assessment. At 12 and 16 weeks postoperatively, the rats in the experimental group exhibited recovery to a stronger stretch force of the knee and higher BBB score, as compared to the control group (p nerve with myelinated and unmyelinated fibers was observed in the experimental group. No significant differences were observed between groups at 8 weeks postoperatively (p > 0.05). Obturator nerve transfer for repairing femoral nerve injury was feasible and effective in a rat model, and can hence be considered as an option for the treatment of femoral nerve injury.

Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases.

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Korkmaz, Mehmet Fatih; Erdem, Mehmet Nuri; Disli, Zeliha; Selcuk, Engin Burak; Karakaplan, Mustafa; Gogus, Abdullah

2014-01-01

In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) classification and the American Society of Anesthesiologists' (ASA) physical status classification (ASA grade). Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. The mean age of the patients was 77.66 years (range: 37-98 years), and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range: 12-75 months). Postoperative radiographs showed a near-anatomical fracture reduction in 78% of patients. The Harris hip score was negatively correlated with the ASA score and patient age. No cases of implant failure were observed. Three patients died before discharge (one due to pulmonary embolism, two due to cardiac arrest), and five patients died due to unrelated medical conditions within the first 3 months of the follow-up. Our study showed that proximal femoral nail is a reliable fixation with good fracture union, and it is not associated with major complications in any type of trochanteric femoral fracture.

Prevalence of the middle mesial canal in non surgical root canal treated mandibular first and second molars in a local military population

Science.gov (United States)

2016-06-13

or second mandibular molar), sex, and age. Materials and Methods Approximately 7, 000 dental records in paper chart format were reviewed at a...Army Post Graduate Dental School Douglas D. Lancaster, COL, DC 3 August 2016 Prevalence of the middle mesial canal in non-surgical root canal...Methods: 7000 dental records were reviewed for non-surgical root canals performed from October 1970 to October 2015. The data collected included

Effects of canal enlargement and irrigation needle depth on the cleaning of the root canal system at 3 mm from the apex

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Ho-Jin Moon

2012-02-01

Full Text Available Objectives The aim of this study was to test the hypothesis, that the effectiveness of irrigation in removing smear layer in the apical third of root canal system is dependent on the depth of placement of the irrigation needle into the root canal and the enlargement size of the canal. Materials and Methods Eighty sound human lower incisors were divided into eight groups according to the enlargement size (#25, #30, #35 and #40 and the needle penetration depth (3 mm from working length, WL-3 mm and 9 mm from working length, WL-9 mm. Each canal was enlarged to working length with Profile.06 Rotary Ni-Ti files and irrigated with 5.25% NaOCl. Then, each canal received a final irrigation with 3 mL of 3% EDTA for 4 min, followed by 5 mL of 5.25% NaOCl at different level (WL-3 mm and WL-9 mm from working length. Each specimen was prepared for the scanning electron microscope (SEM. Photographs of the 3mm area from the apical constriction of each canal with a magnification of ×250, ×500, ×1,000, ×2,500 were taken for the final evaluation. Results Removal of smear layer in WL-3 mm group showed a significantly different effect when the canal was enlarged to larger than #30. There was a significant difference in removing apical smear layer between the needle penetration depth of WL-3 mm and WL-9 mm. Conclusions Removal of smear layer from the apical portion of root canals was effectively accomplished with apical instrumentation to #35/40 06 taper file and 3 mm needle penetration from the working length.

Multiple bony lesions other than femoral heads on {sup 99m}Tc-MDP bone scan in patients with avascular necrosis of the femoral head

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Choi, Yun Young; Yang, Seoung Oh; Moon, Dae Hyuk; Ryu, Jin Sook; Weon, Young Cheol; Shin, Myung Jin; Lee, Soo Ho; Lee, Hee Kyung [Asan Medical Center, Ulsan Univ. College of Medicine, Ulsan (Korea, Republic of); Chun, Hae Kyung [St. Francisco Hospital, Seoul (Korea, Republic of)

