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Sample records for giant trochanteric pressure

  1. Giant trochanteric pressure sore: Use of a pedicled chimeric perforator flap for cover

    Directory of Open Access Journals (Sweden)

    Mehrotra Sandeep

    2009-01-01

    Full Text Available Pressure sores are increasing in frequency commensurate with an ageing population with multi-system disorders and trauma. Numerous classic options are described for providing stable wound cover. With the burgeoning knowledge on perforator anatomy, recent approaches focus on the use of perforator-based flaps in bedsore surgery. A giant neglected trochanteric pressure sore in a paraplegic is presented. Since conventional options of reconstruction appeared remote, the massive ulcer was successfully managed by a chimeric perforator-based flap. The combined muscle and fasciocutaneous flaps were raised as separate paddles based on the anterolateral thigh perforator branches and provided stable cover without complications. Perforators allow versatility in managing complex wounds without compromising on established principles.

  2. [Thigh and leg musculo-cutaneous island flap for giant bilateral trochanteric and perineal pressure sores coverage: Extreme treatment in spinal cord injury].

    Science.gov (United States)

    André, A; Crouzet, C; De Boissezon, X; Grolleau, J-L

    2015-06-01

    Surgical treatment of perineal pressure sores could be done with various fascio-cutaneous or musculo-cutaneous flaps, which provide cover and filling of most of pressure sores after spinal cord injuries. In rare cases, classical solutions are overtaken, then it is necessary to use more complex techniques. We report a case of a made-to-measure lower limb flap for coverage of confluent perineal pressure sores. A 49-year-old paraplegic patient developed multiple pressure sores on left and right ischial tuberosity, inferior pubic bone and bilateral trochanters with hips dislocation. Surgical treatment involved a whole right thigh flap to cover and fill right side lesions, associated to a posterior right leg musculo-cutaneous island flap to cover and fill the left trochanteric pressure sore. The surgical procedure lasted 6.5 hours and required massive blood transfusion. Antibiotics were adapted to bacteriological samples. There were no postoperative complications; complete wound healing occurred after three weeks. A lower limb sacrifice for coverage of a giant perineal pressure sores is an extreme surgical solution, reserved to patients understanding the issues of this last chance procedure. A good knowledge of vascular anatomy is an essential prerequisite, and allows to shape made-to-measure flaps. The success of such a procedure is closely linked to the collaboration with the rehabilitation team (appropriate therapeutic education concerning transfers and positioning). Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Reconstruction of trochanteric pressure sores with pedicled anterolateral thigh myocutaneous flaps.

    Science.gov (United States)

    Wang, Chih-Hsin; Chen, Shih-Yi; Fu, Ju-Peng; Dai, Niann-Tzyy; Chen, Shao-Liang; Chen, Tim-Mo; Chen, Shyi-Gen

    2011-05-01

    To provide an alternative choice for covering trochanteric pressure sores, we report on a modified pedicle anterolateral thigh (ALT) myocutaneous flap based on the descending branch of the lateral circumflex femoral artery. From August 2007 to January 2010, 20 consecutive patients (10 men and 10 women) underwent 21 pedicled ALT myocutaneous flaps for reconstruction of trochanteric pressure sores. The flap was designed and elevated, resembling the ALT perforator flap including part of the vastus lateralis muscle but without skeletonisation of the perforators. The mean age of patients was 79.4 years (range: 46-103). The mean follow-up period was 13.9 months (range: 3-32). The flaps were 8-21 cm long and 5-11 cm wide. All flaps healed without major complications. All donor sites were closed primarily without skin grafting and showed good aesthetic results. No recurrence was observed. This modified design of pedicled ALT myocutaneous flap without skeletonisation of perforators is a reliable and easily harvested flap for reconstruction of trochanteric pressure sores with limited morbidity. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  4. Trochanteric bursitis

    Science.gov (United States)

    ... of the hip; Hip bursitis References Fredericson M, Lin C, Chew K. Greater trochanteric pain syndrome. In: ... Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, ...

  5. Trochanteric fractures

    International Nuclear Information System (INIS)

    Herrlin, K.; Stroemberg, T.; Lidgren, L.; Walloee, A.; Pettersson, H.; Lund Univ.

    1988-01-01

    Four hundred and thirty trochanteric factures operated upon with McLaughlin, Ender or Richard's osteosynthesis were divided into 6 different types based on their radiographic appearance before and immediately after reposition with special reference to the medial cortical support. A significant correlation was found between the fracture type and subsequent mechanical complications where types 1 and 2 gave less, and types 4 and 5 more complications. A comparison of the various osteosyntheses showed that Richard's had significantly fewer complications than either the Ender or McLaughlin types. For Richard's osteosynthesis alone no correlation to fracture type could be made because of the small number of complications in this group. (orig.)

  6. Trochanteric bursitis: radiological findings

    International Nuclear Information System (INIS)

    Revilla, T.Y.; Manjon, P.; Lozaono, C.

    1997-01-01

    To describe the radiological findings associated with trochanteric bursitis. Six patients studied by means of plain radiography (n=6), CT(n=4) and MR(n=2). The conventional radiography study was normal in two patients and disclosed bone abnormalities in four. US showed a hypoechoic or anechoic collection in all the patients. Two patients presented areas suggestive of calcification, and septa were observed in one. CT disclosed the presence of well defined, low-attenuation, unenhanced collections. MR images identified collections with a signal intensity similar to that of water. Trochanteric bursitis is a relatively common cause of hip pain, and can involve any one of a number of etiologies. US is a good imaging technique for diagnosing this pathology. (Author) 10 refs

  7. Trochanteric reduction osteotomy as a treatment for refractory trochanteric bursitis

    NARCIS (Netherlands)

    Govaert, L. H. M.; van der Vis, H. M.; Marti, R. K.; Albers, G. H. R.

    2003-01-01

    We describe a new operative procedure for patients with chronic trochanteric bursitis. Between March 1994 and May 2000, a trochanteric reduction osteotomy was performed on ten patients (12 hips). All had received conservative treatment for at least one year. Previous surgical treatment with a

  8. [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

  9. Colgajo en hacha de tensor de fascia lata para úlceras por presión trocantereas Hatchet-Shaped fascia lata tensor flap for the treatment of trochanteric pressure sores

    Directory of Open Access Journals (Sweden)

    W. Calderón

    2010-12-01

    Full Text Available Las úlceras trocantéreas por presión representan un problema importante a nivel extra e intrahospitalario. Existen múltiples opciones terapéuticas, ya sean colgajos randomizados, musculocutáneos, fasciocutáneos o libres. Presentamos la técnica quirúrgica del colgajo en hacha de tensor de fascia lata para el tratamiento de esta patología. Consiste en el diseño de un colgajo en V con irrigación por su base superior, que contacta con la úlcera por uno de sus extremos, simulando la forma de un hacha. Resecamos la úlcera hasta obtener un lecho vital, resecando además el hueso prominente dicho hasta un plano en que se visualice tejido sano. Levantamos y rotamos el colgajo cubriendo el defecto. Finalmente se realiza el cierre primario en VY sin tensión. La zona donante permite un cierre primario sin tensión. Mantenemos drenajes durante 10 días. Este colgajo permite obtener una buena cobertura para úlceras trocantéreas por decúbito con un adecuado resultado cosmético. Recogemos una casuística de 17 úlceras tratadas mediante el colgajo descrito; como complicaciones se presentaron 3 seromas, resueltos con sistema de cierre con presión negativa externa e interna; 2 casos de dehiscencia de sutura y 2 hematomas resueltos en pabellón de cirugía. Creemos pertinente conocer este colgajo que debe estar siempre presente dentro de las posibilidades terapéuticas para pacientes con úlceras trocantereas por decúbito.The trochanteric pressure sore it´s an important intra and extrahospitalary problem. There are different therapeutic options for this pathology, for example random, musculocutaneous, fasciocutaneous or free flaps. We present the hatchet-shaped fascia lata tensor flap to treat this kind of lesions. We design a V flap with irrigation in the superior base, having one of the extreme in contact with the sore. The shape of the flap is a hatchet. It´s important to get a vital bed resecting affected tissues and prominent bone; then

  10. Greater trochanteric pain syndrome diagnosis and treatment.

    Science.gov (United States)

    Mallow, Michael; Nazarian, Levon N

    2014-05-01

    Lateral hip pain, or greater trochanteric pain syndrome, is a commonly seen condition; in this article, the relevant anatomy, epidemiology, and evaluation strategies of greater trochanteric pain syndrome are reviewed. Specific attention is focused on imaging of this syndrome and treatment techniques, including ultrasound-guided interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. GAIT ANALYSIS IN GIANT ANTEATER (MYRMECOPHAGA TRIDACTYLA) WITH THE USE OF A PRESSURE-SENSITIVE WALKWAY.

    Science.gov (United States)

    de Faria, Luís Guilherme; Rahal, Sheila Canevese; dos Reis Mesquita, Luciane; Agostinho, Felipe Stefan; Kano, Washington Takashi; Teixeira, Carlos Roberto; Monteiro, Frederico Ozanan Barros

    2015-06-01

    The aim of this study was to evaluate the kinetic and temporospatial parameters of clinically healthy juvenile giant anteaters (Myrmecophaga tridactyla) by using a pressure-sensing walkway. Three free-ranging clinically healthy giant anteaters (M. tridactyla), two males and one female, aged 5-7 mo, were used. There was no statistically significant difference between the right and left sides for the kinetic and temporospatial parameters for both forelimbs and hind limbs. Although the gait velocity was similar for all giant anteaters, the stride frequency was higher in the smaller anteaters. The difference in stride frequency is associated with body size, which also influenced other temporospatial parameters. The percentage of body distribution was higher on the forelimbs than the hind limbs. The contact surface and trajectory of the force of the forepaws differed from the hind paws. In conclusion, the anteaters have gait peculiarities associated with the anatomical differences between forelimbs and hind limbs.

  12. Tuberculous, trochanteric and ischial bursitis

    International Nuclear Information System (INIS)

    San Roman, R.; Manjon, P.; Revilla, Y.; Rodriguez, P.

    1998-01-01

    To analyze the radiological signs and clinical presentation of tuberculous bursitis arising in the ischial and trochanteric territories, given the limited available knowledge on these entities and in view of the growing prominence of extra pulmonary tuberculosis (TB) in the field of infectious diseases. We present seven cases dealt with in our hospital from the first medical consultation to the definitive diagnosis and treatment. Five of the patients presented greater trochanter involvement, while ischium was the site in the remaining two, in one of whom the bursitis extended toward pubis. The radiographic images revealed demineralization and/or erosion of the bone surface in six cases, soft tissue calcification in four, soft tissue mass in two, coccygeal involvement in one and avulsion of a bone fragment one. An ultrasound study was carried out in a of case soft tissue abscess and fistulography in a case of peri-ischial abscess reaching the cutaneous level. Images of the ischial and trochanteric tuberosities such as those described in the present report should lead to a suspicion of bursitis accompanied by local osteitis. One of the etiologies that should be considered, probably the most common one, is tuberculosis, given the serious consequences that poor initial management would have (if is often treated as pyogenic) and its growing incidence. (Author) 10 refs

  13. Septic trochanteric bursitis in an adolescent.

    Science.gov (United States)

    Makki, Daoud; Watson, Alex James

    2010-01-01

    Trochanteric bursitis, whether septic or inflammatory in origin, is a condition that affects middle-aged patients. Here we report the rare case of an adolescent with septic trochanteric bursitis (treated successfully with intravenous antibiotics), review the available literature on septic bursitis, illustrate the importance of prompt recognition and treatment of this condition in any age group, and describe the clinical presentation and the radiologic findings.

  14. Trochanteric bursitis: the last great misnomer.

    Science.gov (United States)

    Board, Tim N; Hughes, Simon J; Freemont, Anthony J

    2014-12-05

    Trochanteric bursitis has been used as a general term to describe pain around the greater trochanteric region of the hip. We hypothesised that trochanteric bursitis may not however have an inflammatory component and that accordingly, bursal inflammation has no role in lateral hip pain. This study was designed to test this hypothesis. Patients undergoing primary total hip replacement were enrolled in this prospective, case-controlled, blinded study. Twenty-five patients who met the criteria for diagnosis of trochanteric bursitis (group A) were matched with a control group of 25 patients (group B). Trochanteric bursal samples were harvested from all patients intraoperatively and sent for histological analysis for the presence of inflammation. The intraoperative appearance of the abductor tendon insertion was also noted. None of the samples showed any evidence of acute or chronic inflammatory changes. Intraoperatively, five patients (20%) in group A were noted to have thinning of the gluteus medius tendon but no macroscopic tendon tears were detected in any bursal samples. This study suggests that there is no inflammatory component to so-called trochanteric bursitis, which accordingly casts doubt on both the terminology and the existence of this condition as a separate clinical entity. Clinicians should search for an alternative cause of symptoms in such cases.

  15. Pressure induced giant magnetoresistance in Ce.sub.2./sub.Fe.sub.17./sub. compound

    Czech Academy of Sciences Publication Activity Database

    Arnold, Zdeněk; Honda, F.; Oomi, G.; Eto, T.; Prokhnenko, Olexandr; Kamarád, Jiří

    242-245, - (2002), s. 797-802 ISSN 0304-8853 R&D Projects: GA ČR GA106/99/0183; GA AV ČR IAA1010018; GA MŠk ME 165 Institutional research plan: CEZ:AV0Z1010914 Keywords : intemetallic compounds * pressure effect * magnetoresistance-giant Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 1.046, year: 2002

  16. Reversible Morphological Control of Tubulin-Encapsulating Giant Liposomes by Hydrostatic Pressure.

    Science.gov (United States)

    Hayashi, Masahito; Nishiyama, Masayoshi; Kazayama, Yuki; Toyota, Taro; Harada, Yoshie; Takiguchi, Kingo

    2016-04-19

    Liposomes encapsulating cytoskeletons have drawn much recent attention to develop an artificial cell-like chemical-machinery; however, as far as we know, there has been no report showing isothermally reversible morphological changes of liposomes containing cytoskeletons because the sets of various regulatory factors, that is, their interacting proteins, are required to control the state of every reaction system of cytoskeletons. Here we focused on hydrostatic pressure to control the polymerization state of microtubules (MTs) within cell-sized giant liposomes (diameters ∼10 μm). MT is the cytoskeleton formed by the polymerization of tubulin, and cytoskeletal systems consisting of MTs are very dynamic and play many important roles in living cells, such as the morphogenesis of nerve cells and formation of the spindle apparatus during mitosis. Using real-time imaging with a high-pressure microscope, we examined the effects of hydrostatic pressure on the morphology of tubulin-encapsulating giant liposomes. At ambient pressure (0.1 MPa), many liposomes formed protrusions due to tubulin polymerization within them. When high pressure (60 MPa) was applied, the protrusions shrank within several tens of seconds. This process was repeatedly inducible (around three times), and after the pressure was released, the protrusions regenerated within several minutes. These deformation rates of the liposomes are close to the velocities of migrating or shape-changing living cells rather than the shortening and elongation rates of the single MTs, which have been previously measured. These results demonstrate that the elongation and shortening of protrusions of giant liposomes is repeatedly controllable by regulating the polymerization state of MTs within them by applying and releasing hydrostatic pressure.

  17. 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...

  18. Greater trochanteric fracture with occult intertrochanteric extension.

    Science.gov (United States)

    Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph

    2013-10-01

    Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

  19. The art of trochanteric fracture reduction.

    Science.gov (United States)

    Biber, Roland; Berger, Johanna; Bail, Hermann Josef

    2016-12-01

    The name of Ender is primarily associated with the Ender nails, which were popular for trochanteric fracture fixation more than thirty years ago. However, Ender's concepts were not limited to the implant. Ender developed a unique classification system for trochanteric and subtrochanteric fractures, which provided the theory for closed reduction maneuvers that made the method so successful in his hands. While Ender's nails have become history in the meantime, his principles of fracture reduction can be readily applied on surgery with modern implants such as proximal femoral nails. This article reflects the classification and the principles published by Hans Georg Ender in some print work hardly available nowadays. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Bursectomy, Curettage, and Chemotherapy in Tuberculous Trochanteric Bursitis.

    Science.gov (United States)

    Ramos-Pascua, Luis R; Carro-Fernández, José A; Santos-Sánchez, José A; Casas Ramos, Paula; Díez-Romero, Luis J; Izquierdo-García, Francisco M

    2016-03-01

    We presented three patients with trochanteric tuberculosis and described the clinical and imaging findings of the infection. Histology revealed a necrotizing granulomatous bursitis and microbiology confirmed tuberculosis. All cases were successfully treated with bursectomy and curettage of the trochanteric lesion and antituberculous chemotherapy including isoniazid, pyrazinamide, rifampicin, and ethambutol.

  1. Advantages of Pressurized-Spray Cryosurgery in Giant Cell Tumors of the Bone

    Directory of Open Access Journals (Sweden)

    Nevzat Dabak

    2016-10-01

    Full Text Available Background: Giant Cell Tumor is considered a benign, local and aggressive tumor. Although considered a benign bone tumor, it is still the subject of discussion and research because of the associated local bone destruction, as well as high rates of recurrence and distant metastases. Options are being developed for both surgical techniques and adjuvant therapies. Aims: The present study evaluated the administration of cryotherapy via a pressurized-spray technique in giant cell tumors of the bone. Study Design: Cross-sectional study. Methods: The study included 40 patients who were treated with extensive curettage and cryotherapy at various locations during the period from February 2006 to December 2013. Informed consent forms were obtained from the participants and ethics committee approval was taken from the local ethics committee of Ondokuz Mayıs University. The pressurized-spray technique was performed using liquid nitrogen. The patients were evaluated with respect to age, gender, radiological appearance, treatment modality, duration of follow-up, skin problems and recurrence. Results: Twenty-one patients were female; 19 were male. The average age of the patients was 33 years (range: 16–72 years, and the average duration of follow-up was 43 months (range: 12–80 months. The average time from the onset of the complaints to the diagnosis was 6 months (range: 2–12 months. Based on the Campanacci classification: 9 patients were Grade I; 25 patients were Grade II; six patients were Grade III. The lesion was located in the femur in 14 patients, in the tibia in 11 patients, in the radius in 5 patients, in the pelvis in 4 patients, in the fibula in 3 patients, in the metatarsal in 2 patients and in the phalanges of the hand in one patient. One patient had postoperative early fracture. None of the patients had skin problems and infection. Three (7.5% of the patients had recurrence. Conclusion: It was found that cryotherapy was highly effective in

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

    Science.gov (United States)

    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.

  3. Treatment of recent trochanteric fracture in adults.

    Science.gov (United States)

    Adam, P

    2014-02-01

    Recent trochanteric fracture is frequent in adults, and mainly affects elderly patients who risk loss of independence. Treatment is surgical, of various sorts. Open reduction internal fixation (ORIF) with intra- or extra-medullary implants is the most frequent attitude in these fractures, which usually heal easily. In elderly patients, arthroplasty is an alternative of choice for some authors. These different treatment modalities are presented, focusing on technical details. Possible technical difficulties and the means of dealing with them are considered. Published results help in choosing the treatment most suitable for a particular type of fracture in a particular patient. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  4. Necrotizing fasciitis after internal fixation of fracture of femoral trochanteric ? ??

    OpenAIRE

    Santos, Leandro Em?lio Nascimento; Pires, Robinson Esteves Santos; Figueiredo, Leonardo Brand?o; Soares, Eduardo Augusto Marques

    2014-01-01

    Necrotizing fasciitis is a rare and potentially lethal soft tissue infection. We report a case of trochanteric femur fracture in a patient who underwent fracture fixation and developed necrotizing fasciitis. A literature review on the topic will be addressed.

  5. Trochanteric Stress Fracture in a Female Window Cleaner

    OpenAIRE

    Lee, Bong-Jin; Song, Jyewon

    2016-01-01

    Stress fractures may occur at various sites in the femur including the head, neck, shaft, supracondylar and condylar regions. To the best of our knowledge, stress fracture occurring in the trochanteric region has not been previously reported. We report here a case of trochanteric stress fracture in a 53-year-old female window cleaner treated with hip nailing without adverse consequences. Careful consideration of this entity is needed when evaluating patients who have repetitive jumping up and...

  6. Risk factors for trochanteric and femoral neck fracture.

    Science.gov (United States)

    Díaz, A R; Navas, P Z

    The differences between the two main types of fracture of proximal end of the femur, trochanteric and cervical fractures, are still a subject of study, and could be the key to a better understanding of its pathophysiology and prevention. The aim of this study is to determine whether epidemiological differences in the distribution of risk factors associated with hip fracture exist between these two entities. A descriptive cross-sectional study of 428 patients over the age of 65 admitted for trochanteric or cervical fractures in 2015, in which gender, age, previous diagnosis, external causes associated with fracture and place of the event were recorded. There were 220 patients with a cervical fracture (51.4%) and 208 patients with a trochanteric fracture (48.6%). The average age was higher in the trochanteric fracture, observing a constant increase with age only in women with trochanteric fractures. Cervical fracture showed a significant association with cerebrovascular disease (p=0.039) and trochanteric fracture with accidental falls (p=0.047) and presence of 5-9 previous diseases (p=0.014). A regression analysis maintained this association in the case of a cerebrovascular disease (OR 2.6, 95%CI 1.1-6.4) and the presence of 5-9 diseases (OR 1.5, 95%CI 1.1-2.3). Trochanteric fractures are associated with women patients of more advanced ages, 5-9 previous diseases and accidental falls. Cerebrovascular disease shows a higher prevalence in cervical fractures. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Assessment of trochanteric osteotomy fragment union after acetabular fracture surgery.

    Science.gov (United States)

    Dubina, Andrew G; Wickramaratne, Niluka; O'Toole, Robert V; Manson, Theodore T

    2017-02-01

    Trochanteric osteotomies are performed in conjunction with standard approaches to improve surgical exposure during open reduction and internal fixation (ORIF) of acetabular fractures. The literature on total hip arthroplasty reports nonunion rates as high as 30% associated with trochanteric osteotomies; however, few data exist regarding the outcomes of trochanteric osteotomies for acetabular fracture surgery. Our hypotheses were 1) patients receiving trochanteric osteotomies during ORIF of acetabular fractures have a low rate of nonunion of the osteotomy fragment, and 2) hip abduction precautions are not necessary with digastric type osteotomies. A retrospective review was conducted to identify patients with acetabular fractures between July 2002 and June 2010 (n=734 fractures) who required trochanteric osteotomies (n=64, 9% of fractures). Forty-seven met inclusion criteria of adequate follow-up (>56days). No excluded patient experienced a complication. Fractures were classified using the Letournel-Judet classification system. Only seven (20%) of 35 patients who received digastric osteotomies had hip abduction precautions applied during the postoperative period. All study patients were shown to have radiographic union at the trochanteric osteotomy site (100% union rate, n=47). Hip abduction precautions intended to protect the osteotomy site and reduce the risk of nonunion and fixation failure were infrequently applied to patients with digastric osteotomies (20%) in this cohort. Multiple protective factors against nonunion were present in this study population compared with previous arthroplasty studies from other institutions. Trochanteric osteotomies are not associated with a significant nonunion rate, and digastric osteotomies might be safely managed without hip abduction precautions. Copyright © 2016. Published by Elsevier Ltd.

  8. Influence of slope steepness, foot position and turn phase on plantar pressure distribution during giant slalom alpine ski racing.

    Directory of Open Access Journals (Sweden)

    Thomas Falda-Buscaiot

    Full Text Available The purpose of this study was to investigate the evolution of ground reaction force during alpine skiing turns. Specifically, this study investigated how turn phases and slope steepness affected the whole foot normal GRF pattern while performing giant slalom turns in a race-like setting. Moreover, the outside foot was divided into different plantar regions to see whether those parameters affected the plantar pressure distribution. Eleven skiers performed one giant slalom course at race intensity. Runs were recorded synchronously using a video camera in the frontal plane and pressure insoles under both feet's plantar surface. Turns were divided according to kinematic criteria into four consecutive phases: initiation, steering1, steering2 and completion; both steering phases being separated by the gate passage. Component of the averaged Ground Reaction Force normal to the ski's surface([Formula: see text], /BW, and Pressure Time Integral relative to the entire foot surface (relPTI, % parameters were calculated for each turn phases based on plantar pressure data. Results indicated that [Formula: see text] under the total foot surface differed significantly depending on the slope (higher in steep sections vs. flat sections, and the turn phase (higher during steering2 vs. three other phases, although such modifications were observable only on the outside foot. Moreover, [Formula: see text] under the outside foot was significantly greater than under the inside foot.RelPTI under different foot regions of the outside foot revealed a global shift from forefoot loading during initiation phase, toward heel loading during steering2 phase, but this was dependent on the slope studied. These results suggest a differentiated role played by each foot in alpine skiing turns: the outside foot has an active role in the turning process, while the inside foot may only play a role in stability.

  9. Extended trochanteric osteotomy: current concepts review.

    Science.gov (United States)

    Sambandam, Senthil Nathan; Duraisamy, Gopinath; Chandrasekharan, Jayadev; Mounasamy, Varatharaj

    2016-04-01

    Revision total hip arthroplasty is a technically demanding procedure which has gained importance for more than two decades. It was a nightmare for revision surgeons during its initial years of inception before the advent of extended trochanteric osteotomy (ETO). This technique gains access to the femoral medullary canal without compromising the bone stock and aids removal of primary implant and cement mantle without further damaging the parent bone. Like any other surgery, ETO does have certain limitations and complications as reported by various authors. Though it has been routinely used by revision surgeons, thorough knowledge of technical details of ETO is still lacking. So this review article is aimed at addressing the indications, surgical procedure, fixation technique, implant selection and complication of ETO which has been presented over a period of years by various authors. We searched in the most commonly used portals like MEDLINE (PubMed) and Google scholar using appropriate terminologies for the literature regarding the various preoperative, intraoperative and postoperative clinical scenarios in which revision surgeons utilized ETO. ETO is an important tool in the revision surgeon's armamentarium and can be used in variety of clinical scenarios and for various intraoperative needs and goals. Awareness about biomechanics of ETO, indications, implants selection, fixation techniques and complications is paramount for good intraoperative and postoperative outcome. ETO by posterior approach continues to be a work horse approach for most revision surgeons all over the world.

  10. Repair of femoral trochanteric osteotomy in the dog

    International Nuclear Information System (INIS)

    Whitelock, R.G.; Dyce, J.; Houlton, J.E.F.

    1997-01-01

    The records and radiographs of 24 dogs that underwent femoral trochanteric osteotomy repair were reviewed. Osteotomy repair was performed with either a pin and tension band wire or a lag screw technique. Significant clinical complications associated with the osteotomy were identified in one dog (4 per cent) six weeks after surgery, although abnormal radiographic changes were evident in 15 dogs (62 per cent). The method of repair did not influence healing and there were comparable radiographic complication rates. It is concluded that femoral trochanteric osteotomy is not associated with significant clinical problems, despite a high incidence of abnormal radiographic findings

  11. Avascular necrosis of the femoral head presenting as trochanteric bursitis.

    Science.gov (United States)

    Mandell, B F

    1990-01-01

    Five patients are described with avascular necrosis of the femoral head who presented with ipsilateral trochanteric bursitis, in the absence of clearcut hip joint disease. Avascular necrosis was indicated by magnetic resonance imaging. It is suggested that clinical trochanteric bursitis, especially when refractory to local corticosteroid treatment, may be the initial sign of hip disease. In the patient with risk factor(s) for avascular necrosis that diagnosis should be considered and evaluated with appropriate studies, such as magnetic resonance imaging, to prevent weight bearing at an early stage and permit possible surgical decompression in the hope of postponing or obviating the need for total hip replacement. PMID:2241294

  12. [Trochanteric bursitis due to tuberculosis in an immunocompetent young woman].

    Science.gov (United States)

    Soro Marín, Sandra; Sánchez Trenado, María Asunción; Mínguez Sánchez, María Dolores; Paulino Huertas, Marcos; García Morales, Paula Virginia; Salas Manzanedo, Verónica

    2012-01-01

    Soft tissue infection due to Mycobacterium tuberculosis can affect muscle, tendons, fascia, bursa and synovial tissue. Tuberculous trochanteric bursitis is a rare entity that usually affects immunocompromised patients. Manifestations usually occur insidiously, which delays diagnosis and treatment. We present the case of an immunocompetent young woman who came to our department for chronic left hip pain. The study confirms the diagnosis of tuberculous trochanteric bursitis. This case demonstrates the importance of considering a possible infectious origin of bursitis in immunocompetent patients. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  13. Hemi replacement arthroplasty for unstable inter-trochanteric fractures of femur.

    Science.gov (United States)

    Singh, Sudhir; Shrivastava, Chetan; Kumar, Sanjiv

    2014-10-01

    Unstable inter-trochanteric fracture in the geriatric population is a common injury and is associated with poor bone quality, excessive collapse, loss of fixation, and cut-out of the lag screw, are the common problems of attempts to fix these fractures. Present study is an attempt to evaluate the functional outcome of primary cemented bipolar hemiarthroplasty in unstable inter-trochanteric fractures in elderly patients. This prospective study included 25 cases with unstable inter-trochanteric fracture of femur between 60 -75 y of age in whom primary Cemented Bipolar hemi - arthroplasty was performed. The patients were followed up at six week, three month, six month and one year postoperatively and assessed using Harris Hip Score (HHS), Lower Extremity Functional Scale (LEFS), Visual analogue scale (VAS) for evaluation of outcome. The mean HHS score was 78.86+8.13 by the end of one year. Similarly mean LEFS score was 34.36+7.01 by the end of one year, whereas the mean pain score on VAS Scale by the year end was 1.04+1.02. The changes in HHS, LEFS and VAS up to six months periods are much greater which starts showing a stable trend thereafter. Fair to good scores were observed in all the patients. We compared our results with those reported by other authors and our study gave quite comparable results. We also used lower extremity function status score (LEFS) for assessment of functional ability. The purpose of its use was that while Harris Hip Score (HHS) provides information on a multitude of factors, LEFS is more patient oriented and provides the correct information about the level of activities a patient can resume post-operatively and can be offered as a self assessment tool. No significant complication except for grade I pressure sores in four patients were seen in postoperative period but they all resolved with proper nursing care by six week follow up. No patient required revision surgery. The authors believe that primary cemented bipolar hemiarthroplasty for

  14. Trochanteric Soft Tissue Thickness and Hip Fracture in Older Men

    OpenAIRE

    Nielson, Carrie M.; Bouxsein, Mary L.; Freitas, Sinara S.; Ensrud, Kristine E.; Orwoll, Eric S.

    2009-01-01

    Background: Greater thickness of the tissue extending laterally from the greater trochanter has been associated with a lower risk of hip fracture in women. The effect of trochanteric soft tissue thickness on the risk of incident hip fracture has not been evaluated in men.

  15. Use of tranexamic acid in dynamic hip screw plate fixation for trochanteric fractures.

    Science.gov (United States)

    Baruah, Ranjit Kumar; Borah, Pranab Jyoti; Haque, Russel

    2016-12-01

    To evaluate perioperative blood loss and blood transfusion requirement in patients who underwent dynamic hip screw plate fixation for a stable trochanteric fracture with or without preoperative intravenous tranexamic acid (TXA). 49 men and 11 women (mean age, 56.5 years) who underwent open reduction and internal fixation with a dynamic hip screw plate for a stable trochanteric fracture by a single surgeon were equally randomised to receive either a single dose of intravenous TXA (15 mg/kg) 15 minutes prior to surgery or an equal volume of normal saline by slow infusion. Intra- and post-operative blood loss and the need for blood transfusion were assessed, as was any thromboembolic adverse event. The TXA and control groups were comparable in terms of age, gender, body mass index, blood pressure, pulse rate, time from injury to surgery, operating time, and preoperative haematological data. Blood loss was lower in the TXA than control group intraoperatively (320.3 vs. 403.33 ml, ptrochanteric fractures.

  16. High Pressure Atmospheric Sampling Inlet System for Venus or the Gas Giants, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Thorleaf Research, Inc. proposes to develop a miniaturized high pressure atmospheric sampling inlet system for sample acquisition in extreme planetary environments,...

  17. [Clinical Results of Endoscopic Treatment of Greater Trochanteric Pain Syndrome].

    Science.gov (United States)

    Zeman, P; Rafi, M; Skala, P; Zeman, J; Matějka, J; Pavelka, T

    2017-01-01

    PURPOSE OF THE STUDY This retrospective study aims to present short-term clinical outcomes of endoscopic treatment of patients with greater trochanteric pain syndrome (GTPS). MATERIAL AND METHODS The evaluated study population was composed of a total of 19 patients (16 women, 3 men) with the mean age of 47 years (19-63 years). In twelve cases the right hip joint was affected, in the remaining seven cases it was the left side. The retrospective evaluation was carried out only in patients with greater trochanteric pain syndrome caused by independent chronic trochanteric bursitis without the presence of m. gluteus medius tear not responding to at least 3 months of conservative treatment. In patients from the followed-up study population, endoscopic trochanteric bursectomy was performed alone or in combination with iliotibial band release. The clinical results were evaluated preoperatively and with a minimum follow-up period of 1 year after the surgery (mean 16 months). The Visual Analogue Scale (VAS) for assessment of pain and WOMAC (Western Ontario MacMaster) score were used. In both the evaluated criteria (VAS and WOMAC score) preoperative and postoperative results were compared. Moreover, duration of surgery and presence of postoperative complications were assessed. Statistical evaluation of clinical results was carried out by an independent statistician. In order to compare the parameter of WOMAC score and VAS pre- and post-operatively the Mann-Whitney Exact Test was used. The statistical significance was set at 0.05. RESULTS The preoperative VAS score ranged 5-9 (mean 7.6) and the postoperative VAS ranged 0-5 (mean 2.3). The WOMAC score ranged 56.3-69.7 (mean 64.2) preoperatively and 79.8-98.3 (mean 89.7) postoperatively. When both the evaluated parameters of VAS and WOMAC score were compared in time, a statistically significant improvement (ppain syndrome yields statistically significant improvement of clinical results with the concurrent minimum incidence of

  18. Trochanteric Soft Tissue Thickness and Hip Fracture in Older Men

    Science.gov (United States)

    Nielson, Carrie M.; Bouxsein, Mary L.; Freitas, Sinara S.; Ensrud, Kristine E.; Orwoll, Eric S.

    2009-01-01

    Background: Greater thickness of the tissue extending laterally from the greater trochanter has been associated with a lower risk of hip fracture in women. The effect of trochanteric soft tissue thickness on the risk of incident hip fracture has not been evaluated in men. Methods: We measured trochanteric soft tissue thickness by dual-energy x-ray absorptiometry for all incident hip fracture cases (n = 70) and 222 randomly selected noncases in older men (≥65 yr) enrolled in the Osteoporotic Fractures in Men (MrOS) Study. Differences in tissue thickness between cases and controls were examined. Changes in fall force and factor-of-risk (the ratio of force from a sideways fall to femoral bone strength) associated with tissue thickness were determined. The relative risk for incident hip fracture per sd decrease in tissue thickness was calculated. Results: Mean trochanteric soft tissue thickness did not differ significantly between cases and noncases (29.1 ± 11.9 vs 31.0 ± 11.5 mm; P = 0.2). Although increased tissue thickness reduced both the estimates of fall force and the factor-of-risk, tissue thickness was not associated with the risk of hip fracture (age- and bone mineral density-adjusted relative risk per sd decrease in tissue thickness = 0.90; 95% confidence interval, 0.70–1.16). Conclusions: In this study of elderly community-dwelling men, we found no significant association between trochanteric soft tissue thickness and incident hip fracture. Trochanteric soft tissue thickness in these men was less than previously reported in older women and may explain the difference between these results and those reported in women. PMID:19017753

  19. [Trochanteric femoral fractures: anatomy, biomechanics and choice of implants].

    Science.gov (United States)

    Bonnaire, F; Lein, T; Bula, P

    2011-06-01

    The objective of any surgical care of a trochanteric femoral fracture should be the achievement of a stable osteosynthesis that allows early full weight-bearing mobilisation of the patient, because long-term immobilisation soon becomes a vital threat to the affected patients who are usually elderly with correlating comorbidities. The anatomical references of the proximal femur and the structure of the hip joint contain some specifics that play an essential role in the incurrence of a trochanteric femoral fracture and the planning of the osteosynthesis as well. With reposition and fracture stabilisation particular importance must be attached to the collo-diaphyseal and the antetorsion angle so that they do not interfere with the functional interaction of the hip and knee joint. Uncomplex trochanteric fractures ordinarily stabilise sufficiently after reposition so that even an extramedullary implant can ensure full weight-bearing stability. With evermore distal fracture course and intertrochanteric comminution zone, rotational instability and pivot transfer of the fracture area to lateral and caudal are followed by an increase of the dislocating forces. These kinds of fractures (A2 and A3 according to the AO/ASIF classification) profit from an intramedullary and rotationally stable osteosynthesis. Basically primary total hip arthroplasty is a potential option for surgical care of a trochanteric fracture in elderly patients with relevant coxarthrosis. However this procedure can only be recommended in cases of a stable uncomplex fracture. The more the medial interlocking of the proximal femur is destroyed the more difficult it will be to primarily implant a total hip prosthesis with good offset and without a varus and rotational failure in the fracture zone.The current studies in the main show disadvantages due to increased complications in these patients, so that in cases of an unstable trochanteric fracture a primary osteosynthesis should be performed followed by

  20. Cement technique for reducing post-operative bursitis after trochanteric fixation.

    Science.gov (United States)

    Derman, Peter B; Horneff, John G; Kamath, Atul F; Garino, Jonathan

    2013-02-01

    Post-operative trochanteric bursitis is a known complication secondary to the surgical approach in total hip arthroplasty. This phenomenon may be partially attributable to repetitive microtrauma generated when soft tissues rub against implanted hardware. Significant rates of post-operative trochanteric bursitis have been observed following procedures in which a trochanteric fixation device, such as a bolt-washer mechanism or a cable-grip/claw system, is used to secure the trochanteric fragment after trochanteric osteotomy. We present a simple technique for use with a bolt-washer system or grip plate in which trochanteric components are covered in bone wax followed by a layer of cement to decrease friction and to diminish the risk of post-operative bursitis.

  1. Giant Pressure-Induced Enhancement of Seebeck Coefficient and Thermoelectric Efficiency in SnTe

    Energy Technology Data Exchange (ETDEWEB)

    Baker, Jason; Kumar, Ravhi; Park, Changyong; Kenney-Benson, Curtis; Cornelius, Andrew; Velisavljevic, Nenad (CIW); (LANL); (UNLV)

    2017-10-30

    The thermoelectric properties of polycrystalline SnTe have been measured up to 4.5 GPa at 330 K. SnTe shows an enormous enhancement in Seebeck coefficient, greater than 200 % after 3 GPa, which correlates to a known pressure-induced structural phase transition that is observed through simultaneous in situ X-ray diffraction measurement. Electrical resistance and relative changes to the thermal conductivity were also measured, enabling the determination of relative changes in the dimensionless figure of merit (ZT), which increases dramatically after 3 GPa, reaching 350 % of the lowest pressure ZT value. The results demonstrate a fundamental relationship between structure and thermoelectric behaviours and suggest that pressure is an effective tool to control them.

  2. Pressure effects in the giant magnetocaloric compounds Gd5(SixGe1-x)4

    International Nuclear Information System (INIS)

    Morellon, L; Arnold, Z; Algarabel, P A; Magen, C; Ibarra, M R; Skorokhod, Y

    2004-01-01

    We report a study of the effect of hydrostatic pressure up to 9 kbar on selected compounds of the Gd 5 (Si x Ge 1-x ) 4 series (x = 0.8, 0.45, 0.1) by means of ac magnetic susceptibility, compressibility, and linear thermal expansion measurements. The pressure-induced increase of the transition temperatures at the second-order boundaries of the phase diagram is rather moderate: dT C /dP ∼ +0.3Kk-bar -1 (x = 0.8) and dT N /P ∼+0.7Kkbar -1 (x = 0.1). This effect is stronger in the 0 C /dP ∼ +3 Kk-bar -1 (x = 0.45,0.1), indicating that the ferromagnetic ordering can be simultaneously driven through a pressure-induced structural transformation. The values of d lnT C /d lnV calculated with the use of the measured value of compressibility (k ∼1.8 M-bar -1 ) are significantly lower than those estimated from the concentration dependence of the lattice cell volume, thus demonstrating that the dependence of the transition temperatures upon changing the Si/Ge ratio across the series cannot be explained by a pure volume effect

  3. Arthroscopic bursectomy for recalcitrant trochanteric bursitis after hip arthroplasty.

    Science.gov (United States)

    Van Hofwegen, Christopher; Baker, Champ L; Savory, Carlton G; Baker, Champ L

    2013-01-01

    This study evaluated the use of arthroscopic bursectomy for pain relief in patients with trochanteric bursitis after hip arthroplasty. In this retrospective case series of 12 patients undergoing arthroscopic treatment of recalcitrant trochanteric bursitis after hip arthroplasty, outcomes were assessed via phone interview with a numeric pain rating scale from 1 to 10 and were compared with preoperative pain ratings. Patients were asked the percentage of time they had painless hip function and whether they would have the surgery again. At an average 36-month follow-up (range, 4-85 months), the average numeric pain scale rating improved from 9.3 to 3.3. At an average of 62% of the time, patients had painless use of the hip. Ten of 12 patients in the study felt the pain relief gained was substantial enough to warrant having procedure again. In these patients, arthroscopic bursectomy was a viable option for patients with recalcitrant bursitis after hip arthroplasty.

  4. Trochanteric impingement: is it a source of pain after THR?

    Directory of Open Access Journals (Sweden)

    Mark J. Isaacson, DO

    2015-09-01

    Full Text Available While uncommon, trochanteric-pelvic impingement may lead to significant lateral hip pain. We defined “impingement distance” as the radiographic distance from the medial aspect of the greater trochanter and the corresponding lateral edge of the acetabular bone or component and compared this to the contralateral normal hip. We present two painful total hip replacement (THR cases, each featuring a patient with severe lateral hip pain when walking and sitting. Both patients had diminished femoral offset and trochanteric-pelvic clearance, compared to the contralateral normal hip. The impingement distance was increased an average of 10 mm with the exchange to a longer femoral head. Both patients had immediate and complete pain relief with operative treatment to increase the impingement distance.

  5. Torsional malalignment, how much significant in the trochanteric fractures?

    Science.gov (United States)

    Kim, Tae Young; Lee, Yong Beom; Chang, Jun Dong; Lee, Sang Soo; Yoo, Jae Hyun; Chung, Kook Jin; Hwang, Ji Hyo

    2015-11-01

    The rotational alignment is definitely important in the long bones such as tibias and femurs. We also predict the importance of rotational alignment in the trochanteric fractures. So we measured torsional malalignment in trochanteric fracture and anlaysed their risk factors and their clinical significance. A total of 109 inpatients who had undergone internal fixation following trochanteric fracture and a postoperative pelvic CT scan between 2008 and 2013, with at least one year follow-up, were selected. Factors that affect torsional malalignment, such as age, gender, fracture stability, injured area, operative time, time of surgery after admission, and ASA status, were investigated. Factors that affect the patients' clinical results in malrotation, including ambulation time after surgery, postoperative complication rates, pain assessment of VAS one year postoperatively and Koval score, were also investigated. Of the 109 subjects, torsional malalignment was observed in 28 (25.7%) subjects with a mean torsional malalignment angle of 20.7° (range: -31.2° to 27.1°). Torsional malalignment risk factors were fracture stability (p=0.021) and operative time (p=0.043). In terms of the time to ambulation after surgery, the postoperative complication rates, and the VAS and Koval scores at one year postoperatively, no statistically significant difference was observed between the torsional malalignment patients and the non-deformity patients. In this study, 25.7% of the patients who had undergone internal fixation following trochanteric fracture experienced torsional malalignment. Major factors of the torsional malalignment were an unstable fracture and the consequent delay in the operative time. But the torsional malalignment was deemed to have no effect on clinical results. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Augmentation of proximal femoral nail in unstable trochanteric fractures

    Directory of Open Access Journals (Sweden)

    Gadegone Wasudeo M.

    2017-01-01

    Full Text Available Introduction: Biomechanically proximal femoral nail (PFN is a better choice of implant, still it is associated with screw breakage, cut out of screw through femoral head, Z effect, reverse Z effect, and lateral migration of screws. The purpose of this study is to evaluate the results of augmented PFN in terms of prevention of postoperative complications and failure rates in unstable trochanteric fractures. Material and methods: We carried out a prospective study of 82 cases with unstable trochanteric femoral fractures from April 2010 to December 2015. Forty-two females and 40 males in the age group between 58 and 81 years were included in this study. There were 45 cases of AO 31 A2 (2.2, 2.3 and 37 cases of AO 31 A3 (3.1, 3.2, 3.3. Fractures were fixed by PFN with augmentation by an additional screw from trochanter to inferior quadrant of femoral head or cerclage wire to strengthen the lateral trochanteric wall. Results: The bone healing is observed in all the cases in the mean period of 14.2 weeks. Nine patients developed complications, including lateral migration of neck screws (n = 5, Z effect (n = 1, infection (n = 2, and breakage of distal interlocking bolt in one case. Removal of screws was required in five cases. Patients were followed up for a mean of 8.4 months. At the end of follow-up the Salvati and Wilson hip function was 32 (out of 40 in 88% of patients. Conclusion: The stabilization of lateral trochanteric wall with additional screw or cerclage wire increases the stability of construct.

  7. Factors influencing period from surgery to discharge in patients with femoral trochanteric fractures

    Science.gov (United States)

    Shinoda, Soichiro; Mutsuzaki, Hirotaka; Watanabe, Arata; Morita, Hidetaka; Kamioka, Yumiko

    2017-01-01

    [Purpose] The purpose of this study was to investigate factors influencing the period from surgery to discharge in patients with femoral trochanteric fractures. [Subjects and Methods] Sixty patients with femoral trochanteric fractures were investigated retrospectively. Based on the mean period from surgery to discharge (85.6 ± 26.6 days), the patients were divided into two groups: an under-85-day group (range, 29–78 days) and an over-85-day group (87–128 days). Age, gender, fracture type, presence of lesser trochanteric displacement, discharge destination, and walking ability were investigated. The relationship between these factors and the period from surgery to discharge was analyzed with logistic regression analysis. [Results] Age and lesser trochanteric displacement were significantly higher in the over-85-day group, and walking ability before fracture and at discharge were significantly lower in the over-85-day group. Logistic regression analysis showed that lesser trochanteric displacement and age were predictors of the length from surgery to discharge. Lesser trochanteric displacement were observed in 87.5% of these. Immediate displacement after surgery occurred in 57.8% of lesser trochanteric fractures, while 26.3% displaced 1 to 3 weeks after surgery. [Conclusion] This study revealed that lesser trochanteric displacement, higher age, and lower walking ability before fracture and at discharge were associated with longer hospitalizations in patients with femoral trochanteric fractures. Lesser trochanteric displacement were observed in 87.5% of lesser trochanteric fractures. These displacements occurred within 3 weeks after surgery in 84.1% of cases. PMID:29200639

  8. Anatomical reconstruction of unstable trochanteric fractures through posterior approach

    Directory of Open Access Journals (Sweden)

    Partha Saha

    2015-01-01

    Full Text Available Objective Unstable intertrochanteric fractures continue to be a challenge for orthopedic surgeons due to the functional limitations it results in the postoperative period. Anatomical reconstruction of the posteromedial fragment becomes difficult through conventional lateral approach, leading to excessive fracture collapse and limping. Materials and Methods: prospective, nonrandomized study was done with 40 patients. They were operated in prone position through posterior approach. Cancellous screws or SS-wires were used to fix the greater or lesser trochanteric fragments and dynamic hip screw (DHS or dynamic condylar screw (DCS for the main two fragments. Bone grafts were used to pack cavities at the posterior trochanteric regions. Results: Fracture healing occurred earlier compared to conventional lateral approach without excessive fracture collapse in majority of cases (average time to achieve union was 13.8 weeks; range: 10–18 weeks. Good functional recovery was noted with 75% 'Good' or 'Excellent' Harris Hip Scores at 24 weeks. Conclusion: Anatomical reconstruction of unstable trochanteric fractures becomes easier through posterior approach with earlier and better functional recovery.

  9. The outcome of endoscopy for recalcitrant greater trochanteric pain syndrome.

    Science.gov (United States)

    Drummond, James; Fary, Camdon; Tran, Phong

    2016-11-01

    Greater trochanteric pain syndrome (GTPS), previously referred as trochanteric bursitis, is a debilitating condition characterised by chronic lateral hip pain. The syndrome is thought to relate to gluteal tendinopathy, with most cases responding to non-operative treatment. A number of open and endoscopic surgical techniques targeting the iliotibial band, trochanteric bursa and gluteal tendons have, however, been described for severe recalcitrant cases. We report the outcomes of one such endoscopic approach here. We retrospectively reviewed 49 patients (57 operations) who had undergone endoscopic longitudinal vertical iliotibial band release and trochanteric bursectomy. Inclusion criteria included diagnosed GTPS with a minimum of six months of non-operative treatment. Exclusion criteria included concomitant intra- or extra-articular hip pathology and previous hip surgery including total hip arthroplasty. Outcomes were assessed using the Visual Analogue Scale, Oxford hip Score and International Hip Outcome Tool (iHOT-33). The series included 42 females and 7 males with a mean age of 65.0 years (26.7-88.6). Mean follow-up time was 20.7 months (5.3-41.2). Eight patients had full thickness gluteal tendon tears, of which 7 were repaired. Adjuvant PRP was injected intraoperatively in 38 of 57 operations (67.2 %). At follow-up, overall mean Visual Analogue Scale values had decreased from 7.8 to 2.8 (p < 0.001), Oxford hip Scores had increased from 20.4 to 37.3 (p < 0.001) and iHOT-33 scores had increased from 23.8 to 70.2 (p < 0.001). Of the 57 operations performed, patients reported feeling very satisfied with the surgical outcome in 28 operations (49.1 %), satisfied in 17 operations (29.8 %) and less than satisfied in 12 operations (21.1 %). While the majority of patients with GTPS will improve with non-operative management, endoscopic iliotibial band release, trochanteric bursectomy and gluteal tendon repair is a safe and effective treatment for severe

  10. Correlation of MRI findings with clinical findings of trochanteric pain syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Blankenbaker, Donna G.; Ullrick, Steven R.; Davis, Kirkland W.; De Smet, Arthur A. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Haaland, Ben; Fine, Jason P. [University of Wisconsin School of Medicine and Public Health, Departments of Biostatistics and Medical Informatics and Statistics, Madison, WI (United States)

    2008-10-15

    Greater trochanter pain syndrome due to tendinopathy or bursitis is a common cause of hip pain. The previously reported magnetic resonance (MR) findings of trochanteric tendinopathy and bursitis are peritrochanteric fluid and abductor tendon abnormality. We have often noted peritrochanteric high T2 signal in patients without trochanteric symptoms. The purpose of this study was to determine whether the MR findings of peritrochanteric fluid or hip abductor tendon pathology correlate with trochanteric pain. We retrospectively reviewed 131 consecutive MR examinations of the pelvis (256 hips) for T2 peritrochanteric signal and abductor tendon abnormalities without knowledge of the clinical symptoms. Any T2 peritrochanteric abnormality was characterized by size as tiny, small, medium, or large; by morphology as feathery, crescentic, or round; and by location as bursal or intratendinous. The clinical symptoms of hip pain and trochanteric pain were compared to the MR findings on coronal, sagittal, and axial T2 sequences using chi-square or Fisher's exact test with significance assigned as p<0.05. Clinical symptoms of trochanteric pain syndrome were present in only 16 of the 256 hips. All 16 hips with trochanteric pain and 212 (88%) of 240 without trochanteric pain had peritrochanteric abnormalities (p=0.15). Eighty-eight percent of hips with trochanteric symptoms had gluteus tendinopathy while 50% of those without symptoms had such findings (p=0.004). Other than tendinopathy, there was no statistically significant difference between hips with or without trochanteric symptoms and the presence of peritrochanteric T2 abnormality, its size or shape, and the presence of gluteus medius or minimus partial thickness tears. Patients with trochanteric pain syndrome always have peritrochanteric T2 abnormalities and are significantly more likely to have abductor tendinopathy on magnetic resonance imaging (MRI). However, although the absence of peritrochanteric T2 MR abnormalities

  11. Correlation of MRI findings with clinical findings of trochanteric pain syndrome

    International Nuclear Information System (INIS)

    Blankenbaker, Donna G.; Ullrick, Steven R.; Davis, Kirkland W.; De Smet, Arthur A.; Haaland, Ben; Fine, Jason P.

    2008-01-01

    Greater trochanter pain syndrome due to tendinopathy or bursitis is a common cause of hip pain. The previously reported magnetic resonance (MR) findings of trochanteric tendinopathy and bursitis are peritrochanteric fluid and abductor tendon abnormality. We have often noted peritrochanteric high T2 signal in patients without trochanteric symptoms. The purpose of this study was to determine whether the MR findings of peritrochanteric fluid or hip abductor tendon pathology correlate with trochanteric pain. We retrospectively reviewed 131 consecutive MR examinations of the pelvis (256 hips) for T2 peritrochanteric signal and abductor tendon abnormalities without knowledge of the clinical symptoms. Any T2 peritrochanteric abnormality was characterized by size as tiny, small, medium, or large; by morphology as feathery, crescentic, or round; and by location as bursal or intratendinous. The clinical symptoms of hip pain and trochanteric pain were compared to the MR findings on coronal, sagittal, and axial T2 sequences using chi-square or Fisher's exact test with significance assigned as p<0.05. Clinical symptoms of trochanteric pain syndrome were present in only 16 of the 256 hips. All 16 hips with trochanteric pain and 212 (88%) of 240 without trochanteric pain had peritrochanteric abnormalities (p=0.15). Eighty-eight percent of hips with trochanteric symptoms had gluteus tendinopathy while 50% of those without symptoms had such findings (p=0.004). Other than tendinopathy, there was no statistically significant difference between hips with or without trochanteric symptoms and the presence of peritrochanteric T2 abnormality, its size or shape, and the presence of gluteus medius or minimus partial thickness tears. Patients with trochanteric pain syndrome always have peritrochanteric T2 abnormalities and are significantly more likely to have abductor tendinopathy on magnetic resonance imaging (MRI). However, although the absence of peritrochanteric T2 MR abnormalities

  12. Posterior trochanteric osteotomy in acetabular fractures for 32 cases.

    Science.gov (United States)

    Niu, Yunfei; An, Xiaofei; Xu, Shuogui; Wu, Dajiang; Zhang, Chuncai; Li, Ming

    2014-11-01

    The aim of this study is to explore the method and clinical outcome of posterior trochanteric osteotomy in acetabular fractures. From January 2000 to January 2008, 32 cases of acetabular fractures involving the dome of acetabulum underwent posterior trochanteric osteotomy for a better exposure and internal fixation with acetabular tridimensional memory fixation system. 28 cases (16 men and 12 women, mean age 39.9 years, range 16-73 years) were followed up with an average of 48.9 months (range of 19-95 months) and four were lost during follow up. Of 28 cases, 19 were fresh fractures and 9 were old fractures. The reduction was evaluated with Matta criteria. Clinical evaluation was based on modified Merle d'Aubigne and Postel scoring. Motor strength of the abductors was evaluated according to the Medical Research Council grading system. Ectopic ossification was classified according to Brooker criteria. Anatomical reduction was achieved in 17 cases and satisfied reduction in 10 patients. Poor reduction happened in an old fracture. All acetabular fractures got a direct bone union and no displacement and deep infection occurred. All osteotomies healed within 3.5 months without any nonunion, proximal migration of the greater trochanter, loosing or broken of instrumentation, and deep infection. Two superficial infections were healed with a regular dressing. Two patients underwent removal of implants from greater trochanter because of irritation. The strength of the abductors was of Grade 3/5 in two patients, Grade 4/5 in five patients, and normal in the rest. Clinical scoring was excellent to good in 84 %. Ectopic ossification occurred in five patients, grade 1 in two patients, grade 2 in two, and grade 3 in one. But function of hip joint was not seriously affected. Posterior trochanteric osteotomy can provide an adequate exposure of the dome of acetabulum without the associated complications like nonunion, proximal replacement, and weak of the abductors which often occur

  13. SURGICAL TREATMENT OF TROCHANTERIC FRACTURES BY GAMMA3 NAIL

    Directory of Open Access Journals (Sweden)

    Aleksandar Vukićević

    2010-09-01

    Full Text Available Fractures of the greater trochanter rank amongst severe injuries of bone tissue. They occur most frequently in patients over 65 years of age, nearly all of whom are diagnosed with osteoporosis. Non-surgical treatment does not prove to be satisfactory and results in high mortality rate. Surgical treatment is a method of fracture treatment of the trochanteric region, which enables early activation and thus prevents numerous complications in bedridden patients. Gamma3 nails are one of the most state-of-the-art implants for trochanteric fracture fixation. The implant is easy to embed, which does not require a large surgical team. This implant embedding requires the least invasive surgery and complications are rare.This paper describes 47 patients who received surgical treatment and is focused on the first nine months of 2009. The patients were treated at the Orthopaedics Ward of Health Centre Valjevo. They were in their seventies, average age: 72.21 years, with female sex prevailing (63.82%. The outcome was as follows: excellent in 65.96%, good in 17.02% and satisfactory in 4.25% of patients. Surface infections occurred in 6.38% of patients. One implant broke.We had one death outcome in the early post-surgical treatment.Surgical treatment of trochanteric fractures by Gamma3 implants proved very effective as it resulted in few complications and numerous excellent functional and anatomic outcomes. Thus we recommend it as an option when decision on treatment of this type of fractures is made.

  14. Efficacy of Treatment of Trochanteric Bursitis: A Systematic Review

    Science.gov (United States)

    Lustenberger, David P; Ng, Vincent Y; Best, Thomas M; Ellis, Thomas J

    2013-01-01

    Objective Trochanteric bursitis (TB) is a self-limiting disorder in the majority of patients and typically responds to conservative measures. However, multiple courses of nonoperative treatment or surgical intervention may be necessary in refractory cases. The purpose of this systematic review was to evaluate the efficacy of the treatment of TB. Data Sources A literature search in the PubMed, MEDLINE, CINAHL, and ISI Web of Knowledge databases was performed for all English language studies up to April 2010. Terms combined in a Boolean search were greater trochanteric pain syndrome, trochanteric bursitis, trochanteric, bursitis, surgery, therapy, drug therapy, physical therapy, rehabilitation, injection, Z-plasty, Z-lengthening, aspiration, bursectomy, bursoscopy, osteotomy, and tendon repair. Study Selection All studies directly involving the treatment of TB were reviewed by 2 authors and selected for further analysis. Expert opinion and review articles were excluded, as well as case series with fewer than 5 patients. Twenty-four articles were identified. According to the system described by Wright et al, 2 studies, each with multiple arms, qualified as level I evidence, 1 as level II, 1 as level III, and the rest as level IV. More than 950 cases were included. Data Extraction The authors extracted data regarding the type of intervention, level of evidence, mean age of patients, patient gender, number of hips in the study, symptom duration before the study, mean number of injections before the study, prior hip surgeries, patient satisfaction, length of follow-up, baseline scores, and follow-up scores for the visual analog scale (VAS) and Harris Hip Scores (HHS). Data Synthesis Symptom resolution and the ability to return to activity ranged from 49% to 100% with corticosteroid injection as the primary treatment modality with and without multimodal conservative therapy. Two comparative studies (levels II and III) found low-energy shock-wave therapy (SWT) to be

  15. Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis.

    Science.gov (United States)

    Long, Suzanne S; Surrey, David E; Nazarian, Levon N

    2013-11-01

    Greater trochanteric pain syndrome is a common condition with clinical features of pain and tenderness at the lateral aspect of the hip. Diagnosing the origin of greater trochanteric pain is important because the treatment varies depending on the cause. We hypothesized that sonographic evaluation of sources for greater trochanteric pain syndrome would show that bursitis was not the most commonly encountered abnormality. We performed a retrospective review of musculoskeletal sonographic examinations performed at our institution over a 6-year period for greater trochanteric pain syndrome; completed a tabulation of the sonographic findings; and assessed the prevalence of trochanteric bursitis, gluteal tendon abnormalities, iliotibial band abnormalities, or a combination of findings. Prevalence of abnormal findings, associations of bursitis, gluteal tendinosis, gluteal tendon tears, and iliotibial band abnormalities were calculated. The final study population consisted of 877 unique patients: 602 women, 275 men; average age, 54 years; and age range, 15-87 years). Of the 877 patients with greater trochanteric pain, 700 (79.8%) did not have bursitis on ultrasound. A minority of patients (177, 20.2%) had trochanteric bursitis. Of the 877 patients with greater trochanteric pain, 438 (49.9%) had gluteal tendinosis, four (0.5%) had gluteal tendon tears, and 250 (28.5%) had a thickened iliotibial band. The cause of greater trochanteric pain syndrome is usually some combination of pathology involving the gluteus medius and gluteus minimus tendons as well as the iliotibial band. Bursitis is present in only the minority of patients. These findings have implications for treatment of this common condition.

  16. [DESIGN AND CLINICAL APPLICATION OF LESSER TROCHANTERIC REDUCTION FIXATION SYSTEM].

    Science.gov (United States)

    Guo, Xiaoze; Zhang, Ying; Xiao, Jin; Xie, Huibin; Yu, Jiefeng

    2015-02-01

    To design and produce a lesser trochanteric reduction fixation system and verify its value and effectiveness. A lesser trochanteric reduction fixation system was designed and produced according to the anatomical features of the lesser trochanteric fractures. Sixty-six patients with intertrochanteric fractures of Evans type III were included between January 2010 and July 2012. Of 66 patients, 32 were treated with dynamic hip screw (DHS) assisted with the lesser trochanteric reduction fixation system (study group), and 34 cases were treated with DHS only (control group). The 2 groups were comparable with no significant difference in gender, age, the reasons, and the types of the fractures (P > 0.05). The operation time, intraoperative blood loss, neck-shaft angle, bone healing time, ratio of successful fixations, and the functional evaluation of the hip joint after operation were compared between 2 groups. The study group had shorter operation time [(58.4 ± 5.3) minutes] and less intraoperative blood loss [(186.3 ± 6.6) mL than the control group [(78.5 ± 6.2)minutes and (246.2 ± 8.7) mL], showing significant differences (t = -14.040, P = 0.000; t = -31.145, P = 0.000). There was no significant difference in neck-shaft angle between study group [(138.6 ± 3.0)] and control group [(139.4 ± 2.9) degrees] (t = -1.044, P = 0.301). The wounds healed by first intention in both groups. The 30 and 31 patients were followed up 12 to 24 months (mean, 15 months) in the study group, and 13 to 25 months (mean, 16 months) in the control group, respectively. All fractures healed well in 2 groups. The study group had significantly shorter healing time [(8.8 ± 2.0) weeks] than the control group [(10.7 ± 3.4) weeks] (t = -2.871, P = 0.006). At 12 months after operation, coxa vara happened in 2 cases of the study group with a successful fixation ratio of 93.3% and in 10 cases of the control group with a successful fixation ratio of 67.7%, showing significant difference (Χ2 = 6

  17. The role of trochanteric flip osteotomy in fixation of certain acetabular fractures

    Directory of Open Access Journals (Sweden)

    Sandeep Gupta

    2017-06-01

    Conclusion: Trochanteric flip osteotomy is a very effective technique to fix certain acetabular fractures especially those with dome involvement. It is more accurate and associated with no significant complications compared with conventional way.

  18. Trochanteric bursitis after total hip arthroplasty: incidence and evaluation of response to treatment.

    Science.gov (United States)

    Farmer, Kevin W; Jones, Lynne C; Brownson, Kirstyn E; Khanuja, Harpal S; Hungerford, Marc W

    2010-02-01

    We examined the efficacy of corticosteroid injection as treatment for postarthroplasty trochanteric bursitis and the risk factors for failure of nonoperative treatment. There were 32 (4.6%) cases of postsurgical trochanteric bursitis in 689 primary total hip arthroplasties. Of the 25 hips with follow-up, 11 (45%) required multiple injections. Symptoms resolved in 20 (80%) but persisted in 5. We found no statistically significant differences between patients who did and did not develop trochanteric bursitis, or between those who did and did not respond to treatment. There was a trend toward younger age and greater limb-length discrepancy in nonresponders. In conclusion, (1) corticosteroid injection(s) for postoperative trochanteric bursitis is effective; and (2) nonoperative management may be more likely to fail in young patients and those with leg-length discrepancy. 2010 Elsevier Inc. All rights reserved.

