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Sample records for ipsilateral fibular transport

  1. Reconstrucción tibial: transferencia sóleo-peroné ipsilateral. Tibialización peroneal Tibial reconstruction: ipsilateral soleus-fibula transfer. Fibular tibialization

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    E. Revelo Jiron

    2009-12-01

    Full Text Available Las transferencias óseas peroneales en forma libre o ipsilateral han sido propuestas para la reconstrucción de grandes defectos tibiales. Están también descritas varias modificaciones al respecto, siendo una de ellas la constitución de un colgajo compuesto soleo-peroné realizado como transferencia libre. En este estudio presentamos nuestra experiencia con esta variante, pero en forma ipsilateral. logrando la reconstrucción del defecto tibial por medio de la tibialización peroneal. Escogimos realizar un colgajo compuesto soleo-peroné ipsilateral a flujo anterógrado o retrogrado para la reconstrucción de una serie personal de 14 pacientes consecutivos, 13 hombre y 1 mujer, con edad media de 30 años, y con amplios defectos tibiales y de tejidos blandos causados por accidentes de transito en 12 casos, 1 por proyectil balístico y 1 por artefacto explosivo artesanal. El promedio de tamaño del defecto tibial fue de 9.4 cm. Elegimos la forma ipsilateral por no disponer de infraestructura adecuada para realizar una transferencia libre. La serie de estudio se realizó durante el periodo comprendido entre Abril de 1995 y Abril del 2005. Todos los colgajos sobrevivieron. Dos pacientes desarrollaron pseudoartrosis. El apoyo completo y la marcha en 12 pacientes, se logró en un periodo promedio de 9 meses. El seguimiento postoperatorio ha sido de 3 a 6 años. Doce pacientes se han incorporado a la vida activa. Discutimos algunos aspectos prácticos de la técnica como resultado de la experiencia quirúrgica obtenida de esta serie personal. Consideramos que el método es fiable, fácil de realizar y proporciona excelentes resultados.Fibular flaps such as in there free form or as ipsilateral transfers have been proposed for reconstruction of large tibial defects. Several modifications have been described for the use of this flap. In this study we will present our experience using the ipsilateral transfer of an osteomuscular soleous fibular flap

  2. Ilizarov bone transport versus fibular graft for reconstruction of tibial bone defects in children.

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    Abdelkhalek, Mostafa; El-Alfy, Barakat; Ali, Ayman M

    2016-11-01

    The aim of this study was to compare the results of treatment of segmental tibial defects in the pediatric age group using an Ilizarov external fixator versus a nonvascularized fibular bone graft. This study included 24 patients (age range from 5.5 to 15 years) with tibial bone defects: 13 patients were treated with bone transport (BT) and 11 patients were treated with a nonvascularized fibular graft (FG). The outcome parameters were bone results (union, deformity, infection, leg-length discrepancy) and functional results: external fixation index and external fixation time. In group A (BT), one patient developed refracture at the regenerate site, whereas, in group B (FG), after removal of the external fixator, one of the FGs developed a stress fracture. The external fixator time in group A was 10.7 months (range 8-14.5) versus 7.8 months (range 4-11.5 months) in group B (FG). In group A (BT), one patient had a limb-length discrepancy (LLD), whereas, in group B (FG), three patients had LLD. The functional and bone results of the Ilizarov BT technique were excellent in 23.1 and 30.8%, good in 38.5 and 46.2, fair in 30.8 and 15.4, and poor in 7.6 and 7.6%, respectively. The poor functional result was related to the poor bone result because of prolonged external fixator time resulting in significant pain, limited ankle motion, whereas the functional and bone results of fibular grafting were excellent in 9.1 and 18.2%, good in 63.6 and 45.5%, fair in 18.2 and 27.2%, and poor in 9.1 and 9.1%, respectively. Segmental tibial defects can be effectively treated with both methods. The FG method provides satisfactory results, with early removal of the external fixator. However, it had a limitation in patients with severe infection and those with LLD. Also, it requires a long duration of limb bracing until adequate hypertrophy of the graft. The Ilizarov method has the advantages of early weight bearing, treatment of postinfection bone defect in a one-stage surgery, and the

  3. Vascularized fibular graft in infected tibial bone loss

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    C Cheriyan Kovoor

    2011-01-01

    Full Text Available Background : The treatment options of bone loss with infections include bone transport with external fixators, vascularized bone grafts, non-vascularized autogenous grafts and vascularized allografts. The research hypothesis was that the graft length and intact ipsilateral fibula influenced hypertrophy and stress fracture. We retrospectively studied the graft hypertrophy in 15 patients, in whom vascularized fibular graft was done for post-traumatic tibial defects with infection. Materials and Methods : 15 male patients with mean age 33.7 years (range 18 - 56 years of post traumatic tibial bone loss were analysed. The mean bony defect was 14.5 cm (range 6.5 - 20 cm. The mean length of the graft was 16.7 cm (range 11.5 - 21 cm. The osteoseptocutaneous flap (bone flap with attached overlying skin flap from the contralateral side was used in all patients except one. The graft was fixed to the recipient bone at both ends by one or two AO cortical screws, supplemented by a monolateral external fixator. A standard postoperative protocol was followed in all patients. The hypertrophy percentage of the vascularized fibular graft was calculated by a modification of the formula described by El-Gammal. The followup period averaged 46.5 months (range 24 - 164 months. The Pearson correlation coefficient (r was worked out, to find the relationship between graft length and hypertrophy. The t-test was performed to find out if there was any significant difference in the graft length of those who had a stress fracture and those who did not and to find out whether there was any significant difference in hypertrophy with and without ipsilateral fibula union. The Chi square test was performed to identify whether there was any association between the stress fracture and the fibula union. Given the small sample size we have not used any statistical analysis to determine the relation between the percentage of the graft hypertrophy and stress fracture. Results : Graft

  4. Fibular hemimelia: a case report

    International Nuclear Information System (INIS)

    Kim, Byung Joon; Hong, Suk Joo; Kim, Kyung Min; Seol, Hae Young; Cha, In Ho; Song, Hae Ryong

    2006-01-01

    Fibular hemimelia is the most common congenital absence or hypoplasia of long bone. In addition to fibular absence or hypoplasia, this entity also includes various combined abnormalities of the lower limbs. We present here three cases of fibular hemimelia who underwent diagnosis and treatment in our hospital. We especially focus on the imaging findings of the plain radiographs, and we compare them with the findings found at another presentation

  5. Dual-fibular reconstruction of a massive tibial defect after Ewing's sarcoma resection in a pediatric patient with a vascular variation.

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    Saridis, Alkis G; Megas, Panagiotis D; Georgiou, Christos S; Diamantakis, Georgios M; Tyllianakis, Minos E

    2011-01-01

    In the management of malignancies of the extremities, limb salvage procedures have recently taken on greater significance. For those patients under intense adjuvant chemotherapy and with massive bone loss, free vascularized fibular grafting is currently advocated as a reliable reconstructive option, maybe because of the controversial results of bone transport in similar situations. However, when there is a vascular abnormality of either the recipient or donor extremity, microsurgical procedures are not feasible, further limiting potential reconstructive alternatives. We present the case of a 13-year-old female patient with Ewing's sarcoma of the right tibia. Preoperative angiography showed that vascularity of the affected side depended totally on a single peroneal artery. The patient was treated initially with multiagent chemotherapy, followed by an excision of 23 cm. The defect was bridged by a gradual medial transportation of the ipsilateral fibula with the Ilizarov technique and strengthened by nonvascularized transfer of the contralateral fibula. Total external fixation time was 162 days. After the removal of the Ilizarov frame a walking cast was applied for another month. At 5 years postoperatively there was no recurrence of the malignancy. The patient had full weight-bearing ability on the affected limb, with preservation of the ankle and knee joints motion and without any limb length discrepancy or axial deformity. The functional outcome that was visible was graded excellent. Transverse distraction osteogenesis of the ipsilateral fibula performed well under chemotherapy, showing unproblematic callus formation. Supplemented with nonvascularized transfer of the contralateral fibula, provided a reconstructive option with biological affinity, sufficient biomechanical strength and durability, and with a decreased complication rate. This case report presents a viable option, especially in cases in which vascular abnormalities of either the donor or the recipient

  6. Bimalleolar ankle fracture with proximal fibular fracture

    NARCIS (Netherlands)

    Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.

    2005-01-01

    A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular

  7. Tibial and fibular developmental fields defects

    International Nuclear Information System (INIS)

    Khoury, N.J.; Haddad, M.C.; Hourani, M.H.

    1999-01-01

    Malformations of the lower limbs are rare and heterogeneous anomalies. To explain the diversity and complexity of these abnormalities, authors introduced the concept of tibial and fibular developmental fields. Defects in these fields are responsible for different malformations, which have been described, to our knowledge, in only one report in the radiology literature. We present a case of a newborn with femoral bifurcation, absent fibulae and talar bones, ankle and foot malformations, and associated atrial septal defect. Our case is an example of defects in both fibular and tibial developmental fields. (orig.)

  8. Postoperative radiographic evaluation of vascularized fibular grafts

    International Nuclear Information System (INIS)

    Manaster, B.J.; Coleman, D.A.; Bell, D.A.

    1989-01-01

    This paper reports on thirty-five patients with free vascularized fibular grafts examined postoperatively with plain radiography. Early graft incorporation is seen as a fuzziness of the cortex at the site of its insertion into the host bone. Causes of failure in grafting for bone defects include graft fracture, hardware failure, and infection. A high percentage of complications or at least delayed unions occurred when vascularized fibular grafts were used to fill defects in the lower extremity. Conversely, upper extremity defects bridged by vascularized grafts heal quickly and hypertrophy. Vascularized grafts placed in the femoral head and neck for a vascular necrosis incorporate early on their superior aspect. The osseous tunnel in which they are placed is normally wider than the graft and often becomes sclerotic; this appearance does not represent nonunion

  9. Tibial and fibular angles in homozygous sickle cell disease

    International Nuclear Information System (INIS)

    Akamaguna, A.I.; Odita, J.C.; Ugbodaga, C.I.; Okafor, L.A.

    1986-01-01

    Measurements of the tibial and fibular angles made on ankle radiographs of 34 patients with sickle cell disease were compared with those of 36 normal Nigerians. Widening of the fibular angle, which is an indication of tibiotalar slant, was demonstrated in about 79% of sickle cell disease patients. By using fibular angle measurements as an objective method of assessing subtle tibiotalar slant, it is concluded that the incidence of this deformity is much higher among sickle cell disease patients than previously reported. The mean values of tibial and fibular angles in normal Nigerians are higher than has been reported amongst Caucasians. (orig.)

  10. Vascularized fibular graft combined with vacuum assisted closure in ...

    African Journals Online (AJOL)

    The flowthrough fibular graft combined with Vacuum Assisted Closure (VAC) controlled the infection, shortened the course of treatment, and effectively restored limb function when applied to the treatment of tibial defects. Keywords: Tibial defect, Flow-through fibular graft, Vacuum Assisted Closure, Chronic Osteomyelitis ...

  11. Reconstruction of congenital tibial pseudarthrosis by revascularized fibular transplants

    NARCIS (Netherlands)

    Bos, K. E.; Besselaar, P. P.; van der Eyken, J. W.; Taminiau, A. H.; Verbout, A. J.

    1993-01-01

    Seven patients with congenital Boyd type II pseudoarthrosis of the tibia and fibula were treated with a revascularized osteocutaneous fibular graft from the contralateral side. Follow-up ranged from 20 to 96 months (mean 67 months). All patients had previously undergone major surgery (mean three

  12. Is Fibular Fracture Displacement Consistent with Tibiotalar Displacement?

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    van den Bekerom, Michel P. J.; van Dijk, C. Niek

    2010-01-01

    We believed open reduction with internal fixation is required for supination-external rotation ankle fractures located at the level of the distal tibiofibular syndesmosis (Lauge-Hanssen SER II and Weber B) with 2 mm or more fibular fracture displacement. The rationale for surgery for these ankle

  13. Vascularised Fibular Graft for a Radial Defect following Tumour ...

    African Journals Online (AJOL)

    HP

    The mass was located on the radial aspect of the distal right ... modification, internal or external fixation with bone grafting, structural grafts of ... Our index case report demonstrates that free vascularized fibular graft transfer is a feasible option ... structural support, the potential for graft hypertrophy, relative resistance to ...

  14. Unilateral proximal focal femoral deficiency, fibular aplasia, tibial ...

    African Journals Online (AJOL)

    Rabah M. Shawky

    2014-04-30

    Apr 30, 2014 ... Peer review under responsibility of Ain Shams University. ... The fibular field of the limb bud controls the development of ... The mental and physical developments are ... deficiency, short tibia and absent fibula of the right lower limb compared ... brother has tetrameric transverse defect and a cyanotic con-.

  15. Ipsilateral hemiparesis in ischemic stroke patients.

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    Inatomi, Y; Nakajima, M; Yonehara, T; Ando, Y

    2017-07-01

    To investigate clinical characteristics of ipsilateral hemiparesis in ischemic stroke patients. Patients with acute ischemic stroke were prospectively examined. Ipsilateral hemiparesis was defined as hemiparesis ipsilateral to recent stroke lesions. Patients with ipsilateral hemiparesis were examined with functional neuroimaging studies including transcranial magnetic stimulation (TMS) and functional MRI. Of 8360 patients, ipsilateral hemiparesis was detected in 14 patients (0.17%, mean age 71±6 years, eight men). Lesions responsible for the recent strokes were located in the frontal cortex in three patients, corona radiata in seven, internal capsule in one, and pons in three. These lesions were located along the typical route of the corticospinal tract in all but one patient. Thirteen patients also had a past history of stroke contralateral to the recent lesions; 12 of these had motor deficits contralateral to past stroke lesions. During TMS, ipsilateral magnetic evoked potentials were evoked in two of seven patients and contralateral potentials were evoked in all seven. Functional MRI activated cerebral hemispheres ipsilaterally in eight of nine patients and contralaterally in all nine. Most patients with ipsilateral hemiparesis had a past history of stroke contralateral to the recent one, resulting in motor deficits contralateral to the earlier lesions. Moreover, functional neuroimaging findings indicated an active crossed corticospinal tract in all of the examined patients. Both findings suggest the contribution of the uncrossed corticospinal tract contralateral to stroke lesions as a post-stroke compensatory motor system. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Morbidity after ipsilateral radiotherapy for oropharyngeal cancer

    DEFF Research Database (Denmark)

    Jensen, Kenneth; Overgaard, Marie; Grau, Cai

    2007-01-01

    not negatively influenced by the volume sparring technique. Side effects were reduced, in the ipsilaterally treated group, for all endpoints: xerostomia, dysphagia, hoarseness, atrophy, fibrosis and oedema. The number of patients experiencing moderate to severe toxicity was more than halved with ipsilateral...

  17. Adult outcomes following amputation or lengthening for fibular deficiency.

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    Walker, Janet L; Knapp, Dwana; Minter, Christin; Boakes, Jennette L; Salazar, Juan Carlos; Sanders, James O; Lubicky, John P; Drvaric, David M; Davids, Jon R

    2009-04-01

    Fibular deficiency results in a small, unstable foot and ankle as well as a limb-length discrepancy. The purpose of this study was to assess outcomes in adults who, as children, had had amputation or limb-lengthening, commonly used treatments for fibular deficiency. Retrospective review of existing data collected since 1950 at six pediatric orthopaedic centers identified 248 patients with fibular deficiency who were twenty-one years of age or older at the time of the review. Excluding patients with other anomalies and other treatments (with the excluded group including six who had had lengthening and then amputation), we identified ninety-eight patients who had had amputation or limb-lengthening for the treatment of isolated unilateral fibular deficiency. Sixty-two patients (with thirty-six amputations and twenty-six lengthening procedures) completed several questionnaires, including one asking general demographic questions, the Beck Depression Inventory-II, the Quality of Life Questionnaire, and the American Academy of Orthopaedic Surgeons Lower Limb Questionnaire including the Short Form-36. A group of twenty-eight control subjects completed the Beck Depression Inventory-II and the Quality of Life Questionnaire. There were forty men and twenty-two women. The average age at the time of the interview was thirty-three years. There were more amputations in those with fewer rays and less fibular preservation. Lengthening resulted in more surgical procedures (6.3 compared with 2.4 in patients treated with amputation) and more days in the hospital (184 compared with sixty-three) (both pemployment, income, public assistance or disability payments, pain or use of pain medicine, sports participation, activity restriction, comfort wearing shorts, dislike of limb appearance, or satisfaction with treatment. No patient who had been treated for fibular deficiency reported signs of depression. The only significant difference between treatment groups shown by the Quality of Life

  18. Grebe syndrome with bilateral fibular hemimelia and thumb duplication

    International Nuclear Information System (INIS)

    Rao, Narasimha; Joseph, Benjamin

    2002-01-01

    Grebe syndrome is a rare recessively inherited form of short-limbed dwarfism. Among the skeletal anomalies reported in the past, complete fibular hemimelia and thumb duplication have not been documented. We report a case of Grebe syndrome with these associated anomalies and review the various skeletal anomalies reported in the literature related to this syndrome. Awareness of the skeletal anomalies that can occur in this syndrome should enable an accurate diagnosis. (orig.)

  19. Grebe syndrome with bilateral fibular hemimelia and thumb duplication

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    Rao, Narasimha; Joseph, Benjamin [Department of Orthopaedics, Kasturba Medical College, Karnataka State (India)

    2002-03-01

    Grebe syndrome is a rare recessively inherited form of short-limbed dwarfism. Among the skeletal anomalies reported in the past, complete fibular hemimelia and thumb duplication have not been documented. We report a case of Grebe syndrome with these associated anomalies and review the various skeletal anomalies reported in the literature related to this syndrome. Awareness of the skeletal anomalies that can occur in this syndrome should enable an accurate diagnosis. (orig.)

  20. Ipsilateral femoral neck and trochanter fracture

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    Devdatta S Neogi

    2011-01-01

    Full Text Available Ipsilateral fractures in the neck and trochanteric region of the femur are very rare and seen in elderly osteoporotic patients. We present a case of a young man who presented with ipsilateral fracture of the femoral neck and a reverse oblique fracture in the trochanteric region following a motor vehicle accident. A possible mechanism, diagnostic challenge, and awareness required for identifying this injury are discussed.

  1. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

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    Hayakawa, Katsumi [Department of Radiology, Kyoto City Hospital, 1-2 Higashi-Takada-cho, Mibu, Nakagyo-ku, 604-8845 Kyoto (Japan); Kanda, Toyoko; Yamori, Yuriko [Department of Pediatric Neurology, St. Joseph Hospital for Handicapped Children, 603-8323 Kyoto (Japan)

    2002-10-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  2. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    International Nuclear Information System (INIS)

    Hayakawa, Katsumi; Kanda, Toyoko; Yamori, Yuriko

    2002-01-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  3. Leg lengthening in patients with congenital fibular hemimelia.

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    Jasiewicz, Barbara; Kacki, Wojciech; Koniarski, Arkadiusz; Kasprzyk, Marcin; Zarzycka, Maja; Tesiorowski, Maciej

    2002-08-30

    Background. Anisomelia in patients with congenital fibular deficiencies is a difficult orthopedic problem due to concomitant deformities of the angle and knee. The goal of the present study was to analyze outcomes of tibia lengthening in these patients. Material and methods. In the period 1989-2001 we performed lengthening of 26 limbs in 21 patients with congenital fibular deficiency (11 female, 10 male, average age 10.1 years). Under the Achterman-Kalamchi classification, 8 tibiae were Type 1, 3 were Type 1b, and 10 were Type 2 (including one case with bilateral defect). The average baseline shortening was 4.6 cm, i.e. 15.3%. The Ilizarov method was used in 24 cases, chondrial lengthening in the others. We measured time of lengthening, time of stabilization, total healing time, amount of lengthening, and the lengthening index, as well as the range of ankle and knee movement, the positioning of the foot, and the axis of the tibia at each stage. Problems and complications were classified according to Paley. The average follow-up was 4.9 years Results. The mean time of lengthening was 101 days, stabilization time 177 days, total healing time 269 days, mean lengthening 5.6 cm (22.9%). As of the last examination only 7 patients did not require follow-up surgery, 6 with Type 1a and 1 with Type 1b. Conclusions. Tibia lengthening with axis correction constitutes an alternative to amputation in congenital fibular deficiency. It is a difficult procedure, however, encumbered by a significant risk of complications.

  4. Surgical treatment of AVN of the fibular (lateral) sesamoid.

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    Waizy, Hazibullah; Jäger, Marcus; Abbara-Czardybon, Mona; Schmidt, Troy G; Frank, Daniel

    2008-02-01

    Despite the fact that the hallucal sesamoids play a crucial role in forefoot mechanics, disorders resulting from pathology of these structures are often overlooked or misdiagnosed. Avascular necrosis (AVN) of the hallucal sesamoids is a rare condition that must be differentiated from other pathologies, such as fractures, pseudarthrosis or osteomyelitis. We report on two patients with AVN of the fibular (lateral) hallucal sesamoid (Morbus Renander). In both patients the necrotic part of the fibular sesamoid was excised surgically after failed conservative therapy. The followup was 29 and 26 months. The clinical and radiological results showed a complete relief of pain in both patients without any complications or forefoot deformities. Recent literature and own experiences support non-operative initial management including anti-inflammatory medications, shoe modification and temporary limited weight bearing. If symptoms persist, surgical treatment with excision of the necrotic part of the sesamoid may be an alternative. Consideration by the surgeon should be given to protecting the neurovascular bundle and reattaching intrinsic tendons and ligaments if necessary. Satisfying results can be achieved by surgical removal.

  5. Acute Infantile Hemiplegia Associated with Ipsilateral Retinal ...

    African Journals Online (AJOL)

    An 18-month-old patient with acute infantile hemiplegia, aphasia and ipsilateral retinal vascular occlusion, is described. The opthalmic findings suggest that the lesion was due to emboli originating from both internal carotid arteries, probably as a result of upper respiratory tract infection and otitis media. This report ...

  6. Vesicula seminalis-cyste med ipsilateral nyreagenesi

    DEFF Research Database (Denmark)

    Severin Gråe Harbo, Frederik; Larsen, Lisbet Brønsro

    2015-01-01

    . The lesion was interpreted as a group of enlarged lymph nodes, but PET/CT and MRI later demonstrated that it was a left seminal vesicle cyst. An association between congenital seminal vesicle cysts and ipsilateral renal agenesis is rare and can be explained by their common embryologic origin....

  7. Cavernous angioma associated with ipsilateral hippocampal sclerosis

    International Nuclear Information System (INIS)

    Okujava, M.; Ebner, A.; Schmitt, J.; Woermann, F.G.

    2002-01-01

    We report two cases with extratemporal cavernous angioma (CA) and coexisting ipsilateral hippocampal sclerosis. Classically dual pathology is defined as the association of hippocampal sclerosis with an extrahippocampal lesion. Subtle changes in hippocampus might be overlooked in the presence of an unequivocal extrahippocampal abnormality. Seizure outcome after epilepsy surgery in cases with dual pathology is less favourable if only one of the lesions is removed. Dual pathology must always be considered in diagnostic imaging of patients with intractable epilepsy and CA. (orig.)

  8. Cavernous angioma associated with ipsilateral hippocampal sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Okujava, M [Institute of Radiology and Interventional Diagnostics, Tbilisi (Georgia); Ebner, A; Schmitt, J; Woermann, F G [Bethel Epilepsy Centre, Mara Hospital, Bielefeld (Germany)

    2002-07-01

    We report two cases with extratemporal cavernous angioma (CA) and coexisting ipsilateral hippocampal sclerosis. Classically dual pathology is defined as the association of hippocampal sclerosis with an extrahippocampal lesion. Subtle changes in hippocampus might be overlooked in the presence of an unequivocal extrahippocampal abnormality. Seizure outcome after epilepsy surgery in cases with dual pathology is less favourable if only one of the lesions is removed. Dual pathology must always be considered in diagnostic imaging of patients with intractable epilepsy and CA. (orig.)

  9. Ankle and pantalar arthrodeses using vascularized fibular grafts.

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    Yajima, Hiroshi; Kobata, Yasunori; Tomita, Yasuharu; Kawate, Kenji; Sugimoto, Kazuya; Takakura, Yoshinori

    2004-01-01

    From 1989 to 1998 ankle and pantalar arthrodeses using vascularized fibular grafts were performed for seven patients. The indications for surgery were chronic nonunion following fracture of the distal tibia in four patients, rheumatoid arthritis in two, and talus necrosis in one. The ankle joint was fused in the two patients with a pilon fracture, and in the other five patients, both the ankle and subtalar joints were fused. In one patient, additional bone grafting was required for delayed union. In the other six patients, the mean period required to obtain radiographic bone union was 6 months (range, 4-9 months). The time until the patients could walk without braces ranged from 6 to 20 months (mean, 12.3 months). Local infection was not encountered in any patients. This procedure represents a viable option for patients in whom a standard, less complicated arthrodesis cannot be performed.

  10. Apparently Ipsilateral Parkinsonism in a Patient with Chronic Subdural Hematoma

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    Tae Hwan Roh

    2012-05-01

    Full Text Available Symptomatic parkinsonism secondary to ipsilateral lesion is rarely reported. Although the contribution of the contralateral lesions was assumed in some cases, the pathomechanism remains undetermined. Herein we report a patient with a subdural hematoma, who developed parkinsonism in the ipsilateral hemibody. Structural and functional imaging suggests the contralateral dopaminergic dysfunction as the major culprit of apparently ipsilateral parkinsonism.

  11. Molecular development of fibular reduction in birds and its evolution from dinosaurs.

    Science.gov (United States)

    Botelho, João Francisco; Smith-Paredes, Daniel; Soto-Acuña, Sergio; O'Connor, Jingmai; Palma, Verónica; Vargas, Alexander O

    2016-03-01

    Birds have a distally reduced, splinter-like fibula that is shorter than the tibia. In embryonic development, both skeletal elements start out with similar lengths. We examined molecular markers of cartilage differentiation in chicken embryos. We found that the distal end of the fibula expresses Indian hedgehog (IHH), undergoing terminal cartilage differentiation, and almost no Parathyroid-related protein (PTHrP), which is required to develop a proliferative growth plate (epiphysis). Reduction of the distal fibula may be influenced earlier by its close contact with the nearby fibulare, which strongly expresses PTHrP. The epiphysis-like fibulare however then separates from the fibula, which fails to maintain a distal growth plate, and fibular reduction ensues. Experimental downregulation of IHH signaling at a postmorphogenetic stage led to a tibia and fibula of equal length: The fibula is longer than in controls and fused to the fibulare, whereas the tibia is shorter and bent. We propose that the presence of a distal fibular epiphysis may constrain greater growth in the tibia. Accordingly, many Mesozoic birds show a fibula that has lost its distal epiphysis, but remains almost as long as the tibia, suggesting that loss of the fibulare preceded and allowed subsequent evolution of great fibulo-tibial disparity. © 2016 The Author(s). Evolution published by Wiley Periodicals, Inc. on behalf of The Society for the Study of Evolution.

  12. Ipsilateral humeral neck and shaft fractures

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    Zhu Bin

    2017-01-01

    Full Text Available Background/Aim. Fractures of the proximal humerus or shaft are common, however, ipsilateral neck and shaft humerus fracture is a rare phenomenon. This combination injury is challenging for orthopaedic surgeons because of its complex treatment options at present. The purpose of this study was to review a series of ipsilateral humeral neck and shaft fractures to study the fracture pattern, complications and treatment outcomes of each treatment options used. Methods. A total of six patients (four female and two male with the average age of 42.8 years (range: 36–49 years was collected and reviewed retrospectively. Two of them were treated with double plates and four with antegrade intramedullary nail. According to the Neer’s classification, all proximal fractures were two-part surgical neck fractures. All humeral shaft fractures were located at the middle of one third. Five fractures were simple transverse (A3, one fragmented wedge fracture (B3. One patient had associated radial nerve palsy. Results. All surgical neck fractures except one united uneventfully in the average time span of 8.7 weeks. Four humeral shaft fractures healed in near anatomic alignment. The remaining two patients had the nonunion with no radiological signs of fracture healing. The average University of California, Los Angeles End-Results (UCLA score was 23.1. On the contrary, the average American Shoulder and Elbow Surgeon's (ASES score was 73.3. The patients treated with antegrade intramedullary nails presented 70.5 points. The ASES scores were 79 in the double plates group. Conclusions. Ipsilateral humeral shaft and neck fracture is extremely rare. Both antegrade intramedullar nailing and double plates result in healing of fractures. However the risk of complication is lower in the double plating group.

  13. Evaluation of Fibular Fracture Type vs Location of Tibial Fixation of Pilon Fractures.

    Science.gov (United States)

    Busel, Gennadiy A; Watson, J Tracy; Israel, Heidi

    2017-06-01

    Comminuted fibular fractures can occur with pilon fractures as a result of valgus stress. Transverse fibular fractures can occur with varus deformation. No definitive guide for determining the proper location of tibial fixation exists. The purpose of this study was to identify optimal plate location for fixation of pilon fractures based on the orientation of the fibular fracture. One hundred two patients with 103 pilon fractures were identified who were definitively treated at our institution from 2004 to 2013. Pilon fractures were classified using the AO/OTA classification and included 43-A through 43-C fractures. Inclusion criteria were age of at least 18 years, associated fibular fracture, and definitive tibial plating. Patients were grouped based on the fibular component fracture type (comminuted vs transverse), and the location of plate fixation (medial vs lateral) was noted. Radiographic outcomes were assessed for mechanical failures. Forty fractures were a result of varus force as evidenced by transverse fracture of the fibula and 63 were due to valgus force with a comminuted fibula. For the transverse fibula group, 14.3% mechanical complications were noted for medially placed plate vs 80% for lateral plating ( P = .006). For the comminuted fibular group, 36.4% of medially placed plates demonstrated mechanical complications vs 16.7% for laterally based plates ( P = .156). Time to weight bearing as tolerated was also noted to be significant between groups plated medially and laterally for the comminuted group ( P = .013). Correctly assessing the fibular component for pilon fractures provides valuable information regarding deforming forces. To limit mechanical complications, tibial plates should be applied in such a way as to resist the original deforming forces. Level of Evidence Level III, comparative study.

  14. Harvesting the free fibular graft: A modified approach

    Directory of Open Access Journals (Sweden)

    Amitava Narayan Mukherjee

    2011-01-01

    Full Text Available Background: The conventional technique of free non-vascularized fibular grafting is attended with some amount of morbidity and a long scar. We report a technique with little interference to the surrounding soft tissues to harvest more than one-third of whole length fibula. Patients and Methods: Thirty four patients of average age 23.5 years (range 8 to 51 years having various pathologies like simple bone cysts (n=9, fibrous dysplasias (n=6, giant cell tumors (n=7, fracture non-union (n=10 and aneurysmal bone cysts (n=2 were taken up for the study. The fibula were harvested by two separate incisions, 1 cm each at proximal and distal extent of proposed donor site for taking out of graft after elevating the periosteum circumferentially using a periosteum stripper. Compression bandage and above knee plaster immobilization was applied to reduce the dead space collection . Results: The mean followup is 34 months. The patients were evaluated clinicoradiology. Thirty three patients showed good results. One patient had fair result due to delayed wound healing from hematoma which was treated surgically. Conclusion: The approach of harvesting fibula suggested by author reduces donor site morbidity and is safer than conventional approach.

  15. Computer Simulation Surgery for Mandibular Reconstruction Using a Fibular Osteotomy Guide

    Directory of Open Access Journals (Sweden)

    Woo Shik Jeong

    2014-09-01

    Full Text Available In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

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

    African Journals Online (AJOL)

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

  17. Novel management of distal tibial and fibular fractures with Acumed fibular nail and minimally invasive plating osteosynthesis technique: A case report.

    Science.gov (United States)

    Wang, Tie-Jun; Ju, Wei-Na; Qi, Bao-Chang

    2017-03-01

    Anatomical characteristics, such as subcutaneous position and minimal muscle cover, contribute to the complexity of fractures of the distal third of the tibia and fibula. Severe damage to soft tissue and instability ensure high risk of delayed bone union and wound complications such as nonunion, infection, and necrosis. This case report discusses management in a 54-year-old woman who sustained fractures of the distal third of the left tibia and fibula, with damage to overlying soft tissue (swelling and blisters). Plating is accepted as the first choice for this type of fracture as it ensures accurate reduction and rigid fixation, but it increases the risk of complications. Closed fracture of the distal third of the left tibia and fibula (AO: 43-A3). After the swelling was alleviated, the patient underwent closed reduction and fixation with an Acumed fibular nail and minimally invasive plating osteosynthesis (MIPO), ensuring a smaller incision and minimal soft-tissue dissection. At the 1-year follow-up, the patient had recovered well and had regained satisfactory function in the treated limb. The Kofoed score of the left ankle was 95. Based on the experience from this case, the operation can be undertaken safely when the swelling has been alleviated. The minimal invasive technique represents the best approach. Considering the merits and good outcome in this case, we recommend the Acumed fibular nail and MIPO technique for treatment of distal tibial and fibular fractures.

  18. The vascularised fibular graft for limb salvage after bone tumour surgery A MULTICENTRE STUDY

    NARCIS (Netherlands)

    Hilven, P. H.; Bayliss, L.; Cosker, T.; Dijkstra, P. D. S.; Jutte, P. C.; Lahoda, L. U.; Schaap, G. R.; Bramer, J. A. M.; van Drunen, G. K.; Strackee, S. D.; van Vooren, J.; Gibbons, M.; Giele, H.; van de Sande, M. A. J.

    2015-01-01

    Vascularised fibular grafts (VFGs) are a valuable surgical technique in limb salvage after resection of a tumour. The primary objective of this multicentre study was to assess the risk factors for failure and complications for using a VFG after resection of a tumour. The study involved 74

  19. Ipsilateral Femoral Fracture Non-Union and Delayed Union Treated By Hybrid Plate Nail Fixation and Vascularized Fibula Bone Grafting: A Case Report

    Directory of Open Access Journals (Sweden)

    CK Chan

    2013-07-01

    Full Text Available Non-union is a well recognized complication of femoral neck fractures. The decision whether to attempt fracture fixation or to resort to hip replacement is particularly difficult in patients in the borderline age group in whom complex attempts at gaining union may fail and later present a difficult revision. On the other hand the patient may be young enough that arthroplasty best be avoided . Besides, presence of ipsilateral femoral shaft fracture with delayed union in addition to the femoral neck non-union will pose major problems at operation. We share our experience in treating a femoral neck fracture non-union with ipsilateral femoral shaft delayed union in the shaft and in the distal femur in a fifty years old patient. The fracture was treated with an angle blade plate and supracondylar nail supplemented with a free vascularised fibular bone grafting and autologous cancellous graft. There was radiological union at fourth month. At sixth months, the patient was free of pain and able to walk without support. Thus, we would like to suggest that vascularised fibula bone grafting with supracondylar nailing is a viable option for this pattern of fracture.

  20. Patterns of astragalar fibular facet orientation in extant and fossil primates and their evolutionary implications.

    Science.gov (United States)

    Boyer, Doug M; Seiffert, Erik R

    2013-07-01

    A laterally sloping fibular facet of the astragalus (=talus) has been proposed as one of few osteological synapomorphies of strepsirrhine primates, but the feature has never been comprehensively quantified. We describe a method for calculating fibular facet orientation on digital models of astragali as the angle between the planes of the fibular facet and the lateral tibial facet. We calculated this value in a sample that includes all major extant primate clades, a diversity of Paleogene primates, and nonprimate euarchontans (n = 304). Results show that previous characterization of a divide between extant haplorhines and strepsirrhines is accurate, with little overlap even when individual data points are considered. Fibular facet orientation is conserved in extant strepsirrhines despite major differences in locomotion and body size, while extant anthropoids are more variable (e.g., low values for catarrhines relative to non-callitrichine platyrrhines). Euprimate outgroups exhibit a mosaic of character states with Cynocephalus having a more obtuse strepsirrhine-like facet and sampled treeshrews and plesiadapiforms having more acute haplorhine-like facets. Surprisingly, the earliest species of the adapiform Cantius have steep haplorhine-like facets as well. We used a Bayesian approach to reconstruct the evolution of fibular facet orientation as a continuous character across a supertree of living and extinct primates. Mean estimates for crown Primatomorpha (97.9°), Primates (99.5°), Haplorhini (98.7°), and Strepsirrhini (108.2°) support the hypothesis that the strepsirrhine condition is derived, while lower values for crown Anthropoidea (92.8°) and Catarrhini (88.9°) are derived in the opposite direction. Copyright © 2013 Wiley Periodicals, Inc.

  1. Ipsilateral femoral shaft and vertical patella fracture: a case report

    Science.gov (United States)

    Ozkan, Korhan; Eceviz, Engin; Sahin, Adem; Ugutmen, Ender

    2009-01-01

    Introduction A femoral shaft fracture with an ipsilateral patella fracture has been, to our knowledge, given only cursory attention in English-speaking literature. Case presentation A 15 year old male patient had hitten by a car to his motorcycle came to emergency room and he had been operated for his femoral shaft freacture and vertical patellar fracture which was iniatally missed. Conclusion To us it is vital to obtain CT scan of the patient’s knee if there is an ipsilateral femoral fracture with an ipsilateral knee effusion and a punction which reveals hematoma even in the absence of a fracture line seen in AP and lateral projections. PMID:19829933

  2. frequency of ipsilateral femoral neck fractures in patients

    African Journals Online (AJOL)

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

  3. Ultra-fast ipsilateral DPOAE adaptation not modulated by attention?

    Science.gov (United States)

    Dalhoff, Ernst; Zelle, Dennis; Gummer, Anthony W.

