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Sample records for inadvertent dural tearing

  1. A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.

    Science.gov (United States)

    O'Neill, Kevin R; Fehlings, Michael G; Mroz, Thomas E; Smith, Zachary A; Hsu, Wellington K; Kanter, Adam S; Steinmetz, Michael P; Arnold, Paul M; Mummaneni, Praveen V; Chou, Dean; Nassr, Ahmad; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Smith, Justin S; Shaffrey, Christopher; Tannoury, Chadi A; Tannoury, Tony; Gokaslan, Ziya L; Gum, Jeffrey L; Hart, Robert A; Isaacs, Robert E; Sasso, Rick C; Bumpass, David B; Bydon, Mohamad; Corriveau, Mark; De Giacomo, Anthony F; Derakhshan, Adeeb; Jobse, Bruce C; Lubelski, Daniel; Lee, Sungho; Massicotte, Eric M; Pace, Jonathan R; Smith, Gabriel A; Than, Khoi D; Riew, K Daniel

    2017-04-01

    Retrospective multicenter case series study. Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization. There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( P < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears. In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

  2. Late-presenting dural tear: incidence, risk factors, and associated complications.

    Science.gov (United States)

    Durand, Wesley M; DePasse, J Mason; Kuris, Eren O; Yang, JaeWon; Daniels, Alan H

    2018-04-18

    Unrecognized and inadequately repaired intraoperative durotomies may lead to cerebrospinal fluid leak, pseudomeningocele, and other complications. Few studies have investigated durotomy that is unrecognized intraoperatively and requires additional postoperative management (hereafter, late-presenting dural tear [LPDT]), although estimates of LPDT range from 0.6 to 8.3 per 1,000 spinal surgeries. These single-center studies are based on relatively small sample sizes for an event of this rarity, all with <10 patients experiencing LPDT. This investigation is the largest yet conducted on LPDT, and sought to identify incidence, risk factors for, and complications associated with LPDT. This observational cohort study employed the American College of Surgeons National Surgical Quality Improvement Program dataset (years 2012-2015). Patients who underwent spine surgery were identified based on presence of primary listed Current Procedural Terminology (CPT) codes corresponding to spinal fusion or isolated posterior decompression without fusion. The primary variable in this study was occurrence of LPDT, identified as reoperation or readmission with durotomy-specific CPT or International Classification of Diseases, Ninth Revision, Clinical Modification codes but without durotomy codes present for the index procedure. Descriptive statistics were generated. Bivariate and multivariate analyses were conducted using chi-square tests and multiple logistic regression, respectively, generating both risk factors for LPDT and independent association of LPDT with postoperative complications. Statistical significance was defined as p<.05. In total, 86,212 patients were analyzed. The overall rate of reoperation or readmission without reoperation for LPDT was 2.0 per 1,000 patients (n=174). Of LPDT patients, 97.7% required one or more unplanned reoperations (n=170), and 5.7% of patients (n=10) required two reoperations. On multivariate analysis, lumbar procedures (odds ratio [OR] 2.79, p

  3. Posterior reversible encephalopathy syndrome following an inadvertent dural puncture during an emergency laparotomy for ischemic colitis – a case report

    Directory of Open Access Journals (Sweden)

    Shah R

    2014-01-01

    Full Text Available Reena Shah, Agnieszka Kubisz-Pudelko, Jeremy Reid Yeovil District Hospital, Yeovil, UK Abstract: Posterior reversible encephalopathy syndrome (PRES is a clinico-neuroradiological syndrome characterized by various symptoms of neurological disease. It has commonly been reported in association with acute hypertension, pre-eclampsia, eclampsia, sepsis, and exposure to immunosuppressants. Here, we report on a normotensive woman who developed a severe frontal headache, visual disturbances, and hypertension 3 days after undergoing an emergency laparotomy for ischemic colitis during which she suffered an inadvertent dural puncture. Neuro-imaging revealed features consistent with PRES. The patient went on to make a good recovery, being discharged 21 days postoperatively, with only minor visual disturbances and memory problems. This case highlights the importance of awareness of PRES to all specialties. On reviewing the literature, we feel that PRES may be a potential differential diagnosis to post-procedural neurological symptoms in those patients undergoing routine procedures such as spinal anesthetics or lumbar punctures. Keywords: PRES, neurological disease, lumbar puncture, spinal anesthetic

  4. Inadvertent intrathecal injection of labetalol in a patient undergoing post-partum tubal ligation.

    Science.gov (United States)

    Balestrieri, P J; Hamza, M S; Ting, P H; Blank, R S; Grubb, C T

    2005-10-01

    After receiving a continuous spinal anesthetic for labor following an inadvertent dural puncture with a 17-gauge epidural needle, a morbidly obese parturient underwent post-partum tubal ligation 12 h after vaginal delivery. The patient received a total of 2 mL of 0.75% hyperbaric bupivacaine for the surgery. In response to moderate hypertension the patient received intravenous labetalol hydrochloride 20 mg. She subsequently was inadvertently administered approximately 15 mg of labetalol through the spinal catheter. The spinal catheter was removed immediately after the procedure. She suffered no apparent adverse neurologic effects.

  5. Iatrogene duralæsioner ved dekompressionskirurgi i lumbalcolumna

    DEFF Research Database (Denmark)

    Thomsen, Frederik; Amtoft, Ole; Andersen, Mikkel

    2010-01-01

    at the Private Hospital Hamlet. The study covers cases from the 10-month period from September 1, 2007 to June 30, 2008. Data was collected after this period and consists of surgeon-documented dural tears. At the time of surgery, the surgeon was unaware that there would be a subsequent registration. A total...

  6. Persistent dural cerebrospinal fluid leak shown by retrograde radionuclide myelography: case report

    International Nuclear Information System (INIS)

    Kadrie, H.; Driedger, A.A.; McInnis, W.

    1976-01-01

    Following inadvertent spinal anesthesia for delivery, a patient developed incapacitating post-lumbar puncture headache that persisted for 9 weeks. Scintigrams of the lumbar region, obtained after injection of /sup 99m/Tc-human serum albumin into the cisterna magna, showed the cerebrospinal fluid leak. Blood patch repair was carried out, with immediate relief of all symptoms. Because of subsequent atypical headaches, a second cisternogram was done by the same technique. This study confirmed that there was no further dural leak, and other evidence indicated that the recurrent headache was related to functional problems

  7. Dural ectasia

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    Neha Gupta

    2014-01-01

    Full Text Available Dural ectasia is one of the likely causes of incomplete or failed spinal anaesthesia. Its association with diseases like Marfans syndrome, neurofibromatosis, osteogenesis imperfecta, vertebral fracture, postopertative adhesions, trauma etc., is often overlooked as a reason for inadequate spinal anaesthesia. Greater than normal volume of cerebrospinal fluid in the lumber theca in dural ectasia is postulated to restrict the spread of intrathecally injected Local anaesthetic. Here, we report a case of failed spinal anaesthesia but successful epidural anaesthesia in later setting in a patient with dural ectasia.

  8. Dural enhancement with primary calvarial lesions.

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    Arana, E; Martí-Bonmatí, L; Ricart, V; Pérez-Ebrí, M

    2004-11-01

    The purpose of this study was to relate the pathological and imaging features of dural enhancement and meningeal sign ("dural tail") on contrast-enhanced T1-weighted magnetic resonance (MR) images from patients with primary calvarial lesions as well to assess the accuracy of MR imaging in predicting dural invasion. Thirty-two calvarial tumors studied with contrast-enhanced MR imaging and histopathological examination of the dural specimens were reviewed. Sixteen patients presented dural enhancement, eight with tumor invasion. Tumoral invasion of the dura was observed in one case without enhancement. Malignant lesions showed enhanced dura more commonly than benign lesions (P=0.02). Nodular and discontinuous dural enhancement was statistically associated with dural invasion (P=0.05). Dural tail did not show a specific pathological association. Meningeal enhancement is a nonspecific reaction to calvarial lesions unless nodular and discontinuous. False-negative and -positive cases of dural invasion imply some limitation of contrast-enhanced MR imaging in predicting dural invasion by calvarial neoplasms.

  9. Dural enhancement with primary calvarial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Arana, E. [Clinica Quiron, Department of Radiology, Valencia (Spain); Marti-Bonmati, L. [Clinica Quiron, Department of Radiology, Valencia (Spain); Hospital Universitario Dr. Peset, Department of Radiology, Valencia (Spain); Ricart, V. [Hospital de la Ribera, Department of Radiology, Valencia (Spain); Perez-Ebri, M. [Hospital Universitario Dr. Peset, Department of Pathology, Valencia (Spain)

    2004-11-01

    The purpose of this study was to relate the pathological and imaging features of dural enhancement and meningeal sign (''dural tail'') on contrast-enhanced T1-weighted magnetic resonance (MR) images from patients with primary calvarial lesions as well to assess the accuracy of MR imaging in predicting dural invasion. Thirty-two calvarial tumors studied with contrast-enhanced MR imaging and histopathological examination of the dural specimens were reviewed. Sixteen patients presented dural enhancement, eight with tumor invasion. Tumoral invasion of the dura was observed in one case without enhancement. Malignant lesions showed enhanced dura more commonly than benign lesions (P=0.02). Nodular and discontinuous dural enhancement was statistically associated with dural invasion (P=0.05). Dural tail did not show a specific pathological association. Meningeal enhancement is a nonspecific reaction to calvarial lesions unless nodular and discontinuous. False-negative and -positive cases of dural invasion imply some limitation of contrast-enhanced MR imaging in predicting dural invasion by calvarial neoplasms. (orig.)

  10. Cefalea secundaria a punción dural Headache as a result of dural puncture

    Directory of Open Access Journals (Sweden)

    Ariadna García Rodríguez

    2005-03-01

    Full Text Available Se realizó una revisión bibliográfica sobre cefalea pospunción en el Hospital "Abel Santamaría", de Pinar del Río, en el período comprendido de febrero a junio del 2004, con el objetivo de ampliar los conocimientos de los profesionales de la salud encargados de diagnosticar y tratar esta complicación. La cefalea secundaria a punción dural se debe al escape persistente de LCR (líquido cefalorraquídeo a través del desgarro hecho en la duramadre, causado por la penetración de la aguja; se presenta cuando el paciente adopta la posición erecta y se alivia con el decúbito, característica esta que de no aparecer debe hacer dudar el diagnóstico. La elección de un trocar fino para realizar la punción y la dirección del bisel paralelo a las fibras de la duramadre son los factores determinantes en la profilaxis de la cefalea. Aún existen controversias en cuanto a su tratamiento, pero si hay un consenso unido en que el parche de sangre epidural es el tratamiento definitivo de esta complicación.A review of the most updated literature on dural post-puncture headache was made at Abel Santamaría University Hospital in February - June 2004 aimed at spreading the awareness to health professionals at diagnosing and treating this condition. The headache secondary to dural puncture is caused by the persistent leakage of cerebrospinal fluid through the dura tear because of the needle insertion; it presents when the patient adopts the erect position and it alleviates with the supine position; if this characteristic is not present it may appear some doubts on diagnosis. The selection of a fine trocar for puncture and guiding the bevel parallel to the fibers of dura are the main factors for profilaxis of headache. Its treatment is controversial, but it does exist a consensus in that the epidural blood patch is the definitive treatment for this condition.

  11. Spinal endoscopy combined with selective CT myelography for dural closure of the spinal dural defect with superficial siderosis: technical note.

    Science.gov (United States)

    Arishima, Hidetaka; Higashino, Yoshifumi; Yamada, Shinsuke; Akazawa, Ayumi; Arai, Hiroshi; Tsunetoshi, Kenzo; Matsuda, Ken; Kodera, Toshiaki; Kitai, Ryuhei; Awara, Kousuke; Kikuta, Ken-Ichiro

    2018-01-01

    The authors describe a new procedure to detect the tiny dural hole in patients with superficial siderosis (SS) and CSF leakage using a coronary angioscope system for spinal endoscopy and selective CT myelography using a spinal drainage tube. Under fluoroscopy, surgeons inserted the coronary angioscope into the spinal subarachnoid space, similar to the procedure of spinal drainage, and slowly advanced it to the cervical spine. The angioscope clearly showed the small dural hole and injured arachnoid membrane. One week later, the spinal drainage tube was inserted, and the tip of the drainage tube was located just below the level of the dural defect found by the spinal endoscopic examination. This selective CT myelography clarifies the location of the dural defect. During surgery, the small dural hole could be easily located, and it was securely sutured. It is sometimes difficult to detect the actual location of the small dural hole even with thin-slice MRI or dynamic CT myelography in patients with SS. The use of a coronary angioscope for the spinal endoscopy combined with selective CT myelography may provide an effective examination to assess dural closure of the spinal dural defect with SS in cases without obvious dural defects on conventional imaging.

  12. Automated Inadvertent Intruder Application

    International Nuclear Information System (INIS)

    Koffman, Larry D.; Lee, Patricia L.; Cook, James R.; Wilhite, Elmer L.

    2008-01-01

    The Environmental Analysis and Performance Modeling group of Savannah River National Laboratory (SRNL) conducts performance assessments of the Savannah River Site (SRS) low-level waste facilities to meet the requirements of DOE Order 435.1. These performance assessments, which result in limits on the amounts of radiological substances that can be placed in the waste disposal facilities, consider numerous potential exposure pathways that could occur in the future. One set of exposure scenarios, known as inadvertent intruder analysis, considers the impact on hypothetical individuals who are assumed to inadvertently intrude onto the waste disposal site. Inadvertent intruder analysis considers three distinct scenarios for exposure referred to as the agriculture scenario, the resident scenario, and the post-drilling scenario. Each of these scenarios has specific exposure pathways that contribute to the overall dose for the scenario. For the inadvertent intruder analysis, the calculation of dose for the exposure pathways is a relatively straightforward algebraic calculation that utilizes dose conversion factors. Prior to 2004, these calculations were performed using an Excel spreadsheet. However, design checks of the spreadsheet calculations revealed that errors could be introduced inadvertently when copying spreadsheet formulas cell by cell and finding these errors was tedious and time consuming. This weakness led to the specification of functional requirements to create a software application that would automate the calculations for inadvertent intruder analysis using a controlled source of input parameters. This software application, named the Automated Inadvertent Intruder Application, has undergone rigorous testing of the internal calculations and meets software QA requirements. The Automated Inadvertent Intruder Application was intended to replace the previous spreadsheet analyses with an automated application that was verified to produce the same calculations and

  13. Dural sinus filling defect: intrasigmoid encephalocele

    Science.gov (United States)

    Karatag, Ozan; Cosar, Murat; Kizildag, Betul; Sen, Halil Murat

    2013-01-01

    Filling defects of dural venous sinuses are considered to be a challenging problem especially in case of symptomatic patients. Many lesions have to be ruled out such as sinus thrombosis, arachnoid granulations and tumours. Encephalocele into dural sinus is also a rare cause of these filling defects of dural sinuses. Here, we report an extremely rare case with spontaneous occult invagination of temporal brain tissue into the left sigmoid sinus and accompanying cerebellar ectopia. PMID:24311424

  14. AUTOMATED INADVERTENT INTRUDER APPLICATION

    International Nuclear Information System (INIS)

    Koffman, L; Patricia Lee, P; Jim Cook, J; Elmer Wilhite, E

    2007-01-01

    The Environmental Analysis and Performance Modeling group of Savannah River National Laboratory (SRNL) conducts performance assessments of the Savannah River Site (SRS) low-level waste facilities to meet the requirements of DOE Order 435.1. These performance assessments, which result in limits on the amounts of radiological substances that can be placed in the waste disposal facilities, consider numerous potential exposure pathways that could occur in the future. One set of exposure scenarios, known as inadvertent intruder analysis, considers the impact on hypothetical individuals who are assumed to inadvertently intrude onto the waste disposal site. Inadvertent intruder analysis considers three distinct scenarios for exposure referred to as the agriculture scenario, the resident scenario, and the post-drilling scenario. Each of these scenarios has specific exposure pathways that contribute to the overall dose for the scenario. For the inadvertent intruder analysis, the calculation of dose for the exposure pathways is a relatively straightforward algebraic calculation that utilizes dose conversion factors. Prior to 2004, these calculations were performed using an Excel spreadsheet. However, design checks of the spreadsheet calculations revealed that errors could be introduced inadvertently when copying spreadsheet formulas cell by cell and finding these errors was tedious and time consuming. This weakness led to the specification of functional requirements to create a software application that would automate the calculations for inadvertent intruder analysis using a controlled source of input parameters. This software application, named the Automated Inadvertent Intruder Application, has undergone rigorous testing of the internal calculations and meets software QA requirements. The Automated Inadvertent Intruder Application was intended to replace the previous spreadsheet analyses with an automated application that was verified to produce the same calculations and

  15. DURAL CAROTID-CAVERNOUS FISTULAS

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    Barbara Cvenkel

    2002-12-01

    Full Text Available Background. Dural carotid-cavernous sinus fistulas (CCF are communications fed by meningeal branches of the intracavernous internal carotid artery (ACI or/and external carotid artery (ACE. In contrast to typical CCF, the arteriovenous shunting of blood is usually low flow and low pressure. Spontaneous dural CCF are more common in postmenopausal women. Aetiology is unknown, but congenital malformation or rupture of thin-walled dural arteries within venous sinuses is believed to be the cause.Case reports. 3 cases lacking the typical clinical signs of CCF who had been treated as chronic conjunctivitis, myositis of the extraocular muscle and orbital pseudotumour are presented. Clinical presentation depends on the direction and magnitude of fistular flow and on the anatomy of the collateral branches. If increased blood flow is directed anteriorly in ophthalmic veins the signs of orbito-ocular congestion are present (»redeyed shunt syndrome«. Drainage primarly in the inferior petrosal sinus may cause painful oculomotor and abducens palsies without signs of ocular congestion (»white-eyed shunt syndrome«. Also different therapeutic approaches as well as possible complications are described.Conclusions. For definite diagnosis angiography is obligatory and is also therapeutic as one third to one half of dural CCF close spontaneously. Because of potential severe eye and systemic complications, surgical intervention is indicated only in cases with uncontrolled secondary glaucoma and hypoxic retinopathy.

  16. Fat in the dural sinus

    International Nuclear Information System (INIS)

    Tokiguchi, S.; Ando, K.; Tsuchiya, T.; Ito, J.

    1986-01-01

    Fat density in the dural sinus on computed tomography (CT) is described in eight cases. Of the eight cases, five had fat deposit in the torcular Herophili, and three in the superior sagittal sinus. This finding was incidentally found by CT and there was no common underlying disease in these cases. It is suggested that this finding represents normal adipose tissue in the dural sinus. (orig.)

  17. Tentorial artery embolization in tentorial dural arteriovenous fistulas

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    Rooij, Willem Jan van; Sluzewski, Menno [St. Elisabeth Ziekenhuis, Department of Radiology, Tilburg (Netherlands); Beute, Guus N [St. Elisabeth Ziekenhuis, Department of Neurosurgery, Tilburg (Netherlands)

    2006-10-15

    The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

  18. Tentorial artery embolization in tentorial dural arteriovenous fistulas

    International Nuclear Information System (INIS)

    Rooij, Willem Jan van; Sluzewski, Menno; Beute, Guus N.

    2006-01-01

    The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

  19. Dural ectasia and conventional radiography in the Marfan lumbosacral spine

    International Nuclear Information System (INIS)

    Ahn, N.U.; Nallamshetty, L.; Ahn, U.M.; Buchowski, J.M.; Kebaish, K.M.; Sponseller, P.D.; Rose, P.S.; Garrett, E.S.

    2001-01-01

    Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P 38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

  20. A traumatic dural arteriovenous fistula between the inferolateral trunk of the internal carotid artery and the ophthalmic vein: A case of transvenous coil embolization via the facial vein

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    Kim, Jun Young; Hong, Chang Ki; Suh, Sang Hyun [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Dong Ik [Dept. of of Radiology, CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2017-05-15

    A 31-year-old man was admitted with exophthalmos. He suffered from progressive exophthalmos, bruit and conjunctival chemosis 7 days after head trauma caused by falling down. Cerebral angiography showed a dural arteriovenous fistula (DAVF) draining into the ophthalmic vein caused by tear in the inferolateral trunk, which is a rare presentation of traumatic DAVF. Selective transvenous coil embolization was performed via the facial vein without neurologic complications.

  1. Evaluation of three different measurement methods for dural ectasia in Marfan syndrome

    International Nuclear Information System (INIS)

    Weigang, E.; Ghanem, N.; Chang, X.-C.; Richter, H.; Frydrychowicz, A.; Szabo, G.; Dudeck, O.; Knirsch, W.; Samson, P. von; Langer, M.; Beyersdorf, F.

    2006-01-01

    Aim: Dural ectasia is a major diagnostic criterion for Marfan syndrome using the Ghent nosology. Our aim was to evaluate the efficacy of three different radiological methods previously proposed for the assessment of dural sac diameter in Marfan syndrome. Methods: Marfan syndrome was diagnosed in our study using the Ghent criteria, disregarding dural ectasia as a criterion. Three proposed radiological methods were applied to measure dural sac diameter, examined for 41 patients (18 patients with and 23 without Marfan syndrome) by computed tomography or magnetic resonance imaging. Results: Using Oosterhof's method, 94% of the patients with and 44% of the patients without Marfan syndrome fulfilled the criteria of dural ectasia. According to Villeirs, dural ectasia was diagnosed in 18% of the patients with and in none of the patients without Marfan syndrome. With Ahn's method, dural ectasia was found in 72% of the patients with and in 44% of the patients without Marfan syndrome. In only two patients with Marfan syndrome was dural ectasia diagnosed by all three methods. Conclusion: Our results reveal overt discrepancy between the three methods of assessing dural ectasia. Considering the key role played by dural ectasia in reinforcing the diagnosis of Marfan syndrome according to the Ghent nosology, a standardized and reliable method should be sought

  2. Evaluation of three different measurement methods for dural ectasia in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Weigang, E.; Ghanem, N.; Chang, X.-C.; Richter, H.; Frydrychowicz, A.; Szabo, G.; Dudeck, O.; Knirsch, W.; Samson, P. von; Langer, M.; Beyersdorf, F

    2006-11-15

    Aim: Dural ectasia is a major diagnostic criterion for Marfan syndrome using the Ghent nosology. Our aim was to evaluate the efficacy of three different radiological methods previously proposed for the assessment of dural sac diameter in Marfan syndrome. Methods: Marfan syndrome was diagnosed in our study using the Ghent criteria, disregarding dural ectasia as a criterion. Three proposed radiological methods were applied to measure dural sac diameter, examined for 41 patients (18 patients with and 23 without Marfan syndrome) by computed tomography or magnetic resonance imaging. Results: Using Oosterhof's method, 94% of the patients with and 44% of the patients without Marfan syndrome fulfilled the criteria of dural ectasia. According to Villeirs, dural ectasia was diagnosed in 18% of the patients with and in none of the patients without Marfan syndrome. With Ahn's method, dural ectasia was found in 72% of the patients with and in 44% of the patients without Marfan syndrome. In only two patients with Marfan syndrome was dural ectasia diagnosed by all three methods. Conclusion: Our results reveal overt discrepancy between the three methods of assessing dural ectasia. Considering the key role played by dural ectasia in reinforcing the diagnosis of Marfan syndrome according to the Ghent nosology, a standardized and reliable method should be sought.

  3. Neck massage induced dural sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Verma Ashish

    2007-01-01

    Full Text Available Thrombosis of the intracranial dural sinuses and internal jugular veins may occur as a complication of head and neck infections, surgery, central venous access, local malignancy, polycythemia, hyperhomocysteinemia, neck massage and intravenous drug abuse. A high degree of clinical suspicion followed by adequate imaging is prerequisite to early diagnosis and management. We report a young man who had dural sinus thrombosis with jugular venous thrombosis following neck massage.

  4. Dural ectasia and conventional radiography in the Marfan lumbosacral spine

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, N U [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); Johns Hopkins Outpatient Center, Dept. of Orthopaedic Surgery, Baltimore, MD (United States); Nallamshetty, L; Ahn, U M; Buchowski, J M; Kebaish, K M; Sponseller, P D [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); Rose, P S [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (United States); Garrett, E S [Dept. of Oncology, Division of Biostatistics, Johns Hopkins University School of Medicine, Baltimore (United States)

    2001-06-01

    Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P<0.03); scalloping values at the L1 and L5 levels (P<0.05); sagittal diameters of the vertebral canal at L5-S1 (P<0.03); transverse process to width ratios at L2 (P<0.03). Criteria were developed for diagnosis of dural ectasia in Marfan patients. These included presence of one of the following: interpediculate distance at L4 >38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

  5. Traumatic dural venous sinus thrombosis: A Mini Review

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2016-09-01

    Full Text Available The dural venous sinus thrombosis is a benign disease, representing about 1% of cerebral vascular events. In some cases the development of the disease increased intracranial pressure or symptomatic epilepsy. The development towards a dural venous sinus thrombosis is rare, but is a condition to be considered before the development of ischemic vascular events and a history of recent head trauma. Intracranial hematomas or skull fractures can lead to the establishment of obstructive pathology of the dural venous sinuses. The knowledge of this entity is necessary for the critical care staff and neurosurgery staff.

  6. Symptomatic hemorrhagic complications associated with dural substitutes

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    Po-Yuan Chen

    2018-01-01

    Conclusion: The increased risk of hemorrhagic complications associated with craniotomy is modified by choice of dural replacement. Our results could assist clinicians in their decision-making with respect to the optimal timing for synthetic dural substitutes in patients with tumor infiltration of the patient's dura, severe brain swelling in traumatic brain injury, or a result of shrinkage from exposure and electrocautery.

  7. Bilateral subdural hematoma secondary to accidental dural puncture

    Directory of Open Access Journals (Sweden)

    Sofía Ramírez

    2015-07-01

    Full Text Available We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma.The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time. Resumo: Apresentamos o caso clínico de uma paciente de 25 anos de idade, na qual uma técnica peridural foi realizada durante o trabalho de parto e posteriormente apresentou cefaleia com características de cefaleia pós-punção dural. Foi iniciado tratamento conservador e tampão de sangue peridural. Devido a ausência de melhora clínica e à mudança do componente postural da cefaleia, decidiu-se realizar um exame de imagem cerebral que demostrou a presença de hematoma subdural bilateral.A cefaleia pós-punção dural é relativamente frequente, mas a falta de resposta ao tratamento médico instaurado, assim como a mudança em suas características e a presença de foco neurológico, devem levantar a suspeita de presença de um hematoma subdural que, embora infrequente, pode chegar a ser devastador se não for diagnosticado e tratado oportunamente. Keywords: Accidental dural puncture, Epidural analgesia, Post-dural puncture headache, Subdural hematoma, Epidural blood patch, Palavras chave: Dura-Máter, Analgesia epidural, Cefaleia pós-punção dural, Hematoma subdural, Placa de sangue epidural

  8. Dural ectasia and FBN1 mutation screening of 40 patients with Marfan syndrome and related disorders: role of dural ectasia for the diagnosis.

    Science.gov (United States)

    Attanasio, Monica; Pratelli, Elisa; Porciani, Maria Cristina; Evangelisti, Lucia; Torricelli, Elena; Pellicanò, Giannantonio; Abbate, Rosanna; Gensini, Gian Franco; Pepe, Guglielmina

    2013-07-01

    Marfan syndrome is an autosomal dominant disorder of connective tissue caused by mutations in the gene encoding fibrillin-1 (FBN1), a matrix component of microfibrils. Dural ectasia, i.e. enlargement of the neural canal mainly located in the lower lumbar and sacral region, frequently occurs in Marfan patients. The aim of our study was to investigate the role of dural ectasia in raising the diagnosis of Marfan syndrome and its association with FBN1 mutations. We studied 40 unrelated patients suspected for MFS, who underwent magnetic resonance imaging searching for dural ectasia. In all of them FBN1 gene analysis was also performed. Thirty-seven patients resulted affected by Marfan syndrome according to the '96 Ghent criteria; in 30 of them the diagnosis was confirmed when revaluated by the recently revised criteria (2010). Thirty-six patients resulted positive for dural ectasia. The degree of dural ectasia was grade 1 in 19 patients, grade 2 in 11 patients, and grade 3 in 6 patients. In 7 (24%) patients, the presence of dural ectasia allowed to reach a positive score for systemic feature criterion. Twenty-four patients carried an FBN1 mutation, that were represented by 13 missense (54%), and 11 (46%) mutations generating a premature termination codon (PTC, frameshifts and stop codons). No mutation was detected in the remaining 16 (6 patients with MFS and 10 with related disorders according to revised Ghent criteria). The prevalence of severe (grade 2 and grade 3) involvement of dura mater was higher in patients harbouring premature termination codon (PTC) mutations than those carrying missense-mutations (8/11 vs 2/13, P = 0.0111). Our data emphasizes the importance of dural ectasia screening to reach the diagnosis of Marfan syndrome especially when it is uncertain and indicates an association between PTC mutations and severe dural ectasia in Marfan patients. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  9. A New Classification for Pathologies of Spinal Meninges, Part 1: Dural Cysts, Dissections, and Ectasias.

    Science.gov (United States)

    Klekamp, Jörg

    2017-07-01

    The clinical significance of pathologies of the spinal dura is often unclear and their management controversial. To classify spinal dural pathologies analogous to vascular aneurysms, present their symptoms and surgical results. Among 1519 patients with spinal space-occupying lesions, 66 patients demonstrated dural pathologies. Neuroradiological and surgical features were reviewed and clinical data analyzed. Saccular dural diverticula (type I, n = 28) caused by defects of both dural layers, dissections between dural layers (type II, n = 29) due to defects of the inner layer, and dural ectasias (type III, n = 9) related to structural changes of the dura were distinguished. For all types, symptoms consisted of local pain followed by signs of radiculopathy or myelopathy, while one patient with dural ectasia presented a low-pressure syndrome and 10 patients with dural dissections additional spinal cord herniation. Type I and type II pathologies required occlusion of their dural defects via extradural (type I) or intradural (type II) approaches. For type III pathologies of the dural sac no surgery was recommended. Favorable results were obtained in all 14 patients with type I and 13 of 15 patients with type II pathologies undergoing surgery. The majority of dural pathologies involving root sleeves remain asymptomatic, while those of the dural sac commonly lead to pain and neurological symptoms. Type I and type II pathologies were treated with good long-term results occluding their dural defects, while ectasias of the dural sac (type III) were managed conservatively. Copyright © 2017 by the Congress of Neurological Surgeons

  10. Dural opening/removal for combined petrosal approach: technical note.

    Science.gov (United States)

    Terasaka, Shunsuke; Asaoka, Katsuyuki; Kobayashi, Hiroyuki; Sugiyama, Taku; Yamaguchi, Shigeru

    2011-03-01

    Detailed descriptions of stepwise dural opening/removal for combined petrosal approach are presented. Following maximum bone work, the first dural incision was made along the undersurface of the temporal lobe parallel to the superior petrosal sinus. Posterior extension of the dural incision was made in a curved fashion, keeping away from the transverse-sigmoid junction and taking care to preserve the vein of Labbé. A second incision was made perpendicular to the first incision. After sectioning the superior petrosal sinus around the porus trigeminus, the incision was extended toward the posterior fossa dura in the middle fossa region. The tentorium was incised toward the incisura at a point just posterior to the entrance of the trochlear nerve. A third incision was made longitudinally between the superior petrosal sinus and the jugular bulb. A final incision was initiated perpendicular to the third incision in the presigmoid region and extended parallel to the superior petrosal sinus connecting the second incision. The dural complex consisting of the temporal lobe dura, the posterior fossa dura, and the freed tentorium could then be removed. In addition to extensive bone resection, our strategic cranial base dural opening/removal can yield true advantages for the combined petrosal approach.

  11. Extrasinusal dural arteriovenous malformations

    International Nuclear Information System (INIS)

    Piske, R.L.; Lasjaunias, P.

    1988-01-01

    Of 60 cases of dural arteriovenous malformations (DAVM) explored and treated in the Vascular Neuroradiology Unit of the Hospital of Bicetre between 1980 and 1986, 3 presented in an extrasinusal location: intraorbital, middle cerebral fossa and the region of the superior orbital fissure. We have not found any prior description of DAVMs in these regions in the literature. The classic concept that DAVMs rise in direct relationship with the dural sinuses is limited. We believe that these lesions may also developed in relationship with the venous drainage system of the sinuses and the venous drainage of the peripheral nervous system. We note that the superior ophthalmic vein which drains DAVMs of the orbit and the olfactory vein which drains DAVMs of the anterior cranial fossa and other veins that accompany the cranial nerves through the skull base have the characteristics of emissary veins. It may be that DAVMs can develop wherever veins follow a transosseous trajectory. (orig.)

  12. Effectiveness of a new gelatin sealant system for dural closure.

    Science.gov (United States)

    Kawai, Hisashi; Nakagawa, Ichiro; Nishimura, Fumihiko; Motoyama, Yasushi; Park, Young-Su; Nakamura, Mitsutoshi; Nakase, Hiroyuki; Suzuki, Shuko; Ikada, Yoshito

    2014-10-01

    Watertight dural closure is imperative after neurosurgical procedures because inadequately treated leakage of cerebrospinal fluid (CSF) can have serious consequences. In this study, the authors test the use of a new gelatin glue as a dural sealant in in vitro and in vivo canine models of transdural CSF leakage. The in vitro model was sutured semicircles of canine dura mater and artificial dural substitute. The sutures were sealed with gelatin glue (n  =  20), fibrin glue (n  =  20), or a polyethylene glycol (PEG)-based hydrogel sealant (n  =  20). Each sample was set in a device to measure water pressure, and pressure was increased until leakage occurred. Bonding strength was subjectively evaluated. The in vivo model was dogs who underwent dural excision and received either no sealant (control group; n  =  5) or gelatin glue sealant (n  =  5) before dural closure. Twenty-eight days post-surgery, the maximum intracranial pressure was measured at the cisterna magna using Valsalva maneuver and tissue adhesion was evaluated. The water pressure at which leakage occurred in the in vitro model was higher with gelatin glue (76·5 ± 39·8 mmHg) than with fibrin glue (38·3 ± 27·4 mmHg, P control group (13·8 ± 4·0 mmHg, P control group (P  =  0·005). The new gelatin glue provides an effective watertight closure when used as an adjunct to sutured dural repair.

  13. post-operative morbidity of the obese patient undergoing posterior

    African Journals Online (AJOL)

    urinary tract infection, neurological injury and dural tears. Methods: One hundred consecutive patients undergoing ... muscle mass in the human body, in which weight in kilograms is divided by height in meters2). The current .... complications with the exception of one dural tear occurred in the obese patient group. Table 3.

  14. Efficacy and safety of small intestinal submucosa in dural defect repair in a canine model

    Energy Technology Data Exchange (ETDEWEB)

    He, Shu-kun [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Guo, Jin-hai [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Department of Orthopedics, The Third People' s Hospital of Chengdu, Chengdu, Sichuan 610031 (China); Wang, Zhu-le [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Zhang, Yi [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Tu, Yun-hu [Department of Neurosurgery, Chengdu Military General Hospital, Chengdu, Sichuan 610083 (China); Wu, Shi-zhou [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Huang, Fu-guo [Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Xie, Hui-qi, E-mail: xiehuiqi@scu.edu.cn [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China)

    2017-04-01

    Dural defects are a common problem, and inadequate dural closure can lead to complications. Several types of dural substitute materials have recently been discarded or modified owing to poor biocompatibility or mechanical properties and adverse reactions. The small intestinal submucosa (SIS) is a promising material used in a variety of applications. Based on the limitations of previous studies, we conducted an animal study to evaluate the efficacy and safety of the SIS in preclinical trials. Twenty-four male beagle dogs were subjected to surgical resection to produce dural defects. SIS or autologous dural mater was patched on the dural defect. Gross and histological evaluations were carried out to evaluate the efficacy and safety of the therapy. Our findings demonstrated that the SIS, which stimulated connective and epithelial tissue responses for dural regeneration and functional recovery without immunological rejection, could provide prolonged defect repair and prevent complications. The mechanical properties of the SIS could be adjusted by application of multiple layers, and the biocompatibility of the material was appropriate. Thus, our data suggested that this material may represent an alternative option for clinical treatment of dural defects. - Highlights: • SIS stimulates dura regeneration without immunological rejection. • SIS has adjustable mechanical properties and appropriate biocompatibility. • SIS may be an effective alternative option for clinical treatment of dural defects.

  15. Efficacy and safety of small intestinal submucosa in dural defect repair in a canine model

    International Nuclear Information System (INIS)

    He, Shu-kun; Guo, Jin-hai; Wang, Zhu-le; Zhang, Yi; Tu, Yun-hu; Wu, Shi-zhou; Huang, Fu-guo; Xie, Hui-qi

    2017-01-01

    Dural defects are a common problem, and inadequate dural closure can lead to complications. Several types of dural substitute materials have recently been discarded or modified owing to poor biocompatibility or mechanical properties and adverse reactions. The small intestinal submucosa (SIS) is a promising material used in a variety of applications. Based on the limitations of previous studies, we conducted an animal study to evaluate the efficacy and safety of the SIS in preclinical trials. Twenty-four male beagle dogs were subjected to surgical resection to produce dural defects. SIS or autologous dural mater was patched on the dural defect. Gross and histological evaluations were carried out to evaluate the efficacy and safety of the therapy. Our findings demonstrated that the SIS, which stimulated connective and epithelial tissue responses for dural regeneration and functional recovery without immunological rejection, could provide prolonged defect repair and prevent complications. The mechanical properties of the SIS could be adjusted by application of multiple layers, and the biocompatibility of the material was appropriate. Thus, our data suggested that this material may represent an alternative option for clinical treatment of dural defects. - Highlights: • SIS stimulates dura regeneration without immunological rejection. • SIS has adjustable mechanical properties and appropriate biocompatibility. • SIS may be an effective alternative option for clinical treatment of dural defects.

  16. ''Dural tail'' adjacent to acoustic neuroma on MRI: a case report

    International Nuclear Information System (INIS)

    Lunardi, P.; Mastronardi, L.; Nardacci, B.; Acqui, M.; Fortuna, A.

    1993-01-01

    A 'dural tail' on Gd-DTPA-enhanced MRI has been often observed adjacent to meningiomas and considered to be useful in distinguishing meningioma of the cerebellopontine angle from acoustic neuroma. However, demonstration of a dural tail adjacent to an acoustic neuroma indicates that this sign is not specific. (orig.)

  17. How I do it: surgical ligation of craniocervical junction dural AV fistulas.

    Science.gov (United States)

    Sorenson, Thomas J; La Pira, Biagia; Hughes, Joshua; Lanzino, Giuseppe

    2017-08-01

    Dural arteriovenous fistulas (DAVFs) of the craniocervical junction are uncommon vascular lesions, which often require surgical treatment even in the endovascular era. Most commonly, the fistula is placed laterally, and surgical ligation is performed through a lateral suboccipital craniotomy. After dural opening, the area is inspected, and the arterialized vein is identified emerging from the dura, often adjacent to the entry point of the vertebral artery, and ligated. A far lateral craniotomy is the authors' preferred surgical approach for accessing and treating dural arteriovenous fistulas of the craniocervical junction that cannot be reached endovascularly.

  18. Prevalence of dural ectasia in Loeys-Dietz syndrome: comparison with Marfan syndrome and normal controls.

    Directory of Open Access Journals (Sweden)

    Atsushi K Kono

    Full Text Available BACKGROUND AND PURPOSE: Dural ectasia is well recognized in Marfan syndrome (MFS as one of the major diagnostic criteria, but the exact prevalence of dural ectasia is still unknown in Loeys-Dietz syndrome (LDS, which is a recently discovered connective tissue disease. In this study, we evaluated the prevalence of dural ectasia in LDS according by using qualitative and quantitative methods and compared our findings with those for with MFS and normal controls. MATERIAL AND METHODS: We retrospectively studied 10 LDS (6 males, 4 females, mean age 36.3 years and 20 MFS cases (12 males, 8 females, mean age 37.1 years and 20 controls (12 males, 8 females, mean age 36.1 years both qualitatively and quantitatively using axial CT images and sagittal multi-planar reconstruction images of the lumbosacral region. For quantitative examination, we adopted two methods: method-1 (anteroposterior dural diameter of S1> L4 and method-2 (ratio of anteroposterior dural diameter/vertebral body diameter>cutoff values. The prevalence of dural ectasia among groups was compared by using Fisher's exact test and the Tukey-Kramer test. RESULTS: In LDS patients, the qualitative method showed 40% of dural ectasia, the quantitative method-1 50%, and the method-2 70%. In MFS patients, the corresponding prevalences were 50%, 75%, and 85%, and in controls, 0%, 0%, and 5%. Both LDS and MFS had a significantly wider dura than controls. CONCLUSIONS: While the prevalence of dural ectasia varied depending on differences in qualitative and quantitative methods, LDS as well as MFS, showed, regardless of method, a higher prevalence of dural ectasia than controls. This finding should help the differentiation of LDS from controls.

  19. Firewater system inadvertent actuation frequencies

    International Nuclear Information System (INIS)

    Schroeder, J.A.; Eide, S.A.

    1993-01-01

    This paper presents some recommended generic values for fire protection system inadvertent actuation frequencies. The frequencies are based on actual data from Department of Energy and commercial reactor plant facilities

  20. Intracranial Dural Metastasis of Ewing's Sarcoma: a Case Report

    International Nuclear Information System (INIS)

    Kim, Eung Yeop; Lee, Seung Koo; Kim, Dong Joon; Kim, Jin Na; Lee, Kyu Sung; Jung, Woo Hee; Kim, Dong Ik

    2008-01-01

    Ewing's sarcoma is a malignant bone tumor that can occur anywhere in the body, but it is most commonly observed in the long bones of the arms and legs, the pelvis and in the chest. The predominant sites of metastasis include the lung (38%), bone (including the spine; 31%), and the bone marrow (11%). Metastasis of Ewing's sarcoma to the central nervous system (CNS) is relatively rare, and most of the previous reports have demonstrated involvement of the bony calvarium or brain parenchyma. We describe here the imaging findings of dural metastasis of Ewing's sarcoma, and these imaging findings have not been previously reported on in the medical literature. In conclusion, dural metastasis of Ewing's sarcoma is very rare and its imaging characteristics are similar to those of a primary tumor, which mimic the findings of a schwannoma or meningioma. Despite its rarity, secondary Ewing's sarcoma may be included in the differential diagnosis of extra-axial dural masses

  1. Comparison of the efficiency, side effects and complications of the synthetic dural grafts: Beriplast and Tissudura

    OpenAIRE

    HAMZAOĞLU, Vural; ÖZALP, Hakan; KARKUCAK, Ahmet; ÇOKLUK, Cengiz

    2015-01-01

    The purpose of this study was to compare human fibrinogen-thrombin-based liquid dural graft; Beriplast® (Behring, Malburg, Germany) and collagen-based dural graft; Tissudura® (Baxter, Heidelberg, Germany) in terms of efficiency, side effects and complications. Thirty Spraque Dawley rats were used in this experimental study. A burrhole was opened on the left parietal bone of each subject and experimental dural defect was created. While 10 subjects were in sham group without any dural defect re...

  2. Bacterial Cellulose Membranes Used as Artificial Substitutes for Dural Defection in Rabbits

    Directory of Open Access Journals (Sweden)

    Chen Xu

    2014-06-01

    Full Text Available To improve the efficacy and safety of dural repair in neurosurgical procedures, a new dural material derived from bacterial cellulose (BC was evaluated in a rabbit model with dural defects. We prepared artificial dura mater using bacterial cellulose which was incubated and fermented from Acetobacter xylinum. The dural defects of the rabbit model were repaired with BC membranes. All surgeries were performed under sodium pentobarbital anesthesia, and all efforts were made to minimize suffering. All animals were humanely euthanized by intravenous injection of phenobarbitone, at each time point, after the operation. Then, the histocompatibility and inflammatory effects of BC were examined by histological examination, real-time fluorescent quantitative polymerase chain reaction (PCR and Western Blot. BC membranes evenly covered the surface of brain without adhesion. There were seldom inflammatory cells surrounding the membrane during the early postoperative period. The expression of inflammatory cytokines IL-1β, IL-6 and TNF-α as well as iNOS and COX-2 were lower in the BC group compared to the control group at 7, 14 and 21 days after implantation. BC can repair dural defects in rabbit and has a decreased inflammatory response compared to traditional materials. However, the long-term effects need to be validated in larger animals.

  3. The tear turnover and tear clearance tests - a review.

    Science.gov (United States)

    Garaszczuk, Izabela K; Montes Mico, Robert; Iskander, D Robert; Expósito, Alejandro Cerviño

    2018-03-01

    The aim is to provide a summary of methods available for the assessment of tear turnover and tear clearance rates. The review defines tear clearance and tear turnover and describes their implication for ocular surface health. Additionally, it describes main types of techniques for measuring tear turnover, including fluorescein tear clearance tests, techniques utilizing electromagnetic spectrum and tracer molecule and novel experimental techniques utilizing optical coherence tomography and fluorescein profilometry. Areas covered: Internet databases (PubMed, Science Direct, Google Scholar) and most frequently cited references were used as a principal resource of information on tear turnover rate and tear clearance rate, presenting methodologies and equipment, as well as their definition and implications for the anterior eye surface health and function. Keywords used for data-search were as follows: tear turnover, tear clearance, fluorescein clearance, scintigraphy, fluorophotometry, tear flow, drainage, tear meniscus dynamics, Krehbiel flow and lacrimal functional unit. Expert commentary: After decades, the topic of tear turnover assessment has been reintroduced. Recently, new techniques have been developed to propose less invasive, less time consuming and simpler methodologies for the assessment of tear dynamics that have the potential to be utilized in clinical practice.

  4. Evaluation of venous congestion in dural arteriovenous fistulae using the acetazolamide test

    International Nuclear Information System (INIS)

    Deguchi, Jun; Yamada, Makoto; Kobata, Hitoshi; Kuroiwa, Toshihiko

    2002-01-01

    The pattern of venous drainage determines the clinical presentation of dural arteriovenous fistulas (AVFs). We assessed the degree of venous congestion in dural AVFs using acetazolamide test and stable Xenon-CT. In 11 patients (8 sigmoid-transverse dural AVFs, 3 cavernous dural AVFs) before treatment and in 8 patients 6 months after treatment, cerebral hemodynamics were studied by stable Xenon-CT. Regions of interest (ROI) were placed in the temporo-occipital region in cases of sigmoid-transverse AVFs, and in the frontal operculum in cases of cavernous AVFs. Patients were classified into 5 groups according to Cognard's classification. In the groups without venous reflux (Cognard type I) and reflux only to the venous sinus (type IIa), regional cerebral blood flow (rCBF) at rest and after acetazolamide challenge were normal. In the group showing reflux to the cortical vein (type IIb), the increase in rCBF after acetazolamide challenge on the lesion side was less than that on the opposite side. In the group showing reflux to both cortical vein and sinus (type IIa+b), rCBF did not increase after acetazolamide challenge. The CBF and increase in rCBF after acetazolamide in the symptomatic group were significantly lower than those in the asymptomatic group. After embolization, the increase in rCBF by acetazolamide improved in all except for type III cases. Cerebral venous hypertension in dural AVFs causes weak response to acetazolamide challenge. The degree of venous hypertension can be evaluated quantitatively by acetazolamide challenge and stable Xenon-CT. Therefore acetazolamide challenge is useful for determination of the embolization of dural AVFs. (author)

  5. A dural metastatic small cell carcinoma of the gallbladder as the first manifestation: a case report.

    Science.gov (United States)

    Tonomura, Shuichi; Kitaichi, Tomoko; Onishi, Rina; Kakehi, Yoshiaki; Shimizu, Hisao; Shimada, Keiji; Kanemasa, Kazuyuki; Fukusumi, Akio; Takahashi, Nobuyuki

    2018-03-16

    A dural metastasis is one of the essential differential diagnoses of meningioma. In general, carcinomas of the breast and lung in females and prostate in males have been the most commonly reported primary lesions of dural metastases. However, dural metastasis of gallbladder carcinoma is extremely rare. Here, we report a unique case of a dural matter metastasis of gallbladder carcinoma as the first manifestation, which was autopsy-defined as small cell carcinoma. A 78-year-old man came to our hospital complaining of left hemianopia. Brain computed tomography (CT) revealed a sizeable parasagittal dural-based extra-axial tumor. However, the findings for meningioma were atypical by magnetic resonance imaging, suggesting a meningioma mimic. A contrast-enhanced CT scan of the abdomen revealed a large gallbladder carcinoma. The patient opted for the best supportive care and died 2 months later. The post-mortem examination revealed small cell carcinoma in gallbladder carcinoma. Moreover, an immunologically similar carcinoma was detected in the dural metastasis. To the best of our knowledge, this is the first case of a dural metastasis of gallbladder small cell carcinoma. A systemic examination is essential for clinicians when atypical findings of meningioma are observed, suggesting a meningioma mimic. We present this rare case with a review of the literature.

  6. Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb.

    Science.gov (United States)

    Tirakotai, W; Benes, L; Kappus, C; Sure, U; Farhoud, A; Bien, S; Bertalanffy, H

    2007-01-01

    Dural arteriovenous fistulas located in the vicinity of the jugular foramen are complex vascular malformations and belong to the most challenging skull base lesions to treat. The authors comprehensively analyze multiple features in a series of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb. Four patients who underwent surgery via the transcondylar approach to treat dural arteriovenous fistulas around the jugular foramen were retrospectively reviewed. Previously, endovascular treatment was attempted in all patients. The success of the surgical treatment was examined with postoperative angiography. Complete obliteration of the dural arteriovenous fistulas (DAVFs) was achieved in three patients, and significant flow reduction in one individual. All patients had a good postoperative outcome, and only one experienced mild hypoglossal nerve palsy. Despite extensive bone drilling, an occipitocervical fusion was necessary in only one patient with bilateral lesions. The use of an individually tailored transcondylar approach to treat dural arteriovenous fistulas at the region of the jugular foramen is most effective. This approach allows for complete obliteration of the connecting arterial feeders, and removal of bony structures containing pathological vessels.

  7. Phase-contrast MR angiography of intracranial dural arteriovenous fistulae

    International Nuclear Information System (INIS)

    Cellerini, M.; Mascalchi, M.; Mangiafico, S.; Ferrito, G.P.; Scardigli, V.; Pellicano, G.; Quilici, N.

    1999-01-01

    MRI and phase-contrast MR angiography (PC MRA) were obtained in 13 patients with angiographically confirmed intracranial dural arteriovenous fistulae (DAVF). Three- and two-dimensional PC MRA was obtained with low (6-20 cm/s) and high (>40 cm/s) velocity encoding along the three main body axes. MRI showed focal or diffuse signal abnormalities in the brain parenchyma in six patients, dilated cortical veins in seven, venous pouches in four with type IV DAVF and enlargement of the superior ophthalmic vein in three patients with DAVF of the cavernous sinus. However, it showed none of the fistula sites and did not allow reliable identification of feeding arteries. 3D PC MRA enabled identification of the fistula and enlarged feeding arteries in six cases each. Stenosis or occlusion of the dural sinuses was detected in six of eight cases on 3D PC MRA with low velocity encoding. In six patients with type II DAVF phase reconstruction of 2D PC MRA demonstrated flow reversal in the dural sinuses or superior ophthalmic vein. (orig.)

  8. Cranial dural arteriovenous fistula as a rare cause of tinnitus – case report

    International Nuclear Information System (INIS)

    Kuśmierska, Małgorzata; Gać, Paweł; Nahorecki, Artur; Szuba, Andrzej; JaŸwiec, Przemysław

    2013-01-01

    Tinnitus, occurring at least once in a lifetime in about 10–20% of the population, is an important clinical problem with complex etiology. Rare causes of tinnitus include cranial dural arteriovenous fistulas (DAVFs), which are usually small lesions consisting of abnormal connections between branches of dural arteries and venous sinuses or veins. Authors present a case of a 44-year-old woman with persistent, unilateral, treatment-resistant pulsatile tinnitus caused by a small dural arteriovenous fistula revealed in computed tomography angiography. Computed tomography angiography is a useful diagnostic method that in some cases allows for establishing the cause of unilateral, pulsatile tinnitus

  9. Cranial dural arteriovenous fistula as a rare cause of tinnitus – case report

    Energy Technology Data Exchange (ETDEWEB)

    Kuśmierska, Małgorzata; Gać, Paweł [Department of Medical Radiology and Imaging Diagnostics, 4th Military Clinical Hospital, Wrocław (Poland); Nahorecki, Artur [Department of Internal Diseases, 4th Military Clinical Hospital, Wrocław (Poland); Szuba, Andrzej [Department of Internal Diseases, 4th Military Clinical Hospital, Wrocław (Poland); Medical University, Wrocław (Poland); JaŸwiec, Przemysław [Department of Medical Radiology and Imaging Diagnostics, 4th Military Clinical Hospital, Wrocław (Poland)

    2013-07-01

    Tinnitus, occurring at least once in a lifetime in about 10–20% of the population, is an important clinical problem with complex etiology. Rare causes of tinnitus include cranial dural arteriovenous fistulas (DAVFs), which are usually small lesions consisting of abnormal connections between branches of dural arteries and venous sinuses or veins. Authors present a case of a 44-year-old woman with persistent, unilateral, treatment-resistant pulsatile tinnitus caused by a small dural arteriovenous fistula revealed in computed tomography angiography. Computed tomography angiography is a useful diagnostic method that in some cases allows for establishing the cause of unilateral, pulsatile tinnitus.

  10. Meningeal norepinephrine produces headache behaviors in rats via actions both on dural afferents and fibroblasts.

    Science.gov (United States)

    Wei, Xiaomei; Yan, Jin; Tillu, Dipti; Asiedu, Marina; Weinstein, Nicole; Melemedjian, Ohannes; Price, Theodore; Dussor, Gregory

    2015-10-01

    Stress is commonly reported to contribute to migraine although mechanisms by which this may occur are not fully known. The purpose of these studies was to examine whether norepinephrine (NE), the primary sympathetic efferent transmitter, acts on processes in the meninges that may contribute to the pain of migraine. NE was applied to rat dura using a behavioral model of headache. Primary cultures of rat trigeminal ganglia retrogradely labeled from the dura mater and of rat dural fibroblasts were prepared. Patch-clamp electrophysiology, Western blot, and ELISA were performed to examine the effects of NE. Conditioned media from NE-treated fibroblast cultures was applied to the dura using the behavioral headache model. Dural injection both of NE and media from NE-stimulated fibroblasts caused cutaneous facial and hindpaw allodynia in awake rats. NE application to cultured dural afferents increased action potential firing in response to current injections. Application of NE to dural fibroblasts increased phosphorylation of ERK and caused the release of interleukin-6 (IL-6). These data demonstrate that NE can contribute to pro-nociceptive signaling from the meninges via actions on dural afferents and dural fibroblasts. Together, these actions of NE may contribute to the headache phase of migraine. © International Headache Society 2015.

  11. Detector location selection based on VIP analysis in near-infrared detection of dural hematoma

    Directory of Open Access Journals (Sweden)

    Qiuming Sun

    2018-03-01

    Full Text Available Detection of dural hematoma based on multi-channel near-infrared differential absorbance has the advantages of rapid and non-invasive detection. The location and number of detectors around the light source are critical for reducing the pathological characteristics of the prediction model on dural hematoma degree. Therefore, rational selection of detector numbers and their distances from the light source is very important. In this paper, a detector position screening method based on Variable Importance in the Projection (VIP analysis is proposed. A preliminary modeling based on Partial Least Squares method (PLS for the prediction of dural position μa was established using light absorbance information from 30 detectors located 2.0–5.0 cm from the light source with a 0.1 cm interval. The mean relative error (MRE of the dural position μa prediction model was 4.08%. After VIP analysis, the number of detectors was reduced from 30 to 4 and the MRE of the dural position μa prediction was reduced from 4.08% to 2.06% after the reduction in detector numbers. The prediction model after VIP detector screening still showed good prediction of the epidural position μa. This study provided a new approach and important reference on the selection of detector location in near-infrared dural hematoma detection. Keywords: Detector location screening, Epidural hematoma detection, Variable importance in the projection

  12. Exploring key considerations when determining bona fide inadvertent errors resulting in understatements

    Directory of Open Access Journals (Sweden)

    Chrizanne de Villiers

    2016-03-01

    Full Text Available Chapter 16 of the Tax Administration Act (28 of 2011 (the TA Act deals with understatement penalties. In the event of an ‘understatement’, in terms of Section 222 of the TA Act, a taxpayer must pay an understatement penalty, unless the understatement results from a bona fide inadvertent error. The determining of a bona fide inadvertent error on taxpayers’ returns is a totally new concept in the tax fraternity. It is of utmost importance that this section is applied correctly based on sound evaluation principles and not on professional judgement when determining if the error was indeed the result of a bona fide inadvertent error. This research study focuses on exploring key considerations when determining bona fide inadvertent errors resulting in understatements. The role and importance of tax penalty provisions is explored and the meaning of the different components in the term ‘bona fide inadvertent error’ critically analysed with the purpose to find a possible definition for the term ‘bona fide inadvertent error’. The study also compares the provisions of other tax jurisdictions with regards to errors made resulting in tax understatements in order to find possible guidelines on the application of bona fide inadvertent errors as contained in Section 222 of the TA Act. The findings of the research study revealed that the term ‘bona fide inadvertent error’ contained in Section 222 of the TA Act should be defined urgently and that guidelines must be provided by SARS on the application of the new amendment. SARS should also clarify the application of a bona fide inadvertent error in light of the behaviours contained in Section 223 of the TA Act to avoid any confusion.

  13. Managing Inadvertent Arterial Catheterization During Central Venous Access Procedures

    International Nuclear Information System (INIS)

    Nicholson, Tony; Ettles, Duncan; Robinson, Graham

    2004-01-01

    Purpose: Approximately 200,000 central venous catheterizations are carried out annually in the National Health Service in the United Kingdom. Inadvertent arterial puncture occurs in up to 3.7%. Significant morbidity and death has been reported. We report on our experience in the endovascular treatment of this iatrogenic complication. Methods: Retrospective analysis was carried out of 9 cases referred for endovascular treatment of inadvertent arterial puncture during central venous catheterization over a 5 year period. Results: It was not possible to obtain accurate figures on the numbers of central venous catheterizations carried out during the time period. Five patients were referred with carotid or subclavian pseudoaneurysms and hemothorax following inadvertent arterial catheter insertion and subsequent removal. These patients all underwent percutaneous balloon tamponade and/or stent-graft insertion. More recently 4 patients were referred with the catheter still in situ and were successfully treated with a percutaneous closure device. Conclusion: If inadvertent arterial catheterization during central venous access procedures is recognized and catheters removed, sequelae can be treated percutaneously. However, once the complication is recognized it is better to leave the catheter in situ and seal the artery percutaneously with a closure device

  14. Dural AVM supplied by the ophthalmic artery.

    LENUS (Irish Health Repository)

    Flynn, T H

    2012-02-03

    Dural arteriovenous malformations in the anterior cranial fossa are rare and are especially prone to haemorrhage. These lesions are usually treated by surgical excision. We report the embolization of an anterior cranial fossa DAVM using an endovascular approach via the ophthalmic artery.

  15. As tears go by : Baby tears trigger more brain activity than adult tears in nulliparous women

    NARCIS (Netherlands)

    Hendricx-Riem, M.M.E.; De Carli, P.; van IJzendoorn, M.H.; Vingerhoets, A.J.J.M.; Bakermans-Kranenburg, M.J.

    2017-01-01

    The current functional magnetic resonance imaging study examines brain activity during the perception of infant and adult tears. Infant tears evoke stronger responses in the visual cortex than adult tears, indicating that infant tears are highly salient. In addition, our study shows that infant

  16. Epidural Anesthesia Complicated by Subdural Hygromas and a Subdural Hematoma

    OpenAIRE

    Vien, Christine; Marovic, Paul; Ingram, Brendan

    2016-01-01

    Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause life-threatening subdural hematomas or cerebellar tonsillar herniation. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural hematoma following unintentional dural puncture during initiation of epidural anesthesia.

  17. Preclinical characterization and safety of a novel hydrogel for augmenting dural repair

    International Nuclear Information System (INIS)

    Strong, Michael J; Carnahan, Michael A; D’Alessio, Keith; Butlin, Jared D G; Butt, Mark T; Asher, Anthony L

    2015-01-01

    Cerebrospinal fluid (CSF) leakage is a potentially serious complication in surgical procedures involving opening of the dura mater. Although several materials have been developed to help achieve watertight dural closures, CSF leakages persist. The goal of this study was to evaluate the performance of a novel hydrogel designed to provide augmentation to standard methods of dural repair. Performance measures such as polymerization time, dimensional swelling, burst strength, and elasticity were examined in laboratory situations. Additionally, biocompatibility in an in vivo rat model was examined. The results demonstrate that this novel hydrogel has superior mechanical strength and tissue adherence with enhanced flexibility, reduced swelling, and quicker set time compared with existing hydrogel dural sealants approved for intra-cranial use. Furthermore, biocompatibility studies demonstrate that this compound is both non-toxic and non-immunogenic. (paper)

  18. Spontaneous acute subdural hematoma: A rare presentation of a dural intracranial fistula.

    Science.gov (United States)

    de Aguiar, Guilherme Brasileiro; Veiga, José Carlos Esteves; Silva, João Miguel de Almeida; Conti, Mario Luiz Marques

    2016-03-01

    Dural arteriovenous fistulas are acquired lesions between the meningeal arteries and their associated draining veins. They may have highly variable clinical presentations and evolution, from severe neurological deficit to no or trivial symptoms. Intracranial hemorrhage occurs in less than 24% of all dural fistulas, and the bleeding is usually subarachnoid, more infrequently intracerebral, and rarely in the subdural space. Here, we present a rare case of a patient who presented with a subdural spontaneous hemorrhage. After investigation by cerebral angiography, the diagnosis of a dural arteriovenous fistula was made. The patient underwent uneventful endovascular treatment. As there are with only a few reports in the literature of such a presentation, we present this patient and perform a brief review of the literature. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Dural sinus thrombosis - A rare manifestation of internal jugular venous occlusion

    Directory of Open Access Journals (Sweden)

    Pooja Binnani

    2012-01-01

    Full Text Available The dural sinus thrombosis is an uncommon complication of a commonly done procedure of central venous catheterisation. We present a case of massive hemorrhagic venous infarct with gross cerebral edema due to dural sinus thrombosis along with right internal jugular vein thrombus. A 21-year-old male patient presented to the emergency department with fever and swelling of the right neck four days following discharge after his prior hospitalization two weeks ago for acute renal failure due to severe gastroenteritis, when he underwent hemodialysis through right internal jugular access. On presentation, he was conscious, with swelling on right side of the neck, which was diagnosed as right internal jugular vein occlusion. However, he rapidly dete-riorated and developed signs of raised intracranial pressure despite being on treatment with heparin. He was diagnosed as having massive hemorrhagic cerebral venous infarct with gross cerebral edema complicated with shift of the ventricles to the left due to dural sinus thrombosis. Despite emergency decompressive craniotomy, he succumbed in the next two days due to coning. Asymptomatic catheter-related thrombosis is frequent in the intensive care units, but major complications like retrograde extension into dural sinus causing thrombosis is rare. A high index of suspicion is required to diagnose this major catastrophe for an early and meaningful intervention.

  20. Anterior dural ectasia mimicking a lytic lesion in the posterior vertebral body in ankylosing spondylitis.

    Science.gov (United States)

    Bele, Keerthiraj; Pendharkar, Hima Shriniwas; Venkat, Easwer; Gupta, Arun Kumar

    2011-12-01

    Anterior dural ectasia is an extremely rare finding in ankylosing spondylitis (AS). The authors describe a unique case of AS in which the patient presented with cauda equina syndrome as well as an unusual imaging finding of erosion of the posterior aspect of the L-1 (predominantly) and L-2 vertebral bodies due to anterior dural ectasia. Symptomatic patients with long-standing AS should be monitored for the presence of dural ectasia, which can be anterior in location, as is demonstrated in the present case.

  1. Refractory seizures due to a dural-based cavernoma masquerading as a meningioma.

    Science.gov (United States)

    Zeng, Xianwei; Mahta, Ali; Kim, Ryan Y; Saad, Ali G; Kesari, Santosh

    2012-04-01

    A 37-year-old female presented with medically intractable complex partial seizures with secondary generalization. She was found to have a dural-based lesion with radiologic features of meningioma. A gross total resection was performed and pathology confirmed a diagnosis of cavernous angioma and she became seizure free after the surgical resection. Cavernous angioma should be considered in differential diagnosis of a dural-based lesion manifesting with refractory seizures.

  2. Evaluation of the effect of hemoglobin or hematocrit level on dural sinus density using unenhanced computed tomography.

    Science.gov (United States)

    Lee, Seung Young; Cha, Sang-Hoon; Lee, Sung-Hyun; Shin, Dong-Ick

    2013-01-01

    To identify the relationship between hemoglobin (Hgb) or hematocrit (Hct) level and dural sinus density using unenhanced computed tomography (UECT). Patients who were performed UECT and had records of a complete blood count within 24 hours from UECT were included (n=122). We measured the Hounsfield unit (HU) of the dural sinus at the right sigmoid sinus, left sigmoid sinus and 2 points of the superior sagittal sinus. Quantitative measurement of dural sinus density using the circle regions of interest (ROI) method was calculated as average ROI values at 3 or 4 points. Simple regression analysis was used to evaluate the correlation between mean HU and Hgb or mean HU and Hct. The mean densities of the dural sinuses ranged from 24.67 to 53.67 HU (mean, 43.28 HU). There was a strong correlation between mean density and Hgb level (r=0.832) and between mean density and Hct level (r=0.840). Dural sinus density on UECT is closely related to Hgb and Hct levels. Therefore, the Hgb or Hct levels can be used to determine whether the dural sinus density is within the normal range or pathological conditions such as venous thrombosis.

  3. A Rare Case of Composite Dural Extranodal Marginal Zone Lymphoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

    Directory of Open Access Journals (Sweden)

    Mark Bustoros

    2018-04-01

    Full Text Available BackgroundPrimary extranodal marginal zone lymphoma (MZL of the dura is a rare neoplastic entity in the central nervous system (CNS.MethodsWe used literature searches to identify previously reported cases of primary dural MZL. We also reviewed clinical, pathologic, and radiographic data of an adult patient with concurrent dural MZL and chronic lymphocytic leukemia (CLL/small lymphocytic lymphoma (SLL.ResultsWe identified 104 cases of dural MZL in the literature. None of them presented concurrently with another type of non-Hodgkin lymphoma. This is the first report of composite lymphoma consisting of dural MZL and CLL/SLL in the bone marrow and lymph nodes.ConclusionPrimary dural MZL is a rare, indolent low-grade CNS lymphoma, with a relatively good prognosis. Its treatment is multidisciplinary and often requires surgical intervention due to brain compression, along with low to moderate doses of radiotherapy and/or systemic chemotherapy.

  4. Spontaneous Resolution of a Fetal Dural Sinus Thrombosis: One Case Report and Review of the Literatures

    Directory of Open Access Journals (Sweden)

    Chen Wang

    2012-01-01

    Full Text Available Fetal dural sinus thrombosis is a rare finding. Most cases have been terminated without long-term follow-ups. Recently some reports have indicated the potentially favorable evolution of fetal dural sinus thrombosis. Most of the fetuses showing symptoms have been delivered with normal neurologic outcome. We report a case of fetal dural sinus thrombosis. Serial ultrasound and magnetic resonance images (MRI showed the shrinkage of the thrombosis which indicated good prognosis. No physical or neurological abnormality was observed at 8-months follow-up. Conservative treatment is appropriate to prenatally diagnosed dural sinus thrombosis with favorable prognostic factors. Serial MRI or ultrasound should be taken every 1-2 months to monitor the thrombosis development and fetal well-beings.

  5. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules.

    Science.gov (United States)

    Aspelund, Aleksanteri; Antila, Salli; Proulx, Steven T; Karlsen, Tine Veronica; Karaman, Sinem; Detmar, Michael; Wiig, Helge; Alitalo, Kari

    2015-06-29

    The central nervous system (CNS) is considered an organ devoid of lymphatic vasculature. Yet, part of the cerebrospinal fluid (CSF) drains into the cervical lymph nodes (LNs). The mechanism of CSF entry into the LNs has been unclear. Here we report the surprising finding of a lymphatic vessel network in the dura mater of the mouse brain. We show that dural lymphatic vessels absorb CSF from the adjacent subarachnoid space and brain interstitial fluid (ISF) via the glymphatic system. Dural lymphatic vessels transport fluid into deep cervical LNs (dcLNs) via foramina at the base of the skull. In a transgenic mouse model expressing a VEGF-C/D trap and displaying complete aplasia of the dural lymphatic vessels, macromolecule clearance from the brain was attenuated and transport from the subarachnoid space into dcLNs was abrogated. Surprisingly, brain ISF pressure and water content were unaffected. Overall, these findings indicate that the mechanism of CSF flow into the dcLNs is directly via an adjacent dural lymphatic network, which may be important for the clearance of macromolecules from the brain. Importantly, these results call for a reexamination of the role of the lymphatic system in CNS physiology and disease. © 2015 Aspelund et al.

  6. Conduta na lesão dural intraoperatória em artrodese da coluna lombar Conducta en lesión de duramadre intraoperatoria en artrodesis de la columna lumbar Management of intraoperatory dural tear in lumbar spine arthrodesis

    OpenAIRE

    Fabiano de Mendonça Grandese; Clóvis Yamazato; Fábio Mastromauro de Oliveira; Iberê Ribeiro; José Olympio Catão Bastos Júnior; René Kusabara

    2010-01-01

    OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuário...