1997-03-01

To evaluate the clinical significance of the multiple increased uptake lesions other than in femoral heads as seen on whole body bone scan in patients with avascular necrosis of femoral heads. One hundred and seventy three patients with clinical diagnosis of avascular necrosis of the emoral head underwent a bone scan using Tc-99m MDP. Increased uptake lesions other than in femoral heads were evaluated, including frequency and common sites of in volvement, and correlated with clinical information and plain radiographic findings. Two hundred patients without AVN, who had undergone a bone scan, were included as a control group. Increased uptake lesions in extrafemoral head locations were found in 36 of 173 patients(20.8%); the location of 79 lesions was other than the femoral head. This result is statistically different from patients without avascular necrosis of femoral head(p<0.0001). The most common site of involvement was the knee joint area(62.5%). Other lesions were located in the mid-shafts of the long bones of the lower extremities, calcaneus, proximal humerus, etc., in order of decreasing frequency. Plain radiographs of 17 lesions were nonspecific, except for three lesions showing definite changes associated with avascular necrosis. The risk factors included alcoholism, the prolonged use of steroids, renal transplantation, herbal medication and working as a working as deep-sea diver. Most patients did not complain of pain, except for two with irreversible osteonecrotic changes as seen on plain radiograph. in patients with avascular necrosis of the femur, increased uptake lesions other than in the femoral head as seen on bone scan, may represent the early stage of osteonecrosis, which shows a characteristic appearance on bone scan. In order to aveid possible misdiagnoses of multiple extrafemoral lesions as bony metastasis or traumatic lesions, in patients with avascular necrosis of the femur these should be carefully evaluated.

Traumatic subchondral fracture of the femoral head in a healed trochanteric fracture.

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Lee, Sang Yang; Niikura, Takahiro; Iwakura, Takashi; Kurosaka, Masahiro

2014-07-11

An 82-year-old woman sustained a trochanteric fracture of the left femur after a fall. Fracture fixation was performed using proximal femoral nail antirotation (PFNA) II, and she was able to walk with a T-cane after 3 months. Eleven months following the operation, the patient presented with left hip pain after a fall. Radiographs showed a subchondral collapse of the femoral head located above the blade tip. The authors removed the PFNA-II and subsequently performed cemented bipolar hemiarthroplasty. Histological evaluation of the femoral head showed osteoporosis with no evidence of osteonecrosis. Repair tissue, granulation tissue and callus formation were seen at the collapsed subchondral area. Based on these findings, a traumatic subchondral fracture of the femoral head in a healed trochanteric fracture was diagnosed. A traumatic subchondral fracture of the femoral head may need to be considered as a possible diagnosis after internal fixation of the trochanteric fracture. 2014 BMJ Publishing Group Ltd.

Ipsilateral femoral shaft and vertical patella fracture: a case report

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Ozkan, Korhan; Eceviz, Engin; Sahin, Adem; Ugutmen, Ender

2009-01-01

Introduction A femoral shaft fracture with an ipsilateral patella fracture has been, to our knowledge, given only cursory attention in English-speaking literature. Case presentation A 15 year old male patient had hitten by a car to his motorcycle came to emergency room and he had been operated for his femoral shaft freacture and vertical patellar fracture which was iniatally missed. Conclusion To us it is vital to obtain CT scan of the patient’s knee if there is an ipsilateral femoral fracture with an ipsilateral knee effusion and a punction which reveals hematoma even in the absence of a fracture line seen in AP and lateral projections. PMID:19829933

Morphometric findings in avascular necrosis of the femoral head.

Science.gov (United States)

Kamal, Diana; Trăistaru, Rodica; Alexandru, D O; Kamal, C K; Pirici, D; Pop, O T; Mălăescu, D Gh

2012-01-01

Avascular necrosis of the femoral head is an illness with a controversial etiology, the trigger event being the suppression of blood flow to the femoral head. The disease affects mostly young adults within their third and fifth decade, the majority of the patients being men. The main risk factors are trauma, chronic alcohol consumption, smoking, corticotherapy. The main goal of our study is to describe the morphometric changes found in the bone tissue of patients diagnosed with avascular necrosis of the femoral head, with different risk factors, by comparing the area of bone trabeculae inside the area of necrosis with that from the adjacent viable tissue. The morphometric study used biological material from 16 patients with ages between 29 and 57 years, who underwent surgery for avascular necrosis of the femoral head. They were admitted in the Orthopedics Department at the Emergency County Hospital in Craiova between 2010 and 2011 and were split into four groups. Group I presented trauma as the main risk factor, Group II had corticotherapy as the defining risk factor, Group III presented chronic alcohol consumption and Group IV was represented by the patients who smoked and exhibited chronic alcohol consumption. There was not a significant statistical difference between the areas of bone trabeculae of the four groups when we compared viable bone tissue to the necrotized one. Knowing the risk factors of the avascular necrosis of the femoral head is critical to the management of the disease, because diagnosing it in an early stage is a necessity for obtaining a good result for conservative treatment.