    2018-05-01

    Efferent stimulation of outer hair cells is supposed to attenuate cochlear amplification of sound waves and is accompanied by reduced DPOAE amplitudes. Recently, a method using two subsequent f2 pulses during presentation of a longer f1 pulse was introduced to measure fast ipsilateral adaptation effects on separated DPOAE components. Compensating primary-tone onsets for their latencies at the f2-tonotopic place, the average adaptation measured in four normal-hearing subjects was 5.0 dB with a time constant below 5 ms. In the present study, two experiments were performed to determine the origin of this ultra-fast ipsilateral adaptation effect. The first experiment measured ultra-fast ipsilateral adaptation using a two-pulse paradigm at three frequencies in the four subjects, while controlling for visual attention of the subjects. The other experiment also controlled for visual attention, but utilized a sequence of f2 short pulses in the presence of a continuous f1 tone to sample ipsilateral adaptation effects with longer time constants in eight subjects. In the first experiment, no significant change in the ultra-fast adaptation between non-directed attention and visual attention could be detected. In contrast, the second experiment revealed significant changes in the magnitude of the slower ipsilateral adaptation in the visual-attention condition. In conclusion, the lack of an attentional influence indicates that the ultra-fast ipsilateral DPOAE adaptation is not solely mediated by the medial olivocochlear reflex.

  4. Forelimb training drives transient map reorganization in ipsilateral motor cortex.

    Science.gov (United States)

    Pruitt, David T; Schmid, Ariel N; Danaphongse, Tanya T; Flanagan, Kate E; Morrison, Robert A; Kilgard, Michael P; Rennaker, Robert L; Hays, Seth A

    2016-10-15

    Skilled motor training results in reorganization of contralateral motor cortex movement representations. The ipsilateral motor cortex is believed to play a role in skilled motor control, but little is known about how training influences reorganization of ipsilateral motor representations of the trained limb. To determine whether training results in reorganization of ipsilateral motor cortex maps, rats were trained to perform the isometric pull task, an automated motor task that requires skilled forelimb use. After either 3 or 6 months of training, intracortical microstimulation (ICMS) mapping was performed to document motor representations of the trained forelimb in the hemisphere ipsilateral to that limb. Motor training for 3 months resulted in a robust expansion of right forelimb representation in the right motor cortex, demonstrating that skilled motor training drives map plasticity ipsilateral to the trained limb. After 6 months of training, the right forelimb representation in the right motor cortex was significantly smaller than the representation observed in rats trained for 3 months and similar to untrained controls, consistent with a normalization of motor cortex maps. Forelimb map area was not correlated with performance on the trained task, suggesting that task performance is maintained despite normalization of cortical maps. This study provides new insights into how the ipsilateral cortex changes in response to skilled learning and may inform rehabilitative strategies to enhance cortical plasticity to support recovery after brain injury. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Incidence and Predictors for Ipsilateral Hydronephrosis Following Ureteroscopic Lithotripsy.

    Science.gov (United States)

    Barbour, Meredith L; Raman, Jay D

    2015-09-01

    To review our experience in using ureteroscopy (URS) with lithotripsy for renal or ureteral calculi to determine the incidence and predictors of postprocedural ipsilateral hydronephrosis. Records of 324 URS cases for renal or ureteral calculi with imaging performed 4-12 weeks postprocedure were reviewed. Ipsilateral hydronephrosis was determined by computed tomography scan or renal ultrasound. Univariate and multivariate analyses determined the factors associated with hydronephrosis. 176 men and 148 women with a median age of 50 years were included. Median stone size was 6 mm and operative duration was 60 minutes; 30% of patients had multiple calculi; and 35% had undergone a prior ipsilateral URS. Overall, 49 of 324 patients (15%) had evidence of hydronephrosis, with 65% of these patients having symptoms and 40% requiring ancillary procedures. On multivariate analysis, increasing stone diameter (odds ratio [OR] 8.9, 95% confidence interval [CI] 1.9-23.8, P = .03), prior ipsilateral URS (OR 7.7, 95% CI 1.8-28.2, P = .006), longer operative duration (OR 6.5, 95% CI 1.8-16.3, P = .02), and renal colic symptoms (OR 48.3, 95% CI 14.7-71.4, P hydronephrosis. Conversely, other factors including stone impaction at procedure, ureteral dilation, use of an access sheath, intraoperative perforation, or use of a stent did not associate with ipsilateral hydronephrosis. In this contemporary cohort study, 15% of patients undergoing URS had evidence of ipsilateral hydronephrosis. Larger stone size, longer OR duration, prior ipsilateral URS, and recurrent colic were associated with an increased likelihood for this observation. Patients and stone cases with such characteristics likely warrant imaging modalities beyond plain radiography. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. MINIMUM INCISION PERCUTANEOUS PLATE OSTEOSYNTHESIS FOR DISTAL FIBULAR FRACTURES: A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Ramkumar Reddy

    2015-09-01

    Full Text Available Distal fibular fractures are usually communitted and most of the times osteoporotic especially if they are occurring in females and in geriatric age group. These fractures are usu ally associated with other fractures, which necessitates them to be fixed accurately. Owing to the fact that distal fragment is subcutaneous with scanty soft tissue over bone, which pose these fracture fixations become difficult by open methods in view of wound healing. A prospective study of 26 patients with distal fibular fractures were treated with MIPPO with hook plate were healed with less complications and better outcome. With this background we suggest a minimally invasive incision over proximal frag ment where sufficient soft tissue cover is present. From there pushing the special hook plate subperiosteally to distal fragment, hooking the tip of fibula and fixing the proximal fragment after reduction gives a simple and effective stable fixation

  7. Effect of hip and knee position on nerve conduction in the common fibular nerve.

    Science.gov (United States)

    Broadhurst, Peter Kaas; Robinson, Lawrence R

    2017-09-01

    The aim of this study was to measure the influence that hip and knee position have on routine fibular motor nerve conduction studies. Healthy subjects under age 40 were recruited (n = 24) to have fibular nerve conduction studies completed in various positions, using hip extension-knee extension as a control. A mean increase in conduction velocity of 2.5 m/s across the knee (P = 0.020) was seen during hip flexion compared with hip extension. A mean decrease in velocity of 1.6 m/s through the leg segment (P = 0.016) was seen during knee flexion compared with knee extension. This study shows that the optimal position of the leg during fibular nerve studies is with the hip in flexion and knee in extension, to more accurately reflect nerve length for velocity calculations. This may have implications for other peripheral nerves with respect to proximal joint position affecting calculated velocity. Muscle Nerve 56: 519-521, 2017. © 2017 Wiley Periodicals, Inc.

  8. Motor demand-dependent activation of ipsilateral motor cortex.

    Science.gov (United States)

    Buetefisch, Cathrin M; Revill, Kate Pirog; Shuster, Linda; Hines, Benjamin; Parsons, Michael

    2014-08-15

    The role of ipsilateral primary motor cortex (M1) in hand motor control during complex task performance remains controversial. Bilateral M1 activation is inconsistently observed in functional (f)MRI studies of unilateral hand performance. Two factors limit the interpretation of these data. As the motor tasks differ qualitatively in these studies, it is conceivable that M1 contributions differ with the demand on skillfulness. Second, most studies lack the verification of a strictly unilateral execution of the motor task during the acquisition of imaging data. Here, we use fMRI to determine whether ipsilateral M1 activity depends on the demand for precision in a pointing task where precision varied quantitatively while movement trajectories remained equal. Thirteen healthy participants used an MRI-compatible joystick to point to targets of four different sizes in a block design. A clustered acquisition technique allowed simultaneous fMRI/EMG data collection and confirmed that movements were strictly unilateral. Accuracy of performance increased with target size. Overall, the pointing task revealed activation in contralateral and ipsilateral M1, extending into contralateral somatosensory and parietal areas. Target size-dependent activation differences were found in ipsilateral M1 extending into the temporal/parietal junction, where activation increased with increasing demand on accuracy. The results suggest that ipsilateral M1 is active during the execution of a unilateral motor task and that its activity is modulated by the demand on precision. Copyright © 2014 the American Physiological Society.

  9. Ipsilateral Floating Hip and Floating Knee – A Rare Entity

    Directory of Open Access Journals (Sweden)

    Yashavantha Kumar

    2013-04-01

    Full Text Available Introduction: Ipsilateral floating hip and floating knee are very rare injuries. These injuries so uncommon that only three cases of similar kind have been reported. These injuries are due to high velocity injuries following motor vehicle accidents. Management of such complex injuries is a challenging task even in experienced hands as there are no standard treatment guidelines for such fractures. Case Report: We hereby report a 20 yr old male who sustained ipsilateral floating hip and ipsilateral floating knee injuries following motor vehicle accident. Patient was stabilized initially and later taken up for surgery. Patient was treated with interlocking nail for femur and tibia in the same sitting whereas acetabulam fracture was managed conservatively. At five months all the fractures united well with restoration of good range of motion in both hip and knee. Conclusion: Ipsilateral floating knee and floating hip are very rare injuries seen following high velocity motor vehicle accidents. There are no standard guidelines for treatment of those fractures as only a few cases of similar kind have been reported in literature. Early fixation and aggressive mobilization ensures fracture union and fewer complications. Keywords: Floating hip, Floating Knee, Ipsilateral.

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

    African Journals Online (AJOL)

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

  11. Mammographic CAD: Correlation of regions in ipsilateral views – a ...

    African Journals Online (AJOL)

    Background. Radiologists analyse both standard mammographic views of a breast to confirm the presence of abnormalities and reduce false-positives. However, at present, no computer-aided diagnosis system uses ipsilateral mammograms to confirm the presence of suspicious features. Aim. The aim of this study was to ...

  12. Maxillary palp glomeruli and ipsilateral projections in the antennal ...

    Indian Academy of Sciences (India)

    Maxillary palp glomeruli and ipsilateral projections in the antennal lobe of Drosophila melanogaster. K P Rajashekhar V R ... The number of glomeruli receiving the maxillary palp sensory projections tallies with the number of Drosophila olfactory receptors (seven) reported to be expressed exclusively in the maxillary palp.

  13. Prosthetic Rehabilitation After Fibular Free Flap Surgery of Mandibular Defects in a Patient With Oral Squamous Cell Carcinoma.

    Science.gov (United States)

    Yoon, Hyung-In

    2016-10-01

    This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery. A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects. The implant-supported zirconia-fixed prosthesis can be recommended for use in patients with mandibulectomy and fibular free flaps. Close cooperation between the surgeon and the prosthodontist is mandatory for the satisfaction of the patient.

  14. Fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma

    International Nuclear Information System (INIS)

    Wu Jun; Zhang Qiang

    2003-01-01

    Objective: To evaluate the fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma. Methods: Measure fracture line index of fibular stalk and the ankle joint in 217 adult cases of fracture and dislocation of ankle joint. And the cases were classified by the results of the measurement. Results: Measurement was unavailable in 9 cases of tearing fracture. In 31 cases, the lesions could not be particularly classified. And in the rest 176 cases the trauma were precisely classified. The over all successful rate was 81.6%. Conclusion: Fracture line index of fibular stalk and the ankle joint bone are valuable in classification of the trauma of the angle joint. While the specificity of this method is low in differentiating the adducting and abducting fracture of the medial angle, in which a combined investigation is recommended

  15. Correction of axial deformity during lengthening in fibular hypoplasia: Hexapodal versus monorail external fixation.

    Science.gov (United States)

    Chalopin, A; Geffroy, L; Pesenti, S; Hamel, A; Launay, F

    2017-09-01

    Childhood fibular hypoplasia is a rare pathology which may or may not involve limb-length discrepancy and axial deformity in one or more dimensions. The objective of the present study was to compare the quality of the axial correction achieved in lengthening procedures by hexapodal versus monorail external fixators. The hypothesis was that the hexapodal fixator provides more precise correction. A retrospective multicenter study included 52 children with fibular hypoplasia. Seventy-two tibias were analyzed, in 2 groups: 52 using a hexapodal fixator, and 20 using a monorail fixator. Mean age was 10.2 years. Mean lengthening was 5.7cm. Deformities were analyzed and measured in 3 dimensions and classified in 4 preoperative types and 4 post-lengthening types according to residual deformity. Complete correction was achieved in 26 tibias in the hexapodal group (50%) and 2 tibias in the monorail group (10%). Mean post-correction mechanical axis deviation was smaller in the hexapodal group: 12.83mm, versus 14.29mm in the monorail group. Mean post-correction mechanical lateral distal femoral angle was 87.5° in the hexapodal group, versus 84.3° in the monorail group (P=0.002), and mean mechanical medial proximal tibial angle 86.9° versus 89.5°, respectively (P=0.015). No previous studies focused on this congenital pathology in lengthening and axial correction programs for childhood lower-limb deformity. The present study found the hexapodal fixator to be more effective in conserving or restoring mechanical axes during progressive bone lengthening for fibular hypoplasia. The hexapodal fixator met the requirements of limb-length equalization in childhood congenital lower-limb hypoplasia, providing better axial correction than the monorail fixator. IV. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Success of dental implants in vascularised fibular osteoseptocutaneous flaps used as onlay grafts after marginal mandibulectomy.

    Science.gov (United States)

    Chang, Y-M; Pan, Y-H; Shen, Y-F; Chen, J-K; ALDeek, N F; Wei, F-C

    2016-12-01

    We have evaluated the survival of dental implants placed in vascularised fibular flap onlay grafts placed over marginal mandibulectomies and the effects on marginal bone loss of different types of soft tissue around implants under functional loading. From 2001-2009 we studied a total of 11 patients (1 woman and10 men), three of whom had had ameloblastoma and eight who had had squamous cell carcinomas resected. A total of 38 dental implants were placed either at the time of transfer of the vascularised fibular ostoseptocutaneous flaps (nine patients with 30 implants) or secondarily (two patients with eight implants). Four patients were given palatal mucosal grafts to replace intraoral skin flaps around the dental implants (n=13), and the other seven had the skin flaps around the dental implants thinned (n=25) at the second stage of implantation of the osteointegrated teeth. All vascularised fibular osteoseptocutaneous flaps were successfully transferred, and all implants survived a mean (range) of 73 (33-113) months after occlusal functional loading. The mean (SD) marginal bone loss was 0.5 (0.3) mm on both mesial and distal sides in patients who had palatal mucosal grafts, but 1.8 (1.6) mm, and 1.7 (1.5) mm, respectively, on the mesial and distal sides in the patients who had had thinning of their skin flaps. This difference is significant (p=0.008) with less resorption of bone in the group who had palatal mucosal grafts. Palatal mucosa around the implants helps to reduce resorption of bone after functional loading of implants. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Infant bone age estimation based on fibular shaft length: model development and clinical validation

    International Nuclear Information System (INIS)

    Tsai, Andy; Stamoulis, Catherine; Bixby, Sarah D.; Breen, Micheal A.; Connolly, Susan A.; Kleinman, Paul K.

    2016-01-01

    Bone age in infants (<1 year old) is generally estimated using hand/wrist or knee radiographs, or by counting ossification centers. The accuracy and reproducibility of these techniques are largely unknown. To develop and validate an infant bone age estimation technique using fibular shaft length and compare it to conventional methods. We retrospectively reviewed negative skeletal surveys of 247 term-born low-risk-of-abuse infants (no persistent child protection team concerns) from July 2005 to February 2013, and randomized them into two datasets: (1) model development (n = 123) and (2) model testing (n = 124). Three pediatric radiologists measured all fibular shaft lengths. An ordinary linear regression model was fitted to dataset 1, and the model was evaluated using dataset 2. Readers also estimated infant bone ages in dataset 2 using (1) the hemiskeleton method of Sontag, (2) the hemiskeleton method of Elgenmark, (3) the hand/wrist atlas of Greulich and Pyle, and (4) the knee atlas of Pyle and Hoerr. For validation, we selected lower-extremity radiographs of 114 normal infants with no suspicion of abuse. Readers measured the fibulas and also estimated bone ages using the knee atlas. Bone age estimates from the proposed method were compared to the other methods. The proposed method outperformed all other methods in accuracy and reproducibility. Its accuracy was similar for the testing and validating datasets, with root-mean-square error of 36 days and 37 days; mean absolute error of 28 days and 31 days; and error variability of 22 days and 20 days, respectively. This study provides strong support for an infant bone age estimation technique based on fibular shaft length as a more accurate alternative to conventional methods. (orig.)

  18. Infant bone age estimation based on fibular shaft length: model development and clinical validation

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Andy; Stamoulis, Catherine; Bixby, Sarah D.; Breen, Micheal A.; Connolly, Susan A.; Kleinman, Paul K. [Boston Children' s Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2016-03-15

    Bone age in infants (<1 year old) is generally estimated using hand/wrist or knee radiographs, or by counting ossification centers. The accuracy and reproducibility of these techniques are largely unknown. To develop and validate an infant bone age estimation technique using fibular shaft length and compare it to conventional methods. We retrospectively reviewed negative skeletal surveys of 247 term-born low-risk-of-abuse infants (no persistent child protection team concerns) from July 2005 to February 2013, and randomized them into two datasets: (1) model development (n = 123) and (2) model testing (n = 124). Three pediatric radiologists measured all fibular shaft lengths. An ordinary linear regression model was fitted to dataset 1, and the model was evaluated using dataset 2. Readers also estimated infant bone ages in dataset 2 using (1) the hemiskeleton method of Sontag, (2) the hemiskeleton method of Elgenmark, (3) the hand/wrist atlas of Greulich and Pyle, and (4) the knee atlas of Pyle and Hoerr. For validation, we selected lower-extremity radiographs of 114 normal infants with no suspicion of abuse. Readers measured the fibulas and also estimated bone ages using the knee atlas. Bone age estimates from the proposed method were compared to the other methods. The proposed method outperformed all other methods in accuracy and reproducibility. Its accuracy was similar for the testing and validating datasets, with root-mean-square error of 36 days and 37 days; mean absolute error of 28 days and 31 days; and error variability of 22 days and 20 days, respectively. This study provides strong support for an infant bone age estimation technique based on fibular shaft length as a more accurate alternative to conventional methods. (orig.)

  19. Reconstruction of the cervical spine with two osteocutaneous fibular flap after radiotherapy and resection of osteoclastoma

    DEFF Research Database (Denmark)

    Kaltoft, Britta; Kruse, Anders; Jensen, Lisa Toft

    2012-01-01

    to C3. Two months later, rupture of the pharyngeal wall was noted with exposure of the anterior cage. A few days later, the posterior scar ruptured. The anterior cage was removed and the pharyngeal wall was sutured. Revision of the posterior wound was performed, leaving the implants in place. To secure...... stability of the spine, the patient was treated with a HALO. Once again, the pharyngeal wall ruptured. Reconstruction of the posterior pharyngeal wall and the anterior column of the spine was performed with an osteocutaneous fibular flap from the skull base to C3. Five months later, a computed tomography...

  20. Bilateral transverse (bowdler) fibular spurs with hypophosphatasia in an adolescent girl

    Energy Technology Data Exchange (ETDEWEB)

    Uras, Ismail; Uras, Nurdan; Karadag, Ahmet; Yavuz, Osman Yuksel; Atalar, Hakan [Fatih University Faculty of Medicine, Ankara (Turkmenistan)

    2005-03-15

    Hypophosphatasia is a clinically heterogeneous inheritable disorder characterized by defective bone mineralization and the deficiency of serum and tissue liver/bone/kidney alkaline phosphatase activities. Due to the mineralization defect of the bones, various skeletal findings can be radiologically observed in hypophosphatasia. Bowing and Bowdler spurs of long bones are the characteristic findings. The Bowdler spurs reported on in the previous pertinent literature were observed in the perinatal aged patients and these lesions have rarely involved adolescents. We herein report on a 14-year-old girl with fibular Bowdler spurs.

  1. Bilateral transverse (bowdler) fibular spurs with hypophosphatasia in an adolescent girl

    International Nuclear Information System (INIS)

    Uras, Ismail; Uras, Nurdan; Karadag, Ahmet; Yavuz, Osman Yuksel; Atalar, Hakan

    2005-01-01

    Hypophosphatasia is a clinically heterogeneous inheritable disorder characterized by defective bone mineralization and the deficiency of serum and tissue liver/bone/kidney alkaline phosphatase activities. Due to the mineralization defect of the bones, various skeletal findings can be radiologically observed in hypophosphatasia. Bowing and Bowdler spurs of long bones are the characteristic findings. The Bowdler spurs reported on in the previous pertinent literature were observed in the perinatal aged patients and these lesions have rarely involved adolescents. We herein report on a 14-year-old girl with fibular Bowdler spurs

  2. Association of congenital megacalycosis and ipsilateral segmental megaureter

    International Nuclear Information System (INIS)

    Mandell, G.A.; Keller, M.; Kaplan, J.M.

    1987-01-01

    Four cases of congenital megacalycosis associated with ipsilateral segmental megaureter in children are presented. This association has not been emphasized, although review of the English and French literature revealed eight such cases. In al cases, the concurrent entities are unilateral, with a left-sided predominance and a male prevalence. The diagnosis of megacalycosis is resumed in four of the cases by normal function and prompt emptying of the calyceal systems on diuretic renography and/or urography. The presence of normal caliber renal pelvis interposed between the dilated collecting system and the distal dilated ureter without evidence of vesicoureteral reflux implies the coexistence of ipsilateral idiopathic megaureter. The patients usually present because of urinary tract infection and/or calculus formation, but respond well to conservative therapy. (orig.)

  3. Congenital dislocation of knee with ipsilateral developmental dysplasia of hip

    Directory of Open Access Journals (Sweden)

    Sameer Kakar

    2017-01-01

    Full Text Available We present a rare case of a newborn having congenital knee dislocation (CDK with ipsilateral developmental dysplasia of hip (DDH. This case report shows how abnormal intrauterine pressure leads to dislocation of various joints in utero. We managed this conservatively with Pavlik Harness for DDH and serial corrective casting with manipulation for CDK with a satisfactory result after follow-up of 6 months.

  4. Ipsilateral Medial and Lateral Discoid Meniscus with Medial Meniscus Tear

    OpenAIRE

    Shimozaki, Kengo; Nakase, Junsuke; Ohashi, Yoshinori; Numata, Hitoaki; Oshima, Takeshi; Takata, Yasushi; Tsuchiya, Hiroyuki

    2016-01-01

    Introduction: Discoid meniscus is a well-documented knee pathology, and there are many cases of medial or lateral discoid meniscus reported in the literature. However, ipsilateral concurrent medial and lateral discoid meniscus is very rare, and only a few cases have been reported. Herein, we report a case of concurrent medial and lateral discoid meniscus. Case Report: A 27-year-old Japanese man complained of pain on medial joint space in his right knee that was diagnosed as a complete medial ...

  5. Ipsilateral motor pathways after stroke: implications for noninvasive brain stimulation

    Directory of Open Access Journals (Sweden)

    Lynley V Bradnam

    2013-05-01

    Full Text Available In humans the two cerebral hemispheres have essential roles in controlling the upper limb. The purpose of this article is to draw attention to the potential importance of ipsilateral descending pathways for functional recovery after stroke, and the use of noninvasive brain stimulation (NBS protocols of the contralesional primary motor cortex (M1. Conventionally NBS is used to suppress contralesional M1, and to attenuate transcallosal inhibition onto the ipsilesional M1. There has been little consideration of the fact that contralesional M1 suppression may also reduce excitability of ipsilateral descending pathways that may be important for paretic upper limb control for some patients. One such ipsilateral pathway is the cortico-reticulo-propriospinal pathway (CRPP. In this review we outline a neurophysiological model to explain how contralesional M1 may gain control of the paretic arm via the CRPP. We conclude that the relative importance of the CRPP for motor control in individual patients must be considered before using NBS to suppress contralesional M1. Neurophysiological, neuroimaging and clinical assessments can assist this decision making and facilitate the translation of NBS into the clinical setting.

  6. Anterograde Intra-Arterial Urokinase Injection for Salvaging Fibular Free Flap

    Directory of Open Access Journals (Sweden)

    Dae-Sung Lee

    2013-05-01

    Full Text Available We present a case of a 57-year-old male patient who presented with squamous cell carcinoma on his mouth floor with cervical and mandibular metastases. Wide glossectomy with intergonial mandibular ostectomy, and sequential reconstruction using fibular osteomyocutaneous free flap were planned. When the anastomosis between the peroneal artery of the fibular free flap and the right lingual artery was performed, no venous flow was observed at the vena comitans. Then re-anastomosis followed by topical application of papaverine and lidocaine was attempted. However, the blood supply was not recovered. Warm saline irrigation over 30 minutes was also useless. Microvascular thromboses of donor vessels were clinically suspected, so a solution of 100,000 units of urokinase was infused once through a 26-gauge angiocatheter inserted into the recipient artery just at the arterial anastomotic site, until the solution gushed out through the flap vena comitans. Immediately after the application of urokinase, arterial flow and venous return were restored. There were no complications during the follow-up period of 11 months. We believe that vibrating injuries from the reciprocating saw during osteotomies and flap insetting might be the cause of microvascular thromboses. The use of urokinase may provide a viable option for the treatment of suspicious intraoperative arterial thrombosis.

  7. Comparison of four different nerve conduction techniques of the superficial fibular sensory nerve.

    Science.gov (United States)

    Saffarian, Mathew R; Condie, Nathan C; Austin, Erica A; Mccausland, Katie E; Andary, Michael T; Sylvain, James R; Mull, Iian R; Zemper, Eric D; Jannausch, Mary L

    2017-09-01

    There are many different nerve conduction study (NCS) techniques to study the superficial fibular sensory nerve (SFSN). We present reference distal latency values and comparative data regarding 4 different NCS for the SFSN. Four different NCS techniques, Spartan technique, Izzo techniques (medial and intermediate dorsal cutaneous branches), and Daube technique, were performed on (114) healthy volunteers. A total of 108 subjects with 164 legs were included. The mean latency of the Spartan technique was longest (3.9 ± 0.3 ms) while the Daube technique was the shortest (3.6 ± 0.7 ms). The mean amplitude of the Daube technique displayed the highest (15.2 ± 8.2 μV) with the Spartan technique having the lowest (8.7 ± 4.2 μV). Among the absent sensory nerve action potentials (SNAPs), the Spartan technique was absent only twice (1.2%) and the Izzo Medial technique was absent more than the other techniques (2.9%). All 4 techniques were reliable methods for obtaining the superficial fibular nerve SNAP, present in 95% of individuals. Muscle Nerve 56: 458-462, 2017. © 2017 Wiley Periodicals, Inc.

  8. Nonvascularized fibular grafting in nonunion of femoral neck fracture: A systematic review

    Directory of Open Access Journals (Sweden)

    Sujit Kumar Tripathy

    2016-01-01

    Full Text Available Nonunion of femoral neck fractures following primary fixation and neglected femoral neck fracture in young adults is a challenging task. Every effort should be directed toward hip joint salvage in these patients. Among different available options of hip salvage, nonvascularized fibular graft (NVFG osteosynthesis is simple, easy to perform, and a successful technique. In this review, the available literature on NVFG in neglected and nonunion femoral neck fractures has been analyzed. After review of 15 articles on NVFG, the average nonunion rate was estimated to be 7.86% (range 0-31%. Six articles that evaluated the preoperative and postoperative osteonecrosis reported improvement in 50% patients. The clinical and/or functional outcome was good to excellent in 56-96% patients following fibular osteosynthesis. Few complications such as coxa vara deformity, limb shortening, and intraarticular penetration of the graft or hardware have been reported. However, there are minimal donor site morbidities such as mild ankle pain, transient loss of toe flexors and extensors and transient lateral popliteal nerve palsy.

  9. A rare type of ankle fracture : Syndesmotic rupture combined with a high fibular fracture without medial injury

    NARCIS (Netherlands)

    van Wessem, K. J P; Leenen, L. P H

    High fibular spiral fractures are usually caused by pronation-external rotation mechanism. The foot is in pronation and the talus externally rotates, causing a rupture of the medial ligaments or a fracture of the medial malleolus. With continued rotation the anterior and posterior tibiofibular

  10. Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis.

    Science.gov (United States)

    Wang, Xiaohu; Wei, Lei; Lv, Zhi; Zhao, Bin; Duan, Zhiqing; Wu, Wenjin; Zhang, Bin; Wei, Xiaochun

    2017-02-01

    Objective To explore the effects of proximal fibular osteotomy as a new surgery for pain relief and improvement of medial joint space and function in patients with knee osteoarthritis. Methods From January 2015 to May 2015, 47 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis were retrospectively followed up. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively. Results Medial pain relief was observed in almost all patients after proximal fibular osteotomy. Most patients exhibited improved walking postoperatively. Weight-bearing lower extremity radiographs showed an average increase in the postoperative medial knee joint space. Additionally, obvious correction of alignment was observed in the whole lower extremity radiographs in 8 of 47 patients. Conclusions The present study demonstrates that proximal fibular osteotomy effectively relieves pain and improves joint function in patients with medial compartment osteoarthritis at a mean of 13.38 months postoperatively.

  11. The anterolateral supra-fibular-head approach for plating posterolateral tibial plateau fractures: A novel surgical technique.

    Science.gov (United States)

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

    2016-02-01

    The posterolateral (PL) tibial plateau quadrant is laterally covered by the fibular head and posteriorly covered by a mass of muscle ligament and important neurovascular structures. There are several limitations in exposing and fixing the PL tibial plateau fractures using a posterior approach. The aim of this study is to present a novel anterolateral supra-fibular-head approach for plating PL tibial plateau fractures. Five fresh and ten preserved knee specimens were dissected to measure the following parameters:1) the vertical distance from the apex of the fibular head to the lateral plateau surface, 2) the transverse distance between the PL platform and fibula collateral ligament (FCL), and 3) the tension of the FCL in different knee flexion positions. Clinically, isolated PL quadrant tibial plateau fractures were treated via an anterolateral supra-fibular-head approach and lateral rafting plate fixation. The outcome of the patients was assessed after a short to medium follow-up period. The distance from the apex of the fibular head to the lateral condylar surface was 12.2 ± 1.6 mm on average. With the knee extended and the FCL tensioned, the transverse distance between the PL platform and the FCL was 6.7 ± 1.1 mm. With the knee flexed to 60° and the FCL was in the most relaxed position, the distance increased to 21.1 ± 3.0 mm. Clinically, a series of 7 cases of PL tibial plateau fractures were treated via this anterolateral supra-fibular-head approach. The patient was placed in a lateral decubitus position with the knee flexed to approximately 60 degrees. After the posterior retraction of the FCL, the plate was placed more posteriorly to provide a raft or horizontal belt fixation of the PL tibial plateau fragment. After an average of 14.3 months of follow up, the knee range of motion(ROM) was 121.4° ± 8.8° (range: 105°-135°), the HSS score was 96.7 ± 2.6 (range: 90-100), and the SMFA dysfunction score was 22.4 ± 3.8 (range: 16-28) points. The

  12. Anterior versus posterior approach in reconstruction of infected nonunion of the tibia using the vascularized fibular graft: potentialities and limitations.

    Science.gov (United States)

    Amr, Sherif M; El-Mofty, Aly O; Amin, Sherif N

    2002-01-01

    the anterior aspect of the bone lest it should become devitalized. Any exposed bone on the anterior aspect should be left to granulate alone. This occurs readily when stability has been regained at the fracture site after transfer of the free fibula. The popliteal and posterior tibial vessels are exposed, and the microvascular anastomosis placed in an end-to-side fashion onto either of them, depending on the length of the pedicle and the condition of the vessels themselves. To obtain the maximal length of the pedicle of the graft, the proximal osteotomy is placed at the neck of the fibula after decompressing the peroneal nerve. The distal osteotomy is placed as distally as possible. After detaching the fibula from the donor site, the proximal part of the graft is stripped subperiosteally, osteotomized, and discarded. Thus, a relatively long pedicle could be obtained. To facilitate subperiosteal stripping, the free fibula is harvested without a skin paddle. In this way, the use of a vein graft could be avoided. Patients presenting with infected nonunions of the tibia with extensive scarring of the lower extremity, excessively large areas of skin loss, and with questionable patency of the anterior and posterior tibial vessels are not suitable candidates for the free vascularized fibular graft. Although a vein graft could be used between the recipient popliteal and the donor peroneal vessels, its use decreases flow to the graft considerably. These patients are better candidates for the Ilizarov bone transport method with or without free latissimus dorsi transfer. Copyright 2002 Wiley-Liss, Inc.

  13. The fibular head projection is of limited use as a radiographic landmark in preoperative planning of total knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Matziolis, Doerte; Meiser, Marius; Matziolis, Georg [University Hospital Jena, Orthopedic Department, Eisenberg (Germany); Sieber, Norbert [Radiology Practice Eisenberg, Eisenberg (Germany); Teichgraeber, Ulf [University Hospital Jena, Institute of Diagnostic and Interventional Radiology, Eisenberg (Germany)

    2017-10-15

    The projection of the fibular head is recommended as a quality indicator of a correct radiographic projection. However, this landmark has yet to be sufficiently validated. The MRIs of 334 knee joints were included. On the MRIs, the distance between the FH and lateral tibial cortical bone was simulated in projections parallel to surgically relevant axes. Then, the Pearson correlation coefficient between the distance of the FH to the lateral tibial cortical bone and the projection plane causing this was determined. A projection of the knee joint perpendicular to Akagi's line projected the center of the fibular head on average 4.8 ± 2.9 mm laterally of the tibial cortical bone, parallel to the maximum mediolateral axis of the tibia 7.5 ± 3.4 mm, parallel to the posterior condylar axis 5.6 ± 3.6 mm and parallel to the surgical epicondylar axis 6.1 ± 3.5 mm laterally of the tibial cortical bone. An almost linear correlation was seen, with 1.9 tilting of the projection plane per mm change in distance between the fibular head and tibial cortical bone. At the same time, the interindividual scatter was over 60 . The rule of thumb for a partial overlap of the fibular head by the tibia in the case of a correct antero-posterior projection plane was also confirmed. However, a considerable interindividual variability of the position of the FH was found, which limits a conclusion regarding the quality of the radiographic projection on the basis of the position of the fibular head. (orig.)

  14. Long-term results of ipsilateral radiotherapy for tonsil cancer

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Tae Ryoolk; Wu, Hong Gyun [Dept. of Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-06-15

    We evaluated the effectiveness and safety of ipsilateral radiotherapy for the patient with well lateralized tonsil cancer: not cross midline and <1 cm of tumor invasion into the soft palate or base of tongue. From 2003 to 2011, twenty patients with well lateralized tonsil cancer underwent ipsilateral radiotherapy. Nineteen patients had T1-T2 tumors, and one patient had T3 tumor; twelve patients had N0-N2a disease and eight patients had N2b disease. Primary surgery followed by radiotherapy was performed in fourteen patients: four of these patients received chemotherapy. Four patients underwent induction chemotherapy followed by concurrent chemoradiotherapy (CCRT). The remaining two patients received induction chemotherapy followed by radiotherapy and definitive CCRT, respectively. No patient underwent radiotherapy alone. We analyzed the pattern of failure and complications. The median follow-up time was 64 months (range, 11 to 106 months) for surviving patients. One patient had local failure at tumor bed. There was no regional failure in contralateral neck, even in N2b disease. At five-year, local progression-free survival, distant metastasis-free survival, and progression-free survival rates were 95%, 100%, and 95%, respectively. One patient with treatment failure died, and the five-year overall survival rate was 95%. Radiation Therapy Oncology Group grade 2 xerostomia was found in one patient at least 6 months after the completion of radiotherapy. Ipsilateral radiotherapy is a reasonable treatment option for well lateralized tonsil cancer. Low rate of chronic xerostomia can be expected by sparing contralateral major salivary glands.

  15. Unilateral Eye Blinking Arising From the Ictal Ipsilateral Occipital Area.

    Science.gov (United States)

    Falsaperla, Raffaele; Perciavalle, Valentina; Pavone, Piero; Praticò, Andrea Domenico; Elia, Maurizio; Ruggieri, Martino; Caraballo, Roberto; Striano, Pasquale

    2016-07-01

    We report on an 18-month-old boy with unilateral left eye blinking as a single ictal manifestation without facial twitching. The clinical onset of this phenomenon was first recorded (as an occasional event) at age 3 months, and it was overlooked. By age 6 months, the child's blinking increased to almost daily occurrence in clusters: during blinking the infant showed intact awareness and occasional jerks in the upper limbs and right leg. A video-electroencephalography (video-EEG) documented clinical correlation with a focal pattern arising from the left occipital region, and brain magnetic resonance imaging (MRI) revealed severe brain damage, consisting in poroencephalic hollows and increased spaces in the convexities involving a large area of the left cerebral hemisphere. The boy was prescribed sodium valproate (30 mg/kg/d), resulting in drastic reduction of his clinical seizures. Follow-up to his current age documented good general status, with persistent partial right hemilateral seizures. The blinking progressively disappeared, and is no longer recorded. The pathogenic hypotheses of the unilateral ictal blinking include involvement of the ipsilateral cerebral hemisphere and/or the cerebellar pathways. Review of previous reports of unilateral eye blinking, arising from the ictal ipsilateral brain, revealed that different damaged regions may give rise to blinking ictal phenomena, likely via the trigeminal fibres innervating the subdural intracranial structures and the pial vessels in the ipsilateral affected brain. The eye blinking in the present child represents a further example of an ictal phenomenon, which is predictive of the damaged brain region. © EEG and Clinical Neuroscience Society (ECNS) 2014.