  7. Normal measurement of spinal cord and dural sac by CT myelography

    International Nuclear Information System (INIS)

    Yun, Ku Sub; Choi, Yo Won; Han, Moon Hee; Chang, Kee Hyun

    1988-01-01

    The data on the normal measurement of spinal cord are essential for an objective assessment of equivocal change of spinal cord size in the various clinical settings. The present study was therefore undertaken to evaluate normal range of spinal cord dimensions in Koreas. CT myelography of the cervical and thoracic region was performed in 60 patients who had symptoms referable to lumbosacral region and then computed tomographic measurement of spinal cord and dural sac was performed. The results are as follows: 1. The anteroposterior diameter of spinal cord was maximum at C1 level (8.6±1.4mm) and minimum at T6 level (6.4±1.7mm). 2. The transverse diameter of spinal cord was maximum at C4 and C5 levels (13.3±1.6mm) and minimum at T8 (8.1±1.9mm) and T10 (8.1±1.3mm) levels. 3. The area of spinal cord was maximum at C5 level (76±16mm 2 ) and minimum at T6 (40±24mm 2 ) and T8 (40±23mm 2 ) levels. 4. The ratio of anteroposterior diameter/transverse diameter of spinal cord was smallest at C4 (0.57±0.11) and C5 (0.57±0.09) levels and largest at T12 (0.9±0.17) level. 5. The ratio of anteroposterior diameter of spinal cord/dural sac was maximum at C4 level (0.73±0.14) and minimum at T12 level (0.52±0.15). The ratio of transverse diameter of spinal cord/dural sac was maximum at C3 (0.66±0.10) and C4 (0.66±0.14) levels and minimum at T12 level (0.46±0.18). The ratio of area of spinal cord/dural sac was maximum at C3 level (0.48±0.13) and minimum at T12 level (0.29±0.20). 6. The location of cervical cord in dural sac was mainly ventral (56%) at C1 level, middle (40-73%) from C2 to C6 level and dorsal (44%) at C7 level. The location of thoracic cord in dural sac was chiefly middle (61%) at T2 level and lower thoracic level (T10: 60% and T12: 51%) and mainly ventral (59-84%) at other levels.

  8. Epidural Anesthesia Complicated by Subdural Hygromas and a Subdural Hematoma

    Directory of Open Access Journals (Sweden)

    Christine Vien

    2016-01-01

    Full Text Available Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause life-threatening subdural hematomas or cerebellar tonsillar herniation. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural hematoma following unintentional dural puncture during initiation of epidural anesthesia.

  9. Imaging diagnosis of dural and direct cavernous carotid fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniela dos; Monsignore, Lucas Moretti; Nakiri, Guilherme Seizem; Cruz, Antonio Augusto Velasco e; Colli, Benedicto Oscar; Abud, Daniel Giansante, E-mail: danisantos2404@gmail.com [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2014-07-15

    Arteriovenous fistulae of the cavernous sinus are rare and difficult to diagnose. They are classified into dural cavernous sinus fistulae or direct carotid-cavernous fistulae. Despite the similarity of symptoms between both types, a precise diagnosis is essential since the treatment is specific for each type of fistula. Imaging findings are remarkably similar in both dural cavernous sinus fistulae and carotid-cavernous fistulae, but it is possible to differentiate one type from the other. Amongst the available imaging methods (Doppler ultrasonography, computed tomography, magnetic resonance imaging and digital subtraction angiography), angiography is considered the gold standard for the diagnosis and classification of cavernous sinus arteriovenous fistulae. The present essay is aimed at didactically presenting the classification and imaging findings of cavernous sinus arteriovenous fistulae. (author)

  10. Anterior cruciate ligament tear: comparison of MR features between complete and partial tear

    International Nuclear Information System (INIS)

    Song, Ki Young; Lee, Joo Hyuk; Park, Jin Hee; Lee, Yu Jin; Rho, Eun Jin; Kim, Young Hoon; Yi, Jeong Geun; Ahn, Joong Mo

    1997-01-01

    To determine the MRI features which distinguish complete and partial tear of the anterior cruciate ligament(ACL) and to thus improve MRI interpretation. In 80 patients, we analyzed MR findings of direct and indirect signs of ACL tear (complete tear, 61 cases, partial tear, 19 cases) confirmed by arthroscopy or surgery, and compared the relative incidence of each sign in cases of complete and partial tear. Direct and indirect signs were found in 61 (100%) and 60 cases (98.4%), respectively, in complete tears, but in 16 (84.2%) and 15 cases (78.9%), respectively, in partial tears. Poor visualization, discontinuity and hyperintensity were seen in all complete tears but in only nine cases (47.4%) of partial tear. A wavy or abnormal contour was seen in 53 cases (86.9%) of complete tear and 14 (73.7%) of partial tear. A wavy contour without other direct signs was seen in only five cases (26.3%) of partial tear. Three cases (15.8%) of partial tear showed normal MR finding. Indirect signs, i.e. abnormal ACL angle, abnormal ACL-Blumensaat line angle, abnormal posterior cruciate ligament (PCL) line, abnormal PCL angle, PCL buckling, anterior displacement of tibia, posterior displacement of lateral meniscus, bone bruise, Segond fracture, tear of collateral ligaments, PCL, and tear of meniscus were commoner in complete than in partial tears. Two cases of O'Donoghue's triad and two of popliteus injury were seen only in complete tears. Direct and indirect signs of ACL tear were more commonly noted in complete than in partial tears. The latter showed MR features varying from normal to almost complete tear. We suggest that a wavy contour without other direct signs is indicative of a partial tear, and that O'Donoghue's triad and popliteus muscle injury are indirect signs of a complete tear

  11. Comparison of Porcine and Bovine Collagen Dural Substitutes in Posterior Fossa Decompression for Chiari I Malformation in Adults.

    Science.gov (United States)

    Lee, Christine K; Mokhtari, Tara; Connolly, Ian D; Li, Gordon; Shuer, Lawrence M; Chang, Steven D; Steinberg, Gary K; Hayden Gephart, Melanie

    2017-12-01

    Posterior fossa decompression surgeries for Chiari malformations are susceptible to postoperative complications such as pseudomeningocele, external cerebrospinal fluid (CSF) leak, and meningitis. Various dural substitutes have been used to improve surgical outcomes. This study examined whether the collagen matrix dural substitute type correlated with the incidence of postoperative complications after posterior fossa decompression in adult patients with Chiari I malformations. A retrospective cohort study was conducted of 81 adult patients who underwent an elective decompressive surgery for treatment of symptomatic Chiari I malformations, with duraplasty involving a dural substitute derived from either bovine or porcine collagen matrix. Demographics and treatment characteristics were correlated with surgical outcomes. A total of 81 patients were included in the study. Compared with bovine dural substitute, porcine dural substitute was associated with a significantly higher risk of pseudomeningocele occurrence (odds ratio, 5.78; 95% confidence interval, 1.65-27.15; P = 0.01) and a higher overall complication rate (odds ratio, 3.70; 95% confidence interval, 1.23-12.71; P = 0.03) by univariate analysis. There was no significant difference in the rate of meningitis, repeat operations, or overall complication rate between the 2 dural substitutes. In addition, estimated blood loss was a significant risk factor for meningitis (P = 0.03). Multivariate analyses again showed that porcine dural substitute was associated with pseudomeningocele occurrence, although the association with higher overall complication rate did not reach significance. Dural substitutes generated from porcine collagen, compared with those from bovine collagen, were associated with a higher likelihood of pseudomeningocele development in adult patients undergoing Chiari I malformation decompression and duraplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Prognosis of cerebral vein and dural sinus thrombosis - Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT)

    NARCIS (Netherlands)

    Ferro, José M.; Canhão, Patrícia; Stam, Jan; Bousser, Marie-Germaine; Barinagarrementeria, Fernando

    2004-01-01

    Background and Purpose - The natural history and long-term prognosis of cerebral vein and dural sinus thrombosis (CVT) have not been examined previously by adequately powered prospective studies. Methods - We performed a multinational ( 21 countries), multicenter ( 89 centers), prospective

  13. Streaming tearing mode

    Science.gov (United States)

    Shigeta, M.; Sato, T.; Dasgupta, B.

    1985-01-01

    The magnetohydrodynamic stability of streaming tearing mode is investigated numerically. A bulk plasma flow parallel to the antiparallel magnetic field lines and localized in the neutral sheet excites a streaming tearing mode more strongly than the usual tearing mode, particularly for the wavelength of the order of the neutral sheet width (or smaller), which is stable for the usual tearing mode. Interestingly, examination of the eigenfunctions of the velocity perturbation and the magnetic field perturbation indicates that the streaming tearing mode carries more energy in terms of the kinetic energy rather than the magnetic energy. This suggests that the streaming tearing mode instability can be a more feasible mechanism of plasma acceleration than the usual tearing mode instability.

  14. Mass spectrometric identification of phospholipids in human tears and tear lipocalin.

    Science.gov (United States)

    Dean, Austin W; Glasgow, Ben J

    2012-04-02

    The purpose of this article was to identify by mass spectrometry phosphocholine lipids in stimulated human tears and determine the molecules bound to tear lipocalin or other proteins. Tear proteins were separated isocratically from pooled stimulated human tears by gel filtration fast performance liquid chromatography. Separation of tear lipocalin was confirmed by SDS tricine gradient PAGE. Protein fractions were extracted with chloroform/methanol and analyzed with electrospray ionization MS/MS triple quadrupole mass spectrometry in precursor ion scan mode for select leaving groups. For quantification, integrated ion counts were derived from standard curves of authentic compounds of phosphatidylcholine (PC) and phosphatidylserine. Linear approximation was possible from integration of the mass spectrometrically obtained ion peaks at 760 Da for the PC standard. Tears contained 194 ng/mL of the major intact PC (34:2), m/z 758.6. Ten other monoisotopic phosphocholines were found in tears. A peak at 703.3 Da was assigned as a sphingomyelin. Four lysophosphatidylcholines (m/z 490-540) accounted for about 80% of the total integrated ion count. The [M+H](+) compound, m/z 496.3, accounted for 60% of the signal intensity. Only the tear lipocalin-bearing fractions showed phosphocholines (104 ng/mL). Although the intact phospholipids bound to tear lipocalin corresponded precisely in mass and relative signal intensity to that found in tears, we did not identify phosphocholines between m/z 490 and 540 in any of the gel-filtration fractions. Phospholipids, predominantly lysophospholipids, are present in tears. The higher mass intact PCs in tears are native ligands of tear lipocalin.

  15. Intracranial Dural Metastasis of Ewing's Sarcoma: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eung Yeop; Lee, Seung Koo; Kim, Dong Joon; Kim, Jin Na; Lee, Kyu Sung; Jung, Woo Hee; Kim, Dong Ik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2008-02-15

    Ewing's sarcoma is a malignant bone tumor that can occur anywhere in the body, but it is most commonly observed in the long bones of the arms and legs, the pelvis and in the chest. The predominant sites of metastasis include the lung (38%), bone (including the spine; 31%), and the bone marrow (11%). Metastasis of Ewing's sarcoma to the central nervous system (CNS) is relatively rare, and most of the previous reports have demonstrated involvement of the bony calvarium or brain parenchyma. We describe here the imaging findings of dural metastasis of Ewing's sarcoma, and these imaging findings have not been previously reported on in the medical literature. In conclusion, dural metastasis of Ewing's sarcoma is very rare and its imaging characteristics are similar to those of a primary tumor, which mimic the findings of a schwannoma or meningioma. Despite its rarity, secondary Ewing's sarcoma may be included in the differential diagnosis of extra-axial dural masses.

  16. Dural diverticulum with a symptomatic cerebrospinal fluid leak

    Directory of Open Access Journals (Sweden)

    Nicholas Armstrong, MD

    2016-03-01

    Full Text Available A case report of a 63-year-old female patient with a cervical spinal dural diverticulum and intracranial hypotension secondary to a symptomatic CSF leak after minor trauma. The patient responded well after the cervical approach epidural blood patch procedure.

  17. Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Suraj Mammen

    2017-01-01

    Full Text Available Background: In dural venous sinus thrombosis (DVST, the mortality ranges 5–30%. Deep venous system involvement and septic dural sinus thrombosis have a higher mortality rate. In acute occlusion, collateral flow may not be established, which may result in significant edema and mass effect. Endovascular interventions may be considered as a treatment option in appropriate high-risk patients with DVST. Materials and Methods: Eight patients with magnetic resonance imaging (MRI-confirmed dural sinus thrombosis, who did not respond to the conventional standard medical treatment, were subsequently treated with mechanical thrombectomy using the Penumbra System®. In all cases, medical treatment including anticoagulants were continued following the procedure for a minimum period of 1 year. Results: Recanalization of the dural sinus thrombosis was achieved in all 8 cases. There were no immediate or late endovascular-related complications. One death occurred due to an unrelated medical event. At 6 months, there was notable improvement in the modified Rankin Score (mRS, with 5/8 (62% patients achieving mRS of 2 or less. The follow-up ranged between 3 months and 26 months (mean: 14.5 months, and there were no new neurological events during the follow-up period. Conclusion: Cerebral venous sinus thrombosis is a rare but life-threatening condition that demands timely diagnosis and therapy. In cases of rapidly declining neurological status despite standard therapy with systemic anticoagulation and anti-edema measures, mechanical thrombectomy could be a lifesaving and effective option. In this study, good outcomes were observed in the majority of patients at long-term follow up.

  18. In utero magnetic resonance imaging for diagnosis of dural venous sinus ectasia with thrombosis in the fetus

    Energy Technology Data Exchange (ETDEWEB)

    Fanou, Evgenia Maria [University Hospital of North Staffordshire, Stoke-on-Trent (United Kingdom); Reeves, Mike J.; Griffiths, Paul D. [Royal Hallamshire Hospital, University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Howe, David T. [Princess Anne Hospital, Wessex Fetal Medicine Unit, Southampton (United Kingdom); Joy, Harriet [University Hospital of Southampton, Department of Radiology, Southampton (United Kingdom); Morris, Susan [University Hospital of Wales, Radiology Department, Cardiff, Wales (United Kingdom); Russell, Sarah [St. Mary' s Hospital, Radiology Department, Manchester (United Kingdom)

    2013-12-15

    Dural venous sinus ectasia with thrombosis (DVSET) in the fetus is a rare condition that can be diagnosed prenatally with the use of fetal MR imaging, yet with limited indication of long-term clinical significance. To describe and evaluate the diagnostic value of fetal MR imaging in the prenatal diagnosis of dural venous sinus ectasia with thrombosis and its clinical significance. We report a series of nine fetuses with dural venous sinus ectasia with thrombosis. The mothers, located in four feto-maternal centres, were referred for fetal MR imaging due to space occupying lesions identified on second-trimester antenatal ultrasound. In all but one case the dural venous sinus ectasia with thrombosis was in the vicinity of the venous confluence (VC) with various extension in the posterior dural sinuses. Antenatal follow-up imaging was performed in seven cases and showed progression in one, stable appearances in one and regression in five cases. Three pregnancies were terminated. In the remaining six cases there was no reported neurological deficit at up to 44 months of clinical follow-up. This is among the largest series of postnatal clinical follow-up in cases of prenatal diagnosis of dural venous sinus ectasia with thrombosis in the literature. Clinical follow-up suggests a good prognosis when antenatal follow-up shows partial or complete thrombus resolution. (orig.)

  19. Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome

    International Nuclear Information System (INIS)

    Soeylen, Bahar; Schmidtke, Joerg; Arslan-Kirchner, Mine; Hinz, Kerstin; Prokein, Jana; Becker, Hartmut

    2009-01-01

    This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described. (orig.)

  20. Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Soeylen, Bahar; Schmidtke, Joerg; Arslan-Kirchner, Mine [Hannover Medical School, Institute of Human Genetics, Hannover (Germany); Hinz, Kerstin [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany); Vivantes Klinikum Neukoelln, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Prokein, Jana [Hannover Medical School, Institute for Biometrics, Hannover (Germany); Becker, Hartmut [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany)

    2009-06-15

    This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described. (orig.)

  1. A Special Tear Pattern of Anterior Horn of the Lateral Meniscus: Macerated Tear.

    Science.gov (United States)

    Zheng, Jiapeng; Zhai, Wenliang; Li, Qiang; Jia, Qianxin; Lin, Dasheng

    2017-01-01

    We describe a special, interesting phenomenon found in the anterior horn of the lateral meniscus (AHLM): most tear patterns in the AHLM are distinctive, with loose fibers in injured region and circumferential fiber bundles were separated. We name it as macerated tear. The goal of this study was to bring forward a new type of meniscal tear in the AHLM and investigate its clinical value. AHLM tears underwent arthroscopic surgery from January 2012 to December 2014 were included. Data regarding the integrity of AHLM were prospectively recorded in a data registry. Tear morphology and treatment received were subsequently extracted by 2 independent reviewers from operative notes and arthroscopic surgical photos. A total of 60 AHLM tears in 60 patients (mean age 27.1 years) were grouped into horizontal tears (n = 15, 25%), vertical tears (n = 14, 23%), complex tears (n = 6, 10%), and macerated tears (n = 25, 42%). There were 6 patients with AHLM cysts in macerated tear group and one patient in vertical tear group. 60 patients were performed arthroscopic meniscus repairs and were followed-up with averaged 18.7 months. Each group had significant postoperative improvement in Lysholm and IKDC scores (p 0.05). This study demonstrated that the macerated tear is common in the tear pattern of AHLM. However, feasibility of the treatment of this type of meniscal tear, especially the meniscus repairs still requires further study.

  2. Dural metastasis of Ewing's sarcoma.

    Science.gov (United States)

    Ben Nsir, Atef; Boughamoura, Mohamed; Maatouk, Mezri; Kilani, Mohamed; Hattab, Nejib

    2013-01-01

    Metastatic Ewing's sarcoma to the central nervous system is an uncommon condition and debate concerning the true origin of its metastases is still up to date. To the best of our knowledge, only two cases of dural metastatic Ewing's sarcoma have been published in the English medical literature. We present an additional case in a 24-year-old female and discuss the pathogenesis of these unusual tumors with review of the relevant literature concerning their treatment and outcome. A 24-year-old female with previous history of pelvis Ewing's sarcoma and recently discovered lung metastases, presented with moderate headache for the past 2 weeks and weakness in her left leg for the past 2 days. Computed tomography scan and magnetic resonance imaging revealed an extra-axial right frontoparietal mass invading the superior sagittal sinus but with clear delineation with brain parenchyma. Imaging features were suggestive of a meningioma as no abnormalities in the skull abutting to the tumor were noted. The patient underwent surgical removal of her tumor. Near total resection was achieved and histological examination showed evidence of metastatic Ewing's sarcoma. Postoperative adjuvant radiation and chemotherapy were administered. The patient improved well postoperatively with full recovery of her motor weakness. She is symptom free with no signs of progression, at most recent follow-up, 8 months after surgery. Despite its rarity, metastatic Ewing's sarcoma must be considered in the differential diagnosis of extra-axial dural masses particularly meningiomas.

  3. Spinal movement and dural sac compression during airway management in a cadaveric model with atlanto-occipital instability.

    Science.gov (United States)

    Liao, Shiyao; Schneider, Niko R E; Weilbacher, Frank; Stehr, Anne; Matschke, Stefan; Grützner, Paul A; Popp, Erik; Kreinest, Michael

    2017-12-01

    To analyze the compression of the dural sac and the cervical spinal movement during performing different airway interventions in case of atlanto-occipital dislocation. In six fresh cadavers, atlanto-occipital dislocation was performed by distracting the opened atlanto-occipital joint capsule and sectioning the tectorial membrane. Airway management was done using three airway devices (direct laryngoscopy, video laryngoscopy, and insertion of a laryngeal tube). The change of dural sac's width and intervertebral angulation in stable and unstable atlanto-occipital conditions were recorded by video fluoroscopy with myelography. Three-dimensional overall movement of cervical spine was measured in a wireless human motion track system. Compared with a mean dural sac compression of - 0.5 mm (- 0.7 to - 0.3 mm) in stable condition, direct laryngoscopy caused an increased dural sac compression of - 1.6 mm (- 1.9 to - 0.6 mm, p = 0.028) in the unstable atlanto-occipital condition. No increased compression on dural sac was found using video laryngoscopy or the laryngeal tube. Moreover, direct laryngoscopy caused greater overall extension and rotation of cervical spine than laryngeal tube insertion in both stable and unstable conditions. Among three procedures, the insertion of a laryngeal tube took the shortest time. In case of atlanto-occipital dislocation, intubation using direct laryngoscopy exacerbates dural sac compression and may cause damage to the spinal cord.

  4. A method of posterior fossa dural incision to minimize hemorrhage from the occipital sinus: the "mosquito" method.

    Science.gov (United States)

    Lee, Hee Chang; Lee, Ji Yeoun; Ryu, Seul Ki; Lim, Jang Mi; Chong, Sangjoon; Phi, Ji Hoon; Kim, Seung-Ki; Wang, Kyu-Chang

    2016-12-01

    The posterior fossa dural opening requires the ligation of the occipital sinus to gain successful exposure. However, there could be a prominent occipital sinus which is functioning as the main drainage route and is harboring the risk of unpredictable massive hemorrhage during the dural opening. We introduce a safe method of posterior fossa dural incision to minimize hemorrhage from the occipital sinus using four curved hemostat clamps. For the dural incision at the midline part of the posterior cranial fossa, we used four curved hemostat clamps to occlude the prominent occipital sinus: one pair of clamps at the proximal part and the other pair at the distal part to occlude the occipital sinus. Dural incision was made between the two pairs of the curved hemostat clamps. By clamping of the sinus, it allows observation of possible brain swelling after occlusion of the occipital sinus as well as minimizes hemorrhage during incision of the midline dura of the posterior fossa. This method allows observation of brain swelling after occipital sinus occlusion and is an easy and safe incision of the midline dura minimizing hemorrhage in selected cases with a prominent occipital sinus.

  5. Deltoid muscle and tendon tears in patients with chronic rotator cuff tears

    International Nuclear Information System (INIS)

    Ilaslan, Hakan; Recht, Michael P.; Iannotti, Joseph P.

    2007-01-01

    To describe the magnetic resonance imaging (MRI) appearances of tears of the deltoid muscle and tendon in patients with rotator cuff tears and without a prior history of shoulder surgery. Deltoid tears diagnosed on MR examinations were prospectively recorded between February 2003 through June 2004. The images of these patients were then retrospectively reviewed to determine the location of the deltoid tear, the presence of rotator cuff tears, tendon retraction, muscle atrophy, degree of humeral head subluxation, bony erosive changes involving the undersurface of the acromion, and the presence of edema or fluid-like signal intensity in the deltoid muscle and overlying subcutaneous tissues. There were 24 (0.3%) patients with deltoid tears; nine men and 15 women. The age range was 54 to 87 (average 73) years. The right side was involved in 20 cases, and the left in four cases. Fifteen patients had full thickness and nine had partial thickness tears of the deltoid. Shoulder pain was the most common presenting symptom. The physical examination revealed a defect in the region of the deltoid in two patients. Nineteen patients had tears in the muscle belly near the musculotendinous junction, and five had avulsion of the tendon from the acromial origin. Full thickness rotator cuff tears were present in all of the patients, and 22 patients had associated muscle atrophy. Subcutaneous edema and fluid-like signal was present in 15 patients. Tears of the deltoid muscle or tendon is an unusual finding, but they can be seen in patients with chronic massive rotator cuff tears. Partial thickness tears tend to involve the undersurface of the deltoid muscle and tendon. Associated findings such as intramuscular cyst or ganglion in the deltoid muscle belly and subcutaneous edema or fluid-like signal overlying the deltoid in a patient with a rotator cuff tear should raise the suspicion of a deltoid tear. (orig.)

  6. Deltoid muscle and tendon tears in patients with chronic rotator cuff tears

    Energy Technology Data Exchange (ETDEWEB)

    Ilaslan, Hakan; Recht, Michael P. [Cleveland Clinic, Musculoskeletal Radiology/A21, Division of Radiology, Cleveland, OH (United States); Iannotti, Joseph P. [Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, OH (United States)

    2007-06-15

    To describe the magnetic resonance imaging (MRI) appearances of tears of the deltoid muscle and tendon in patients with rotator cuff tears and without a prior history of shoulder surgery. Deltoid tears diagnosed on MR examinations were prospectively recorded between February 2003 through June 2004. The images of these patients were then retrospectively reviewed to determine the location of the deltoid tear, the presence of rotator cuff tears, tendon retraction, muscle atrophy, degree of humeral head subluxation, bony erosive changes involving the undersurface of the acromion, and the presence of edema or fluid-like signal intensity in the deltoid muscle and overlying subcutaneous tissues. There were 24 (0.3%) patients with deltoid tears; nine men and 15 women. The age range was 54 to 87 (average 73) years. The right side was involved in 20 cases, and the left in four cases. Fifteen patients had full thickness and nine had partial thickness tears of the deltoid. Shoulder pain was the most common presenting symptom. The physical examination revealed a defect in the region of the deltoid in two patients. Nineteen patients had tears in the muscle belly near the musculotendinous junction, and five had avulsion of the tendon from the acromial origin. Full thickness rotator cuff tears were present in all of the patients, and 22 patients had associated muscle atrophy. Subcutaneous edema and fluid-like signal was present in 15 patients. Tears of the deltoid muscle or tendon is an unusual finding, but they can be seen in patients with chronic massive rotator cuff tears. Partial thickness tears tend to involve the undersurface of the deltoid muscle and tendon. Associated findings such as intramuscular cyst or ganglion in the deltoid muscle belly and subcutaneous edema or fluid-like signal overlying the deltoid in a patient with a rotator cuff tear should raise the suspicion of a deltoid tear. (orig.)

  7. Tear secretion and tear stability of women on hormonal contraceptives

    Directory of Open Access Journals (Sweden)

    Faustina Kemdinum Idu

    2013-01-01

    Conclusions: Injectable hormonal contraceptives had no significant effects on tear secretion and tear stability of healthy women of childbearing age. Further studies may be required to determine the effects of hormonal contraceptives on tear volume and stability of women with dry eyes.

  8. Comparison of dural puncture epidural technique versus conventional epidural technique for labor analgesia in primigravida

    Directory of Open Access Journals (Sweden)

    Pritam Yadav

    2018-01-01

    Full Text Available >Background: Dural puncture epidural (DPE is a method in which a dural hole is created prior to epidural injection. This study was planned to evaluate whether dural puncture improves onset and duration of labor analgesia when compared to conventional epidural technique.Methods and Materials: Sixty term primigravida parturients of ASA grade I and II were randomly assigned to two groups of 30 each (Group E for conventional epidural and Group DE for dural puncture epidural. In group E, epidural space was identified and 18-gauge multi-orifice catheter was threaded 5 cm into the epidural space. In group DE, dura was punctured using the combines spinal epidural (CSE spinal needle and epidural catheter threaded as in group E followed by 10 ml of injection of Ropivacaine (0.2% with 20 mcg of Fentanyl (2 mcg/ml in fractions of 2.5 ml. Later, Ropivacaine 10 ml was given as a top-up on patient request. Onset, visual analouge scale (VAS, sensory and motor block, haemodynamic variables, duration of analgesia of initial dose were noted along with mode of delivery and the neonatal outcome.Results: Six parturients in group DE achieved adequate analgesia in 5 minutes while none of those in group E (P 0.05.Conclusions: Both techniques of labor analgesia are efficacious; dural puncture epidural has the potential to fasten onset and improve quality of labor analgesia when compared with conventional epidural technique.

  9. Imaging findings in patients with ventral dural defects and herniation of neural tissue

    International Nuclear Information System (INIS)

    Baur, A.; Staebler, A.; Reiser, M.; Psenner, K.; Hamburger, C.

    1997-01-01

    The aim of this paper is to describe clinical and imaging findings in three patients with ventral dural defects and herniation of the spinal cord or cauda equina. The literature is reviewed and the clinical, radiological and operative findings are compared. Three patients with ventral dural defects of different etiologies are presented. One patient gave a longstanding history of ankylosing spondylitis, the second patient presents 37 years after spinal trauma, and the third patient presents with spontaneous spinal cord herniation. All patients had typically slowly progressive neurological symptoms with multiple hospitalizations until diagnosis was made. Characteristic findings in postmyelographic CT included a ventral or ventrolateral displacement with deformation of the spinal cord or the cauda equina. Sagittal MRI showed this abrupt and localized anterior deviation of the spinal cord or the cauda equina to the posterior portions of a vertebral body with or without a bony vertebral defect optimally. Additionally, due to the ventral displacement of the spinal cord, the dorsal subarachnoid space was relatively enlarged without evidence of an arachnoid cyst, in all patients. Magnetic resonance imaging and postmyelographic CT can diagnose ventral dural defects with spinal cord herniation or nerve root entrapment. Dural defects must be considered in the presence of neurological symptoms in cases of longstanding ankylosing spondylitis, late sequelae of fractures of vertebral bodies, and without history of spinal trauma or surgery. (orig.). With 3 figs

  10. MR inflow angiography for the evaluation of dural sinus patency

    International Nuclear Information System (INIS)

    Poncelet, B.; Baleriaux, D.; Grand, C.; Van Dijk, P.; De Graaf, R.; Segebarth, C.

    1990-01-01

    This paper assesses dural sinus patency with two-dimensional inflow MR angiography. Twelve patients with potential dural sinus (superior sagittal and transverse sinus) involvement related to tumors of the falx or the convexity (meningiomas, metastasis) were examined with digital subtraction angiography (DSA), Mr imaging (1.5-T Gyroscan system), including T1-weighted (pre- and post-agadolinium) and T2-weighted spin-echo imaging, and MR angiography. For the MR angiographic study, a gradient-echo fast field echo sequence with flow compensation was used. Thin (2-mm), contiguous coronal or transverse sections were acquired sequentially. Three-dimensional reconstruction with MIP processing was then performed. CT, DSA, and MR imaging were performed for presurgical evaluation. Surgical confirmation of sinus patency was obtained for all patients

  11. Neural-Dural Transition at the Thoracic and Lumbar Spinal Nerve Roots: A Histological Study of Human Late-Stage Fetuses

    Directory of Open Access Journals (Sweden)

    Kwang Ho Cho

    2016-01-01

    Full Text Available Epidural blocks have been used extensively in infants. However, little histological information is available on the immature neural-dural transition. The neural-dural transition was histologically investigated in 12 late-stage (28–30 weeks fetuses. The dural sheath of the spinal cord was observed to always continue along the nerve roots with varying thicknesses between specimens and segments, while the dorsal root ganglion sheath was usually very thin or unclear. Immature neural-dural transitions were associated with effective anesthesia. The posterior radicular artery was near the dorsal root ganglion and/or embedded in the nerve root, whereas the anterior radicular artery was separated from the nearest nerve root. The anterior radicular artery was not associated with the dural sheath but with thin mesenchymal tissue. The numbers of radicular arteries tended to become smaller in larger specimens. Likewise, larger specimens of the upper thoracic and lower lumbar segments did not show the artery. Therefore, elimination of the radicular arteries to form a single artery of Adamkiewicz was occurring in late-stage fetuses. The epidural space was filled with veins, and the loose tissue space extended ventrolaterally to the subpleural tissue between the ribs. Consequently, epidural blocks in infants require special attention although immature neural-dural transitions seemed to increase the effect.

  12. Transcutaneous Drainage of Gel-Like Substance after Application of Hydrogel Dural Sealant: Report of Two Cases.

    Science.gov (United States)

    Siman, Homayoun; Techy, Fernando

    2016-02-01

    Study Design Case report. Objective Incidental durotomy (IDT) is a common complication of spinal surgery. The use of collagen matrix graft along with hydrogel dural sealant is a common method of IDT repair. With this method, there have been several reported cases of detrimental dural sealant expansion in the literature. One case study reported an expansion rate greater than 300%; many report neurologic damage. This article reports the clinical course of two patients who developed postoperative transcutaneous drainage of a gel-like substance after the use of a dural sealant, which is a previously unreported complication. Methods The clinical course and treatment outcome of two patients is presented. Results Both patients experienced postoperative transcutaneous drainage of a gel-like substance at the surgical site. Case one began draining this substance on postoperative day 14. This patient required no further intervention, and the drainage ended after 3 mL of a gel-like substance was expressed from his incision while in the clinic. Case two began draining the gel on postoperative day 16. This patient underwent two washout procedures and resolution of the drainage. No infection was ever detected. Conclusions To our knowledge, our patients are the first reported cases of transcutaneous drainage of expanded dural sealant. It is important to take into consideration the unexpected expansion of a dural sealant when using it for the repair of IDT.

  13. A comparison of basal and eye-flush tears for the analysis of cat tear proteins.

    Science.gov (United States)

    Petznick, Andrea; Evans, Margaret D M; Madigan, Michele C; Markoulli, Maria; Garrett, Qian; Sweeney, Deborah F

    2011-02-01

    To identify a rapid and effective tear collection method providing sufficient tear volume and total protein content (TPC) for analysis of individual proteins in cats. Domestic adult short-haired cats (12-37 months; 2.7-6.6 kg) were used in the study. Basal tears without stimulation and eye-flush tears after instillation of saline (10 μl) were collected using microcapillary tubes from animal eyes either unwounded control or wounded with 9-mm central epithelial debridement giving four groups with n = 3. Tear comparisons were based on total time and rate for tear collection, TPC using micro bicinchoninic acid (BCA), tear immunoglobulin A (IgA), total matrix-metalloproteinase (MMP)-9 concentration using sandwich enzyme-linked immunosorbent assay (ELISA) and MMP-9 activity. Eye-flush tears were collected significantly faster than basal tears in wounded eyes with higher rates for tear collection in unwounded control and wounded eyes. TPC was significantly lower in eye-flush tears compared to basal tears. The relative proportion of tear IgA normalized to TPC (% IgA of TPC) was not significantly different between basal and eye-flush tears. In unwounded control eyes, MMP-9 was slightly higher in eye-flush than in basal tears; activity of MMP-9 in both tear types was similar. In wounded eyes, eye-flush tears showed highest MMP-9 levels and activity on Day 1, which subsequently decreased to Day 7. MMP-9 activity in basal tears from wounded eyes did not display changes in expression. Eye-flush tears can be collected rapidly providing sufficient tear volume and TPC. This study also indicates that eye-flush tears may be more suitable than basal tears for the analysis of MMPs following corneal wounding. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

  14. The adverse effects of inadvertent intraoperative intravenous ...

    African Journals Online (AJOL)

    Inadvertent intravenous injection of 1% phenylephrine (10 mg) induced severe hypertension and tachycardia in a previously healthy female patient undergoing elective gynaecological surgery. This medical error was investigated using the criticalincident technique that is available in our department. This case report ...

  15. Ureteroscopic holmium laser cutting for inadvertently sutured drainage tube (report of five cases).

    Science.gov (United States)

    Gao, Xu; Lu, Xin; Ren, Shancheng; Xu, Chuanliang; Sun, Yinghao

    2008-07-01

    The aim of this paper is to report a simple solution for inadvertently sutured drainage tube after urological surgery and discuss the different managements according to different types of this embarrassing complication. From September 2001 to January 2007, five inadvertently sutured drainage tubes were treated with ureteroscopic holmium laser cutting for the suture. All drainage tubes were removed after the operation without other complications. Holmium laser cutting via ureteroscope is a simple solution for the embarrassing problem of inadvertently sutured drainage tube. It can save the patient from undergoing another open surgery.

  16. Blocked Tear Duct

    Science.gov (United States)

    ... of the nose (lacrimal sac). From there tears travel down a duct (the nasolacrimal duct) draining into your nose. Once in the nose, tears are reabsorbed. A blockage can occur at any point in the tear drainage system, from the puncta ...

  17. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations.

    Science.gov (United States)

    Zakhary, Sherry M; Hoehmann, Christopher L; Cuoco, Joshua A; Hitscherich, Kyle; Alam, Hamid; Torres, German

    2017-06-01

    A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5-10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a case of a 67-year-old female with a spinal dural arteriovenous fistula, provide a pertinent clinical history to the case nosology, and discuss the biology of adhesive proteins, chemotactic molecules, and transcription factors that modify the behavior of the vasculature to possibly cause sensorimotor deficits.

  18. Cavernous sinus invasion by pituitary adenomas. Relationship between magnetic resonance imaging findings and histologically verified dural invasion

    Energy Technology Data Exchange (ETDEWEB)

    Daita, Go; Yonemasu, Yukichi; Nakai, Hirofumi; Takei, Hidetoshi; Ogawa, Katsuhiro [Asahikawa Medical Coll., Hokkaido (Japan)

    1995-01-01

    The relationship between magnetic resonance (MR) imaging findings and histologically verified invasion of the cavernous sinus by tumor cells was studied in 26 patients treated surgically for pituitary adenoma. Dural invasion of the sellar floor by tumor cells was found in 10 cases (38%). All patients were classified according to MR imaging findings into three types. Type I showed a gadolinium-enhanced stripe medial to the carotid artery (5 patients), none of which showed dural invasion. Type II showed no enhanced stripe (17 patients), six of which showed dural invasion. Within this type, tumor size and dural invasion showed no correlation. Type III showed displacement or encasement of the carotid artery by the tumor with or without extracranial extension (4 patients), all of which showed massive infiltration of the tumor cells into the dura mater. This study shows that preoperative MR imaging can provide information for assessment of invasion into the cavernous sinus in patients with pituitary adenoma. (author).

  19. Tear-Film Evaporation Rate from Simultaneous Ocular-Surface Temperature and Tear-Breakup Area.

    Science.gov (United States)

    Dursch, Thomas J; Li, Wing; Taraz, Baseem; Lin, Meng C; Radke, Clayton J

    2018-01-01

    A corneal heat-transfer model is presented to quantify simultaneous measurements of fluorescein tear-breakup area (TBA) and ocular-surface temperature (OST). By accounting for disruption of the tear-film lipid layer (TFLL), we report evaporation rates through lipid-covered tear. The modified heat-transfer model provides new insights into evaporative dry eye. A quantitative analysis is presented to assess human aqueous tear evaporation rate (TER) through intact TFLLs from simultaneous in vivo measurement of time-dependent infrared OST and fluorescein TBA. We interpret simultaneous OST and TBA measurements using an extended heat-transfer model. We hypothesize that TBAs are ineffectively insulated by the TFLL and therefore exhibit higher TER than does that for a well-insulting TFLL-covered tear. As time proceeds, TBAs increase in number and size, thereby increasing the cornea area-averaged TER and decreasing OST. Tear-breakup areas were assessed from image analysis of fluorescein tear-film-breakup video recordings and are included in the heat-transfer description of OST. Model-predicted OSTs agree well with clinical experiments. Percent reductions in TER of lipid-covered tear range from 50 to 95% of that for pure water, in good agreement with literature. The physical picture of noninsulating or ruptured TFLL spots followed by enhanced evaporation from underlying cooler tear-film ruptures is consistent with the evaporative-driven mechanism for local tear rupture. A quantitative analysis is presented of in vivo TER from simultaneous clinical measurement of transient OST and TBA. The new heat-transfer model accounts for increased TER through expanding TBAs. Tear evaporation rate varies strongly across the cornea because lipid is effectively missing over tear-rupture troughs. The result is local faster evaporation compared with nonruptured, thick lipid-covered tear. Evaporative-driven tear-film ruptures deepen to a thickness where fluorescein quenching commences and local

  20. Dural arteriovenous fistula as a treatable dementia.

    Science.gov (United States)

    Enofe, Ikponmwosa; Thacker, Ike; Shamim, Sadat

    2017-04-01

    Dementia is a chronic loss of neurocognitive function that is progressive and irreversible. Although rare, dural arteriovenous fistulas (DAVFs) could present with a rapid decline in neurocognitive function with or without Parkinson-like symptoms. DAVFs represent a potentially treatable and reversible cause of dementia. Here, we report the case of an elderly woman diagnosed with a DAVF after presenting with new-onset seizures, deteriorating neurocognitive function, and Parkinson-like symptoms.

  1. Prevention of the inadvertent movement and illicit trafficking of radioactive materials

    International Nuclear Information System (INIS)

    2004-05-01

    By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

  2. Prevention of the inadvertent movement and illicit trafficking of radioactive materials

    International Nuclear Information System (INIS)

    2004-12-01

    By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

  3. Prevention of the inadvertent movement and illicit trafficking of radioactive materials

    International Nuclear Information System (INIS)

    2003-08-01

    By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

  4. Prevention of the inadvertent movement and illicit trafficking of radioactive materials

    International Nuclear Information System (INIS)

    2003-05-01

    By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

  5. Prevention of the inadvertent movement and illicit trafficking of radioactive materials

    International Nuclear Information System (INIS)

    2002-09-01

    By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

  6. Contribution of dynamic contrast MR imaging to the differentiation between dural metastasis and meningioma

    International Nuclear Information System (INIS)

    Kremer, S.; Grand, S.; Le Bas, J.F.; Remy, C.; Pasquier, B.; Benabid, A.L.; Bracard, S.

    2004-01-01

    To determine the perfusion-sensitive characteristics of cerebral dural metastases and compare them with the data on meningiomas. Twenty-two patients presenting with dural tumor underwent conventional and dynamic susceptibility-contrast MR imaging: breast carcinoma metastases, two patients; colorectal carcinoma metastasis, one patient; lung carcinoma metastasis, one patient; Merkel carcinoma metastasis, one patient; lymphoma, one patient; meningiomas, 16 patients. The imaging characteristics were analyzed using conventional MR imaging. The cerebral blood volume (CBV) maps were obtained for each patient and the relative CBV (rCBV) in different areas was calculated using the ratio between the CBV in the pathological area (CBVp) and in the contralateral white matter (CBVn). The differentiation between a meningioma and a dural metastasis can be difficult using conventional MR imaging. The rCBVs of lung carcinoma metastasis (1 case: 1.26), lymphoma (1 case: 1.29), breast carcinoma metastasis (2 cases: 1.50,1.56) and rectal carcinoma metastasis (1 case: 3.34) were significantly lower than that of meningiomas (16 cases: mean rCBV = 8.97±4.34, range 4-18). Merkel carcinoma metastasis (1 case: 7.56) showed an elevated rCBV, not different from that of meningiomas. Dural metastases are sometimes indistinguishable from meningiomas using conventional MR imaging. rCBV mapping can provide additional information by demonstrating a low rCBV which may suggest the diagnosis of metastasis. (orig.)

  7. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations

    Directory of Open Access Journals (Sweden)

    Sherry M. Zakhary, DO

    2017-06-01

    Full Text Available A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5–10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a case of a 67-year-old female with a spinal dural arteriovenous fistula, provide a pertinent clinical history to the case nosology, and discuss the biology of adhesive proteins, chemotactic molecules, and transcription factors that modify the behavior of the vasculature to possibly cause sensorimotor deficits.

  8. Retrograde flow in the dural sinuses detected by three-dimensional time-of-flight MR angiography

    International Nuclear Information System (INIS)

    Uchino, Akira; Nomiyama, Keita; Takase, Yukinori; Nakazono, Takahiko; Tominaga, Yukiko; Imaizumi, Takeshi; Kudo, Sho

    2007-01-01

    Retrograde flow in the left dural sinuses is sometimes detected by three-dimensional time-of-flight (3D-TOF) magnetic resonance (MR) angiography. The purpose of this study was to evaluate the incidence of this phenomenon and its characteristic features on 3D-TOF MR angiograms. We retrospectively reviewed cranial MR angiography images of 1,078 patients examined at our institution. All images were obtained by the 3D-TOF technique with one of two 1.5-T scanners. Maximum intensity projection (MIP) images in the horizontal rotation view were displayed stereoscopically. We reviewed the source images, inferosuperior MIP images, and horizontal MIP images and identified retrograde flow in the dural sinuses. We found retrograde flow in the dural sinuses of 67 patients on the source images from 3D-TOF MR angiography; the incidence was 6.2%. In 47 of the 67 patients, retrograde flow was identified in the left inferior petrosal sinus, in 13, it was seen in the left sigmoid sinus, and in 6, it was seen in the left inferior petrosal and left sigmoid sinuses. The remaining patient had retrograde flow in the left inferior petrosal and left and right sigmoid sinuses. The mean age of the patients with retrograde flow was slightly greater than that of the patients without this phenomenon (70 years vs 63 years). Retrograde flow in the dural sinuses frequently occurs on the left side in middle-aged and elderly patients during 3D-TOF MR angiography performed with the patient in the supine position. This phenomenon should not be misdiagnosed as a dural arteriovenous fistula. (orig.)

  9. Radiographic anatomy of the distal dural SAC

    International Nuclear Information System (INIS)

    Larsen, J.L.; Olsen, K.O.

    1991-01-01

    A radio-anatomical study was performed of the distal dural sac (DS) in 121 patients subjected to myelography. In 83.4% the termination of the DS was located from the upper half of the S1-segment to the lower half of the S2-segment. In the remaining patients the dural terminations were more distally located. The average location of the DS-termination was higher than that found in a previous anatomic study. The inference is that in patients with low-back pain and sciatica, the DS tends to terminate at a higher spinal level than in a non-selected anatomic material. The caudal reduction in sagittal diameter of the DS was less than that of the frontal diameter of the sac. The linear diminution in cross-sectional area of the DS from the level of L3 towards the lumbosacral junction was not correlated with the degree of caudal extension of the DS into the sacrum. Thus the length of the DS and its transverse diameters are independent of each other. These results supported the view that the location of the termination of the DS (and hence that of the spinal cord) is not related to stenosis of the central spinal canal. (orig.)

  10. Tearing instabilities in turbulence

    International Nuclear Information System (INIS)

    Ishizawa, A.; Nakajima, N.

    2009-01-01

    Full text: Effects of micro-turbulence on tearing instabilities are investigated by numerically solving a reduced set of two-fluid equations. Micro-turbulence excites both large-scale and small-scale Fourier modes through energy transfer due to nonlinear mode coupling. The energy transfer to large scale mode does not directly excite tearing instability but it gives an initiation of tearing instability. When tearing instability starts to grow, the excited small scale mode plays an important role. The mixing of magnetic flux by micro-turbulence is the dominant factor of non-ideal MHD effect at the resonant surface and it gives rise to magnetic reconnection which causes tearing instability. Tearing instabilities were investigated against static equilibrium or flowing equilibrium so far. On the other hand, the recent progress of computer power allows us to investigate interactions between turbulence and coherent modes such as tearing instabilities in magnetically confined plasmas by means of direct numerical simulations. In order to investigate effects of turbulence on tearing instabilities we consider a situation that tearing mode is destabilized in a quasi-equilibrium including micro-turbulence. We choose an initial equilibrium that is unstable against kinetic ballooning modes and tearing instabilities. Tearing instabilities are current driven modes and thus they are unstable for large scale Fourier modes. On the other hand kinetic ballooning modes are unstable for poloidal Fourier modes that are characterized by ion Larmor radius. The energy of kinetic ballooning modes spreads over wave number space through nonlinear Fourier mode coupling. We present that micro-turbulence affects tearing instabilities in two different ways by three-dimensional numerical simulation of a reduced set of two-fluid equations. One is caused by energy transfer to large scale modes, the other is caused by energy transfer to small scale modes. The former is the excitation of initial

  11. Divalent cations in tears, and their influence on tear film stability in humans and rabbits.

    Science.gov (United States)

    Wei, Xiaojia Eric; Markoulli, Maria; Millar, Thomas J; Willcox, Mark D P; Zhao, Zhenjun

    2012-06-05

    Reduced tear film stability is reported to contribute to dry eye. Rabbits are known to have a more stable tear film than humans. Thus, we sought to examine the tears of rabbits and humans for metal cations, and to test how they influence tear film stability. Tears were collected from 10 healthy humans and 6 rabbits. Tear osmolality was measured by vapor pressure osmometer, and metals analyzed using inductively coupled plasma (ICP) mass spectrometry or ICP atomic emission spectroscopy. The influence of divalent cations on tears was analyzed by measuring surface tension using the Langmuir trough in vitro, using different concentrations of cations in the subphase, and grading the tear break-up in rabbits in vivo after instillation of chelating agents. Rabbit tears had a higher osmolality compared to humans. Major metals did not differ between species; however, rabbits had higher levels of Mg(2+) (1.13 vs. 0.39 mM) and Ca(2+) (0.75 vs. 0.36 mM). In rabbit tears in vitro, diminishing divalent cations resulted in a decrease in the maximum surface pressure from 37 to 30 mN/m. In vivo, an increase in the amount of tear film that was broken-up was found. In contrast, when changing divalent cation concentrations in human tears, the maximum surface pressure remained at 26 mN/m. The normal osmolality of rabbit tears is significantly higher than that in humans. While divalent cations had little influence on human tears, they appear to have an important role in maintaining tear film stability in rabbits.

  12. Cranial dural arteriovenous shunts. Part 4. Clinical presentation of the shunts with leptomeningeal venous drainage.

    Science.gov (United States)

    Baltsavias, Gerasimos; Spiessberger, Alex; Hothorn, Torsten; Valavanis, Anton

    2015-04-01

    Cranial dural arteriovenous fistulae have been classified into high- and low-risk lesions mainly based on the pattern of venous drainage. Those with leptomeningeal venous drainage carry a higher risk of an aggressive clinical presentation. Recently, it has been proposed that the clinical presentation should be considered as an additional independent factor determining the clinical course of these lesions. However, dural shunts with leptomeningeal venous drainage include a very wide spectrum of inhomogeneous lesions. In the current study, we correlated the clinical presentation of 107 consecutive patients harboring cranial dural arteriovenous shunts with leptomeningeal venous drainage, with their distinct anatomic and angiographic features categorized into eight groups based on the "DES" (Directness and Exclusivity of leptomeningeal venous drainage and features of venous Strain) concept. We found that among these groups, there are significant angioarchitectural differences, which are reflected by considerable differences in clinical presentation. Leptomeningeal venous drainage of dural sinus shunts that is neither direct nor exclusive and without venous strain manifested only benign symptoms (aggressive presentation 0%). On the other end of the spectrum, the bridging vein shunts with direct and exclusive leptomeningeal venous drainage and venous strain are expected to present aggressive symptoms almost always and most likely with bleeding (aggressive presentation 91.5%). Important aspects of the above correlations are discussed. Therefore, the consideration of leptomeningeal venous drainage alone, for prediction of the clinical presentation of these shunts appears insufficient. Angiographic analysis based on the above concept, offers the possibility to distinguish the higher- from the lower-risk types of leptomeningeal venous drainage. In this context, consideration of the clinical presentation as an additional independent factor for the prediction of their clinical

  13. Meniscus Tears (For Teens)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Meniscus Tears KidsHealth / For Teens / Meniscus Tears What's in this ... surgery to fix it. What Is a Meniscus Tear? Your knee is made up of three bones: ...

  14. [Rotator cuff tear athropathy prevalence].

    Science.gov (United States)

    Guerra-Soriano, F; Encalada-Díaz, M I; Ruiz-Suárez, M; Valero-González, F S

    2017-01-01

    Glenohumeral arthritis secondary to massive rotator cuff tear presents with a superior displacement and femoralization of the humeral head with coracoacromial arch acetabularization. The purpose of this study was to establish prevalence of rotator cuff tear artropathy (CTA) at our institution. Four hundred electronic records were reviewed from which we identified 136 patients with rotator cuff tears. A second group was composed with patients with massive cuff tears that were analized and staged by the Seebauer cuff tear arthropathy classification. Thirty four patients with massive rotator cuff tears were identified, 8 male and 26 female (age 60.1 ± 10.26 years). Massive rotator cuff tear prevalence was 25%. CTA prevalence found in the rotator cuff group was 19 and 76% in the massive cuff tears group. Patients were staged according to the classification with 32% in stage 1a, 11% 1b, 32% 2a and 0% 2b. CTA prevalence in patients with rotator cuff tears and massive cuff tears is higher than the one reported in American population. We consider that a revision of the Seebauer classification to be appropriate to determine its reliability.

  15. Probability of inadvertent operation of electrical components in harsh environments

    International Nuclear Information System (INIS)

    Knoll, A.

    1989-01-01

    Harsh environment, which means humidity and high temperature, may and will affect unsealed electrical components by causing leakage ground currents in ungrounded direct current systems. The concern in a nuclear power plant is that such harsh environment conditions could cause inadvertent operation of normally deenergized components, which may have a safety-related isolation function. Harsh environment is a common cause failure, and one way to approach the problem is to assume that all the unsealed electrical components will simultaneously and inadvertently energize as a result of the environmental common cause failure. This assumption is unrealistically conservative. Test results indicated that insulating resistences of any terminal block in harsh environments have a random distribution in the range of 1 to 270 kΩ, with a mean value ∼59 kΩ. The objective of this paper is to evaluate a realistic conditional failure probability for inadvertent operation of electrical components in harsh environments. This value will be used thereafter in probabilistic safety evaluations of harsh environment events and will replace both the overconservative common cause probability of 1 and the random failure probability used for mild environments

  16. Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study.

    Science.gov (United States)

    Guo, W-Y; Lee, C-C J; Lin, C-J; Yang, H-C; Wu, H-M; Wu, C-C; Chung, W-Y; Liu, K-D

    2017-01-01

    Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas. Forty-three cases of dural arteriovenous fistula in the transverse-sigmoid sinus were reviewed and divided into 3 groups: Cognard type I, type IIa, and types with cortical venous drainage. Sinus stenosis and the double peak sign (occurrence of 2 peaks in the time-density curve of the ipsilateral drainage of the internal jugular vein) in dural arteriovenous fistula were evaluated. "TTP" was defined as the time at which a selected angiographic point reached maximum concentration. TTP of the vein of Labbé, TTP of the ipsilateral normal transverse sinus, trans-fistula time, and trans-stenotic time were compared across the 3 groups. Thirty-six percent of type I, 100% of type IIa, and 84% of types with cortical venous drainage had sinus stenosis. All sinus stenosis cases demonstrated loss of the double peak sign that occurs in dural arteriovenous fistula. Trans-fistula time (2.09 seconds) and trans-stenotic time (0.67 seconds) in types with cortical venous drainage were the most prolonged, followed by those in type IIa and type I. TTP of the vein of Labbé was significantly shorter in types with cortical venous drainage. Six patients with types with cortical venous drainage underwent venoplasty and stent placement, and 4 were downgraded to type IIa. Sinus stenosis indicated dysfunction of venous drainage and is more often encountered in dural arteriovenous fistula with more aggressive types. Venoplasty ameliorates cortical venous drainage in dural arteriovenous fistulas and serves as a bridge treatment to stereotactic radiosurgery in most cases. © 2017 by American Journal of Neuroradiology.

  17. Dynamic subtraction magnetic resonance venography: a new real time imaging technique for the detection of dural sinus thrombosis

    International Nuclear Information System (INIS)

    Mandel, C.; Birchall, D.; Connolly, D.; English, P.

    2002-01-01

    Full text: Requests for imaging suspected dural sinus thrombosis are increasing. Conventional magnetic imaging (MRI) and magnetic resonance venography (MRV) are often used to detect venous sinus thrombosis, but these techniques are prone to technical problems. Catheter angiography is sometimes required as the final arbiter in the evaluation of the dural venous sinuses. Recent technical developments in MR scanning have allowed the development of dynamic subtraction MRA. This technique is beginning to be applied to the assessment of intracranial vascular malformations. We have recently applied the technique to the imaging of the dural venous sinuses, and describe our early experience with the technique. Imaging was performed on a Philips Intera 1.5T scanner with gradient strength 33 mT and slew rate 130 T/m/sec. T1-weighed fast field echo imaging was performed (flip angle 400, TR 1.5 msec) during bolus injection of gadolinium (5ml gadolinium followed by a 10 ml saline chaser) at 5-6 ml/sec using a MRI-compatible pump injector. Slice thickness depended on the plane of acquisition, but was between 100- 150 mm. Images were acquired in three orthogonal projections in each case, using 3 separate contrast injections. Mask images were obtained before the arrival of contrast, and subtracted reconstructed images were obtained in real time, providing a dynamic display of the intracranial circulation including the dural venous sinuses. Frame rate was 1 frame per 0.8 seconds. We will present dynamic MR angiographic images in a number of patients. Normal appearances and those seen in venous sinus thrombosis will be presented in the video display. Dynamic MR venography is a new technique for the imaging of dural venous sinuses. In our practice, it has proved a valuable adjunct for the imaging of patients with dural venous sinus thrombosis. Copyright (2002) Blackwell Science Pty Ltd

  18. Human tears contain a chemosignal.

    Science.gov (United States)

    Gelstein, Shani; Yeshurun, Yaara; Rozenkrantz, Liron; Shushan, Sagit; Frumin, Idan; Roth, Yehudah; Sobel, Noam

    2011-01-14

    Emotional tearing is a poorly understood behavior that is considered uniquely human. In mice, tears serve as a chemosignal. We therefore hypothesized that human tears may similarly serve a chemosignaling function. We found that merely sniffing negative-emotion-related odorless tears obtained from women donors induced reductions in sexual appeal attributed by men to pictures of women's faces. Moreover, after sniffing such tears, men experienced reduced self-rated sexual arousal, reduced physiological measures of arousal, and reduced levels of testosterone. Finally, functional magnetic resonance imaging revealed that sniffing women's tears selectively reduced activity in brain substrates of sexual arousal in men.

  19. Antimicrobial compounds in tears.

    Science.gov (United States)

    McDermott, Alison M

    2013-12-01

    The tear film coats the cornea and conjunctiva and serves several important functions. It provides lubrication, prevents drying of the ocular surface epithelia, helps provide a smooth surface for refracting light, supplies oxygen and is an important component of the innate defense system of the eye providing protection against a range of potential pathogens. This review describes both classic antimicrobial compounds found in tears such as lysozyme and some more recently identified such as members of the cationic antimicrobial peptide family and surfactant protein-D as well as potential new candidate molecules that may contribute to antimicrobial protection. As is readily evident from the literature review herein, tears, like all mucosal fluids, contain a plethora of molecules with known antimicrobial effects. That all of these are active in vivo is debatable as many are present in low concentrations, may be influenced by other tear components such as the ionic environment, and antimicrobial action may be only one of several activities ascribed to the molecule. However, there are many studies showing synergistic/additive interactions between several of the tear antimicrobials and it is highly likely that cooperativity between molecules is the primary way tears are able to afford significant antimicrobial protection to the ocular surface in vivo. In addition to effects on pathogen growth and survival some tear components prevent epithelial cell invasion and promote the epithelial expression of innate defense molecules. Given the protective role of tears a number of scenarios can be envisaged that may affect the amount and/or activity of tear antimicrobials and hence compromise tear immunity. Two such situations, dry eye disease and contact lens wear, are discussed here. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Tear progression of symptomatic full-thickness and partial-thickness rotator cuff tears as measured by repeated MRI.

    Science.gov (United States)

    Kim, Yang-Soo; Kim, Sung-Eun; Bae, Sung-Ho; Lee, Hyo-Jin; Jee, Won-Hee; Park, Chang Kyun

    2017-07-01

    The purpose of this study was to analyse the natural course of symptomatic full-thickness and partial-thickness rotator cuff tears treated non-operatively and to identify risk factors affecting tear enlargement. One hundred and twenty-two patients who received non-surgical treatment for a partial- or full-thickness supraspinatus tear were included in this study. All rotator cuff tears were diagnosed with magnetic resonance imaging (MRI), and the same modality was used for follow-up studies. Follow-up MRI was performed after at least a 6-month interval. We evaluated the correlation between tear enlargement and follow-up duration. Eleven risk factors were analysed by both univariate and multivariate analyses to identify factors that affect enlargement of rotator cuff tears. The mean follow-up period was 24.4 ± 19.5 months. Out of 122 patients, 34 (27.9%) patients had an initial full-thickness tear and 88 (72.1%) patients had a partial-thickness tear. Considering all patients together, tear size increased in 51/122 (41.8%) patients, was unchanged in 65/122 (53.3%) patients, and decreased in 6/122 (4.9%) patients. Tear size increased for 28/34 (82.4%) patients with full-thickness tears and 23/88 (26.1%) patients with partial-thickness tears. From the two groups which were followed over 12 months, a higher rate of enlargement was observed in full-thickness tears than in partial-thickness tears (6-12 months, n.s.; 12-24 months, P = 0.002; over 24 months, P rotator cuff tears and 23/88 (26.1%) of symptomatic partial-thickness tears increased in size over a follow-up period of 6-100 months. Full-thickness tears showed a higher rate of enlargement than partial-thickness tears regardless of the follow-up duration. Univariate and multivariate analyses suggested that full-thickness tear was the most reliable risk factor for tear enlargement. The clinical relevance of these observations is that full-thickness rotator cuff tears treated conservatively should be

  1. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations

    OpenAIRE

    Zakhary, Sherry M.; Hoehmann, Christopher L.; Cuoco, Joshua A.; Hitscherich, Kyle; Alam, Hamid; Torres, German

    2017-01-01

    A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5–10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a cas...

  2. Histology of the distal dural ring.

    Science.gov (United States)

    Graffeo, Christopher S; Perry, Avital; Copeland, William R; Raghunathan, Aditya; Link, Michael J

    2017-09-01

    The distal dural ring (DDR) is a conserved intracranial anatomic structure marking the boundary point at which the internal carotid artery (ICA) exits the cavernous sinus (CS) and enters the subarachnoid space. Although the CS has been well described in a range of anatomic studies, to our knowledge no prior study has analyzed the histologic relationship between the ICA and DDR. Correspondingly, our objective was to assess the relationship of the DDR to the ICA and determine whether the DDR can be dissected from the ICA and thus divided, or can only be circumferentially trimmed around the artery. The authors examined ten fresh-frozen, adult cadaveric specimens. A standard frontotemporal craniotomy, orbito-optic osteotomy, and extradural anterior clinoidectomy was performed bilaterally. The cavernous ICA, DDR, and supraclinoid ICA were harvested as an en bloc specimen. Specimens formalin-fixed and paraffin-embedded prior to routine histochemical staining with hematoxylin and eosin and Masson trichrome. In all specimens, marked microscopic investment of the DDR throughout the ICA adventitia was noted. Dural collagen fibers extensively permeated the arterial layers superficial to the muscularis propria, with no evidence of a clear separation between the DDR and arterial adventitia. Histologic analysis suggests that the ICA and DDR are highly interrelated, continuous structures, and therefore attempted intraoperative dissection between these structures may carry an elevated risk of injury to the ICA. We correspondingly recommend careful circumferential trimming of the DDR in lieu of direct dissection in cases requiring mobilization of the clinoidal ICA. Clin. Anat. 30:742-746, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  3. Use of collagen film as a dural substitute: preliminary animal studies.

    Science.gov (United States)

    Collins, R L; Christiansen, D; Zazanis, G A; Silver, F H

    1991-02-01

    Cadaver grafts, laminated metallic materials, and synthetic fabrics have been evaluated as dural substitutes. Use of cadaver tissues is limited by fear of transmission of infectious disease while use of synthetic materials is associated with implant encapsulation and foreign body reactions. The purpose of this study is to evaluate the use of collagen film as a dural substitute. Collagen films prepared from bovine skin were used to replace the dura of rabbits and histological observations were made at 16, 28, 42, and 56 days postimplantation. Controls consisted of dura that was removed and then reattached. Control dura showed no signs of inflammation or adhesion to underlying tissue at 16 and 28 days postimplantation. By 56 days postimplantation, extensive connective tissue deposition was observed in close proximity to adjacent bone as well as pia arachnoid adhesions. Implanted collagen film behaved in a similar manner to control dura showing minimal inflammatory response at all time periods. At 56 days postimplantation collagen film appeared strongly infiltrated by connective tissue cells that deposited new collagen. The results of this study suggest that a reconstituted type I collagen film crosslinked with cyanamide acts as a temporary barrier preventing loss of fluid and adhesion formation. It is replaced after approximately 2 months with host collagen with limited inflammatory and fibrotic complications. Further studies are needed to completely characterize the new connective tissue formed as well as long-term biocompatibility and functioning of a reconstituted collagen dural substitute.

  4. Inadvertent Intruder Analysis For The Portsmouth On-Site Waste Disposal Facility (OSWDF)

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Frank G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Phifer, Mark A. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2014-01-22

    The inadvertent intruder analysis considers the radiological impacts to hypothetical persons who are assumed to inadvertently intrude on the Portsmouth OSWDF site after institutional control ceases 100 years after site closure. For the purposes of this analysis, we assume that the waste disposal in the OSWDF occurs at time zero, the site is under institutional control for the next 100 years, and inadvertent intrusion can occur over the following 1,000 year time period. Disposal of low-level radioactive waste in the OSWDF must meet a requirement to assess impacts on such individuals, and demonstrate that the effective dose equivalent to an intruder would not likely exceed 100 mrem per year for scenarios involving continuous exposure (i.e. chronic) or 500 mrem for scenarios involving a single acute exposure. The focus in development of exposure scenarios for inadvertent intruders was on selecting reasonable events that may occur, giving consideration to regional customs and construction practices. An important assumption in all scenarios is that an intruder has no prior knowledge of the existence of a waste disposal facility at the site. Results of the analysis show that a hypothetical inadvertent intruder at the OSWDF who, in the worst case scenario, resides on the site and consumes vegetables from a garden established on the site using contaminated soil (chronic agriculture scenario) would receive a maximum chronic dose of approximately 7.0 mrem/yr during the 1000 year period of assessment. This dose falls well below the DOE chronic dose limit of 100 mrem/yr. Results of the analysis also showed that a hypothetical inadvertent intruder at the OSWDF who, in the worst case scenario, excavates a basement in the soil that reaches the waste (acute basement construction scenario) would receive a maximum acute dose of approximately 0.25 mrem/yr during the 1000 year period of assessment. This dose falls well below the DOE acute dose limit of 500 mrem/yr. Disposal inventory

  5. Analysis of inadvertent containment spray actuation for NPP Krsko

    International Nuclear Information System (INIS)

    Grgic, D.; Spalj, S.; Fancev, T.

    2000-01-01

    Refueling Water Storage Tank (RWST) supplies borated water to the Chemical and Volume Control System, Emergency Core Cooling System and Containment Spray System. In the analyses of the containment external pressure the spray temperature is assumed to be equal to the RWST lower temperature limit. This value ensures that the design negative containment pressure will not be exceeded in the event of inadvertent actuation of the Containment Spray. For NPP Kriko the negative containment pressure has to be kept below 0.1 kp/cm2 to avoid the loss of containment integrity. This paper pursuents the analysis of Inadvertent Containment Spray Actuation in order to check the influence of change in RWST water temperature on containment negative pressure. GOTHIC computer code was used for calculation of containment thermal hydraulic behavior during this accident. (author)

  6. Examination of rotator cuff re-tear

    International Nuclear Information System (INIS)

    Kitahara, Hiroyuki; Yabe, Yoshihiro; Norimatsu, Takahiro; Adachi, Shinji; Sera, Keisuke

    2010-01-01

    The six-month post-operative re-tear rate in 72 arthroscopic rotator cuff repair cases was 16.3% by MRI. The re-tear rate of massive tears was 50%. We investigated the details of the re-tears by MRI and arthroscopic findings. High re-tear rates were connected with cuff tear size and fatty degeneration of muscle belly. Cases with poor cuff quality in arthroscopically showed high re-tear rate. These results suggest that surgery operation should be performed as soon as possible after diagnosis of cuff tear to obtain good results. Cases with damage of long head of the biceps (LHB) are likely to develop impingement causes of re-tears. Some type of rehabilitation is required to avoid impingement in such cases. (author)

  7. Preventing Inadvertent Placement of Foley Catheter into Prostatic ...

    African Journals Online (AJOL)

    Percutaneous suprapubic trocar cystostomy (SPC) is often needed to drain the bladder when urethral catheterization either fails or is not advisable.[1] It is ... vertical or slightly tilting its tip toward umbilicus during foley placement, prevents the inadvertent migration of catheter into prostatic urethra and further complications.

  8. Implementation of coordinated global serotype 2 oral poliovirus vaccine cessation: risks of inadvertent trivalent oral poliovirus vaccine use.

    Science.gov (United States)

    Duintjer Tebbens, Radboud J; Hampton, Lee M; Thompson, Kimberly M

    2016-06-01

    The endgame for polio eradication includes coordinated global cessation of oral poliovirus vaccine (OPV), starting with the cessation of vaccine containing OPV serotype 2 (OPV2) by switching all trivalent OPV (tOPV) to bivalent OPV (bOPV). The logistics associated with this global switch represent a significant undertaking, with some possibility of inadvertent tOPV use after the switch. We used a previously developed poliovirus transmission and OPV evolution model to explore the relationships between the extent of inadvertent tOPV use, the time after the switch of the inadvertent tOPV use and corresponding population immunity to serotype 2 poliovirus transmission, and the ability of the inadvertently introduced viruses to cause a serotype 2 circulating vaccine-derived poliovirus (cVDPV2) outbreak in a hypothetical population. We then estimated the minimum time until inadvertent tOPV use in a supplemental immunization activity (SIA) or in routine immunization (RI) can lead to a cVDPV2 outbreak in realistic populations with properties like those of northern India, northern Pakistan and Afghanistan, northern Nigeria, and Ukraine. At low levels of inadvertent tOPV use, the minimum time after the switch for the inadvertent use to cause a cVDPV2 outbreak decreases sharply with increasing proportions of children inadvertently receiving tOPV. The minimum times until inadvertent tOPV use in an SIA or in RI can lead to a cVDPV2 outbreak varies widely among populations, with higher basic reproduction numbers, lower tOPV-induced population immunity to serotype 2 poliovirus transmission prior to the switch, and a lower proportion of transmission occurring via the oropharyngeal route all resulting in shorter times. In populations with the lowest expected immunity to serotype 2 poliovirus transmission after the switch, inadvertent tOPV use in an SIA leads to a cVDPV2 outbreak if it occurs as soon as 9 months after the switch with 0.5 % of children aged 0-4 years inadvertently

  9. What emotional tears convey : Tearful individuals are seen as warmer, but also as less competent

    NARCIS (Netherlands)

    van de Ven, Niels; Meijs, Maartje; Vingerhoets, A.J.J.M.