  19. Effect of prophylactic trochanteric epiphyseodesis in older children with Perthes' disease.

    Science.gov (United States)

    Shah, Hitesh; Siddesh, Nandi D; Joseph, Benjamin; Nair, Sreekumaran N

    2009-12-01

    To evaluate the effect of prophylactic epiphyseodesis of the greater trochanter in Perthes' disease, 62 children with unilateral Perthes' disease who underwent trochanteric epiphyseodesis combined with varus osteotomy of the femur during the active stage of the disease (mean age at surgery: 8.4 y) and 20 controls were followed up until skeletal maturity. On radiographs taken at skeletal maturity, the articulo-trochanteric distance, the center-trochanteric distance, the length of the abductor lever arm, the neck-shaft angle, the radius of the femoral head, and the Reimer's migration index of normal and affected hips were measured. The shape of the femoral head was assessed according to the criteria of Mose. The range of hip motion, the strength of hip abduction, and limb lengths were measured and the Trendelenburg sign was elicited. The mean values of articulo-trochanteric distance and center-trochanteric distance were greater and the frequency of a positive Trendelenburg sign was less in children who had undergone trochanteric epiphyseodesis than in children who had no surgery (P<0.01). Trochanteric epiphyseodesis achieved optimal trochanteric growth arrest in 60% of operated children; the procedure was not effective in 30%, and in 10% of children there was overcorrection. Logistic regression analysis showed that the size of the femoral head at healing and the age at surgery were variables that significantly influenced the effectiveness of trochanteric growth arrest. At skeletal maturity, the mean shortening of the affected limb in operated children was 0.44 cm (SD 0.68 cm), whereas that of non-operated children was 0.86 cm (SD 0.78 cm) (P<0.05). The range of motion of the hip was excellent and there were no significant differences in the range of motion among children with optimal correction, under-correction, and overcorrection. A probability curve plotted on the basis of a logistic regression model suggests that effective trochanteric arrest may be achieved in a

  20. A study on management of extracapsular trochanteric fractures by proximal femoral nail

    Directory of Open Access Journals (Sweden)

    K Ramaprathap Reddy

    2016-01-01

    Full Text Available Background: Trochanteric fractures of femur like intertrochanteric and subtrochanteric fractures are a leading cause of hospital admissions in elderly people. Conservative methods of treatment results in malunion with shortening and limitation of hip movement as well as complications of prolonged immobilizations such as bed sores, deep vein thrombosis, and respiratory infections. This study is done to analyze the surgical management of trochanteric fractures of the femur using a proximal femoral nail (PFN. Methodology: This is a prospective study of 40 cases of trochanteric and subtrochanteric fractures admitted to Government General Hospital, Vijayawada, Andhra Pradesh. Cases were taken according to inclusion and exclusion criteria, i.e., patients with trochanteric fractures femur above the age of 20 years. Medically unsuitable, open fractures and patients not willing for surgery were excluded from the study. Results: Forty percentage of cases were admitted due to slip and fall and with a slight predominance of the right side. Out of 40 cases, 26 were trochanteric, and 14 were subtrochanteric. In trochanteric class, 37.5% were body and griffin Type 2, in subtrochanteric class 12.5% were sinsheimer Type 3a and 10% were 2b. Out of 30 remaining cases, 25 were trochanteric, and 05 were subtrochanteric. Good to excellent results are seen in 100% cases of trochanteric fractures and 90% cases in subtrochanteric fractures. Conclusion: From this sample study, we consider that PFN is an excellent implant for the treatment of pertrochanteric fractures. The terms of successful outcome include a good understanding of fracture biomechanics, proper patient selection, good preoperative planning, accurate instrumentation, good image intensifier, and exactly performed osteosynthesis.

  1. Trochanteric bursitis--a frequent cause of 'hip' pain in rheumatoid arthritis.

    Science.gov (United States)

    Raman, D; Haslock, I

    1982-01-01

    One hundred consecutive patients with rheumatoid arthritis (RA) were examined for the presence of trochanteric bursitis. This condition was found in 15. Ten patients responded to a single local injection of corticosteroid and the remaining 5 to a second injection. Trochanteric bursitis is an underdiagnosed, easily remediable cause of pain in RA. Specific examination for in presence should be a routine in all patients with RA, especially those with hip pain. PMID:7149797

  2. Differential impact of some risk factors on trochanteric and cervical hip fractures.

    Science.gov (United States)

    Tal, Sari; Gurevich, Alexander; Sagiv, Shaul; Guller, Vladimir

    2015-04-01

    To investigate the potential distinct risk factors associated with trochanteric and cervical hip fractures. Elderly patients aged 65 years and older (n = 1161) were admitted to the orthopedic department with hip fractures during the years 2006-2011. Demographic and clinical data, as well as routine blood tests, were retrieved from the patient electronic medical records. Approximately 58% of patients had trochanteric fractures and 42% had cervical fractures. Women were more likely to have trochanteric fractures than men (P = 0.002). Female sex, frailty, falls, diabetes and subnormal calcium, as well as subnormal hemoglobin levels, were significant risk factors for trochanteric fractures (OR 1.39, P = 0.0202, OR 1.36, P = 0.0166, OR 1.49, P = 0.0015, OR 1.33, P = 0.0343, OR 0.68, P = 0.0054, OR 0.70, P = 0.0036, respectively). Patients with Parkinson's disease were at a lower risk for trochanteric fractures (OR 0.6, P = 0.007). As there are some differences between risk factors for trochanteric and cervical hip fractures, there is a need for further studies in order to understand the etiology of fractures and to be able to carry out effective preventive efforts. © 2014 Japan Geriatrics Society.

  3. The trochanteric gamma nail versus the dynamic hip screw

    DEFF Research Database (Denmark)

    Ovesen, Ole; Andersen, Mikkel; Poulsen, Thomas

    2006-01-01

    In a prospective, randomized trial we compared the trochanteric gamma nail (TGN) and the dynamic hip screw (DHS) in the treatment of 146 intertrochanteric fractures. Follow-up was after four and 12 months. The operation time was significantly shorter in the DHS group. At discharge the need...... for walking aids was less in the DHS group. There were no differences in intraoperative blood loss, medical complications, mortality or length of hospital stay. Major fracture complications occurred twiceas often in the TGN group compared with the DHS group, however they were not statistically significant....... Any potential for the TGN leading to a less invasive procedure and a more rapid postoperative mobilisation could not be demonstrated. Compared with the TGN we prefer the DHS for most intertrochanteric fractures in a setting where the majority of these fractures are treated by younger doctors...

  4. [Treatment of trochanteric fractures of the femoral bone].

    Science.gov (United States)

    Wierer, I; Pospísil, M; Holubár, J; Volf, V

    1994-01-01

    The authors present the evaluation of some most often methods of treatment of trochanteric fractures of femur. They analyze the group of 235 patients in the years 1987 - 1991 treated for fractures by the McLaughlin technique and by Ender nailing. The first method was performed on 121 people and the technique of Ender nailing on 97 people. The results and complications of these methods of osteosynthesis are presented in the paper. The experiences of the authors confirm the advantage of Ender nailing in treating fractures of the oldest injured patients. The Ender nailing method of osteosynthesis is the more advantageous, because the operation takes less time and is easier for patients. After Ender nailing, the possibility of functional rehabilitation and walking on crutches is greater. McLaughlin osteosynthesis of these fractures proved the more advantageous in younger injured patients.

  5. Improving greater trochanteric reattachment with a novel cable plate system.

    Science.gov (United States)

    Baril, Yannick; Bourgeois, Yan; Brailovski, Vladimir; Duke, Kajsa; Laflamme, G Yves; Petit, Yvan

    2013-03-01

    Cable-grip systems are commonly used for greater trochanteric reattachment because they have provided the best fixation performance to date, even though they have a rather high complication rate. A novel reattachment system is proposed with the aim of improving fixation stability. It consists of a Y-shaped fixation plate combined with locking screws and superelastic cables to reduce cable loosening and limit greater trochanter movement. The novel system is compared with a commercially available reattachment system in terms of greater trochanter movement and cable tensions under different greater trochanteric abductor application angles. A factorial design of experiments was used including four independent variables: plate system, cable type, abductor application angle, and femur model. The test procedure included 50 cycles of simultaneous application of an abductor force on the greater trochanter and a hip force on the femoral head. The novel plate reduces the movements of a greater trochanter fragment within a single loading cycle up to 26%. Permanent degradation of the fixation (accumulated movement based on 50-cycle testing) is reduced up to 46%. The use of superelastic cables reduces tension loosening up to 24%. However this last improvement did not result in a significant reduction of the grater trochanter movement. The novel plate and cables present advantages over the commercially available greater trochanter reattachment system. The plate reduces movements generated by the hip abductor. The superelastic cables reduce cable loosening during cycling. Both of these positive effects could decrease the risks related to grater trochanter non-union. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  6. Giant grains

    International Nuclear Information System (INIS)

    Leitch-Devlin, M.A.; Millar, T.J.; Williams, D.A.

    1976-01-01

    Infrared observations of the Orion nebula have been interpreted by Rowan-Robinson (1975) to imply the existence of 'giant' grains, radius approximately 10 -2 cm, throughout a volume about a parsec in diameter. Although Rowan-Robinson's model of the nebula has been criticized and the presence of such grains in Orion is disputed, the proposition is accepted, that they exist, and in this paper situations in which giant grains could arise are examined. It is found that, while a giant-grain component to the interstellar grain density may exist, it is difficult to understand how giant grains arise to the extent apparently required by the Orion nebula model. (Auth.)

  7. Variability of computational fluid dynamics solutions for pressure and flow in a giant aneurysm: the ASME 2012 Summer Bioengineering Conference CFD Challenge.

    Science.gov (United States)

    Steinman, David A; Hoi, Yiemeng; Fahy, Paul; Morris, Liam; Walsh, Michael T; Aristokleous, Nicolas; Anayiotos, Andreas S; Papaharilaou, Yannis; Arzani, Amirhossein; Shadden, Shawn C; Berg, Philipp; Janiga, Gábor; Bols, Joris; Segers, Patrick; Bressloff, Neil W; Cibis, Merih; Gijsen, Frank H; Cito, Salvatore; Pallarés, Jordi; Browne, Leonard D; Costelloe, Jennifer A; Lynch, Adrian G; Degroote, Joris; Vierendeels, Jan; Fu, Wenyu; Qiao, Aike; Hodis, Simona; Kallmes, David F; Kalsi, Hardeep; Long, Quan; Kheyfets, Vitaly O; Finol, Ender A; Kono, Kenichi; Malek, Adel M; Lauric, Alexandra; Menon, Prahlad G; Pekkan, Kerem; Esmaily Moghadam, Mahdi; Marsden, Alison L; Oshima, Marie; Katagiri, Kengo; Peiffer, Véronique; Mohamied, Yumnah; Sherwin, Spencer J; Schaller, Jens; Goubergrits, Leonid; Usera, Gabriel; Mendina, Mariana; Valen-Sendstad, Kristian; Habets, Damiaan F; Xiang, Jianping; Meng, Hui; Yu, Yue; Karniadakis, George E; Shaffer, Nicholas; Loth, Francis

    2013-02-01

    Stimulated by a recent controversy regarding pressure drops predicted in a giant aneurysm with a proximal stenosis, the present study sought to assess variability in the prediction of pressures and flow by a wide variety of research groups. In phase I, lumen geometry, flow rates, and fluid properties were specified, leaving each research group to choose their solver, discretization, and solution strategies. Variability was assessed by having each group interpolate their results onto a standardized mesh and centerline. For phase II, a physical model of the geometry was constructed, from which pressure and flow rates were measured. Groups repeated their simulations using a geometry reconstructed from a micro-computed tomography (CT) scan of the physical model with the measured flow rates and fluid properties. Phase I results from 25 groups demonstrated remarkable consistency in the pressure patterns, with the majority predicting peak systolic pressure drops within 8% of each other. Aneurysm sac flow patterns were more variable with only a few groups reporting peak systolic flow instabilities owing to their use of high temporal resolutions. Variability for phase II was comparable, and the median predicted pressure drops were within a few millimeters of mercury of the measured values but only after accounting for submillimeter errors in the reconstruction of the life-sized flow model from micro-CT. In summary, pressure can be predicted with consistency by CFD across a wide range of solvers and solution strategies, but this may not hold true for specific flow patterns or derived quantities. Future challenges are needed and should focus on hemodynamic quantities thought to be of clinical interest.

  8. Older Male Physicians Have Lower Risk of Trochanteric but Not Cervical Hip Fractures

    Directory of Open Access Journals (Sweden)

    Hsiu-Nien Shen

    2015-02-01

    Full Text Available Background: Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures. Methods: Data regarding older (≥65 years physicians (n = 4303 and matched non-medical persons (control were retrieved from Taiwan’s National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR of hip fracture associated with older physicians. Results: The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively, whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively. Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37–0.79; by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged. Conclusions: Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures.

  9. Older Male Physicians Have Lower Risk of Trochanteric but Not Cervical Hip Fractures

    Science.gov (United States)

    Shen, Hsiu-Nien; Lin, Wei-Ting; Lu, Chin-Li; Li, Chung-Yi

    2015-01-01

    Background: Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures. Methods: Data regarding older (≥65 years) physicians (n = 4303) and matched non-medical persons (control) were retrieved from Taiwan’s National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR) of hip fracture associated with older physicians. Results: The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively), whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively). Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37–0.79); by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged. Conclusions: Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures. PMID:25689999

  10. Dual head screw hip nailing for trochanteric fractures

    Science.gov (United States)

    Mavrogenis, Andreas F.; Igoumenou, Vasilios G.; Megaloikonomos, Panayiotis D.; Panagopoulos, George N.; Galanopoulos, Ioannis P.; Vottis, Christos Th.; Karamanis, Eirinaios; Koulouvaris, Panayiotis; Papagelopoulos, Panayiotis J.

    2017-01-01

    Introduction: There are limited information and inconclusive results for dual head screw intramedullary hip nails for trochanteric fractures. Therefore, we performed a prospective study to evaluate the healing of fractures, and survival, function, and complications of patients operated with this implant. Methods: We prospectively studied 79 patients (61 women and 18 men; mean age: 84.7 years; range: 65–96 years) with a low-energy trochanteric fracture, treated with a dual head screw intramedullary hip nail from 2013 to 2016. The mean follow-up was 2.1 years (range: 1–3 years); seven patients were lost to follow up. This left 72 patients for further analysis. We evaluated the healing of fractures, and survival, function, and complications of patients. Results: Fracture healing was evident in 70 patients (97.2%) at 2–3 months postoperatively. One patient experienced cut-out and z-effect phenomenon of the head screws. Another patient experienced a periprosthetic femoral diaphysis fracture at the distal tip of the nail. A third patient experienced an acute postoperative superficial skin infection that was treated successfully with wound dressing changes and a course of antibiotics. Sixteen patients (22.2%) deceased within 12 months postoperatively. In the remaining patients, the Harris Hip Score (HHS) at 12 months postoperatively was excellent in 16 (28.6%), good in 23 (41.1%), fair in 10 (17.8%), and poor in 7 patients (12.5%). The function declined after the patients’ fracture. Fair and poor results were related to age > 85 years, poor pre-fracture level of function, and AO/OTA-31-A3 fracture types. Conclusion: The dual head screw intramedullary hip nail is associated with high healing and low complication rates for intertrochanteric fractures. The function of the patients is good or excellent in most cases; however, it declines, especially for those patients with age > 85 years, poor pre-fracture level of function, and AO/OTA-31-A3 fracture types

  11. Dual head screw hip nailing for trochanteric fractures

    Directory of Open Access Journals (Sweden)

    Mavrogenis Andreas F.

    2017-01-01

    Full Text Available Introduction: There are limited information and inconclusive results for dual head screw intramedullary hip nails for trochanteric fractures. Therefore, we performed a prospective study to evaluate the healing of fractures, and survival, function, and complications of patients operated with this implant. Methods: We prospectively studied 79 patients (61 women and 18 men; mean age: 84.7 years; range: 65–96 years with a low-energy trochanteric fracture, treated with a dual head screw intramedullary hip nail from 2013 to 2016. The mean follow-up was 2.1 years (range: 1–3 years; seven patients were lost to follow up. This left 72 patients for further analysis. We evaluated the healing of fractures, and survival, function, and complications of patients. Results: Fracture healing was evident in 70 patients (97.2% at 2–3 months postoperatively. One patient experienced cut-out and z-effect phenomenon of the head screws. Another patient experienced a periprosthetic femoral diaphysis fracture at the distal tip of the nail. A third patient experienced an acute postoperative superficial skin infection that was treated successfully with wound dressing changes and a course of antibiotics. Sixteen patients (22.2% deceased within 12 months postoperatively. In the remaining patients, the Harris Hip Score (HHS at 12 months postoperatively was excellent in 16 (28.6%, good in 23 (41.1%, fair in 10 (17.8%, and poor in 7 patients (12.5%. The function declined after the patients’ fracture. Fair and poor results were related to age > 85 years, poor pre-fracture level of function, and AO/OTA-31-A3 fracture types. Conclusion: The dual head screw intramedullary hip nail is associated with high healing and low complication rates for intertrochanteric fractures. The function of the patients is good or excellent in most cases; however, it declines, especially for those patients with age > 85 years, poor pre-fracture level of function, and AO/OTA-31-A3

  12. Trans trochanteric approach with coronal osteotomy of the great trochanter

    Directory of Open Access Journals (Sweden)

    Steffann Francois

    2015-01-01

    Full Text Available Several surgical approaches could be used in hip arthroplasty or trauma surgery: anterior, anterolateral, lateral, posterior (with or without trochanterotomy, using or not an orthopedic reduction table. Subtrochanteric and extra-capsular trochanteric fractures (ECTF are usually treated by internal fixation with mandatory restrictions on weight bearing. Specific complications have been widely described. Mechanical failures are particularly high in unstable fractures. Hip fractures are a major public health issue with a mortality rate of 12%–23% at 1 year. An alternative option is to treat ECTF by total hip arthroplasty (THA to prevent decubitus complications, to help rapid recovery, and to permit immediate weight bearing as well as quick rehabilitation. However, specific risks of THA have to be considered such as dislocation or cardiovascular failure. The classical approach (anterior or posterior requires the opening of the joint and capsule, weakening hip stability and the repair of the great trochanter is sometimes hazardous. For 15 years, we have been treating unstable ECTF by THA with cementless stem, dual mobility cup (DMC, greater trochanter (GT reattachment, and a new surgical approach preserving capsule, going through the fracture and avoiding joint dislocation. Bombaci first described a similar approach in 2008; our trans fractural digastric approach (medial gluteus and lateral vastus is different. A coronal GT osteotomy is performed when there is no coronal fracture line. It allows easy access to the femoral neck and acetabulum. The THA is implanted without femoral internal rotation to avoid extra bone fragment displacement. With pre-operative planning, cup implantation is easy and stem positioning is adjusted referring to the top of the GT after trial reduction and preoperative planning. The longitudinal osteotomy and trochanteric fracture are repaired with wires and the digastric incision is closed. This variant of Bombaci

  13. Treatment of trochanteric fractures using the Gamma nail

    Directory of Open Access Journals (Sweden)

    Botnaru V.

    2015-02-01

    Full Text Available A retrospective study on 2 years and 4 months (April 2012 - August 2014 on 430 patients admitted with trochanteric fractures in our Clinic. The surgical indications depended on the patients age, degree of osteoporosis, level activity, associated pathologies and the anatomo-clinical particularity of the fractures. The fractures were operated with gamma nail. The surgery was done in the first 24-72 hours, patients were followed clinically and radiographically at 2, 4, 6 months postoperative. The age of the patients were between 28-95 years, female sex was predominant in 65% of case. It was reported a case of a fracture produced intraoperatory during progression of the nail, 11 bronhopulmonary complications, 5 phlebitis, 7 cases of hematoma after surgery, a case of pseudarthrosis with loosening of implant and 4 dead. There were no septic complications. Fractures consolidate within 12- 14 weeks. The results were appreciated according to fracture reduction, stability of implant, consolidation time and possibility of walking and weight bearing on operated limb.

  14. Traumatic subchondral fracture of the femoral head in a healed trochanteric fracture.

    Science.gov (United States)

    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.

  15. Unusual Presentation of Pseudoaneurysm with Trochanteric Fracture Femur with Associated Long-Term Antiepileptic Therapy

    Directory of Open Access Journals (Sweden)

    Nipun Rana

    2014-01-01

    Full Text Available Arterial injury following impalement due to a trochanteric hip fracture-fragment per se has been documented rarely. We report a case of pseudoaneurysm of profunda femoris artery at the first perforator branch in a 48-year-old male, with trochanteric hip fracture following a fall during an epileptic episode. Persistent recalcitrant pain, globular swelling in the groin, unexplained drop in the haemoglobin level, and color doppler ultrasonography findings were salient features to the diagnosis. Additionally, we collected all reported cases of pseudoaneurysm associated with hip fractures. We reviewed the literature regarding the incidence, treatment, and prognosis for the same. Acute vascular injury was probably caused by the spikes of fractured lesser trochanter which was found to be displaced superomedially. All trochanteric fractures especially those with displaced lesser trochanter fragment should be closely watched for the possibility of vascular injury. Early diagnosis and treatment in a staged manner can prevent the catastrophic vascular event and hence the limb.

  16. Modeling UV Radiation Feedback from Massive Stars. II. Dispersal of Star-forming Giant Molecular Clouds by Photoionization and Radiation Pressure

    Science.gov (United States)

    Kim, Jeong-Gyu; Kim, Woong-Tae; Ostriker, Eve C.

    2018-05-01

    UV radiation feedback from young massive stars plays a key role in the evolution of giant molecular clouds (GMCs) by photoevaporating and ejecting the surrounding gas. We conduct a suite of radiation hydrodynamic simulations of star cluster formation in marginally bound, turbulent GMCs, focusing on the effects of photoionization and radiation pressure on regulating the net star formation efficiency (SFE) and cloud lifetime. We find that the net SFE depends primarily on the initial gas surface density, Σ0, such that the SFE increases from 4% to 51% as Σ0 increases from 13 to 1300 {M}ȯ {pc}}-2. Cloud destruction occurs within 2–10 Myr after the onset of radiation feedback, or within 0.6–4.1 freefall times (increasing with Σ0). Photoevaporation dominates the mass loss in massive, low surface density clouds, but because most photons are absorbed in an ionization-bounded Strömgren volume, the photoevaporated gas fraction is proportional to the square root of the SFE. The measured momentum injection due to thermal and radiation pressure forces is proportional to {{{Σ }}}0-0.74, and the ejection of neutrals substantially contributes to the disruption of low mass and/or high surface density clouds. We present semi-analytic models for cloud dispersal mediated by photoevaporation and by dynamical mass ejection, and show that the predicted net SFE and mass loss efficiencies are consistent with the results of our numerical simulations.

  17. Factors influencing period from surgery to discharge in patients with femoral trochanteric fractures

    OpenAIRE

    Shinoda, Soichiro; Mutsuzaki, Hirotaka; Watanabe, Arata; Morita, Hidetaka; Kamioka, Yumiko

    2017-01-01

    [Purpose] The purpose of this study was to investigate factors influencing the period from surgery to discharge in patients with femoral trochanteric fractures. [Subjects and Methods] Sixty patients with femoral trochanteric fractures were investigated retrospectively. Based on the mean period from surgery to discharge (85.6 ± 26.6 days), the patients were divided into two groups: an under-85-day group (range, 29–78 days) and an over-85-day group (87–128 days). Age, gender, fracture type, pre...

  18. MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Andrew; Van der Vliet, Andrew [Regional Imaging Border, Albury, NSW (Australia); Zadow, Steven [Dr Jones and Partners Medical Imaging, Adelaide, SA (Australia)

    2007-07-15

    Greater trochanteric pain syndrome is commonly due to gluteus minimus or medius injury rather than trochanteric bursitis. Gluteal tendinopathy most frequently occurs in late-middle aged females. In this pictorial review the pertinent MRI and US anatomy of the gluteal tendon insertions on the greater trochanter and the adjacent bursae are reviewed. The direct (peritendinitis, tendinosis, partial and complete tear) and indirect (bursal fluid, bony changes and fatty atrophy) MRI signs of gluteal tendon injury are illustrated. The key sonographic findings of gluteal tendinopathy are also discussed. (orig.)

  19. Circumferential wires as a supplement to intramedullary nailing in unstable trochanteric hip fractures

    DEFF Research Database (Denmark)

    Ban, Ilija; Birkelund, Lasse; Palm, Henrik

    2012-01-01

    Fixation of unstable trochanteric fractures is challenging. Application of a circumferential wire may facilitate bone contact and avoid postoperative fracture displacement. However, the use of circumferential wires remains controversial due to possible disturbance of the blood supply to the under......Fixation of unstable trochanteric fractures is challenging. Application of a circumferential wire may facilitate bone contact and avoid postoperative fracture displacement. However, the use of circumferential wires remains controversial due to possible disturbance of the blood supply...... to the underlying bone. We evaluated the results of applied circumferential wires, concentrating mainly on complications and reoperations....

  20. Giant Overlap between the Magnetic and Superconducting Phases of CeAu_{2}Si_{2} under Pressure

    Directory of Open Access Journals (Sweden)

    Z. Ren

    2014-09-01

    Full Text Available High pressure provides a powerful means for exploring unconventional superconductivity which appears mostly on the border of magnetism. Here, we report the discovery of pressure-induced heavy-fermion superconductivity up to 2.5 K in the antiferromanget CeAu_{2}Si_{2} (T_{N}≈10  K. Remarkably, the magnetic and superconducting phases are found to overlap across an unprecedentedly wide pressure interval from 11.8 to 22.3 GPa. Moreover, both the bulk T_{c} and T_{M} are strongly enhanced when increasing the pressure from 16.7 to 20.2 GPa. T_{c} reaches a maximum at a pressure slightly below p_{c}≈22.5  GPa, at which magnetic order disappears. Furthermore, the scaling behavior of the resistivity provides evidence for a continuous delocalization of the Ce 4f electrons associated with a critical end point lying just above p_{c}. We show that the maximum T_{c} of CeAu_{2}Si_{2} actually occurs at almost the same unit-cell volume as that of CeCu_{2}Si_{2} and CeCu_{2}Ge_{2}, and when the Kondo and crystal-field splitting energies become comparable. Dynamical mean-filed theory calculations suggest that the peculiar behavior in pressurized CeAu_{2}Si_{2} might be related to its Ce-4f orbital occupancy. Our results not only provide a unique example of the interplay between superconductivity and magnetism, but also underline the role of orbital physics in understanding Ce-based heavy-fermion systems.

  1. Treatment of unstable trochanteric fractures : the balance between man and material

    NARCIS (Netherlands)

    I.B. Schipper (Inger)

    2003-01-01

    textabstractTreatment of unstable trochanteric fractures poses a challenge to surgeons in many ways. Accepting this challenge requires understanding of those parameters that determine the outcome. In operative fracture care at least four elements influence the outcome of treatment: the patient, the

  2. Perioperative lateral trochanteric wall fractures: sliding hip screw versus percutaneous compression plate for intertrochanteric hip fractures.

    Science.gov (United States)

    Langford, Joshua; Pillai, Gita; Ugliailoro, Anthony D; Yang, Edward

    2011-04-01

    This study was performed to determine the incidence of perioperative lateral wall fractures with a standard sliding hip screw (SHS) versus a percutaneous compression plate (PCCP) using identical meticulous closed reduction techniques in both groups. Retrospective analysis of a prospective trauma registry. Urban Level I trauma center. Over a 7-year period, 337 patients with intertrochanteric hip fractures were treated with either a SHS or a PCCP at our institution. The PCCP group (Group 1) consisted of 200 patients, of which 141 (71%) had adequate images to be included in the study. The SHS group (Group 2) consisted of 137 patients, of which 100 (73%) had adequate images to be included in the study. Closed reduction and plate application with either a standard sliding hip screw or a percutaneous compression plate for an Orthopaedic Trauma Association 31A1 or 31A2 intertrochanteric hip fracture. : Radiographic evidence of lateral trochanteric wall fracture as measured by intraoperative and perioperative radiographs. There was an overall lateral wall fracture incidence of 20% in the SHS group versus 1.4% in the PCCP group (P fracture types, there was a lateral wall fracture incidence of 29.8% in the SHS group versus 1.9% in the PCCP group (P trochanteric wall fracture compared with the SHS group. This difference became greater when just unstable intertrochanteric fractures were analyzed. An anatomic reduction, combined with a device (PCCP) that uses small-diameter defects in the lateral trochanteric wall, essentially eliminates perioperative lateral trochanteric wall fractures.

  3. Treatment of Unstable Trochanteric Femur Fractures: Proximal Femur Nail Versus Proximal Femur Locking Compression Plate.

    Science.gov (United States)

    Singh, Ashutosh Kumar; Narsaria, Nidi; G R, Arun; Srivastava, Vivek

    Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients). Perioperative data and complications were recorded. All cases were followed up for 2 years. The groups did not differ significantly (P > .05) in operative time, reduction quality, complications, hospital length of stay, union rate, or time to union. Compared with the PFLCP group, the PFN group had shorter incisions and less blood loss. Regarding functional outcomes, there was no significant difference in mean Harris Hip Score (P = .48) or Palmer and Parker mobility score (P = .58). Both PFN and PFLCP are effective in internal fixation of unstable trochanteric femur fractures.

  4. Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail.

    NARCIS (Netherlands)

    Schipper, I.B.; Steyerberg, E.W.; Castelein, R.M.; Heijden, F.H. van der; Hoed, P.T. den; Kerver, A.J.; Vugt, A.B. van

    2004-01-01

    The proximal femoral nail (PFN) is a recently introduced intramedullary system, designed to improve treatment of unstable trochanteric fractures of the hip. In a multicentre prospective clinical study, the intra-operative use, complications and outcome of treatment using the PFN (n = 211) were

  5. Elderly patient's mortality and morbidity following trochanteric fracture. A prospective study of 100 cases.

    Science.gov (United States)

    Mnif, H; Koubaa, M; Zrig, M; Trabelsi, R; Abid, A

    2009-11-01

    Trochanteric fractures are a major source of mortality, morbidity and functional impairment in the elderly. Morbidity is closely related to the degree of instability and comminution and is substantially influenced by the quality of reduction and internal fixation. Advanced age and associated co-morbidities are two decisive factors of mortality secondary to trochanteric fracture. This prospective study examined the epidemiological profile of trochanteric fractures and assessed mortality and morbidity with the aim of establishing management guidelines and improving prevention strategies. One hundred patients were included; 60% were male. Mean age was 76 years (range, 60-96 yrs). One, or more than one, co-morbidities were present in 68% of cases. The fractures were caused by a simple fall in 90% of cases. Fractures were classified according to the criteria of Ramadier and the ones of Ender. Sixty-five percent of these fractures were unstable. A dynamic hip screw was systematically used as the standard means of internal fixation. Anatomic and functional results were analyzed in 82 patients (18 had died within the first year following fracture occurrence). Mean follow-up period was 24 months (range, 12-36 months). Bone healing was achieved in 96% of cases. There were numerous postoperative complications (four cases of thromboembolism, fourteen immobility-related complications, two infections, six secondary displacement combined to loss of fixation, four non-unions, and nine malunions). At 2 years follow-up, 28 patients had died. Mortality was strongly correlated with older age (over 90 years), associated co-morbidity and fracture instability. Good functional outcomes (72%) correlated with younger age (60-74 years), fracture stability, adequate reduction and internal fixation. In stable trochanteric fractures, osteosynthesis by dynamic screw-plate is more effective than alternative techniques (blade-plate, nail-plate, Ender nail or even trochanteric nail). In unstable

  6. Giant Chancroid

    Directory of Open Access Journals (Sweden)

    Bhushan Kumar

    1980-01-01

    Full Text Available A case of giant chancroid following rupture of inguinal bubo and having systemic symptoms is described. Response with sulfa and streptomycin combination was excellent and the lesion healed completely in 3 weeks. Early diagnosis and treatment of chancroid will prevent this debilitating complication.

  7. Giant microelectronics

    International Nuclear Information System (INIS)

    Della Sala, D.; Privato, C.; Di Lazzaro, P.; Fortunato, G.

    1999-01-01

    Giant microelectronics, on which the technology of flat liquid-crystal screens is based, is an example of fruitful interaction among independently-developed technologies, in this case thin film micro devices and laser applications. It typifies the interdisciplinary approach needed to produce innovations in microelectronics [it

  8. Fixation of Trochanteric Fragments in Cementless Bipolar Hemiarthroplasty of Unstable Intertrochanteric Fracture: Cerclage Wiring.

    Science.gov (United States)

    Lee, Young-Kyun; Park, Chan Ho; Koo, Kyung-Hoi

    2017-12-01

    Bipolar hemiarthroplasty (HA) is an option for the treatment of unstable intertrochanteric fracture in elderly patients. There is a raising concern regarding cable-grip related complications for the fixation of trochanteric fragments. Therefore, the aim of this study was to evaluate outcome of cementless HA with fixation for the trochanteric fragments using monofilament wires in unstable intertrochanteric fracture. We reviewed 92 cementless bipolar HAs using a grit-blasted long stem design for unstable intertrochanteric fractures in 91 elderly patients with a mean age of 81.7 years. During the arthroplasty, trochanteric fracture fragments were fixed using 1 or 2 vertical wires and transverse wires. We evaluated the clinical outcomes such as abductor power, ambulatory ability and wire-related complications, and radiologic outcomes including the union of the trochanteric fragment and subsidence of stem. Sixty-two patients were followed for a minimum of 2 years (mean, 59 months) postoperatively. The mean abductor power and Koval category was 4.1 (range, 3 to 5) and 4.6 (range, 1 to 6). The wire was broken in 3 hips (4.8%) and the nonunion of the greater trochanter occurred in 1 hips (1.6%). Two stems subsided by 3 mm and 8 mm, respectively, during postoperative 6 weeks, after which the subsidence was not progressive. Cerclage wiring of the trochanter using monofilament wire leads to acceptable outcome in cementless HA for senile patients with unstable intertrochanteric fracture. Cerclage wiring using a monofilament wire is recommended for the fixation of trochanteric fragments.

  9. Giant paraganglioma in

    Directory of Open Access Journals (Sweden)

    Alka Gupta

    2017-07-01

    Full Text Available Paraganglioma is a rare neuroendocrine catecholamine producing tumour in childhood which arises outside the adrenal medulla. We present a 12 year old girl with giant paraganglioma with severe hypertension and end organ damage. Diagnosis was confirmed with 24 h urinary Vanillymandelic Acid (VMA and CT scan. Preoperative blood pressure was controlled with intravenous nitroprusside, and oral prazosin, amlodepine, labetalol and metoprolol. General anaesthesia with epidural analgesia was given. Intra operative blood pressure rise was managed with infusion of nitriglycerine (NTG, esmolol, nitroprusside and propofol.

  10. Influence of Lateral Muscle Loading in the Proximal Femur after Fracture Stabilization with a Trochanteric Gamma Nail (TGN)

    Science.gov (United States)

    Sitthiseripratip, Kriskrai; Mahaisavariya, Banchong; Suwanprateeb, Jintamai; Bohez, Erik; Vander Sloten, Jos

    The purpose of this study was to investigate the influence of lateral muscle loading on the stress/strain distributions of the trochanteric Gamma nail (TGN) fixation within the healed, trochanteric and subtrochanteric femoral fractures by means of a finite element method. The effect of three muscle groups, the abductors (ABD), the vastus lateralis (VL) and the iliotibial band (ITB), were investigated. The analytical results showed that addition of lateral muscle forces, iliotibial band and vastus lateralis, produced compensation of forces and reduction of bending moments in the bone and in the trochanteric Gamma nail especially in the lateral aspect. The iliotibial band produced a higher impact as compared to the vastus lateralis. Therefore in the finite element analysis of the proximal femur with the trochanteric Gamma nail fracture fixation should include the lateral muscle forces to simulate load condition with maximal physiological relevance to the closed nailing technique.

  11. Giant arachnoid granulation in a patient with benign intracranial hypertension

    International Nuclear Information System (INIS)

    Kiroglu, Yilmaz; Yaqci, Baki; Cirak, Bayram; Karabulut, Nevzat

    2008-01-01

    We report magnetic resonance (MR), computed tomography (CT) and angiographic imaging of an unusual giant arachnoid granulation in the superior sagittal sinus in a man with headache and vertigo. Intrasinus pressure measurements revealed a significant pressure gradient across the lesion. MR imaging is useful to identify giant arachnoid granulation and dural sinus thrombosis, whereas dural sinus pressure measurement in certain cases of giant arachnoid granulations can be used to evaluate the lesion as the cause of the patient's symptoms. (orig.)

  12. Giant arachnoid granulation in a patient with benign intracranial hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Kiroglu, Yilmaz; Yaqci, Baki; Cirak, Bayram; Karabulut, Nevzat [Pamukkale University, Department of Radiology, School of Medicine, Denizli (Turkey)

    2008-10-15

    We report magnetic resonance (MR), computed tomography (CT) and angiographic imaging of an unusual giant arachnoid granulation in the superior sagittal sinus in a man with headache and vertigo. Intrasinus pressure measurements revealed a significant pressure gradient across the lesion. MR imaging is useful to identify giant arachnoid granulation and dural sinus thrombosis, whereas dural sinus pressure measurement in certain cases of giant arachnoid granulations can be used to evaluate the lesion as the cause of the patient's symptoms. (orig.)

  13. [The rotationally stable screw-anchor with trochanteric stabilizing plate (RoSA/TSP) : First results in unstable trochanteric femur fractures].

    Science.gov (United States)

    Maier, K-J; Bücking, B; Horst, K; Andruszkow, H; Hildebrand, F; Knobe, M

    2017-12-01

    In unstable trochanteric fractures, the extramedullary rotationally stable screw-anchor (RoSA) combines the benefits of the load and rotational stability of the blade with the advantages of the screw (pull-out resistance, compression capability) in a single load carrier, and was designed to prevent femoral neck shortening by using an additional locked trochanteric stabilizing plate (TSP). The aim of the current prospective cohort study was the clinical evaluation of the RoSA/TSP system regarding the mechanical re-operation rate and the amount of postoperative femoral neck shortening. From September 2011 to January 2014 80 patients with unstable trochanteric fractures underwent internal extramedullary fixation with the RoSA/TSP (Königsee Implantate GmbH, Allendorf, Germany). Due to fracture stability and after induction of compression, additional long locked antitelescoping screws (AT, n = 1-4) were placed reaching the femoral head. Radiological (femoral neck shortening) and clinical re-examination of patients (n = 61) was performed 6-10 weeks and 6-10 months later. In the 61 re-examined patients (76 %) femoral neck shortening was very low with 2 mm 6-10 months after operation. Re-operations occurred in 8 % (n = 6) and in 4 % (n = 3) as prophylactic surgical intervention. Whereas one-third (4 %) of re-operations occurred due to iatrogenic surgical problems from the first operation two-thirds of patients (8 %) had a re-operation due to delay of bone union (3× nonunion, 3 planned removals of AT-screws to improve healing). The in-hospital mortality was 3 % (n = 2). The fixation of unstable trochanteric femur fractures using the RoSA/TSP in a first clinical setting led to a great primary stability, with significant advantages with regard to limited femoral neck shortening. However, the rigidity of the construct with its consequences regarding bone healing can be challenging for the surgeon. Nevertheless, in some cases of revision it could be beneficial

  14. Trochanteric Fixation With a Third-Generation Cable-Plate System: An Independent Experience.

    Science.gov (United States)

    Stewart, Andrew D; Abdelbary, Hesham; Beaulé, Paul E

    2017-09-01

    Greater trochanteric fracture/nonunion can be a devastating complication with significant functional impact after total hip arthroplasty, and their fixation remains a challenge because of the significant forces being transmitted as well as the poor bone quality often associated with these fractures. The objective of this study is to investigate the rates of reoperation and trochanteric nonunion using a third-generation cable-plate system at one center. Thirty-five patients, mean age 72.9 years (range 46-98 years) with 24 women and 11 men, underwent fixation of their fractured greater trochanter using a third-generation cable-plate system. The indications were: periprosthetic fracture (n = 17), complex primary arthroplasty (n = 5), and complex revision arthroplasty (n = 13). Primary outcomes included rates of reoperation and radiographic union. At a mean follow-up of 2.5 years, trochanteric union rate was 62.9% with nonunion rate of 31.4%, and fibrous union in 5.7%. In regard to quality of initial apposition, only 40% achieved a perfect bone on bone reduction. Ten patients (28.6%) had evidence of wire breakage. Five patients (14.3%) required reoperation and removal of the internal fixation because of lateral hip pain. Fixation of the trochanteric fractures remains a challenge with a relatively high reoperation rate. Poor bone quality and capacity to maintain a stable reduction continue to make this complication after total hip arthroplasty a difficult problem to solve. Copyright © 2017. Published by Elsevier Inc.

  15. Extent and Morbidity of Lateralization of a Trochanteric Fixation Nail Blade.

    Science.gov (United States)

    Sandifer, Phillip A; Hulick, Robert M; Graves, Matthew L; Spitler, Clay A; Russell, George V; Hydrick, Josie M; Jones, LaRita C; Bergin, Patrick F

    2017-09-01

    This study examined the incidence and risk factors associated with lateral helical blade migration and trochanteric pain with the trochanteric fixation nail. A retrospective review was performed of 141 cases of pertrochanteric femur fracture treated with a trochanteric fixation nail at a level I trauma center over a period of 42 months. Exclusion criteria included follow-up of less than 60 days, preexisting osteonecrosis of the femoral head, and prophylactic trochanteric fixation nail treatment. Patient demographics, operative findings, and radiographic findings were recorded. Medical records were reviewed to identify symptomatic hardware. Overall, 27 patients (19.1%) were symptomatic, and 3 (2.1%) required revision surgery for blade prominence. Of the patients, 42 (30%) had lateralization of greater than 1 cm, and 16 of these (38.1%) were symptomatic (Pfractures showing lateralization of greater than 1 cm. The quality of calcar reduction nearly reached statistical significance, and 44.8% of patients who had inadequate reduction had lateralization of greater than 1 cm compared with 26.4% of patients who had adequate reduction (P=.054). Lateralization of greater than 1 cm was directly associated with the presence of symptoms (Ptrochanteric pain (P=.007). Multivariate analysis showed that increasing tip-apex distance, inadequate calcar reduction, and greater fracture severity were predictive of excessive lateralization of greater than 1 cm. Nearly 20% of patients had lateral hip pain associated with cephalomedullary fixation. Final lateralization of the helical blade of greater than 1 cm was a very strong predictor of symptoms. During preoperative counseling, surgeons should caution patients about this relatively frequent and likely underreported complication. [Orthopedics. 2017; 40(5):e886-e891.]. Copyright 2017, SLACK Incorporated.

  16. Calcar femorale grafting in the hemiarthroplasty of the hip for unstable inter trochanteric fractures.

    Science.gov (United States)

    Thakkar, Chandrashekar J; Thakkar, Savyasachi; Kathalgere, Rajshekhar T; Kumar, Malhar N

    2015-01-01

    The sliding screw-plate devices and cephalo-medullary nail devices have performed well in stable inter-trochanteric fractures in patients with reasonably good quality of bone. However, their suboptimal performance in comminuted fractures in the presence of osteoporotic bone has prompted many surgeons to consider bipolar hemiarthroplasty as the primary modality of management of comminuted inter-trochanteric fractures in elderly patients. However, long term stability of the hemiarthroplasty implant also may be compromised due to the presence of postero-medial bone loss at the area of the calcar. We have presented a simple and effective technique of calcar grafting by harvesting cortical bone strut from the neck of the fractured femur. A total of 34 patients with inter-trochanteric fractures of the femur were treated with calcar grafting. The mean age was 79.2 years. The graft was harvested from the calcar region of the head and neck fragment of the femur and wedged between the medial femoral cortex and medial edge of the prosthesis. The mean followup period was 54.5 months. In 32 of 34 (94%) patients in our series, the calcar graft healed well without dislodgement. There was graft resorption in two patients associated with subsidence of the implant and loosening. Calcar grafting using this technique provides stability to the implant in the presence of comminution and incorporates well in the majority of patients. Donor site morbidity of graft harvesting is also avoided.

  17. Modeling and simulation of flow field in giant magnetostrictive pump

    Science.gov (United States)

    Zhao, Yapeng; Ren, Shiyong; Lu, Quanguo

    2017-09-01

    Recent years, there has been significant research in the design and analysis of giant magnetostrictive pump. In this paper, the flow field model of giant magnetostrictive pump was established and the relationship between pressure loss and working frequency of piston was studied by numerical simulation method. Then, the influence of different pump chamber height on pressure loss in giant magnetostrictive pump was studied by means of flow field simulation. Finally, the fluid pressure and velocity vector distribution in giant magnetostrictive pump chamber were simulated.

  18. Does a trochanteric lag screw improve fixation of vertically oriented femoral neck fractures? A biomechanical analysis in cadaveric bone.

    Science.gov (United States)

    Hawks, Michael A; Kim, Hyunchul; Strauss, Joseph E; Oliphant, Bryant W; Golden, Robert D; Hsieh, Adam H; Nascone, Jason W; O'Toole, Robert V

    2013-10-01

    We assessed the biomechanical performances of a trochanteric lag screw construct and a traditional inverted triangle construct in the treatment of simulated Pauwels type 3 femoral neck fractures. An inverted triangle construct (three 7.3-mm cannulated screws placed in inverted triangle orientation) and a trochanteric lag screw construct (two 7.3-mm cannulated screws placed across the superior portion of the femoral neck and one 4.5-mm lag screw placed perpendicular to the fracture in superolateral to inferomedial orientation) were tested in nine matched pairs of non-osteoporotic human cadaveric femora. We used a previously described vertically oriented femoral neck fracture model and testing protocol that incrementally loaded the constructs along the mechanical axis of the femur to 1400 N. Specimens that survived incremental loading underwent cyclic loading. Apparent construct stiffness, force at 3mm of displacement, and survival of incremental loading were recorded. The trochanteric lag screw group had a 70% increase in stiffness (261 N/mm [29 standard deviation] versus 153 N/mm [16 standard deviation]; P=0.026) and a 43% increase in force required for displacement (620 N versus 435 N; P=0.018) compared with the inverted triangle group. One trochanteric lag screw and no inverted triangle specimen survived incremental loading. A trochanteric lag screw construct applied to vertically oriented femoral neck fractures provides marked improvement in mechanical performance compared with the inverted triangle construct. © 2013.

  19. Hip fracture and anthropometric variations: dominance among trochanteric soft tissue thickness, body height and body weight during sideways fall.

    Science.gov (United States)

    Majumder, Santanu; Roychowdhury, Amit; Pal, Subrata

    2013-01-01

    Hip fracture depends on various anthropometric parameters such as trochanteric soft tissue thickness, body height and body weight. The objective was to evaluate the responses to the variations in anthropometric parameters during sideways fall, and to identify the most dominant parameter among them. Seven finite element models were developed having anthropometric variations in trochanteric soft tissue thickness (5-26 mm), body height (1.70-1.88 m), and body weight (63-93.37 kg). These were simulated for sideways fall with ANSYS-LS-DYNA® code. Significant effect of trochanteric soft tissue thickness variation was found on 'normalized peak impact force with respect to the body weight' (p=0.004, r²=0.808) and strain ratio (p=0.083, r²=0.829). But, variation in body height was found to be less significant on normalized peak impact force (p=0.478, r²=0.105) and strain ratio (p=0.292, r²=0.217). Same was true for the variation in body weight on normalized peak impact force (p=0.075, r²=0.456) and strain ratio (p=0.857, r²=0.007). The risk factor for fracture was also well correlated to the strain ratio for the inter-trochanteric zone (pfractures are clinically observed to happen. Trochanteric soft tissue thickness was found likely to be the most dominant parameter over body height and body weight, signifying that a slimmer elderly person, taller or shorter, with less trochanteric soft tissue thickness should be advised to take preventive measures against hip fracture under sideways fall. © 2013.

  20. Quantitative ultrasound parameters as well as bone mineral density are better predictors of trochanteric than cervical hip fractures in elderly women. Results from the EPIDOS study.

    Science.gov (United States)

    Schott, A M; Hans, D; Duboeuf, F; Dargent-Molina, P; Hajri, T; Bréart, G; Meunier, P J

    2005-12-01

    Hip fractures can be separated into cervical and trochanteric fractures. Trochanteric fractures have been associated with up to twice the short-term mortality of cervical fractures in the elderly. There is also evidence suggesting that the mechanisms are different. Evidence from the literature remains limited on the predictive power of bone mineral density (BMD) and quantitative ultrasounds (QUS) for both types of hip fractures. 5703 elderly women aged 75 years or more, who were recruited from the voting lists in the EPIDOS study, and had baseline calcaneal ultrasounds (QUS) and DXA measurements at the hip and the whole body, were analyzed in this paper. Among those, 192 hip fractures occurred during an average follow-up of 4 years, 108 cervical and 84 trochanteric fractures. Femoral neck, trochanteric and whole body BMD were able to predict trochanteric hip fracture (RR's and 95% CI were, respectively, 3.2 (2.4-4.2); 4.8 (3.5-6.6); and 2.8 (2.2-3.6)) more accurately than cervical fractures (respectively, 2.1 (1.7-2.7); 2.3 (1.8-3.0); 1.2 (1.0-1.6)). All ultrasound parameters, SOS, BUA, and stiffness index (SI) were significant predictors of trochanteric (RR's respectively 3.0 (2.2-4.1), 2.5(2.0-3.1), and 3.5(2.6-4.7)) but not cervical fractures. After adjustment for femoral neck or trochanteric BMD ultrasound parameters were still significant predictors of trochanteric fracture, and stiffness tended to be a better predictor of trochanteric fractures than either BUA or SOS with a relative risk of 2.25 (1.6-3.1). A significant decrease of all bone measurements, BMD and QUS, was highly predictive of trochanteric fractures, whereas a decrease of femoral neck and trochanteric BMD were only associated with a slight increase in cervical fracture risk and a low total body BMD or QUS parameters were not significant predictors of cervical fractures. In women who sustained a hip fracture, the decrease of BMD and QUS values increases the risk of trochanteric fracture as

  1. [Posterior partial trochanteric osteotomy for the treatment of the roof involved acetabular fractures].

    Science.gov (United States)

    Wang, Pan-Feng; Xu, Shuo-Gui; Zhang, Chun-Cai; Fu, Qing-Ge; Zhang, Yun-Tong; Liu, Xin-Wei; Niu, Yun-Fei; Tang, Yang

    2013-11-01

    To introduce a new trochanteric osteotomy,and evaluate the outcome of the procedure combined a posterior lateral approach in treating acetabular fractures which involving the roof. Between March 2007 and Novmber 2010,30 patients with displaced acetabular fractures involving the dome need trochanteric osteotomy were retrospectively reviewed. There were 21 males and 9 females,ranging in age from 18 to 70 years with an average of 35.2 years at the time of injury. According to Letournel-Judet classification, there were 10 posterior wall fractures,7 posterior column fractures,5 transverse fractures, 2 T-shape fractures, 1 transverse associated with posterior wall fracture, 3 posterior column and wall fractures and 2 bicolumn fractures. The standards of Matta,the modified Merle d'Aubigne-Postel, Medical Research Council were respectively used to evaluate the reduction result, function of hip joint and the strength of hip abduction. All patients were followed up with an average time of 25 months (18 to 40) and all osteotomy sites obtained bone union with an average time of 8.4 weeks (6 to 12). No bone non-union, bone block displaceing, internal fixation looseing and breaking,infection of deep part were found. Seventeen patients got anatomic reduction, 12 got satisfied reduction, and 1 got unsatisfied result according to the criteria of Matta. At final follow-up, function of hip joint obtained excellent results in 11 cases, good in 15, fair in 3 and poor in 1. The strength of the abductors of 3 patients were grade 4 and 27 patients were grade 5. Posterior partial great trochanteric osteotomy can enhance the exposure and provide a more accurate reduction and degrade the difficulty of acetabular fracture fixation without increasing the risk of complications. The method provide a new way for the treatment of the roof involved acetabular fractures.

  2. The role of trochanteric flip osteotomy in fixation of certain acetabular fractures.

    Science.gov (United States)

    Gupta, Sandeep; Singh, Jagdeep; Virk, Jagandeep Singh

    2017-06-01

    Complete visualization of certain acetabular fractures of posterior wall or column with cranial extension involving superior dome from standard surgical exposures is a challenge. Osteotomy of the greater trochanter has been used to enhance fracture visualization, especially the dome, in posterior and lateral exposures of the acetabulum. It also decreases the need for excessive muscle retraction. The purpose of the study was to investigate the outcome associated with trochanteric flip osteotomy in the management of certain acetabulum fractures. From January 2011 to December 2013, 25 displaced acetabular fractures were treated by open reduction and internal fixation. The fractures were managed using a Kocher-Langenbeck approach along with trochanteric flip osteotomy. At 3rd, 6th and 24th month follow-up, all patients had radiographic examination and underwent a final clinical evaluation based on the modified Merle d'Aubigne and Postel score. The strength of the abductors was assessed according to the Medical Research Council (MRC) grading system. Congruent reduction was achieved in all patients and all osteotomies healed within an average period of 3.8 months. All our patients were allowed full weight bearing at the end of 3 months and with no abductor lurch at the end of 6 months follow-up. There were no cases of avascular necrosis of femoral head. None of the patients had any neurovascular complication or infection by the end of the follow-up period. Trochanteric flip osteotomy is a very effective technique to fix certain acetabular fractures especially those with dome involvement. It is more accurate and associated with no significant complications compared with conventional way. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  3. [Bilateral pathological sub-trochanteric fracture in a long-term biphosphonate user].

    Science.gov (United States)

    Kľoc, P; Tomčovčík, L; Kľoc, J

    2011-01-01

    The number of papers reporting the occurrence of specific pathological fractures in long-term biphosphonate users has recently increased. They refer to the forms of stress fracture probably resulting from an extreme decrease in bone turnover, which may involve sub-trochanteric or isolated transverse fractures, or short transverse fractures with a unicortical beak in an area of cortical hypertrophy. At the time of prodromal signs and symptoms, cortical bone at the site of impeding fracture appears rougher on radiographs. Gradually, an incomplete fracture develops, with a subsequent complete fracture often sustained without any mechanism of injury noted. The occurrence of such fractures is reported in the range of 2 to 8 years from the start of biphosphonate use. The fractures are often bilateral and, at the time the first occurs, it is often possible to diagnose contralateral pathological changes similar to those before the first fracture. The paper presents the case of a female patient who sustained a bilateral pathological sub-trochanteric fracture; the first fracture occurred after 5 and the other after 9 years of Rizendronat use. She was followed up for unilateral incomplete sub-trochanteric fracture from the fourth year of its use. In that period, magnetic resonance imaging showed a pathological finding in the contralateral extremity. She had already had prodromal signs manifested as lasting hip pain before the first fracture. Both fractures were surgically treated. Thirty-three months later she had to undergo repeat surgery for pseudoarthrosis at the site of the first fracture. The pseudoarthrosis healed without complications. However, in the second fracture non-union was still present at 7 months after surgery. The patient took Rizendronat during the whole treatment period and thereafter. In the discussion, certain aspects of long-term biphosphonate use are addressed, as well as some preventive, diagnostic and therapeutic procedures related to this rare

  4. PROXIMAL FEMURAL VALGUS SUBTROCHANTERIC OSTEOTOMY FOR NON UNION OF TROCHANTERIC FRACTURES.

    Science.gov (United States)

    Silva, Paulo; Coelho, Danilo Lopes; Curi, Calim; de Oliveira, Leandro Alves; de Moraes, Frederico Barra; do Amaral, Rogério Andrade; Rebello, Percival Rosa

    2012-01-01

    To evaluate valgus subtrochanteric osteotomy for the treatment of trochanteric non-union. A retrospective study of cases series. From 1998 September to 2009 January, seventeen (17) cases with a diagnosis of non-union of trochanteric fracture were re-operated by the hip group of the Ortophaedic And Traumatology service of the Hospital Geral de Goiania (HGG). The patients presented pain at the fracture site, a femoral varus angle of less than 120°, and non-union of the fracture in the 3(rd) months after the initial surgery. Patients with ages ranging from 30 to 73 years, with a maximum follow-up of 09 years and minimum of 09 years. The mean time from first surgery to osteotomy was six months. Bone union was observed in 16 patients, with a mean union time of 12 weeks after surgery. The mean hip varus angle was 105(0) (120(0) to 90(0)). After surgery, the mean hip valgus angle was 144(0) (155(0) to 135(0)). We had one unsuccessful case; a 78-year old patient who had osteogtomy, fixed with DHS of 150(0), with valgization to 154(0). After six months of follow-up without union of the fracture, it was decided to perform total cemented hip artroplasthy, without complications. Valgus subtrochanteric osteotomies can be indicated for the treatment of trochanteric treatment of pseudoarthroses, with good final results for bone union, avoiding the need for total hip artroplasthy and maintaining biological fixation, as well as reestablishing the mechanical and anatomical axis of the affected limb.

  5. Breakage of cephalomedullary nailing in operative treatment of trochanteric and subtrochanteric femoral fractures.

    Science.gov (United States)

    von Rüden, Christian; Hungerer, Sven; Augat, Peter; Trapp, Oliver; Bühren, Volker; Hierholzer, Christian

    2015-02-01

    Mechanical breakage of cephalomedullary nail osteosynthesis is a rare complication attributed to delayed fracture union or nonunion. This study presents a series of cases of breakage and secondary lag screw dislocation after cephalomedullary nailing. The aim of this study was to identify factors that contribute to cephalomedullary nail breakage. In a retrospective case series review between 02/2005 and 12/2013, we analyzed 453 patients with trochanteric and subtrochanteric fracture who had been treated by cephalomedullary nailing. Fractures were classified according to AO/OTA classification. 13 patients with cephalomedullary nail breakage were included (failure rate 2.9 %). Seven patients were women, and six men with a mean age of 72 years (range 35-94). Implant breakage occurred 6 months postoperatively (range 1-19 months). In ten cases, breakage was secondary to delayed or nonunion, which was thought to be mainly due to insufficient reduction of the fracture, and in two cases due to loss of the lag screw because of missing set screw. In one case, breakage was apparent during elective metal removal following complete fracture healing. Short-term outcome was evaluated 6 months after operative revision using Harris hip score in 11 out of 13 patients showing a mean score of 84 %. Complete radiological fracture healing has been found in 11 patients available for follow-up within 6 months after revision surgery. Breakage of cephalomedullary nail osteosynthesis of trochanteric fractures is a severe complication. The results of our study demonstrate that revision surgery provides good clinical and radiological short-term results. Predominately, failures of trochanteric fractures are related to lack of surgeon performance. Therefore, application of the implant requires accurate preoperative planning, advanced surgical experience to evaluate the patient and the fracture classification, and precise surgical technique including attention to detail and anatomical

  6. Comparison of femoral morphology and bone mineral density between femoral neck fractures and trochanteric fractures.

    Science.gov (United States)

    Maeda, Yuki; Sugano, Nobuhiko; Saito, Masanobu; Yonenobu, Kazuo

    2011-03-01

    Many studies that analyzed bone mineral density (BMD) and skeletal factors of hip fractures were based on uncalibrated radiographs or dual-energy xray absorptiometry (DXA). Spatial accuracy in measuring BMD and morphologic features of the femur with DXA is limited. This study investigated differences in BMD and morphologic features of the femur between two types of hip fractures using quantitative computed tomography (QCT). Forty patients with hip fractures with normal contralateral hips were selected for this study between 2003 and 2007 (trochanteric fracture, n=18; femoral neck fracture, n=22). Each patient underwent QCT of the bilateral femora using a calibration phantom. Using images of the intact contralateral femur, BMD measurements were made at the point of minimum femoral-neck cross-sectional area, middle of the intertrochanteric region, and center of the femoral head. QCT images also were used to measure morphologic features of the hip, including hip axis length, femoral neck axis length, neck-shaft angle, neck width, head offset, anteversion of the femoral neck, and cortical index at the femoral isthmus. No significant differences were found in trabecular BMD between groups in those three regions. Patients with trochanteric fractures showed a smaller neck shaft angle and smaller cortical index at the femoral canal isthmus compared with patients with femoral neck fractures. We conclude that severe osteoporosis with thinner cortical bone of the femoral diaphysis is seen more often in patients with trochanteric fracture than in patients with femoral neck fracture. Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

  7. Risks of subsequent contralateral fractures of the trochanteric region in elderly.

    Science.gov (United States)

    Pogliacomi, Francesco; Pellegrini, Andrea; Tacci, Fabrizio; Pedrini, Martina Francesca; Costantino, Cosimo; Pedrazzini, Alessio; Pedrazzi, Giuseppe; Lauretani, Fulvio; Vaienti, Enrico; Ceccarelli, Francesco

    2017-01-16

    Fractures in elderly are always a dramatic event and the healing is often not complete. In a context of bone fragility, repeated fractures are a growing problem in the industrialized world, in which the mean age of population is increasing. The aim of this study was to identify those general factors which may increase the risk of subsequent trochanteric fractures after an initial lesion. Three-hundred and thirty-one patients who underwent intramedullary fixation for trochanteric fractures between January 2012 and December 2013 were studied. Forty subjects yet alive (group 1), affected by a subsequent contralateral hip fracture, were compared with 202 patients (group 2) affected by isolated trochanteric fracture. Days of hospitalization before surgery, hospitalization, period of rehabilitation, type of discharge and comorbidities, that are reported in literature as possible risk factors for hip refracture, were analyzed. In addition, all patients were interviewed in order to assess if a therapy for osteoporosis was prescribed after the initial fracture and how their gait had been modified by fractures. Days of hospitalization before surgery, hospitalization, period of rehabilitation and type of discharge were not predictive factors for subsequent fractures, as well as diabetes mellitus, hypertension and cardiac diseases. The presence of neurologic and respiratory diseases were associated to a higher risk of refractures, as well as the absence of specific medical treatment for osteoporosis. Neurologic and respiratory comorbidities and the absence of osteoporosis medical treatment are the variables associated to a higher risk of contralateral fractures. Physicians can do more in terms of prevention and strategies must consider these risk factors.

  8. Trochanteric fracture-implant motion during healing - A radiostereometry (RSA) study.

    Science.gov (United States)

    Bojan, Alicja J; Jönsson, Anders; Granhed, Hans; Ekholm, Carl; Kärrholm, Johan

    2018-03-01

    Cut-out complication remains a major unsolved problem in the treatment of trochanteric hip fractures. A better understanding of the three-dimensional fracture-implant motions is needed to enable further development of clinical strategies and countermeasures. The aim of this clinical study was to characterise and quantify three-dimensional motions between the implant and the bone and between the lag screw and nail of the Gamma nail. Radiostereometry Analysis (RSA) analysis was applied in 20 patients with trochanteric hip fractures treated with an intramedullary nail. The following three-dimensional motions were measured postoperatively, at 1 week, 3, 6 and 12 months: translations of the tip of the lag screw in the femoral head, motions of the lag screw in the nail, femoral head motions relative to the nail and nail movements in the femoral shaft. Cranial migration of the tip of the lag screw dominated over the other two translation components in the femoral head. In all fractures the lag screw slid laterally in the nail and the femoral head moved both laterally and inferiorly towards the nail. All femoral heads translated posteriorly relative to the nail, and rotations occurred in both directions with median values close to zero. The nail tended to retrovert in the femoral shaft. Adverse fracture-implant motions were detected in stable trochanteric hip fractures treated with intramedullary nails with high resolution. Therefore, RSA method can be used to evaluate new implant designs and clinical strategies, which aim to reduce cut-out complications. Future RSA studies should aim at more unstable fractures as these are more likely to fail with cut-out. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Spatial Differences in the Distribution of Bone Between Femoral Neck and Trochanteric Fractures.

    Science.gov (United States)

    Yu, Aihong; Carballido-Gamio, Julio; Wang, Ling; Lang, Thomas F; Su, Yongbin; Wu, Xinbao; Wang, Manyi; Wei, Jie; Yi, Chen; Cheng, Xiaoguang

    2017-08-01

    There is little knowledge about the spatial distribution differences in volumetric bone mineral density and cortical bone structure at the proximal femur between femoral neck fractures and trochanteric fractures. In this case-control study, a total of 93 women with fragility hip fractures, 72 with femoral neck fractures (mean ± SD age: 70.6 ± 12.7 years) and 21 with trochanteric fractures (75.6 ± 9.3 years), and 50 control subjects (63.7 ± 7.0 years) were included for the comparisons. Differences in the spatial distributions of volumetric bone mineral density, cortical bone thickness, cortical volumetric bone mineral density, and volumetric bone mineral density in a layer adjacent to the endosteal surface were investigated using voxel-based morphometry (VBM) and surface-based statistical parametric mapping (SPM). We compared these spatial distributions between controls and both types of fracture, and between the two types of fracture. Using VBM, we found spatially heterogeneous volumetric bone mineral density differences between control subjects and subjects with hip fracture that varied by fracture type. Interestingly, femoral neck fracture subjects, but not subjects with trochanteric fracture, showed significantly lower volumetric bone mineral density in the superior aspect of the femoral neck compared with controls. Using surface-based SPM, we found that compared with controls, both fracture types showed thinner cortices in regions in agreement with the type of fracture. Most outcomes of cortical and endocortical volumetric bone mineral density comparisons were consistent with VBM results. Our results suggest: 1) that the spatial distribution of trabecular volumetric bone mineral density might play a significant role in hip fracture; 2) that focal cortical bone thinning might be more relevant in femoral neck fractures; and 3) that areas of reduced cortical and endocortical volumetric bone mineral density might be more relevant for

  10. Transforming giants.

    Science.gov (United States)

    Kanter, Rosabeth Moss

    2008-01-01

    Large corporations have long been seen as lumbering, inflexible, bureaucratic--and clueless about global developments. But recently some multinationals seem to be transforming themselves: They're engaging employees, moving quickly, and introducing innovations that show true connection with the world. Harvard Business School's Kanter ventured with a research team inside a dozen global giants--including IBM, Procter & Gamble, Omron, CEMEX, Cisco, and Banco Real--to discover what has been driving the change. After conducting more than 350 interviews on five continents, she and her colleagues came away with a strong sense that we are witnessing the dawn of a new model of corporate power: The coordination of actions and decisions on the front lines now appears to stem from widely shared values and a sturdy platform of common processes and technology, not from top-down decrees. In particular, the values that engage the passions of far-flung workforces stress openness, inclusion, and making the world a better place. Through this shift in what might be called their guidance systems, the companies have become as creative and nimble as much smaller ones, even while taking on social and environmental challenges of a scale that only large enterprises could attempt. IBM, for instance, has created a nonprofit partnership, World Community Grid, through which any organization or individual can donate unused computing power to research projects and see what is being done with the donation in real time. IBM has gained an inspiring showcase for its new technology, helped business partners connect with the company in a positive way, and offered individuals all over the globe the chance to contribute to something big.

  11. Real frequency of ordinary and atypical sub-trochanteric and diaphyseal fractures in France based on X-rays and medical file analysis.