  16. Ipsilateral femoral autograft reconstruction after resection of a pelvic tumor.

    Science.gov (United States)

    Biau, David J; Thévenin, Fabrice; Dumaine, Valérie; Babinet, Antoine; Tomeno, Bernard; Anract, Philippe

    2009-01-01

    Reconstruction of bone after the resection of a pelvic tumor is challenging. The purpose of the present study was to evaluate the use of the ipsilateral femur as the graft material for reconstruction. We performed a retrospective review of thirteen patients with a malignant pelvic lesion who underwent resection followed by reconstruction with an ipsilateral femoral autograft and insertion of a total hip replacement. The study group included nine men and four women with a median age of fifty-one years at the time of the reconstruction. The diagnosis was chondrosarcoma in eight patients, metastasis in three, and myeloma and radiation-induced malignant disease in one each. The surviving patients were assessed functionally and radiographically; the cumulative probability of revision was estimated while taking into account competing risks. The median duration of follow-up was forty-nine months. At the time of the latest follow-up, seven patients were alive and disease-free and six had died from metastatic disease. Four patients had had revision of the reconstruction, two for the treatment of mechanical complications and two for the treatment of infection. Three other patients had mechanical complications but had not had a revision. The cumulative probability of revision of the reconstruction for mechanical failure was 8% (95% confidence interval, 0% to 23%), 8% (95% confidence interval, 0% to 23%), and 16% (95% confidence interval, 0% to 39%) at one, two, and four years, respectively. Although it has attendant complications consistent with pelvic tumor surgery, an ipsilateral femoral autograft reconstruction may be an option for reconstruction of pelvic discontinuity in a subgroup of patients following tumor resection. This innovative procedure requires longer-term follow-up studies.

  17. Multi-fasciculated anterior talo-fibular ligament: reassessment of normal findings

    Energy Technology Data Exchange (ETDEWEB)

    Delfaut, E.M.; Boutry, N.; Cotten, A. [Department of Musculo-Skeletal Radiology, Roger Salengro Hospital, CHRU Lille, Bd du Professeur Jules Leclercq, 59037, Lille (France); Demondion, X. [Department of Musculo-Skeletal Radiology, Roger Salengro Hospital, CHRU Lille, Bd du Professeur Jules Leclercq, 59037, Lille (France); Department of Anatomy, Faculty of Medicine, Roger Salengro Hospital, CHRU Lille, Place de Verdun, 59037, Lille Cedex (France); Cotten, H. [Pathology Laboratory, 128 Bd de la Liberte, 59000, Lille (France); Mestdagh, H. [Department of Orthopaedic Surgery, Roger Salengro Hospital, CHRU Lille, Bd du Professeur Jules Leclercq, 59037, Lille Cedex (France)

    2003-08-01

    The aims of this study were to (a) provide an accurate description of the anterior talo-fibular ligament (ATFL) multifasciculated feature by means of cadaver study, and (b) to further delineate contour and signal variations on MR images related to this feature in a group of asymptomatic subjects. After MR imaging, three cadaveric feet were frozen and cut in the coronal plane. The ATFL were harvested and sent to pathology. Another cadaveric foot was dissected. The MR imaging was performed in 3 healthy volunteers and 19 patients without pathology of the ATFL. For both cadaveric feet and subjects, MR imaging protocol consisted of axial and coronal proton-density (PD) and T2-weighted turbo-spin-echo (TSE) sequences (TR/TE: 3500 ms/17-119 ms). On MR images, ATFL signal and fascicle numbers were assessed, respectively, in the axial and coronal planes. Gross anatomy and pathology confirmed the ATFL bifasciculated aspect. On cadaveric coronal MR images, 3 of 4 ATFLs were bifasciculated and one of four was striated. On patients' coronal MR images, 2 of 22 of the ATFL were monofasciculated, 12 of 22 bifasciculated, and 8 of 22 striated. On axial MR images, 16 of 22 of the ATFL demonstrated a low signal intensity and 8 of 22 an intraligamentous subtle increased signal intensity. Two of 22 of the ATFL had contour irregularities. Isolated anterior talo-fibular intraligamentous signal abnormalities or contour irregularities on axial PD and T2-weighted MR images with an otherwise normal ATFL aspect on coronal MR images and no other MRI criteria for ankle sprain may reflect normal anatomy. (orig.)

  18. Multi-fasciculated anterior talo-fibular ligament: reassessment of normal findings

    International Nuclear Information System (INIS)

    Delfaut, E.M.; Boutry, N.; Cotten, A.; Demondion, X.; Cotten, H.; Mestdagh, H.

    2003-01-01

    The aims of this study were to (a) provide an accurate description of the anterior talo-fibular ligament (ATFL) multifasciculated feature by means of cadaver study, and (b) to further delineate contour and signal variations on MR images related to this feature in a group of asymptomatic subjects. After MR imaging, three cadaveric feet were frozen and cut in the coronal plane. The ATFL were harvested and sent to pathology. Another cadaveric foot was dissected. The MR imaging was performed in 3 healthy volunteers and 19 patients without pathology of the ATFL. For both cadaveric feet and subjects, MR imaging protocol consisted of axial and coronal proton-density (PD) and T2-weighted turbo-spin-echo (TSE) sequences (TR/TE: 3500 ms/17-119 ms). On MR images, ATFL signal and fascicle numbers were assessed, respectively, in the axial and coronal planes. Gross anatomy and pathology confirmed the ATFL bifasciculated aspect. On cadaveric coronal MR images, 3 of 4 ATFLs were bifasciculated and one of four was striated. On patients' coronal MR images, 2 of 22 of the ATFL were monofasciculated, 12 of 22 bifasciculated, and 8 of 22 striated. On axial MR images, 16 of 22 of the ATFL demonstrated a low signal intensity and 8 of 22 an intraligamentous subtle increased signal intensity. Two of 22 of the ATFL had contour irregularities. Isolated anterior talo-fibular intraligamentous signal abnormalities or contour irregularities on axial PD and T2-weighted MR images with an otherwise normal ATFL aspect on coronal MR images and no other MRI criteria for ankle sprain may reflect normal anatomy. (orig.)

  19. Free fibular strut graft in neglected femoral neck fractures in adult

    Directory of Open Access Journals (Sweden)

    Azam Md Quamar

    2009-01-01

    Full Text Available Background: Neglected femoral neck fracture in adults still poses a formidable challenge. Existing treatment options varies from osteotomy (with or without graft to osteosynthesis using various implants and grafting techniques (muscle pedicle, vascularized, and nonvascularized fibula. The aim of this study was to assess outcome of nonvascularized fibular strut graft and cancellous screw fixation in neglected femoral neck fractures in the younger age group. Materials and Methods: Medical records of 32 patients of neglected femoral neck fracture, in the age group of 22-45 years (mean 37.8 years, operated between May 1994 to December 2001, were retrospectively reviewed. After the application of inclusion and exclusion criteria, 28 patients having three years minimum follow-up (mean 4.6 years were included. Delay between injury and operation varied from four weeks to 42 weeks (mean 16.4 weeks. Closed reduction was achieved in 17 patients; open reduction through Watson-Jones anterolateral approach was performed in the remaining 15 patients in whom closed reduction failed. The fracture was transfixed with three parallel guide wires. Appropriate sized cannulated lag screw (7 mm was then inserted in two of the wires. Selection of the third guide wire for fibula depended on the space available in both anteroposterior and lateral view. Results: Satisfactory bony union was obtained in 25 patients, of whom in four cases, the union occurred in 10-20° (mean 15° of varus. Nonunion occurred in three patients (9.37%, and aseptic necrosis occurred in another six patients (18.75%. Of the 25 patients where union was achieved, five patients showed excellent results; 14 good and six had poor functional result, as evaluated using modified Anglen criteria. Conclusion: Nonvascularized fibular strut graft along with cancellous screws provides a dependable and technically less-demanding alternative procedure for neglected femoral neck fractures in young adults. Fibula

  20. Oral rehabilitation with dental implants and quality of life following mandibular reconstruction with free fibular flap.

    Science.gov (United States)

    Jacobsen, Hans-Christian; Wahnschaff, Falko; Trenkle, Thomas; Sieg, Peter; Hakim, Samer G

    2016-01-01

    Bony reconstruction of jaw defects using the free fibular flap and dental rehabilitation mostly requires insertion of dental implants within the transferred fibula bone. The aim of this paper was to discuss results of the implant stability with data on the possible benefit for the patient's quality of life after such treatment. For clinical outcome of implants, we evaluated 26 patients with a total number of 94 dental implants after a follow-up period of 12 to 132 months. A group of 38 patients who underwent mandibular reconstruction with free fibular flap could be included in the life-quality study. Evaluation included 23 patients with and 15 patients without implant-borne restoration. The quality of life was assessed using the standard QLQ C-30 questionnaire and the H&N35 module of the European Organisation for Research and Treatment of Cancer (EORTC). Of implants, 94.7 % were stable at the time of investigation and could be used for prosthesis. Patients with dental implants reported improvement of life quality along with better scores in most function and symptom scales; however, only values for global health status (QL2), absence of dyspnea (DY) and absence of feeding tube (HNFE) were significantly better than in the control group. Dental implant insertion in fibula grafts along with implant-borne restoration is a proven concept and might lead to improved quality of life following ablative surgery of the jaw. The effect on the quality of life is not as predictable as on the implant stability. Patients with bony defects of the jaw require bony reconstruction. This allows further masticatory rehabilitation using dental implants and might lead to improved quality of life.

  1. Ipsilateral sensory disturbances in Complex Regional Pain Syndrome (CRPS)

    DEFF Research Database (Denmark)

    Knudsen, Lone

    Aim of investigation: CRPS may spread from the primary affected limb to other body parts [1]. Even without subjective reports of a spread of CRPS, a spread of pressure hyperalgesia from the affected limb to the ipsilateral forehead is present in the majority of patients [2-4]. This may indicate...... of this study was to investigate sensitivity to pressure and pinprick at multiple body sites remote from the CRPS limb. Methods: Preliminary results from 10 CRPS patients (F/M: 8/2; mean age 43.2, range 24-61) with lower (n=2) or upper (n=8) limb affection and 10 age and sex matched healthy controls...... sites in controls. Patients also rated spontaneous pain on a numeric rating scale (0-10). Results: Mean of all PPTs were lower in CRPS patients (119 ± 15 kPa) than in controls (166 ± 15 kPa; p = 0.04), and PPTs were in general lower on the body side ipsilateral to pain in the CRPS patients (107 ± 13 k...

  2. Treatment of osteonecrosis of the femoral head by free vascularized fibular grafting: an analysis of surgical outcome and patient health status

    Science.gov (United States)

    Louie, Brian E.; McKee, Michael D.; Richards, Robin R.; Mahoney, James L.; Waddell, James P.; Beaton, Dorcas E.; Schemitsch, Emil H.; Yoo, Daniel J.

    1999-01-01

    Objective To evaluate the limb-specific outcome and general health status of patients with osteonecrosis of the femoral head treated with vascularized fibular grafting. Design A retrospective review. Setting A single tertiary care centre. Patients Fifty-five consecutive patients with osteonecrosis of the femoral head who underwent fibular grafting (8 bilaterally). Intervention Vascularized fibular grafting. Outcome measures Limb-specific scores (Harris Hip Score, St. Michael’s Hospital Hip Score), general health status (Nottingham Health Profile, SF-36 health status survey) and radiographic outcome measures (Steinberg stage). Results Patients were young (mean age 34 years, range from 18 to 52 years) and 80% had advanced osteonecrosis (Steinberg stages IV and V). Fifty-nine hips were followed up for an average of 50 months (range from 24 to 117 months) after vascularized fibular grafting. Sixteen hips (27%) were converted to total hip arthroplasty (THA). To date, 73% of hips treated with vascularized fibular grafting have required no further surgery. Preoperative and postoperative Harris Hip Scores were 57.3 and 83.6 respectively (p < 0.001). As measured by patient-oriented health status questionnaires (SF-36, Nottingham Health Profile) and compared with population controls, patients had normal mental health scores and only slight decreases in physical component scores. Conclusions Free vascularized fibular grafting for osteonecrosis of the femoral head provides satisfactory pain relief, functional improvement and general health status and halts the progression of symptomatic disease. PMID:10459327

  3. Arteria Tibial Anterior Hipoplásica Asociada con la Continuación de la Arteria Fibular como Arteria Dorsal del Pié: Un Reporte de Caso

    OpenAIRE

    Shetty, Surekha D; Nayak, Satheesha; Kumar, Naveen; Abhinitha, P

    2013-01-01

    Arterial variations of distal parts of lower limb are well documented. However, continuation of fibular artery as dorsalis pedis artery is a rare finding. Unusual course and distribution of the anterior tibial artery and fibular artery were observed during routine anatomical dissection of the right lower limb of an approximately 40-year-old male cadaver. The arteries of the crural region arose from the popliteal artery, as usual. However the anterior tibial artery was hypoplastic. The fibular...

  4. Second conservative radiosurgical treatment for ipsilateral breast cancer recurrence

    International Nuclear Information System (INIS)

    Castelli, J.; Courdi, A.; Hannoun-Levi, J.M.; Figl, A.; Raoust, I.; Lallement, M.; Flipo, B.; Ettore, F.; Chapelier, C.; Ferrero, J.M.

    2011-01-01

    Purpose. - Currently, radical mastectomy represents the gold standard for ipsilateral breast cancer recurrence. However, we already showed that a second conservative treatment was feasible combining lumpectomy plus low-dose rate interstitial brachytherapy. In this study, we reported the preliminary results of a second conservative treatment using a high-dose rate brachytherapy. Patients and methods. - From June 2005 to July 2009, 42 patients presenting with an ipsilateral breast cancer recurrence underwent a second conservative treatment. Plastic tubes were implanted intraoperatively at the time of the lumpectomy. After a post-implant CT scan, a total dose of 34 Gy in 10 fractions over 5 consecutive days was delivered through an ambulatory procedure. The toxicity evaluation used the Common Terminology Criteria for Adverse Events v3.0. Results. - The median follow-up was 21 months (6-50 months), median age at the time of the local recurrence was 65 years (30-85 years). The median delay between the primary and the recurrence was 11 years (1-35 years). The location of the recurrence was in the tumor bed for 22 patients (52.4%), in the same quadrant for 14 patients (33.3%) and unknown for six patients (14.3%). The median tumor size of the recurrence was 12 mm (2-30 mm). The median number of plastic tubes and plans were nine (5-12) and two (1-3) respectively. The median CTV was 68 cm 3 (31.2-146 cm 3 ). The rate of second local control was 97%. Twenty-two patients (60%) experienced complications. The most frequent side effect consisted in cutaneous and sub-cutaneous fibrosis (72% of all the observed complications). Conclusion. - A second conservative treatment for ipsilateral breast cancer recurrence using high-dose rate brachytherapy appears feasible leading to encouraging results in terms of second local control with an acceptable toxicity. Considering that a non-inferiority randomized trial comparing mastectomy versus second conservative treatment could be difficult

  5. Ununited fracture neck of femur treated with closed reduction and internal fixation with cancellous screw and fibular strut graft

    Directory of Open Access Journals (Sweden)

    Singh Daria

    2006-01-01

    Full Text Available Background: Ununited fracture neck of femur in young adults has been tackled in various ways. Methods: Twenty five patients of ununited fracture neck of femur in age group 21-55 years were treated by closed reduction, cancellous screw fixation and fibular strut graft and followed up for 2-6 years. Time gap between injury and operation was 6 weeks to 58 weeks. Five cases were previously fixed with various fixation devices. Results: Osseous union was achieved in 24 cases with average time of 18.16 weeks. Main complication encountered in follow-up was avascular necrosis of femoral head, others were joint stiffness and shortening. Functional end results were good to excellent in 24 cases. Conclusion: Closed reduction with internal fixation by cancellous screw and fibular strut grafting is easy and useful procedure.

  6. Total Maxillary Reconstruction Using a Double-Barreled and Double Skin Paddle Fibular Flap after Total Maxillectomy

    Directory of Open Access Journals (Sweden)

    Miguel de la Parra

    2013-11-01

    Full Text Available Chondroblastomas are rare entities accounting for approximately 1% of all primary bone tumors. We describe a case of a 7-year-old girl with a giant chondroblastoma of the maxilla, treated with bilateral class III maxillectomy and reconstruction with a double-barreled and double skin paddle fibular free flap. We show evidence of an excellent aesthetic outcome at 6 months' follow up with no evidence of tumor recurrence.

  7. Total Maxillary Reconstruction Using a Double-Barreled and Double Skin Paddle Fibular Flap after Total Maxillectomy

    Science.gov (United States)

    Sanchez, Gerardo; Lopez, Jaime; Perez, Adrian; Naal, Norberto

    2013-01-01

    Chondroblastomas are rare entities accounting for approximately 1% of all primary bone tumors. We describe a case of a 7-year-old girl with a giant chondroblastoma of the maxilla, treated with bilateral class III maxillectomy and reconstruction with a double-barreled and double skin paddle fibular free flap. We show evidence of an excellent aesthetic outcome at 6 months' follow up with no evidence of tumor recurrence. PMID:24286054

  8. Ipsilateral femoral neck and shaft fractures: An overlooked association

    International Nuclear Information System (INIS)

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

    1991-01-01

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

  9. Ipsilateral femoral neck and shaft fractures: An overlooked association

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-05-01

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

  10. A rare type of ankle fracture: Syndesmotic rupture combined with a high fibular fracture without medial injury.

    Science.gov (United States)

    van Wessem, K J P; Leenen, L P H

    2016-03-01

    High fibular spiral fractures are usually caused by pronation-external rotation mechanism. The foot is in pronation and the talus externally rotates, causing a rupture of the medial ligaments or a fracture of the medial malleolus. With continued rotation the anterior and posterior tibiofibular ligament will rupture, and finally, the energy leaves the fibula by creating a spiral fracture from anterior superior to posterior inferior. In this article we demonstrate a type of ankle fracture with syndesmotic injury and high fibular spiral fractures without a medial component. This type of ankle fractures cannot be explained by the Lauge-Hansen classification, since it lacks injury on the medial side of the ankle, but it does have the fibular fracture pattern matching the pronation external rotation injury (anterior superior to posterior inferior fracture). We investigated the mechanism of this injury illustrated by 3 cases and postulate a theory explaining the biomechanics behind this type of injury. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Failed vascularized proximal fibular epiphyseal transfer for hip reconstruction following infection in children.

    Science.gov (United States)

    Debarge, Romain; Chotel, Franck; Gazarian, Aram; Viola, Jérémy; Berard, Jérôme

    2009-08-01

    Treatment of the sequellae of hip infection with epiphyseal destruction in children has had limited success to date. The aim of this study was to report mid-term results after hip epiphyseal reconstruction using a proximal vascularized fibular graft in three children presenting with massive epiphyseal destruction of the proximal femur following infection. Three children suffered from hip articular destruction type IVB according to the Choi classification after neonatal septic arthritis. The mean age at reconstruction was 4.3 years (range 3-6 years). The Hunka et al. criteria were used to evaluate the functional results, and the clinical evaluation was based on the Musculo-Skeletal Tumor Society (MSTS) score. Growth and fusion of the graft and hip morphology were evaluated on simple X-rays and by magnetic resonance imaging (MRI). A ratio between cephalic diameter and inter-acetabular gap was defined on the MRI scan as the "acetabular filling index". No intraoperative complication was reported. With a mean follow-up of 4.8 years (3-6 years), the MSTS score was 22.7/30 (range 20-26), while the average lower limb length discrepancy was 3 cm. Patient 1 required a secondary derotation osteotomy of the femur because of abnormal external rotation and a bad result due to the unexplained occurrence of a painful and stiff hip joint. A secondary distal transfer of the greater trochanter was performed in patient 2, and good results based on Hunka et al.'s criteria were achieved. The X-rays of patients 1 and 2 showed signs of bone growth and a major remodeling process; the MRI filling indices were 83 and 67%, respectively. Patient 3 developed an early slipped capital (fibular) epiphysis 1 month postoperatively, which was treated by percutaneous pinning; this early complication led to a bad result with full resorption of the graft. In contrast to its success in upper limb reconstruction, in this series of three patients with hip articular destruction, articular reconstruction

  12. [Tibia reconstruction using cross-leg pedicled fibular flaps: report of two cases].

    Science.gov (United States)

    Molski, M

    2000-01-01

    The paper presents the results of treatment of two children with cross-leg pedicle fibular flaps. A boy (10 years old) was operated because of an extensive defect of the proximal tibial shaft (15 cm) and soft tissue deficit due to osteosarcoma. He had been previously operated several times: tumor resection with chemiotherapy, bone reconstruction using allografts and two other procedures because of inflammatory complications. The second case was a 9-year old girl who underwent an extensive excision of congenital pseudoarthrosis of the tibia due to neurofibroma and reconstruction of the further fragment of the tibia. Vascularized fibula was nailed deep into the tibial shaft, beyond the previously implanted metal elements. This allowed to maintain a correct axis of the limb, a firm stabilization of the transplant and probably evoked a quick periosteal reaction of the tibia. Plaster of Paris was used to immobilize the limb. Postoperative course showed no complications. The flap pedicle was cut off after 3-4 weeks. Progressive bone healing followed by bony hypertrophy was observed after 8 weeks. The children were able to fully load the operated extremities and ambulate without crutches (the boys 12 months post-surgery and the girl 6 months post-surgery).

  13. A-Frame free Vascularized Fibular Graft and Femoral Lengthening for Osteosarcoma Pediatric Patients.

    Science.gov (United States)

    Cashin, Megan; Coombs, Christopher; Torode, Ian

    2018-02-01

    Pediatric limb reconstruction after resection of a malignant tumor presents specific challenges. Multiple surgical techniques have been used to treat these patients. This paper describes a staged surgical technique for the reconstruction of large distal femoral defects due to tumor resection in skeletally immature patients. Three pediatric patients with osteosarcoma of the distal femur underwent staged reconstruction. Neoadjuvant chemotherapy was followed by en bloc tumor resection and immediate reconstruction of the distal femoral defect with a vascularized free fibular autograft utilizing a unique A-frame construct combined with intramedullary nail fixation. The second stage was a planned gradual lengthening of the healed construct, over a custom-made magnetically driven expandable intramedullary nail. All patients achieved bony union and satisfactory length with minimal complications. The patients all returned to full, unlimited physical activities. The early results confirm that the described technique is a safe and reliable procedure for the reconstruction of large femoral defects in pediatric patients with osteosarcoma. Level IV-therapeutic.

  14. Dislocation of the fibular head in an unusual sports injury: a case report

    Directory of Open Access Journals (Sweden)

    Ahmad Riaz

    2008-05-01

    Full Text Available Abstract Introduction One of the primary functions of the proximal tibiofibular joint is slight rotation to accommodate rotational stress at the ankle. Proximal tibiofibular joint dislocation is a rare injury and accounts for less than 1% of all knee injuries. This dislocation has been reported in patients who had been engaged in football, ballet dancing, equestrian jumping, parachuting and snowboarding. Case presentation A 20-year-old man was injured whilst playing football. He felt a pop in the right knee and was subsequently unable to bear weight on it. The range of movement in his knee joint was limited. Anterior-posterior and lateral X-rays of the knee revealed anterolateral dislocation of the proximal tibiofibular joint. Comparison views confirmed the anterolateral dislocation. He had a failed manipulation under anaesthesia and the joint needed an open reduction in which the fibular head was levered back into place. Operative findings revealed a horizontal type of joint. Conclusion An exceedingly rare dislocation of a horizontal type of proximal tibiofibular joint was presented following a football injury. This dislocation was irreducible by a closed method.

  15. [How to make your own custom cutting guides for both mandibular and fibular stair step osteotomies?

    Science.gov (United States)

    Rem, K; Bosc, R; De Kermadec, H; Hersant, B; Meningaud, J-P

    2017-12-01

    Using tailored cutting guides for osteocutaneous free fibula flap in complex mandibular reconstruction after cancer resection surgery constitutes a substantial improvement. Autonomously conceiving and manufacturing the cutting guides within a plastic surgery department with computer-aided design (CAD) and three-dimensional (3D) printing allows planning more complex osteotomies, such as stair-step osteotomies, in order to achieve more stable internal fixations. For the past three years, we have been producing by ourselves patient-tailored cutting guides using CAD and 3D printing. Osteotomies were virtually planned, making the cutting lines more complex in order to optimize the internal fixation stability. We also printed reconstructed mandible templates and shaped the reconstruction plates on them. We recorded data including manufacturing techniques and surgical outcomes. Eleven consecutive patients were operated on for an oral cavity cancer. For each patient, we planned the fibular and mandibular stair-step osteotomies and we produced tailored cutting guides. In all patients, we achieved to get immediately stable internal fixations and in 10 patients, a complete bone consolidation after 6 months. Autonomously manufacturing surgical cutting guides for mandibular reconstruction by free fibula flap is a significant improvement, regarding ergonomics and precision. Planning stair-step osteotomies to perform complementary internal fixation increases contact surface and congruence between the bone segments, thus improving the reconstructed mandible stability. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. A RARE CASE OF IPSILATERAL HIP AND KNEE DISLOCATION

    Directory of Open Access Journals (Sweden)

    Deepak

    2015-06-01

    Full Text Available High velocity road traffic accidents leads to complicated lower limb injuries. Such injuries demand highly experienced surgeon and are associated with high morbidity and mortality. Hip or knee dislocations are two different orthopaedic emergencies. Concomitant fracture dislocation of the hip and knee is rare and very few cases have been reported in the literature. A 45 year old man with history of fall from motorcycle came to the casualty. He had ipsilateral hip and knee dislocation. Immediately patient was shifted to operation theatre and closed reduction was performed under general anaesthesia. Reduction was confirmed under fluoroscopy and post-operative x-rays were taken. The functional results were excellent. After 2 months patient made an uncomplicated recovery and had satisfactory functional outcome with right hip having 110⁰ flexion and right knee flexes to 120⁰.There was no neurological deficit. The urgency, that the treating surgeon shows in managing these injuries, significantly affects the prognosis and outcome finally achieved by these patients (golden period in reducing the hip joint has been described to be 6 hours.

  17. Endovascular management of renal transplant dysfunction secondary to hemodynamic effects related to ipsilateral femoral arteriovenous graft

    Science.gov (United States)

    Salsamendi, Jason; Pereira, Keith; Quintana, David; Bleicher, Drew; Tabbara, Marwan; Goldstein, Michael; Narayanan, Govindarajan

    2016-01-01

    Hemodialysis access options become complex in long-term treatment for patients with renal disease, while awaiting renal transplantation (RT). Once upper extremity sites are exhausted, lower extremities are used. RT is preferably in the contralateral iliac fossa, rarely ipsilateral. In current literature, RT dysfunction secondary to the hemodynamic effects of an ipsilateral femoral arteriovenous graft (AVG) has been rarely described. To our knowledge, AVG ligation is the only published technique for hemodynamic correction of an ipsilateral AVG. We present a simple, potentially reversible endovascular approach to manage the hemodynamic effects of an AVG, without potentially permanently losing future AVG access. PMID:26899147

  18. Lateral medullary infarction with ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy.

    Science.gov (United States)

    Li, Xiaodi; Wang, Yuzhou

    2014-04-01

    Here, we present a rare case of a lateral medullary infarction with ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy. In this case, we proved Opalski's hypothesis by diffusion tensor tractography that ipsilateral hemiparesis in a medullary infarction is due to the involvement of the decussated corticospinal tract. We found that the clinical triad of ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy, which had been regarded as a variant of medial medullary syndrome, turned out to be caused by lateral lower medullary infarction. Therefore, this clinical triad does not imply the involvement of the anteromedial part of medulla oblongata, when it is hard to distinguish a massive lateral medullary infarction from a hemimedullary infarction merely from MR images. At last, we suggest that hyperreflexia and Babinski's sign may not be indispensable to the diagnosis of Opalski's syndrome and we propose that "hemimedullary infarction with ipsilateral hemiparesis" is intrinsically a variant of lateral medullary infarction.

  19. Severe ipsilateral carotid stenosis and middle cerebral artery disease in lacunar ischaemic stroke: innocent bystanders?

    Science.gov (United States)

    Mead, G E; Lewis, S C; Wardlaw, J M; Dennis, M S; Warlow, C P

    2002-03-01

    Lacunar infarcts are thought to be mostly due to intracranial small vessel disease. Therefore, when a stroke patient with a relevant lacunar infarct does have severe ipsilateral internal carotid artery (ICA) or middle cerebral artery (MCA) disease, it is unclear whether the arterial disease is causative or coincidental. If causative, we would expect ICA/MCA disease to be more severe on the symptomatic side than on the asymptomatic side. Therefore, our aim was to compare the severity of ipsilateral with contralateral ICA and MCA disease in patients with lacunar ischaemic stroke. We studied 259 inpatients and outpatients with a recent lacunar ischaemic stroke and no other prior stroke. We used carotid Duplex ultrasound and transcranial Doppler (TCD) ultrasound to identify ICA and MCA disease, and compared our results with previously published data. In our study, there was no difference between the severity of ipsilateral and contralateral ICA stenosis within individuals (median difference 0%, Wilcoxon paired data p=0.24, comparing severity of ipsilateral and contralateral stenosis). The overall prevalence of severe ipsilateral stenosis was 5%, and the prevalence of severe contralateral stenosis was 4% (OR 1.6, 95% CI 0.6, 4.8). There was no difference in the prevalence of ipsilateral and contralateral MCA disease. A systematic review of the other available studies strengthened this conclusion. Carotid stenosis in patients with a lacunar ischaemic stroke may be coincidental. Further studies are required to elucidate the causes of lacunar stroke, and to evaluate the role of carotid endarterectomy.

  20. Effect of fibular repositioning taping in adult basketball players with chronic ankle instability: a randomized, placebo-controlled, crossover trial.

    Science.gov (United States)

    Alves, Yanina; Ribeiro, Fernando; Silva, Anabela G

    2017-07-05

    Chronic ankle instability presents a high incidence and prevalence in basketbal players. It's important to develop strategies to reduce the functional and mechanical limitations resulting from this condition. To compare the effect of Mulligan ́s fibular repositioning taping with a placebo taping immediatly after application and after a running test (Yo-Yo IRT). 16 adult basketball players (10 male, 6 female) with chronic ankle instability and mean age 21.50 ± 2.76 years old. Assessment of static postural control (15 seconds of unipedal stance test with eyes closed in a force platform), functional performance (figure 8 hop test and lateral hop test) and neuromuscular control (peroneus longus latency time in sudden inversion) in two conditions: Mulligan and Placebo. No significant effect was found for the intervantion factor in both hop tests (p>0.170), but there was a significant effect for the time factor (p<0.03). For the peroneus longus latency time, there was a significant interaction between factors (p=0.028) and also for time (p=0.042). No significant effect was found for any of the static postural control variables (area, speed and total displacement) (p≥0.10). There was no differences between Mulligan's fibular repositioning taping and Placebo taping in postural control and functional performance in basketball players with chronic ankle instability. However, Mulligan's taping appears to reduce peroneus longus latency time after a running when compared with a placebo taping.

  1. Total Maxillary Reconstruction With a Bi-Paddle Double-Barrel Osteocutaneous Fibular Flap and Arteriovenous Saphenous Loop After a Globe-Sparing Total Maxillectomy Due to Osteosarcoma.

    Science.gov (United States)

    Tseng, Wan-Ling; Chang, Tzu-Yen; Hung, Kuo-Shu; Chen, Szu-Han; Hsiao, Jenn-Ren; Lee, Yao-Chou

    2017-01-01

    The titanium mesh or bone graft is usually used for orbital support after a globe-sparing total maxillectomy. However, its use can invite complications, such as infection, exposure, and absorption, especially for patients who require adjuvant radiotherapy. Here, the authors present a patient who received total maxillary reconstruction with an osteocutaneous fibular flap. A 53-year-old man with the diagnosis of maxillary osteosarcoma received a globe-sparing total maxillectomy. A bi-paddle double-barrel osteocutaneous fibular flap was used for orbital support, alveolar ridge recreation, and oro-sino-nasal separation. The short pedicle length inherent in the double-barrel design of the fibular flap was overcome by creating an arteriovenous saphenous loop. The postoperative recovery was uneventful. During the 9 months follow-up, the patient was tumor-free and satisfied with his appearance, speech, and intake functions. Reconstruction with a bi-paddle double-barrel osteocutaneous fibular flap after a globe-sparing total maxillectomy can achieve satisfactory aesthetic and functional results.

  2. Osteocutaneous Free Fibular Flap for Anatomical Reconstruction of the Mandible Following Tumor Resection

    International Nuclear Information System (INIS)

    Amin, A.A.

    2003-01-01

    The development of microvascular free tissue transfer has revolutionized the current approaches for mandible reconstruction. It allowed one stage reconstruction of complex bony and soft tissue defects with high reliability. This study presents our experience using vascularized free fibular graft for reconstruction of different anatomical mandibular defects following tumor ablation. Methods: This study involves a total of 16 patients who were treated over 3-year period at the National Cancer Institute, Cairo University. All patients underwent mandibular resection and immediate reconstruction using free fibula osteocutaneous flap. Mandibular resections were performed due to either primary mandibular tumors, or tumors directly invading the mandible from adjacent areas. The extent of mandibular involvement by tumor was preoperatively assessed by X-ray panoramic view and CT scan. Mandibular defects were classified according to HCL system where H defects are lateral defect of any length including the condyle, L defects are the same without condyle and C defects represent the central segment between the mental foramina. The success rate, recipient vessels used, complications and functional as well as cosmetic outcome will be discussed. Results: Of sixteen patients, ten were males and 6 were females. The age ranged from 4 to 68 years. Five patients had preoperative chemotherapy; two had radiation therapy, while six patients received postoperative radiation therapy. All patients had preoperative histological diagnosis; squamous cell carcinoma was the most common histology. Mandibular defects consisted of central segment (3 C), lateral defect (9 L) and 4 patients with H defects. The skin island was used to provide inner mucosal lining in II patients and as external monitor in 5 patients. The free flap was successful in 13 patients. There were 3 complete free flap necrosis; all were due to venous thromboses. Salvage surgery was attempted in all failing flaps, however, it was

  3. Association of Ipsilateral Rib Fractures With Displacement of Midshaft Clavicle Fractures.

    Science.gov (United States)

    Stahl, Daniel; Ellington, Matthew; Brennan, Kindyle; Brennan, Michael

    2017-04-01

    To determine whether the presence of ipsilateral rib fractures affects the rate of a clavicle fracture being unstable (>100% displacement). A retrospective review from 2002-2013 performed at a single level 1 trauma center evaluated 243 midshaft clavicle fractures. Single Level 1 trauma center. These fractures were subdivided into those with ipsilateral rib fractures (CIR; n = 149) and those without ipsilateral rib fractures (CnIR; n = 94). The amount of displacement was measured on the initial injury radiograph and subsequent follow-up radiographs. Fractures were classified into either 100% displacement, based on anteroposterior radiographs. Ipsilateral rib fractures were recorded based on which number rib was fractured and the total number of fractured ribs. One hundred sixteen (78%) of the CIR group and 51 (54%) of the CnIR group were found to have >100% displacement at follow-up (P = 0.0047). Seventy-two percent of the CIR group demonstrated progression from 100% displacement of the fracture compared with only 54% of the CnIR group (P fracture to >100% was 4.08 (P = 0.000194) when ribs 1-4 were fractured and not significant for rib fractures 5-8 or 9-12. The presence of concomitant ipsilateral rib fractures significantly increases the rate of midshaft clavicle fractures being >100% displaced. In addition, a fracture involving the upper one-third of the ribs significantly increases the rate of the clavicle fracture being >100% displaced on early follow-up. Clavicle fractures with associated ipsilateral rib fractures tend to demonstrate an increased amount of displacement on follow-up radiographs compared with those without ipsilateral rib fractures. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

  4. [Effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation].

    Science.gov (United States)

    Ge, Qihang; Wan, Chunyou; Liu, Yabei; Ji, Xu; Ma, Jihai; Cao, Haikun; Yong, Wei; Liu, Zhao; Zhang, Ningning

    2017-08-01

    To investigate the effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation. The data of 45 cases with tibial and fibular open fractures treated by Taylor space stent fixation who meet the selection criteria between January 2015 and June 2016 were retrospectively analysed. The patients were divided into trial group (23 cases) and control group (22 cases) according to whether the axial stress stimulation was performed after operation. There was no significant difference in gender, age, affected side, cause of injury, type of fracture, and interval time from injury to operation between 2 groups ( P >0.05). The axial stress stimulation was performed in trial group after operation. The axial load sharing ratio was tested, and when the value was less than 10%, the external fixator was removed. The fracture healing time, full weight-bearing time, and external fixator removal time were recorded and compared. After 6 months of external fixator removal, the function of the limb was assessed by Johner-Wruhs criteria for evaluation of final effectiveness of treatment of tibial shaft fractures. There were 2 and 3 cases of needle foreign body reaction in trial group and control group, respectively, and healed after symptomatic anti allergic treatment. All the patients were followed up 8-12 months with an average of 10 months. All the fractures reached clinical healing, no complication such as delayed union, nonunion, or osteomyelitis occurred. The fracture healing time, full weight-bearing time, and external fixator removal time in trial group were significantly shorter than those in control group ( P good in 6 cases, fair in 3 cases, and poor in 1 case in trial group, with an excellent and good rate of 82.6%; and was excellent in 5 cases, good in 10 cases, fair in 4 cases, and poor in 3 cases in control group, with an excellent and good rate of 68.2%, showing significant difference between 2 groups ( Z =-2.146, P =0

  5. Lateral supraorbital approach to ipsilateral PCA-P1 and ICA-PCoA aneurysms.

    Science.gov (United States)

    Goehre, Felix; Jahromi, Behnam Rezai; Elsharkawy, Ahmed; Lehto, Hanna; Shekhtman, Oleg; Andrade-Barazarte, Hugo; Munoz, Francisco; Hijazy, Ferzat; Makhkamov, Makhkam; Hernesniemi, Juha

    2015-01-01

    Aneurysms of the posterior cerebral artery (PCA) are rare and often associated with anterior circulation aneurysms. The lateral supraorbital approach allows for a very fast and safe approach to the ipsilateral lesions Circle of Willis. A technical note on the successful clip occlusion of two aneurysms in the anterior and posterior Circle of Willis via this less invasive approach has not been published before. The objective of this technical note is to describe the simultaneous microsurgical clip occlusion of an ipsilateral PCA-P1 and an internal carotid artery - posterior communicating artery (ICA-PCoA) aneurysm via the lateral supraorbital approach. The authors present a technical report of successful clip occlusions of ipsilateral located PCA-P1 and ICA-PCoA aneurysms. A 59-year-old female patient was diagnosed with a PCA-P1 and an ipsilateral ICA-PCoA aneurysm by computed tomography angiography (CTA) after an ischemic stroke secondary to a contralateral ICA dissection. The patient underwent microsurgical clipping after a lateral supraorbital craniotomy. The intraoperative indocyanine green (ICG) videoangiography and the postoperative CTA showed a complete occlusion of both aneurysms; the parent vessels (ICA and PCA) were patent. The patient presents postoperative no new neurologic deficit. The lateral supraorbital approach is suitable for the simultaneous microsurgical treatment of proximal anterior circulation and ipsilateral proximal PCA aneurysms. Compared to endovascular treatment, direct visual control of brainstem perforators is possible.