    Earlier research found that the mere sight of tears promotes the willingness to provide support to the person shedding the tears. Other research, however, found that deliberate responses towards tearful persons could be more negative as well. We think this is because tears have ambivalent effects on

  10. ''Dural tail'' adjacent to a giant posterior cerebral artery aneurysm: case report and review of the literature

    International Nuclear Information System (INIS)

    Good, C.D.; Kingsley, D.P.E.; Taylor, W.J.; Harkness, W.F.

    1997-01-01

    The ''dural tail'' sign on gadolinium (Gd-DTPA)-enhanced MRI has been described in association with meningiomas. Various series with histopathological correlation have shown that in some cases there is tumour invasion into the dura mater, but in the majority of cases it represents a hypervascular, non-neoplastic reaction. While this sign was originally thought to be specific for meningioma, subsequent case reports have described the presence of a dural tail in other intra- and extra-axial lesions. We present a patient with a giant aneurysm arising from the P2 segment of the right posterior cerebral artery, adjacent to the tentorium, with a prominent dural tail on Gd-DTPA-enhanced MRI. In this location, differentiation of an aneurysm from a meningioma was critical. (orig.). With 2 figs

  11. Transcutaneous Drainage of Gel-Like Substance after Application of Hydrogel Dural Sealant: Report of Two Cases

    OpenAIRE

    Siman, Homayoun; Techy, Fernando

    2015-01-01

    Study Design?Case report. Objective?Incidental durotomy (IDT) is a common complication of spinal surgery. The use of collagen matrix graft along with hydrogel dural sealant is a common method of IDT repair. With this method, there have been several reported cases of detrimental dural sealant expansion in the literature. One case study reported an expansion rate greater than 300%; many report neurologic damage. This article reports the clinical course of two patients who developed postoperativ...

  12. A Controlled Study on the Correlation between Tear Film Volume and Tear Film Stability in Diabetic Patients.

    Science.gov (United States)

    Eissa, Iman M; Khalil, Noha M; El-Gendy, Heba A

    2016-01-01

    Purpose. To assess the tear film quantity and correlate it with the quality and stability of the tear film in diabetics and compare them to age matched controls. Introduction. Diabetes affects tear film parameters in multiple ways. Poor metabolic control and neuropathy are postulated factors. To further understand how diabetes affects tear film parameters this study was conducted. Subjects and Methods. Tear meniscus height was measured by anterior segment OCT, along with tear thinning time, a subtype of noninvasive tear break-up time, and blinking rate per minute which were all recorded for 22 diabetic patients. Correlations between these tear film parameters were studied and then compared to 16 age matched controls. Results. A statistically significant difference was found in blinking rate between the diabetic and the control group (P = 0.002), with higher blinking rate among diabetics. All tear film parameters were negatively correlated with duration of diabetes. A positive correlation was found between tear film volume and stability. Conclusion. Diabetes affects the tear film in various ways. Diabetics should be examined for dry eye signs even in absence of symptoms which may be masked by associated neuropathy. Duration of diabetes has an impact on tear film status.

  13. TFOS DEWS II Tear Film Report.

    Science.gov (United States)

    Willcox, Mark D P; Argüeso, Pablo; Georgiev, Georgi A; Holopainen, Juha M; Laurie, Gordon W; Millar, Tom J; Papas, Eric B; Rolland, Jannick P; Schmidt, Tannin A; Stahl, Ulrike; Suarez, Tatiana; Subbaraman, Lakshman N; Uçakhan, Omür Ö; Jones, Lyndon

    2017-07-01

    The members of the Tear Film Subcommittee reviewed the role of the tear film in dry eye disease (DED). The Subcommittee reviewed biophysical and biochemical aspects of tears and how these change in DED. Clinically, DED is characterized by loss of tear volume, more rapid breakup of the tear film and increased evaporation of tears from the ocular surface. The tear film is composed of many substances including lipids, proteins, mucins and electrolytes. All of these contribute to the integrity of the tear film but exactly how they interact is still an area of active research. Tear film osmolarity increases in DED. Changes to other components such as proteins and mucins can be used as biomarkers for DED. The Subcommittee recommended areas for future research to advance our understanding of the tear film and how this changes with DED. The final report was written after review by all Subcommittee members and the entire TFOS DEWS II membership. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Assessment of lamellar tearing

    International Nuclear Information System (INIS)

    McEnerney, J.W.

    1978-03-01

    Information on lamellar tearing is summarized and related to proposed ASME Code requirements. Lamellar tearing is characterized as a complex phenomenon related to poor short transverse ductility and through-thickness strain. The material, welding, and design variables that affect lamellar tearing are shown to be complex and interrelated. The commonly reported tests for assessing material susceptibility are described, with the controversy over their validity being carefully detailed. Although the use of a nondestructive test such as ultrasonic examination is most desirable, a widely applicable test method does not appear to be available. Of the destructive tests, the short transverse tensile reduction-of-area currently offers the most applicable means of assessing material susceptibility. However, because of the importance of matrix toughness, the short transverse Charpy V-notch test should be considered for use as an additional test if acceptance limits are developed. The ultrasonic detection of lamellar tears is susceptible to interpretation errors, which can make it overly conservative and lead to unnecessary repairs. The repair of tears is described as costly, difficult, and sometimes ineffective. Current design requirements appear to preclude any failures during static and fatigue service loads. However, without improvement of short transverse ductility, certain dynamic service loads could cause lamellar tearing failures. Two alternate design paths are recommended to prevent tearing during fabrication or service loading. The current and proposed ASME requirements dealing with lamellar tearing are reviewed and recommendations are made

  15. Suitability of cerebrospinal fluid as a signal-intensity reference on MRI: evaluation of signal-intensity variations in the lumbosacral dural sac

    International Nuclear Information System (INIS)

    Luoma, E.K.; Luukkonen, R.; Riihimaeki, H.A.; Raininko, R.; Manninen, H.I.; Nummi, P.J.

    1997-01-01

    The suitability of the cerebrospinal fluid (CSF) in the lumbosacral dural sac as an internal signal-intensity reference was studied on magnetic resonance imaging (MRI) of the lumbar spine using a surface coil and motion artefact suppression technique. A signal-intensity reference is needed when signal is compared between images, studies or subjects. Homogeneity of the CSF was estimated visually on T2-weighted images of 60 subjects at 1.5 T and of another 60 subjects at 0.1 T. Spines with a severely narrowed dural sac or marked scoliosis were excluded from the study to avoid partial volume effect. CSF was homogeneous in 82% and 73% of the examinations at 1.5 T and 0.1 T, respectively. The type and location of the local inhomogeneities did not relate to local narrowings of the dural sac. The signal intensity of CSF was measured in 108 examinations at 0.1 T after correcting the spatially-dependent signal-intensity nonuniformities with a phantom-based method. The signal-intensity difference between the CSF in the upper and lower lumbar dural sac was less than 10% in 73% of the examinations. The CSF in the lumbosacral dural sac can be a useful signal-intensity reference for estimation of the signal of the adjacent structures in patients without severe narrowing of the dural sac or marked scoliosis. It may contribute to assessing spinal disease processes. (orig.). With 1 fig., 3 tabs

  16. Documented development of a dural arteriovenous fistula in an infant subsequent to sinus thrombosis: case report and review of the literature

    International Nuclear Information System (INIS)

    Morales, Humberto; Jones, Blaise V.; Leach, James L.; Abruzzo, Todd A.

    2010-01-01

    Controversy exists as to whether sinus thrombosis is the cause or the result of dural arteriovenous fistula (DAVF) and to whether DAVF are congenital or acquired lesions, especially in children. An infant presented with rupture of an anterior communicating artery aneurysm diagnosed with computed tomography angiography and catheter angiography. Pretreatment hospital course was complicated by extensive dural sinus thrombosis. Subsequent arteriography showed a new adult-type dural arteriovenous fistula to the previously thrombosed right sigmoid sinus. This is the first report of definitive angiographic documentation of the development of an adult-type DAVF after recanalization of a thrombosed dural sinus in a child. This case confirms the acquired etiology of at least one type of DAVF in children, even at this young age. We review the previously documented cases of formation of DAVF subsequent to sinus thrombosis with serial angiography in adults. (orig.)

  17. Tear dynamics in healthy and dry eyes.

    Science.gov (United States)

    Cerretani, Colin F; Radke, C J

    2014-06-01

    Dry-eye disease, an increasingly prevalent ocular-surface disorder, significantly alters tear physiology. Understanding the basic physics of tear dynamics in healthy and dry eyes benefits both diagnosis and treatment of dry eye. We present a physiological-based model to describe tear dynamics during blinking. Tears are compartmentalized over the ocular surface; the blink cycle is divided into three repeating phases. Conservation laws quantify the tear volume and tear osmolarity of each compartment during each blink phase. Lacrimal-supply and tear-evaporation rates are varied to reveal the dependence of tear dynamics on dry-eye conditions, specifically tear osmolarity, tear volume, tear-turnover rate (TTR), and osmotic water flow. Predicted periodic-steady tear-meniscus osmolarity is 309 and 321 mOsM in normal and dry eyes, respectively. Tear osmolarity, volume, and TTR all match available clinical measurements. Osmotic water flow through the cornea and conjunctiva contribute 10 and 50% to the total tear supply in healthy and dry-eye conditions, respectively. TTR in aqueous-deficient dry eye (ADDE) is only half that in evaporative dry eye (EDE). The compartmental periodic-steady tear-dynamics model accurately predicts tear behavior in normal and dry eyes. Inclusion of osmotic water flow is crucial to match measured tear osmolarity. Tear-dynamics predictions corroborate the use of TTR as a clinical discriminator between ADDE and EDE. The proposed model is readily extended to predict the dynamics of aqueous solutes such as drugs or fluorescent tags.

  18. Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning.

    Science.gov (United States)

    Begley, Carolyn; Simpson, Trefford; Liu, Haixia; Salvo, Eliza; Wu, Ziwei; Bradley, Arthur; Situ, Ping

    2013-04-12

    The purpose of this study was to test the association between tear film fluorescence changes during tear break-up (TBU) or thinning and the concurrent ocular sensory response. Sixteen subjects kept one eye open as long as possible (MBI), indicated their discomfort level continuously, and rated ocular sensations of irritation, stinging, burning, pricking, and cooling using visual analog scales (VAS). Fluorescence of the tear film was quantified by a pixel-based analysis of the median pixel intensity (PI), TBU, and percentage of dark pixels (DarkPix) over time. A cutoff of 5% TBU was used to divide subjects into either break-up (BU) or minimal break-up (BUmin) groups. Tear film fluorescence decreased (median PI) and the percentage of TBU and DarkPix increased in all trials, with the rate significantly greater in the BU than the BUmin group (Mann-Whitney U test, P film thinning best explains decreasing tear film fluorescence during trials. This was highly correlated with increasing ocular discomfort, suggesting that both tear film thinning and TBU stimulate underlying corneal nerves, although TBU produced more rapid stimulation. Slow increases in tear film hyperosmolarity may cause the gradual increase in discomfort during slow tear film thinning, whereas the sharp increases in discomfort during TBU suggest a more complex stimulus.

  19. Posterior horn lateral meniscal tears simulating meniscofemoral ligament attachment in the setting of ACL tear: MRI findings

    International Nuclear Information System (INIS)

    Park, Lawrence S.; Jacobson, Jon A.; Jamadar, David A.; Caoili, Elaine; Kalume-Brigido, Monica; Wojtys, Edward

    2007-01-01

    We have noted apparent far lateral meniscal attachment of the meniscofemoral ligament (MFL) with an anterior cruciate ligament (ACL) tear. This study evaluates MFL attachment and association with posterior horn lateral meniscus (PHLM) tear. Nine months of knee arthroscopy reports were reviewed to classify the PHLM and ACL as torn or normal. After excluding those with prior knee surgery, MR images were reviewed by two radiologists to determine the number of images lateral to PCL, which showed the ligaments of Humphrey and Wrisberg visible as structures separate from the PHLM. Any patient with abnormal PHLM surface signal not continuous with the MFL was excluded. MRI findings were compared with arthroscopy using Student's t test and Fisher's exact test. Of the 54 participants, 5 had PHLM tears and 49 were normal. Twenty-one had ACL tears; all those with an PHLM tear had an ACL tear. The ligament of Humphrey inserted on average 0.9 consecutive images lateral to the PCL without an PHLM tear and 4.7 with an PHLM tear; the ligament of Wrisberg inserted on average 3.0 consecutive images without an PHLM tear and 4.5 with an PHLM tear (slice thickness/gap = 3 mm/0.5 mm). There was a significant association between PHLM tear and number of images (p = 0.0028), and between ACL tear and this type of PHLM tear (p = 0.0064). Apparent far lateral meniscal extension of a meniscofemoral ligament (greater than or equal to four images lateral to the PCL) should be considered as a possible PHLM tear, especially in the setting of an ACL tear. (orig.)

  20. A Controlled Study on the Correlation between Tear Film Volume and Tear Film Stability in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Iman M. Eissa

    2016-01-01

    Full Text Available Purpose. To assess the tear film quantity and correlate it with the quality and stability of the tear film in diabetics and compare them to age matched controls. Introduction. Diabetes affects tear film parameters in multiple ways. Poor metabolic control and neuropathy are postulated factors. To further understand how diabetes affects tear film parameters this study was conducted. Subjects and Methods. Tear meniscus height was measured by anterior segment OCT, along with tear thinning time, a subtype of noninvasive tear break-up time, and blinking rate per minute which were all recorded for 22 diabetic patients. Correlations between these tear film parameters were studied and then compared to 16 age matched controls. Results. A statistically significant difference was found in blinking rate between the diabetic and the control group (P=0.002, with higher blinking rate among diabetics. All tear film parameters were negatively correlated with duration of diabetes. A positive correlation was found between tear film volume and stability. Conclusion. Diabetes affects the tear film in various ways. Diabetics should be examined for dry eye signs even in absence of symptoms which may be masked by associated neuropathy. Duration of diabetes has an impact on tear film status.

  1. Cyclodialysis cleft with late hypotony maculopathy after inadvertent cannula detachment during cataract surgery.

    Science.gov (United States)

    Kahawita, Shyalle; Cugati, Sudha; Casson, Robert

    2015-05-01

    We present the case of a 69-year-old woman who presented with hypotony several years after an inadvertent cannula detachment presumably formed a cyclodialysis cleft during phacoemulsification cataract extraction and posterior chamber intraocular lens implantation in her right eye. To our knowledge, this is the first report of late hypotony maculopathy as a result of inadvertent cannula release. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  2. Epistaxis caused by a dural AV-fistula at the cribriform plate

    NARCIS (Netherlands)

    van Dijk, J. Marc C.; Korsten-Meijer, Astrid G. W.; Mazuri, Aryan

    2014-01-01

    Objectives/HypothesisA dural arteriovenous fistula (DAVF) with cortical venous reflux (CVR) is a dangerous neurovascular entity. A DAVF at the cribriform plate is typically silent until its inevitable presentation with intracranial hemorrhage. Case SummaryA 67-year-old male presented with severe

  3. Dural ectasia of the optic nerve sheath: is it always benign?

    Directory of Open Access Journals (Sweden)

    Berker Bakbak

    2009-11-01

    Full Text Available Berker Bakbak1, Hava Dönmez2, Tülay Kansu3, Hayyam Kiratli41Hacettepe University Institute of Neurological Sciences and Psychiatry, Neuro-ophthalmology Unit, Ankara, Turkey; 2Diskapi Yildirim Beyazid Education and Research Hospital Neurology Clinic, Ankara, Turkey; 3Hacettepe University Medical Faculty, Department of Neurology, Neuro-Ophthalmology Unit, Ankara, Turkey; 4Hacettepe University Medical Faculty, Department of Ophthalmology, Ocular Oncology Unit, Ankara, TurkeyAbstract: A 36-year-old woman with a 3-month history of progressive visual loss had papilledema, dilatation of the optic nerve sheaths and normal cerebrospinal fluid pressures. She was diagnosed as dural ectasia of the optic nerve sheaths and surgical decompression was performed. In this case report, severe visual loss is described as a serious complication of this rare disease and the importance of early surgical intervention is emphasized.Keywords: optic nerve, dural ectasia, meningocele

  4. Software Simulation of Hot Tearing

    DEFF Research Database (Denmark)

    Andersen, S.; Hansen, P.N.; Hattel, Jesper Henri

    1999-01-01

    The brittleness of a solidifying alloy in a temperature range near the solidus temperature has been recognised since the fifties as the mechanism responsible for hot tearing. Due to this brittlenes, the metal will crack under even small amounts of strain in that temperature range. We see these hot...... tears in castings close to hot centres, where the level of strain is often too high.Although the hot tearing mechanism is well understood, until now it has been difficult to do much to reduce the hot tearing tendency in a casting. In the seventies, good hot tearing criteria were developed by considering...... the solidification rate and the strain rate of the hot tear prone areas. But, until recently it was only possible to simulate the solidification rate, so that the criteria could not be used effectively.Today, with new software developments, it is possible to also simulate the strain rate in the hot tear prone areas...

  5. Experimental inflammation following dural application of complete Freund's adjuvant or inflammatory soup does not alter brain and trigeminal microvascular passage

    DEFF Research Database (Denmark)

    Lundblad, Cornelia; Haanes, Kristian A; Grände, Gustaf

    2015-01-01

    , following dural application of complete Freund's adjuvant (CFA) or inflammatory soup (IS) on brain and trigeminal microvascular passage. METHODS: In order to address this issue, we induced local inflammation in male Sprague-Dawley-rats dura mater by the addition of CFA or IS directly on the dural surface...

  6. Effects of topical cyclosporine a plus artificial tears versus artificial tears treatment on conjunctival goblet cell density in dysfunctional tear syndrome.

    Science.gov (United States)

    Demiryay, Elvan; Yaylali, Volkan; Cetin, Ebru Nevin; Yildirim, Cem

    2011-09-01

    The aim was to compare the effects of topical cyclosporine A and artificial tears combination with artificial tears alone in patients with dysfunctional tear syndrome (DTS). Forty-two eyes of 42 patients with DTS were enrolled in the study. The inclusion criteria for the study were Schirmer I (without anesthesia) scores below 10 mm/5 min and tear film break-up time (BUT) below 10 sec. The patients were randomly divided into two groups. The study group (22 patients) underwent 0.05% cyclosporine A treatment twice a day and preservative-free artificial tears for four times a day for 4 months. The control group (20 patients) was administered only preservative-free artificial tears four times a day for 4 months. The BUT, Schirmer test scores, corneal fluorescein staining, conjunctival lissamine green staining, and goblet cell density derived by impression cytology were recorded before and after treatment in each group. In the study group, all parameters improved statistically significantly after treatment at the 4-month follow-up compared with the pretreatment values (Ptears treatment significantly increases goblet cell density, decreases the signs of DTS, and improves ocular surface health.

  7. Alternative technique in atypical spinal decompression: the use of the ultrasonic scalpel in paediatric achondroplasia

    Science.gov (United States)

    Woodacre, Timothy; Sewell, Matthew; Clarke, Andrew J; Hutton, Mike

    2016-01-01

    Spinal stenosis can be a very disabling condition. Surgical decompression carries a risk of dural tear and neural injury, which is increased in patients with severe stenosis or an atypical anatomy. We present an unusual case of symptomatic stenosis secondary to achondroplasia presenting in a paediatric patient, and highlight a new surgical technique used to minimise the risk of dural and neural injury during decompression. PMID:27288205

  8. Classification of ulnar triangular fibrocartilage complex tears. A treatment algorithm for Palmer type IB tears.

    Science.gov (United States)

    Atzei, A; Luchetti, R; Garagnani, L

    2017-05-01

    The classical definition of 'Palmer Type IB' triangular fibrocartilage complex tear, includes a spectrum of clinical conditions. This review highlights the clinical and arthroscopic criteria that enable us to categorize five classes on a treatment-oriented classification system of triangular fibrocartilage complex peripheral tears. Class 1 lesions represent isolated tears of the distal triangular fibrocartilage complex without distal radio-ulnar joint instability and are amenable to arthroscopic suture. Class 2 tears include rupture of both the distal triangular fibrocartilage complex and proximal attachments of the triangular fibrocartilage complex to the fovea. Class 3 tears constitute isolated ruptures of the proximal attachment of the triangular fibrocartilage complex to the fovea; they are not visible at radio-carpal arthroscopy. Both Class 2 and Class 3 tears are diagnosed with a positive hook test and are typically associated with distal radio-ulnar joint instability. If required, treatment is through reattachment of the distal radio-ulnar ligament insertions to the fovea. Class 4 lesions are irreparable tears due to the size of the defect or to poor tissue quality and, if required, treatment is through distal radio-ulnar ligament reconstruction with tendon graft. Class 5 tears are associated with distal radio-ulnar joint arthritis and can only be treated with salvage procedures. This subdivision of type IB triangular fibrocartilage complex tear provides more insights in the pathomechanics and treatment strategies. II.

  9. Normal values of the sagittal diameter of the lumbar spine (vertebral body and dural sac) in children measured by MRI

    International Nuclear Information System (INIS)

    Knirsch, Walter; Kurtz, Claudia; Langer, Mathias; Haeffner, Nicole; Kececioglu, Deniz

    2005-01-01

    The definition of normal values is a prerequisite for the reliable evaluation of abnormality in the lumbar spine, such as spinal canal stenosis or dural ectasia in patients with Marfan syndrome. Values for vertebral body diameter (VBD) and dural sac diameter (DSD) for the lumbar spine have been published in adults. In children, normal values have been established using conventional radiography or myelography, but not by MRI. To define normal values for the sagittal diameter of the vertebral body and dural sac, and to calculate a dural sac ratio (DSR) in the lumbosacral spine (L1-S1) in healthy children using MRI. A total of 75 healthy children between 6 years and 17 years of age were examined using a sagittal T2-weighted sequence. Sagittal VBD and DSD were measured and a DSR was calculated. This was a retrospective and cross-sectional study. With increasing age there is a significant increase of VBD, a slight increase of DSD, and a slight decrease of DSR. There is no significant sex difference. DSR in healthy children is higher than in healthy adults. MRI is a reliable method demonstrating the natural shape of the lumbosacral spine and its absolute values. These normal values compare well with those established by conventional radiological techniques. Our data may serve as a reference for defining dural ectasia in children with Marfan syndrome. (orig.)

  10. Normal values of the sagittal diameter of the lumbar spine (vertebral body and dural sac) in children measured by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Knirsch, Walter [University Children' s Hospital Freiburg, Department of Pediatric Cardiology, Freiburg (Germany); University Children' s Hospital Zurich, Division of Paediatric Cardiology, Zurich (Switzerland); Kurtz, Claudia; Langer, Mathias [University Hospital Freiburg, Department of Radiology, Freiburg (Germany); Haeffner, Nicole; Kececioglu, Deniz [University Children' s Hospital Freiburg, Department of Pediatric Cardiology, Freiburg (Germany)

    2005-04-01

    The definition of normal values is a prerequisite for the reliable evaluation of abnormality in the lumbar spine, such as spinal canal stenosis or dural ectasia in patients with Marfan syndrome. Values for vertebral body diameter (VBD) and dural sac diameter (DSD) for the lumbar spine have been published in adults. In children, normal values have been established using conventional radiography or myelography, but not by MRI. To define normal values for the sagittal diameter of the vertebral body and dural sac, and to calculate a dural sac ratio (DSR) in the lumbosacral spine (L1-S1) in healthy children using MRI. A total of 75 healthy children between 6 years and 17 years of age were examined using a sagittal T2-weighted sequence. Sagittal VBD and DSD were measured and a DSR was calculated. This was a retrospective and cross-sectional study. With increasing age there is a significant increase of VBD, a slight increase of DSD, and a slight decrease of DSR. There is no significant sex difference. DSR in healthy children is higher than in healthy adults. MRI is a reliable method demonstrating the natural shape of the lumbosacral spine and its absolute values. These normal values compare well with those established by conventional radiological techniques. Our data may serve as a reference for defining dural ectasia in children with Marfan syndrome. (orig.)

  11. A rare case of spinal dural arteriovenous fistula

    Directory of Open Access Journals (Sweden)

    Mariya Apostolova

    2012-12-01

    Full Text Available Spinal dural arteriovenous fistula (SDAVF is a rare vascular malformation of the spine. Only a limited number of cases of SDAVF have been reported in the current literature. We describe the case of a 74 year old male who presented with gradually progressive bilateral lower extremity weakness and bladder dysfunction and was subsequently diagnosed with SDAVF affecting both the thoracic and lumbar spine. The patient later underwent embolization with some improvement in his neurologic symptoms.

  12. Closure Using a Surgical Closure Device of Inadvertent Subclavian Artery Punctures During Central Venous Catheter Placement

    International Nuclear Information System (INIS)

    Berlet, Matthew H.; Steffen, Diana; Shaughness, George; Hanner, James

    2001-01-01

    Severe complications can and do occur when central venous catheters are inadvertently placed into subclavian arteries. Two cases are discussed that describe how these inadvertent arterial punctures can be closed using the Perclose device (Abbott Laboratories, Redwood City, CA, USA)

  13. Mitigating Inadvertent Insider Threats with Incentives

    Science.gov (United States)

    Liu, Debin; Wang, Xiaofeng; Camp, L. Jean

    Inadvertent insiders are trusted insiders who do not have malicious intent (as with malicious insiders) but do not responsibly managing security. The result is often enabling a malicious outsider to use the privileges of the inattentive insider to implement an insider attack. This risk is as old as conversion of a weak user password into root access, but the term inadvertent insider is recently coined to identify the link between the behavior and the vulnerability. In this paper, we propose to mitigate this threat using a novel risk budget mechanism that offers incentives to an insider to behave according to the risk posture set by the organization. We propose assigning an insider a risk budget, which is a specific allocation of risk points, allowing employees to take a finite number of risk-seeking choice. In this way, the employee can complete her tasks without subverting the security system, as with absolute prohibitions. In the end, the organization penalizes the insider if she fails to accomplish her task within the budget while rewards her in the presence of a surplus. Most importantly. the risk budget requires that the user make conscious visible choices to take electronic risks. We describe the theory behind the system, including specific work on the insider threats. We evaluated this approach using human-subject experiments, which demonstrate the effectiveness of our risk budget mechanism. We also present a game theoretic analysis of the mechanism.

  14. Use of computer-assisted design and manufacturing to localize dural venous sinuses during reconstructive surgery for craniosynostosis.

    Science.gov (United States)

    Iyer, Rajiv R; Wu, Adela; Macmillan, Alexandra; Musavi, Leila; Cho, Regina; Lopez, Joseph; Jallo, George I; Dorafshar, Amir H; Ahn, Edward S

    2018-01-01

    Cranial vault remodeling surgery for craniosynostosis carries the potential risk of dural venous sinus injury given the extensive bony exposure. Identification of the dural venous sinuses can be challenging in patients with craniosynostosis given the lack of accurate surface-localizing landmarks. Computer-aided design and manufacturing (CAD/CAM) has allowed surgeons to pre-operatively plan these complex procedures in an effort to increase reconstructive efficiency. An added benefit of this technology is the ability to intraoperatively map the dural venous sinuses based on pre-operative imaging. We utilized CAD/CAM technology to intraoperatively map the dural venous sinuses for patients undergoing reconstructive surgery for craniosynostosis in an effort to prevent sinus injury, increase operative efficiency, and enhance patient safety. Here, we describe our experience utilizing this intraoperative technology in pediatric patients with craniosynostosis. We retrospectively reviewed the charts of children undergoing reconstructive surgery for craniosynostosis using CAD/CAM surgical planning guides at our institution between 2012 and 2016. Data collected included the following: age, gender, type of craniosynostosis, estimated blood loss, sagittal sinus deviation from the sagittal suture, peri-operative outcomes, and hospital length of stay. Thirty-two patients underwent reconstructive cranial surgery for craniosynostosis, with a median age of 11 months (range, 7-160). Types of synostosis included metopic (6), unicoronal (6), sagittal (15), lambdoid (1), and multiple suture (4). Sagittal sinus deviation from the sagittal suture was maximal in unicoronal synostosis patients (10.2 ± 0.9 mm). All patients tolerated surgery well, and there were no occurrences of sagittal sinus, transverse sinus, or torcular injury. The use of CAD/CAM technology allows for accurate intraoperative dural venous sinus localization during reconstructive surgery for craniosynostosis and

  15. Artificial tears potpourri: a literature review

    Directory of Open Access Journals (Sweden)

    Moshirfar M

    2014-07-01

    Full Text Available Majid Moshirfar,1 Kasey Pierson,2,* Kamalani Hanamaikai,3,* Luis Santiago-Caban,1 Valliammai Muthappan,1 Samuel F Passi11Department of Ophthalmology, John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2University of Arizona College of Medicine, Phoenix, Phoenix, AZ, USA; 3A T Still University, School of Osteopathic Medicine in Arizona, Mesa, AZ, USA *These authors contributed equally to this work Abstract: Numerous brands and types of artificial tears are available on the market for the treatment of dysfunctional tear syndrome. Past literature has focused on comparing the components of these products on patient’s clinical improvement. The wide array of products on the market presents challenges to both clinicians and patients when trying to choose between available tear replacement therapies. Different formulations affect patients based on etiology and severity of disease. In order to provide an unbiased comparison between available tear replacement therapies, we conducted a literature review of existing studies and National Institutes of Health clinical trials on commercially available, brand name artificial tears. Outcomes evaluated in each study, as well as the percent of patients showing clinical and symptomatic improvement, were analyzed. Fifty-one studies evaluating different brands of artificial tears, and their efficacy were identified. Out of the 51 studies, 18 were comparison studies testing brand name artificial tears directly against each other. Nearly all formulations of artificial tears provided significant benefit to patients with dysfunctional tear syndrome, but some proved superior to others. From the study data, a recommended treatment flowchart was derived. Keywords: dry eye, tear film, dysfunctional tear syndrome, ophthalmic lubricant, artificial tears, lipid layer, tear osmolarity, TBUT, Systane®, Refresh®, Blink®, GenTeal®, Soothe®, Lacrisert®, ocular surface inflammatory disease, Sjogren

  16. Idiopathic Bilateral Bloody Tearing

    Directory of Open Access Journals (Sweden)

    Emrullah Beyazyıldız

    2015-01-01

    Full Text Available Bloody tear is a rare and distinct clinic phenomenon. We report a case presenting with the complaint of recurrent episodes of bilateral bloody tearing. A 16-year-old girl presented to our clinic with complaint of bloody tearing in both eyes for 3 months. Bloody tearing was not associated with her menses. A blood-stained discharge from the punctum was not observed during the compression of both nasolacrimal ducts. Nasolacrimal passage was not obstructed. Imaging studies such as dacryocystography and gradient-echo magnetic resonance imaging (MRI of nasolacrimal canal were normal. Intranasal endoscopic evaluation was normal. We collected samples from bloody tears two times and pathological examination was performed. Pathological analysis showed lots of squamous cells and no endometrial cells; dysplastic cells were found. Further evaluations for underlying causes were unremarkable. No abnormalities were found in ophthalmologic, radiologic, and pathologic investigations. This condition is likely a rare abnormality and the least recognized aetiology for the idiopathic phenomenon.

  17. Percentage Level of Tannin fur Rabbit for Leather Concerning Stitch Tearing Strength, Tearing Strength and Flexibility

    Directory of Open Access Journals (Sweden)

    Mustakim Mustakim

    2012-02-01

    Full Text Available The purpose of this study was to find out the appropriate of tannin level for rabbit fur leather concerning stitch tearing strength, tearing strength, and flexibility. The result were expected to contribute good information for the society, leather craftsman, and further researchers about fur leather tanning especially rabbit fur leather with tannin concerning stitch tearing strength, tearing strength and flexibility. The material that used were 12 pieces of four months of rabbit skin. The research method was Completely Randomized Design, consist of three treatments of tannin, they were: M1 (mimosa 15%, M2 (mimosa 20%, and M3 (mimosa 25%. Each of treatment hold on four repetition, the variables which measured were stitch tearing strength, tearing strength, and flexibility of fur leather. Data were  analysed by analysis variance followed by Duncan’s Multiple Range Test. The result of this research indicate that the use level of tannin give significant influence (P<0.05 among stitch tearing strength, tearing strength. It gave a very significant influence (P<0.01 for flexibility of rabbit fur leather. Based on the result, can be concluded that 25 % of tannin (mimosa, produce the best  result on stitch tearing strength and tearing strength. The increase of tannin offer will decrease the flexibility of fur leather but the lowest tannin produced the best flexibility of fur leather (15 percent. The best quality of rabbit fur leather produced by 25 % of tannin.   Keywords : leather, tannin, quality

  18. Artificial tears potpourri: a literature review

    Science.gov (United States)

    Moshirfar, Majid; Pierson, Kasey; Hanamaikai, Kamalani; Santiago-Caban, Luis; Muthappan, Valliammai; Passi, Samuel F

    2014-01-01

    Numerous brands and types of artificial tears are available on the market for the treatment of dysfunctional tear syndrome. Past literature has focused on comparing the components of these products on patient’s clinical improvement. The wide array of products on the market presents challenges to both clinicians and patients when trying to choose between available tear replacement therapies. Different formulations affect patients based on etiology and severity of disease. In order to provide an unbiased comparison between available tear replacement therapies, we conducted a literature review of existing studies and National Institutes of Health clinical trials on commercially available, brand name artificial tears. Outcomes evaluated in each study, as well as the percent of patients showing clinical and symptomatic improvement, were analyzed. Fifty-one studies evaluating different brands of artificial tears, and their efficacy were identified. Out of the 51 studies, 18 were comparison studies testing brand name artificial tears directly against each other. Nearly all formulations of artificial tears provided significant benefit to patients with dysfunctional tear syndrome, but some proved superior to others. From the study data, a recommended treatment flowchart was derived. PMID:25114502

  19. Ultrasound determination of rotator cuff tear repairability

    Science.gov (United States)

    Tse, Andrew K; Lam, Patrick H; Walton, Judie R; Hackett, Lisa

    2015-01-01

    Background Rotator cuff repair aims to reattach the torn tendon to the greater tuberosity footprint with suture anchors. The present study aimed to assess the diagnostic accuracy of ultrasound in predicting rotator cuff tear repairability and to assess which sonographic and pre-operative features are strongest in predicting repairability. Methods The study was a retrospective analysis of measurements made prospectively in a cohort of 373 patients who had ultrasounds of their shoulder and underwent rotator cuff repair. Measurements of rotator cuff tear size and muscle atrophy were made pre-operatively by ultrasound to enable prediction of rotator cuff repairability. Tears were classified following ultrasound as repairable or irreparable, and were correlated with intra-operative repairability. Results Ultrasound assessment of rotator cuff tear repairability has a sensitivity of 86% (p tear size (p tear size ≥4 cm2 or anteroposterior tear length ≥25 mm indicated an irreparable rotator cuff tear. Conclusions Ultrasound assessment is accurate in predicting rotator cuff tear repairability. Tear size or anteroposterior tear length and age were the best predictors of repairability. PMID:27582996

  20. Endovascular management of dural carotid-cavernous sinus fistulas in 141 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, M. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Universitaetsklinikum Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany); Henkes, H.; Liebig, T.; Weber, W.; Golik, S.; Kuehne, D. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Esser, J. [Universitaetsklinikum Essen, Zentrum fuer Augenheilkunde, Essen (Germany)

    2006-07-15

    Introduction: The purpose of this study was to evaluate the single-centre experience with transvenous coil treatment of dural carotid-cavernous sinus fistulas. Methods: Between November 1991 and December 2005, a total of 141 patients (112 female) with dural carotid-cavernous sinus fistula underwent 161 transvenous treatment sessions. The patient files and angiograms were analysed retrospectively. Clinical signs and symptoms included chemosis (94%), exophthalmos (87%), cranial nerve palsy (54%), increased intraocular pressure (60%), diplopia (51%), and impaired vision (28%). Angiography revealed in addition cortical drainage in 34% of the patients. Partial arterial embolization was carried out in 23% of the patients. Transvenous treatment comprised in by far the majority of patients complete filling of the cavernous sinus and the adjacent segment of the superior and inferior ophthalmic vein with detachable coils. Complete interruption of the arteriovenous shunt was achieved in 81% of the patients. A minor residual shunt (without cortical or ocular drainage) remained in 13%, a significant residual shunt (with cortical or ocular drainage) remained in 4%, and the attempted treatment failed in 2%. There was a tendency for ocular pressure-related symptoms to resolve rapidly, while cranial nerve palsy and diplopia improved slowly (65%) or did not change (11%). The 39 patients with visual impairment recovered within the first 2 weeks after endovascular treatment. After complete interruption of the arteriovenous shunt, no recurrence was observed. The transvenous coil occlusion of the superior and inferior ophthalmic veins and the cavernous sinus of the symptomatic eye is a highly efficient and safe treatment in dural carotid-cavernous sinus fistulas. In the majority of patients a significant and permanent improvement in clinical signs and symptoms can be achieved. (orig.)

  1. Iatrogenic tracheal tear.

    LENUS (Irish Health Repository)

    Dias, A

    2010-10-01

    Large post intubation tracheal tears are usually detected intra-operatively due to unstable signs namely impaired ventilation and mediastinal emphysema and often require surgical management. Smaller tracheal tears are often missed during anaesthesia and recognized during the postoperative period. Conservative management should be considered in these latter cases.

  2. Headache in the parturient: Pathophysiology and management of post-dural puncture headache

    Directory of Open Access Journals (Sweden)

    Gita Nath

    2011-01-01

    Full Text Available Headache in the postpartum period is common and multifactorial in origin. Apart from primary causes such as tension headaches and migraine, secondary headaches such as post-dural puncture headache (PDPH are increasingly common because of increasing use of regional anaesthesia and analgesia during childbirth. Preventive measures for PDPH include the use of smaller gauge pencil-point needles for spinal blocks; epidural needles of 18 G or less; using saline rather than air for epidural space identification and the use of ultrasound guidance, especially for difficult cases such as morbid obesity and spinal deformities. In case of accidental dural puncture (ADP, the choice is between inserting the catheter in an adjacent space or intrathecal catheterization. Current evidence seems to be in favour of inserting the epidural catheter into the subarachnoid space and using the intrathecal catheter for analgesia/anaesthesia after prominently labelling it as intrathecal, to prevent misuse. It should be removed after at least 24 hours and a 10 ml bolus of saline injected before removal of catheter may be helpful. Either way, having written protocols for the management of accidental dural puncture helps to reduce the incidence of PDPH. PDPH can be disabling in severity and can mar the whole experience of childbirth. In addition, severe untreated PDPH can cause complications such as nerve palsies, subdural hematoma and cerebral venous thrombosis. Conservative methods of treatment should be tried first such as adequate hydration, paracetamol, caffeine, sumatriptan or ACTH/hydrocortisone. Epidural blood patching is the most effective treatment for PDPH. It is more effective if done 24-48 hours after dural puncture. It is an invasive procedure with its own complications as well as a failure rate of up to 30%, so that a second or even third patch may be necessary. Both these facts should be intimated to the patient beforehand. Meticulous follow-up and evaluation

  3. Inadvertent presence of genetically modified elements in maize food ...

    African Journals Online (AJOL)

    Kenya has a biosafety law and has tested genetically modified (GM) maize under confinement and containment, but has neither released nor commercialized any GM crop. This study assessed various maize food products from the Kenyan farms and markets for the inadvertent presence of GMOs. It assessed the possibility ...

  4. Anterior Segment Optical Coherence Tomography for Tear Meniscus Evaluation and its Correlation with other Tear Variables in Healthy Individuals

    Science.gov (United States)

    Dhasmana, Renu; Nagpal, Ramesh Chander

    2016-01-01

    Introduction Dry eye is one of the most common ocular diseases in this cyber era. Despite availability of multiple tests, no single test is accurate for the diagnosis of dry eye. Anterior segment optical coherence tomography is the recent tool which can be added in the armentarium of dry eye tests. Aim To evaluate tear meniscus with anterior segment optical coherence tomography and its correlation with other tear variables in normal healthy individuals. Materials and Methods In this prospective cross-sectional observational study, right eye of 203 consecutive patients were studied. All the patients were divided into three groups Group 1, 2 and 3 according to their age ≤20 years, 21-40 years and >40 years respectively. All patients underwent routine ophthalmologic examinations along with slit-lamp bio-microscopy for tear meniscus height measurement, tear film break up time, Schirmer’s I test (with anaesthesia) and optical coherence tomography imaging of inferior tear meniscus height. After focusing of the instrument with a Cross Line (CL) centered on lower tear meniscus at 6’0 clock of cornea, a 6 mm long scan was obtained. The tear meniscus height (μm) and tear meniscus area (mm2) were measured manually with help of callipers by joining upper corneo-meniscus junction to the lower lid-meniscus junction and tear meniscus height and area within the plotted line respectively and calculated by using the integrated analysis available in the custom software. Results There was significant decrease in the all tear variables with the increase in the age. According to age groups in group 1, the mean Schirmer’s (24.0±4.9)mm, tear film break up time (11.1±1.9) sec, tear meniscus height on slit lamp (600.2±167.3)mm were higher but decreased in group 2 (21.5±5.4,10.8±1.4, 597.5±186.3) and group 3 (19.8 ± 5.1, 10.2 ± 1.6, 485.6 ± 157.7) respectively. Schirmer’s test values and tear film break up time were similar in both sexes (p=0.1 and p= 0.9). Tear meniscus

  5. Beverage can stay-tabs: still a source for inadvertently ingested foreign bodies in children

    Energy Technology Data Exchange (ETDEWEB)

    Donnelly, Lane F. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); University of Cincinnati, College of Medicine, Departments of Radiology and Pediatrics, Cincinnati, OH (United States)

    2010-09-15

    In the 1970s in part to avoid inadvertent ingestion, the beverage-can industry changed can construction from pull-tabs to the stay-tabs (remain attached to can after opening) used today. Our purpose is to identify the number of inadvertent ingestions of beverage-can stay-tabs by children recognized at our institution. The medical information system of a children's hospital was searched with key terms to identify cases in which a witnessed or self-reported inadvertent ingestion of a beverage-can stay-tab resulted in a radiograph to rule out presence of a foreign body. Demographics, identification of stay-tab on radiographs, associated abnormalities, and patient management were reviewed. Nineteen cases of stay-tab ingestion were identified over 16 years. Mean age of ingesters was 8.5 years with the majority being teenagers and 15 (79%) >5 years of age. The stay-tab could be seen radiographically only in 4 (21%) cases - all with the stay-tab identified in the stomach. The identification of 19 children who inadvertently ingested beverage-can stay-tabs at a single children's hospital suggests that such ingestions still occur. Radiologists should be aware that stay-tabs are radiographically visible in the minority (21%) of cases. (orig.)

  6. Beverage can stay-tabs: still a source for inadvertently ingested foreign bodies in children

    International Nuclear Information System (INIS)

    Donnelly, Lane F.

    2010-01-01

    In the 1970s in part to avoid inadvertent ingestion, the beverage-can industry changed can construction from pull-tabs to the stay-tabs (remain attached to can after opening) used today. Our purpose is to identify the number of inadvertent ingestions of beverage-can stay-tabs by children recognized at our institution. The medical information system of a children's hospital was searched with key terms to identify cases in which a witnessed or self-reported inadvertent ingestion of a beverage-can stay-tab resulted in a radiograph to rule out presence of a foreign body. Demographics, identification of stay-tab on radiographs, associated abnormalities, and patient management were reviewed. Nineteen cases of stay-tab ingestion were identified over 16 years. Mean age of ingesters was 8.5 years with the majority being teenagers and 15 (79%) >5 years of age. The stay-tab could be seen radiographically only in 4 (21%) cases - all with the stay-tab identified in the stomach. The identification of 19 children who inadvertently ingested beverage-can stay-tabs at a single children's hospital suggests that such ingestions still occur. Radiologists should be aware that stay-tabs are radiographically visible in the minority (21%) of cases. (orig.)

  7. Hot tearing studies in AA5182

    Science.gov (United States)

    van Haaften, W. M.; Kool, W. H.; Katgerman, L.

    2002-10-01

    One of the major problems during direct chill (DC) casting is hot tearing. These tears initiate during solidification of the alloy and may run through the entire ingot. To study the hot tearing mechanism, tensile tests were carried out in semisolid state and at low strain rates, and crack propagation was studied in situ by scanning electron microscopy (SEM). These experimentally induced cracks were compared with hot tears developed in an AA5182 ingot during a casting trial in an industrial research facility. Similarities in the microstructure of the tensile test specimens and the hot tears indicate that hot tearing can be simulated by performing tensile tests at semisolid temperatures. The experimental data were compared with existing hot tearing models and it was concluded that the latter are restricted to relatively high liquid fractions because they do not take into account the existence of solid bridges in the crack.

  8. Classification and localization of acetabular labral tears

    International Nuclear Information System (INIS)

    Blankenbaker, D.G.; De Smet, A.A.; Keene, J.S.; Fine, J.P.

    2007-01-01

    The purpose of this study was to compare the findings on hip MR arthrography (MRA) with the published MRA and arthroscopic classifications of hip labral tears and to evaluate a clock-face method for localizing hip labral tears. We retrospectively reviewed 65 hip MRA studies with correlative hip arthroscopies. Each labrum was evaluated on MRA using the classification system of Czerny and an MRA modification of the Lage arthroscopic classification. In addition, each tear was localized on MRA by using a clock-face description where 6 o'clock was the transverse ligament and 3 o'clock was anterior. These MRA findings were then correlated with the arthroscopic findings using the clock-face method of localization and the Lage arthroscopic classification of labral tears. At MRA, there were 42 Czerny grade 2 and 23 grade 3 labral tears and 22 MRA Lage type 1, 11 type 2, 22 type 3 and 10 type 4 tears. At arthroscopy, there were 10 Lage type 1 flap tears, 20 Lage type 2 fibrillated tears, 18 Lage type 3 longitudinal peripheral tears and 17 Lage type 4 unstable tears. The Czerny MRA classification and the modified MRA Lage classification had borderline correlation with the arthroscopic Lage classification. Localization of the tears using a clock-face description was within 1 o'clock of the arthroscopic localization of the tears in 85% of the patients. The Lage classification, which is the only published arthroscopic classification system for hip labral tears, does not correlate well with the Czerny MRA or an MRA modification of the Lage classification. Using a clock-face description to localize tears provides a way to accurately localize a labral tear and define its extent. (orig.)

  9. Tearing mode saturation with finite pressure

    International Nuclear Information System (INIS)

    Lee, J.K.

    1988-01-01

    With finite pressure, the saturation of the current-driven tearing mode is obtained in three-dimensional nonlinear resistive magnetohydrodynamic simulations for Tokamak plasmas. To effectively focus on the tearing modes, the perturbed pressure effects are excluded while the finite equilibrium pressure effects are retained. With this model, the linear growth rates of the tearing modes are found to be very insensitive to the equilibrium pressure increase. The nonlinear aspects of the tearing modes, however, are found to be very sensitive to the pressure increase in that the saturation level of the nonlinear harmonics of the tearing modes increases monotonically with the pressure rise. The increased level is associated with enhanced tearing island sizes or increased stochastic magnetic field region. (author)

  10. [The correlations between corneal sensation, tear meniscus volume, and tear film osmolarity after femtosecond laser-assisted LASIK].

    Science.gov (United States)

    Zhang, Luyan; Sun, Xiyu; Yu, Ye; Xiong, Yan; Cui, Yuxin; Wang, Qinmei; Hu, Liang

    2016-01-01

    To investigate the correlations between corneal sensation, tear meniscus volume, and tear film osmolarity after femtosecond laser-assisted LASIK (FS-LASIK) surgery. In this prospective clinical study, 31 patients undergoing FS-LASIK for myopia were recruited. The upper and lower tear meniscus volumes (UTMV and LTMV) were measured by customized anterior segment optical coherence tomography, tear film osmolarity was measured by a TearLab Osmolarity test device, central corneal sensation was measured by a Cochet-Bonner esthesiometer preoperatively, at 1 week, 1 and 3 months postoperatively. Repeated measures analysis of variance was used to evaluate whether the tear film osmolarity, tear meniscus volume, and corneal sensation were changed after surgery. The correlations between these variables were analyzed by the Pearson correlation analysis. The tear film osmolarity was (310.03 ± 16.48) mOsms/L preoperatively, (323.51 ± 15.92) mOsms/L at 1 week, (319.93 ± 14.27) mOsms/L at 1 month, and (314.97±12.91) mOsms/L at 3 months. The UTMV was (0.42±0.15), (0.25± 0.09), (0.30±0.11), and (0.35±0.09) μL, respectively; the LTMV was (0.60±0.21),(0.37±0.08), (0.44± 0.14), and (0.52±0.17) μL, respectively. The tear film osmolarity was significantly higher at 1 week and 1 month postoperatively compared with the baseline (P=0.001, 0.004), and reduced to the preoperative level at 3 months (P=0.573). The UTMV, LTMV, and corneal sensation values presented significant decreases at all postoperative time points (all Psensation at 1 week after surgery (r=0.356,P=0.005). There were significant correlations between the preoperative LTMV and corneal sensation at 1 week, 1 and 3 months (respectively, r=0.422, 0.366, 0.352;P=0.001, 0.004, 0.006). No significant correlations were found between the tear film osmolarity, tear meniscus volume, and corneal sensation after surgery (all P>0.05). The tear film osmolarity, tear meniscus volume, and corneal sensation became aggravated due

  11. Percentage Level of Tannin fur Rabbit for Leather Concerning Stitch Tearing Strength, Tearing Strength and Flexibility

    OpenAIRE

    Mustakim Mustakim; Aris Sri Widati; Lisa Purnaningtyas

    2012-01-01

    The purpose of this study was to find out the appropriate of tannin level for rabbit fur leather concerning stitch tearing strength, tearing strength, and flexibility. The result were expected to contribute good information for the society, leather craftsman, and further researchers about fur leather tanning especially rabbit fur leather with tannin concerning stitch tearing strength, tearing strength and flexibility. The material that used were 12 pieces of four months of rabbit skin. The re...

  12. Interaction of tearing modes

    International Nuclear Information System (INIS)

    Satya, Y.; Schmidt, G.

    1979-01-01

    A fully developed tearing mode modifies the magnetic field profile. The effect of this profile modification on the linear growth rate of a different tearing mode in a slab and cylindrical geometry is investigated

  13. MRI diagnosis of meniscal tears

    International Nuclear Information System (INIS)

    Kuga, Naoyuki; Oh, Toshihiro

    1996-01-01

    We studied the accuracy of magnetic resonance imaging (MRI) of the knee in fifty-six patients who were also examined arthroscopically. The accuracy, sensitivity, and specificity were 96%, 100%, and 95% for medial meniscal tears, and 91%, 67%, and 100% for lateral meniscal tears respectively. Two MRIs of the medial meniscus were false-positives. These MRI findings were both meniscocapsular separation of the medial meniscus, but the arthroscopic findings were normal. One case was an ACL injury and the other PCL and MCL injury. Hemorrhage and edema of the medial capsule caused by valgus stress at injury may look like a meniscal pseudo-tear on MRI. Five MRIs of the lateral meniscus were false-negatives. All menisci showed normal signal and shape on MRI but traumatic and stable tears of the lateral meniscus were identified arthroscopically. All were associated with ACL tears and lateral condylar bone bruise. The traumatic and stable tear of the meniscus tended to be overlooked on MRI because a meniscus without degeneration shows a normal signal. (author)

  14. Preservation of Frontal Sinus Anatomy and Outflow Tract Following Frontal Trauma with Dural Defect

    Directory of Open Access Journals (Sweden)

    James Wei Ming Kwek, MBBS, MRCS

    2015-02-01

    Full Text Available Summary: Our case report describes a young male mechanic who was hit in his face by a spring while repairing a car, resulting in traumatic injury to the frontal sinus, with fractures of both the anterior and the posterior tables with dural defect and cerebrospinal fluid leak. Current guidelines recommend that comminuted and/or displaced fractures of the posterior table of the frontal sinus with dural defects should be either cranialized or obliterated. In this patient, instead of cranializing or obliterating the frontal sinus, we managed to preserve the frontal sinus anatomy and its outflow tract using a combined open bicoronal and nasoendoscopic approach. This avoids the long-term complications associated with cranialization or obliteration including mucocele formation and frontocutaneous fistula.

  15. Response to events involving the inadvertent movement or illicit trafficking of radioactive materials

    International Nuclear Information System (INIS)

    2002-09-01

    By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

  16. Response to events involving the inadvertent movement or illicit trafficking of radioactive materials

    International Nuclear Information System (INIS)

    2004-08-01

    By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

  17. Response to events involving the inadvertent movement or illicit trafficking of radioactive materials

    International Nuclear Information System (INIS)

    2002-08-01

    By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

  18. Response to events involving the inadvertent movement or illicit trafficking of radioactive materials

    International Nuclear Information System (INIS)

    2003-08-01

    By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

  19. The interperiosteo-dural concept applied to the perisellar compartment: a microanatomical and electron microscopic study.

    Science.gov (United States)

    François, Patrick; Travers, Nadine; Lescanne, Emmanuel; Arbeille, Brigitte; Jan, Michel; Velut, Stéphane

    2010-11-01

    The dura mater has 2 dural layers: the endosteal layer (outer layer), which is firmly attached to the bone, and the meningeal layer (inner layer), which directly covers the brain. These 2 dural layers join together in the middle temporal fossa or the convexity and separate into the orbital, lateral sellar compartment (LSC), or spinal epidural space to form the extradural neural axis compartment (EDNAC). The aim of this work was to anatomically verify the concept of the EDNAC by using electron microscopy. The authors studied the cadaveric heads obtained from 13 adults. Ten of the specimens (or 20 perisellar areas) were injected with colored latex and fixed in formalin. They carefully removed each brain to allow a superior approach to the perisellar area. The 3 other specimens were studied by microscopic and ultrastructural methods to describe the EDNAC in the perisellar area. Special attention was paid to the dural layers surrounding the perisellar area. The authors studied the anatomy of the meningeal architecture of the LSC, the petroclival venous confluence, the orbit, and the trigeminal cave. After dissection, the authors took photographs of the dural layers with the aid of optical magnification. The 3 remaining heads, obtained from fresh cadavers, were prepared for electron microscopic study. The EDNAC is limited by the endosteal layer and the meningeal layer and contains fat and/or venous blood. The endosteal layer and meningeal layer were not identical on electron microscopy; this finding can be readily related to the histology of the meninges. In this study, the authors demonstrated the existence of the EDNAC concept in the perisellar area by using dissected cadaveric heads and verified the reality of the concept of the meningeal layer with electron microscopy. These findings clearly demonstrated the existence of the EDNAC, a notion that has generally been accepted but never demonstrated microscopically.

  20. MR diagnosis of dural sinus thrombosis. Diagnostico por RM de las trombosis de senos durales

    Energy Technology Data Exchange (ETDEWEB)

    Rovira Caellas, A.; Turon Estrada, A.; Alvarez Sabin, J.; Lozano Sanchez, M.; Castao Duque, Ch.; Grive Isern, E.; Sumalla Sue, J. (Hospital General Vall d' Hebron Barcelona (Spain))

    1994-01-01

    Four adult patients were diagnosed as having dural sinus thrombosis (DST) by means of magnetic resonance (MR). In the three cases of acute thrombosis, MR disclosed diffuse or segmental hyperintensity in the sinuses involved, which persisted regardless of the sequence and orientation of the plane selected. MR angiography (MRA) provided diagnostic information that proved useful in the chronic case, as well as in the two cases in which follow-up was carried out to determine the degree to which permeability was restored to the sinuses involved. MR diagnosis of DST can produce false positives and negatives, the causes of which should be known, as well as the ways to avoid them, in order to prevent diagnostic errors. MR, when applied and interpreted correctly, can be considered the first, and in many cases the only, choice as a diagnostic method in DST. (Author)

  1. The dural entrance of cerebral bridging veins into the superior sagittal sinus: an anatomical comparison between cadavers and digital subtraction angiography

    International Nuclear Information System (INIS)

    Han, Hui; Tao, Wei; Zhang, Ming

    2007-01-01

    Intracranial venous structures have received increasing attention due to improved neuroimaging techniques and increased awareness of cerebral venous disease. To date, few studies have attempted to investigate the dural entrance of the cerebral bridging vein (BV). The aim of this study was to use the superior sagittal sinus (SSS) as an example to identify anatomical features of the dural entrance of the BVs into the SSS in both human cadavers and digital subtraction angiography (DSA) images. A total of 30 adult and 7 fetal human cadavers and 36 patients were examined with anatomical dissections, vascular casting and DSA. The number, diameter and angle of the BVs entering the SSS were measured and compared between the cadavers and DSA images. The results demonstrated that (1) the way a BV entered the SSS varied in three dimensions, and thus the BV dural entrance was difficult to precisely localize by DSA, (2) the distribution pattern of the dural entrance of the BVs into the SSS was relatively constant and a nontributary segment of the SSS was centered at the coronal suture and was identifiable by DSA, and (3) nearly all the BVs (97%, 561/581) entered the SSS at an angle opposite to the direction of blood flow. Unique anatomical features of the dural entrance of a BV into the SSS should be considered in neuroimaging interpretation of the sinus and its associated veins. (orig.)

  2. Assessment of tear film osmolarity using the TearLab™ osmometer in normal dogs and dogs with keratoconjunctivitis sicca.

    Science.gov (United States)

    Sebbag, Lionel; Park, Shin Ae; Kass, Philip H; Maggs, David J; Attar, Mayssa; Murphy, Christopher J

    2017-07-01

    To evaluate repeatability and reproducibility of tear osmolarity measured using the TearLab ™ osmometer in normal dogs and to assess its diagnostic potential in dogs with keratoconjunctivitis sicca (KCS). Beagle dogs; six normal and five with KCS. Tear osmolarity and Schirmer tear test-1 (STT-1) values were obtained at various times. Normal dogs were assessed for diurnal variation and repeatability and reproducibility of measurements. Dogs with KCS were evaluated before and after 5 months' topical twice-daily therapy with 2% cyclosporine. Mean ± SD tear osmolarity (mOsm/L) was significantly higher in normal dogs (337.4 ± 16.2) than in dogs with KCS before therapy (306.2 ± 18.0; P dogs, tear osmolarity readings were stable during the daytime (P = 0.99). Repeated measurements revealed high variability and typically poor-to-moderate repeatability and reproducibility, although this was improved by taking three successive measurements at each session. Considering combined data from all dogs, a positive correlation existed between STT-1 and tear osmolarity measurements (Pearson's correlation test, P = 0.04, r = 0.62). Canine tear osmolarity as determined by TearLab ™ osmometer was variable, required multiple readings to be informative, and differed from values reported for humans. Dogs with KCS had a lower tear osmolarity than did normal dogs, and this increased following cyclosporine therapy. © 2016 American College of Veterinary Ophthalmologists.

  3. Dural metastases from prostate carcinoma: A systematic review of the literature apropos of six patients

    International Nuclear Information System (INIS)

    Vasconcelos Sobreira Guedes, Bruno de; Rocha, Antonio Jose da; Pereira Pinto Gama, Hugo; Silva, Carlos Jorge da

    2011-01-01

    Intracranial metastases are a rare manifestation of prostate carcinoma and the dura mater is the most affected site. We report a series of six patients with dural prostate metastases (DPM) and perform a systematic review of the current literature in order to depict imaging trademarks of this condition. This review points to a magnetic resonance imaging (MRI) pattern of meningeal involvement characterized by a diffuse smooth thickening, nodular appearance or dural-based masses. We also demonstrate an osteoblastic pattern of lesions, particularly in sphenoid wing, by computed tomography (CT) scans. We suggest that these imaging findings may support an elevated index of suspicion of DPM in elderly men, including those patients without urologic symptoms.

  4. Danish translation and validation of the International Skin Tear Advisory Panel Skin Tear Classification System

    DEFF Research Database (Denmark)

    Skiveren, J; Bermark, S; LeBlanc, K

    2015-01-01

    OBJECTIVE: The aim of this study was to translate, validate and establish reliability of the International Skin Tear Classification System in Danish. METHOD: Phase 1 of the project involved the translation of the International Skin Tear Advisory Panel (ISTAP) Skin Tear Classification System......) and social and health-care assistants (non-RN) from both primary health care and a Danish university hospital in Copenhagen. Thirty photographs, with equal representation of the three types of skin tears, were selected to test validity. The photographs chosen were those originally used for internal...... and external validation by the ISTAP group. The subjects were approached in their place of work and invited to participate in the study and to attend an educational session related to skin tears. RESULTS: The Danish translation of the ISTAP classification system was tested on 270 non-wound specialists...

  5. Large capillary hemangioma of the temporal bone with a dural tail sign: A case report

    KAUST Repository

    YANG, GUANG

    2014-05-13

    The present study reports a rare case of large capillary hemangioma of the temporal bone with a dural tail sign. A 57-year-old female presented with pulsatile tinnitus and episodic vertigo associated with a ten-year history of an intermittent faint headache. Magnetic resonance imaging revealed a mass in the right petrous bone, which was hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, and showed a dural tail sign following gadolinium administration. Pre-operatively, this tumor was believed to be a meningioma. During surgery, the vascular tumor was removed by a modified pterional approach. A histopathological examination indicated that the tumor was a capillary hemangioma. Although intraosseous capillary hemangiomas are rare, they most frequently affect the temporal bone. Hemangiomas of the temporal bone may mimic other more common basal tumors. The diagnosis is most often made during surgical resection. The dural tail sign is not specific for meningioma, as it also occurs in other intracranial or extracranial tumors. The treatment of intratemporal hemangiomas is complete surgical excision, with radiotherapy used for unresectable lesions. To the best of our knowledge, the present study is the fourth case of intraosseous intracranial capillary hemangioma, but the largest intratemporal hemangioma to be reported in the literature to date.

  6. Large capillary hemangioma of the temporal bone with a dural tail sign: A case report

    KAUST Repository

    YANG, GUANG; LI, CHENGUANG; CHEN, XIN; LIU, YAOHUA; HAN, DAYONG; Gao, Xin; KAWAMOTO, KEIJI; ZHAO, SHIGUANG

    2014-01-01

    The present study reports a rare case of large capillary hemangioma of the temporal bone with a dural tail sign. A 57-year-old female presented with pulsatile tinnitus and episodic vertigo associated with a ten-year history of an intermittent faint headache. Magnetic resonance imaging revealed a mass in the right petrous bone, which was hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, and showed a dural tail sign following gadolinium administration. Pre-operatively, this tumor was believed to be a meningioma. During surgery, the vascular tumor was removed by a modified pterional approach. A histopathological examination indicated that the tumor was a capillary hemangioma. Although intraosseous capillary hemangiomas are rare, they most frequently affect the temporal bone. Hemangiomas of the temporal bone may mimic other more common basal tumors. The diagnosis is most often made during surgical resection. The dural tail sign is not specific for meningioma, as it also occurs in other intracranial or extracranial tumors. The treatment of intratemporal hemangiomas is complete surgical excision, with radiotherapy used for unresectable lesions. To the best of our knowledge, the present study is the fourth case of intraosseous intracranial capillary hemangioma, but the largest intratemporal hemangioma to be reported in the literature to date.

  7. Linear stability of tearing modes

    International Nuclear Information System (INIS)

    Cowley, S.C.; Kulsrud, R.M.; Hahm, T.S.

    1986-05-01

    This paper examines the stability of tearing modes in a sheared slab when the width of the tearing layer is much smaller than the ion Larmor radius. The ion response is nonlocal, and the quasineutrality retains its full integal form. An expansion procedure is introduced to solve the quasineutrality equation in powers of the width of the tearing layer over the ion Larmor radius. The expansion procedure is applied to the collisionless and semi-collisional tearing modes. The first order terms in the expansion we find to be strongly stabilizing. The physics of the mode and of the stabilization is discussed. Tearing modes are observed in experiments even though the slab theory predicts stability. It is proposed that these modes grow from an equilibrium with islands at the rational surfaces. If the equilibrium islands are wider than the ion Larmor radius, the mode is unstable when Δ' is positive

  8. Arthroscopic repair of large U-shaped rotator cuff tears without margin convergence versus repair of crescent- or L-shaped tears.

    Science.gov (United States)

    Park, Jin-Young; Jung, Seok Won; Jeon, Seung-Hyub; Cho, Hyoung-Weon; Choi, Jin-Ho; Oh, Kyung-Soo

    2014-01-01

    For large-sized tears of the rotator cuff, data according to the tear shape have not yet been reported for repair methodology, configuration, and subsequent integrity. The retear rate after the repair of large mobile tears, such as crescent- or L-shaped tears, is believed to be lower compared with retear rates after the repair of large U-shaped tears that are accompanied by anterior or posterior leaves of the rotator cuff. Cohort study; Level of evidence, 3. Data were collected and analyzed from 95 consecutive patients with a large-sized rotator cuff tear who underwent arthroscopic suture-bridge repair. Patients were divided into 2 groups: those having crescent- or L-shaped tears (mobile tear group, 53 patients) and those having U-shaped tears (U-shaped tear group, 42 patients). The integrity of the repaired constructs was determined by ultrasonography at 4.5, 12, and 24 months. Moreover, clinical evaluations were performed by using the Constant score, the American Shoulder and Elbow Surgeons (ASES) score, and muscle strength at intervals of 3, 6, 12, and 24 months postoperatively. On ultrasonography at 4.5, 12, and 24 months, a retear was detected in 6, 2, and 1 patients in the mobile tear group and in 5, 2, and 1 patients in the U-shaped tear group, respectively. Significant differences in retear rates were not detected between the groups overall or at each time point. Moreover, clinical scores were similar between groups, except for the presence of a temporarily higher Constant score at 12 months in the mobile tear group. With regard to shoulder strength, between-group comparisons indicated no statistically significant difference, either in abduction or external rotation, except for the presence of temporarily higher external rotation strength at 3 months in the mobile tear group. Arthroscopic repair of large-sized rotator cuff tears yielded substantial improvements in shoulder function, regardless of tear retraction, during midterm follow-up. Moreover, the

  9. A review on hot tearing of magnesium alloys

    Directory of Open Access Journals (Sweden)

    Jiangfeng Song

    2016-09-01

    Full Text Available Hot tearing is often a major casting defect in magnesium alloys and has a significant impact on the quality of their casting products. Hot tearing of magnesium alloys is a complex solidification phenomenon which is still not fully understood, it is of great importance to investigate the hot tearing behaviour of magnesium alloys. This review attempts to summarize the investigations on hot tearing of magnesium alloys over the past decades. The hot tearing criteria including recently developed Kou's criterion are summarized and compared. The numeric simulation and assessing methods of hot tearing, factors influencing hot tearing, and hot tearing susceptibility (HTS of magnesium alloys are discussed.

  10. Standardization and validation of a novel and simple method to assess lumbar dural sac size

    International Nuclear Information System (INIS)

    Daniels, M.L.A.; Lowe, J.R.; Roy, P.; Patrone, M.V.; Conyers, J.M.; Fine, J.P.; Knowles, M.R.; Birchard, K.R.

    2015-01-01

    Aim: To develop and validate a simple, reproducible method to assess dural sac size using standard imaging technology. Materials and methods: This study was institutional review board-approved. Two readers, blinded to the diagnoses, measured anterior–posterior (AP) and transverse (TR) dural sac diameter (DSD), and AP vertebral body diameter (VBD) of the lumbar vertebrae using MRI images from 53 control patients with pre-existing MRI examinations, 19 prospectively MRI-imaged healthy controls, and 24 patients with Marfan syndrome with prior MRI or CT lumbar spine imaging. Statistical analysis utilized linear and logistic regression, Pearson correlation, and receiver operating characteristic (ROC) curves. Results: AP-DSD and TR-DSD measurements were reproducible between two readers (r = 0.91 and 0.87, respectively). DSD (L1–L5) was not different between male and female controls in the AP or TR plane (p = 0.43; p = 0.40, respectively), and did not vary by age (p = 0.62; p = 0.25) or height (p = 0.64; p = 0.32). AP-VBD was greater in males versus females (p = 1.5 × 10 −8 ), resulting in a smaller dural sac ratio (DSR) (DSD/VBD) in males (p = 5.8 × 10 −6 ). Marfan patients had larger AP-DSDs and TR-DSDs than controls (p = 5.9 × 10 −9 ; p = 6.5 × 10 −9 , respectively). Compared to DSR, AP-DSD and TR-DSD better discriminate Marfan from control subjects based on area under the curve (AUC) values from unadjusted ROCs (AP-DSD p < 0.01; TR-DSD p = 0.04). Conclusion: Individual vertebrae and L1–L5 (average) AP-DSD and TR-DSD measurements are simple, reliable, and reproducible for quantitating dural sac size without needing to control for gender, age, or height. - Highlights: • DSD (L1-L5) does not differ in the AP or TR plane by gender, height, or age. • AP- and TR-DSD measures correlate well between readers with different experience. • Height is positively correlated to AP-VBD in both males and females. • Varying

  11. Embolization of intracranial dural arteriovenous fistulas using PHIL liquid embolic agent in 26 patients

    DEFF Research Database (Denmark)

    Lamin, S.; Chew, H. S.; Chavda, S.