    Science.gov (United States)

    Beaudouin-Bazire, Constance; Dalmas, Noémie; Bourgeois, Julie; Babinet, Antoine; Anract, Philippe; Chantelot, Christophe; Farizon, Frédéric; Chopin, Florence; Briot, Karine; Roux, Christian; Cortet, Bernard; Thomas, Thierry

    2013-03-01

    Atypical sub-trochanteric and femoral shaft fractures have been reported in patients treated with bisphosphonates. Their incidence has been determined from registered data analysis using international codes. Therefore, the aim of our study was to estimate the real frequency of typical and atypical sub-trochanteric or diaphyseal fractures, based on radiological and clinical data compared to registered data. In the registers of three large French University Hospitals, patients identified with International Classification of Diseases, 10th Revision diagnosis codes for sub-trochanteric or diaphyseal fracture were selected. Frequencies of ordinary and atypical fractures were calculated after both registered data, radiological and clinical files analysis. Among the 4592 patients hospitalized for a femoral fracture over 5 years, 574 were identified to have had a sub-trochanteric or femoral shaft fracture. 47.7% of the sub-trochanteric and femoral shaft fractures were misclassified, predominantly in the sub-trochanteric fractures subset. 12 patients had an atypical fracture (4% of the sub-trochanteric and femoral shaft fractures) and 11 fractures presented radiological features of atypical fractures, whereas clinical files analysis revealed they were pathological or traumatic fractures. Atypical fractures frequency is very low. Because of their low frequency and the unreliability of registered databases, the risk of atypical fractures is very difficult to estimate retrospectively. A prospective study is needed to clarify the risk factors associated with these fractures. Copyright © 2012 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  12. Giant Cell Arteritis

    Science.gov (United States)

    Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. ... arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia ...

  13. Injuries of the trochanteric region: can analysis of radiographic indices help in prediction of recurrent osteoporotic hip fractures?

    Science.gov (United States)

    Pellegrini, Andrea; Tacci, Fabrizio; Leigheb, Massimiliano; Costantino, Cosimo; Pedrazzini, Alessio; Pedrazzi, Giuseppe; Vaienti, Enrico; Ceccarelli, Francesco; Pogliacomi, Francesco

    2017-10-18

    In a context of bone fragility, primitive and subsequent fractures are a growing problem in the industrialized countries where the mean age of the population is constantly increasing. Among the various factors that favor a fragility fracture, the most important is osteoporosis, a pathology that can be prevented through diagnostic screenings and treated by pharmacological and rehabilitative therapies. The aim of this study is to identify the subjects who are likely to have a higher risk of subsequent fractures of the trochanteric region through a retrospective radiographic evaluation of patients affected by low-energy trochanteric fractures and operated by intramedullary fixation between June 2013 and June 2015, so they can be targeted for prevention interventions. Three hundred and sixty-one patients yet alive were analyzed 2 years after surgery. Fifty-one (group 1), characterized by another contralateral trochanteric femoral fracture, were included. All subjects were retrospectively examined with the analysis of contralateral femur X-ray performed at the time of initial trauma in order to detect a condition of bone fragility and a predisposition to fractures by evaluating three radiographic indices (Singh index, Dorr's classification and Cortical Thickness Index). Patients of group 1 were compared to the other 310 patients (group 2) affected by isolated trochanteric fracture. Group 1 had all radiographic indices worse than group 2. The results observed suggest that orthopedists can use radiographic indices, in particular Cortical Thickness Index, as a valuable, simple and inexpensive screening tool for prevention of recurrent osteoporotic fractures.

  14. A Prospective Study to Evaluate the Management of Sub-trochanteric Femur Fractures with Long Proximal Femoral Nail

    Directory of Open Access Journals (Sweden)

    Kumar M

    2017-11-01

    Full Text Available INTRODUCTION: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN. MATERIALS AND METHODS: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification. All patients were assessed functionally by Harris Hip Score. RESULTS: Average duration of union was 17.08 weeks (range 13 to 32 weeks, union was achieved in 92% cases. Closed reduction was achieved in 68% cases and open reduction was required in 32% cases. Various intraoperative complications were seen in 12% and delayed complications in 26% of cases. Good anatomical results were achieved in 86% of cases and 14% were fair. As per Harris Hip score, excellent results were noted in 28% cases, good in 56% cases and fair in 16% cases. CONCLUSION: The long PFN is a reliable implant for sub-trochanteric femur fractures, with high rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and biomechanical advantages, but the surgery is technically demanding.

  15. Gamma nail in the treatment of closed trochanteric fractures. Results and indications of 121 cases.

    Science.gov (United States)

    Kempf, I; Grosse, A; Taglang, G; Favreul, E

    2014-02-01

    The Gamma Nail is the latest advance in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures. Its design is based on Küntscher's Y-nail and locking intramedullary (IM) nails. This paper reports the results from the first-ever series of 121 patients operated between 1988 and 1990. They were followed until bone union was achieved. The mean patient age was 75 years. Most patients were in poor general health and had unstable fractures. Anatomical preoperative reduction was achieved in 72% of cases. Fixation was good in 66% of cases and acceptable in 27% of cases. Intra-operative complications consisted of nine fractures without consequences. Of the treated patients, 83.4% resumed weight-bearing during the first week. There was one case of deep infection that resolved with treatment. The mortality rate was 12.3% at three months. We noted 7 alunions in varus, 3 in valgus, 2 in external rotation and 1 in internal rotation. There were no cases of non-union. In six cases, the screw had cut out of the femoral head. The drawbacks associated with surgical treatment methods for trochanteric fractures also apply to the Gamma nail. Nevertheless, one of its primary advantages is the possibility of using a closed procedure. When compared to Ender nailing, knee pain is absent and weight-bearing can be achieved in all patients, no matter the fracture type. Copyright © 2014. Published by Elsevier Masson SAS.

  16. Treatment options for unstable trochanteric fractures: Screw or helical proxima femoral nail.

    Science.gov (United States)

    Bajpai, Jeetendra; Maheshwari, Rajesh; Bajpai, Akansha; Saini, Sumit

    2015-01-01

    To compare treatment outcome of screw proximal femoral nail (PFN) system with that of a helical PFN. The study included 77 patients with closed unstable intertrochanteric fracture classified as AO 31A2&31A3, between June 2008 to August 2011. Inclusion criteria were: all mature skeletons above 50 years of age; closed unstable trochanteric fracture classified as AO 31A2&A3. Exclusion criteria were: immature skeleton, pathological fracture of any cause other than osteoporosis, inability to walk inde- pendently prior to injury. Patients were randomized to 2 treatment groups based on admission sequence. Forty patients were treated with screw PFN and thirty seven were treated with helical PFN. Both groups were similar in respect of time of surgery, blood loss and functional assessment and duration of hospitalization. In screw PFN group 2 patients had superficial wound infection, 1 patient had persistent hip pain and 1 patient had shortening>1 cm buttrochanteric fractures even in Indian patients where the bones are narrow and neck diameter is small. It is an implant of choice for osteoporotic and unstable trochanteric fractures.

  17. Dealing with sub-trochanteric fracture in a child with osteopetrosis : A case report.

    Science.gov (United States)

    Behera, P; Khurana, A; Saibaba, B; Aggarwal, S

    2016-12-01

    Osteopetrosis is a rare hereditary condition which may have autosomal recessive or autosomal dominant inheritance. Patients tend to present most commonly with fractures but involvement of cranial nerves and hematopoetic system is not uncommon. Patients with infantile and intermediate type tend to present more often with problems other than orthopaedic problems. While diagnosis can be made on the basis of radiographs, management needs to be customized for every patient. Non operative and operative management both have their advantages and disadvantages. We are here reporting a case of sub-trochanteric fracture in an eight-year-old child which was managed successfully with a dynamic hip screw (DHS). Surgery could be performed successfully by taking precautions during reduction, drilling and screw placement. At the latest follow up, which was after one and half years of surgery, the fracture had united well and the child faced no limitations of activities. Thus, open reduction and fixation with DHS can be considered as an effective management modality for pediatric sub-trochanteric fractures in osteopetrosis.

  18. Migration of trochanteric cerclage cable debris to the knee joint

    Directory of Open Access Journals (Sweden)

    Kathleen M. Kollitz, BS

    2014-01-01

    Full Text Available Migrating orthopedic hardware has widely been reported in the literature. Most reported cases of migrating hardware involve smooth Kirschner wires or loosening/fracture of hardware involved with joint stabilization/fixation. It is unusual for hardware to migrate within the soft tissues. In some cases, smooth Kirschner wires have migrated within the thoracic cage—a proposed mechanism for this phenomenon is the negative intrathoracic pressure. While wires have also been reported to gain access to circulation, transporting them over larger distances, the majority of broken or retained wires remain local. We report a case of a 34-year-old man in whom numerous fragments of braided cable migrated from the hip to the knee.

  19. Trans trochanteric approach with coronal osteotomy of the great trochanter: A new technique for extra-capsular trochanteric fracture patients treated by total hip arthroplasty (THA) in elderly.

    Science.gov (United States)

    Steffann, Francois; Prudhon, Jean-Louis; Puch, Jean-Marc; Ferreira, André; Descamps, Loys; Verdier, Régis; Caton, Jacques

    2015-06-05

    Several surgical approaches could be used in hip arthroplasty or trauma surgery: anterior, anterolateral, lateral, posterior (with or without trochanterotomy), using or not an orthopedic reduction table. Subtrochanteric and extra-capsular trochanteric fractures (ECTF) are usually treated by internal fixation with mandatory restrictions on weight bearing. Specific complications have been widely described. Mechanical failures are particularly high in unstable fractures. Hip fractures are a major public health issue with a mortality rate of 12%-23% at 1 year. An alternative option is to treat ECTF by total hip arthroplasty (THA) to prevent decubitus complications, to help rapid recovery, and to permit immediate weight bearing as well as quick rehabilitation. However, specific risks of THA have to be considered such as dislocation or cardiovascular failure. The classical approach (anterior or posterior) requires the opening of the joint and capsule, weakening hip stability and the repair of the great trochanter is sometimes hazardous. For 15 years, we have been treating unstable ECTF by THA with cementless stem, dual mobility cup (DMC), greater trochanter (GT) reattachment, and a new surgical approach preserving capsule, going through the fracture and avoiding joint dislocation. Bombaci first described a similar approach in 2008; our trans fractural digastric approach (medial gluteus and lateral vastus) is different. A coronal GT osteotomy is performed when there is no coronal fracture line. It allows easy access to the femoral neck and acetabulum. The THA is implanted without femoral internal rotation to avoid extra bone fragment displacement. With pre-operative planning, cup implantation is easy and stem positioning is adjusted referring to the top of the GT after trial reduction and preoperative planning. The longitudinal osteotomy and trochanteric fracture are repaired with wires and the digastric incision is closed. This variant of Bombaci approach could be use

  20. Causes and treatments of lag screw's cut out after intramedullary nailing osteosinthesis for trochanteric fractures.

    Science.gov (United States)

    Gazzotti, Gabriele; Matino, Giovanni; Tsatsis, Christos; Sacchetti, GianLuigi; Baudi, Paolo; Catani, Fabio

    2014-08-20

    Background. Superior cut-out of a lag screw remains a serious complication in the treatment of trochanteric or subtrochanteric fractures and it is related to many factors: the type of fracture, osteoporosis and the stability of fracture reduction. Little is known about the outcome after revision surgery for complications of the gamma nail. We assessed the outcome in patients who had revision surgery because of lag screw's cut out after gamma nailing for a trochanteric fracture.Material and Method. We present a study of 20 consecutive patients who underwent treatment after 20 cut-out of the lag screw fixation of a trochanteric fracture with Gamma Locking Nail from September 2004 to November 2010. In 16 patients hip prothesis was performed, in 1 the removal of the implant and in 3 the reosteosynthesis. We reviewed 13 patients: 10 total hip arthroplasty, 2 endoprothesis and 1 reosteosynthesis of nail and lag screw (mean follow up: 26 months, mean age: 73 years old), 7 patients died. Patients were reviewed retrospectively by an independent observer. Clinical evaluation was performed, Oxford score and Harris Hip score were measured. X-Ray examination was performed after a minimum of 12 months of follow up.Results. Mean Harris Hip Score mean was 67 and mean Oxford score was 32 in hip prothesis group (12 patients). We had several complications, Implant-related complications were: 2 ipometria > 2cm, 2 recurrent hip arthroplasty dislocations (1 reoperated), 4 persistent thigh pain. In only 4 patients none complications were observed. Another patient,  who had been subjected to reosteosinthesis, obtained better results (HHS:95, Oxford score:45) but with a 2 cm ipometria and occasional pain in the thigh.Conclusion. Cut out after gamma nail is consequent to biological or mechanical causes. Treatment of this complication is hip prosthesis (parzial or total hip arthroplasty), reosteosynthesis of the lag screw and/or the nail and the removal of the implant. Conversion to total

  1. UNSTABLE INTERTROCHANTERIC FRACTURE IN ELDERLY TREATED WITH CEMENTED BIPOLAR HEMIARTHROPLASTY AND TROCHANTERIC RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    Jagadeesh Kumar

    2015-06-01

    Full Text Available INTRODUCTION : Unstable inter - trochanteric fracture in the geriatric population is a common injury and is associated with poor bone quality, excessive collapse, loss of fixation, and cut - out of the lag screw, are the common problems of attempts to fix these fractures. Pr esent study is an attempt to evaluate the functional outcome of primary cemented bipolar hemiarthroplasty and trochanter reconstruction in these patients. MATERIALS AND METHOD S : This prospective study included 30 cases of elderly osteoporotic patients with mean age of 65.4 years who sustained comminuted inter - trochanteric femur fracture treated with cemented bipolar hemiarthroplasty& tension band wiring for greater trochanter rec onstruction. It is an essential technical step to avoid complication like abductor lurch gait. W e here describe a technique of reconstruction and fixation of greater trochanter using tension band wiring in figure of eight pattern. The patients were followe d up at six week, three month, six month and one year postoperatively and assessed using Harris Hip Score (HHS. RESULTS : The mean HHS score was was 85.6+SD 9.5 (range from 74 to 96. B y the end of one year. The main clinical measures were early post - opera tive full weight bearing, post - operative complication & functional outcome. The time to full weight bearing, the rate of post - operative complications & functional outcome was significantly better in cemented bipolar arthroplasty group . DISCUSSION : The chan ges in HHS up to six months periods are much greater which starts showing a stable trend thereafter. Fair to good scores were observed in all the patients. The purpose of its use was that while Harris Hip Score (HHS provides information on a multitude of factors. Superficial infection in 2 patients, anterior thigh pain in a patient, shortening less than 2cms in 2 patients, abductor lurch in a patient are the complications noted in post - operative period, but no patient required

  2. Interval hypoxic training in complex treatment of fractures of trochanteric area of the femur

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    Василь Михайлович Шимон

    2015-05-01

    Full Text Available The method of interval hypoxic training (IHT is used to increase physical endurance of athletes and for treatment of certain systemic diseases, due to the ability of IHT affect metabolism, homeostasis and the immune system. The aims of the article are improving the results of treatment and rehabilitation of patients with fractures of the trochanteric area of the femur by the method of interval hypoxic training and study its influence on bone metabolism.Materials and methods. 17 patients who were hospitalized in the clinic of general surgery UzhNU with fractures of the trochanteric area of the femur are examined in the period from 2012 to 2015.The first group consisted of 6 patients who from day-patient treatment is conducted IHT by gas mixture of 12 % oxygen. The second group consisted of 4 patients with thyrotoxicosis who are also receiving IHT by gas mixture of 12% oxygen.The control group consisted of 7 patients with fractures of the trochanteric area of the femur who refused from IHT.Results and its discussion. The best physical activity is observed in the first group. Starting physical activity is the lowest in the second group, but its development is faster. Slowly increase the duration of physical activity compared with the first two groups is observed in the control group.In the control study after 1 month it is noted that calcium level increased in all three groups. Increase in the second group is biggest. The level of phosphorus decreased in the first and the control group and increased in the second group.The levels of osteocalcin and alkaline phosphatase increased. Rates were higher and increase was substantial in the first two groups in comparison with the control group.Conclusions.• Intensive growth of length of one-time physical activity most notably in patients with thyrotoxicosis is observed in patients who are receiving IHT.• Improvement of the activity of bone metabolism is observed in patients after IHT

  3. Trochanteric fractures. Classification and mechanical stability in McLaughlin, Ender and Richard osteosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Herrlin, K.; Stroemberg, T.; Lidgren, L.; Walloee, A.; Pettersson, H.

    Four hundred and thirty trochanteric factures operated upon with McLaughlin, Ender or Richard's osteosynthesis were divided into 6 different types based on their radiographic appearance before and immediately after reposition with special reference to the medial cortical support. A significant correlation was found between the fracture type and subsequent mechanical complications where types 1 and 2 gave less, and types 4 and 5 more complications. A comparison of the various osteosyntheses showed that Richard's had significantly fewer complications than either the Ender or McLaughlin types. For Richard's osteosynthesis alone no correlation to fracture type could be made because of the small number of complications in this group.

  4. Femoral neck fractures after removal of hardware in healed trochanteric fractures.

    Science.gov (United States)

    Barquet, Antonio; Giannoudis, Peter V; Gelink, Andrés

    2017-12-01

    Hardware removal in healed trochanteric fractures (TF) in the absence of infection or significant mechanical complications is rarely indicated. However, in patients with persistent pain, prominent material and discomfort in the activities of daily living, the implant is eventually removed. Publications of ipsilateral femoral neck fracture after removal of implants from healed trochanteric fractures (FNFARIHTF) just because of pain or discomfort are rare. The purpose of this systematic review of the literature is to report on the eventual risk factors, the mechanisms, the clinical presentation, and frequency, and to pay special emphasis in their prevention. A comprehensive review of the literature was undertaken using the PRISMA guidelines with no language restriction. Case reports of FNFARIHTF and series of TF with cases of FNFARIHTF due to pain or discomfort published between inception of journals to December 2016 were eligible for inclusion. Relevant information was divided in two parts. Part I included the analysis of cases of FNFARIHTF, with the objective of establishing the eventual risk factors, mechanisms and pathoanatomy, clinical presentation and diagnosis, treatment and prevention. Part II analyzed series of TF which included cases of FNFARIHTF for assessing the incidence of femoral neck fractures in this condition. Overall 24 publications with 45 cases of FNFARIHTF met the inclusion criteria. We found that the only prevalent factors for FNFARIHTF were: 1) preexisisting systemic osteoporosis, as most patients were older and elder females, with lower bone mineral density and bone mass; 2) local osteoporosis as a result of preloading by the fixation device in the femoral neck, leading to stress protection, reducing the strain at the neck, and increasing bone loss and weakness; and 3) the removal of hardware from the femoral neck, with reduction of the failure strength of the neck. The femoral neck fractures were spontaneous, i.e. not related to trauma or

  5. Do intramedullary implants improve survival in elderly patients with trochanteric fractures? A retrospective study.

    Science.gov (United States)

    Vermesan, D; Prejbeanu, R; Poenaru, D V; Petrescu, H; Apostol, E; Inchingolo, F; Dipalma, G; Abbinante, A; Caprio, M; Potenza, M A; Cagiano, R; Malcangi, G; Inchingolo, A D; Haragus, H

    2015-01-01

    There is currently no consensus regarding superiority of the intramedullary fixation over the sliding hip screw. Regional variation remains high and not backed up by solid evidence. Given these premises we aimed to analyze weather implant preference can influence the postoperative survival. Secondary objectives were determining the trend for implant choice and confounding factors associated with intramedullary nails compared to sliding hip screws. Retrospective data was obtained from patient charts with the main diagnosis of extracapsular/ trochanteric fractures, corresponding to ICD S72.1 codes. Between 2008-2012, 441 patients underwent osteosynthesis with a dynamic hip screw and 155 with intramedullary nail respectively. The living status was determined by comparing the patient identification number against the national population evidence records. The lifetable shows similar survival for both implants over the 5 year period. The yearly mortality was 19.4% for the dynamic hip screw and 21.8% for the intramedullary implant respectively, even though the later were used predominantly in older patients. This age difference is significant according to both parametric and non-parametric tests whereas duration of hospital stay are similar. We found a clear increase in the proportion of intramedullary implants, for a total of 11.2% over the 5 year period. There is no difference for the one year mortality and overall survival between sliding screw plates and intramedullary constructs. A clear increase in the use of intramedullary implants for trochanteric fractures was observed. This is even more apparent for older ages, presumably due to an higher surgeon confidence with the biomechanical stability of the intramedullary constructs.

  6. A STUDY OF UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURES TREATED BY TROCHANTERIC FEMORAL NAIL

    Directory of Open Access Journals (Sweden)

    Sreenivasa Neikar

    2017-11-01

    Full Text Available BACKGROUND Intertrochanteric fracture is one of the most common fracture of the hip especially in the elderly. The incidence of intertrochanteric fracture is rising because of the increase in number of elderly population along with superadded osteoporosis. MATERIALS AND METHODS Study included cases of unstable intertrochanteric fractures (AO and OTA Classification 31-A2 and 31-A3 fracture patterns that were operated with the short trochanteric femoral nail, which fitted into the inclusion criteria done in medical college hospital, Vijayanagara Institute of Medical Sciences, Bellary, from February 2015 to September 2016. RESULTS The age distribution was from 40 to 80 years. The largest group of patients were from 61 to 70 years. The average age was 60.5 years. The number of male patients in our series was 20 (66.7% and female was 10 (33.3%. Right side was affected in 11 cases (36.7% and left side in 19 cases (63.3%. Good reduction was achieved in 23 patients (76.7%. Acceptable reduction was achieved in 7 (23.3% patients due to severe comminution. In our study, 25 patients (83.33% had no complications. We encountered one intraoperative complication in the form of greater trochanter splintering, while inserting the nail. In our study, we encountered following postoperative complications. We noticed one case of delayed union, one case of Z effect and 2 cases of varus malunion. CONCLUSION We conclude that short trochanteric femoral nail provides good fixation for unstable intertrochanteric fractures if proper preoperative planning, good reduction and surgical technique are followed leading to high rate of bone union and minimal soft tissue damage especially for Asian patients with relatively small femora.

  7. Failure after osteosynthesis of trochanteric fractures. Where is the limit of osteoporosis?

    Science.gov (United States)

    Konstantinidis, L; Papaioannou, C; Blanke, P; Hirschmüller, A; Südkamp, N P; Helwig, P

    2013-10-01

    The aim of this study is to identify osteoporosis values, beyond which there is a high risk of osteosynthesis failure. Bone mineral density (BMD) of 30 cadaveric femora with a pertrochanteric fracture osteotomy was correlated to the risk of cut out after osteosynthesis on a biomechanical testing approach. For a BMD less than 250 mg/cm(3), there is a high risk of fixation failure after surgical treatment of pertrochanteric fractures. This value can be regarded as a reference value for future experimental and clinical studies. Despite continuous modification of intramedullary load carriers for the surgical stabilization of trochanteric fractures, cut out remains the most frequent complication. The aim of this experimental study was to identify threshold osteoporosis values, beyond which there is a high risk of osteosynthesis failure. Bone mineral density (BMD) of 30 cadaveric femora was recorded for the femoral head by QCT measurement. Subsequently, a standardized osteotomy mimicking an unstable trochanteric type fracture was stabilized by intramedullary nailing. The constructs were loaded axially at a force of 2,100 N up to 20,000 cycles. Cut out at the femoral head was documented by radiograph. Statistical evaluation of the cohort group was performed by calculation of relative risk in relation to the BMD values. In total, there were six cases of cut out after 10,000 cycles. The incidence of cut out for BMD less than 250 mg/cm(3) was 0.55 (5 of 9) and for BMD greater than 250 mg/cm(3), it was 0.05 (1 of 21). Therefore, the relative risk of cut out for BMD 250 mg/cm(3). After 20,000 cycles, an additional test caused one cut out (relative risk of cut out for a BMD fractures. Although this value is based on an experimental in vitro study design with all its associated limitations, it can be regarded as a reference value for future experimental and clinical studies.

  8. Trochanteric fragility fractures : Treatment using the cement-augmented proximal femoral nail antirotation.

    Science.gov (United States)

    Neuerburg, C; Mehaffey, S; Gosch, M; Böcker, W; Blauth, M; Kammerlander, C

    2016-06-01

    Use of standardized cement augmentation of the proximal femur nail antirotation (PFNA) for the treatment of trochanteric fragility fractures, which are associated with high morbidity and mortality, to achieve safer conditions for immediate full weight-bearing and mobilization, thus, improving preservation of function and independency of orthogeriatric patients. Trochanteric fragility fractures (type 31-A1-3). Ipsilateral arthritis of the hip, leakage of contrast agent into the hip joint, femoral neck fractures. Reduction of the fracture on a fracture table if possible, or minimally invasive open reduction of the proximal femur, i. e., using collinear forceps if necessary. Positioning of guidewires for adjustment of the PFNA and the spiral blade, respectively. Exclusion of leakage of contrast agent and subsequent injection of TRAUMACEM™ V(+) into the femoral head-neck fragment via a trauma needle kit introduced into the spiral blade. Dynamic or static locking of the PFNA at the diaphyseal level. Immediate mobilization of the patients with full weight-bearing and secondary prevention, such as osteoporosis management is necessary to avoid further fractures in the treatment of these patients. A total of 110 patients older than 65 years underwent the procedure. Of the 72 patients available for follow-up (average age 85.3 years), all fractures healed after an average of 15.3 months. No complications related with cement augmentation were observed. Approximately 60 % of patients achieved the mobility level prior to trauma.

  9. Should the Endangered Status of the Giant Panda Really Be Reduced? The Case of Giant Panda Conservation in Sichuan, China.

    Science.gov (United States)

    Ma, Ben; Lei, Shuo; Qing, Qin; Wen, Yali

    2018-05-03

    The International Union for Conservation of Nature (IUCN) reduced the threat status of the giant panda from “endangered” to “vulnerable” in September 2016. In this study, we analyzed current practices for giant panda conservation at regional and local environmental scales, based on recent reports of giant panda protection efforts in Sichuan Province, China, combined with the survey results from 927 households within and adjacent to the giant panda reserves in this area. The results showed that household attitudes were very positive regarding giant panda protection efforts. Over the last 10 years, farmers’ dependence on the natural resources provided by giant panda reserves significantly decreased. However, socio-economic development increased resource consumption, and led to climate change, habitat fragmentation, environmental pollution, and other issues that placed increased pressure on giant panda populations. This difference between local and regional scales must be considered when evaluating the IUCN status of giant pandas. While the status of this species has improved in the short-term due to positive local attitudes, large-scale socio-economic development pressure could have long-term negative impacts. Consequently, the IUCN assessment leading to the classification of giant panda as “vulnerable” instead of “endangered”, should not affect its conservation intensity and effort, as such actions could negatively impact population recovery efforts, leading to the extinction of this charismatic species.

  10. Should the Endangered Status of the Giant Panda Really Be Reduced? The Case of Giant Panda Conservation in Sichuan, China

    Directory of Open Access Journals (Sweden)

    Ben Ma

    2018-05-01

    Full Text Available The International Union for Conservation of Nature (IUCN reduced the threat status of the giant panda from “endangered” to “vulnerable” in September 2016. In this study, we analyzed current practices for giant panda conservation at regional and local environmental scales, based on recent reports of giant panda protection efforts in Sichuan Province, China, combined with the survey results from 927 households within and adjacent to the giant panda reserves in this area. The results showed that household attitudes were very positive regarding giant panda protection efforts. Over the last 10 years, farmers’ dependence on the natural resources provided by giant panda reserves significantly decreased. However, socio-economic development increased resource consumption, and led to climate change, habitat fragmentation, environmental pollution, and other issues that placed increased pressure on giant panda populations. This difference between local and regional scales must be considered when evaluating the IUCN status of giant pandas. While the status of this species has improved in the short-term due to positive local attitudes, large-scale socio-economic development pressure could have long-term negative impacts. Consequently, the IUCN assessment leading to the classification of giant panda as “vulnerable” instead of “endangered”, should not affect its conservation intensity and effort, as such actions could negatively impact population recovery efforts, leading to the extinction of this charismatic species.

  11. Presence of a nail in the medullary canal; is it enough to prevent femoral neck shortening in trochanteric fracture?

    Science.gov (United States)

    Song, Hyung Keun; Yoon, Han Kuk; Yang, Kyu Hyun

    2014-09-01

    Presence of a cephalomedullary nail (CMN) in the medullary canal has been thought as advantageous in the control of femoral neck shortening (FNS) and lag screw sliding in trochanteric fracture compared to extramedullary fixation system. However, researches on the factors that influence the degree of FNS after cephalomedullary nailing are lacking. We observed 95 patients (mean age, 75±2.8 years) with trochanteric fractures who were treated with a CMN, and evaluated the relationship between FNS and patient factors including age, gender, fracture type (AO/OTA), bone mineral density, medullary canal diameter, canal occupancy ratio (COR=nail size/canal diameter), and tip-apex distance using initial, immediate postoperative, and follow-up radiography. Univariate regression analyses revealed that the degree of FNS was significantly correlated with fracture type (A1 versus A3, pfracture type (pfracture.

  12. Physical properties of the red giant envelopes

    Energy Technology Data Exchange (ETDEWEB)

    Maciel, W J [Instituto de Astronomia e Geofisico da Universidade de Sao Paulo (Brazil)

    1978-12-01

    In this work, several model envelopes are calculated for cool giant stars with mass loss due to the action of stellar radiation pressure on molecules and grains. Molecular profiles as well as average values of some physical parameters of the envelopes are obtained.

  13. Physical properties of the red giant envelopes

    International Nuclear Information System (INIS)

    Maciel, W.J.

    1978-01-01

    In this work, several model envelopes are calculated for cool giant stars with mass loss due to the action of stellar radiation pressure on molecules and grains. Molecular profiles as well as average values of some physical parameters of the envelopes are obtained [pt

  14. Comparison of cutout resistance of dynamic condylar screw and proximal femoral nail in reverse oblique trochanteric fractures: A biomechanical study

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    Gursimrat Singh Cheema

    2012-01-01

    Results: The bending moment of the PFN group was approximately 50% less than that of the DCS group (P<0.0001. The PFN group resisted more number of cycles than the DCS group (P=0.03 and showed lesser number of component failures as compared with the DCS group (P=0.003. Conclusions: The PFN is biomechanically superior to DCS for the fixation of reverse oblique trochanteric fractures of femur.

  15. Comparison in bone turnover markers during early healing of femoral neck fracture and trochanteric fracture in elderly patients

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    Shota Ikegami

    2009-10-01

    Full Text Available Healing of fractures is different for each bone and bone turnover markers may reflect the fracture healing process. The purpose of this study was to determine the characteristic changes in bone turnover markers during the fracture healing process. The subjects were consecutive patients with femoral neck or trochanteric fracture who underwent surgery and achieved bone union. There were a total of 39 patients, including 33 women and 6 men. There were 18 patients (16 women and 2 men with femoral neck fracture and 21 patients (17 women and 4 men with trochanteric fracture. Serum bone-specific alkaline phosphatase (BAP was measured as a bone formation marker. Urine and serum levels of N-terminal telopeptide of type I collagen (NTX, as well as urine levels of C-terminal telopeptide of type I collagen (CTX and deoxypyridinoline (DPD, were measured as markers of bone resorption. All bone turnover markers showed similar changes in patients with either type of fracture, but significantly higher levels of both bone formation and resorption markers were observed in trochanteric fracture patients than in neck fracture patients. BAP showed similar levels at one week after surgery and then increased. Bone resorption markers were increased after surgery in patients with either fracture. The markers reached their peak values at three weeks (BAP and urinary NTX, five weeks (serum NTX and DPD, and 2-3 weeks (CTX after surgery. The increase in bone turnover markers after hip fracture surgery and the subsequent decrease may reflect increased bone formation and remodeling during the healing process. Both fractures had a similar bone turnover marker profile, but the extent of the changes differed between femoral neck and trochanteric fractures.

  16. Comparison in bone turnover markers during early healing of femoral neck fracture and trochanteric fracture in elderly patients.

    Science.gov (United States)

    Ikegami, Shota; Kamimura, Mikio; Nakagawa, Hiroyuki; Takahara, Kenji; Hashidate, Hiroyuki; Uchiyama, Shigeharu; Kato, Hiroyuki

    2009-10-10

    Healing of fractures is different for each bone and bone turnover markers may reflect the fracture healing process. The purpose of this study was to determine the characteristic changes in bone turnover markers during the fracture healing process. The subjects were consecutive patients with femoral neck or trochanteric fracture who underwent surgery and achieved bone union. There were a total of 39 patients, including 33 women and 6 men. There were 18 patients (16 women and 2 men) with femoral neck fracture and 21 patients (17 women and 4 men) with trochanteric fracture. Serum bone-specific alkaline phosphatase (BAP) was measured as a bone formation marker. Urine and serum levels of N-terminal telopeptide of type I collagen (NTX), as well as urine levels of C-terminal telopeptide of type I collagen (CTX) and deoxypyridinoline (DPD), were measured as markers of bone resorption. All bone turnover markers showed similar changes in patients with either type of fracture, but significantly higher levels of both bone formation and resorption markers were observed in trochanteric fracture patients than in neck fracture patients. BAP showed similar levels at one week after surgery and then increased. Bone resorption markers were increased after surgery in patients with either fracture. The markers reached their peak values at three weeks (BAP and urinary NTX), five weeks (serum NTX and DPD), and 2-3 weeks (CTX) after surgery. The increase in bone turnover markers after hip fracture surgery and the subsequent decrease may reflect increased bone formation and remodeling during the healing process. Both fractures had a similar bone turnover marker profile, but the extent of the changes differed between femoral neck and trochanteric fractures.

  17. Pressure enhancement of the giant magnetocaloric effect in LaFe.sub.11.6./sub.Si.sub.1.4./sub..

    Czech Academy of Sciences Publication Activity Database

    Sun, Y.; Arnold, Zdeněk; Kamarád, Jiří; Wang, G.-J.; Shen, B.G.; Cheng, Z.-H.

    2006-01-01

    Roč. 89, č. 17 (2006), 172513/1-172513/3 ISSN 0003-6951 R&D Projects: GA ČR GA202/06/0178 Institutional research plan: CEZ:AV0Z10100521 Keywords : intermetallic compounds * magnetocaloric effect * pressure effect Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 3.977, year: 2006

  18. Nanodielectrics with giant permittivity

    Indian Academy of Sciences (India)

    Following the prediction, during the last couple of years we have investigated the effect of giant permittivity in one-dimensional systems of conventional metals and conjugated polymer chains. In this article, we have tried to summarize the works on giant permittivity and finally the fabrication of nanocapacitor using metal ...

  19. Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note.

    Science.gov (United States)

    Lee, Joong-Myung; Cho, Yongsuk; Kim, Junhyun; Kim, Dong-Won

    2017-03-01

    Femoral intertrochanteric fractures are common in the elderly. Appropriate surgical fixation of trochanteric fracture fragments can restore normal anatomical structure and ambulation, and can aid in the recovery of biomechanical function of the hip. We evaluated clinical outcomes of bipolar hemiarthroplasty using a wiring technique for trochanteric fracture fragment fixation. From September 2006 to February 2015, a total of 260 cases underwent simultaneous bipolar hemiarthroplasty and wire fixation. A total of 65 patients (69 hips) with an average age of 78 years and more than one year of follow-up was included in the study. Using pre-, postoperative and follow-up radiograms, we evaluated wire fixation failure and also assessed changes in walking ability. Loosening or osteolysis around the stem was not observed; however, we did observe bone growth around the stem (54 cases), cortical hypertrophy (6 cases), a wide range of sclerotic lines but no stem subsidence (1 case), wire breakage (9 cases), and fracture fragment migration with no significant functional deficiency (2 cases). Our study showed that additional wiring for trochanteric fracture fragment fixation following bipolar hemiarthroplasty can help restore normal anatomy. The added stability results in faster rehabilitation, and good clinical and radiographic outcomes. We recommend this procedure in this type of fracture.

  20. A Prospective Study to Evaluate the Management of Sub-trochanteric Femur Fractures with Long Proximal Femoral Nail.

    Science.gov (United States)

    Kumar, M; Akshat, V; Kanwariya, A; Gandhi, M

    2017-11-01

    Introduction: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN). Materials and Methods: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification. All patients were assessed functionally by Harris Hip Score. Results: Average duration of union was 17.08 weeks (range 13 to 32 weeks), union was achieved in 92% cases. Closed reduction was achieved in 68% cases and open reduction was required in 32% cases. Various intraoperative complications were seen in 12% and delayed complications in 26% of cases. Good anatomical results were achieved in 86% of cases and 14% were fair. As per Harris Hip score, excellent results were noted in 28% cases, good in 56% cases and fair in 16% cases. Conclusion: The long PFN is a reliable implant for subtrochanteric femur fractures, with high rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and biomechanical advantages, but the surgery is technically demanding.

  1. Differences in monthly variation, cause, and place of injury between femoral neck and trochanteric fractures: 6-year survey (2008–2013) in Kyoto prefecture, Japan

    Science.gov (United States)

    Horii, Motoyuki; Fujiwara, Hiroyoshi; Mikami, Yasuo; Ikeda, Takumi; Ueshima, Keiichiro; Ikoma, Kazuya; Shirai, Toshiharu; Nagae, Masateru; Oka, Yoshinobu; Sawada, Koshiro; Kuriyama, Nagato; Kubo, Toshikazu

    2016-01-01

    Summary Background The incidence of femoral neck and trochanteric fractures reportedly differ by age and regionality. We investigated differences in monthly variations of the occurrence of femoral neck and trochanteric fractures as well as place and cause of injury in the Kyoto prefecture over a 6-year period. Methods Fracture type (neck or trochanteric fracture), age, sex, place of injury, and cause of injury were surveyed among patients aged ≥ 65 years with hip fractures that occurred between 2008 and 2013 who were treated in 1 of 13 participating hospitals (5 in an urban area and 8 in a rural area). The proportion of sick beds in the participating hospitals was 24.7% (4,151/16,781). Monthly variations in the number of patients were investigated in urban and rural areas in addition to the entire Kyoto prefecture. Place of injury was classified as indoors or outdoors, and cause of injury was categorized as simple fall, accident, or uncertain. Results There were 2,826 patients with neck fractures (mean age, 82.1 years) and 3,305 patients with trochanteric fractures (mean age, 85.0 years). There were similarities in the monthly variation of the number of fractures in addition to the place and cause of injury between neck and trochanteric fractures. Indoors (approximately 74%) and simple falls (approximately 78%) were the primary place and cause of injury, respectively. The place of injury was not significantly different by fracture type with each age group. Significantly more patients with neck fracture had “uncertain” as the cause of injury than trochanteric fracture in all age groups. Conclusions Based on the results of the present study, the injury pattern might not have a great effect on the susceptibility difference between neck and trochanteric fractures. PMID:27252738

  2. Differences in monthly variation, cause, and place of injury between femoral neck and trochanteric fractures: 6-year survey (2008-2013) in Kyoto prefecture, Japan.

    Science.gov (United States)

    Horii, Motoyuki; Fujiwara, Hiroyoshi; Mikami, Yasuo; Ikeda, Takumi; Ueshima, Keiichiro; Ikoma, Kazuya; Shirai, Toshiharu; Nagae, Masateru; Oka, Yoshinobu; Sawada, Koshiro; Kuriyama, Nagato; Kubo, Toshikazu

    2016-01-01

    The incidence of femoral neck and trochanteric fractures reportedly differ by age and regionality. We investigated differences in monthly variations of the occurrence of femoral neck and trochanteric fractures as well as place and cause of injury in the Kyoto prefecture over a 6-year period. Fracture type (neck or trochanteric fracture), age, sex, place of injury, and cause of injury were surveyed among patients aged ≥ 65 years with hip fractures that occurred between 2008 and 2013 who were treated in 1 of 13 participating hospitals (5 in an urban area and 8 in a rural area). The proportion of sick beds in the participating hospitals was 24.7% (4,151/16,781). Monthly variations in the number of patients were investigated in urban and rural areas in addition to the entire Kyoto prefecture. Place of injury was classified as indoors or outdoors, and cause of injury was categorized as simple fall, accident, or uncertain. There were 2,826 patients with neck fractures (mean age, 82.1 years) and 3,305 patients with trochanteric fractures (mean age, 85.0 years). There were similarities in the monthly variation of the number of fractures in addition to the place and cause of injury between neck and trochanteric fractures. Indoors (approximately 74%) and simple falls (approximately 78%) were the primary place and cause of injury, respectively. The place of injury was not significantly different by fracture type with each age group. Significantly more patients with neck fracture had "uncertain" as the cause of injury than trochanteric fracture in all age groups. Based on the results of the present study, the injury pattern might not have a great effect on the susceptibility difference between neck and trochanteric fractures.

  3. Pressure-induced three-dimensional ferromagnetic correlations in the giant magnetocaloric compound Gd.sub.5./sub.Ge.sub.4./sub..

    Czech Academy of Sciences Publication Activity Database

    Magen, C.; Arnold, Zdeněk; Morellon, L.; Skorokhod, Yuriy; Algarabel, P. A.; Ibarra, M. R.; Kamarád, Jiří

    2003-01-01

    Roč. 91, č. 20 (2003), s. 207202-1 - 207202-4 ISSN 0031-9007 R&D Projects: GA ČR GA106/02/0943 Grant - others:CICYT(ES) MAT2000-1756 Institutional research plan: CEZ:AV0Z1010914 Keywords : magneto-caloric compounds * pressure effect * magnetism Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 7.035, year: 2003

  4. Pressure effects in the giant magnetocaloric compounds Gd.sub.5./sub.(Si.sub.x./sub.Ge.sub.1 - x./sub.).sub.4./sub..

    Czech Academy of Sciences Publication Activity Database

    Morellon, L.; Arnold, Zdeněk; Algarabel, P. A.; Magen, C.; Ibarra, M. R.; Skorokhod, Yuriy

    2004-01-01

    Roč. 16, - (2004), s. 1623-1630 ISSN 0953-8984 R&D Projects: GA ČR GA106/02/0943 Grant - others:CICYT(ES) MAT2000-1756 Institutional research plan: CEZ:AV0Z1010914 Keywords : magnetocaloric effect * high pressure * Gd 5 Si 4-x Ge x * magnetic transitions Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 2.049, year: 2004

  5. Formation of giant planets

    International Nuclear Information System (INIS)

    Perri, F.

    1975-01-01

    When a planetary core composed of condensed matter is accumulated in the primitive solar nebula, the gas of the nebula becomes gravitationally concentrated as an envelope surrounding the planetary core. Models of such gaseous envelopes have been constructed subject to the assumption that the gas everywhere is on the same adiabat as that in the surrounding nebula. The gaseous envelope extends from the surface of the core to the distance at which the gravitational attraction of core plus envelope becomes equal to the gradient of the gravitational potential in the solar nebula; at this point the pressure and temperature of the gas in the envelope are required to attain the background values characteristic of the solar nebula. In general, as the mass of the condensed core increases, increasing amounts of gas became concentrated in the envelope, and these envelopes are stable against hydrodynamic instabilities. However, the core mass then goes through a maximum and starts to decrease. In most of the models tested the envelopes were hydrodynamically unstable beyond the peak in the core mass. An unstable situation was always created if it was insisted that the core mass contain a larger amount of matter than given by these solutions. For an initial adiabat characterized by a temperature of 450 0 K and a pressure of 5 x 10 -6 atmospheres, the maximum core mass at which instability occurs is approximately 115 earth masses. It is concluded that the giant planets obtained their large amounts of hydrogen and helium by a hydrodynamic collapse process in the solar nebula only after the nebula had been subjected to a considerable period of cooling

  6. PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY WITH TROCHANTERIC AND CALCAR RECONSTRUCTION IN UNSTABLE INTERTROCHANTERIC FRACTURES IN ELDERLY: A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Pandu Ranga Vital

    2015-09-01

    Full Text Available INTRODUCTION : To avoid the complications and morbidity associated with attempted Osteosynthesis of the so called Unstable inter - trochanteric fractures in the elderly population, Primary Cemented Bipolar hemiarthroplasty been around for over three decades now. But, hardly any emphasis been given over the technical aspects to i mprove the functional outcome. Present study is one such, following reconstructive attempts ( O f primary cemented bipolar hemiarthroplasty with trochanter and calcar reconstruction in the elderly population to reduce the risk of unstable Hemiarthroplasty. MATERIALS AND METHODS: This prospective study included 20 cases of elderly patients with mean age of 73.5 years (Age range 66 to 82 yr who sustained multifragmentary/communited inter - trochanteric femur fracture treated with Primary cemented bipolar hemiar throplasty with trochanteric and calcar reconstruction to emphasize the importance of restoration soft tissue tension to reduce the risk of unstable Hemiarthroplasty. Essential Technical steps include Figure of eight / multiple wire loop technique of recons truction ( with or without K ‘wires of greater trochanter/ abductor mechanism and calcar reconstruction either by wiring Lesser trochanteric fragment and or insertion of cortical piece of bone graft (medially under the collar of the prosthesis harvested f rom head and neck fragment. The patients were followed up at six week, three month, six month and one year postoperatively and assessed using Harris Hip Score (HHS. RESULTS: The mean HHS score was 85 (range 69 to 91 at the end of one year. The main clini cal measures were early post - operative full weight bearing, post - operative complication & functional outcome. The time to full weight bearing, the rate of post - operative complications & functional outcome was significantly better in cemented bipolar arthro plasty group. CONCLUSION: The authors strongly believe that primary cemented bipolar

  7. Pressure induced insulator–metal transition and giant negative piezoresistance in Pr{sub 0.6}Ca{sub 0.4}Mn{sub 0.96}Al{sub 0.04}O{sub 3} polycrystal

    Energy Technology Data Exchange (ETDEWEB)

    Arumugam, S., E-mail: sarumugam1963@yahoo.com [Centre for High Pressure Research, School of Physics, Bharathidasan University, Tiruchirapalli 620024, Tamil Nadu (India); Thiyagarajan, R. [Center for High Pressure Science and Technology Advanced Research (HPSTAR), Shanghai 201203 (China); Kalaiselvan, G.; Sivaprakash, P. [Centre for High Pressure Research, School of Physics, Bharathidasan University, Tiruchirapalli 620024, Tamil Nadu (India)

    2016-11-01

    The effect of external hydrostatic pressure (P) on the magnetization (M) and resistivity (ρ) properties of charge-orbital (CO) ordered-insulating phase-separated manganite Pr{sub 0.6}Ca{sub 0.4}Mn{sub 0.96}Al{sub 0.04}O{sub 3} system is reported here. At ambient P, CO ordering transition and spin-canting in the AFM are observed at 223 K and 55 K respectively in M(T) and ρ(T) measurements. Application of P increases simultaneously the magnitude of magnetization (M) and transition temperature, and weakens the CO ordering in M(T) measurements up to 0.98 GPa. During ρ(T) measurements, P induces an insulator–metallic transition (T{sub IM}) at 1.02 GPa, and further increase of P up to 2.84 GPa leads to increase of T{sub IM} (dT{sub IM}/dP =21.6 K/GPa). ρ at T{sub IM} is reduced about three orders of magnitude at 2.84 GPa, and leads to the giant negative piezoresistance (~98%). These results are analyzed separately in two temperature regions i.e., below and above T{sub IM} by power function equation and small polaronic hopping model respectively. It is understood from these analyses that the application of P suppresses the Jahn–Teller distortions, electron–electron and electron–magnon scattering factors, and induces the insulator–metal transition in Pr{sub 0.6}Ca{sub 0.4}Mn{sub 0.96}Al{sub 0.04}O{sub 3} system. - Highlights: • Application of P on Pr{sub 0.6}Ca{sub 0.4}Mn{sub 0.96}Al{sub 0.04}O{sub 3} reduces resistivity (ρ) remarkably at low-temperatures, and exhibits an insulator to metallic transition at 1.02 GPa. • The reduction in ρ by P is about three orders of magnitude at 2.84 GPa, leads to the giant negative piezoresistance about 98%. • The effect of the suppression of Jahn–Teller distortions, electron–electron and electron–magnon scattering under an applied P exhibits to the metal-Insulator transition. • The phase-separation in this system has been tuned by both internal and external perturbations.

  8. Evaluation of the health-related quality of life in elderly patients according to the type of hip fracture: femoral neck or trochanteric

    Directory of Open Access Journals (Sweden)

    Tânia Maria da Silva Mendonça

    2008-01-01

    Full Text Available OBJECTIVE: To evaluate the effect the type of hip fracture (femoral neck or trochanteric has on the Health-Related Quality of Life of elderly subjects. METHODS: Forty-five patients with hip fractures (mean 74.30 ± 7.12 years, 24 with a femoral neck fracture and 21 with a trochanteric fracture, completed the 36-item Short Form Health Survey (SF-36 at baseline and four months after fracture. The Health-Related Quality of Life scores were compared according to fracture type, undisplaced and displaced femoral neck fractures, and stable and unstable trochanteric fractures. RESULTS: Compared to baseline, all patients scored lower in the physical functioning, role limitation-physical, bodily pain and vitality categories four months after the fracture had occurred. The SF-36 scores for all the scales did not differ significantly between patients with femoral neck versus trochanteric fractures, or between patients with displaced versus undisplaced femoral neck fractures and stable versus unstable trochanteric fractures. CONCLUSIONS: The mental and physical quality of life of elderly patients with a hip fracture is severely impaired one month after fracture, with partial recovery by the end of the fourth month. The negative impact on the Health-Related Quality of Life did not differ significantly according to fracture type.

  9. High failure rate of trochanteric fracture osteosynthesis with proximal femoral locking compression plate.

    Science.gov (United States)

    Wirtz, C; Abbassi, F; Evangelopoulos, D S; Kohl, S; Siebenrock, K A; Krüger, A

    2013-06-01

    Stable reconstruction of proximal femoral (PF) fractures is especially challenging due to the peculiarity of the injury patterns and the high load-bearing requirement. Since its introduction in 2007, the PF-locking compression plate (LCP) 4.5/5.0 has improved osteosynthesis for intertrochanteric and subtrochanteric fractures of the femur. This study reports our early results with this implant. Between January 2008 and June 2010, 19 of 52 patients (12 males, 7 females; mean age 59 years, range 19-96 years) presenting with fractures of the trochanteric region were treated at the authors' level 1 trauma centre with open reduction and internal fixation using PF-LCP. Postoperatively, partial weight bearing was allowed for all 19 patients. Follow-up included a thorough clinical and radiological evaluation at 1.5, 3, 6, 12, 24, 36 and 48 months. Failure analysis was based on conventional radiological and clinical assessment regarding the type of fracture, postoperative repositioning, secondary fracture dislocation in relation to the fracture constellation and postoperative clinical function (Merle d'Aubigné score). In 18 patients surgery achieved adequate reduction and stable fixation without intra-operative complications. In one patient an ad latus displacement was observed on postoperative X-rays. At the third month follow-up four patients presented with secondary varus collapse and at the sixth month follow-up two patients had 'cut-outs' of the proximal fragment, with one patient having implant failure due to a broken proximal screw. Revision surgeries were performed in eight patients, one patient receiving a change of one screw, three patients undergoing reosteosynthesis with implantation of a condylar plate and one patient undergoing hardware removal with secondary implantation of a total hip prosthesis. Eight patients suffered from persistent trochanteric pain and three patients underwent hardware removal. Early results for PF-LCP osteosynthesis show major

  10. Outcomes of osteoporotic trochanteric fractures treated with cement-augmented dynamic hip screw

    Science.gov (United States)

    Gupta, Rakesh Kumar; Gupta, Vinay; Gupta, Navdeep

    2012-01-01

    Background: Dynamic hip screw (DHS) has been the standard treatment for stable trochanteric fracture patterns, but complications of lag screw cut out from a superior aspect, due to inadequate bone anchorage, occur frequently in elderly osteoporotic patients. Polymethylmethacrylate (PMMA) has been used as an augmentation tool to facilitate fixation stability in cadaveric femora for biomechanical studies and in pathological fractures. However, there are very few reports on the utilization of PMMA cement to prevent these complications in fresh intertrochanteric fractures. A prospective study was conducted to evaluate the outcome and efficacy of PMMA augmented DHS in elderly osteoporotic patients with intertrochanteric fractures. Materials and Methods: The study included 64 patients (AO type31-A2.1 in eight, A2.2 in 29, A2.3 in 17 patients, and 31-A3.1 in five, A3.2 in three, and A3.3 in two patients) with an average age of 72 years (60 – 94 years) of which 60 were available for final followup. PMMA augmentation of DHS was performed in all cases by injecting PMMA cement into the femoral head with a custommade gun designed by the authors. The clinical outcome was rated as per the Salvati and Wilson scoring system at the time of final followup of one year. Results were graded as excellent (score > 31), good (score 24 – 31), fair (score 16 – 23), and poor (score < 16). Results: Fracture united in all patients and the average time to union was 13.8 weeks (range 12 – 16 weeks). At an average followup of 18 months (range 12 – 24 months), no incidence of varus collapse or superior screw cut out was observed in any of the patients in spite of weightbearing ambulation from the early postoperative period. There was no incidence of avascular necrosis (AVN) or cement penetration into the joint in our series. Most of the patients were able to regain their prefracture mobility status with a mean hip pain score of 8.6. Conclusion: Cement augmentation of DHS appears to be an

  11. Outcomes of osteoporotic trochanteric fractures treated with cement-augmented dynamic hip screw

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar Gupta

    2012-01-01

    Full Text Available Background: Dynamic hip screw (DHS has been the standard treatment for stable trochanteric fracture patterns, but complications of lag screw cut out from a superior aspect, due to inadequate bone anchorage, occur frequently in elderly osteoporotic patients. Polymethylmethacrylate (PMMA has been used as an augmentation tool to facilitate fixation stability in cadaveric femora for biomechanical studies and in pathological fractures. However, there are very few reports on the utilization of PMMA cement to prevent these complications in fresh intertrochanteric fractures. A prospective study was conducted to evaluate the outcome and efficacy of PMMA augmented DHS in elderly osteoporotic patients with intertrochanteric fractures. Materials and Methods: The study included 64 patients (AO type31-A2.1 in eight, A2.2 in 29, A2.3 in 17 patients, and 31-A3.1 in five, A3.2 in three, and A3.3 in two patients with an average age of 72 years (60 − 94 years of which 60 were available for final followup. PMMA augmentation of DHS was performed in all cases by injecting PMMA cement into the femoral head with a custommade gun designed by the authors. The clinical outcome was rated as per the Salvati and Wilson scoring system at the time of final followup of one year. Results were graded as excellent (score > 31, good (score 24 − 31, fair (score 16 − 23, and poor (score < 16. Results: Fracture united in all patients and the average time to union was 13.8 weeks (range 12 − 16 weeks. At an average followup of 18 months (range 12 − 24 months, no incidence of varus collapse or superior screw cut out was observed in any of the patients in spite of weightbearing ambulation from the early postoperative period. There was no incidence of avascular necrosis (AVN or cement penetration into the joint in our series. Most of the patients were able to regain their prefracture mobility status with a mean hip pain score of 8.6. Conclusion: Cement augmentation of DHS appears

  12. Lipase polystyrene giant amphiphiles.

    Science.gov (United States)

    Velonia, Kelly; Rowan, Alan E; Nolte, Roeland J M

    2002-04-24

    A new type of giant amphiphilic molecule has been synthesized by covalently connecting a lipase enzyme headgroup to a maleimide-functionalized polystyrene tail (40 repeat units). The resulting biohybrid forms catalytic micellar rods in water.

  13. Metaphyseal giant cell tumor

    International Nuclear Information System (INIS)

    Pereira, L.F.; Hemais, P.M.P.G.; Aymore, I.L.; Carmo, M.C.R. do; Cunha, M.E.P.R. da; Resende, C.M.C.

    1986-01-01

    Three cases of metaphyseal giant cell tumor are presented. A review of the literature is done, demostrating the lesion is rare and that there are few articles about it. Age incidence and characteristics of the tumor are discussed. (Author) [pt

  14. Giant CP stars

    International Nuclear Information System (INIS)

    Loden, L.O.; Sundman, A.

    1989-01-01

    This study is part of an investigation of the possibility of using chemically peculiar (CP) stars to map local galactic structure. Correct luminosities of these stars are therefore crucial. CP stars are generally regarded as main-sequence or near-main-sequence objects. However, some CP stars have been classified as giants. A selection of stars, classified in literature as CP giants, are compared to normal stars in the same effective temperature interval and to ordinary 'non giant' CP stars. There is no clear confirmation of a higher luminosity for 'CP giants', than for CP stars in general. In addition, CP characteristics seem to be individual properties not repeated in a component star or other cluster members. (author). 50 refs., 5 tabs., 3 figs

  15. Cemented Hemiarthroplasty in Elderly Osteoporotic Unstable Trochanteric Fractures using Fracture Window

    Directory of Open Access Journals (Sweden)

    Thakur A

    2016-03-01

    Full Text Available Introduction: We would like to analyze the role of cemented hemiarthroplasty in elderly osteoporotic unstable intertrochanteric fractures through trochanteric fracture window. Materials and Methods: The study was conducted from July 2011 to July 2014. From a total of 265 consecutive patients with intertrochanteric fractures of 42 patients were selected according to inclusion criteria and results were analyzed prospectively. All patients were operated at tertiary care institute. Patients which matched the inclusion criteria were selected. 42 patients entered the study and all completed the study. Primary cemented hemiarthroplasty was done in all patients. Modified Harris Hip Score was used to assess all the patients. Results: 42 patients were included in the study with an average age of 80.7 years. Only AO/OTA type 31-A2.2 and 31-A2.3 were included, average HHS at final follow up of three years was 86.2. No revision or reoperation was done. Conclusion: In a selected cohort of patients primary prosthetic replacement in elderly osteoporotic unstable intertrochanteric fractures is good option and the surgical technique allowed us to perform it more easily.

  16. 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.

  17. Complications and fixation techniques of trochanteric fractures with the TARGON(®) PF.

    Science.gov (United States)

    Takigawa, Naohide; Moriuchi, Hiromitsu; Abe, Muneki; Yasui, Kenji; Eshiro, Hisako; Kinoshita, Mitsuo

    2014-01-01

    The purpose of this study was to analyse clinical results of elderly patients with trochanteric fractures that were treated with use of TARGON(®) PF nail. Overall, 494 patients (113 males) were available for this study. On the basis of Jensen classification, there were 76 cases in type I, 164 cases in type II, 70 in type III, 129 in type IV and 55 in type V. (1) Sliding amount of lag screw in relation to the Jensen classification, (2) sliding amount of lag screw according to the Ikuta's classification that categorises the reduction in lateral view in three, Subtype A, Subtype N and Subtype P, (3) sliding amount of lag screw in correlation between Jensen classification and Ikuta's classification and (4) postoperative complications (9 cases; 1.7%) were assessed. Cut-out and back-out cases were seen in 6 cases (1.1%), and these severe complications were evaluated in details. In correlation between Jensen classification and Ikuta's classification, the excessive sliding of lag screw was prominent with the Subtype P, which was preoperatively in Jensen type III or V. Cut-out or back-out cases were caused either from (1) Subtype P that were preoperatively Jensen types III or V, or from (2) the fracture where there was bony defect anteriorly. Therefore, special care must be taken for these types. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Demystifying the Clinical Diagnosis of Greater Trochanteric Pain Syndrome in Women.

    Science.gov (United States)

    Ganderton, Charlotte; Semciw, Adam; Cook, Jill; Pizzari, Tania

    2017-06-01

    To evaluate the diagnostic accuracy of 10 clinical tests that can be used in the diagnosis of greater trochanteric pain syndrome (GTPS) in women, and to compare these clinical tests to magnetic resonance imaging (MRI) findings. Twenty-eight participants with GTPS (49.5 ± 22.0 years) and 18 asymptomatic participants (mean age ± standard deviation [SD], 52.5 ± 22.8 years) were included. A blinded physiotherapist performed 10 pain provocation tests potentially diagnostic for GTPS-palpation of the greater trochanter, resisted external derotation test, modified resisted external derotation test, standard and modified Ober's tests, Patrick's or FABER test, resisted hip abduction, single-leg stance test, and the resisted hip internal rotation test. A sample of 16 symptomatic and 17 asymptomatic women undertook a hip MRI scan. Gluteal tendons were evaluated and categorized as no pathology, mild tendinosis, moderate tendinosis/partial tear, or full-thickness tear. Clinical test analyses show high specificity, high positive predictive value, low to moderate sensitivity, and negative predictive value for most clinical tests. All symptomatic and 88% of asymptomatic participants had pathological gluteal tendon changes on MRI, from mild tendinosis to full-thickness tear. The study found the Patrick's or FABER test, palpation of the greater trochanter, resisted hip abduction, and the resisted external derotation test to have the highest diagnostic test accuracy for GTPS. Tendon pathology on MRI is seen in both symptomatic and asymptomatic women.

  19. Minimally invasive treatment of trochanteric fractures with intramedullary nails. Technique and results.

    Science.gov (United States)

    Todor, Adrian; Pojar, Adina; Lucaciu, Dan

    2013-01-01

    The aim of the study was to evaluate the results of minimally invasive treatment of trochanteric fractures with the use of intramedullary nails. From September 2010 to September 2012 we treated 21 patients with pertrochanteric fractures by a minimally invasive technique using the Gamma 3 (Stryker, Howmedica) nail. There were 13 females and 8 men with a mean age of 74.1 years, ranging from 58 to 88 years. Fractures were classified as being stable (AO type 31-A1) in 5 cases and unstable (AO type 31-A2 and A3) in the rest of 16 cases. Patients were reviewed at 6 weeks and 3 months postoperatively. Mean surgery time was 46.8 minutes and mean hospital stay was 14.9 days. No patients required blood transfusions. During the hospital stay all the patients were mobilized with weight bearing as tolerated. All patients were available for review at 6 weeks, and 2 were lost to the 3 months follow up. 16 patients regained the previous level of activity. This minimally invasive technique using a gamma nail device for pertrochanteric fractures gives reliable good results with excellent preservation of hip function.

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

    Science.gov (United States)

    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.

  1. BMD T-score discriminates trochanteric fractures from unfractured controls, whereas geometry discriminates cervical fracture cases from unfractured controls of similar BMD.

    Science.gov (United States)

    Pulkkinen, P; Partanen, J; Jalovaara, P; Jämsä, T

    2010-07-01

    The ability of bone mineral density (BMD) to discriminate cervical and trochanteric hip fractures was studied. Since the majority of fractures occur among people who are not diagnosed as having osteoporosis, we also examined this population to elucidate whether geometrical risk factors can yield additional information on hip fracture risk beside BMD. The study showed that the T-score criterion was able to discriminate fracture patients from controls in the cases of trochanteric fractures, whereas geometrical measures may discriminate cervical fracture cases in patients with T-score >-2.5. Low bone mineral density (BMD) is a well-established risk factor for hip fracture. However, majority of fractures occur among people not diagnosed as having osteoporosis. We studied the ability of BMD to discriminate cervical and trochanteric hip fractures. Furthermore, we examined whether geometrical measures can yield additional information on the assessment of hip fracture risk in the fracture cases in subjects with T-score >-2.5. Study group consisted of postmenopausal females with non-pathologic cervical (n = 39) or trochanteric (n = 18) hip fracture (mean age 74.2 years) and 40 age-matched controls. BMD was measured at femoral neck, and femoral neck axis length, femoral neck and shaft cortex thicknesses (FNC and FSC), and femoral neck-shaft angle (NSA) were measured from radiographs. BMD T-score threshold of -2.5 was able to discriminate trochanteric fractures from controls (p trochanteric fractures occurred in individuals with T-score fractures. Twenty of these fractures (51.3%) occurred in individuals with BMD in osteoporotic range and 19 (48.7%) in individuals with T-score >-2.5. Within these non-osteoporotic cervical fracture patients (N = 19) and non-osteoporotic controls (N = 35), 83.3% were classified correctly based on a model including NSA and FNC (p trochanteric fractures could be discriminated based on a BMD T-score fracture cases would remain under-diagnosed if

  2. The ′reading man flap′ for pressure sore reconstruction

    Directory of Open Access Journals (Sweden)

    Stamatis Sapountzis

    2011-01-01

    Full Text Available Background: The treatment of pressure sores represents a significant challenge to health care professionals. Although, pressure wound management demands a multidisciplinary approach, soft tissue defects requiring reconstruction are often considered for surgical management. Myocutaneous and fasciocutaneous flaps can provide stable coverage of pressure sores. Purpose: Here, we describe our experience using a recent fasciocutaneous flap, which is named ′reading man′ flap, in sacral, ischial, and trochanteric pressure sores. Materials and Methods: During a period of 1 year the authors operated 16 patients, 11 men, and 5 women, using the reading man flap. The ages of the patients ranged from 24 to 78 years. The location of pressure sores was 8 sacral, 5 ischial, and 3 trochanteric pressure sores. The mean size of pressure sores was 8 cm × 9 cm. Results: All pressure sores covered bt the Reading Man flap healed asymptomatically. After follow-up of 2-8 months, no recurrences were encountered and no further surgical intervention was required. Conclusion: The reading man flap was found to be a useful technique for the closure of pressure sore in different anatomic locations. The advantage of tension-free closure and the minimal additional healthy skin excision made this flap a useful tool in pressure sore reconstructions.

  3. Giant Urinary Bladder and Bilateral Giant Hydronephrosis due to Bladder Neck Obstruction: One Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Mohammed Fadl Tazi

    2012-01-01

    Full Text Available Bilateral hydronephrosis secondary to urinary obstruction leads to a buildup of back pressure in the urinary tract and may lead to impairment of renal function. Cases of giant hydronephrosis are rare and usually contain no more than 1-2 litres of fluid in the collecting system. Here, we report a rarely seen case with giant urinary bladder and bilateral giant hydronephrosis due to bladder neck obstruction which contains 4000 mL fluid in the collecting system of the kidney mimicking an ascites in an adult male.

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

    Science.gov (United States)

    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.