C-SHAPED CONFIGURATION OF THE ROOT CANAL SYSTEM – PROBLEMS AND SOLUTIONS.

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Janet Kirilova

2014-06-01

Full Text Available Introduction: The patients with C-shaped configuration of the root canal system are definitely a problem in the everyday dental practice. The C-shaped configuration of the root canal can be seen in the mandibular and maxillary molars. The treatment of these teeth is very difficult. Purpose: To trace the treatment of clinical cases with C-shaped configuration of the root canal system. Material and methods: There are some different cases that are described with a C-shaped configuration of the root canal system with one, two, three and four separate root canals. Careful exploration of the floor of the pulp chamber, inspection with magnification, use of ultrasonic irrigation and a modified filling technique are of particular use. Results and Discussion: Clinical cases of a C-shaped pulp chamber and root canal system shows that this root canal aberration occurs in a wide variety and variability with a single root canal up to two, three and four separate root canals. The diameter of the root canal themselves also varies from very wide to such with a small diameter. Conclusions: Knowledge of the different anatomical variations will improve the endododntic practice of the general dental practitioners.

Malignant transformation from benign papillomatosis of the external auditory canal.

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Miah, Mohammed S; Crawford, Mairi; White, Sharon J; Hussain, Syed Shah Musheer

2012-06-01

Report a case of malignant transformation of benign ear canal papillomatosis to malignant squamous cell carcinoma (SCC) of the temporal bone. A 73-year-old with papillomata involving the posterior and inferior walls of the right external auditory canal (EAC), which subsequently transformed into SCC. Radical mastoidectomy and excision of the tumor and then radical radiotherapy. Loco-regional disease control. Recovery of facial nerve function. Approximately 20 months post-treatment, the patient remains disease free. No recovery of facial nerve function. Malignant transformation of a benign EAC papilloma to SCC of the temporal bone has not been reported previously. The association of human papillomavirus with temporal bone SCC has been reported in small number of studies with human papillomavirus subtypes 16 and 18 isolated in a high proportion of cases. With the increased availability in genotyping, the question over whether there should be further genetic analysis of benign lesions to assess their susceptibility to malignant transformation has merit.

Incidence and predictors of post-catheterization femoral artery pseudoaneurysms

OpenAIRE

Kassem, Hussein Heshmat; Elmahdy, Mahmoud Farouk; Ewis, Essam Baligh; Mahdy, Soilman Ghareeb

2013-01-01

Background: Femoral artery pseudoaneurysm (FAP) is a troublesome complication after transfemoral catheter procedures. The incidence and predictors of FAP as a separate entity have not been extensively studied. Aim: Detect prospectively the incidence and predictors of post catheterization FAP. Methods: From June 2009 till June 2011, we prospectively included all patients who underwent catheterization from the femoral approach. Duplex ultrasound was performed in cases with clinical suspic...

[Treatment of femoral neck fracture--preference to internal fixation].

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Minato, Izumi

2011-03-01

In the guidelines for the treatment of femoral neck fracture, prosthetic replacement is recommended in displaced one and internal fixation is in undisplaced one. However, in the long view, survived femoral head after internal fixation can be superior to prosthesis which will deteriorate as time goes by. Surgical method should be considered not only by type of fracture but general status of the patient.