    2017-01-01

    BACKGROUND AND PURPOSE: The introduction of liquid embolic agents has revolutionized endovascular approach to cranial vascular malformations. The aim of the study was to retrospectively assess the efficacy and safety of Precipitating Hydrophobic Injectable Liquid (PHIL), a new nonadhesive liquid......: This was a retrospective multicenter study. Twenty-six consecutive patients with dural arteriovenous fistulas (de novo or previously treated) treated by injection of PHIL only or with PHIL in combination with other embolization products (such as Onyx or detachable coils) were included in the study. Recruitment started......, 3 were retreated with PHIL and 1 achieved angiographic cure. An adverse event was seen in 1 patient who developed worsening of preexisting ataxia due to acute thrombosis of the draining vein. CONCLUSIONS: PHIL appears to be safe and effective for endovascular treatment of cranial dural arteriovenous...

  12. Rotator cuff tears: correlation between geometric tear patterns on MRI and arthroscopy and pre- and postoperative clinical findings.

    Science.gov (United States)

    Sela, Yaron; Eshed, Iris; Shapira, Shachar; Oran, Ariel; Vogel, Guy; Herman, Amir; Perry Pritsch, Moshe

    2015-02-01

    Magnetic resonance imaging (MRI) is considered to be the best non-invasive procedure for the evaluation of rotator cuff (RC) tendon tears. Burkhart's classification is a geometric classification of full-thickness RC tears on MRI. To correlate MRI and arthroscopic geometric full-thickness RC tears according to the Burkhart's classification with pre- and postoperative clinical findings. Patients who underwent arthroscopic RC repair between 2006 and 2010 were retrospectively evaluated. Preoperative MRI and arthroscopic surgical reports were reviewed for tear geometry (Burkhart's) by three (1 radiologist, 2 surgeons) and two (surgeons) readers. MRIs were also evaluated for tear size and change of tear size in successive sagittal sections and for muscle mass and fatty infiltration. Clinical examinations were performed preoperatively and at least 12 months afterwards. Postoperative function questionnaires were filled in by the patients. Forty-six patients (35 men, 11 women; mean age, 57 years; range, 41-72 years) were evaluated. Tears depicted on MRIs were classified as crescent in 11 patients (24%), longitudinal in three (6.5%), massive contracted in 29 (63%), and cuff arthropathy in three (6.5%). Muscle changes were noted almost exclusively in patients with massive tears and cuff arthropathy (16/32 patients, P = 0.013). MRIs and arthroscopic geometric classifications were in close agreement. Tear type did not correlate with pre- and postoperative physical examination or with postoperative clinical questionnaires scores. Geometric RC tear characterizations on preoperative MRIs were closely associated with arthroscopic findings. Postoperative results were not affected by the geometric pattern of the tears. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. MRI of meniscal bucket-handle tears

    Energy Technology Data Exchange (ETDEWEB)

    Magee, T.H.; Hinson, G.W. [Menorah Medical Center, Overland Park, KS (United States). Dept. of Radiology

    1998-09-01

    A meniscal bucket-handle tear is a tear with an attached fragment displaced from the meniscus of the knee joint. Low sensitivity of MRI for detection of bucket-handle tears (64% as compared with arthroscopy) has been reported previously. We report increased sensitivity for detecting bucket-handle tears with the use of coronal short tau inversion recovery (STIR) images. Results. By using four criteria for diagnosis of meniscal bucket-handle tears, our overall sensitivity compared with arthroscopy was 93% (28 of 30 meniscal bucket-handle tears seen at arthroscopy were detected by MRI). The meniscal fragment was well visualized in all 28 cases on coronal STIR images. The double posterior cruciate ligament sign was seen in 8 of 30 cases, the flipped meniscus was seen in 10 of 30 cases and a fragment in the intercondylar notch was seen in 18 of 30 cases. (orig.)

  14. Comparison of low-abundance biomarker levels in capillary-collected nonstimulated tears and washout tears of aqueous-deficient and normal patients.

    Science.gov (United States)

    Guyette, Nicole; Williams, Larezia; Tran, My-Tho; Than, Tammy; Bradley, John; Kehinde, Lucy; Edwards, Clara; Beasley, Mark; Fullard, Roderick

    2013-05-01

    Low tear volume limits the use of nonstimulated (NS) microcapillary tear collection in aqueous-deficient (AD) patients. Adding a small amount of "washout" fluid to the eye prior to tear collection is a potentially viable alternative method for abundant proteins, but is relatively untested for low-abundance biomarkers. This study determined the feasibility of the washout (WO) method as an NS alternative for low-abundance biomarkers. NS and WO biomarker profiles were compared between AD patients and non-AD controls to determine if the two methods identify the same intergroup differences. Matching NS and WO tears were collected from 48 patients by micropipette, the WO sample after instillation of 10 μL saline. Tear cytokine levels were measured by 27-Plex Bio-Rad assay. Bland-Altman analyses for each biomarker determined the agreement between tear sample types. Patients were grouped as AD or non-AD based on Schirmer score to determine if NS profile between-group differences were preserved in WO tears. Bland-Altman plots showed good biomarker level agreement between NS and WO tears for most cytokines. Five biomarkers, among those most often cited as differing in AD dry eye, differed significantly between non-AD and AD groups in both tear types. Additional biomarker differences were seen in NS tears only. The WO tear collection method is a viable alternative to NS tears for many low-abundance biomarkers and is able to replicate major NS tear differences between dry eye groups. More subtle intergroup differences are lost in WO samples because of reduced statistical power.

  15. Warm and touching tears: tearful individuals are perceived as warmer because we assume they feel moved and touched.

    Science.gov (United States)

    Zickfeld, Janis H; Schubert, Thomas W

    2018-01-31

    Recent work investigated the inter-individual functions of emotional tears in depth. In one study (Van de Ven, N., Meijs, M. H. J., & Vingerhoets, A. (2017). What emotional tears convey: Tearful individuals are seen as warmer, but also as less competent. British Journal of Social Psychology, 56(1), 146-160. Https://doi.org/10.1111/bjso.12162) tearful individuals were rated as warmer, and participants expressed more intentions to approach and help such individuals. Simultaneously, tearful individuals were rated as less competent, and participants expressed less intention to work with the depicted targets. While tearful individuals were perceived as sadder, perceived sadness mediated only the effect on competence, but not on warmth. We argue that tearful individuals might be perceived as warm because they are perceived as feeling moved and touched. We ran a pre-registered extended replication of Van de Ven et al. Results replicate the warmth and helping findings, but not the competence and work effects. The increase in warmth ratings was completely mediated by perceiving feeling moved and touched. Possible functions of feeling moved and touched with regard to emotional tears are discussed.

  16. Comparative study of lubricating properties of tear substitutes Systane® Ultra and Visine® Clear Tears

    Directory of Open Access Journals (Sweden)

    Yu. A. Pavlova

    2014-07-01

    Full Text Available Purpose: To compare tear substitutive properties of Systane® Ultra and Visine® Clear Tears in dry eye therapy.Methods: 20 patients with dry eye due to chronic blepharoconjunctivitis and 20 patients with neurotrophic dry eye following corneal refractive surgery were examined. Treatment schedule was the following: in the first 7 days, Systane® Ultra was instilled in the right eye and Visine® Clear Tears was instilled in the left eye, while from day 8 to day 30, only one medicine selected by the patient was applied. Their efficacy was measured by tear film stability and patients’ subjective sensations.Results: Norn test results improved to day 7 in patients with dry eye following corneal refractive surgery and to day 30 in patients with dry eye due to blepharoconjunctivitis regardless of eye drops used. As to patients’ comfort, Systane® Ultra is preferable to Visine® Clear Tears.Conclusion: Systane® Ultra is therapeutically similar to but preferable to Visine® Clear Tears due to good tolerability.

  17. Comparative study of lubricating properties of tear substitutes Systane® Ultra and Visine® Clear Tears

    Directory of Open Access Journals (Sweden)

    Yu. A. Pavlova

    2013-01-01

    Full Text Available Purpose: To compare tear substitutive properties of Systane® Ultra and Visine® Clear Tears in dry eye therapy.Methods: 20 patients with dry eye due to chronic blepharoconjunctivitis and 20 patients with neurotrophic dry eye following corneal refractive surgery were examined. Treatment schedule was the following: in the first 7 days, Systane® Ultra was instilled in the right eye and Visine® Clear Tears was instilled in the left eye, while from day 8 to day 30, only one medicine selected by the patient was applied. Their efficacy was measured by tear film stability and patients’ subjective sensations.Results: Norn test results improved to day 7 in patients with dry eye following corneal refractive surgery and to day 30 in patients with dry eye due to blepharoconjunctivitis regardless of eye drops used. As to patients’ comfort, Systane® Ultra is preferable to Visine® Clear Tears.Conclusion: Systane® Ultra is therapeutically similar to but preferable to Visine® Clear Tears due to good tolerability.

  18. Tear exchange and contact lenses: a review.

    Science.gov (United States)

    Muntz, Alex; Subbaraman, Lakshman N; Sorbara, Luigina; Jones, Lyndon

    2015-01-01

    Tear exchange beneath a contact lens facilitates ongoing fluid replenishment between the ocular surface and the lens. This exchange is considerably lower during the wear of soft lenses compared with rigid lenses. As a result, the accumulation of tear film debris and metabolic by-products between the cornea and a soft contact lens increases, potentially leading to complications. Lens design innovations have been proposed, but no substantial improvement in soft lens tear exchange has been reported. Researchers have determined post-lens tear exchange using several methods, notably fluorophotometry. However, due to technological limitations, little remains known about tear hydrodynamics around the lens and, to-date, true tear exchange with contact lenses has not been shown. Further knowledge regarding tear exchange could be vital in aiding better contact lens design, with the prospect of alleviating certain adverse ocular responses. This article reviews the literature to-date on the significance, implications and measurement of tear exchange with contact lenses. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  19. MR Imaging of a Posterior Root Tear of the Medial Meniscus: Diagnostic Accuracy of Various Tear Configurations and Associated Knee Abnormalities

    International Nuclear Information System (INIS)

    Lee, Hyang Mi; Shim, Jae Chan; Kim, Jin Goo; Lee, Jae Myeong; Nam, Mee Young; Lee, Ghi Jai; Kim, Ho Kyun; Suh, Jung Ho

    2010-01-01

    To evaluate the diagnostic accuracy of the various tear configurations in a medial meniscal posterior horn root tear and assess whether any correlation exists with other associated knee abnormalities in MR imaging. A retrospective review of 146 preoperative knee MR images were performed by one experienced musculoskeletal radiologist. The tear configuration and other abnormalities were evaluated. Sensitivity, specificity, and diagnostic accuracy of each configuration in the medial meniscal posterior horn root tear were calculated. A total of 48 medial meniscal posterior horn root tears including 38 full-thickness radial, 7 partial-thickness radial, and 3 complex tears were confirmed during arthroscopy. Overall, the sensitivity, specificity, and accuracy for the detection of medial meniscal posterior horn root tear were 92% (44/48), 99% (97/98), and 97% (141/146), respectively. For each tear configuration, sensitivity, specificity, and accuracy were 82% (31/38), 97% (105/108), and 93% (136/146) for full-thickness radial tears, respectively, and 43% (3/7), 94% (131/139), and 91% (134/146) for partial-thickness radial tears, respectively. The incidence of degenerative joint disease was 85% (41/48) for the tear group, revealing a strong association. In patients with a root tear and with degenerative joint disease, the incidence of high grade cartilage defects involving the medial femoral condyle was at 80% (33/41), compared to 56% (23/41) for the presence of medial meniscal extrusion. In contrast, a similar comparison of incidence for patients with no root tears but with degenerative joint disease was at 68% (17/25) and 26% (8/31), respectively. MR imaging is very sensitive for the detection of medial meniscal root tears, but has reduced the accuracy with regard to each tear configuration. Medial meniscal root tears showed a strong association with degenerative joint disease. High grade cartilage defects of the medial femoral condyle and medial meniscal extrusions also

  20. MR Imaging of a Posterior Root Tear of the Medial Meniscus: Diagnostic Accuracy of Various Tear Configurations and Associated Knee Abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyang Mi; Shim, Jae Chan; Kim, Jin Goo; Lee, Jae Myeong; Nam, Mee Young; Lee, Ghi Jai; Kim, Ho Kyun; Suh, Jung Ho [Inje University College of Medicine, Seoul Paik Hospital, Seoul (Korea, Republic of)

    2010-11-15

    To evaluate the diagnostic accuracy of the various tear configurations in a medial meniscal posterior horn root tear and assess whether any correlation exists with other associated knee abnormalities in MR imaging. A retrospective review of 146 preoperative knee MR images were performed by one experienced musculoskeletal radiologist. The tear configuration and other abnormalities were evaluated. Sensitivity, specificity, and diagnostic accuracy of each configuration in the medial meniscal posterior horn root tear were calculated. A total of 48 medial meniscal posterior horn root tears including 38 full-thickness radial, 7 partial-thickness radial, and 3 complex tears were confirmed during arthroscopy. Overall, the sensitivity, specificity, and accuracy for the detection of medial meniscal posterior horn root tear were 92% (44/48), 99% (97/98), and 97% (141/146), respectively. For each tear configuration, sensitivity, specificity, and accuracy were 82% (31/38), 97% (105/108), and 93% (136/146) for full-thickness radial tears, respectively, and 43% (3/7), 94% (131/139), and 91% (134/146) for partial-thickness radial tears, respectively. The incidence of degenerative joint disease was 85% (41/48) for the tear group, revealing a strong association. In patients with a root tear and with degenerative joint disease, the incidence of high grade cartilage defects involving the medial femoral condyle was at 80% (33/41), compared to 56% (23/41) for the presence of medial meniscal extrusion. In contrast, a similar comparison of incidence for patients with no root tears but with degenerative joint disease was at 68% (17/25) and 26% (8/31), respectively. MR imaging is very sensitive for the detection of medial meniscal root tears, but has reduced the accuracy with regard to each tear configuration. Medial meniscal root tears showed a strong association with degenerative joint disease. High grade cartilage defects of the medial femoral condyle and medial meniscal extrusions also

  1. Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction

    Directory of Open Access Journals (Sweden)

    Anmar M. Abdul-Rahman

    2017-01-01

    Full Text Available Purpose: To report a case of inadvertent bleb formation presenting 18 months after pars plana M3 Molteno implant tube obstruction in a patient with mixed mechanism glaucoma. Materials and Methods: An 84-year-old Caucasian male with mixed mechanism glaucoma underwent slit-lamp examination, gonioscopy, colour anterior segment photography and anterior segment optical coherence tomography (AS-OCT. Results: An inadvertent bleb developed 18 months after pars plana implant tube re-positioning with a 6/0 Vicryl tie ligature. The bleb was located in the area anterior to the implant plate; it was characterised by a thin, transparent, avascular and multi-cystic wall, with a visible stoma at the posterior edge of the bleb. The bleb was functioning as demonstrated by an intraocular pressure of 6 mm Hg at presentation and a punctate fluorescein uptake pattern of the bleb wall. The bleb over the plate of the Molteno implant was non-functioning, likely secondary to tube obstruction by vitreous in the early postoperative period. AS-OCT showed a tract from the anterior chamber commencing at an entry wound through a corneal tunnel to the posterior stoma at the base of the inadvertent bleb. Conclusions: We hypothesise that the pathophysiologic factors resulting in an inadvertent bleb are a result of a combination of apoptosis, late-onset wound dehiscence and internal gaping of a centrally placed corneal wound. In addition, aqueous hydrodynamic factors may play a role.

  2. Potential impact of DOE's performance objective for protection of inadvertent intruders on low-level waste disposals at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Kocher, D.C.

    1993-01-01

    Performance objectives for disposal of low-level radioactive waste at Department of Energy (DOE) sites include limits on radiation dose to inadvertent intruders. This paper investigates the potential impact of DOE's performance objective for protection of inadvertent intruders on the acceptability of low-level waste disposals at Oak Ridge National Laboratory (ORNL). The analysis is based on waste volumes and radionuclide inventories for recent disposals and estimated doses to an inadvertent intruder for assumed exposure scenarios. The analysis indicates that more than 99% of the total volume of waste in recent disposals meets the performance objective for inadvertent intruders, and the volume of waste found to be unacceptable for disposal is only about 16 m 3 . Therefore, DOE's performance objective for protection of inadvertent intruders probably will not have unreasonably adverse impacts on acceptable waste disposals at ORNL

  3. Interferometric characterization of tear film dynamics

    Science.gov (United States)

    Primeau, Brian Christopher

    The anterior refracting surface of the eye is the thin tear film that forms on the surface of the cornea. When a contact lens is on worn, the tear film covers the contact lens as it would a bare cornea, and is affected by the contact lens material properties. Tear film irregularity can cause both discomfort and vision quality degradation. Under normal conditions, the tear film is less than 10 microns thick and the thickness and topography change in the time between blinks. In order to both better understand the tear film, and to characterize how contact lenses affect tear film behavior, two interferometers were designed and built to separately measure tear film behavior in vitro and in vivo. An in vitro method of characterizing dynamic fluid layers applied to contact lenses mounted on mechanical substrates has been developed using a phase-shifting Twyman-Green interferometer. This interferometer continuously measures light reflected from the surface of the fluid layer, allowing precision analysis of the dynamic fluid layer. Movies showing this fluid layer behavior can be generated. The fluid behavior on the contact lens surface is measured, allowing quantitative analysis beyond what typical contact angle or visual inspection methods provide. The in vivo interferometer is a similar system, with additional modules included to provide capability for human testing. This tear film measurement allows analysis beyond capabilities of typical fluorescein visual inspection or videokeratometry and provides better sensitivity and resolution than shearing interferometry methods.

  4. [Alterations in tears aqueous layer during cytostatics treatment].

    Science.gov (United States)

    Wojciechowska, Katarzyna; Wieckowska-Szakiel, Marzena; Rózalska, Barbara; Jurowski, Piotr

    2013-01-01

    The aim of the study was to evaluate tears secretion, pH and lysozyme activity in tears aqueous layer during chemotherapy in lung, breast and bowel cancer. 36 patients were enrolled to the study. Depending on the type of cancer and type of chemotherapy patients were divided into three groups. Group I (12 patients) diagnosed with non-small-cell lung cancer treated with PE schema (cisplatin, etoposide), Group II (12 patients) with breast cancer treated with FAC schema (fluorouracil, doxorubicin, cyclophosphamide), Group III (12 patients) with bowel cancer treated with FU/LV schema (fluorouracil, leucovorin). In all the patients: Schirmer's I test, pH measurements and lysozyme test were performed. Patients were examined before chemotherapy, after 2nd, 4th, 6th cycle. In group I and II lowering of tears secretion (p tears secretion (p tears film in all groups (p tears aqueous layer causing alterations of tears secretions. PH alterations depending on type of chemotherapy was observed. Lowering of lysozyme activity in tears was observed. All the deteriorations aggravate with duration of chemotherapy. Alterations of tears film parameters during chemotherapy may influence upon eye surface homeostasis and infectious complication. tears aqueous layer, Schirmer's test, lysozyme activity, tears pH.

  5. Magnetic resonance imaging of meniscal bucket-handle tears

    International Nuclear Information System (INIS)

    Dfouni, N.; Garcia, J.; Kindynis, Ph.; Bosson, D.

    1997-01-01

    To define MR signs of meniscal bucket-handle tears and evaluate the diagnostic efficiency of this technique. Retrospective study of 30 patients with a meniscal bucket-handle tear and 30 with a different type of tear, all proven by arthroscopy. The following MR signs of a bucket-handle tear were evaluated: 'separate meniscal fragment, 'double posterior cruciate ligament', 'snake sign' and 'double anterior horn'. A correct diagnosis of a bucket-handle tear was only made in 18/30 of patients. Several of the MR signs were seen in the same patient in 17 cases. A double posterior cruciate ligament was present only in cases of medial meniscus tears. The 12 menisci without these signs, and therefore not diagnosed as bucket-handle tears, were all classified as meniscal tears on the basis of signal extending to the meniscal surface. Nine of these were not displaced into the inter-condylar notch at arthroscopy. The interobserver agreement was excellent: kappa 0.88. The diagnosis of a bucket-handle meniscal tear, if it is displaced, can be made when one or more of the four MR evaluated signs are present. Other forms of meniscal tears are only exceptionally diagnosed as bucket-handle tears. (authors)

  6. Quadriceps Strength and Endurance After Posterior Cruciate Ligament Tears Versus Matched Group With Anterior Cruciate Ligament Tears.

    Science.gov (United States)

    Lee, Dae-Hee; Han, Seung-Beom; Lee, Jin-Hyuck; Lee, Seok-Joo; Suh, Dong-Won; Jeong, Hye-Jin

    2015-06-01

    This study was designed to compare the preoperative strengths and endurances of the quadriceps and hamstring muscles in patients with anterior cruciate ligament (ACL) versus posterior cruciate ligament (PCL) tears. Quadriceps and hamstring muscle strength and endurance were compared between 20 prospectively enrolled patients with isolated PCL tears and a retrospective, matched control group of 20 patients with isolated ACL tears. The maximal torque (60°/s) and total work (180°/s) of the quadriceps and hamstring were evaluated with an isokinetic testing device. Total work (1,094.4 ± 505.8 J v 797.5 ± 332.7 J, P = .035) and peak torque (129.9 ± 56.2 N ∙ m v 98.2 ± 37.4 N ∙ m, P = .046) of the quadriceps muscle on the involved side were higher in the PCL tear group than in the ACL tear group. However, there were no significant differences between the PCL tear group and ACL tear group in hamstring muscle strength (45.8 ± 42.3 N ∙ m and 46.0 ± 24.4 N ∙ m, respectively; P = .940) and endurance (429.3 ± 238.9 J and 382.4 ± 256.1 J, respectively; P = .574) on the involved side. The strength and endurance of the quadriceps muscle of the injured limb were greater after PCL tears than after ACL tears. However, there were no significant between-group differences in hamstring muscle strength and endurance on the involved side. Level III, retrospective comparative study. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  7. Intracranial dural arterio-venous fistula presenting with progressive myelopathy.

    LENUS (Irish Health Repository)

    Ogbonnaya, Ebere Sunny

    2011-01-01

    Spinal dural arterio-venous fistula (DAVF) is rare and usually involves the thoracic segments. The classical presentation is a slowly progressive ataxia. Clinical presentation of intracranial DAVF depends on the site of the DAVF, as well as the vessels involved. Patients may present with pulsatile tinnitus, occipital bruit, headache, dementia, visual impairment as well as neurological deterioration distant from the DAVF as a result of venous hypertension and cortical haemorrhage. The authors present a rare case of progressive myelopathy secondary to an intracranial DAVF.

  8. Tearing modes in toroidal geometry

    International Nuclear Information System (INIS)

    Connor, J.W.; Cowley, S.C.; Hastie, R.J.; Hender, T.C.; Hood, A.; Martin, T.J.

    1988-01-01

    The separation of the cylindrical tearing mode stability problem into a resistive resonant layer calculation and an external marginal ideal magnetohydrodynamic (MHD) calculation (Δ' calculation) is generalized to axisymmetric toroidal geometry. The general structure of this separation is analyzed and the marginal ideal MHD information (the toroidal generalization of Δ') required to discuss stability is isolated. This can then, in principle, be combined with relevant resonant layer calculations to determine tearing mode growth rates in realistic situations. Two examples are given: the first is an analytic treatment of toroidally coupled (m = 1, n = 1) and (m = 2, n = 1) tearing modes in a large aspect ratio torus; the second, a numerical treatment of the toroidal coupling of three tearing modes through finite pressure effects in a large aspect ratio torus. In addition, the use of a coupling integral approach for determining the stability of coupled tearing modes is discussed. Finally, the possibility of using initial value resistive MHD codes in realistic toroidal geometry to determine the necessary information from the ideal MHD marginal solution is discussed

  9. Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization.

    Science.gov (United States)

    Tian, Bing; Xu, Bing; Lu, Jianping; Liu, Qi; Wang, Li; Wang, Minjie

    2015-06-01

    This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ=1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Rotator cuff tear: A detailed update

    Directory of Open Access Journals (Sweden)

    Vivek Pandey

    2015-01-01

    Full Text Available Rotator cuff tear has been a known entity for orthopaedic surgeons for more than two hundred years. Although the exact pathogenesis is controversial, a combination of intrinsic factors proposed by Codman and extrinsic factors theorized by Neer is likely responsible for most rotator cuff tears. Magnetic resonance imaging remains the gold standard for the diagnosis of rotator cuff tears, but the emergence of ultrasound has revolutionized the diagnostic capability. Even though mini-open rotator cuff repair is still commonly performed, and results are comparable to arthroscopic repair, all-arthroscopic repair of rotator cuff tear is now fast becoming a standard care for rotator cuff repair. Appropriate knowledge of pathology and healing pattern of cuff, strong and biological repair techniques, better suture anchors, and gradual rehabilitation of postcuff repair have led to good to excellent outcome after repair. As the healing of degenerative cuff tear remains unpredictable, the role of biological agents such as platelet-rich plasma and stem cells for postcuff repair augmentation is still under evaluation. The role of scaffolds in massive cuff tear is also being probed.

  11. Evaporation-driven instability of the precorneal tear film.

    Science.gov (United States)

    Peng, Cheng-Chun; Cerretani, Colin; Braun, Richard J; Radke, C J

    2014-04-01

    Tear-film instability is widely believed to be a signature of eye health. When an interblink is prolonged, randomly distributed ruptures occur in the tear film. "Black spots" and/or "black streaks" appear in 15 to 40 s for normal individuals. For people who suffer from dry eye, tear-film breakup time (BUT) is typically less than a few seconds. To date, however, there is no satisfactory quantitative explanation for the origin of tear rupture. Recently, it was proposed that tear-film breakup is related to locally high evaporative thinning. A spatial variation in the thickness of the tear-film lipid layer (TFLL) may lead to locally elevated evaporation and subsequent tear-film breakup. We examine the local-evaporation-driven tear-film-rupture hypothesis in a one-dimensional (1-D) model for the evolution of a thin aqueous tear film overriding the cornea subject to locally elevated evaporation at its anterior surface and osmotic water influx at its posterior surface. Evaporation rate depends on mass transfer both through the coating lipid layer and through ambient air. We establish that evaporation-driven tear-film breakup can occur under normal conditions but only for higher aqueous evaporation rates. Predicted roles of environmental conditions, such as wind speed and relative humidity, on tear-film stability agree with clinical observations. More importantly, locally elevated evaporation leads to hyperosmolar spots in the tear film and, hence, vulnerability to epithelial irritation. In addition to evaporation rate, tear-film instability depends on the strength of healing flow from the neighboring region outside the breakup region, which is determined by the surface tension at the tear-film surface and by the repulsive thin-film disjoining pressure. This study provides a physically consistent and quantitative explanation for the formation of black streaks and spots in the human tear film during an interblink. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Fate of the three embryonic dural sinuses in infants: the primitive tentorial sinus, occipital sinus, and falcine sinus.

    Science.gov (United States)

    Mizutani, Katsuhiro; Miwa, Tomoru; Akiyama, Takenori; Sakamoto, Yoshiaki; Fujiwara, Hirokazu; Yoshida, Kazunari

    2018-03-01

    The primitive tentorial, occipital, and falcine sinuses are thought to attain the adult pattern or regress between the fetal stage and adulthood. The anatomy of these three primitive dural sinuses has seldom been studied in the infant population, and it remains unclear when these dural sinuses reach the adult condition. Using computed tomography digital subtraction venography (CT-DSV), we analyzed the anatomy of these embryonic dural sinuses in infants. We included 13 infants who underwent CT-DSV prior to neurosurgery and 35 cases with unruptured cerebral aneurysms as normal adult controls. Three embryonic dural sinuses, i.e., the primitive tentorial, occipital, and falcine sinuses, were retrospectively analyzed in CT-DSV images of infants and adults. We also analyzed the drainage patterns of the superficial middle cerebral vein (SMCV), determined by the connection between the primitive tentorial sinus and the cavernous sinus. The primitive tentorial, occipital, and falcine sinuses were present in 15.4%, 46.2%, and none of the infants, respectively, and in 10.0, 8.6, and 2.9% of the adults, respectively. The difference in SMCV draining pattern between infants and adults was insignificant. The incidence of the occipital sinus was significantly higher in infants than in adults. The connection between the primitive tentorial sinus and the cavernous sinus appears to be established before birth. The occipital sinus is formed at the embryonic stage and mostly regresses after infancy. The falcine sinus is usually obliterated prenatally. Our findings form the basis for interventions by pediatric interventional neuroradiologists and neurosurgeons.

  13. Progressive subcortical calcifications secondary to venous hypertension in an intracranial dural arteriovenous fistula.

    Science.gov (United States)

    Pascoe, Heather M; Lui, Elaine H; Mitchell, Peter; Gaillard, Frank

    2017-05-01

    Intracranial dural arteriovenous fistulas (dAVF) are acquired lesions, with the most commonly reported findings on CT haemorrhage or focal oedema. We describe a case of progressive subcortical calcification on CT secondary to venous hypertension from a high grade dAVF. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. MR diagnosis of dural sinus thrombosis

    International Nuclear Information System (INIS)

    Rovira Canellas, A.; Turon Estrada, A.; Alvarez Sabin, J.; Lozano Sanchez, M.; Castano Duque, Ch.; Grive Isern, E.; Sumalla Sune, J.

    1994-01-01

    Four adult patients were diagnosed as having dural sinus thrombosis (DST) by means of magnetic resonance (MR). In the three cases of acute thrombosis, MR disclosed diffuse or segmental hyperintensity in the sinuses involved, which persisted regardless of the sequence and orientation of the plane selected. MR angiography (MRA) provided diagnostic information that proved useful in the chronic case, as well as in the two cases in which follow-up was carried out to determine the degree to which permeability was restored to the sinuses involved. MR diagnosis of DST can produce false positives and negatives, the causes of which should be known, as well as the ways to avoid them, in order to prevent diagnostic errors. MR, when applied and interpreted correctly, can be considered the first, and in many cases the only, choice as a diagnostic method in DST. (Author)

  15. Thermal effects on tearing mode saturation

    International Nuclear Information System (INIS)

    Kim, J.S.; Chu, M.S.; Greene, J.M.

    1988-01-01

    The effect of geometry on tearing modes, saturated states of tearing modes, and the thermal effect on tearing modes are presented. The configuration of current and magnetic fields are quite different in slabs and in Tokamaks. However, for any magnetic island regardless of geometry and heating conditions, at island saturation the product of resistivity and current is the same at magnetic O and X lines. The temperature perturbation effect on the nonlinear development of tearing modes is investigated. Thermal conduction along the field lines is much faster than that in the perpendicular direction, and thus the temperature profile follows the island structure. Utilizing Spitzer's conductivity relation, the temperature perturbation is modelled as helical components of resistivity. For a usual tearing mode unstable Tokamak, where shear is positive, the islands continue to grow to a larger size when the islands are cooled. When they are heated, the island sizes are reduced. The temperature perturbation can induce islands even for equilibria stable with respect to tearing modes. Again, the islands appear when cooling takes place. The equilibria with the cooled islands show enhanced field line stochasticity, thus enhanced heat transport. Therefore, thermal instability can be directly related to pressure disruptions. (author)

  16. The influence of age on positions of the conus medullaris, Tuffier's line, dural sac, and sacrococcygeal membrane in infants, children, adolescents, and young adults.

    Science.gov (United States)

    Jung, Ji-Yun; Kim, Eun-Hee; Song, In-Kyung; Lee, Ji-Hyun; Kim, Hee-Soo; Kim, Jin-Tae

    2016-12-01

    The purpose of this study was to analyze the distances between the conus medullaris and the Tuffier's line, and between the dural sac and the sacrococcygeal membrane (SCM) in the same pediatric population. Spinal magnetic resonance images and simple X-ray images of 350 patients aged from 1 month to 20 years were reviewed. Positions of the conus medullaris, Tuffier's line, the dural sac, and the SCM were identified. Each position was recorded in relation to the corresponding vertebral body segments. The distances between the conus medullaris and Tuffier's line, and between the dural sac and the SCM, were measured and then assessed according to age using an analysis of variance and a linear regression analysis. The median levels of the conus medullaris and Tuffier's line were in the lower third of L1 [the first lumbar vertebral body] and the middle third of L5, respectively. The levels of the conus medullaris and Tuffier's line were lower in younger populations. The distance between the conus medullaris and Tuffier's line ranged from 1.5 to 4.75 vertebral body height. However, a narrow range of 1.5-2.5 vertebral height was observed only in children younger than 2 years. The level of the dural sac did not differ greatly by age, but the upper limit of the SCM was lower in older populations. The distance between the dural sac and the upper limit of the SCM increased with age. In children, there is a distance of 1.5-4.75 vertebral body height between the conus medullaris and the Tuffier's line. However, these distances were narrower among younger populations. The distance between the dural sac and the upper limit of the SCM increased with age. © 2016 John Wiley & Sons Ltd.

  17. MR accuracy and arthroscopic incidence of meniscal radial tears

    Energy Technology Data Exchange (ETDEWEB)

    Magee, Thomas; Shapiro, Marc; Williams, David [Department of Radiology, Neuroimaging Institute, 27 East Hibiscus Blvd., Melbourne, FL 32901 (United States)

    2002-12-01

    A meniscal radial tear is a vertical tear that involves the inner meniscal margin. The tear is most frequent in the middle third of the lateral meniscus and may extend outward in any direction. We report (1) the arthroscopic incidence of radial tears, (2) MR signs that aid in the detection of radial tears and (3) our prospective accuracy in detection of radial tears. Design and patients. Three musculoskeletal radiologists prospectively read 200 consecutive MR examinations of the knee that went on to arthroscopy by one orthopedic surgeon. MR images were assessed for location and MR characteristics of radial tears. MR criteria used for diagnosis of a radial tear were those outlined by Tuckman et al.: truncation, abnormal morphology and/or lack of continuity or absence of the meniscus on one or more MR images. An additional criterion used was abnormal increased signal in that area on fat-saturated proton density or T2-weighted coronal and sagittal images. Prospective MR readings were correlated with the arthroscopic findings.Results. Of the 200 consecutive knee arthroscopies, 28 patients had radial tears reported arthroscopically (14% incidence). MR readings prospectively demonstrated 19 of the 28 radial tears (68% sensitivity) when the criteria for diagnosis of a radial tear were truncation or abnormal morphology of the meniscus. With the use of the additional criterion of increased signal in the area of abnormal morphology on fat-saturated T2-weighted or proton density weighted sequences, the prospective sensitivity was 25 of 28 radial tears (89% sensitivity). There were no radial tears described in MR reports that were not demonstrated on arthroscopy (i.e., there were no false positive MR readings of radial tears in these 200 patients). Radial tears are commonly seen at arthroscopy. There was a 14% incidence in this series of 200 patients who underwent arthroscopy. Prospective detection of radial tears was 68% as compared with arthroscopy when the criteria as

  18. MR accuracy and arthroscopic incidence of meniscal radial tears

    International Nuclear Information System (INIS)

    Magee, Thomas; Shapiro, Marc; Williams, David

    2002-01-01

    A meniscal radial tear is a vertical tear that involves the inner meniscal margin. The tear is most frequent in the middle third of the lateral meniscus and may extend outward in any direction. We report (1) the arthroscopic incidence of radial tears, (2) MR signs that aid in the detection of radial tears and (3) our prospective accuracy in detection of radial tears. Design and patients. Three musculoskeletal radiologists prospectively read 200 consecutive MR examinations of the knee that went on to arthroscopy by one orthopedic surgeon. MR images were assessed for location and MR characteristics of radial tears. MR criteria used for diagnosis of a radial tear were those outlined by Tuckman et al.: truncation, abnormal morphology and/or lack of continuity or absence of the meniscus on one or more MR images. An additional criterion used was abnormal increased signal in that area on fat-saturated proton density or T2-weighted coronal and sagittal images. Prospective MR readings were correlated with the arthroscopic findings.Results. Of the 200 consecutive knee arthroscopies, 28 patients had radial tears reported arthroscopically (14% incidence). MR readings prospectively demonstrated 19 of the 28 radial tears (68% sensitivity) when the criteria for diagnosis of a radial tear were truncation or abnormal morphology of the meniscus. With the use of the additional criterion of increased signal in the area of abnormal morphology on fat-saturated T2-weighted or proton density weighted sequences, the prospective sensitivity was 25 of 28 radial tears (89% sensitivity). There were no radial tears described in MR reports that were not demonstrated on arthroscopy (i.e., there were no false positive MR readings of radial tears in these 200 patients). Radial tears are commonly seen at arthroscopy. There was a 14% incidence in this series of 200 patients who underwent arthroscopy. Prospective detection of radial tears was 68% as compared with arthroscopy when the criteria as

  19. Intentional and inadvertent non-adherence in adult coeliac disease. A cross-sectional survey.

    Science.gov (United States)

    Hall, Nicola J; Rubin, Gregory P; Charnock, Anne

    2013-09-01

    Adherence to a gluten-free diet is the mainstay of treatment for coeliac disease. Non-adherence is common as the diet is restrictive and can be difficult to follow. This study aimed to determine the rates of intentional and inadvertent non-adherence in adult coeliac disease and to examine the factors associated with both. A self-completion questionnaire was mailed to adult coeliac patients identified from the computer records of 31 family practices within the North East of England. We received 287 responses after one reminder. Intentional gluten consumption was reported by 115 (40%) of respondents. 155 (54%) had made at least one known mistaken lapse over the same period and 82 (29%) reported neither intentional nor mistaken gluten consumption. Using logistic regression analysis, low self-efficacy, perceptions of tolerance to gluten and intention were found to be independently predictive of intentional gluten consumption. A statistical model predicted 71.8% of cases reporting intentional lapses. Intentional non-adherence to the GFD was found to be common but not as frequent as inadvertent lapses. Distinguishing the factors influencing both intentional and inadvertent non-adherence is useful in understanding dietary self-management in coeliac disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Tear and decohesion of bovine pericardial tissue.

    Science.gov (United States)

    Tobaruela, Almudena; Elices, Manuel; Bourges, Jean Yves; Rojo, Francisco Javier; Atienza, José Miguel; Guinea, Gustavo

    2016-10-01

    The aim of this study was to evaluate quantitatively the fracture-by tear and delamination-of bovine pericardium tissues which are usually employed for the manufacture of bioprosthetic valves. A large number of samples (77) were tested in root-to-apex and circumferential directions, according to a standardised tear test (ASTM D 1938). Before performing the tear test, some samples were subjected to 1000 cycles of fatigue to a maximum stress of 3MPa. Fracture toughness of tearing and delamination were computed by following a simple fracture model. The study showed significantly lower values of delamination toughness compared with tear delamination. Moreover, tear forces were different in each test direction, revealing a clear orthotropic behaviour. All these results, as well as the testing procedure, could be of value for future research in the physiological function of pericardium tissues and clinical applications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Evaluating tear clearance rate with optical coherence tomography.

    Science.gov (United States)

    Garaszczuk, Izabela K; Mousavi, Maryam; Cervino Exposito, Alejandro; Bartuzel, Maciej M; Montes-Micó, Robert; Iskander, D Robert

    2018-02-01

    To assess the early-phase of tear clearance rate (TCR) with anterior segment optical coherence tomography (OCT) and to determine the association between TCR and other clinical measures of the tear film in a group of young subjects with different levels of tear film quality. TCR was classified as the percentage decrease of subject's inferior tear meniscus height 30s after instillation of 5μl 0.9% saline solution. Fifty subjects (32F and 18M) aged (mean±standard deviation) 25.5±4.3 years volunteered for the study. It consisted of a review of medical history, Ocular Surface Disease Index (OSDI) questionnaire, tear film osmolarity measurements, slit lamp examination and TCR estimation based on dynamic measurements of the lower tear meniscus with OCT. Estimates of TCR were contrasted against subject age and tear film measures commonly used for dry eye diagnosis, which includes OSDI score, fluorescein tear film break-up time (FBUT), tear meniscus height (TMH), blinking frequency, tear film osmolarity and corneal staining. The group mean TCR was 29±13% and 36±19% respectively after 30 and 60s margin after saline solution instillation. Statistically significant correlations were found between TCR and FBUT (r 2 =0.319, placrimal functional unit. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  2. Tearing mode instability due to anomalous resistivity

    International Nuclear Information System (INIS)

    Furuya, Atsushi; Itoh, Sanae I.; Yagi, Masatoshi

    2000-01-01

    Tearing mode instability in the presence of microscopic truculence is investigates. The effects of microscopic turbulence on tearing mode are taken as drags which are calculated by one-point renormalization method and mean-field approximation. These effects are reduced to effective diffusivities in reduced MHD equations. Using these equations, the stability analyses of the tearing mode are performed. It is shown that a finite amplitude of fluctuation enhances the growth rate of tearing mode. For very high values of turbulent diffusivities, marginally stable state exists. The effects of each turbulent diffusivity on mode stability are examined near marginal stability boundary. Parameter dependence of the resistive ballooning mode turbulence on tearing mode is analyzed as an example. (author)

  3. Two-Tunnel Transtibial Repair of Radial Meniscus Tears Produces Comparable Results to Inside-Out Repair of Vertical Meniscus Tears.

    Science.gov (United States)

    Cinque, Mark E; Geeslin, Andrew G; Chahla, Jorge; Dornan, Grant J; LaPrade, Robert F

    2017-08-01

    Radial meniscus tears disrupt the circumferential fibers and thereby compromise meniscus integrity. Historically, radial tears were often treated with meniscectomy because of an incomplete understanding of the biomechanical consequences of these tears, limited information regarding the biomechanical performance of repair, and the technical difficulty associated with repair. There is a paucity of studies on the outcomes of the repair of radial meniscus tears. Purpose/Hypothesis: The purpose was to determine the outcomes of 2-tunnel transtibial repair of radial meniscus tears and compare these results to the outcomes of patients who underwent the repair of vertical meniscus tears with a minimum of 2-year follow-up. The hypothesis was that radial and vertical meniscus tear repair outcomes were comparable. Cohort study; Level of evidence, 3. Patients who underwent 2-tunnel transtibial pullout repair for a radial meniscus tear were included in this study and compared with patients who underwent inside-out repair for a vertical meniscus tear. Subjective questionnaires were administered preoperatively and at a minimum of 2-year follow-up, including the Lysholm score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Short Form-12 (SF-12) physical component summary (PCS), the Tegner activity scale, and patient satisfaction. Analysis of covariance was used to compare postoperative outcome scores between the meniscus repair groups while accounting for baseline scores. Adjusted mean effects relative to the radial repair group were reported with 95% CIs. Twenty-seven patients who underwent 2-tunnel transtibial pullout repair for radial meniscus tears and 33 patients who underwent inside-out repair for vertical meniscus tears were available for follow-up at a mean of 3.5 years (range, 2.0-5.4 years). No preoperative outcome score significantly differed between the groups. There were no significant group differences for any of the 2-year

  4. The internal vertebral venous plexus prevents compression of the dural sac during atlanto-axial rotation

    Energy Technology Data Exchange (ETDEWEB)

    Reesink, E.M.; Lataster, L.M.A.; Mameren, H. van [Dept. of Anatomy/Embryology, Maastricht Univ. (Netherlands); Wilmink, J.T. [Dept. of Radiology, University Hospital Maastricht (Netherlands); Kingma, H. [Dept. of ENT, University Hospital Maastricht (Netherlands)

    2001-10-01

    Deformation of the extradural space and the possibility of impression upon the dural sac during atlanto-axial rotation are investigated. Atlanto-axial rotation leads to a reduction in the cross-sectional area of the bony spinal canal of approximately 40 %. Atlanto-axial rotation was recorded by endocanalar views from a video camera fixed inside the skull of six unembalmed cadavers. Axial thin-section T1-weighted MRI slice sets were acquired from three volunteers (mid-position and maximal left and right rotation of the head and cervical spine). The axial cross-sectional areas of the bony spinal canal, dural sac and spinal cord were measured. In two other persons post-gadolinium contrast-enhanced T1-weighted MRI volume scans with fat-suppression prepulse were acquired (mid-position and rotation) to determine venous contents of the extradural space. The 50:50 ratio between left and right extradural halves in mid-position changed to an ipsilateral:contralateral ratio of 20:80 in maximum rotation at the level just above the lateral C1-C2 joints. Directly below these joints the opposite occurred. The post-contrast studies showed an enhancing internal vertebral venous plexus (IVVP), which almost completely occupied the extradural space at the atlanto-axial level. This could not be shown in the cadaver experiments, because of absence of blood and cerebrospinal fluid (CSF) pressure. During atlanto-axial rotation blood displacement in the IVVP allows major deformations of the extradural space. This prevents dural sac impression. (orig.)

  5. Dural Ectasia of the Optic Nerve and Unilateral Proptosis-Two Rare Comorbidities Associated with Idiopathic Intracranial Hypertension

    Directory of Open Access Journals (Sweden)

    Serkan Dağdelen

    2013-08-01

    Full Text Available A 24-year-old woman with a recent history of visual abnormality (obscurations had bilateral optic disc swellings, dilatation of the optic nerve sheaths, monocular proptosis, and increased cerebrospinal fluid pressures. She was diagnosed as idiopathic intracranial hypertension (IIH. IIH can present with both papilledema and dural ectasia although the latter is usually seen as an isolated entity. Various conditions also have been implicated in IIH. However, apart from female sex, recent weight gain and obesity, there are no proven associations. In this case report, we present a case of IHH associated with two different pathologies: dural ectasia of the optic nerve sheaths and monocular proptosis. (Turk J Ophthalmol 2013; 43: 297-300

  6. Chemosignalling effects of human tears revisited: Does exposure to female tears decrease males' perception of female sexual attractiveness?

    Science.gov (United States)

    Gračanin, Asmir; van Assen, Marcel A L M; Omrčen, Višnja; Koraj, Ivana; Vingerhoets, Ad J J M

    2017-01-01

    Gelstein et al. reported the results of three experiments suggesting a dampening influence of inhalation of female emotional tears on males' arousal and perception of female sexual attractiveness, specifically in non-sexual situations. This prompted the hypothesis that crying exerts its influence on others not only via the auditory and visual mode but also via chemosignals. In three studies, we attempted to replicate and extend Gelstein et al.'s findings by including an additional condition with irritant tears, by using pictures of sexually attractive women, and by testing related hypotheses on the pro-social effects of exposure to tears. All three studies, separately or combined in a meta-analysis, failed to replicate the original inhibitory effects of tears. In addition, sniffing tears did not affect measures of connectedness, aggression and pro-social behaviour. It is concluded that the effects of female tears on male arousal and perception of female sexual attractiveness, if any, are very weak at best. Rather, it seems that crying exerts its strong inter-personal effects through the visual and auditory sensory channels.

  7. Effectiveness of Combined Tear Film Therapy in Patients with Evaporative Dry Eye with Short Tear Film Breakup Time.

    Science.gov (United States)

    Kim, Yung Hui; Kang, Yeon Soo; Lee, Hyo Seok; Choi, Won; You, In Cheon; Yoon, Kyung Chul

    2017-10-01

    The aim of this study was to evaluate the effectiveness of combined tear film therapy targeted to aqueous, mucin, and lipid layers in patients with refractory evaporative dry eye (EDE) with short tear film breakup time (TBUT). The patients who had EDE with short TBUT and severe symptoms refractory to artificial tears were treated with hyaluronic acid (HA) 0.15% and diquafosol tetrasodium (DQS) 3% (Group 1), HA and carbomer-based lipid-containing eyedrops (Liposic EDO Gel, LPO) (Group 2), or HA, DQS, and LPO (Group 3). Ocular Surface Disease Index (OSDI) score, visual analog scale (VAS) symptom score, TBUT, Schirmer score, and corneal and conjunctival staining scores were evaluated, and noninvasive tear film breakup time (NIBUT) and tear meniscus height were measured using Keratograph ® 5 M before and 1 and 3 months after treatment. OSDI scores, VAS scores, TBUT, and NIBUT were improved at 1 and 3 months after treatment in all groups (all P film layers was most effective in improving ocular symptoms and tear film quality.

  8. The entire dural sinus tree is compressed in patients with idiopathic intracranial hypertension: a longitudinal, volumetric magnetic resonance imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Rohr, Axel; Bindeballe, Jan; Riedel, Christian; Jansen, Olav [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neuroradiology, Kiel (Germany); Baalen, Andreas van [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neuropediatrics, Kiel (Germany); Bartsch, Thorsten [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neurology, Kiel (Germany); Doerner, Lutz [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neurosurgery, Kiel (Germany)

    2012-01-15

    The objective of this study was to explore the volumetric alterations of dural sinuses in patients with idiopathic intracranial hypertension (IIH). Standardized cranial magnetic resonance imaging (MRI) was used in 17 patients prior to and following treatment of IIH and in seven controls. Magnetic resonance venographies (MRV) were employed for (a) judgement of circumscript dural sinus stenoses and (b) computation of sinus volumes. Cross-sectional areas (CSA) of the superior sagittal sinuses (SSS) were measured on T2-weighted images. Results of the initial MRIs were compared to those on follow-up MRIs and to results of controls. Stenoses of the transverse sinuses (TS) resulting in cranial venous outflow obstruction (CVOO) were present in 15/17 (88%) patients, normalizing in 7/15 cases (47%) after treatment of IIH. CVOO was not detected in the control group. Segmentation of MRV revealed decreased dural sinus volumes in patients with IIH as compared to controls (P = 0.018). Sinus volumes increased significantly with normalization of intracranial pressure independent from disappearing of TS stenoses (P = 0.007). The CSA of the SSS were normal on the initial MRIs of patients with IIH and increased on follow-up after treatment (P < 0.001). However, volumetries displayed overlap in patients and controls. Patients with IIH not only exhibit bilateral stenoses of the TS as has been reported, but volume changes of their entire dural sinus system also occur. The potential etiopathological and diagnostic roles of these changes are discussed. (orig.)

  9. Tear ferning test in healthy dogs.

    Science.gov (United States)

    Oriá, Arianne P; Raposo, Ana Claudia S; Araújo, Nayone L L C; Lima, Felipe B; Masmali, Ali M

    2017-11-07

    To evaluate and compare three tear sampling methods using two grading scales for administering the tear ferning test (TFT) to healthy dogs. In total, 90 dogs (180 eyes) were subjected to tear sampling using millimetered strips, reused after the Schirmer tear test (STT) (Schirmer group, SG). Then, the dogs were subdivided into three groups according to sampling approach: micropipette (MPG), microcapillary (MCG), and Schirmer sample 2 (S2G). The collected tears were dried on a clean microscope glass slide at room temperature and humidity. The ferning patterns were observed under a polarized light microscope and classified according to the Rolando and Masmali grading scales. Although all three methods were feasible, the STT was easier to perform in clinical settings. Type I and Grade 1 were the most commonly observed (64.17% and 61.7%, respectively) regardless of collection method. There was no significant difference between the STT median values and the TFT classifications. The TFT is appropriate for dogs and can be performed using the three suggested sampling methods, with a higher frequency of Type I and Grade 1. Thus, it is possible to use both grading scales in the classification of tear ferning in dogs. © 2017 American College of Veterinary Ophthalmologists.

  10. Tear clearance implications for ocular surface health.

    Science.gov (United States)

    de Paiva, Cintia Sade; Pflugfelder, Stephen C

    2004-03-01

    Tear clearance/turnover provides a global assessment of the function of the lacrimal functional unit and of tear exchange on the ocular surface. It is an indirect measure of dry eye induced inflammation on the ocular surface. It shows better correlation with the severity of ocular irritation symptoms and corneal epithelial disease in dry eye than the Schirmer 1 test. Delayed tear clearance may prove to be the best measure for identifying patients with tear film disorders who may respond to anti-inflammatory therapy.

  11. Role of MRI in predicting meniscal tear reparability

    Energy Technology Data Exchange (ETDEWEB)

    Felisaz, Paolo Florent [Universita degli Studi di Pavia, Pavia (Italy); Fondazione IRCCS Policlinico San Matteo, Istituto di Radiologia, Pavia (Italy); Alessandrino, Francesco; Perelli, Simone [Universita degli Studi di Pavia, Pavia (Italy); Zanon, Giacomo; Benazzo, Francesco [Fondazione IRCCS Policlinico San Matteo, Clinica Ortopedica e Traumatologica, Pavia (Italy); Calliada, Fabrizio; Sammarchi, Luigi [Fondazione IRCCS Policlinico San Matteo Radiologia, Diagnostica per Immagini-Istituto di Radiologia, Pavia (Italy)

    2017-10-15

    To elucidate the role of MRI in predicting meniscal tear reparability according to tear type and location in relation to vascular zones. In this retrospective study, two readers evaluated 79 pre-surgical MRIs of meniscal tears arthroscopically treated with meniscectomy or meniscal repair. Tears were classified according to type into vertical, horizontal, radial, complex, flaps and bucket handle and were considered reparable if the distance measured from the tear to the menisco-capsular junction was less than or equal to 5 mm. Predictions were compared with the surgical procedure performed in arthroscopy. We assessed the diagnostic performance of MRI, agreement between MRI and arthroscopy, and interrater agreement. Then, we conducted an ROC analysis on the distances measured by the first reader and built a multivariate logistic regression model. MRI had a sensitivity, specificity, PPV, NPV and accuracy, respectively, of 85%, 79%, 86%, 76% and 83% in predicting meniscal tear reparability. Correct predictions for the specific tear pattern were 76% for vertical, 84% for horizontal, 88% for radial, 86% for complex, 84% for flaps and 86% for bucket handle. Agreement between the two readers' predictions and arthroscopy was good (k = 0.65 and 0.61, respectively). Inter-rater agreement was almost excellent (k = 0.79). The ROC analysis revealed sensitivity and specificity of 73% and 83% with a cutoff value of <4 mm (p < 0.001). Anterior cruciate ligament injury and medial meniscal tear increased the likelihood of meniscal tear reparability. MRI can be a reliable and accurate tool to predict the reparability of meniscal tears, with higher prediction rates for bucket-handle tears. (orig.)

  12. Antioxidant content and ultraviolet absorption characteristics of human tears.

    Science.gov (United States)

    Choy, Camus Kar Man; Cho, Pauline; Benzie, Iris F F

    2011-04-01

    Dry eye syndrome is a common age-related disorder, and decreased antioxidant/ultraviolet (UV) radiation protection in tears may be part of the cause. This study aimed to compare the tear antioxidant content and flow rate in young and older adults. The total antioxidant content and UV absorbing properties of various commercially available ophthalmic solutions used to alleviate dry eye symptoms were also examined. Minimally stimulated tears were collected from 120 healthy Chinese adults with no ocular pathology. Two age groups were studied: 19 to 29 years (n = 58) and 50 to 75 years (n = 62). Tear samples from each subject and 13 ophthalmic solutions were analyzed for total antioxidant content (as the Ferric Reducing/Antioxidant Power value). Tear flow rates were estimated from time taken to collect a fixed volume of tear fluid. UV absorbance spectra of pooled fresh reflex tear fluid and the ophthalmic solutions were determined. Results showed that the antioxidant content of minimally stimulated tears from older subjects (398 ± 160 μmol/l) was not significantly lower than that of younger subjects (348 ± 159 μmol/l; p = 0.0915). However, there was a significant difference in the tear flow rates between the two groups (p tears. The effect of low flow rate on the dynamic antioxidant supply to the corneal surface indicates that older subjects have poorer overall defense against photooxidative and other oxidative processes. This could predispose older persons to corneal stress and development of dry eye syndrome. The commercially available artificial tears tested lack both the antioxidant content and UV absorbing characteristics of natural tears. Artificial tears formulations that help restore natural antioxidant and UV absorbing properties to the tear film of the aging eye may help prevent or improve dry eye symptoms and promote ocular health.

  13. A study of re-tear cases after ARCR

    International Nuclear Information System (INIS)

    Ishida, Yasuyuki; Chosa, Etsuo; Yano, Hiroaki

    2011-01-01

    Recently, good clinical outcomes of arthroscopic rotator cuff repair (ARCR) are reported, but the re-tear rate of massive and large rotator cuff tears is still high. The purpose of this study is to review the clinical outcome and postoperative cuff integrity of ARCR in our hospital. We evaluated 80 shoulders (61 males, 19 females), whose age rauged from 30 to 78 (average: 61.8 years old). The size of tears were 8 small, 22 medium, 36 large, and 14 massive. We evaluated the pre-and postoperative Japanese Orthopedic Association (JOA) scored, and MRI findings 12 months postoperatively. We evaluated the cuff integrity and fatty degeneration of the ruptured cuff by Goutallier's classification. Postoperative MRI findings showed complete repair in 56 shoulders (70%) and re-tear in 24 shoulders (30%). Postoperative JOA score was poor in cases with large re-tears. Retear rates were high in large and massive tears, tears with advanced fatty degeneration, and subscapularis tears. As this operation is not a replacement procedure, the quality of the ruptured rotator cuff is important. Further discussion on the operative indication and method is necessary. (author)

  14. Post-operative morbidity of the obese patient undergoing posterior ...

    African Journals Online (AJOL)

    Outcome measures: Post-operative morbidity measures – infection, seroma, pulmonary embolism, urinary tract infection, neurological injury and dural tears. Methods: One hundred consecutive patients undergoing posterior lumbar spine surgery were enrolled in the study. Three fellowship trained attending orthopaedic ...

  15. Changes of tear film after trabeculectomy in glaucoma

    Directory of Open Access Journals (Sweden)

    Xue-Jun Li

    2015-07-01

    Full Text Available AIM: To learn the changes of the tear film before and after the trabeculectomy of glaucoma and explore the incidence of dry eye and the prevention and control measures.METHODS: The 36 patients(60 eyesof glaucoma were examined in detail before 3d of trabeculectomy and after the surgery at 3, 7, 14 and 30d. The examinations include lower eyelid central river of tears, break-up time(BUT, Schirmer Ⅰ test(SⅠtand staining scores of corneal fluorescein under slit lamp microscope.RESULTS:The tear meniscus height of central lower eyelid was increased and the tear film BUT was shortened at the same time, the scores of SⅠt was reduced and corneal fluorescein staining score was increased at postoperative 3 and 7d compared with that of preoperation. The tear meniscus height of central lower eyelid, tear film BUT and SIt and score of corneal fluorescein staining began to recover in most of the affected eyes after surgery 14d. At 30d after surgery, 22% of patients tear film failed to recover to the preoperative level; dry eye occured in 18% preoperative eyes with normal tear film.CONCLUSION:Trabeculectomy of glaucoma may affect the stability of the tear film and some patients showeing obvious dry eye and should be intervened and treatmented timely.

  16. Impact of environmental adaptation on tear film assessments.

    Science.gov (United States)

    Fagehi, R

    2018-03-01

    The purpose of this study was to investigate the effect of ocular environmental adaptation on clinical tear film assessment. Thirty subjects (male, mean age 23±2.5) participated in this study. A number of clinical tear film tests were applied, including: fluorescein tear break-up time (FTBUT), Schirmer test and tear prism height test (TPH). The tear physiology of each subject was evaluated twice, once immediately when they arrived from the external environment, and then after 30minutes adaptation in the exam room environment. The mean values were: Schirmer test A (22.1±2.99), Schirmer test B (24.2±2.63), FTBUT A (8.00±1.94), FTBUT B (9.13±2.04), TPH A (0.179±0.026) and TPH B* (0.187±0.023). Statistical testing using Wilcoxon-signed rank test showed a significant difference between the Schirmer test results measured at the different times (P=0.008). Also, the FTBUT and tear prism height test results showed significant differences between the two evaluation times, (P=0.001, 0.011, respectively) (A: tear assessed when the subject comes from the outside environment, B: tear film assessed after 30min adaptation in the clinical environment). This study showed a significant difference between the tear film test results evaluated when the subjects were assessed immediately from the outside environment and after an adaptation time in the clinic environment. Practitioners must consider the effect of differences between external and clinical environment adaptation on clinical tear film physiology. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  17. MR imaging-based diagnosis and classification of meniscal tears.

    Science.gov (United States)

    Nguyen, Jie C; De Smet, Arthur A; Graf, Ben K; Rosas, Humberto G

    2014-01-01

    Magnetic resonance (MR) imaging is currently the modality of choice for detecting meniscal injuries and planning subsequent treatment. A thorough understanding of the imaging protocols, normal meniscal anatomy, surrounding anatomic structures, and anatomic variants and pitfalls is critical to ensure diagnostic accuracy and prevent unnecessary surgery. High-spatial-resolution imaging of the meniscus can be performed using fast spin-echo and three-dimensional MR imaging sequences. Normal anatomic structures that can mimic a tear include the meniscal ligament, meniscofemoral ligaments, popliteomeniscal fascicles, and meniscomeniscal ligament. Anatomic variants and pitfalls that can mimic a tear include discoid meniscus, meniscal flounce, a meniscal ossicle, and chondrocalcinosis. When a meniscal tear is identified, accurate description and classification of the tear pattern can guide the referring clinician in patient education and surgical planning. For example, longitudinal tears are often amenable to repair, whereas horizontal and radial tears may require partial meniscectomy. Tear patterns include horizontal, longitudinal, radial, root, complex, displaced, and bucket-handle tears. Occasionally, meniscal tears can be difficult to detect at imaging; however, secondary indirect signs, such as a parameniscal cyst, meniscal extrusion, or linear subchondral bone marrow edema, should increase the radiologist's suspicion for an underlying tear. Awareness of common diagnostic errors can ensure accurate diagnosis of meniscal tears. Online supplemental material is available for this article. ©RSNA, 2014.

  18. Influence of preoperative artificial tears on tear film after phacoemulsification on dry eye of diabetes patients

    Directory of Open Access Journals (Sweden)

    Rui Su

    2015-05-01

    Full Text Available AIM: To discuss the artificial tears on the tear film of diabetic patients with dry eye preoperatively, and the influence on the tear film's fuctional after phacoemulsification.METHODS: Fifty-four diabetic patients with dry eye(60 eyeswere followed up before phacoemulsification. Preoperatively, group A(30 eyes in 28 caseswas treated with Hydroxyl Indican eye drops and group B(30 eyes in 26 caseswas not treated. Postoperatively, both group A and B were treated with Tobramycin Dexamethasone eye drops, Oprah Winfrey Ibuprofen eye drops and Hydroxyl Indican eye drops. Dry eye symptoms, break up time(BUT, Schirmer Ⅰ test(S Ⅰ t, fluorescein stain test(FIwere measured at 3d preoperatively, and 1, 7, 30, 90d postoperatively.RESULTS: At 3d preoperatively, there was no statistical differences between the two groups for dry eye symptoms, BUT, SⅠt, FI(P>0.05. At 1 and 7d postoperatively, there were significant statistical differents between the two groups for dry eye symptoms(PPP>0.05.CONCLUSION: Using artificial tears before phacoemulsification can improve symptoms of the diabetic patients with dry eye and accelerate the recovery of the tear film.

  19. Dural arteriovenous fistula presenting with exophthalmos and seizures.

    Science.gov (United States)

    Feyissa, Anteneh M; Ponce, Lucido L; Patterson, Joel T; Von Ritschl, Rudiger H; Smith, Robert G

    2014-03-15

    Concomitant seizures and exophthalmos in the context of a temporal dural arteriovenous fistula (dAVF) has not been described before. Here, we report a 55-year-old-male who presented with an 8-month history of progressive painless exophthalmos of his left eye, conjunctival chemosis, reduced vision and new onset complex partial seizures. Cerebral angiography demonstrated Cognard Type IIa left cerebral dAVF fed by branches from the left occipital artery and an accessory meningeal artery, with drainage to the superior ophthalmic vein. Following surgical obliteration of dAVF feeding vessels, our patient had dramatic improvement in visual acuity, proptosis and chemosis along with cessation of clinical seizures. Published by Elsevier B.V.

  20. MR imaging of rotator cuff tears

    International Nuclear Information System (INIS)

    Kumagai, Hideo

    1992-01-01

    A total of 115 patients with clinical symptoms and signs suggesting rotator cuff tears underwent MR imaging with a 1.5-Tesla system. The body coil was used as the receiver coil in 24 patients and a single 10 cm surface coil in 91. Arthrography or MR imaging with intra-articular Gd-DTPA (MR arthrography) was performed in 95 of the 115. T2-weighted images with the body coil showed high signal intensity lesions in rotator cuffs in only seven of the 10 patients who had tears demonstrated by arthrography or MR arthrography. On the other hand, T2-weighted images with the surface coil demonstrated high signal intensity lesions in cuffs in all 27 patients who were diagnosed to have tears by arthrography or MR arthrography. In 12 patietns, T2-wighted images with the surface coil showed high signal intensity lesions in cuffs, while arthrography and MR arthrography did not show tears. Surgery was performed in four of the 12 patients and partial tears were confirmed. A single 10 cm surface coil, 3 mm slice thickness and 2.5 second repetition time seem to account for the fine visualization of cuff tears by the T2-weighted images. These results suggest that T2-weighted images obtained with the surface coil are superior to arthrography and MR arthrography. (author)

  1. Diagnostic value of self-reported mechanical symptoms for diagnosing large meniscal tears in patients aged 40 years or older with meniscal tears

    DEFF Research Database (Denmark)

    Pihl, Kenneth; Englund, Martin; Lohmander, Stefan

    2017-01-01

    Purpose: Meniscal tears, which are longitudinal-vertical tears (e.g. bucket-handle tears) and/or involve all three meniscal sub regions (anterior horn, body and posterior horn), are typically large and assumed to cause patient perceived mechanical knee symptoms (knee grinding or clicking and knee...... catching or locking). However, whether the presence of such mechanical symptoms is useful for diagnosing these forms of meniscus tears is unknown. Therefore, we investigated the diagnostic values of having mechanical symptoms in diagnosing a bucket-handle tear and/or a tear involving all three meniscal sub...... regions in middle-aged and older patients undergoing arthroscopic meniscal surgery. Methods: This study is a secondary analysis of Pihl et al. OARSI 2017. The study included patients aged 40 years or older undergoing surgery for a meniscal tear from Knee Arthroscopy Cohort Southern Denmark (KACS...

  2. A microcontroller-based simulation of dural venous sinus injury for neurosurgical training.

    Science.gov (United States)

    Cleary, Daniel R; Siler, Dominic A; Whitney, Nathaniel; Selden, Nathan R

    2018-05-01

    OBJECTIVE Surgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of available scenarios have inhibited wider integration of simulation in neurosurgical education. In this study the authors provide initial validation of a novel, low-cost simulation platform that recreates the stress of surgery using a combination of hands-on, model-based, and computer elements. Trainee skill was quantified using multiple time and performance measures. The simulation was initially validated using trainees at the start of their intern year. METHODS The simulation recreates intraoperative superior sagittal sinus injury complicated by air embolism. The simulator model consists of 2 components: a reusable base and a disposable craniotomy pack. The simulator software is flexible and modular to allow adjustments in difficulty or the creation of entirely new clinical scenarios. The reusable simulator base incorporates a powerful microcomputer and multiple sensors and actuators to provide continuous feedback to the software controller, which in turn adjusts both the screen output and physical elements of the model. The disposable craniotomy pack incorporates 3D-printed sections of model skull and brain, as well as artificial dura that incorporates a model sagittal sinus. RESULTS Twelve participants at the 2015 Western Region Society of Neurological Surgeons postgraduate year 1 resident course ("boot camp") provided informed consent and enrolled in a study testing the prototype device. Each trainee was required to successfully create a bilateral parasagittal craniotomy, repair a dural sinus tear, and recognize and correct an air embolus. Participant stress was measured using a heart rate wrist monitor. After participation, each resident completed a 13-question categorical survey. CONCLUSIONS All trainee participants experienced tachycardia during the simulation, although the point in the simulation

  3. Influence of Ophthalmic Solutions on Tear Components.

    Science.gov (United States)

    Shigeyasu, Chika; Yamada, Masakazu; Akune, Yoko

    2016-11-01

    Tear fluids are a mixture of secretions derived from lacrimal glands, accessory lacrimal glands, conjunctiva, and meibomian glands. Compositional changes to tears occur in the normal state and during ocular surface disease, such as dry eye conditions. We have investigated compositional changes to tears after topical application of ophthalmic solutions, with regard to tear-specific proteins (secretory immunoglobulin A, lactoferrin, lipocalin-1, and lysozyme) and ocular surface mucin in normal and dry eye conditions using high-performance liquid chromatography. After application of saline solution (0.9% sodium chloride) in normal subjects, transient but significant decreases in all tear components were observed. The recovery of protein concentrations took up to 30 minutes and lasted longer when the saline solution was applied more frequently. When applying ophthalmic solutions, a balance between washout and dilutional effects should be considered in addition to the therapeutic effect. Investigation of the effect of diquafosol solution (3%) in normal subjects revealed a significant increase in sialic acid concentration, a marker of ocular mucin, at 5 minutes after application, whereas a significant decrease was observed with saline. This result indicates the accelerated secretion of mucin from ocular tissues induced by diquafosol. A clinical study to determine the efficacy of diquafosol in patients with dry eye revealed improvements in tear breakup time, keratoconjunctival staining scores, and Schirmer test score, accompanied by an increase in sialic acid concentration in tears. Investigating normal and dry eye conditions through tear analysis may clarify the pathophysiology of dry eye conditions and support the efficacy of treatments.