  6. Corticofugal modulation of initial neural processing of sound information from the ipsilateral ear in the mouse.

    Directory of Open Access Journals (Sweden)

    Xiuping Liu

    2010-11-01

    Full Text Available Cortical neurons implement a high frequency-specific modulation of subcortical nuclei that includes the cochlear nucleus. Anatomical studies show that corticofugal fibers terminating in the auditory thalamus and midbrain are mostly ipsilateral. Differently, corticofugal fibers terminating in the cochlear nucleus are bilateral, which fits to the needs of binaural hearing that improves hearing quality. This leads to our hypothesis that corticofugal modulation of initial neural processing of sound information from the contralateral and ipsilateral ears could be equivalent or coordinated at the first sound processing level.With the focal electrical stimulation of the auditory cortex and single unit recording, this study examined corticofugal modulation of the ipsilateral cochlear nucleus. The same methods and procedures as described in our previous study of corticofugal modulation of contralateral cochlear nucleus were employed simply for comparison. We found that focal electrical stimulation of cortical neurons induced substantial changes in the response magnitude, response latency and receptive field of ipsilateral cochlear nucleus neurons. Cortical stimulation facilitated auditory response and shortened the response latency of physiologically matched neurons whereas it inhibited auditory response and lengthened the response latency of unmatched neurons. Finally, cortical stimulation shifted the best frequencies of cochlear neurons towards those of stimulated cortical neurons.Our data suggest that cortical neurons enable a high frequency-specific remodelling of sound information processing in the ipsilateral cochlear nucleus in the same manner as that in the contralateral cochlear nucleus.

  7. Ebselen reduces autophagic activation and cell death in the ipsilateral thalamus following focal cerebral infarction.

    Science.gov (United States)

    Li, Yiliang; Zhang, Jian; Chen, Li; Xing, Shihui; Li, Jingjing; Zhang, Yusheng; Li, Chuo; Pei, Zhong; Zeng, Jinsheng

    2015-07-23

    Previous studies have demonstrated that both oxidative stress and autophagy play important roles in secondary neuronal degeneration in the ipsilateral thalamus after distal middle cerebral artery occlusion (MCAO). This study aimed to investigate whether oxidative stress is associated with autophagy activation within the ipsilateral thalamus after distal MCAO. Sixty stroke-prone renovascular hypertensive rats were subjected to distal MCAO or sham operation, and were killed at 14 days after MCAO. Mn-SOD, LC3-II, Beclin-1 and p62 expression were evaluated by immunostaining and immunoblotting. Secondary damage in the thalamus was assessed with Nissl staining and immunostaining. The association of oxidative stress with autophagy activation was investigated by the antioxidant, ebselen. We found that treatment with ebselen at 24h after MCAO significantly reduced the expression of Mn-SOD in the ipsilateral thalamus at 14 days following focal cerebral infarction. In parallel, it prevented the elevation of LC3-II and Beclin-1, and the reduction of p62. Furthermore, ebselen attenuated the neuronal loss and gliosis in the ipsilateral thalamus. These results suggested that ebselen reduced oxidative stress, autophagy activation and secondary damage in the ipsilateral thalamus following MCAO. There are associations between oxidative stress, autophagy activation and secondary damage in the thalamus after MCAO. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Double elevator weakening for unilateral congenital superior oblique palsy with ipsilateral superior rectus contracture and lax superior oblique tendon.

    Science.gov (United States)

    Khan, Arif O

    2012-06-01

    In unilateral congenital superior oblique palsy, a large hypertropia is sometimes associated with ipsilateral contracture of the superior rectus muscle and apparent overaction of the contralateral superior oblique. Ipsilateral double elevator weakening is one surgical approach; however, this procedure could compromise supraduction. We report a series of three consecutive patients who underwent ipsilateral superior rectus and inferior oblique recessions for unilateral superior oblique palsy. Intraoperatively, all three patients were found to have a lax ipsilateral superior oblique tendon. Postoperatively, all three patients had satisfactory correction of the hypertropia and abnormal head position with minimal supraduction defect. This procedure seems to be an acceptable initial surgical option for treating congenital superior oblique muscle palsy with ipsilateral contracture of the superior rectus muscle, even when the ipsilateral superior oblique tendon is lax. Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  9. Modified Grice-Green subtalar arthrodesis performed using a partial fibular graft yields satisfactory results in patients with cerebral palsy.

    Science.gov (United States)

    Güven, Melih; Tokyay, Abbas; Akman, Budak; Encan, Mehmet E; Altintaş, Faik

    2016-03-01

    The aim of this study was to report the experience with the use of a modified Grice-Green technique, which was performed using a partial subperiosteal fibular bone graft because of valgus unstable foot in children with cerebral palsy. Fifteen feet of 11 patients were evaluated on the basis of the appearance of the feet, clinical symptoms, and radiographic measurements. After an average follow-up duration of 24 (9-39) months, all feet showed satisfactory clinical and radiological results. Solid fusion and sustained correction took place in all feet. The gap at the donor site was bridged with new bone in all cases. No donor-site morbidity was detected. This modification of the Grice-Green technique can be used effectively in the correction of planovalgus foot in cerebral palsy.

  10. Cisto sinovial intraneural do nervo fibular: relato de caso Intraneural synovial cyst of the peroneal nerve: case report

    Directory of Open Access Journals (Sweden)

    Roberto Sergio Martins

    1997-01-01

    Full Text Available Os autores apresentam um caso de um cisto sinovial intraneural ocorrendo no nervo fibular comum. O paciente apresentou-se com quadro de dor e dificuldade para a flexão dorsal e eversão do pé sendo submetido a exploração cirúrgica com exérese do cisto. Neste estudo são discutidos a patogênese, manifestações clínicas e tratamento desta rara lesão.The authors report the case of an intraneural synovial cyst of the peroneal nerve. The initial symptom was pain and weakness of dorsiflexion and eversion of the right foot. The patient was operated on and the cyst was totally resected. The authors discuss the pathogenesis, clinical diagnosis as well as the treatment of that uncommon lesion.

  11. Return to National Basketball Association Competition Following Anterior Cruciate Ligament and Fibular Collateral Ligament Injuries: A Case Report.

    Science.gov (United States)

    LaPrade, Robert F; O'Brien, Luke; Kennedy, Nicholas I; Cinque, Mark E; Chahla, Jorge

    2017-01-01

    Numerous outcome studies regarding anterior cruciate ligament (ACL) reconstruction demonstrate the ability of athletes to return to a high level of play. However, to our knowledge, there is limited literature regarding return to play following injury to both the ACL and the fibular collateral ligament (FCL). We describe the case of a National Basketball Association (NBA) player who sustained a combined ACL and FCL knee injury and subsequently underwent surgical reconstruction of both affected ligaments. He was able to return to a preinjury level of competition at 9 months postoperatively. It is possible for athletes to return to competitive basketball and maintain a high production level following a single-staged reconstruction of both the ACL and the FCL.

  12. High frequency electrical stimulation concurrently induces central sensitization and ipsilateral inhibitory pain modulation.

    Science.gov (United States)

    Vo, L; Drummond, P D

    2013-03-01

    In healthy humans, analgesia to blunt pressure develops in the ipsilateral forehead during various forms of limb pain. The aim of the current study was to determine whether this analgesic response is induced by ultraviolet B radiation (UVB), which evokes signs of peripheral sensitization, or by high-frequency electrical stimulation (HFS), which triggers signs of central sensitization. Before and after HFS and UVB conditioning, sensitivity to heat and to blunt and sharp stimuli was assessed at and adjacent to the treated site in the forearm. In addition, sensitivity to blunt pressure was measured bilaterally in the forehead. The effect of ipsilateral versus contralateral temple cooling on electrically evoked pain in the forearm was then examined, to determine whether HFS or UVB conditioning altered inhibitory pain modulation. UVB conditioning triggered signs of peripheral sensitization, whereas HFS conditioning triggered signs of central sensitization. Importantly, ipsilateral forehead analgesia developed after HFS but not UVB conditioning. In addition, decreases in electrically evoked pain at the HFS-treated site were greater during ipsilateral than contralateral temple cooling, whereas decreases at the UVB-treated site were similar during both procedures. HFS conditioning induced signs of central sensitization in the forearm and analgesia both in the ipsilateral forehead and the HFS-treated site. This ipsilateral analgesia was not due to peripheral sensitization or other non-specific effects, as it failed to develop after UVB conditioning. Thus, the supra-spinal mechanisms that evoke central sensitization might also trigger a hemilateral inhibitory pain modulation process. This inhibitory process could sharpen the boundaries of central sensitization or limit its spread. © 2012 European Federation of International Association for the Study of Pain Chapters.

  13. Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies

    Directory of Open Access Journals (Sweden)

    VVS Chandrasekharam

    2015-01-01

    Full Text Available Aim: Ipsilateral ureteroureterostomy is an established method for the treatment of duplication anomalies in children. With the advent of pediatric laparoscopy, many urologic procedures in children are being performed using minimal access techniques. We present our experience with laparoscopic ipsilateral ureteroureterostomy (LIUU for duplex anomalies. Patients and Methods: The data of children who underwent LIUU was reviewed for demographic parameters, clinical and operative details, follow-up and results. Results: Over 3 years period, LIUU was performed in eight children (age 6-60 months. Five children had complete ipsilateral duplication with ectopic upper moiety ureter, one child each had ipsilateral incomplete duplication and bilateral duplex systems (with ipsilateral ectopic upper moiety ureter. One child had ipsilateral complete duplex with Grade V vesicoureteric reflux into the lower moiety ureter. Four children had antenatal diagnosis of hydronephrosis; three children had a urinary infection and two children presented with urinary incontinence. The surgical procedure consisted of cystoscopy, retrograde studies and cannulation of the recipient ureter. Then, LIUU was performed using three ports. The ectopic (donor ureter was divided at the pelvic brim; the recipient ureter was opened and end-to-side LIUU was performed with 5/0 vicryl stitches over a double J (DJ stent placed in the recipient ureter. Bladder catheter was removed after 2 days, and DJ stent was removed after 4 weeks. At a mean follow-up of 19 months (3-36, all children are asymptomatic and continent, with a significant reduction in hydroureteronephrosis on ultrasound. The cosmetic results were excellent. Conclusion: LIUU is a safe and effective technique in the management of duplication anomalies in children. It could be performed with minimal blood loss, minimal postoperative pain, excellent cosmesis and good success.

  14. Ipsilateral hemiparesis and contralateral lower limb paresis caused by anterior cerebral artery territory infarct.

    Science.gov (United States)

    Xu, Yongfeng; Liu, Lan

    2016-07-01

    Ipsilateral hemiparesis is rare after a supratentorial stroke, and the role of reorganization in the motor areas of unaffected hemisphere is important for the rehabilitation of the stroke patients. In this study, we present a patient who had a subclinical remote infarct in the right pons developed ipsilateral hemiparesis and contralateral lower limb paresis caused by a new infarct in the left anterior cerebral artery territory. Our case suggests that the motor areas of the unaffected hemisphere might be reorganized after stroke, which is important for the rehabilitation of stroke patients.

  15. Giant seminal vesicle cyst with ipsilateral hypoplastic kidney: Report of a case with review of literature

    Directory of Open Access Journals (Sweden)

    Dilip Kumar Pal

    2006-01-01

    Full Text Available We report a case of a congenital seminal vesicle cyst with ipsilateral hypoplastic kidney in a 51 year-old Indian man presenting with features of bladder outlet obstruction. Abdominal and pelvic Ultrasonography (USG, computed tomography revealed a retrovesical cystic mass measuring 10cm x 9cm with indentations over the left infero-lateral wall of the urinary bladder. On USG and radionuclide renal scanning the ipsilateral kidney was not found, which was located only on the CT scan. The cyst and the hypoplastic kidney was excised with an uneventful recovery.

  16. Compartment syndrome of the thigh complicating surgical treatment of ipsilateral femur and ankle fractures

    Science.gov (United States)

    Moore, M. R.; Garfin, S. R.; Hargens, A. R.

    1987-01-01

    A 26-year-old man presented with ipsilateral femur and ankle fractures. The patient was treated with interlocking nail of his femur fracture, followed by open reduction and internal fixation of his ankle fracture under tourniquet control. Postoperatively, the patient developed compartment syndrome of his thigh with elevated pressures, requiring decompressive fasciotomies. This case illustrates the possible complication of treating a femur fracture with intramedullary nailing and then immediately applying a tourniquet to treat an ipsilateral extremity fracture. Because of the complication with this patient, we feel the procedure should be staged, or a tourniquet should be avoided if possible.

  17. Transportation

    National Research Council Canada - National Science Library

    Adams, James; Carr, Ron; Chebl, Maroun; Coleman, Robert; Costantini, William; Cox, Robert; Dial, William; Jenkins, Robert; McGovern, James; Mueller, Peter

    2006-01-01

    ...., trains, ships, etc.) and maximizing intermodal efficiency. A healthy balance must be achieved between the flow of international commerce and security requirements regardless of transportation mode...

  18. Transportation

    International Nuclear Information System (INIS)

    Anon.

    1998-01-01

    Here is the decree of the thirtieth of July 1998 relative to road transportation, to trade and brokerage of wastes. It requires to firms which carry out a road transportation as well as to traders and to brokers of wastes to declare their operations to the prefect. The declaration has to be renewed every five years. (O.M.)

  19. [Calcaneo-fibular ligament surgery for chronic lateral instability of the upper ankle : Broström technique with modification by Wille. Video article].

    Science.gov (United States)

    Kosiol, J; Wille, M; Putzer, D; Biedermann, R

    2015-11-01

    An acute ligament rupture of the lateral ligament complex of the ankle joint is treated without surgery. Treatment failure may lead to a chronically unstable situation of the ankle joint, in which case surgery is an effective procedure for stabilizing the ruptured ligaments. Anatomical reconstruction is the best operative technique if the ligament tissue is of good quality. In our video we demonstrate a new possibility for the positioning of an anchor to tighten the calcaneo-fibular ligament. Modified Broström repairs are described in the literature in which the calcaneo-fibular ligament is released and reattached to the fibula to tighten it. We present the option to release the ligament at the calcaneus and reattach it using a suture anchor. This offers the advantage of preventing the possible dislocation of the peroneal tendons.

  20. Total hip arthroplasty in a patient with arthrogryphosis and an ipsilateral above knee amputation.

    LENUS (Irish Health Repository)

    Leonard, Michael

    2010-10-01

    The authors present the case of a young man with arthrogryphosis multiplex congenita and an above knee amputation who underwent an ipsilateral total hip replacement. The unique aspects of the case and technical difficulties are highlighted. Follow-up at five years revealed an excellent clinical and radiological outcome.

  1. Didelphic uterus with imperforate unilateral vagina and ipsilateral renal agenesis: Magnetic resonance

    International Nuclear Information System (INIS)

    Rodrigo, R.M.; Saez, F.; Astigarraga, E.; Rodriguez, O.

    1993-01-01

    We present two cases of didelphic uterus with the clinical appearance of a pelvic mass produced by the hematometra-hematocolpos retained by an imperforate unilateral hemivagina. In both cases, this anomaly was accompanied by ipsilateral renal agenesis. We basically review the diagnosis of this disorder, focusing on magnetic resonance as the technique of choice. (Author) 10 refs

  2. Ureterocystoplasty using the lower pole ureter of a duplex kidney with preservation of ipsilateral renal function

    OpenAIRE

    John Lazarus

    2012-01-01

    We describe the case of a 9 year old boy with neurogenic bladder dysfunction who co-incidentally had a unilateral duplex kidney with Grade 5 vesico-ureteric reflux into a poorly functioning lower moiety allowing heminephrectomy and ureterocystoplasty with preservation of ipsilateral renal function.

  3. Magnetic resonance direct thrombus imaging differentiates acute recurrent ipsilateral deep vein thrombosis from residual thrombosis.

    Science.gov (United States)

    Tan, Melanie; Mol, Gerben C; van Rooden, Cornelis J; Klok, Frederikus A; Westerbeek, Robin E; Iglesias Del Sol, Antonio; van de Ree, Marcel A; de Roos, Albert; Huisman, Menno V

    2014-07-24

    Accurate diagnostic assessment of suspected ipsilateral recurrent deep vein thrombosis (DVT) is a major clinical challenge because differentiating between acute recurrent thrombosis and residual thrombosis is difficult with compression ultrasonography (CUS). We evaluated noninvasive magnetic resonance direct thrombus imaging (MRDTI) in a prospective study of 39 patients with symptomatic recurrent ipsilateral DVT (incompressibility of a different proximal venous segment than at the prior DVT) and 42 asymptomatic patients with at least 6-month-old chronic residual thrombi and normal D-dimer levels. All patients were subjected to MRDTI. MRDTI images were judged by 2 independent radiologists blinded for the presence of acute DVT and a third in case of disagreement. The sensitivity, specificity, and interobserver reliability of MRDTI were determined. MRDTI demonstrated acute recurrent ipsilateral DVT in 37 of 39 patients and was normal in all 42 patients without symptomatic recurrent disease for a sensitivity of 95% (95% CI, 83% to 99%) and a specificity of 100% (95% CI, 92% to 100%). Interobserver agreement was excellent (κ = 0.98). MRDTI images were adequate for interpretation in 95% of the cases. MRDTI is a sensitive and reproducible method for distinguishing acute ipsilateral recurrent DVT from 6-month-old chronic residual thrombi in the leg veins. © 2014 by The American Society of Hematology.

  4. Surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, Clare; Boachie, Charles; Fraser, Cynthia; MacLennan, Graeme; Mowatt, Graham; Thomas, Ruth E. [University of Aberdeen, Health Services Research Unit, Aberdeen (United Kingdom); Ragupathy, Senthil Kumar Arcot [NHS Grampian, Radiology Department, Aberdeen Royal Infirmary, Aberdeen (United Kingdom); Heys, Steve D. [University of Aberdeen and Aberdeen Royal Infirmary, NHS Grampian, Division of Applied Medicine, School of Medicine and Dentistry, Aberdeen (United Kingdom); Gilbert, Fiona J. [University of Aberdeen and Aberdeen Royal Infirmary, NHS Grampian, Aberdeen Biomedical Imaging Centre, Aberdeen (United Kingdom)

    2011-12-15

    To determine the diagnostic accuracy of surveillance mammography for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. A systematic review of surveillance mammography compared with ultrasound, magnetic resonance imaging (MRI), specialist-led clinical examination or unstructured primary care follow-up, using histopathological assessment for test positives and follow-up for test negatives as the reference standard. Nine studies met our inclusion criteria. Variations in study comparisons precluded meta-analysis. For routine ipsilateral breast tumour detection, surveillance mammography sensitivity ranged from 64-67% and specificity ranged from 85-97%. For MRI, sensitivity ranged from 86-100% and specificity was 93%. For non-routine ipsilateral breast tumour detection, sensitivity and specificity for surveillance mammography ranged from 50-83% and 57-75% and for MRI 93-100% and 88-96%. For routine metachronous contralateral breast cancer detection, one study reported sensitivity of 67% and specificity of 50% for both surveillance mammography and MRI. Although mammography is associated with high sensitivity and specificity, MRI is the most accurate test for detecting ipsilateral breast tumour recurrence and metachronous contralateral breast cancer in women previously treated for primary breast cancer. Results should be interpreted with caution because of the limited evidence base. (orig.)

  5. Decision-making for complex scapula and ipsilateral clavicle fractures: a review.

    Science.gov (United States)

    Hess, Florian; Zettl, Ralph; Smolen, Daniel; Knoth, Christoph

    2018-03-23

    Complex scapula with ipsilateral clavicle fracures remains a challange and treatment recommendations are still missing.  This review provides an overview of the evolution of the definition, classification and treatment strategies for complex scapula and ipsilateral clavicle fractures. As with other rare conditions, consensus has not been reached on the most suitable management strategies to treat these patients. The aim of this review is twofold: to compile and summarize the currently available literature on this topic, and to recommend treatment approaches. Included in the review are the following topics: biomechanics of scapula and ipsilateral clavicle fractures, preoperative radiological evaluation, surgical treatment of the clavicle only, surgical treatment of both the clavicle and scapula, and nonsurgical treatment options. A decision-making algorithm is proposed for different treatment strategies based on pre-operative parameters, and an example of a case treated our institution is presented to illustrate use of the algorithm. The role of instability in complex scapula with ipsilateral clavicle fractures remains unclear. The question of stability is preoperatively less relevant than the question of whether the dislocated fragments lead to compromised shoulder function.

  6. Ipsilateral Brachial Plexus Block and Hemidiaphragmatic Paresis as Adverse Effect of a High Thoracic Paravertebral Block

    NARCIS (Netherlands)

    Renes, Steven H.; van Geffen, Geert J.; Snoeren, Miranda M.; Gielen, Matthieu J.; Groen, Gerbrand J.

    Background: Thoracic paravertebral block is regularly used for unilateral chest and abdominal surgery and is associated with a low complication rate. Case Reports: We describe 2 patients with an ipsilateral brachial plexus block with Horner syndrome after a high continuous thoracic paravertebral

  7. Ipsilateral hemiparesis in lateral medullary infarction: Clinical investigation of the lesion location on magnetic resonance imaging.

    Science.gov (United States)

    Uemura, Masahiro; Naritomi, Hiroaki; Uno, Hisakazu; Umesaki, Arisa; Miyashita, Kotaro; Toyoda, Kazunori; Minematsu, Kazuo; Nagatsuka, Kazuyuki

    2016-06-15

    In 1946, Opalski reported two cases of Wallenberg syndrome with ipsilateral hemiparesis (IH). His hypothesis seems to be based on the view that IH is caused by post-decussating pyramidal tract damage. Afterwards, other researchers proposed a different hypothesis that ipsilateral sensory symptoms of limbs (ISSL) or ipsilateral limb ataxia (ILA) caused by lateral medullary infarction (LMI) might lead to ipsilateral motor weakness. The present study is aimed to clarify whether IH in LMI patients is attributable mainly to ISSL/ILA or disruption of ipsilateral post-decussating pyramidal tract. Thirty-two patients with acute LMI admitted during the last 13years were divided to IH Group (n=7) and Non-IH Group (n=25). Lesion location/distribution on MRI and neurological findings were compared between the two groups. LMI involved the lower medulla in all seven IH patients and 12 of 25 Non-IH patients. The lower medullary lesion extended to the cervico-medullary junction (CMJ) in four of seven IH patients and one of 12 Non-IH patients. Definitive extension to upper cervical cord (UCC) was confirmed in none of the patients. ISSL was found in two IH and three Non-IH patients all showing only superficial sensory impairments. ILA or hypotonia was observed in 57% of IH and 60% of Non-IH patients. IH in LMI appears to be due mainly to post-decussating pyramidal tract damage at the lower medulla instead of ILA or ISSL participation. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Midshaft clavicle fractures with associated ipsilateral acromioclavicular joint dislocations: Incidence and risk factors.

    Science.gov (United States)

    Ottomeyer, Christina; Taylor, Benjamin C; Isaacson, Mark; Martinez, Lara; Ebaugh, Pierce; French, Bruce G

    2017-02-01

    Simultaneous ipsilateral clavicle and acromioclavicular (AC) joint injury have been infrequently reported in the literature at this time. The purpose of this study was to assess incidence as well as assess risk factors for this dual injury pattern. We performed a retrospective review of a prospectively collected database (Level III evidence), evaluating 383 adult patients without previous shoulder girdle injury or trauma with a minimum 1-year follow-up who sustained a displaced diaphyseal clavicle fracture. All patients in the study underwent either nonoperative management or surgical reduction and stabilization of a diaphyseal clavicle fracture with a plate and screw construct. Study subjects were followed with serial radiographs. Clavicle and shoulder radiographs, as well as chest radiographs and contralateral films in questionable cases, were used to assess for acromioclavicular joint injury in both operative and nonoperative groups. Additional data was collected on concurrent injuries, patient demographics, fracture characteristics, fixation techniques, surgical/post-operative data, and operative or nonoperative treatment. We found that 13/183 (7.1%) of patients undergoing fixation of a diaphyseal clavicle fracture had an ipsilateral AC joint injury, while 13/200 (6.5%) of patients undergoing conservative management had an ipsilateral AC joint injury. Critical analysis of the data revealed that presence of ipsilateral scapular body fractures, and a likely incidental association with superior plating fixation, were associated with an increased rate of this injury pattern. Ipsilateral clavicle fracture and AC joint injury is much more common than traditionally believed, with an incidence of 6.8% overall. It is unknown how the presence of an associated AC injury influences outcome, as AC injury was not universally symptomatic. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Maxillary reconstruction with a double-barrel osteocutaneous fibular flap and arteriovenous saphenous loop after a globe-sparing total maxillectomy-A Case Report.

    Science.gov (United States)

    Chen, Szu-Han; Hung, Kuo-Shu; Lee, Yao-Chou

    2017-05-01

    Maxillary reconstruction using titanium mesh or bone grafts can invite unwanted complications, such as graft resorption, infection, and mesh exposure, especially for patients who require postoperative radiotherapy. Here, we reported a 58-year-old male patient who was diagnosed with maxillary sinus squamous cell carcinoma. The patient received cancer ablation by a globe-sparing total maxillectomy and was immediately reconstructed with a double-barrel osteocutaneous fibular flap to simultaneously restore the alveolar ridge, orbital support, and oro-sinonasal separation. The short pedicle length inherent in the double-barrel design of the fibular flap and the depletion of healthy recipient vessels in the midface after cancer ablation were overcome by creating an arteriovenous saphenous loop in the neck region. Though there was venous congestion on postoperative day 2, the postoperative recovery was uneventful after the revision of the venous anastomoses. During the 6-months follow-up, the outcome was functionally and aesthetically satisfactory. We believe that the double-barrel fibular osteocutaneous flap, which avoids using titanium mesh and bone grafts, may be a viable reconstructive option in cancer patients with globe-sparing total maxillectomy defects, especially for those who require postoperative radiotherapy. © 2015 Wiley Periodicals, Inc. Microsurgery 37:334-338, 2017. © 2015 Wiley Periodicals, Inc.

  10. Biomechanical competence of six different bone screws for reconstructive surgery in three different transplants: Fibular, iliac crest, scapular and artificial bone.

    Science.gov (United States)

    Pietsch, Arnold P; Raith, Stefan; Ode, Jan-Eric; Teichmann, Jan; Lethaus, Bernd; Möhlhenrich, Stephan C; Hölzle, Frank; Duda, Georg N; Steiner, Timm

    2016-06-01

    The goal of this study was to determine a combination of screw and transplantation type that offers optimal primary stability for reconstructive surgery. Fibular, iliac crest, and scapular transplants were tested along with artificial bone substrate. Six different kinds of bone screws (Medartis(©)) were compared, each type utilized with one of six specimens from human transplants (n = 6). Controlled screw-in-tests were performed and the required torque was protocolled. Subsequently, pull-out-tests were executed to determine the retention forces. The artificial bone substitute material showed significantly higher retention forces than real bone samples. The self-drilling screws achieved the significantly highest retention values in the synthetic bone substitute material. Cancellous screws achieved the highest retention in the fibular transplants, while self-drilling and cancellous screws demonstrated better retention than cortical screws in the iliac crest. In the scapular graft, no significant differences were found between the screw types. In comparison to the human transplant types, the cortical screws showed the significantly highest values in the fibula and the lowest values in the iliac crest. The best retention was found in the combination of cancellous screws with fibular graft (514.8 N + -252.3 N). For the flat bones (i.e., scapular and illiac crest) we recommend the cancellous screws. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  11. Transportation

    National Research Council Canada - National Science Library

    Allshouse, Michael; Armstrong, Frederick Henry; Burns, Stephen; Courts, Michael; Denn, Douglas; Fortunato, Paul; Gettings, Daniel; Hansen, David; Hoffman, D. W; Jones, Robert

    2007-01-01

    .... The ability of the global transportation industry to rapidly move passengers and products from one corner of the globe to another continues to amaze even those wise to the dynamics of such operations...

  12. One-stage treatment and reconstruction of Gustilo Type III open tibial shaft fractures with a vascularized fibular osteoseptocutaneous flap graft.

    Science.gov (United States)

    Zhen, Ping; Hu, Yun-Yu; Luo, Zhuo-Jing; Liu, Xing-Yan; Lu, Hao; Li, Xu-Sheng

    2010-12-01

    This study evaluated the usefulness of a single-stage, free-fibular vascularized osteoseptocutaneous flap transfer for Type III open tibial shaft fractures with segmental bone loss for the reconstruction of combined bone and soft tissue defects. Nonrandomized retrospective study. University Level I trauma center. All Gustilo Type III open tibial shaft fractures with segmental bone loss that were treated at one institution between 2000 and 2007 were identified from a trauma registry. The study group consisted of 28 patients with Type III open tibial fractures: 27 were Gustilo-Anderson Type IIIB and one was Grade IIIC. The cause of tibial injury included eight industrial accidents, seven motor vehicle accidents, five crushing injuries caused by heavy objects, five falls from a height, and three motorcycle crashes. The lengths of the preoperative segmental tibial bone loss ranged from 9 to 17 cm and the size of the associated soft tissue defects ranged from 8 × 6 cm to 15 × 7 cm. The free fibular vascularized osteoseptocutaneous flap was used to graft and reconstruct combined bone and soft tissue defects. The radical wound débridement, soft tissue and bone revision, fracture stabilization, and early soft tissue coverage were achieved by this technique in a one-stage procedure. The average duration from injury to one-stage reconstruction was 15.8 hours (range, 5.3 hours to 6.5 days). Radiographic and functional evaluation of the lower extremity. All free fibular osteoseptocutaneous flaps survived completely. The average time to overall union for the entire group was 32 weeks after surgery (range, 26-41 weeks). None of the patients in this series had a nonunion. Acceptable radiographic alignment, defined as 5° of angulation in any plane, was obtained in 22 patients (78.6%). Malunion affected six (21.4%) fractures. According to the lower extremity functional assessment, excellent and good results were achieved for 82.1% (23 of 28), fair results were seen in 14

  13. Hyperintensity on diffusion weighted image along ipsilateral cortical spinal tract after cerebral ischemic stroke: A diffusion tensor analysis

    International Nuclear Information System (INIS)

    Liu Xiang; Tian Wei; Li Lilin; Kolar, Balasubramanya; Qiu Xing; Chen, Feng; Dogra, Vikram S.

    2012-01-01

    Purpose: Hyperintensity along the ipsilateral cortical spinal tract (CST) on a diffusion weighted imaging (DWI) has been reported to may be associated with motor disability after brain infarction and can be misdiagnosed as a new infarction. However, the underlying patho-physiology related to this finding is not clear. The goal of our study was to analyze the diffusion tensor imaging (DTI) changes in patients with this hyperintensity. Materials and methods: Eight patients (50 ± 10 years) who exhibited hyperintensity on DWI along ipsilateral CST from 3 to 21 days after stroke onset were reviewed as positive group, including 5 patients with serial DTI examinations. Twelve patients without hyperintensity during the matched examination time were classified as reference group. The apparent diffusion coefficient (ADC), fractional anisotropy (FA), and eigenvalues and their ratios (ipsilateral/contralateral value) in cerebral peduncle were measured, their correlation with motor function scale at eight months after stroke onset were evaluated. Results: The serial examinations showed that hyperintensity could eventually disappear. Both the ipsilateral ADC and FA values were significantly decreased (p < 0.05) compared to the contralateral side. The ipsilateral FA significantly correlated with motor function scale in both groups (r = 0.875, 0.738; p = 0.004, 0.006 respectively). Conclusions: The hyperintensity on DWI is a transient pathological process of Wallerian degeneration after ischemic stroke, its diffusion characteristics include concurrent significant decrease of ipsilateral ADC and FA. The ipsilateral FA value has the potential to predict neurological motor function outcome in such patients.

  14. Restoring a functional and mobile shoulder following reconstruction of the sternoclavicular joint with a free vascularized fibular flap

    Directory of Open Access Journals (Sweden)

    Abby Choke

    2018-06-01

    Full Text Available Infection of the sternoclavicular joint (SCJ is rare and often missed at early stage. In extensive disease with bony and soft tissue destruction, radical excision is indicated. The loss of SCJ results in exposure of vital structures of the anterior mediastinum and instability of the shoulder girdle. SCJ reconstruction using locoregional muscle flaps like the pectoralis major or latissimus dorsi flap has been well described. While these options can provide soft tissue coverage, they do not restore the structural framework of the SCJ which is important for shoulder excursion and chest wall movement. We describe a case of SCJ reconstruction using a free vascularized fibular flap following the resection of sternoclavicular tubercular osteomyelitis. The fibula bone was used to restore the clavicular strut by anchoring it to the remaining manubrium with a steel wire and by plating the lateral end to the remnant clavicle. The steel wire served as a “defunctioning” cerclage that allowed motion of the joint to induce fibrous union. A strict post-operative rehabilitation protocol keeping the shoulder adducted at the initial phase was prescribed. At one year follow up, the patient achieved good shoulder function with 140 degrees of shoulder abduction and 110 degrees flexion.

  15. Hydatid disease of scapula and upper third of humerus treated by en bloc excision and fibular bone grafting

    Directory of Open Access Journals (Sweden)

    Chari P

    2007-01-01

    Full Text Available 35-year-old male patient presented with gradually increasing painful swelling of the right shoulder, which was incised and drained and wound persisted as a discharging sinus on the anterolateral aspect of the deltoid region with seropurulent discharge. A clinical diagnosis of tuberculosis of the shoulder was made. Plain skiagram of the right shoulder revealed multicystic lesion involving the entire scapula and upper third of the humerus with loss of joint space and pathological fracture at the junction of upper one-third and lower two-thirds of the humerus. A clinico-radiological diagnosis of hydatid disease was made. In view of the extensive involvement of the scapula with stiff shoulder and an active sinus, a two-stage surgical procedure was performed. Stage 1 consisted of en bloc excision of the scapula, upper half of the humerus and lateral end of the clavicle. Stage II surgery, consisting of fibular bone grafting. Tablet albendazole (400 mg, thrice daily was given as systemic scolicidal agent. This case is reported in view of it′s rarity and to highlight the management.

  16. Unilateral occlusion of duplicated uterus with ipsilateral renal anomaly in young girls: a study with MRI

    International Nuclear Information System (INIS)

    Li, Y.W.; Shieh, C.P.; Chen, W.J.

    1995-01-01

    Twenty-four young girls (mean age 13.0 years) with unilateral occlusion of a duplicated uterus and ipsilateral renal agenesis, dysplasia or hypoplasia were studied with magnetic resonance imaging (MRI) following ultrasound examination. Hydrocolpos (n=4), hydrometrocolpos (n=2), hematocolpos (n=11), hematometrocolpos (n=5), hematocolpometra, hematosalpinx (n=3) and hematometra, hematosalpinx (n=1) were noted (two of these patients had presented with hydrocolpos and hematocolpos before and after the menarche). Twenty-two of these girls presented with ipsilateral renal agenesis (right 11, left 11) with ectopic ureters to Gartner's dust cysts (GDC) in two, in one renal hypoplasia and in one renal dysplasia with ectopic ureters to GDC. MRI offered specific images of the genital tract, showing the exact type of muellerian duct anomaly and providing high diagnostic accuracy. Such preoperative identification of a uterine anomaly, complemented with appropriate surgical intervention, can assist young girls in achieving normal fertility in the future. (orig.)

  17. Retention of retinal axon collateral is responsible for induced ipsilateral retinotectal projections in adult goldfish.

    Science.gov (United States)

    Sharma, S C; Tsai, C

    1991-01-01

    In normal goldfish, optic axons innervate only the contralateral optic tectum. When one eye was enucleated and the optic nerve of the other eye crushed, the regenerating optic axons innervated both optic tecta. We studied the presence of bilaterally projecting retinal ganglion cells by double retrograde cell labeling methods using Nuclear Yellow and True Blue dyes. About 10% of the retinal ganglion cells were double labeled and these cells were found throughout the retina. In addition, HRP application to the ipsilateral tectum revealed retrogradely-labeled retinal ganglion cells of all morphological types. These results suggest that induced ipsilateral projections are formed by regenerating axon collaterals and that all cell types are involved in the generation of normal mirror image typography.

  18. Asymmetric Functional Connectivity of the Contra- and Ipsilateral Secondary Somatosensory Cortex during Tactile Object Recognition

    Directory of Open Access Journals (Sweden)

    Yinghua Yu

    2018-01-01

    Full Text Available In the somatosensory system, it is well known that the bilateral secondary somatosensory cortex (SII receives projections from the unilateral primary somatosensory cortex (SI, and the SII, in turn, sends feedback projections to SI. Most neuroimaging studies have clearly shown bilateral SII activation using only unilateral stimulation for both anatomical and functional connectivity across SII subregions. However, no study has unveiled differences in the functional connectivity of the contra- and ipsilateral SII network that relates to frontoparietal areas during tactile object recognition. Therefore, we used event-related functional magnetic resonance imaging (fMRI and a delayed match-to-sample (DMS task to investigate the contributions of bilateral SII during tactile object recognition. In the fMRI experiment, 14 healthy subjects were presented with tactile angle stimuli on their right index finger and asked to encode three sample stimuli during the encoding phase and one test stimulus during the recognition phase. Then, the subjects indicated whether the angle of test stimulus was presented during the encoding phase. The results showed that contralateral (left SII activity was greater than ipsilateral (right SII activity during the encoding phase, but there was no difference during the recognition phase. A subsequent psycho-physiological interaction (PPI analysis revealed distinct connectivity from the contra- and ipsilateral SII to other regions. The left SII functionally connected to the left SI and right primary and premotor cortex, while the right SII functionally connected to the left posterior parietal cortex (PPC. Our findings suggest that in situations involving unilateral tactile object recognition, contra- and ipsilateral SII will induce an asymmetrical functional connectivity to other brain areas, which may occur by the hand contralateral effect of SII.