Subchondral bone density distribution in the human femoral head

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Wright, David A.; Meguid, Michael; Lubovsky, Omri; Whyne, Cari M. [Sunnybrook Research Institute, Orthopaedic Biomechanics Laboratory, Toronto, Ontario (Canada)

2012-06-15

This study aims to quantitatively characterize the distribution of subchondral bone density across the human femoral head using a computed tomography derived measurement of bone density and a common reference coordinate system. Femoral head surfaces were created bilaterally for 30 patients (14 males, 16 females, mean age 67.2 years) through semi-automatic segmentation of reconstructed CT data and used to map bone density, by shrinking them into the subchondral bone and averaging the greyscale values (linearly related to bone density) within 5 mm of the articular surface. Density maps were then oriented with the center of the head at the origin, the femoral mechanical axis (FMA) aligned with the vertical, and the posterior condylar axis (PCA) aligned with the horizontal. Twelve regions were created by dividing the density maps into three concentric rings at increments of 30 from the horizontal, then splitting into four quadrants along the anterior-posterior and medial-lateral axes. Mean values for each region were compared using repeated measures ANOVA and a Bonferroni post hoc test, and side-to-side correlations were analyzed using a Pearson's correlation. The regions representing the medial side of the femoral head's superior portion were found to have significantly higher densities compared to other regions (p < 0.05). Significant side-to-side correlations were found for all regions (r {sup 2} = 0.81 to r {sup 2} = 0.16), with strong correlations for the highest density regions. Side-to-side differences in measured bone density were seen for two regions in the anterio-lateral portion of the femoral head (p < 0.05). The high correlation found between the left and right sides indicates that this tool may be useful for understanding 'normal' density patterns in hips affected by unilateral pathologies such as avascular necrosis, fracture, developmental dysplasia of the hip, Perthes disease, and slipped capital femoral head epiphysis. (orig.)

Characterization of an Ex vivo Femoral Head Model Assessed by Markers of Bone and Cartilage Turnover

Science.gov (United States)

Madsen, Suzi Hoegh; Goettrup, Anne Sofie; Thomsen, Gedske; Christensen, Søren Tvorup; Schultz, Nikolaj; Henriksen, Kim; Bay-Jensen, Anne-Christine; Karsdal, Morten Asser

2011-01-01

Objective: The pathophysiology of osteoarthritis involves the whole joint and is characterized by cartilage degradation and altered subchondral bone turnover. At present, there is a need for biological models that allow investigation of the interactions between the key cellular players in bone/cartilage: osteoblasts, osteoclasts, and chondrocytes. Methods: Femoral heads from 3-, 6-, 9-, and 12-week-old female mice were isolated and cultured for 10 days in serum-free media in the absence or presence of IGF-I (100 nM) (anabolic stimulation) or OSM (10 ng/mL) + TNF-α (20 ng/mL) (catabolic stimulation). Histology on femoral heads before and after culture was performed, and the growth plate size was examined to evaluate the effects on cell metabolism. The conditioned medium was examined for biochemical markers of bone and cartilage degradation/formation. Results: Each age group represented a unique system regarding the interest of bone or cartilage metabolism. Stimulation over 10 days with OSM + TNF-α resulted in depletion of proteoglycans from the cartilage surface in all ages. Furthermore, OSM + TNF-α decreased growth plate size, whereas IGF-I increased the size. Measurements from the conditioned media showed that OSM + TNF-α increased the number of osteoclasts by approximately 80% and induced bone and cartilage degradation by approximately 1200% and approximately 2600%, respectively. Stimulation with IGF-I decreased the osteoclast number and increased cartilage formation by approximately 30%. Conclusion: Biochemical markers and histology together showed that the catabolic stimulation induced degradation and the anabolic stimulation induced formation in the femoral heads. We propose that we have established an explant whole-tissue model for investigating cell-cell interactions, reflecting parts of the processes in the pathogenesis of joint degenerative diseases. PMID:26069585

Avascular necrosis of femoral head: findings of contrast-enhanced MR imaging

International Nuclear Information System (INIS)

Shin, Yong Moon; Kang, Heung Sik; Kim, Chu Wan; Kim, Hee Joong; Kim, Young Min

1995-01-01

To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. Sixteen patients with avascular necorsis of femoral head were examined with MRI. T1-weighted and T2-weighted image and contrast-enhanced T1-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the potions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease

Avascular necrosis of femoral head: findings of contrast-enhanced MR imaging

Energy Technology Data Exchange (ETDEWEB)

Shin, Yong Moon; Kang, Heung Sik; Kim, Chu Wan; Kim, Hee Joong; Kim, Young Min [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1995-06-15

To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. Sixteen patients with avascular necorsis of femoral head were examined with MRI. T1-weighted and T2-weighted image and contrast-enhanced T1-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the potions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease.