  4. Efficacy of artificial tears for children xerophthalmia

    Directory of Open Access Journals (Sweden)

    Jie Yang

    2016-03-01

    Full Text Available AIM:To observe the efficacy and safety of artificial tears for children xerophthalmia.METHODS:Fifty-eight cases with 116 eyes were diagnosed as xerophthalmia by tear break-up time(BUT, Schirmer Ⅰ test(SⅠt, tear meniscus height, corneal staining, meibomian gland function test and were given artificial tears therapy for 1mo. Then the aforementioned tests were conducted again for statistical analysis.RESULTS:The mean BUT of all the children before treatments was 6.03±1.19s, SⅠt was 7.67±2.32mm/5min, tear meniscus height was 0.20±0.02mm, corneal staining was 1.02±0.13 scores and meibomian gland function was 2.45±0.86 scores. Sixty-two eyes in 31 cases were the lipid-deficient type, 40 eyes in 20 cases were aqueous-deficient type, and 14 eyes in 7 cases were other types. According to their types, corresponding artificial tears therapy was given. At 1mo after treatments, the clinical symptoms were improved significantly. BUT was 13.72±1.83s, SⅠt was 12.38±3.64mm/5min, tear meniscus height was 0.36±0.08mm, corneal fluorescein staining was 0.03±0.24 scores and meibomian gland function was 1.57±0.93 scores. Compared with those before treatments, the difference of each observed indicators was statistically significant(PCONCLUSION:Artificial tears treatment for children xerophthalmia is safe and effective.

  5. Long-Term MRI Findings in Operated Rotator Cuff Tear

    International Nuclear Information System (INIS)

    Kyroelae, K.; Niemitukia, L.; Jaroma, H.; Vaeaetaeinen, U.

    2004-01-01

    Purpose: To describe magnetic resonance imaging (MRI) findings at long-term follow-up after rotator cuff (RC) tear using standard MRI sequences without fat saturation. Material and Methods: Twenty-eight patients aged 55.8±7.6 underwent MRI examination 4.6±2.1 years after surgery for RC tear. Standard sequences in oblique coronal, oblique sagittal, and axial planes were obtained. The RC, including re-tears and tendon degeneration, was independently evaluated by two observers. Thickness of the supraspinatus tendon and narrowing of the subacromial space were measured. The clinical outcome was evaluated with the Constant score and compared with the MRI findings. Results: The RC tear was traumatic in 18 (64%) patients and degenerative in 10 (36%). At follow-up, 11 (39%) had normal RC tendons with good clinical outcome. Four (14%) patients had painful tendinosis without RC tear. A full-thickness RC tear was found in 7 (25%) patients and a partial tear in 6 (21%). In one patient with a full-thickness tear, and in two with partial tear, tendinosis was found in another of the RC tendons. The subacromial space was narrowed in 13 (46%) of the patients. A narrowing of the subacromial space correlated with re-tear (P<0.05). Conclusions: The RC may be evaluated with standard MRI sequences without fat saturation at long-term follow-up. A normal appearance of the RC is correlated with good clinical outcome, while re-tear and tendinosis are associated with pain

  6. Epidemiology, natural history, and indications for treatment of rotator cuff tears.

    Science.gov (United States)

    Tashjian, Robert Z

    2012-10-01

    The etiology of rotator cuff disease is likely multifactorial, including age-related degeneration and microtrauma and macrotrauma. The incidence of rotator cuff tears increases with aging with more than half of individuals in their 80s having a rotator cuff tear. Smoking, hypercholesterolemia, and genetics have all been shown to influence the development of rotator cuff tearing. Substantial full-thickness rotator cuff tears, in general, progress and enlarge with time. Pain, or worsening pain, usually signals tear progression in both asymptomatic and symptomatic tears and should warrant further investigation if the tear is treated conservatively. Larger (>1-1.5 cm) symptomatic full-thickness cuff tears have a high rate of tear progression and, therefore, should be considered for earlier surgical repair in younger patients if the tear is reparable and there is limited muscle degeneration to avoid irreversible changes to the cuff, including tear enlargement and degenerative muscle changes. Smaller symptomatic full-thickness tears have been shown to have a slower rate of progression, similar to partial-thickness tears, and can be considered for initial nonoperative treatment due to the limited risk for rapid tear progression. In both small full-thickness tears and partial-thickness tears, increasing pain should alert physicians to obtain further imaging as it can signal tear progression. Natural history data, along with information on factors affecting healing after rotator cuff repair, can help guide surgeons in making appropriate decisions regarding the treatment of rotator cuff tears. The management of rotator cuff tears should be considered in the context of the risks and benefits of operative versus nonoperative treatment. Tear size and acuity, the presence of irreparable changes to the rotator cuff or glenohumeral joint, and patient age should all be considered in making this decision. Initial nonoperative care can be safely undertaken in older patients (>70

  7. Anabolic agents: recent strategies for their detection and protection from inadvertent doping

    Science.gov (United States)

    Geyer, Hans; Schänzer, Wilhelm; Thevis, Mario

    2014-01-01

    According to the World Anti-Doping Agency (WADA) Prohibited List, anabolic agents consist of exogenous anabolic androgenic steroids (AAS), endogenous AAS and other anabolic agents such as clenbuterol and selective androgen receptor modulators (SARMs). Currently employed strategies for their improved detection include the prolongation of the detection windows for exogenous AAS, non-targeted and indirect analytical approaches for the detection of modified steroids (designer steroids), the athlete’s biological passport and isotope ratio mass spectrometry for the detection of the misuse of endogenous AAS, as well as preventive doping research for the detection of SARMs. The recent use of these strategies led to 4–80-fold increases of adverse analytical findings for exogenous AAS, to the detection of the misuse of new designer steroids, to adverse analytical findings of different endogenous AAS and to the first adverse analytical findings of SARMs. The strategies of the antidoping research are not only focused on the development of methods to catch the cheating athlete but also to protect the clean athlete from inadvertent doping. Within the past few years several sources of inadvertent doping with anabolic agents have been identified. Among these are nutritional supplements adulterated with AAS, meat products contaminated with clenbuterol, mycotoxin (zearalenone) contamination leading to zeranol findings, and natural products containing endogenous AAS. The protection strategy consists of further investigations in case of reasonable suspicion of inadvertent doping, publication of the results, education of athletes and development of methods to differentiate between intentional and unintentional doping. PMID:24632537

  8. MRI in the liquor hypotension syndrome: a case report and review of literature

    International Nuclear Information System (INIS)

    Costa Machado Junior, Marcos Alberto da; Barbosa, Veronica Aline Oliveira; Taglietti, Isabella; D'Almeida Filho, Fernando.

    1996-01-01

    The case of a man is presented, who suddenly suffered headaches, with no other neurological disorder or clinical symptom, that partially remitted only in horizontal decubitus. The magnetic resonance imaging (MRI) investigation showed isointense dural thickening or detachment of the convexity in T1, that was hyperintense in T2. After contrast medium i.v. injection, MRI images showed diffuse and marked dural enhancement of the convexity, along the tentorium, at the base, in the upper cervix. Liquor hypotension, accompanied by dural thickening and enhancement visible by MRI have been reported in the literature. In this case, no loss of cerebrospinal fluid was identified as a possible cause for its reduced pressure. Within the frame work of essential liquor hypotension, the authors underline the postural nature of headaches, and hypothesizes the dural alterations are the expression of traction inducing tears in the dural border cell layer with consequent blood extravasation. The correlation of the radiological aspects with these alterations and their changes are discussed. (author). 11 refs., 2 figs

  9. A prospective evaluation of survivorship of asymptomatic degenerative rotator cuff tears.

    Science.gov (United States)

    Keener, Jay D; Galatz, Leesa M; Teefey, Sharlene A; Middleton, William D; Steger-May, Karen; Stobbs-Cucchi, Georgia; Patton, Rebecca; Yamaguchi, Ken

    2015-01-21

    The purpose of this prospective study was to report the long-term risks of rotator cuff tear enlargement and symptom progression associated with degenerative asymptomatic tears. Subjects with an asymptomatic rotator cuff tear in one shoulder and pain due to rotator cuff disease in the contralateral shoulder enrolled as part of a prospective longitudinal study. Two hundred and twenty-four subjects (118 initial full-thickness tears, fifty-six initial partial-thickness tears, and fifty controls) were followed for a median of 5.1 years. Validated functional shoulder scores were calculated (visual analog pain scale, American Shoulder and Elbow Surgeons [ASES], and simple shoulder test [SST] scores). Subjects were followed annually with shoulder ultrasonography and clinical evaluations. Tear enlargement was seen in 49% of the shoulders, and the median time to enlargement was 2.8 years. The occurrence of tear-enlargement events was influenced by the severity of the final tear type, with enlargement of 61% of the full-thickness tears, 44% of the partial-thickness tears, and 14% of the controls (p tear enlargement. One hundred subjects (46%) developed new pain. The final tear type was associated with a greater risk of pain development, with the new pain developing in 28% of the controls, 46% of the shoulders with a partial-thickness tear, and 50% of those with a full-thickness tear (p tear enlargement was associated with the onset of new pain (p muscle were associated with tear enlargement, with supraspinatus muscle degeneration increasing in 4% of the shoulders with a stable tear compared with 30% of the shoulders with tear enlargement (p tear showed increased infraspinatus muscle degeneration compared with 28% of those in which the tear had enlarged (p = 0.07). This study demonstrates the progressive nature of degenerative rotator cuff disease. The risk of tear enlargement and progression of muscle degeneration is greater for shoulders with a full-thickness tear, and tear

  10. Dural attachment of intracranial meningiomas: evaluation with contrast-enhanced three-dimensional fast imaging with steady-state acquisition (FIESTA) at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Junkoh; Takahashi, Mayu; Aoyama, Yuichi; Soejima, Yoshiteru; Saito, Takeshi; Akiba, Daisuke; Nishizawa, Shigeru [University of Occupational and Environmental Health, Department of Neurosurgery, Kitakyusyu (Japan); Kakeda, Shingo; Korogi, Yukunori [University of Occupational and Environmental Health, Department of Radiology, Kitakyusyu (Japan)

    2011-06-15

    The purpose of this study was to evaluate the role of contrast-enhanced fast imaging with steady-state acquisition (CE-FIESTA) for assessing whether dural attachment in intracranial meningiomas is adhesive or not by correlation with intraoperative findings. Fourteen consecutive patients who were candidates for surgical treatment of meningiomas were prospectively analyzed with preoperative magnetic resonance imaging, including CE-FIESTA at 3 T. First, two neuroradiologists assessed several characteristics of the attachment of the meningioma to the dura mater or skull base on CE-FIESTA images. Second, the surgical findings of adhesion at the dural attachment of meningiomas were evaluated by two neurosurgeons. Finally, the CE-FIESTA findings were correlated with the surgical findings by one neurosurgeon and one neuroradiologist by consensus. CE-FIESTA clearly depicted a hypointense marginal line at the attachment site of the meningioma. When CE-FIESTA revealed smooth marginal lines or hyperintense zones along the marginal lines, tumors were detached easily from the dura mater. On the contrary, when CE-FIESTA showed an irregularity, such as partial disruption of the marginal lines, vessels, or bony hyperostosis, the tumors tended to adhere firmly to the dura mater, which was found to contain small vessels and fine fibrous tissues. There seems to be an excellent correlation between the characteristics of dural attachment of meningiomas on CE-FIESTA images and intraoperative findings. Therefore, for operative planning, CE-FIESTA may provide useful information regarding the adhesiveness of dural attachment. (orig.)

  11. Dural attachment of intracranial meningiomas: evaluation with contrast-enhanced three-dimensional fast imaging with steady-state acquisition (FIESTA) at 3 T

    International Nuclear Information System (INIS)

    Yamamoto, Junkoh; Takahashi, Mayu; Aoyama, Yuichi; Soejima, Yoshiteru; Saito, Takeshi; Akiba, Daisuke; Nishizawa, Shigeru; Kakeda, Shingo; Korogi, Yukunori

    2011-01-01

    The purpose of this study was to evaluate the role of contrast-enhanced fast imaging with steady-state acquisition (CE-FIESTA) for assessing whether dural attachment in intracranial meningiomas is adhesive or not by correlation with intraoperative findings. Fourteen consecutive patients who were candidates for surgical treatment of meningiomas were prospectively analyzed with preoperative magnetic resonance imaging, including CE-FIESTA at 3 T. First, two neuroradiologists assessed several characteristics of the attachment of the meningioma to the dura mater or skull base on CE-FIESTA images. Second, the surgical findings of adhesion at the dural attachment of meningiomas were evaluated by two neurosurgeons. Finally, the CE-FIESTA findings were correlated with the surgical findings by one neurosurgeon and one neuroradiologist by consensus. CE-FIESTA clearly depicted a hypointense marginal line at the attachment site of the meningioma. When CE-FIESTA revealed smooth marginal lines or hyperintense zones along the marginal lines, tumors were detached easily from the dura mater. On the contrary, when CE-FIESTA showed an irregularity, such as partial disruption of the marginal lines, vessels, or bony hyperostosis, the tumors tended to adhere firmly to the dura mater, which was found to contain small vessels and fine fibrous tissues. There seems to be an excellent correlation between the characteristics of dural attachment of meningiomas on CE-FIESTA images and intraoperative findings. Therefore, for operative planning, CE-FIESTA may provide useful information regarding the adhesiveness of dural attachment. (orig.)

  12. Attention and Facilitation: Converging Information Versus Inadvertent Reading in Stroop Task Performance

    NARCIS (Netherlands)

    Roelofs, A.P.A.

    2010-01-01

    Disagreement exists about whether color-word Stroop facilitation is caused by converging information (e.g.. Cohen et al.. 1990: Roelofs, 2003) or inadvertent reading (MacLeod & MacDonald, 2000). Four experiments tested between these hypotheses by examining Stroop effects oil response time (RT) both

  13. [Ropivacaine use in transnasal sphenopalatine ganglion block for post dural puncture headache in obstetric patients - case series].

    Science.gov (United States)

    Furtado, Inês; Lima, Isabel Flor de; Pedro, Sérgio

    2018-02-02

    Sphenopalatine ganglion block is widely accepted in chronic pain; however it has been underestimated in post dural puncture headache treatment. The ganglion block does not restore normal cerebrospinal fluid dynamics but effectively reduces symptoms associated with resultant hypotension. When correctly applied it may avoid performance of epidural blood patch. The transnasal approach is a simple and minimally invasive technique. In the cases presented, we attempted to perform and report the ganglion block effectiveness and duration, using ropivacaine. We present four obstetrics patients with post dural puncture headache, after epidural or combined techniques, with Tuohy needle 18G that underwent a safe and successful Sphenopalatine ganglion block. We performed the block 24-48h after dural puncture, with 4mL of ropivacaine 0.75% in each nostril. In three cases pain recurred within 12-48h, although less intense. In one patient a second block was performed with complete relief and without further recurrence. In the other two patients a blood patch was performed without success. All patients were asymptomatic within 7 days. The average duration of analgesic effect of the block remains poorly defined. In the cases reported, blocking with ropivacaine was a simple, safe and effective technique, with immediate and sustained pain relief for at least 12-24h. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  14. Kinetic theory of tearing instabilities

    International Nuclear Information System (INIS)

    Drake, J.F.; Lee, Y.C.

    1977-01-01

    The transition of the tearing instability from the collisional to the collisionless regime is investigated kinetically using a Fokker--Planck collision operator to represent electron-ion collisions. As a function of the collisionality of the plasma, the tearing instability falls into three regions, which are referred to as collisionless, semi-collisional, and collisional. The width Δ of the singular layer around kxB 0 =0 is limited by electron thermal motion along B 0 in the collisional and semi-collisional regimes and is typically smaller than rho/sub i/, the ion Larmor radius. Previously accepted theories, which are based on the assumption Δvery-much-greater-thanrho/sub i/, are found to be valid only in the collisional regime. The effects of density and temperature gradients on the instabilities are also studied. The tearing instability is only driven by the temperature gradient in the collisional and semi-collisional regimes. Numerical calculations indicate that the semi-collisional tearing instability is particularly relevant to present day high temperature tokamak discharges

  15. Posterior horn medial meniscal root tear: the prequel

    Energy Technology Data Exchange (ETDEWEB)

    Umans, H. [Albert Einstein College of Medicine, Bronx, NY (United States); Lenox Hill Radiology and Imaging Associates, New York, NY (United States); Morrison, W. [Thomas Jefferson University Hospital, Philadelphia, PA (United States); DiFelice, G.S. [Hospital for Special Surgery, New York, NY (United States); Vaidya, N. [Crystal Run Healthcare, Middletown, NY (United States); Winalski, C.S. [Cleveland Clinic, Imaging Institute, Department of Biomedical Engineering, Lerner Research Institute, Cleveland, OH (United States)

    2014-06-15

    To determine whether subarticular marrow changes deep to the posterior horn medial meniscal root anchor might predict subsequent medial meniscal root tear. Fifteen patients with MR-diagnosed posterior horn medial meniscal root (PHMMR) tear and a knee MRI antecedent to the tear were identified at three imaging centers over a 7-year period. The pre- and post-tear MR images were evaluated for marrow signal changes deep to the root anchor, meniscal root signal intensity, medial compartment articular cartilage thinning, and meniscal body extrusion. Images of 29 age- and gender-matched individuals with two MRIs of the same knee were reviewed as a control group. MRI in 11 of 15 (73 %) cases with subsequent PHMMR tear demonstrated linear subcortical marrow edema deep to the meniscal root anchor on the antecedent MRI compared to only 1 of 29 (3 %) non-tear controls (p < 0.0001). The abnormal signal resolved on post-tear MRI in all but two patients. Cyst-like changes deep to the PHMMR were present on initial MRI in three of 15 (23 %) cases and three of 29 (10 %) controls, persisting in all but one case on follow-up imaging. The PHMMR was gray on the initial MRI in seven of 15 (47 %) of cases that developed tears compared to four of 29 (14 %) controls (p < 0.0001). There was medial meniscal extrusion (MME) prior to tear in two of 15 (13 %) patients and in ten of 15 (67 %) patients after PHMMR failure. In the control group, MME was present in one (3 %) and three (10 %) of 29 subjects on the initial and follow-up MRIs, respectively. Articular cartilage loss was noted in two of 15 (15 %) cases before tear and nine of 15 (69 %) on follow-up imaging, as compared to one (3 %) and four (14 %) of 29 subjects in the control group. Subcortical marrow edema deep to the PHMMR may result from abnormal stresses and thus be a harbinger of meniscal root failure. This hypothesis is supported by resolution of these marrow signal changes after root tear. Following tear, extrusion of the

  16. Human tears reveal insights into corneal neovascularization.

    Science.gov (United States)

    Zakaria, Nadia; Van Grasdorff, Sigi; Wouters, Kristien; Rozema, Jos; Koppen, Carina; Lion, Eva; Cools, Nathalie; Berneman, Zwi; Tassignon, Marie-José

    2012-01-01

    Corneal neovascularization results from the encroachment of blood vessels from the surrounding conjunctiva onto the normally avascular cornea. The aim of this study is to identify factors in human tears that are involved in development and/or maintenance of corneal neovascularization in humans. This could allow development of diagnostic tools for monitoring corneal neovascularization and combination monoclonal antibody therapies for its treatment. In an observational case-control study we enrolled a total of 12 patients with corneal neovascularization and 10 healthy volunteers. Basal tears along with reflex tears from the inferior fornix, superior fornix and using a corneal bath were collected along with blood serum samples. From all patients, ocular surface photographs were taken. Concentrations of the pro-angiogenic cytokines interleukin (IL)-6, IL-8, Vascular Endothelial Growth Factor (VEGF), Monocyte Chemoattractant Protein 1 (MCP-1) and Fas Ligand (FasL) were determined in blood and tear samples using a flow cytometric multiplex assay. Our results show that the concentration of pro-angiogenic cytokines in human tears are significantly higher compared to their concentrations in serum, with highest levels found in basal tears. Interestingly, we could detect a significantly higher concentration of IL- 6, IL-8 and VEGF in localized corneal tears of patients with neovascularized corneas when compared to the control group. This is the first study of its kind demonstrating a significant difference of defined factors in tears from patients with neovascularized corneas as compared to healthy controls. These results provide the basis for future research using animal models to further substantiate the role of these cytokines in the establishment and maintenance of corneal neovascularization.

  17. The natural course of nonoperatively treated rotator cuff tears: an 8.8-year follow-up of tear anatomy and clinical outcome in 49 patients.

    Science.gov (United States)

    Moosmayer, Stefan; Gärtner, Anne V; Tariq, Rana

    2017-04-01

    The natural course of nonoperatively treated rotator cuff tears is not fully understood. We explored the long-term development of tear anatomy and assessed functional outcomes. Eighty-nine small to medium-sized full-thickness tears of the rotator cuff, all primarily treated by physiotherapy, were identified retrospectively. Twenty-three tears needed surgical treatment later on, and 17 patients were unable to meet for follow-up. The remaining 49 still unrepaired tears were re-examined after 8.8 (8.2-11.0) years with sonography. Re-examination by magnetic resonance imaging was possible for 37 patients. Shoulder function was assessed with shoulder scores. Primary outcome measures were progression of tear size, muscle atrophy, and fatty degeneration and the Constant score (CS). Mean tear size increased by 8.3 mm in the anterior-posterior plane (P = .001) and by 4.5 mm in the medial-lateral plane (P = .001). Increase of tear size was -5 to +9.9 mm in 33 patients, 10 to 19.9 mm in 8 patients, and ≥20 mm in 8 patients. The CS was 81 points for tear increases Muscle atrophy and fatty degeneration progressed in 18 and 15 of the 37 patients, respectively. In tears with no progression of atrophy, the CS was 82 points compared with 75.5 points in tears with progression (P = .04). Anatomic tear deterioration was found in the majority of patients, but it was often moderate. Large tear size increases and progression of muscle atrophy were correlated to a poorer functional outcome. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  18. Evaluation of two different epidural catheters in clinical practice. narrowing down the incidence of paresthesia!

    Science.gov (United States)

    Bouman, E A C; Gramke, H F; Wetzel, N; Vanderbroeck, T H T; Bruinsma, R; Theunissen, M; Kerkkamp, H E M; Marcus, M A E

    2007-01-01

    Although epidural anesthesia is considered safe, several complications may occur during puncture and insertion of a catheter. Incidences of paresthesia vary between 0.2 and 56%. A prospective, open, cohort-controlled pilot study was conducted in 188 patients, ASA I-III, age 19-87 years, scheduled for elective surgery and epidural anesthesia. We evaluated a 20 G polyamide (standard) catheter and a 20 G combined polyurethane-polyamide (new) catheter. Spontaneous reactions upon catheter-insertion, paresthesia on questioning, inadvertent dural or intravascular puncture, and reasons for early catheter removal were recorded. The incidence of paresthesia reported spontaneously was 21.3% with the standard catheter and 16.7% with the new catheter. Systematically asking for paresthesia almost doubled the paraesthesia rate. Intravascular cannulation occurred in 5%. No accidental dural punctures occurred. An overall incidence of 13.3% of technical problems led to early catheter removal. The new catheter was at least equivalent to the standard regarding epidural success rate and safety : rate of paresthesia, intravascular and dural cannulation.

  19. Age-related changes in the signal value of tears.

    Science.gov (United States)

    Zeifman, Debra M; Brown, Sarah A

    2011-08-12

    Emotional tears may be uniquely human and are an effective signal of distress in adults. The present study explored whether tears signal distress in younger criers and whether the effect of tears on observers is similar in magnitude across the life span. Participants rated photographs of crying infants, young children, and adults, with tears digitally removed or added. The effectiveness of tears in conveying sadness and eliciting sympathy was greatest for images of adults, intermediate for images of children, and least potent for images of infants. These findings suggest that the signal value of tears varies with the age of the crier. The results may shed light on the functional significance of crying at different stages of human development.

  20. Time course of changes in tear meniscus radius and blink rate after instillation of artificial tears.

    Science.gov (United States)

    Bandlitz, Stefan; Purslow, Christine; Murphy, Paul J; Pult, Heiko

    2014-08-26

    Using a novel digital meniscometer (PDM), alterations in tear meniscus radius (TMR) were measured simultaneously with blink rate (BR) following the instillation of artificial tears. Central TMR and BR of 22 subjects (11 male and 11 female; mean age, 24.3 ± 2.6 SD years) were measured at baseline, and 0, 1, 5, 10, and 30 minutes after instillation of an artificial tear containing hydroxypropyl-guar and glycol (SYS) or saline (SAL). A dose of 35 μL was applied in one eye in a randomized order with a washout period between each drop. For SAL, compared to baseline TMR (0.33 ± 0.08 mm), TMR significantly increased with drop instillation (1.55 ± 0.69 mm) and at 1 minute (0.66 ± 0.36 mm; P tears. Difference in residence time reflects the different viscosity of each drop. An overload with a large drop may result in an initially increased BR. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  1. MR Imaging of Rotator Cuff Tears: Correlation with Arthroscopy

    Science.gov (United States)

    Bhandary, Sudarshan; Khandige, Ganesh; Kabra, Utkarsh

    2017-01-01

    Introduction Rotator cuff tears are quite common and can cause significant disability. Magnetic Resonance Imaging (MRI) has now emerged as the modality of choice in the preoperative evaluation of patients with rotator cuff injuries, in view of its improved inherent soft tissue contrast and resolution. Aim To evaluate the diagnostic accuracy of routine MRI in the detection and characterisation of rotator cuff tears, by correlating the findings with arthroscopy. Materials and Methods This prospective study was carried out between July 2014 and August 2016 at the AJ Institute of Medical Sciences, Mangalore, Karnataka, India. A total of 82 patients were diagnosed with rotator cuff injury on MRI during this period, out of which 45 patients who underwent further evaluation with arthroscopy were included in this study. The data collected was analysed for significant correlation between MRI diagnosis and arthroscopic findings using kappa statistics. The sensitivity, specificity, predictive value and accuracy of MRI for the diagnosis of full and partial thickness tears were calculated using arthroscopic findings as the reference standard. Results There were 27 males and 18 females in this study. The youngest patient was 22 years and the oldest was 74 years. Majority of rotator cuff tears (78%) were seen in patients above the age of 40 years. MRI showed a sensitivity of 89.6%, specificity of 100%, positive predictive value of 100% and negative predictive value of 83.3% for the diagnosis of full thickness rotator cuff tears. For partial thickness tears, MRI showed a sensitivity of 100%, specificity of 86.6%, positive predictive value of 78.9% and negative predictive value of 100%. The accuracy was 93.1% for full thickness tears and 91.1% for partial thickness tears. The p-value was less than 0.01 for both full and partial thickness tears. There was good agreement between the MRI and arthroscopic findings, with kappa value of 0.85 for full thickness tears and 0.81 for partial

  2. Utility of the magnetic resonance in the evaluation of the dural sinus occlusive disease

    International Nuclear Information System (INIS)

    Delgado, Jorge Andres; Toro, Nancy; Bolivar, Guillermo; Pulgarin, Luis German

    1998-01-01

    The dural sinus occlusive disease is potentially fatal (20-78% cases) and of unspecific clinical symptoms. CT sensibility is only 75% and angiography is invasive. The MRI offers several advantages in the diagnosis due to its high sensibility to flow, high intrinsic contrast and no invasively. The MRI findings in 7 cases are described

  3. Meniscotibial (coronary) ligament tears

    International Nuclear Information System (INIS)

    El-Khoury, G.Y.; Usta, H.Y.; Berger, R.A.

    1984-01-01

    Preservation of the meniscus whenever possible is essential in maintaining knee stability and preventing premature osteoarthritis. Peripheral meniscal tears are the most amenable to surgical repair. This study evaluates the peripheral attachments of the medial meniscus and focuses on a specific tear limited to the meniscotibial ligament (coronary ligament). The diagnosis is made arthrographically when the medial meniscus floats above the tibial plateau without separating completely from the capsule. The lateral meniscus is rarely involved in this type of injury. (orig.)

  4. SLAP tears of the glenoid labrum in contact athletes.

    Science.gov (United States)

    Funk, Lennard; Snow, Martyn

    2007-01-01

    To describe the distribution and clinical presentation of labral injuries in rugby players and the time taken for them to return to sports. Retrospective cohort study. Busy shoulder practice in the North West of England, treating a large number of professional athletes. A review of 51 shoulder arthroscopies performed on professional rugby players over a 35 month period. All patients diagnosed with a SLAP lesion at arthroscopy were identified. Eighteen patients had a documented SLAP tear; this group represented our study population. Arthroscopic debridement and/or stabilization was carried out for all labral injuries using Panaloc anchors and No. 2 PDS via a 2 portal technique. Classification of injury, Satisfaction, Time to return to play. The incidence of SLAP tears in our study population was 35%. There were 11 isolated SLAP tears (61%), 3 SLAP tears associated with a Bankart lesion (17%), 2 SLAP tears associated with a posterior labral lesion (11%), and 2 SLAP tears associated with an anterior and posterior labral injuries (11%). Of the 18 SLAP tears, 14 (78%) were type 2, 3 (17%) were type 3, and 1 (5%) was type 4. None of the patients with a SLAP tear presented with symptoms of instability. MR Arthrogram had a 76% sensitivity for detecting SLAP tears. By 6 months postsurgery, 89% of patients were satisfied. Patients with isolated SLAP tears were the quickest to return to sports, at an average of 2.6 months postsurgery. SLAP tears are a common injury in rugby players. These can often be diagnosed with MR arthrography. Arthroscopic repair is associated with excellent results and early return to sports.

  5. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

    International Nuclear Information System (INIS)

    Villeirs, G.M.; Verstraete, K.L.; Kunnen, M.F.; Tongerloo, A.J. van; Paepe, A.M. de

    1999-01-01

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, χ 2 -test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  6. Indocyanine green videoangiography "in negative": definition and usefulness in intracranial dural arteriovenous fistulae.

    Science.gov (United States)

    Simal Julián, Juan Antonio; Miranda Lloret, Pablo; Aparici Robles, Fernando; Beltrán Giner, Andrés; Botella Asunción, Carlos

    2013-09-01

    Indocyanine green videoangiography (IGV) raises important limitations when we use it in vascular pathology, especially in cases with arterialization of the venous system such as arteriovenous malformations and fistulae. Our objective was to provide a simple procedure that overcomes the limitations of conventional IGV. We define IGV in negative (IGV-IN), so-called because, in its first phase, the vessel to analyze is clipped, and we report 3 cases of intracranial dural arteriovenous fistulae treated with this procedure. In 2011, we applied IGV-IN to 3 patients at our center with Borden type III intracranial arteriovenous fistulae. In all 3 cases, IGV-IN enabled both diagnosis and post-dural arteriovenous fistula exclusion control in 1 integrated procedure no longer than 1 minute, requiring only 1 visualization. IGV-IN is an improvement over the conventional IGV method and is able to provide more information in a shorter period of time. It is an intuitive and highly visual procedure, and, more importantly, it is reversible. Studies with larger samples are necessary to determine whether IGV-IN can further reduce the need for postoperative digital subtraction angiography.

  7. Advanced Rotator Cuff Tear Score (ARoCuS): a multi-scaled tool for the classification and description of rotator cuff tears.

    Science.gov (United States)

    Walter, S G; Stadler, T; Thomas, T S; Thomas, W

    2018-03-02

    To introduce a (semi-)quantitative surgical score for the classification of rotator cuff tears. A total of 146 consecutive patients underwent rotator cuff repair and were assessed using the previously defined Advanced Rotator Cuff Tear Score (ARoCuS) criteria: muscle tendon, size, tissue quality, pattern as well as mobilization of the tear. The data set was split into a training (125 patients) and a testing set (21 patients). The training data set fitted a nonlinear predictive model of the tear score based on the ARoCuS criteria, while the testing data served as control. Based on the scoring results, rotator cuff tears were assigned to one of four categories (ΔV I-IV) and received a stage-adapted treatment. For statistical analysis, mean values ± standard deviation, interclass correlation coefficients (ICC) and kappa values were calculated. Overall, 32 patients were classified as ΔV I, 68 as ΔV II and 37 as ΔV III. Nine patients showed ΔV IV tears. Patients of all ΔV groups improved significantly their Constant scores (p tears in a standardized and reproducible manner.

  8. Potential impact of DOE's performance objective for protection of inadvertent intruders on low-level waste disposals at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Kocher, D.C.

    1992-01-01

    The Department of Energy's Order 5820.2A, Chapter III, specifies performance objectives for disposal of low-level radioactive waste which include limits on effective dose equivalent for inadvertent intruders. This paper investigates the potential impact of the performance objective for protection of inadvertent intruders on the acceptability of waste disposals in Solid Waste Storage Area (SWSA) 6 at Oak Ridge National Laboratory (ORNL). The analysis is based on radionuclide inventories and waste volumes for recent disposals in SWSA 6 and calculated doses to an inadvertent intruder per unit concentration of radionuclides in disposed waste for assumed exposure scenarios

  9. Detecting meniscal tears in primary care

    NARCIS (Netherlands)

    Snoeker, B.A.M.

    2017-01-01

    Although meniscal tears are a very common phenomenon uncertainty exists about the diagnosis and treatment of meniscal tears in primary care. This thesis aims to provide evidence for general practitioners and physical therapists regarding the diagnosis and management of patients with a suspected

  10. Duplex Tear Film Evaporation Analysis.

    Science.gov (United States)

    Stapf, M R; Braun, R J; King-Smith, P E

    2017-12-01

    Tear film thinning, hyperosmolarity, and breakup can cause irritation and damage to the human eye, and these form an area of active investigation for dry eye syndrome research. Recent research demonstrates that deficiencies in the lipid layer may cause locally increased evaporation, inducing conditions for breakup. In this paper, we explore the conditions for tear film breakup by considering a model for tear film dynamics with two mobile fluid layers, the aqueous and lipid layers. In addition, we include the effects of osmosis, evaporation as modified by the lipid, and the polar portion of the lipid layer. We solve the system numerically for reasonable parameter values and initial conditions and analyze how shifts in these cause changes to the system's dynamics.

  11. Dural venous sinuses distortion and compression with supratentorial mass lesions: a mechanism for refractory intracranial hypertension?

    Science.gov (United States)

    Qureshi, Adnan I.; Qureshi, Mushtaq H.; Majidi, Shahram; Gilani, Waqas I.; Siddiq, Farhan

    2014-01-01

    Objective To determine the effect of supratentorial intraparenchymal mass lesions of various volumes on dural venous sinuses structure and transluminal pressures. Methods Three set of preparations were made using adult isolated head derived from fresh human cadaver. A supratentorial intraparenchymal balloon was introduced and inflated at various volumes and effect on dural venous sinuses was assessed by serial intravascular ultrasound, computed tomographic (CT), and magnetic resonance (MR) venograms. Contrast was injected through a catheter placed in sigmoid sinus for both CT and MR venograms. Serial trasluminal pressures were measured from middle part of superior sagittal sinus in another set of experiments. Results At intraparenchymal balloon inflation of 90 cm3, there was attenuation of contrast enhancement of superior sagittal sinus with compression visualized in posterior part of the sinus without any evidence of compression in the remaining sinus. At intraparenchymal balloon inflation of 180 and 210 cm3, there was compression and obliteration of superior sagittal sinus throughout the length of the sinus. In the coronal sections, at intraparenchymal balloon inflations of 90 and 120 cm3, compression and obliteration of the posterior part of superior sagittal sinus were visualized. In the axial images, basal veins were not visualized with intraparenchymal balloon inflation of 90 cm3 or greater although straight sinus was visualized at all levels of inflation. Trasluminal pressure in the middle part of superior sagittal sinus demonstrated a mild increase from 0 cm H2O to 0.4 cm H2O and 0.5 cm H2O with inflation of balloon to volume of 150 and 180 cm3, respectively. There was a rapid increase in transluminal pressure from 6.8 cm H2O to 25.6 cm H2O as the supratentorial mass lesion increased from 180 to 200 cm3. Conclusions Our experiments identified distortion and segmental and global obliteration of dural venous sinuses secondary to supratentorial mass lesion and

  12. Diet, nutraceuticals and the tear film.

    Science.gov (United States)

    Jalbert, Isabelle

    2013-12-01

    Nutrition disorders and their correlates such as obesity are increasingly prevalent worldwide. A number of studies to date have suggested numerous potential associations between diet and tear film health; this paper will provide a summary of the available literature. The tear film is characterized through its protein and lipid content and through clinical measurements of characteristics such as osmolarity, volume and stability. Malnutrition, protein and vitamin-A deficiencies are extremely deleterious to tear film health and supplementation with oral vitamin A in this setting is of clear benefit. The relative impact of diet on tear film within what would be considered normal ranges of consumption is less clear. A number of population studies have suggested that hyperlipidemia and a diet low in omega-3 fatty acids are risks factor for dry eye disease. Numerous studies have investigated the effectiveness of oral supplementation with antioxidants, omega-3 (e.g. fish oil and linseed oil) and omega-6 (e.g. evening primrose oil) fatty acids in the last 10 years. Taken together, these suggest a small benefit of oral supplementation on tear film volume, stability and decreased ocular symptoms in patients previously diagnosed with diseases involving the ocular surface (e.g. Sjögren's syndrome, meibomian gland dysfunction, dry eye disease) and contact lens wearers suffering from dry eye. More research is required to determine the exact composition, dosage and indications for their use and to fully characterize how these nutraceuticals modulate the tear film. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. MRI evaluation of the posterior meniscus root tear

    International Nuclear Information System (INIS)

    Zhang Jianjun; Zheng Zhuozhao; Li Xuan

    2010-01-01

    Objective: To determine the value of MRI for diagnosing the posterior meniscus root tear. Methods: MR examinations of 30 patients with tear of the posterior meniscus root confirmed by knee arthroscopies were retrospectively reviewed. Of the 30 patients, 17 with posterior medial meniscus root tear (MMRT) and 13 with posterior lateral meniscus root tear (LMRT). The diagnostic sensitivity of' MRI for the posterior meniscus root tear was analyzed. Fisher's exact test was used to compare the detection rate of MRI for MMRT with that for LMRT. Results: All 17 cases with MMRT and 9 cases out of 13 with LMRT were correctly diagnosed by MRI and the diagnostic sensitivity of MRI for the posterior meniscus root tear was 86.7% (26/30). The main MR appearance of the posterior meniscus root tear was distortion of the meniscal root, with its low signal replaced by abnormal high signal. The detection rate of MRI for MMRT (17/17) was significantly greater than that for LMRT (9/13) (P=0.026). The prevalence of MMRT associated with meniscus extrusion (15/17) was significantly greater than that of LMRT (6/13) (P=0.020), but the prevalence of MMRT associated with anterior cruciate ligament (ACL) injury (5/17) was significantly lower than that of LMRT (11/13) (P=0.004). Conclusion: MRI is a relatively good method for detection of posterior meniscus root tears and associated injuries. (authors)

  14. Comparison of Medial and Lateral Meniscus Root Tears.

    Directory of Open Access Journals (Sweden)

    Ji Hyun Koo

    Full Text Available The meniscus root plays an essential role in maintaining the circumferential hoop tension and preventing meniscal displacement. Studies on meniscus root tears have investigated the relationship of osteoarthritis and an anterior cruciate ligament tear. However, few studies have directly compared the medial and lateral root tears. To assess the prevalence of meniscal extrusion and its relationship with clinical features in medial and lateral meniscus root tears, we performed a retrospective review of the magnetic resonance imaging (MRI results of 42 knee patients who had meniscus posterior horn root tears and who had undergone arthroscopic operations. The presence of meniscal extrusion was evaluated and the exact extent was measured from the tibial margin. The results were correlated with arthroscopic findings. Clinical features including patients' ages, joint abnormalities, and previous trauma histories were evaluated. Twenty-two patients had medial meniscus root tears (MMRTs and twenty patients had lateral meniscus root tears (LMRTs. Meniscal extrusion was present in 18 MMRT patients and one LMRT patient. The mean extent of extrusion was 4.2mm (range, 0.6 to 7.8 in the MMRT group and 0.9mm (range, -1.9 to 3.4 in the LMRT group. Five patients with MMRT had a history of trauma, while 19 patients with LMRT had a history of trauma. Three patients with MMRT had anterior cruciate ligament (ACL tears, while 19 patients with LMRT had ACL tears. The mean age of the patients was 52 years (range: 29-71 years and 30 years (range: 14-62 years in the MMRT and LMRT group, respectively. There was a significant correlation between a MMRT and meniscal extrusion (p<0.0001, and between an ACL tear and LMRT (p<0.0001. A history of trauma was significantly common in LMRT (p<0.0001. LMRT patients were significantly younger than MMRT patients (p<0.0001. Kellgren-Lawrence (K-L grade differed significantly between MMRT and LMRT group (p<0.0001. Meniscal extrusion is

  15. Lipid peroxidation is increased in tears from the elderly.

    Science.gov (United States)

    Benlloch-Navarro, Soledad; Franco, Ilenia; Sánchez-Vallejo, Violeta; Silvestre, Dolores; Romero, Francisco Javier; Miranda, María

    2013-10-01

    We describe a procedure in which tears, obtained from Schirmer strips, are used to measure a marker of lipid peroxidation, malondialdehyde (MDA). We also compared the levels of proteins and MDA in tears from two groups of people: young adults (18-30 years old) and elderly adults (65-85 years old), because the data related to total protein concentration of human tears vary widely and because the majority of people over the age of 65 experience some symptoms of dry eyes and this condition has been recognized as an oxidative stress-induced disease. Our results show a significant difference in the protein concentration of the tears taken from the two age categories, younger adults (18-30 years old) and older adults (65-85 years old). Herein, we report for the first time an increase in MDA concentrations determined by HPLC in human tears based on age. It is possible that alterations in the tear lipid layer may lead to an increase in lipid peroxidation. Further studies are needed to understand the nature and function of tear film and stability in order to obtain new methods to analyze tears in patients with different diseases. In this sense, it would be interesting to compare MDA concentration in tears from control subjects and from people with meibomian gland dysfunction. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Effects of tear film dynamics on quality of vision.

    Science.gov (United States)

    Koh, Shizuka; Tung, Cynthia I; Inoue, Yasushi; Jhanji, Vishal

    2018-06-15

    The precorneal tear film is maintained by blinking and exhibits different phases in the tear cycle. The tear film serves as the most anterior surface of the eye and plays an important role as a first refractive component of the eye. Alterations in tear film dynamics may cause both vision-related and ocular surface-related symptoms. Although the optical quality associated with the tear film dynamics previously received little attention, objective measurements of optical quality using wavefront sensors have enabled us to quantify optical aberrations induced by the tear film. This has provided an objective method for assessing reduced optical quality in dry eye; thus, visual disturbances were included in the definition of dry eye disease in the 2007 Dry Eye Workshop report. In addition, sequential measurements of wavefront aberrations have provided us with valuable insights into the dynamic optical changes associated with tear film dynamics. This review will focus on the current knowledge of the mechanisms of wavefront variations that are caused by different aspects of tear film dynamics: specifically, quality, quantity and properties of the tear film, demonstrating the respective effects of dry eye, epiphora and instillation of eye drops on the quality of vision. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. The social impact of emotional tears

    NARCIS (Netherlands)

    Vingerhoets, A.J.J.M.; van de Ven, N.; van der Velden, Y.

    2016-01-01

    The question what specific functions the production of emotional tears fulfills has received only limited attention of behavioral scientists. We report the results of two studies on the social impact of emotional tears. In Study 1 (96 Dutch females), perceived helplessness and felt connectedness

  18. US detection of rotator cuff tear

    International Nuclear Information System (INIS)

    Soble, M.G.; Guay, R.C.; Kaye, A.D.

    1988-01-01

    Between June 1986 and April 1988, 75 patients suspected of having a tear of the rotator cuff underwent shoulder sonography and arthrography. Compared with anthrography, US demonstrated 92% of rotor cuff tears, with a specificity of 84% and a negative predictive value of 95%. In 30 patients who underwent surgery for a rotator cuff tear or other soft-tissue abnormality, sonography demonstrated a sensitivity of 93% and specificity of 73%, while arthrography demonstrated a sensitivity of 87% and specificity of 100%. The above data indicate that US is a useful, noninvasive screening procedure for patients suspected of having rotator cuff injury

  19. Allergy and allergic mediators in tears.

    Science.gov (United States)

    Leonardi, Andrea

    2013-12-01

    The identification of inflammatory mediators in the tear fluid have been extensively used in ocular allergy to find either a 'disease marker', to better understand the immune mechanisms involved in the ocular surface inflammation, or to identify potential targets for therapeutic interventions. While the clinical characteristics allow a relatively convincing diagnosis of ocular allergic diseases, in the initial, non active phases, or in the chronic stages, the diagnosis may not be clear. Although not highly specific, total tear IgE can be measured with local tests by inserting a paper strip in the lower meniscus. The measurement of tear specific inflammatory markers, such as histamine, tryptase, ECP, IL-4, IL-5 and eotaxin, may be useful for the diagnosis or monitoring ocular allergy. New technologies such as multiplex bead assays, membrane-bound antibody array and proteomic techniques can characterize the distribution of a wide range of bioactive trace proteins in tears. Dozens of mediators, cytokines, chemokines, growth factors, angiogenic modulators, enzymes and inhibitors were thus identified in small tear samples using these techniques, providing the possible identification of specific biomarker for either specific disease or disease activity. However, to date, there is no a single specific laboratory test suitable for the diagnosis and monitoring of allergic conjunctivitis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. MR imaging of meniscal tears: correlation with history of trauma

    International Nuclear Information System (INIS)

    Choi, Jong Cheul; Yang, Seoung Oh; Choi, Sun Seob; Son, Seok Hyun; Lee, Yung Il; Chung, Duck Hwan; Kim, Kyung Taek; Sohn, Sung Keun; Lee, Jung Yoon

    1994-01-01

    The medial meniscus is injured much more than the lateral meniscus. Because the medial meniscus is much larger in diameter, is thinner in its periphery and narrower in body than the lateral meniscus, and dose not attach to either cruciate ligament. We evaluated correlations with sites of tear and history of trauma. We reviewed retrospectively in 43 patients with meniscal tears on MR(51 cases) and correlated them with history of trauma. The most common site of injury was the posterior horn of the medial meniscuc(32/51), but high incidence of lateral meniscal tear compared with previous reports was seen. In the cases which had history of trauma, the posterior horn of medial meniscus was most commonly injured(26/34) and 5 meniscal tears were combined with meniscal tear in the other site. The tear in the anterior horn of the medial meniscus was seen only in a patient which had history of trauma and combined with meniscal tear in the other site. But in the meniscal tears without definite history of trauma, the incidence of meniscal tear was different from the meniscal tear with history of trauma. The incidence of lateral meniscal tear(11/17) was higher than medial meniscal tear and the posterior horn of lateral meniscus was commonly injured. We concluded that the medial meniscus was commonly injured, especially posterior horn, but in the cases which had no definite history of trauma, the lateral meniscus was commonly injured. An awareness of prevalent site of meniscal injuries may be helpful in the diagnostic interpretation of MR imaging of knee

  1. Attention and Facilitation: Converging Information versus Inadvertent Reading in Stroop Task Performance

    Science.gov (United States)

    Roelofs, Ardi

    2010-01-01

    Disagreement exists about whether color-word Stroop facilitation is caused by converging information (e.g., Cohen et al., 1990; Roelofs, 2003) or inadvertent reading (MacLeod & MacDonald, 2000). Four experiments tested between these hypotheses by examining Stroop effects on response time (RT) both within and between languages. Words cannot be…

  2. Tearing modes with pressure gradient effect in pair plasmas

    International Nuclear Information System (INIS)

    Cai Huishan; Li Ding; Zheng Jian

    2009-01-01

    The general dispersion relation of tearing mode with pressure gradient effect in pair plasmas is derived analytically. If the pressure gradients of positron and electron are not identical in pair plasmas, the pressure gradient has significant influence at tearing mode in both collisionless and collisional regimes. In collisionless regime, the effects of pressure gradient depend on its magnitude. For small pressure gradient, the growth rate of tearing mode is enhanced by pressure gradient. For large pressure gradient, the growth rate is reduced by pressure gradient. The tearing mode can even be stabilized if pressure gradient is large enough. In collisional regime, the growth rate of tearing mode is reduced by the pressure gradient. While the positron and electron have equal pressure gradient, tearing mode is not affected by pressure gradient in pair plasmas.

  3. Tear dysfunction and the cornea: LXVIII Edward Jackson Memorial Lecture.

    Science.gov (United States)

    Pflugfelder, Stephen C

    2011-12-01

    To describe the cause and consequence of tear dysfunction-related corneal disease. Perspective on effects of tear dysfunction on the cornea. Evidence is presented on the effects of tear dysfunction on corneal morphology, function, and health, as well as efficacy of therapies for tear dysfunction-related corneal disease. Tear dysfunction is a prevalent eye disease and the most frequent cause for superficial corneal epithelial disease that results in corneal barrier disruption, an irregular optical surface, light scattering, optical aberrations, and exposure and sensitization of pain-sensing nerve endings (nociceptors). Tear dysfunction-related corneal disease causes irritation and visual symptoms such as photophobia and blurred and fluctuating vision that may decrease quality of life. Dysfunction of 1 or more components of the lacrimal functional unit results in changes in tear composition, including elevated osmolarity and increased concentrations of matrix metalloproteinases, inflammatory cytokines, and chemokines. These tear compositional changes promote disruption of tight junctions, alter differentiation, and accelerate death of corneal epithelial cells. Corneal epithelial disease resulting from tear dysfunction causes eye irritation and decreases visual function. Clinical and basic research has improved understanding of the pathogenesis of tear dysfunction-related corneal epithelial disease, as well as treatment outcomes. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. The anterior medullary-anterior pontomesencephalic venous system and its bridging veins communicating to the dural sinuses: normal anatomy and drainage routes from dural arteriovenous fistulas

    International Nuclear Information System (INIS)

    Kiyosue, Hiro; Tanoue, Shuichi; Sagara, Yoshiko; Okahara, Mika; Kashiwagi, Junji; Mori, Hiromu; Hori, Yuzo; Nagatomi, Hirofumi

    2008-01-01

    We evaluated the normal venous anatomy of the anterior medullary/anterior pontomesencephalic venous (AMV/APMV) system and bridging veins connected to the dural sinuses using magnetic resonance (MR) imaging and demonstrated cases of dural arteriovenous fistulas (DAVFs) with bridging venous drainage. MR images obtained using a 3D gradient echo sequence in 70 patients without lesions affecting the deep or posterior venous channels were reviewed to evaluate the normal anatomy of the AMV/APMV system and bridging veins. MR images and digital subtraction angiography in 80 cases with intracranial or craniocervical junction DAVFs were reviewed to evaluate the bridging venous drainage from DAVFs. MR images clearly revealed AMV/APMV in 35 cases. Fifteen cases showed a direct connection between AMV and APMV, while 15 cases showed an indirect communication via the transverse pontine vein or the bridging vein. In the five remaining cases, the AMV and APMV end separately to the bridging vein or the transverse pontine vein. Bridging veins were identified in 34 cases, connecting to the cavernous sinus in 33, to the suboccipital cavernous sinus in 11, and the inferior petrosal sinus in five cases. In 80 DAVF cases, seven of 40 cavernous sinus DAVFs, two craniocervical junction DAVFs, and one inferior petrosal sinus DAVF drained via bridging veins to the brain stem. The AMV/APMV and bridging veins showed various anatomies and frequently showed a connection to the cavernous sinus. Knowledge of the venous anatomy is helpful for the diagnosis and intravascular treatment of DAVFs. (orig.)

  5. Immunoglobulin Concentration in Tears of Contact Lens Wearers

    Science.gov (United States)

    Maurya, Rajendra P.; Bhushan, Prashant; Singh, Virendra P.; Singh, Mahendra K.; Kumar, Prakash; Bhatia, Ravindra P.S.; Singh, Usha

    2014-01-01

    Purpose: To evaluate changes in the concentration of tear immunoglobulins in contact lens wearers. Methods: A total of 45 cases including 23 contact lens wearers (43 eyes) and 22 age and sex matched healthy controls having no ocular pathology were studied for immunoglobulins (IgA, IgG, IgM) in their tears by single radial immunodiffusion method. Results: Most of the cases used soft (56.6%) and semi-soft gas permeable (30.4%) contact lenses. Tear IgM was detected in only 17.4% and tear IgG in 43.6% of contact lens wearers, while in controls IgG was detected in 9.1% but none of the controls had IgM. There was a significant rise in total tear IgA (13.17 ± 4.44 mg/dl) in contact lens wearer as compared to controls (8.93 ± 3.79 mg/dl). Rise of tear IgA was more in symptomatic patients (15.38 ± 5.28 mg/dl) and in those wearing hard (19.73 ± 5.43 mg/dl) and semi-soft contact lenses (13.31 ± 5.43 mg/dl). A significant increase in tear IgA was noticed in subjects wearing lenses for >3 years (15.69 ± 5.39 mg/dl). About 43.4% of lens wearers were symptomatic and 80% of their lenses showed deposits and/or haziness. All cases with IgM in tear were symptomatic. Conclusion: The relation of immunoglobulin concentration with increasing duration of wear and material of contact lens shows that tear immunoglobulin rise accrues due to mechanical stimulation, hence contact lenses should not be used for a long period and lenses of hard nature should be discouraged. The maintenance, cleaning and deproteinization of the lenses are of high importance to avoid immunostimulation. PMID:25667732

  6. Tearing mode analysis in tokamaks, revisited

    International Nuclear Information System (INIS)

    Nishimura, Y.; Callen, J.D.; Hegna, C.C.

    1997-12-01

    A new Δ' shooting code has been developed to investigate tokamak plasma tearing mode stability in a cylinder and large aspect ratio (ε ≤ 0.25) toroidal geometries, neglecting toroidal mode coupling. A different computational algorithm is used (shooting out from the singular surface instead of into it) to resolve the strong singularities at the mode rational surface, particularly in the presence of finite pressure term. Numerical results compare favorably with Furth et al. results. The effects of finite pressure, which are shown to decrease Δ', are discussed. It is shown that the distortion of the flux surfaces by the Shafranov shift, which modifies the geometry metric element stabilizes the tearing mode significantly, even in a low β regime before the toroidal magnetic curvature effects come into play. Double tearing modes in toroidal geometries are examined as well. Furthermore, m ≥ 2 tearing mode stability criteria are compared with three dimensional initial value MHD simulation by the FAR code

  7. [Effects of acupuncture on lactoferrin content in tears and tear secretion in patients suffering from dry eyes: a randomized controlled trial].

    Science.gov (United States)

    Shi, Jing-lin; Miao, Wan-hong

    2012-09-01

    With the understanding of the immune inflammatory response in the pathogenesis of dry eyes, and the limitations of widely used artificial tears and numerous pharmaceuticals and methods to promote tear secretion, clinicians pay more attention to the therapies that can promote tear secretion actively. Acupuncture treatment for dry eye may meet this requirement. To observe the clinical efficacy of acupuncture treatment on dry eye and the effects on duration, and to examine the mechanisms of acupuncture in treating patients with dye eyes. The study was performed at Department of Ophthalmology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine from August 2010 to May 2011. Patients with the primary diagnosis of dry eye were enrolled. Sixty-five patients were randomly divided into treatment group and control group, and were given 3 weeks of acupuncture treatment or artificial tear therapy respectively. The enzyme-linked immunosorbent assay was used to detect the lactoferrin content of the tears before and after treatment. In order to evaluate the efficacy of the treatment methods, the Schirmer I test and break-up time were also measured. Compared with before treatment, the lactoferrin content in the tears of patients in the treatment group increased, break-up time was prolonged and the result of the Schirmer I test showed improvement after 3 weeks of treatment. The indexes mentioned above did not change in the control group after treatment. There were no significant differences in tear lactoferrin and Schirmer I test between one week after treatment and after 3-week treatment in the treatment group, but break-up time was significantly shortened. The result of Schirmer I test in the treatment group was significantly higher than that in the control group one week after treatment. Acupuncture can increase tear lactoferrin level, extend tear film break-up time and promote tear secretion in patients with dry eye in a time-limited trial. With the end of

  8. Is there a dural wall between the cavernous sinus and the pituitary fossa? Anatomical and MRI findings

    International Nuclear Information System (INIS)

    Dietemann, J.L.; Diniz, R.; Reis, M. Jr.; Neugroschl, C.; Vinclair, L.; Maillot, C.

    1998-01-01

    We compared MRI studies of the sellar area and embryological and adult histological studies of the cavernous sinuses and pituitary fossa. MRI studies were performed in 50 normal subjects with coronal sections using a fast inversion-recovery sequence to demonstrate the dural walls of the cavernous sinus and pituitary fossa. With this sequence, dura mater appears as a high-signal linear structure. The lateral and superior walls of the cavernous sinus was easily identified on all studies, but demonstration of a dural wall separating the cavernous sinus from the pituitary fossa was not possible. These results correlated well with embryological and adult histological studies obtained from 14 specimens. The absence of a strong separation between the pituitary fossa and the cavernous sinus explains the high incidence of extension of pituitary tumours to the cavernous sinuses and vice versa. (orig.) (orig.)

  9. Relationships between rotator cuff tear types and radiographic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Soo Hyun; Chun, Kyung Ah; Lee Soo Jung; Kang, Min Ho; Yi, Kyung Sik; Zhang, Ying [Dept. of Diagnostic Radiology, College of Medicine, Chungbuk National University, Cheongju (Korea, Republic of)

    2014-11-15

    To determine relationships between different types of rotator cuff tears and radiographic abnormalities. The shoulder radiographs of 104 patients with an arthroscopically proven rotator cuff tear were compared with similar radiographs of 54 age-matched controls with intact cuffs. Two radiologists independently interpreted all radiographs for; cortical thickening with subcortical sclerosis, subcortical cysts, osteophytes in the humeral greater tuberosity, humeral migration, degenerations of the acromioclavicular and glenohumeral joints, and subacromial spurs. Statistical analysis was performed to determine relationships between each type of rotator cuff tears and radiographic abnormalities. Inter-observer agreements with respect to radiographic findings were analyzed. Humeral migration and degenerative change of the greater tuberosity, including sclerosis, subcortical cysts, and osteophytes, were more associated with full-thickness tears (p < 0.01). Subacromial spurs were more common for full-thickness and bursal-sided tears (p < 0.01). No association was found between degeneration of the acromioclavicular or glenohumeral joint and the presence of a cuff tear. Different types of rotator cuff tears are associated with different radiographic abnormalities.

  10. Relationships between rotator cuff tear types and radiographic abnormalities

    International Nuclear Information System (INIS)

    Lee, Soo Hyun; Chun, Kyung Ah; Lee Soo Jung; Kang, Min Ho; Yi, Kyung Sik; Zhang, Ying

    2014-01-01

    To determine relationships between different types of rotator cuff tears and radiographic abnormalities. The shoulder radiographs of 104 patients with an arthroscopically proven rotator cuff tear were compared with similar radiographs of 54 age-matched controls with intact cuffs. Two radiologists independently interpreted all radiographs for; cortical thickening with subcortical sclerosis, subcortical cysts, osteophytes in the humeral greater tuberosity, humeral migration, degenerations of the acromioclavicular and glenohumeral joints, and subacromial spurs. Statistical analysis was performed to determine relationships between each type of rotator cuff tears and radiographic abnormalities. Inter-observer agreements with respect to radiographic findings were analyzed. Humeral migration and degenerative change of the greater tuberosity, including sclerosis, subcortical cysts, and osteophytes, were more associated with full-thickness tears (p < 0.01). Subacromial spurs were more common for full-thickness and bursal-sided tears (p < 0.01). No association was found between degeneration of the acromioclavicular or glenohumeral joint and the presence of a cuff tear. Different types of rotator cuff tears are associated with different radiographic abnormalities.

  11. Meniscus tears of the knee: Postarthrogram high resolution CT

    International Nuclear Information System (INIS)

    Kim, Jae Hyoung; Do, Young Soo; You, Jin Jong; Gong, Jae Chul; Kim, Hyung Jin; Chung, Sung Hoon

    1990-01-01

    Thirty-eight knees with clinically suspected meniscal tears were examined with high resolution computed tomography(HRCT) immediately following double contrast arthrography. All subsequently underwent arthroscopy. The findings of postarthrogram HRCT and arthroscopy were compared to evaluated the usefulness of postarthrogram HRCT in diagnosis of the meniscal tears. The sensitivity, specificity and accuracy of HRCT were 96.2%. 83.3% and 92.1% respectively. The anatomic details of the meniscal tears were clearly visible on the HRCT scans. Sagittal and coronal reformation views well visualized the horizontal tears and the relationship of torn meniscal fragments, and well differential the peripheral tears from the synovial recess. Our result indicate that postarthrogram HRCT not only is a sensitive and effective method for the detection and characterization of the meniscal tears, but also provides arthroscopists with the appropriate surgical plans

  12. Tear film measurement by optical reflectometry technique

    Science.gov (United States)

    Lu, Hui; Wang, Michael R.; Wang, Jianhua; Shen, Meixiao

    2014-01-01

    Abstract. Evaluation of tear film is performed by an optical reflectometer system with alignment guided by a galvanometer scanner. The reflectometer system utilizes optical fibers to deliver illumination light to the tear film and collect the film reflectance as a function of wavelength. Film thickness is determined by best fitting the reflectance-wavelength curve. The spectral reflectance acquisition time is 15 ms, fast enough for detecting film thickness changes. Fast beam alignment of 1 s is achieved by the galvanometer scanner. The reflectometer was first used to evaluate artificial tear film on a model eye with and without a contact lens. The film thickness and thinning rate have been successfully quantified with the minimum measured thickness of about 0.3 μm. Tear films in human eyes, with and without a contact lens, have also been evaluated. A high-contrast spectral reflectance signal from the precontact lens tear film is clearly observed, and the thinning dynamics have been easily recorded from 3.69 to 1.31 μm with lipid layer thickness variation in the range of 41 to 67 nm. The accuracy of the measurement is better than ±0.58% of the film thickness at an estimated tear film refractive index error of ±0.001. The fiber-based reflectometer system is compact and easy to handle. PMID:24500519

  13. Magnetic resonance findings in skeletal muscle tears

    International Nuclear Information System (INIS)

    De Smet, A.A.

    1993-01-01

    Magnetic resonance (MR) images of skeletal muscle tears can clearly delineate the severity of muscle injury. Although MR imaging is seldom necessary in patients with acute musle trauma, it can be helpful in deciding on clinical management. The two major MR findings in acute muscle tears are deformity of the muscle and the presence of abnormal signal reflecting hemorrhage and edema. In acute tears, methemoglobin within the extravascular blood causes high-signal areas on both T1- and T2-weighted images. With partial tears, the blood may dissect in a distinctive linear pattern along the muscle bundles and fibers. As healing begins, the muscle signal diminishes, first on the T1-weighted images and then on the T2-weighted images. When there is residual abnormal signal on images obtained more than several months after the injury, it is presumed to represent hemorrhage from recurrent tears. In patients with a questionable history of a remote injury, the clinical presentation may be that of persistent pain or a soft tissue mass. In these cases MR imaging may identify the cause of the pain and can exclude a neoplasm by proving that the mass is a hypertrophied or retracted musle. Thus, MR imaging has a limited, but occasionally important role in selected patients with skeletal muscle tears. (orig.)

  14. Superior glenoid inclination and rotator cuff tears.

    Science.gov (United States)

    Chalmers, Peter N; Beck, Lindsay; Granger, Erin; Henninger, Heath; Tashjian, Robert Z

    2018-03-23

    The objectives of this study were to determine whether glenoid inclination (1) could be measured accurately on magnetic resonance imaging (MRI) using computed tomography (CT) as a gold standard, (2) could be measured reliably on MRI, and (3) whether it differed between patients with rotator cuff tears and age-matched controls without evidence of rotator cuff tears or glenohumeral osteoarthritis. In this comparative retrospective radiographic study, we measured glenoid inclination on T1 coronal MRI corrected into the plane of the scapula. We determined accuracy by comparison with CT and inter-rater reliability. We compared glenoid inclination between patients with full-thickness rotator cuff tears and patients aged >50 years without evidence of a rotator cuff tear or glenohumeral arthritis. An a priori power analysis determined adequate power to detect a 2° difference in glenoid inclination. (1) In a validation cohort of 37 patients with MRI and CT, the intraclass correlation coefficient was 0.877, with a mean difference of 0° (95% confidence interval, -1° to 1°). (2) For MRI inclination, the inter-rater intraclass correlation coefficient was 0.911. (3) Superior glenoid inclination was 2° higher (range, 1°-4°, P rotator cuff tear group of 192 patients than in the control cohort of 107 patients. Glenoid inclination can be accurately and reliably measured on MRI. Although superior glenoid inclination is statistically greater in those with rotator cuff tears than in patients of similar age without rotator cuff tears or glenohumeral arthritis, the difference is likely below clinical significance. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  15. Landmarks for Sacral Debridement in Sacral Pressure Sores.

    Science.gov (United States)

    Choo, Joshua H; Wilhelmi, Bradon J

    2016-03-01

    Most cases of sacral osteomyelitis arising in the setting of sacral pressure ulcers require minimal cortical debridement. When faced with advanced bony involvement, the surgeon is often unclear about how much can safely be resected. Unfamiliarity with sacral anatomy can lead to concerns of inadvertent entry into the dural space and compromise of future flap options. A cadaveric study (n = 6), in which a wide posterior dissection of the sacrum, was performed. Relationships of the dural sac to bony landmarks of the posterior pelvis were noted. The termination of the dural sac was found in our study to occur at the junction of S2/S3 vertebral bodies, which was located at a mean distance of 0.38 ± 0.16 cm distal to the inferior-most extent of the posterior superior iliac spine (PSIS). The mean thickness of the posterior table of sacrum at this level was 1.7 cm at the midline and 0.5 cm at the sacral foramina. The PSIS is a reliable landmark for localizing the S2/S3 junction and the termination of the dural sac. Sacral debridement medial to the sacral foramina above the level of PSIS must be conservative whenever possible. If aggressive debridement is necessary above this level, the surgeon must be alert to the possibility of dural involvement.

  16. Electrostatic effect for the collisionless tearing mode

    International Nuclear Information System (INIS)

    Hoshino, M.

    1987-01-01

    Electron dynamics has not been self-consistently considered in collisionless tearing mode theories to date because of the mathematical complexity of the Vlasov-Maxwell equations. We have found using computer simulations that electrostatic fields play an important role in the tearing mode. Vlasov theory, including the electrostatic field, is investigated for topologies with both antiparallel and nonantiparallel magnetic field lines. The electrostatic field influences the resonant current in the neutral sheet which is a non-MHD effect, and modifies the linear growth rate. At the magnetopause, where the field lines are not antiparallel, the electrostatic effect acts to raise the linear growth rate of the tearing mode. On the other hand, in the magnetotail, where magnetic field lines are antiparallel, the electrostatic effect reduces the tearing mode growth rate. copyright American Geophysical Union 1987

  17. Spectral-domain optical coherence tomography study on dynamic changes of human tears after instillation of artificial tears.

    Science.gov (United States)

    Napoli, Pietro Emanuele; Satta, Giovanni Maria; Coronella, Franco; Fossarello, Maurizio

    2014-07-01

    To analyze in vivo the dynamic changes induced by different artificial tears (ATs) in the precorneal tear film (PCTF) and lower tear meniscus (LTM) by using spectral-domain (SD) anterior segment optical coherence tomography (OCT). We prospectively examined 42 normal human eyes by using SD-OCT imaging. On the day before OCT imaging, all enrolled subjects were evaluated for abnormalities of ocular surface. All tear film images were obtained before and after instillation of three different types of ATs (mucomimetic, lipid-based, and saline) in five serial scans: immediately (within 30 seconds), at the first, fifth, 10th, and 20th minute. Subjects received a drop of 35 μL in one randomly selected eye. All examinations were conducted in the same conditions of temperature, brightness, humidity, and time of day. Changes in the morphological pattern of both LTM and PCTF were associated with the type of artificial tear instilled on the ocular surface. Similarly, the radius of curvature (rc), the height (h), and the depth (d) showed dynamic variations depending on treatment. Although by the 20th minute, both h and d returned to baseline values in all groups, a significant difference in rc (compared with baseline) was detected for mucomimetic ATs (P = 0.04) and lipid ATs (P = 0.02). Spectral-domain OCT imaging has preliminarily proved to be a noninvasive tool to evaluate, in real time, the different changes induced by ATs instillation. An important stride in understanding the clinical response to various tear substitutes can be achieved by this objective and quantitative approach. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  18. A case of recurrent bloody tears

    Directory of Open Access Journals (Sweden)

    Karslıoğlu Ş

    2011-07-01

    Full Text Available Şafak Karslioğlu1, Ilke Bahçeci Şimşek2, Müslime Akbaba11Ìstanbul Oculoplastic and Orbital Surgery and Ocular Oncology Center, 2Ophthalmology Department, Medicine Hospital, Ìstanbul, TurkeyAbstract: Well-known causes of blood-tinged epiphora are conjunctival lesions, tumors of the lacrimal apparatus, and systemic bleeding disorders. We describe an unusual patient who presented with recurrent episodes of bloody tearing which began following an erythema multiforme-like drug eruption. He experienced chronic conjunctivitis which resulted in a few minor symblephara. One year later, the patient developed attacks of bloody tearing. All clinical, radiologic, and laboratory investigations related to bloody epiphora were within normal limits except for a mild, nonspecific chronic inflammatory reaction in the perivascular tissues of the lacrimal gland and orbital soft tissues. Also, an increase in vascular permeability and contrast extravasation on carotid angiography was detected. High-dose vitamin C was administered. The patient continued to have unilateral bloody tears intermittently for two years, but the episodes became much less frequent and had resolved by three years. It is conceivable that increased vascular permeability following the systemic inflammatory process could have played a role in the etiology of recurrent bloody tears in this atypical patient.Keywords: bloody tears, erythema multiforme, drug eruption, vitamin C

  19. Sonographic Visualization of the Rotator Cable in Patients With Symptomatic Full-Thickness Rotator Cuff Tears: Correlation With Tear Size, Muscular Fatty Infiltration and Atrophy, and Functional Outcome.