  5. Kendrick's extrication device and unstable pelvic fractures: Should a trochanteric belt be added? A cadaveric study.

    Science.gov (United States)

    Reynard, Floran A; Flaris, Alexandros N; Simms, Eric R; Rouvière, Olivier; Roy, Pascal; Prat, Nicolas J; Damizet, Jean-Gabriel; Caillot, Jean-Louis; Voiglio, Eric J

    2016-03-01

    Pre-hospital pelvic stabilisation is advised to prevent exsanguination in patients with unstable pelvic fractures (UPFs). Kendrick's extrication device (KED) is commonly used to extricate patients from cars or crevasses. However the KED has not been tested for potential adverse effects in patients with pelvic fractures. The aim of this study was to examine the effect of the KED on pubic symphysis diastasis (SyD) with and without the use of a trochanteric belt (TB) during the extraction process following a MVC. Left-sided "open-book" UPFs were created in 18 human cadavers that were placed in seven different positions simulating pre-extraction and extraction positions using the KED with and without a TB in two different positions (through and over the thigh straps). The SyD was measured using anteroposterior radiographs. The effects of the KED with and without TB, on the SyD, were evaluated. The KED alone resulted in a non-significant increase of the SyD compared to baseline, whereas the addition of a TB to the KED resulted in a significant reduction of the SyD (p<0.001). The TB through the straps provided a significantly better reduction than the TB over the straps in the extracted position (p<0.05). Our study demonstrated that a TB in combination with the KED on UPFs is an effective way to achieve early reduction. The addition of the TB in combination with the KED could be considered for Pre-Hospital Trauma Life Support (PHTLS) training protocols. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Giant nuclear resonances

    International Nuclear Information System (INIS)

    Snover, K.A.

    1989-01-01

    Giant nuclear resonances are elementary mods of oscillation of the whole nucleus, closely related to the normal modes of oscillation of coupled mechanical systems. They occur systematically in most if not all nuclei, with oscillation energies typically in the range 10-30 MeV. One of the best - known examples is the giant electric dipole (El) resonance, in which all the protons and all the neutrons oscillate with opposite phase, producing a large time - varying electric dipole moment which acts as an effective antenna for radiating gamma ray. This paper discusses this mode as well as quadrupole and monopole modes

  7. Nursery of Giants

    Science.gov (United States)

    2004-01-01

    Hidden behind a shroud of dust in the constellation Cygnus is a stellar nursery called DR21, which is giving birth to some of the most massive stars in our galaxy. Visible light images reveal no trace of this interstellar cauldron because of heavy dust obscuration. In fact, visible light is attenuated in DR21 by a factor of more than 10,000,000,000,000,000,000,000,000,000,000,000,000,000 (ten thousand trillion heptillion). New images from NASA's Spitzer Space Telescope allow us to peek behind the cosmic veil and pinpoint one of the most massive natal stars yet seen in our Milky Way galaxy. The never-before-seen star is 100,000 times as bright as the Sun. Also revealed for the first time is a powerful outflow of hot gas emanating from this star and bursting through a giant molecular cloud. This image is a large-scale mosaic assembled from individual photographs obtained with the InfraRed Array Camera (IRAC) aboard Spitzer. The image covers an area about two times that of a full moon. The mosaic is a composite of images obtained at mid-infrared wavelengths of 3.6 microns (blue), 4.5 microns (green), 5.8 microns (orange) and 8 microns (red). The brightest infrared cloud near the top center corresponds to DR21, which presumably contains a cluster of newly forming stars at a distance of 10,000 light-years. Protruding out from DR21 toward the bottom left of the image is a gaseous outflow (green), containing both carbon monoxide and molecular hydrogen. Data from the Spitzer spectrograph, which breaks light into its constituent individual wavelengths, indicate the presence of hot steam formed as the outflow heats the surrounding molecular gas. Outflows are physical signatures of processes that create supersonic beams, or jets, of gas. They are usually accompanied by discs of material around the new star, which likely contain the materials from which future planetary systems are formed. Additional newborn stars, depicted in green, can be seen surrounding the DR21 region

  8. Intramedullary femoral nailing through the trochanteric fossa versus greater trochanter tip : a randomized controlled study with in-depth functional outcome results

    NARCIS (Netherlands)

    Moein, C. M. Ansari; ten Duis, H. J.; Oey, P. L.; de Kort, G. A. P.; van der Meulen, W.; van der Werken, Chr

    2011-01-01

    In a level 1 university trauma center, an explorative randomized controlled study was performed to compare soft tissue damage and functional outcome after antegrade femoral nailing through a trochanteric fossa (also known as piriform fossa) entry point to a greater trochanter entry point in patients

  9. Intramedullary nails versus sliding hip screws for AO/OTA 31-A2 trochanteric fractures in adults: A meta-analysis.

    Science.gov (United States)

    Zhu, Qianzheng; Xu, Xiaodong; Yang, Xi; Chen, Xingzuo; Wang, Liqiang; Liu, Chenggang; Lin, Peng

    2017-07-01

    The optimum treatment with intramedullary nails (IMN) or sliding hip screws (SHS) for type 31-A2 trochanteric fractures remains controversial. Therefore, we performed a meta-analysis of randomized controlled trials (RCTs) to compare IMN with SHS in AO/OTA 31-A2 trochanteric fractures. Databases including PubMed, Cochrane, and Embase were searched to identify RCTs published before December 2016, which compared IMN with SHS for intraoperative and postoperative outcomes in AO/OTA 31-A2 trochanteric fractures. A total of 909 patients from six RCTs were subjected to the meta-analysis. The results showed that the IMN group was associated with less operative blood loss, leg shortening, wound infections, length of hospital stay, and days to mobilization with walking aids and also yielded a higher Parker score as compared to the SHS group. No significant difference was seen in the other parameters including operative details, fracture fixation complications, postoperative complications, and 1 year mortality. IMN fixation was found to be the superior treatment of choice for 31-A2 trochanteric fractures as compared with SHS fixation in our meta-analysis. The adverse effects appeared comparable between the two groups. However, due to the variations in the included studies, more large-sample, measures-unified, and high-quality RCTs are needed to validate these conclusions. Copyright © 2017. Published by Elsevier Ltd.

  10. Plate fixation in periprosthetic femur fractures Vancouver type B1-Trochanteric hook plate or subtrochanterical bicortical locking?

    Science.gov (United States)

    Lenz, Mark; Stoffel, Karl; Kielstein, Heike; Mayo, Keith; Hofmann, Gunther O; Gueorguiev, Boyko

    2016-12-01

    Proximal plate fixation in periprosthetic femur fractures can be improved by plate anchorage in the greater trochanter (lateral tension band principle) or bicortical locking screw placement beside the prosthesis stem in an embracement configuration. Both concepts were compared in a biomechanical test using a femoral hook plate (hook) or a locking attachment plate (LAP). After bone mineral density (BMD) measurement in the greater trochanter, six pairs of fresh frozen human femora were assigned to two groups and instrumented with cemented hip endoprostheses. A transverse osteotomy was set distal to the tip of the prosthesis, simulating a Vancouver B1 fracture. Each pair was instrumented using a plate tensioner with either hook or LAP construct. Cyclic testing (2Hz) with physiologic profile and monotonically increasing load was performed until catastrophic failure. Plate stiffness was compared in a four-point-bending-test. Paired student's-t-test was used for statistical evaluation (pTrochanteric fixation is highly BMD dependent and may be restricted to major greater trochanteric involvement requiring stabilization. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Comparative study of the second and third generation of gamma nail for trochanteric fractures: review of 218 cases.

    Science.gov (United States)

    Mingo-Robinet, Juan; Torres-Torres, Miguel; Martínez-Cervell, Carmen; Alonso Del Olmo, Juan Antonio; Rivas Laso, Jose A; Aguado-Hernández, Hector; Burón-Alvarez, Isidro

    2015-03-01

    The aim of this study was to compare the complications of the trochanteric gamma nail (TGN) and the Gamma3 Nail (G3), focusing on cutout failure. Retrospective comparative cohort analysis. Level II Teaching Trauma Center academic trauma center. Two hundred eighteen trochanteric fractures with a mean follow-up of 15 months were included in the study. They were treated either with the TGN or the G3 between January 2005 and December 2010. Bivariate, stratified, and logistic regression analysis was conducted to determine the association between cutout and the independent variables. Proximal anterograde nailing with either the TGN or the G3. Patient age, sex, type of intramedullary device, stability fracture pattern, tip-apex distance (TAD), distraction at the fracture site, cervical angle, and cutout. The relative risk (RR) of cutout was 4.71 times higher in the group treated with G3 (P fractures compared with stable fractures was 3.07 (1.01-9.35). In unstable fractures, the RR of cutout was 8.78 times higher in patients with G3 (P 25 mm (P = 0.4). We have not found any relationship between cutout rate and TAD. Only the fracture pattern and the type of implant have shown to be associated with cutout risk. In our study, Gamma3 Nail has higher cutout rates than TGN in unstable fractures. Therapeutic level III. See Instructions for Authors for a complete description of levels of evidence.

  12. Clinical profiles and risk factors for outcomes in older patients with cervical and trochanteric hip fracture: similarities and differences

    Science.gov (United States)

    2012-01-01

    Background Data on clinical characteristics and outcomes in regard to hip fracture (HF) type are controversial. This study aimed to evaluate whether clinical and laboratory predictors of poorer outcomes differ by HF type. Methods Prospective evaluation of 761 consecutively admitted patients (mean age 82.3 ± 8.8 years; 74.9% women) with low-trauma non-pathological HF. Clinical characteristics and short-term outcomes were recorded. Haematological, renal, liver and thyroid status, C-reactive protein, cardiac troponin I, serum 25(OH) vitamin D, PTH, leptin, adiponectin and resistin were determined. Results The cervical compared to the tronchanteric HF group was younger, have higher mean haemoglobin, albumin, adiponectin and resistin and lower PTH levels (all P trochanteric HF only hyperparathyroidism; for post-operative myocardial injury dementia, smoking and renal impairment in the former group and coronary artery disease (CAD), hyperparathyroidism and hypoleptinaemia in the latter; for LOS > 20 days CAD, and age > 75 years and hyperparathyroidism, respectively. Need of institutionalisation was predicted by age > 75 years and dementia in both groups and also by hypovitaminosis D in the cervical and by hyperparathyroidism in the trochanteric HF. Conclusions Clinical characteristics and incidence of poorer short-term outcomes in the two main HF types are rather similar but risk factors for certain outcomes are site-specific reflecting differences in underlying mechanisms. PMID:22333003

  13. A comparison of two fixation methods for femoral trochanteric fractures: a new generation intramedullary system vs sliding hip screw.

    Science.gov (United States)

    Carulli, Christian; Piacentini, Federico; Paoli, Tommaso; Civinini, Roberto; Innocenti, Massimo

    2017-01-01

    Trochanteric fractures are frequent and generally associated with bone fragility. There is still debate on the best fixation device to treat stable or rather stable trochanteric fractures: we report our clinical and radiological results of fixation with Proximal Femoral Nail "antirotation" (PFNa) in a population of patients compared to a control group treated by Sliding Hip Screw (SHS). A prospective study was conducted in 71 consecutive patients treated by PFNa (group A), and 69 by a SHS (group B), with a mean age of 81.6 and 83.4 years respectively. Short Form 12 was administered to check postoperative results, and the following parameters were evaluated: range of motion, evaluation of pain, gait ability, X-rays, and Tip Apex Distance Index. A minimum follow-up was conducted in 128 patients: 66 subjects belonging to the PFNa group and 62 to the DHS group. All patients in the group A were able to reach partial or full weight-bearing on the operated leg before leaving the hospital. Forty-four patients (63.8%) of the group B were able to walk with partial weight-bearing before discharge. We recorded 17 complications with a final overall percentage of 17.2% on the overall study population with one single case of failure in both the two groups. A statistical significance (ptrochanteric fractures as well as DHS. The light superiority of PFNa may be principally related to its mechanical advantages.

  14. Posterior dislocation of a native hip joint associated with ipsilateral per-trochanteric fracture: A rare case report

    Directory of Open Access Journals (Sweden)

    Mazin Fageir

    2018-02-01

    Full Text Available We describe a case of traumatic posterior dislocation of a native hip joint associated with ipsilateral comminuted inter-trochanteric femoral fracture. In our case, closed reduction was attempted but proved unsuccessful. Taking into account the planned subsequent intra-medullary femoral nail, open reduction through a lateral incision was undertaken. Post-operatively, the planned mobility was for a non-weight bearing period of 6 weeks followed by a partial-weight bearing period of 6 weeks before progressing to full-weight bearing. Post-operatively, the patient completed a comprehensive course of physiotherapy. At five months, he was able to walk for five miles over the course of a weekend. At six months, the patient was looking at phased return to work as a fire fighter. Radiographs taken at the time demonstrated evidence of healing to his inter-trochanteric fracture. At ten months, the patient was back to normal duties at work as a fire fighter.

  15. Precise placement of lag screws in operative treatment of trochanteric femoral fractures with a new guide system.

    Science.gov (United States)

    Poyanli, Oguz S; Soylemez, Salih; Ozkut, Afsar T; Uygur, Esat; Kemah, Bahattin; Unal, Omer K

    2015-11-01

    We assessed the accuracy of a new guide system that we developed to place lag screws in the proper position with the minimum number of attempts for operative treatment of trochanteric femoral fractures. A total of 55 consecutive trochanteric femoral fractures were treated with a cephalomedullary nail. The first 27 consecutive patients were treated with the standard operation (group A), while the new guide system was used in the last 28 consecutive patients (group B). The numbers of attempts to place K wires and the duration of surgery were noted. Accuracy of lag screw placement was evaluated by measuring the angle of deviation from the central axis of the femoral head. Deviation values ranged from -11̊ to +15̊ for the 27 cases in group A, with a median absolute deviation of 8̊±6̊. That in the 28 cases after the introduction of the new guide system (group B) ranged from -5̊ to +6̊, with a median absolute deviation of 0.5̊±3̊ (Pfractures. The present study indicated that this new guide system and nail facilitate accurate placement of lag screws in the appropriate position with the minimum number of attempts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Greater Trochanteric Pain Syndrome: Percutaneous Tendon Fenestration Versus Platelet-Rich Plasma Injection for Treatment of Gluteal Tendinosis.

    Science.gov (United States)

    Jacobson, Jon A; Yablon, Corrie M; Henning, P Troy; Kazmers, Irene S; Urquhart, Andrew; Hallstrom, Brian; Bedi, Asheesh; Parameswaran, Aishwarya

    2016-11-01

    The purpose of this study was to compare ultrasound-guided percutaneous tendon fenestration to platelet-rich plasma (PRP) injection for treatment of greater trochanteric pain syndrome. After Institutional Review Board approval was obtained, patients with symptoms of greater trochanteric pain syndrome and ultrasound findings of gluteal tendinosis or a partial tear (Pain scores were recorded at baseline, week 1, and week 2 after treatment. Retrospective clinic record review assessed patient symptoms. The study group consisted of 30 patients (24 female), of whom 50% were treated with fenestration and 50% were treated with PRP. The gluteus medius was treated in 73% and 67% in the fenestration and PRP groups, respectively. Tendinosis was present in all patients. In the fenestration group, mean pain scores were 32.4 at baseline, 16.8 at time point 1, and 15.2 at time point 2. In the PRP group, mean pain scores were 31.4 at baseline, 25.5 at time point 1, and 19.4 at time point 2. Retrospective follow-up showed significant pain score improvement from baseline to time points 1 and 2 (P.99). Our study shows that both ultrasound-guided tendon fenestration and PRP injection are effective for treatment of gluteal tendinosis, showing symptom improvement in both treatment groups. © 2016 by the American Institute of Ultrasound in Medicine.

  17. Giant Congenital Melanocytic Nevus

    DEFF Research Database (Denmark)

    Rasmussen, Bo Sonnich; Henriksen, Trine Foged; Kølle, Stig-Frederik Trojahn

    2015-01-01

    Giant congenital melanocytic nevi (GCMN) occur in 1:20,000 livebirths and are associated with increased risk of malignant transformation. The treatment of GCMN from 1981 to 2010 in a tertiary referral center was reviewed evaluating the modalities used, cosmetic results, associated complications...

  18. Waking the Sleeping Giant

    NARCIS (Netherlands)

    Ollenburger, Mary H.; Descheemaeker, Katrien; Crane, Todd A.; Sanogo, Ousmane M.; Giller, Ken E.

    2016-01-01

    The World Bank argued that West Africa's Guinea Savannah zone forms part of “Africa's Sleeping Giant,” where increases in agricultural production could be an engine of economic growth, through expansion of cultivated land in sparsely populated areas. The district of Bougouni, in southern Mali,

  19. Isotopic effect giant resonances

    International Nuclear Information System (INIS)

    Buenerd, M.; Lebrun, D.; Martin, P.; Perrin, G.; Saintignon, P. de; Chauvin, J.; Duhamel, G.

    1981-10-01

    The systematics of the excitation energy of the giant dipole, monopole, and quadrupole resonances are shown to exhibit an isotopic effect. For a given element, the excitation energy of the transition decreases faster with the increasing neutron number than the empirical laws fitting the overall data. This effect is discussed in terms of the available models

  20. from the Giant Panda

    African Journals Online (AJOL)

    STORAGESEVER

    2009-06-03

    Jun 3, 2009 ... 1College of Life Science, China West Normal University, 44# Yuying Road, 637002, Nanchong, China. 2Zhan Jiang educational ... in Escherichia coli and the RPS28 protein fusioned with the N-terminally GST -tagged protein gave rise ... long Conservation Center of the Giant Panda, Sichuan, China. The.

  1. Giant scrotal elephantiasis.

    Science.gov (United States)

    Kuepper, Daniel

    2005-02-01

    How much can a man carry? Penoscrotal elephantiasis is a debilitating syndrome. This is a case report of a patient with giant genital elephantiasis secondary to long-standing lymphogranuloma venereum infection in Ethiopia. Complete surgical resection of the pathologic tissue and penile reconstruction was undertaken with good cosmetic and functional results.

  2. Giant vesical calculus

    African Journals Online (AJOL)

    Giant vesical calculus. A case report. H. H. LAUBSCHER. Summary. An exceptional case of bladder stone is presented. The case is unusual as regards the size of the stone and the fact that the patient did··not seek medical assistance much earlier, as this was readily avail- able. Furthermore, recovery after removal of the.

  3. Juvenile giant fibroadenoma

    Directory of Open Access Journals (Sweden)

    Vipul Yagnik

    2011-07-01

    Full Text Available Fibroadenomas are benign solid tumor associated with aberration of normal lobular development. Juvenile giant fibroadenoma is usually single and >5 cm in size /or >500 gms in weight. Important differential diagnoses are: phyllodes tumor and juvenile gigantomastia. Simple excision is the treatment of choice.

  4. Giant abdominal cystic lymphangioma

    International Nuclear Information System (INIS)

    Vazquez, V.; Florencio, I.; Boluda, F.

    1996-01-01

    We present a case of giant abdominal cystic lymphangioma in a 10-year-old boy. Despite numerous consultations with physicians to identify the underlying problem, it had originally been attributed to ascites of unknown cause. We review the characteristics of this lesion and the diagnostic features that aid in differentiating it from ascites

  5. Giant peritoneal loose bodies

    African Journals Online (AJOL)

    2015-03-27

    Mar 27, 2015 ... not be familiar with the entity, can potentially be confused with malignant or parasitic lesions. Familiarity with their characteristic computed tomographic ... preventing unnecessary surgical intervention in an asymptomatic patient.3,4 It is important to differentiate giant peritoneal loose bodies from lesions such ...

  6. Risk factors for cervical and trochanteric hip fractures in elderly women: a population-based 10-year follow-up study.

    Science.gov (United States)

    Jokinen, Heikki; Pulkkinen, Pasi; Korpelainen, Juha; Heikkinen, Jorma; Keinänen-Kiukaanniemi, Sirkka; Jämsä, Timo; Korpelainen, Raija

    2010-07-01

    We evaluated the contribution of lifestyle-related factors, calcaneal ultrasound, and radial bone mineral density (BMD) to cervical and trochanteric hip fractures in elderly women in a 10-year population-based cohort study. The study population consisted of 1,681 women (age range 70-73 years). Seventy-two percent (n = 1,222) of them participated in the baseline measurements. Calcaneal ultrasound was assessed with a quantitative ultrasound device. BMD measurements were performed at the distal and ultradistal radius by dual-energy X-ray absorptiometry. Forward stepwise logistic regression analysis was used to find the most predictive variables for hip fracture risk. During the follow-up, 53 of the women had hip fractures, including 32 cervical and 21 trochanteric ones. The fractured women were taller and thinner and had lower calcaneal ultrasound values than those without fractures. High body mass index (BMI) was a protective factor against any hip fractures, while low functional mobility was a risk factor of hip fractures. Specifically, high BMI protected against cervical hip fractures, while low physical activity was a significant predictor of these fractures. Similarly, high BMI protected against trochanteric fractures, whereas low functional mobility and high coffee consumption were significant predictors of trochanteric fractures. Cervical and trochanteric hip fractures seem to have different risk factors. Therefore, fracture type should be taken into account in clinical fracture risk assessment and preventative efforts, including patient counseling. However, the study is not conclusive due to the limited number of observed fractures during follow-up, and the results have to be confirmed in future studies.

  7. Urban versus rural differences in the occurrence of hip fractures in Japan’s Kyoto prefecture during 2008–2010: a comparison of femoral neck and trochanteric fractures

    Science.gov (United States)

    2013-01-01

    Background To investigate the differences in the characteristics of femoral neck and trochanteric fractures between urban and rural areas of Kyoto Prefecture in Japan. Methods Fracture type (neck vs. trochanteric), age, sex, place where fracture occurred (indoors vs. outdoors), and cause of injury were surveyed among patients aged ≥65 years who sustained hip fractures between 2008 and 2010 and who were treated at 1 of 13 participating hospitals (5 urban, 8 rural). The ratio of sick beds to total number of beds at the participating hospitals was 19.6% (2,188/11,158) in the urban area and 34.9% (1,963/5,623) in the rural area. We also investigated the incidence of hip fracture in Tango medical district as a representative rural area. Results There were 1,346 neck (mean age, 82.4 years) and 1,606 trochanteric fractures (mean age, 85.0 years). The ratio of neck to trochanteric fractures was higher in the urban area than in the rural area in all age groups (65–74, 75–84, and ≥ 85 years). There were no apparent differences in place or cause of injury. The incidence of hip fracture in the women of Tango medical district was lower than the national average. Conclusions There was a difference in the ratio of neck to trochanteric fractures between urban and rural areas. This difference is estimated to be caused by the high and low incidence of neck fracture in urban and rural areas, respectively. PMID:24156244

  8. How evolution of the nailing system improves results and reduces orthopedic complications: more than 2000 cases of trochanteric fractures treated with the Gamma Nail System.

    Science.gov (United States)

    Pascarella, R; Fantasia, R; Maresca, A; Bettuzzi, C; Amendola, L; Violini, S; Cuoghi, F; Sangiovanni, P; Cerbasi, S; Boriani, S; Tigani, D S

    2016-04-01

    The incidence of trochanteric fractures has increased significantly during the last few decades, especially in elderly patients with osteoporosis. The dynamic/sliding hip screw and the cephalomedullary nail are the most commonly used fixation methods to treat trochanteric fractures. The improvements in the Gamma Nail System (GNS) associated with a correct surgical technique reduced the postoperative orthopedic complications. The purpose of this study was to compare the results of the different Gamma Nails. The present study is a retrospective analysis of 2144 patients treated with GNS between January 1997 and December 2011 for trochanteric fractures, classified according to AO classification method. The patients were divided into three groups according to the nailing system: 525 were treated with Standard Gamma Nail (SGN), 422 with Trochanteric Gamma Nail (TGN) and 1197 with Gamma3 Nail. The overall incidence of intra-operative complications was 1.21 %; the incidence of intra-operative complications for each group was 1.71 % for SGN group, 0.47 % for TGN group and 1.25 % for Gamma3 Nail group. The overall incidence of postoperative complications was 5.48 %, and the incidence for each group was 10.73 % for SGN group, 9.92 % for TGN group and 2.92 % for Gamma3 Nail group. The GNS is a safe device with a low rate of intra-operative complications. The evolution of this nail system reduces postoperative complications, thus improving the results at follow-up and confirming that the Gamma3 Nail is a safe and predictable device to fix trochanteric fracture.

  9. [Application of the anatomic plate and trapezoid plate in comminuted intertrochanteric fracture combined with trochanteric coronal position fracture: a controlled clinical trial].

    Science.gov (United States)

    Zhen, Ping; Liu, Xing-Yan; Gao, Ming-Xuan; Tian, Qi

    2010-05-01

    To investigate the therapeutic effect and operative characteristic of the anatomic plate and trapezoid plate for treament of the comminuted intertrochanteric fracture combined with trochanteric coronal position fracture. From Jan. 1998 to Mar. 2007, 57 patients suffered from comminuted intertrochanteric fracture combined with trochanteric coronal position fracture were randomly divided into two groups, 21 patients in trapezoid plate group were treated with the trapezoid compression plate, included 11 males and 10 females with an average age of 41.8 years; and 36 patients in anatomic plate group were treated with the anatomic plate, included 17 males and 19 females with an average age of 42.1 years. All of the 57 fractures were A3 type according to AO classification. The functions of hip joints were evaluated according to the Harris hip functional standard score. All 57 patients were followed-up for 5 months to 9 years and 3 months with an average of 4.8 years. The healing time of the fractures was from 8 to 20 weeks with an average of 12.8 weeks. The results of Harris scoring showed the pain scores of the anatomic plate group were higher than that of the trapezoid plate group (P 0.05). In unstable comminuted intertrochanteric fracture combined with trochanteric coronal position fracture, the lateral wall of trochanteric is often destroyed. The anatomic plate and the trapeziod compression plate can provide effective internal fixation, while many othere internal fixation methods were limited in this kind of fracture. As compared with the anatomic plate fixation, the trapezoid compression plate fixation of comminuted intertrochanteric fracture combined with trochanteric coronal position fracture have several advantages, such as fewer complications, faster union of fracture and earlier recovery of joint functions.

  10. Unstable intertrochanteric femur fractures in geriatric patients treated with the DLT trochanteric nail.

    Science.gov (United States)

    Temiz, Aytun; Durak, Aslihan; Atici, Teoman

    2015-07-01

    To evaluate clinical-functional and radiological results of geriatric patients with unstable intertrochanteric femur fracture treated with intramedullary nail. Thirty-two patients treated with intramedullary nail (DLT trochanteric nail) due to unstable intertrochanteric femur fractures were reviewed retrospectively. Fractures 31-A2 and 31-A3 (AO classification) were evaluated. Operation time, blood loss, and blood transfusion requirements, hospitalization period, time to fracture union were evaluated and perioperative and postoperative complications were recorded. According to the modified Baumgaertner criteria fracture reduction was analyzed radiologically, and nail tip-apex distance was measured. Femoral neck-shaft angle was also evaluated. Harris Hip Score for clinical evaluation and Kyo criteria for walking capacity were used. The mean age was 72 years (65-81), mean follow up time was 18.3 months (12-26). Nineteen patients had type 31-A2 and 13 had type 31-A3 fractures. Mean operation time was 36.3min (25-45), blood loss 185.9ml (100-250). Blood transfusion was required in 7 patients. The average hospitalization duration was 6 days (4-14) while the time to surgery from admission was 2.9 days (2-6). Radiologically, in 21 of the cases fracture reduction was well (65.6%), acceptable in 9 (28.1%), and poor in 2 (6.3%). In early postoperative period, the mean collo-diaphyseal angle was 129.1° (120-140°), mean tip-apex distance was 15.5mm (10-27). The mean Harris Hip Score was 63.4 (38-90). Two patients (6.3%) had excellent, 21 patients (65.6%) had good, 7 patients (21.8%) had moderate, and 2 patients (6.3%) had poor results. Walking capacity in the last follow-up in 20 of the cases (62.5%) was pre-fracture level. While complications were observed in seventeen patients (53.1%) (5 superficial wound infections, 5 fractures of the greater trochanter, 3 cases of secondary varus angulation and 4 cases of heterotopic ossification) none of them required additional surgery

  11. 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

    : 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. Conclusion: 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. Keywords: ASA, femoral fracture, Harris score, proximal femoral nail

  12. Avascular necrosis of the femoral head following trochanteric fractures in adults: a systematic review.

    Science.gov (United States)

    Barquet, Antonio; Mayora, Gabriel; Guimaraes, Joao Matheus; Suárez, Roberto; Giannoudis, Peter V

    2014-12-01

    Avascular necrosis of the femoral head (ANFH) following trochanteric fractures (TFx) is infrequent. The causal relationship between ANFH and TFx remains controversial. Although several major risk factors for ANFH have been proposed, most of them remain under discussion. In this study we undertook a systematic review of the literature to investigate the incidence of AVN, risk factors and outcomes following Tfx fixation. A comprehensive review of the literature was undertaken using the PRISMA guidelines with no language restriction. Case reports of ANFH and series of TFx with or without cases of ANFH published between inception of journals to December 2013 were eligible for inclusion. Relevant information was divided in two sections. Part I: included the analysis of detailed case reports of ANFH, either published isolated or included in series of TFx, with the objective of establishing potential risk factors, clinical and radiological presentation, time to development, treatment and outcome of this complication. Part II: analyzed series of TFx, which included cases of ANFH with or without details of aetiology, treatment modalities and outcomes, with the objective of assessing the incidence of ANFH in TFx. Overall 80 articles with 192 cases of ANFH after TFx met the inclusion criteria. The most probable developmental pathway appears to be a disruption of the extra osseous arterial blood supply to the femoral head. Suggested risk factors included high-energy trauma with fracture comminution and displacement, and an atypical course of the fracture line, more proximal, at the base of the neck. Most cases were diagnosed within the first two years after fracture. The clinical and radiological features appear to be similar to those of idiopathic avascular necrosis of the femoral head. The incidence of AVFH with a minimum of 1-year follow-up was calculated 0.95%, and with a minimum 2-year follow-up it was 1.37%. Total hip replacement was the mainstay of treatment. The

  13. Giant cystic craniopharyngiomas

    International Nuclear Information System (INIS)

    Young, S.C.; Zimmerman, R.A.; Nowell, M.A.; Bilaniuk, L.T.; Hackney, D.B.; Grossman, R.I.; Goldberg, H.I.

    1987-01-01

    Three cases of giant cystic craniopharyngiomas with large areas of extension beyond the suprasellar area are presented. The magnetic resonance (MR) appearance in one case is described. These giant tumors had large, multilobulated cysts that comprised the bulk of the tumors. In one case, there was an unusual extension of the large tumor cyst into the lateral ventricle. In two cases, the tumors extended to the level of the foramen magnum. On CT, the cyst contents of these two tumors were hyperdense and became hypodense postoperatively. All three tumors harbored calcifications in the form of clumps in the suprasellar region and rim calcifications around the cysts. None of the tumors exhibited contrast enhancement. A literature review of the radiographic features of craniopharyngiomas is discussed. (orig.)

  14. Giant duodenal ulcers

    Institute of Scientific and Technical Information of China (English)

    Eric Benjamin Newton; Mark R Versland; Thomas E Sepe

    2008-01-01

    Giant duodenal ulcers (GDUs) are a subset of duodenal ulcers that have historically resulted in greater morbidity than usual duodenal ulcers. Until recently,few cases had been successfully treated with medical therapy. However, the widespread use of endoscopy,the introduction of H-2 receptor blockers and proton pump inhibitors, and the improvement in surgical techniques all have revolutionized the diagnosis,treatment and outcome of this condition. Nevertheless,GDUs are still associated with high rates of morbidity,mortality and complications. Thus, surgical evaluation of a patient with a GDU should remain an integral part of patient care. These giant variants, while usually benign, can frequently harbor malignancy. A careful review of the literature highlights the important differences when comparing GDUs to classical peptic ulcers and why they must be thought of differently than their more common counterpart.

  15. Multispin giant magnons

    International Nuclear Information System (INIS)

    Bobev, N. P.; Rashkov, R. C.

    2006-01-01

    We investigate giant magnons from classical rotating strings in two different backgrounds. First we generalize the solution of Hofman and Maldacena and investigate new magnon excitations of a spin chain which are dual to a string on RxS 5 with two nonvanishing angular momenta. Allowing string dynamics along the third angle in the five sphere, we find a dispersion relation that reproduces the Hofman and Maldacena one and the one found by Dorey for the two spin case. In the second part of the paper we generalize the two 'spin' giant magnon to the case of β-deformed AdS 5 xS 5 background. We find agreement between the dispersion relation of the rotating string and the proposed dispersion relation of the magnon bound state on the spin chain

  16. Red giants seismology

    Science.gov (United States)

    Mosser, B.; Samadi, R.; Belkacem, K.

    2013-11-01

    The space-borne missions CoRoT and Kepler are indiscreet. With their asteroseismic programs, they tell us what is hidden deep inside the stars. Waves excited just below the stellar surface travel throughout the stellar interior and unveil many secrets: how old is the star, how big, how massive, how fast (or slow) its core is dancing. This paper intends to paparazze the red giants according to the seismic pictures we have from their interiors.

  17. Giant Otters in Peru

    OpenAIRE

    Schenk C.; Staib E.

    1992-01-01

    We are in the second year of fieldwork surveying for Giant Otters in the southeastern rainforest of Peru, in three areas with differing levels of legal protection. While there is some illegal hunting still happening outside the protected areas, the main threat to the otters is badly-conducted tourism. Well-organised tourism can be a promising argument for establishing protected areas like national parks.

  18. Intraoral giant condyloma acuminatum

    Directory of Open Access Journals (Sweden)

    Gupta R

    2001-09-01

    Full Text Available A case of intraoral giant condyloma acuminatum is reported in a 50- year- old Indian. He did not respond to topical application of podophyllin 20% but responded partially to electric cauterisation. Surgical excision was done to get rid of the warty growh completely. Since there were no skin or genital lesions and no history of marital or extramarital sexual contact the lesion was probably acquired from environmental sources. Nonsexual transmission should be considered especially when the lesions are extragenital.

  19. Giant prolactinomas in women

    DEFF Research Database (Denmark)

    Delgrange, Etienne; Raverot, Gerald; Bex, Marie

    2014-01-01

    OBJECTIVE: To characterise distinctive clinical features of giant prolactinomas in women. DESIGN: A multicentre, retrospective case series and literature review. METHODS: We collected data from 15 female patients with a pituitary tumour larger than 4 cm and prolactin levels above 1000 μg/l and id......OBJECTIVE: To characterise distinctive clinical features of giant prolactinomas in women. DESIGN: A multicentre, retrospective case series and literature review. METHODS: We collected data from 15 female patients with a pituitary tumour larger than 4 cm and prolactin levels above 1000 μg....../l and identified 19 similar cases from the literature; a gender-based comparison of the frequency and age distribution was obtained from a literature review. RESULTS: The initial PubMed search using the term 'giant prolactinomas' identified 125 patients (13 women) responding to the inclusion criteria. The female......:male ratio was 1:9. Another six female patients were found by extending the literature search, while our own series added 15 patients. The median age at diagnosis was 44 years in women compared with 35 years in men (Pwomen (n=34), we...

  20. 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.

  1. Internal fixation versus conservative treatment for elderly patients with a trochanteric hip fracture in conjunction with post-stroke hemiplegia.

    Science.gov (United States)

    Li, Kainan; Zheng, Yingjie

    2016-10-01

    To retrospectively evaluated Gamma nail internal fixation in the treatment of elderly patients with post-stroke hemiplegia experiencing trochanteric hip fracture. The patients were obtained consecutively from January 2005 to December 2010 with inclusion criteria. The total number was 138 and allocated to two groups: treated with the Gamma nail (n=72,group A) and continuous skin traction (n=66,group B). Preoperative variables including patient age, gender, duration of cerebrovascular accident, duration of hypertension, ASA risk score, Harris hip score and fracture type were recorded and compared. After treatment, time of patients activity on the bed, ambulation time, Harris hip score, mortality, complications were recorded and used to compare the outcomes. (1) Follow-up was undertaken from 3 to 10 years, with an average of 5.8 years. (2) No statistical difference in preoperative variables was found between the 2 groups. (3) two groups had statistical significance (P=0.000) in the time of patients activity on the bed and ambulation time and group A can activities on the bed and ambulates earlier. (4) There were significant differences between 2 groups in Harris hip score at 1 and 3 years and group A was significantly higher than group B. (5) there were statistically significant differences in mortality of 3 years, 5 years and 10 years and the group B was significantly higher than the group A. (6) There was a statistical significance in complications between 2 groups and group B was higher than group A. Major complications in group A were pain, lag screw cut out, implant infection and distal femoral fractures caused by fall after the surgery. On elderly patients with trochanteric hip fracture on the hemiplegic lower side, Gamma nail internal fixation treatment can achieve better effect, patients can be early activity, fewer complications, and less mortality. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Sliding hip screw versus the Targon PFT nail for trochanteric hip fractures: a randomised trial of 400 patients.

    Science.gov (United States)

    Parker, M J; Cawley, S

    2017-09-01

    To compare the outcomes for trochanteric fractures treated with a sliding hip screw (SHS) or a cephalomedullary nail. A total of 400 patients with a trochanteric hip fracture were randomised to receive a SHS or a cephalomedullary nail (Targon PFT). All surviving patients were followed up to one year from injury. Functional outcome was assessed by a research nurse blinded to the implant used. Recovery of mobility, as assessed by a mobility scale, was superior for those treated with the intramedullary nail compared with the SHS at eight weeks, three and nine months (p-values between 0.01 and 0.04), the difference at six and 12 months was not statistically significant (p = 0.15 and p = 0.18 respectively). The mean difference was around 0.4 points (0.3 to 0.5) on a nine point scale. Surgical time for the nail was four minutes less than that for the SHS (p Fracture healing complications were similar for the two groups. There were no statistically significant differences between implants for any other recorded outcomes including the need for post-operative blood transfusion, wound healing complications, general medical complications, hospital stay or mortality. This study confirms the findings of a previous study that both methods of treatment produce similar results, although intramedullary fixation does result in marginally improved regain of mobility in comparison with the SHS. Cite this article: Bone Joint J 2017;99-B:1210-15. ©2017 The British Editorial Society of Bone & Joint Surgery.

  3. Occurrence of secondary fracture around intramedullary nails used for trochanteric hip fractures: a systematic review of 13,568 patients.

    Science.gov (United States)

    Norris, Rory; Bhattacharjee, Dhritiman; Parker, Martyn J

    2012-06-01

    A sliding hip screw (SHS) is currently the treatment of choice for trochanteric hip fractures, largely due to the low incidence of complications. An alternative treatment is the use of intramedullary proximal femoral nails. Unfortunately these implants have been associated with a risk of later fracture around the implant. The aim of this study was to see if any improvements have been made to the current intramedullary nails, to reduce the incidence of secondary fracture around the distal tip of the nail. We analysed data related to 13,568 patients from 89 studies, focusing on the incidence of post operative secondary femoral shaft fracture following the use of intramedullary nails in the fixation of trochanteric hip fractures. The overall reported incidence of secondary fracture around the nail was 1.7%. The incidence of fracture has reduced in the 3rd generation Gamma nails when compared to the older Gamma nail (1.7% versus 2.6%, p value 0.03). However, the incidence of secondary fracture in the 3rd generation Gamma nails is still significantly higher than the other brands of short nail (1.7% versus 0.7%, p value 0.0005). Long nails had a slight tendency towards a lower risk of fracture although the difference was not statistically significant (1.1% versus 1.7%, p value 0.28). There was a significantly lower risk of fracture for those nails with a biaxial fixation as opposed to uniaxial fixation (0.6% versus 1.9%, p value fracture around a proximal femoral nail is one of the most significant of fracture healing complications, and this study suggests that continuing design changes to this method of fixation has reduced the risk of this complication occurring. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Operational durability of a giant ER valve for Braille display

    Science.gov (United States)

    Luning, Xu; Han, Li; Yufei, Li; Shen, Rong; Kunquan, Lu

    2017-05-01

    The compact configuration of giant ER (electrorheological) valves provides the possibility of realizing a full-page Braille display. The operational durability of ER valves is a key issue in fulfilling a Braille display. A giant ER valve was used to investigate the variations in pressure drops and critical pressure drops of the valves over a long period under some typical operational parameters. The results indicate that neither the pressure drops nor critical pressure drops of giant ER valves show apparent deterioration over a long period. Without ER fluid exchange, a blockage appears in the channel of the valve because the ER structures induced by an external electric field cannot be broken by the Brownian motion of hydraulic oil molecules when the external electric field is removed. Forcing ER fluid flow is an effective and necessary method to keep the channel of the valve unblocked. Thus the operational durability of the valve using giant ER fluids is able to meet the demands of Braille display.

  5. Grain-gas interaction in envelopes of red giants

    International Nuclear Information System (INIS)

    Maciel, W.J.

    1976-01-01

    A model for the ejection of the dust shell of red giant stars through the action of the stellar radiation pressure is developed. Being momentum-coupled to the gas, the dust shell can drive an effective mass loss. On the other hand, the grain injection rate into the interstellar space can be estimated [pt

  6. Isoscalar giant resonances

    Energy Technology Data Exchange (ETDEWEB)

    Youngblood, D. H. [Texas A and M Univ., College Station (USA). Cyclotron Inst.; Ikegami, H.; Muraoka, M. [eds.

    1980-01-01

    The current status of the knowledges of giant quadrupole resonance (GQR), low energy octupole resonance (LEOR), and giant monopole resonance (GMR), is described. In the lowest order of multipole resonance, both isoscalar and isovector modes can occur. The characteristics of the GQR in light nuclei are apparent in the experimental result for Mg-24. All of the isoscalar E2 strength are known in Mg-24. The Goldhaber-Teller model is preferred over the Steinwedel-Jensen model for the giant dipole resonance (GDR) transition density. A few interesting and puzzling features have been seen in Pb-208. There is some conflict between inelastic alpha and electron scatterings. About LEOR, the RPA calculation of Liu and Brown was compared to the data for 3/sup -/ strength in Ca-40, Zr-90 and Pb-208. The calculation was employed the residual interaction of the Skyrme type. The agreement in Zr-90 was excellent. The effect of quadrupole deformation on the LEOR in Sm isotopes was large. The inelastic alpha scattering data on Al-27, Ca-40, Ti-48, Ni-58, Zn-64 and 66, Zr-90, Sn-116, 118, 120 and 124, Sm-144, 148 and 154, and Pb-208 were utilized in order to identify the GMR, and the GMR parameters were obtained. The GMR exhausting a large fraction of the sum rule was apparent in the nuclei with mass larger than 90. The splitting of the GDR and the broadening of the GQR in permanently deformed nuclei were established. The splitting of GMR was seen in Sm-154. The studies with heavy ions are also described.

  7. Magma ocean formation due to giant impacts

    Science.gov (United States)

    Tonks, W. B.; Melosh, H. J.

    1993-01-01

    The thermal effects of giant impacts are studied by estimating the melt volume generated by the initial shock wave and corresponding magma ocean depths. Additionally, the effects of the planet's initial temperature on the generated melt volume are examined. The shock pressure required to completely melt the material is determined using the Hugoniot curve plotted in pressure-entropy space. Once the melting pressure is known, an impact melting model is used to estimate the radial distance melting occurred from the impact site. The melt region's geometry then determines the associated melt volume. The model is also used to estimate the partial melt volume. Magma ocean depths resulting from both excavated and retained melt are calculated, and the melt fraction not excavated during the formation of the crater is estimated. The fraction of a planet melted by the initial shock wave is also estimated using the model.

  8. Giant Ulcerative Dermatofibroma

    Directory of Open Access Journals (Sweden)

    Turgut Karlidag

    2013-01-01

    Full Text Available Dermatofibroma is a slowly growing common benign cutaneous tumor characterized by hard papules and nodules. The rarely seen erosions and ulcerations may cause difficulties in the diagnosis. Dermatofibrosarcoma protuberans, which is clinically and histopathologically of malignant character, displays difficulties in the diagnosis since it has similarities with basal cell carcinoma, epidermoid carcinoma, and sarcomas. Head and neck involvement is very rare. In this study, a giant dermatofibroma case, which is histopathologically, ulcerative dermatofibroma, the biggest lesion of the head and neck region and seen rarely in the literature that has characteristics similar to dermatofibrosarcoma protuberans, has been presented.

  9. GIANT PROSTHETIC VALVE THROMBUS

    Directory of Open Access Journals (Sweden)

    Prashanth Kumar

    2015-04-01

    Full Text Available Mechanical prosthetic valves are predisposed to bleeding, thrombosis & thromboembolic complications. Overall incidence of thromboembolic complications is 1% per year who are on oral anticoagulants, whereas bleeding complications incidence is 0.5% to 6.6% per year. 1, 2 Minimization of Scylla of thromboembolic & Charybdis of bleeding complication needs a balancing act of optimal antithrombotic therapy. We are reporting a case of middle aged male patient with prosthetic mitral valve presenting in heart failure. Patient had discontinued anticoagulants, as he had subdural hematoma in the past. He presented to our institute with a giant prosthetic valve thrombus.

  10. A Giant Urethral Calculus.

    Science.gov (United States)

    Sigdel, G; Agarwal, A; Keshaw, B W

    2014-01-01

    Urethral calculi are rare forms of urolithiasis. Majority of the calculi are migratory from urinary bladder or upper urinary tract. Primary urethral calculi usually occur in presence of urethral stricture or diverticulum. In this article we report a case of a giant posterior urethral calculus measuring 7x3x2 cm in a 47 years old male. Patient presented with acute retention of urine which was preceded by burning micturition and dribbling of urine for one week. The calculus was pushed in to the bladder through the cystoscope and was removed by suprapubic cystolithotomy.

  11. GIANT INTRACANALICULAR FIBROADENOMA

    Science.gov (United States)

    Smith, Clyn; Parsons, Robert J.; Bogart, William M.

    1951-01-01

    Five cases of giant intracanalicular fibroadenoma (“cystosarcoma phylloides”) were observed at one hospital in a period of three years. In a search of the literature, additional reports of breast tumors of this kind, not included in previous reviews, were noted. As there is record of 229 cases, it would appear that this rapidly growing benign tumor should be kept in mind in the diagnosis of masses in the breast. If removal is incomplete, there may be recurrence. Simple mastectomy is the treatment of choice. Radical mastectomy should be avoided. ImagesFigure 1Figure 2.Figure 3Figure 4Figure 5 PMID:14848732

  12. Microwave plasmatrons for giant integrated circuit processing

    Energy Technology Data Exchange (ETDEWEB)

    Petrin, A.B.

    2000-02-01

    A method for calculating the interaction of a powerful microwave with a plane layer of magnetoactive low-pressure plasma under conditions of electron cyclotron resonance is presented. In this paper, the plasma layer is situated between a plane dielectric layer and a plane metal screen. The calculation model contains the microwave energy balance, particle balance, and electron energy balance. The equation that expressed microwave properties of nonuniform magnetoactive plasma is found. The numerical calculations of the microwave-plasma interaction for a one-dimensional model of the problem are considered. Applications of the results for microwave plasmatrons designed for processing giant integrated circuits are suggested.

  13. The administration of intermittent parathyroid hormone affects functional recovery from trochanteric fractured neck of femur: a randomised prospective mixed method pilot study.

    Science.gov (United States)

    Chesser, T J S; Fox, R; Harding, K; Halliday, R; Barnfield, S; Willett, K; Lamb, S; Yau, C; Javaid, M K; Gray, A C; Young, J; Taylor, H; Shah, K; Greenwood, R

    2016-06-01

    We wished to assess the feasibility of a future randomised controlled trial of parathyroid hormone (PTH) supplements to aid healing of trochanteric fractures of the hip, by an open label prospective feasibility and pilot study with a nested qualitative sub study. This aimed to inform the design of a future powered study comparing the functional recovery after trochanteric hip fracture in patients undergoing standard care, versus those who undergo administration of subcutaneous injection of PTH for six weeks. We undertook a pilot study comparing the functional recovery after trochanteric hip fracture in patients 60 years or older, admitted with a trochanteric hip fracture, and potentially eligible to be randomised to either standard care or the administration of subcutaneous PTH for six weeks. Our desired outcomes were functional testing and measures to assess the feasibility and acceptability of the study. A total of 724 patients were screened, of whom 143 (20%) were eligible for recruitment. Of these, 123 were approached and 29 (4%) elected to take part. However, seven patients did not complete the study. Compliance with the injections was 11 out of 15 (73%) showing the intervention to be acceptable and feasible in this patient population. Only 4% of patients who met the inclusion criteria were both eligible and willing to consent to a study involving injections of PTH, so delivering this study on a large scale would carry challenges in recruitment and retention. Methodological and sample size planning would have to take this into account. PTH administration to patients to enhance fracture healing should still be considered experimental. Cite this article: Bone Joint J 2016;98-B:840-5. ©2016 Chesser et al.

  14. Long versus short cephalomedullary nail for trochanteric femur fractures (OTA 31-A1, A2 and A3): a systematic review.

    Science.gov (United States)

    Dunn, John; Kusnezov, Nicholas; Bader, Julia; Waterman, Brian R; Orr, Justin; Belmont, Philip J

    2016-12-01

    Both long and short cephalomedullary nails (CMN) may be used to treat trochanteric femur fractures. The objective of this paper was to compare the clinical outcomes between long and short CMN in the treatment of trochanteric hip fractures. A literature search was performed, identifying 135 papers; 4 of which met inclusion and exclusion criteria. Papers included were those that compared cohorts of long and short nails for stable trochanteric femur fractures of level III evidence or superior. Data was pooled and analyzed, focusing on reoperation rate, secondary femoral shaft fracture rate, estimated blood loss, transfusion rate, operative time and length of stay. Included in the analysis were 1276 patients, with 438 short and 838 long CMN. The average age was 82.0 years for short CMN and 79.0 years for long CMN (P = 0.0002). The average follow up was 18 months, 46 % were male, and 71 % had an ASA (American Society of Anesthesiologists score) classification ≥3. The rate of reoperation was 5.0 % and 3.8 % for short and long CMN, respectively (P = 0.31). The rate of refracture was 1.6 % and 0.95 % for short and long CMN, respectively (P = 0.41). As compared to long nails, short nails had an average blood loss of 39 mL less (P = 0.0003), an 8.8 % decrease in transfusion rate (P = 0.07), and incurred 19 min less operative time (P trochanteric femur fractures, short CMN have a low reoperation rate while significantly decreasing operative time and estimated blood loss with the additional benefit of being cost effective. Level 3.

  15. New quantitative ultrasound techniques for bone analysis at the distal radius in hip fracture cases: differences between femoral neck and trochanteric fractures.

    Science.gov (United States)

    Horii, Motoyuki; Fujiwara, Hiroyoshi; Sakai, Ryo; Sawada, Koshiro; Mikami, Yasuo; Toyama, Syogo; Ozaki, Etsuko; Kuriyama, Nagato; Kurokawa, Masao; Kubo, Toshikazu

    2017-01-01

    Ample evidence on etiological and pathological differences between femoral neck and trochanteric fracture cases suggests the possibility of individualized treatment. There are many issues related to areal bone mineral density and other quantitative computed tomography parameters of the proximal femur. Although osteoporosis is a systemic problem, little has been reported regarding differences in bone structural parameters, including bone mineral density, between them in regions other than the proximal femur. Participants were consecutive female patients >50 years of age admitted to the Saiseikai Suita Hospital (Osaka prefecture, Japan) for their first hip fracture between January 2012 and September 2014. Cortical thickness (CoTh, mm), volumetric trabecular bone mineral density (TBD, mg/cm 3 ), and elastic modulus of trabecular bone (EMTb, GPa) were obtained as the new QUS parameters using the LD-100 system (Oyo Electric, Kyoto, Japan). The mean values of these parameters were compared between femoral neck and trochanteric fracture cases. In addition, correlations between age and each QUS parameter were investigated for each fracture type. A receiver operating characteristic (ROC) curve analysis was performed to examine the degree of effect each parameter on the fracture types. The area under the curve (AUC) for each parameter was compared to the AUC for age. There were 63 cases of femoral neck fracture (mean age, 78.2 years) and 37 cases of trochanteric fracture (mean age, 85.9 years). Mean TBD and EMTb were significantly higher for femoral neck fractures. There were significant negative correlations between QUS parameters and age for femoral neck fractures (P fractures were above those for trochanteric fractures for TBD and EMTb. AUCs were 0.72 for age, and 0.61, 0.65, and 0.65 for CoTh, TBD, and EMTb, respectively. The new QUS parameters indicated that TR fracture cases were more osteoporotic than were FN fracture cases, even at the distal radius. There might be

  16. Do PFNA devices and Intertan nails both have the same effects in the treatment of trochanteric fractures? A prospective clinical study.

    Science.gov (United States)

    Seyhan, Mustafa; Turkmen, Ismail; Unay, Koray; Ozkut, Afsar Timucin

    2015-11-01

    To clinically and radiologically compare third-generation intramedullary nails used in the treatment of trochanteric hip fractures and to determine their efficacy. Seventy-five of 88 patients admitted to our hospital with trochanteric fractures were enrolled in the study; 43 were treated with PFNA devices and 32 with Intertan nails. The amount of compression applied during the procedure, duration of the procedure, amount of subsequent shortening in the proximal femoral area, subsequent backup of proximal screws, and changes in the tip-apex and tip-cortex distances were compared between groups. The postoperative change in the varus angle of the proximal femur and times to mobilization, full weight bearing, and fracture union were also evaluated. On early postoperative radiographs, the tip-apex distance was ≤25 mm in 86 % of patients in the PFNA group and 96.9 % of those in the Intertan group. Twelve months postoperatively, the tip-apex distance did not differ between groups. No cut-out of the screws into the coxofemoral joint was observed. Fracture healing was achieved in all patients. At 12 months postoperatively, the rates of proximal screw backup, proximal femoral shortening, and decrease in the varus angle of the proximal femur were significantly higher in the PFNA group than in the Intertan group. Trochanteric fractures may be treated effectively with PFNA devices or Intertan nails. During the healing period, the rates of reverse displacement of the proximal screw, shortening of the proximal femur, and decrease in the varus angle of the proximal femur were significantly higher in the PFNA group than in the Intertan group. Surgical technique, implant positioning, and the choice of implant play roles in the successful treatment of trochanteric fractures. Level 1, prospective, prognostic study.

  17. Giant VAC in a patient with extensive necrotizing fasciitis.

    Science.gov (United States)

    Steinstraesser, Lars; Sand, Michael; Steinau, Hans-Ulrich

    2009-03-01

    The authors present a case of an extensive fulminant necrotizing fasciitis of the left flank, thigh, and lower parts of the leg treated with debridement, split-thickness skin grafting, and a giant negative pressure wound dressing covering 0.53 m( 2) or 18% of the body surface. To the authors' knowledge, this is the largest split-thickness grafted body surface successfully treated with negative pressure wound dressing documented in the literature.

  18. Allometry indicates giant eyes of giant squid are not exceptional.

    Science.gov (United States)

    Schmitz, Lars; Motani, Ryosuke; Oufiero, Christopher E; Martin, Christopher H; McGee, Matthew D; Gamarra, Ashlee R; Lee, Johanna J; Wainwright, Peter C

    2013-02-18

    The eyes of giant and colossal squid are among the largest eyes in the history of life. It was recently proposed that sperm whale predation is the main driver of eye size evolution in giant squid, on the basis of an optical model that suggested optimal performance in detecting large luminous visual targets such as whales in the deep sea. However, it is poorly understood how the eye size of giant and colossal squid compares to that of other aquatic organisms when scaling effects are considered. We performed a large-scale comparative study that included 87 squid species and 237 species of acanthomorph fish. While squid have larger eyes than most acanthomorphs, a comparison of relative eye size among squid suggests that giant and colossal squid do not have unusually large eyes. After revising constants used in a previous model we found that large eyes perform equally well in detecting point targets and large luminous targets in the deep sea. The eyes of giant and colossal squid do not appear exceptionally large when allometric effects are considered. It is probable that the giant eyes of giant squid result from a phylogenetically conserved developmental pattern manifested in very large animals. Whatever the cause of large eyes, they appear to have several advantages for vision in the reduced light of the deep mesopelagic zone.

  19. Recurrent giant juvenile fibroadenoma

    Directory of Open Access Journals (Sweden)

    Kathryn S. King

    2017-11-01

    Full Text Available Breast masses in children, though rare, present a difficult clinical challenge as they can represent a wide variety of entities from benign fibroadenomas to phyllodes tumors. Rapidly growing or recurrent masses can be particularly concerning to patients, families and physicians alike. Clinical examination and conventional imaging modalities are not efficacious in distinguishing between different tumor types and surgical excision is often recommended for both final diagnosis and for treatment of large or rapidly growing masses. While surgical excision can result in significant long-term deformity of the breast there are some surgical techniques that can be used to limit deformity and/or aid in future reconstruction. Here we present a case of recurrent giant juvenile fibroadenoma with a review of the clinical presentation, diagnostic tools and treatment options.

  20. Hadron excitation of giant resonances

    International Nuclear Information System (INIS)

    Morsch, H.-P.

    1985-01-01

    A review is given on giant resonance studies in heavy nuclei using scattering of different hadronic probes. Concerning isoscalar giant resonances compression modes are discussed with the possibility to obtain more detailed structure information. From detailed studies of α scattering the distribution of isoscalar strengths of multipolarity up to L=6 was obtained. Some recent aspects of heavy ion excitation of collective modes are mentioned. The possibility to study isovector giant resonances in hadron charge exchange reactions is discussed. Finally, a comparison is made between α and 200 MeV proton scattering from which isoscalar and spin-isospin continuum response are extracted. (orig.)

  1. Maxillomandibular giant osteosclerotic lesions

    Directory of Open Access Journals (Sweden)

    Constantino LEDESMA-MONTES

    2018-06-01

    Full Text Available Abstract Giant Osteosclerotic Lesions (GOLs are a group of rarely reported intraosseous lesions. Their precise diagnosis is important since they can be confused with malignant neoplasms. Objective This retrospective study aimed to record and analyze the clinical and radiographic Giant Osteosclerotic Lesions (GOLs detected in the maxillomandibular area of patients attending to our institution. Materials and Methods: Informed consent from the patients was obtained and those cases of 2.5 cm or larger lesions with radiopaque or mixed (radiolucid-radiopaque appearance located in the maxillofacial bones were selected. Assessed parameters were: age, gender, radiographic aspect, shape, borders, size, location and relations to roots. Lesions were classified as radicular, apical, interradicular, interradicular-apical, radicular-apical or located in a previous teeth extraction area. Additionally, several osseous and dental developmental alterations (DDAs were assessed. Results Seventeen radiopacities in 14 patients were found and were located almost exclusively in mandible and were two types: idiopathic osteosclerosis and condensing osteitis. GOLs were more frequent in females, and in the anterior and premolar zones. 94.2% of GOLs were qualified as idiopathic osteosclerosis and one case was condensing osteitis. All studied cases showed different osseous and dental developmental alterations (DDAs. The most common were: Microdontia, hypodontia, pulp stones, macrodontia and variations in the mental foramina. Conclusions GOLs must be differentiated from other radiopaque benign and malignant tumors. Condensing osteitis, was considered an anomalous osseous response induced by a chronic low-grade inflammatory stimulus. For development of idiopathic osteosclerosis, two possible mechanisms could be related. The first is modification of the normal turnover with excessive osseous deposition. The second mechanism will prevent the normal bone resorption, arresting the

  2. Intracavitary drainage procedure for giant bullae in compromised patients.

    Science.gov (United States)

    Verma, R K; Nishiki, M; Mukai, M; Fujii, T; Kuranishi, F; Yoshioka, S; Ohtani, M; Dohi, K

    1991-09-01

    Two cases of giant bullae were treated by intracavitary suction and drainage procedure under local anesthesia because of the poor pulmonary function. After staged bullectomy, the patients returned to normal life. The first case was admitted to our intensive care unit (ICU). Tube drainage was performed in the giant bulla of the left lung immediately after admission. One month after recovery from right heart failure and mediastinal shift to the right side, bullectomy was performed using linear stapler. The patient was discharged 20 days later. The second case was admitted with severe dyspnea and bilateral giant bullae were noticed. We performed tube drainage for larger bulla of the left lung under local anesthesia. Two months later, bullectomy was performed on the right side, because the bulla on the left side became smaller and the general condition of the patient improved. The patient was discharged three months later on foot and has since been asymptomatic. Giant bulla is a well-established clinical entity which includes abnormal dilatation of various parts of the tracheo-bronchial tree and other discrete sacs originating from the interstitial portion of the lung. Giant bullae are frequently associated with marked dyspnea and emphysematous symptoms. However, these symptoms depend upon various factors: size, location, valvular mechanism, condition of the contiguous lung parenchyma and the changes that may take place in the intrathoracic pressure.

  3. [Options for flap coverage in pressure sores].

    Science.gov (United States)

    Nae, S; Antohi, N; Stîngu, C; Stan, V; Parasca, S

    2010-01-01

    Despite improvements in reconstructive techniques for pressure sores, recurrences are still seen frequently, and success rate remains variable. During 2003 - 2007, at the Emergency Hospital for Plastic Surgery and Burns in Bucharest, 27 patients underwent surgical repair of 45 pressure sores located at sacral (22 ulcers), ischial (12 ulcers) and trochanteric (11 ulcers) regions. The mean patient age was 57, 1 years (range 26 to 82 years). Mean postoperative follow-up was 6 months (range 2 months - 2 years). There were 18 complications for the 45 sores (40%). At 6 months postoperatively, recurrence was noted in 12 ulcers (27%). Details regarding indications, contraindications, advantages and disadvantages for different coverage options are outlined. The authors advocate the importance of surgical coverage in reducing morbidity, mortality and treatment costs.

  4. Collective motion and giant resonances

    International Nuclear Information System (INIS)

    Wilhelmi, Z.; Kicinska-Habior, M.

    1984-01-01

    The report contains 15 papers devoted to problems of giant collective excitations of nuclei, heavy-ion induced reactions and their bearing on various aspects of nuclear structure. In some of them the numerical data are given. (A.S.)

  5. Greater Trochanteric Fixation Using a Cable System for Partial Hip Arthroplasty: A Clinical and Finite Element Analysis

    Directory of Open Access Journals (Sweden)

    Fırat Ozan

    2014-01-01

    Full Text Available The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA. Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%, good in 17 patients (53.1%, average in 5 patients (15.6%, and poor in 1 patient (9.3%. Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%, fibrous union in 12 (37.5%, and no union in 6 (18.7%. FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery.

  6. Greater Trochanteric Fixation Using a Cable System for Partial Hip Arthroplasty: A Clinical and Finite Element Analysis

    Science.gov (United States)

    Ozan, Fırat; Koyuncu, Şemmi; Pekedis, Mahmut; Altay, Taşkın; Yıldız, Hasan; Toker, Gökhan

    2014-01-01

    The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women) was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA). Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%), good in 17 patients (53.1%), average in 5 patients (15.6%), and poor in 1 patient (9.3%). Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%), fibrous union in 12 (37.5%), and no union in 6 (18.7%). FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery. PMID:25177703

  7. An in-vitro biomechanical study of different fixation techniques for the extended trochanteric osteotomy in revision THA.

    Science.gov (United States)

    Zhu, Zhonglin; Ding, Hui; Shao, Hongyi; Zhou, Yixin; Wang, Guangzhi

    2013-04-09

    The wire fixation and the cable grip fixation have been developed for the extended trochanteric osteotomy (ETO) in the revision of total hip arthroplasty (THA). Many studies reported the postoperative performance of the patients, but with little quantitative biomechanical comparison of the two fixation systems. An in-vitro testing approach was designed to record the loosening between the femoral bed and the greater trochanter after fixations. Ten cadaveric femurs were chosen in this study. Each femur underwent the THA, revision by ETO and fixations. The tension to the greater trochanter was from 0 to 500N in vertical and lateral direction, respectively. The translation and rotation of the greater trochanter with respect to the bony bed were captured by an optical tracking system. In the vertical tension tests, the overall translation of the greater trochanter was observed 0.4 mm in the cable fixations and 7.0 mm in the wire fixations. In the lateral tension tests, the overall motion of the greater trochanter was 2.0 mm and 1.2° in the cable fixations, while it was 6.2 mm and 5.3° in the wire fixations. The result was significantly different between the two fixation systems. The stability of the proximal femur after ETO using different fixations in the revision THA was investigated. The cable grip fixation was significantly more stable than the wire fixation.

  8. Bringing Low the Giants

    CERN Multimedia

    2001-01-01

    Their work goes on unseen, because they a hundred metres beneath your feet. But while the race against the clock to build the LHC has begun on the surface, teams underground are feverishly engaged to dismantle LEP and its experiments. Four months after the start of dismantling, the technical coordinators of the different experiments discuss the progress of work. Little men attack the giant ALEPH. The barrel and its two endcaps have been removed to the end of the cavern and stripped of their cables. The breaking up of the detector can now begin. At ALEPH, counting rooms removed all in one go Jean-Paul Fabre, technical coordinator at ALEPH:'After making safe the structure, the first step was to remove the wiring and cables. Some 210 cubic metres were brought out. Then the counting rooms all round the detector were taken out. They were brought up from the cavern all in one go, up through the shaft, which is 10 metres wide and 150 metres deep. They made it with 15 centimetres to spare. They have been emptied of...

  9. Giant high occipital encephalocele

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2016-03-01

    Full Text Available Encephaloceles are rare embryological mesenchymal developmental anomalies resulting from inappropriate ossification in skull through with herniation of intracranial contents of the sac. Encephaloceles are classified based on location of the osseous defect and contents of sac. Convexity encephalocele with osseous defect in occipital bone is called occipital encephalocele. Giant occipital encephaloceles can be sometimes larger than the size of baby skull itself and they pose a great surgical challenge. Occipital encephaloceles (OE are further classified as high OE when defect is only in occipital bone above the foramen magnum, low OE when involving occipital bone and foramen magnum and occipito-cervical when there involvement of occipital bone, foramen magnum and posterior upper neural arches. Chiari III malformation can be associated with high or low occipital encephaloceles. Pre-operatively, it is essential to know the size of the sac, contents of the sac, relation to the adjacent structures, presence or absence of venous sinuses/vascular structures and osseous defect size. Sometimes it becomes imperative to perform both CT and MRI for the necessary information. Volume rendered CT images can depict the relation of osseous defect to foramen magnum and provide information about upper neural arches which is necessary in classifying these lesions.