Canal transportation and centering ability of protaper and self-adjusting file system in long oval canals: An ex-vivo cone-beam computed tomography analysis.

Science.gov (United States)

Shah, Dipali Yogesh; Wadekar, Swati Ishwara; Dadpe, Ashwini Manish; Jadhav, Ganesh Ranganath; Choudhary, Lalit Jayant; Kalra, Dheeraj Deepak

2017-01-01

The purpose of this study was to compare and evaluate the shaping ability of ProTaper (PT) and Self-Adjusting File (SAF) system using cone-beam computed tomography (CBCT) to assess their performance in oval-shaped root canals. Sixty-two mandibular premolars with single oval canals were divided into two experimental groups ( n = 31) according to the systems used: Group I - PT and Group II - SAF. Canals were evaluated before and after instrumentation using CBCT to assess centering ratio and canal transportation at three levels. Data were statistically analyzed using one-way analysis of variance, post hoc Tukey's test, and t -test. The SAF showed better centering ability and lesser canal transportation than the PT only in the buccolingual plane at 6 and 9 mm levels. The shaping ability of the PT was best in the apical third in both the planes. The SAF had statistically significant better centering and lesser canal transportation in the buccolingual as compared to the mesiodistal plane at the middle and coronal levels. The SAF produced significantly less transportation and remained centered than the PT at the middle and coronal levels in the buccolingual plane of oval canals. In the mesiodistal plane, the performance of both the systems was parallel.

Shaping ability of several nickel–titanium systems in double-curved simulated canals

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Mothanna Alrahabi

2017-06-01

Conclusion: The iRaCe, ProTaper Next, Wave One, and TF systems preserved the original shape of the double-curved (S-shaped canal with minimum root canal transportation. These systems produced satisfactory root canal instrumentation in S-shaped canals.

Ascending central canal dilation and progressive ependymal disruption in a contusion model of rodent chronic spinal cord injury

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Keirstead Hans S

2007-09-01

Full Text Available Abstract Background Chronic spinal cord injury (SCI can lead to an insidious decline in motor and sensory function in individuals even years after the initial injury and is accompanied by a slow and progressive cytoarchitectural destruction. At present, no pathological mechanisms satisfactorily explain the ongoing degeneration. Methods Adult female Sprague-Dawley rats were anesthetized laminectomized at T10 and received spinal cord contusion injuries with a force of 250 kilodynes using an Infinite Horizon Impactor. Animals were randomly distributed into 5 groups and killed 1 (n = 4, 28 (n = 4, 120 (n = 4, 450 (n = 5, or 540 (n = 5 days after injury. Morphometric and immunohistochemical studies were then performed on 1 mm block sections, 6 mm cranial and 6 mm caudal to the lesion epicenter. The SPSS 11.5 t test was used to determine differences between quantitative measures. Results Here, we document the first report of an ascending central canal dilation and progressive ependymal disruption cranial to the epicenter of injury in a contusion model of chronic SCI, which was characterized by extensive dural fibrosis and intraparenchymal cystic cavitation. Expansion of the central canal lumen beyond a critical diameter corresponded with ependymal cell ciliary loss, an empirically predictable thinning of the ependymal region, and a decrease in cell proliferation in the ependymal region. Large, aneurysmal dilations of the central canal were accompanied by disruptions in the ependymal layer, periependymal edema and gliosis, and destruction of the adjacent neuropil. Conclusion Cells of the ependymal region play an important role in CSF homeostasis, cellular signaling and wound repair in the spinal cord. The possible effects of this ascending pathology on ependymal function are discussed. Our studies suggest central canal dilation and ependymal region disruption as steps in the pathogenesis of chronic SCI, identify central canal dilation as a marker of

Emergency Stenting of a Ruptured Infected Anastomotic Femoral Pseudoaneurysm

International Nuclear Information System (INIS)

Klonaris, Chris; Katsargyris, Athanasios; Matthaiou, Alexandros; Giannopoulos, Athanasios; Tsigris, Chris; Papadopouli, Katerina; Tsiodras, Sotiris; Bastounis, Elias