  19. Ipsilateral Irradiation for Oral and Oropharyngeal Carcinoma Treated With Primary Surgery and Postoperative Radiotherapy

    International Nuclear Information System (INIS)

    Vergeer, Marije R.; Doornaert, Patricia; Jonkman, Anja; Kaanders, Johannes H.A.M.; Ende, Piet L.A. van den; Jong, Martin A. de; Leemans, C. Rene; Slotman, Ben J.; Langendijk, Johannes A.

    2010-01-01

    Purpose: The purpose was to evaluate the contralateral nodal control (CLNC) in postoperative patients with oral and oropharyngeal cancer treated with ipsilateral irradiation of the neck and primary site. Late radiation-induced morbidity was also evaluated. Methods and Materials: The study included 123 patients with well-lateralized squamous cell carcinomas treated with surgery and unilateral postoperative irradiation. Most patients had tumors of the gingiva (41%) or buccal mucosa (21%). The majority of patients underwent surgery of the ipsilateral neck (n = 102 [83%]). The N classification was N0 in 73 cases (59%), N1 or N2a in 23 (19%), and N2b in 27 cases (22%). Results: Contralateral metastases developed in 7 patients (6%). The 5-year actuarial CLNC was 92%. The number of lymph node metastases was the only significant prognostic factor with regard to CLNC. The 5-year CLNC was 99% in N0 cases, 88% in N1 or N2a cases, and 73% in N2b cases (p = 0.008). Borderline significance (p = 0.06) was found for extranodal spread. Successful salvage could be performed in 71% of patients with contralateral metastases. The prevalence of Grade 2 or higher xerostomia was 2.6% at 5 years. Conclusions: Selected patients with oral or oropharyngeal carcinoma treated with primary surgery and postoperative ipsilateral radiotherapy have a very high CLNC with a high probability of successful salvage in case of contralateral metastases. However, bilateral irradiation should be applied in case of multiple lymph node metastases in the ipsilateral neck, particularly in the presence of extranodal spread. The incidence of radiation-induced morbidity is considerably lower as observed after bilateral irradiation.

  20. Emphysema lung lobe volume reduction: effects on the ipsilateral and contralateral lobes

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Matthew S.; Kim, Hyun J.; Abtin, Fereidoun G.; Galperin-Aizenberg, Maya; Pais, Richard; Da Costa, Irene G.; Ordookhani, Arash; Chong, Daniel; Ni, Chiayi; McNitt-Gray, Michael F.; Goldin, Jonathan G. [David Geffen School of Medicine at UCLA, Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, Los Angeles, CA (United States); Strange, Charlie [Medical University of South Carolina, Department of Pulmonary and Critical Care Medicine, Columbia, SC (United States); Tashkin, Donald P. [David Geffen School of Medicine at UCLA, Division of Pulmonary and Critical Care Medicine, Los Angeles, CA (United States)

    2012-07-15

    To investigate volumetric and density changes in the ipsilateral and contralateral lobes following volume reduction of an emphysematous target lobe. The study included 289 subjects with heterogeneous emphysema, who underwent bronchoscopic volume reduction of the most diseased lobe with endobronchial valves and 132 untreated controls. Lobar volume and low-attenuation relative area (RA) changes post-procedure were measured from computed tomography images. Regression analysis (Spearman's rho) was performed to test the association between change in the target lobe volume and changes in volume and density variables in the other lobes. The target lobe volume at full inspiration in the treatment group had a mean reduction of -0.45 L (SE = 0.034, P < 0.0001), and was associated with volume increases in the ipsilateral lobe (rho = -0.68, P < 0.0001) and contralateral lung (rho = -0.16, P = 0.006), and overall reductions in expiratory RA (rho = 0.31, P < 0.0001) and residual volume (RV)/total lung capacity (TLC) (rho = 0.13, P = 0.03). When the volume of an emphysematous target lobe is reduced, the volume is redistributed primarily to the ipsilateral lobe, with an overall reduction. Image-based changes in lobar volumes and densities indicate that target lobe volume reduction is associated with statistically significant overall reductions in air trapping, consistent with expansion of the healthier lung. (orig.)

  1. The mechanism of ipsilateral ataxia in lacunar hemiparesis: SPECT perfusion imaging.

    Science.gov (United States)

    Yamamoto, Ryoo; Johkura, Ken; Nakae, Yoshiharu; Tanaka, Fumiaki

    2015-01-01

    Although ataxic hemiparesis is a common lacunar syndrome, the precise mechanism underlying hemiataxia is not clear. We attempted to identify ataxia-related, cerebral blood flow changes in patients presenting with ataxic hemiparesis after acute capsular infarct. We used 99mTc-ECD brain perfusion single-photon emission computed tomography to evaluate regional cerebral blood flow in 12 patients with ataxic hemiparesis caused by capsular infarct, and we compared the regional blood flow of these patients with that of 11 patients with pure motor hemiparesis caused by similar lesions. The ipsilateral red nucleus blood flow was significantly decreased in the ataxic hemiparesis patients, whereas the ipsilateral red nucleus blood flow was increased in the pure motor hemiparesis patients. Crossed cerebellar diaschisis (decreased contralateral cerebellar blood flow) was seen in ataxic hemiparesis patients; similarly, it was seen in pure motor hemiparesis patients. Our findings suggest that ataxia in hemiparetic patients with capsular infarct can be caused by ipsilateral red nucleus dysfunction secondary to cortico-rubral pathway disruption at the internal capsule.

  2. Metabolic activity in striate and extrastriate cortex in the hooded rat: contralateral and ipsilateral eye input

    International Nuclear Information System (INIS)

    Thurlow, G.A.; Cooper, R.M.

    1988-01-01

    The extent of changes in glucose metabolism resulting from ipsilateral and contralateral eye activity in the posterior cortex of the hooded rat was demonstrated by means of the C-14 2-deoxyglucose autoradiographic technique. By stimulating one eye with square wave gratings and eliminating efferent activation from the other by means of enucleation or intraocular TTX injection, differences between ipsilaterally and contralaterally based visual activity in the two hemispheres were maximized. Carbon-14 levels in layer IV of autoradiographs of coronal sections were measured and combined across sections to form right and left matrices of posterior cortex metabolic activity. A difference matrix, formed by subtracting the metabolic activity matrix of cortex contralateral to the stimulated eye from the ipsilateral depressed matrix, emphasized those parts of the visual cortex that received monocular visual input. The demarcation of striate cortex by means of cholinesterase stain and the examination of autoradiographs from sections cut tangential to the cortical surface aided in the interpretation of the difference matrices. In striate cortex, differences were maximal in the medial monocular portion, and the lateral or binocular portion was shown to be divided metabolically into a far lateral contralaterally dominant strip along the cortical representation of the vertical meridian, and a more medial region of patches of more or less contralaterally dominant binocular input. Lateral peristriate differences were less than those of striate cortex, and regions of greater and lesser monocular input could be distinguished. We did not detect differences between the two hemispheres in either anterior or medial peristriate areas

  3. Double uterus with obstructed hemivagina and ipsilateral renal agenesis: pelvic anatomic variants in 87 cases.

    Science.gov (United States)

    Fedele, L; Motta, F; Frontino, G; Restelli, E; Bianchi, S

    2013-06-01

    What are the anatomic variants (and their frequencies) of double uterus, obstructed hemivagina and ipsilateral renal agenesis? Most cases examined (72.4%) were of the classic anatomic variant of the Herlyn-Werner-Wunderlich syndrome (with didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis) but the 27.6% of cases are of a rare variant of the syndrome (with uterus septum or cervical agenesis), showing relevant clinical and surgical implications. The extreme variability of anatomic structures involved in this syndrome (both uterus, cervico-vaginal and renal anomalies) is well known, even if a complete and uniform analysis of all its heterogeneous presentations in a large series is lacking. This is a retrospective study with 87 patients referred to our third level referral center between 1981 and 2011. We analyzed the laparoscopic and chart records of 87 women, who referred to our institute with double uterus, unilateral cervico-vaginal obstruction and ipsilateral renal anomalies. Sixty-three of 87 patients had the more classic variant of didelphys uterus with obstructed hemivagina; 10/87 patients had septate bicollis uterus with obstructed hemivagina; 9/87 patients had bicornuate bicollis uterus with obstructed hemivagina; 4/87 patients had didelphys uterus with unilateral cervical atresia; 1/87 patients had bicornuate uterus with one septate cervix and unilateral obstructed hemivagina. This is a retrospective study with a long enrolling period (30 years). New insights in the anatomic variants of this rare syndrome with their relevant surgical implications.

  4. Ipsilateral mamillary body atrophy after infarction of the posterior cerebral artery territory: MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Sawada, Akihiro; Takase, Yukinori; Nomiyama, Keita; Egashira, Ryoko; Kudo, Sho [Saga Medical School, Department of Radiology, Saga (Japan)

    2005-11-01

    We describe herein magnetic resonance (MR) features of ipsilateral mamillary body atrophy after infarction of the posterior cerebral artery (PCA) territory. During the period May 2000 through July 2004, 13 patients with infarction of the PCA territory underwent cranial MR imaging in the chronic stage. Two 1.5-T scanners were used to obtain axial T1- and T2-weighted images with conventional spin-echo and fast spin-echo pulse sequences, respectively. The slice thickness was 6 mm, with a 2-mm interslice gap. Five of the 13 patients with PCA territory infarction had ipsilateral mamillary body atrophy. However, this asymmetry of the mamillary bodies was unclear in two of the five patients because of the thickness of the axial image slices. All five patients had a temporo-parieto-occipital infarction. The remaining eight patients had a parieto-occipital or an occipital infarction. Unilateral transneuronal mamillary body degeneration after infarction of the ipsilateral PCA territory including the posteromedial temporal lobe can be detected on conventional thick axial MR images. (orig.)

  5. Emphysema lung lobe volume reduction: effects on the ipsilateral and contralateral lobes

    International Nuclear Information System (INIS)

    Brown, Matthew S.; Kim, Hyun J.; Abtin, Fereidoun G.; Galperin-Aizenberg, Maya; Pais, Richard; Da Costa, Irene G.; Ordookhani, Arash; Chong, Daniel; Ni, Chiayi; McNitt-Gray, Michael F.; Goldin, Jonathan G.; Strange, Charlie; Tashkin, Donald P.

    2012-01-01

    To investigate volumetric and density changes in the ipsilateral and contralateral lobes following volume reduction of an emphysematous target lobe. The study included 289 subjects with heterogeneous emphysema, who underwent bronchoscopic volume reduction of the most diseased lobe with endobronchial valves and 132 untreated controls. Lobar volume and low-attenuation relative area (RA) changes post-procedure were measured from computed tomography images. Regression analysis (Spearman's rho) was performed to test the association between change in the target lobe volume and changes in volume and density variables in the other lobes. The target lobe volume at full inspiration in the treatment group had a mean reduction of -0.45 L (SE = 0.034, P < 0.0001), and was associated with volume increases in the ipsilateral lobe (rho = -0.68, P < 0.0001) and contralateral lung (rho = -0.16, P = 0.006), and overall reductions in expiratory RA (rho = 0.31, P < 0.0001) and residual volume (RV)/total lung capacity (TLC) (rho = 0.13, P = 0.03). When the volume of an emphysematous target lobe is reduced, the volume is redistributed primarily to the ipsilateral lobe, with an overall reduction. Image-based changes in lobar volumes and densities indicate that target lobe volume reduction is associated with statistically significant overall reductions in air trapping, consistent with expansion of the healthier lung. (orig.)

  6. Locoregional treatment outcomes for breast cancer patients with ipsilateral supraclavicular metastases at diagnosis

    International Nuclear Information System (INIS)

    Huang, Eugene H.; Strom, Eric A.; Valero, Vicente; Fornage, Bruno; Perkins, George H.; Oh, Julia L.; Yu, T.-K.; Tereffe, Welela; Woodward, Wendy A.; Hunt, Kelly K.; Meric-Bernstam, Funda; Sahin, Aysegul A.; Bedrosian, Isabelle; Hortobagyi, Gabriel N.; Buchholz, Thomas A.

    2007-01-01

    Purpose: To evaluate the locoregional efficacy of multimodality treatment for breast cancer patients who present with ipsilateral supraclavicular (SCV) disease without systemic metastases. Methods: We retrospectively reviewed the data from 71 patients with ipsilateral SCV involvement at presentation. SCV involvement in 16 patients (23%) was diagnosed by ultrasound examination only, without palpable disease. All patients were treated with curative intent using neoadjuvant chemotherapy, mastectomy or breast-conserving surgery (BCT), and radiotherapy. Results: The 5-year SCV control, locoregional control (LRC), disease-free survival, and overall survival rate was 90%, 77%, 30%, and 47%, respectively. Patients with persistent SCV disease after neoadjuvant chemotherapy by physical examination had a lower rate of LRC (64% vs. 86%, p = 0.026), as did those with persistent SCV disease by ultrasound examination (66% vs. 96%, p = 0.007). Of those with a complete response of SCV disease by physical examination after neoadjuvant chemotherapy, those with persistently abnormal ultrasound findings had significantly worse disease-free survival (0% vs. 55%, p = 0.03). BCT was not associated with lower rates of LRC (82% for BCT vs. 76% for mastectomy, p = 0.80). Conclusion: Radiotherapy achieved excellent LRC after surgery for patients with ipsilateral SCV metastases who achieved a complete response of the SCV disease after neoadjuvant chemotherapy. For patients who achieved a complete response of the SCV disease by physical examination, ultrasonography of the SCV fossa may help assess the risk of disease recurrence. SCV involvement should not be considered a contraindication for BCT

  7. Referred pain to the ipsilateral forehead and orbit: An unusual phenomenon during bronchial artery embolization

    International Nuclear Information System (INIS)

    Ramakantan, Ravi; Ketkar, Manoj; Maddali, Krishna; Deshmukh, Hemant

    1999-01-01

    Purpose: We report an unusual pattern of referred pain to the ipsilateral forehead and orbit observed during bronchial artery embolization (BAE) for massive hemoptysis due to pulmonary tuberculosis (TB) and postulate possible neural mechanisms for its occurrence.Methods: Seven men, from a series of 194 patients (171 men, 23 women) undergoing BAE (right bronchial artery 4, left 3) with gelatin sponge for control of massive hemoptysis due to pulmonary TB form the subject of this report.Results: Embolization was successful in achieving control of hemoptysis in these patients and there were no complications following the embolization. Transient, moderately severe, ipsilateral supraorbital and/or retroorbital pain occurred only during the injection of the gelatin sponge contrast mixture into the bronchial artery. The pain did not occur during the injection of heparinized saline or ionic contrast medium.Conclusions: Referred pain during BAE is an unusual phenomenon. Acute vessel distension triggering visceral sensations is probably the causative mechanism. Sympathetic afferents from the bronchi coursing through the posterior pulmonary plexus eventually pass to the trigeminal ganglion via the carotid sympathetic chain. The ophthalmic and maxillary divisions of the trigeminal nerve then mediate pain sensation to the ipsilateral forehead and orbit. Similarly, parasympathetic afferents from the pulmonary plexus crossing the nucleus of the spinal tract of the trigeminal nerve may be responsible for interexchange of impulses to the neurons in this nucleus. Sensory fibers of the ophthalmic and maxillary nerves relaying in this nucleus are then involved in this pain being referred to the forehead and orbit.

  8. Ipsilateral mamillary body atrophy after infarction of the posterior cerebral artery territory: MR imaging

    International Nuclear Information System (INIS)

    Uchino, Akira; Sawada, Akihiro; Takase, Yukinori; Nomiyama, Keita; Egashira, Ryoko; Kudo, Sho

    2005-01-01

    We describe herein magnetic resonance (MR) features of ipsilateral mamillary body atrophy after infarction of the posterior cerebral artery (PCA) territory. During the period May 2000 through July 2004, 13 patients with infarction of the PCA territory underwent cranial MR imaging in the chronic stage. Two 1.5-T scanners were used to obtain axial T1- and T2-weighted images with conventional spin-echo and fast spin-echo pulse sequences, respectively. The slice thickness was 6 mm, with a 2-mm interslice gap. Five of the 13 patients with PCA territory infarction had ipsilateral mamillary body atrophy. However, this asymmetry of the mamillary bodies was unclear in two of the five patients because of the thickness of the axial image slices. All five patients had a temporo-parieto-occipital infarction. The remaining eight patients had a parieto-occipital or an occipital infarction. Unilateral transneuronal mamillary body degeneration after infarction of the ipsilateral PCA territory including the posteromedial temporal lobe can be detected on conventional thick axial MR images. (orig.)

  9. Transportation

    Science.gov (United States)

    2007-01-01

    Faculty ii INDUSTRY TRAVEL Domestic Assistant Deputy Under Secretary of Defense (Transportation Policy), Washington, DC Department of...developed between the railroad and trucking industries. Railroads: Today’s seven Class I freight railroad systems move 42% of the nation’s intercity ...has been successfully employed in London to reduce congestion and observed by this industry study during its travels . It is currently being

  10. Negative BOLD signal changes in ipsilateral primary somatosensory cortex are associated with perfusion decreases and behavioral evidence for functional inhibition

    DEFF Research Database (Denmark)

    Schäfer, Katharina; Blankenburg, Felix; Kupers, Ron

    2012-01-01

    that the negative BOLD signal is associated with functional inhibition. Electrical stimulation of the median nerve at 7Hz evoked robust negative BOLD signals in the primary somatosensory cortex (SI) ipsilateral to stimulation, and positive BOLD signals in contralateral SI. The negative BOLD signal in ipsilateral SI......) at the ipsilateral finger during concomitant stimulation of the contralateral median nerve increased significantly, suggesting augmented functional inhibition. Since the CPT in the ipsilateral hallux did not significantly change in response to median nerve stimulation, it is more likely that the CPT......-increase for the finger is due to functional inhibition (Kastrup et al., 2008) than to changes in selective attention. In conclusion, our data provide evidence that stimulus-induced reductions in relative rCBF may underlie the negative BOLD signal, which in turn may reflect increments in functional inhibition....

  11. Lower Ipsilateral Hippocampal Integrity after Ischemic Stroke in Young Adults: A Long-Term Follow-Up Study

    NARCIS (Netherlands)

    Schaapsmeerders, P.; Tuladhar, A.M.; Maaijwee, N.A.M.M.; Rutten-Jacobs, L.C.A.; Arntz, R.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.A.; Dijk, E.J. van; Kessels, R.P.C.; Leeuw, H.F. de

    2015-01-01

    Background and purpose Memory impairment after stroke is poorly understood as stroke rarely occurs in the hippocampus. Previous studies have observed smaller ipsilateral hippocampal volumes after stroke compared with controls. Possibly, these findings on macroscopic level are not the first

  12. Lower Ipsilateral Hippocampal Integrity after Ischemic Stroke in Young Adults: A Long-Term Follow-Up Study

    NARCIS (Netherlands)

    Schaapsmeerders, P.; Tuladhar, A.M.; Maaijwee, N.A.M.M.; Rutten-Jacobs, L.C.A.; Arntz, R.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.; Dijk, E.J. van; Kessels, R.P.C.; Leeuw, F.E. de

    2015-01-01

    BACKGROUND AND PURPOSE: Memory impairment after stroke is poorly understood as stroke rarely occurs in the hippocampus. Previous studies have observed smaller ipsilateral hippocampal volumes after stroke compared with controls. Possibly, these findings on macroscopic level are not the first

  13. Fluoroscopy-guided reduction and fibular nail fixation to manage unstable ankle fractures in patients with diabetes: a retrospective cohort study.

    Science.gov (United States)

    Ashman, B D; Kong, C; Wing, K J; Penner, M J; Bugler, K E; White, T O; Younger, A S E

    2016-09-01

    Patients with diabetes are at increased risk of wound complications after open reduction and internal fixation of unstable ankle fractures. A fibular nail avoids large surgical incisions and allows anatomical reduction of the mortise. We retrospectively reviewed the results of fluoroscopy-guided reduction and percutaneous fibular nail fixation for unstable Weber type B or C fractures in 24 adult patients with type 1 or type 2 diabetes. The re-operation rate for wound dehiscence or other indications such as amputation, mortality and functional outcomes was determined. Two patients developed lateral side wound infection, one of whom underwent wound debridement. Three other patients required re-operation for removal of symptomatic hardware. No patient required a below-knee amputation. Six patients died during the study period for unrelated reasons. At a median follow-up of 12 months (7 to 38) the mean Short Form-36 Mental Component Score and Physical Component Score were 53.2 (95% confidence intervals (CI) 48.1 to 58.4) and 39.3 (95% CI 32.1 to 46.4), respectively. The mean Visual Analogue Score for pain was 3.1 (95% 1.4 to 4.9). The mean Ankle Osteoarthritis Scale total score was 32.9 (95% CI 16.0 to 49.7). Fluoroscopy-guided reduction and fibular nail fixation of unstable ankle fractures in patients with diabetes was associated with a low incidence of wound and overall complications, while providing effective surgical fixation. Cite this article: Bone Joint J 2016;98-B:1197-1201. ©2016 The British Editorial Society of Bone & Joint Surgery.

  14. Ground reaction vector re-adjustment-the secret of success in treatment of medial compartment knee osteoarthritis by novel high fibular osteotomy.

    Science.gov (United States)

    Xie, Wenjun; Zhang, Yu; Qin, Xiaodong; Song, Lijun; Chen, Qun

    2018-03-01

    High fibular osteotomy has been preliminarily proved to be an effective treatment of knee osteoarthritis by excising a segment of bone at the proximal part of fibula. This imaginative procedure is clinical validated by its instant and explicit knee pain resorption and eventually deformity correction. The rationale of this treatment is named non-uniform settlement of the tibial plateau and used to elucidate the cause of knee joint degeneration, but cannot illuminate the reason of prompt postoperative pain resorption faithfully. To assist in better understanding of this therapeutic method and raising alert to possible unexpected complications, we proposed a new theory to elucidate the pain relief mechanism.

  15. Reconstruction of juxta-articular huge defects of distal femur with vascularized fibular bone graft and Ilizarov's distraction osteogenesis.

    Science.gov (United States)

    Lai, Davy; Chen, Chuan-Mu; Chiu, Fang-Yao; Chang, Ming-Chau; Chen, Tain-Hsiung

    2007-01-01

    We evaluate the effect of reconstructing huge defects (mean, 15.8 cm) of the distal femur with Ilizarov's distraction osteogenesis and free twin-barreled vascularized fibular bone graft (TVFG). We retrospectively reviewed a consecutive series of five patients who had cases of distal femoral fractures with huge defects and infection that were treated by the Ilizarov's distraction osteogenesis. After radical debridement, two of the five cases had free TVFG and monolocal distraction osteogenesis, and another two cases had multilocal distraction osteogenesis with knee fusion because of loss of the joint congruity. The other case with floating knee injury had bilocal distraction osteogenesis and a preserved knee joint. The mean defect of distal femur was 15.8 cm (range, 14-18 cm) in length. The mean length of distraction osteogenesis by Ilizarov's apparatus was 8.2 cm. The mean length of TVFG was 8 cm. The average duration from application of Ilizarov's apparatus to achievement of bony union was 10.2 months (range, 8-13 months). At the end of the follow-up, ranges of motion of three knees were 0 to 45 degrees, 0 to 60 degrees, and 0 to 90 degrees. Two cases had knee arthrodesis with bony fusion because of loss of the joint congruity. There were no leg length discrepancies in all five patients. In addition, three patients had pin tract infections and one case had a 10 degree varus deformity of the femur. Juxta-articular huge defect (>10 cm) of distal femur remains a challenge to orthopedic surgeons. Ilizarov's technique provides the capability to maintain stability, eradicate infection, restore leg length, and to perform adjuvant reconstructive procedure easily. In this study, we found that combining Ilizarov's distraction osteogenesis with TVFG results in improved patient outcome for patients with injuries such as supracondylar or intercondylar infected fractures or nonunion of distal femur with huge bone defect.

  16. Implant Utilization and Time to Prosthetic Rehabilitation in Conventional and Advanced Fibular Free Flap Reconstruction of the Maxilla and Mandible.

    Science.gov (United States)

    Chuka, Richelle; Abdullah, Wael; Rieger, Jana; Nayar, Suresh; Seikaly, Hadi; Osswald, Martin; Wolfaardt, Johan

    Precisely designed jaw reconstruction rehabilitation (JRR) is important to the integrity of the jaw structure and oral functions. Advanced three-dimensional (3D) digital surgical design and simulation (SDS) techniques have the potential to reduce time to reconstructive and dental treatment completion, thereby promoting early functional oral rehabilitation. This study investigated the use of SDS in JRR procedures. A retrospective chart review was conducted on adult head and neck tumor (HNT) participants who completed JRR treatment with a fibular free flap (FFF) reconstruction. Two treatment approaches, advanced 3D SDS technique (with-SDS) and conventional, nondigitally planned technique (without-SDS), included the use of osseointegrated implants. Data were collected from adult patients treated between January 2000 and March 2014 at the Institute for Reconstructive Sciences in Medicine (iRSM). Participants were excluded if they underwent a bone-containing augmentation to the FFF reconstruction. The without-SDS group underwent a conventional, nonguided FFF reconstruction followed by nonguided implant placement. The with-SDS group underwent a guided FFF reconstruction with guided implant placement during the reconstructive surgery. The outcome measures included implant utilization (ratio of implants placed to connected) and time to prosthetic connection after FFF reconstruction. Mann-Whitney U test was used to analyze the data. The digital SDS technique (with-SDS) group completed prosthetic treatment with a significantly higher utilization of implants as well as a significantly shorter time to prosthetic delivery. SDS allows an interdisciplinary treatment team to work together to create a virtual plan that leads to greater efficiency in patient treatment time and utilization of dental implants.

  17. Renal dysplasia with the ipsilateral ectopic ureter mimicking abscess of the prostate

    Directory of Open Access Journals (Sweden)

    Grbić Dragan

    2014-01-01

    Full Text Available Introduction. In males the ectopic ureter usualy drains into the prostate (50%. During ureteric developement a thin membrane (Chawalla’s membrane separates the lumen of the ureter and the urogenital sinus at the point where the ureter joins the urogenital sinus. This membrane ruptures allowing urin to drain from the ureter to the urogenital sinus. The authors reported a case of renal dysplasia associated with ipsilateral uretral ectopia mimicking prostatic abscess. Case report. A subfebrile (37.3°C, 23-year-old patient, otherwise healthy, presented with persistent ascending perineal pain non-responsive to antibiotics and analgetics. Digitorectal examination (DRE showed asymmetric prostate with a soft, tender, buldging left lobe suggestive of prostatic abscess. The diagnosis was suspected using transrectal ultrasonography (TRUS, but the picture of the anechoic tubular structure in the left lobe of the prostate with a proximal undefined extraprostatic extension and a caudal intraprostatic blind end was incoclusive for the definitive diagnosis of prostatic abscess. Magnetic resonance imaging (MRI was ordered and definitive diagnosis of renal dysplasia associated with the ipsilateral ectopic ureter filled with inflamed content mimicking prostatic abscess was made. Transurethral incision/minimal resection of the distal, blindly closed end of left ectopic ureter was done. Endoscopic surgical treatment was sufficient for relief of clinical symptoms. The patient’s recovery was uneventful. Conclusion. To the best of our knowledge, a case of renal dysplasia with the ipsilateral ectopic ureter mimicking prostate abscess has not been reported so far. Cystic pelvic malformations in males may result from too craniall sprouting of the ureteral bud, with delayed absorption and ectopic opening of the distal end of the ureter.

  18. Basal ganglia germinoma in children with associated ipsilateral cerebral and brain stem hemiatrophy

    Energy Technology Data Exchange (ETDEWEB)

    Ozelame, Rodrigo V.; Shroff, Manohar; Wood, Bradley; Bouffet, Eric; Bartels, Ute; Drake, James M.; Hawkins, Cynthia; Blaser, Susan [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, Ontario (Canada)

    2006-04-15

    Germinoma is the most common and least-malignant intracranial germ cell tumor, usually found in the midline. Germinoma that arises in the basal ganglia, called ectopic germinoma, is a rare and well-documented entity representing 5% to 10% of all intracranial germinomas. The association of cerebral and/or brain stem atrophy with basal ganglia germinoma on CT and MRI is found in 33% of the cases. To review the literature and describe the CT and MRI findings of basal ganglia germinoma in children, known as ectopic germinoma, with associated ipsilateral cerebral and brain stem hemiatrophy. Three brain CT and six brain MRI studies performed in four children at two institutions were retrospectively reviewed. All patients were male (case 1, 14 years; case 2, 13 years; case 3, 9 years; case 4, 13 years), with pathologically proved germinoma arising in the basal ganglia, and associated ipsilateral cerebral and/or brain stem hemiatrophy on the first imaging study. It is important to note that three of these children presented with cognitive decline, psychosis and slowly progressive hemiparesis as their indication for imaging. Imaging results on initial scans were varied. In all patients, the initial study showed ipsilateral cerebral and/or brain stem hemiatrophy, representing Wallerian degeneration. All patients who underwent CT imaging presented with a hyperdense or calcified lesion in the basal ganglia on unenhanced scans. Only one of these lesions had a mass effect on the surrounding structures. In one of these patients a large, complex, heterogeneous mass appeared 15 months later. Initial MR showed focal or diffusely increased T2 signal in two cases and heterogeneous signal in the other two. (orig.)

  19. Neural correlates of hemispheric dominance and ipsilaterality within the vestibular system.

    Science.gov (United States)

    Janzen, J; Schlindwein, P; Bense, S; Bauermann, T; Vucurevic, G; Stoeter, P; Dieterich, M

    2008-10-01

    Earlier functional imaging studies on the processing of vestibular information mainly focused on cortical activations due to stimulation of the horizontal semicircular canals in right-handers. Two factors were found to determine its processing in the temporo-parietal cortex: a dominance of the non-dominant hemisphere and an ipsilaterality of the neural pathways. In an investigation of the role of these factors in the vestibular otoliths, we used vestibular evoked myogenic potentials (VEMPs) in a fMRI study of monaural saccular-otolith stimulation. Our aim was to (1) analyze the hemispheric dominance for saccular-otolith information in healthy left-handers, (2) determine if there is a predominance of the ipsilateral saccular-otolith projection, and (3) evaluate the impact of both factors on the temporo-parieto-insular activation pattern. A block design with three stimulation and rest conditions was applied: (1) 102 dB-VEMP stimulation; (2) 65 dB-control-acoustic stimulation, (3) 102 dB-white-noise-control stimulation. After subtraction of acoustic side effects, bilateral activations were found in the posterior insula, the superior/middle/transverse temporal gyri, and the inferior parietal lobule. The distribution of the saccular-otolith activations was influenced by the two factors but with topographic disparity: whereas the inferior parts of the temporo-parietal cortex were mainly influenced by the ipsilaterality of the pathways, the upper parts reflected the dominance of the non-dominant hemisphere. This is in contrast to the processing of acoustic stimulation, which showed a predominance of the contralateral pathways. Our study proves the importance of the hemispheric preponderance also in left-handers, which is of relevance in the superior parts of the insula gyrus V, the inferior parietal lobule, and the superior temporal gyri.

  20. The Effects of Mirror Feedback during Target Directed Movements on Ipsilateral Corticospinal Excitability

    Directory of Open Access Journals (Sweden)

    Mathew Yarossi

    2017-05-01

    Full Text Available Mirror visual feedback (MVF training is a promising technique to promote activation in the lesioned hemisphere following stroke, and aid recovery. However, current outcomes of MVF training are mixed, in part, due to variability in the task undertaken during MVF. The present study investigated the hypothesis that movements directed toward visual targets may enhance MVF modulation of motor cortex (M1 excitability ipsilateral to the trained hand compared to movements without visual targets. Ten healthy subjects participated in a 2 × 2 factorial design in which feedback (veridical, mirror and presence of a visual target (target present, target absent for a right index-finger flexion task were systematically manipulated in a virtual environment. To measure M1 excitability, transcranial magnetic stimulation (TMS was applied to the hemisphere ipsilateral to the trained hand to elicit motor evoked potentials (MEPs in the untrained first dorsal interosseous (FDI and abductor digiti minimi (ADM muscles at rest prior to and following each of four 2-min blocks of 30 movements (B1–B4. Targeted movement kinematics without visual feedback was measured before and after training to assess learning and transfer. FDI MEPs were decreased in B1 and B2 when movements were made with veridical feedback and visual targets were absent. FDI MEPs were decreased in B2 and B3 when movements were made with mirror feedback and visual targets were absent. FDI MEPs were increased in B3 when movements were made with mirror feedback and visual targets were present. Significant MEP changes were not present for the uninvolved ADM, suggesting a task-specific effect. Analysis of kinematics revealed learning occurred in visual target-directed conditions, but transfer was not sensitive to mirror feedback. Results are discussed with respect to current theoretical mechanisms underlying MVF-induced changes in ipsilateral excitability.

  1. Intracranial arteriovenous malformation: relationships between clinical and radiographic factors and ipsilateral steal severity

    International Nuclear Information System (INIS)

    Batjer, H.H.; Devous, M.D. Sr.; Seibert, G.B.; Purdy, P.D.; Ajmani, A.K.; Delarosa, M.; Bonte, F.J.

    1988-01-01

    Intracranial arteriovenous malformations (AVMs) are high flow shunts that may jeopardize the perfusion of adjacent tissue. Clinical and radiographic data from 62 patients were analyzed to determine their relationship to the severity of steal measured by single photon emission computed tomography (SPECT). The ipsilateral steal index [ISteal(i)] was determined by dividing regional cerebral blood flow (rCBF) values within hand-drawn regions of hypoperfusion in the ipsilateral hemisphere by total brain flow, which was calculated as the average rCBF of each hemisphere. Of the patients, 40% were less than 30 years of age, 45% were 30 to 50 years old, and 15% were over 50. Forty-eight per cent presented with hemorrhage and 34% presented with progressive deficits. There was angiographic steal in 37%, and postoperative hyperemic complications developed in 21%. All patients had ipsilateral regions of hypoperfusion. The ISteal(i) was less than 0.7 in 23 (37%), 0.7 to 0.8 in 20 (32%), and greater than 0.8 in 19 (31%). The ISteal(i) was significantly less severe in the patients over 50; 78% of these patients had an ISteal(i) of greater than 0.8 (P less than 0.01). A history of hemorrhage was associated with less severe steal than that in patients who had not bled (P = 0.088). Patients presenting with a history of progressive deficits had increased severity of steal compared with those without progressive deficits (P less than 0.05). A trend toward decreased severity of steal was noted in patients with unfavorable outcomes

  2. Basal ganglia germinoma in children with associated ipsilateral cerebral and brain stem hemiatrophy

    International Nuclear Information System (INIS)

    Ozelame, Rodrigo V.; Shroff, Manohar; Wood, Bradley; Bouffet, Eric; Bartels, Ute; Drake, James M.; Hawkins, Cynthia; Blaser, Susan

    2006-01-01

    Germinoma is the most common and least-malignant intracranial germ cell tumor, usually found in the midline. Germinoma that arises in the basal ganglia, called ectopic germinoma, is a rare and well-documented entity representing 5% to 10% of all intracranial germinomas. The association of cerebral and/or brain stem atrophy with basal ganglia germinoma on CT and MRI is found in 33% of the cases. To review the literature and describe the CT and MRI findings of basal ganglia germinoma in children, known as ectopic germinoma, with associated ipsilateral cerebral and brain stem hemiatrophy. Three brain CT and six brain MRI studies performed in four children at two institutions were retrospectively reviewed. All patients were male (case 1, 14 years; case 2, 13 years; case 3, 9 years; case 4, 13 years), with pathologically proved germinoma arising in the basal ganglia, and associated ipsilateral cerebral and/or brain stem hemiatrophy on the first imaging study. It is important to note that three of these children presented with cognitive decline, psychosis and slowly progressive hemiparesis as their indication for imaging. Imaging results on initial scans were varied. In all patients, the initial study showed ipsilateral cerebral and/or brain stem hemiatrophy, representing Wallerian degeneration. All patients who underwent CT imaging presented with a hyperdense or calcified lesion in the basal ganglia on unenhanced scans. Only one of these lesions had a mass effect on the surrounding structures. In one of these patients a large, complex, heterogeneous mass appeared 15 months later. Initial MR showed focal or diffusely increased T2 signal in two cases and heterogeneous signal in the other two. (orig.)

  3. Electromyography findings of the cricopharyngeus in association with ipsilateral pharyngeal and laryngeal muscles.

    Science.gov (United States)

    Halum, Stacey L; Shemirani, Nima L; Merati, Albert L; Jaradeh, Safwan; Toohill, Robert J

    2006-04-01

    We reviewed a large series of cricopharyngeal (CP) muscle electromyography (EMG) results and compared them with the EMG results from the inferior constrictor (IC), thyroarytenoid, (TA), cricothyroid (CT), and posterior cricoarytenoid (PCA) muscles. We performed a retrospective review of all CP muscle EMG reports from studies performed between January 1996 and June 2003. All of the tested elements from the CP muscle EMG reports were recorded. The EMG results were recorded for the ipsilateral IC, TA, CT, and PCA muscles if they were simultaneously tested. Each muscle result was classified as normal, neurogenic inactive axonal injury (IAI), or neurogenic active axonal injury (AAI), and the muscle findings were compared. A patient chart review was performed to determine a clinical correlation. Fifty-nine patients underwent CP muscle EMG. Eighteen patients had bilateral EMG studies, making a total of 77 CP muscle studies. Nineteen sets of CP muscle results were normal, 43 demonstrated neurogenic IAI, and 15 demonstrated neurogenic AAI. The ipsilateral IC and CP muscles had the same innervation status in 27 of 28 studies (p muscle was studied simultaneously with the CP muscle, 31 of 50 studies had the same innervation status (p = .005). The ipsilateral CT and CP muscles demonstrated the same innervation status in 40 of 50 studies (p muscle findings and between the CP and CT muscle findings were both stronger than the correlation between the CP and TA muscle findings (p muscle findings have the strongest correlation with IC muscle findings, followed by the CT and TA muscles. This outcome does not support theories indicating that the recurrent laryngeal nerve innervates the CP muscle in all cases.