    Science.gov (United States)

    Bureau, Nathalie J; Blain-Paré, Etienne; Tétreault, Patrice; Rouleau, Dominique M; Hagemeister, Nicola

    2016-09-01

    To assess the prevalence of sonographic visualization of the rotator cable in patients with symptomatic full-thickness rotator cuff tears and asymptomatic controls and to correlate rotator cable visualization with tear size, muscular fatty infiltration and atrophy, and the functional outcome in the patients with rotator cuff tears. Fifty-seven patients with rotator cuff tears and 30 asymptomatic volunteers underwent shoulder sonography for prospective assessment of the rotator cable and rotator cuff tear and responded to 2 functional outcome questionnaires (shortened Disabilities of the Arm, Shoulder, and Hand [QuickDASH] and Constant). In the patients with rotator cuff tears, appropriate tests were used to correlate rotator cable visualization with the tear size, functional outcome, muscular fatty infiltration, and atrophy. The patients with rotator cuff tears included 25 women and 32 men (mean age,57 years; range, 39-67 years), and the volunteers included 13 women and 17 men (mean age, 56 years; range, 35-64 years). The rotator cable was identified in 77% (23 of 30) of controls and 23% (13 of 57) of patients with rotator cuff tears. In the patients, nonvisualization of the rotator cable correlated with larger tears (P tears than asymptomatic controls and was associated with a larger tear size and greater supraspinatus fatty infiltration and atrophy. Diligent assessment of the supraspinatus muscle should be done in patients with rotator cuff tears without a visible rotator cable, as the integrity of these anatomic structures may be interdependent.

  20. ProTec Tear-Offs: A Preliminary Assessment

    International Nuclear Information System (INIS)

    Peeler, D

    2005-01-01

    The Savannah River National Laboratory (SRNL) has conducted a series of ''scoping'' tests (referred to as Phase 1) to assess the potential use of a Mylar(reg s ign) tear-off system as a primary or secondary protective barrier to minimize acid etching (''frosting''), accidental scratching, and/or radiation damage for shielded cells windows. Conceptually, thin, multi-layered sheets of Mylar (referred to as a ''tear-off'' system) could be directly applied to the Lexan(reg s ign) sheet or glovebox/hood sash window to serve as a secondary (or primary) barrier. Upon degradation of visual clarity due to accidental scratching, spills/splatters, and/or radiation damage, the outer layer (or sheet) of Mylar could be removed ''refreshing'' or restoring the view. Due to the multi-layer aspect, the remaining Mylar layers would provide continued protection for the window from potential reoccurrences (which could be immediate or after some extended time period). Although the concept of using a tear-off system as a protective barrier was conceptually enticing, potential technical issues were identified and addressed as part of this Phase 1 feasibility study. These included resistance to: (1) acid(s) (concentrated (28.9 M) HF, concentrated (15.9M) HNO 3 , 6M HCl, and 0.6M H 3 BO 3 ), (2) base (a simulated sludge with pH of 12.9), (3) gamma radiation (cumulative dose of ∼200,000 rad), and (4) scratch resistance (simulating accidental scratching with the manipulators). Not only can these four factors play a significant role in determining the visual clarity of the integrated system, they can also contribute to the mechanical integrity issues which could dictate the ability to remove the outer layer when visual clarity has degraded. The results of the Phase 1 study clearly indicate that the Mylar tear-off concept (as a primary or secondary protective barrier) is a potential technical solution to prevent or retard excessive damage that would result from acid etching, base damage (as a

  1. Posterior meniscus root tears: associated pathologies to assist as diagnostic tools.

    Science.gov (United States)

    Matheny, Lauren M; Ockuly, Andrew C; Steadman, J Richard; LaPrade, Robert F

    2015-10-01

    The purpose of this study was to investigate associated pathologies identified at arthroscopy in patients with meniscus root tears. This study was Institutional Review Board approved. All patients who underwent arthroscopic knee surgery where a complete meniscus root tear was identified were included in this study. Concurrent ligament tears and articular cartilage changes ≥Outerbridge grade 2 were recorded and stored in a data registry. Fifty patients (28 males, 22 females) [mean age = 36.5 years (range 17.1-68.1 years)] who were diagnosed with a medial or lateral meniscus root tear at arthroscopy were included in this study out of 673 arthroscopic surgeries (prevalence 7.4 %). Twenty-three (46 %) patients had a medial meniscus root tear, 26 (52 %) patients had a lateral meniscus root tear and one (2 %) patient had both. Thirty-four per cent of patients (n = 17) underwent partial meniscectomy, while 60 % (n = 31) underwent suture repair. During arthroscopy, 60 % (n = 30) of patients were diagnosed with an anterior cruciate ligament (ACL) tear. Patients with lateral meniscus root tears were 10.3 times (95 % CI 2.6-42.5) more likely to have ACL tears than patients with medial meniscus root tears (p = 0.012). Patients who had medial meniscus root tears were 5.8 times (95 % CI 1.6-20.5) more likely to have chondral defects than patients who had lateral meniscus root tears (p = 0.044). In this study, patients' preoperative functional scores and activity levels were low. Patients with lateral meniscal root tears were more likely to have an ACL tear. Patients with medial meniscal root tears were more likely to have an knee articular cartilage defect with an Outerbridge grade 2 or higher chondral defect. This study confirms the importance of comprehensive assessment of concurrent injuries to properly diagnose meniscus root tears. IV.

  2. Tear ferning in normal dogs and dogs with keratoconjunctivitis sicca ...

    African Journals Online (AJOL)

    This study evaluates tear ferning as an ancillary technique for the evaluation of the canine tear film in normal eyes and eyes affected by keratoconjunctivitis sicca (KCS). Thirty dogs with KCS and 50 control dogs with normal tear film were evaluated with a full ophthalmoscopic examination and a Schirmer tear test type 1 ...

  3. Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization

    International Nuclear Information System (INIS)

    Tian, Bing; Xu, Bing; Lu, Jianping; Liu, Qi; Wang, Li; Wang, Minjie

    2015-01-01

    Highlights: • 4D CTA showed excellent agreement with DSA with regard to identification of feeding arteries and drainage veins. • The most important finding was 4D CTA in determining the impact of DAVF treatment with transarterial embolization. • 4D CTA provides images similar to those obtained with DSA both before and after treatment. - Abstract: Purpose: This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Patients and Methods: Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Results: Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ = 1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Conclusion: Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings

  4. Forced tearing of ductile and brittle thin sheets.

    Science.gov (United States)

    Tallinen, T; Mahadevan, L

    2011-12-09

    Tearing a thin sheet by forcing a rigid object through it leads to complex crack morphologies; a single oscillatory crack arises when a tool is driven laterally through a brittle sheet, while two diverging cracks and a series of concertinalike folds forms when a tool is forced laterally through a ductile sheet. On the other hand, forcing an object perpendicularly through the sheet leads to radial petallike tears in both ductile and brittle materials. To understand these different regimes we use a combination of experiments, simulations, and simple theories. In particular, we describe the transition from brittle oscillatory tearing via a single crack to ductile concertina tearing with two tears by deriving laws that describe the crack paths and wavelength of the concertina folds and provide a simple phase diagram for the morphologies in terms of the material properties of the sheet and the relative size of the tool.

  5. Assessment and treatment strategies for rotator cuff tears

    Science.gov (United States)

    Al-Hakim, Wisam; Noorani, Ali

    2014-01-01

    Tears of the rotator cuff are common and becoming an increasingly frequent problem. There is a vast amount of literature on the merits and limitations of the various methods of clinical and radiological assessment of rotator cuff tears. This is also the case with regard to treatment strategies. Certain popular beliefs and principles practiced widely and the basis upon which they are derived may be prone to inaccuracy. We provide an overview of the historical management of rotator cuff tears, as well as an explanation for how and why rotator cuff tears should be managed, and propose a structured methodology for their assessment and treatment. PMID:27582960

  6. Inadvertent raising of levels in the FFTF primary sodium pumps. Final unusual occurrence report, HEDL 79-34 (FFTF-58)

    International Nuclear Information System (INIS)

    Kuechle, J.D.

    1981-01-01

    The final unusual occurrence report describes the inadvertent raising of the sodium level in the FFTF primary sodium pumps during system testing. This event is now judged to have caused permanent deformation of the primary pump shaft on loop 1 during a period when pump rotation was stopped and sodium level in the pump tank was inadvertently increased. The shaft was subsequently removed, straightened, and returned to service in the spare FFTF pump

  7. Acute Tetraparesis with Respiratory Failure after Steroid Administration in a Patient with a Dural Arteriovenous Fistula at the Craniocervical Junction

    Science.gov (United States)

    Takahashi, Hisashi; Ueshima, Taiki; Goto, Daiki; Kimura, Tadashi; Yuki, Natsuko; Inoue, Yasuo; Yoshioka, Akira

    2017-01-01

    A 63-year-old man developed vomiting, paraparesis, dysuria, bulbar palsy, and orthostatic hypotension over a period of 5 months. Neuroradiological examinations showed a swollen lower brainstem with a dural arteriovenous fistula at the craniocervical junction (DAVF-CCJ). A steroid was administered intravenously in the hospital to relieve brainstem edema. A few hours later, however, the patient developed acute tetraparesis with respiratory failure. Recently, there have been several reports describing the acute worsening of paraparesis in patients with a spinal dural arteriovenous fistula after steroid treatment. In addition to these reports, the present case suggests the risk of administering steroids to patients with DAVF-CCJ, especially those with brainstem dysfunction. PMID:29225249

  8. Tear function and ocular surface after Muller muscle-conjunctival resection.

    Science.gov (United States)

    Uğurbaş, Suat Hayri; Alpay, Atilla; Bahadır, Burak; Uğurbaş, Sılay Cantürk

    2014-05-01

    Muller muscle-conjunctival resection (MCR) is a surgical technique to correct mild and moderate ptosis. In this study, tear function tests and ocular surface are evaluated in patients who underwent unilateral surgery. Sixteen patients with normal preoperative tear function who underwent unilateral MCR were evaluated prospectively. The fellow eyes of the patients were taken as the control group. A dry eye assessment questionnaire, Schirmer testing, tear film break-up time, fluorescein stain, Rose-Bengal stain, and conjunctival impression cytology were used to assess the tear film functions and ocular surface changes in the operated and non-operated eyes. There was no statistically significant difference in the tear function tests and goblet cell densities between the operated and non-operated eyes. The results indicate that an MCR procedure has no apparent effect on tear function tests and goblet cell density in patients with normal preoperative tear function.

  9. Effect of Hemoconcentration on Dural Sinus Computed Tomography Density in a Pediatric Population.

    Science.gov (United States)

    Yurttutan, Nursel; Kizildag, Betul; Sarica, Mehmet Akif; Baykara, Murat

    2016-10-01

    Unenhanced brain computed tomography (CT) is inexpensive, easily available, and the first-choice imaging modality for patients presenting with various neurologic symptoms. Venous thrombosis is not rare in childhood, but diagnosis can be difficult. In some cases, only denser vessels can be used to highlight an issue. The aim of this study was to retrospectively evaluate the relationship between X-ray attenuation and hemoconcentration in a pediatric population. This study enrolled 99 pediatric patients who had been referred radiology department for unenhanced brain CT. Images were retrospectively evaluated for measurement of dural sinus densities from four distinct dural sinus locations. Correlation between mean Hounsfield unit (HU) values and hemoglobin/hematocrit (Hb/Htc) levels, as well as age and gender were further analyzed. There was a strong correlation between mean HU and Hb levels (r = 0.411; standard deviation: 0.001) and also between mean HU and Htc levels (r = 0.393; p pediatric group. In conclusion, before deciding between a diagnosis of thrombosis and a determination of normal findings during an evaluation of unenhanced CT in a pediatric population, radiologists should consider complete blood count results as well as H:H ratios. Georg Thieme Verlag KG Stuttgart · New York.

  10. Progression of Fatty Muscle Degeneration in Atraumatic Rotator Cuff Tears.

    Science.gov (United States)

    Hebert-Davies, Jonah; Teefey, Sharlene A; Steger-May, Karen; Chamberlain, Aaron M; Middleton, William; Robinson, Kathryn; Yamaguchi, Ken; Keener, Jay D

    2017-05-17

    The purpose of this prospective study was to examine the progression of fatty muscle degeneration over time in asymptomatic shoulders with degenerative rotator cuff tears. Subjects with an asymptomatic rotator cuff tear in 1 shoulder and pain due to rotator cuff disease in the contralateral shoulder were enrolled in a prospective cohort. Subjects were followed annually with shoulder ultrasonography, which evaluated tear size, location, and fatty muscle degeneration. Tears that were either full-thickness at enrollment or progressed to a full-thickness defect during follow-up were examined. A minimum follow-up of 2 years was necessary for eligibility. One hundred and fifty-six shoulders with full-thickness rotator cuff tears were potentially eligible. Seventy shoulders had measurable fatty muscle degeneration of at least 1 rotator cuff muscle at some time point. Patients with fatty muscle degeneration in the shoulder were older than those without degeneration (mean, 65.8 years [95% confidence interval (CI), 64.0 to 67.6 years] compared with 61.0 years [95% CI, 59.1 to 62.9 years]; p tears at baseline was larger in shoulders with degeneration than in shoulders that did not develop degeneration (13 and 10 mm wide, respectively, and 13 and 10 mm long; p Tears with fatty muscle degeneration were more likely to have enlarged during follow-up than were tears that never developed muscle degeneration (79% compared with 58%; odds ratio, 2.64 [95% CI, 1.29 to 5.39]; p muscle degeneration occurred more frequently in shoulders with tears that had enlarged (43%; 45 of 105) than in shoulders with tears that had not enlarged (20%; 10 of 51; p tears with enlargement and progression of muscle degeneration were more likely to extend into the anterior supraspinatus than were those without progression (53% and 17%, respectively; p tear size (p = 0.56). The median time from tear enlargement to progression of fatty muscle degeneration was 1.0 year (range, -2.0 to 6.9 years) for the

  11. Sonographic evaluation of digital annular pulley tears

    International Nuclear Information System (INIS)

    Martinoli, C.; Derchi, L.E.; Bianchi, S.; Garcia, J.F.; Nebiolo, M.

    2000-01-01

    Objective. To evaluate the sonographic (US) appearance of digital annular pulley (DAP) tears in high-level rock climbers. Design and patients. We performed a retrospective analysis of the US examinations of 16 high-level rock climbers with clinical signs of DAP lesions. MRI and surgical evaluation were performed in five and three patients respectively. The normal US and MRI appearances of DAP were evaluated in 40 and three normal fingers respectively. Results. Nine of 16 patients presented a DAP tear. In eight subjects (seven with complete tears involving the fourth finger and one the fifth finger), US diagnosis was based on the indirect sign of volar bowstringing of the flexor tendons. Injured pulleys were not appreciated by US. Tears concerned the A2 and A3 in six patients and the A3 and A4 in two patients. A2 pulley thickening and hypoechogenicity compatible with a partial tear was demonstrated in one patient. MRI and surgical data correlated well with the US findings. Four patients had tenosynovitis of the flexor tendons but no evidence of pulley disruption. US examinations of three patients were normal. In the healthy subjects US demonstrated DAP in 16 of 40 digits. Conclusion. US can diagnose DAP tears and correlates with the MRI and surgical data. Because of its low cost and non-invasiveness we suggest US as the first imaging modality in the evaluation of injuries of the digital pulley. (orig.)

  12. Sonographic evaluation of digital annular pulley tears

    Energy Technology Data Exchange (ETDEWEB)

    Martinoli, C.; Derchi, L.E. [Istituto di Radiologia, Universita di Genova, Genoa (Italy); Bianchi, S.; Garcia, J.F. [Dept. de Radiologie, Hopital Cantonal Universitaire de Geneve (Switzerland); Nebiolo, M. [Reparto Pronto Soccorso Medico, Pietra Ligure (Italy)

    2000-07-01

    Objective. To evaluate the sonographic (US) appearance of digital annular pulley (DAP) tears in high-level rock climbers. Design and patients. We performed a retrospective analysis of the US examinations of 16 high-level rock climbers with clinical signs of DAP lesions. MRI and surgical evaluation were performed in five and three patients respectively. The normal US and MRI appearances of DAP were evaluated in 40 and three normal fingers respectively. Results. Nine of 16 patients presented a DAP tear. In eight subjects (seven with complete tears involving the fourth finger and one the fifth finger), US diagnosis was based on the indirect sign of volar bowstringing of the flexor tendons. Injured pulleys were not appreciated by US. Tears concerned the A2 and A3 in six patients and the A3 and A4 in two patients. A2 pulley thickening and hypoechogenicity compatible with a partial tear was demonstrated in one patient. MRI and surgical data correlated well with the US findings. Four patients had tenosynovitis of the flexor tendons but no evidence of pulley disruption. US examinations of three patients were normal. In the healthy subjects US demonstrated DAP in 16 of 40 digits. Conclusion. US can diagnose DAP tears and correlates with the MRI and surgical data. Because of its low cost and non-invasiveness we suggest US as the first imaging modality in the evaluation of injuries of the digital pulley. (orig.)

  13. Comparative studies of MRI and operative findings in rotator cuff tear

    International Nuclear Information System (INIS)

    Yamakawa, Seigo; Ichikawa, Norikazu; Itadera, Eichi; Hashizume, Hiroyuki; Inoue, Hajime

    2001-01-01

    A prospective study was performed to determine the accuracy of magnetic resonance imaging (MRI) compared with operative findings in the evaluation of patients associated with rotator cuff tears. Fifty-four of 60 shoulders (58 patients) examined by MRI were confirmed as full-thickness tears and 6 as partial-thickness tears at the time of surgery. The oblique coronal, oblique sagittal, and axial planes of T2-weighted images with the 0.5 tesla MRI system were obtained preoperatively and compared with operative findings. MRI correctly identified 46 of 54 full-thickness rotator cuff tears and 5 of 6 partial-thickness tears. A comparison of MRI and operative findings in full-thickness cuff tears showed a sensitivity of 85%, a specificity of 83%, and a positive prospective value (PPV) of 99%. A comparison of partial-thickness tears showed a sensitivity of 83%, a specificity of 85%, and PPV of 39%. Linear regression analysis showed an excellent correlation between the MRI assessment and measurement at the time of surgery (r=0.90, P<0.01). MRI was useful in evaluating large and medium-sized rotator cuff tears, but less useful in distinguishing small full-thickness tears from partial-thickness tears. (author)

  14. Tearing resistance of some co-polyester sheets

    International Nuclear Information System (INIS)

    Kim, Ho Sung; Karger-Kocsis, Jozsef

    2004-01-01

    A three-zone model consisting of initial, evolutionary and stabilised plastic zones for tearing resistance was proposed for polymer sheets. An analysis with the model, based on the essential work of fracture (EWF) approach, was demonstrated to be capable for predicting specific total work of fracture along the tear path across all the plastic zones although accuracy of specific essential work of fracture is subject to improvement. Photo-elastic images were used for identification of plastic deformation sizes and profiles. Fracture mode change during loading was described in relation with the three zones. Tearing fracture behaviour of extruded mono- and bi-layer sheets of different types of amorphous co-polyesters and different thicknesses was investigated. Thick material exhibited higher specific total work of tear fracture than thin mono-layer sheet in the case of amorphous polyethylene terephthalate (PET). This finding was explained in terms of plastic zone size formed along the tear path, i.e., thick material underwent larger plastic deformation than thin material. When PET and polyethylene terephthalate glycol (PETG) were laminated with each other, specific total work of fracture of the bi-layer sheets was not noticeably improved over that of the constituent materials

  15. Rotator cuff tear measurement by arthropneumotomography

    International Nuclear Information System (INIS)

    Kilcoyne, R.F.; Matsen, F.A. III

    1983-01-01

    Five years of experience with a method of shoulder arthrography using upright tomography in cases of suspected or known rotator cuff tears has demonstrated its effectiveness. The value of the procedure lies in its ability to demonstrate the size of the cuff tear and the thickness of the remaining cuff tissue. This information provides the surgeon with a preoperative estimate of the difficulty of the repair and the prognosis for a good functional recovery. In 33 cases, there was good correlation between the upright thin-section tomogram findings and the surgical results. The tomograms provided better information about the size of the tear and the quality of the remaining cuff than did plain arthrograms

  16. Partial Thickness Rotator Cuff Tears: Current Concepts

    Science.gov (United States)

    Matthewson, Graeme; Beach, Cara J.; Nelson, Atiba A.; Woodmass, Jarret M.; Ono, Yohei; Boorman, Richard S.; Lo, Ian K. Y.; Thornton, Gail M.

    2015-01-01

    Partial thickness rotator cuff tears are a common cause of pain in the adult shoulder. Despite their high prevalence, the diagnosis and treatment of partial thickness rotator cuff tears remains controversial. While recent studies have helped to elucidate the anatomy and natural history of disease progression, the optimal treatment, both nonoperative and operative, is unclear. Although the advent of arthroscopy has improved the accuracy of the diagnosis of partial thickness rotator cuff tears, the number of surgical techniques used to repair these tears has also increased. While multiple repair techniques have been described, there is currently no significant clinical evidence supporting more complex surgical techniques over standard rotator cuff repair. Further research is required to determine the clinical indications for surgical and nonsurgical management, when formal rotator cuff repair is specifically indicated and when biologic adjunctive therapy may be utilized. PMID:26171251

  17. Partial Thickness Rotator Cuff Tears: Current Concepts

    Directory of Open Access Journals (Sweden)

    Graeme Matthewson

    2015-01-01

    Full Text Available Partial thickness rotator cuff tears are a common cause of pain in the adult shoulder. Despite their high prevalence, the diagnosis and treatment of partial thickness rotator cuff tears remains controversial. While recent studies have helped to elucidate the anatomy and natural history of disease progression, the optimal treatment, both nonoperative and operative, is unclear. Although the advent of arthroscopy has improved the accuracy of the diagnosis of partial thickness rotator cuff tears, the number of surgical techniques used to repair these tears has also increased. While multiple repair techniques have been described, there is currently no significant clinical evidence supporting more complex surgical techniques over standard rotator cuff repair. Further research is required to determine the clinical indications for surgical and nonsurgical management, when formal rotator cuff repair is specifically indicated and when biologic adjunctive therapy may be utilized.

  18. Cemental tear: To know what we have neglected in dental practice

    Directory of Open Access Journals (Sweden)

    Po-Yuan Jeng

    2018-04-01

    Full Text Available Cemental tear is a special kind of root surface fracture, contributing to periodontal and periapical breakdown. However, it is a challenge for doctors to diagnose, resulting in delayed or improper treatment. We reviewed the predisposing factors, location, radiographic/clinical characteristics, diagnosis and treatments of cemental tears. From the literature, patients with cemental tear were mainly males, over 60 year-old. Possible predisposing factors include gender, age, tooth type, traumatic occlusal force and vital teeth. Cemental tears were common in upper and lower anterior teeth, single or multiple, and can be present in cervical, middle and apical third of roots. Morphology of cemental tears can be either piece-shaped or U-shaped. Clinically, cemental tear shows a unitary periodontal pocket and signs/symptoms mimicking localized periodontitis, apical periodontitis and vertical root fractures. Treatment of cemental tears include scaling, root planning, root canal treatment, periodontal/periapical surgery, guided tissue regeneration, bone grafting, and intentional replantation. Recurrence of cemental tear is possible especially when the fracture involves root apex. Extraction is recommended for teeth with poor prognosis. In conclusion, cemental tears can involve both periodontal and periapical area. Dentists should understand the predisposing factors and clinical features of cemental tears for early diagnosis/treatment to prevent bone loss/tooth extraction. Keywords: Cemental tear, Clinical characteristics, Surface root fracture, Periodontal/periapical breakdown, Recurrence, Predisposing factors

  19. MR imaging of the traumatic triangular fibrocartilaginous complex tear

    Science.gov (United States)

    Griffith, James F.; Fung, Cindy S. Y.; Lee, Ryan K. L.; Tong, Cina S. L.; Wong, Clara W. Y.; Tse, Wing Lim; Ho, Pak Cheong

    2017-01-01

    Triangular fibrocartilage complex is a major stabilizer of the distal radioulnar joint (DRUJ). However, triangular fibrocartilage complex (TFCC) tear is difficult to be diagnosed on MRI for its intrinsic small and thin structure with complex anatomy. The purpose of this article is to review the anatomy of TFCC, state of art MRI imaging technique, normal appearance and features of tear on MRI according to the Palmar’s classification. Atypical tear and limitations of MRI in diagnosis of TFCC tear are also discussed. PMID:28932701

  20. Induced dural lymphangiogenesis facilities soluble amyloid-beta clearance from brain in a transgenic mouse model of Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Ya-Ru Wen

    2018-01-01

    Full Text Available Impaired amyloid-β clearance from the brain is a core pathological event in Alzheimer's disease. The therapeutic effect of current pharmacotherapies is unsatisfactory, and some treatments cause severe side effects. The meningeal lymphatic vessels might be a new route for amyloid-β clearance. This study investigated whether promoting dural lymphangiogenesis facilitated the clearance of amyloid-β from the brain. First, human lymphatic endothelial cells were treated with 100 ng/mL recombinant human vascular endothelial growth factor-C (rhVEGF-C protein. Light microscopy verified that rhVEGF-C, a specific ligand for vascular endothelial growth factor receptor-3 (VEGFR-3, significantly promoted tube formation of human lymphatic endothelial cells in vitro. In an in vivo study, 200 μg/mL rhVEGF-C was injected into the cisterna magna of APP/PS1 transgenic mice, once every 2 days, four times in total. Immunofluorescence staining demonstrated high levels of dural lymphangiogenesis in Alzheimer's disease mice. One week after rhVEGF-C administration, enzyme-linked immunosorbent assay results showed that levels of soluble amyloid-β were decreased in cerebrospinal fluid and brain. The Morris water maze test demonstrated that spatial cognition was restored. These results indicate that the upregulation of dural lymphangiogenesis facilities amyloid-β clearance from the brain of APP/PS1 mice, suggesting the potential of the VEGF-C/VEGFR-3 signaling pathway as a therapeutic target for Alzheimer's disease.

  1. Accuracy of MR imaging in partial tears of rotator cuff

    International Nuclear Information System (INIS)

    Eto, Masao; Ito, Nobuyuki; Tomonaga, Tadashi; Harada, Shin'ichi; Rabbi, M.E.; Iwasaki, Katsuro

    1997-01-01

    MRI is very useful for the diagnosis of the rotator cuff tear However. in case of partial tears it is sometimes controvertible. In this study, we studied the accuracy of MRI in the diagnosis of partial tears. 67 patients who underwent MRI investigation before operation were chosen for this study. There were 61 males and 6 females, ranging from 30 to 80 years (mean: 54.8 years at the time of operation). MRI was performed with 1.5T superconductive system with shoulder surface coil. MPGR T2-weighted images were performed in the coronal oblique and sagittal oblique planes. Complete tears were diagnosed when full thickness high intensity was observed in the rotator cuff, whereas with partial high intensity of the rotator cuff, was considered as partial tears. MRI demonstrated 77.8% sensitivity, 91.4% specificity and 89.6% accuracy in the diagnosis of partial tear. In 8 cases MRI had misinterpretation. In MPGR T2-weighted images, not only the partial tears but the degenerative changes also show high intensity of the rotator cuff. Therefore, it is difficult to differentiate and maybe this is the reason of misinterpretations of partial tears by MRI. MRI provided with useful pre-operative informations of partial tears of the rotator cuff. However, in few cases it is hard to differentiate for the degenerative changes of the rotator cuff. (author)

  2. Instability threshold of neoclassical tearing mode, double tearing mode and off-axis sawteeth crash in tokamaks

    International Nuclear Information System (INIS)

    Li, D.

    2001-01-01

    The neoclassical and double tearing modes have been analyzed with related new phenomena in the reversed magnetic shear tokamak plasmas. The instability threshold, and the linear and nonlinear evolution are derived for the neoclassical tearing modes. It is found that the perturbed bootstrap current in the resistive layer has a stabilizing effect while the equilibrium bootstrap current in the outer region can destabilize the modes. The dispersion relation is derived for the double tearing mode. It is found that the onset of ''annular crash'' is due to the fast reconnection of the hot and cold islands, triggered by the interaction of both branches. The onset of ''core crash'' is mainly due to the coalescence between the hot islands, triggered by the explosive growth of the inner branch. (author)

  3. Instability threshold of neoclassical tearing mode, double tearing mode and off-axis sawteeth crash in tokamaks

    International Nuclear Information System (INIS)

    Li Ding

    1999-01-01

    The neoclassical and double tearing modes have been analyzed with related new phenomena in the reversed magnetic shear tokamak plasmas. The instability threshold, and the linear and nonlinear evolution are derived for the neoclassical tearing modes. It is found that the perturbed bootstrap current in the resistive layer has a stabilizing effect while the equilibrium bootstrap current in the outer region can destabilize the modes. The dispersion relation is derived for the double tearing mode. It is found that the onset of 'annular crash' is due to the fast reconnection of the hot and cold islands, triggered by the interaction of both branches. The onset of 'core crash' is mainly due to the coalescence between the hot islands, triggered by the explosive growth of the inner branch. (author)

  4. Diagnostic accuracy of 3T conventional shoulder MRI in the detection of the long head of the biceps tendon tears associated with rotator cuff tendon tears

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ro Woon; Choi, Soo-Jung; Ahn, Jae Hong; Shin, Dong Rock; Kang, Chae Hoon [University of Ulsan, College of Medicine, Department of Radiology, Asan Foundation, Gangneung Asan Hospital, Gangneung-si, Gangwon-do (Korea, Republic of); Lee, Man Ho [Andong Medical Center, Department of Radiology, Andong-si, Gyeongsangbuk-do (Korea, Republic of); Lee, Ki Won [University of Ulsan, College of Medicine, Department of Orthopedic Surgery, Asan Foundation, Gangneung Asan Hospital, Gangneung-si, Gangwon-do (Korea, Republic of)

    2016-12-15

    To evaluate the diagnostic performance (DP) of 3T (3 Tesla field strength) conventional shoulder magnetic resonance imaging (MRI) in detecting the long head of the biceps tendon (LHBT) tears in association with rotator cuff tendon tears. This study included 80 consecutive patients who underwent arthroscopic surgery for rotator cuff tendon tears. Two radiologists independently evaluated the preoperative 3T shoulder MRI for the presence of LHBT tears. The DP of MRI was evaluated using the results of arthroscopy as the reference standard. We also evaluated the DP of several MR signs of LHBT in detection of partial LHBT tears. Arthroscopic examination revealed 35 partial and 5 complete tears. According to the results of evaluation by reviewers 1 and 2, shoulder MRI exhibited sensitivities of 77.14 and 80 % and specificities of 71.11 and 73.33 % in detection of partial LHBT tears and sensitivities of 80 and 100 % and a specificity of 100% (both) in detection of complete LHBT tears. In detecting partial LHBT tears, increased T2 signal intensity of the LHBT exhibited high sensitivities (reviewers 1 and 2; 82.85 and 80 %, respectively) and the presence of intratendinous defects or C-signs exhibited the highest specificities (reviewers 1 and 2; 95.55 and 93.33 %, respectively), followed by abnormalities in shape and outer margins of the LHBT (reviewers 1 and 2; 91.11 and 82 %; 91.11 and 86.66 %, respectively). Non-contrast-enhanced 3T shoulder MRI is potentially highly accurate in detection of complete LHBT tears, but moderately accurate in detection of partial LHBT tears. (orig.)

  5. Diagnostic accuracy of 3T conventional shoulder MRI in the detection of the long head of the biceps tendon tears associated with rotator cuff tendon tears

    International Nuclear Information System (INIS)

    Lee, Ro Woon; Choi, Soo-Jung; Ahn, Jae Hong; Shin, Dong Rock; Kang, Chae Hoon; Lee, Man Ho; Lee, Ki Won

    2016-01-01

    To evaluate the diagnostic performance (DP) of 3T (3 Tesla field strength) conventional shoulder magnetic resonance imaging (MRI) in detecting the long head of the biceps tendon (LHBT) tears in association with rotator cuff tendon tears. This study included 80 consecutive patients who underwent arthroscopic surgery for rotator cuff tendon tears. Two radiologists independently evaluated the preoperative 3T shoulder MRI for the presence of LHBT tears. The DP of MRI was evaluated using the results of arthroscopy as the reference standard. We also evaluated the DP of several MR signs of LHBT in detection of partial LHBT tears. Arthroscopic examination revealed 35 partial and 5 complete tears. According to the results of evaluation by reviewers 1 and 2, shoulder MRI exhibited sensitivities of 77.14 and 80 % and specificities of 71.11 and 73.33 % in detection of partial LHBT tears and sensitivities of 80 and 100 % and a specificity of 100% (both) in detection of complete LHBT tears. In detecting partial LHBT tears, increased T2 signal intensity of the LHBT exhibited high sensitivities (reviewers 1 and 2; 82.85 and 80 %, respectively) and the presence of intratendinous defects or C-signs exhibited the highest specificities (reviewers 1 and 2; 95.55 and 93.33 %, respectively), followed by abnormalities in shape and outer margins of the LHBT (reviewers 1 and 2; 91.11 and 82 %; 91.11 and 86.66 %, respectively). Non-contrast-enhanced 3T shoulder MRI is potentially highly accurate in detection of complete LHBT tears, but moderately accurate in detection of partial LHBT tears. (orig.)

  6. Surface tearing modes in tokamaks

    International Nuclear Information System (INIS)

    Takizuka, Tomonori; Kurita, Gen-ichi; Azumi, Masafumi; Takeda, Tatsuoki

    1985-10-01

    Surface tearing modes in tokamaks are studied numerically and analytically. The eigenvalue problem is solved to obtain the growth rate and the mode structure. We investigate in detail dependences of the growth rate of the m/n = 2/1 resistive MHD modes on the safety factor at the plasma surface, current profile, wall position, and resistivity. The surface tearing mode moves the plasma surface even when the wall is close to the surface. The stability diagram for these modes is presented. (author)

  7. Haemolacria (bloody tears)

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2014-08-06

    Aug 6, 2014 ... menstruation, drugs, hyperthyroidism, nasolacrimal tu- berculosis ... no bleeding from any other body orifice. However ... All age groups can be affected from infancy to ... the system and thus lead to bloody tears emerging from.

  8. Nonlinear drift tearing mode

    International Nuclear Information System (INIS)

    Zelenyj, L.M.; Kuznetsova, M.M.

    1989-01-01

    Nonlinear study of magnetic perturbation development under single-mode conditions in collision-free plasma in configurations with the magnetic field shear is investigated. Results are obtained with regard of transverse component of electrical field and its effect on ion dynamics within wide range of ion Larmor radius value and values of magnetic field shear. Increments of nonlinear drift tearing mode are obtained and it is shown that excitation drastic conditions of even linearly stable modes are possible. Mechanism of instability nonlinear stabilization is considered and the value of magnetic island at the saturation threshold is estimeted. Energy of nonlinear drift tearing mode is discussed

  9. Rotator cuff tears: An evidence based approach

    Science.gov (United States)

    Sambandam, Senthil Nathan; Khanna, Vishesh; Gul, Arif; Mounasamy, Varatharaj

    2015-01-01

    Lesions of the rotator cuff (RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an age-dependent increase in numbers. Other associated factors include a history of trauma, limb dominance, contralateral shoulder, smoking-status, hypercholesterolemia, posture and occupational dispositions. The challenge lies in early diagnosis since a high proportion of patients are asymptomatic. Pain and decreasing shoulder power and function should alert the heedful practitioner in recognizing promptly the onset or aggravation of existing RC tears. Partial-thickness tears (PTT) can be bursal-sided or articular-sided tears. Over the course of time, PTT enlarge and propagate into full-thickness tears (FTT) and develop distinct chronic pathological changes due to muscle retraction, fatty infiltration and muscle atrophy. These lead to a reduction in tendon elasticity and viability. Eventually, the glenohumeral joint experiences a series of degenerative alterations - cuff tear arthropathy. To avert this, a vigilant clinician must utilize and corroborate clinical skill and radiological findings to identify tear progression. Modern radio-diagnostic means of ultrasonography and magnetic resonance imaging provide excellent visualization of structural details and are crucial in determining further course of action for these patients. Physical therapy along with activity modifications, anti-inflammatory and analgesic medications form the pillars of nonoperative treatment. Elderly patients with minimal functional demands can be managed conservatively and reassessed at frequent intervals. Regular monitoring helps in isolating patients who require surgical interventions. Early surgery should be considered in younger, active and symptomatic, healthy patients. In addition to being cost-effective, this helps in providing a functional shoulder with a stable cuff. An easily reproducible technique of maximal strength and

  10. The relationship between tear severity, fatty infiltration, and muscle atrophy in the supraspinatus.

    Science.gov (United States)

    Barry, Jeffrey J; Lansdown, Drew A; Cheung, Sunny; Feeley, Brian T; Ma, C Benjamin

    2013-01-01

    Fatty infiltration and muscle atrophy have been described as interrelated characteristic changes that occur within the muscles of the rotator cuff after cuff tears, and both are independently associated with poor outcomes after surgical repair. We hypothesize that fatty infiltration and muscle atrophy are two distinct processes independently associated with supraspinatus tears. A retrospective review of 377 patients who underwent shoulder magnetic resonance imaging at one institution was performed. Multivariate analysis was performed based on parameters including age, sex, rotator cuff tear severity, fatty infiltration grade, and muscle atrophy. A total of 116 patients (30.8%) had full-thickness tears of the supraspinatus, 153 (40.6%) had partial thickness tears, and 108 (28.7%) had no evidence of tear. With increasing tear severity, the prevalence of substantial fatty infiltration (grade ≥2) increased: 6.5% of patients with no tears vs 41.4% for complete tears (P tear severity: 36.1% of no tears vs 77.6% of complete tears (P muscle atrophy when taking into account sex, age, and tear severity. Fatty infiltration and muscle atrophy are independently associated processes. Fatty infiltration is also related to increasing age, muscle tear severity, and sex, whereas muscle atrophy is related to increasing age but not tear severity. In patients without rotator cuff tears, fatty infiltration and atrophy prevalence increased independently with increasing age. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  11. Anterior versus posterior, and rim-rent rotator cuff tears: prevalence and MR sensitivity

    International Nuclear Information System (INIS)

    Tuite, M.J.; Turnbull, J.R.; Orwin, J.F.

    1998-01-01

    Purpose. To determine the relative distribution of the locations of rotator cuff tears, and the sensitivity of anterior versus posterior tears on MR images. Patients and methods. We identified 110 consecutive patients who had a shoulder MR and either a partial-thickness or a small full-thickness rotator cuff tear diagnosed at arthroscopy. MR sensitivity and patient age were compared between patients with tears in the anterior and posterior halves of the cuff. In addition, in patients with partial tears less than 2 cm in diameter, an age comparison between those with tears in the critical zone and those with articular surface tears adjacent to the bony insertion (rim-rent tear) was performed. Results. The tear was centered in the anterior half of the rotator cuff in 79% of the patients younger than 36 years old, and in 89% of the patients 36 years old and over. The average age of the patients with tears in the anterior half (44 years) was not significantly different from the average age of those with posterior tears (40 years). The sensitivity of MR for anterior tears was 0.69, and for posterior tears it was 0.56. Five of the nine rim-rent tears (0.56) were interpreted correctly on the original MR report; two of the other tears were misinterpreted as intratendinous fluid but were diagnosable in retrospect. Conclusion. Even in patients less than 36 years old, most partial and small full-thickness rotator cuff tears are centered in the anterior half of the supraspinatus. Although our figure for MR sensitivity for these tears is lower than in recent articles, we found no significant difference between the sensitivity of MR for diagnosing posterior tears versus tears in the anterior half of the supraspinatus tendon. Rim-rent tears can be mistaken for intratendinous signal, and should be carefully looked for in younger patients with shoulder pain. (orig.)

  12. Influence of toroidal rotation on tearing modes

    Science.gov (United States)

    Cai, Huishan; Cao, Jintao; Li, Ding

    2017-10-01

    Tearing modes stability analysis including toroidal rotation is studied. It is found that rotation affects the stability of tearing modes mainly through the interaction with resistive inner region of tearing mode. The coupling of magnetic curvature with centrifugal force and Coriolis force provides a perturbed perpendicular current, and a return parallel current is induced to affect the stability of tearing modes. Toroidal rotation plays a stable role, which depends on the magnitude of Mach number and adiabatic index Γ, and is independent on the direction of toroidal rotation. For Γ >1, the scaling of growth rate is changed for typical Mach number in present tokamaks. For Γ = 1 , the scaling keeps unchanged, and the effect of toroidal rotation is much less significant, compared with that for Γ >1. National Magnetic Confinement Fusion Science Program and National Science Foundation of China under Grants No. 2014GB106004, No. 2013GB111000, No. 11375189, No. 11075161 and No. 11275260, and Youth Innovation Promotion Association CAS.

  13. Role of ultrasound in rotator cuff tears

    International Nuclear Information System (INIS)

    Siddiqi, H.A.; Mirza, T.

    2010-01-01

    The study was designed to evaluate the efficacy of ultrasound in rotator cuff tears and to compare it with MRI. Total number of patients was thirty. All of these were above thirty years of age and were referred by clinicians, with shoulder pain for diagnostic workup. Post operative patients were excluded. Ultrasound and Magnetic Resonance Imaging (MRI) were performed on each patient. Same operator performed ultrasound in all patients. Ultrasound (US) and Magnetic Resonance Imaging (MRI) detected equal number of full thickness tears while two partial thickness tears were missed on US. Hypoechoic defect was the most important primary sign while cortical irregularity and fluid in subacromial and subdeltroid busra were the most important secondary signs on US. US was equally effective to MRI in detection of rotator cuff tears. It should be the primary investigation because of its availability, cost effective and real time evaluation provided significant expertise is developed, as it is highly operator dependent. (author)

  14. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    International Nuclear Information System (INIS)

    Zbojniewicz, Andrew M.; Emery, Kathleen H.; Maeder, Matthew E.; Salisbury, Shelia R.

    2014-01-01

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  15. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    Energy Technology Data Exchange (ETDEWEB)

    Zbojniewicz, Andrew M.; Emery, Kathleen H. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Maeder, Matthew E. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Lenox Hill Hospital, Department of Radiology, New York, NY (United States); Salisbury, Shelia R. [University of Cincinnati College of Medicine, Division of Biostatistics and Epidemiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States)

    2014-06-15

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  16. Anterior versus posterior, and rim-rent rotator cuff tears: prevalence and MR sensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Tuite, M J; Turnbull, J R; Orwin, J F [Wisconsin Univ., Madison, WI (United States). Dept. of Radiology

    1998-05-01

    Purpose. To determine the relative distribution of the locations of rotator cuff tears, and the sensitivity of anterior versus posterior tears on MR images. Patients and methods. We identified 110 consecutive patients who had a shoulder MR and either a partial-thickness or a small full-thickness rotator cuff tear diagnosed at arthroscopy. From the arthroscopy videotapes, we classified the tears as centered in the anterior or posterior half of the cuff, and as either in the critical zone or adjacent to the bony insertion. The original MR interpretation was compared with the arthroscopic findings. MR sensitivity and patient age were compared between patients with tears in the anterior and posterior halves of the cuff. In addition, in patients with partial tears less than 2 cm in diameter, an age comparison between those with tears in the critical zone and those with articular surface tears adjacent to the bony insertion (rim-rent tear) was performed. Results. The tear was centered in the anterior half of the rotator cuff in 79% of the patients younger than 36 years old, and in 89% of the patients 36 years old and over. The average age of the patients with tears in the anterior half (44 years) was not significantly different from the average age of those with posterior tears (40 years)(P=0.23). The sensitivity of MR for anterior tears was 0.69, and for posterior tears it was 0.56 (P=0.17). The average age of the 9 patients with rim-rent tears was 31 years, while that of the 28 patients with similarly-sized partial tears not involving the insertion was 40 years old (P=0.048). Five of the nine rim-rent tears (0.56) were interpreted correctly on the original MR report; two of the other tears were misinterpreted as intratendinous fluid but were diagnosable in retrospect. Conclusion. Even in patients less than 36 years old, most partial and small full-thickness rotator cuff tears are centered in the anterior half of the supraspinatus. Although our figure for MR sensitivity

  17. Tearing relaxation and the globalization of transport in field-reversed configurations

    International Nuclear Information System (INIS)

    Steinhauer, Loren; Barnes, D. C.

    2009-01-01

    Tearing instability of field-reversed configurations (FRC) is investigated using the method of neighboring equilibria. It is shown that the conducting wall position in experiment lies very close to the location needed for tearing stability. This strongly suggests that vigorous but benign tearing modes, acting globally, are the engine of continual self-organization in FRCs, i.e., tearing relaxation. It also explains the ''profile consistency'' and anomalous loss rate of magnetic flux. In effect, tearing globalizes the effect of edge-driven transport.

  18. Evaluation of SPACE code for simulation of inadvertent opening of spray valve in Shin Kori unit 1

    International Nuclear Information System (INIS)

    Kim, Seyun; Youn, Bumsoo

    2013-01-01

    SPACE code is expected to be applied to the safety analysis for LOCA (Loss of Coolant Accident) and Non-LOCA scenarios. SPACE code solves two-fluid, three-field governing equations and programmed with C++ computer language using object-oriented concepts. To evaluate the analysis capability for the transient phenomena in the actual nuclear power plant, an inadvertent opening of spray valve in startup test phase of Shin Kori unit 1 was simulated with SPACE code. To evaluate the analysis capability for the transient phenomena in the actual nuclear power plant, an inadvertent opening of spray valve in startup test phase of Shin Kori unit 1 was simulated with SPACE code

  19. The uptake of radionuclides from inadvertent consumption of soil by grazing animals

    International Nuclear Information System (INIS)

    Green, N.; Dodd, N.J.

    1988-01-01

    Investigations of the transfer to man of artificially-produced radionuclides through food chains have shown that the inadvertent consumption of soil by grazing animals can give variations in estimates of transfer coefficients, especially for radionuclides that are poorly absorbed by plant roots. Even small masses of soil adhering to herbage or directly ingested can make a significant contribution to the intake inventory in terms of activity. Although the activity concentrations of soil-contaminated herbage are elevated, the radionuclides associated with the soil may not necessarily be in a form which is easily absorbed by the animal. Attempts must be made, therefore, to quantify soil intake and the subsequent radionuclide uptake by this mechanism. A field investigation of the uptake of radionuclides by farm animals grazing near the Sellafield nuclear reprocessing plant has been pursued. The aims of the study were to estimate the transfer to muscle and other tissues. This paper describes the methods used to estimate both the soil intake and the consequent availability of radionuclides associated with the soil. The measurements were used to evaluate the contribution to tissue content of inadvertent consumption of soil by cows and sheep. 10 refs.; 2 tabs

  20. Hip Labral Tear

    Science.gov (United States)

    ... that joint in the future. Prevention Hip labral tears are often associated with sports participation. If your sport puts a lot of strain on your hips, condition the surrounding muscles with strength and flexibility exercises. Try to avoid ...

  1. Ultrasonography of symptomatic rotator cuff tears compared with MR imaging and surgery

    International Nuclear Information System (INIS)

    Fotiadou, Anastasia N.; Vlychou, Marianna; Papadopoulos, Periklis; Karataglis, Dimitrios S.; Palladas, Panagiotis; Fezoulidis, Ioannis V.

    2008-01-01

    Purpose: To compare the accuracy of ultrasonography and magnetic resonance imaging in the detection of rotator cuff tears. Materials and methods: Ninety-six patients with clinically suspected rotator cuff pathology underwent ultrasonography and magnetic resonance imaging of the shoulder. The findings in 88 patients were compared with arthroscopy or open surgery. Results: Full-thickness tear was confirmed in 57 cases, partial-thickness tear in 30 cases and degenerative changes without tear in 1. In all 57 cases of full-thickness tear and in 28 out of 30 cases of partial-thickness tear the supraspinatus tendon was involved. The accuracy in the detection of full-thickness tears was 98 and 100% for ultrasonography and magnetic resonance imaging, respectively. The accuracy in the detection of bursal or articular partial-thickness tears was 87 and 90% for ultrasonography and magnetic resonance imaging, respectively. Conclusions: In experienced hands ultrasonography should be considered as an accurate modality for the initial investigation of rotator cuff, especially supraspinatus, tears

  2. Ultrasonography of symptomatic rotator cuff tears compared with MR imaging and surgery

    Energy Technology Data Exchange (ETDEWEB)

    Fotiadou, Anastasia N. [Radiology Department, University Hospital of Larissa, Mezourlo 41110, Larissa (Greece); Radiology Department, G. Papanikolaou Hospital, Exochi 32100, Thessaloniki (Greece)], E-mail: natfot@yahoo.gr; Vlychou, Marianna [Radiology Department, University Hospital of Larissa, Mezourlo 41110, Larissa (Greece)], E-mail: mvlychou@med.uth.gr; Papadopoulos, Periklis [University Orthopaedic Clinic, G. Papanikolaou Hospital, Exochi 32100, Thessaloniki (Greece)], E-mail: perpap@otenet.gr; Karataglis, Dimitrios S. [University Orthopaedic Clinic, G. Papanikolaou Hospital, Exochi 32100, Thessaloniki (Greece)], E-mail: dkarataglis@yahoo.gr; Palladas, Panagiotis [Radiology Department, G. Papanikolaou Hospital, Exochi 32100, Thessaloniki (Greece)], E-mail: palladaspan@in.gr; Fezoulidis, Ioannis V. [Radiology Department, University Hospital of Larissa, Mezourlo 41110, Larissa (Greece)], E-mail: oswestanast@yahoo.gr

    2008-10-15

    Purpose: To compare the accuracy of ultrasonography and magnetic resonance imaging in the detection of rotator cuff tears. Materials and methods: Ninety-six patients with clinically suspected rotator cuff pathology underwent ultrasonography and magnetic resonance imaging of the shoulder. The findings in 88 patients were compared with arthroscopy or open surgery. Results: Full-thickness tear was confirmed in 57 cases, partial-thickness tear in 30 cases and degenerative changes without tear in 1. In all 57 cases of full-thickness tear and in 28 out of 30 cases of partial-thickness tear the supraspinatus tendon was involved. The accuracy in the detection of full-thickness tears was 98 and 100% for ultrasonography and magnetic resonance imaging, respectively. The accuracy in the detection of bursal or articular partial-thickness tears was 87 and 90% for ultrasonography and magnetic resonance imaging, respectively. Conclusions: In experienced hands ultrasonography should be considered as an accurate modality for the initial investigation of rotator cuff, especially supraspinatus, tears.

  3. On tear film breakup (TBU): dynamics and imaging.

    Science.gov (United States)

    Braun, Richard J; Driscoll, Tobin A; Begley, Carolyn G; King-Smith, P Ewen; Siddique, Javed I

    2018-06-13

    We report the results of some recent experiments to visualize tear film dynamics. We then study a mathematical model for tear film thinning and tear film breakup (TBU), a term from the ocular surface literature. The thinning is driven by an imposed tear film thinning rate which is input from in vivo measurements. Solutes representing osmolarity and fluorescein are included in the model. Osmolarity causes osmosis from the model ocular surface, and the fluorescein is used to compute the intensity corresponding closely to in vivo observations. The imposed thinning can be either one-dimensional or axisymmetric, leading to streaks or spots of TBU, respectively. For a spatially-uniform (flat) film, osmosis would cease thinning and balance mass lost due to evaporation; for these space-dependent evaporation profiles TBU does occur because osmolarity diffuses out of the TBU into the surrounding tear film, in agreement with previous results. The intensity pattern predicted based on the fluorescein concentration is compared with the computed thickness profiles; this comparison is important for interpreting in vivo observations. The non-dimensionalization introduced leads to insight about the relative importance of the competing processes; it leads to a classification of large vs small TBU regions in which different physical effects are dominant. Many regions of TBU may be considered small, revealing that the flow inside the film has an appreciable influence on fluorescence imaging of the tear film.

  4. 49 CFR 173.340 - Tear gas devices.

    Science.gov (United States)

    2010-10-01

    ... SHIPMENTS AND PACKAGINGS Gases; Preparation and Packaging § 173.340 Tear gas devices. (a) Packagings for...) Tear gas devices may not be assembled with, or packed in the same packaging with, mechanically- or manually-operated firing, igniting, bursting, or other functioning elements unless of a type and design...

  5. Measurement of the cross-sectional area of the dural tube in the lumbar spine on magnetic resonance imaging. Comparison between normal, pre- and post-discectomy conditions

    International Nuclear Information System (INIS)

    Matsubayashi, Yasutomo

    1997-01-01

    This study evaluated the usefulness of pre- and postoperative magnetic resonance imaging (MRI) of lumbar disc hernia with special attention to measurement of the cross-sectional area of the dural tube. Twenty-five patients (20 men and 5 women; 25 discs) who underwent posterior lumbar discectomy and 73 normal individuals (44 men and 29 women; 219 discs) of a similar age distribution were studied. Axial MRI was mainly used for the measurement of the dural tube. In the patient group, MRI examination was performed 1, 3, 6, and 12 months postoperatively. Assessment of the clinical symptoms was also included and used for comparison with the MRI evaluation. The cross-sectional area was significantly reduced to about 50% of the normal preoperatively. One month postoperatively, there was no significant increase in the size of the area, but after three months, the area increased significantly and progressed to the normal size within a year. One-month postoperatively, MRI examination was not considered useful because of postoperative hematoma and/or edema at the surgical site. The increase in the size of the cross-sectional area of the dural tube correlated well with the improvement in clinical symptoms. Three-months postoperatively, MRI evaluation of the lumbar disc seemed useful and measurement of the cross-sectional area of the dural tube appeared to serve as an indicator of the effectiveness of the surgery. (author)

  6. Measurement of the cross-sectional area of the dural tube in the lumbar spine on magnetic resonance imaging. Comparison between normal, pre- and post-discectomy conditions

    Energy Technology Data Exchange (ETDEWEB)

    Matsubayashi, Yasutomo [Juntendo Univ., Tokyo (Japan). School of Medicine

    1997-07-01

    This study evaluated the usefulness of pre- and postoperative magnetic resonance imaging (MRI) of lumbar disc hernia with special attention to measurement of the cross-sectional area of the dural tube. Twenty-five patients (20 men and 5 women; 25 discs) who underwent posterior lumbar discectomy and 73 normal individuals (44 men and 29 women; 219 discs) of a similar age distribution were studied. Axial MRI was mainly used for the measurement of the dural tube. In the patient group, MRI examination was performed 1, 3, 6, and 12 months postoperatively. Assessment of the clinical symptoms was also included and used for comparison with the MRI evaluation. The cross-sectional area was significantly reduced to about 50% of the normal preoperatively. One month postoperatively, there was no significant increase in the size of the area, but after three months, the area increased significantly and progressed to the normal size within a year. One-month postoperatively, MRI examination was not considered useful because of postoperative hematoma and/or edema at the surgical site. The increase in the size of the cross-sectional area of the dural tube correlated well with the improvement in clinical symptoms. Three-months postoperatively, MRI evaluation of the lumbar disc seemed useful and measurement of the cross-sectional area of the dural tube appeared to serve as an indicator of the effectiveness of the surgery. (author)

  7. Progression from calcifying tendinitis to rotator cuff tear

    Energy Technology Data Exchange (ETDEWEB)

    Gotoh, Masafumi; Higuchi, Fujio; Suzuki, Ritsu; Yamanaka, Kensuke [Department of Orthopaedic Surgery, Medical Center of Kurume University, 155-1 Kokubu-machi, Kurume City, Fukuoka 839-0862 (Japan)

    2003-02-01

    This report documents the clinical, radiographic and histologic findings in a 46-year-old man with calcifying tendinitis in his left shoulder which progressed to rotator cuff tear. The patient had a 1-year history of repeated calcifying tendinitis before being referred to our hospital. On the initial visit, radiographs and magnetic resonance imaging (MRI) revealed calcium deposition localized in the supraspinatus tendon without apparent tear. Three months after the first visit, MRI revealed a partial-thickness rotator cuff tear at the site of calcium deposition. Surgical and histologic findings demonstrated that calcium deposition was the cause of cuff rupture. To our knowledge, based on a review of the English literature, this is the first case report in which the progression from calcifying tendinitis to rotator cuff tear has been serially observed. (orig.)

  8. Progression from calcifying tendinitis to rotator cuff tear

    International Nuclear Information System (INIS)

    Gotoh, Masafumi; Higuchi, Fujio; Suzuki, Ritsu; Yamanaka, Kensuke

    2003-01-01

    This report documents the clinical, radiographic and histologic findings in a 46-year-old man with calcifying tendinitis in his left shoulder which progressed to rotator cuff tear. The patient had a 1-year history of repeated calcifying tendinitis before being referred to our hospital. On the initial visit, radiographs and magnetic resonance imaging (MRI) revealed calcium deposition localized in the supraspinatus tendon without apparent tear. Three months after the first visit, MRI revealed a partial-thickness rotator cuff tear at the site of calcium deposition. Surgical and histologic findings demonstrated that calcium deposition was the cause of cuff rupture. To our knowledge, based on a review of the English literature, this is the first case report in which the progression from calcifying tendinitis to rotator cuff tear has been serially observed. (orig.)

  9. Bilateral Giant Retinal Tear and Sequential Vitrectomy.

    Science.gov (United States)

    Mustapha, Mushawiahti; Roufail Franzco, Edward

    2017-01-01

    To describe the excellent outcome of surgery for bilateral giant retinal tears (GRTs) with better options of endotamponade. This is a case report of a 62-year-old man who presented with bilateral GRTs and associated retinal detachment. The tear in the right eye was supero-temporal and silicone oil was used as an endotamponade. The tear in the left eye was infero-temporal and perfluorocarbon liquid was used as an endotamponade. The outcome at 6 months after surgery was excellent with visual acuities of 6/6 in both eyes. Improved availability of endotamponade agents allows repair of bilateral GRTs to be done at the same time, with good surgical outcomes.

  10. A review of patient and skin characteristics associated with skin tears.

    Science.gov (United States)

    Rayner, R; Carville, K; Leslie, G; Roberts, P

    2015-09-01

    Skin tears are the most common wound among the elderly and have the potential to cause infection, form chronic wounds, reduce quality of life and increase health-care costs. Our aim was to identify studies that reviewed patient and skin characteristics associated with skin tears. A review of skin tear studies reported in the English literature between 1980 and 2013 was undertaken using the following electronic databases: PubMed, Medline, CINAHL, Embase, Scopus, Evidence Based and Medicine Reviews (EBM). Search terms included aged, skin, tears or lacerations, skin tearing, geri tear, epidermal tear and prevalence. There were 343 articles found with using the search terms. After abstract review nine were found to be relevant to the search. The principle findings from these eight published articles and one unpublished study revealed that the most common patient characteristics were a history of skin tears, impaired mobility and impaired cognition. Skin characteristics associated with skin tears included senile purpura, ecchymosis and oedema. This review provides an overview of identified patient and skin characteristics that predispose the elderly to skin tears and exposes the lack of research within this domain. R. Rayner is a recipient of a 2013 Australian Postgraduate Award, Curtin University Postgraduate Scholarship and a Wound Management Cooperative Research Centre (CRC) PhD stipend. The School of Nursing, Midwifery and Paramedicine, Curtin University and the Silver Chain Group, Western Australia are participants in the Wound Management Innovation CRC. No conflict of interest exists among the authors.

  11. Radiographic anatomy of the distal dural SAC; A myelographic investigation of dimensions and termination

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, J.L.; Olsen, K.O. (Haukeland Sykehus, Bergen (Norway). Dept. of Diagnostic Radiology)

    1991-05-01

    A radio-anatomical study was performed of the distal dural sac (DS) in 121 patients subjected to myelography. In 83.4% the termination of the DS was located from the upper half of the S1-segment to the lower half of the S2-segment. In the remaining patients the dural terminations were more distally located. The average location of the DS-termination was higher than that found in a previous anatomic study. The inference is that in patients with low-back pain and sciatica, the DS tends to terminate at a higher spinal level than in a non-selected anatomic material. The caudal reduction in sagittal diameter of the DS was less than that of the frontal diameter of the sac. The linear diminution in cross-sectional area of the DS from the level of L3 towards the lumbosacral junction was not correlated with the degree of caudal extension of the DS into the sacrum. Thus the length of the DS and its transverse diameters are independent of each other. These results supported the view that the location of the termination of the DS (and hence that of the spinal cord) is not related to stenosis of the central spinal canal. (orig.).

  12. Comparison of non-invasive tear film stability measurement techniques.

    Science.gov (United States)

    Wang, Michael Tm; Murphy, Paul J; Blades, Kenneth J; Craig, Jennifer P

    2018-01-01

    Measurement of tear film stability is commonly used to give an indication of tear film quality but a number of non-invasive techniques exists within the clinical setting. This study sought to compare three non-invasive tear film stability measurement techniques: instrument-mounted wide-field white light clinical interferometry, instrument-mounted keratoscopy and hand-held keratoscopy. Twenty-two subjects were recruited in a prospective, randomised, masked, cross-over study. Tear film break-up or thinning time was measured non-invasively by independent experienced examiners, with each of the three devices, in a randomised order, within an hour. Significant correlation was observed between instrument-mounted interferometric and keratoscopic measurements (p 0.05). Tear film stability values obtained from the hand-held device were significantly shorter and demonstrated narrower spread than the other two instruments (all p 0.05). Good clinical agreement exists between the instrument-mounted interferometric and keratoscopic measurements but not between the hand-held device and either of the instrument-mounted techniques. The results highlight the importance of specifying the instrument employed to record non-invasive tear film stability. © 2017 Optometry Australia.

  13. Acute Medial Plantar Fascia Tear.

    Science.gov (United States)

    Pascoe, Stephanie C; Mazzola, Timothy J

    2016-06-01

    A 32-year-old man who participated in competitive soccer came to physical therapy via direct access for a chief complaint of plantar foot pain. The clinical examination findings and mechanism of injury raised a concern for a plantar fascia tear, so the patient was referred to the physician and magnetic resonance imaging was obtained. The magnetic resonance image confirmed a high-grade, partial-thickness, proximal plantar fascia tear with localized edema at the location of the medial band. J Orthop Sports Phys Ther 2016;46(6):495. doi:10.2519/jospt.2016.0409.

  14. Management of intracranial dural arteriovenous shunts in adults

    International Nuclear Information System (INIS)

    Sarma, Dipanka; Brugge, Karel ter

    2003-01-01

    Dural arteriovenous shunts are abnormal arteriovenous communications within the dura. They are thought to be an acquired condition in adults and can present with a variety of clinical features, ranging from benign bruits to intracranial hemorrhage and neurological deficits. The presentation and natural history of these shunts is largely determined by the pattern of venous drainage. Knowledge of natural history and careful study of the angioarchitexture by angiography is therefore mandatory for correct management of these lesions. In this review, principles of management in adults and the various factors that influence treatment decisions are discussed, with a focus on endovascular therapy. Retrograde leptomeningeal or cortical venous drainage has a strong correlation with adverse clinical events and the requirement for aggressive management in this situation is highlighted. Indications for endovascular treatment, therapeutic goals, approaches and techniques are reviewed. The role of surgical treatment is also briefly discussed

  15. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-02-27

    Feb 27, 2015 ... custody is an additional risk factor in the development of this complication. [4] After a dural tear, the majority of anesthesiologists, as was the case in our observation, search the epidural space in an intervertebral spacing or sus- underlying for epidural analgesia [5, 6]. However, it should be emphasized that.

  16. Pele's tears and spheres

    Science.gov (United States)

    Porritt, L. A.; Quane, S.; Russell, K.

    2011-12-01

    Pele's tears are a well known curiosity commonly associated with low viscosity basaltic explosive eruptions. However, these pyroclasts are rarely studied in detail and there is no full explanation for their formation. These intriguing pyroclasts have smooth glassy surfaces, vesiculated interiors, and fluidal morphologies tending towards droplets and then spheres as they decrease in size to Pele's tears from the 1959 fire-fountaining eruption of Kilauea Iki involving size and density measurements. Using thin section and SEM analysis we also consider their internal and external morphologies, porosity and bubble size distributions, and surface textures. Finally we consider the mechanisms of magma fragmentation, timescales of relaxation, and cooling rates that are responsible for their formation.

  17. Magnetic resonance imaging in acute and chronic rotator cuff tears

    International Nuclear Information System (INIS)

    Buirski, G.

    1990-01-01

    Magnetic resonance imaging has been assessed in patients with acute rotator cuff tears and normal radiographs (9 cases) and those with chronic tears and changes of cuff arthropathy (9 cases). All images were obtained using a low field strength system (FONAR 0.3 T). Particular attention was placed on the appearances of the tendon and the cuff muscles themselves. Six complete acute tears were clearly identified, but MRI failed to demonstrate two partial tears. Muscle bulk was preserved in all patients in this group. In contrast, all patients with cuff arthropathy had complete tears of the supraspinatus tendon with marked tendon retraction and associated muscle atrophy: These changes precluded primary surgical repair. MRI should be used to assess muscle atrophy preoperatively in those patients with acute tears. When plain radiographs demonstrate cuff arthropathy, the MRI appearances are predictable and primary repair is unlikely to be successful. Further imaging is therefore not indicated. (orig.)

  18. Hemi-bucket-handle tears of the meniscus: appearance on MRI and potential surgical implications

    Energy Technology Data Exchange (ETDEWEB)

    Engstrom, Bjorn I.; Vinson, Emily N.; Helms, Clyde A. [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC (United States); Taylor, Dean C.; Garrett, William E. [Duke University Medical Center, Department of Orthopaedics, Box 3810, Durham, NC (United States)

    2012-08-15

    To describe a type of meniscus flap tear resembling a bucket-handle tear, named a ''hemi-bucket-handle'' tear; to compare its imaging features with those of a typical bucket-handle tear; and to discuss the potential therapeutic implications of distinguishing these two types of tears. Five knee MR examinations were encountered with a type of meniscus tear consisting of a flap of tissue from the undersurface of the meniscus displaced toward the intercondylar notch. A retrospective analysis of 100 MR examinations prospectively interpreted as having bucket-handle type tears yielded 10 additional cases with this type of tear. Cases of hemi-bucket-handle tears were reviewed for tear location and orientation, appearance of the superior articular surface of the meniscus, presence and location of displaced meniscal tissue, and presence of several classic signs of bucket-handle tears. A total of 15/15 tears involved the medial meniscus, had tissue displaced toward the notch, and were mainly horizontal in orientation. The superior surface was intact in 11/15 (73.3%). In 1/15 (6.7%) there was an absent-bow-tie sign; 6/15 (40%) had a double-PCL sign; 14/15 (93.3%) had a double-anterior horn sign. We describe a type of undersurface flap tear, named a hemi-bucket-handle tear, which resembles a bucket-handle tear. Surgeons at our institution feel this tear would likely not heal if repaired given its predominantly horizontal orientation, and additionally speculate the tear could be overlooked at arthroscopy. Thus, we feel it is important to distinguish this type of tear from the typical bucket-handle tear. (orig.)

  19. Hemi-bucket-handle tears of the meniscus: appearance on MRI and potential surgical implications

    International Nuclear Information System (INIS)

    Engstrom, Bjorn I.; Vinson, Emily N.; Helms, Clyde A.; Taylor, Dean C.; Garrett, William E.

    2012-01-01

    To describe a type of meniscus flap tear resembling a bucket-handle tear, named a ''hemi-bucket-handle'' tear; to compare its imaging features with those of a typical bucket-handle tear; and to discuss the potential therapeutic implications of distinguishing these two types of tears. Five knee MR examinations were encountered with a type of meniscus tear consisting of a flap of tissue from the undersurface of the meniscus displaced toward the intercondylar notch. A retrospective analysis of 100 MR examinations prospectively interpreted as having bucket-handle type tears yielded 10 additional cases with this type of tear. Cases of hemi-bucket-handle tears were reviewed for tear location and orientation, appearance of the superior articular surface of the meniscus, presence and location of displaced meniscal tissue, and presence of several classic signs of bucket-handle tears. A total of 15/15 tears involved the medial meniscus, had tissue displaced toward the notch, and were mainly horizontal in orientation. The superior surface was intact in 11/15 (73.3%). In 1/15 (6.7%) there was an absent-bow-tie sign; 6/15 (40%) had a double-PCL sign; 14/15 (93.3%) had a double-anterior horn sign. We describe a type of undersurface flap tear, named a hemi-bucket-handle tear, which resembles a bucket-handle tear. Surgeons at our institution feel this tear would likely not heal if repaired given its predominantly horizontal orientation, and additionally speculate the tear could be overlooked at arthroscopy. Thus, we feel it is important to distinguish this type of tear from the typical bucket-handle tear. (orig.)