2007-01-01

A 74-year-old man presented with a ruptured infected anastomotic femoral pseudoaneurysm. Due to severe medical comorbidities he was considered unsuitable for conventional surgical management and underwent an emergency endovascular repair with a balloon-expandable covered stent. The pseudoaneurysm was excluded successfully and the patient had an uneventful postoperative recovery with long-term suppressive antimicrobials. He remained well for 10 months after the procedure with no signs of recurrent local or systemic infection and finally died from an acute myocardial infarction. To our knowledge, emergency endovascular treatment of a free ruptured bleeding femoral artery pseudoaneurysm has not been documented before in the English literature. This case illustrates that endovascular therapy may be a safe and efficient alternative in the emergent management of ruptured infected anastomotic femoral artery pseudoaneurysms when traditional open surgery is contraindicated

Femoral Artery Stenosis Following Percutaneous Closure Using a Starclose Closure Device

International Nuclear Information System (INIS)

Bent, Clare Louise; Kyriakides, Constantinos; Matson, Matthew

2008-01-01

Starclose (Abbott Vascular Devices, Redwood City, CA) is a new arterial closure device that seals a femoral puncture site with an extravascular star-shaped nitinol clip. The clip projects small tines into the arterial wall which fold inward, causing the arterial wall to pucker, producing a purse-string-like seal closing the puncture site. The case history is that of a 76-year-old female patient who underwent day-case percutaneous diagnostic coronary angiography. A Starclose femoral artery closure device was used to achieve hemostasis with subsequent femoral artery stenosis.

[Growth and deformity after in situ fixation of slipped capital femoral epiphysis].

Science.gov (United States)

Druschel, C; Placzek, R; Funk, J F

2013-08-01

For mild to moderate slipped capital femoral epiphysis (SCFE) in situ fixation is the current treatment standard. However, concerning the implant selection (screw versus k-wires) as well as the prophylactic stabilisation of the non-affected hip, controversies still exist. The aim of this study was to analyse femoral residual growth and femoral deformities after in situ fixation of SCFE either with k-wires or screws. We conducted a retrospective analysis of the radiographs of adolescents treated for SCFE in our department between 01/2003 and 02/2011. To evaluate femoral growth the articulo-trochanteric distance, centro-trochanteric distance, caput-collum-diaphyseal angle, pin-joint ratio and pin-physis ratio were determined. The femoral deformity was assessed by measuring the sphericity of the femoral head. Degenerative changes were evaluated in the final radiographs. Statistical analysis was performed concerning differences between therapeutically and prophylactically treated hips as well as stabilisations with k-wires and screws. A total of 22 patients (female : male = 14 : 8, mean age girls: 11 ± 1 years, boys: 13 ± 2 years) with 26 slipped capital femoral epiphyses was analysed. K-wires were used for fixation in 4 hips each therapeutically and prophylactically, 22 hips with SCFE and 14 non-affected hips were stabilised with screws. Treatment with screws did not lead to significantly earlier physeal closure than k-wire pinning. Regarding the femoral growth parameters a significant decrease in the articulo-trochanteric distance and CCD angle was detectable in all groups. The pin-joint ratio revealed an adequate residual growth in 58 % of the therapeutically and in 72 % of the prophylactically treated hips without significant difference between k-wires and screws. The pin-physis ratio demonstrated similar values. Regarding the femoral deformity the SCFE hips resulted in a significantly reduced sphericity, which remained unchanged during follow-up. The

Determination of bone blood supply with /sup 99m/Tc red blood cells and /sup 113m/In transferrin in fractures of femoral neck: concise communication

Energy Technology Data Exchange (ETDEWEB)

Kempi, V.; Sandegard, J.

1982-05-01

The uptake of in vivo labeled /sup 99m/Tc RBCs and /sup 113/In transferrin was studied in femoral bone of 21 patients who had recent operations for fracture of the femoral neck. Femoral bone biopsies and blood samples were obtained during the operation. The activity values for bone biopsies, erythrocytes, and serum were determined, and the uptake ratios between bone and erythrocyte cpm/g and between bone and serum were calculated. Biopsy samples were taken from the femoral head in 21 cases and from the trochanteric region in 14. The activity ratios for the two tracers correlated well: r . 0.94 for femoral head biopsies (P less than 0.001) and r . 0.98 for samples from the trochanteric region (P less than 0.001). Thus, the procedures are interchangeable and either may be valuable in assessing bone blood supply. An additional patient, studied only with /sup 99m/Tc RBCs, had a subsequent operation for nonunion of a fracture. Samples of both cancellous and cortical bone were obtained from the removed head. The activity ratios for the two types of bone tissue differed significantly (P . 0.02).