  4. Lumbar nerve root avulsions with secondary ipsilateral hip dysplasia in a child

    Energy Technology Data Exchange (ETDEWEB)

    Polyzoidis, Konstandinos; Vranos, Georgios [Department of Neurosurgery, Medical School, University of Ioannina, 45110, Ioannina (Greece); Petropoulou, Calliope; Argyropoulou, Paraskevi I.; Argyropoulou, Maria I. [Department of Radiology, Medical School, University of Ioannina, 45110, Ioannina (Greece); Sarmas, Ioannis [Department of Neurology, Medical School, University of Ioannina, 45110, Ioannina (Greece)

    2002-09-01

    We report on an 8-year-old child with avulsions of the left L3, L4 and L5 nerve roots and traumatic meningoceles that were not associated with lumbar spine or pelvic girdle fractures. The patient had a history of a road traffic accident. Plain radiographs of the pelvis revealed left hip dysplasia. The magnetic resonance imaging findings of the lumbar spine are illustrated. The pathogenesis of lumbar nerve root avulsions and their association with ipsilateral hip dysplasia are discussed. (orig.)

  5. Cephalomedullary fixation for femoral neck/intertrochanteric and ipsilateral shaft fractures: surgical tips and pitfalls

    Directory of Open Access Journals (Sweden)

    Bali Kamal

    2013-02-01

    Full Text Available 【Abstract】Objective: Surgical management op-tions for femoral shaft fracture and ipsilateral proximal fe-mur fracture vary from single-implant to double-implant fixation. Cephalomedullary fixation in such fractures has rela-tive advantages over other techniques especially because of less soft tissue dissection and immediate postoperative weight bearing with accelerated rehabilitation. However, the surgery is technically demanding and there is a paucity of literature describing the surgical techniques for this fixation. The aim of the study was to describe the surgical technique of cephalomedullary fixation for femoral shaft fracture and ipsilateral proximal femur fracture. Methods: Sixteen cases (10 males and 6 females with a mean age of 41.8 years of ipsilateral proximal femur and shaft fractures were treated by single-stage cephalomedullary fixa-tion at tertiary level trauma center in northern India. The fractures were classified according to AO classification. An intraoperative record of duration of surgery as well as tech-nical challenges unique to each fracture pattern was kept for all the patients. Results: The most common proximal femoral pattern was AO B2.1 observed in 9 of our patients. The AO B2.3 fractures were seen in 4 patients while the AO A1.2 fractures in 3 patients. Four of the AO B2.1 and 2 of the AO B2.3 frac-tures required open reduction with Watson-Jones approach. The mean operative time was around 78 minutes, which tended to decrease as the surgical experience increased. There was only one case of malreduction, which required revision surgery. Conclusion: Combination of ipsilateral femoral shaft fracture and neck/intertrochanteric fracture is a difficult frac-ture pattern for trauma surgeons. Cephalomedullary nail is an excellent implant for such fractures but it requires careful insertion to avoid complications. Surgery is technically de-manding with a definite learning curve. Nevertheless, a ma-jority of these

  6. Lumbar nerve root avulsions with secondary ipsilateral hip dysplasia in a child

    International Nuclear Information System (INIS)

    Polyzoidis, Konstandinos; Vranos, Georgios; Petropoulou, Calliope; Argyropoulou, Paraskevi I.; Argyropoulou, Maria I.; Sarmas, Ioannis

    2002-01-01

    We report on an 8-year-old child with avulsions of the left L3, L4 and L5 nerve roots and traumatic meningoceles that were not associated with lumbar spine or pelvic girdle fractures. The patient had a history of a road traffic accident. Plain radiographs of the pelvis revealed left hip dysplasia. The magnetic resonance imaging findings of the lumbar spine are illustrated. The pathogenesis of lumbar nerve root avulsions and their association with ipsilateral hip dysplasia are discussed. (orig.)

  7. The Floating Upper Limb: Multiple Injuries Involving Ipsilateral, Proximal, Humeral, Supracondylar, and Distal Radial Limb.

    Science.gov (United States)

    Manaan, Qazi; Bashir, Adil; Zahoor, Adnan; Mokhdomi, Taseem A; Danish, Qazi

    2016-09-01

    Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation.

  8. Subcutaneous rupture of the Achilles tendon and ipsilateral fracture of the medial malleolus

    Directory of Open Access Journals (Sweden)

    Richards Paula J

    2006-07-01

    Full Text Available Abstract Background Although ankle fractures and an Achilles tendon rupture are relatively frequent in isolation, their association in the same injury is uncommon. Case presentation A 38 year old male tree surgeon fell six meters from a tree, sustaining a subcutaneous rupture of the Achilles tendon and an ipsilateral closed fracture of the medial malleolus. The injuries were diagnosed following clinical examination and imaging. Conclusion This injury combination is infrequent, and management of the Achilles tendon rupture should take into account the necessity not to secondarily displace the fracture of the medial malleollus.

  9. Use of latissimus dorsi flap pedicle as a T-junction to facilitate simultaneous free fibular flap inset in lower extremity salvage.

    Science.gov (United States)

    Hwang, Kyu Tae; Youn, Seungki; Kim, Jeong Tae; Lee, Seung Hoon; Ng, Siew-Weng; Kim, Youn Hwan

    2012-04-01

    Marjolin's ulcer is a very aggressive form of squamous cell carcinoma arising from chronic wounds or unstable scars. A resection margin of at least 2 cm with clear deep margin is required on removal. A 79-year-old male presented with chronic osteomyelitis of the left anterior tibial region with chronic ulceration. Biopsy revealed squamous cell carcinoma. The tumour, measuring 8 cm, was resected with surrounding unstable scar tissue including en bloc resection of the involved tibial bone, leaving the posterior cortex. Reconstruction was done with a fibular free flap from the contralateral side, but the pedicle length was too short to reach the anterior tibial vessels. To bridge the vascular gap, and to cover the soft-tissue defect, a latissimus dorsi free flap was harvested using the muscle-sparing method. The thoracodorsal vessels were used as an interpositional graft to anastomose the peroneal vessels of the fibular flap. The patient was ambulatory by 4 months, and complete bone union was seen after 6 months. During the 18-month follow-up period, there was no evidence of recurrence. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Locking plate and fibular strut-graft augmentation in the reconstruction of unicameral bone cyst of proximal femur in the paediatric population.

    Science.gov (United States)

    Jamshidi, Khodamorad; Mirkazemi, Masoud; Izanloo, Azra; Mirzaei, Alireza

    2018-01-01

    Several therapeutic strategies have been used for managing unicameral bone cyst (UBC) of the proximal femur. However, there is insufficient evidence to support one treatment over another, and the optimal treatment is controversial. This study aims at describing our experience with surgical reconstruction of paediatric UBCs of the proximal femur using a proximal locking plate and fibular strut allograft. In total, 14 consecutive paediatric patients with Dormans types IB (four cases) and IIB (10 cases) UBC were assessed. Mean patient age was 8.6 ± 2.3 years, and mean follow-up period was 41.7 ± 29.8 months. Six patients (42.8%) were referred with a pathologic fracture. Clinical/radiological outcome and complication rates were evaluated at the final follow-up session. No cysts were Capanna's class III (recurrence) or IV (no response). Complete healing (Capanna's class I) was seen in ten cysts, while four other cysts healed with residual radiolucent areas (Capanna's class II). Mean healing period was 14.1 ± 5.1 (9-24 months). One patient had superficial infection, one heterotopic ossification, and one mild coxa vara, and mean Musculoskeletal Tumor Society (MSTS) score was 99.5%. According to our results, locking plate and fibular strut graft in Dormans classification types IB and IIB results in a favorable outcome in managing UBC of the proximal femur in the paediatric population.

  11. Deterioration of pre-existing hemiparesis due to injury of the ipsilateral anterior corticospinal tract.

    Science.gov (United States)

    Jang, Sung Ho; Kwon, Hyeok Gyu

    2013-05-29

    The anterior corticospinal tract (CST) has been suggested as one of the ipsilateral motor pathways, which contribute to motor recovery following stroke. In this study, we report on a patient who showed deterioration of pre-existing hemiparesis due to an injury of the ipsilateral anterior CST following a pontine infarct, as evaluated by diffusion tensor tractography (DTT). A 55-year-old male patient showed quadriparesis after the onset of an infarct in the right pontine basis. He had history of an infarct in the left middle cerebral artery territory 7 years ago. Consequently, he showed right hemiparesis before onset of the right pontine infarct. Following this, his right hemiparesis deteriorated whereas his left hemiparesis newly developed. The DTTs for whole CST of the right hemisphere in the patient and both hemispheres in control subjects descended through the known CST pathway. By contrast, the DTT for the left whole CST of the patient showed a complete injury finding. The DTTs for the anterior CST of control subjects passed through the known pathway of the CST from cerebral cortex to medulla and terminated in the anterior funiculus of the upper cervical cord. However, the DTT for right anterior CST in the patient showed discontinuation below the right pontine infarct. It appeared that the deterioration of the pre-existing right hemiparesis was ascribed to an injury of the right anterior CST due to the right pontine infarct.

  12. Anticipation increases tactile stimulus processing in the ipsilateral primary somatosensory cortex.

    Science.gov (United States)

    van Ede, Freek; de Lange, Floris P; Maris, Eric

    2014-10-01

    Stimulus anticipation improves perception. To account for this improvement, we investigated how stimulus processing is altered by anticipation. In contrast to a large body of previous work, we employed a demanding perceptual task and investigated sensory responses that occur beyond early evoked activity in contralateral primary sensory areas: Stimulus-induced modulations of neural oscillations. For this, we recorded magnetoencephalography in 19 humans while they performed a cued tactile identification task involving the identification of either a proximal or a distal stimulation on the fingertips. We varied the cue-target interval between 0 and 1000 ms such that tactile targets occurred at various degrees of anticipation. This allowed us to investigate the influence of anticipation on stimulus processing in a parametric fashion. We observed that anticipation increases the stimulus-induced response (suppression of beta-band oscillations) originating from the ipsilateral primary somatosensory cortex. This occurs in the period in which the tactile memory trace is analyzed and is correlated with the anticipation-induced improvement in tactile perception. We propose that this ipsilateral response indicates distributed processing across bilateral primary sensory cortices, of which the extent increases with anticipation. This constitutes a new and potentially important mechanism contributing to perception and its improvement following anticipation. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Ipsilateral wrist-ankle movements in the sagittal plane encoded in extrinsic reference frame.

    Science.gov (United States)

    Muraoka, Tetsuro; Ishida, Yuki; Obu, Takashi; Crawshaw, Larry; Kanosue, Kazuyuki

    2013-04-01

    When performing oscillatory movements of two joints in the sagittal plane, there is a directional constraint for performing such movements. Previous studies could not distinguish whether the directional constraint reflected movement direction encoded in the extrinsic (outside the body) reference frame or in the intrinsic (the participants' torso/head) reference frame since participants performed coordinated movements in a sitting position where the torso/head was stationary relative to the external world. In order to discern the reference frame in the present study, participants performed paced oscillatory movements of the ipsilateral wrist and ankle in the sagittal plane in a standing position so that the torso/head moved relative to the external world. The coordinated movements were performed in one of two modes of coordination, moving the hand upward concomitant with either ankle plantarflexion or ankle dorsiflexion. The same directional mode relative to extrinsic space was more stable and accurate as compared with the opposite directional mode. When forearm position was changed from the pronated position to the supinated position, similar results were obtained, indicating that the results were independent of a particular coupling of muscles. These findings suggest that the directional constraint on ipsilateral joints movements in the sagittal plane reflects movement direction encoded in the extrinsic reference frame. Copyright © 2013 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

  14. Cooperation Not Competition: Bihemispheric tDCS and fMRI Show Role for Ipsilateral Hemisphere in Motor Learning.

    Science.gov (United States)

    Waters, Sheena; Wiestler, Tobias; Diedrichsen, Jörn

    2017-08-02

    What is the role of ipsilateral motor and premotor areas in motor learning? One view is that ipsilateral activity suppresses contralateral motor cortex and, accordingly, that inhibiting ipsilateral regions can improve motor learning. Alternatively, the ipsilateral motor cortex may play an active role in the control and/or learning of unilateral hand movements. We approached this question by applying double-blind bihemispheric transcranial direct current stimulation (tDCS) over both contralateral and ipsilateral motor cortex in a between-group design during 4 d of unimanual explicit sequence training in human participants. Independently of whether the anode was placed over contralateral or ipsilateral motor cortex, bihemispheric stimulation yielded substantial performance gains relative to unihemispheric or sham stimulation. This performance advantage appeared to be supported by plastic changes in both hemispheres. First, we found that behavioral advantages generalized strongly to the untrained hand, suggesting that tDCS strengthened effector-independent representations. Second, functional imaging during speed-matched execution of trained sequences conducted 48 h after training revealed sustained, polarity-independent increases in activity in both motor cortices relative to the sham group. These results suggest a cooperative rather than competitive interaction of the two motor cortices during skill learning and suggest that bihemispheric brain stimulation during unimanual skill learning may be beneficial because it harnesses plasticity in the ipsilateral hemisphere. SIGNIFICANCE STATEMENT Many neurorehabilitation approaches are based on the idea that is beneficial to boost excitability in the contralateral hemisphere while attenuating that of the ipsilateral cortex to reduce interhemispheric inhibition. We observed that bihemispheric transcranial direct current stimulation (tDCS) with the excitatory anode either over contralateral or ipsilateral motor cortex

  15. Corticospinal activation of internal oblique muscles has a strong ipsilateral component and can be lateralised in man.

    Science.gov (United States)

    Strutton, Paul H; Beith, Iain D; Theodorou, Sophie; Catley, Maria; McGregor, Alison H; Davey, Nick J

    2004-10-01

    Trunk muscles receive corticospinal innervation ipsilaterally and contralaterally and here we investigate the degree of ipsilateral innervation and any cortical asymmetry in pairs of trunk muscles and proximal and distal limb muscles. Transcranial magnetic stimulation (TMS) was applied to left and right motor cortices in turn and bilateral electromyographic (EMG) recordings were made from internal oblique (IO; lower abdominal), deltoid (D; shoulder) and first dorsal interosseus (1DI; hand) muscles during voluntary contraction in ten healthy subjects. We used a 7-cm figure-of-eight stimulating coil located 2 cm lateral and 2 cm anterior to the vertex over either cortex. Incidence of ipsilateral motor evoked potentials (MEPs) was 85% in IO, 40% in D and 35% in 1DI. Mean (+/- S.E.M.) ipsilateral MEP latencies were longer ( Pmuscle (IO: n=16; D: n=8; 1DI: n=7 ratios). Mean values for these ratios were 0.70+/-0.20 (IO), 0.14+/-0.05 (D) and 0.08+/-0.02 (1DI), revealing stronger ipsilateral drive to IO. Comparisons of the sizes of these ratios revealed a bias towards one cortex or the other (four subjects right; three subjects left). The predominant cortex showed a mean ratio of 1.21+/-0.38 compared with 0.26+/-0.06 in the other cortex ( Pmuscles and also shows hemispheric asymmetry.

  16. Ipsilateral Fracture Shaft Femur with Neglected Dislocation of Prosthesis: A Case Report

    Directory of Open Access Journals (Sweden)

    Mantu Jain

    2013-10-01

    Full Text Available Introduction: Neglected hip dislocation is rare in today’s world and after prosthesis replacement even rarer finding. However such patients may not report to surgeons until they develop secondary complications. Management of such patient’s is a challenge to the treating surgeon and need to be tailored suiting to patient’s demands, expectations and constraints of financial resources. We did not find a similar case in the electronic and print media and therefore report this case which was innovatively managed. Case Report: A 60 year farmer presented with fracture shaft femur and ipsilateral dislocation prosthesis of right hip. He had a hemiarthroplasty done for fracture neck of femur in the past but used to walk with a lurch since he started to ambulate after discharge. However he was satisfied despite “some problems” which had caused shortening of his limb. The patient was informed of the various treatment options and their possible complications. He expressed his inability to afford a Total Hip Arthroplasty (THA at any stage and consented for other options discussed with him. The patient was positioned supine and adductor tenotomy done. Next he was positioned laterally and the fracture was fixed with heavy duty broad dynamic compression plate and screws. The wound was temporarily closed. Now through the previous scar via posterior approach the hip was exposed. The prosthesis was found to be firmly fixed to the proximal femur. The acetabulum was cleared with fibrous tissue. All attempts the prosthesis to relocate the prosthesis failed after several attempts and it was best decided to leave alone. Post operatively period was uneventful. At follow up he refused for any further manoeuvre in future inform of heavy traction and attempts to reduce the same. At one year when he was walking unaided and his X-rays showed that fracture had well united his SF-36 score was PCS – 49.6 and MCS – 51.9. Conclusion: Ipsilateral shaft femur fracture

  17. Contribution of SPECT/CT for sentinel node localization in patients with ipsilateral breast cancer relapse

    Energy Technology Data Exchange (ETDEWEB)

    Borrelli, Pablo [Antoni Van Leeuwenhoek Hospital, Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam (Netherlands); Hospital La Fe, Nuclear Medicine, Medical Imaging Clinical Area, Valencia (Spain); Donswijk, Maarten L.; Stokkel, Marcel P.; Teixeira, Suzana C. [Antoni Van Leeuwenhoek Hospital, Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam (Netherlands); Tinteren, Harm van [Antoni Van Leeuwenhoek Hospital, Department of Biometrics, The Netherlands Cancer Institute, Amsterdam (Netherlands); Rutgers, Emiel J.T. [Antoni Van Leeuwenhoek Hospital, Department of Surgery, The Netherlands Cancer Institute, Amsterdam (Netherlands); Valdes Olmos, Renato A. [Antoni Van Leeuwenhoek Hospital, Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam (Netherlands); Leiden University Medical Centre, Nuclear Medicine Section and Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden (Netherlands)

    2017-04-15

    In recent years repeat sentinel node (SN) biopsy has been proven to be feasible in local breast cancer recurrence (LBCR). However, in these patients SNs outside the ipsilateral axilla are frequently observed. This study evaluates the contribution of SPECT/CT for SN localization and surgical adjustment in LBCR patients. SN biopsy was performed in 122 LBCR patients (median age 60.5 years, range 24-87), enrolled from August 2006 to July 2015. Median disease-free time lapse was 109.5 months (range 9-365). Axillary lymph node dissection (ALND) had previously been performed in 55 patients, SN biopsy in 44, both techniques in 13 and fine-needle aspiration in 10. Primary breast cancer treatment included radiotherapy in 104 patients (85.3 %) and chemotherapy in 40 (32.8 %). Preoperative lymphatic mapping, using planar scintigraphy (PS) and SPECT/CT included report of SN location according to lymph node territory. In case of a territorial PS-SPECT/CT mismatch, surgery was adjusted according to SPECT/CT findings. SPECT/CT SN visualization rate was higher than PS (53.3 % vs. 43.4 %, p n.s.) with, in total, 19 additional SN (118 vs. 99, p n.s.). PS-SPECT/CT territory mismatch, found in 60 % (39/65) of patients with SN visualization, led to surgical adjustment in 21.3 % (26/122) of patients. The SN procedure was finally performed in 104 patients resulting in a 65.7 % surgical retrieval rate with a total of 132 removed SNs (1.86/patient). SN metastases were found in 17/71 patients (23.9 %), in 16 of them (94 %) in ipsilateral basins outside the axilla or in the contralateral axilla. Using SPECT/CT there is a trend to visualize more SNs in LBCR, providing at the same time important anatomical information to adjust intraoperative SN procedures. The addition of SPECT/CT to the standard imaging protocol may lead to better staging mainly in patients presenting drainage outside the ipsilateral axilla. (orig.)

  18. Congenital giant megaureter associated with ipsilateral multicystic dysplastic kidney in newborn

    Directory of Open Access Journals (Sweden)

    Rajendran Ramaswamy

    2016-01-01

    Full Text Available Congenital giant megaureter presents as abdominal mass and impose diagnostic difficulties. It can be associated with other upper urinary tract anomalies. A female newborn with antenatal diagnosis of polycystic kidneys was admitted at birth due to lower abdominal mass. Ultrasound and CT scans diagnosed a multiloculated cystic lesion in the mid and lower abdomen along with right side multicystic kidney. At laparotomy, an extaperitoneal, lobulated cystic swelling was found due to rightside giant megaureter. Its lower end was of normal caliber and orthotopic. End cutaneous ureterostomy was done. Intravenous urogram and isotope renograms showed nonfunctioning right kidney. She also had grade II vesicoureteral reflux on left side. Child suffered urinary infection twice. At 9m age, right nephroureterectomy was done. Histopathologic examination was consistent with cystic renal dysplasia and dilated ureter. This is the first case report of giant megaureter associated with ipsilateral multicystic dysplastic kidney in newborn.

  19. Combined Ipsilateral Oculomotor Nerve Palsy and Contralateral Downbeat Nystagmus in a Case of Cerebral Infarction

    Directory of Open Access Journals (Sweden)

    Kosuke Matsuzono

    2014-04-01

    Full Text Available We report a patient with acute cerebral infarction of the left paramedian thalamus, upper mesencephalon and cerebellum who exhibited ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus. The site of the infarction was considered to be the paramedian thalamopeduncular and cerebellar regions, which are supplied by the superior cerebellar artery containing direct perforating branches or both the superior cerebellar artery and the superior mesencephalic and posterior thalamosubthalamic arteries. Contralateral and monocular downbeat nystagmus is very rare. Our case suggests that the present downbeat nystagmus was due to dysfunction of cerebellar-modulated crossed oculovestibular fibers of the superior cerebellar peduncle or bilateral downbeat nystagmus with one-sided oculomotor nerve palsy.

  20. Ipsilateral reexpansion pulmonary edema after drainage of a spontaneous pneumothorax: a case report

    Directory of Open Access Journals (Sweden)

    Conen Anna

    2007-09-01

    Full Text Available Abstract We report a case of ipsilateral reexpansion pulmonary edema occurring after the insertion of a chest tube in a patient with spontaneous pneumothorax. The patient received supplemental oxygen via a non-rebreather face mask to compensate for hypoxemia. 24 hours after the acute event, the patient recovered completely without residual hypoxemia. Reexpansion pulmonary edema after the insertion of a thoracic drainage for pneumothorax or pleural effusion is a rare complication with a high mortality rate up to 20%. It should be considered in case of hypoxemia following the insertion of a chest tube. The exact pathophysiology leading to this complication is not known. Risk factors for reexpansion pulmonary edema should be evaluated and considered prior to the insertion of chest tubes. Treatment is supportive.

  1. Uterus bicornis bicollis, imperforate hemivagina and ipsilateral renal agenesis: case report and literature review.

    Science.gov (United States)

    DaCosta, V; Christie, L; Wynter, S; Harriott, J; Frederick, J

    2009-09-01

    We present a case of a patient with Uterus bicornis bicollis, imperforate hemivagina and ipsilateral renal agenesis. This group of congenital malformations is often asymptomatic until puberty, when it presents as cyclic dysmenorrhoea, leucorrhoea or a pelvic mass. Magnetic resonance imaging is becoming the preferred modality for delineation of uterine malformations. When congenital abnormalities of the reproductive tract are encountered, a search should also be made for renal anomalies. Patients with Uterus bicornis bicollis and unilateral imperforate vagina are often seen with pain severe enough to mimic an acute abdomen. It is important to keep this unusual congenital malformation in mind in the differential diagnosis of vaginal discharge, pelvic mass and/or abdominopelvic pain in young women so as to avoid inappropriate surgical procedures.

  2. Profunda Anchor Technique for Ipsilateral Antegrade Approach in Endovascular Treatment of Superficial Femoral Artery Ostial Occlusion

    International Nuclear Information System (INIS)

    Pua, Uei

    2015-01-01

    Endovascular treatment of the superficial femoral artery (SFA) is challenging in the presence of flush ostial occlusion. One of the main challenges is the availability of access sites for intervention. Contralateral retrograde femoral access followed by cross-over and antegrade intervention while commonly used, may not be feasible in cases of altered iliac anatomy (e.g. kissing iliac stents). Ipsilateral antegrade intervention using common femoral artery (CFA) access in these instances while possible is typically challenging due to inadequate working length of the CFA for interrogation of the SFA ostium, compounded by the lack of sheath stability. The “profunda anchor” technique uses a buddy wire in the profunda femoris artery (PFA) to stabilize the sheath and allow catheter manipulation for antegrade intervention at the level of the SFA ostium. The PFA is further used as a conduit for deployment of closure device to avoid interference with the treated SFA

  3. [Right patent ductus arteriosus with an ipsilateral aortic arch: percutaneous closure with amplatzer devices].

    Science.gov (United States)

    Santiago, Justo; Acuña, Manuel; Arispe, Elizabeth; Camargo, Ronaldo; Neves, Juliana; Arnoni, Daniel; Fontes, Valmir F; Pedra, Carlos A

    2007-03-01

    The association of a right aortic arch with an ipsilateral patent ductus arteriosus is rare, especially when there are no other intracardiac anomalies. We report three female patients aged 26, 35 and 9 years with this combination in whom previous attempts at surgical closure by thoracotomy and sternotomy were unsuccessful and who subsequently underwent successful percutaneous closure of the defects using Amplatzer devices. In two patients, although angiography demonstrated the presence of type-A patent ductus arteriosus, it was not possible to determine the minimum diameter accurately and it was necessary to measure it using a sizing balloon. An Amplatzer duct occluder was used in two patients and an Amplatzer muscular ventricular septal defect occluder, in the other. In all patients, full closure was confirmed in the catheterization laboratory and the patients were discharged on the same day with no complications. Percutaneous closure of a right patent ductus arteriosus associated with a right aortic arch is feasible, safe and effective.

  4. Profunda Anchor Technique for Ipsilateral Antegrade Approach in Endovascular Treatment of Superficial Femoral Artery Ostial Occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

    2015-04-15

    Endovascular treatment of the superficial femoral artery (SFA) is challenging in the presence of flush ostial occlusion. One of the main challenges is the availability of access sites for intervention. Contralateral retrograde femoral access followed by cross-over and antegrade intervention while commonly used, may not be feasible in cases of altered iliac anatomy (e.g. kissing iliac stents). Ipsilateral antegrade intervention using common femoral artery (CFA) access in these instances while possible is typically challenging due to inadequate working length of the CFA for interrogation of the SFA ostium, compounded by the lack of sheath stability. The “profunda anchor” technique uses a buddy wire in the profunda femoris artery (PFA) to stabilize the sheath and allow catheter manipulation for antegrade intervention at the level of the SFA ostium. The PFA is further used as a conduit for deployment of closure device to avoid interference with the treated SFA.

  5. Ipsilateral proximal femur and shaft fractures treated with hip screws and a reamed retrograde intramedullary nail.

    Science.gov (United States)

    Ostrum, Robert F; Tornetta, Paul; Watson, J Tracy; Christiano, Anthony; Vafek, Emily

    2014-09-01

    Although not common, proximal femoral fractures associated with ipsilateral shaft fractures present a difficult management problem. A variety of surgical options have been employed with varying results. We investigated the use of hip screws and a reamed retrograde intramedullary (IM) nail for the treatment of this combined fracture pattern in terms of postoperative alignment (malunion), nonunion, and complications. Between May 2002 and October 2011, a total of 95 proximal femoral fractures with associated shaft fractures were treated at three participating Level 1 trauma centers; all were treated with hip screw fixation (cannulated screws or sliding hip screws) and retrograde reamed IM nails. The medical records of these patients were reviewed retrospectively for alignment, malunion, nonunion, and complications. Followup was available on 92 of 95 (97%) of the patients treated with hip screws and a retrograde nail. Forty were treated with a sliding hip screw, and 52 were treated with cannulated screws. There were five proximal malunions in this series (5%). The union rate was 98% (90 of 92) for the femoral neck fractures and 91.3% (84 of 92) for the femoral shaft fractures after the initial surgery. There were two nonunions of comminuted femoral neck fractures after cannulated screw fixation. There was no difference in femoral neck union or alignment when comparing cannulated screws to a sliding hip screw. Four open comminuted femoral shaft fractures went on to nonunion and required secondary surgery to obtain union, and one patient developed symptomatic avascular necrosis. The treatment of ipsilateral proximal femoral neck and shaft fractures with hip screw fixation and a reamed retrograde nail demonstrated a high likelihood of union for the femoral neck fractures and a low risk of malunion. Comminution and initial displacement of the proximal femoral fracture may still lead to a small incidence of malunion or nonunion, and open comminuted femoral shaft fractures

  6. Ressecção ampla e transposição fibular no tratamento do TCG da extremidade distal do rádio Wide resection and fibular transposition in the treatment of GCT on radius distal end

    Directory of Open Access Journals (Sweden)

    Alex Guedes

    2009-01-01

    Full Text Available OBJETIVO: Avaliação funcional e oncológica do tratamento do TCG do segmento distal do rádio (estadio B3 mediante ressecção ampla e reconstrução com enxerto autólogo avascular da extremidade proximal da fíbula. MÉTODOS: A função residual foi avaliada mediante escore ISOLS, medida do arco residual global do punho operado, do percentual residual da força de preensão da mão e da preensão entre o polegar e o indicador. O controle oncológico foi avaliado mediante exame clínico do membro operado e avaliação por imagens do punho e do tórax. RESULTADOS: 17 pacientes avaliados, dez do sexo feminino (58,8% e sete do sexo masculino (41,2% com idades entre 16 e 61 anos (média de 32,3 anos, todos destros. Na avaliação funcional (ISOLS observamos 11 resultados excelentes, dois bons e um ruim; os três casos que demandaram artrodese evoluíram com escore excelente. O arco residual global foi de 196,2 ± 116,6º. O arco residual do punho operada correspondeu a 58,9% do controle. A força de preensão da mão correspondeu a 55,4 ± 17,4% do controle. O percentual de "pinça" foi de 80,6 ± 14,8% do controle. Não constatamos recidiva ou metástases nesta casuística. CONCLUSÃO: A técnica propiciou resultados funcionais alentadores, assegurando o retorno dos pacientes às suas atividades. A ausência de recidiva local e/ou metástases, observada inclusive nos pacientes com seguimento mais longo, permite sugerir que a técnica parece ser segura no controle oncológico do tumor.OBJECTIVE: To functionally and oncologically assess the treatment of GCT on radius distal end (stage B3 following wide resection and reconstruction with avascular autologous graft from proximal fibular end. METHODS: The residual function was assessed using ISOLS score, measurement of the global residual arch of the operated wrist, residual percentage of the hand apprehension strength between thumb and index fingers. The oncologic monitoring was assessed by clinical

  7. Do stress fractures induce hypertrophy of the grafted fibula? A report of three cases received free vascularized fibular graft treatment for tibial defects.

    Science.gov (United States)

    Qi, Yong; Sun, Hong-Tao; Fan, Yue-Guang; Li, Fei-Meng; Lin, Zhou-Sheng

    2016-06-01

    The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting (FVFG) is considered to be a reliable reconstructive procedure. Stress fractures are a common complication following this surgery, and hypertrophy is the main physiological change of the grafted fibula. The exact mechanism of hypertrophy is not completely known. To the best of our knowledge, no studies have examined the possible relationship between stress fractures and hypertrophy. We herein report three cases of patients underwent FVFG. Two of them developed stress fractures and significant hypertrophy, while the remaining patient developed neither stress fractures nor significant hypertrophy. This phenomenon indicates that a relationship may exist between stress fractures and hypertrophy of the grafted fibula, specifically, that the presence of a stress fracture may initiate the process of hypertrophy.

  8. Reconstruction of the Midfoot Using a Free Vascularized Fibular Graft After En Bloc Excision for Giant Cell Tumor of the Tarsal Bones: A Case Report.

    Science.gov (United States)

    Hara, Hitomi; Kawamoto, Teruya; Onishi, Yasuo; Fujioka, Hiroyuki; Nishida, Kotaro; Kuroda, Ryosuke; Kurosaka, Masahiro; Akisue, Toshihiro

    2016-01-01

    We report the case of a 32-year-old Japanese female with a giant cell tumor of bone involving multiple midfoot bones. Giant cell tumors of bone account for approximately 5% of all primary bone tumors and most often arise at the ends of long bones. The small bones, such as those of the hands and feet, are rare sites for giant cell tumors. Giant cell tumors of the small bones tend to exhibit more aggressive clinical behavior than those of the long bones. The present patient underwent en bloc tumor excision involving multiple tarsals and metatarsals. We reconstructed the longitudinal arch of the foot with a free vascularized fibular graft. At the 2-year follow-up visit, bony union had been achieved, with no tumor recurrence. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Comparison of the effects of dexketoprofen trometamol, meloxicam and diclofenac sodium on fibular fracture healing, kidney and liver: an experimental rat model.

    Science.gov (United States)

    Inal, Sermet; Kabay, Sahin; Cayci, M Kasim; Kuru, H Isa; Altikat, Sayit; Akkas, Gizem; Deger, Aysenur

    2014-03-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are particularly used in patients with bone fractures, but there are limited studies on whether one NSAID is superior to another. In this study, we used histopathological and biochemical parameters to determine whether there are differences between the effects of the administration of clinical doses of dexketoprofen trometamol (DEXT), meloxicam (MEL) and diclofenac sodium (DIC) on the healing of closed fibular fractures and the toxicity of both the liver and kidney. Twenty-eight male Sprague-Dawley rats were randomly divided into four groups of seven each. Closed diaphyseal fractures were formed in the left fibulas of all of the rats. The NSAIDs dexketoprofen trometamol (DEXT) (Arveles(®)), meloxicam (MEL) (Melox(®)) and diclofenac sodium (DIC) (Voltaren(®)) were intramuscularly administered to Groups I, II, and III, respectively, for a period of 10 days after the fibular fractures were performed. No pharmacological agents were administered to Group IV (Control group). Blood samples were collected from all of the rats after the fractures were performed, and the rats were sacrificed on day 28. The histopathological findings were compared, and the blood samples were evaluated to determine any differences between the levels of superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA). Our results suggest that DEXT and MEL impair the healing of bone fractures and that DIC does not histopathologically affect the healing process of bone fractures. We also found that DEXT, MEL, and DIC impaired the renal histopathology compared with the control group. However, the liver histopathological analysis showed that DEXT and MEL caused a higher degree of parenchymal necrosis compared with DIC. Based on our results, DIC can be considered a relatively safe medication in patients with fractures. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. The activity of the primary motor cortex ipsilateral to the exercising hand decreases during repetitive handgrip exercise

    International Nuclear Information System (INIS)

    Shibuya, Kenichi

    2011-01-01

    The brain function controlling muscle force production is not yet fully understood. The purpose of this study was to examine bilateral primary motor cortex (M1) oxygenation during static-handgrip exercises performed with the right hand (60% maximal voluntary contraction; 10 s exercise/75 s rest; five sets). Twelve healthy, right-handed male subjects participated in this study. Near-infrared spectroscopy probes were positioned over the bilateral M1 to measure cortical oxygenation during handgrip exercises. The maximum values of the changes in concentrations of oxyhemoglobin (HbO 2 ) and deoxyhemoglobin (Hb) across the trials (i) did not change significantly during the contralateral M1 activation (p > 0.05), whereas (ii) in the case of the ipsilateral M1 activation a significant (p < 0.05) decrease in HbO 2 and a significant (p < 0.01) decrease in Hb could be measured. The activation in ipsilateral M1 at the fifth trial was significantly decreased compared with that in the first trial (HbO 2 : p < 0.001; Hb: p < 0.001). The present results suggest that the ipsilateral M1 is recruited during the motor task in compensation for the contralateral M1 and the habituation to motor task might alter the efficiency for interaction of the ipsilateral M1 to the contralateral M1. The interhemispheric interaction might change due to habituation to motor task

  11. Stenting versus endarterectomy for restenosis following prior ipsilateral carotid endarterectomy : An individual patient data meta-analysis

    NARCIS (Netherlands)

    Fokkema, Margriet; Vrijenhoek, Joyce E P; Ruijter, Hester M Den; Groenwold, Rolf H H; Schermerhorn, Marc L.; Bots, Michiel L.; Pasterkamp, Gerard; Moll, Frans L.; De Borst, Gert Jan

    2015-01-01

    Objective: To study perioperative results and restenosis during follow-up of carotid artery stenting (CAS) versus carotid endarterectomy (CEA) for restenosis after prior ipsilateral CEA in an individual patient data (IPD) metaanalysis. Background: The optimal treatment strategy for patients with

  12. Progression of Unilateral Hearing Loss in Children With and Without Ipsilateral Cochlear Nerve Canal Stenosis: A Hazard Analysis.