  10. Anogenital giant seborrheic keratosis.

    Science.gov (United States)

    Wollina, Uwe; Chokoeva, Anastasiya; Tchernev, Georgi; Heinig, Birgit; Schönlebe, Jacqueline

    2017-08-01

    Seborrheic keratosis (SK) are very common benign epidermal tumors. Giant seborrheic keratosis (GSK) is a rare variant with clinical characteristics, which leads very often to misdiagnosis. A genital site of SK is very unusual clinical manifestation and although the cause is still unknown, current literature data point to a possible pathogenetic role of chronic friction and HPV infection. The rare genital localization makes Buschke-Löwenstein tumor and verrucous carcinoma important differential diagnoses. GSK may also show some clinical features of a melanoacanthoma, which makes cutaneous melanoma as another possible differential diagnosis. The clinical diagnosis of genital GSK is often a very difficult one, because the typical clinical features of GSK disappear and the most common dermoscopic features of GSK are usually not seen in the genital region lesions. The diagnosis of GSK of the anogenital area should be made only and always after the exact histological verification and variety of differential diagnosis should be carefully considered. The treatment of GSK is primary surgically. We present a rare case of GSK with concomitant HPV infection in the anogenital region of 72-year-old patient. Surgical approach was performed with excellent outcome.

  11. Aplicación de terapia de vacío en el tratamiento de nevus pigmentario gigante en la infancia Negative pressure therapy in the treatment of a giant melanocytic nevus in chilhood

    Directory of Open Access Journals (Sweden)

    J. Fregenal

    2011-12-01

    Full Text Available Los nevus melanocíticos gigantes congénitos son muy infrecuentes. Su incidencia de malignización varía según las series clínicas entre el 2 y el 45%. Este riesgo de malignización y los problemas de adaptación psicosocial que suelen acarrear hacen recomendable el inicio del tratamiento quirúrgico de este tipo de lesiones antes de la edad escolar. Presentamos el caso de un niño de 7 años de edad con nevus melanocítico congénito gigante que afectaba a la espalda y al flanco derecho, de 30 x 19 cm de diámetro. Desarrollamos un protocolo terapéutico mediante programación de intervenciones quirúrgicas seriadas de mínima morbilidad, con postoperatorio simple y poco doloroso. En un primer tiempo realizamos extirpación de la lesión con bisturí ultrasónico y cobertura temporal del defecto creado con dermis artificial. En un segundo tiempo intentamos cobertura definitiva con piel cultivada autóloga, siendo necesario un tercer tiempo de cobertura con autoinjerto de espesor ultrafino. En este caso, el sistema de terapia de presión negativa VAC® mostró su eficacia para inmovilizar los apósitos de forma segura, indolora y en régimen ambulatorio.Giant congenital melanocytic nevi are very uncommon. Malignization incidence varies according to clinical series between 2 and 45%. This risk of malignization and psychosocial adaptation problems make necessary to begin the surgical treatment before school age. We present a 7-year-old child with a giant melanocytic nevus in the back and right flank, 30 x 19 cm in size. A therapeutic protocol using serial surgical interventions with minimal morbidity and an easy and painless postoperative care were developed. In the first surgery we removed the nevus with ultrasonic scalpel and used artificial dermis as a temporary coverage. In the second time we tried to complete the definitive coverage with autologous cultured skin, but we needed a third time to apply definitive ultrathin skin autograft. In

  12. Excitation of giant resonances in heavy ion collisions

    International Nuclear Information System (INIS)

    Kuehn, W.

    1991-01-01

    Introduction: What are Giant Resonances? General Features of Giant Resonances, Macroscopic Description and Classification, Basic Excitation Mechanisms, Decay Modes, Giant Resonances Built on Excited States, Relativistic Coulomb Excitation of Giant Resonances, Experimental Situation. (orig.)

  13. Proposal of new classification of femoral trochanteric fracture by three-dimensional computed tomography and relationship to usual plain X-ray classification.

    Science.gov (United States)

    Shoda, Etsuo; Kitada, Shimpei; Sasaki, Yu; Hirase, Hitoshi; Niikura, Takahiro; Lee, Sang Yang; Sakurai, Atsushi; Oe, Keisuke; Sasaki, Takeharu

    2017-01-01

    Classification of femoral trochanteric fractures is usually based on plain X-ray findings using the Evans, Jensen, or AO/OTA classification. However, complications such as nonunion and cut out of the lag screw or blade are seen even in stable fracture. This may be due to the difficulty of exact diagnosis of fracture pattern in plain X-ray. Computed tomography (CT) may provide more information about the fracture pattern, but such data are scarce. In the present study, it was performed to propose a classification system for femoral trochanteric fractures using three-dimensional CT (3D-CT) and investigate the relationship between this classification and conventional plain X-ray classification. Using three-dimensional (3D)-CT, fractures were classified as two, three, or four parts using combinations of the head, greater trochanter, lesser trochanter, and shaft. We identified five subgroups of three-part fractures according to the fracture pattern involving the greater and lesser trochanters. In total, 239 femoral trochanteric fractures (45 men, 194 women; average age, 84.4 years) treated in four hospitals were classified using our 3D-CT classification. The relationship between this 3D-CT classification and the AO/OTA, Evans, and Jensen X-ray classifications was investigated. In the 3D-CT classification, many fractures exhibited a large oblique fragment of the greater trochanter including the lesser trochanter. This fracture type was recognized as unstable in the 3D-CT classification but was often classified as stable in each X-ray classification. It is difficult to evaluate fracture patterns involving the greater trochanter, especially large oblique fragments including the lesser trochanter, using plain X-rays. The 3D-CT shows the fracture line very clearly, making it easy to classify the fracture pattern.

  14. What is the optimal salvage procedure for cut-out after surgical fixation of trochanteric fractures with the PFNA or TFN?: A multicentre study.

    Science.gov (United States)

    Brunner, Alexander; Büttler, Markus; Lehmann, Uwe; Frei, Hans Curd; Kratter, Renato; Di Lazzaro, Marco; Scola, Alexander; Sermon, An; Attal, Rene

    2016-02-01

    To evaluate the outcome after different types of revision operations for blade 'cut-out' and 'cut-through' after fixation of trochanteric fractures with proximal femoral nail antirotation (PFNA) or a trochanter fixation nail (TFN). Twenty hospitals participated in this multicentre study. A total of 4109 patients were retrospectively screened for cut-out or cut-through complications after nailing of trochanteric fractures using PFNA or TFN. Fifty-seven patients (28 with 'cut-through' and 29 with 'cut-out') were included in the study. In the 'cut-through' group, 16 patients underwent a blade exchange, six patients had a blade exchange with bone cement augmentation, and six received total hip arthroplasty (THA). In the 'cut-out' group, three patients had a blade exchange, one had a blade exchange with augmentation, three underwent re-nailing of the fracture with a new PFNA, one had a girdlestone procedure and 21 had THA procedures. In the 'cut-through' group, eight patients who had a blade exchanges (50%) and two patients with blade exchange and augmentation (33%) required further revision operations. THA was the definite treatment in all 6 cases. In the 'cut-out' group, two patients (66%) who had blade exchanges and two (66%) who underwent re-nailing required additional revision operations during the subsequent course. One patient (4%) who had total hip arthroplasty needed revision surgery for acetabular replacement. Overall, a total of 81 revision procedures were performed. Based on the data from this study, we recommend THA as the only valid salvage procedure for 'cut-out' and 'cut-through' of helical blades after fixation of trochanteric fractures with the PFNA and TFN. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. [Curative effect analysis on proximal frmoral nail antirotation for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall].

    Science.gov (United States)

    Wei, Jie; Qin, De-an; Guo, Xiu-sheng

    2015-06-01

    To explore clinical efficacy and key matters for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall by proximal frmoral nail antirotation (PFNA). From June 2010 to December 2012,210 femoral intertrochanteric fracture patients treated with PFNA were retrospectively analyzed, including 76 males and 134 females aged from 46 to 96 years old with an average of 71 years old. All fracture were caused by injury and classified to type I (5 cases) type II (16 cases), type III (73 cases) and type IV (116 cases) according to Evans classification. The time of getting out of bed, postoperative complications and displacement of screw blade and fracture healing were observed, Baumgaertner criteria were used to evaluate quality of fracture reduction, Harris criteria were used to evaulate hip joint function. All incisions were healed at stage I, no complications occurred except incomplete of lateral trochanteric wall patients without reconstruction, other patients could get out of bed with crutches at one week and all patients discharged from hospital at 10 days after operation. One hundred and seventy-eight patients were followed up from 3 to 17 months with an average of 10 months. One case occurred unhealed fracture displacement caused by screw blade cutting, 2 cases occurred screw blade transfomed to proximal and out femoral head, other patients obtained fracture healing at 12 to 16 weeks after operation. According to Baumgaertner criteria, 130 cases obtained good results, 45 cases acceptable, and 3 poor; while 107 cases obtained excellent results, 65 good, 3 good and 3 poor according to Harris score. PFNA with mechanical advantage of intramedullary fixation has advantsges of stable fixation, shorter operation time, minimally invasive. Satisfied clinical effects could obtained by grasping fixation principle, dealing with negative factors in operation. Intraoperative reconstruction for integrity of lateral trochanteric wall could assure

  16. Sliding hip screw versus IM nail in reverse oblique trochanteric and subtrochanteric fractures. A study of 2716 patients in the Norwegian Hip Fracture Register.

    Science.gov (United States)

    Matre, Kjell; Havelin, Leif Ivar; Gjertsen, Jan-Erik; Vinje, Tarjei; Espehaug, Birgitte; Fevang, Jonas Meling

    2013-06-01

    Intramedullary nailing is commonly recommended as the treatment of choice for transverse/reverse oblique trochanteric (AO/OTA type A3=intertrochanteric) and subtrochanteric fractures. However, only to a limited extent is this approach supported by superior results in well designed clinical trials, and the sliding hip screw (SHS) is still a frequently used implant for these fractures. The aim of the present study was to compare IM nails and SHS in the treatment of transverse/reverse oblique trochanteric and subtrochanteric fractures using data from the Norwegian Hip Fracture Register (NHFR). Data on 2716 operations for acute transverse/reverse oblique trochanteric or subtrochanteric fractures were collected from the NHFR from 2005 to 2010. Surgeons reported patient characteristics and details from initial surgery and reoperations, and patients answered questionnaires about pain, satisfaction, and quality of life (EQ-5D) 4, 12, and 36 months postoperatively. Reoperation rates were calculated using Kaplan-Meier analyses. Primary outcome measures were pain (Visual Analogue Scale (VAS)), satisfaction (VAS), quality of life (EQ-5D), and reoperation rates at one year. The treatment groups were similar regarding age, gender, ASA-class, cognitive impairment, and preoperative EQ-5Dindex score. At one year reoperation rates were 6.4% and 3.8% for SHS and IM nails, respectively (p=0.011). Patients treated with SHS also had slightly more pain (VAS 30 vs. 27, p=0.037) and were less satisfied (VAS 31 vs. 36, p=0.003) compared to patients treated with IM nail. There was no statistically significant difference in the EQ-5Dindex score, but the mobility was significantly better for the IM nail group. 12 months postoperatively patients with transverse/reverse oblique trochanteric and subtrochanteric fractures operated with a SHS had a higher reoperation rate compared to those operated with an IM nail. Small differences regarding pain, satisfaction, quality of life, and mobility were

  17. On Landau Vlasov simulations of giant resonances

    International Nuclear Information System (INIS)

    Pi, M.; Schuck, P.; Suraud, E.; Gregoire, C.; Remaud, B.; Sebille, F.

    1987-05-01

    We present VUU calculations of giant resonances obtained in energetic heavy ion collisions. Also is considered the case of the giant dipole in 40 Ca and the possibility of studying the effects of rotation on such collective modes

  18. Giant lobelias exemplify convergent evolution

    Directory of Open Access Journals (Sweden)

    Givnish Thomas J

    2010-01-01

    Full Text Available Abstract Giant lobeliads on tropical mountains in East Africa and Hawaii have highly unusual, giant-rosette growth forms that appear to be convergent on each other and on those of several independently evolved groups of Asteraceae and other families. A recent phylogenetic analysis by Antonelli, based on sequencing the widest selection of lobeliads to date, raises doubts about this paradigmatic example of convergent evolution. Here I address the kinds of evidence needed to test for convergent evolution and argue that the analysis by Antonelli fails on four points. Antonelli's analysis makes several important contributions to our understanding of lobeliad evolution and geographic spread, but his claim regarding convergence appears to be invalid. Giant lobeliads in Hawaii and Africa represent paradigmatic examples of convergent evolution.

  19. CMB lensing and giant rings

    Energy Technology Data Exchange (ETDEWEB)

    Rathaus, Ben; Itzhaki, Nissan, E-mail: nitzhaki@post.tau.ac.il, E-mail: ben.rathaus@gmail.com [Raymond and Beverly Sackler Faculty of Exact Sciences, School of Physics and Astronomy, Tel-Aviv University, Ramat-Aviv, 69978 (Israel)

    2012-05-01

    We study the CMB lensing signature of a pre-inationary particle (PIP), assuming it is responsible for the giant rings anomaly that was found recently in the WMAP data. Simulating Planck-like data we find that generically the CMB lensing signal to noise ratio associated with such a PIP is quite small and it would be difficult to cross correlate the temperature giant rings with the CMB lensing signal. However, if the pre-inationary particle is also responsible for the bulk flow measured from the local large scale structure, which happens to point roughly at the same direction as the giant rings, then the CMB lensing signal to noise ratio is fairly significant.

  20. Lateral migration with telescoping of a trochanteric fixation nail in the treatment of an intertrochanteric hip fracture.

    Science.gov (United States)

    Liu, Wanjun; Wang, Junqiang; Weaver, Michael J; Vrahas, Mark S; Zhou, Dongsheng

    2014-01-01

    The trochanteric fixation nail (TFN) can be used to treat stable and unstable fractures of intertrochanteric hip fractures. We study the common lateral migration that occurs with telescoping of intertrochanteric hip fractures treated with TFN and identify the predictors and relationships to clinical outcomes. Patient demographic information, fracture type (Arbeitsgemeinschaft für Osteosynthesefragen (AO)/Orthopaedic Trauma Association (OTA) classification), radiographic data, and clinical data were collected. Lateral migration with telescoping was measured. Statistical analyses were performed to determine which variables predicted lateral migration with telescoping. Patient outcome scores were recorded using the Modified Harris Hip Score (MHHS), Hip Outcome Score-Activity of Daily Living (HOS-ADL), and Visual Analog Scale for pain. Two hundred and twenty-three patients (67 males, 156 females) fitted the radiographic and follow-up (average 24.6 months) criteria. The average age was 77.2 years. The average lateral migration with telescoping was 4.8 mm. Twenty-one patients (9.4%) had excessive lateral migration with telescoping ( = 10 mm). The quality of calcar reduction (P = 0.01) and unstable fracture patterns (P = 0.006) were significant predictive factors of lateral migration with telescoping. The mean outcome scores (MHHS and HOS-ADL) were 80.1 points and 78.7 points, respectively. All subjects had no significant relationship to lateral migration with telescoping (P > 0.05). Of all the patients who developed lateral migration with telescoping, only one required removal of the blade for hip pain and all patients went on to uneventful union at an average time of 4.5 months. Lateral migration with telescoping is a common mechanical complication of intertrochanteric hip fracture treated with the TFN procedure. It was predicted by the quality of calcar reduction and fracture type. However, this did not affect stable fixation and fracture healing, so rarely leads to

  1. Anterior greater trochanteric muscle pedicle bone grafting: a viable graft option adjunct to hip osteotomy or fracture surgery.

    Science.gov (United States)

    Limpaphayom, Noppachart; Osateerakun, Phatcharapa; Wilairatana, Vajara; Prasongchin, Pairatch

    2017-05-12

    The objectives were to evaluate a technique, outcome and complications following anterior greater trochanteric with gluteus medius muscle pedicle bone graft (AMG) procedure in the treatment of adolescent and active adult hip disorders. 20 patients (20 hips) with a mean age of 22.7 ± 15.6 (range 10.0-63.5) years who had undergone AMG and been followed up more than 12 months postoperative were retrospectively enrolled in our study. The AMG procedure was performed in conjunction with subcapital osteotomy for slipped capital femoral epiphysis in 12 and open reduction for fracture/dislocation in 8 hips. At the most recent evaluation, patient functional status was rated by the Harris Hip Score (HHS) and radiographic changes were graded according to Tönnis criteria. Complications were defined as Tönnis grade >2 or hip requiring further surgery. Univariate analysis was used to explore factors associated with complications. Spearman's rank correlation coefficient was calculated between HHS and Tönnis grading. At mean follow-up of 4.4 ± 2.6 (range 1.1-9.5) years, mean HHS was 87.4. Tönnis grading was rated as 0 in 10 hips, 1 in 5 hips, 2 in 2 hips, and 3 in 3 hips. Avascular necrosis of the femoral head as a complication developed in 3 hips (15%). Clinical parameters including age at surgery, duration of follow-up and diagnosis were not significantly associated with postoperative complications. A negative correlation between HHS and Tönnis grade was shown by Spearman's rank correlation (rs = -0.49, p = 0.03). The AMG can be safely recommended as an adjunct bone graft procedure when performing anterior open reduction of adolescent and active adult hip disorders.

  2. Incidence of greater trochanteric pain syndrome in patients suspected for femoroacetabular impingement evaluated using magnetic resonance arthrography of the hip.

    Science.gov (United States)

    Pozzi, Grazia; Lanza, Ezio; Parra, Cleber Garcia; Merli, Ilaria; Sconfienza, Luca Maria; Zerbi, Alberto

    2017-03-01

    We evaluated the incidence of greater trochanter pain syndrome (GTPS) in patients who underwent magnetic resonance arthrography (MRA) of the hip for a suspected femoroacetabular impingement (FAI) syndrome. Hip MRA performed at our institution (3/2012-1/2014) were reviewed. The absence/presence of FAI (cam, pincer, and mixed) was noted. GTPS diagnosis was based on gluteus medius/minimus tendinopathy/tears, trochanteric bursitis, fascia lata thickening, and trochanter bone oedema/erosion. Subgroup analysis for age (under/over 40 years) and FAI type (cam, pincer, and mixed) was also performed. N = 189 patients were included (n = 125 males; age 39 ± 12 years). FAI was diagnosed in n = 133 (70, 4%): cam type, n = 85 (63, 9%); pincer type, n = 22 (16, 6%); and mixed type, n = 26 (19, 5%). N = 72 patients (38.1%) had tendinopathy, n = 14 (7.4%) had trochanter erosion, n = 31 (16.4%) had bursitis, n = 4 had bone oedema (2.1%), and n = 3 (1.6%) had fascia lata thickening, resulting in GTPS diagnosis in n = 74 patients (39.2%). The association of normal hip morphology/GTPS was significantly higher (P = 0.023) than that of FAI/GTPS. Under 40 years, GTPS incidence was higher in patients with normal hip and pincer-type FAI (P = 0.028). Over 40 years, no difference between patients with/without FAI (P = 0.119) was seen. GTPS was more frequently observed in patients with normal hip morphology than in patients with FAI, particularly in patients under 40.

  3. Imaging of giant pituitary adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Majos, C.; Coll, S.; Aguilera, C.; Pons, L.C. [Bellvitge Univ., Barcelona (Spain). Inst. de Diagnostice per la Imatge; Acebes, J.J. [Department of Neurosurgery, Ciutat Sanitaria i Universitaria de Bellvitge, L`Hospitalet de Llobregat, Barcelona (Spain)

    1998-10-01

    We present five proven giant pituitary adenomas studied by CT and MRI, and review the clinical and imaging findings. Our aim was to examine the radiologic appearances and to search for criteria useful in distinguishing these tumors from other sellar and suprasellar tumours, mainly craniopharyngioma. The main differences from small adenomas were high prevalence of macrocysts, a more invasive behaviour and a clinical picture dominated by mass effect rather than endocrine disturbance. Factors supporting the diagnosis of pituitary adenoma in a giant intra- and suprasellar mass include: infrasellar extension, absence of calcification and presence of low-signal cysts on T1-weighted images. (orig.) (orig.) With 4 figs., 2 tabs., 9 refs.

  4. [Giant intradiploic infratentorial epidermoid cyst].

    Science.gov (United States)

    Alberione, F; Caire, F; Fischer-Lokou, D; Gueye, M; Moreau, J J

    2007-10-01

    Epidermoid cysts are benign, uncommon lesions (1% of all intracranial tumors). Their localization is intradiploic in 25% of cases, and exceptionally subtentorial. We report here a rare case of giant intradiploic infratentorial epidermoid cyst. A 74-year old patient presented with recent diplopia and sindrome cerebellar. CT scan and MR imaging revealed a giant osteolytic extradural lesion of the posterior fossa (5.2 cm x 3.8 cm) with a small area of peripheral enhancement after contrast injection. Retrosigmoid suboccipital craniectomy allowed a satisfactory removal of the tumor, followed by an acrylic cranioplasty. The outcome was good. Neuropathological examination confirmed an epidermoid cyst. We review the literature and discuss our case.

  5. Percolation with multiple giant clusters

    International Nuclear Information System (INIS)

    Ben-Naim, E; Krapivsky, P L

    2005-01-01

    We study mean-field percolation with freezing. Specifically, we consider cluster formation via two competing processes: irreversible aggregation and freezing. We find that when the freezing rate exceeds a certain threshold, the percolation transition is suppressed. Below this threshold, the system undergoes a series of percolation transitions with multiple giant clusters ('gels') formed. Giant clusters are not self-averaging as their total number and their sizes fluctuate from realization to realization. The size distribution F k , of frozen clusters of size k, has a universal tail, F k ∼ k -3 . We propose freezing as a practical mechanism for controlling the gel size. (letter to the editor)

  6. Statistical decay of giant resonances

    International Nuclear Information System (INIS)

    Dias, H.; Teruya, N.; Wolynec, E.

    1986-01-01

    Statistical calculations to predict the neutron spectrum resulting from the decay of Giant Resonances are discussed. The dependence of the resutls on the optical potential parametrization and on the level density of the residual nucleus is assessed. A Hauser-Feshbach calculation is performed for the decay of the monople giant resonance in 208 Pb using the experimental levels of 207 Pb from a recent compilation. The calculated statistical decay is in excelent agreement with recent experimental data, showing that the decay of this resonance is dominantly statistical, as predicted by continuum RPA calculations. (Author) [pt

  7. Giant resonances: reaction theory approach

    International Nuclear Information System (INIS)

    Toledo Piza, A.F.R. de; Foglia, G.A.

    1989-09-01

    The study of giant resonances through the use of reaction theory approach is presented and discussed. Measurements of cross-sections to the many available decay channels following excitation of giant multipole resonances (GMR) led one to view these phenomena as complicated dynamical syndromes so that theoretical requirements for their study must be extended beyond the traditional bounds of nuclear structure models. The spectra of decay products following GMR excitation in heavy nuclei are well described by statistical model (Hauser-Feshback, HF) predictions indicated that spreading of the collective modes plays a major role in shaping exclusive cross-sections. (A.C.A.S.) [pt

  8. Statistical decay of giant resonances

    International Nuclear Information System (INIS)

    Dias, H.; Teruya, N.; Wolynec, E.

    1986-02-01

    Statistical calculations to predict the neutron spectrum resulting from the decay of Giant Resonances are discussed. The dependence of the results on the optical potential parametrization and on the level density of the residual nucleus is assessed. A Hauser-Feshbach calculation is performed for the decay of the monopole giant resonance in 208 Pb using the experimental levels of 207 Pb from a recent compilation. The calculated statistical decay is in excellent agreement with recent experimental data, showing that decay of this resonance is dominantly statistical, as predicted by continuum RPA calculations. (Author) [pt

  9. Migration of accreting giant planets

    Science.gov (United States)

    Robert, C.; Crida, A.; Lega, E.; Méheut, H.

    2017-09-01

    Giant planets forming in protoplanetary disks migrate relative to their host star. By repelling the gas in their vicinity, they form gaps in the disk's structure. If they are effectively locked in their gap, it follows that their migration rate is governed by the accretion of the disk itself onto the star, in a so-called type II fashion. Recent results showed however that a locking mechanism was still lacking, and was required to understand how giant planets may survive their disk. We propose that planetary accretion may play this part, and help reach this slow migration regime.

  10. Giant serpentine intracranial aneurysm: a case report

    International Nuclear Information System (INIS)

    Park, Jae Seong; Lee, Myeong Sub; Kim, Myung Soon; Kim, Dong Jin; Park, Joong Wha; Whang, Kum

    2001-01-01

    The authors present a case of giant serpentine aneurysm (a partially thrombosed aneurysm containing tortuous vascular channels with a separate entrance and outflow pathway). Giant serpentine aneurysms form a subgroup of giant intracranial aneurysms, distinct from saccular and fusiform varieties, and in this case, too, the clinical presentation and radiographic features of CT, MR imaging and angiography were distinct

  11. Giant multipole resonances: perspectives after ten years

    International Nuclear Information System (INIS)

    Bertrand, F.E.

    1980-01-01

    Nearly ten years ago evidence was published for the first of the so-called giant multipole resonances, the giant quadrupole resonance. During the ensuing years research in this field has spread to many nuclear physics laboratories throughout the world. The present status of electric giant multipole resonances is reviewed. 24 figures, 1 table

  12. Giant pulses of pulsar radio emission

    OpenAIRE

    Kuzmin, A. D.

    2007-01-01

    Review report of giant pulses of pulsar radio emission, based on our detections of four new pulsars with giant pulses, and the comparative analysis of the previously known pulsars with giant pulses, including the Crab pulsar and millisecond pulsar PSR B1937+21.

  13. Charting the Giants

    Science.gov (United States)

    2004-06-01

    zero expansion asymptotically after an infinite time and has a flat geometry). All three observational tests by means of supernovae (green), the cosmic microwave background (blue) and galaxy clusters converge at a Universe around Ωm ~ 0.3 and ΩΛ ~ 0.7. The dark red region for the galaxy cluster determination corresponds to 95% certainty (2-sigma statistical deviation) when assuming good knowledge of all other cosmological parameters, and the light red region assumes a minimum knowledge. For the supernovae and WMAP results, the inner and outer regions corespond to 68% (1-sigma) and 95% certainty, respectively. References: Schuecker et al. 2003, A&A, 398, 867 (REFLEX); Tonry et al. 2003, ApJ, 594, 1 (supernovae); Riess et al. 2004, ApJ, 607, 665 (supernovae) Galaxy clusters are far from being evenly distributed in the Universe. Instead, they tend to conglomerate into even larger structures, "super-clusters". Thus, from stars which gather in galaxies, galaxies which congregate in clusters and clusters tying together in super-clusters, the Universe shows structuring on all scales, from the smallest to the largest ones. This is a relict of the very early (formation) epoch of the Universe, the so-called "inflationary" period. At that time, only a minuscule fraction of one second after the Big Bang, the tiny density fluctuations were amplified and over the eons, they gave birth to the much larger structures. Because of the link between the first fluctuations and the giant structures now observed, the unique REFLEX catalogue - the largest of its kind - allows astronomers to put considerable constraints on the content of the Universe, and in particular on the amount of dark matter that is believed to pervade it. Rather interestingly, these constraints are totally independent from all other methods so far used to assert the existence of dark matter, such as the study of very distant supernovae (see e.g. ESO PR 21/98) or the analysis of the Cosmic Microwave background (e

  14. On the origin of the giant isotopic effect of hydrogen on the magnetic properties of YFe.sub.2./sub.A.sub.4.2./sub. (A = H, D): a high pressure study

    Czech Academy of Sciences Publication Activity Database

    Isnard, O.; Paul-Boncour, V.; Arnold, Zdeněk

    2013-01-01

    Roč. 102, č. 12 (2013), "122408-1"-"122408-4" ISSN 0003-6951 R&D Projects: GA ČR GAP204/12/0692 Institutional support: RVO:68378271 Keywords : antiferromagnetic materials * compressibility * ferromagnetic materials * ferromagnetic-antiferromagnetic transitions * high- pressure effects * iron compoounds Subject RIV: BE - Theoretical Physics Impact factor: 3.515, year: 2013

  15. Giant lipomas of the hand

    Directory of Open Access Journals (Sweden)

    Gokce Yildiran

    2015-04-01

    Conclusion: Giant lipomas of the hand are very rare and may cause compressions and other complications. Thus, they require a careful preoperative evaluation in order to make a proper differential diagnosis. [Hand Microsurg 2015; 4(1.000: 8-11

  16. Management of giant paraesophageal hernia.

    Science.gov (United States)

    Awais, O; Luketich, J D

    2009-04-01

    Management of giant paraesophageal hernia remains one of the most difficult challenges faced by surgeons treating complex benign esophageal disorders. These large hernias are acquired disorders; therefore, they invariably present in elderly patients. The dilemma that surgeons faced in the open surgical era was the risk of open surgery in this elderly, sick patient population versus the life threatening catastrophic complications, nearly 30% in some series, observed with medical management. During the 1990s, it was clearly recognized that laparoscopic surgery led to decreased morbidity with a quicker recovery. This has lead to a 6-fold increase in the surgical management of giant paraesophageal hernias over the last decade compared to a period of five decades of open surgery; however, this has not necessarily translated into better outcomes. One of the major issues with giant paraesophageal hernias is recognizing short esophagus and performing a lengthening procedure, if needed. Open series which report liberal use of Collis gastroplasty leading to a tension-free intraabdominal fundoplication have shown the best anatomic and clinical outcomes. As we duplicate the open experience laparoscopically, the principle of identifying a shortened esophagus and constructing a neo-esophagus must be honored for the success of the operation. The benefits of laparoscopy are obvious but should not come at the cost of a lesser operation. This review will illustrate that laparoscopic repair of giant paraesophageal hernia at experienced centers can be performed safely with similar outcomes to open series when the fundamental principles of the operation are maintained.

  17. A Giant or a Dwarf?

    DEFF Research Database (Denmark)

    Schmid, Herman

    2005-01-01

    EU may appear to be a giant when it can act on behalf of a united Europe, but usually it is hampered by conflicting member state interests. The EU economic and administrative resources for foreign and trade policy are quite small (on level with one of its major member states) and the hopes in many...

  18. Giant resonances on excited states

    International Nuclear Information System (INIS)

    Besold, W.; Reinhard, P.G.; Toepffer, C.

    1984-01-01

    We derive modified RPA equations for small vibrations about excited states. The temperature dependence of collective excitations is examined. The formalism is applied to the ground state and the first excited state of 90 Zr in order to confirm a hypothesis which states that not only the ground state but every excited state of a nucleus has a giant resonance built upon it. (orig.)

  19. Determination of giant resonance strengths

    International Nuclear Information System (INIS)

    Serr, F.E.

    1983-01-01

    Using theoretical strength functions to describe the different giant resonances expected at excitation energies of the order of (60-85)/Asup(1/3) MeV, we calculate the double differential cross sections d 2 sigma/dΩ dE associated with the reactions 208 Pb(α, α') and 90 Zr(α, α') (Esub(α) = 152 MeV). The angular distributions for the giant quadrupole and giant monopole resonances obtained from fits to these spectra, making simple, commonly used assumptions for the peak shapes and background, are compared to the original angular distributions. The differences between them are an indication of some of the uncertainties affecting the giant resonance strengths extracted from hadron inelastic scattering data. Fits to limited angular regions lead to errors of up to 50% in the value of the energy-weighted sum rule, depending on the angles examined. While it seems possible to extract the correct EWSR for the GMR by carrying out the analyses at 0 0 , no single privileged angle seems to exist in the case of the GQR. (orig.)

  20. Michigan has a sleeping giant

    CERN Multimedia

    Brock, Raymond; Nichols, Sue

    2007-01-01

    "That giant is 750 miles of fiber optic cable that lassoes its three biggest research universities and Van Andel Institute to the future. Its mission: to uncover the nature of the Big Bang by connecton U.S. physicists to their huge experiment ATLAS in Geneva.." (4 pages)

  1. Giant right atrial aneurysm presenting as right heart failure

    Directory of Open Access Journals (Sweden)

    V.S. Narain

    2012-03-01

    Full Text Available Idiopathic aneurysmal dilatations of the right atrium are rare anomalies. We report one such case of a young man presenting with fatigue, abdominal distension, pedal oedema, unremarkable cardiac examination except for raised jugular venous pressure, an electrocardiogram showing normal sinus rhythm with right bundle-branch block, and an radiograph of the chest showing cardiomegaly. The echocardiographic examination revealed a giant right atrium with low pressure tricuspid regurgitation. The computed tomography confirmed the findings of two-dimensional echocardiography. He was put on medical treatment and remained symptomatically controlled on follow-up.

  2. Giant hydronephrosis mimicking progressive malignancy

    Science.gov (United States)

    Schrader, Andres Jan; Anderer, Georgia; von Knobloch, Rolf; Heidenreich, Axel; Hofmann, Rainer

    2003-01-01

    Background Cases of giant hydronephroses are rare and usually contain no more than 1–2 litres of fluid in the collecting system. We report a remarkable case of giant hydronephrosis mimicking a progressive malignant abdominal tumour. Case presentation A 78-year-old cachectic woman presented with an enormous abdominal tumour, which, according to the patient, had slowly increased in diameter. Medical history was unremarkable except for a hysterectomy >30 years before. A CT scan revealed a giant cystic tumour filling almost the entire abdominal cavity. It was analysed by two independent radiologists who suspected a tumour originating from the right kidney and additionally a cystic ovarian neoplasm. Subsequently, a diagnostic and therapeutic laparotomy was performed: the tumour presented as a cystic, 35 × 30 × 25 cm expansive structure adhesive to adjacent organs without definite signs of invasive growth. The right renal hilar vessels could finally be identified at its basis. After extirpation another tumourous structure emerged in the pelvis originating from the genital organs and was also resected. The histopathological examination revealed a >15 kg hydronephrotic right kidney, lacking hardly any residual renal cortex parenchyma. The second specimen was identified as an ovary with regressive changes and a large partially calcified cyst. There was no evidence of malignant growth. Conclusion Although both clinical symptoms and the enormous size of the tumour indicated malignant growth, it turned out to be a giant hydronephrosis. Presumably, a chronic obstruction of the distal ureter had caused this extraordinary hydronephrosis. As demonstrated in our case, an accurate diagnosis of giant hydronephrosis remains challenging due to the atrophy of the renal parenchyma associated with chronic obstruction. Therefore, any abdominal cystic mass even in the absence of other evident pathologies should include the differential diagnosis of a possible hydronephrosis. Diagnostic

  3. Bisphosphonate-associated atypical sub-trochanteric femur fractures: paired bone biopsy quantitative histomorphometry before and after teriparatide administration.

    Science.gov (United States)

    Miller, Paul D; McCarthy, Edward F

    2015-04-01

    Bisphosphonate-associated atypical sub-trochanteric femur fractures (ASFF) may be seen with long-term bisphosphonate use, though these fractures are also seen in patients never exposed to bisphosphonates. One theory for the mechanism of action whereby bisphosphonates may induce these ASFF is over-suppression of bone turnover. Bisphosphonates suppress bone turnover, but in bisphosphonate clinical trials, over-suppression defined whether by maintaining the biochemical markers of bone turnover below the defined reference range or by quantitative bone histomorphometry, has not been observed. We studied 15 clinic patients referred to The Colorado Center for Bone Research (CCBR) after they had a bisphosphonate-associated ASFF and performed quantitative bone histomorphometry both before and after 12 months of teriparatide (20µg SQ/day). All patients had been on long-term alendronate (mean = 7 years, range: 6-11 years) and had already had intramedullary rods placed when first seen (6 weeks to 7 months after rod placement). Alendronate had been discontinued in all patients at the time of their first clinic visit to CCBR. All of the fractures fulfilled The American Society for Bone and Mineral Research major radiological criteria for ASFF. Three key dynamic histomorphometric features show that 7 of the 15 patients had unmeasurable bone formation, mineralizing surface, and mineral apposition, while the other 8 patients had measurable dynamic parameters; although for all 15 patients, the mean values for all 3 dynamic parameters was far below the average for the published normal population. Administration of teriparatide was associated with an increase in all 3 dynamic histomorphometric parameters. Baseline bone turnover markers did not correlate with the baseline histomorphometry. While there is heterogeneity in the bone turnover in patients with bisphosphonate ASFF, there is a large portion in this uncontrolled series that had absent bone turnover at the standard biopsy site

  4. Low-dose external beam radiotherapy for greater trochanteric pain syndrome. Target volume definition and treatment outcome

    International Nuclear Information System (INIS)

    Kaltenborn, Alexander; Carl, Ulrich Martin; Hinsche, Tanja; Nitsche, Mirko; Hermann, Robert Michael

    2017-01-01

    Low-dose external beam radiotherapy (ED-EBRT) is frequently used in the therapy of refractory greater trochanteric pain syndrome (GTPS). As studies reporting treatment results are scarce, we retrospectively analyzed our own patient collectives. In all, 60 patients (74 hips) received LD-EBRT (6 x 0.5 Gy in 29 hips, 6 x 1 Gy in 45). The endpoint was the patient's reported subjective response to treatment. The influence of different patient and treatment characteristics on treatment outcome was investigated. At the end of LD-EBRT, 69% reported partial remission, 4% complete remission, no change 28%. A total of 3 months later (n = 52 hips), the results were 37, 33, and 30% and 18 months after LD-EBRT (n = 47) 21, 51, and 28%. In univariate analysis ''inclusion of the total femoral head into the PTV'' and ''night pain before LD-EBRT'' were correlated with symptom remission at the end of LD-EBRT, while ''initial increase in pain during LD-EBRT'' was significantly associated with treatment failure. In multivariable modeling ''initial increase in pain'' was identified as a risk factor for treatment failure (p = 0.007; odds ratio [OR] 0.209; 95% confidence interval [CI] 0.048-0.957), while ''night pain'' was an independent factor for remission (p = 0.038; OR 3.484; 95% CI 1.004-12.6). Three months after LD-EBRT ''night pain'' and ''inclusion of the complete femoral neck circumference into the PTV'' were predictive for remission. LD-EBRT represents a useful treatment option for patients suffering from GTPS. Three months after therapy two-thirds of the patients reported a partial or complete symptom remission. Especially patients who suffered from nocturnal pain seemed to benefit. Treatment appeared to be more effective when the entire circumference of the femoral neck was encompassed. (orig.) [de

  5. Making "Green Giants"

    DEFF Research Database (Denmark)

    Jones, Geoffrey; Lubinski, Christina

    2014-01-01

    This article examines the evolution of corporate environmentalism in the West German chemical industry between the 1950s and the 1980s. It focuses on two companies, Bayer and Henkel, and traces the evolution of their environmental strategies in response to growing evidence of pollution...... and resulting political pressures. Although German business has been regarded as pioneering corporate environmentalism, this study reveals major commonalities between the German and American chemical industries until the 1970s, when the two German firms diverged from their American counterparts in using public...... relations strategies not only to contain fallout from criticism, but also as opportunities for changes in corporate culture. The article finds no evidence for variety of capitalism explanations why German firms should have been early in their sustainability strategies, partly because of the importance...

  6. Theoretical red-giant branches for globular clusters

    International Nuclear Information System (INIS)

    VandenBerg, D.A.

    1984-01-01

    The authors reports computations of stellar evolutionary sequences from the base of the red-giant branch to the helium flash. Representative models with masses in the range of 0.8 to 0.9 solar masses were selected in order that the stars on the giant branches had ages of approximately 16 billion yr. Initial numerical experiments indicated that a value of α = 1.6 for the ratio of the mixing length to the pressure scale height was needed to provide the best of the Z = 0.0001 model sequence with the observations of M92. Sequences for the other assumed metallicities, Z = 0.0003, 0.001, 0.003, and 0.006, were then computed for the same value of the mixing-length parameter and overlayed directly on the observations. (Auth.)

  7. Use of the Gamma3™ nail in a teaching hospital for trochanteric fractures: mechanical complications, functional outcomes, and quality of life.

    Science.gov (United States)

    Buecking, Benjamin; Bliemel, Christopher; Struewer, Johannes; Eschbach, Daphne; Ruchholtz, Steffen; Müller, Thorben

    2012-11-23

    Trochanteric fractures are common fractures in the elderly. Due to characteristic demographic changes, the incidence of these injuries is rapidly increasing. Treatment of these fractures is associated with high rates of complications. In addition, the long-term results remain poor, with high morbidity, declines in function, and high mortality. Therefore, in this study, complication rates and patients' outcomes were evaluated after fixation of geriatric trochanteric fractures using the Gamma3™ nail. Patients aged 60 years old or older, with pertrochanteric and subtrochanteric femoral fractures, were included. Patients with polytrauma or pathological fractures were excluded. Age, sex, and fracture type were collected on admission. In addition, data were recorded concerning the surgeon (resident vs. consultant), time of operation, and local or systemic perioperative complications. Complications were also collected at the 6- and 12-month follow-ups after trauma. Barthel Index, IADL, and EQ-5D measurements were evaluated retrospectively on admission, as well as at discharge and during the follow-up. Ninety patients were prospectively included between April 2009 and September 2010. The patients' average age was 81 years old, and their average ASA score was 3. The incision/suture time was 53 min (95% CI 46-60 min). Hospital mortality was 4%, and overall mortality was 22% at the 12-month follow-up. Eight local complications occurred (4 haematomas, 1 deep infection, 1 cutting out, 1 irritation of the iliotibial tract, 1 periosteosynthetic fracture). The incidence of relevant systemic complications was 6%. Forty-two percent of the patients were operated on by residents in training, without significant differences in duration of surgery, complication rate, or mortality rate. The Barthel Index (82 to 71, p fracture levels during the follow-up period of 12 months. The results showed a relatively low complication rate using the Gamma3™ nail, even if the nailing was performed

  8. Coping with gravity: the foliar water relations of giant sequoia.

    Science.gov (United States)

    Williams, Cameron B; Reese Næsborg, Rikke; Dawson, Todd E

    2017-10-01

    In tall trees, the mechanisms by which foliage maintains sufficient turgor pressure and water content against height-related constraints remain poorly understood. Pressure-volume curves generated from leafy shoots collected crown-wide from 12 large Sequoiadendron giganteum (Lindley) J. Buchholz (giant sequoia) trees provided mechanistic insights into how the components of water potential vary with height in tree and over time. The turgor loss point (TLP) decreased with height at a rate indistinguishable from the gravitational potential gradient and was controlled by changes in tissue osmotica. For all measured shoots, total relative water content at the TLP remained above 75%. This high value has been suggested to help leaves avoid precipitous declines in leaf-level physiological function, and in giant sequoia was controlled by both tissue elasticity and the balance of water between apoplasm and symplasm. Hydraulic capacitance decreased only slightly with height, but importantly this parameter was nearly double in value to that reported for other tree species. Total water storage capacity also decreased with height, but this trend essentially disappeared when considering only water available within the typical range of water potentials experienced by giant sequoia. From summer to fall measurement periods we did not observe osmotic adjustment that would depress the TLP. Instead we observed a proportional shift of water into less mobile apoplastic compartments leading to a reduction in hydraulic capacitance. This collection of foliar traits allows giant sequoia to routinely, but safely, operate close to its TLP, and suggests that gravity plays a major role in the water relations of Earth's largest tree species. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Giant first-forbidden resonances

    International Nuclear Information System (INIS)

    Krmpotic, F.; Nakayama, K.; Sao Paulo Univ.; Pio Galeao, A.; Sao Paulo Univ.

    1983-01-01

    Recent experimental data on first-forbidden charge-exchange resonances are discussed in the framework of a schematic model. We also evaluate the screening of the weak coupling constants induced by both the giant resonances and the δ-isobar. It is shown that the last effect does not depend on the multipolarity of the one-particle moment. Due to the same reason, the fraction of the reaction strength pushed up into the δ-resonance region is always the same regardless of the quantum numbers carried by the excitation. Simple expressions are derived for the dependence of the excitation energies of the first-forbidden giant resonances on the mass number and isospin of the target. The model reproduces consistently both the Gamow-Teller and the first-forbidden resonances. (orig.)

  10. Giant Low Surface Brightness Galaxies

    Science.gov (United States)

    Mishra, Alka; Kantharia, Nimisha G.; Das, Mousumi

    2018-04-01

    In this paper, we present radio observations of the giant low surface brightness (LSB) galaxies made using the Giant Metrewave Radio Telescope (GMRT). LSB galaxies are generally large, dark matter dominated spirals that have low star formation efficiencies and large HI gas disks. Their properties suggest that they are less evolved compared to high surface brightness galaxies. We present GMRT emission maps of LSB galaxies with an optically-identified active nucleus. Using our radio data and archival near-infrared (2MASS) and near-ultraviolet (GALEX) data, we studied morphology and star formation efficiencies in these galaxies. All the galaxies show radio continuum emission mostly associated with the centre of the galaxy.

  11. Giant condyloma acuminatum of vulva

    Directory of Open Access Journals (Sweden)

    S. M. Ramiz Ahmed

    2017-09-01

    Full Text Available In this paper, A 23 year old married woman who was diagnosed as a case of giant condyloma acuminatum of vulva measuring about 15 x 8 x 3 cm, irregular surface with multiple projections, oval in shape, firm to hard in consistency, mildly tender, exophytic, cauliflower like growth involving the whole vulva (lower part of mons pubis, labia, vestibule, clitoris, around vaginal opening. Another multiple small lesions were present at perineal region but there was no inguinal lymphadenopathy. She underwent a combined electro cauterization and cryotherapy for small to moderate size multiple primary and recurrent warty lesions and wide surgical excision with fasciocutaneous advancement flaps procedure for a giant lesions in the vulva. Excisional biopsies were performed to detect potential malignancy but malignancy was not found histologically. The patient was advised to first follow-up 1 month after operation when multiple small warty lesions were developed and treated and the subsequent follow-ups for 3 months.

  12. A Giant Juvenile Nasopharyngeal Angiofibroma

    Science.gov (United States)

    Yüce, Salim; Uysal, İsmail Önder; Doğan, Mansur; Polat, Kerem; Şalk, İsmail; Müderris, Suphi

    2012-01-01

    Juvenile nasopharyngeal angiofibroma (JNA) are locally growing highly vascular tumours. They are treated primarily by surgical excision ranging from open approach to endoscopic approach. We presented a 20-year-old male with a giant nasopharyngeal juvenile angiofibroma obliterating the pterygopalatine fossa bilaterally, invasing the sphenoid bone and extending to the left nasal passage. His complaints were epistaxis and nasal obstruction. After embolization, the patient was treated surgically with endoscopic approach and discharged as cured without any complication. PMID:23714961

  13. [Treatment of giant acoustic neuromas].

    Science.gov (United States)

    Samprón, Nicolás; Altuna, Xabier; Armendáriz, Mikel; Urculo, Enrique

    2014-01-01

    To analyze the treatment modality and outcome of a series of patients with giant acoustic neuromas, a particular type of tumour characterised by their size (extracanalicular diameter of 4cm or more) and high morbidity and mortality. This was a retrospective unicentre study of patients with acoustic neuromas treated in a period of 12 years. In our institutional series of 108 acoustic neuromas operated on during that period, we found 13 (12%) cases of giant acoustic neuromas. We reviewed the available data of these cases, including presentation and several clinical, anatomical, and microsurgical aspects. All patients were operated on by the same neurosurgeon and senior author (EU) using the suboccipital retrosigmoid approach and complete microsurgical removal was achieved in 10 cases. In one case, near total removal was deliberately performed, in another case a CSF shunt was placed as the sole treatment measure, and in the remaining case no direct treatment was given. One patient died in the immediate postoperative period. One year after surgery, 4 patients showed facial nerve function of iii or more in the House-Brackman scale. The 4 most important prognostic characteristics of giant acoustic neuromas are size, adhesion to surrounding structures, consistency and vascularity. Only the first of these is evident in neuroimaging. Giant acoustic neuromas are characterised by high morbidity at presentation as well as after treatment. Nevertheless, the objective of complete microsurgical removal with preservation of cranial nerve function is attainable in some cases through the suboccipital retrosigmoid approach. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  14. Giant pediatric cervicofacial lymphatic malformations.

    Science.gov (United States)

    Benazzou, Salma; Boulaadas, Malik; Essakalli, Leila

    2013-07-01

    Lymphatic malformations (LMs) are benign lesions. Most of them are found in head and neck regions as asymptomatic mass, but giant lymphangiomas may affect breathing or swallowing and constitute a major therapeutic challenge. A retrospective analysis of giant head and neck LMs with impairment of respiration or swallow for the past 11 years was performed in the Department of Maxillofacial Surgery and ENT of the Avicenne Medical University Center. Seven patients with large and extensive LMs of the head and neck were identified. There were 3 males and 4 females with a mean age of 6 years. The predominant reason for referral was airway compromise necessitating tracheostomy (57%) and dysphagia (43%). Three patients had macrocystic lesions; others were considered mixed or microcystic. All the patients underwent surgical excision as a primary treatment modality. Complete surgical resection was realized in 4 patients, and subtotal resection in 3 patients. Of 7 patients, 4 patients had complications including nerve damage and recurrence of the disease. The majority of the patients underwent only a single surgical procedure. Cervicofacial LMs in children should be managed in multidisciplinary setting. Surgery remains the first treatment for managing giant, life-threatening lesions.

  15. Guiding the Giant

    Science.gov (United States)

    1998-08-01

    New ESO Survey Provides Targets for the VLT Giant astronomical telescopes like the ESO Very Large Telescope (VLT) must be used efficiently. Observing time is expensive and there are long waiting lines of excellent research programmes. Thus the work at the telescope must be very well prepared and optimized as much as possible - mistakes should be avoided and no time lost! Astronomers working with the new 8-m class optical/infrared telescopes must base their observations on detailed lists of suitable target objects if they want to perform cutting-edge science. This is particularly true for research programmes that depend on observations of large samples of comparatively rare, distant objects. This type of work requires that extensive catalogues of such objects must be prepared in advance. One such major catalogue - that will serve as a very useful basis for future VLT observations - has just become available from the new ESO Imaging Survey (EIS). The Need for Sky Surveys Astronomers have since long recognized the need to carry out preparatory observations with other telescopes in order to "guide" large telescopes. To this end, surveys of smaller or larger parts of the sky have been performed by wide-field telescopes, paving the way for subsequent work at the limits of the largest available ground-based telescopes. For instance, a complete photographic survey of the sourthern sky (declination work at the 3.6-m telescope at the ESO La Silla observatory. However, while until recently most observational programmes could rely on samples of objects found on photographic plates, this is no longer possible. New image surveys must match the fainter limiting magnitudes reached by the new and larger telescopes. Modern digital, multi-colour, deep imaging surveys have thus become an indispensable complement to the 8-m telescopes. The new generation of imaging surveys will, without doubt, be the backbone of future research and are likely to be as long-lived as their earlier

  16. Giant Planets: Good Neighbors for Habitable Worlds?

    Science.gov (United States)

    Georgakarakos, Nikolaos; Eggl, Siegfried; Dobbs-Dixon, Ian

    2018-04-01

    The presence of giant planets influences potentially habitable worlds in numerous ways. Massive celestial neighbors can facilitate the formation of planetary cores and modify the influx of asteroids and comets toward Earth analogs later on. Furthermore, giant planets can indirectly change the climate of terrestrial worlds by gravitationally altering their orbits. Investigating 147 well-characterized exoplanetary systems known to date that host a main-sequence star and a giant planet, we show that the presence of “giant neighbors” can reduce a terrestrial planet’s chances to remain habitable, even if both planets have stable orbits. In a small fraction of systems, however, giant planets slightly increase the extent of habitable zones provided that the terrestrial world has a high climate inertia. In providing constraints on where giant planets cease to affect the habitable zone size in a detrimental fashion, we identify prime targets in the search for habitable worlds.

  17. Solitary ulcerated congenital giant juvenile xanthogranuloma

    Directory of Open Access Journals (Sweden)

    Su Yuen Ng

    2015-01-01

    Full Text Available A 3-month-old female patient with a giant ulcerated nodule over the back since birth was diagnosed as congenital giant juvenile xanthogranuloma (JXG based on clinical and histopathological examination. Congenital giant JXG with ulceration at birth is a rare presentation of JXG and commonly misdiagnosed. This case emphasizes the importance of being aware of the myriad presentations of JXG in order to make a correct diagnosis and avoid unnecessary investigations or treatment.

  18. Giant resonances in heavy-ion reactions

    International Nuclear Information System (INIS)

    Hussein, M.S.

    1982-11-01

    The several roles of multipole giant resonances in heavy-ion reactions are discussed. In particular, the modifications in the effective ion-ion potencial due to the virtual excitation of giant resonances at low energies, are considered and estimated for several systems. Real excitation of giant resonances in heavy-ion reactions at intermediate energies are then discussed and their importance in the approach phase of deeply inelastic processes in emphasized. Several demonstrative examples are given. (Author) [pt

  19. Effect of greater trochanteric epiphysiodesis after femoral varus osteotomy for lateral pillar classification B and B/C border Legg-Calvé-Perthes disease: A retrospective observational study.

    Science.gov (United States)

    Kwon, Keun-Sang; Wang, Sung Il; Lee, Ju-Hyung; Moon, Young Jae; Kim, Jung Ryul

    2017-08-01

    This is a retrospective observational study. Greater trochanteric epiphysiodesis (GTE) has been recommended to prevent Trendelenburg gait and limitation of the hip joint motion due to trochanteric overgrowth after femoral varus osteotomy (FVO) in Legg-Calvé-Perthes disease (LCPD). However, capital femoral physeal arrest frequently occurs in patients with severe disease (lateral pillar C), so GTE might not be as effective in these patients. The aim of this study was to compare trochanteric growth inhibition due to GTE after FVO between 2 age groups (8 years) in patients with lateral pillar B and B/C border LCPD and evaluate the effectiveness of GTE compared with the normal, unaffected hip.This study included 19 children with lateral pillar B and B/C border LCPD in 1 leg who underwent FVO followed by GTE. Of the 19 children, 9 underwent GTE before the age of 8 years and 10 underwent GTE after 8 years of age. On radiographs taken at the immediate postoperative period and at skeletal maturity, the articulo-trochanteric distance (ATD), center-trochanteric distance (CTD), and neck-shaft angle (NSA) were compared between the 2 age groups. The amount of correction was compared between groups. The contralateral, unaffected hip was used as a control for trochanteric growth. The patients were clinically evaluated with Iowa hip score at the final follow-up.There was no significant difference between the 2 age groups in terms of time to GTE, length of follow-up, or lateral pillar classification. In the affected hip, the amount of correction of the ATD, CTD, and NSA was significantly greater in patients  8 years. However, in the unaffected hip, the change in the ATD, CTD, and NSA did not differ significantly between the 2 groups.We suggest that FVO followed by GTE for lateral pillar B and B/C border LCPD in patients under the age of 8 years can affect growth of the greater trochanter. However, effective growth inhibition due to GTE was not achieved after 8 years of age.

  20. Red giants: then and now

    Science.gov (United States)

    Faulkner, John

    Fred Hoyle's work on the structure and evolution of red giants, particularly his pathbreaking contribution with Martin Schwarzschild (Hoyle and Schwarzschild 1955), is both lauded and critically assessed. In his later lectures and work with students in the early 1960s, Hoyle presented more physical ways of understanding some of the approximations used, and results obtained, in that seminal paper. Although later ideas by other investigators will be touched upon, Hoyle's viewpoint - that low-mass red giants are essentially white dwarfs with a serious mass-storage problem - is still extremely fruitful. Over the years, I have further developed his method of attack. Relatively recently, I have been able to deepen and broaden the approach, finally extending the theory to provide a unifying treatment of the structure of low-mass stars from the main sequence though both the red-giant and horizontal-branch phases of evolution. Many aspects of these stars that had remained puzzling, even mysterious, for decades have now fallen into place, and some questions have been answered that were not even posed before. With low-mass red giants as the simplest example, this recent work emphasizes that stars, in general, may have at least two distinct but very important centres: (I) a geometrical centre, and (II) a separate nuclear centre, residing in a shell outside a zero-luminosity dense core for example. This two-centre perspective leads to an explicit, analytical, asymptotic theory of low-mass red-giant structure. It enables one to appreciate that the problem of understanding why such stars become red giants is one of anticipating a remarkable yet natural structural bifurcation that occurs in them. This bifurcation occurs because of a combination of known and understandable facts just summarized namely that, following central hydrogen exhaustion, a thin nuclear-burning shell does develop outside a more-or-less dense core. In the resulting theory, both ρsh/ρolinec and

  1. Giant multipole resonances: an experimental review

    International Nuclear Information System (INIS)

    Bertrand, F.E.

    1979-01-01

    During the past several years experimental evidence has been published for the existance of nondipole giant resonances. These giant multipole resonances, the so-called new giant resonances were first observed through inelastic hadron and electron scattering and such measurements have continued to provide most of the information in this field. A summary is provided of the experimental evidence for these new resonances. The discussion deals only with results from inelastic scattering and only with the electric multipoles. Emphasis is placed on the recent observations of the giant monopole resonance. Results from recent heavy-ion and pion inelastic scattering are discussed. 38 references

  2. Giant dipole resonance in hot nuclei

    International Nuclear Information System (INIS)

    Mau, N.V.

    1993-01-01

    Giant resonances built on an excited state of the nucleus at a finite temperature T are studied. The following questions are investigated: how long such collective effects occur in a nucleus when T increases. How the properties of the giant resonances vary when the temperature increases. How the study of giant resonances in hot nuclei can give information on the structure of the nucleus in a highly excited state. The special case of the giant dipole resonance is studied. Some of the experimental results are reviewed and in their theoretical interpretation is discussed. (K.A.). 56 refs., 20 figs., 4 tabs

  3. Fracture morphology of AO/OTA 31-A trochanteric fractures: A 3D CT study with an emphasis on coronal fragments.

    Science.gov (United States)

    Cho, Jae-Woo; Kent, William T; Yoon, Yong-Cheol; Kim, Youngwoo; Kim, Hyungon; Jha, Ashutosh; Durai, Senthil Kumar; Oh, Jong-Keon

    2017-02-01

    This study was designed to assess the incidence and morphology of coronal plane fragments in AO/OTA 31-A trochanteric fractures. 156 cases of AO/OTA 31-A trochanteric fractures were retrospectively evaluated. Lateral radiographs were analyzed for the presence of coronal plane fragments followed by analysis of 3D CT reconstructions in these fractures. The incidence of coronal fragments identified on the lateral radiograph and 3D CT reconstructions were both calculated. Coronal fragment morphology was described based upon the origin and exit points of fracture lines and the number of fragments. On plain radiographs, a coronal plane fracture was identified in 59 cases, an incidence of 37.8% (59/156). In comparison, 3D CT reconstructions identified coronal plane fractures in 138 cases for an incidence of 88.4% (138/156). 3D CT reconstructions identified coronal fracture fragments in 81.9% (50/61) of AO/OTA 31-A1 cases, 94.5% (69/73) of 31-A2 cases, and 86.3% (19/22) of 31-A3 cases. Incidence of coronal fractures identified on plain radiographs of 3 AO/OTA 31-A1,A2,A3 groups was lower when compared to the incidence of coronal fractures identified on 3D CT. Of the 138 cases that had coronal plane fracture, 82 cases (59.4%) had a single coronal fragment (GT fragment 35 cases, GLT fragment 19 cases, GLPC fragment 28 cases). The remaining 56 cases (40.5%) had two coronal fragments. There is a high incidence of coronal fragments in intertrochanteric femur fractures when analyzed with 3D CT reconstructions. Our study suggests that these coronal fragments are difficult to identify on plain radiographs. Knowledge of the incidence and morphology of coronal fragments helps to avoid potential intraoperative pitfalls. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Three-dimensional bone-implant movements in trochanteric hip fractures: Precision and accuracy of radiostereometric analysis in a phantom model.

    Science.gov (United States)

    Bojan, Alicja J; Bragdon, Charles; Jönsson, Anders; Ekholm, Carl; Kärrholm, Johan

    2015-05-01

    The accuracy and precision of RSA were evaluated in the experimental study of screw cut-out complication after fixation of trochanteric fractures. A plastic bone model of a two-part trochanteric fracture was constructed with a Gamma nail implant incorporating RSA markers. The femoral head fragment was attached to a separate rotational table and the femoral shaft was mounted on the micrometer. Three main motions were simulated: Femoral head translation and rotation along the axis of the lag screw and fracture fragment translation along anatomical axes. Accuracy and precision were determined according to ISO 16,087 and ASTM standard F2385-04. Translations along the lag screw axis were measured with a precision within  ±0.14 mm and an accuracy within ±0.03 mm. With simultaneous translations along all three anatomical axes, lowest precision was measured for the x-axis (±0.29, 0.07 mm, respectively), but improved when analyzed as a vector (±0.08, 0.03 mm). The precision and accuracy of femoral head rotations were within 0.5° and 0.18°, respectively. The resolution of the RSA method tested in this model was high, though it varied depending on the type of analyzed motion. This information is valuable when selecting and interpreting outcome parameters evaluating implant migration and osteosynthesis stability in future clinical RSA studies. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  5. The Trochanteric Localization is a Mediator of Slower Short-Term Functional Recovery in Overweight and Obese Elderly Women with Recent Hip Fracture: The BREAK Study.

    Science.gov (United States)

    Gonnelli, Stefano; Caffarelli, Carla; Rossi, Stefania; Siviero, Paola; Maggi, Stefania; Crepaldi, Gaetano; Nuti, Ranuccio

    2015-12-01

    The hypothesis tested in this study, carried out on elderly Italian women with recent hip fracture, was to assess the extent to which the effect of a condition of being overweight/obese on short-term functional recovery as evaluated by the "time to permitted load" could be explained by a mediator variable (type of hip fracture). We studied 727 women aged 60 years or over with a recent low trauma surgically treated hip fracture and for whom an information on post-surgery complications and on the time to permitted load was available. To assess for mediation, the statistical analyses were carried out following the procedure described by Baron and Kenny. In this study, 46 % of women with hip fracture presented a time to permitted load of ≥ 10 days. The women with a post-surgery time to permitted load of ≥ 10 days showed a significantly higher proportion of trochanteric fracture localization (72.1 vs 42 %), of total overweight/obesity (46.5 vs 36.8 %) and of post-surgery complications (38.8 vs 18.8 %). The mediating effect of hip fracture localization on the association between overweight/obesity and the time of permitted load was demonstrated and confirmed in a multivariate logistic regression model. This study, carried out using a "mediator" statistical analysis, suggests that in elderly women with hip fracture being overweight/obese is associated with a slower short-term functional recovery as evaluated by the time to permitted load and that this association is mediated by the trochanteric localization of hip fracture.

  6. Effects of trochanteric soft tissue thickness and hip impact velocity on hip fracture in sideways fall through 3D finite element simulations.

    Science.gov (United States)

    Majumder, Santanu; Roychowdhury, Amit; Pal, Subrata

    2008-09-18

    A major worldwide health problem is hip fracture due to sideways fall among the elderly population. The effects of sideways fall on the hip are required to be investigated thoroughly. The objectives of this study are to evaluate the responses to trochanteric soft tissue thickness (T) variations and hip impact velocity (V) variations during sideways fall based on a previously developed CT scan derived 3D non-linear and non-homogeneous finite element model of pelvis-femur-soft tissue complex with simplified biomechanical representation of the whole body. This study is also aimed at quantifying the effects [peak impact force (F(max)), time to F(max), acceleration and peak principal compressive strain (epsilon(max))] of these variations (T,V) on hip fracture. It was found that under constant impact energy, for 81% decrease in T (26-5mm), F(max) and epsilon(max) increased by 38% and 97%, respectively. Hence, decrease in T (as in slimmer persons) strongly correlated to risk for hip fracture (phi) and strain ratio (SR) by 0.972 and 0.988, respectively. Also under same T and body weight, for 75% decrease in V (4.79-1.2m/s), F(max) and epsilon(max) decreased by 70% and 86%, respectively. Hence, increase in V (as in taller persons) strongly correlated to phi and SR by 0.995 and 0.984, respectively. For both variations in T and V, inter-trochanteric fracture situations were well demonstrated by phi as well as by SR and strain contours, similar to clinically observed fractures. These quantifications would be helpful for effective design of person-specific hip protective devices.

  7. Comparison and analysis of reoperations in two different treatment protocols for trochanteric hip fractures - postoperative technical complications with dynamic hip screw, intramedullary nail and Medoff sliding plate.

    Science.gov (United States)

    Paulsson, Johnny; Stig, Josefine Corin; Olsson, Ola

    2017-08-24

    In treatment of unstable trochanteric fractures dynamic hip screw and Medoff sliding plate devices are designed to allow secondary fracture impaction, whereas intramedullary nails aim to maintain fracture alignment. Different treatment protocols are used by two similar Swedish regional emergency care hospitals. Dynamic hip screw is used for fractures considered as stable within the respective treatment protocol, whereas one treatment protocol (Medoff sliding plate/dynamic hip screw) uses biaxial Medoff sliding plate for unstable pertrochanteric fractures and uniaxial Medoff sliding plate for subtrochanteric fractures, the second (intramedullary nail/dynamic hip screw) uses intramedullary nail for subtrochanteric fractures and for pertrochanteric fractures with intertrochanteric comminution or subtrochanteric extension. All orthopedic surgeries are registered in a regional database. All consecutive trochanteric fracture operations during 2011-2012 (n = 856) and subsequent technical reoperations (n = 40) were derived from the database. Reoperations were analysed and classified into the categories adjustment (percutaneous removal of the locking screw of the Medoff sliding plate or the intramedullary nail, followed by fracture healing) or minor, intermediate (reosteosynthesis) or major (hip joint replacement, Girdlestone or persistent nonunion) technical complications. The relative risk of intermediate or major technical complications was 4.2 (1.2-14) times higher in unstable pertrochanteric fractures and 4.6 (1.1-19) times higher in subtrochanteric fractures with treatment protocol: intramedullary nail/dynamic hip screw, compared to treatment protocol: Medoff sliding plate/dynamic hip screw. Overall rates of intermediate and major technical complications in unstable pertrochanteric and subtrochanteric fractures were with biaxial Medoff sliding plate 0.68%, with uniaxial Medoff sliding plate 1.4%, with dynamic hip screw 3.4% and with intramedullary nail 7.2%. The

  8. Inner Super-Earths, Outer Gas Giants: How Pebble Isolation and Migration Feedback Keep Jupiters Cold

    Science.gov (United States)

    Fung, Jeffrey; Lee, Eve J.