Determination of bone blood supply with /sup 99m/Tc red blood cells and /sup 113m/In transferrin in fractures of femoral neck: concise communication

International Nuclear Information System (INIS)

Kempi, V.; Sandegard, J.

1982-01-01

The uptake of in vivo labeled /sup 99m/Tc RBCs and 113 In transferrin was studied in femoral bone of 21 patients who had recent operations for fracture of the femoral neck. Femoral bone biopsies and blood samples were obtained during the operation. The activity values for bone biopsies, erythrocytes, and serum were determined, and the uptake ratios between bone and erythrocyte cpm/g and between bone and serum were calculated. Biopsy samples were taken from the femoral head in 21 cases and from the trochanteric region in 14. The activity ratios for the two tracers correlated well: r . 0.94 for femoral head biopsies (P less than 0.001) and r . 0.98 for samples from the trochanteric region (P less than 0.001). Thus, the procedures are interchangeable and either may be valuable in assessing bone blood supply. An additional patient, studied only with /sup 99m/Tc RBCs, had a subsequent operation for nonunion of a fracture. Samples of both cancellous and cortical bone were obtained from the removed head. The activity ratios for the two types of bone tissue differed significantly

Prognostic value of dynamic MRI in assessing post-traumatic femoral head vascularity

Energy Technology Data Exchange (ETDEWEB)

Kaushik, Abhishek; Varghese, Mathew [St Stephen' s Hospital, Department of Orthopaedics, Delhi, New Delhi (India); Sankaran, Balu [St Stephen' s Hospital, Delhi, New Delhi (India)

2009-06-15

The vascular status of femoral heads in the post-traumatic period of intracapsular femoral neck fracture (ICFNF) remains uncertain until the patient actually develops avascular necrosis (AVN). Several methods for predicting the viability of femoral head have been reported, that are not effective or widely used because of unreliability, potential complications, and technical difficulties. The present study involved the use of Dynamic MRI (DMRI) in assessing femoral head vascularity to predict AVN. The role of DMRI was studied prospectively in 30 patients with 31 ICFNF. Fractures were divided in to three types (Type A, B, or C) based on the femoral head vascularity shown by dynamic curve patterns on MRI evaluation. Type A was preserved vascularity, Type B was some decrease in vascularity but still viable while Type C was significantly reduced vascularity. These were followed-up for 6 months to 2 years to observe the final outcome in terms of union, non-union, or AVN. We found that Type A curves correlate well with vascular status and Type C curves correlate well with poor vascularity of the femoral heads. No AVN was seen in any of Type A (13/31) or Type B (eight out of 31). Five cases showed AVN and all of them were of Type C dynamic curves. Dynamic MRI is a reliable tool to evaluate vascularity of femoral heads and thus reduces the uncertainty of outcome of treatment of ICFNFs. DMRI can be a useful tool to formulate a treatment algorithm in management of ICFNF. (orig.)

Arthroscopic treatment of femoral nerve paresthesia caused by an acetabular paralabral cyst.

Science.gov (United States)