    Science.gov (United States)

    Purcell, Patricia L; Shinn, Justin R; Coggeshall, Scott S; Phillips, Grace; Paladin, Angelisa; Sie, Kathleen C Y; Horn, David L

    2017-07-01

    To investigate the risk of hearing loss progression in each ear among children with unilateral hearing loss associated with ipsilateral bony cochlear nerve canal (BCNC) stenosis. Tertiary pediatric referral center. Children diagnosed with unilateral hearing loss who had undergone temporal bone computed tomography imaging and had at least 6 months of follow-up audiometric testing were identified from a prospective audiological database. Two pediatric radiologists blinded to affected ear evaluated imaging for temporal bone anomalies and measured bony cochlear canal width independently. All available audiograms were reviewed, and air conduction thresholds were documented. Progression of hearing loss was defined by a 10 dB increase in air conduction pure-tone average. One hundred twenty eight children met inclusion criteria. Of these, 54 (42%) had a temporal bone anomaly, and 22 (17%) had ipsilateral BCNC stenosis. At 12 months, rates of progression in the ipsilateral ear were as follows: 12% among those without a temporal bone anomaly, 13% among those with a temporal bone anomaly, and 17% among those with BCNC stenosis. Children with BCNC stenosis had a significantly greater risk of progression in their ipsilateral ear compared with children with no stenosis: hazard ratio (HR) 2.17, 95% confidence interval (CI) (1.01, 4.66), p value 0.046. When we compared children with BCNC stenosis to those with normal temporal bone imaging, we found that the children with stenosis had nearly two times greater risk estimate for progression, but this difference did not reach significance, HR 1.9, CI (0.8, 4.3), p = 0.1. No children with BCNC stenosis developed hearing loss in their contralateral year by 12 months of follow-up. Children with bony cochlear nerve canal stenosis may be at increased risk for progression in their ipsilateral ear. Audiometric and medical follow-up for these children should be considered.

  13. Association between Champagne Bottle Neck Sign of Internal Carotid Artery and Ipsilateral Hemorrhagic Stroke in Patients with Moyamoya Disease.

    Science.gov (United States)

    Wang, Jian; Chen, Gong; Yang, Yongbo; Zhang, Bing; Jia, Zhongzhi; Gu, Peiyuan; Wei, Dong; Ji, Jing; Hu, Weixing; Zhao, Xihai

    2018-06-15

    To assess the association between champagne bottle neck sign (CBNS) in carotid artery and intracranial hemorrhage in patients with moyamoya disease (MMD). From January 2016 to December 2017, a total of 76 consecutive patients with MMD without definite risk factors associated intracranial hemorrhage who underwent preoperative angiography were included in this retrospective study. CBNS was defined as luminal diameter of internal carotid artery (ICA)/common carotid artery (CCA) ≤ 0.5 on angiographic imaging. The right and left cerebral hemisphere in each patient was separately identified as hemorrhagic and none-hemorrhagic. The association between CBNS and intracranial hemorrhage was analyzed. Of 76 MMD patients, intracranial hemorrhage was found in 44 (28.9%) hemispheres of 152 and 6.8% (3/44) had multiple events. Compared carotid arteries without intracranial hemorrhage in the ipsilateral hemispheres, those with intracranial hemorrhage in the ipsilateral hemispheres had significantly smaller luminal diameter ratio of ICA/CCA (0.49 ± 0.11 vs. 0.55 ± 0.12, p < 0.01) and higher prevalence of CBNS (63.7% vs. 41.7%, p = 0.01). For hemispheres with intracranial hemorrhage, those with ipsilateral carotid artery CBNS had significantly higher prevalence of hemorrhage at posterior territories than those without (57.1% vs. 23.1%, p=0.05). Logistic regression revealed that CBNS was significantly associated with ipsilateral intracranial hemorrhage before (OR, 2.45; 95% CI, 1.19-5.05; p=0.02) and after (OR, 3.43; 95% CI, 1.50-7.87; p<0.01) adjusted for female, lenticulostriate anastomosis, and choroidal anastomosis. CBNS is significantly associated with intracranial hemorrhage at ipsilateral hemisphere in MMD patients, particularly for intracranial hemorrhage at posterior territories. Copyright © 2018. Published by Elsevier Inc.

  14. Long-term Outcome of Unconstrained Primary Total Hip Arthroplasty in Ipsilateral Residual Poliomyelitis.

    Science.gov (United States)

    Buttaro, Martín A; Slullitel, Pablo A; García Mansilla, Agustín M; Carlucci, Sofía; Comba, Fernando M; Zanotti, Gerardo; Piccaluga, Francisco

    2017-03-01

    Incapacitating articular sequelae in the hip joint have been described for patients with late effects of poliomyelitis. In these patients, total hip arthroplasty (THA) has been associated with a substantial rate of dislocation. This study was conducted to evaluate the long-term clinical and radiologic outcomes of unconstrained THA in this specific group of patients. The study included 6 patients with ipsilateral polio who underwent primary THA between 1985 and 2006. Patients with polio who underwent THA on the nonparalytic limb were excluded. Mean follow-up was 119.5 months (minimum, 84 months). Clinical outcomes were evaluated with the modified Harris Hip Score (mHHS) and the visual analog scale (VAS) pain score. Radiographs were examined to identify the cause of complications and determine the need for revision surgery. All patients showed significantly better functional results when preoperative and postoperative mHHS (67.58 vs 87.33, respectively; P=.002) and VAS pain score (7.66 vs 2, respectively; P=.0003) were compared. Although 2 cases of instability were diagnosed, only 1 patient needed acetabular revision as a result of component malpositioning. None of the patients had component loosening, osteolysis, or infection. Unconstrained THA in the affected limb of patients with poliomyelitis showed favorable long-term clinical results, with improved function and pain relief. Nevertheless, instability may be a more frequent complication in this group of patients compared with the general population. [Orthopedics. 2017; 40(2):e255-e261.]. Copyright 2016, SLACK Incorporated.

  15. Ipsilateral deficits in 1-handed shoe tying after left or right hemisphere stroke.

    Science.gov (United States)

    Poole, Janet L; Sadek, Joseph; Haaland, Kathleen Y

    2009-10-01

    Poole JL, Sadek J, Haaland KY. Ipsilateral deficits in 1-handed shoe tying after left or right hemisphere stroke. To examine 1-handed shoe tying performance and whether cognitive deficits more associated with left or right hemisphere damage differentially affect it after unilateral stroke. Observational cohort comparing ipsilesional shoe tying, spatial and language skills, and limb praxis. Primary care Veterans Affairs and private medical center. Not applicable. Volunteer right-handed sample of adults with left or right hemisphere damage and healthy demographically matched adults. The number of correct trials and the total time to complete 10 trials tying a shoe using the 1-handed method. Both stroke groups had fewer correct trials and were significantly slower tying the shoe than the control group. Spatial skills predicted accuracy and speed after right hemisphere damage. After left hemisphere damage, accuracy was predicted by spatial skills and limb praxis, while speed was predicted by limb praxis only. Ipsilesional shoe tying is similarly impaired after left or right hemisphere damage, but for different reasons. Spatial deficits had a greater influence after right hemisphere damage, and limb apraxia had a greater influence after left hemisphere damage. Language deficits did not affect performance, indicating that aphasia does not preclude using this therapy approach. These results suggest that rehabilitation professionals should consider assessment of limb apraxia and ipsilesional skill training in the performance of everyday tasks.

  16. Ipsilateral Hip Dysplasia in Patients with Sacral Hemiagenesis: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Tadatsugu Morimoto

    2015-01-01

    Full Text Available Sacral agenesis (SA is a rare condition consisting of the imperfect development of any part of the sacrum. This paper describes two cases of the rare cooccurrence of ipsilateral SA and developmental dysplasia of the hip (DDH and analyzes possible contributory factors for SA and DDH. Each of a 16-year-old female and 13-year-old female visited our hospital for left hip pain and limping. The findings of physical examinations showed a lower limb length discrepancy (left side in both cases, as well as left hip pain without limitations of the range of motion or neurological deficits. Initial radiographs demonstrated left subluxation of the left hip with associated acetabular dysplasia and partial left sacral agenesis. MRI revealed a tethering cord with a fatty filum terminale, and periacetabular osteotomy combined with allogeneic bone grafting was performed. After the surgery, the patients experienced no further pain, with no leg length discrepancy and were able to walk without a limp, being neurologically normal with a normal left hip range of motion. The cooccurrence of SA and DDH suggests a plausible hypothesis to explain the embryogenic relationship between malformation of the sacrum and hip.

  17. Midterm Experience of Ipsilateral Axillary-Axillary Arteriovenous Loop Graft as Tertiary Access for Haemodialysis

    Directory of Open Access Journals (Sweden)

    J. P. Hunter

    2014-01-01

    Full Text Available Objectives. To present a series of ipsilateral axillary artery to axillary vein loop arm grafts as an alternative vascular access procedure for haemodialysis in patients with difficult access. Design. Retrospective case series. Methods. Patients who underwent an axillary loop arteriovenous graft from September 2009 to September 2012 were included. Preoperative venous imaging to exclude central venous stenosis and to image arm/axillary veins was performed. A cuffed PTFE graft was anastomosed to the distal axillary artery and axillary vein and looped on the arm. Results. 25 procedures were performed on 22 patients. Median age was 51 years, with 9 males and 13 females. Median number of previous access procedures was 3 (range 0–7. Median followup was 16.4 months (range 1–35. At 3 months and 1 year, the primary and secondary patency rates were 70% and 72% and 36% and 37%, respectively. There were 11 radiological interventions in 6 grafts including 5 angioplasties and 6 thrombectomies. There were 19 surgical procedures in 10 grafts, including thrombectomy, revision, repair for bleeding, and excision. Conclusions. Our series demonstrates that the axillary loop arm graft yields acceptable early patency rates in a complex group of patients but to maintain graft patency required high rates of surgical and radiological intervention, in particular graft thrombectomy.

  18. Agenesia renal unilateral e criptorquidismo ipsilateral em um felino: relato de caso

    Directory of Open Access Journals (Sweden)

    E.R. Santos

    2015-04-01

    Full Text Available A agenesia renal é uma afecção congênita rara na espécie felina, frequentemente associada a uma malformação reprodutiva. O presente trabalho relata o caso de um felino com agenesia renal unilateral associada a criptorquidismo ipsilateral, com ênfase no diagnóstico, tratamento e acompanhamento. O paciente foi conduzido ao Hospital de Clínicas Veterinárias da Universidade Federal do Rio Grande do Sul para avaliação de criptorquidismo. A agenesia renal foi um achado durante a ecografia abdominal do felino. Durante a laparotomia, foi confirmada a ausência do rim e ureter direito, hipertrofia do rim esquerdo e presença de um testículo ectópico. O paciente teve alta após a recuperação anestésica e se mantém clinicamente estável, transcorridos seis meses da cirurgia. A agenesia renal unilateral é uma condição compatível com a vida, contanto que o rim existente apresente funcionamento aceitável. Assim, sugere-se que a possibilidade de rim único em felinos criptorquidas deve ser investigada sempre que possível, tendo em vista a alta correlação entre essas malformações, e objetivando um acompanhamento da função renal do paciente ao longo da vida.

  19. Ocular Image and Haemodynamic Features Associated with Different Gradings of Ipsilateral Internal Carotid Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Hui Wang

    2017-01-01

    Full Text Available Objectives. To analyse the changes of ocular haemodynamics and morphology in Chinese patients with internal carotid artery (ICA stenosis in the current study. Methods. A retrospective case-control study was conducted with 219 patients. The haemodynamic characteristics, the calibre of retinal vessels, and the subfoveal choroidal thickness (SFChT were compared. We analysed the correlations with the degree of ipsilateral ICA stenosis. Results. There were no significant differences among the groups in the central retinal artery equivalent (CRAE, central retinal vein equivalent (CRVE, and AVR (p=0.073, p=0.188, and p=0.738, resp.. The peak systolic velocity (PSV and end diastolic velocity (EDV in the central retinal artery (CRA and the posterior ciliary artery (PCA were significantly lower than normal eyes (p<0.001. The outer retinal layer thickness and SFChT values of the ICA stenosis groups were significantly lower than normal eyes (p=0.030 and p<0.001, resp.. Conclusion. The PSV and EDV in CRA and PCA and the SFChT and outer retinal layer thickness of ICA eyes were significantly lower than normal eyes. ICA stenosis may impact choroidal haemodynamics, and decreased choroidal circulation might affect the discordance of the SFChT and the outer retinal layer thickness.

  20. Idiopathic Ninth, Tenth, and Twelfth Cranial Nerve Palsy with Ipsilateral Headache: A Case Report

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    Sun Seung-Ho

    2012-12-01

    Full Text Available Objective: This case report is to report the effect of Korean traditional treatment for idiopathic ninth, tenth, and twelfth cranial nerve palsy with ipsilateral headache. Methods: The medical history and imaging and laboratory test of a 39-year-old man with cranial palsy were tested to identify the cause of disease. A 0.2-mL dosage of Hwangyeonhaedoktang pharmacopuncture was administered at CV23 and CV17, respectively. Acupuncture was applied at P06, Li05, TE05, and G37 on the right side of the body. Zhuapiandutongbang (左偏頭痛方 was administered at 30 minutes to 1 hour after mealtime three times a day. The symptoms were investigated using Visual Analogue Scale (VAS. Results: The results of magnetic resonance imaging (MRI, computed tomography (CT, and laboratory tests were normal. The medical history showed no trauma, other illnesses, family history of diseases, medications, smoking, drinking and so on. All symptoms disappeared at the 10th day of treatment. Conclusion: Korean traditional treatment such as acupuncture, pharmcopuncture, and herbal medicine for the treatment of ninth, tenth, and twelfth cranial nerve palsy of unknown origin is suggested to be effective even though this conclusion is based on a single.

  1. Chronic eosinophilic pneumonia presenting with ipsilateral pleural effusion: a case report.

    Science.gov (United States)

    Sriratanaviriyakul, Narin; La, Hanh H; Albertson, Timothy E

    2016-08-12

    Chronic eosinophilic pneumonia is a rare idiopathic interstitial lung disease. The nearly pathognomonic radiographic finding is the peripheral distribution of alveolar opacities. Pleural effusions are rarely seen. We report a case of chronic eosinophilic pneumonia with transudative eosinophilic pleural effusion. A 57-year-old Hispanic woman, a nonsmoker with a history of controlled asthma, presented to the hospital with unresolving pneumonia despite three rounds of antibiotics over a 2-month period. She was later diagnosed with chronic eosinophilic pneumonia based on the presence of peripheral blood eosinophilia, the peripheral distribution of alveolar infiltrates on chest radiograph, and a lung parenchymal biopsy with infiltrates of eosinophils. Upon presentation, our patient had a right-sided moderate-sized pleural effusion. The pleural fluid profile was consistent with a transudative effusion with eosinophil predominance. Our patient responded promptly to oral corticosteroid treatment in a few days. The pulmonary infiltrates and pleural effusion subsided on a 1-month follow-up chest radiograph after starting corticosteroid treatment. We report the first case of chronic eosinophilic pneumonia presenting with pneumonia with ipsilateral transudative eosinophilic pleural effusion. Like other cases of chronic eosinophilic pneumonia, early recognition and diagnosis is essential and prompt treatment with corticosteroids is the mainstay of therapy. Pleural effusion resolved without the further need for therapeutic thoracentesis.

  2. Shrinkage of ipsilateral taste buds and hyperplasia of contralateral taste buds following chorda tympani nerve transection.

    Science.gov (United States)

    Li, Yi-Ke; Yang, Juan-Mei; Huang, Yi-Bo; Ren, Dong-Dong; Chi, Fang-Lu

    2015-06-01

    The morphological changes that occur in the taste buds after denervation are not well understood in rats, especially in the contralateral tongue epithelium. In this study, we investigated the time course of morphological changes in the taste buds following unilateral nerve transection. The role of the trigeminal component of the lingual nerve in maintaining the structural integrity of the taste buds was also examined. Twenty-four Sprague-Dawley rats were randomly divided into three groups: control, unilateral chorda tympani nerve transection and unilateral chorda tympani nerve transection + lingual nerve transection. Rats were allowed up to 42 days of recovery before being euthanized. The taste buds were visualized using a cytokeratin 8 antibody. Taste bud counts, volumes and taste receptor cell numbers were quantified and compared among groups. No significant difference was detected between the chorda tympani nerve transection and chorda tympani nerve transection + lingual nerve transection groups. Taste bud counts, volumes and taste receptor cell numbers on the ipsilateral side all decreased significantly compared with control. On the contralateral side, the number of taste buds remained unchanged over time, but they were larger, and taste receptor cells were more numerous postoperatively. There was no evidence for a role of the trigeminal branch of the lingual nerve in maintaining the structural integrity of the anterior taste buds.

  3. Unilateral severe chronic periodontitis associated with ipsilateral surgical resection of cranial nerves V, VI, and VII.

    Science.gov (United States)

    Zavarella, Matthew M; Leblebicioglu, Binnaz; Claman, Lewis J; Tatakis, Dimitris N

    2006-01-01

    The central and peripheral nervous systems participate in several local physiological and pathological processes. There is experimental evidence that the inflammatory, local immune, and wound healing responses of a tissue can be modulated by its innervation. The aim of this clinical report is to present a case of unilateral severe periodontitis associated with ipsilateral surgical resection of the fifth, sixth, and seventh cranial nerves and to discuss the possible contribution of the nervous system to periodontal pathogenesis. A 39-year-old female patient with a history of a cerebrovascular accident caused by a right pontine arteriovenous malformation and destruction of the right fifth, sixth, and seventh cranial nerves was diagnosed with severe chronic periodontitis affecting only the right maxillary and mandibular quadrants. The patient's oral hygiene was similar for right and left sides of the mouth. Percentages of tooth surfaces carrying dental plaque were 41% and 36% for right and left sides, respectively. Non-surgical and surgical periodontal therapy was performed, and the patient was placed on a regular periodontal maintenance schedule. Healing following initial periodontal therapy and osseous periodontal surgery occurred without complications. Follow-up clinical findings at 1 year revealed stable periodontal health. This case report suggests that periodontal innervation may contribute to the regulation of local processes involved in periodontitis pathogenesis. It also suggests that periodontal therapy can be performed successfully at sites and in patients affected by paralysis.

  4. Shrinkage of ipsilateral taste buds and hyperplasia of contralateral taste buds following chorda tympani nerve transection

    Directory of Open Access Journals (Sweden)

    Yi-ke Li

    2015-01-01

    Full Text Available The morphological changes that occur in the taste buds after denervation are not well understood in rats, especially in the contralateral tongue epithelium. In this study, we investigated the time course of morphological changes in the taste buds following unilateral nerve transection. The role of the trigeminal component of the lingual nerve in maintaining the structural integrity of the taste buds was also examined. Twenty-four Sprague-Dawley rats were randomly divided into three groups: control, unilateral chorda tympani nerve transection and unilateral chorda tympani nerve transection + lingual nerve transection. Rats were allowed up to 42 days of recovery before being euthanized. The taste buds were visualized using a cytokeratin 8 antibody. Taste bud counts, volumes and taste receptor cell numbers were quantified and compared among groups. No significant difference was detected between the chorda tympani nerve transection and chorda tympani nerve transection + lingual nerve transection groups. Taste bud counts, volumes and taste receptor cell numbers on the ipsilateral side all decreased significantly compared with control. On the contralateral side, the number of taste buds remained unchanged over time, but they were larger, and taste receptor cells were more numerous postoperatively. There was no evidence for a role of the trigeminal branch of the lingual nerve in maintaining the structural integrity of the anterior taste buds.

  5. Management of non-traumatic avascular necrosis of the femoral head-a comparative analysis of the outcome of multiple small diameter drilling and core decompression with fibular grafting.

    Science.gov (United States)

    Mohanty, S P; Singh, K A; Kundangar, R; Shankar, V

    2017-04-01

    The purpose of this study was to compare the clinical and radiological outcomes of multiple small diameter drilling and core decompression with fibular strut grafting in the management of non-traumatic avascular necrosis (AVN) of the femoral head. Outcomes of patients with AVN treated by multiple small diameter drilling (group 1) were compared retrospectively with patients treated by core decompression and fibular grafting (group 2). Harris hip score (HHS) was used to assess the clinical status pre- and postoperatively. Modified Ficat and Arlet classification was used to assess the radiological stage pre- and postoperatively. Forty-six patients (68 hips) were included in this study. Group 1 consisted of 33 hips, and group 2 consisted of 35 hips. In stages I and IIB, there was no statistically significant difference in the final HHS between the two groups. However, in stages IIA and III, hips in group 2 had a better final HHS (P < 0.05). In terms of radiographic progression, there was no statistical difference between hips in stages I, IIA and stage IIB. However, in stage III, hips belonging to group 2 had better results (P < 0.05). Kaplan-Meier survivorship analysis showed better outcome in group 2 in stage III (P < 0.05). Hips with AVN in the precollapse stage can be salvaged by core decompression with or without fibular grafting. Multiple small diameter drilling is relatively simple and carries less morbidity and hence preferred in stages I and II. However, in stage III disease, core decompression with fibular strut grafting gives better results.

  6. A Case Report of Breast Sparganosis in a Patient with Ipsilateral Breast Cancer: MRI and Ultrasonographic Findings

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    Lee, Yoo Jin; Bae, Young Tae; Kim, Jee Yeon [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Choo, Ki Seok [Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2010-12-15

    Sparganosis of the breast is a quite rare parasitic infection of humans and presents as soft tissue masses that mimic breast malignancy or benign tumor, such as fibroadenoma. We present here a case of histologically confirmed breast sparganosis in the upper inner quadrant of the right breast with coexisting breast cancer in the ipsilateral breast upper outer quadrant. Ultrasonography of breast sparganosis showed a well defined, tubular hypoechoic mass with discrete multilayered wall and tubule-in tubule appearance, surrounded by heterogenous hyperechoic areas in the subcutaneous fat layer of the breast. MRI revealed an elongated tubular structure with persistent and progressive enhancement. This is the second report concerned with the MRI and ultrasonographic findings of breast sparganosis and the first report of breast sparganosis in a patient with ipsilateral breast cancer

  7.  Uterus Didelphys with Obstructed Right Hemivagina, Ipsilateral Renal Agenesis and Right Pyocolpos: A Case Report

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    Hansa Dhar

    2011-11-01

    Full Text Available  Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis (OHVIRA Syndrome is a rare congenital anomaly of the female genital tract. Uterus didelphys occurs when the midline fusion of the mullerian ducts is arrested, either completely or incompletely. Women with didelphic uterus may be asymptomatic and unaware of having a double uterus. They may present with complaints of dysmenorrhoea and dyspareunia. A 25 year old woman attending the infertility clinic at Nizwa regional referral hospital presented with history of dysmenorrhoea and foul vaginal discharge with right cystic pelvic mass. She was diagnosed as a case of double uterus with obstructed right hemivagina and right pyocolpos with ipsilateral renal agenesis after routine ultrasonography in the clinic followed by MRI. Excision of the right vaginal septum with drainage of 200 ml of purulent discharge was performed. She was relieved of her symptoms and conceived promptly after the surgical excision of the partial vaginal septum.

  8. Congenital agenesis of unilateral parotid gland with ipsilateral type I first branchial cleft anomaly: A rare presentation

    OpenAIRE

    Tripti Maithani; Apoorva Pandey; Seema Acharya

    2014-01-01

    Aim: To report a rare case of unilateral parotid agenesis with ipsilateral type I first branchial cleft anomaly. Material and methods: A case study with special emphasis on the embryology, outlining the complex developmental process of parotid and branchial arches and highlighting the probable reason for development of such anomalies. Results: The literature states that unilateral parotid agenesis is a rare entity with few reported cases occurring solely or in conjunction with other hea...

  9. Ipsilateral irradiation for well lateralized carcinomas of the oral cavity and oropharynx: results on tumor control and xerostomia

    International Nuclear Information System (INIS)

    Cerezo, Laura; Martín, Margarita; López, Mario; Marín, Alicia; Gómez, Alberto

    2009-01-01

    In head and neck cancer, bilateral neck irradiation is the standard approach for many tumor locations and stages. Increasing knowledge on the pattern of nodal invasion leads to more precise targeting and normal tissue sparing. The aim of the present study was to evaluate the morbidity and tumor control for patients with well lateralized squamous cell carcinomas of the oral cavity and oropharynx treated with ipsilateral radiotherapy. Twenty consecutive patients with lateralized carcinomas of the oral cavity and oropharynx were treated with a prospective management approach using ipsilateral irradiation between 2000 and 2007. This included 8 radical oropharyngeal and 12 postoperative oral cavity carcinomas, with Stage T1-T2, N0-N2b disease. The actuarial freedom from contralateral nodal recurrence was determined. Late xerostomia was evaluated using the European Organization for Research and Treatment of Cancer QLQ-H&N35 questionnaire and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), version 3. At a median follow-up of 58 months, five-year overall survival and loco-regional control rates were 82.5% and 100%, respectively. No local or contralateral nodal recurrences were observed. Mean dose to the contralateral parotid gland was 4.72 Gy and to the contralateral submandibular gland was 15.30 Gy. Mean score for dry mouth was 28.1 on the 0-100 QLQ-H&N35 scale. According to CTCAE v3 scale, 87.5% of patients had grade 0-1 and 12.5% grade 2 subjective xerostomia. The unstimulated salivary flow was > 0.2 ml/min in 81.2% of patients and 0.1-0.2 ml/min in 19%. None of the patients showed grade 3 xerostomia. In selected patients with early and moderate stages, well lateralized oral and oropharyngeal carcinomas, ipsilateral irradiation treatment of the primary site and ipsilateral neck spares salivary gland function without compromising loco-regional control

  10. Ipsilateral free semitendinosus tendon graft transfer for reconstruction of chronic tears of the Achilles tendon

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    Gougoulias Nikolaos

    2008-07-01

    Full Text Available Abstract Background Many techniques have been developed for the reconstruction of the Achilles tendon in chronic tears. In presence of a large gap (greater than 6 centimetres, tendon augmentation is required. Methods We present our method of minimally invasive semitendinosus reconstruction for the Achilles tendon using one para-midline and one midline incision. Results The first incision is a 5 cm longitudinal incision, made 2 cm proximal and just medial to the palpable end of the residual tendon. The second incision is 3 cm long and is also longitudinal but is 2 cm distal and in the midline to the distal end of the tendon rupture. The distal and proximal Achilles tendon stumps are mobilised. After trying to reduce the gap of the ruptured Achilles tendon, if the gap produced is greater than 6 cm despite maximal plantar flexion of the ankle and traction on the Achilles tendon stumps, the ipsilateral semitendinosus tendon is harvested. The semitendinosus tendon is passed through small incisions in the substance of the proximal stump of the Achilles tendon, and it is sutured to the Achilles tendon. It is then passed beneath the intact skin bridge into the distal incision, and passed from medial to lateral through a transverse tenotomy in the distal stump. With the ankle in maximal plantar flexion, the semitendinosus tendon is sutured to the Achilles tendon at each entry and exit point Conclusion This minimally invasive technique allows reconstruction of the Achilles tendon using the tendon of semitendinosus preserving skin integrity over the site most prone to wound breakdown, and can be especially used to reconstruct the Achilles tendon in the presence of large gap (greater than 6 centimetres.

  11. Pattern of Ipsilateral Breast Tumor Recurrence After Breast-Conserving Therapy

    International Nuclear Information System (INIS)

    Jobsen, Jan; Palen, Job van der; Riemersma, Sietske; Heijmans, Harald; Ong, Francisca; Struikmans, Henk

    2014-01-01

    Purpose: To analyze the incidence and prognostic factors of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) in a large, population-based, single-center study with long-term follow-up. Methods and Materials: We analyzed 3595 cases in which BCT was performed in 3824 women with stage I or II breast cancer. The incidence of IBTR was analyzed over time and was based on IBTR as first event. Results: The 15-year local relapse-free survival was 90.9%. The hazard estimates for IBTR showed a time course with 2 peaks, the first at approximately 5 years and the second, twice as high, at 12 years. Stratifying subjects by age and margin status showed that, for women ≤40 years old with negative margins, adjuvant systemic therapy led to a 5-fold reduced risk of recurrence compared to none, and the presence of lymph vascular space invasion (LVSI) had a 3-fold increased risk compared to its absence. For women >40 years old, the presence of LVSI (hazard ratio [HR] 2.5) and the presence of lobular carcinoma in situ in the lumpectomy specimen (HR 2.3) were the only 2 risk factors. Conclusions: We demonstrated a pattern in risk of IBTR over time, with 2 peaks, first at approximately 5 years and a second, much higher peak at approximately 12 years, especially for women ≤40 years old. For women ≤40 years old with tumor-free resection margins, we noted that the absence of adjuvant systemic therapy and the presence of LVSI were independent prognostic factors of IBTR. For women >40 years old, the presence of LVSI and the presence of lobular carcinoma in situ were independent risk factors

  12. Pattern of Ipsilateral Breast Tumor Recurrence After Breast-Conserving Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jobsen, Jan, E-mail: j.jobsen@mst.nl [Department of Radiation Oncology, Medisch Spectrum Twente, Enschede (Netherlands); Palen, Job van der [Department of Epidemiology, Medisch Spectrum Twente, Enschede (Netherlands); Department of Research Methodology, Measurement, and Data Analysis, Faculty of Behavioral Science, University of Twente, Enschede (Netherlands); Riemersma, Sietske [Laboratory for Pathology Oost Nederland, Hengelo (Netherlands); Heijmans, Harald [Department of Surgery, Ziekenhuis Groep Twente, Hengelo (Netherlands); Ong, Francisca [Department of Radiation Oncology, Medisch Spectrum Twente, Enschede (Netherlands); Struikmans, Henk [Department of Radiation Oncology, Leiden University Medical Centre, Leiden (Netherlands); Radiotherapy Centre West, Medical Centre Haaglanden, The Hague (Netherlands)

    2014-08-01

    Purpose: To analyze the incidence and prognostic factors of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) in a large, population-based, single-center study with long-term follow-up. Methods and Materials: We analyzed 3595 cases in which BCT was performed in 3824 women with stage I or II breast cancer. The incidence of IBTR was analyzed over time and was based on IBTR as first event. Results: The 15-year local relapse-free survival was 90.9%. The hazard estimates for IBTR showed a time course with 2 peaks, the first at approximately 5 years and the second, twice as high, at 12 years. Stratifying subjects by age and margin status showed that, for women ≤40 years old with negative margins, adjuvant systemic therapy led to a 5-fold reduced risk of recurrence compared to none, and the presence of lymph vascular space invasion (LVSI) had a 3-fold increased risk compared to its absence. For women >40 years old, the presence of LVSI (hazard ratio [HR] 2.5) and the presence of lobular carcinoma in situ in the lumpectomy specimen (HR 2.3) were the only 2 risk factors. Conclusions: We demonstrated a pattern in risk of IBTR over time, with 2 peaks, first at approximately 5 years and a second, much higher peak at approximately 12 years, especially for women ≤40 years old. For women ≤40 years old with tumor-free resection margins, we noted that the absence of adjuvant systemic therapy and the presence of LVSI were independent prognostic factors of IBTR. For women >40 years old, the presence of LVSI and the presence of lobular carcinoma in situ were independent risk factors.

  13. Mapping the human brain during a specific Vojta's tactile input: the ipsilateral putamen's role.

    Science.gov (United States)

    Sanz-Esteban, Ismael; Calvo-Lobo, Cesar; Ríos-Lago, Marcos; Álvarez-Linera, Juan; Muñoz-García, Daniel; Rodríguez-Sanz, David

    2018-03-01

    A century of research in human brain parcellation has demonstrated that different brain areas are associated with functional tasks. New neuroscientist perspectives to achieve the parcellation of the human brain have been developed to know the brain areas activation and its relationship with different stimuli. This descriptive study aimed to compare brain regions activation by specific tactile input (STI) stimuli according to the Vojta protocol (STI-group) to a non-STI stimulation (non-STI-group). An exploratory functional magnetic resonance imaging (fMRI) study was performed. The 2 groups of participants were passively stimulated by an expert physical therapist using the same paradigm structure, although differing in the place of stimulation. The stimulation was presented to participants using a block design in all cases. A sample of 16 healthy participants, 5 men and 11 women, with mean age 31.31 ± 8.13 years was recruited. Indeed, 12 participants were allocated in the STI-group and 4 participants in the non-STI-group. fMRI was used to map the human brain in vivo while these tactile stimuli were being applied. Data were analyzed using a general linear model in SPM12 implemented in MATLAB. Differences between groups showed a greater activation in the right cortical areas (temporal and frontal lobes), subcortical regions (thalamus, brainstem, and basal nuclei), and in the cerebellum (anterior lobe). STI-group had specific difference brain activation areas, such as the ipsilateral putamen. Future studies should study clinical implications in neurorehabilitation patients.

  14. The refinement of ipsilateral eye retinotopic maps is increased by removing the dominant contralateral eye in adult mice.

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    Spencer L Smith

    2010-03-01

    Full Text Available Shortly after eye opening, initially disorganized visual cortex circuitry is rapidly refined to form smooth retinotopic maps. This process asymptotes long before adulthood, but it is unknown whether further refinement is possible. Prior work from our lab has shown that the retinotopic map of the non-dominant ipsilateral eye develops faster when the dominant contralateral eye is removed. We examined whether input from the contralateral eye might also limit the ultimate refinement of the ipsilateral eye retinotopic map in adults. In addition, we examined whether the increased refinement involved the recruitment of adjacent cortical area.By surgically implanting a chronic optical window over visual cortex in mice, we repeatedly measured the degree of retinotopic map refinement using quantitative intrinsic signal optical imaging over four weeks. We removed the contralateral eye and observed that the retinotopic map for the ipsilateral eye was further refined and the maximum magnitude of response increased. However, these changes were not accompanied by an increase in the area of responsive cortex.Since the retinotopic map was functionally refined to a greater degree without taking over adjacent cortical area, we conclude that input from the contralateral eye limits the normal refinement of visual cortical circuitry in mice. These findings suggest that the refinement capacity of cortical circuitry is normally saturated.

  15. Prior failed ipsilateral percutaneous endovascular intervention in patients with critical limb ischemia predicts poor outcome after lower extremity bypass

    Science.gov (United States)

    Nolan, Brian W.; De Martino, Randall R.; Stone, David H.; Schanzer, Andres; Goodney, Philip P.; Walsh, Daniel W.; Cronenwett, Jack L.

    2017-01-01

    Background Although open surgical bypass remains the standard revascularization strategy for patients with critical limb ischemia (CLI), many centers now perform peripheral endovascular intervention (PVI) as the first-line treatment for these patients. We sought to determine the effect of a prior ipsilateral PVI (iPVI) on the outcome of subsequent lower extremity bypass (LEB) in patients with CLI. Methods A retrospective cohort analysis of all patients undergoing infrainguinal LEB between 2003 and 2009 within hospitals comprising the Vascular Study Group of New England (VSGNE) was performed. Primary study endpoints were major amputation and graft occlusion at 1 year postoperatively. Secondary outcomes included in-hospital major adverse events (MAE), 1-year mortality, and composite 1-year major adverse limb events (MALE). Event rates were determined using life table analyses and comparisons were performed using the log-rank test. Multivariate predictors were determined using a Cox proportional hazards model with multilevel hierarchical adjustment. Results Of 1880 LEBs performed, 32% (n = 603) had a prior infrainguinal revascularization procedure (iPVI, 7%; ipsilateral bypass, 15%; contralateral PVI, 3%; contralateral bypass, 17%). Patients with prior iPVI, compared with those without a prior iPVI, were more likely to be women (32 vs 41%; P = .04), less likely to have tissue loss (52% vs 63%; P = .02), more likely to require arm vein conduit (16% vs 5%; P = .001), and more likely to be on statin (71% vs 54%; P = .01) and beta blocker therapy (92% vs 81%; P = .01) at the time of their bypass procedure. Other demographic factors were similar between these groups. Prior PVI or bypass did not alter 30-day MAE and 1-year mortality after the index bypass. In contrast, 1-year major amputation and 1-year graft occlusion rates were significantly higher in patients who had prior iPVI than those without (31% vs 20%; P = .046 and 28% vs 18%; P = .009), similar to patients who

  16. Metabolite changes in the ipsilateral and contralateral cerebral hemispheres in rats with middle cerebral artery occlusion

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    Lei Ruan

    2017-01-01

    difference in the metabolite changes induced by ischemic injury in the contralateral and ipsilateral cerebral hemispheres. Our findings demonstrate the presence of characteristic changes in metabolites in the contralateral hemisphere and suggest that they are most likely caused by metabolic changes in the ischemic hemisphere.

  17. Low Frequency Electroacupuncture Alleviated Spinal Nerve Ligation Induced Mechanical Allodynia by Inhibiting TRPV1 Upregulation in Ipsilateral Undamaged Dorsal Root Ganglia in Rats

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    Yong-Liang Jiang

    2013-01-01

    Full Text Available Neuropathic pain is an intractable problem in clinical practice. Accumulating evidence shows that electroacupuncture (EA with low frequency can effectively relieve neuropathic pain. Transient receptor potential vanilloid type 1 (TRPV1 plays a key role in neuropathic pain. The study aimed to investigate whether neuropathic pain relieved by EA administration correlates with TRPV1 inhibition. Neuropathic pain was induced by right L5 spinal nerve ligation (SNL in rats. 2 Hz EA stimulation was administered. SNL induced mechanical allodynia in ipsilateral hind paw. SNL caused a significant reduction of TRPV1 expression in ipsilateral L5 dorsal root ganglia (DRG, but a significant up-regulation in ipsilateral L4 and L6 DRGs. Calcitonin gene-related peptide (CGRP change was consistent with that of TRPV1. EA alleviated mechanical allodynia, and inhibited TRPV1 and CGRP overexpressions in ipsilateral L4 and L6 DRGs. SNL did not decrease pain threshold of contralateral hind paw, and TRPV1 expression was not changed in contralateral L5 DRG. 0.001, 0.01 mg/kg TRPV1 agonist 6′-IRTX fully blocked EA analgesia in ipsilateral hind paw. 0.01 mg/kg 6′-IRTX also significantly decreased pain threshold of contralateral paw. These results indicated that inhibition of TRPV1 up-regulation in ipsilateral adjacent undamaged DRGs contributed to low frequency EA analgesia for mechanical allodynia induced by spinal nerve ligation.

  18. Combined retrograde flexible ureteroscopic lithotripsy with holmium YAG laser for renal calculi associated with ipsilateral ureteral stones.