  20. MRI diagnosis in meniscal tears: a Meta analysis

    International Nuclear Information System (INIS)

    Liu Xiaosheng; Xu Jianrong; Hua Jia; Wang Baisong

    2007-01-01

    Objective: To perform a Meta-analysis to evaluate the overall diagnostic value of magnetic resonance imaging (MRI) in patients with suspected meniscal tears. Methods: All the papers concerning the diagnosis of meniscal tears using MRI in both English and Chinese published from 1998 to 2004 had been searched and reviewed, and the studies with the arthroscopy as the gold standard were adopted as eligible. Statistical analysis was performed employing SAS 8.0. Heterogeneity of the included articles was tested, which was used to select proper effect model to calculate pooled weighted sensitivity, specificity and accuracy. Summary receiver operating characteristic (SROC) analyses were performed for tears of both menisci. Finally, subgroup analysis on magnetic field strength was performed. Results: Totally 11 studies were met the inclusion criteria with a total of 1221 patients. The pooled indexes of diagnostic performance and SROC demonstrated a high discriminatory power for detecting tears of the medial and lateral menisci. The value of TPR * for medial and lateral menisci showed no significant difference (0.90, 0.86, respectively, Z=0.11, P>0.05). Subgroup analysis demonstrated no statistically significant difference on diagnostic performance for various magnetic field strength (P>0.05). Conclusion: MRI is a highly accurate diagnostic tool for detecting tears of the medial and lateral menisci. At present, there is no evidence to ascertain that higher magnetic field strength improves discriminatory power for meniscal tears. (authors)

  1. Plate Tearing Under Mixed Mode Loading

    DEFF Research Database (Denmark)

    Andersen, Rasmus Grau; Nielsen, Kim Lau; Felter, Christian Lotz

    2016-01-01

    the mesh cannot accurately capture the localization process that precedes ductile failure. To fertilize accurate predictions of such sheet tearing, the energy dissipated during localization must, therefore, be accounted for in the cohesive traction-separation law. The fact is that the local thinning...... that takes place in front of an advancing crack can significantly enhance the crack growth resistanceas the energy going into thinning the sheet typically dominates the total fracture energy.This has been investigated in great details for the case of pure Mode I tearing and both the energy dissipation, peak...... stress, and shape of the cohesive traction-separation law have been laid out. In a similar fashion, the present study resolves the sequence of failure details related to steady-state sheet tearing under mixed mode loading by employing the micro-mechanics based Gurson model. But, the fracture process...

  2. Oxidative Stress Measures of Lipid and DNA Damage in Human Tears.

    Science.gov (United States)

    Haworth, Kristina M; Chandler, Heather L

    2017-05-01

    We evaluate feasibility and repeatability of measures for lipid peroxidation and DNA oxidation in human tears, as well as relationships between outcome variables, and compared our findings to previously reported methods of evaluation for ocular sun exposure. A total of 50 volunteers were seen for 2 visits 14 ± 2 days apart. Tear samples were collected from the inferior tear meniscus using a glass microcapillary tube. Oxidative stress biomarkers were quantified using enzyme-linked immunosorbent assay (ELISA): lipid peroxidation by measurement of hexanoyl-lysine (HEL) expression; DNA oxidation by measurement of 8-oxo-2'-deoxyguinosone (8OHdG) expression. Descriptive statistics were generated. Repeatability estimates were made using Bland-Altman plots with mean differences and 95% limits of agreement were calculated. Linear regression was conducted to evaluate relationships between measures. Mean (±SD) values for tear HEL and 8OHdG expression were 17368.02 (±9878.42) nmol/L and 66.13 (±19.99) ng/mL, respectively. Repeatability was found to be acceptable for both HEL and 8OHdG expression. Univariate linear regression supported tear 8OHdG expression and spring season of collection to be predictors of higher tear HEL expression; tear HEL expression was confirmed as a predictor of higher tear 8OHdG expression. We demonstrate feasibility and repeatability of estimating previously unreported tear 8OHdG expression. Seasonal temperature variation and other factors may influence tear lipid peroxidation. Support is demonstrated to suggest lipid damage and DNA damage occur concurrently on the human ocular surface.

  3. MRI diagnosis of ACL bundle tears: value of oblique axial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Alex W.H.; Griffith, James F.; Hung, Esther H.Y. [Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR (China); Law, Kan Yip; Yung, Patrick S.H. [Chinese University of Hong Kong, Department of Orthopedics and Traumatology, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR (China)

    2013-02-15

    To investigate the diagnostic accuracy of oblique axial intermediate weighting MR imaging in detecting partial thickness anterior cruciate ligament (ACL) bundle tears. The study protocol was approved by the institutional ethics committee. Sixty-one subjects (43 male, 18 female; mean age 27.4 years; range 9 to 57 years) with clinically suspected ACL tear or meniscal tear between September 2009 and January 2011 were studied with MRI and arthroscopy. Detection of partial tear for the ACL as a whole and for each ACL bundle by protocol A (standard orthogonal sequences) and protocol B (standard orthogonal sequences plus oblique axial intermediate weighted imaging) was compared in a blinded fashion. Performance characteristics for protocol A and protocol B were compared using sensitivity, specificity, accuracy and ROC curves. A two-tailed p value of <0.05 indicated statistical significance. Fifteen (24.6%) normal, 15 (24.6%) partial and 31 complete tears were diagnosed by arthroscopy. Sensitivity, specificity and accuracy of protocol A for the diagnosis of partial tear of the ACL was 33%, 87% and 74%, while for protocol B the values were 87%, 87% and 87% respectively. The area under the curve (AUC) for the diagnosis of partial ACL tear and individual bundle tear was higher for protocol B, although this difference did not reach statistical significance (p > 0.05). The addition of oblique axial imaging to standard MR imaging improves diagnostic accuracy for detecting partial tears of the ACL as well as individual bundle tears of the ACL. (orig.)

  4. Proteases, proteolysis and inflammatory molecules in the tears of people with keratoconus.

    Science.gov (United States)

    Balasubramanian, Sivaraman Arumugam; Mohan, Sujatha; Pye, David Cecil; Willcox, Mark Duncan Perry

    2012-06-01

    To investigate the expression of proteases, proteolytic activity and cytokines in the tear film of people with keratoconus. Basal tears from people with keratoconus, from individuals who had undergone corneal collagen cross-linking for the treatment of keratoconus, and from normal controls were collected using a capillary tube. Corneal curvature of each subject was mapped. The total protein in tears was estimated. Levels and activity of proteases in the tears were analysed using specific antibody arrays and activity assays. The total tear protein level was significantly reduced in keratoconus (4.1 ± 0.9 mg/ml) compared with normals (6.7 ± 1.4 mg/ml) (p tear expression of matrix metalloproteinases (MMP) -1, -3, -7, -13, interleukins (IL) -4, -5, -6, -8 and tumour necrosis factor (TNF) -α, -β were evident in keratoconus. Tear IL-6 was the only cytokine significantly (p tears of keratoconus subjects compared with the collagen cross-linked group. No significant difference in tear proteases were observed between the normal and the cross-linked groups, although the expression of TNF-α was significantly (p tears from keratoconus compared with normal subjects. The activity of tear gelatinases (69.6 ± 22.2 FIU) and collagenases (5.7 ± 3.3 FIU) in the collagen cross-linked group was not significantly different compared with either keratoconus or normals. Tears of people with keratoconus had 1.9 times higher levels of proteolytic activity and over expression of several MMPs and cytokines compared with tears from controls. Further investigations are required to study the possible implications of these changes and whether they can be used to monitor disease progression or determine the success of corneal collagen cross-linking. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  5. Complex descemet′s membrane tears and detachment during phacoemulsification

    Directory of Open Access Journals (Sweden)

    Faik Orucoglu

    2015-01-01

    Full Text Available Purpose: To report a case of complex Descemet′s membrane detachment (DMD and tears during phacoemulsification cataract surgery. Case Report: A 64-year-old woman underwent phacoemulsification surgery in her right eye and developed tears and partial loss of Descemet′s membrane (DM while the aspiration port was inserted through the main incision. Massive corneal edema obscured the view and the anterior chamber was barely visible the following day. Scheimpflug imaging was used to complement slit lamp examination in the postoperative period. Frequent topical corticosteroid drops were initiated. After 5 days of treatment, multiple tears and detachment of DM were visible and the anterior chamber was filled with air. After 5 weeks, the cornea regained much of its clarity despite large DM tears and focal loss of DM. Conclusion: Despite partial loss of DM, the corneal edema mostly disappeared after 5 weeks of air bubble injection. Scheimpflug imaging was beneficial in the diagnosis and monitoring of DM tears and detachments.

  6. Neoclassical tearing modes in a tokamak

    International Nuclear Information System (INIS)

    Hahm, T.S.

    1988-08-01

    Linear tearing instability is studied in the banana collisionality regime in tokamak geometry. Neoclassical effects produce significant modifications of Ohm's law and the vorticity equation so that the growth rate of tearing modes driven by Δ' is dramatically reduced compared to the usual resistive MHD value. Consequences of this result, regarding the presence of pressure-gradient-driven neoclassical resistive interchange instabilities and the evolution of magnetic islands in the Rutherford regime, are discussed. 10 refs

  7. Introduction to the linear theory of tearing instabilities

    International Nuclear Information System (INIS)

    Hazeltine, R.D.

    1978-02-01

    The reasons why tearing instabilities might bear importantly on tokamak performance are considered. The mechanism of tearing is described and the method by which this mechanism is analyzed is outlined. A survey is given of typical growth rate predictions

  8. Posterior vitreous detachment - prevalence of and risk factors for retinal tears

    Directory of Open Access Journals (Sweden)

    Bond-Taylor M

    2017-09-01

    Full Text Available Martin Bond-Taylor,1 Gunnar Jakobsson,1,2 Madeleine Zetterberg1,2 1Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, 2Department of Clinical Neuroscience/Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden Purpose: The present study aimed to describe clinical characteristics of patients with posterior vitreous detachment (PVD, to determine the prevalence of retinal tears in PVD patients, and to find predictors for retinal tears in this patient group. Methods: Retrospective analysis of medical records on patients diagnosed with PVD, retinal tears, or vitreous hemorrhage at the Department of Ophthalmology at Sahlgrenska University Hospital, a tertiary eye center. Results: Between February and July 2009, 365 patients consulted the Department of Ophthalmology for PVD-related symptoms. The incidence of retinal tears was 14.5% (n=53 and that of vitreous and/or retinal hemorrhage was 22.7% (n=83. For analysis of possible predictors for complications to PVD, patients diagnosed with retinal tears or vitreous hemorrhage between May and July 2009 were also included in the study, resulting in a total of 426 patients. Predictors of a retinal tear were symptoms of visual impairment (P=0.024, the presence of vitreous or retinal hemorrhage at examination (P<0.001, and a duration of symptoms for <24 hours (P=0.004. Symptoms of flashes did not constitute an extra risk of retinal tears (P=0.135. Subsequent retinal pathology (follow-up time 4.5 years, including vitreous detachment/hemorrhage or retinal tears/detachment, occurred more often in patients presenting with a retinal tear. For patients with a retinal tear, the relative risk of having a retinal detachment in the same eye during the follow-up time was 17.7 when compared to patients without a retinal tear (risk ratio 17.7, 95% confidence interval 2.2–145. Conclusion: Patients seeking care on the first day have a

  9. Supraspinatus tendon tears: comparison of 3D US and MR arthrography with surgical correlation

    International Nuclear Information System (INIS)

    Kang, Chang Ho; Kim, Sam Soo; Kim, Jung Hyuk; Chung, Kyoo Byung; Kim, Yun Hwan; Oh, Yu-Whan; Jeong, Woong-Kyo; Kim, Baek Hyun

    2009-01-01

    The objective of the study was to compare the diagnostic reliability of 3D US with MR arthrography in diagnosing supraspinatus tendon tears, with arthroscopic findings used as the standard. In a prospective study 50 patients who later underwent arthroscopic surgery of the rotator cuff were examined pre-operatively by 3D US with MR arthrography. The presence or absence of a full- or partial-thickness supraspinatus tendon tear and the tear size as demonstrated by each imaging and arthroscopy was recorded. The tear size was divided into three grades: small ( 3 cm). The arthroscopic diagnosis was a full-thickness tear in 40 patients, partial-thickness tears in 5, and intact supraspinatus tendon in 5. 3D US correctly diagnosed 35 out of 40 full-thickness tears and MR arthrography 39 out of 40 full-thickness tears. Regarding partial-thickness tears, 3D US underestimated 2 cases as no tear and overestimated 1 case as a full-thickness tear. MR arthrography underestimated 1 case as a partial-thickness tear and overestimated 2 cases as full-thickness and partial-thickness tears respectively. 3D US and MR arthrography yield a sensitivity for full-thickness tears of 87.5% and 97.5% with specificity of 90.0% and 90.0%. Based on the grading system, 3D US measurements correctly predicted the tear size of 23 (65.7%) of the 35 full-thickness tears and MR arthrography 30 (75.0%) of the 39 full-thickness tears. Three-dimensional ultrasound seems to be a promising imaging modality comparable to MR arthrography for the assessment of the supraspinatus tendon tears. (orig.)

  10. Supraspinatus tendon tears: comparison of 3D US and MR arthrography with surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Chang Ho [Kangwon National University Hospital, Department of Radiology, Kangwon-do (Korea); Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea); Kim, Sam Soo [Kangwon National University Hospital, Department of Radiology, Kangwon-do (Korea); Kim, Jung Hyuk; Chung, Kyoo Byung; Kim, Yun Hwan; Oh, Yu-Whan [Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea); Jeong, Woong-Kyo [Korea University Anam Hospital, Korea University College of Medicine, Orthopaedic Surgery, Seoul (Korea); Kim, Baek Hyun [Korea University Ansan Hospital, Korea University College of Medicine, Department of Radiology, Ansan City (Korea)

    2009-11-15

    The objective of the study was to compare the diagnostic reliability of 3D US with MR arthrography in diagnosing supraspinatus tendon tears, with arthroscopic findings used as the standard. In a prospective study 50 patients who later underwent arthroscopic surgery of the rotator cuff were examined pre-operatively by 3D US with MR arthrography. The presence or absence of a full- or partial-thickness supraspinatus tendon tear and the tear size as demonstrated by each imaging and arthroscopy was recorded. The tear size was divided into three grades: small (<1 cm), medium (1-3 cm), and large (>3 cm). The arthroscopic diagnosis was a full-thickness tear in 40 patients, partial-thickness tears in 5, and intact supraspinatus tendon in 5. 3D US correctly diagnosed 35 out of 40 full-thickness tears and MR arthrography 39 out of 40 full-thickness tears. Regarding partial-thickness tears, 3D US underestimated 2 cases as no tear and overestimated 1 case as a full-thickness tear. MR arthrography underestimated 1 case as a partial-thickness tear and overestimated 2 cases as full-thickness and partial-thickness tears respectively. 3D US and MR arthrography yield a sensitivity for full-thickness tears of 87.5% and 97.5% with specificity of 90.0% and 90.0%. Based on the grading system, 3D US measurements correctly predicted the tear size of 23 (65.7%) of the 35 full-thickness tears and MR arthrography 30 (75.0%) of the 39 full-thickness tears. Three-dimensional ultrasound seems to be a promising imaging modality comparable to MR arthrography for the assessment of the supraspinatus tendon tears. (orig.)

  11. Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation

    International Nuclear Information System (INIS)

    Waldt, S.; Bruegel, M.; Mueller, D.; Holzapfel, K.; Rummeny, E.J.; Woertler, K.; Imhoff, A.B.

    2007-01-01

    We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins. (orig.)

  12. Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Waldt, S.; Bruegel, M.; Mueller, D.; Holzapfel, K.; Rummeny, E.J.; Woertler, K. [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Imhoff, A.B. [Technische Universitaet Muenchen, Department of Sports Orthopedics, Munich (Germany)

    2007-02-15

    We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins. (orig.)

  13. Supraspinatus tendon tears: comparison of US and MR arthrography with surgical correlation

    International Nuclear Information System (INIS)

    Ferrari, Francesco S.; Governi, Simone; Burresi, Francesca; Vigni, Francesco; Stefani, Paolo

    2002-01-01

    The aim of this study was to compare the diagnostic reliability of US with MR arthrography in diagnosing supraspinatus tendon tears. Surgical findings were used as the gold standard in detecting tears. A total of 44 patients were assessed with transverse and longitudinal US scans with respect to the long axis of the rotator cuff tendons and then examined with MR arthrography. This technique involved free-hand injection of contrast medium into the shoulder joint. At surgery 20 incomplete and 24 complete tears were observed. Ultrasound offered good results for the large tears, but its sensitivity decreased proportionally with the size of the tears. Magnetic resonance arthrography correctly diagnosed 43 tears, whereas only one false-negative diagnosis of tendinosis was made for a partial tear on the bursal side. Since it improves the diagnosis of small tears, MR arthrography must be performed on all patients for whom surgical repair is necessary in order to restore normal functions. (orig.)

  14. Supraspinatus tendon tears: comparison of US and MR arthrography with surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Ferrari, Francesco S.; Governi, Simone; Burresi, Francesca; Vigni, Francesco; Stefani, Paolo [Department of Radiologic and Orthopaedic-Rehabilitative Sciences, University Hospital Siena (Italy)

    2002-05-01

    The aim of this study was to compare the diagnostic reliability of US with MR arthrography in diagnosing supraspinatus tendon tears. Surgical findings were used as the gold standard in detecting tears. A total of 44 patients were assessed with transverse and longitudinal US scans with respect to the long axis of the rotator cuff tendons and then examined with MR arthrography. This technique involved free-hand injection of contrast medium into the shoulder joint. At surgery 20 incomplete and 24 complete tears were observed. Ultrasound offered good results for the large tears, but its sensitivity decreased proportionally with the size of the tears. Magnetic resonance arthrography correctly diagnosed 43 tears, whereas only one false-negative diagnosis of tendinosis was made for a partial tear on the bursal side. Since it improves the diagnosis of small tears, MR arthrography must be performed on all patients for whom surgical repair is necessary in order to restore normal functions. (orig.)

  15. MR imaging of delamination tears of the rotator cuff tendons

    International Nuclear Information System (INIS)

    Walz, Daniel M.; Chen, Steven; Miller, Theodore T.; Hofman, Josh

    2007-01-01

    The objective was to describe the imaging appearances and location of delamination tears of the rotator cuff tendons on non-contrast conventional MR imaging. This study was reviewed and approved by our Institutional Review Board. The reports of 548 consecutive MR examinations of the shoulder were reviewed, looking for mention or description of delamination tears of the rotator cuff. The images of the identified cases were then reviewed by two radiologists to confirm the findings. Correlation with surgical and arthroscopic information was then performed. Delamination tears were defined as horizontal retraction of either the bursal or articular surface of the tendon, manifest as thickening of the torn retracted edge, and/or interstitial splitting of the tendon, manifest as fluid-like high signal intensity on fat-suppressed T2-weighted oblique coronal images. Fourteen cases of delamination tears were identified in 13 patients. Ten of the cases involved the supraspinatus tendon, all with articular surface involvement. Nine of these supraspinatus cases were isolated tears and one occurred as part of a full thickness tear. All 10 of these supraspinatus cases showed medial retraction of the articular surface of the tendon, with thickening of the retracted edge, and 5 of the 10 had a demonstrable horizontal cleft in the interstitium. Four cases involved the subscapularis tendon, with articular surface disruption in three and pure interstitial delamination in one. Medial subluxation of the tendon of the long head of the biceps was present in all four cases. No delamination tears occurred on the bursal surface. Only three of the 14 shoulders underwent surgical repair with one confirmation of supraspinatus delamination, one confirmation of a subscapularis tear that had become a full thickness tear 10 months after initial imaging and another interstitial subscapularis delamination that was not identified arthroscopically. Delamination tears occur most often in the

  16. MR imaging of delamination tears of the rotator cuff tendons

    Energy Technology Data Exchange (ETDEWEB)

    Walz, Daniel M.; Chen, Steven [North Shore University Hospital, Department of Radiology, Manhasset, NY (United States); Miller, Theodore T. [Hospital for Special Surgery, Department of Radiology and Imaging, New York, NY (United States); Hofman, Josh [Long Island Jewish Medical Center, New Hyde Park, NY (United States)

    2007-05-15

    The objective was to describe the imaging appearances and location of delamination tears of the rotator cuff tendons on non-contrast conventional MR imaging. This study was reviewed and approved by our Institutional Review Board. The reports of 548 consecutive MR examinations of the shoulder were reviewed, looking for mention or description of delamination tears of the rotator cuff. The images of the identified cases were then reviewed by two radiologists to confirm the findings. Correlation with surgical and arthroscopic information was then performed. Delamination tears were defined as horizontal retraction of either the bursal or articular surface of the tendon, manifest as thickening of the torn retracted edge, and/or interstitial splitting of the tendon, manifest as fluid-like high signal intensity on fat-suppressed T2-weighted oblique coronal images. Fourteen cases of delamination tears were identified in 13 patients. Ten of the cases involved the supraspinatus tendon, all with articular surface involvement. Nine of these supraspinatus cases were isolated tears and one occurred as part of a full thickness tear. All 10 of these supraspinatus cases showed medial retraction of the articular surface of the tendon, with thickening of the retracted edge, and 5 of the 10 had a demonstrable horizontal cleft in the interstitium. Four cases involved the subscapularis tendon, with articular surface disruption in three and pure interstitial delamination in one. Medial subluxation of the tendon of the long head of the biceps was present in all four cases. No delamination tears occurred on the bursal surface. Only three of the 14 shoulders underwent surgical repair with one confirmation of supraspinatus delamination, one confirmation of a subscapularis tear that had become a full thickness tear 10 months after initial imaging and another interstitial subscapularis delamination that was not identified arthroscopically. Delamination tears occur most often in the

  17. Cytokine changes in tears and relationship to contact lens discomfort.

    Science.gov (United States)

    Willcox, Mark D P; Zhao, Zhenjun; Naduvilath, Thomas; Lazon de la Jara, Percy

    2015-01-01

    To determine the reproducibility of a multiplex bead assay for measuring cytokines in tears and correlations between ocular discomfort with or without contact lens wear and the concentration of cytokines in tears. Ninety participants (divided into two groups) were enrolled in this prospective study. They were asked to rate their ocular comfort and collect their tears in the morning and just before sleep for 10 days with or without contact lenses. The participants collected their tears using a glass microcapillary tube for both stages. Galyfilcon A lenses were worn on a daily disposable basis during the contact lens stage, and comfort scores and tears were collected before lens insertion and prior to lens removal at the end of the day. Tears were analyzed for cytokine concentrations using a 27-plex multibead assay. Correlations were sought between cytokine concentrations and comfort. There was a significant (p-0.5 Log pg/ml, p-0.2 Log pg/ml, ptears was correlated to ocular comfort, but this was not changed by contact lens wear. Ocular comfort during the day is magnified by contact lens wear. However, the increase in the change in comfort during lens wear was not associated with changes in 15 cytokines in the tear film.

  18. Meniscal Tear Film Fluid Dynamics Near Marx’s Line

    KAUST Repository

    Zubkov, V. S.

    2013-07-03

    Extensive studies have explored the dynamics of the ocular surface fluid, though theoretical investigations are typically limited to the use of the lubrication approximation, which is not guaranteed to be uniformly valid a-priori throughout the tear meniscus. However, resolving tear film behaviour within the meniscus and especially its apices is required to characterise the flow dynamics where the tear film is especially thin, and thus most susceptible to evaporatively induced hyperosmolarity and subsequent epithelial damage. Hence, we have explored the accuracy of the standard lubrication approximation for the tear film by explicit comparisons with the 2D Navier-Stokes model, considering both stationary and moving eyelids. Our results demonstrate that the lubrication model is qualitatively accurate except in the vicinity of the eyelids. In particular, and in contrast to lubrication theory, the solution of the full Navier-Stokes equations predict a distinct absence of fluid flow, and thus convective mixing in the region adjacent to the tear film contact line. These observations not only support emergent hypotheses concerning the formation of Marx\\'s line, a region of epithelial cell staining adjacent to the contact line on the eyelid, but also enhance our understanding of the pathophysiological consequences of the flow profile near the tear film contact line. © 2013 Society for Mathematical Biology.

  19. Growing skull fracture - rupture of coronal suture caused by vacuum extraction

    International Nuclear Information System (INIS)

    Hansen, K.N.; Pedersen, H.; Petersen, M.B.

    1987-01-01

    Growing skull fracture is a well known complication to calvarian fracture with underlying dural tear and brain injury in infancy and early childhood. This has been reported in three cases after forceps delivery. To our best knowledge it has never been described after disruption of a calvarian suture caused by vacuum extraction delivery. (orig.)

  20. Tear osmolarity and dry eye symptoms in diabetics

    Directory of Open Access Journals (Sweden)

    Fuerst N

    2014-03-01

    Full Text Available Nicole Fuerst,1 Nicole Langelier,1 Mina Massaro-Giordano,1 Maxwell Pistilli,1 Kalliopi Stasi,1 Carrie Burns,2 Serena Cardillo,2 Vatinee Y Bunya1 1Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 2Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Purpose: To assess the relationship between tear osmolarity and dry eye symptoms in patients with diabetes. Patients and methods: Fifty patients with diabetes were enrolled. Demographic information and past medical history were recorded. Symptoms were assessed using the ocular surface disease index (OSDI. Tear osmolarity of each eye was measured with the TearLab® Osmolarity System. Results: The majority of the subjects were female (76%, African American (56%, and/or had a diagnosis of type 2 diabetes (82%. The mean ± standard deviation (SD for age was 54.6±13.4, and maximum tear osmolarity was 304.6±12.7 mOsm/L. Men had higher osmolarity than women (mean ± standard error (SE 311.8±4.0 mOsm/L versus 302.3±1.9 mOsm/L, P=0.02. Age, race, use of artificial tears, years of diabetes, and hemoglobin A1c did not have a statistically significant association with tear osmolarity. Longer duration of diabetes was associated with lower (less severe OSDI scores (r=-0.35, P=0.01. Higher tear osmolarity was associated with lower (less severe OSDI scores (r=-0.29, P=0.04. Conclusion: Approximately half of the diabetic subjects in our study had elevated tear osmolarity, and half of our population also reported symptoms consistent with dry eye disease. However, the two were slightly inversely related in that those with higher osmolarity reported fewer symptoms. Subjects with a longer duration of diabetes also reported fewer dry eye symptoms. Therefore, health care providers should be aware that patients who are most likely to have ocular surface disease, including those with

  1. Goldmann tonometry tear film error and partial correction with a shaped applanation surface.

    Science.gov (United States)

    McCafferty, Sean J; Enikov, Eniko T; Schwiegerling, Jim; Ashley, Sean M

    2018-01-01

    The aim of the study was to quantify the isolated tear film adhesion error in a Goldmann applanation tonometer (GAT) prism and in a correcting applanation tonometry surface (CATS) prism. The separation force of a tonometer prism adhered by a tear film to a simulated cornea was measured to quantify an isolated tear film adhesion force. Acrylic hemispheres (7.8 mm radius) used as corneas were lathed over the apical 3.06 mm diameter to simulate full applanation contact with the prism surface for both GAT and CATS prisms. Tear film separation measurements were completed with both an artificial tear and fluorescein solutions as a fluid bridge. The applanation mire thicknesses were measured and correlated with the tear film separation measurements. Human cadaver eyes were used to validate simulated cornea tear film separation measurement differences between the GAT and CATS prisms. The CATS prism tear film adhesion error (2.74±0.21 mmHg) was significantly less than the GAT prism (4.57±0.18 mmHg, p film adhesion error was independent of applanation mire thickness ( R 2 =0.09, p =0.04). Fluorescein produces more tear film error than artificial tears (+0.51±0.04 mmHg; p film adhesion error (1.40±0.51 mmHg) was significantly less than that of the GAT prism (3.30±0.38 mmHg; p =0.002). Measured GAT tear film adhesion error is more than previously predicted. A CATS prism significantly reduced tear film adhesion error bŷ41%. Fluorescein solution increases the tear film adhesion compared to artificial tears, while mire thickness has a negligible effect.

  2. Increasing age and tear size reduce rotator cuff repair healing rate at 1 year.

    Science.gov (United States)

    Rashid, Mustafa S; Cooper, Cushla; Cook, Jonathan; Cooper, David; Dakin, Stephanie G; Snelling, Sarah; Carr, Andrew J

    2017-12-01

    Background and purpose - There is a need to understand the reasons why a high proportion of rotator cuff repairs fail to heal. Using data from a large randomized clinical trial, we evaluated age and tear size as risk factors for failure of rotator cuff repair. Patients and methods - Between 2007 and 2014, 65 surgeons from 47 hospitals in the National Health Service (NHS) recruited 447 patients with atraumatic rotator cuff tendon tears to the United Kingdom Rotator Cuff Trial (UKUFF) and 256 underwent rotator cuff repair. Cuff integrity was assessed by imaging in 217 patients, at 12 months post-operation. Logistic regression analysis was used to determine the influence of age and intra-operative tear size on healing. Hand dominance, sex, and previous steroid injections were controlled for. Results - The overall healing rate was 122/217 (56%) at 12 months. Healing rate decreased with increasing tear size (small tears 66%, medium tears 68%, large tears 47%, and massive tears 27% healed). The mean age of patients with a healed repair was 61 years compared with 64 years for those with a non-healed repair. Mean age increased with larger tear sizes (small tears 59 years, medium tears 62 years, large tears 64 years, and massive tears 66 years). Increasing age was an independent factor that negatively influenced healing, even after controlling for tear size. Only massive tears were an independent predictor of non-healing, after controlling for age. Interpretation - Although increasing age and larger tear size are both risks for failure of rotator cuff repair healing, age is the dominant risk factor.

  3. Comparison Of Lateral Mass Screw Fixation Technique And Hartshill Rectangle Technique In The Treatment Of Sub-Axial Cervical Spine Fractures

    Directory of Open Access Journals (Sweden)

    Mohit KM

    2012-11-01

    Full Text Available INTRODUCTION: Cervical injury in a polytrauma patient is one of the most critical injuries. The aim of this study was to compare the lateral mass screw technique with the Hartshill rectangle technique for treatment of such cases. MATERIALS AND METHODS: This prospective study consisted of 40 patients. Both groups were followed for three years clinically and radiologically. RESULTS: In the lateral mass technique, there were no cases of vertebral artery injury, radiculopathy, screw pullout, dural tears, residual kyphosis or persistent pain. In the Hartshill technique 3 patients experienced intra- operative dural tears, 1 case of wire breakage at the six months follow up, 6 patients with persistent neck pain and 1 with worsening neurological status. One hundred per cent fusion was achieved in both groups. There was significant radiation exposure in the lateral mass group. Post-operative immobilisation was required only in the Hartshill. CONCLUSION: Lateral mass screw technique is definitely a relatively better procedure. But Hartshill rectangle still stands out in certain practical situations.

  4. Evaluation of the tear film stability after laser in situ keratomileusis using the tear film stability analysis system.

    Science.gov (United States)

    Goto, Tomoko; Zheng, Xiaodong; Klyce, Stephen D; Kataoka, Hisashi; Uno, Toshihiko; Yamaguchi, Masahiko; Karon, Mike; Hirano, Sumie; Okamoto, Shigeki; Ohashi, Yuichi

    2004-01-01

    To evaluate the tear film stability of patients before and after laser in situ keratomileusis (LASIK) using the tear film stability analysis system (TSAS). Prospective observational case series. New videokeratography software for a topographic modeling system (TMS-2N) was developed that can automatically capture consecutive corneal surface images every second for 10 seconds. Thirty-four subjects (64 eyes) who underwent myopia LASIK were enrolled in this study. All subjects were examined with the new system before LASIK and at 1 week, 1 month, 3 months, and 6 months after the surgery. Corneal topographs were analyzed for tear breakup time (TMS breakup time) and breakup area (TMS breakup area). Based on pre-LASIK TSAS analysis, subjects were separated into normal and abnormal TSAS value groups. The criteria for the normal group were either TMS breakup time more than 5 seconds or TMS breakup area less than 0.2. The percentage of the occurrence of superficial punctuate keratitis was compared between the two groups with regard to subject's dry eye signs and symptoms. Tear film stability decreased significantly during the early period after LASIK, as indexed by decreased TMS breakup time and increased TMS breakup area. Tear film instability resolved at 6 months after surgery. Before LASIK, 22 subjects (43 eyes) had normal TSAS evaluation and 12 subjects (21 eyes) were abnormal. After LASIK, among normal TSAS value eyes, 8 of 43 (18.6%) eyes developed superficial punctuate keratitis. In sharp contrast, 14 of 21 (66.7%) eyes in the abnormal group displayed superficial punctuate keratitis, correlating well with the patients' dry eye symptoms. The difference in the presence of superficial punctuate keratitis after LASIK between normal and abnormal TSAS value groups was statistically significant (P <.001). Subjects with abnormal TSAS evaluation also displayed resistance to dry eye treatment and had extended period of recovery. Tear film stability analysis can be a useful

  5. Dural afferents express acid-sensing ion channels: a role for decreased meningeal pH in migraine headache.

    Science.gov (United States)

    Yan, Jin; Edelmayer, Rebecca M; Wei, Xiaomei; De Felice, Milena; Porreca, Frank; Dussor, Gregory

    2011-01-01

    Migraine headache is one of the most common neurological disorders. The pathological conditions that directly initiate afferent pain signaling are poorly understood. In trigeminal neurons retrogradely labeled from the cranial meninges, we have recorded pH-evoked currents using whole-cell patch-clamp electrophysiology. Approximately 80% of dural-afferent neurons responded to a pH 6.0 application with a rapidly activating and rapidly desensitizing ASIC-like current that often exceeded 20nA in amplitude. Inward currents were observed in response to a wide range of pH values and 30% of the neurons exhibited inward currents at pH 7.1. These currents led to action potentials in 53%, 30% and 7% of the dural afferents at pH 6.8, 6.9 and 7.0, respectively. Small decreases in extracellular pH were also able to generate sustained window currents and sustained membrane depolarizations. Amiloride, a non-specific blocker of ASIC channels, inhibited the peak currents evoked upon application of decreased pH while no inhibition was observed upon application of TRPV1 antagonists. The desensitization time constant of pH 6.0-evoked currents in the majority of dural afferents was less than 500ms which is consistent with that reported for ASIC3 homomeric or heteromeric channels. Finally, application of pH 5.0 synthetic-interstitial fluid to the dura produced significant decreases in facial and hind-paw withdrawal threshold, an effect blocked by amiloride but not TRPV1 antagonists, suggesting that ASIC activation produces migraine-related behavior in vivo. These data provide a cellular mechanism by which decreased pH in the meninges following ischemic or inflammatory events directly excites afferent pain-sensing neurons potentially contributing to migraine headache. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  6. Massive granular cell ameloblastoma with dural extension and atypical morphology

    Directory of Open Access Journals (Sweden)

    Vandana Raghunath

    2014-01-01

    Full Text Available Ameloblastomas are rare histologically benign, locally aggressive tumors arising from the oral ectoderm that occasionally reach a gigantic size. Giant ameloblastomas are a rarity these days with the advent of panoramic radiography in routine dental practice. Furthermore, the granular cell variant is an uncommon histological subtype of ameloblastoma where the central stellate reticulum like cells in tumor follicles is replaced by granular cells. Although granular cell ameloblastoma (GCA is considered to be a destructive tumor with a high recurrence rate, the significance of granular cells in predicting its biologic behavior is debatable. However, we present a rare case of giant GCA of remarkable histomorphology showing extensive craniofacial involvement and dural extension that rendered a good prognosis following treatment.

  7. Goldmann tonometry tear film error and partial correction with a shaped applanation surface

    Directory of Open Access Journals (Sweden)

    McCafferty SJ

    2018-01-01

    Full Text Available Sean J McCafferty,1–4 Eniko T Enikov,5 Jim Schwiegerling,2,3 Sean M Ashley1,3 1Intuor Technologies, 2Department of Ophthalmology, University of Arizona College of Medicine, 3University of Arizona College of Optical Science, 4Arizona Eye Consultants, 5Department of Mechanical and Aerospace, University of Arizona College of Engineering, Tucson, AZ, USA Purpose: The aim of the study was to quantify the isolated tear film adhesion error in a Goldmann applanation tonometer (GAT prism and in a correcting applanation tonometry surface (CATS prism.Methods: The separation force of a tonometer prism adhered by a tear film to a simulated cornea was measured to quantify an isolated tear film adhesion force. Acrylic hemispheres (7.8 mm radius used as corneas were lathed over the apical 3.06 mm diameter to simulate full applanation contact with the prism surface for both GAT and CATS prisms. Tear film separation measurements were completed with both an artificial tear and fluorescein solutions as a fluid bridge. The applanation mire thicknesses were measured and correlated with the tear film separation measurements. Human cadaver eyes were used to validate simulated cornea tear film separation measurement differences between the GAT and CATS prisms.Results: The CATS prism tear film adhesion error (2.74±0.21 mmHg was significantly less than the GAT prism (4.57±0.18 mmHg, p<0.001. Tear film adhesion error was independent of applanation mire thickness (R2=0.09, p=0.04. Fluorescein produces more tear film error than artificial tears (+0.51±0.04 mmHg; p<0.001. Cadaver eye validation indicated the CATS prism’s tear film adhesion error (1.40±0.51 mmHg was significantly less than that of the GAT prism (3.30±0.38 mmHg; p=0.002.Conclusion: Measured GAT tear film adhesion error is more than previously predicted. A CATS prism significantly reduced tear film adhesion error by ~41%. Fluorescein solution increases the tear film adhesion compared to

  8. HIGH-RESOLUTION ULTRASONOGRAPHY OF SHOULDER FOR ROTATOR CUFF TEAR: CORRELATION WITH ARTHROSCOPIC FINDINGS

    Directory of Open Access Journals (Sweden)

    Vishnumurthy H. Y

    2016-09-01

    Full Text Available INTRODUCTION Rotator cuff disease is the most common cause of shoulder pain. Ultrasonography being non-invasive, widely available, more cost-effective method and is the first choice in imaging of rotator cuff tears. Arthroscopy of shoulder is considered as the gold standard for diagnosis of rotator cuff tears. Objective of this study was to compare the diagnostic accuracy of high-resolution ultrasonography of shoulder for rotator cuff tears with arthroscopy of shoulder. METHODS Thirty patients clinically suspected to have rotator cuff tear who underwent ultrasonography and arthroscopy of shoulder were included in the study. Duration of study was for two years. All ultrasonography examinations were conducted in ultrasound machine using GE Voluson 730 PRO high frequency (10-12 MHz linear array transducer done by two experienced radiologists. Arthroscopies were done by two experienced shoulder arthroscopic surgeons. RESULTS Age of the patients with rotator cuff tears ranged from 40 to 80 years. 57% were females and 43% were males among the patients who had rotator cuff tears. 71.43% of the rotator cuff tears were found in the dominant arm. 64.28% of patients with rotator cuff tear had given history of fall or trauma to the corresponding shoulder within 6 months prior to presentation. 39.28% of patients who had rotator cuff tears were known diabetics. Supraspinatus tendon was the most commonly affected tendon, followed by infraspinatus and subscapularis tendons. For overall detection of rotator cuff tears, ultrasonography in comparison with the arthroscopy has sensitivity and specificity of 92.85% and 100%. For detection of full thickness rotator cuff tear, its sensitivity and specificity was 94.73% and 100% and for partial thickness rotator cuff tears 76.92% and 100%. Ultrasonography has 100% sensitivity and specificity for detection of supraspinatus full thickness tear. For supraspinatus partial thickness tear, sensitivity and specificity was 88

  9. Comparisons of the Various Partial-Thickness Rotator Cuff Tears on MR Arthrography and Arthroscopic Correlation

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    Chun, Kyung Ah; Kim, Min Sung; Kim, Young Joo [Catholic University of Korea Uijeongbu St.Mary' s Hospital, Uijeongbu (Korea, Republic of)

    2010-10-15

    To assess the diagnostic performance of MR arthrography in the diagnosis of the various types of partial-thickness rotator cuff tears by comparing the MR imaging findings with the arthroscopic findings. The series of MR arthrography studies included 202 patients consisting of 100 patients with partial-thickness rotator cuff tears proved by arthroscopy and a control group of 102 patients with arthroscopically intact rotator cuffs, which were reviewed in random order. At arthroscopy, 54 articularsided, 26 bursal-sided, 20 both articular- and bursal-sided partial-thickness tears were diagnosed. The MR arthrographies were analyzed by two radiologists for articular-sided tears, bursal-sided tears, and both articular- and bursal-sided tears of the rotator cuff. The sensitivity and specificity of each type of partial-thickness tears were determined. Kappa statistics was calculated to determine the interand intra-observer agreement of the diagnosis of partial-thickness rotator cuff tears. The sensitivity and specificity of the various types of rotator cuff tears were 85% and 90%, respectively for articular-sided tears, 62% and 95% for bursal- sided tears, as well as 45% and 99% for both articular- and bursal-sided tears. False-negative assessments were primarily observed in the diagnosis of bursal-sided tears. Conversely, both articular- and bursal-sided tears were overestimated as full-thickness tears. Inter-observer agreement was excellent for the diagnosis of articular-sided tears (k = 0.70), moderate (k = 0.59) for bursal-sided tears, and fair (k = 0.34) for both articular- and bursal-sided tears, respectively. Intra-observer agreement for the interpretation of articular- and bursal-sided tears was excellent and good, respectively, whereas intra-observer agreement for both articular- and bursal-sided tears was moderate. MR arthrography is a useful diagnostic tool for partial-thickness rotator cuff tears, but has limitations in that it has low sensitivity in bursal- and

  10. Comparisons of the Various Partial-Thickness Rotator Cuff Tears on MR Arthrography and Arthroscopic Correlation

    International Nuclear Information System (INIS)

    Chun, Kyung Ah; Kim, Min Sung; Kim, Young Joo

    2010-01-01

    To assess the diagnostic performance of MR arthrography in the diagnosis of the various types of partial-thickness rotator cuff tears by comparing the MR imaging findings with the arthroscopic findings. The series of MR arthrography studies included 202 patients consisting of 100 patients with partial-thickness rotator cuff tears proved by arthroscopy and a control group of 102 patients with arthroscopically intact rotator cuffs, which were reviewed in random order. At arthroscopy, 54 articularsided, 26 bursal-sided, 20 both articular- and bursal-sided partial-thickness tears were diagnosed. The MR arthrographies were analyzed by two radiologists for articular-sided tears, bursal-sided tears, and both articular- and bursal-sided tears of the rotator cuff. The sensitivity and specificity of each type of partial-thickness tears were determined. Kappa statistics was calculated to determine the interand intra-observer agreement of the diagnosis of partial-thickness rotator cuff tears. The sensitivity and specificity of the various types of rotator cuff tears were 85% and 90%, respectively for articular-sided tears, 62% and 95% for bursal- sided tears, as well as 45% and 99% for both articular- and bursal-sided tears. False-negative assessments were primarily observed in the diagnosis of bursal-sided tears. Conversely, both articular- and bursal-sided tears were overestimated as full-thickness tears. Inter-observer agreement was excellent for the diagnosis of articular-sided tears (k = 0.70), moderate (k = 0.59) for bursal-sided tears, and fair (k = 0.34) for both articular- and bursal-sided tears, respectively. Intra-observer agreement for the interpretation of articular- and bursal-sided tears was excellent and good, respectively, whereas intra-observer agreement for both articular- and bursal-sided tears was moderate. MR arthrography is a useful diagnostic tool for partial-thickness rotator cuff tears, but has limitations in that it has low sensitivity in bursal- and

  11. From current-driven to neoclassically driven tearing modes.

    Science.gov (United States)

    Reimerdes, H; Sauter, O; Goodman, T; Pochelon, A

    2002-03-11

    In the TCV tokamak, the m/n = 2/1 island is observed in low-density discharges with central electron-cyclotron current drive. The evolution of its width has two distinct growth phases, one of which can be linked to a "conventional" tearing mode driven unstable by the current profile and the other to a neoclassical tearing mode driven by a perturbation of the bootstrap current. The TCV results provide the first clear observation of such a destabilization mechanism and reconcile the theory of conventional and neoclassical tearing modes, which differ only in the dominant driving term.

  12. Diagnosis of subscapularis lesion in rotator cuff tears

    International Nuclear Information System (INIS)

    Terrier, F.; Wegmueller, H.; Vock, P.; Gerber, C.

    1989-01-01

    In rotator cuff tears, the subscapularis tendon is more often involved than previously suspected, and this lesion is often missed at arthrography. Because preoperative diagnosis is important for planning surgical repair, the authors have evaluated MR imaging and US in the detection of subscapularis tears. Fifteen patients with clinically suspected rotator cuff tears underwent MR imaging and US. Ten of 15 patients were treated surgically, and the other five were treated conservatively. MR imaging was performed with a 1.5-T Signa MR system. T1-weighted spin-echo (SE) and T2-weighted gradient-echo (GE) images were obtained

  13. Acetabular labral tears in patients with sports injury.

    Science.gov (United States)

    Kang, Chan; Hwang, Deuk-Soo; Cha, Soo-Min

    2009-12-01

    We wanted to investigate acetabular labral tears and their correlation with femoroacetabular impingement in patients with sports injury. Among 111 patients who were diagnosed with the acetabular labral tears after arthroscopic treatment from January 2004 to December 2007, we selected 41 patients with sports injury. There were 12 cases of Taekwondo injury, 5 of golf injury, 4 of soccer injury, 3 of gymnastics injury, 2 of Hapkido injury, 2 of aerobics injury, 2 of rock-climbing injury, 2 of fitness training injury and 9 of other sports injuries. We checked the subtypes of acetabular labral tears and the accompanying femoroacetabular impingement. For the cases with accompanying femoroacetabular impingement, we investigated the subtypes according to the types of sports, gender and age. At last follow-up, we checked the Harris Hip Score (HHS), the Hip Outcome Score (HOS) sports scale and the percentage of patients who returned to their sports activity. The average age of symptomatic onset was 26 years (range, 12 to 65 years). The ratio of males to females was 29 : 12. An average duration of the hip pain was 17 months (range, 1 to 60 months). The degenerative type of acetabular labral tears was the most prevalent with 32 cases (78%), and there were 9 cases (22%) of the partial tear type. Thirty cases (73%) were accompanied by femoroacetabular impingement. The average age of the 23 cases (56%) of the cam-type was 23 years (range, 12 to 48 years), and it was more likely to occur in men (87%) and for people practicing martial arts such as Taekwondo or Hapkido. An average age of the 5 cases (12%) of the pincer-type was 26 (range, 16 to 43 years), it usually occurred in women (60%) and for non-martial arts such as golf and gymnastics. There were 2 cases of the mixed type (cam + pincer-type). At 27 months follow-up, the HHS was 61 to 92 points, the HOS sports scale increased 43 to 75%, and the rate of returning to sports was 71%. In spite of the early expression of symptoms

  14. Interferometer for measuring the dynamic surface topography of a human tear film

    Science.gov (United States)

    Primeau, Brian C.; Greivenkamp, John E.

    2012-03-01

    The anterior refracting surface of the eye is the thin tear film that forms on the surface of the cornea. Following a blink, the tear film quickly smoothes and starts to become irregular after 10 seconds. This irregularity can affect comfort and vision quality. An in vivo method of characterizing dynamic tear films has been designed based upon a near-infrared phase-shifting interferometer. This interferometer continuously measures light reflected from the tear film, allowing sub-micron analysis of the dynamic surface topography. Movies showing the tear film behavior can be generated along with quantitative metrics describing changes in the tear film surface. This tear film measurement allows analysis beyond capabilities of typical fluorescein visual inspection or corneal topography and provides better sensitivity and resolution than shearing interferometry methods. The interferometer design is capable of identifying features in the tear film much less than a micron in height with a spatial resolution of about ten microns over a 6 mm diameter. This paper presents the design of the tear film interferometer along with the considerations that must be taken when designing an interferometer for on-eye diagnostics. Discussions include eye movement, design of null optics for a range of ocular geometries, and laser emission limits for on-eye interferometry.

  15. Skin tears: care and management of the older adult at home.

    Science.gov (United States)

    Holmes, Regina F; Davidson, Martha W; Thompson, Bonnie J; Kelechi, Teresa J

    2013-02-01

    Skin tears experienced by older adults require special skills to promote healing. Home healthcare providers are in key positions to manage skin tears and prevent further skin trauma. Several guidelines, risk assessments, classifications, and products exist to manage high-risk patients. Frequent evaluation of the effectiveness of the treatment and prevention strategies in an overall skin care protocol for home care patients is critical to reduce skin tear incidence and promote prompt healing when skin tears are present.

  16. T-Fix endoscopic meniscal repair: technique and approach to different types of tears.

    Science.gov (United States)

    Barrett, G R; Richardson, K; Koenig, V

    1995-04-01

    Endoscopic meniscus repair using the T-Fix suture device (Acufex Microsurgical, Inc, Mansfield, MA) allows ease of suture placement for meniscus stability without the problems associated with ancillary incisions such as neurovascular compromise. It is ideal for the central posterior horn tears that are difficult using conventional techniques. Vertical tears, bucket handle tears, flap tears, and horizontal tears can be approached using a temporary "anchor stitch" to stabilize the meniscus before T-Fix repair. The basic method of repair and our approach to these different types of tears is presented.

  17. Ponderomotive modification of drift tearing modes

    International Nuclear Information System (INIS)

    Urquijo, G.; Singh, R.; Sen, A.

    1997-01-01

    The linear characteristics of drift tearing modes are investigated in the presence of a significant background of radio-frequency (RF) waves in the ion cyclotron range of frequencies. The ponderomotive force, arising from the radial gradients in the RF field energy, is found to significantly modify the inner layer solutions of the drift tearing modes. It can have a stabilizing influence, even at moderate RF powers, provided the field energy has a decreasing radial profile at the mode rational surface. (author)

  18. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

    Energy Technology Data Exchange (ETDEWEB)

    Villeirs, G.M.; Verstraete, K.L.; Kunnen, M.F. [Dept. of Radiology, Univ. Hospital, Gent (Belgium); Tongerloo, A.J. van; Paepe, A.M. de [Dept. of Medical Genetics, Univ. Hospital, Gent (Belgium)

    1999-11-01

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, {chi} {sup 2}-test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  19. Non-invasive pre-lens tear film assessment with high-speed videokeratoscopy.

    Science.gov (United States)

    Llorens-Quintana, Clara; Mousavi, Maryam; Szczesna-Iskander, Dorota; Iskander, D Robert

    2018-02-01

    To evaluate the effect of two types of daily contact lenses (delefilcon A and omafilcon A) on the tear film and establish whether it is dependent on pre-corneal tear film characteristics using a new method to analyse high-speed videokeratoscopy recordings, as well as to determine the sensitivity of the method in differentiating between contact lens materials on eye. High-speed videokeratoscopy recordings were analysed using a custom made automated algorithm based on a fractal dimension approach that provides a set of parameters directly related to tear film stability. Fifty-four subjects participated in the study. Baseline measurements, in suppressed and natural blinking conditions, were taken before subjects were fitted with two different daily contact lenses and after four hours of contact lens wear. The method for analysing the stability of the tear film provides alternative parameters to the non-invasive break up time to assess the quality of the pre-corneal and pre-lens tear film. Both contact lenses significantly decreased the quality of the tear film in suppressed and natural blinking conditions (pfilm characteristics were not correlated with the decrease in pre-lens tear film quality. High-speed videokeratoscopy equipped with an automated method to analyse the dynamics of the tear film is able to distinguish between contact lens materials in vivo. Incorporating the assessment of pre-lens tear film to the clinical practice could aid improving contact lens fitting and understand contact lens comfort. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  20. Artificially modified collagen fibril orientation affects leather tear strength.

    Science.gov (United States)

    Kelly, Susyn J; Wells, Hannah C; Sizeland, Katie H; Kirby, Nigel; Edmonds, Richard L; Ryan, Tim; Hawley, Adrian; Mudie, Stephen; Haverkamp, Richard G

    2018-07-01

    Ovine leather has around half the tear strength of bovine leather and is therefore not suitable for high-value applications such as shoes. Tear strength has been correlated with the natural collagen fibril alignment (orientation index, OI). It is hypothesized that it could be possible to artificially increase the OI of the collagen fibrils and that an artificial increase in OI could increase tear strength. Ovine skins, after pickling and bating, were strained biaxially during chrome tanning. The strain ranged from 2 to 15% of the initial sample length, either uniformly in both directions by 10% or with 3% in one direction and 15% in the other. Once tanned, the leather tear strengths were measured and the collagen fibril orientation was measured using synchrotron-based small-angle X-ray scattering. The OI increased as a result of strain during tanning from 0.48 to 0.79 (P = 0.001) measured edge-on and the thickness-normalized tear strength increased from 27 to 43 N mm -1 (P leather was strained 10% in two orthogonal directions. This is evidence to support a causal relationship between high OI (measured edge-on), highly influenced by thickness, and tear strength. It also provides a method to produce stronger leather. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  1. Determination of Ductile Tearing Resistance Curve in Weld Joints

    International Nuclear Information System (INIS)

    Marie, S.; Gilles, P.; Ould, P.

    2010-01-01

    Steels present in the ductile domain a tearing resistance which increase with the crack propagation up to the failure. This ductile tearing resistance is in general characterised with curves giving the variation of a global parameter (opening displacement at the crack tip delta, integral J) versus the crack extension Delta a. These global approaches depend more or less on the specimen geometry and on the type of the imposed loading. Local approaches based on the description of the ductile tearing mechanisms provide reliable solution to the transferability problem (from the lab specimen to the component) but are complex and costly to use and are not codified. These problems get worse in the case of a weld joint where no standard is available for the measurement of their ductile tearing resistance. But the welded joints are often the weak point of the structure because of greater risk of defects, the heterogeneity of the microstructure of the weld, deformation along the interface between two materials with different yield stress (mismatch).... After briefly recalling the problems of transferability of the ductile tearing resistance curves obtained on lab specimen to the case of components, this article identifies the factors complicating the determination of the toughness in the welded joints and gives recommendations for the experimental determination of ductile tearing resistance curves of welded joints

  2. Spinal Dural Arteriovenous Fistula (SDAVF in a Patient with Progressive Paraparesia: A Case Report

    Directory of Open Access Journals (Sweden)

    Mehrdokht Mazdeh

    2016-07-01

    Full Text Available Background: Spinal dural arteriovenous fistula (SDAVF is a known cause of nontraumatic slow progressive araparesia and is frequently overlooked because its clinical features overlap with more common causes of myelopathy and also neuroimaging may be normal. Case Report: A 53 year-old man with developed weakness of both lower limbs had symptoms begun spontaneously 3.5 month before admission and progressed from 1 month ago with bowel and bladder incontinence. The patient's physical examination was normal and neurologic testing revealed lower extremity motor strength of 3/5. Deep tendon reflexes were decreased and superficial abdominal reflexes were absent. Sensation of pinprick and temperature was absent distal to the T4-T5 level. Vibration and proprioception were decreased to the ankle and saddle anesthesia and the patient was non ambulatory. Laboratory routine and specific tests for vitamin B12 level, hepatitis, HIV, HTLV1, 2 were negative. MRI of spine with and without contrast raised the possibility of dural arteriovenous malformation extended from T3 level to conus medullaris which was confirmed by angiography. The patient referred to neurosurgeon for deciding route of treatment. Conclusion: SDAVF can be a significant non traumatic slowly progressive cause of myelopathy. The majority of the affected patients are males older than 50 years of age. Rapid diagnosis in these patients leads to significant improvement.

  3. Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Merzoug, Valerie; Drissi, Cyrine; Adamsbaum, Catherine [Hopital Saint Vincent de Paul, Service de Radiopediatrie, Paris (France); Flunker, Sabrina; Couture, Alain [Hopital Arnaud de Villeneuve, Service de Radiopediatrie, Montpellier cedex 5 (France); Eurin, Danielle [Hopital Charles Nicolle, Service de Radiopediatrie, Rouen (France); Grange, Gilles [Hopital Cochin, Service de Gyneco-Obstetrique, Maternite Port-Royal, Paris (France); Garel, Catherine [Hopital Armand Trousseau, Service de Radiopediatrie, Paris (France); Richter, Brigitte [Hopital Clemenceau, Service de Radiopediatrie, Caen (France); Geissler, Frederic [Centre Hospitalier Universitaire, Service de Radiopediatrie, Clermont Ferrand (France)

    2008-04-15

    Dural sinus malformations (DSM) are rare malformations mainly reported after birth. The objectives of this study are to describe their prenatal patterns and to focus on their possible favorable outcome. This multicenter retrospective study reported 13 cases of DSM prenatally diagnosed. The admission criterion was a dural mass posterior to the vermis. In 12 patients, MRI was performed after US. Follow-up in 10 born babies (mean: 8 months) and three neuropathological examinations were available. In all fetuses, DSM presented as a well-delimited round mass involving the torcular. The follow-up examinations (n = 10) revealed progressive thrombosis of the DSM marked by a heterogeneous pattern (US and MRI) with concentric rings. The volume of the mass decreased, with complete regression in seven patients (five before and two after birth). One child died at the age of 5 months in the context of major hydrocephalus and another developed atrophy of the frontal lobes. The eight other babies were doing well (5 days to 3 years) without any treatment (n = 6) or following treatment for hydrocephalus (n = 2). Prenatal DSM may have a typical MR pattern, and the prognosis might not be as bad as has previously been reported. In the absence of criterion to predict the hydrovenous cerebral imbalance, it is mandatory to check the parenchyma and the ventricles during the pregnancy. (orig.)

  4. Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up

    International Nuclear Information System (INIS)

    Merzoug, Valerie; Drissi, Cyrine; Adamsbaum, Catherine; Flunker, Sabrina; Couture, Alain; Eurin, Danielle; Grange, Gilles; Garel, Catherine; Richter, Brigitte; Geissler, Frederic

    2008-01-01

    Dural sinus malformations (DSM) are rare malformations mainly reported after birth. The objectives of this study are to describe their prenatal patterns and to focus on their possible favorable outcome. This multicenter retrospective study reported 13 cases of DSM prenatally diagnosed. The admission criterion was a dural mass posterior to the vermis. In 12 patients, MRI was performed after US. Follow-up in 10 born babies (mean: 8 months) and three neuropathological examinations were available. In all fetuses, DSM presented as a well-delimited round mass involving the torcular. The follow-up examinations (n = 10) revealed progressive thrombosis of the DSM marked by a heterogeneous pattern (US and MRI) with concentric rings. The volume of the mass decreased, with complete regression in seven patients (five before and two after birth). One child died at the age of 5 months in the context of major hydrocephalus and another developed atrophy of the frontal lobes. The eight other babies were doing well (5 days to 3 years) without any treatment (n = 6) or following treatment for hydrocephalus (n 2). Prenatal DSM may have a typical MR pattern, and the prognosis might not be as bad as has previously been reported. In the absence of criterion to predict the hydrovenous cerebral imbalance, it is mandatory to check the parenchyma and the ventricles during the pregnancy. (orig.)

  5. Hot tearing susceptibility of binary Mg–Y alloy castings

    International Nuclear Information System (INIS)

    Wang, Zhi; Huang, Yuanding; Srinivasan, Amirthalingam; Liu, Zheng; Beckmann, Felix; Kainer, Karl Ulrich; Hort, Norbert

    2013-01-01

    Highlights: ► Quantitatively and qualitatively assessing hot tearing susceptibility for different alloys. ► Monitoring the hot tearing propagation process. ► Detecting the hot tearing initiation/onset temperature. ► Recording the stress and strain evolution during the casting solidification and the subsequent cooling. - Abstract: The influence of Y content on the hot tearing susceptibility (HTS) of binary Mg–Y alloys has been predicted using thermodynamic calculations based on Clyne and Davies model. The calculated results are compared with experimental results determined using a constrained rod casting (CRC) apparatus with a load cell and data acquisition system. Both thermodynamic calculations and experimental measurements indicate that the hot tearing susceptibility as a function of Y content follows the “λ” shape. The experimental results show that HTS first increases with increase in Y content, reaches the maximum at about 0.9 wt.%Y and then decreases with further increase the Y content. The maximum susceptibility observed in Mg–0.9 wt.%Y alloy is attributed to its coarsened columnar microstructure, large solidification range and small amount of eutectic at the time of hot tearing. The initiation of hot cracks is monitored during CRC experiments. It corresponds to a drop in load increment on the force curves. The critical solid fractions at which the hot cracks are initiated are in the range from 0.9 to 0.99. It is also found that it decreases with increasing the content of Y. The hot cracks propagate along the dendritic or grain boundaries through the interdendritic separation or tearing of interconnected dendrites. Some of the formed cracks are possible to be healed by the subsequent refilling of the remained liquids

  6. Slab tears and intermediate-depth seismicity

    Science.gov (United States)

    Meighan, Hallie E.; ten Brink, Uri S.; Pulliam, Jay

    2013-01-01

    Active tectonic regions where plate boundaries transition from subduction to strike slip can take several forms, such as triple junctions, acute, and obtuse corners. Well-documented slab tears that are associated with high rates of intermediate-depth seismicity are considered here: Gibraltar arc, the southern and northern ends of the Lesser Antilles arc, and the northern end of Tonga trench. Seismicity at each of these locations occurs, at times, in the form of swarms or clusters, and various authors have proposed that each marks an active locus of tear propagation. The swarms and clusters start at the top of the slab below the asthenospheric wedge and extend 30–60 km vertically downward within the slab. We propose that these swarms and clusters are generated by fluid-related embrittlement of mantle rocks. Focal mechanisms of these swarms generally fit the shear motion that is thought to be associated with the tearing process.

  7. Inadvertent Splenectomy During Resection for Colorectal Cancer Does Not Increase Long-term Mortality in a Propensity Score Model: A Nationwide Cohort Study.

    Science.gov (United States)

    Lolle, Ida; Pommergaard, Hans-Christian; Schefte, David F; Bulut, Orhan; Krarup, Peter-Martin; Rosenstock, Steffen J

    2016-12-01

    Previous studies suggest that long-term mortality is increased in patients who undergo splenectomy during surgery for colorectal cancer. The reason for this association remains unclear. The purpose of this study was to investigate the association between inadvertent splenectomy attributed to iatrogenic lesion to the spleen during colorectal cancer resections and long-term mortality in a national cohort of unselected patients. This was a retrospective, nationwide cohort study. Data were collected from the database of the Danish Colorectal Cancer Group and merged with data from the National Patient Registry and the National Pathology Databank. Danish patients with colorectal cancer undergoing curatively intended resection between 2001 and 2011 were included in the study. The primary outcome was long-term mortality for patients surviving 30 days after surgery. Secondary outcomes were 30-day mortality and risk factors for inadvertent splenectomy. Multivariable and propensity-score matched Cox regression analyses were used to adjust for potential confounding. In total, 23,727 patients were included, of which 277 (1.2%) underwent inadvertent splenectomy. There was no association between inadvertent splenectomy and long-term mortality (adjusted HR = 1.15 (95% CI, 0.95-1.40); p = 0.16) in the propensity score-matched model, whereas 30-day mortality was significantly increased (adjusted HR = 2.31 (95% CI, 1.71-3.11); p splenectomy was most often seen during left hemicolectomy (left hemicolectomy vs right hemicolectomy: OR = 24.76 (95% CI, 15.30-40.06); p splenectomy during resection for colorectal cancer does not seem to increase long-term mortality. The previously reported reduced overall survival after inadvertent splenectomy may be explained by excess mortality in the immediate postoperative period.

  8. Partial and complete tear of the anterior cruciate ligament. Direct and indirect MR signs

    International Nuclear Information System (INIS)

    Chen, W.T.; Tu, H.Y.; Chen, R.C.; Shih, T.T.F.; Shau, W.Y.

    2002-01-01

    Purpose: To analyze MR direct and indirect signs for knees with anterior cruciate ligament (ACL) partial or complete tear. Material and Methods: According to documented MR direct and indirect signs for ACL tear, we retrospectively reviewed the incidence of those signs in 15 partial ACL tear and 17 complete ACL tear patients. The findings were also compared with duration of injury (less or more than 6 weeks, as acute or chronic stages). Results: A residual straight and tight ACL fiber in at least one pulse sequence was more frequently detected in partial ACL tears. The empty notch sign, a wavy contour of ACL, bone contusion at lateral compartment and lateral meniscus posterior horn tear were significantly more frequently seen in complete tear cases. The posterior cruciate ligament angle in chronic complete ACL tear cases (109 deg ±20 deg) had a tendency to be less than in chronic partial ACL tear cases (119 deg ±18 deg). Conclusion: The empty notch sign, a wavy ACL, bone contusion, and posterior horn of lateral meniscus tears are suggestive of a complete ACL tear. A residual straight and tight ACL fiber seen in at least one image section is a helpful sign to diagnosis of partial ACL tear. In the acute ACL injury stage, a focal increase of the ACL signal intensity is more suggestive of a partial ACL tear

  9. Glycan involvement in the adhesion of Pseudomonas aeruginosa to tears.

    Science.gov (United States)

    Kautto, Liisa; Nguyen-Khuong, Terry; Everest-Dass, Arun; Leong, Andrea; Zhao, Zhenjun; Willcox, Mark D P; Packer, Nicolle H; Peterson, Robyn

    2016-04-01

    The human eye is constantly bathed by tears, which protect the ocular surface via a variety of mechanisms. The O-linked glycans of tear mucins have long been considered to play a role in binding to pathogens and facilitating their removal in the tear flow. Other conjugated glycans in tears could similarly contribute to pathogen binding and removal but have received less attention. In the work presented here we assessed the contribution of glycan moieties, in particular the protein attached N-glycans, presented by the broad complement of tear proteins to the adhesion of the opportunistic pathogen Pseudomonas aeruginosa, a leading cause of microbial keratitis and ulceration of the cornea. Our adhesion assay involved immobilising the macromolecular components of tears into the wells of a polyvinyl difluoride (PVDF) microtitre filter plate and probing the binding of fluorescently labelled bacteria. Three P. aeruginosa strains were studied: a cytotoxic strain (6206) and an invasive strain (6294) from eye infections, and an invasive strain (320) from a urinary tract infection (UTI). The ocular isolates adhered two to three times more to human tears than to human saliva or porcine gastric mucin, suggesting ocular niche-specific adaptation. Support for the role of the N-glycans carried by human tear proteins in the binding and removal of P. aeruginosa from the eye was shown by: 1) pre-incubation of the bacteria with free component sugars, galactose, mannose, fucose and sialyl lactose (or combination thereof) inhibiting adhesion of all the P. aeruginosa strains to the immobilised tear proteins, with the greatest inhibition of binding of the ocular cytotoxic 6206 and least for the invasive 6294 strain; 2) pre-incubation of the bacteria with N-glycans released from the commercially available human milk lactoferrin, an abundant protein that carries N-linked glycans in tears, inhibiting the adhesion to tears of the ocular bacteria by up to 70%, which was significantly more

  10. Peripheral Neuropathy and Tear Film Dysfunction in Type 1 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Stuti L. Misra

    2014-01-01

    Full Text Available Purpose. To compare tear film metrics in patients with type 1 diabetes mellitus (DM and healthy controls and investigate the association between peripheral neuropathy and ocular surface quality. Methods. Dry eye symptoms were quantified in 53 patients with type 1 DM and 40 age-matched controls. Ocular examination included tear film lipid layer thickness grading, tear film stability and quantity measurement, and retinal photography. DM individuals additionally underwent a detailed neuropathy assessment. Results. Neither mean age nor dry eye symptom scores differed significantly between the DM and control groups (P=0.12 and P=0.33, resp.. Tear lipid thickness (P=0.02, stability (P<0.0001, and quantity (P=0.01 were significantly lower in the DM group. Corneal sensitivity was also reduced in the DM group (P<0.001 and tear film stability was inversely associated with total neuropathy score (r=-0.29, P=0.03. Conclusion. The DM group exhibited significantly reduced tear film stability, secretion, and lipid layer quality relative to the age-matched control group. The negative correlation between tear film parameters and total neuropathy score suggests that ocular surface abnormalities occur in parallel with diabetic peripheral neuropathy.

  11. Tear film lipid layer: A molecular level view

    Czech Academy of Sciences Publication Activity Database

    Cwiklik, Lukasz

    2016-01-01

    Roč. 1858, č. 10 (2016), s. 2421-2430 ISSN 0005-2736 R&D Projects: GA ČR GA15-14292S Institutional support: RVO:61388955 Keywords : tear film * tear film lipid layer * molecular dynamics simulations Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 3.498, year: 2016

  12. Predictive MRI correlates of lesser metatarsophalangeal joint plantar plate tear

    Energy Technology Data Exchange (ETDEWEB)

    Umans, Rachel L. [Cornell University Medical College, New York, NY (United States); Umans, Benjamin D. [Harvard University, Cambridge, MA (United States); Umans, Hilary [Albert Einstein College of Medicine, Bronx, NY (United States); Lenox Hill Radiology and Imaging Associates, New York, NY (United States); Elsinger, Elisabeth [Albert Einstein College of Medicine, Bronx, NY (United States); Montefiore Medical Center, Bronx, NY (United States)

    2016-07-15

    To identify correlated signs on non-enhanced MRI that might improve diagnostic detection of plantar plate (PP) tear. We performed an IRB-approved, HIPAA-compliant retrospective analysis of 100 non-contrast MRI (50 PP tear, 50 controls). All were anonymized, randomized, and reviewed; 20 were duplicated to assess consistency. One musculoskeletal radiologist evaluated qualitative variables. A trained non-physician performed measurements. Consistency and concordance were assessed. Pearson's Chi-square test was used to test the correlation between qualitative findings and PP tear status. Correlation between measurements and PP status was assessed using t tests and Wilcoxon's rank-sum test (p values < 0.05 considered significant). Classification and regression trees were utilized to identify attributes that, taken together, would consistently distinguish PP tear from controls. Quantitative measurements were highly reproducible (concordance 0.88-0.99). Elevated 2nd MT protrusion, lesser MT supination and rotational divergence of >45 between the 1st-2nd MT axis correlated with PP tear. Pericapsular soft tissue thickening correlated most strongly with PP tear, correctly classifying 95 % of cases and controls. Excluding pericapsular soft tissue thickening, sequential assessment of 2nd toe enthesitis, 2nd flexor tendon subluxation, and splaying of the second and third toes accurately classified PP status in 92 %. Pericapsular soft tissue thickening most strongly correlated with PP tear. For cases in which it might be difficult to distinguish pericapsular fibrosis from neuroma, sequential assessment of 2nd toe enthesitis, flexor tendon subluxation and splaying of the 2nd and 3rd toe is most helpful for optimizing accurate diagnosis of PP tear. (orig.)