Kanauchi, Taira; Suganuma, Jun; Mochizuki, Ryuta; Uchikawa, Shinichi

2014-05-01

This report describes a rare case of femoral nerve paresthesia caused by an acetabular paralabral cyst of the hip joint. A 68-year-old woman presented with a 6-month history of right hip pain and paresthesia along the anterior thigh and radiating down to the anterior aspect of the knee. Radiography showed osteoarthritis with a narrowed joint space in the right hip joint. Magnetic resonance imaging showed a cyst with low T1- and high T2-weighted signal intensity arising from a labral tear at the anterior aspect of the acetabulum. The cyst was connected to the joint space and displaced the femoral nerve to the anteromedial side. The lesion was diagnosed as an acetabular paralabral cyst causing femoral neuropathy. Because the main symptom was femoral nerve paresthesia and the patient desired a less invasive procedure, arthroscopic labral repair was performed to stop synovial fluid flow to the paralabral cyst that was causing the femoral nerve paresthesia. After surgery, the cyst and femoral nerve paresthesia disappeared. At the 18-month follow-up, the patient had no recurrence. There have been several reports of neurovascular compression caused by the cyst around the hip joint. To the authors' knowledge, only 3 cases of acetabular paralabral cysts causing sciatica have been reported. The current patient appears to represent a rare case of an acetabular paralabral cyst causing femoral nerve paresthesia. The authors suggest that arthroscopic labral repair for an acetabular paralabral cyst causing neuropathy can be an option for patients who desire a less invasive procedure. Copyright 2014, SLACK Incorporated.

Prognostic value of dynamic MRI in assessing post-traumatic femoral head vascularity

International Nuclear Information System (INIS)

Kaushik, Abhishek; Varghese, Mathew; Sankaran, Balu

2009-01-01

The vascular status of femoral heads in the post-traumatic period of intracapsular femoral neck fracture (ICFNF) remains uncertain until the patient actually develops avascular necrosis (AVN). Several methods for predicting the viability of femoral head have been reported, that are not effective or widely used because of unreliability, potential complications, and technical difficulties. The present study involved the use of Dynamic MRI (DMRI) in assessing femoral head vascularity to predict AVN. The role of DMRI was studied prospectively in 30 patients with 31 ICFNF. Fractures were divided in to three types (Type A, B, or C) based on the femoral head vascularity shown by dynamic curve patterns on MRI evaluation. Type A was preserved vascularity, Type B was some decrease in vascularity but still viable while Type C was significantly reduced vascularity. These were followed-up for 6 months to 2 years to observe the final outcome in terms of union, non-union, or AVN. We found that Type A curves correlate well with vascular status and Type C curves correlate well with poor vascularity of the femoral heads. No AVN was seen in any of Type A (13/31) or Type B (eight out of 31). Five cases showed AVN and all of them were of Type C dynamic curves. Dynamic MRI is a reliable tool to evaluate vascularity of femoral heads and thus reduces the uncertainty of outcome of treatment of ICFNFs. DMRI can be a useful tool to formulate a treatment algorithm in management of ICFNF. (orig.)

A new method for measurement of femoral anteversion using 3D imaging technique

International Nuclear Information System (INIS)

Kim, S.I.; Lee, Y.H.; Park, S.-B.; Lee, K.-M.

1996-01-01

Conventional methods that use cross-sectional computed tomography (CT) images to estimate femoral anteversion have several problems because of the complex 3 dimensional structure of the femur. These are the ambiguity of defining the femoral neck axis and condylar line, and the dependence on patient positioning. Especially, the femoral neck axis that is known as a major source of error is hard to determine from a single or multiple 2-dimensional transverse CT images. In this study, we are presenting a new method that we have devised form the measurement of femoral anteversion by utilizing the 3 dimensional imaging technique. Poster 176. (author)

Report from the Panama Canal Stakeholder Working Group.

Science.gov (United States)

2013-03-01

This project assists the Texas Department of Transportation (TxDOT) in assessing the potential impacts of the Panama Canal expansion on Texas ports and the landside transportation system. TxDOT formed a Panama Canal Stakeholder Working Group (PCSWG) ...

Long-term functional outcome following intramedullary nailing of femoral shaft fractures

NARCIS (Netherlands)

el Moumni, Mostafa; Voogd, Emma Heather; ten Duis, Henk Jan; Wendt, Klaus Wilhelm

Background: The management of femoral shaft fractures using intramedullary nailing is a popular method. The purpose of this study was to evaluate the long-term functional outcome after antegrade or retrograde intramedullary nailing of traumatic femoral shaft fractures. We further determined

Comparison of Curved Root Canals Prepared with Various Chelating Agents

Science.gov (United States)

2012-06-01

aqueous base (11). According to Bramante and Betti, instrumentation with NiTi hand files using EDTA caused greater deviation of the root canal from...15. Peters OA, Peters CI, Schonenberger K, Barbakow F. ProTaper rotary root canal preparation: effects of canal anatomy on final shape analysed by