    2018-06-01

    The majority of gas giants (planets of masses ≳102 M ⊕) are found to reside at distances beyond ∼1 au from their host stars. Within 1 au, the planetary population is dominated by super-Earths of 2–20 M ⊕. We show that this dichotomy between inner super-Earths and outer gas giants can be naturally explained should they form in nearly inviscid disks. In laminar disks, a planet can more easily repel disk gas away from its orbit. The feedback torque from the pile-up of gas inside the planet’s orbit slows down and eventually halts migration. A pressure bump outside the planet’s orbit traps pebbles and solids, starving the core. Gas giants are born cold and stay cold: more massive cores are preferentially formed at larger distances, and they barely migrate under disk feedback. We demonstrate this using two-dimensional hydrodynamical simulations of disk–planet interaction lasting up to 105 years: we track planet migration and pebble accretion until both come to an end by disk feedback. Whether cores undergo runaway gas accretion to become gas giants or not is determined by computing one-dimensional gas accretion models. Our simulations show that in an inviscid minimum mass solar nebula, gas giants do not form inside ∼0.5 au, nor can they migrate there while the disk is present. We also explore the dependence on disk mass and find that gas giants form further out in less massive disks.

  9. On the enhanced X-ray emission from SGR 1900+14 after the August 27th giant flare

    International Nuclear Information System (INIS)

    Ertan, Ue.; Alpar, M.A.

    2004-01-01

    We show that the giant flares of soft gamma ray repeaters (E∼10 44 erg) can push the inner regions of a fall-back disk out to larger radii by radiation pressure, while matter remains bound to the system for plausible parameters. The subsequent relaxation of this pushed-back matter can account for the observed enhanced X-ray emission after the August 27 th giant flare of SGR 1900+14

  10. Deep Biosphere Secrets of the Mediterranean Salt Giant

    Science.gov (United States)

    Aloisi, Giovanni; Lugli, Stefano; McGenity, Terry; Kuroda, Junichiro; Takai, Ken; Treude, Tina; Camerlenghi, Angelo

    2015-04-01

    One component of the IODP multi-platform drilling proposal called DREAM (Deep-Sea Record of Mediterranean Messisnian Events), plans to investigate the deep biosphere associated to the Messinian Salinity Crisis (MSC) Salt Giant. We propose that the MSC Salt Giant, because of the variety of chemical environments it produces, has the potential to harbour an unprecedented diversity of microbial life with exceptional metabolic activity. Gypsum and anhydrite deposits provide a virtually unlimited source of sulphate at depths where oxidants are a rarity in other sedimentary environments. When reduced organic carbon comes into contact with these minerals there is the potential for a dynamic deep biosphere community of sulphate reducers to develop, with implications for sedimentary biogeochemical cycles and the souring of cruide oil. But the thickness of the Messinian evaporites and the range of chemical environments it harbours poses fundamental questions: will the interaction of several extreme conditions of temperature, salinity, pressure and chemical composition limit the ability of microbes to take advantage of such favourable thermodynamic conditions? And has such a diverse set of physical and chemical environments fostered microbal diversity, rather than phylogenetic specialization, as recent research into deep Mediterranean brine systems seems to indicate ? Over three kilometres in thickness, approaching the known temperature limits of life and with fluids precipitating carbonate, sulphate, halite and potash salts, microbes living within and around the MSC Salt Giant will be subject to the most exotic combinations of extremes, and have likely evolved yet unknown adaptations. Gypsum and Halite crystals contain fluid inclusions that are a micro-habitat in which microbes survive for tens of thousands, to possibly millions, of years, posing the fundamental question of cells devoting nearly all of their energy flow to somatic maintenance needs, rather than growth and

  11. Giant Planets in Reflected Light: What Science Can We Expect?

    Science.gov (United States)

    Marley, Mark

    2016-01-01

    Interpreting the reflection spectra of cool giant planets will be a challenge. Spectra of such worlds are expected to be primarily shaped by scattering from clouds and hazes and punctuated by absorption bands of methane, water, and ammonia. While the warmest giants may be cloudless, their atmospheres will almost certainly sport substantial photochemical hazes. Furthermore the masses of most direct imaging targets will be constrained by radial velocity observations, their radii, and thus atmospheric gravity, will be imperfectly known. The uncertainty in planet radius and gravity will compound with uncertain aerosol properties to make estimation of key absorber abundances difficult. To address such concerns our group is developing atmospheric retrieval tools to constrain quantities of interest, particular gas mixing ratios. We have applied our Markov Chain Monte Carlo methods to simulated data of the quality expected from the WFIRST CGI instrument and found that given sufficiently high SNR data we can confidentially identify and constrain the abundance of methane, cloud top pressures, gravity, and the star-planet-observer phase angle. In my presentation I will explain the expected characteristics of cool extrasolar giant planet reflection spectra, discuss these and other challenges in their interpretation, and summarize the science results we can expect from direct imaging observations.

  12. Presence of mixed modes in red giants in binary systems

    Directory of Open Access Journals (Sweden)

    Themeßl Nathalie

    2017-01-01

    Full Text Available The frequencies of oscillation modes in stars contain valueable information about the stellar properties. In red giants the frequency spectrum also contains mixed modes, with both pressure (p and gravity (g as restoring force, which are key to understanding the physical conditions in the stellar core. We observe a high fraction of red giants in binary systems, for which g-dominated mixed modes are not pronounced. This trend leads us to investigate whether this is specific for binary systems or a more general feature. We do so by comparing the fraction of stars with only p-dominated mixed modes in binaries and in a larger set of stars from the APOKASC sample. We find only p-dominated mixed modes in about 50% of red giants in detached eclipsing binaries compared to about 4% in the large sample. This could indicate that this phenomenon is tightly related to binarity and that the binary fraction in the APOKASC sample is about 8%.

  13. Evolution of the giant planets

    International Nuclear Information System (INIS)

    Bodenheimer, P.

    1985-01-01

    The theory of the evolution of the giant planets is discussed with emphasis on detailed numerical calculations in the spherical approximation. Initial conditions are taken to be those provided by the two main hypotheses for the origin of the giant planets. If the planets formed by gravitational instability in the solar nebula, the initial mass is comparable to the present mass or larger. The evolution then goes through the following phases: (1) an initial contraction phase in hydrostatic equilibrium; (2) a hydrodynamic collapse induced by molecular dissociation; and (3) a second equilibrium phase involving contraction and cooling to the present state. During phase (1) a rock-ice core must form by precipitation or accretion. If, on the other hand, the giant planets formed by first accreting a solid core and then capturing gas from the surrounding nebula, then the evolutionary phases are as follows: (1) a period during which planetesimals accrete to form a core of about one earth mass, composed of rock and ice; (2) a gas accretion phase, during which a relatively low-mass gaseous envelope in hydrostatic equilibrium exists around the core, which itself continues to grow to 10 to 20 Earth masses; (3) the point of arrival at the ''critical'' core mass at which point the accretion of gas is much faster than the accretion of the core, and the envelope contracts rapidly; (4) continuation of accretion of gas from the nebula and buildup of the envelope mass to its present value (for the case of Jupiter or Saturn); and (5) a final phase, after termination of accretion, during which the protoplanet contracts and cools to its present state. Some observational constraints are described, and some problems with the two principal hypotheses are discussed

  14. Analysis of giant electrorheological fluids.

    Science.gov (United States)

    Seo, Youngwook P; Seo, Yongsok

    2013-07-15

    The yield stress dependence on electric field strength for giant electrorheological (GER) fluids over the full range of electric fields was examined using Seo's scaling function which incorporated both the polarization and the conductivity models. If a proper scaling was applied to the yield stress data to collapse them onto a single curve, the Seo's scaling function could correctly fit the yield stress behavior of GER suspensions, even at very high electric field strengths. The model predictions were also compared with recently proposed Choi et al.'s model to allow a consideration of the universal framework of ER fluids. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Giant magneto-resistance devices

    CERN Document Server

    Hirota, Eiichi; Inomata, Koichiro

    2002-01-01

    This book deals with the application of giant magneto-resistance (GMR) effects to electronic devices. It will appeal to engineers and graduate students in the fields of electronic devices and materials. The main subjects are magnetic sensors with high resolution and magnetic read heads with high sensitivity, required for hard-disk drives with recording densities of several gigabytes. Another important subject is novel magnetic random-access memories (MRAM) with non-volatile non-destructive and radiation-resistant characteristics. Other topics include future GMR devices based on bipolar spin transistors, spin field-effect transistors (FETs) and double-tunnel junctions.

  16. Nutritional evaluation of the giant grassropper (Zonocerus ...

    African Journals Online (AJOL)

    The biological value of giant grasshopper protein (Zonocerus variegatus) was evaluated by comparing the weight gained, food efficiency ratio (FER), protein efficiency ratio (PER) of rats fed standard laboratory chow with that of rats fed giant grasshopper, Soyabean(Glycine max) and crayfish. The effect of high fibre content ...

  17. Static electromagnetic properties of giant resonances

    International Nuclear Information System (INIS)

    Koo, W.K.

    1986-03-01

    Static electric monopole and quadrupole matrix elements, which are related to the mean square radius and quadrupole moment respectively, are derived for giant resonances of arbitrary multipolarity. The results furnish information on the size and shape of the nucleus in the excited giant states. (author)

  18. Totally thrombosed giant anterior communicating artery aneurysm

    Directory of Open Access Journals (Sweden)

    V R Roopesh Kumar

    2015-01-01

    Full Text Available Giant anterior communicating artery aneurysmsarerare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass.At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery.The difficulty in preoperative diagnosis and relevant literature are reviewed.

  19. IONIZATION OF EXTRASOLAR GIANT PLANET ATMOSPHERES

    International Nuclear Information System (INIS)

    Koskinen, Tommi T.; Cho, James Y-K.; Achilleos, Nicholas; Aylward, Alan D.

    2010-01-01

    Many extrasolar planets orbit close in and are subject to intense ionizing radiation from their host stars. Therefore, we expect them to have strong, and extended, ionospheres. Ionospheres are important because they modulate escape in the upper atmosphere and can modify circulation, as well as leave their signatures, in the lower atmosphere. In this paper, we evaluate the vertical location Z I and extent D I of the EUV ionization peak layer. We find that Z I ∼1-10 nbar-for a wide range of orbital distances (a = 0.047-1 AU) from the host star-and D I /H p ∼>15, where H p is the pressure scale height. At Z I , the plasma frequency is ∼80-450 MHz, depending on a. We also study global ion transport, and its dependence on a, using a three-dimensional thermosphere-ionosphere model. On tidally synchronized planets with weak intrinsic magnetic fields, our model shows only a small, but discernible, difference in electron density from the dayside to the nightside (∼9 x 10 13 m -3 to ∼2 x 10 12 m -3 , respectively) at Z I . On asynchronous planets, the distribution is essentially uniform. These results have consequences for hydrodynamic modeling of the atmospheres of close-in extrasolar giant planets.

  20. From red giants to planetary nebulae

    International Nuclear Information System (INIS)

    Kwok, S.

    1982-01-01

    The transition from red giants to planetary nebulae is studied by comparing the spectral characteristics of red giant envelopes and planetary nebulae. Observational and theoretical evidence both suggest that remnants of red giant envelopes may still be present in planetary nebula systems and should have significant effects on their formation. The dynamical effects of the interaction of stellar winds from central stars of planetary nebulae with the remnant red giant envelopes are evaluated and the mechanism found to be capable of producing the observed masses and momenta of planetary nebulae. The observed mass-radii relation of planetary nebulae may also be best explained by the interacting winds model. The possibility that red giant mass loss, and therefore the production of planetary nebulae, is different between Population I and II systems is also discussed

  1. 臀下动脉穿支蒂复合组织瓣修复骶尾部巨大褥疮的解剖与临床应用%Anatomy study and clinical applications of complex tissue flap pedicled with inferior gluteal artery perforator for repairing giant sacrococcygeal pressure sore

    Institute of Scientific and Technical Information of China (English)

    谢昀; 林建华; 叶君健; 郑和平

    2014-01-01

    Objective To discuss the technical feasibility and clinical effectiveness of using complex tissue flap pedicled with inferior gluteal artery perforator for repair giant sacrococcygeal pressure sore.Methods Thirty embalmed lower limbs of adult cadavers perfused with red latex were used for anatomical study,and the followings were observed:①The course,branche and distribution of gluteal artery.②The course and distribution of the posterior femoral cutaneous nerve.③Anastomosis between the posterior cutaneous branch of gluteal artery and nutrient vessels of the posterior femoral cutaneous nerve.8 cases aging from 17 years to 56 years were completed during May 2007 to July 2013,6 cases were males and 2 cases were females.The sizes of pressure sore with the depth to Ⅳ degree were ranged from 16 cm × 9 cm to 22 cm × 10 cm.The sizes of flaps were harvested from 32 cm × 10 cm to 25 cm × 9 cm.Results The gluteal artery crossed the edge of the piriformis,the main stem was (3.1 ± 0.4) mm in diameter and gave out 2-5 muscular branches to supply the gluteus maximus.The posterior femoral cutaneous nerve crossed the edge of gluteus maximus and descended between biceps femoris and semitendinosus.Perforating deep fascia point located was (5.9 ± 0.8) cm above the line between medial and lateral femoral epicondyle.The constant anastomosis were formed by the posterior cutaneous branch of gluteal artery,the obturator artery perforator and the direct popliteal artery perforator around the posterior femoral cutaneous nerve.The complex flap survived successfully in all patients.Sutures were removed at 14 days postoperatively and the wounds healed well.All supplied areas were closed by directly suturing.Recurrent sacrococcygeal pressure sore was not observed in all cases with satisfied appearance and normal color during the outpatient follow-up period from 5 months to 5 years.Conclusion The united flap of gluteal myocutaneous flap and the posterior femoral cutaneous

  2. Electromagnetic decay of giant resonances

    International Nuclear Information System (INIS)

    Beene, J.R.; Bertrand, F.E.; Halbert, M.L.; Auble, R.L.; Hensley, D.C.; Horen, D.J.; Robinson, R.L.; Sayer, R.O.; Sjoreen, T.P.

    1985-01-01

    Coincidence experiments were done to investigate the photon and neutron emission from the giant resonance regions of 208 Pb and 90 Zr using the ORNL Spin Spectrometer, a 72-segment NaI detector system. We have determined the total gamma-decay probability, the ground-state gamma branching ratio, and the branching ratios to a number of low-lying states as a function of excitation energy in 208 Pb to approx.15 MeV. Similar data were also obtained on 90 Zr. The total yield of ground-state E2 gamma radiation in 208 Pb and the comparative absence of such radiation in 90 Zr can only be understood if decay of compound (damped) states is considered. Other observations in 208 Pb include the absence of a significant branch from the giant quadrupole resonance (GQR) to the 3 - state at 2.6 MeV, a strong branch to a 3 - state at 4.97 MeV from the same region, and transitions to various 1 - states between 5 to 7 MeV from the E* approx. 14 MeV region (EO resonance)

  3. [A variant of island flaps for the covering of pressure sores: the hatchet flap. Apropos of 31 cases].

    Science.gov (United States)

    Quillot, M; Lodde, J P; Pegorier, O; Reynaud, J P; Cormerais, A

    1994-08-01

    The authors propose a modification of the classical design of island flaps for cover of pressure sores, applied to gluteus maximus and tensor fascia lata muscles: the hatchet flap. 31 flaps have been used including 13 gluteus maximus superior flaps for sacral pressure sores, 9 gluteal inferior flaps for ischial pressure sores and 9 tensor fascia lata flaps for trochanteric pressure sores. A small partial necrosis and two cases of sepsis were observed in this series, but did not require surgical revision. The authors emphasize the value of this modification of the classical flap design, which preserves an even better musculocutaneous capital in these patients, who are often already multi-operated. The very rapid recovery of patients supports the authors' application of hatchet flaps to the surgery of pressure sores, and suggests the extension to other musculocutaneous flaps in the future.

  4. The giant impact produced a precipitated Moon

    Science.gov (United States)

    Cameron, A. G. W.

    1993-03-01

    The author's current simulations of Giant Impacts on the protoearth show the development of large hot rock vapor atmospheres. The Balbus-Hawley mechanism will pump mass and angular momentum outwards in the equatorial plane; upon cooling and expansion the rock vapor will condense refractory material beyond the Roche distance, where it is available for lunar formation. During the last seven years, the author together with several colleagues has carried out a series of numerical investigations of the Giant Impact theory for the origin of the Moon. These involved three-dimensional simulations of the impact and its aftermath using Smooth Particle Hydrodynamics (SPH), in which the matter in the system is divided into discrete particles whose motions and internal energies are determined as a result of the imposed initial conditions. Densities and pressures are determined from the combined overlaps of the particles, which have a bell-shaped density distribution characterized by a smoothing length. In the original series of runs all particle masses and smoothing lengths had the same values; the matter in the colliding bodies consisted of initial iron cores and rock (dunite) mantles. Each of 41 runs used 3,008 particles, took several weeks of continuous computation, and gave fairly good representations of the ultimate state of the post-collision body or bodies but at best crude and qualitative information about individual particles in orbit. During the last two years an improved SPH program was used in which the masses and smoothing lengths of the particles are variable, and the intent of the current series of computations is to investigate the behavior of the matter exterior to the main parts of the body or bodies subsequent to the collisions. These runs are taking times comparable to a year of continuous computation in each case; they use 10,000 particles with 5,000 particles in the target and 5,000 in the impactor, and the particles thus have variable masses and smoothing

  5. [Surgical coverage technics of pressure sores and their outcomes].

    Science.gov (United States)

    Bilkay, Ufuk; Helvaci, Evren; Tokat, Cenk; Ozek, Cüneyt; Akin, Yalçin

    2006-04-01

    We reviewed the outcome of 66 patients with 100 pressure sores between 1984 and 2002. In the current study, 100 pressure sores in 66 patients (45 male, 21 female; mean age 39.4; range 13 to 80 years) who underwent surgical repair of pressure sores reconstructed using myocutaneous or fasciocutaneous flaps, skin grafts, excision and closure. The risk factors for pressure sores included acute trauma-induced spinal cord injury in 40 (61%) patients with paraplegia and in 5 (7%) patients with quadriplegia; congenital spina bifida and multiple sclerosis in 7 (11%) patients and prolonged immobilization in 14 (21 patients) patients. We achieved an overall pressure sore recurrence rate of 22% and overall patient recurrence of 24% in a-3-year follow-up. The recurrence rates according to anatomic sites; 23% (10 of 43) for the ischial pressure sore, sacral 21% (8 of 37), and trochanteric 20% (4 of 20). Fasciocutaneous and myocutaneous flap reconstructions were the most durable, as they were associated with 17% (6 of 34) and 12% recurrence rates (5 of 39). To reduce the recurrence rates the authors advocate the use of myocutaneous and fasciocutaneous flaps instead of skin grafts or direct closure for the coverage of pressure sores.

  6. Low-dose external beam radiotherapy for greater trochanteric pain syndrome. Target volume definition and treatment outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kaltenborn, Alexander [Federal Armed Forces Hospital Westerstede, Department of Orthopedic and Trauma Surgery, Westerstede (Germany); Hannover Medical School, Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover (Germany); Carl, Ulrich Martin; Hinsche, Tanja [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); Nitsche, Mirko [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); University of Schleswig Holstein, Campus Kiel, Department of Radiotherapy, Karl-Lennert Cancer Center, Kiel (Germany); Hermann, Robert Michael [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); Hannover Medical School, Department of Radiotherapy and Special Oncology, Hannover (Germany)

    2017-04-15

    Low-dose external beam radiotherapy (ED-EBRT) is frequently used in the therapy of refractory greater trochanteric pain syndrome (GTPS). As studies reporting treatment results are scarce, we retrospectively analyzed our own patient collectives. In all, 60 patients (74 hips) received LD-EBRT (6 x 0.5 Gy in 29 hips, 6 x 1 Gy in 45). The endpoint was the patient's reported subjective response to treatment. The influence of different patient and treatment characteristics on treatment outcome was investigated. At the end of LD-EBRT, 69% reported partial remission, 4% complete remission, no change 28%. A total of 3 months later (n = 52 hips), the results were 37, 33, and 30% and 18 months after LD-EBRT (n = 47) 21, 51, and 28%. In univariate analysis ''inclusion of the total femoral head into the PTV'' and ''night pain before LD-EBRT'' were correlated with symptom remission at the end of LD-EBRT, while ''initial increase in pain during LD-EBRT'' was significantly associated with treatment failure. In multivariable modeling ''initial increase in pain'' was identified as a risk factor for treatment failure (p = 0.007; odds ratio [OR] 0.209; 95% confidence interval [CI] 0.048-0.957), while ''night pain'' was an independent factor for remission (p = 0.038; OR 3.484; 95% CI 1.004-12.6). Three months after LD-EBRT ''night pain'' and ''inclusion of the complete femoral neck circumference into the PTV'' were predictive for remission. LD-EBRT represents a useful treatment option for patients suffering from GTPS. Three months after therapy two-thirds of the patients reported a partial or complete symptom remission. Especially patients who suffered from nocturnal pain seemed to benefit. Treatment appeared to be more effective when the entire circumference of the femoral neck was encompassed. (orig.) [German] In der Behandlung des

  7. Prospective study of the reproducibility of X-rays and CT scans for assessing trochanteric fracture comminution in the elderly: a series of 110 cases.

    Science.gov (United States)

    Isida, Ronald; Bariatinsky, Varenka; Kern, Gregory; Dereudre, Gregoire; Demondion, Xavier; Chantelot, Christophe

    2015-10-01

    Trochanteric fractures are common but difficult to analyse in the elderly on plain X-rays. Fixation failures are related to the severity of the comminution, but comminution and the degree of instability are not easy to determine on standard X-rays. Use of computed tomography (CT) improves assessment of complex fractures, but this finding has not been confirmed versus intraoperative data. The primary objective of this prospective study was to determine the error rate when evaluating comminution on X-rays and CT scans. The secondary objectives were to determine whether CT data on comminution and stability were consistent with intraoperative findings and to define the fracture characteristics. Standard X-ray assessment underestimates the complexity of trochanteric fractures and is not very reproducible. Between January and December 2013, all proximal femur fractures in the trochanter area of patients aged 75 years or older (mean age 85) were analysed prospectively with standard X-rays and computed tomography (CT). One hundred and ten patients (88 women and 22 men) with trochanteric fractures were included in the study. Fracture stability was evaluated using the Müller AO classification; the other fracture characteristics were evaluated independently. A senior surgeon evaluated the anonymised X-rays. A radiologist specialised in musculoskeletal imaging interpreted the CT scan images. All patients underwent total hip arthroplasty (110 patients) and 104 fixations of the greater trochanter. The X-ray and CT findings were compared to the intraoperative findings (gold standard) to evaluate their reproducibility. The reproducibility of the X-ray evaluation was poor for comminution, with a kappa of 0.4, sensitivity of 44 % and a negative predictive value of 29 % but a positive predictive value and specificity of 100 %. The CT evaluation had a kappa of 0.94, sensitivity of 95 % and negative predictive value of 79 %. According to the AO classification, unstable fractures were

  8. Electromagnetic decay of giant resonances

    International Nuclear Information System (INIS)

    Beene, J.R.; Bertrand, F.E.; Halbert, M.L.; Auble, R.L.; Hensley, D.C.; Horen, D.J.; Robinson, R.L.; Sayer, R.O.; Sjoreen, T.P.

    1985-01-01

    Coincidence experiments are carried out to investigate the photon and neutron emission from the giant resonance regions of 208 Pb and 90 Zr using the ORNL Spin Spectrometer, a 72-segment NaI detector system. The authors determined the total gamma-decay probability, the ground-state gamma branching ratio, and the branching ratios to a number of low-lying states as a function of excitation energy in 208 Pb to ∼15 MeV. Similar data were also obtained on 90 Zr. The total yield of ground-state E2 gamma radiation in 208 Pb and the comparative absence of such radiation in 90 Zr can only be understood if decay of compound (damped) states is considered. (Auth.)

  9. Giant trichobezoar mimicking gastric tumour

    International Nuclear Information System (INIS)

    Ali, S.A.; Soomro, A.G.; Jarwar, M.; Memon, A.S.; Siddiqui, A.J.

    2012-01-01

    We present a case of giant gastric trichobezoar retrieved through a long gastrotomy in a 40 years old married women from rural Sindh with unreported psychological disturbance. Trichobezoar almost exclusively occur in females with an underlying psychiatric disorder. It has an insidious development of symptoms which accounts for its delayed presentation and large size at the time of diagnosis. They are associated with trichophagia (habit of compulsive hair eating) and are usually diagnosed on CT Scans or upper GI Endoscopy. They can give rise to complications like gastro-duodenal ulceration, haemorrhage, perforation, peritonitis or obstruction with a high rate of mortality. The treatment is endoscopic, laparoscopic or surgical removal and usually followed by psychiatric opinion. (author)

  10. Giant Congenital Melanocytic Naevi: review of literature

    Directory of Open Access Journals (Sweden)

    A. Marchesi

    2012-04-01

    Full Text Available giant congenital pigmented naevi is a great reconstructive challenge for the pediatric and plastic surgeons. due to the increased risk of malignant transformation in such lesions, many procedures have been used to remove giant congenital naevi like dermoabrasion, laser treatment or surgical excision combined with reconstruction through skin expansion or skin grafting; among these, only a complete excision can offer an efficacious treatment. in our centre we use the “tissue expansion” technique in order to achieve a sufficient quantity of normal skin to perform a both staged and radical excision of these giant lesions.

  11. Multipole giant resonances in highly excited nuclei

    International Nuclear Information System (INIS)

    Xia Keding; Cai Yanhuang

    1989-01-01

    The isoscalar giant surface resonance and giant dipole resonance in highly excited nuclei are discussed. Excitation energies of the giant modes in 208 Pb are calculated in a simplified model, using the concept of energy wieghted sum rule (EWSR), and the extended Thomas-Fermi approximation at the finite temperature is employed to describe the finite temperature is employed to describe the finite temperature equilibrium state. It is shown that EWSR and the energy of the resonance depend only weakly on temperature in the system. This weak dependence is analysed

  12. Giant cell arteritis of fallopian tube.

    Science.gov (United States)

    Azzena, A; Altavilla, G; Salmaso, R; Vasoin, F; Pellizzari, P; Doria, A

    1994-01-01

    One case of giant cells arteritis involving tubaric arteries in a postmenopausal woman is described. The patient was 59 years old and presented with asthenia, anemia, fever, weight loss, an abdominal palpable mass and elevated erythrocyte sedimentation rate. Exploratory laparotomy revealed a large ovarian cyst of 14 cm in diameter. Extensive giant cell arteritis, Horton's type, of the small-sizes arteries was found unexpectedly in the fallopian tube of the patient who had had a prior ovariectomy. Giant cell arteritis of the female genital tract is a rare finding in elderly women and may occur as an isolated finding or as part of generalised arteritis.

  13. Gamma graphic findings in giant hepatic hemangioma

    International Nuclear Information System (INIS)

    Cano, R.; Morales, R.; Mendoza, P.; Ramirez, E.; Aguilar, C.

    1994-01-01

    The aim of the present work is to describe gamma graphic findings in patients with giant hepatic hemangiomas, when evaluated with 99m Tc red blood cell (RBC) imaging. Three patients with clinical suspicion of giant hepatic hemangiomas, who had had, ultrasound and computed tomography were studied with RBC using in vivo labelling with pyrophosphate. All cases had dynamic and static views. All cases showed hypoperfusion in dynamics views and over perfusion in delayed studies. Surgery confirmed diagnosis in two cases. 99m Tc RBC is a good method for diagnosis of giant hepatic hemangioma, which generally needs surgical treatment. (Authors). 24 refs., 2 figs

  14. Treatment of trochanteric fractures with the gamma3 nail - methodology and early results of a prospective consecutive monitored clinical case series.

    Science.gov (United States)

    A C, Unger; E, Wilde; B, Kienast; C, Jürgens; A P, Schulz

    2014-01-01

    There is only sparse data on clinical results and complications of the third-generation Gamma nailing system (Gamma3, Stryker). Therefore, we started a large multi-centre case series in 2008. The aim of this paper is to present the study design and early results of a single arm of a prospective, consecutive, monitored, post-market follow-up evaluation of Gamma3 nails. From September 2009 to January 2012, 154 consecutive patients with an average age of 80 ± 1.43 years (50-99 years) and a trochanteric femoral fracture were included in the local arm of the trial. All patients that fulfilled the inclusion criteria were treated with a Gamma3 nail. Preoperative variables included age, gender, fracture classification, walking ability (Merle d'Aubigné score), daily activity level (retrospective Zuckerman score), ASA rating of operative risk, waiting time for operation, use of walker or crutches and body mass index (BMI). Skin-to-skin time, fluoroscopy time, blood loss, intraoperative complications and device information were recorded for each patient. Follow-up postoperative assessment was undertaken at 4, 12 and 24 months. Hip range of motion, pain around the hip and the tight, walking ability (Merle d'Aubigné score, Sahlgrenska mobility score) and management of daily life (Zuckerman score) were used to evaluate the outcome. The descriptive data of age, gender, BMI, ASA classification, fracture type and skin-to-skin time is similar to other studies. Median fluoroscopy time was 62 seconds (range: 4-225 seconds) and significantly shorter in closed reductions. No intraoperative implant-related complication was recorded. A cut-out of the leg-screw during assessment period occurred in 2.6% patients (n = 4). At the 12-month assessment two (1.8%) non-unions were identified and two patients (1.8%) had broken the femoral shaft below the 180 mm nail after a fall. Analysis of the scores showed significantly declined mobility and activity in daily life four months after operation

  15. Tests of the Giant Impact Hypothesis

    Science.gov (United States)

    Jones, J. H.

    1998-01-01

    The giant impact hypothesis has gained popularity as a means of explaining a volatile-depleted Moon that still has a chemical affinity to the Earth. As Taylor's Axiom decrees, the best models of lunar origin are testable, but this is difficult with the giant impact model. The energy associated with the impact would be sufficient to totally melt and partially vaporize the Earth. And this means that there should he no geological vestige of Barber times. Accordingly, it is important to devise tests that may be used to evaluate the giant impact hypothesis. Three such tests are discussed here. None of these is supportive of the giant impact model, but neither do they disprove it.

  16. Giant planets. Holweck prize lecture 1982

    Energy Technology Data Exchange (ETDEWEB)

    Hide, R. (Meteorological Office, Bracknell (UK))

    1982-10-01

    The main characteristics of the giant planets, Jupiter and Saturn, are outlined. Studies which have been made of the circulation of their atmospheres, the structure of their interiors and the origin of their magnetic fields are discussed.

  17. Giant Omental Lipoma in a Child

    International Nuclear Information System (INIS)

    Chaudhary, Vikas; Narula, Mahender Kaur; Anand, Rama; Gupta, Isha; Kaur, Gurmeen; Kalra, Kanika

    2011-01-01

    Omental lipomas are extremely rare tumors of childhood. We report a case of solitary giant lipoma of the omentum in a child, successfully managed by complete excision, without any recurrence on follow-up study

  18. AFSC/ABL: Female Giant Grenadier maturity

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Giant grenadiers Albatrossia pectoralis are caught as bycatch in deep-sea commercial fisheries in relatively large numbers. The population appears to be stable,...

  19. Giant pubertal prolactinoma: Complete resolution following short ...

    African Journals Online (AJOL)

    2016-04-06

    Apr 6, 2016 ... disappeared in a short time with cabergoline treatment. Key words: ... Hyperprolactinemia may cause impotence and hypogonadism in adult men, and rarely ... safe treatment method for male patients with giant prolactinoma.

  20. Who's working on giant clam culture?

    OpenAIRE

    Vega, M.J.M.

    1990-01-01

    An examination is made of the literature on giant clam (Tridacna ) culture methods induced spawning, larvae, larval and post-larval rearing and socioeconomics. ASFA and the ICLARM library and professional staff collections were used for the search.

  1. [Tissular expansion in giant congenital nevi treatment].

    Science.gov (United States)

    Nguyen Van Nuoi, V; Francois-Fiquet, C; Diner, P; Sergent, B; Zazurca, F; Franchi, G; Buis, J; Vazquez, M-P; Picard, A; Kadlub, N

    2014-08-01

    Surgical management of giant melanotic naevi remains a surgical challenge. Tissue expansion provides tissue of the same quality for the repair of defects. The aim of this study is to review tissular expansion for giant melanotic naevi. We conducted a retrospective study from 2000 to 2012. All children patients who underwent a tissular expansion for giant congenital naevi had been included. Epidemiological data, surgical procedure, complication rate and results had been analysed. Thirty-tree patients had been included; they underwent 61 procedures with 79 tissular-expansion prosthesis. Previous surgery, mostly simple excision had been performed before tissular expansion. Complete naevus excision had been performed in 63.3% of the cases. Complications occurred in 45% of the cases, however in 50% of them were minor. Iterative surgery increased the complication rate. Tissular expansion is a valuable option for giant congenital naevus. However, complication rate remained high, especially when iterative surgery is needed. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  2. Red giants as precursors of planetary nebulae

    International Nuclear Information System (INIS)

    Renzini, A.

    1981-01-01

    It is generally accepted that Planetary Nebulae are produced by asymptotic giant-branch stars. Therefore, several properties of planetary nebulae are discussed in the framework of the current theory of stellar evolution. (Auth.)

  3. Surgical treatment for giant incisional hernia

    DEFF Research Database (Denmark)

    Eriksson, A; Rosenberg, J; Bisgaard, T

    2014-01-01

    INTRODUCTION: Repair for giant incisional hernias is a challenge due to unacceptable high morbidity and recurrence rates. Several surgical techniques are available, but all are poorly documented. This systematic review was undertaken to evaluate the existing literature on repair for giant...... % with a wide range between studies of 4-100 %. The mortality ranged from 0 to 5 % (median 0 %) and recurrence rate ranged from 0 to 53 % (median 5 %). Study follow-up ranged from 15 to 97 months (median 36 months). Mesh repair should always be used for patients undergoing repair for a giant hernia......, and the sublay position may have advantages over onlay positioning. To avoid tension, it may be advisable to use a mesh in combination with a component separation technique. Inlay positioning of the mesh and repair without a mesh should be avoided. CONCLUSIONS: Evidence to optimise repair for giant hernias...

  4. AGB [asymptotic giant branch]: Star evolution

    International Nuclear Information System (INIS)

    Becker, S.A.

    1987-01-01

    Asymptotic giant branch stars are red supergiant stars of low-to-intermediate mass. This class of stars is of particular interest because many of these stars can have nuclear processed material brought up repeatedly from the deep interior to the surface where it can be observed. A review of recent theoretical and observational work on stars undergoing the asymptotic giant branch phase is presented. 41 refs

  5. Tensor fascia lata flap versus tensor fascia lata perforator-based island flap for the coverage of extensive trochanteric pressure sores.

    Science.gov (United States)

    Kim, Youn Hwan; Kim, Sang Wha; Kim, Jeong Tae; Kim, Chang Yeon

    2013-06-01

    Tensor fascia lata (TFL) musculocutaneous flaps often require a donor site graft when harvesting a large flap. However, a major drawback is that it also sacrifices the muscle. To overcome this disadvantage, we designed a TFL perforator-based island flap that was harvested from a site near the defect and involved transposition within 90 degrees without full isolation of the pedicles. We performed procedures on 17 musculocutaneous flaps and 23 perforator-based island flaps, and compared the outcomes of these surgeries. The overall complication rate was 27.5% (11 regions). There were 7 complications related to the musculocutaneous flaps and 4 complications related to the perforator flaps. Although there were no statistical differences between those groups, lower complication rates were associated with procedures involving perforator flaps. The TFL perforator procedure is a simple and fast operation that avoids sacrificing muscle. This decreases complication rates compared to true perforator flap techniques that require dissection around the perforator or pedicle.

  6. Macroscopic description of isoscalar giant multipole resonances

    International Nuclear Information System (INIS)

    Nix, J.R.; Sierk, A.J.

    1980-01-01

    On the basis of a simple macroscopic model, we calculate the isoscalar giant-resonance energy as a function of mass number and multipole degree. The restoring force is determined from the distortion of the Fermi surface, and the inertia is determined for the incompressible, irrotational flow of nucleons with unit effective mass. With no adjustable parameters, the resulting closed expression reproduces correctly the available experimental data, namely the magnitude and dependence upon mass number of the giant quadrupole energy and the magnitude of the giant octupole energy for 208 Pb. We also calculate the isoscalar giant-resonance width as a function of mass number and multipole degree for various macroscopic damping mechanisms, including two-body viscosity, one-body dissipation, and modified one-body dissipation. None of these damping mechanisms reproduces correctly all features of the available experimental data, namely the magnitude and dependence upon mass number of the giant quadrupole width and the magnitude of the giant octupole width for 208 Pb

  7. Swiss roll operation for giant fibroadenoma.

    Science.gov (United States)

    Soomro, Saleem A; Memon, Sohail A; Mohammad, Noor; Maher, Mumtaz

    2009-01-01

    Fibroadenoma 5 cm or more is called giant fibroadenoma. Giant fibroadenoma can distort the shape of breast and causes asymmetry, so it should be excised. There are several techniques for excision of giant fibroadenoma. In our technique we remove them through cosmetically acceptable circumareolar incision to maintain the shape and symmetry of breast. The objectives were to assess the cosmetic results of Swiss roll operation for giant fibroadenoma. The study was conducted for six years from January, 2002 to December, 2007. Seventy patients of giant fibroadenoma were included in this study. They were diagnosed on history and clinical examination supported by ultrasound and postoperative histopathological examination. Data were collected from outpatient department and operation theatre. Swiss roll operation was performed under general anaesthesia. Mean tumor size was 6.38 cm. Three cm and 4 cm incisions were used for tumour 6 cm in size respectively. Skin closed with Vicryl 3/0 subcuticular stitches. Sixteen out of 70 patients had no scar while others hadminimal scar. All patients had normal shape and symmetry of breast. On histopathology fibroadenoma was confirmed. Giant fibroadenoma should be removed through cosmetically acceptable cicumareolar incision especially in unmarried young females who have small breast. Swiss-roll operation is superior in maintaining the shape and symmetry of breast. No major complication was found in our series except seroma formation in 10 patients.

  8. Surface effects on the red giant branch

    Science.gov (United States)

    Ball, W. H.; Themeßl, N.; Hekker, S.

    2018-05-01

    Individual mode frequencies have been detected in thousands of individual solar-like oscillators on the red giant branch (RGB). Fitting stellar models to these mode frequencies, however, is more difficult than in main-sequence stars. This is partly because of the uncertain magnitude of the surface effect: the systematic difference between observed and modelled frequencies caused by poor modelling of the near-surface layers. We aim to study the magnitude of the surface effect in RGB stars. Surface effect corrections used for main-sequence targets are potentially large enough to put the non-radial mixed modes in RGB stars out of order, which is unphysical. Unless this can be circumvented, model-fitting of evolved RGB stars is restricted to the radial modes, which reduces the number of available modes. Here, we present a method to suppress gravity modes (g-modes) in the cores of our stellar models, so that they have only pure pressure modes (p-modes). We show that the method gives unbiased results and apply it to three RGB solar-like oscillators in double-lined eclipsing binaries: KIC 8410637, KIC 9540226 and KIC 5640750. In all three stars, the surface effect decreases the model frequencies consistently by about 0.1-0.3 μHz at the frequency of maximum oscillation power νmax, which agrees with existing predictions from three-dimensional radiation hydrodynamics simulations. Though our method in essence discards information about the stellar cores, it provides a useful step forward in understanding the surface effect in RGB stars.

  9. A computational study on the effect of fracture intrusion distance in three- and four-part trochanteric fractures treated with Gamma nail and sliding hip screw.

    Science.gov (United States)

    Goffin, Jérôme M; Pankaj, Pankaj; Simpson, A Hamish

    2014-01-01

    Using finite element analysis, the behaviors of the Gamma nail and the sliding hip screw (SHS) were compared in an osteoporotic bone model for the fixation of three- and four-part trochanteric fractures (31-A2 in the AO classification, types IV and V in Evans' classification). The size of the medial fragment was varied based on clinical data, and the case of a fractured greater trochanter was also considered. Our results showed that for Evans' type V stabilized with a Gamma nail and for Evans' types IV and V with the SHS, cancellous bone around the lag screw is susceptible to yielding, thus indicating a risk of cut-out. The volume of bone susceptible to yielding increases with an increase in size of the medial fragment. Conversely, Evans' type IV with a Gamma nail was not predicted to cut out. Our findings suggest that future clinical trials investigating fixation of unstable proximal fractures should include the size of the medial fragment and the integrity of the greater trochanter as covariables and be powered to evaluate whether intramedullary devices are superior to SHSs for Evans' type IV fractures and inferior/equivalent for type V. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  10. Comparison of the reconstruction trochanteric antigrade nail (TAN) with the proximal femoral nail antirotation (PFNA) in the management of reverse oblique intertrochanteric hip fractures.

    Science.gov (United States)

    Makki, Daoud; Matar, Hosam E; Jacob, Nebu; Lipscombe, Stephen; Gudena, Ravindra

    2015-12-01

    Reverse oblique intertrochanteric fractures have unique mechanical characteristics and are often treated with intramedullary implants. We compared the outcomes of the reconstruction trochanteric antegrade nail (TAN) with the proximal femoral nail antirotation (PFNA). Between July 2008 and February 2014, we reviewed all patients with reverse oblique intertrochanteric fractures treated at our hospital. Patients with pathological fractures and those who were treated with other than TAN and PFNA nailing systems were excluded. Preoperative assessment included the Abbreviated mental test score (AMT), the ASA grade, pre-injury mobility and place of residence. Postoperative outcome measures included the type of implant used, time to fracture union, failures of fixation and revision surgeries. Fifty-eight patients were included and divided into two groups based on the treatment: 22 patients treated with TAN and 36 patients treated with PFNA systems. The two groups were well matched with regards to demographics and fracture type. The overall union rate was similar in both groups but the time to union was shorter in the TAN group. There were 8 implant failures in the PFNA (22.2%) group compare to none in the TAN group. Implant failure was associated with the severity of fracture (AO 31.A3.3) but was not related to fracture malreduction or screw position (Tip-apex-distance). Our study suggests that the use of reconstruction system with two screws such as TAN may be more suitable implant for reverse oblique intertrochanteric hip fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. SOLUBILITY OF IRON IN METALLIC HYDROGEN AND STABILITY OF DENSE CORES IN GIANT PLANETS

    International Nuclear Information System (INIS)

    Wahl, Sean M.; Wilson, Hugh F.; Militzer, Burkhard

    2013-01-01

    The formation of the giant planets in our solar system, and likely a majority of giant exoplanets, is most commonly explained by the accretion of nebular hydrogen and helium onto a large core of terrestrial-like composition. The fate of this core has important consequences for the evolution of the interior structure of the planet. It has recently been shown that H 2 O, MgO, and SiO 2 dissolve in liquid metallic hydrogen at high temperature and pressure. In this study, we perform ab initio calculations to study the solubility of an innermost metallic core. We find dissolution of iron to be strongly favored above 2000 K over the entire pressure range (0.4-4 TPa) considered. We compare with and summarize the results for solubilities on other probable core constituents. The calculations imply that giant planet cores are in thermodynamic disequilibrium with surrounding layers, promoting erosion and redistribution of heavy elements. Differences in solubility behavior between iron and rock may influence evolution of interiors, particularly for Saturn-mass planets. Understanding the distribution of iron and other heavy elements in gas giants may be relevant in understanding mass-radius relationships, as well as deviations in transport properties from pure hydrogen-helium mixtures

  12. Infiltrating giant cellular blue naevus.

    Science.gov (United States)

    Bittencourt, A L; Monteiro, D A; De Pretto, O J

    2007-01-01

    Cellular blue naevi (CBN) measure 1-2 cm in diameter and affect the dermis, occasionally extending into the subcutaneous fat. The case of a 14-year-old boy with a giant CBN (GCBN) involving the right half of the face, the jugal mucosa and the lower eyelid with a tumour that had infiltrated the bone and the maxillary and ethmoidal sinuses is reported. Biopsies were taken from the skin, jugal mucosa and maxillary sinus. The following markers were used in the immunohistochemical evaluation: CD34, CD56, HMB-45, anti-S100, A-103, Melan A and MIB-1. The biopsy specimens showed a biphasic pattern affecting the lower dermis, subcutaneous fat, skeletal muscle, bone, jugal mucosa and maxillary sinus, but there was no histological evidence of malignancy. The tumour cells were CD34-, CD56-, HMB45+, anti-S100+ and A-103+. Melan A was focally expressed. No positive MIB-1 cells were identified. The present case shows that GCBN may infiltrate deeply, with no evidence of malignancy.

  13. Giant hepatocellular adenoma; case report

    Energy Technology Data Exchange (ETDEWEB)

    Pitella, F.A.; Coutinho, A.M.N.; Coura Filho, G.B.; Costa, P.L.A.; Ono, C.R.; Watanabe, T.; Sapienza, M.T.; Hironaka, F.; Cerri, G.G.; Buchpiguel, C.A. [Universidade de Sao Paulo (FM/USP), SP (Brazil). Inst. de Radiologia. Servico de Medicina Nuclear

    2008-07-01

    Full text: Introduction: Hepatocellular adenoma is a benign hepatic tumor identified mainly in women during fertility age, with estimated incidence of 4/1000 inhabitants. It is usually unique, well circumscribed, with or without a capsule, size varying from 1 to 30 cm, with possible central areas of necrosis and hemorrhage. Case Report: A 37-year-old female patient presenting with no comorbities, use of hormonal birth control pills for 18 years, a condition of reduction in the consistency of feces, increase in number of daily defecations, abdominal cramps, and a stuffed sensation after meals for two years. A palpable abdominal mass extending from the right hypochondriac to the right iliac fossa was noticed four months ago. A computerized tomography (CT) showed an extensive hepatic mass on the right which was considered, within the diagnostic hypotheses, hepatic adenomatosis, without ruling out secondary lesions. A hepatic scintillography with {sup 99m}Tc-DISIDA showed an extensive exophytic area from segment V to the right iliac fossa with arterialized blood flow and hepatocytic activity, as well as a hepatic nodule in segment VII with hepatocytic activity consistent with the hepatic adenomas hypothesis. The biopsy confirmed the hepatic adenoma diagnosis and the patient was submitted to a partial hepatectomy and cholecystectomy with good clinical evolution. Conclusion: Nuclear Medicine may supplement the assessment of hepatic nodules, including giant masses, thus suggesting new hypotheses and direction to therapeutic conduct. (author)

  14. Migration of accreting giant planets

    Science.gov (United States)

    Crida, A.; Bitsch, B.; Raibaldi, A.

    2016-12-01

    We present the results of 2D hydro simulations of giant planets in proto-planetary discs, which accrete gas at a more or less high rate. First, starting from a solid core of 20 Earth masses, we show that as soon as the runaway accretion of gas turns on, the planet is saved from type I migration : the gap opening mass is reached before the planet is lost into its host star. Furthermore, gas accretion helps opening the gap in low mass discs. Consequently, if the accretion rate is limited to the disc supply, then the planet is already inside a gap and in type II migration. We further show that the type II migration of a Jupiter mass planet actually depends on its accretion rate. Only when the accretion is high do we retrieve the classical picture where no gas crosses the gap and the planet follows the disc spreading. These results impact our understanding of planet migration and planet population synthesis models. The e-poster presenting these results in French can be found here: L'e-poster présentant ces résultats en français est disponible à cette adresse: http://sf2a.eu/semaine-sf2a/2016/posterpdfs/156_179_49.pdf.

  15. The Giant Planet Satellite Exospheres

    Science.gov (United States)

    McGrath, Melissa A.

    2014-01-01

    Exospheres are relatively common in the outer solar system among the moons of the gas giant planets. They span the range from very tenuous, surface-bounded exospheres (e.g., Rhea, Dione) to quite robust exospheres with exobase above the surface (e.g., lo, Triton), and include many intermediate cases (e.g., Europa, Ganymede, Enceladus). The exospheres of these moons exhibit an interesting variety of sources, from surface sputtering, to frost sublimation, to active plumes, and also well illustrate another common characteristic of the outer planet satellite exospheres, namely, that the primary species often exists both as a gas in atmosphere, and a condensate (frost or ice) on the surface. As described by Yelle et al. (1995) for Triton, "The interchange of matter between gas and solid phases on these bodies has profound effects on the physical state of the surface and the structure of the atmosphere." A brief overview of the exospheres of the outer planet satellites will be presented, including an inter-comparison of these satellites exospheres with each other, and with the exospheres of the Moon and Mercury.

  16. Endoscopically removed giant submucosal lipoma

    Directory of Open Access Journals (Sweden)

    Jovanović Ivan

    2007-01-01

    Full Text Available Background. Although uncommon, giant submucosal colon lipomas merit attention as they are often presented with dramatic clinical features such as bleeding, acute bowel obstruction, perforation and sometimes may be mistaken for malignancy. There is a great debate in the literature as to how to treat them. Case report. A patient, 67-year old, was admitted to the Clinic due to a constipation over the last several months, increasing abdominal pain mainly localized in the left lower quadrant accompanied by nausea, vomiting and abdominal distension. Physical examination was unremarkable and the results of the detailed laboratory tests and carcinoembryonic antigen remained within normal limits. Colonoscopy revealed a large 10 cm long, and 4 to 5 cm in diameter, mobile lesion in his sigmoid colon. Conventional endoscopic ultrasound revealed 5 cm hyperechoic lesion of the colonic wall. Twenty MHz mini-probe examination showed that lesion was limited to the submucosa. Since polyp appeared too large for a single transaction, it was removed piecemeal. Once the largest portion of the polyp has been resected, it was relatively easy to place the opened snare loop around portions of the residual polyp. Endoscopic resection was carried out safely without complications. Histological examination revealed the common typical histological features of lipoma elsewhere. The patient remained stable and eventually discharged home. Four weeks later he suffered no recurrent symptoms. Conclusion. Colonic lipomas can be endoscopically removed safely eliminating unnecessary surgery.

  17. YOUNG SOLAR SYSTEM's FIFTH GIANT PLANET?

    International Nuclear Information System (INIS)

    Nesvorný, David

    2011-01-01

    Studies of solar system formation suggest that the solar system's giant planets formed and migrated in the protoplanetary disk to reach the resonant orbits with all planets inside ∼15 AU from the Sun. After the gas disk's dispersal, Uranus and Neptune were likely scattered by the gas giants, and approached their current orbits while dispersing the transplanetary disk of planetesimals, whose remains survived to this time in the region known as the Kuiper Belt. Here we performed N-body integrations of the scattering phase between giant planets in an attempt to determine which initial states are plausible. We found that the dynamical simulations starting with a resonant system of four giant planets have a low success rate in matching the present orbits of giant planets and various other constraints (e.g., survival of the terrestrial planets). The dynamical evolution is typically too violent, if Jupiter and Saturn start in the 3:2 resonance, and leads to final systems with fewer than four planets. Several initial states stand out in that they show a relatively large likelihood of success in matching the constraints. Some of the statistically best results were obtained when assuming that the solar system initially had five giant planets and one ice giant, with the mass comparable to that of Uranus and Neptune, and which was ejected to interstellar space by Jupiter. This possibility appears to be conceivable in view of the recent discovery of a large number of free-floating planets in interstellar space, which indicates that planet ejection should be common.

  18. Young Solar System's Fifth Giant Planet?

    Science.gov (United States)

    Nesvorný, David

    2011-12-01

    Studies of solar system formation suggest that the solar system's giant planets formed and migrated in the protoplanetary disk to reach the resonant orbits with all planets inside ~15 AU from the Sun. After the gas disk's dispersal, Uranus and Neptune were likely scattered by the gas giants, and approached their current orbits while dispersing the transplanetary disk of planetesimals, whose remains survived to this time in the region known as the Kuiper Belt. Here we performed N-body integrations of the scattering phase between giant planets in an attempt to determine which initial states are plausible. We found that the dynamical simulations starting with a resonant system of four giant planets have a low success rate in matching the present orbits of giant planets and various other constraints (e.g., survival of the terrestrial planets). The dynamical evolution is typically too violent, if Jupiter and Saturn start in the 3:2 resonance, and leads to final systems with fewer than four planets. Several initial states stand out in that they show a relatively large likelihood of success in matching the constraints. Some of the statistically best results were obtained when assuming that the solar system initially had five giant planets and one ice giant, with the mass comparable to that of Uranus and Neptune, and which was ejected to interstellar space by Jupiter. This possibility appears to be conceivable in view of the recent discovery of a large number of free-floating planets in interstellar space, which indicates that planet ejection should be common.

  19. THE PROPERTIES OF HEAVY ELEMENTS IN GIANT PLANET ENVELOPES

    Energy Technology Data Exchange (ETDEWEB)

    Soubiran, François; Militzer, Burkhard [Department of Earth and Planetary Science, University of California, Berkeley, CA 94720 (United States)

    2016-09-20

    The core-accretion model for giant planet formation suggests a two-layer picture for the initial structure of Jovian planets, with heavy elements in a dense core and a thick H–He envelope. Late planetesimal accretion and core erosion could potentially enrich the H–He envelope in heavy elements, which is supported by the threefold solar metallicity that was measured in Jupiter’s atmosphere by the Galileo entry probe. In order to reproduce the observed gravitational moments of Jupiter and Saturn, models for their interiors include heavy elements, Z , in various proportions. However, their effect on the equation of state of the hydrogen–helium mixtures has not been investigated beyond the ideal mixing approximation. In this article, we report results from ab initio simulations of fully interacting H–He– Z mixtures in order to characterize their equation of state and to analyze possible consequences for the interior structure and evolution of giant planets. Considering C, N, O, Si, Fe, MgO, and SiO{sub 2}, we show that the behavior of heavy elements in H–He mixtures may still be represented by an ideal mixture if the effective volumes and internal energies are chosen appropriately. In the case of oxygen, we also compute the effect on the entropy. We find the resulting changes in the temperature–pressure profile to be small. A homogeneous distribution of 2% oxygen by mass changes the temperature in Jupiter’s interior by only 80 K.

  20. MASSIVE SATELLITES OF CLOSE-IN GAS GIANT EXOPLANETS

    International Nuclear Information System (INIS)

    Cassidy, Timothy A.; Johnson, Robert E.; Mendez, Rolando; Arras, Phil; Skrutskie, Michael F.

    2009-01-01

    We study the orbits, tidal heating and mass loss from satellites around close-in gas giant exoplanets. The focus is on large satellites which are potentially observable by their transit signature. We argue that even Earth-size satellites around hot Jupiters can be immune to destruction by orbital decay; detection of such a massive satellite would strongly constrain theories of tidal dissipation in gas giants, in a manner complementary to orbital circularization. The star's gravity induces significant periodic eccentricity in the satellite's orbit. The resulting tidal heating rates, per unit mass, are far in excess of Io's and dominate radioactive heating out to planet orbital periods of months for reasonable satellite tidal Q. Inside planet orbital periods of about a week, tidal heating can completely melt the satellite. Lastly, we compute an upper limit to the satellite mass loss rate due to thermal evaporation from the surface, valid if the satellite's atmosphere is thin and vapor pressure is negligible. Using this upper limit, we find that although rocky satellites around hot Jupiters with orbital periods less than a few days can be significantly evaporated in their lifetimes, detectable satellites suffer negligible mass loss at longer orbital periods.

  1. Bending-Induced Giant Polarization in Ferroelectric MEMS Diaphragm

    KAUST Repository

    Wang, Zhihong

    2016-09-09

    The polarization induced by the strain gradient, i.e. the flexoelectric effect, has been observed in a micromachined Pb(Zr0.52Ti0.48)O3 (PZT) diaphragms. Applying air pressure to bend a flat diaphragm which initially does not exhibit any electromechanical coupling can induce a resonance peak in its impedance spectrum. This result supposes that bending, thus the strain gradient in the diaphragm causes polarization in PZT film. We also investigated the switching behaviors of the polarization in response to an external electric field in a bent diaphragm and further quantified the polarization induced by the strain gradient. The effective flexoelectric coefficient of the PZT film has been calculated as large as 2.0 × 10−4 C/m. A giant flexoelectric polarization of the order of 1 μC/cm2 was characterized which is of the same order of magnitude as the normal remnant ferroelectric polarization of PZT film. The suggested explanation for the giant polarization is the large strain gradient in the diaphragm and the strain gradient induced reorientation of the polar nanodomains.

  2. Electrodynamics on extrasolar giant planets

    Energy Technology Data Exchange (ETDEWEB)

    Koskinen, T. T.; Yelle, R. V. [Lunar and Planetary Laboratory, University of Arizona, 1629 East University Boulevard, Tucson, AZ 85721-0092 (United States); Lavvas, P. [Groupe de Spectroscopie Moléculaire et Atmosphérique UMR CNRS 7331, Université Reims Champagne-Ardenne, F-51687 Reims (France); Cho, J. Y-K., E-mail: tommi@lpl.arizona.edu [Astronomy Unit, School of Mathematical Sciences, Queen Mary, University of London, Mile End Road, London E1 4NS (United Kingdom)

    2014-11-20

    Strong ionization on close-in extrasolar giant planets (EGPs) suggests that their atmospheres may be affected by ion drag and resistive heating arising from wind-driven electrodynamics. Recent models of ion drag on these planets, however, are based on thermal ionization only and do not include the upper atmosphere above the 1 mbar level. These models are also based on simplified equations of resistive magnetohydrodynamics that are not always valid in extrasolar planet atmospheres. We show that photoionization dominates over thermal ionization over much of the dayside atmosphere above the 100 mbar level, creating an upper ionosphere dominated by ionization of H and He and a lower ionosphere dominated by ionization of metals such as Na, K, and Mg. The resulting dayside electron densities on close-in exoplanets are higher than those encountered in any planetary ionosphere of the solar system, and the conductivities are comparable to the chromosphere of the Sun. Based on these results and assumed magnetic fields, we constrain the conductivity regimes on close-in EGPs and use a generalized Ohm's law to study the basic effects of electrodynamics in their atmospheres. We find that ion drag is important above the 10 mbar level where it can also significantly alter the energy balance through resistive heating. Due to frequent collisions of the electrons and ions with the neutral atmosphere, however, ion drag is largely negligible in the lower atmosphere below the 10 mbar level for a reasonable range of planetary magnetic moments. We find that the atmospheric conductivity decreases by several orders of magnitude in the night side of tidally locked planets, leading to a potentially interesting large-scale dichotomy in electrodynamics between the day and night sides. A combined approach that relies on UV observations of the upper atmosphere, phase curve and Doppler measurements of global dynamics, and visual transit observations to probe the alkali metals can potentially

  3. A GIANT SAMPLE OF GIANT PULSES FROM THE CRAB PULSAR

    International Nuclear Information System (INIS)

    Mickaliger, M. B.; McLaughlin, M. A.; Lorimer, D. R.; Palliyaguru, N.; Langston, G. I.; Bilous, A. V.; Kondratiev, V. I.; Lyutikov, M.; Ransom, S. M.

    2012-01-01

    We observed the Crab pulsar with the 43 m telescope in Green Bank, WV over a timespan of 15 months. In total we obtained 100 hr of data at 1.2 GHz and seven hours at 330 MHz, resulting in a sample of about 95,000 giant pulses (GPs). This is the largest sample, to date, of GPs from the Crab pulsar taken with the same telescope and backend and analyzed as one data set. We calculated power-law fits to amplitude distributions for main pulse (MP) and interpulse (IP) GPs, resulting in indices in the range of 2.1-3.1 for MP GPs at 1.2 GHz and in the range of 2.5-3.0 and 2.4-3.1 for MP and IP GPs at 330 MHz. We also correlated the GPs at 1.2 GHz with GPs from the Robert C. Byrd Green Bank Telescope (GBT), which were obtained simultaneously at a higher frequency (8.9 GHz) over a span of 26 hr. In total, 7933 GPs from the 43 m telescope at 1.2 GHz and 39,900 GPs from the GBT were recorded during these contemporaneous observations. At 1.2 GHz, 236 (3%) MP GPs and 23 (5%) IP GPs were detected at 8.9 GHz, both with zero chance probability. Another 15 (4%) low-frequency IP GPs were detected within one spin period of high-frequency IP GPs, with a chance probability of 9%. This indicates that the emission processes at high and low radio frequencies are related, despite significant pulse profile shape differences. The 43 m GPs were also correlated with Fermi γ-ray photons to see if increased pair production in the magnetosphere is the mechanism responsible for GP emission. A total of 92,022 GPs and 393 γ-ray photons were used in this correlation analysis. No significant correlations were found between GPs and γ-ray photons. This indicates that increased pair production in the magnetosphere is likely not the dominant cause of GPs. Possible methods of GP production may be increased coherence of synchrotron emission or changes in beaming direction.

  4. A GIANT SAMPLE OF GIANT PULSES FROM THE CRAB PULSAR

    Energy Technology Data Exchange (ETDEWEB)

    Mickaliger, M. B.; McLaughlin, M. A.; Lorimer, D. R.; Palliyaguru, N. [Department of Physics, West Virginia University, Morgantown, WV 26506 (United States); Langston, G. I. [National Radio Astronomy Observatory, Green Bank, WV 24944 (United States); Bilous, A. V. [Department of Astronomy, University of Virginia, P.O. Box 400325, Charlottesville, VA 22904 (United States); Kondratiev, V. I. [Netherlands Institute for Radio Astronomy (ASTRON), Postbus 2, 7990 AA Dwingeloo (Netherlands); Lyutikov, M. [Department of Physics, Purdue University, 525 Northwestern Avenue, West Lafayette, IN 47907-2036 (United States); Ransom, S. M. [National Radio Astronomy Observatory, Charlottesville, VA 22903 (United States)

    2012-11-20

    We observed the Crab pulsar with the 43 m telescope in Green Bank, WV over a timespan of 15 months. In total we obtained 100 hr of data at 1.2 GHz and seven hours at 330 MHz, resulting in a sample of about 95,000 giant pulses (GPs). This is the largest sample, to date, of GPs from the Crab pulsar taken with the same telescope and backend and analyzed as one data set. We calculated power-law fits to amplitude distributions for main pulse (MP) and interpulse (IP) GPs, resulting in indices in the range of 2.1-3.1 for MP GPs at 1.2 GHz and in the range of 2.5-3.0 and 2.4-3.1 for MP and IP GPs at 330 MHz. We also correlated the GPs at 1.2 GHz with GPs from the Robert C. Byrd Green Bank Telescope (GBT), which were obtained simultaneously at a higher frequency (8.9 GHz) over a span of 26 hr. In total, 7933 GPs from the 43 m telescope at 1.2 GHz and 39,900 GPs from the GBT were recorded during these contemporaneous observations. At 1.2 GHz, 236 (3%) MP GPs and 23 (5%) IP GPs were detected at 8.9 GHz, both with zero chance probability. Another 15 (4%) low-frequency IP GPs were detected within one spin period of high-frequency IP GPs, with a chance probability of 9%. This indicates that the emission processes at high and low radio frequencies are related, despite significant pulse profile shape differences. The 43 m GPs were also correlated with Fermi {gamma}-ray photons to see if increased pair production in the magnetosphere is the mechanism responsible for GP emission. A total of 92,022 GPs and 393 {gamma}-ray photons were used in this correlation analysis. No significant correlations were found between GPs and {gamma}-ray photons. This indicates that increased pair production in the magnetosphere is likely not the dominant cause of GPs. Possible methods of GP production may be increased coherence of synchrotron emission or changes in beaming direction.

  5. Effects of certain burning treatments on veld condition in Giant's ...

    African Journals Online (AJOL)

    Effects of certain burning treatments on veld condition in Giant's Castle Game Reserve. ... Keywords: above-ground standing crop; basal cover; burning; composition change; giant's castle game reserve; natal ... AJOL African Journals Online.

  6. Hepatic Giant Cell Arteritis and Polymyalgia Rheumatica

    Directory of Open Access Journals (Sweden)

    Donald R Duerksen

    1994-01-01

    Full Text Available Polymyalgia rheumatica (PMR is a clinical syndrome of the elderly characterized by malaise, proximal muscle aching and stiffness, low grade fever, elevated erythrocyte sedimentation rare and the frequent association with temporal giant cell arteritis. The authors describe a case of PMR associated with hepatic giant cell arteritis. This lesion has been described in two other clinical reports. The distribution of the arteritis may be patchy; in this report, diagnosis was made with a wedge biopsy performed after an initial nonspecific percutaneous liver biopsy. The authors review the spectrum of liver involvement in PMR and giant cell arteritis. Hepatic abnormalities respond to systemic corticosteroids, and patients with hepatic arteritis have a good prognosis.

  7. Excitation of giant resonances through inelastic scattering

    International Nuclear Information System (INIS)

    Kailas, S.