  13. [Evaluation of chemokines in tears of patients with infectious keratitis].

    Science.gov (United States)

    Hori, Shinsuke; Shoji, Jun; Inada, Noriko; Sawa, Mitsuru

    2013-02-01

    To investigate the chemokine profile in tears of patients with infectious keratitis. Subjects were 32 eyes of 16 patients with infectious keratitis and 5 eyes of 5 healthy volunteers as a control. The patients with infectious keratitis were classified into two groups of eyes: 10 with bacterial keratitis and 6 with Acanthamoeba keratitis. Tear fluid was obtained from both eyes of the patients with infectious keratitis and from the right eyes of the control subjects using filter paper. Chemokine concentration (unit: Odu/mm2) and its profile in tears was analyzed using an antibody-array. In terms of chemokine profile in the bacterial keratitis group, the expression volume of interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) in the diseased eyes was significantly higher than in the healthy eyes (p tears of the Acanthamoeba keratitis group. Regarding the chemokine ratio, the IL-8/MEC ratio in the diseased eyes of the Pseudomonas keratitis group and the MCP-1/IL-8 in the diseased eyes of the Acanthamoeba keratitis group showed a significantly high level (p tears of infectious keratitis patients is useful as a clinical tear laboratory test to interpret the pathologic condition of infectious keratitis

  14. Tear film proteome in age-related macular degeneration.

    Science.gov (United States)

    Winiarczyk, Mateusz; Kaarniranta, Kai; Winiarczyk, Stanisław; Adaszek, Łukasz; Winiarczyk, Dagmara; Mackiewicz, Jerzy

    2018-06-01

    Age-related macular degeneration (AMD) is the main reason for blindness in elderly people in the developed countries. Current screening protocols have limitations in detecting the early signs of retinal degeneration. Therefore, it would be desirable to find novel biomarkers for early detection of AMD. Development of novel biomarkers would help in the prevention, diagnostics, and treatment of AMD. Proteomic analysis of tear film has shown promise in this research area. If an optimal set of biomarkers could be obtained from accessible body fluids, it would represent a reliable way to monitor disease progression and response to novel therapies. Tear films were collected on Schirmer strips from a total of 22 patients (8 with wet AMD, 6 with dry AMD, and 8 control individuals). 2D electrophoresis was used to separate tear film proteins prior to their identification with matrix-assisted laser desorption/ionization time of flight spectrometer (MALDI-TOF/TOF) and matching with functional databases. A total of 342 proteins were identified. Most of them were previously described in various proteomic studies concerning AMD. Shootin-1, histatin-3, fidgetin-like protein 1, SRC kinase signaling inhibitor, Graves disease carrier protein, actin cytoplasmic 1, prolactin-inducible protein 1, and protein S100-A7A were upregulated in the tear film samples isolated from AMD patients and were not previously linked with this disease in any proteomic analysis. The upregulated proteins supplement our current knowledge of AMD pathogenesis, providing evidence that certain specific proteins are expressed into the tear film in AMD. As far we are aware, this is the first study to have undertaken a comprehensive in-depth analysis of the human tear film proteome in AMD patients.

  15. Freezing Range, Melt Quality, and Hot Tearing in Al-Si Alloys

    Science.gov (United States)

    Uludağ, Muhammet; Çetin, Remzi; Dispinar, Derya

    2018-02-01

    In this study, three different aluminum-silicon alloys (A356, A413, and A380) that have different solidification morphology and solidification ranges were examined with an aim to evaluate the hot tearing susceptibility. T-shape mold and Constrained Rod Casting (CRC) mold were used for the characterization. Reduced Pressure Test (RPT) was used to quantify the casting quality by measuring bifilm index. It was found that bifilm index and solidification range have an important role on the hot tearing formation. As it is known, bifilms can cause porosity and in this case, it was shown that porosity formed by bifilms decreased hot tearing tendency. As the freezing range of alloy increases, bifilms find the time to unravel that reduces hot tearing. However, for eutectic alloy (A413), due to zero freezing range, regardless of bifilm content, hot tearing was never observed. A380.1 alloy had the highest tendency for hot tearing due to having the highest freezing range among the alloys investigated in this work.

  16. Meniscal Tear Film Fluid Dynamics Near Marx’s Line

    KAUST Repository

    Zubkov, V. S.; Breward, C. J. W.; Gaffney, E. A.

    2013-01-01

    meniscus. However, resolving tear film behaviour within the meniscus and especially its apices is required to characterise the flow dynamics where the tear film is especially thin, and thus most susceptible to evaporatively induced hyperosmolarity

  17. Threshold condition for nonlinear tearing modes in tokamaks

    International Nuclear Information System (INIS)

    Zabiego, M.F.; Callen, J.D.

    1996-03-01

    Low-mode-number tearing, mode nonlinear evolution is analyzed emphasizing the need for a threshold condition, to account for observations in tokamaks. The discussion is illustrated by two models recently introduced in the literature. The models can be compared with the available data and/or serve as a basis for planning some experiments in order to either test theory (by means of beta-limit scaling laws, as proposed in this paper) or attempt to control undesirable tearing modes. Introducing a threshold condition in the tearing mode stability analysis is found to reveal some bifurcation points and thus domains of intrinsic stability in the island dynamics operational space

  18. Single-Session Hematoma Removal and Transcranial Coil Embolization for a Cavernous Sinus Dural Arteriovenous Fistula: A Technical Case Report.

    Science.gov (United States)

    Akamatsu, Yosuke; Sato, Kenichi; Endo, Hidenori; Matsumoto, Yasushi; Tominaga, Teiji

    2017-08-01

    Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. We present a case of surgical transvenous embolization in an 84-year-old woman with CS dAVF who presented with massive intracerebral hematoma. Cerebral angiograms revealed the dural AVF drained only into the superficial middle cerebral vein. Because an emergent mass reduction and prevention of rebleeding were necessary, single-session hematoma removal and transcranial embolization of a CS dAVF were performed in the neurosurgical operating room, using a mobile C-arm fluoroscopy. After the right frontotemporal craniotomy, intracerebral hematoma was removed and coil packing of the affected cavernous sinus was successfully performed via the dilated superficial middle cerebral vein. The transcortical vein approach enables occlusion of CS dAVF with isolated cortical venous drainage and may be a valuable alternative approach for some cases needed emergency craniotomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Tear film stability analysis system: introducing a new application for videokeratography.

    Science.gov (United States)

    Goto, Tomoko; Zheng, Xiaodong; Okamoto, Shigeki; Ohashi, Yuichi

    2004-11-01

    To review our previous studies regarding the development of a tear stability analysis system (TSAS) using videokeratography and the clinical application of TSAS for evaluation of tear film stability in patients subject to laser in situ keratomileusis (LASIK). New software, namely TSAS, was developed for the videokeratography system TMS-2N (topographic modeling system). TSAS automatically captures consecutive corneal surface images every second for 10 seconds. Corneal topographs were analyzed for tear breakup time (TMS-BUT) and tear breakup area (TMS-BUA, the ratio of breakup area to entire color-code area). First, we recruited volunteers to test the sensitivity and specificity of this new system in comparison with the routine method for tear stability analysis, tear film breakup time evaluation by slit-lamp microscope (SLE-BUT), with fluorescence staining. Second, we investigated the practicability of TSAS in dynamic evaluation of tear film stability before and after LASIK. TMS-BUT had a positive correlation with SLE-BUT, whereas TMS-BUA showed a negative correlation. Although they showed similar rates of specificity as SLE-BUT, the sensitivity rates of TMS-BUT and TMS-BUA were 97.5% and 95%, respectively, significantly higher than that of SLE-BUT (75%). The study on patients subject to LASIK showed that tear film stability significantly decreased during the early time period following LASIK and resolved at 6 months after surgery. Eyes that had abnormal TSAS evaluation tended to have higher risk of developing superficial punctuate keratitis and dry eye symptoms after LASIK, and their responses to treatment were slow. TSAS is a noninvasive and objective method with higher sensitivity for tear film stability analysis than SLE-BUT.

  20. Prevalence of triceps tendon tears on MRI of the elbow and clinical correlation.

    Science.gov (United States)

    Koplas, Monica C; Schneider, Erika; Sundaram, Murali

    2011-05-01

    Triceps tendon injuries are reported to be very rare. To our knowledge, there have been no studies describing its prevalence or injury patterns on MR imaging. The purpose of this retrospective study was to determine the prevalence and patterns of triceps injuries based on a large series of consecutive MR examinations. Clinical correlation was obtained. From 801 consecutive elbow MR examinations over a 15-year period, 28 patients with 30 triceps tendon injuries were identified and graded as partial tendon tear and complete tendon tear. The patients' medical records were reviewed to determine age, gender, cause of tears, and management. The prevalence of triceps tendon injuries was 3.8%. There were 5 women and 23 men with partial or complete tears (mean age: 46.6 years; range: 2.7 to 75.1 years). The most common injury was partial tear, found in 18 patients. There were 10 patients with 12 complete tears (2 had re-torn following surgical repair). A tear was suspected in 12 out 28 (43%) patients prior to the MRI. The most common presenting symptom was pain. The most common cause was athletic injury (8 patients [29%], including weightlifting [2 patients]). Tendon tear was found to be a complication of infection in 6 patients, and in 3 patients the tears were a complication of steroid use. Thirteen tendon tears were surgically repaired (8 of these were complete tears). Triceps tendon injury is not as rare as commonly reported and may often be clinically underdiagnosed.

  1. Chronic changes in pituitary adenylate cyclase-activating polypeptide and related receptors in response to repeated chemical dural stimulation in rats.

    Science.gov (United States)

    Han, Xun; Ran, Ye; Su, Min; Liu, Yinglu; Tang, Wenjing; Dong, Zhao; Yu, Shengyuan

    2017-01-01

    Background Preclinical experimental studies revealed an acute alteration of pituitary adenylate cyclase-activating polypeptide in response to a single activation of the trigeminovascular system, which suggests a potential role of pituitary adenylate cyclase-activating polypeptide in the pathogenesis of migraine. However, changes in pituitary adenylate cyclase-activating polypeptide after repeated migraine-like attacks in chronic migraine are not clear. Therefore, the present study investigated chronic changes in pituitary adenylate cyclase-activating polypeptide and related receptors in response to repeated chemical dural stimulations in the rat. Methods A rat model of chronic migraine was established by repeated chemical dural stimulations using an inflammatory soup for a different numbers of days. The pituitary adenylate cyclase-activating polypeptide levels were quantified in plasma, the trigeminal ganglia, and the trigeminal nucleus caudalis using radioimmunoassay and Western blotting in trigeminal ganglia and trigeminal nucleus caudalis tissues. Western blot analysis and real-time polymerase chain reaction were used to measure the protein and mRNA expression of pituitary adenylate cyclase-activating polypeptide-related receptors (PAC1, VPAC1, and VPAC2) in the trigeminal ganglia and trigeminal nucleus caudalis to identify changes associated with repetitive applications of chemical dural stimulations. Results All rats exhibited significantly decreased periorbital nociceptive thresholds to repeated inflammatory soup stimulations. Radioimmunoassay and Western blot analysis demonstrated significantly decreased pituitary adenylate cyclase-activating polypeptide levels in plasma and trigeminal ganglia after repetitive chronic inflammatory soup stimulation. Protein and mRNA analyses of pituitary adenylate cyclase-activating polypeptide-related receptors demonstrated significantly increased PAC1 receptor protein and mRNA expression in the trigeminal ganglia, but not

  2. Standard sonography and arthrosonography in the study of rotator cuff tears

    International Nuclear Information System (INIS)

    El-Dalati, Ghassan; Martone, Enrico; Caffarri, Sabrina; Fusaro, Michele; Pozzi Mucelli, Roberto; Castellarin, Gianluca; Ricci, Matteo; Vecchini, Eugenio

    2005-01-01

    Purpose. The aim of this study was to evaluate the sensitivity of ultrasonography, integrating standard ultrasound and arthrosonography after injecting a saline solution into the glenohumeral cavity in cases of suspected rotator cuff tears. Materials and methods. We respectively examinated 40 patients awaiting shoulder arthroscopy for suspected or diagnosed tears of the rotator cuff. A radiologist, unaware of the pre-operative diagnosis, performed an ultrasound scan on all the patients before and after the injection of saline solution into the glenohumeral cavity. The parameters considered were presence or absence of a rotator cuff injury; type of injury according to Snyder and its extent along the longitudinal and transverse planes; presence or absence of effusion into the articular cavity; subacromial/subdeltoid bursal distension. All the patients underwent arthroscopy either the same day of the day after the ultrasound examination. Results. Standard sonography showed 26 complete rotator cuff tears (type C according to Snyder), 2 partial tears (type B according to Snyder) and 12 intact rotator cuffs. Arthrosonography detected 31 complete rotator cuff tears (type C according to Snyder), 1 partial tear (type B according to Snyder) and 8 intact rotator cuffs. Arthroscopy identified 32 complete rotator cuff tears (type C according to Snyder), 1 partial tear (type B according to Snyder) and 8 intact rotator cuffs. Analysis of the results shows that, taking arthroscopy as the gold standard, the sensitivity of normal sonography is 81.2%, whereas that of arthosonography is 96.8% (p [it

  3. Relationship of Tear Size and Location to Fatty Degeneration of the Rotator Cuff

    Science.gov (United States)

    Kim, H. Mike; Dahiya, Nirvikar; Teefey, Sharlene A.; Keener, Jay D.; Galatz, Leesa M.; Yamaguchi, Ken

    2010-01-01

    Background: Fatty degeneration of the rotator cuff muscles may have detrimental effects on both anatomical and functional outcomes following shoulder surgery. The purpose of this study was to investigate the relationship between tear geometry and muscle fatty degeneration in shoulders with a deficient rotator cuff. Methods: Ultrasonograms of both shoulders of 262 patients were reviewed to assess the type of rotator cuff tear and fatty degeneration in the supraspinatus and infraspinatus muscles. The 251 shoulders with a full-thickness tear underwent further evaluation for tear size and location. The relationship of tear size and location to fatty degeneration of the supraspinatus and infraspinatus muscles was investigated with use of statistical comparisons and regression models. Results: Fatty degeneration was found almost exclusively in shoulders with a full-thickness rotator cuff tear. Of the 251 shoulders with a full-thickness tear, eighty-seven (34.7%) had fatty degeneration in either the supraspinatus or infraspinatus, or both. Eighty-two (32.7%) of the 251 full-thickness tears had a distance of 0 mm between the biceps tendon and anterior margin of the tear. Ninety percent of the full-thickness tears with fatty degeneration in both muscles had a distance of 0 mm posterior from the biceps, whereas only 9% of those without fatty degeneration had a distance of 0 mm. Tears with fatty degeneration had significantly greater width and length than those without fatty degeneration (p Tears with fatty degeneration had a significantly shorter distance posterior from the biceps than those without fatty degeneration (p tear width and length were found to be the most important predictors for infraspinatus fatty degeneration. Conclusions: Fatty degeneration of the rotator cuff muscles is closely associated with tear size and location. The finding of this study suggests that the integrity of the anterior supraspinatus tendon is important to the development of fatty

  4. Daytime Variations of Tear Osmolarity Measurement in Dry Eye Patients

    Directory of Open Access Journals (Sweden)

    Ulviye Yiğit

    2013-12-01

    Full Text Available Purpose: We have targeted primarily to show the variations of tear osmolarity during the daytime period in subjects with dry eyes and non-dry eyes and, secondarily, to evaluate the relationship of these variations with Schirmer’s test and break-up time (BUT. Material and Method: Twenty newly diagnosed dry eye patients and 20 healthy voluntary subjects with similar age and gender were included in this prospective study. In addition to the full ophthalmic examination, Schirmer’s test and BUT test were applied to all participants. Tear osmolarity measurements were done after pre-examination but in different day. The measurements were registered with TearLab Osmolarity System (TearLab Corporation, San Diego, CA, USA every 3 hours within 8:00 AM and 5:00 PM. The results were evaluated statistically. Results: No statistically significant difference was found between the mean age and gender of dry eye syndrome (DES and control groups (p>0.05. The mean measurements of Schirmer’s test and BUT in the DES group were statistically significantly lower than those in the control group (p=0.0001. The mean measurements of tear osmolarity at 8:00 AM, 11:00 AM, 2:00 PM, and 5:00 PM in the DES group were statistically significantly higher than those in the control group (p=0.001, p=0.0001. No statistically significant difference in tear osmolarity at 8:00 AM, 11: 00 AM, 2:00 PM, and 5:00 PM was found between the groups, and within DES and control groups (p>0.05. Discussion: We did not determine significant change in daytime variations of the tear osmolarity in dry eye patients and healthy subjects. As a secondary result, we can conclude that there is no difference among tear osmolarity, Shirmer’s and BUT tests in the diagnosis of DES. (Turk J Ophthalmol 2013; 43: 437-41

  5. Magnetic resonance imaging appearance of partial latissimus dorsi muscle tendon tear

    International Nuclear Information System (INIS)

    Le, Huy B.Q.; Lee, Steven T.; Lane, Michael D.; Munk, Peter L.; Malfair, David; Blachut, Piotr A.

    2009-01-01

    There is still a paucity of information about the clinical presentation, treatment and imaging findings of latissimus muscle tears. Only one study has specifically described the magnetic resonance imaging (MRI) features of latissimus tendon tears. We describe a case of a high-grade tear in the latissimus muscle tendon in an active water skier with no significant prior medical history. MRI demonstrated at least a 50% tear of the latissimus tendon, manifesting as increased signal intensity on T2-weighted sequences and surrounding edema, as well as a diminutive tendon at the humeral insertion. (orig.)

  6. Non-linear evolution of double tearing modes in tokamaks

    International Nuclear Information System (INIS)

    Fredrickson, E.; Bell, M.; Budny, R.V.; Synakowski, E.

    1999-01-01

    The delta prime formalism with neoclassical modifications has proven to be a useful tool in the study of tearing modes in high beta, collisionless plasmas. In this paper the formalism developed for the inclusion of neoclassical effects on tearing modes in monotonic q-profile plasmas is extended to plasmas with hollow current profiles and double rational surfaces. First, the classical formalism of tearing modes in the Rutherford regime in low beta plasmas is extended to q profiles with two rational surfaces. Then it is shown that this formalism is readily extended to include neoclassical effects

  7. Potential of FTIR spectroscopy for analysis of tears for diagnosis purposes.

    Science.gov (United States)

    Travo, Adrian; Paya, Clément; Déléris, Gérard; Colin, Joseph; Mortemousque, Bruno; Forfar, Isabelle

    2014-04-01

    It has been widely reported that the tear film, which is crucially important as a protective barrier of the eye, undergoes biochemical changes as a result of a wide range of ocular pathology. This tends to suggest the possibility of early detection of ocular diseases on the basis of biochemical analysis of tears. However, studies of tears by conventional methods of biomolecular and biochemical analysis are often limited by methodological difficulties. Moreover, such analysis could not be applied in the clinic, where structural and morphological analyses by, mainly, slit-lamp biomicroscopy remains the recommended method. In this study, we assessed, for the first time, the potential of FTIR spectroscopy combined with advanced chemometric processing of spectral data for analysis of raw tears for diagnosis purposes. We first optimized sampling and spectral acquisition (tears collection method, tear sample volume, and preservation of the samples) for accurate spectral measurement. On the basis of the results, we focused our study on the possibility of discriminating tears from normal individuals from those of patients with different ocular pathologies, and showed that the most discriminating spectral range is that corresponding to variations of CH2 and CH3 of lipid aliphatic chains. We also report more subtle discrimination of tears from patients with keratoconus and those from patients with non-specific inflammatory ocular diseases, on the basis of variations in spectral ranges attributed notably to lipid and carbohydrate vibrations. Finally, we also succeeded in distinguishing tears from patients with early-stage and late-stage keratoconus on the basis of spectral features attributed to protein structure. Therefore, this study strongly suggests that FTIR spectral analysis of tears could be developed as a valuable and cost-saving tool for biochemical-based detection of ocular diseases, potentially before the appearance of the first morphological signs of diseases

  8. The Tear Osmolarity Changes After Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Banu Öncel

    2012-01-01

    Full Text Available Pur po se: To determine the tear osmolarity changes in patients who had undergone phacoemulsification surgery. Ma te ri al and Met hod: Tear osmolarity measurements were performed in 30 eyes of 30 patients who had undergone cataract surgery without any complication. Measurements were performed before surgery and consecutively at 1st month, 3rd month, and 6th month after the surgery. TearLab osmometer (TearLab Corporation, San Diego, CA, USA device was used for the measurements and paired ttest was used for statistical analysis. Re sults: The mean age of the patients was 72.3±3.7 (67-78 years. Thirteen patients were men and 17 patients were women. The mean osmolarity values were 305.8±6.5 mOsm/L before the surgery and 312.3±6.4 mOsm/L at 1st month, 307.5±5.1 mOsm/L at 3rd month and 305.1±5.7 at 6th month after the surgery. The difference between the values before surgery and at 1st month was found statistically significant (p=0.001. Dis cus si on: The tear osmolarity increases at the first month after surgery but decreases to the levels measured before surgery at the 3rd month. The increase at the first month may be due to the corneal incisions and medication used after the surgery. We think that we have to take into account this similarity increase in all cataract patients, especially in those who also have dry eye disease. (Turk J Ophthalmol 2012; 42: 35-7

  9. Anatomical and visual outcomes of ranibizumab injections in retinal pigment epithelium tears

    Directory of Open Access Journals (Sweden)

    Muhammet Kazım Erol

    2015-06-01

    Full Text Available ABSTRACT Purpose: To report the anatomical and visual results in patients diagnosed as having retinal pigment epithelium (RPE tears after receiving ranibizumab injections. Methods: Eyes diagnosed as having RPE tears with a minimum 6-month follow-up were retrospectively evaluated. Each eye was treated with at least three doses of ranibizumab at monthly intervals. Best-corrected visual acuity (BCVA, anterior segment findings, intraocular pressure, and fundus examination results were evaluated during control visits. Color fundus photography, fundus fluorescein angiographies, fundus autofluorescence, and spectral domain optical coherence tomography (SD-OCT images were obtained. The height of pigment epithelial detachment (PED was measured by SD-OCT. Results: Twelve eyes with RPE tears were studied. Nine eyes (75% developed RPE tears during ranibizumab injections for choroidal neovascularization (eight eyes with vascularized PED and one eye with choroidal osteoma, and tears occurred in three eyes before any injections. The median number of ranibizumab injections after diagnosis of RPE tears was 3 (min 2, max 5. In the most recent follow-up visit, there was no statistically significant correlation between the grade of RPE and logMAR of BCVA (p>0.05, r=0.112. Eight of twelve eyes had PED, and seven of these had irregular PED contours before injection therapy. The mean PED height was 447 ± 122 µm. Conclusions: In this series, RPE tears developed mostly after intravitreal anti-VEGF injections for vascularized PED. Increased vertical height and irregular contours of the PEDs can be risk factors for the formation of RPE tears. The continuation of anti-VEGF therapy after tear formation is beneficial for vision improvement in eyes with RPE tears.

  10. Simulation of saturated tearing modes in tokamaks

    International Nuclear Information System (INIS)

    Nguyen, Canh N.; Bateman, Glenn; Kritz, Arnold H.

    2004-01-01

    A quasi-linear model, which includes the effect of the neoclassical bootstrap current, is developed for saturated tearing modes in order to compute magnetic island widths in axisymmetric toroidal plasmas with arbitrary aspect ratio and cross-sectional shape. The model is tested in a simple stand-alone code and is implemented in the BALDUR [C. E. Singer et al., Comput. Phys. Commun. 49, 275 (1982)] predictive modeling code. It is found that the widths of tearing mode islands increase with decreasing aspect ratio and with increasing elongation. Also, the island widths increase when the gradient of the current density increases at the edge of the islands and when the current density inside the islands is suppressed, such as the suppression caused by the near absence of the bootstrap current within the islands. In simulations of tokamak discharges, it is found that tearing mode island widths oscillate in time in response to periodic sawtooth crashes. The local enhancements in the transport produced by magnetic islands have a noticeable effect on global plasma confinement in simulations of low aspect ratio, high beta tokamaks, where saturated tearing mode islands can occur with widths that are greater than 15% of the plasma minor radius

  11. Experimental inflammation following dural application of complete Freund's adjuvant or inflammatory soup does not alter brain and trigeminal microvascular passage.

    Science.gov (United States)

    Lundblad, Cornelia; Haanes, Kristian A; Grände, Gustaf; Edvinsson, Lars

    2015-01-01

    Migraine is a paroxysmal, disabling primary headache that affects 16 % of the adult population. In spite of decades of intense research, the origin and the pathophysiology mechanisms involved are still not fully known. Although triptans and gepants provide effective relief from acute migraine for many patients, their site of action remains unidentified. It has been suggested that during migraine attacks the leakiness of the blood-brain barrier (BBB) is altered, increasing the passage of anti-migraine drugs. This study aimed to investigate the effect of experimental inflammation, following dural application of complete Freund's adjuvant (CFA) or inflammatory soup (IS) on brain and trigeminal microvascular passage. In order to address this issue, we induced local inflammation in male Sprague-Dawley-rats dura mater by the addition of CFA or IS directly on the dural surface. Following 2, 24 or 48 h of inflammation we calculated permeability-surface area product (PS) for [(51)Cr]-EDTA in the trigeminal ganglion (TG), spinal trigeminal nucleus, cortex, periaqueductal grey and cerebellum. We observed that [(51)Cr]-EDTA did not pass into the central nervous system (CNS) in a major way. However, [(51)Cr]-EDTA readily passed the TG by >30 times compared to the CNS. Application of CFA or IS did not show altered transfer constants. With these experiments we show that dural IS/CFA triggered TG inflammation, did not increase the BBB passage, and that the TG is readily exposed to circulating molecules. The TG could provide a site of anti-migraine drug interaction with effect on the trigeminal system.

  12. Significance of tear β2-MG radioimmunoassay in herpes simplex keratitis

    International Nuclear Information System (INIS)

    Feng Zhuxu; Zhao Suzhen; Zhang Qiliang; Chen Fengfen; Tang Baoyi

    1994-01-01

    Levels of tear and serum β 2 -MG are determined with radioimmunoassay in 35 patients with herpes simplex keratitis and 40 normal subjects. The results show that tear β 2 -MG levels of patients with herpes simplex keratitis (13.21 +- 6.15 mg/l) and normal subjects (8.43 +- 1.52 mg/l) are significantly different (P 2 -MG levels of tear and that of serum in normal subjects (P 2 -MG levels of tear and that of serum in patients with herpes simplex keratitis (P 2 -MG levels of patients with herpes simplex keratitis and that of normal subjects (P>0.05). The β 2 -MG levels of tear is higher than that of serum in normal subjects which reflects more correctly immune condition of patients with herpes simplex keratitis than that of serum

  13. Prevalence of triceps tendon tears on MRI of the elbow and clinical correlation

    International Nuclear Information System (INIS)

    Koplas, Monica C.; Schneider, Erika; Sundaram, Murali

    2011-01-01

    Triceps tendon injuries are reported to be very rare. To our knowledge, there have been no studies describing its prevalence or injury patterns on MR imaging. The purpose of this retrospective study was to determine the prevalence and patterns of triceps injuries based on a large series of consecutive MR examinations. Clinical correlation was obtained. From 801 consecutive elbow MR examinations over a 15-year period, 28 patients with 30 triceps tendon injuries were identified and graded as partial tendon tear and complete tendon tear. The patients' medical records were reviewed to determine age, gender, cause of tears, and management. The prevalence of triceps tendon injuries was 3.8%. There were 5 women and 23 men with partial or complete tears (mean age: 46.6 years; range: 2.7 to 75.1 years). The most common injury was partial tear, found in 18 patients. There were 10 patients with 12 complete tears (2 had re-torn following surgical repair). A tear was suspected in 12 out 28 (43%) patients prior to the MRI. The most common presenting symptom was pain. The most common cause was athletic injury (8 patients [29%], including weightlifting [2 patients]). Tendon tear was found to be a complication of infection in 6 patients, and in 3 patients the tears were a complication of steroid use. Thirteen tendon tears were surgically repaired (8 of these were complete tears). Triceps tendon injury is not as rare as commonly reported and may often be clinically underdiagnosed. (orig.)

  14. Prevalence of triceps tendon tears on MRI of the elbow and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Koplas, Monica C. [University of Mississippi Medical Center, Section of Musculoskeletal Radiology, Department of Radiology, Jackson, MS (United States); Schneider, Erika [Cleveland Clinic, Imaging Institute, Cleveland, OH (United States); Sundaram, Murali [Cleveland Clinic, Section of Musculoskeletal Radiology, Imaging Institute, Cleveland, OH (United States)

    2011-05-15

    Triceps tendon injuries are reported to be very rare. To our knowledge, there have been no studies describing its prevalence or injury patterns on MR imaging. The purpose of this retrospective study was to determine the prevalence and patterns of triceps injuries based on a large series of consecutive MR examinations. Clinical correlation was obtained. From 801 consecutive elbow MR examinations over a 15-year period, 28 patients with 30 triceps tendon injuries were identified and graded as partial tendon tear and complete tendon tear. The patients' medical records were reviewed to determine age, gender, cause of tears, and management. The prevalence of triceps tendon injuries was 3.8%. There were 5 women and 23 men with partial or complete tears (mean age: 46.6 years; range: 2.7 to 75.1 years). The most common injury was partial tear, found in 18 patients. There were 10 patients with 12 complete tears (2 had re-torn following surgical repair). A tear was suspected in 12 out 28 (43%) patients prior to the MRI. The most common presenting symptom was pain. The most common cause was athletic injury (8 patients [29%], including weightlifting [2 patients]). Tendon tear was found to be a complication of infection in 6 patients, and in 3 patients the tears were a complication of steroid use. Thirteen tendon tears were surgically repaired (8 of these were complete tears). Triceps tendon injury is not as rare as commonly reported and may often be clinically underdiagnosed. (orig.)

  15. Bucket handle tears of the medial meniscus: meniscal intrusion rather than meniscal extrusion

    International Nuclear Information System (INIS)

    Schlossberg, S.; Umans, H.; Flusser, G.; DiFelice, G.S.; Lerer, D.B.

    2007-01-01

    To determine the frequency of medial meniscal extrusion (MME) versus ''medial meniscal intrusion'' in the setting of bucket handle tears. Images were evaluated for previously reported risk factors for MME, including: medial meniscal root tear, radial tear, degenerative joint disease and joint effusion. Forty-one consecutive cases of bucket handle tear of the medial meniscus were reviewed by consensus by two musculoskeletal radiologists. Imaging was performed using a 1.5 GE Signa MR unit. Patient age, gender, medial meniscal root integrity, MME, medial meniscal intrusion, degenerative joint disease, effusion and anterior cruciate ligament (ACL) tear were recorded. Thirteen females and 27 males (age 12-62 years, median=30 years) were affected; one had bucket handle tear of each knee. Effusion was small in 13, moderate in 9 and large in 18. Degenerative joint disease was mild in three, moderate in two and severe in one. 26 ACL tears included three partial and three chronic. Medial meniscal root tear was complete in one case and partial thickness in two. None of the 40 cases with an intact or partially torn medial meniscal root demonstrated MME. MME of 3.1 mm was seen in the only full-thickness medial meniscal root tear, along with chronic ACL tear, moderate degenerative joint disease and large effusion. Medial meniscal intrusion of the central bucket handle fragment into the intercondylar notch was present in all 41 cases. Given an intact medial meniscal root in the setting of a ''pure'' bucket handle tear, there is no MME. (orig.)

  16. [The incidence of retinal tears in patients with posterior vitreous detachment].

    Science.gov (United States)

    Karaman, Ksenija; Gverović-Antunica, Antonela; Bućan, Kajo; Znaor, Ljubo; Bulović, Dijana; Skelin, Sinia

    2006-01-01

    Posterior vitreous detachment (PVD) is a common finding in older patients, characterized by detachment of the posterior hyaloid membrane (PHM) from the retinal surface. The detachment of PHM normally occurs without complications, however, one has to be aware that retinal tear is its most common complication. The aim of the study was to determine the incidence of retinal tears in eyes with PVD. A series of 40 patients (70 eyes) with PVD were included in this retrospective study. Eyes with a history of ocular trauma, surgery or intraocular inflammation were excluded. Patient charts were reviewed to collect the following information: age, sex, profession, type and duration of symptoms, best corrected visual acuity, refractive status, prior ocular disease, coincidental retinal pathology-lattice degeneration, number, type and location of retinal tears and treatment. Statistical analysis was done with the SPSS 11.0.3 software (SPSS Inc., USA). Besides descriptive statistics, Student's t-test and chi2-test were used. Among all study eyes with PVD, 34 (48.6%) were myopic, 24 (34.3%) hypermetropic and 12 (17.1%) emetropic; statistical analysis showed a significant difference (chi2 = 10.40, df=2, p lattice malignant degeneration of peripheral retinal was diagnosed. Thorough examination of the fundus periphery revealed 16 (22.8%) eyes with PVD were found to have retinal tears, 11 (15.7%) had only one retinal tear and 5 (7.1%) two retinal tears. All retinal tears were treated with argon laser photocoagulation. Superotemporal eye quadrant was the most common localization of retinal tears (56.25%). These results indicate that thorough fundus periphery examination should be done in all patients with PVD because it can cause rather rarely though retinal tears that represent a potentially sight threatening condition.

  17. The relation between invasive and non-invasive tear break-up time ...

    African Journals Online (AJOL)

    Tear stability normal to Nigerians with consideration of gender and age has not been reported. Tear stability in young adults was measured using invasive and non-invasive tear break-up time (TBUT and NIBUT). Forty –five subjects aged 20 to 30 years were selected from among the students of University of. Benin, Edo ...

  18. Emotional tears facilitate the recognition of sadness and the perceived need for social support.

    Science.gov (United States)

    Balsters, Martijn J H; Krahmer, Emiel J; Swerts, Marc G J; Vingerhoets, Ad J J M

    2013-02-12

    The tearing effect refers to the relevance of tears as an important visual cue adding meaning to human facial expression. However, little is known about how people process these visual cues and their mediating role in terms of emotion perception and person judgment. We therefore conducted two experiments in which we measured the influence of tears on the identification of sadness and the perceived need for social support at an early perceptional level. In two experiments (1 and 2), participants were exposed to sad and neutral faces. In both experiments, the face stimuli were presented for 50 milliseconds. In experiment 1, tears were digitally added to sad faces in one condition. Participants demonstrated a significant faster recognition of sad faces with tears compared to those without tears. In experiment 2, tears were added to neutral faces as well. Participants had to indicate to what extent the displayed individuals were in need of social support. Study participants reported a greater perceived need for social support to both sad and neutral faces with tears than to those without tears. This study thus demonstrated that emotional tears serve as important visual cues at an early (pre-attentive) level.

  19. Tears of Wine

    Science.gov (United States)

    Gugliotti, Marcos

    2004-01-01

    The unique occurrence of the upward motion of a thin film of wine, and its formation into drops inside the wall of a wine glass is explained. Evaporation of alcohol generates a surface tension gradient, moving the film of wine upwards on the internal sides of a wine glass, where it collects and forms into drops or tears.

  20. MRI study of associated shoulder pathology in patients with full-thickness subscapularis tendon tears.

    Science.gov (United States)

    Li, Xinning; Fallon, Jonathan; Egge, Natalie; Curry, Emily J; Patel, Ketan; Owens, Brett D; Busconi, Brian D

    2013-01-01

    Subscapularis tendon tears are a well-established cause of shoulder pain. The objective of the current study was to evaluate the associated shoulder pathology in patients with full-thickness subscapularis tendon tears using magnetic resonance imaging. Forty-seven magnetic resonance imaging studies taken between 2008 and 2009 with a diagnosis of full-thickness subscapularis tendon tears were reviewed. The size of the subscapularis tendon tear, amount of muscle volume loss, Goutallier grade, biceps tendon pathology, coracohumeral distance, and associated rotator cuff tears were recorded. Statistical analysis was performed. Patients 55 years and older vs those 54 years and younger had an average subscapularis tear size of 35 vs 19 mm, an average Goutallier grade of 2.7 vs 0.8, and a total muscle volume loss of 25% vs 5%, respectively. Patients with a dislocated vs normal biceps tendons had an average subscapularis tear size of 37 vs 23 mm, an average Goutallier grade of 3 vs 0.9, and a total muscle volume loss of 28% vs 7%, respectively. Patients with vs without concomitant rotator cuff tears had an average subscapularis tear size of 32 vs 17 mm, an average Goutallier grade of 2.3 vs 0.6, and a total muscle volume loss of 21% vs 3%, respectively. Overall average coracohumeral distance measured in the axial plane was 10.8±4.6 mm. Average coracaohumeral distance was 14.8 vs 8.1 mm in patients with a Goutallier grade of 0 vs 3 or 4, resepectively, and 13.6 vs 8.5 mm in patients with no rotator cuff tear vs those with a supra- and infraspinatus tear, respectively. Increased age, dislocated biceps tendons, and concomitant rotator cuff tears in patients with full-thickness subscapularis tendon tears are associated with larger subscapularis tendon tear size, higher Goutallier grades, and increased subscapularis muscle volume loss. Decreased coracohumeral distance is associated with a higher Goutallier grade and rotator cuff tears. Copyright 2013, SLACK Incorporated.

  1. Postanaesthetic tear production and ocular irritation in cats.

    Science.gov (United States)

    Peche, N; Köstlin, R; Reese, S; Pieper, K

    2015-01-01

    General anaesthesia significantly reduces tear production and normal values are not immediately re-established on ending anaesthesia. Therefore, adequate protection of the cornea has to be assured during the perianaesthetic period. There are various methods available, including taping of the eyelids and the application of eye ointments, gels and drops. In human medicine studies, different formulations were found to induce signs of ocular irritation. The aim of the present study was to determine tear production in cats after general anaesthesia, and to identify possible causes of irritation. Tear production was determined in 41 cats after general anaesthesia and eyes were examined for signs of irritation. Two different anaesthetic protocols were used. To protect the cornea, an ointment and gel were applied to the right and left eyes, respectively. Postoperatively, tear production was significantly reduced for 6 hours and 18 hours in the right and left eyes, respectively. Two hours after anaesthesia, blepharospasm of the right eye was observed in 92.7% (n = 38) of the cats. In contrast, the left eye was always held open. This study demonstrated that tear production in cats is significantly decreased both during and after anaesthesia. The degree of reduction was independent of the anaesthetic protocol. Both the eye ointment and gel proved effective in protecting the corneal surface. However, eye gel use is recommended because the eye ointment consistently caused an irritation comparable to the foreign-body sensation reported in humans.

  2. Dural invasion of meningiomas adjacent to the tumor margin on Gd-DTPA-enhanced MR images: histopathologic correlation

    International Nuclear Information System (INIS)

    Hutzelmann, A.; Palmie, S.; Freund, M.; Heller, M.; Buhl, R.

    1998-01-01

    In intracranial meningiomas a flat, contrast-enhancing, dural structure adjacent to the tumor can occasionally be observed on gadolinium-DTPA-enhanced MR images. We wished to evaluate whether there is a correlation between MR images and meningeal invasion of intracranial meningiomas. The study included 54 patients with intracranial meningioma and the meningeal sign. MR studies included T2-weighted and gadolinium-DTPA-enhanced T1-weighted images in axial, coronal, and sagittal planes. Histopathologic examinations were done on the meningiomas adjacent to the dura mater. The meningeal sign on MRI was observed from 2 up to 35 mm from the main tumor mass in 31 (57 %) of the 54 patients. In 20 of these 31 the histopathologic examination showed tumor invasion, while 11 patients had no tumor invasion but tissue proliferation, hypervascularity, and vascular dilatation. Seven of the 23 meningiomas without the meningeal sign had histologically proven infiltration of the adjacent dura. MR imaging is not able to determine definitive whether or not there is dural infiltration of the meningiomas. In conclusion, resection of the tumor with a wide margin is necessary to achieve complete excision of meningioma and to avoid recurrence. (orig.)

  3. Conduta na lesão dural intraoperatória em artrodese da coluna lombar Conducta en lesión de duramadre intraoperatoria en artrodesis de la columna lumbar Management of intraoperatory dural tear in lumbar spine arthrodesis

    Directory of Open Access Journals (Sweden)

    Fabiano de Mendonça Grandese

    2010-12-01

    Full Text Available OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuários revisados, após terem sido tratados por meio de um protocolo embasado em reparo primário da lesão, drenagem subaracnoidea fechada, subfascial e subcutânea aspirativa realizados por cirurgião experiente, associado a repouso relativo com mobilidade precoce e terapia medicamentosa. Suas anotações e exames radiológicos foram verificados com seguimento pós-operatório e direcionados para identificação de sintomas sugestivos de complicações. RESULTADOS: todos os pacientes apresentaram boa evolução, sem ocorrência de fístula liquórica ou infecção pós-operatória; três deles apresentaram cefaleia pós-operatória de leve intensidade. Não houve necessidade de reoperação em nenhum desses pacientes. CONCLUSÃO: concluiu-se que a conduta adotada é segura e de bom resultado para os pacientes quando ocorre esse tipo de lesão, independentemente da extensão da mesma.OBJETIVO: un estudio retrospectivo de pacientes con lesión de la duramadre intraoperatoria de cirugía en la columna lumbar, llevada a cabo por medio de un protocolo independiente de la extensión de la lesión, complicaciones asociadas y los resultados de seguimiento después de un mínimo de un año. MÉTODOS: 10 pacientes con durotomía accidental en la descompresión quirúrgica y artrodesis de la columna vertebral lumbar, en el período de enero de 2007 a enero de 2009, para el tratamiento de enfermedades degenerativas, tuvieron sus registros revisados después de

  4. Rotator cuff tears noncontrast MRI compared to MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hyun; Yoon, Young Cheol [Sungkyunkwan University, School of Medicine, Department of Radiology, Samsung Medical Center, Gangnam-gu, Seoul (Korea, Republic of); Jung, Jee Young [Chungang University School of Medicine, Department of Radiology, Chungang University Hospital, Seoul (Korea, Republic of); Yoo, Jae Chul [Sungkyunkwan University, School of Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Seoul (Korea, Republic of)

    2015-12-15

    To compare the accuracy of indirect magnetic resonance arthrography and noncontrast magnetic resonance imaging for diagnosing rotator cuff tears. In total, 333 patients who underwent noncontrast magnetic resonance imaging or indirect magnetic resonance arthrography were included retrospectively. Two musculoskeletal radiologists evaluated the images for the presence of supraspinatus-infraspinatus and subscapularis tendon tears. The overall diagnostic performance was calculated using the arthroscopic findings as the reference standard. Statistical differences between the diagnostic performances of the two methods were analyzed. Ninety-six and 237 patients who underwent noncontrast magnetic resonance imaging and indirect magnetic resonance arthrography were assigned into groups A and B, respectively. Sensitivity for diagnosing articular-surface partial-thickness supraspinatus-infraspinatus tendon tear was slightly higher in group B than in group A. Statistical significance was confirmed by multivariate analysis using the generalized estimating equation (p = 0.046). The specificity for diagnosing subscapularis tendon tear (85 % vs. 68 %, p = 0.012) and grading accuracy (57 % vs. 40 %, p = 0.005) was higher in group B than in group A; the differences were statistically significant for one out of two readers. Univariate analysis using the generalized estimating equation showed that the accuracy for diagnosing subscapularis tendon tear in group B was higher than in group A (p = 0.042). There were no statistically significant differences between the diagnostic performances of both methods for any other parameters. Indirect magnetic resonance arthrography may facilitate more accurate diagnosis and grading of subscapularis tendon tears compared with noncontrast magnetic resonance imaging. (orig.)

  5. Rotator cuff tears noncontrast MRI compared to MR arthrography

    International Nuclear Information System (INIS)

    Lee, Ji Hyun; Yoon, Young Cheol; Jung, Jee Young; Yoo, Jae Chul

    2015-01-01

    To compare the accuracy of indirect magnetic resonance arthrography and noncontrast magnetic resonance imaging for diagnosing rotator cuff tears. In total, 333 patients who underwent noncontrast magnetic resonance imaging or indirect magnetic resonance arthrography were included retrospectively. Two musculoskeletal radiologists evaluated the images for the presence of supraspinatus-infraspinatus and subscapularis tendon tears. The overall diagnostic performance was calculated using the arthroscopic findings as the reference standard. Statistical differences between the diagnostic performances of the two methods were analyzed. Ninety-six and 237 patients who underwent noncontrast magnetic resonance imaging and indirect magnetic resonance arthrography were assigned into groups A and B, respectively. Sensitivity for diagnosing articular-surface partial-thickness supraspinatus-infraspinatus tendon tear was slightly higher in group B than in group A. Statistical significance was confirmed by multivariate analysis using the generalized estimating equation (p = 0.046). The specificity for diagnosing subscapularis tendon tear (85 % vs. 68 %, p = 0.012) and grading accuracy (57 % vs. 40 %, p = 0.005) was higher in group B than in group A; the differences were statistically significant for one out of two readers. Univariate analysis using the generalized estimating equation showed that the accuracy for diagnosing subscapularis tendon tear in group B was higher than in group A (p = 0.042). There were no statistically significant differences between the diagnostic performances of both methods for any other parameters. Indirect magnetic resonance arthrography may facilitate more accurate diagnosis and grading of subscapularis tendon tears compared with noncontrast magnetic resonance imaging. (orig.)

  6. Does the Rotator Cuff Tear Pattern Influence Clinical Outcomes After Surgical Repair?

    Science.gov (United States)

    Watson, Scott; Allen, Benjamin; Robbins, Chris; Bedi, Asheesh; Gagnier, Joel J; Miller, Bruce

    2018-03-01

    Limited literature exists regarding the influence of rotator cuff tear morphology on patient outcomes. To determine the effect of rotator cuff tear pattern (crescent, U-shape, L-shape) on patient-reported outcomes after rotator cuff repair. Cohort study; Level of evidence, 3. Patients undergoing arthroscopic repair of known full-thickness rotator cuff tears were observed prospectively at regular intervals from baseline to 1 year. The tear pattern was classified at the time of surgery as crescent, U-shaped, or L-shaped. Primary outcome measures were the Western Ontario Rotator Cuff Index (WORC), the American Shoulder and Elbow Surgeons (ASES), and a visual analog scale (VAS) for pain. The tear pattern was evaluated as the primary predictor while controlling for variables known to affect rotator cuff outcomes. Mixed-methods regression and analysis of variance (ANOVA) were used to examine the effects of tear morphology on patient-reported outcomes after surgical repair from baseline to 1 year. A total of 82 patients were included in the study (53 male, 29 female; mean age, 58 years [range, 41-75 years]). A crescent shape was the most common tear pattern (54%), followed by U-shaped (25%) and L-shaped tears (21%). There were no significant differences in outcome scores between the 3 groups at baseline. All 3 groups showed statistically significant improvement from baseline to 1 year, but analysis failed to show any predictive effect in the change in outcome scores from baseline to 1 year for the WORC, ASES, or VAS when tear pattern was the primary predictor. Further ANOVA also failed to show any significant difference in the change in outcome scores from baseline to 1 year for the WORC ( P = .96), ASES ( P = .71), or VAS ( P = .86). Rotator cuff tear pattern is not a predictor of functional outcomes after arthroscopic rotator cuff repair.

  7. Effect of castor oil emulsion eyedrops on tear film composition and stability.

    Science.gov (United States)

    Maïssa, Cécile; Guillon, Michel; Simmons, Peter; Vehige, Joseph

    2010-04-01

    An emulsion eyedrop containing castor oil has been shown to modify the tear film lipid layer and increase tear film stability. The primary objectives of this investigation were to measure the prevalence of castor oil in the tear fluid over time and quantify the effects on the lipid layer. A secondary objective was to quantify the initial effects on ocular symptomatology. The investigation was an open label pilot study on 5 normal and 10 dry eye subjects. A single eyedrop (Castor oil emulsion, Allergan) was instilled in each eye; the tear film appearance and composition were monitored for 4h via in vivo visualisation using the Tearscope and post in vivo tear samples analysis by HPLC. Combined results for both normal and dry eye subjects showed that castor oil was detected up to 4h after a single eyedrop instillation and associated with an increase in the level of tear film lipid. The relative amount of various lipid families was also changed. An increase in tear lipid layer thickness was significant up to one hour post-instillation for the symptomatic sub-population. The changes in tear film characteristics were associated with significantly lower symptoms up to four hours post-instillation for the symptomatic sub-population. This pilot investigation showed that castor oil eyedrops achieved a residence time of at least four hours post-instillation, producing a more stable tear film and an associated significant decrease in ocular symptoms over the entire follow-up period for the symptomatic subjects. 2009 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  8. Effect of blinking on tear elimination as evaluated by dacryoscintigraphy

    International Nuclear Information System (INIS)

    White, W.L.; Glover, A.T.; Buckner, A.B.

    1991-01-01

    To document the change in drainage of tears that occurs with blinking, the authors evaluated 17 lacrimal systems of 12 individuals with dacryoscintigraphy. A significant difference in tear drainage was found by keeping the eyelids closed during the first 2 minutes after drop placement (P less than 0.03), but not from 2 to 5 minutes (P greater than 0.4). Retardation of tear drainage after droplet placement can be achieved by simple eyelid closure for 2 minutes

  9. The Effect of Polar Lipids on Tear Film Dynamics

    KAUST Repository

    Aydemir, E.; Breward, C. J. W.; Witelski, T. P.

    2010-01-01

    In this paper, we present a mathematical model describing the effect of polar lipids, excreted by glands in the eyelid and present on the surface of the tear film, on the evolution of a pre-corneal tear film. We aim to explain the interesting

  10. Detection of endogenous cortisol in equine tears and blood at rest and after simulated stress.

    Science.gov (United States)

    Monk, Caroline S; Hart, Kelsey A; Berghaus, Roy D; Norton, Natalie A; Moore, Phillip A; Myrna, Kathern E

    2014-07-01

    To determine whether cortisol is present in equine tears at rest and during simulated stress and compare tear cortisol to serum free and total cortisol. Fourteen healthy adult horses were included. Paired tear total cortisol and serum total and free cortisol concentrations were measured with ELISA, chemiluminescent immunoassay, and ultrafiltration methodology, respectively, in 10 horses at rest once daily for five consecutive days. In an additional four horses, paired tear and serum samples were collected for cortisol measurement before and after adrenocorticotropic hormone (ACTH) stimulation (cosyntropin, 1 μg/kg IV). Cortisol was detectable in equine tears at rest. Following ACTH stimulation, tear cortisol increased significantly from baseline at 60-120 min (P ≤ 0.001). Serum total and free cortisol also increased significantly at 30-180 min after ACTH stimulation (P ≤ 0.001). Both serum and tear cortisol returned to baseline concentrations by 360 min. Changes in tear cortisol were similarly associated with changes in serum total and free cortisol, although high tear cortisol concentrations suggest a portion of tear cortisol may be protein-bound. Cortisol is present in equine tears and increases in concert with serum cortisol following ACTH stimulation. Further study is needed to determine whether endogenous cortisol in tears contributes to ocular pathology. © 2013 American College of Veterinary Ophthalmologists.

  11. Tearing modes in tokamaks with lower hybrid current drive

    International Nuclear Information System (INIS)

    Xu, X.Q.

    1990-08-01

    In this paper, the effect of current drive on the tearing modes in the semi-collisional regime is analyzed using the drift-kinetic equation. A collisional operator is developed to model electron parallel conductivity. For the pure tearing modes the linear and quasilinear growth rates in the Rutherford regimes have been found to have roughly the same forms with a modified resistivity as without current drive. One interesting result is the prediction of a new instability. This instability, driven by the current gradient inside the tearing mode layer, is possibly related to MHD behavior observed in these experiments. 9 refs

  12. Local effect of equilibrium current on tearing mode stability

    International Nuclear Information System (INIS)

    Cozzani, F.

    1985-12-01

    The local effect of the equilibrium current on the linear stability of low poloidal number tearing modes in tokamaks is investigated analytically. The plasma response inside the tearing layer is derived from fluid theory and the local equilibrium current is shown to couple to the mode dynamics through its gradient, which is proportional to the local electron temperature gradient under the approximations used in the analysis. The relevant eigenmode equations, expressing Ampere's law and the plasma quasineutrality condition, respectively, are suitably combined in a single integral equation, from which a variational principle is formulated to derive the mode dispersion relations for several cases of interest. The local equilibrium current is treated as a small perturbation of the known results for the m greater than or equal to 2 and the m = 1 tearing modes in the collisional regime, and the m greater than or equal to 2 tearing mode in the semicollisional regime; its effect is found to enhance stabilization for the m greater than or equal to 2 drift-tearing mode in the collisional regime, whereas the m = 1 growth rate is very slightly increased and the stabilizing effect of the parallel thermal conduction on the m greater than or equal to 2 mode in the semicollisional regime is slightly reduced

  13. Peroneus longus tears associated with pathology of the os peroneum.

    Science.gov (United States)

    Stockton, Kristopher G; Brodsky, James W

    2014-04-01

    There is a range of different types of tears and pathology of the peroneal tendons. One of the least common types is the tear of the peroneus longus associated with fracture, enlargement, or entrapment at the cuboid tunnel of the os peroneum. The purpose of this study was to evaluate the pathologic patterns of these uncommon peroneal tendon tears, to review the treatment, and to report the patient outcomes following treatment with excision of the os peroneum, debridement, and tenodesis of the peroneus longus to the peroneus brevis. A 5-year retrospective review of all patients with peroneal tendon tears identified 12 patients operatively treated for peroneus longus tendon tears with associated pathology of the os peroneum, and in whom there was a viable peroneus brevis. All patients were treated with an operative procedure consisting of excision of the os peroneum, debridement, and tenodesis of the peroneus longus to the peroneus brevis. Mean age was 51.5 (range, 33 to 73) years, including 7 males and 5 females. Operative and radiographic records were reviewed to characterize the nature of the peroneus longus tears and associated pathology. Preoperative and postoperative AOFAS hindfoot, SF-36 questionnaires, and Visual Analog Scale (VAS) pain scores were compiled and patient records were reviewed for complications. Mean follow-up after surgery was 63.3 (range, 12 to 114) months. All of the patients had an os peroneum associated with a complex, irreparable tear of the peroneus longus tendon. The peroneus longus was typically enlarged, fibrotic, and adhered to the surrounding tissues. In 8 patients, the peroneus longus tendon tear was associated with a fracture of the os peroneum, and in 4 patients with an enlarged and entrapped os peroneum which prevented movement at the cuboid tunnel. Of the 12 patients, 9 had partial tears of the peroneus brevis, which were treated with debridement and suture repair. AOFAS hindfoot scores increased from a preoperative mean of 61

  14. Superior labrum anterior-to-posterior tear.

    Science.gov (United States)

    Sum, Jonathan C; Omid, Reza

    2012-12-01

    The patient was a 25-year-old male college student with a chief complaint of right shoulder pain. The patient was initially diagnosed with bicipital tendinitis by his physician and had been treated for 4 weeks by a physical therapist. However, his symptoms did not improve and he was unable to return to his preinjury activity levels, so he sought the services of another physical therapist for a second opinion. Due to concern for a labrum tear, the physical therapist referred the patient to an orthopaedic surgeon. Magnetic resonance arthrography revealed findings consistent with a superior labrum anterior-to-posterior tear.

  15. Two types of peak emotional responses to music: The psychophysiology of chills and tears

    Science.gov (United States)

    Mori, Kazuma; Iwanaga, Makoto

    2017-01-01

    People sometimes experience a strong emotional response to artworks. Previous studies have demonstrated that the peak emotional experience of chills (goose bumps or shivers) when listening to music involves psychophysiological arousal and a rewarding effect. However, many aspects of peak emotion are still not understood. The current research takes a new perspective of peak emotional response of tears (weeping, lump in the throat). A psychophysiological experiment showed that self-reported chills increased electrodermal activity and subjective arousal whereas tears produced slow respiration during heartbeat acceleration, although both chills and tears induced pleasure and deep breathing. A song that induced chills was perceived as being both happy and sad whereas a song that induced tears was perceived as sad. A tear-eliciting song was perceived as calmer than a chill-eliciting song. These results show that tears involve pleasure from sadness and that they are psychophysiologically calming; thus, psychophysiological responses permit the distinction between chills and tears. Because tears may have a cathartic effect, the functional significance of chills and tears seems to be different. We believe that the distinction of two types of peak emotions is theoretically relevant and further study of tears would contribute to more understanding of human peak emotional response. PMID:28387335

  16. Two types of peak emotional responses to music: The psychophysiology of chills and tears.

    Science.gov (United States)

    Mori, Kazuma; Iwanaga, Makoto

    2017-04-07

    People sometimes experience a strong emotional response to artworks. Previous studies have demonstrated that the peak emotional experience of chills (goose bumps or shivers) when listening to music involves psychophysiological arousal and a rewarding effect. However, many aspects of peak emotion are still not understood. The current research takes a new perspective of peak emotional response of tears (weeping, lump in the throat). A psychophysiological experiment showed that self-reported chills increased electrodermal activity and subjective arousal whereas tears produced slow respiration during heartbeat acceleration, although both chills and tears induced pleasure and deep breathing. A song that induced chills was perceived as being both happy and sad whereas a song that induced tears was perceived as sad. A tear-eliciting song was perceived as calmer than a chill-eliciting song. These results show that tears involve pleasure from sadness and that they are psychophysiologically calming; thus, psychophysiological responses permit the distinction between chills and tears. Because tears may have a cathartic effect, the functional significance of chills and tears seems to be different. We believe that the distinction of two types of peak emotions is theoretically relevant and further study of tears would contribute to more understanding of human peak emotional response.

  17. Superior Labrum Anterior-Posterior Tears in the National Football League.

    Science.gov (United States)

    Chambers, Caitlin C; Lynch, T Sean; Gibbs, Daniel B; Ghodasra, Jason H; Sahota, Shawn; Franke, Kristina; Mack, Christina D; Nuber, Gordon W

    2017-01-01

    Shoulder disorders are common in football players, with up to 50% of National Football League (NFL) recruits reporting a history of shoulder injuries. Superior labrum anterior-posterior (SLAP) tears are an entity with well-described detrimental effects on return to play in overhead-throwing athletes but with minimal data in contact athletes. To identify the incidence, predisposing factors, and effect of SLAP tears in NFL athletes and prospects as well as the treatment patterns of NFL team physicians. Descriptive epidemiology study. This study was a comprehensive analysis of SLAP tears in elite football players using a dual approach: (1) SLAP injuries recorded in the NFL Injury Surveillance System from 2000 to 2014 were evaluated by player position, type of play, days/games lost, and surgical intervention; (2) NFL Scouting Combine athletes from 2003 to 2011 with prior SLAP repair were evaluated for draft success, and drafted athletes were compared with matched controls for career length and performance scores. SLAP tears represented a small portion (3.1%) of shoulder injuries in NFL athletes from 2000 to 2014, occurring most commonly in offensive linemen (28%). Surgically treated SLAP tears (42%) resulted in more days missed than did nonoperatively managed tears (140.2 vs 21.5 days; P football players, it is clear that these injuries have the potential to cause significant detriment to an athlete's career.

  18. Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

    International Nuclear Information System (INIS)

    Byrd, Sharon E.; Elias, Dean; Abramowicz, Jacques S.; Kent, Paul; Kimura, Robert E.; Heydeman, Peter T.

    2012-01-01

    Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature. (orig.)

  19. Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Byrd, Sharon E.; Elias, Dean [Rush Medical College and Rush University Medical Center, Department of Diagnostic Radiology and Nuclear Medicine Section of Neuroradiology, Chicago, IL (United States); Abramowicz, Jacques S. [Rush Medical College and Rush University Medical Center, Department of Obstetrics and Gynecology, Rush Fetal and Neonatal Medicine Center, Chicago, IL (United States); Kent, Paul [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Hematology and Oncology, Chicago, IL (United States); Kimura, Robert E. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Neonatology, Chicago, IL (United States); Heydeman, Peter T. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Pediatric Neurology, Chicago, IL (United States)

    2012-05-15

    Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature

  20. Effectiveness Of Plain Shoulder Radiograph In Detecting Degenerate Rotator Cuff Tears.

    Science.gov (United States)

    Hussain, Adnan; Muzzammil, Muhammad; Butt, Faisal; Valsamis, Epaminondas Markos; Dwyer, Amitabh J

    2018-01-01

    Studies have demonstrated radiographic findings of sclerosis and cortical irregularity at the greater tuberosity can suggest a rotator cuff tear. Plain radiographs are the most easily attainable first-line investigations in evaluating shoulder injuries. This study determines the effectiveness in predicting degenerate rotator cuff tears by detecting radiographic changes on shoulder x-rays. Retrospective cross-sectional study with a consecutive series of patients conducted in Hinchingbrooke Hospital, Huntingdon, United Kingdom from January 2015 to June 2017. Anteroposterior shoulder radiographs of 150 symptomatic patients who underwent shoulder arthroscopy were independently analysed by surgeons who were blinded from the arthroscopic results. Patients aged fewer than 30 and over 70 years were excluded. Patients with advanced osteoarthritis and cuff tear arthropathy evident on x-rays were also excluded. Sixty-five patients included in the study had rotator cuff tears on arthroscopy. Radiographic changes were correlated with arthroscopic findings to determine this test's ability to predict degenerate rotator cuff tears. When both cortical irregularity and sclerosis were present on the plain radiograph, these signs had a sensitivity of 78.8% [95% CI 65.7, 87.8%] and specificity 77.4% [95% CI 67.2, 85.0%] with a positive predictive value of 68.3%, using contingency table analysis. The presence of cortical irregularity was found to be a better predictor of a tear as compared to sclerosis. This study concludes that plain radiograph are good modality for initial evaluation of rotator cuff tears and detecting when both cortical irregularity and sclerosis. Consideration of these radiographic findings serves as a useful adjunct in diagnostic workup and can guide subsequent investigations and treatment when evaluating rotator cuff tears of the shoulder.

  1. The Effect of Polar Lipids on Tear Film Dynamics

    KAUST Repository

    Aydemir, E.

    2010-06-17

    In this paper, we present a mathematical model describing the effect of polar lipids, excreted by glands in the eyelid and present on the surface of the tear film, on the evolution of a pre-corneal tear film. We aim to explain the interesting experimentally observed phenomenon that the tear film continues to move upward even after the upper eyelid has become stationary. The polar lipid is an insoluble surface species that locally alters the surface tension of the tear film. In the lubrication limit, the model reduces to two coupled non-linear partial differential equations for the film thickness and the concentration of lipid. We solve the system numerically and observe that increasing the concentration of the lipid increases the flow of liquid up the eye. We further exploit the size of the parameters in the problem to explain the initial evolution of the system. © 2010 Society for Mathematical Biology.

  2. Tearing mode dynamics and sawtooth oscillation in Hall-MHD

    Science.gov (United States)

    Ma, Zhiwei; Zhang, Wei; Wang, Sheng

    2017-10-01

    Tearing mode instability is one of the most important dynamic processes in space and laboratory plasmas. Hall effects, resulted from the decoupling of electron and ion motions, could cause the fast development and perturbation structure rotation of the tearing mode and become non-negligible. We independently developed high accuracy nonlinear MHD code (CLT) to study Hall effects on the dynamic evolution of tearing modes with Tokamak geometries. It is found that the rotation frequency of the mode in the electron diamagnetic direction is in a good agreement with analytical prediction. The linear growth rate increases with increase of the ion inertial length, which is contradictory to analytical solution in the slab geometry. We further find that the self-consistently generated rotation largely alters the dynamic behavior of the double tearing mode and the sawtooth oscillation. National Magnetic Confinement Fusion Science Program of China under Grant No. 2013GB104004 and 2013GB111004.

  3. Post-lens tear turbidity and visual quality after scleral lens wear.

    Science.gov (United States)

    Carracedo, Gonzalo; Serramito-Blanco, Maria; Martin-Gil, Alba; Wang, Zicheng; Rodriguez-Pomar, Candela; Pintor, Jesús

    2017-11-01

    The aim was to evaluate the turbidity and thickness of the post-lens tear layer and its effect on visual quality in patients with keratoconus after the beginning of lens wear and before lens removal at the end of eight hours. Twenty-six patients with keratoconus (aged 36.95 ± 8.95 years) participated voluntarily in the study. The sample was divided into two groups: patients with intrastromal corneal ring (ICRS group) and patients without ICRS (KC group). Distance visual acuity (VA), contrast sensitivity, pachymetry, post-lens tear layer height and post-lens tear layer turbidity (percentage area occupied and number of particles per mm 2 ) were evaluated with optical coherence tomography before and after wearing a scleral lens. A significant increase of turbidity was found in all groups assessed (p turbidity parameters with distance VA but no correlation between turbidity and post-lens tear layer thickness at the beginning was found (p > 0.05). A strong correlation in all groups between the post-lens tear layer at the beginning and differences of tear layer thickness between two measures was also found (p turbidity. © 2017 Optometry Australia.

  4. A common-sense probabilistic approach to assessing inadvertent human intrusion into low-level radioactive waste at the Nevada Test Site

    International Nuclear Information System (INIS)

    Black, P.; Hooten, M.; Black, K.; Moore, B.; Rawlinson, S.; Barker, L.

    1997-01-01

    Each site disposing of low-level radioactive waste is required to prepare and maintain a site-specific performance assessment (1) to determine potential risks posed by waste management systems to the public, and the environment, and (2) to compare these risks to established performance objectives. The DOE Nevada Operations Office, Waste Management Program recently completed a one-year study of site-specific scenarios for inadvertent human intrusion by drilling into buried low-level radioactive waste sites, as part of ongoing performance assessment studies. Intrusion scenarios focus on possible penetration of buried waste through drilling for sources of groundwater. The probability of drilling penetration into waste was judged to be driven primarily by two settlement scenarios: (1) scattered individual homesteaders, and (2) a community scenario consisting of a cluster of settlers that share drilling and distribution systems for groundwater. Management control factors include institutional control, site knowledge, placards and markers, surface barriers, and subsurface barriers. The Subject Matter Experts concluded that institutional control and site knowledge may be important factors for the first few centuries, but are not significant over the evaluation period of 10,000 years. Surface barriers can be designed that would deter the siting of a drill rig over the waste site to an effectiveness of 95%. Subsurface barriers and placards and markers will not as effectively prevent inadvertent human intrusion. Homestead and community scenarios were considered by the panel to render a site-specific probability of around 10% for inadvertent human intrusion. If management controls are designed and implemented effectively, then the probability of inadvertent human intrusion can be reduced to less than 1%

  5. Acute and chronic tears of anterior cruciate ligament : role of gadolinium-enhanced MR imaging

    International Nuclear Information System (INIS)

    Lee, Eun Jung; Jee, Won Hee; Im, Soo A; Chun, Ho Jong; Jung, Hyun Seouk; Kim, Soo Young; Kwon, Tae An; Song, Sun Wha; Choi, Kyu Ho

    1998-01-01

    To evaluate the efficacy of fat-suppressed gadolinium-enhanced MR imaging in differentiating acute from chronic ligament tears of anterior cruciate ligament. Materials and Methods : MR images of 22 patients with arthroscopically proven complete tear of the anterior cruciate ligament were retrospectively reviewed. The interval between injury and MR examination was one day to seven years. When ligament tear was detected on MR image with three months of injury, the case was considered acute;if detected after three months had elapsed, it was judged to be chronic. The extent of contrast enhancement was graded as 1, 2 or 3; grade 1, enhancement was confined to the expected ligament region; grade 2, enhancement extended to the joint capsule; grade 3, enhancement extended beyond the joint capsule. The grades of contrast enhancement correlated with the acute and chronic stages of ligament tears. Associated bone bruise and/or adjacent soft tissue edema were also evaluated. Results : Among 15 patients with acute ligament tear, nine (60%) showed grade 3 enhancement; among seven in whom tearing was chronic, four (57%) showed grade 1 enhancement. Bone bruising was present in 100% of acute tears (15/15) and 29 % of chronic tears (2/7). Soft tissue edema was associated in 87% of acute tears (13/15) and 29% of chronic tears(2/7). Conclusion : Fat-suppressed gadolinium-enhanced MR imaging could help differentiate acute from chronic tears of anterior cruciate ligament, as well as bone bruising and tissue edema

  6. Behavioral and neural responses to infant and adult tears: The impact of maternal love withdrawal.

    Science.gov (United States)

    Riem, Madelon M E; van IJzendoorn, Marinus H; De Carli, Pietro; Vingerhoets, Ad J J M; Bakermans-Kranenburg, Marian J

    2017-09-01

    The current study examined behavioral and neural responses to infant and adult tears, taking into account childhood experiences with parental love-withdrawal. With functional MRI (fMRI), we measured neural reactivity to pictures of infants and adults with and without tears on their faces in nulliparous women with varying childhood experiences of maternal use of love withdrawal. Behavioral responses to infant and adult tears were measured with an approach-avoidance task. We found that individuals with experiences of love withdrawal showed less amygdala and insula reactivity to adult tears, but love withdrawal did not affect amygdala and insula reactivity to infant tears. During the approach-avoidance task, individuals responded faster to adult tears in the approach condition compared with the avoidance condition, indicating that adult tears facilitate approach behavior. Individuals responded faster to infant tears than to adult tears, regardless of approach or avoidance condition. Our findings suggest that infant tears are highly salient and may, therefore, overrule the effects of contextual and personal characteristics that influence the perception of adult crying. (PsycINFO Database Record (c) 2017 APA, all rights reserved).