    1981-01-01

    In the last few years, exciting developments have taken place in the study of giant resonances (GR). In addition to the already well known gjant dipole resonance (GDR), the presence of at least two more new GRs viz. giant quadrupole resonance (GQR) and giant monopole resonance (GMR) has been experimentally established. The systematics covering these GRs is found to be consistent with the theoretical expectation. Though the existence of higher multipoles has been predjcted by theory, so far only some of these have been found to be excited experimentally. Various probe particles - electrons, protons (polarized and unpolarized), light and heavy ions and pions - at different bombarding energies have been used to excite the GR region, primarily through the inelastic scattering process. Detailed experiments, looking at the decay modes of GR region, have also been performed. These studies have contributed significantly to a better understanding of the phenomenon of nuclear collective excitation. In this report, the current status of 'GR' research is reviewed. (author)

  8. LITHIUM-RICH GIANTS IN GLOBULAR CLUSTERS

    Energy Technology Data Exchange (ETDEWEB)

    Kirby, Evan N.; Cohen, Judith G. [California Institute of Technology, 1200 E. California Boulevard, MC 249-17, Pasadena, CA 91125 (United States); Guhathakurta, Puragra [UCO/Lick Observatory and Department of Astronomy and Astrophysics, University of California, 1156 High Street, Santa Cruz, CA 95064 (United States); Zhang, Andrew J. [The Harker School, 500 Saratoga Avenue, San Jose, CA 95129 (United States); Hong, Jerry [Palo Alto High School, 50 Embarcadero Road, Palo Alto, CA, 94301 (United States); Guo, Michelle [Stanford University, 450 Serra Mall, Stanford, CA 94305 (United States); Guo, Rachel [Irvington High School, 41800 Blacow Road, Fremont, CA 94538 (United States); Cunha, Katia [Observatório Nacional, São Cristóvão Rio de Janeiro (Brazil)

    2016-03-10

    Although red giants deplete lithium on their surfaces, some giants are Li-rich. Intermediate-mass asymptotic giant branch (AGB) stars can generate Li through the Cameron–Fowler conveyor, but the existence of Li-rich, low-mass red giant branch (RGB) stars is puzzling. Globular clusters are the best sites to examine this phenomenon because it is straightforward to determine membership in the cluster and to identify the evolutionary state of each star. In 72 hours of Keck/DEIMOS exposures in 25 clusters, we found four Li-rich RGB and two Li-rich AGB stars. There were 1696 RGB and 125 AGB stars with measurements or upper limits consistent with normal abundances of Li. Hence, the frequency of Li-richness in globular clusters is (0.2 ± 0.1)% for the RGB, (1.6 ± 1.1)% for the AGB, and (0.3 ± 0.1)% for all giants. Because the Li-rich RGB stars are on the lower RGB, Li self-generation mechanisms proposed to occur at the luminosity function bump or He core flash cannot explain these four lower RGB stars. We propose the following origin for Li enrichment: (1) All luminous giants experience a brief phase of Li enrichment at the He core flash. (2) All post-RGB stars with binary companions on the lower RGB will engage in mass transfer. This scenario predicts that 0.1% of lower RGB stars will appear Li-rich due to mass transfer from a recently Li-enhanced companion. This frequency is at the lower end of our confidence interval.

  9. PROSPECTIVE ASSESSMENT OF THE CLINICAL, RADIOGRAPHIC AND FUNCTIONAL EVOLUTION OF TREATMENT FOR UNSTABLE TROCHANTERIC FRACTURES OF THE FEMUR USING A CEPHALOMEDULLARY NAIL.

    Science.gov (United States)

    Borger, Richard Armelin; Borger, Frederico Araújo; Pires de Araújo, Rodrigo; Pereira, Thiago Ferreira Nunes; Queiroz, Roberto Dantas

    2011-01-01

    To assess the clinical, radiological and functional evolution of osteosynthesis using a cephalomedullary nail, in unstable trochanteric fractures of the femur, over a one-year postoperative follow-up. Fourteen men and 23 women of mean age 77.7 years were evaluated. Twenty-seven of them had fractures classified as AO/ASIF 31A2 and ten as 31A3. The patients were evaluated clinically, radiologically and functionally one week, two weeks, one month, two months, six months and one year after the operation. The clinical complications comprised five cases of death, one case of calcaneal ulcer, one case of acute arterial obstruction and two cases of deep vein thrombosis. The radiographic evaluation showed that the mean cervicodiaphyseal angle in the immediate postoperative period was 132.5°. The mean tip-apex index was 22.8 mm. After one year, the mean cervicodiaphyseal angle was 131.7°. Fracture consolidation was seen in all the patients six months after the operation, except in one case that presented cut-out. There were no cases of fracture below the implant. The functional evaluation using the Harris score after one year showed a mean of 69.3 points. The evaluation of walking progress showed that after one year, 40.6% of the patients had the same ability to walk that they had before the fracture. The visual analogue pain scale showed that a significant decrease in pain complaints occurred, going from 5.19 in the first week to 2.25 after 1 year. Osteosynthesis using a cephalomedullary nail resulted in low rates of clinical and mechanical complications and adequate functional outcomes.

  10. Femoral Medialization, Fixation Failures, and Functional Outcome in Trochanteric Hip Fractures Treated With Either a Sliding Hip Screw or an Intramedullary Nail From Within a Randomized Trial.

    Science.gov (United States)

    Bretherton, Christopher P; Parker, Martyn J

    2016-12-01

    The aim of this study was to determine if femoral medialization influences residual pain and mobility and to determine if fixation method or fracture pattern influences the tendency to medialize. This study used data from within a randomized controlled trial. Peterborough City Hospital, UK. Eight hundred forty-four patients presenting with a trochanteric hip fracture were randomized. Five hundred thirty-eight were available for 1-year follow-up. Fractures were classified according to OTA/AO classification as 31 A1, A2, and A3. Randomized to fixation with a Targon proximal femoral nail or sliding hip screw (SHS). Femoral medialization was calculated from follow-up x-rays at a minimum of 28 days post-fixation. Pain and mobility scores were assessed at 1 year by an independent blinded observer. Fixation failure and revision procedures were assessed at a minimum of 1 year from injury. Patients with >50% medialization had worse pain (P = 0.012) and mobility scores (P = 0.013) at 1 year. They also had more fracture healing complications (P = 0.021) and required more revision procedures (P = 0.014). Fractures treated with SHS were more likely to medialize >50% compared with intramedullary nail (P fractures were more likely to medialize, and A3 fractures were more likely to undergo >50% medialization (P fractures treated with SHS to undergo femoral medialization and correlates this with worse functional outcomes. It supports the use of intramedullary nails for A3 fractures, which have a significant tendency to medialize. Prognostic level II. See Instructions for Authors for a complete description of levels of evidence.

  11. Treatment for Trochanteric Fracture of the Femur with Short Femoral Nail: A Comparison between the Asian Intramedullary Hip Screw (IMHS) and the Conventional IMHS.

    Science.gov (United States)

    Kawaji, Hidemi; Uematsu, Takuya; Oba, Ryosuke; Satake, Yoshihiko; Hoshikawa, Naoya; Takai, Shinro

    2016-01-01

    We usually use short femoral nails for the treatment of trochanteric fracture of the femur. In this retrospective study, we investigated and compared the clinical results of the conventional intramedullary hip screw (IMHS) and the Asian IMHS, which is a redesigned version of the former. The subjects were 42 patients; 21 treated with the Asian IMHS and 21 were treated with the conventional IMHS. From the clinical records, we retrospectively investigated the patients' age, sex, in-hospital waiting period for operation, operating time, intraoperative blood loss, walking ability before fracture and at discharge, and complication pertaining to the operation. The 21 patients (4 men and 17 women) receiving the Asian IMHS and the 21 patients (5 men and 16 women) receiving the conventional IMHS did not differ significantly in mean age, sex ratio, preoperative waiting period, mean postoperative hospital stay, mean operation time, or mean intraoperative blood loss. Among patients receiving the Asian IMHS, the complications of intraoperative fractures of the femur developed in 3 patients and breakage of the implant occurred in 1 patient. No complications occurred in patients receiving the conventional IMHS. Compared with the conventional IMHS, the Asian IMHS is smaller, has increased variations in the shaft/neck angle of the lag screw, and has a titanium-alloy construction, allowing magnetic resonance imaging. The intraoperative fracture may have occurred because of the configuration of the distal interlocking screw in the Asian IMHS. Breakage of the implant likely occurred because the nail was too small in diameter, and too short in length for the unstable AO 31-A3 fracture. If careful attention is paid to the configuration of its distal interlocking screw intraoperatively and a nail of appropriate size is selected, the Asian IMHS is better suited than the conventional IMHS for treating Japanese patients, who generally have a small physique, because of its many variations in

  12. The relationship of femoral neck shaft angle and adiposity to greater trochanteric pain syndrome in women. A case control morphology and anthropometric study

    Science.gov (United States)

    Fearon, AM; Stephens, S; Cook, JL; Smith, PN; Neeman, T; Cormick, W; Scarvell, JM

    2012-01-01

    Objective To evaluate if pelvic or hip width predisposed women to developing greater trochanteric pain syndrome (GTPS). Design Prospective case control study. Participants Four groups were included in the study: those gluteal tendon reconstructions (n=31, GTR), those with conservatively managed GTPS (n=29), those with hip osteoarthritis (n=20, OA) and 22 asymptomatic participants (ASC). Methods Anterior-posterior pelvic x-rays were evaluated for femoral neck shaft angle; acetabular index, and width at the lateral acetabulum, and the superior and lateral aspects of the greater trochanter. Body mass index, and waist, hip and greater trochanter girth were measured. Data were analysed using a one-way analysis of variance (ANOVA; posthoc Scheffe analysis), then multivariate analysis. Results The GTR group had a lower femoral neck shaft angle than the other groups (p=0.007). The OR (95% CI) of having a neck shaft angle of less than 134°, relative to the ASC group: GTR=3.33 (1.26 to 8.85); GTPS=1.4 (0.52 to 3.75); OA=0.85 (0.28 to 2.61). The OR of GTR relative to GTPS was 2.4 (1.01 to 5.6). No group difference was found for acetabular or greater trochanter width. Greater trochanter girth produced the only anthropometric group difference (mean (95% CI) in cm) GTR=103.8 (100.3 to 107.3), GTPS=105.9 (100.2 to 111.6), OA=100.3 (97.7 to 103.9), ASC=99.1 (94.7 to 103.5), (ANOVA: p=0.036). Multivariate analysis confirmed adiposity is associated with GTPS. Conclusion A lower neck shaft angle is a risk factor for, and adiposity is associated with, GTPS in women. PMID:22547561

  13. Giant Epidermoid Cyst of the Thigh

    Directory of Open Access Journals (Sweden)

    NH Mohamed Haflah

    2011-11-01

    Full Text Available Epidermoid cyst is a common benign cutaneous swelling frequently encountered in surgical practice. It usually presents as a painless lump frequently occurring in hairbearing areas of the body particularly the scalp, scrotum, neck, shoulder and back. Giant epidermoid cysts commonly occur in hairy areas such as the scalp. We present here the case of a rare occurrence of a giant epidermoid cyst in the less hairy area of the right upper thigh mimicking a soft tissue sarcoma. Steps are highlighted for the management of this unusual cyst.

  14. Giant Spermatocele Mimicking Hydrocele: A Case Report

    Directory of Open Access Journals (Sweden)

    Hsin-Chih Yeh

    2007-07-01

    Full Text Available Spermatoceles are usually asymptomatic and often found incidentally during physical examination. We report a case of giant spermatocele that mimicked a hydrocele. A 55-year-old man suffered from right scrotal enlargement for several years. As the heavy sensation and scrotal soreness worsened in recent months, he came to our outpatient clinic for help. Hydrocele was suspected due to transilluminating appearance of the scrotal content. Surgical exploration was arranged and a giant spermatocele was found. Total excision of the spermatocele was performed and the patient recovered well. The specimen was sent for pathology and spermatocele with spermatozoa was noted.

  15. Neglected Giant Scalp Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Anne Kristine Larsen, MD

    2014-03-01

    Full Text Available Summary: Rarely, basal cell carcinoma grows to a giant size, invading the underlying deep tissue and complicating the treatment and reconstruction modalities. A giant basal cell carcinoma on the scalp is in some cases treated with a combination of surgery and radiation therapy, resulting in local control, a satisfactory long-term cosmetic and functional result. We present a case with a neglected basal cell scalp carcinoma, treated with wide excision and postoperative radiotherapy, reconstructed with a free latissimus dorsi flap. The cosmetic result is acceptable and there is no sign of recurrence 1 year postoperatively.

  16. Giant HII regions as distance indicators

    International Nuclear Information System (INIS)

    Melnick, Jorge; Terlevich, Robert; Moles, Mariano

    1987-01-01

    The correlations between the integrated Hβ luminosities, the velocity widths of the nebular lines and the metallicities of giant HII regions and HII galaxies are demonstrated to provide powerful distance indicators. They are calibrated on a homogeneous sample of giant HII regions with well determined distances and applied to distant HII galaxies to obtain a value of H 0 =95+-10 for the Hubble parameter, consistent with the value obtained by the Tully-Fisher technique. The effect of Malmquist bias and other systematic effects on the HII region method are discussed in detail. (Author)

  17. Isovector giant quadrupole resonance in 63Cu

    International Nuclear Information System (INIS)

    Wolynec, E.; Pastura, V.F.S.; Martins, M.N.

    1988-01-01

    The decay of the isovector E2 giant resonance in 63 Cu has been studied by measuring the (e,2n) cross section, in the incident electron energy range 22-45 MeV. The photodisintegration induced by bremsstrahlung was also measured. The electrodisintegration results have been analyzed using the distorted wave Born approximation E1 and E2 virtual photon spectra to obtain these multipole components in the corresponding (γ,2n) cross section. It is found that the isovector E2 giant resonance decays dominantly by two-neutron emission in 63 Cu. This decay channel exhausts 65 percent of the energy weighted E2 sum. (author0 [pt

  18. Probing giant magnetoresistance with THz spectroscopy

    DEFF Research Database (Denmark)

    Jin, Zuanming; Tkach, Alexander; Casper, Frederick

    2014-01-01

    We observe a giant magnetoresistance effect in CoFe/Cu-based multistack using THz time-domain spectroscopy. The magnetic field-dependent dc conductivity, electron scattering time, as well as spin-asymmetry parameter of the structure are successfully determined. © 2014 OSA.......We observe a giant magnetoresistance effect in CoFe/Cu-based multistack using THz time-domain spectroscopy. The magnetic field-dependent dc conductivity, electron scattering time, as well as spin-asymmetry parameter of the structure are successfully determined. © 2014 OSA....

  19. Atypical visual loss in giant cell arteritis

    DEFF Research Database (Denmark)

    Thystrup, Jan Deichmann; Knudsen, G M; Mogensen, A M

    1994-01-01

    Three patients with atypical ocular involvement due to histologically verified giant cell arteritis are reported. Prior to diagnosis, the first patient had periods of amaurosis fugax. He presented with normal vision. In spite of high-dose systemic corticosteroid therapy, he became blind in the te......Three patients with atypical ocular involvement due to histologically verified giant cell arteritis are reported. Prior to diagnosis, the first patient had periods of amaurosis fugax. He presented with normal vision. In spite of high-dose systemic corticosteroid therapy, he became blind...

  20. Giant Condyloma Acuminatum: A Surgical Riddle

    Directory of Open Access Journals (Sweden)

    Shukla

    2016-08-01

    Full Text Available Giant condyloma acuminatum (GCA commonly known as Buschke-Lowenstein tumor (BLT is a rare sexually transmitted disease, which is always preceded by condyloma accuminata and linked to human papillomavirus (HPV. Most commonly affected sites are male and female genitalia, anal and perianal regions. Giant condyloma acuminatum is well-known as slow growing but locally destructive with a high rate of recurrence and increased frequency of malignant transformation. Surgical management is considered to be the best among all the options.

  1. Observing giant panda habitat and forage abundance from space

    NARCIS (Netherlands)

    Wang, T.

    2009-01-01

    Giant pandas are obligate bamboo grazers. The bamboos favoured by giant
    pandas are typical forest understorey plants. Therefore, the availability and
    abundance of understorey bamboo is a key factor in determining the quantity
    and quality of giant panda food resources. However,

  2. Evidence for deformation effect on the giant monopole resonance

    International Nuclear Information System (INIS)

    Buenerd, M.; Lebrun, D.; Martin, P.; de Saintignon, P.; Perrin, C.

    1980-01-01

    The giant monopole resonance in the region of deformed nuclei has been investigated by inelastic scattering of 108.5 MeV 3 He at very small scattering angles. Evidence is reported for coupling between the giant monopole and giant quadrupole vibrations, based both on energy shift and transition strength

  3. Giant urinary bladder calculus: Case report | Otieno | East African ...

    African Journals Online (AJOL)

    A vertical calculus weighing more than 100 g is categorised as a giant urinary bladder stone. Giant urinary bladder stones are very rare and very few cases have been reported in English literature and only one case from Africa. This is a case report of a patient with a giant urinary bladder calculus presenting as a rectal ...

  4. Staged Closure of Giant Omphalocele using Synthetic Mesh

    OpenAIRE

    Parida, Lalit; Pal, Kamalesh; Al Buainain, Hussah; Elshafei, Hossam

    2014-01-01

    Giant omphalocele is difficult to manage and is associated with a poor outcome. A male newborn presented to our hospital with a giant omphalocele. We performed a staged closure of giant omphalocele using synthetic mesh to construct a silo and then mesh abdominoplasty in the neonatal period that led to a successful outcome within a reasonable period of hospital stay.

  5. Giant Panda habitat selection in the Foping Nature Reserve, China

    NARCIS (Netherlands)

    Liu, X.; Toxopeus, A.G.; Skidmore, A.K.; Shao, X.; Dang, D.; Wang, T.; Prins, H.H.T.

    2005-01-01

    Little is known about habitat selection of the giant panda (Ailuropoda melanoleuca), especially about the relationship between giant panda presence and bamboo and tree structures. We presented data on giant panda habitat use and selection in Foping Nature Reserve (NR), China. We used 1,066

  6. Autologous Dermis Graft Implantation: A Novel Approach to Reinforcement in Giant Hiatal Hernias

    Directory of Open Access Journals (Sweden)

    Balázs Kovács

    2018-01-01

    Full Text Available Objectives. Nonreinforced tensile repair of giant hiatal hernias is susceptible to recurrence, and the role of mesh graft implantation remains controversial. Creating a new and viable choice without the use of high-cost biological allografts is desirable. This study presents the application of dermis graft reinforcement, a cost-efficient, easily adaptable alternative, in graft reinforcement of giant hiatal hernia repairs. Methods. A 62-year-old female patient with recurrent giant hiatal hernia (9 × 11 cm and upside down stomach, immediately following the Belsey repair done in another department, was selected for the pilot procedure. The standard three-stitch nonabsorbable reconstruction of diaphragmatic crura was undertaken via laparoscopic approach. A 12 × 6 cm dermis autograft was harvested from the loose abdominal skin. “U” figure onlay reinforcement of diaphragm closure was secured with titanium staples. The procedure was completed with a standard Dor fundoplication. One- and seven-month follow-ups were conducted. Results. No short-term postoperative complications were observed. One-month follow-up showed normal anatomical location of abdominal viscera on computed tomography imaging. High-resolution manometry showed normal lower esophageal sphincter pressure. Preoperative abdominal complaints were resolved. Procedural costs were lower than the average cost following mesh graft reinforcement. Conclusion. Dermis graft reinforcement is a cheap, easily adaptable procedure in the repair of giant hiatal hernias, even in the setting of laparoscopic reoperative procedure.

  7. Giant sigmoid diverticulum with coexisting metastatic rectal carcinoma: a case report

    Directory of Open Access Journals (Sweden)

    Quinn Aidan

    2010-10-01

    Full Text Available Abstract Introduction Giant diverticulum of the colon is a rare but clinically significant condition, usually regarded as a complication of an already existing colonic diverticular disease. This is the first report of a giant diverticulum of the colon with a co-existing rectal carcinoma. Case presentation We report a case of a 66-year-old Caucasian woman who presented with lower abdominal pain, chronic constipation and abdominal swelling. Preoperative abdominal computed tomography revealed a giant diverticulum of the colon with a coexisting rectal carcinoma and pulmonary metastasis revealed on a further thoracic computed tomography. An en bloc anterior resection of the rectum along with sigmoid colectomy, partial hysterectomy and right salpingoophorectomy was subsequently performed due to extensive adhesions. Conclusion This report shows that the presence of a co-existing distal colorectal cancer can potentially lead to progressive development of a colonic diverticulum to become a giant diverticulum by increasing colonic intra-luminal pressure and through the ball-valve mechanism. This may be of interest to practising surgeons and surgical trainees.

  8. THE REDSHIFT DISTRIBUTION OF GIANT ARCS IN THE SLOAN GIANT ARCS SURVEY

    International Nuclear Information System (INIS)

    Bayliss, Matthew B.; Gladders, Michael D.; Koester, Benjamin P.; Oguri, Masamune; Hennawi, Joseph F.; Sharon, Keren; Dahle, Haakon

    2011-01-01

    We measure the redshift distribution of a sample of 28 giant arcs discovered as a part of the Sloan Giant Arcs Survey. Gemini/GMOS-North spectroscopy provides precise redshifts for 24 arcs, and 'redshift desert' constrains for the remaining 4 arcs. This is a direct measurement of the redshift distribution of a uniformly selected sample of bright giant arcs, which is an observable that can be used to inform efforts to predict giant arc statistics. Our primary giant arc sample has a median redshift z = 1.821 and nearly two-thirds of the arcs, 64%, are sources at z ∼> 1.4, indicating that the population of background sources that are strongly lensed into bright giant arcs resides primarily at high redshift. We also analyze the distribution of redshifts for 19 secondary strongly lensed background sources that are not visually apparent in Sloan Digital Sky Survey imaging, but were identified in deeper follow-up imaging of the lensing cluster fields. Our redshift sample for the secondary sources is not spectroscopically complete, but combining it with our primary giant arc sample suggests that a large fraction of all background galaxies that are strongly lensed by foreground clusters reside at z ∼> 1.4. Kolmogorov-Smirnov tests indicate that our well-selected, spectroscopically complete primary giant arc redshift sample can be reproduced with a model distribution that is constructed from a combination of results from studies of strong-lensing clusters in numerical simulations and observational constraints on the galaxy luminosity function.

  9. The Giant Radio Array for Neutrino Detection

    DEFF Research Database (Denmark)

    Martineau-Huynh, Olivier; Bustamante, Mauricio; Carvalho, Washington

    2017-01-01

    The Giant Radio Array for Neutrino Detection (GRAND) is a planned array of ~200 000 radio antennas deployed over ~200 000 km2 in a mountainous site. It aims primarly at detecting high-energy neutrinos via the observation of extensive air showers induced by the decay in the atmosphere of taus...

  10. Nitrogen depletion in field red giants

    DEFF Research Database (Denmark)

    Masseron, T.; Lagarde, N.; Miglio, A.

    2017-01-01

    , the behaviour of nitrogen data along the evolution confirms the existence of non-canonical extramixing on the red giant branch (RGB) for all low-mass stars in the field. But more surprisingly, the data indicate that nitrogen has been depleted between the RGB tip and the red clump. This may suggest that some...

  11. Robust giant magnetoresistive effect type multilayer sensor

    NARCIS (Netherlands)

    Lenssen, K.M.H.; Kuiper, A.E.T.; Roozeboom, F.

    2002-01-01

    A robust Giant Magneto Resistive effect type multilayer sensor comprising a free and a pinned ferromagnetic layer, which can withstand high temperatures and strong magnetic fields as required in automotive applications. The GMR multi-layer has an asymmetric magneto-resistive curve and enables

  12. Giant omental lipoblastoma and CD56 expression

    Directory of Open Access Journals (Sweden)

    Go Miyano

    2013-01-01

    Full Text Available We report a case of giant omental lipoblastoma in a 13-month-old boy, which was treated successfully by total excision. Tumor cells were positive for S100, CD34 and CD56. This is the first report of lipoblastoma expressing CD56, a fact that could be used to differentiate lipoblastoma from liposarcoma.

  13. [Giant paraovarian cyst in childhood - Case report].

    Science.gov (United States)

    Torres, Janina P; Íñiguez, Rodrigo D

    2015-01-01

    Paraovarian cysts are very uncommon in children To present a case of giant paraovarian cyst case in a child and its management using a modified laparoscopic-assisted technique A 13-year-old patient with a 15 day-history of intermittent abdominal pain, located in the left hemiabdomen and associated with progressive increase in abdominal volume. Diagnostic imaging was inconclusive, describing a giant cystic formation that filled up the abdomen, but without specifying its origin. Laboratory tests and tumor markers were within normal range. Video-assisted transumbilical cystectomy, a modified laparoscopic procedure with diagnostic and therapeutic intent, was performed with a successful outcome. The histological study reported giant paraovarian cyst. Cytology results were negative for tumor cells. The patient remained asymptomatic during the postoperative follow-up. The video-assisted transumbilical cystectomy is a safe procedure and an excellent diagnostic and therapeutic alternative for the treatment of giant paraovarian cysts. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  14. The operation of giant incisional hernia

    DEFF Research Database (Denmark)

    Eriksson, Axelina; Krag, Christen; Jørgensen, Lars Nannestad

    2014-01-01

    Incisional hernia is a common complication to laparotomy impacting negatively on quality of life, risk of emergency surgery and cosmesis. The operation of giant incisional hernia (cross diameter of hernia defect > 20 cm) is a high risk procedure and the surgical techniques are not based on high...

  15. Study of giant resonances with pions

    International Nuclear Information System (INIS)

    Baer, H.W.

    1984-01-01

    Recent results on giant resonances obtained with pion-inelastic scattering and with single- and double-charge-exchange scattering are reviewed. The states discussed are isobaric analog states, double-isobaric analog states, and isovector L = 0, 1, and 2 collective states. 36 references

  16. Air pollution effects on giant sequoia ecosystems.

    Science.gov (United States)

    P.R. Miller; Nancy Grulke; K.W. Stolte

    1994-01-01

    Giant sequoia [Sequoiadendron giganteum (Lindl.) Buchholz] groves are found entirely within the Sierra Nevada mixed-conifer type. Several of its companion tree species, mainly ponderosa pine (Pinus ponderosa Dougl. ex Laws.) and Jeffrey pine (P. jeffreyi Grev. & Balf.), show foliar injury after...

  17. Think big--giant genes in bacteria.

    Science.gov (United States)

    Reva, Oleg; Tümmler, Burkhard

    2008-03-01

    Long genes should be rare in archaea and eubacteria because of the demanding costs of time and resources for protein production. The search in 580 sequenced prokaryotic genomes, however, revealed 0.2% of all genes to be longer than 5 kb (absolute number: 3732 genes). Eighty giant bacterial genes of more than 20 kb in length were identified in 47 taxa that belong to the phyla Thermotogae (1), Chlorobi (3), Planctomycetes (1), Cyanobacteria (2), Firmicutes (7), Actinobacteria (9), Proteobacteria (23) or Euryarchaeota (1) (number of taxa in brackets). Giant genes are strain-specific, differ in their tetranucleotide usage from the bulk genome and occur preferentially in non-pathogenic environmental bacteria. The two longest bacterial genes known to date were detected in the green sulfur bacterium Chlorobium chlorochromatii CaD3 encoding proteins of 36 806 and 20 647 amino acids, being surpassed in length only by the human titin coding sequence. More than 90% of bacterial giant genes either encode a surface protein or a polyketide/non-ribosomal peptide synthetase. Most surface proteins are acidic, threonine-rich, lack cystein and harbour multiple amino acid repeats. Giant proteins increase bacterial fitness by the production of either weapons towards or shields against animate competitors or hostile environments.

  18. Ectopic pancreas in a giant mediastinal cyst

    NARCIS (Netherlands)

    Li, Wilson W.; van Boven, Wim Jan; Jurhill, Roy R.; Bonta, Peter I.; Annema, Jouke T.; de Mol, Bas A.

    2016-01-01

    Ectopic pancreas located in the mediastium is an extremely rare anomaly. We present a case of an ectopic pancreas located in a giant mediastinal cyst in an 18-year-old man. He presented with symptoms of dyspnea due to external compression of the cyst on the left main bronchus. Complete surgical

  19. Giant lower oesophageal ulcer Bushman baby

    African Journals Online (AJOL)

    1983-02-26

    Feb 26, 1983 ... The case of a giant, penetrating lower oesophageal ulcer in a 14-month-old Bushman baby is reported. This would probably be classified as a Barrett's ulcer. Histological examination showed that the ulcer developed in columnar epithelium and that there was normal stratified squamous oesophageal.

  20. Excess mortality in giant cell arteritis

    DEFF Research Database (Denmark)

    Bisgård, C; Sloth, H; Keiding, Niels

    1991-01-01

    A 13-year departmental sample of 34 patients with definite (biopsy-verified) giant cell arteritis (GCA) was reviewed. The mortality of this material was compared to sex-, age- and time-specific death rates in the Danish population. The standardized mortality ratio (SMR) was 1.8 (95% confidence...

  1. Looking inside giant resonance fine structure

    International Nuclear Information System (INIS)

    Ponomarev, V.Yu.; Voronov, V.V.

    1993-01-01

    Microscopic calculations of the fine structure of giant resonances for spherical nuclei are presented. Excited states are treated by wave function which takes into account coupling of simple one-phonon configurations with more complex ones. Nuclear structure calculations are applied to the description of the γ-decay of resonances into the ground and low-lying excited states. 16 refs.; 4 figs

  2. Giant Retroperitoneal Lipoma in an Infant

    African Journals Online (AJOL)

    2010-06-29

    Jun 29, 2010 ... We are reporting the case of a six-month-old child who presented with a giant retroperitoneal lipoma that was successfully managed by complete ... Retroperitoneal lipoma is an unusual entity that is most often found in adults between 40 and 60 years of age and rarely occurs in the first decade of life.

  3. Giant light enhancement in atomic clusters

    International Nuclear Information System (INIS)

    Gadomsky, O. N.; Gadomskaya, I. V.; Altunin, K. K.

    2009-01-01

    We show that the polarizing effect of the atoms in an atomic cluster can lead to full compensation of the radiative damping of excited atomic states, a change in the sign of the dispersion of the atomic polarizability, and giant light enhancement by the atomic cluster.

  4. Polarization Spectra of Extrasolar Giant Planets

    NARCIS (Netherlands)

    Stam, D.M.

    2004-01-01

    We present simulated spectra of the flux and degree of polarization of starlight that is reflected by extrasolar giant planets (EGPs). In particular the polarization depends strongly on the structure of the planetary atmosphere, and appears to be a valuable tool for the characterization of EGPs.

  5. Giant resonances in the deformed continuum

    International Nuclear Information System (INIS)

    Nakatsukasa, T.; Yabana, K.

    2004-01-01

    Giant resonances in the continuum for deformed nuclei are studied with the time-dependent Hartree-Fock (TDHF) theory in real time and real space. The continuum effect is effectively taken into account by introducing a complex Absorbing Boundary Condition (ABC). (orig.)

  6. Total hip arthroplasty for giant cell tumour.

    Directory of Open Access Journals (Sweden)

    Kulkarni S

    1996-07-01

    Full Text Available A 32 month follow up of an uncommon case of a Giant Cell Tumour affecting the proximal end of femur is presented. Following a wide excision, the hip was reconstructed using Charnley type of low friction total hip arthroplasty. At a 32 month review, there was no recurrence and the function was good.

  7. Giant dipole resonances built on excited states

    International Nuclear Information System (INIS)

    Snover, K.A.

    1983-01-01

    The properties of giant dipole resonances built on excited nuclear states are reviewed, with emphasis on recent results. Nonstatistical (p,γ) reactions in light nuclei, and statistical complex-particle reactions in light and heavy nuclei are discussed. 27 references

  8. Reading on the Shoulders of Giants

    Science.gov (United States)

    Ben-Chaim, Michael; Riendeau, Michael

    2012-01-01

    Reflecting on his successful scientific career, Isaac Newton highlighted his intellectual debt to his predecessors. "If I have seen further," he wrote, "it was "only" by standing on the shoulders of giants." The authors have chosen the title of their article as a token of recognition of their debt to the teachings of…

  9. Giant cell angiofibroma or localized periorbital lymphedema?

    Science.gov (United States)

    Lynch, Michael C; Chung, Catherine G; Specht, Charles S; Wilkinson, Michael; Clarke, Loren E

    2013-12-01

    Giant cell angiofibroma represents a rare soft tissue neoplasm with a predilection for the orbit. We recently encountered a mass removed from the lower eyelid of a 56-year-old female that histopathologically resembled giant cell angiofibroma. The process consisted of haphazardly arranged CD34-positive spindled and multinucleated cells within an edematous, densely vascular stroma. However, the patient had recently undergone laryngectomy and radiotherapy for a laryngeal squamous cell carcinoma. A similar mass had arisen on the contralateral eyelid, and both had developed several months post-therapy. Lymphedema of the orbit can present as tumor-like nodules and in some cases may share histopathologic features purported to be characteristic of giant cell angiofibroma. A relationship between giant cell angiofibroma and lymphedema has not been established, but our case suggests there may be one. The potential overlap of these two conditions should be recognized, as should other entities that may enter the differential diagnosis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Kepler Asteroseismology of Red-giant Stars

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, J.

    2012-01-01

    The Kepler mission, launched in March 2009, has revolutionized asteroseismology, providing detailed observations of thousands of stars. This has allowed in-depth analyses of stars ranging from compact hot subdwarfs to red giants, and including the detection of solar-like oscillations in hundreds ...

  11. Asteroseismic Diagram for Subgiants and Red Giants

    Energy Technology Data Exchange (ETDEWEB)

    Gai, Ning; Tang, Yanke [College of Physics and Electronic information, Dezhou University, Dezhou 253023 (China); Yu, Peng [College of Physics and Electronic Engineering, Chongqing Normal University, Chongqing 401331 (China); Dou, Xianghua, E-mail: ning_gai@163.com, E-mail: tyk450@163.com [Shandong Provincial Key Laboratory of Biophysics, Dezhou University, Dezhou 253023 (China)

    2017-02-10

    Asteroseismology is a powerful tool for constraining stellar parameters. NASA’s Kepler mission is providing individual eigenfrequencies for a huge number of stars, including thousands of red giants. Besides the frequencies of acoustic modes, an important breakthrough of the Kepler mission is the detection of nonradial gravity-dominated mixed-mode oscillations in red giants. Unlike pure acoustic modes, mixed modes probe deeply into the interior of stars, allowing the stellar core properties and evolution of stars to be derived. In this work, using the gravity-mode period spacing and the large frequency separation, we construct the ΔΠ{sub 1}–Δ ν asteroseismic diagram from models of subgiants and red giants with various masses and metallicities. The relationship ΔΠ{sub 1}–Δ ν is able to constrain the ages and masses of the subgiants. Meanwhile, for red giants with masses above 1.5 M {sub ⊙}, the ΔΠ{sub 1}–Δ ν asteroseismic diagram can also work well to constrain the stellar age and mass. Additionally, we calculate the relative “isochrones” τ , which indicate similar evolution states especially for similar mass stars, on the ΔΠ{sub 1}–Δ ν diagram.

  12. Giant Plagioclase Basalts, eruption rate versus time

    Indian Academy of Sciences (India)

    R.Narasimhan(krishtel emaging) 1461 1996 Oct 15 13:05:22

    I found the GPB lavas to be very interest- ing because in some ... by Venkatesan et al (1993) and thus in a way validates my approach. ... and age calculation of lavas from phenocrysts. Keywords. Deccan Trap; Giant Plagioclase Basalts; eruption duration. Proc. Indian Acad. Sci. (Earth Planet. Sci.), 111, No. 4, December ...

  13. Surface Magnetic Fields on Giants and Supergiants

    Science.gov (United States)

    Lebre, Agnès

    2018-04-01

    After a short introduction to spectropolarimetry and the tecnics allowing for the detection of surface fields, I will review the numerous and various detections of magnetic fields at the surface of giant and supergiant stars. On Betelgeuse, the prototype of Red Supergiants, I will present recent results collected after a 10 years long spectropolarimetric survey.

  14. Giant dipole resonance by many levels theory

    International Nuclear Information System (INIS)

    Mondaini, R.P.

    1977-01-01

    The many levels theory is applied to photonuclear effect, in particular, in giant dipole resonance. A review about photonuclear dipole absorption, comparing with atomic case is done. The derivation of sum rules; their modifications by introduction of the concepts of effective charges and mass and the Siegert theorem. The experimental distributions are compared with results obtained by curve adjustment. (M.C.K.) [pt

  15. Infrared studies of asymptotic giant branch stars

    International Nuclear Information System (INIS)

    Willems, F.J.

    1987-01-01

    In this thesis studies are presented of asymptotic giant branch stars, which are thought to be an important link in the evolution of the galaxy. The studies were performed on the basis of data collected by the IRAS, the infrared astronomical satelite. 233 refs.; 33 figs.; 16 tabs

  16. Giant pseudoaneurysm from Vieussens' arterial ring.

    Science.gov (United States)

    Kocica, Mladen J; Vranes, Mile R; Djukic, Petar L; Mikic, Aleksandar Dj; Velinovic, Milos M; Havelka, Marija; Kanjuh, Vladimir I

    2004-11-01

    A giant coronary pseudoaneurysm of uncertain cause, arising from Vieussens' arterial ring, was preoperatively diagnosed in an oligosymptomatic female patient. Successful off-pump surgical excision without additional bypass grafting was performed. Difficulties in diagnostic algorithm, as well as possible cause and extremely rare localization were discussed.

  17. Stability of the giant dipole resonance

    International Nuclear Information System (INIS)

    Espino, J.M.; Gallardo, M.

    1987-01-01

    The Giant Dipole Resonance (GDR), because of its stability and its typical period of vibration, can be used as a test for compound nucleus reactions at high temperatures. This stability is studied in a simple model up to 6 MeV of temperature. The experimental methods for getting the properties of the GDR at T ≠ 0 are also commented. (author)

  18. Giant Mucinous Cystadenoma in Nnewi, Nigeria

    African Journals Online (AJOL)

    Ovarian mucinous cystadenoma is a benign tumor that arises from the surface ... abdomen. On vaginal examination, the vulva, vaginal and cervix ... Multilocular cyst. Discussion. Giant ovarian tumors have become rare in recent times because most of them are discovered early during routine medical check or incidental ...

  19. Tuberculosis Detection by Giant African Pouched Rats

    Science.gov (United States)

    Poling, Alan; Weetjens, Bart; Cox, Christophe; Beyene, Negussie; Durgin, Amy; Mahoney, Amanda

    2011-01-01

    In recent years, operant discrimination training procedures have been used to teach giant African pouched rats to detect tuberculosis (TB) in human sputum samples. This article summarizes how the rats are trained and used operationally, as well as their performance in studies published to date. Available data suggest that pouched rats, which can…

  20. Giant viruses of amoebas: an update

    Directory of Open Access Journals (Sweden)

    Sarah eAherfi

    2016-03-01

    Full Text Available During the 12 past years, five new or putative virus families encompassing several members, namely Mimiviridae, Marseilleviridae, pandoraviruses, faustoviruses, and virophages were described. In addition, Pithovirus sibericum and Mollivirus sibericum represent type strains of putative new giant virus families. All these viruses were isolated using amoebal coculture methods. These giant viruses were linked by phylogenomic analyses to other large DNA viruses. They were then proposed to be classified in a new viral order, the Megavirales, on the basis of their common origin, as shown by a set of ancestral genes encoding key viral functions, a common virion architecture, and shared major biological features including replication inside cytoplasmic factories. Megavirales is increasingly demonstrated to stand in the tree of life aside Bacteria, Archaea and Eukarya, and the megavirus ancestor is suspected to be as ancient as cellular ancestors. In addition, giant amoebal viruses are visible under a light microscope and display many phenotypic and genomic features not found in other viruses, while they share other characteristics with parasitic microbes. Moreoever, these organisms appear to be common inhabitants of our biosphere, and mimiviruses and marseilleviruses were isolated from human samples and associated to diseases. In the present review, we describe the main features and recent findings on these giant amoebal viruses and virophages.

  1. Standing on the shoulders of giants.

    Science.gov (United States)

    Romanovsky, Andrej A

    2014-01-01

    In this editorial, the author explains that the journal Temperature stands on the shoulders of giants-prominent scientists of the past and current members of the Temperature community. Temperature also uses the best tools, such as Google Scholar profiles. The editorial includes a new puzzle: why does warm water freeze faster than cold water?

  2. Floret-like multinucleated giant cells in neurofibroma

    Directory of Open Access Journals (Sweden)

    Golka Dariusz

    2007-12-01

    Full Text Available Abstract This short report discusses a case of neurofibroma containing floret-like multinucleated giant cells. This being the second such case in the literature. Floret-like multinucleated giant cells have been reported in gynaecomastia and neurofibroma in neurofibromatosis type 1. These cells have been reported in uncommon soft tissue tumours including pleomorphic lipoma, giant cell collagenoma, giant cell fibroblastoma and giant cell angiofibroma. We recommend these cells to be interpreted carefully keeping in mind the rare malignant change in neurofibromas. Immunohistochemistry would help in defining the nature of such cells.

  3. Rapid formation of gas giants, ice giants and super-Earths

    Energy Technology Data Exchange (ETDEWEB)

    Boss, A P [DTM, Carnegie Institution of Washington, 5241 Broad Branch Road, NW, Washington, DC 20015 (United States)], E-mail: boss@dtm.ciw.edu

    2008-08-15

    Giant planets might have been formed by either of the two basic mechanisms, top-down (disk instability) or bottom-up (core accretion). The latter mechanism is the most generally accepted mechanism and it begins with the collisional accumulation of solid cores that may then accrete sufficient gas to become gas giants. The former mechanism is more heretical and begins with the gravitational instability of the protoplanetary disk gas, leading to the formation of self-gravitating protoplanets, within which the dust settles to form a solid core. The disk instability mechanism has been thought of primarily as a mechanism for the formation of gas giants, but if it occurs in a disk that is being photoevaporated by the ultraviolet radiation from nearby massive stars, then the outer gaseous protoplanets can be photoevaporated as well and stripped of their gaseous envelopes. The result would then be ice giants (cold super-Earths), such as the objects discovered recently by microlensing orbiting two presumed M dwarf stars. M dwarfs that form in regions of future high-mass star formation would be expected to produce cold super-Earths orbiting at distances of several astronomical units (AU) and beyond, while M dwarfs that form in regions of low-mass star formation would be expected to have gas giants at those distances. Given that most stars are born in the former rather than in the latter regions, M dwarfs should have significantly more super-Earths than gas giants on orbits of several AU or more.

  4. Rapid formation of gas giants, ice giants and super-Earths

    International Nuclear Information System (INIS)

    Boss, A P

    2008-01-01

    Giant planets might have been formed by either of the two basic mechanisms, top-down (disk instability) or bottom-up (core accretion). The latter mechanism is the most generally accepted mechanism and it begins with the collisional accumulation of solid cores that may then accrete sufficient gas to become gas giants. The former mechanism is more heretical and begins with the gravitational instability of the protoplanetary disk gas, leading to the formation of self-gravitating protoplanets, within which the dust settles to form a solid core. The disk instability mechanism has been thought of primarily as a mechanism for the formation of gas giants, but if it occurs in a disk that is being photoevaporated by the ultraviolet radiation from nearby massive stars, then the outer gaseous protoplanets can be photoevaporated as well and stripped of their gaseous envelopes. The result would then be ice giants (cold super-Earths), such as the objects discovered recently by microlensing orbiting two presumed M dwarf stars. M dwarfs that form in regions of future high-mass star formation would be expected to produce cold super-Earths orbiting at distances of several astronomical units (AU) and beyond, while M dwarfs that form in regions of low-mass star formation would be expected to have gas giants at those distances. Given that most stars are born in the former rather than in the latter regions, M dwarfs should have significantly more super-Earths than gas giants on orbits of several AU or more

  5. Giant hepatic regenerative nodules in Alagille syndrome

    International Nuclear Information System (INIS)

    Rapp, Jordan B.; Bellah, Richard D.; Anupindi, Sudha A.; Maya, Carolina; Pawel, Bruce R.

    2017-01-01

    Children with Alagille syndrome undergo surveillance radiologic examinations as they are at risk for developing cirrhosis and hepatocellular carcinoma. There is limited literature on the imaging of liver masses in Alagille syndrome. We report the ultrasound (US) and magnetic resonance imaging (MRI) appearances of incidental benign giant hepatic regenerative nodules in this population. To describe the imaging findings of giant regenerative nodules in patients with Alagille syndrome. A retrospective search of the hospital database was performed to find all cases of hepatic masses in patients with Alagille syndrome during a 10-year period. Imaging, clinical charts, laboratory data and available pathology were reviewed and analyzed and summarized for each patient. Twenty of 45 patients with confirmed Alagille syndrome had imaging studies. Of those, we identified six with giant focal liver masses. All six patients had large central hepatic masses that were remarkably similar on US and MRI, in addition to having features of cirrhosis. In each case, the mass was located in hepatic segment VIII and imaging showed the mass splaying the main portal venous branches at the hepatic hilum, as well as smaller portal and hepatic venous branches coursing through them. On MRI, signal intensity of the mass was isointense to liver on T1-weighted sequences in four of six patients, but hyperintense on T1 in two of six patients. In all six cases, the mass was hypointense on T2- weighted sequences. The mass post-contrast was isointense to adjacent liver in all phases in five the cases. Five out of six patients had pathological correlation demonstrating preserved ductal architecture confirming the final diagnosis of a regenerative nodule. Giant hepatic regenerative nodules with characteristic US and MR features can occur in patients with Alagille syndrome with underlying cirrhosis. Recognizing these lesions as benign giant hepatic regenerative nodules should, thereby, mitigate any need for

  6. Giant hepatic regenerative nodules in Alagille syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Rapp, Jordan B. [Lewis Katz School of Medicine at Temple University, Department of Radiology, Temple University Hospital, Philadelphia, PA (United States); Bellah, Richard D.; Anupindi, Sudha A. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); Maya, Carolina [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Pawel, Bruce R. [University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); The Children' s Hospital of Philadelphia, Department of Pathology and Laboratory Medicine, Philadelphia, PA (United States)

    2017-02-15

    Children with Alagille syndrome undergo surveillance radiologic examinations as they are at risk for developing cirrhosis and hepatocellular carcinoma. There is limited literature on the imaging of liver masses in Alagille syndrome. We report the ultrasound (US) and magnetic resonance imaging (MRI) appearances of incidental benign giant hepatic regenerative nodules in this population. To describe the imaging findings of giant regenerative nodules in patients with Alagille syndrome. A retrospective search of the hospital database was performed to find all cases of hepatic masses in patients with Alagille syndrome during a 10-year period. Imaging, clinical charts, laboratory data and available pathology were reviewed and analyzed and summarized for each patient. Twenty of 45 patients with confirmed Alagille syndrome had imaging studies. Of those, we identified six with giant focal liver masses. All six patients had large central hepatic masses that were remarkably similar on US and MRI, in addition to having features of cirrhosis. In each case, the mass was located in hepatic segment VIII and imaging showed the mass splaying the main portal venous branches at the hepatic hilum, as well as smaller portal and hepatic venous branches coursing through them. On MRI, signal intensity of the mass was isointense to liver on T1-weighted sequences in four of six patients, but hyperintense on T1 in two of six patients. In all six cases, the mass was hypointense on T2- weighted sequences. The mass post-contrast was isointense to adjacent liver in all phases in five the cases. Five out of six patients had pathological correlation demonstrating preserved ductal architecture confirming the final diagnosis of a regenerative nodule. Giant hepatic regenerative nodules with characteristic US and MR features can occur in patients with Alagille syndrome with underlying cirrhosis. Recognizing these lesions as benign giant hepatic regenerative nodules should, thereby, mitigate any need for

  7. Modeling Impacts of Climate Change on Giant Panda Habitat

    Directory of Open Access Journals (Sweden)

    Melissa Songer

    2012-01-01

    Full Text Available Giant pandas (Ailuropoda melanoleuca are one of the most widely recognized endangered species globally. Habitat loss and fragmentation are the main threats, and climate change could significantly impact giant panda survival. We integrated giant panda habitat information with general climate models (GCMs to predict future geographic distribution and fragmentation of giant panda habitat. Results support a major general prediction of climate change—a shift of habitats towards higher elevation and higher latitudes. Our models predict climate change could reduce giant panda habitat by nearly 60% over 70 years. New areas may become suitable outside the current geographic range but much of these areas is far from the current giant panda range and only 15% fall within the current protected area system. Long-term survival of giant pandas will require the creation of new protected areas that are likely to support suitable habitat even if the climate changes.

  8. GIANT IMPACT: AN EFFICIENT MECHANISM FOR THE DEVOLATILIZATION OF SUPER-EARTHS

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Shang-Fei [Department of Earth and Planetary Sciences, University of California, Santa Cruz, CA 95064 (United States); Hori, Yasunori; Lin, D. N. C. [Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064 (United States); Asphaug, Erik, E-mail: sliu26@ucsc.edu, E-mail: yahori@ucsc.edu, E-mail: lin@ucolick.org, E-mail: easphaug@asu.edu [School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287 (United States)

    2015-10-20

    Mini-Neptunes and volatile-poor super-Earths coexist on adjacent orbits in proximity to host stars such as Kepler-36 and Kepler-11. Several post-formation processes have been proposed for explaining the origin of the compositional diversity between neighboring planets: mass loss via stellar XUV irradiation, degassing of accreted material, and in situ accumulation of the disk gas. Close-in planets are also likely to experience giant impacts during the advanced stage of planet formation. This study examines the possibility of transforming volatile-rich super-Earths/mini-Neptunes into volatile-depleted super-Earths through giant impacts. We present the results of three-dimensional hydrodynamic simulations of giant impacts in the accretionary and disruptive regimes. Target planets are modeled with a three-layered structure composed of an iron core, silicate mantle, and hydrogen/helium envelope. In the disruptive case, the giant impact can remove most of the H/He atmosphere immediately and homogenize the refractory material in the planetary interior. In the accretionary case, the planet is able to retain more than half of the original gaseous envelope, while a compositional gradient suppresses efficient heat transfer as the planetary interior undergoes double-diffusive convection. After the giant impact, a hot and inflated planet cools and contracts slowly. The extended atmosphere enhances the mass loss via both a Parker wind induced by thermal pressure and hydrodynamic escape driven by the stellar XUV irradiation. As a result, the entire gaseous envelope is expected to be lost due to the combination of those processes in both cases. Based on our results, we propose that Kepler-36b may have been significantly devolatilized by giant impacts, while a substantial fraction of Kepler-36c’s atmosphere may remain intact. Furthermore, the stochastic nature of giant impacts may account for the observed large dispersion in the mass–radius relationship of close-in super

  9. Subtrochanteric femoral fractures treated with the Long Gamma3® nail: A historical control case study versus Long trochanteric Gamma nail®.

    Science.gov (United States)

    Georgiannos, D; Lampridis, V; Bisbinas, I

    2015-10-01

    Gamma nail was developed for the treatment of subtrochanteric hip fractures. Despite its advantages over extramedullary devices, gamma nail has been historically related to significant complications (implant breakage, femoral fractures at the tip of the nail). There is limited data to determine if the rate of these complications was minimized by using a new design of the gamma nail. Therefore we performed a case control study between the long gamma3 nail (LG3N) and the long trochanteric gamma nail (LTGN) to assess if: (1) the complication rate in the treatment of subtrochanteric fractures using the LG3N was lower than the one using the LTGN; (2) the reoperation rate was lower after using the LG3N. The complication rate after fixation of subtrochanteric fracture of the femur is lower with LG3N than with the LTGN. This study prospectively recorded the intra- and postoperative complications of 75 patients with subtrochanteric fractures treated with the LG3N and compared them with those of a historical cohort of 83 patients treated with the LTGN. The two groups were matched regarding age, gender and fracture type. Patients with open, pathological, or impending fractures were excluded. Intraoperative complications in the LG3N group were lower (4 cases, 5.3%) compared with those in the LTGN group (9 cases, 10.8%; P=0.04). The major intraoperative complication encountered with the use of LTGN was fracture of the femur in 3 cases. We encountered in total 9 postoperative complications in LG3N (12%) and 20 in group LTGN (24%). The most frequent complication in both groups was the cut out of the lag screw (3 cases in LG3N and 7 cases in LTGN group). The overall reoperation rate was higher in LTGN group (20.4% vs 10.6%; P=0.03). As a result of the improvement of its mechanical characteristics, LG3N has proved a safe and efficient implant for the treatment of subtochanteric fractures. The new design seems superior to previous generation, giving promising outcomes, reduced

  10. A case of diminished pericardial effusion after treatment of a giant hepatic cyst.

    Science.gov (United States)

    Okano, Hiroshi; Tochio, Tomomasa; Kumazawa, Hiroaki; Isono, Yoshiaki; Tanaka, Hiroki; Matsusaki, Shimpei; Sase, Tomohiro; Saito, Tomonori; Mukai, Katsumi; Nishimura, Akira; Kitamura, Tetsuya; Mori, Takuya

    2017-08-01

    A 75-year-old woman was discovered to have a pericardial effusion when she was admitted to our hospital because of a giant hepatic cyst. We could not detect the cause of the effusion and diagnosed idiopathic pericardial effusion. The patient underwent transcutaneous drainage of the hepatic cyst and an injection of antibiotics. There was no communication between the pericardial effusion and the hepatic cyst. Although the hepatic cyst was reduced in size, the pericardial effusion showed no remarkable change immediately after treatment; however, 5 months later, the pericardial effusion was found to be diminished. The pericardial effusion might have been caused by the physical pressure of the giant hepatic cyst and disturbance in the balance between the production and reabsorption of the pericardial fluid. When we experience a huge hepatic cyst, we should take into account its influence against the surrounding organs, including the intrapleural space.

  11. Modelling linewidths of Kepler red giants in NGC 6819

    Science.gov (United States)

    Aarslev, Magnus J.; Houdek, Günter; Handberg, Rasmus; Christensen-Dalsgaard, Jørgen

    2018-04-01

    We present a comparison between theoretical, frequency-dependent, damping rates and linewidths of radial-mode oscillations in red-giant stars located in the open cluster NGC 6819. The calculations adopt a time-dependent non-local convection model, with the turbulent pressure profile being calibrated to results of 3D hydrodynamical simulations of stellar atmospheres. The linewidths are obtained from extensive peakbagging of Kepler lightcurves. These observational results are of unprecedented quality owing to the long continuous observations by Kepler. The uniqueness of the Kepler mission also means that, for asteroseismic properties, this is the best data that will be available for a long time to come. We therefore take great care in modelling nine RGB stars in NGC 6819 using information from 3D simulations to obtain realistic temperature stratifications and calibrated turbulent pressure profiles. Our modelled damping rates reproduce well the Kepler observations, including the characteristic depression in the linewidths around the frequency of maximum oscillation power. Furthermore, we thoroughly test the sensitivity of the calculated damping rates to changes in the parameters of the nonlocal convection model.

  12. Photon scattering by the giant dipole resonance

    International Nuclear Information System (INIS)

    Bowles, T.J.; Holt, R.J.; Jackson, H.E.; McKeown, R.D.; Specht, J.R.

    1979-01-01

    Although many features of the giant dipole resonance are well known, the coupling between the basic dipole oscillation and other nuclear collective degrees of freedom such as surface vibrations and rotations is poorly understood. This aspect was investigated by elastic and inelastic bremsstrahlung scattering of tagged photons over the energy range 15 to 22 MeV. Target nuclei were 60 Ni, 52 Cr, 56 Fe, 92 Mo, and 96 Mo. Scattering and absorption cross sections are tabulated, along with parameters obtained from a two-Lorentzian analysis of the scattering cross sections; measured spectra are shown. It was necessary to remove Thomson scattering from the experimental results. It was found that coupling to surface vibrations in the giant dipole resonance is much weaker than the dynamic collective model suggests. The elastic scattering cross section for all targets but 60 Ni showed structure that is not evident in the absorption cross section measurement. 12 figures, 2 tables

  13. Thermal escape from extrasolar giant planets.

    Science.gov (United States)

    Koskinen, Tommi T; Lavvas, Panayotis; Harris, Matthew J; Yelle, Roger V

    2014-04-28

    The detection of hot atomic hydrogen and heavy atoms and ions at high altitudes around close-in extrasolar giant planets (EGPs) such as HD209458b implies that these planets have hot and rapidly escaping atmospheres that extend to several planetary radii. These characteristics, however, cannot be generalized to all close-in EGPs. The thermal escape mechanism and mass loss rate from EGPs depend on a complex interplay between photochemistry and radiative transfer driven by the stellar UV radiation. In this study, we explore how these processes change under different levels of irradiation on giant planets with different characteristics. We confirm that there are two distinct regimes of thermal escape from EGPs, and that the transition between these regimes is relatively sharp. Our results have implications for thermal mass loss rates from different EGPs that we discuss in the context of currently known planets and the detectability of their upper atmospheres.

  14. Electroexcitation of giant resonances in 181Ta

    International Nuclear Information System (INIS)

    Hicks, R.S.; Auer, I.P.; Bergstrom, J.C.; Caplan, H.S.

    1977-01-01

    The giant resonance region of 181 Ta has been investigated by means of inelastic electron scattering with primary electron energies of 79.1 to 118.3 MeV. A peak-fitting procedure was employed to separate the measured spectrum into nine different resonance components. Multipolarity and strength assignments were deduced using DWBA analysis with the Goldhaber-Teller and Steinwedel-Jensen models. In addition to the well-known giant dipole structure, other resonances were identified at 23.2+-0.3 MeV (E2), 9.5+-0.2 and 11.5+-0.2 MeV (E2 or E0), 19.5+-0.8 MeV (E3), 3.70+-0.14 MeV (E3 or E4), and 5.40+-0.15 MeV (E4 or E5). The model dependence of the analysis is discussed. (Auth.)

  15. Tracheostomy in the giant anteater (Myrmecophaga tridactyla).

    Science.gov (United States)

    Brainard, Benjamin M; Newton, Alisa; Hinshaw, Keith C; Klide, Alan M

    2008-12-01

    Anesthesia in the giant anteater (Myrmecophaga tridactyla) may be complicated by apnea. Although emergent orotracheal intubation may be possible in other species, the particular anatomy of the anteater prevents a smooth intubation. A technique, developed on a cadaver model, is described for a surgical approach to the trachea of the giant anteater that may be used to secure an airway in an anesthetized animal under emergent conditions. The approach is complicated by the presence of the large paired submaxillary salivary gland and the relatively deep and caudal position of the larynx relative to the ramus of the mandible. This procedure, however, appears to be a feasible method to achieve endotracheal intubation in the anteater.

  16. Giant cells reparative granuloma of the spine

    International Nuclear Information System (INIS)

    Toro, Nancy; Jorge Andres Delgado; Walter Leon

    1998-01-01

    The giant cell reparative granuloma (GCRG), was first described by Jaffe in 1953, which found it to be clinically and histopathologically different from the giant cell tumor. The GCRG accounts for 1.0 % of the osseous tumoral lesions, is more frequently found in females (68%) and in patients less than 30 years old (74%). It was believed that it only affected the jaw; it has been reported compromising other locations including the spine (7 cases). We report a case affecting the vertebral bodies of C2-C3 in a 10 years old, female patient, who was studied by plain film and MRI. The histological diagnosis was established at surgery, this report is the first one described in a cervical location and the second studied by MRI

  17. Atypical presentations of retroperitoneal giant schwannomas

    Directory of Open Access Journals (Sweden)

    Sait Ozbir

    2011-06-01

    Full Text Available Schwannomas are usually benign rare tumors that originating from Schwann cells of peripheral nerve sheaths. Presentation is generally varied and changed in a non-specific range from abdominal mass, flank pain to incidental findings. Herein we report 2 cases of retroperitoneal giant schwannomas with different clinical presentations, of whom one presented with vague abdominal pain, palpable abdominal mass for 4 years, swelling and bilateral hydronephrosis that caused by giant abdominal mass; the other one presented with right flank pain, rectal hemorrhage and lower extremities edema. Two patients were treated by complete surgical excision of masses. The histological and immunohistochemical diagnosis was reported as benign schwannoma. Both of patients are doing well and had no recurrence in 9 years and 28 months follow-up, respectively.

  18. Study of giant resonances in heavy nuclei

    International Nuclear Information System (INIS)

    Cataldi, M.I.C.

    1986-01-01

    The electrodisintegration cross section for 181 Ta, 208 Pb and 209 Bi was measured by counting the emitted neutrons, with incident electrons in the energy range 8-22 MeV. The data was analysed using the virtual photon method, in order to obtain a multipole decomposition and the intensities of Magnetic Dipole and Electric Quadrupole, isoscalar and isovector, in the Giant Resonance. The results obtained for the isovector Giant Quadrupole Resonance are compared with the measured photodisintegration cross section, using data from Saclay and Livermore. This comparision indicates that the photodisintegration data can be well explained assuming an isovector E2 Resonance located between 120 and 130 A -1/3 MeV, with an intensity of one isovector E2 sum. (author) [pt

  19. The giant calculus within the prostatic urethra.

    Science.gov (United States)

    Demir, Omer; Kefi, Aykut; Cahangirov, Asif; Cihan, Ahmet; Obuz, Funda; Esen, Adil Ahmet; Celebi, Ilhan

    2011-08-01

    The giant calculus within the prostatic urethra is a rare clinical entity in the young population. Most of the calculi within the urethra migrate from the urinary bladder and obliterate the urethra. These stones are often composed of calcium phosphate or calcium oxalate. The decision of treatment strategy is affected by the size, shape and position of the calculus and by the status of the urethra. If the stone is large and immovable, it may be extracted via the perineal or the suprapubic approach. In most cases, the giant calculi were extracted via the transvesical approach and external urethrotomy. Our case is the biggest prostatic calculus, known in the literature so far, which was treated endoscopically by the combination of laser and the pneumatic lithotriptor.

  20. Spectroscopy of late type giant stars

    Science.gov (United States)

    Spaenhauer, A.; Thevenin, F.

    1984-06-01

    An attempt to calibrate broadband RGU colors of late type giant stars in terms of the physical parameters of the objects is reported. The parameters comprise the effective temperature, surface gravity and global metal abundance with respect to the sun. A selection of 21 giant star candidates in the Basel fields Plaut 1, Centaurus III and near HD 95540 were examined to obtain a two color plot. Attention is focused on the G-R color range 1.5-2.15 mag, i.e., spectral types K0-K5. A relationship between R and the metallicity is quantified and shown to have a correlation coefficient of 0.93. No correlation is found between metallicity and gravity or R and the effective temperature.

  1. Triple Giant Resonance Excitations: A Microscopic Approach

    International Nuclear Information System (INIS)

    Lanza, E.G.; Andres, M.V.; Catara, F.; Chomaz, Ph.; Fallot, M.; Scarpaci, J.A.

    2007-01-01

    We present, for the first time, microscopic calculations of inelastic cross sections of the triple excitation of giant resonances induced by heavy ion probes. We start from a microscopic approach based on RPA. The mixing of three-phonon states among themselves and with two- and one-phonon states is considered within a boson expansion with Pauli corrections. In this way we go beyond the standard harmonic approximations and get anharmonic excitation spectra. At the same time we also introduce non-linearities in the external field. The calculations are done by solving semiclassical coupled channel equations, the channels being superpositions of one-, two- and three-phonon states. Previous calculations for the Double Giant Resonance excitation show good agreement with experimental cross sections. The inclusion of the three phonon components confirms the previous results for the DGR and produces a strong increase in the Triple GR energy region

  2. On the red giant titanium oxide bands

    Science.gov (United States)

    Hanni, L.; Sitska, J.

    1985-12-01

    The dependence of TiO absorption in cool oxygen-sequence giant stars on the Teff and log g of their atmospheres is investigated theoretically on the basis of spectra simulated using the computer program described by Hanni (1983) and the giant model atmospheres of Johnson et al. (1980). The temperature dependence of the intensity jumps at the head of the alpha(1.0) band is determined from simulated spectra, and the jumps are related to spectral types using the calibration of Ridgway et al. (1980). The results are presented in tables and graphs and shown to be in good agreement with the empirical Teff/intensity-jump correlation of Boyarchuk (1969).

  3. Pleomorphic lipoma: A gentle giant of pathology

    OpenAIRE

    Uma Sakhadeo; Rajesh Mundhe; Maria A DeSouza; Roshan F Chinoy

    2015-01-01

    Pleomorphic lipoma is a relatively rare adipocytic neoplasm, occurring predominantly in elderly males in the subcutaneous tissues of the neck or shoulder. To the best of our knowledge, only five cases have been reported in which the lesion was intramuscular. We hereby report a case of a 60-year-old female patient, presenting with an intramuscular, posterior shoulder mass. The aspirate showed a giant cell-rich lesion, admixed with short, plump-looking, spindly cells. There was no overt evidenc...

  4. The overshoot problem and giant structures

    International Nuclear Information System (INIS)

    Itzhaki, Nissan

    2008-01-01

    Models of small-field inflation often suffer from the overshoot problem. A particularly efficient resolution to the problem was proposed recently in the context of string theory. We show that this resolution predicts the existence of giant spherically symmetric overdense regions with radius of at least 110 Mpc. We argue that if such structures will be found they could offer an experimental window into string theory.

  5. On the shape of giant soap bubbles

    NARCIS (Netherlands)

    Cohen, C.; Darbois Texier, B.; Reyssat, E.; Snoeijer, Jacobus Hendrikus; Quere, D.; Clanet, Christophe

    2017-01-01

    We study the effect of gravity on giant soap bubbles and show that it becomes dominant above the critical size ℓ=a2/e0ℓ=a2/e0, where e0e0 is the mean thickness of the soap film and a=γb/ρg−√a=γb/ρg is the capillary length ( γbγb stands for vapor–liquid surface tension, and ρρ stands for the liquid

  6. On the shape of giant soap bubbles

    NARCIS (Netherlands)

    Cohen, C.; Texier, B.D.; Reyssat, E.; Snoeijer, J.H.; Quéré, D.; Clanet, C.

    2017-01-01

    We study the effect of gravity on giant soap bubbles and show that it becomes dominant above the critical size ℓ = a2 /e0, where e0 is the mean thickness of the soap film and a = √γb/ρg is the capillary length (γb stands for vapor-liquid surface tension, and ρ stands for the liquid density). We

  7. Giant solitary trichoepithelioma: A Case report

    Directory of Open Access Journals (Sweden)

    Recep Bedir

    2013-03-01

    Full Text Available Trichoepithelioma is a benign cutaneus tumour originatingfrom hair follicles. It is most commonly found on theface and scalp. Histopathologic examination was composedof band-like nests of basaloid cells showing peripheralpalization, abortive hair papilla and horn cysts ina fibrocellular stroma. A 82-year-old woman applied for a10-year old groin mass that recently slowly growing. Thelesion was excised and it was diagnosed as giant solitarytrichoephitelioma.Key words: Groin, hair follicle, skin neoplasms

  8. Giant osteoblastoma of temporal bone: case report

    Directory of Open Access Journals (Sweden)

    FIGUEIREDO EBERVAL GADELHA

    1998-01-01

    Full Text Available Benign osteoblastoma is an uncommon bone tumor accounting for approximately 1% of all bone tumors. There are only 35 cases of skull osteoblastoma reported in the literature. We describe the case of a 23 year old male with a giant osteoblastoma of temporal bone submitted to a total removal of the tumor after an effective embolization of all external carotid branches. The authors discuss diagnostic and management aspects of this uncommon skull tumor.

  9. Mass loss on the Asymptotic Giant Branch

    OpenAIRE

    Zijlstra, Albert

    2006-01-01

    Mass loss on the Asymptotic Giant Branch provides the origin of planetary nebulae. This paper reviews several relevant aspects of AGB evolution: pulsation properties, mass loss formalisms and time variable mass loss, evidence for asymmetries on the AGB, binarity, ISM interaction, and mass loss at low metallicity. There is growing evidence that mass loss on the AGB is already asymmetric, but with spherically symmetric velocity fields. The origin of the rings may be in pulsational instabilities...

  10. Giant polypoid gastric heterotopia of jejunum

    Directory of Open Access Journals (Sweden)

    Suresh Ramchandra Shenovi Mandrekar

    2016-01-01

    Full Text Available Heterotopic gastric tissue has been described in various parts of the gastrointestinal tract as an incidental finding. However, its presentation as a mass in the jejunum with obstructive manifestations is a rare event. We report here a rare case of giant polypoid gastric heterotopia in the jejunum that presented with intestinal obstruction in a 22-year-old female, along with a brief review of the literature.

  11. Giant resonance effects in radiative capture

    International Nuclear Information System (INIS)

    Snover, K.A.

    1979-01-01

    The technique of capture reaction studies of giant resonance properties is described, and a number of examples are given. Most of the recent work of interest has been in proton capture, in part because of the great utility (and availability) of polarized beams; most of the discussion concerns this reaction. Alpha capture, which has been a useful tool for exploring isoscalar E2 strength, and neutron capture are, however, also treated. 46 references, 14 figures

  12. Giant Leiomyosarcoma of the Urinary Bladder.

    Science.gov (United States)

    Ribeiro, José G A; Klojda, Carlos A B; Araújo, Claudio P De; Pires, Lucas A S; Babinski, Marcio A

    2016-05-01

    The bladder leiomyosarcoma is a rare and agressive mesenchymal tumour, and adult women of reproductive age have a higher incidence of developing the bladder leiomyosarcoma. The pathophysiology of the disease is not certain, and its main symptoms are hematuria, dysuria and abdominal pain. There are not a considerable amount of cases described in the literature. We report a case of a giant leiomyosarcoma of the urinary bladder in a 31-year-old woman.

  13. Giant anurysin of the common hepatic artery

    International Nuclear Information System (INIS)

    Montenegro Gaite, T.; Gonzalez Garcia, A.; Cortes Gonzalez, A.; Mayol Deya, A.; Fernandez de Bobadilla, M.

    1994-01-01

    Hepatic artery aneurysms are relatively infrequent and asymptomatic processes, but are very important since their rupture can prove fatal. We present a case of partially thrombosed giant aneurysm of the common hepatic artery in a 55-year-old man. The patient presented relatively nonspecific clinical signs (pain in right abdomen was the major symptom), and was diagnosed by ultrasound computerized tomography (CT) and digital subtraction angiography. (Author) 12 refs

  14. Recurrent giant fibrovascular polyp of the esophagus

    OpenAIRE

    Lee, Ser Yee; Chan, Weng Hoong; Sivanandan, Ranjiv; Lim, Dennis Teck Hock; Wong, Wai Keong

    2009-01-01

    Giant fibrovascular polyps of the esophagus and hypopharynx are rare benign esophageal tumors. They arise most commonly in the upper esophagus and may, rarely, originate in the hypopharynx. They can vary significantly in size. Even though they are benign, they may be lethal due to either bleeding or, rarely, asphyxiation if a large polyp is regurgitated. Patients commonly present with dysphagia or hematemesis. The polyps may not be well visualized on endoscopy and imaging plays a vital role i...

  15. Giant basal cell carcinoma Carcinoma basocelular gigante

    Directory of Open Access Journals (Sweden)

    Nilton Nasser

    2012-06-01

    Full Text Available The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no signs of dissemination or local recurrence have been detected after follow up of five years.O carcinoma basocelular é o tipo mais comum de câncer de pele, mas o carcinoma basocelular gigante vegetante não atinge 0,5% de todos os tipos de carcinomas basocelulares. O Carcinoma Basocelular Gigante, definido como lesão maior que 5 cm no maior diâmetro, é uma forma rara de carcinoma basocelular e comumente ocorre no tronco. Este paciente apresenta um Carcinoma Basocelular Gigante com 180cm² no ombro direito e foi negligente em procurar tratamento. Foi realizado tratamento cirúrgico e nenhum sinal de disseminação ou recorrência local foi detectada após 5 anos.

  16. Three cases giant panda attack on human at Beijing Zoo

    OpenAIRE

    Zhang, Peixun; Wang, Tianbing; Xiong, Jian; Xue, Feng; Xu, Hailin; Chen, Jianhai; Zhang, Dianying; Fu, Zhongguo; Jiang, Baoguo

    2014-01-01

    Panda is regarded as Chinese national treasure. Most people always thought they were cute and just ate bamboo and had never imagined a panda could be vicious. Giant panda attacks on human are rare. There, we present three cases of giant panda attacks on humans at the Panda House at Beijing Zoo from September 2006 to June 2009 to warn people of the giant panda’s potentially dangerous behavior.

  17. Three cases giant panda attack on human at Beijing Zoo.

    Science.gov (United States)

    Zhang, Peixun; Wang, Tianbing; Xiong, Jian; Xue, Feng; Xu, Hailin; Chen, Jianhai; Zhang, Dianying; Fu, Zhongguo; Jiang, Baoguo

    2014-01-01

    Panda is regarded as Chinese national treasure. Most people always thought they were cute and just ate bamboo and had never imagined a panda could be vicious. Giant panda attacks on human are rare. There, we present three cases of giant panda attacks on humans at the Panda House at Beijing Zoo from September 2006 to June 2009 to warn people of the giant panda's potentially dangerous behavior.

  18. Functional annotation from the genome sequence of the giant panda

    OpenAIRE

    Huo, Tong; Zhang, Yinjie; Lin, Jianping

    2012-01-01

    The giant panda is one of the most critically endangered species due to the fragmentation and loss of its habitat. Studying the functions of proteins in this animal, especially specific trait-related proteins, is therefore necessary to protect the species. In this work, the functions of these proteins were investigated using the genome sequence of the giant panda. Data on 21,001 proteins and their functions were stored in the Giant Panda Protein Database, in which the proteins were divided in...

  19. Emergency endovascular coiling of a ruptured giant splenic artery aneurysm

    DEFF Research Database (Denmark)

    Wernheden, Erika; Brenøe, Anne Sofie; Shahidi, Saeid

    2017-01-01

    Splenic artery aneurysms (SAAs) are the third most common abdominal aneurysm. Endovascular treatment of SAAs is preferred, and coiling is the most commonly used technique. Ruptured giant (>5 cm) SAAs are usually treated with open surgery including splenectomy. We present a rare case of a ruptured...... 15-cm giant SAA in an 84-year-old woman treated successfully with emergency endovascular coiling. To our knowledge, this is one of the few reports of emergency endovascular treatment for ruptured giant SAA....

  20. Aetiology of pressure sores in patients with spinal cord injury.

    Science.gov (United States)

    Thiyagarajan, C; Silver, J R

    1984-01-01

    One hundred consecutive patients admitted to the National Spinal Injuries Centre, Stoke Mandeville Hospital, with pressure sores were studied to assess the relative importance of factors known to predispose to the development of scores. Loss of feeling was critical, because patients were unable to appreciate pain when the sore was developing. Risk of developing a sore increased with age, but duration of the paralysis was of equal importance. After discharge from hospital the presence of a caring relative or friend was essential for survival. Many patients developed sores because of poor facilities at home or inappropriate advice from those who looked after them. An even more distressing factor was the number of patients who developed sores in hospital owing to inadequate nursing care. There are relatively few paralysed patients in the community, but the lessons learnt in this study may be applied to all patients with orthopaedic injuries and to geriatric patients with limited mobility. Nursing and medical staff must turn patients regularly and ensure that there is proper equipment to relieve pressure on the skin. Patients should not be allowed to sit in a chair if they develop a sacral or trochanteric sore. More effort should be directed towards the appropriate education of patients, their relatives, and all those who are concerned with their welfare. Images FIG 1 FIG 2 FIG 3 PMID:6439284

  1. Giant Impacts on Earth-Like Worlds

    Science.gov (United States)

    Kohler, Susanna

    2016-05-01

    Earth has experienced a large number of impacts, from the cratering events that may have caused mass extinctions to the enormous impact believed to have formed the Moon. A new study examines whether our planets impact history is typical for Earth-like worlds.N-Body ChallengesTimeline placing the authors simulations in context of the history of our solar system (click for a closer look). [Quintana et al. 2016]The final stages of terrestrial planet formation are thought to be dominated by giant impacts of bodies in the protoplanetary disk. During this stage, protoplanets smash into one another and accrete, greatly influencing the growth, composition, and habitability of the final planets.There are two major challenges when simulating this N-body planet formation. The first is fragmentation: since computational time scales as N^2, simulating lots of bodies that split into many more bodies is very computationally intensive. For this reason, fragmentation is usually ignored; simulations instead assume perfect accretion during collisions.Total number of bodies remaining within the authors simulations over time, with fragmentation included (grey) and ignored (red). Both simulations result in the same final number of bodies, but the ones that include fragmentation take more time to reach that final number. [Quintana et al. 2016]The second challengeis that many-body systems are chaotic, which means its necessary to do a large number of simulations to make statistical statements about outcomes.Adding FragmentationA team of scientists led by Elisa Quintana (NASA NPP Senior Fellow at the Ames Research Center) has recently pushed at these challenges by modeling inner-planet formation using a code that does include fragmentation. The team ran 140 simulations with and 140 without the effects of fragmentation using similar initial conditions to understand how including fragmentation affects the outcome.Quintana and collaborators then used the fragmentation-inclusive simulations to

  2. Ultrabass Sounds of the Giant Star xi Hya

    Science.gov (United States)

    2002-05-01

    of the star is necessary before the observed oscillation frequencies (periods) can be properly interpreted. Current models of the Sun are accurate and represent a typical main-sequence star at midlife, and the oscillations are well understood. The sound spectrum corresponding to the full disk - i.e., what we would observe if the Sun were as distant as other stars and we would therefore see it as a light point in the sky - shows a regular pattern in which the observed frequencies are separated by two different and constant intervals, the "large" and the "small" separations. It is much more difficult to "model" the interior of a giant star as the core has changed a lot during the evolution of the star. The nuclear fuel has been exhausted, the stellar core has contracted and the envelope has expanded substantially [3]. The resulting sound spectrum has therefore also changed considerably. Now there is only a small group of oscillating modes that display the same regular pattern as seen in the Sun. They are the radial modes , pressure modes that correspond to a radial expansion and contraction of the star (up and down motion of the surface). The modes in the Sun are sound waves for which most of the oscillation energy is concentrated in the outer parts of the Sun. In stars as highly evolved as xi Hya , they partly take on the character of gravity modes in the interior of the star. Gravity modes are oscillations that move matter up and down in the gravity field, under the influence of buoyancy, with only small changes of the pressure. This is the same effect that makes an air-filled ball pop to the surface when released under water. Gravity modes are normally trapped in the stable interior inside the upper (convective) envelope of a star. So far gravity modes have not been detected in the Sun. In a giant star, however, there is a chance to see some, because some of the oscillations have a mixed character : they behave like gravity modes in the interior and like sound waves

  3. Giant Clams and Rising CO2: Light May Ameliorate Effects of Ocean Acidification on a Solar-Powered Animal.

    Directory of Open Access Journals (Sweden)

    Sue-Ann Watson

    Full Text Available Global climate change and ocean acidification pose a serious threat to marine life. Marine invertebrates are particularly susceptible to ocean acidification, especially highly calcareous taxa such as molluscs, echinoderms and corals. The largest of all bivalve molluscs, giant clams, are already threatened by a variety of local pressures, including overharvesting, and are in decline worldwide. Several giant clam species are listed as 'Vulnerable' on the IUCN Red List of Threatened Species and now climate change and ocean acidification pose an additional threat to their conservation. Unlike most other molluscs, giant clams are 'solar-powered' animals containing photosynthetic algal symbionts suggesting that light could influence the effects of ocean acidification on these vulnerable animals. In this study, juvenile fluted giant clams Tridacna squamosa were exposed to three levels of carbon dioxide (CO2 (control ~400, mid ~650 and high ~950 μatm and light (photosynthetically active radiation 35, 65 and 304 μmol photons m-2 s-1. Elevated CO2 projected for the end of this century (~650 and ~950 μatm reduced giant clam survival and growth at mid-light levels. However, effects of CO2 on survival were absent at high-light, with 100% survival across all CO2 levels. Effects of CO2 on growth of surviving clams were lessened, but not removed, at high-light levels. Shell growth and total animal mass gain were still reduced at high-CO2. This study demonstrates the potential for light to alleviate effects of ocean acidification on survival and growth in a threatened calcareous marine invertebrate. Managing water quality (e.g. turbidity and sedimentation in coastal areas to maintain water clarity may help ameliorate some negative effects of ocean acidification on giant clams and potentially other solar-powered calcifiers, such as hard corals.

  4. Giant Clams and Rising CO2: Light May Ameliorate Effects of Ocean Acidification on a Solar-Powered Animal.

    Science.gov (United States)

    Watson, Sue-Ann

    2015-01-01

    Global climate change and ocean acidification pose a serious threat to marine life. Marine invertebrates are particularly susceptible to ocean acidification, especially highly calcareous taxa such as molluscs, echinoderms and corals. The largest of all bivalve molluscs, giant clams, are already threatened by a variety of local pressures, including overharvesting, and are in decline worldwide. Several giant clam species are listed as 'Vulnerable' on the IUCN Red List of Threatened Species and now climate change and ocean acidification pose an additional threat to their conservation. Unlike most other molluscs, giant clams are 'solar-powered' animals containing photosynthetic algal symbionts suggesting that light could influence the effects of ocean acidification on these vulnerable animals. In this study, juvenile fluted giant clams Tridacna squamosa were exposed to three levels of carbon dioxide (CO2) (control ~400, mid ~650 and high ~950 μatm) and light (photosynthetically active radiation 35, 65 and 304 μmol photons m-2 s-1). Elevated CO2 projected for the end of this century (~650 and ~950 μatm) reduced giant clam survival and growth at mid-light levels. However, effects of CO2 on survival were absent at high-light, with 100% survival across all CO2 levels. Effects of CO2 on growth of surviving clams were lessened, but not removed, at high-light levels. Shell growth and total animal mass gain were still reduced at high-CO2. This study demonstrates the potential for light to alleviate effects of ocean acidification on survival and growth in a threatened calcareous marine invertebrate. Managing water quality (e.g. turbidity and sedimentation) in coastal areas to maintain water clarity may help ameliorate some negative effects of ocean acidification on giant clams and potentially other solar-powered calcifiers, such as hard corals.

  5. Opportunities for Laboratory Opacity Chemistry Studies to Facilitate Characterization of Young Giant Planets and Brown Dwarfs

    Science.gov (United States)

    Marley, Mark; Freedman, Richard S.

    2015-01-01

    The thermal emission spectra of young giant planets is shaped by the opacity of atoms and molecules residing in their atmospheres. While great strides have been made in improving the opacities of important molecules, particularly NH3 and CH4, at high temperatures, much more work is needed to understand the opacity and chemistry of atomic Na and K. The highly pressure broadened fundamental band of Na and K in the optical stretches into the near-infrared, strongly influencing the shape of the Y and K spectral bands. Since young giant planets are bright in these bands it is important to understand the influences on the spectral shape. Discerning gravity and atmospheric composition is difficult, if not impossible, without both good atomic opacities as well as an excellent understanding of the relevant atmospheric chemistry. Since Na and K condense at temperatures near 500 to 600 K, the chemistry of the condensation process must be well understood as well, particularly any disequilibrium chemical pathways. Comparisons of the current generation of sophisticated atmospheric models and available data, however, reveal important shortcomings in the models. We will review the current state of observations and theory of young giant planets and will discuss these and other specific examples where improved laboratory measurements for alkali compounds have the potential of substantially improving our understanding of these atmospheres.

  6. Mass loss from red giants - A simple evolutionary model for NGC 7027

    Science.gov (United States)

    Jura, M.

    1984-01-01

    NGC 7027 is a young planetary nebula with the remnants of a red giant circumstellar envelope surrounding the central, ionized region. By comparing the outer molecular envelope with the inner ionized material, it is argued that the mass loss rate has decreased by at least a factor of 3, and more probably by about a factor of 10, during the past 1000 years. From this result, it is argued that the luminosity of the central star has also decreased substantially during the same time, consistent with models for the rapid evolution of stars just after they evolve off the asymptotic giant branch. In this picture, the distance to NGC 7027 is less than 1300 pc. NGC 7027 was the last (and best) example of a star where apparently the momentum in the outflowing mass /M(dot)v/ is considerably greater than the momentum in the radiation field (L/c). With the above description of this object, the evidence is now strong that quite often the mass lost from late-type giants is ultimately driven to infinity by radiation pressure on grains. If M(dot)v is as large as L/c for asymptotic branch stars, then it is expected that the total amount of mass lost during this stage of evolution is of the same magnitude as the initial mass of the star, and therefore this mass loss can profoundly affect the star's ultimate fate.

  7. Giant cell glioblastoma in childhood - clinical case from our practice and literature survey

    International Nuclear Information System (INIS)

    Marinova, L.; Hristozova, I.; Minkin, K.; Mihaylova, I.; Katzarov, D.

    2015-01-01

    We present a rare clinical case of brain tumor in childhood - giant cells glioblastoma- The disease was diagnosed in July 2014. Following an evidently total tumor excision, a course of chemotherapy with Vincristine, Vepesid and Cisplatine was applied followed by external beam radiotherapy of total dose 56 Gy. After 4 courses of chemotherapy (Vepesid, Cisplatine and Cyclophosphamide), on the regular MRI - performed in January 2015, local tumor recurrence was discovered requiring re-operation. A local progression of the disease was manifested after 6 courses chemotherapy (Temodal 100 mg 1 tablet daily for 5 days monthly) with increased intracranial pressure, followed by exitus letalis of the patient, 12 months after the diagnosis being made. A rarely met pathology subtype of giant cells glioblastoma in childhood was discussed, its typical MRI image, unfavorable prognosis and manifested radio- and chemo-resistance. Despite the complex treatment including total tumor excision, postoperative radiotherapy with radical irradiation dose and adjuvant chemotherapy the risk of local recurrences and tumor progression is high. With the help of this rarely diagnosed aggressive brain tumor in childhood, we present the need of optimization of the multidisciplinary treatment approach. (authors) Key words: Giant Cell Glioblastoma. Childhood. Surgery. Radiotherapy. Chemotherapy. Complex Treatment

  8. Electrified BPS giants: BPS configurations on giant gravitons with static electric field

    International Nuclear Information System (INIS)

    Ali-Akbari, Mohammad; Sheikh-Jabbari, Mohammad Mahdi

    2007-01-01

    We consider D3-brane action in the maximally supersymmetric type IIB plane-wave background. Upon fixing the light-cone gauge, we obtain the light-cone Hamiltonian which is manifestly supersymmetric. The 1/2 BPS solutions of this theory (solutions which preserve 16 supercharges) are either of the form of spherical three branes, the giant gravitons, or zero size point like branes. We then construct specific classes of 1/4 BPS solutions of this theory in which static electric field on the brane is turned on. These solutions are deformations about either of the two 1/2 BPS solutions. In particular, we study in some detail 1/4 BPS configurations with electric dipole on the three sphere giant, i.e. BIons on the giant gravitons, which we hence call BIGGons. We also study BPS configurations corresponding to turning on a background uniform constant electric field. As a result of this background electric field the three sphere giant is deformed to squashed sphere, while the zero size point like branes turn into circular or straight fundamental strings in the plane-wave background, with their tension equal to the background electric field

  9. Measuring Precise Radii of Giants Orbiting Giants to Distinguish Between Planet Evolution Models

    Science.gov (United States)

    Grunblatt, Samuel; Huber, Daniel; Lopez, Eric; Gaidos, Eric; Livingston, John

    2017-10-01

    Despite more than twenty years since the initial discovery of highly irradiated gas giant planets, the mechanism for planet inflation remains unknown. However, proposed planet inflation mechanisms can now be separated into two general classes: those which allow for post-main sequence planet inflation by direct irradiation from the host star, and those which only allow for slowed cooling of the planet over its lifetime. The recent discovery of two inflated warm Jupiters orbiting red giant stars with the NASA K2 Mission allows distinction between these two classes, but uncertainty in the planet radius blurs this distinction. Observing transits of these planets with the Spitzer Space Telescope would reduce stellar variability and thus planet radius uncertainties by approximately 50% relative to K2, allowing distinction between the two planet inflation model classes at a 3-sigma level. We propose to observe one transit of both known warm Jupiters orbiting red giant stars, K2-97b and EPIC228754001.01, to distinguish between planet model inflation classes and measure the planetary heating efficiency to 3-sigma precision. These systems are benchmarks for the upcoming NASA TESS Mission, which is predicted to discover an order of magnitude more red giant planet systems after launching next year.

  10. Blood pressure

    Science.gov (United States)

    Normal blood pressure is important for proper blood flow to the body's organs and tissues. The force of the blood on the walls of the arteries is called blood pressure. Blood pressure is measured both as the heart ...

  11. Giant encephalocele: a study of 14 patients.

    Science.gov (United States)

    Mahapatra, A K

    2011-01-01

    Giant encephalocele is a rare condition and few published reports are available in the English literature. It is a challenge to neurosurgeons, even today. This series consists of 14 patients with giant encephaloceles treated at our institute. Over a period of 8 years, from 2002 to 2009, 110 patients with encephaloceles were managed at our institute. Amongst them, 14 were children with giant encephaloceles. All patients had CT/MRI or both prior to surgery, and all were operated upon. Four patients were neonates, under 1 month of age, and 9/14 patients (64%) were under 3 months. The youngest child was a newborn baby aged 2 days. Except for 1 with an anterior encephalocele, the rest were patients with occipital encephaloceles. A CT scan was performed on 5 and an MRI on 1 patient. Both CT and MRI scans were performed on the other 8 patients. MRI/CT showed hydrocephalus in 10/14 patients. Of these, 7 required ventriculoperitoneal (VP) shunt, and the remaining 3 with mild to moderate hydrocephalus did not. Of the 7 patients who underwent VP shunt, 5 had a shunt during the encephalocele repair and 2 had a postoperative shunt for increasing hydrocephalus. Other associated anomalies recorded were acquired Chiari malformation in 3 patients, secondary craniostenosis with microcephaly in 5, and syringomyelia in 1 patient. All the patients underwent repair of encephalocele and 4 had suturectomy of coronal suture for the secondary craniostenosis. There were 2 postoperative deaths due to hypothermia. Among the 12 surviving patients, 9 had a good outcome and 3 had poor mental development. The present study shows overall good outcomes in 9/14 (66%) patients. Copyright © 2012 S. Karger AG, Basel.

  12. DO GIANT PLANETS SURVIVE TYPE II MIGRATION?

    International Nuclear Information System (INIS)

    Hasegawa, Yasuhiro; Ida, Shigeru

    2013-01-01

    Planetary migration is one of the most serious problems to systematically understand the observations of exoplanets. We clarify that the theoretically predicted type II, migration (like type I migration) is too fast, by developing detailed analytical arguments in which the timescale of type II migration is compared with the disk lifetime. In the disk-dominated regime, the type II migration timescale is characterized by a local viscous diffusion timescale, while the disk lifetime is characterized by a global diffusion timescale that is much longer than the local one. Even in the planet-dominated regime where the inertia of the planet mass reduces the migration speed, the timescale is still shorter than the disk lifetime except in the final disk evolution stage where the total disk mass decays below the planet mass. This suggests that most giant planets plunge into the central stars within the disk lifetime, and it contradicts the exoplanet observations that gas giants are piled up at r ∼> 1 AU. We examine additional processes that may arise in protoplanetary disks: dead zones, photoevaporation of gas, and gas flow across a gap formed by a type II migrator. Although they make the type II migration timescale closer to the disk lifetime, we show that none of them can act as an effective barrier for rapid type II migration with the current knowledge of these processes. We point out that gas flow across a gap and the fraction of the flow accreted onto the planets are uncertain and they may have the potential to solve the problem. Much more detailed investigation for each process may be needed to explain the observed distribution of gas giants in extrasolar planetary systems

  13. Giant fibroepithelial polyp of the vulva

    Directory of Open Access Journals (Sweden)

    Selma Korkmaz

    2014-12-01

    Full Text Available Fibroepithelial polyps are among common benign skin lesions. They are usually small and skin-colored lesions and are located frequently in the axilla and neck. They are rarely seen in the vulva. There is a small number of cases that reach the giant sizes in this area in the literature. A 20-year-old female patient presented with a pedunculated mass measuring 25 cm in diameter, localized to the right labium majus. The lesion was excised and the histopathological diagnosis was fibroepithelial polyp. We present this case because of it is the largest reported fibroepithelial polyp of the vulva in the literature.

  14. Hypophosphatemic rickets associated with giant hairy nevus

    Directory of Open Access Journals (Sweden)

    Sameer Aggarwal

    2013-01-01

    Full Text Available The association of multisystem pathologic conditions and epidermal nevi, known as the epidermal nevus syndrome, includes disorders of bone, central nervous system, eye, kidney, vasculature and skin. Rarely, congenital nevomelanocytic nevus also known as hairy nevus has also been reported in association with hypophosphatemic rickets. Studies suggest that phosphaturia, caused by circulating factors, called "phosphatonins" may be secreted by an epidermal or hairy nevus. We report here, a rare case of hypophosphatemic rickets associated with a giant hairy nevus in a 10-year-old boy.

  15. STARDUST FROM ASYMPTOTIC GIANT BRANCH STARS

    International Nuclear Information System (INIS)

    Gail, H.-P.; Zhukovska, S. V.; Hoppe, P.; Trieloff, M.

    2009-01-01

    The formation of dust in the outflows of low- and intermediate-mass stars on the first giant branch and asymptotic giant branch (AGB) is studied and the relative contributions of stars of different initial masses and metallicities to the interstellar medium (ISM) at the instant of solar system formation are derived. These predictions are compared with the characteristics of the parent stars of presolar dust grains found in primitive meteorites and interplanetary dust particles (IDPs) inferred from their isotopic compositions. For this purpose, model calculations for dust condensation in stellar outflows are combined with synthetic models of stellar evolution on the first giant branch and AGB and an evolution model of the Milky Way for the solar neighborhood. The dust components considered are olivine, pyroxene, carbon, SiC, and iron. The corresponding dust production rates are derived for the solar vicinity. From these rates and taking into account dust destruction by supernova shocks in the ISM, the contributions to the inventory of presolar dust grains in the solar system are derived for stars of different initial masses and metallicities. It is shown that stars on the first giant branch and the early AGB are not expected to form dust, in accord with astronomical observations. Dust formation is concentrated in the last phase of evolution, the thermally pulsing AGB. Due to the limited lifetime of dust grains in the ISM only parent stars from a narrow range of metallicities are expected to contribute to the population of presolar dust grains. Silicate and silicon carbide dust grains are predicted to come from parent stars with metallicities not less than about Z ∼ 0.008 (0.6 x solar). This metallicity limit is higher than that inferred from presolar SiC grain isotope data. The population of presolar carbon dust grains is predicted to originate from a wider range of metallicities, down to Z ∼ 0.004. Masses of AGB stars that produce C-rich dust are in the range

  16. Giant Components in Biased Graph Processes

    OpenAIRE

    Amir, Gideon; Gurel-Gurevich, Ori; Lubetzky, Eyal; Singer, Amit

    2005-01-01

    A random graph process, $\\Gorg[1](n)$, is a sequence of graphs on $n$ vertices which begins with the edgeless graph, and where at each step a single edge is added according to a uniform distribution on the missing edges. It is well known that in such a process a giant component (of linear size) typically emerges after $(1+o(1))\\frac{n}{2}$ edges (a phenomenon known as ``the double jump''), i.e., at time $t=1$ when using a timescale of $n/2$ edges in each step. We consider a generalization of ...

  17. Giant Submandibular Calculus Eroding Oral Cavity Mucosa.

    Science.gov (United States)

    Lim, Eng Haw; Nadarajah, Sanjeevan; Mohamad, Irfan

    2017-09-01

    Sialolithiasis is the formation of calculi or sialoliths in the salivary gland. It is the most common benign condition of the salivary gland. Sialolithiasis can occur in all salivary glands. The submandibular gland is most commonly affected followed by the parotid gland. Calculi commonly measure less than 10 mm. Calculi of more than 15 mm are termed giant salivary gland calculi and are infrequently reported in the literature. Here, we report a case of unusually large submandibular gland calculus of 5 cm in greatest dimension which caused erosion of the oral cavity.

  18. Monopole Giant Resonances and TDHF boundary conditions

    International Nuclear Information System (INIS)

    Stevenson, P.D.; Almehed, D.; Reinhard, P.-G.; Maruhn, J.A.

    2007-01-01

    Using time-dependent Hartree-Fock, we induce isoscalar and isovector monopole vibrations and follow the subsequent vibrations of both the same and opposite isospin nature in the N Z nucleus 132 Sn. By suitable scaling of the proton and neutron parts of the excitation operators, the coupling between the modes is studied, and the approximate normal modes found. Chaotic dynamics are then analysed in the isoscalar giant monopole resonance by using reflecting boundaries in a large space to build up a large number of 0 + states whose spacings are then analysed. A Wigner-like distribution is found

  19. Isotopic dependence of giant multipole resonances

    International Nuclear Information System (INIS)

    Bar Touv, J.; Moalem, A.; Shlomo, S.

    1980-01-01

    A procedure is presented which allows the application of linear response theory and the random phase approximation to an open shell. The procedure is applied to Ca isotopes. The general features of giant multipole resonances are found to vary smoothly with the mass. The resonances exhibit more structure in the open lfsub(7/2) shell nuclei. While the energy-weighted dipole sum is practically constant in all isotopes, the isoscalar quadrupole and octupole energy weighted sums increase continuously by approx. 30% from 40 Ca to 48 Ca. (orig.)

  20. Temperature dependence of giant dipole resonance width

    International Nuclear Information System (INIS)

    Vdovin, A.I.; Storozhenko, A.N.

    2005-01-01

    The quasiparticle-phonon nuclear model extended to finite temperature within the framework of the thermo field dynamics is applied to calculate a temperature dependence of the spreading width Γ d own of a giant dipole resonance. Numerical calculations are made for 12S n and 208 Pb nuclei. It is found that the width Γ d own increases with T. The reason of this effect is discussed as well as a relation of the present approach to other ones existing in the literature

  1. Chylous Ascites Secondary to Giant Liver Hemangioma

    Directory of Open Access Journals (Sweden)

    Darius L. Lazarus

    2012-07-01

    Full Text Available Chylous ascites is rare in clinical practice. It is characterized by milky-appearing peritoneal fluid with a triglycerides concentration of >1.25 mmol/l (110 mg/dl. Its pathophysiology is related to a disruption in the normal lymphatic flow. It is more common after trauma (including post surgery, neoplasia or atypical infections such as tuberculosis or filariasis. Other rare medical causes have been reported. The treatment is supportive and focused on correction of the underlying pathology. We report here the first case of chylous ascites caused by giant liver hemangioma and discuss the management of this condition.

  2. Collective Hamiltonians for dipole giant resonances

    International Nuclear Information System (INIS)

    Weiss, L.I.

    1991-07-01

    The collective hamiltonian for the Giant Dipole resonance (GDR), in the Goldhaber-Teller-Model, is analytically constructed using the semiclassical and generator coordinates method. Initially a conveniently parametrized set of many body wave functions and a microscopic hamiltonian, the Skyrme hamiltonian - are used. These collective Hamiltonians are applied to the investigation of the GDR, in He 4 , O 16 and Ca 40 nuclei. Also the energies and spectra of the GDR are obtained in these nuclei. The two sets of results are compared, and the zero point energy effects analysed. (author)

  3. Isoscalar giant resonances in a relativistic model

    International Nuclear Information System (INIS)

    L'Huillier, M.; Nguyen Van Giai.

    1988-07-01

    Isoscalar giant resonances in finite nuclei are studied in a relativistic Random Phase Approximation (RRPA) approach. The model is self-consistent in the sense that one set of coupling constants generates the Dirac-Hartree single-particle spectrum and the residual particle-hole interaction. The RRPA is used to calculate response functions of multipolarity L = 0,2,3, and 4 in light and medium nuclei. It is found that monopole and quadrupole modes exhibit a collective character. The peak energies are overestimated, but not as much as one might think if the bulk properties (compression modulus, effective mass) were the only relevant quantities

  4. Ulcerative colitis masked by giant urticaria.

    Science.gov (United States)

    Caroselli, C; Plocco, M; Pratticò, F; Bruno, C; Antonaglia, C; Rota, F; Curreli, I; Caroselli, A; Bruno, G

    2007-01-01

    The occurrence of giant urticaria and ulcerative colitis is very infrequent. A 23 year-old female reported the initial eruption of short-lived cutaneous itchy weals on her arms. Then lesions ran together and became confluent, extending to her legs, followed by undefined abdominal pain and a slight increase of body temperature. Exams showed hystologically confirmed ulcerative colitis, with perinuclear anti-neutrophil cytoplasmic antibody positivity. Ulcerative colitis therapy led not only to the remission of the colitic symptoms, but also to the prompt recovery of skin manifestations. Urticaria was the epiphenomenon of ulcerative colitis.

  5. Lyme carditis mimicking giant cell arteritis

    Directory of Open Access Journals (Sweden)

    Krati Chauhan

    2015-10-01

    Full Text Available Presenting an interesting case of a patient who complained of myalgias, fatigue, headache, jaw claudication and scalp tenderness. Patient’s physical examination was unremarkable. Laboratory findings showed elevated erythrocyte sedimentation rate and C-reactive protein, bilateral temporal artery biopsy results were negative and first degree atrioventricular block was seen on electrocardiogram. Serology for Borrelia burgdorferi was positive; patient was diagnosed with Lyme carditis and treated with doxycycline. Lyme is a tick-borne, multi-system disease and occasionally its presentation may mimic giant cell arteritis. On follow-up there was complete resolution of symptoms and electrocardiogram findings.

  6. High temperature giant dipole and isoscalar resonances

    International Nuclear Information System (INIS)

    Navarro, J.; Barranco, M.; Garcias, F.; Suraud, E.

    1990-01-01

    We present a systematic study of the Giant Dipole Resonance (GDR) at high temperatures (T > ∼ 4 MeV) in the framework of a semi-classical approximation that uses the m 1 and m 3 RPA sum rules to estimate the GDR mean energy. We focus on the evolution with T of the collective nature of the GDR and of the L = 0,2,3 and 4 isoscalar resonances. We find that the GDR remains particularly collective at high T, suggesting that it might be possible to observe it experimentally even at temperatures close to the maximum one a nucleus can sustain

  7. Giant tubercular brainstem abscess: A case report

    Directory of Open Access Journals (Sweden)

    Pragati Chigurupati

    2014-01-01

    Full Text Available Tubercular brain abscesses are uncommon and tubercular brainstem abscesses are rarely reported. Most of these cases occur in immunocompromised patients. We report a case of giant brainstem abscess in a 5-year-old human immunodeficiency virus-seronegative female child who presented with complaints of headache, diplopia and unsteadiness of gait since 6 months. Diagnosis was made by a magnetic resonance imaging scan of brain. The patient demonstrated a remarkable clinical recovery after microsurgery combined with a course of antituberculous therapy. Microbiological and histological findings confirmed the diagnosis of a tuberculous abscess.

  8. Taxonomy Icon Data: giant panda [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available giant panda Ailuropoda melanoleuca Chordata/Vertebrata/Mammalia/Theria/Eutheria/Carnivora Ailuropoda_mela...noleuca_L.png Ailuropoda_melanoleuca_NL.png Ailuropoda_melanoleuca_S.png Ailuropoda_mela...noleuca_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Ailuropoda+melanoleuca&t=L http://bioscien...cedbc.jp/taxonomy_icon/icon.cgi?i=Ailuropoda+melanoleuca&t=NL http://biosciencedb...c.jp/taxonomy_icon/icon.cgi?i=Ailuropoda+melanoleuca&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Ailuropoda+melanoleuca&t=NS ...

  9. Trails of river monsters: Detecting critically endangered Mekong giant catfish Pangasianodon gigas using environmental DNA

    Directory of Open Access Journals (Sweden)

    Bellemain Eva

    2016-07-01

    Full Text Available Pressures on freshwater biodiversity in Southeast Asia are accelerating, yet the status and conservation needs of many of the region’s iconic fish species are poorly known. The Mekong is highly species diverse and supports four of the six largest freshwater fish globally, three of which, including Mekong giant catfish (Pangasianodon gigas, are Critically Endangered. Emerging environmental DNA (eDNA techniques have potential for monitoring threatened freshwater biodiversity, yet have not been applied in complex and biodiverse tropical ecosystems such as the Mekong. We developed species-specific primers for amplifying Mekong giant catfish DNA. In situ validation demonstrated that the DNA amplification was successful for all samples taken in reservoirs with known presence of Mekong giant catfish independent of fish density. We collected water samples from six deep pools on the Mekong, identified through Local Ecological Knowledge, in Cambodia, Lao PDR, and Thailand. DNA was extracted and amplified from these samples using the designed primers and probes. Mekong giant catfish DNA was detected from one sample from the species’ presumed spawning grounds on the Mekong mainstream, near the border between northern Thailand and Lao PDR. eDNA sampling using species-specific primers has potential for surveying and monitoring poorly known species from complex tropical aquatic environments. However accounting for false absences is likely to be required for the method to function with precision when applied to extremely rare species that are highly dispersed within a large river system. We recommend that such approach be utilised more widely by freshwater conservation practitioners for specific applications. The method is best suited for baseline biodiversity assessments or to identify and prioritise locations for more rigorous sampling. Our methods are particularly relevant for systems or species with limited baseline data or with physical characteristics

  10. Unusual giant prostatic urethral calculus | Bello | Journal of Surgical ...

    African Journals Online (AJOL)

    Giant vesico-prostatic urethral calculus is uncommon. Urethral stones rarely form primarily in the urethra, and they are usually associated with urethral strictures, posterior urethral valve or diverticula. We report a case of a 32-year-old man with giant vesico-prostatic (collar-stud) urethral stone presenting with sepsis and ...

  11. Giant calculus: review and report of a case.

    Science.gov (United States)

    Woodmansey, Karl; Severine, Anthony; Lembariti, Bakari S

    2013-01-01

    Dental calculus is a common oral finding. The term giant calculus is used to describe unusually large deposits of dental calculus. Several extreme cases have been reported in the dental literature. The specific etiology of these cases remains uncertain. This paper reviews previously reported cases, and presents another extreme example of giant calculus.

  12. Surgical sterilization of the African giant pouched rats | Werema ...

    African Journals Online (AJOL)

    ... to all principles of surgery. This study has demonstrated the three surgical procedures for African Giant pouched rats as being useful to veterinarians in public/private practice and/or in biomedical research facilities. Keywords: Surgical sterilization, ovariectomy, ovariohysterectomy, orchidectomy, African giant pouched rats ...

  13. Giant fibroadenoma presenting like fungating breast cancer in a ...

    African Journals Online (AJOL)

    Background: Giant fibroadenoma of the breast is a rare benign breast tumour which seldom grows to a giant size, it is even rarer for this benign tumour to grow rapidly, ulcerate spontaneously and present like a fungating breast tumour in a way mimicking breast cancer. Case presentation: This is a presentation of a 14 year ...

  14. Asteroseismology of 16,000 Kepler Red Giants

    DEFF Research Database (Denmark)

    Yu, Jie; Huber, Daniel; Bedding, Timothy R.

    2018-01-01

    (sigma(M) = 7.8%), radius (sigma(R) = 2.9%), and thus surface gravity (sigma(log g) = 0.01 dex). Thanks to the large red giant sample, we confirm that red-giant-branch (RGB) and helium-core-burning (HeB) stars collectively differ in the distribution of oscillation amplitude, granulation power, and width...

  15. in Chinese giant salamander ( Andrias davidianus , Blanchard, 1871)

    African Journals Online (AJOL)

    A disease in farmed Chinese giant salamander (Andrias davidianus) was a common event, being an economically important threat for Chinese farms. Based on the clinical signs, epizootiology and pathogens belonging to the genus, Ranavirus was suspected as the possible etiology. Although in a cultured Chinese giant ...

  16. [Giant idiopathic hydronephrosis: toward a two-step therapeutic approach].

    Science.gov (United States)

    Boudhaye, Taher Ismail; Sidimalek, Mohamed; Jdoud, Cheikhani

    2017-01-01

    Giant hydronephrosis is rare. It is usually caused by ureteropelvic junction syndrome. We here report the unusual case of a patient hospitalized with giant hydronephrosis associated with impaired general condition. Diagnosis was based on CT scan. The patient underwent deferred nephrectomy after percutaneous drainage.

  17. Giant Calculus In The Mouth Of Partially Edentulous Woman, (Case ...

    African Journals Online (AJOL)

    Objective: This case report is to create awareness of the presence of giant calculus in the mouth, the possible causes and its prevention. Report: This describes the oral condition of a partially edentulous woman with a giant calculus in the mouth. It highlights the effect of such an enormous calculus in the oral cavity.

  18. CASE REPORT: A GIANT URINARY BLADDER STONE IN A ...

    African Journals Online (AJOL)

    A vesical calculus weighing more than 100g is categorized as a giant urinary bladder stone. Male preponderance for urinary bladder calculi is well known. A rare case of a giant urinary bladder calculus weighing 1200g and occurring in a female patient is reported. The stone was removed by open vesicolithotomy.

  19. A new abdominal wall reconstruction strategy for giant omphalocele

    Directory of Open Access Journals (Sweden)

    Yoshiaki Takahashi

    2018-04-01

    Full Text Available The mortality rate of giant omphalocele has improved; however long-term follow-up has revealed umbilical defects and deformities after primary closure. We herein report the efficacy of a new abdominal wall reconstruction strategy combining a component separation technique with delayed natural and deep umbilicoplasty. Keywords: Giant omphalocele, Component separation technique, Delayed natural and deep umbilicoplasty, Abdominal wall defect

  20. Chemical Analysis of Asymptotic Giant Branch Stars in M62

    NARCIS (Netherlands)

    Lapenna, E.; Mucciarelli, A.; Ferraro, F. R.; Origlia, L.; Lanzoni, B.; Massari, D.; Dalessandro, E.

    2015-01-01

    We have collected UVES-FLAMES high-resolution spectra for a sample of 6 asymptotic giant branch (AGB) and 13 red giant branch (RGB) stars in the Galactic globular cluster (GC) M62 (NGC 6266). Here we present the detailed abundance analysis of iron, titanium, and light elements (O, Na, Mg, and Al).

  1. Malignant Giant Cell Tumour of Bone with Axillary Metastasis

    African Journals Online (AJOL)

    2002-06-06

    Jun 6, 2002 ... SUMMARY. Giant Cell Tumour of bone is a typically benign and solitary tumour. However, multiple lesions have been described and 5-10% of lesions may be malignant. We present a case of a malignant giant cell tumour of the distal radius with metastasis to the ipsilateral axilla (an uncommon location).

  2. Giant aneurysm in a left coronary artery fistula

    DEFF Research Database (Denmark)

    Frestad, Daria; Helqvist, Steffen; Helvind, Morten

    2013-01-01

    Congenital coronary artery fistula complicated with giant coronary artery aneurysm is a very rare condition. In this case report, we present a 65-year-old woman, referred to us with a continuous heart murmur, occasional atypical chest pain and few episodes of fainting. A giant aneurysm...

  3. Giant Double Radio Source DA 240: Purveyor of Galaxies

    Science.gov (United States)

    Chen, Ru-Rong; Strom, Richard; Peng, Bo

    2018-05-01

    Galaxies of stars are building blocks of the baryonic universe. Their composition, structure, and kinematics have been well studied, but details of their origins remain sketchy. The collapse of gas clouds, induced by external forces whereby gravity overcomes internal pressure to form stars, is the likely starting point. Among the perturbing initiators of galaxy formation, radio source beams (jets) are quite effective. Typically, a beam may spawn one galaxy, though instances of several aligned with the radio axis are known. Recently, we found an impressive 14 companions in the lobes of the giant radio galaxy DA 240, which we argue formed as the result of jet instigation. This conclusion is bolstered by the fact that the galaxy groups display Z-shaped symmetry with respect to the radio axis. There is some evidence for star formation among the aligned companions. We also conclude that galaxy alignments at low redshift may derive from line-emitting gas observed in radio components of high-redshift galaxies.

  4. Metastatic giant basal cell carcinoma: a case report.

    Science.gov (United States)

    Bellahammou, Khadija; Lakhdissi, Asmaa; Akkar, Othman; Rais, Fadoua; Naoual, Benhmidou; Elghissassi, Ibrahim; M'rabti, Hind; Errihani, Hassan

    2016-01-01

    Basal cell carcinoma is the most common skin cancer, characterised by a slow growing behavior, metastasis are extremely rare, and it occurs in less than 0, 1% of all cases. Giant basal cell carcinoma is a rare form of basal cell carcinoma, more aggressive and defined as a tumor measuring more than 5 cm at its largest diameter. Only 1% of all basal cell carcinoma develops to a giant basal cell carcinoma, resulting of patient's negligence. Giant basal cell carcinoma is associated with higher potential of metastasis and even death, compared to ordinary basal cell carcinoma. We report a case of giant basal cell carcinoma metastaticin lung occurring in a 79 years old male patient, with a fatal evolution after one course of systemic chemotherapy. Giant basal cell carcinoma is a very rare entity, early detection of these tumors could prevent metastasis occurrence and improve the prognosis of this malignancy.

  5. New properties of giant resonances in highly excited nuclei

    International Nuclear Information System (INIS)

    Morsch, H.P.

    1991-01-01

    Studies on the giant dipole resonance in very hot nuclei investigated in heavy ion-induced particle-γ coincidence experiments are reviewed. A signature is found in the γ-decay of excited nuceli which shows direct decay of the giant dipole resonance. This provides a new dimension in giant resonance studies and the possibility to study the dependence of giant resonance energy, width and sum rule strength on excitation energy and rotation of the system. Further, the fact that the giant resonance splits in deformed nuclei provides a unique way to get information on the shape of hot nuclei. First results are obtained on the following questions: (i)What is the nuclear shape at high temperature (T≥2 MeV)? (ii)Is there a phase transition in the nuclear shape at T∼1.7 MeV? (iii)Does motional narrowing exist in hot nuclei? (author). 19 refs., 11 figs

  6. Giant Planets Can Act as Stabilizing Agents on Debris Disks

    Energy Technology Data Exchange (ETDEWEB)

    Muñoz-Gutiérrez, M. A.; Pichardo, B.; Peimbert, A., E-mail: mmunoz.astro@gmail.com [Instituto de Astronomía, Universidad Nacional Autónoma de México, Apdo. postal 70-264 Ciudad Universitaria, México (Mexico)

    2017-07-01

    We have explored the evolution of a cold debris disk under the gravitational influence of dwarf-planet-sized objects (DPs), both in the presence and absence of an interior giant planet. Through detailed long-term numerical simulations, we demonstrate that when the giant planet is not present, DPs can stir the eccentricities and inclinations of disk particles, in linear proportion to the total mass of the DPs; on the other hand, when the giant planet is included in the simulations, the stirring is approximately proportional to the mass squared. This creates two regimes: below a disk mass threshold (defined by the total mass of DPs), the giant planet acts as a stabilizing agent of the orbits of cometary nuclei, diminishing the effect of the scatterers; above the threshold, the giant contributes to the dispersion of the particles.

  7. Semimicroscopic description of the giant quadrupole resonances in deformed nuclei

    International Nuclear Information System (INIS)

    Kurchev, G.; Malov, L.A.; Nesterenko, V.O.; Soloviev, V.G.

    1976-01-01

    The calculation results of the giant quadrupole isoscalar and isovector resonances performed within the random phase approximation are represented. The strength functions for E2-transitions are calculated for doubly even deformed nuclei in the regions 150 (<=) A < 190 and 228 (<=) A < 248 in the energy interval (0-40) MeV. The following integral characteristics of giant quadrupole resonances are obtained: the position, widths, the contribution to the energy weighted sum rule and the contribution to the total cross section of photoabsorption. The calculations have shown that giant quadrupole resonances are common for all the considered nuclei. The calculated characteristics of the isoscalar giant quadrupole resonance agree with the available experimental data. The calculations also show that the semimicroscopic theory can be successfully applied for the description of giant multipole resonances

  8. Actual problems of giant resonance physics

    International Nuclear Information System (INIS)

    Zhalov, M.B.; Sliv, L.A.

    1982-01-01

    The raper deals with the discussion of theoretical problems associated with investigation into nuclear giant multipole resoonances (GMR). Analysis of test data on inelastic scattering of particles on nuclei is carried out to obtain the main GMR characteristics from the present experimental data. Giant isoscalar resonances and their structures in the random phase approximatmion (RPA) with Skyrm forces described by the microscopic theory are discussed. Cross section of 40 Ca excitation in reaction of α-particle inelastic scattering calculated in RPA with exact accountancy of one-nucleon continuum is graphically displayed as an example. Modified RPA used for calculation of GMR width is suggested. Conducted is comparison of energies of 40 Ca, 58 Ni, 90 Zr, 208 Pb nuclei isoscalar resonances calculated in RPA and their contributions to energy weighted sum rule the results of which are tabulated. Integral strength of resonance excitation in RPA by inelastic-scattered α particles and protons on 40 Ca and 208 Pb nuclei is considered. Channels of GMR disintegration are discussed. The most significant theoretical and experimental problems the solution of which is necessary for complete investigation of GMR are pointed out

  9. The interiors of the giant planets - 1983

    International Nuclear Information System (INIS)

    Smoluchowski, R.

    1983-01-01

    The last few years brought progress in understanding the interiors of the giant planets especially of the two larger ones which have been visited by Pioneer and Voyager spacecraft. An analysis of the formation of the giant planets also helped to clarify certain important common features. The presently available model of Jupiter is still based on certain somewhat bothersome approximations but it appears to satisfy the main observational constraints. Saturn's interior is much better understood than it was previously although the quantitative aspects of the role of the miscibility gap in the hydrogen-helium system have not yet been entirely resolved. Much attention has been directed at the interiors of Uranus and Neptune and the outstanding question appears to be the location and the amount of ices and methane present in their outer layers. Both the two- and the three-layer models are moderately successful. Serious difficulties arise from the considerable uncertainties concerning the rotational periods of both planets. Also the estimates of the internal heat fluxes and of the magnetic fields of both planets are not sufficiently certain. It is hoped that the forthcoming flyby of these two planets by a Voyager spacecraft will provide important new data for a future study of their interiors. (Auth.)

  10. The Fuzziness of Giant Planets’ Cores

    International Nuclear Information System (INIS)

    Helled, Ravit; Stevenson, David

    2017-01-01

    Giant planets are thought to have cores in their deep interiors, and the division into a heavy-element core and hydrogen–helium envelope is applied in both formation and structure models. We show that the primordial internal structure depends on the planetary growth rate, in particular, the ratio of heavy elements accretion to gas accretion. For a wide range of likely conditions, this ratio is in one-to-one correspondence with the resulting post-accretion profile of heavy elements within the planet. This flux ratio depends sensitively on the assumed solid-surface density in the surrounding nebula. We suggest that giant planets’ cores might not be distinct from the envelope and includes some hydrogen and helium, and the deep interior can have a gradual heavy-element structure. Accordingly, Jupiter’s core may not be well defined. Accurate measurements of Jupiter’s gravitational field by Juno could put constraints on Jupiter’s core mass. However, as we suggest here, the definition of Jupiter’s core is complex, and the core’s physical properties (mass, density) depend on the actual definition of the core and on the planet’s growth history.

  11. The Fuzziness of Giant Planets’ Cores

    Energy Technology Data Exchange (ETDEWEB)

    Helled, Ravit [Institute for Computational Science, University of Zurich, Zurich (Switzerland); Stevenson, David [Division of Geological and Planetary Sciences, Caltech, Pasadena, CA (United States)

    2017-05-01

    Giant planets are thought to have cores in their deep interiors, and the division into a heavy-element core and hydrogen–helium envelope is applied in both formation and structure models. We show that the primordial internal structure depends on the planetary growth rate, in particular, the ratio of heavy elements accretion to gas accretion. For a wide range of likely conditions, this ratio is in one-to-one correspondence with the resulting post-accretion profile of heavy elements within the planet. This flux ratio depends sensitively on the assumed solid-surface density in the surrounding nebula. We suggest that giant planets’ cores might not be distinct from the envelope and includes some hydrogen and helium, and the deep interior can have a gradual heavy-element structure. Accordingly, Jupiter’s core may not be well defined. Accurate measurements of Jupiter’s gravitational field by Juno could put constraints on Jupiter’s core mass. However, as we suggest here, the definition of Jupiter’s core is complex, and the core’s physical properties (mass, density) depend on the actual definition of the core and on the planet’s growth history.

  12. Excitation of giant monopole and quadrupole resonances

    Energy Technology Data Exchange (ETDEWEB)

    Ogata, H. [Osaka Univ., Suita (Japan). Research Center for Nuclear Physics; Yamagata, T.; Tanaka, M. [and others; Ikegami, H.; Muraoka, M. [eds.; Osaka Univ., Suita (Japan). Research Center for Nuclear Physics

    1980-01-01

    Recent studies on the giant monopole resonance (GMR) and the giant quadrupole resonance (GQR) in /sup 144/Sm and /sup 208/Pb using the ..cap alpha..-scattering performed at RCNP are summarized. The observed angular range covered 1.6/sup 0/ -- 7/sup 0/ with a coupled system of a dipole and a triplet quadrupole magnet. The incident energy was changed from 84 to 119 MeV. The resonance shapes and energy-weighted sum-rule strengths of the GMR and the GQR were reliably deduced as a function of incident energy. The quadrupole strength of --20% was found in the GMR region. The observed excitation function of the GMR was compared with the DWBA calculation, in which the Satchler's Version I was used as a form factor representing the compressional motion of the nucleus. It was found that the experimental excitation function of the GMR shows steeper decrease as lowering the incident energy than the DWBA prediction whereas that of the GQR is successfully described by the DWBA. This suggests that examination of the model describing the GMR is necessary.

  13. Condensed matter view of giant resonance phenomena

    International Nuclear Information System (INIS)

    Zangwill, A.

    1987-01-01

    The intent of this article is to present a view of giant resonance phenomena (an essentially atomic phenomenon) from the perspective of a condensed matter physicist with an interest in the optical properties of matter. As we shall see, this amounts to a particular prejudice about how one should think about many-body effects in a system of interacting electrons. Some of these effects are special to condensed matter systems and will be dealt with in the second half of this paper. However, it turns out that the authors view of the main ingredient to a giant resonance differs significantly from that normally taken by scientists trained in the traditional methods of atomic physics. Therefore, in the first section the author will take advantage of the fact that his contribution to this volume was composed and delivered to the publishers somewhat after the conclusion of the School (rather than before as requested by the organizers) and try to clearly distinguish the differences of opinion presented by the lecturers from the unalterable experimental facts. 46 references, 9 figures

  14. Post-giant evolution of helium stars

    International Nuclear Information System (INIS)

    Schoenberner, D.

    1977-01-01

    Extremely hydrogen deficient stars (helium stars and R Coronae Borealis variables) are considered to be remnants of double shell source stars (of the asymptotic giant branch). The evolution of stars with a condensed C/O-core and a helium envelope is followed numerically from the red giant stage to the white dwarf domain, crossing the regions of R CrB- and helium stars (so far analyzed). They have typically masses M/M(sun) = 0.7 and luminosities log L/L(sun) = 4.1. The time for crossing the helium star domain is some 10 3 years. The corresponding times in the R CrB-region amounts up to several 10 4 years. The lower limit of the death rate of helium stars is estimated to be 4 x 10 -14 pc -3 yr -1 . This value is only a factor of ten lower than the birth rate of all non-DA white dwarfs. It is therefore possible that the helium stars are the precursors of helium rich white dwarfs. As a consequence, a significant fraction of all stars which end their lives as white dwarfs should pass through the helium star phase. (orig.) [de

  15. Giant fibrovascular esophageal polyp misdiagnosed as achalasia.

    Science.gov (United States)

    Cordoş, I; Istrate, A; Codreşi, M; Bolca, C

    2012-01-01

    A 59 years old woman was admitted in our unit accusing longtime dysphagia and regurgitation. On admission, the patient was wearing a 3 month old definitive feeding gastrostomy tube. The contrast swallow, endoscopy and esophageal manometry established the diagnostic--achalasia. We removed the gastrostomy tube and we performed an open Heller myotomy. The postoperative period was uneventful and the patient was discharged one week later with affirmatively unimpaired deglutition. One month later, the patient was admitted via emergency with a giant fibrous tumor arising from her mouth after an episode of strong coughing and vomiting. The repeated endoscopy showed a giant esophageal polyp that was missed by the previous investigations, originating from pharingoesophageal junction. The esophageal polyp was resected by cervical approach with good postoperative outcome. The polyp's particular extreme dimensions (27 cm) prevented the acute asphyxia by blockage at the laryngeal level, possibly provoked by smaller tumors. As postoperative one month barium swallow showed a normal esophageal aspect, a final question remains--was achalasia real or an erroneous diagnosis was established the second time too?

  16. Giant proximity effect in ferromagnetic bilayers

    Science.gov (United States)

    Ramos, Silvia; Charlton, Tim; Quintanilla, Jorge; Suter, Andreas; Moodera, Jagadeesh; Prokscha, Thomas; Salman, Zaher; Forgan, Ted

    2013-03-01

    The proximity effect is a phenomenon where an ordered state leaks from a material into an adjacent one over some finite distance, ξ. For superconductors, this distance is ~ the coherence length. Nevertheless much longer-range, ``giant'' proximity effects have been observed in cuprate junctions. This surprising effect can be understood as a consequence of critical opalescence. Since this occurs near all second order phase transitions, giant proximity effects should be very general and, in particular, they should be present in magnetic systems. The ferromagnetic proximity effect has the advantage that its order parameter (magnetization) can be observed directly. We investigate the above phenomenon in Co/EuS bilayer films, where both materials undergo ferromagnetic transitions but at rather different temperatures (bulk TC of 1400K for Co and 16.6K for EuS). A dramatic increase in the range of the proximity effect is expected near the TC of EuS. We present the results of our measurements of the magnetization profiles as a function of temperature, carried out using the complementary techniques of low energy muon rotation and polarized neutron reflectivity. Work supported by EPSRC, STFC and ONR grant N00014-09-1-0177 and NSF grant DMR 0504158.

  17. Giant magnetoresistance through a single molecule.

    Science.gov (United States)

    Schmaus, Stefan; Bagrets, Alexei; Nahas, Yasmine; Yamada, Toyo K; Bork, Annika; Bowen, Martin; Beaurepaire, Eric; Evers, Ferdinand; Wulfhekel, Wulf

    2011-03-01

    Magnetoresistance is a change in the resistance of a material system caused by an applied magnetic field. Giant magnetoresistance occurs in structures containing ferromagnetic contacts separated by a metallic non-magnetic spacer, and is now the basis of read heads for hard drives and for new forms of random access memory. Using an insulator (for example, a molecular thin film) rather than a metal as the spacer gives rise to tunnelling magnetoresistance, which typically produces a larger change in resistance for a given magnetic field strength, but also yields higher resistances, which are a disadvantage for real device operation. Here, we demonstrate giant magnetoresistance across a single, non-magnetic hydrogen phthalocyanine molecule contacted by the ferromagnetic tip of a scanning tunnelling microscope. We measure the magnetoresistance to be 60% and the conductance to be 0.26G(0), where G(0) is the quantum of conductance. Theoretical analysis identifies spin-dependent hybridization of molecular and electrode orbitals as the cause of the large magnetoresistance.

  18. Literature review of giant gartersnake (Thamnophis gigas) biology and conservation

    Science.gov (United States)

    Halstead, Brian J.; Wylie, Glenn D.; Casazza, Michael L.

    2015-08-03

    This report reviews the available literature on giant gartersnakes (Thamnophis gigas) to compile existing information on this species and identify knowledge gaps that, if addressed, would help to inform conservation efforts for giant gartersnakes.  Giant gartersnakes comprise a species of semi-aquatic snake precinctive to wetlands in the Central Valley of California.  The diversion of surface water and conversion of wetlands to agricultural and other land uses resulted in the loss of more than 90 percent of natural giant gartersnake habitats.  Because of this habitat loss, giant gartersnakes are now listed by the United States and California Endangered Species Acts as Threatened.  Most extant populations occur in the rice-growing regions of the Sacramento Valley, which comprises the northern portion of the giant gartersnake’s former range.  The huge demand for water in California for agriculture, industry, recreation, and other human consumption, combined with periodic severe drought, places remaining giant gartersnake habitats at increased risk of degradation and loss.  This literature review summarizes the available information on giant gartersnake distribution, habitat relations, behavior, demography, and other aspects of its biology relevant to conservation.  This information is then compiled into a graphical conceptual model that indicates the importance of different aspects of giant gartersnake biology for maintaining positive population growth, and identifies those areas for which important information relevant for conservation is lacking.  Directing research efforts toward these aspects of giant gartersnake ecology will likely result in improvements to conserving this unique species while meeting the high demands for water in California.

  19. Giant cells around bone biomaterials: Osteoclasts or multi-nucleated giant cells?

    Science.gov (United States)

    Miron, Richard J; Zohdi, Hamoon; Fujioka-Kobayashi, Masako; Bosshardt, Dieter D

    2016-12-01

    Recently accumulating evidence has put into question the role of large multinucleated giant cells (MNGCs) around bone biomaterials. While cells derived from the monocyte/macrophage lineage are one of the first cell types in contact with implanted biomaterials, it was originally thought that specifically in bone tissues, all giant cells were bone-resorbing osteoclasts whereas foreign body giant cells (FBGCs) were found associated with a connective tissue foreign body reaction resulting in fibrous encapsulation and/or material rejection. Despite the great majority of bone grafting materials routinely found with large osteoclasts, a special subclass of bone biomaterials has more recently been found surrounded by large giant cells virtually incapable of resorbing bone grafts even years after their implantation. While original hypotheses believed that a 'foreign body reaction' may be taking place, histological data retrieved from human samples years after their implantation have put these original hypotheses into question by demonstrating better and more stable long-term bone volume around certain bone grafts. Exactly how or why this 'special' subclass of giant cells is capable of maintaining long-term bone volume, or methods to scientifically distinguish them from osteoclasts remains extremely poorly studied. The aim of this review article was to gather the current available literature on giant cell markers and differences in expression patterns between osteoclasts and MNGCs utilizing 19 specific markers including an array of CD-cell surface markers. Furthermore, the concept of now distinguishing between pro-inflammatory M1-MNGCs (previously referred to as FBGCs) as well as wound-healing M2-MNGCs is introduced and discussed. This review article presents 19 specific cell-surface markers to distinguish between osteoclasts and MNGCs including an array of CD-cell surface markers. Furthermore, the concept of now distinguishing between pro-inflammatory M1-MNGCs (often

  20. Predicting the Atmospheric Composition of Extrasolar Giant Planets

    Science.gov (United States)

    Sharp, A. G.; Moses, J. I.; Friedson, A. J.; Fegley, B., Jr.; Marley, M. S.; Lodders, K.

    2004-01-01

    To date, approximately 120 planet-sized objects have been discovered around other stars, mostly through the radial-velocity technique. This technique can provide information about a planet s minimum mass and its orbital period and distance; however, few other planetary data can be obtained at this point in time unless we are fortunate enough to find an extrasolar giant planet that transits its parent star (i.e., the orbit is edge-on as seen from Earth). In that situation, many physical properties of the planet and its parent star can be determined, including some compositional information. Our prospects of directly obtaining spectra from extrasolar planets may improve in the near future, through missions like NASA's Terrestrial Planet Finder. Most of the extrasolar giant planets (EGPs) discovered so far have masses equal to or greater than Jupiter's mass, and roughly 16% have orbital radii less than 0.1 AU - extremely close to the parent star by our own Solar-System standards (note that Mercury is located at a mean distance of 0.39 AU and Jupiter at 5.2 AU from the Sun). Although all EGPs are expected to have hydrogen-dominated atmospheres similar to Jupiter, the orbital distance can strongly affect the planet's temperature, physical, chemical, and spectral properties, and the abundance of minor, detectable atmospheric constituents. Thermochemical equilibrium models can provide good zero-order predictions for the atmospheric composition of EGPs. However, both the composition and spectral properties will depend in large part on disequilibrium processes like photochemistry, chemical kinetics, atmospheric transport, and haze formation. We have developed a photochemical kinetics, radiative transfer, and 1-D vertical transport model to study the atmospheric composition of EGPs. The chemical reaction list contains H-, C-, O-, and N-bearing species and is designed to be valid for atmospheric temperatures ranging from 100-3000 K and pressures up to 50 bar. Here we examine