    Science.gov (United States)

    Cocuzza, Marcello; Colombo, Jose R; Ganpule, Arvind; Turna, Burak; Cocuzza, Antonio; Dhawan, Divyar; Santos, Bruno; Mazzucchi, Eduardo; Srougi, Miguel; Desai, Mahesh; Desai, Mihir

    2009-02-01

    The purpose of this study was to evaluate the effectiveness of combined ureteroscopic holmium YAG lithotripsy for renal calculi associated with ipsilateral ureteral stones. Between August 2002 and March 2007, retrograde flexible ureteroscopic stone treatment was attempted in 351 cases. Indication for treatment was concurrent symptomatic ureteral stones in 63 patients (group I). Additional operative time and perioperative complication rates were compared to a group of 39 patients submitted to ureteroscopic treatment for ureteral calculi exclusively (group II). Mean ureteral stone size was 8.0 +/- 2.6 mm and 8.1 +/- 3.4 mm for groups I and II, respectively. Mean operative time for group I was 67.9 +/- 29.5 minutes and for group 2 was 49.3 +/- 13.2 minutes (p stone size was 10.7 +/- 6.4 mm, overall stone free rate in group I was 81%. However, considering only patients with renal stones smaller than 15 mm, the stone free rate was 88%. Successful treatment occurred in 81% of patients presenting lower pole stones, but only 76% of patients with multiple renal stones became stone free. As expected, stone free rate showed a significant negative correlation with renal stone size (p = 0.03; r = -0.36). Logistic regression model indicated an independent association of renal stones smaller than 15 mm and stone free rate (OR = 13.5; p = 0.01). Combined ureteroscopic treatment for ureteral and ipsilateral renal calculi is a safe and attractive option for patients presenting for symptomatic ureteral stone and ipsilateral renal calculi smaller than 15 mm.

  19. A rare case of concomitant sicca keratopathy and ipsilateral central facial palsy in Wallenberg’s dorsolateral medullary syndrome

    Directory of Open Access Journals (Sweden)

    De Bruyn, Deborah

    2017-03-01

    Full Text Available Objective: To describe a patient with a right-sided supranuclear facial palsy and concomitant sicca keratopathy of the right eye following right-sided dorsolateral medullary infarction. Methods: Our patient underwent a complete ophthalmologic and neurologic examination including biomicroscopy, fundus examination, cranial nerve examination, Shirmer I test, and magnetic resonance imaging of the brain.Results: A 61-year-old woman presented in emergency with a central facial nerve palsy on the right side and truncal ataxia. Neurologic assessment revealed a concurrent dysphagia, dysarthria, hypoesthesia of the right face, and weakness of the right upper limb. Magnetic resonance imaging of the brain showed an old left-sided cerebellar infarction, but a recent ischemic infarction at the level of the right dorsolateral medulla oblongata was the cause of our patient’s current problems. One month after diagnosis of the right-sided dorsolateral medullary syndrome, there were complaints of ocular irritation and a diminished visual acuity in the right eye. Biomicroscopy showed a sicca keratopathy with nearly complete absence of tear secretion on the Shirmer I test, but with normal eye closure and preserved corneal reflexes and sensitivity.Conclusion: A dorsolateral medullary syndrome can have a variable expression in symptomatology. Our case is special because of the combination of an ipsilateral supranuclear facial palsy with normal upper facial muscle function together with an ipsilateral sicca keratopathy as a result of a nearly absent tear secretion. We hypothesized that the mechanism underlying the patient’s sicca keratopathy ipsilateral to the supranuclear facial palsy involved the superior salivatory nucleus, which is situated in the caudal pons inferiorly of the motor facial nucleus and is most probably affected by a superior extension of the infarcted area in the right medulla oblongata.

  20. Genetic Ablation of V2a Ipsilateral Interneurons Disrupts Left-Right Locomotor Coordination in Mammalian Spinal Cord

    DEFF Research Database (Denmark)

    Crone, Steven A.; Quinlan, Katharina A.; Zagoraiou, Laskaro

    2008-01-01

    The initiation and coordination of activity in limb muscles are the main functions of neural circuits that control locomotion. Commissural neurons connect locomotor circuits on the two sides of the spinal cord, and represent the known neural substrate for left-right coordination. Here we......-extensor coordination is unaffected. Anatomical tracing studies reveal a direct excitatory input of V2a interneurons onto commissural interneurons, including a set of molecularly defined V0 neurons that drive left-right alternation. Our findings imply that the neural substrate for left-right coordination consists...... of at least two components; commissural neurons and a class of ipsilateral interneurons that activate commissural pathways....

  1. Ipsilateral irradiation for well lateralized carcinomas of the oral cavity and oropharynx: results on tumor control and xerostomia

    Directory of Open Access Journals (Sweden)

    Marín Alicia

    2009-09-01

    Full Text Available Abstract Background In head and neck cancer, bilateral neck irradiation is the standard approach for many tumor locations and stages. Increasing knowledge on the pattern of nodal invasion leads to more precise targeting and normal tissue sparing. The aim of the present study was to evaluate the morbidity and tumor control for patients with well lateralized squamous cell carcinomas of the oral cavity and oropharynx treated with ipsilateral radiotherapy. Methods Twenty consecutive patients with lateralized carcinomas of the oral cavity and oropharynx were treated with a prospective management approach using ipsilateral irradiation between 2000 and 2007. This included 8 radical oropharyngeal and 12 postoperative oral cavity carcinomas, with Stage T1-T2, N0-N2b disease. The actuarial freedom from contralateral nodal recurrence was determined. Late xerostomia was evaluated using the European Organization for Research and Treatment of Cancer QLQ-H&N35 questionnaire and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE, version 3. Results At a median follow-up of 58 months, five-year overall survival and loco-regional control rates were 82.5% and 100%, respectively. No local or contralateral nodal recurrences were observed. Mean dose to the contralateral parotid gland was 4.72 Gy and to the contralateral submandibular gland was 15.30 Gy. Mean score for dry mouth was 28.1 on the 0-100 QLQ-H&N35 scale. According to CTCAE v3 scale, 87.5% of patients had grade 0-1 and 12.5% grade 2 subjective xerostomia. The unstimulated salivary flow was > 0.2 ml/min in 81.2% of patients and 0.1-0.2 ml/min in 19%. None of the patients showed grade 3 xerostomia. Conclusion In selected patients with early and moderate stages, well lateralized oral and oropharyngeal carcinomas, ipsilateral irradiation treatment of the primary site and ipsilateral neck spares salivary gland function without compromising loco-regional control.

  2. Ipsilateral irradiation for well lateralized carcinomas of the oral cavity and oropharynx: results on tumor control and xerostomia

    Science.gov (United States)

    Cerezo, Laura; Martín, Margarita; López, Mario; Marín, Alicia; Gómez, Alberto

    2009-01-01

    Background In head and neck cancer, bilateral neck irradiation is the standard approach for many tumor locations and stages. Increasing knowledge on the pattern of nodal invasion leads to more precise targeting and normal tissue sparing. The aim of the present study was to evaluate the morbidity and tumor control for patients with well lateralized squamous cell carcinomas of the oral cavity and oropharynx treated with ipsilateral radiotherapy. Methods Twenty consecutive patients with lateralized carcinomas of the oral cavity and oropharynx were treated with a prospective management approach using ipsilateral irradiation between 2000 and 2007. This included 8 radical oropharyngeal and 12 postoperative oral cavity carcinomas, with Stage T1-T2, N0-N2b disease. The actuarial freedom from contralateral nodal recurrence was determined. Late xerostomia was evaluated using the European Organization for Research and Treatment of Cancer QLQ-H&N35 questionnaire and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), version 3. Results At a median follow-up of 58 months, five-year overall survival and loco-regional control rates were 82.5% and 100%, respectively. No local or contralateral nodal recurrences were observed. Mean dose to the contralateral parotid gland was 4.72 Gy and to the contralateral submandibular gland was 15.30 Gy. Mean score for dry mouth was 28.1 on the 0-100 QLQ-H&N35 scale. According to CTCAE v3 scale, 87.5% of patients had grade 0-1 and 12.5% grade 2 subjective xerostomia. The unstimulated salivary flow was > 0.2 ml/min in 81.2% of patients and 0.1-0.2 ml/min in 19%. None of the patients showed grade 3 xerostomia. Conclusion In selected patients with early and moderate stages, well lateralized oral and oropharyngeal carcinomas, ipsilateral irradiation treatment of the primary site and ipsilateral neck spares salivary gland function without compromising loco-regional control. PMID:19723329

  3. An Unusual Case of Recurrent Pyocolpos Following Midtrimester Miscarriage Revealed as Obstructed Hemivagina with Ipsilateral Renal Agenesis (OHVIRA Syndrome

    Directory of Open Access Journals (Sweden)

    Haldar M

    2014-08-01

    Full Text Available Obstructed hemivagina with ipsilateral renal agenesis (OHVIRA Syndrome is a rare congenital anomaly. It mostly presents with severe dysmenorrhea and a palpable mass due to unilateral hematocolpos. Sometime it presents in unusual way with prolonged vaginal bleeding and profuse vaginal discharge. Here we report case of an 18 years old married female with OHVIRA syndrome presenting late with symptoms of recurrent pyocolpos following dilatation and evacuation for midtrimester miscarriage that was diagnosed on the basis of MRI and managed by vaginal septotomy.

  4. Herlyn-Werner-Wunderlich Syndrome Consisting of Uterine Didelphys, Obstructed Hemivagina and Ipsilateral Renal Agenesis in a Newborn

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    Tsung-Hsin Wu

    2012-02-01

    Full Text Available Herlyn-Werner-Wunderlich (HWW syndrome is a rare variant of Müllerian duct anomalies consisting of uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Patients with HWW syndrome are usually asymptomatic until menarche, when they present with acute lower abdominal pain. Here we report a case of a female newborn with right renal agenesis diagnosed during the pregnancy. The patient presented with a protruding mass over the vaginal introitus that was associated with an obstructed hemivagina and uterine didelphys.

  5. [Surgery of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws].

    Science.gov (United States)

    Zhang, P; Dong, Q R; Wang, Z Y; Chen, B; Wan, J H; Wang, L

    2016-11-08

    Objective: To explore the manual operation skills of operative treatment of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws, and to study the clinical results. Method: From Jan 2009 to Dec 2014, the clinical data of 13 patients with ipsilateral Hawkins Ⅲ talus neck and ankle joint fractres via internal and lateral approaches with Herbert screws were retrospectively analyzed in our department.There were 10 males and 3 female, ranging in age from 20 to 60 years with an average age of 31.5 years.The fractures occurred on the right side in 9 patients and on the left side in 4 patients.Three cases had the complication of medial malleolar fracture.Ten cases had the complication of medial and lateral malleolar fracture. Totally 11 cases were made calcaneal skeletal traction, and all the were made CT with three-dimensional image reconstruction.Two cases were treated with emergency operation.Eleven cases were treated with selective operation.The operation time was 5 hours-10 days after injury. The functional results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS). Result: The average duration of follow-up was 22.6 months (range, 14-65 months). There was skin necrosis in one cases, no incision infection, malunion and nonunion of the fractures and loss of reduction. At final follow-up, AOFAS ankle score was 75.2 (range, 42 to 93), higher than preoperative 39.2 (range, 23 to 60), the difference was statistically significant ( P =0.023). The result was excellent in 4 cases, good in 5 cases, fair in 3 cases and 1 cases in poor, and the overall excellent or good rate was 69.2%. Avascular necrosis occurred in 3 cases (23.1%, 3/13). Traumatic arthritis was found in 5 cases (38.5%, 5/13), involved tibial astragaloid joint in 2 cases, involved subtalar joint in 1 case, involved tibial astragaloid joint and subtalar joint in 2 cases. Conclusion: The effect of surgical treatment for ipsilateral

  6. Inhibition of Cathepsins B Induces Neuroprotection Against Secondary Degeneration in Ipsilateral Substantia Nigra After Focal Cortical Infarction in Adult Male Rats

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    Xialin Zuo

    2018-05-01

    Full Text Available Stroke is the leading cause of adult disability in the world. In general, recovery from stroke is incomplete. Accumulating evidences have shown that focal cerebral infarction leads to dynamic trans-neuronal degeneration in non-ischemic remote brain regions, with the disruption of connections to synapsed neurons sustaining ischemic insults. Previously, we had reported that the ipsilateral striatum, thalamus degenerated in succession after permanent distal branch of middle cerebral artery occlusion (dMCAO in Sprague-Dawley (SD rats and cathepsin (Cath B was activated before these relay degeneration. Here, we investigate the role of CathB in the secondary degeneration of ipsilateral substantia nigra (SN after focal cortical infarction. We further examined whether the inhibition of CathB with L-3-trans-(Propyl-carbamoyloxirane-2-carbonyl-L-isoleucyl-L-proline methyl ester (CA-074Me would attenuate secondary degeneration through enhancing the cortico-striatum-nigral connections and contribute to the neuroprotective effects. Our results demonstrated that secondary degeneration in the ipsilateral SN occurred and CathB was upregulated in the ipsilateral SN after focal cortical infarction. The inhibition of CathB with CA-074Me reduced the neuronal loss and gliosis in the ipsilateral SN. Using biotinylated dextran amine (BDA or pseudorabies virus (PRV 152 as anterograde or retrograde tracer to trace striatum-nigral and cortico-nigral projections pathway, CA-074Me can effectively enhance the cortico-striatum-nigral connections and exert neuroprotection against secondary degeneration in the ipsilateral SN after cortical ischemia. Our study suggests that the lysosomal protease CathB mediates the secondary damage in the ipsilateral SN after dMCAO, thus it can be a promising neuroprotective target for the rehabilitation of stroke patients.

  7. The Aortic Bifurcation Angle as a Factor in Application of the Outback for Femoropopliteal Lesions in Ipsilateral Versus Contralateral Approaches.

    Science.gov (United States)

    Raskin, Daniel; Khaitovich, Boris; Balan, Shmuel; Silverberg, Daniel; Halak, Moshe; Rimon, Uri

    2018-01-01

    To assess the technical success of the Outback reentry device in contralateral versus ipsilateral approaches for femoropopliteal arterial occlusion. A retrospective review of patients treated for critical limb ischemia (CLI) using the Outback between January 2013 and July 2016 was performed. Age, gender, length and site of the occlusion, approach site, aortic bifurcation angle, and reentry site were recorded. Calcification score was assigned at both aortic bifurcation and reentry site. Technical success was assessed. During the study period, a total of 1300 endovascular procedures were performed on 489 patients for CLI. The Outback was applied on 50 femoropopliteal chronic total occlusions. Thirty-nine contralateral and 11 ipsilateral antegrade femoral were accessed. The device was used successfully in 41 patients (82%). There were nine failures, all in the contralateral approach group. Six due to inability to deliver the device due to acute aortic bifurcation angle and three due to failure to achieve luminal reentry. Procedural success was significantly affected by the aortic bifurcation angle (p = 0.013). The Outback has high technical success rates in treatment of femoropopliteal occlusion, when applied from either an ipsi- or contralateral approach. When applied in contralateral access, acute aortic bifurcation angle predicts procedural failure.

  8. [Obstructed hemivagina and ipsilateral renal anomaly: unusual cause of piocolpos. Report a case and review of literature ].

    Science.gov (United States)

    Cortés-Contreras, Diana Karen; Juárez-Cruz, Patricio Manuel; Vázquez-Flores, José; Vázquez-Flores, Al David

    2014-10-01

    OHVIRA (Obstructed hemivagina and ipsilateral renal anomaly) by acronym and abbreviations in English or Herlyn Werner Wunderlich syndrome is a rare congenital malformation caused by an alteration in the Mullerian ducts and Wolffian Ducts. Which is characterized by a triad: uterus didelphys, obstructed and ipsilateral renal agenesis hemivagina still uncertain etiology. Patients are usually asymptomatic until menarche where the most common clinical presentation is pelvic pain, followed by a vaginal or abdominal mass, normal menstrual periods, infertility, and vaginal discharge rarely appears. The case of a female patient of 15 years, nubile with chronic fetid vaginal discharge, initially diagnosed and treated as pelvic inflammatory disease occurs, however because it is an exceptional condition with the background of the patient, by complementary studies were conducted where pelvic ultrasound revealed pyocolpos and absence of left kidney, uterus didelphys, blind hemivagina by other imaging studies, where we could integrate Herlyn-Werner-Wunderlich syndrome. In conclusion, abnormalities in the development of the Miillerian ducts are difficult to diagnose early, so you must have the embryological knowledge, conduct thorough clinical assessment and detailed picture in whom the coridition is suspected to identify malformations coexisting urinary tract and vaginal defects with the importance of preserving reproductive success through appropriate planning of surgical approach, given that the fertility rate in these patients is comparable to the average.

  9. Changes in ipsilateral motor cortex activity during a unilateral isometric finger task are dependent on the muscle contraction force

    International Nuclear Information System (INIS)

    Shibuya, Kenichi; Kuboyama, Naomi; Tanaka, Junya

    2014-01-01

    It is possible to examine bilateral primary motor cortex (M1) activation during a sustained motor task using near-infrared spectroscopy (NIRS), in which it is assumed that increased oxygenation reflects cortical activation. The purpose of this study was to examine bilateral M1 activation in response to graded levels of force production during a unilateral finger task. Ten healthy right-handed male subjects participated in this study. NIRS probes were placed over the cortex to measure M1 activity while the subjects performed the finger task. The subjects performed a 10 s finger task at 20%, 40%, and 60% of the maximal voluntary contraction (MVC). Symmetrical activation was found over both M1 areas at all force levels investigated. In the contralateral M1, there were significant differences in oxygenation between 20% and 60% MVC, as well as between 40% and 60% MVC. In the ipsilateral M1, there were significant differences among all force levels. These results indicate the ipsilateral M1 takes part in muscle force control. (paper)

  10. Correlation between US and MRI for prenatal lung volumetry in diaphragmatic hernia, and use of Doppler to identify the ipsilateral lung cap

    Energy Technology Data Exchange (ETDEWEB)

    Castellote, Amparo; Mencho, Sandra; Cadavid, Lina; Piqueras, Joaquim; Enriquez, Goya [University Children' s Hospital Vall d' Hebron, Department of Pediatric Radiology, Barcelona (Spain); Carreras, Elena; Higueras, Teresa [University Hospital Vall d' Hebron, Department of Obstetrics and Gynecology, Barcelona (Spain)

    2011-12-15

    Pulmonary hypoplasia is a common cause of neonatal death. To describe the correlation between relative fetal lung volume (RFLV) and lung-to-head ratio (LHR) in fetuses with unilateral diaphragmatic hernia. Additionally, to describe identification of the ipsilateral lung cap by power Doppler. Single-institution study of consecutive fetuses with diaphragmatic hernia. LHR (by US) and RFLV (by MRI) were correlated in fetuses with and without an ipsilateral lung cap seen at MRI. In four, color/power Doppler was used to follow the pulmonary artery of the ipsilateral lung to identify the compressed cap. The study included 48 fetuses of 20-38 weeks' gestational age (mean, 26 weeks). Mean LHR was 1.52 (range, 0.6-3) in fetuses with a lung cap and 1.15 (range, 0.6-2.58) in fetuses without (P = 0.043). Mean RFLV was 47.4% (range, 18-80%) in fetuses with and 32.9% (range, 14-57%) in fetuses without a lung cap (P = 0.005). RFLV and LHR correlated (r = 0.41, P = 0.01 in those with a cap; r = 0.50, P = 0.05 in those without). Power Doppler identified the ipsilateral lung cap and pulsed Doppler confirmed pulmonary vascularization in four of four fetuses. LHR underestimates lung volume in fetuses with an ipsilateral lung cap. Power Doppler may be useful for identifying the cap. (orig.)

  11. Correction of tibial malunion in a patient with ipsilateral total knee and ankle prostheses using external ring fixation and the ilizarov method

    Directory of Open Access Journals (Sweden)

    Alexander M Smith

    2017-01-01

    Full Text Available Total ankle replacement (TAR aims at reestablishing a functional and painless ankle joint while maintaining motion and preventing adjacent joint arthritis. TAR can be complicated by comorbidities such as ipsilateral knee arthritis and deformity with subsequent arthroplasty and/or other lower extremity malalignment issues. We present a case of a 67-year-old female with severe right ankle pain and a history of ipsilateral subtalar and calcaneocuboid fusion, bilateral total knee arthroplasty, and a malunion of a conservatively treated ipsilateral segmental tibial fracture. Following TAR, there was recurrent lateral hindfoot pain due to subtle malalignment from the tibial malunion which resulted in persistent hindfoot valgus. This caused symptomatic subfibular impingement in addition to limb length discrepancy. To address that, a circular external fixator was applied to realign the ankle and lengthen the tibia, eliminating pain and avoiding complications with either implant.

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

    Science.gov (United States)

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

    2016-04-01

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

  13. Between-hand difference in ipsilateral deactivation is associated with hand lateralization: fMRI mapping of 284 volunteers balanced for handedness

    Directory of Open Access Journals (Sweden)

    Nathalie eTzourio-Mazoyer

    2015-02-01

    Full Text Available In right-handers, an increase in the pace of dominant hand movement results in increased ipsilateral deactivation of the primary motor cortex (M1. By contrast, an increase in non-dominant hand movement frequency is associated with reduced ipsilateral deactivation. This pattern suggests that inhibitory processes support right hand dominance in right-handers and raises the issues of whether this phenomenon also supports left hand preference in left-handers, and/or whether it relates to asymmetry of manual ability in either group. Thanks to the BIL&GIN, a database dedicated to the investigation of hemispheric specialization, we studied the variation in M1 activity during right and left finger tapping tasks in a sample of 284 healthy participants balanced for handedness. An M1 fMRI localizer was defined for each participant as an 8 mm diameter sphere centered on the motor activation peak. Right-handers exhibited significantly larger deactivation of the ipsilateral M1 when moving their dominant hand than their non-dominant hand. In contrast, left-handers exhibited comparable ipsilateral M1 deactivation during either hand movement, reflecting a bilateral cortical specialization. This pattern is likely related to left-handers’ good performances with their right hand and consequent lower asymmetry in manual ability compared with right-handers. Finally, inter-individual analyses over the whole sample demonstrated that the larger the difference in manual skill across hands, the larger the difference in ipsilateral deactivation. Overall, we propose that difference in ipsilateral deactivation is a marker of difference in manual ability asymmetry reflecting differences in the strength of transcallosal inhibition when a given hand is moving.

  14. Ipsilateral hippocampal atrophy is associated with long-term memory dysfunction after ischemic stroke in young adults.

    Science.gov (United States)

    Schaapsmeerders, Pauline; van Uden, Inge W M; Tuladhar, Anil M; Maaijwee, Noortje A M; van Dijk, Ewoud J; Rutten-Jacobs, Loes C A; Arntz, Renate M; Schoonderwaldt, Hennie C; Dorresteijn, Lucille D A; de Leeuw, Frank-Erik; Kessels, Roy P C

    2015-07-01

    Memory impairment after stroke in young adults is poorly understood. In elderly stroke survivors memory impairments and the concomitant loss of hippocampal volume are usually explained by coexisting neurodegenerative disease (e.g., amyloid pathology) in interaction with stroke. However, neurodegenerative disease, such as amyloid pathology, is generally absent at young age. Accumulating evidence suggests that infarction itself may cause secondary neurodegeneration in remote areas. Therefore, we investigated the relation between long-term memory performance and hippocampal volume in young patients with first-ever ischemic stroke. We studied all consecutive first-ever ischemic stroke patients, aged 18-50 years, admitted to our academic hospital center between 1980 and 2010. Episodic memory of 173 patients was assessed using the Rey Auditory Verbal Learning Test and the Rey Complex Figure and compared with 87 stroke-free controls. Hippocampal volume was determined using FSL-FIRST, with manual correction. On average 10 years after stroke, patients had smaller ipsilateral hippocampal volumes compared with controls after left-hemispheric stroke (5.4%) and right-hemispheric stroke (7.7%), with most apparent memory dysfunctioning after left-hemispheric stroke. A larger hemispheric stroke was associated with a smaller ipsilateral hippocampal volume (b=-0.003, Pstroke (b=-0.028 ml, P=0.002) and right-hemispheric stroke (b=-0.015 ml, P=0.03). Our results suggest that infarction is associated with remote injury to the hippocampus, which may lower or expedite the threshold for cognitive impairment or even dementia later in life. © 2015 Wiley Periodicals, Inc.

  15. Ipsilateral stress fracture of the proximal fibula after total knee arthroplasty in a patient with severe valgus knee deformity on a background of Rheumatoid arthritis

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    Hirokazu Takai

    Full Text Available Introduction: Previous studies have reported a lower extremity stress fracture after total knee arthroplasty (TKA. However, a fibular fracture after TKA is quite rare. We report a case of proximal fibula fracture after TKA in a patient with rheumatoid arthritis (RA. Presentation of case: A 45 year old woman with RA had severe knee and foot pain with an antalgic gait disturbance. There was a significant joint deformity in many of lower limb joints. Interval bilateral TKAs were performed two weeks apart. Right TKA was performed using a constraint-type prosthesis, through lateral parapatellar approach. Left TKA was performed using a posterior-stabilized (PS prosthesis through the more commonly employed, medial parapatellar approach. Seven weeks after the right TKA, the patient was found to have an atraumatic proximal fibular fracture. The fracture went on to heal conservatively. Discussion: The fracture was considered to have occurred after the TKA. The callus appeared eleven weeks after the TKA. The factors that contributed to the fracture were thought to be overload of the fragile bone secondarily to disuse osteopaenia, RA or potentially the significant valgus malalignment correction. The surgical approach, the implant or implantation or the persisting joint deformity, were thought to be contributing factors to the aetiology of the stress fracture. The resultant change in clinical outcome/course is outlined in this case report. Conclusion: A stress fracture of the proximal fibula has the potential in the aetiology of may cause other stress fractures, joint other instability, and/or malalignment of the total lower extremity. Keywords: Stress fracture, Insufficiency fracture, Total knee arthroplasty, Fibula fracture, Valgus deformity, Rheumatoid arthritis

  16. A novel dual-site transcranial magnetic stimulation paradigm to probe fast facilitatory inputs from ipsilateral dorsal premotor cortex to primary motor cortex

    DEFF Research Database (Denmark)

    Groppa, Sergiu; Werner-Petroll, Nicole; Münchau, Alexander

    2012-01-01

    The dorsal premotor cortex (PMd) plays an import role in action control, sensorimotor integration and motor recovery. Animal studies and human data have demonstrated direct connections between ipsilateral PMd and primary motor cortex hand area (M1(HAND)). In this study we adopted a multimodal app...

  17. Effect of ipsilateral ureteric obstruction on contralateral kidney and role of renin angiotensin system blockade on renal recovery in experimentally induced unilateral ureteric obstruction

    Directory of Open Access Journals (Sweden)

    Shasanka S Panda

    2013-01-01

    Full Text Available Aims: To study, the effects of ipsilateral ureteric obstruction on contralateral kidney and the role of renin angiotensin system (RAS blockade on renal recovery in experimentally induced unilateral ureteric obstruction. Materials and Methods: Unilateral upper ureteric obstruction was created in 96 adult Wistar rats that were reversed after pre-determined intervals. Losartan and Enalapril were given to different subgroups of rats following relief of obstruction. Results: The severity of dilatation on the contralateral kidney varied with duration of ipsilateral obstruction longer the duration more severe the dilatation. There is direct correlation between renal parenchymal damage, pelvi-ureteric junction (PUJ fibrosis, inflammation and severity of pelvi-calyceal system dilatation of contralateral kidney with duration of ipsilateral PUJ obstruction. Conclusions: Considerable injury is also inflicted to the contralateral normal kidney while ipsilateral kidney remains obstructed. Use of RAS blocking drugs has been found to significantly improve renal recovery on the contralateral kidney. It can, thus, be postulated that contralateral renal parenchymal injury was mediated through activation of RAS.

  18. Electrical stimulation of motor cortex in the uninjured hemisphere after chronic unilateral injury promotes recovery of skilled locomotion through ipsilateral control.

    Science.gov (United States)

    Carmel, Jason B; Kimura, Hiroki; Martin, John H

    2014-01-08

    Partial injury to the corticospinal tract (CST) causes sprouting of intact axons at their targets, and this sprouting correlates with functional improvement. Electrical stimulation of motor cortex augments sprouting of intact CST axons and promotes functional recovery when applied soon after injury. We hypothesized that electrical stimulation of motor cortex in the intact hemisphere after chronic lesion of the CST in the other hemisphere would restore function through ipsilateral control. To test motor skill, rats were trained and tested to walk on a horizontal ladder with irregularly spaced rungs. Eight weeks after injury, produced by pyramidal tract transection, half of the rats received forelimb motor cortex stimulation of the intact hemisphere. Rats with injury and stimulation had significantly improved forelimb control compared with rats with injury alone and achieved a level of proficiency similar to uninjured rats. To test whether recovery of forelimb function was attributable to ipsilateral control, we selectively inactivated the stimulated motor cortex using the GABA agonist muscimol. The dose of muscimol we used produces strong contralateral but no ipsilateral impairments in naive rats. In rats with injury and stimulation, but not those with injury alone, inactivation caused worsening of forelimb function; the initial deficit was reinstated. These results demonstrate that electrical stimulation can promote recovery of motor function when applied late after injury and that motor control can be exerted from the ipsilateral motor cortex. These results suggest that the uninjured motor cortex could be targeted for brain stimulation in people with large unilateral CST lesions.

  19. Colgajo libre osteoseptocutáneo de peroné en la reconstrucción primaria de la radionecrosis masiva mandibular Fibular osteoseptocutaneous free flap in the primary reconstruction after massive radionecrosis of the mandible

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    P. Infante Cossío

    2004-06-01

    Full Text Available Resumen: Una de las complicaciones más serias del uso de la radioterapia en el tratamiento del carcinoma epidermoide de la cavidad oral, es la osteorradionecrosis. En este trabajo, presentamos cuatro pacientes afectos de osteorradionecrosis masiva de la mandíbula que habían fracasado inicialmente con medidas conservadoras y que fueron tratados con resección radical y reconstrucción primaria con un colgajo libre osteoseptocutáneo de peroné. El defecto mandibular tras la resección ósea midió una media de 10 cm e incluyó mucosa intraoral, piel o ambos. En dos casos de reconstrucción, se empleó el colgajo libre de peroné con doble paleta para reconstruir defectos extensos intra y extraorales. Se realizaron osteotomías en el peroné vascularizado en todos los casos para recrear el contorno mandibular. Todos los colgajos sobrevivieron completamente. Tres pacientes curaron primariamente con buenos resultados estéticos y funcionales. Una paciente falleció en el primer mes tras la operación por una pancreatitis aguda y fallo renal. En un paciente se han insertado implantes osteointegrados. En nuestra experiencia, el colgajo libre osteoseptocutáneo de peroné puede ser una opción ideal para la reconstrucción en un solo tiempo de defectos complejos mandibulares compuestos en pacientes afectos de osteorradionecrosis masiva.Abstract: Osteoradionecrosis is one of the most serious complications after radiation therapy of squamous carcinoma of the oral cavity. In this article, we report four cases of massive osteoradionecrosis of the mandible, all of whom had failed initial conservative management and treated with radical resection and primary reconstructed with fibular osteoseptocutaneous free flap. Mandible defects after radical resection were around 10 cm long and included intraoral mucosa, skin or both. A doubled-paddle peroneal tissue transfer was used in two cases for reconstruction of an extensive extra- or intraoral defects. The

  20. Transport Statistics - Transport - UNECE

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    Sustainable Energy Statistics Trade Transport Themes UNECE and the SDGs Climate Change Gender Ideas 4 Change UNECE Weekly Videos UNECE Transport Areas of Work Transport Statistics Transport Transport Statistics About us Terms of Reference Meetings and Events Meetings Working Party on Transport Statistics (WP.6

  1. Low-Energy Traumatic Obturator Hip Dislocation with Ipsilateral Femoral Shaft Fracture in a Patient with Omolateral Knee Arthroplasty

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    G. Gazzotti

    2016-01-01

    Full Text Available Ipsilateral obturator hip dislocation and femoral shaft fracture are rare. We report such a case in an older woman after a low-energy injury. She had a knee prostheses in the same limb. The patient was treated by open manipulative reduction of the luxation without opening joint and open reduction and internal fixation of the femur with angular stability plate and screws. We could not find a similar case in the literature. An early diagnosis of the dislocation is crucial in order to obtain good results. Great awareness and radiologic examination are fundamental to achieve precocious diagnosis of both these rare combined injuries, as treatment in these cases is considered an emergency. The first step was an attempt to reduce the dislocation by closed means but it failed. Then we performed a short approach at the trochanteric region and used Lambotte forceps to manoeuvre the proximal femur without opening the joint achieving reduction. Thereafter the femoral shaft fracture underwent open reduction and internal fixation with an angular stable plate. After a 2-year follow-up the outcome was very good.

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

    Directory of Open Access Journals (Sweden)

    Mazin Fageir

    2018-02-01

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

  3. Ipsilateral distortion product otoacoustic emission (2 f1-f2) suppression in children with sensorineural hearing loss

    Science.gov (United States)

    Abdala, Carolina; Fitzgerald, Tracy S.

    2003-08-01

    Distortion product otoacoustic emission (DPOAE) ipsilateral suppression has been applied to study cochlear function and maturation in laboratory animals and humans. Although DPOAE suppression appears to be sensitive to regions of specialized cochlear function and to cochlear immaturity, it is not known whether it reflects permanent cochlear damage, i.e., sensorineural hearing loss (SNHL), in a reliable and systematic manner in humans. Eight school-aged children with mild-moderate SNHL and 20 normal-hearing children served as subjects in this study. DPOAE (2 f1-f2) suppression data were collected at four f2 frequencies (1500, 3000, 4000, and 6000 Hz) using moderate-level primary tones. Features of the DPOAE iso-suppression tuning curves and suppression growth were analyzed for both subject groups. Results show that DPOAE suppression tuning curves from hearing-impaired subjects can be reliably recorded. DPOAE suppression tuning curves were generally normal in appearance and shape for six out of eight hearing-impaired subjects but showed subtle abnormalities in at least one feature. There was not one single trend or pattern of abnormality that characterized all hearing-impaired subjects. The most prominent patterns of abnormality included: broadened tuning, elevated tip, and downward shift of tip frequency. The unique patterns of atypical DPOAE suppression in subjects with similar audiograms may suggest different patterns of underlying sensory cell damage. This speculation warrants further investigation.

  4. Demonstration of ipsilateral brain activation by noise in patients profoundly deaf with cochlear implant, or unilaterally deaf

    International Nuclear Information System (INIS)

    Herzog, H.; Wieler, H.; Morgenstern, C.; Lipman, J.; Langen, K.-J.; Schmid, A.; Rota, E.; Patton, D.; Feinendegen, L.F.

    1986-01-01

    Two groups of patients with hearing handicaps have been investigated with PET and F-18-2-FDG. Since these patients were unilaterally deaf or profoundly deaf with a cochlear implant installed, monaural stimulation was possible excluding any effects of bone conduction to the contralateral ear. White noise was used as acoustic stimulus in unilaterally deaf patients. The peripheral auditory nerve of cochlear implant patients was stimulated by electrical impulses which were encoded from music or a 4-tone mixture by an electronic speech processor. The non-music stimuli were chosen to avoid associative cortical reactions. In both groups response to the stimuli by increase of glucose consumption (LCMRglc) was found not only in the contralateral primary auditory cortex as expected from neuroanatomical knowledge, but also in the ipsilateral auditory cortex. Furthermore there was no correlation between the hemisphere showing increased LCMRglc and the side of stimulation or the type of stimulus. The similarity of results obtained in both groups by acoustical and electrical stimulation of the auditory nerve suggests that this kind of measurement might be a tool to predict or check the performance of a cochlear implant in a profoundly deaf patient. The finding of increased LCMRglc in the area of the normal auditory cortex in patients profoundly deaf since birth contradicts the hypothesis of degeneration of this cortical center in such patients. (Author)

  5. Open segmental fracture of both bone forearm and dislocation of ipsilateral elbow with extruded middle segment radius

    Directory of Open Access Journals (Sweden)

    Pawan Kumar

    2013-01-01

    Full Text Available Extruded middle segment of radius with open segmental fracture both bone forearm and dislocation of ipsilateral elbow is a rare injury. A 12-year-old child presented to us within 4 hours following fall from tree. The child′s mother was carrying a 12-cm-long extruded soiled segment of radius. The extruded bone was thoroughly washed. The medullary cavity was properly syringed with antiseptic solution. The bone was autoclaved and put in the muscle plane of the distal forearm after debridement of the wound. After 5 days, a 2.5-mm K-wire was introduced by retrograde method into the proximal radius by passing through the extruded segment. Another 2.5-mm K-wire was passed in ulna. The limb was evaluated clinicoradiologically every 2 weeks. The wound was healed by primary intention. At 4 months, the reposed bone appeared less dense radiologically and K-wire seemed to be out of the bone. In the subsequent months, the roentgenograms show remodeling of the extruded fragment. After 20 weeks, the K-wires were removed (first ulnar and then radial. Complete union was achieved with full range of movement except loss of few degrees of extension of elbow and thumb. This case is reported to show a good outcome following successful incorporation of an extruded segment of radius in an open fracture.

  6. Arachidonic acid containing phosphatidylcholine increases due to microglial activation in ipsilateral spinal dorsal horn following spared sciatic nerve injury.

    Directory of Open Access Journals (Sweden)

    Tomohiro Banno

    Full Text Available Peripheral nerve injury induces substantial molecular changes in the somatosensory system that leads to maladaptive plasticity and cause neuropathic pain. Understanding the molecular pathways responsible for the development of neuropathic pain is essential to the development of novel rationally designed therapeutics. Although lipids make up to half of the dry weight of the spinal cord, their relation with the development of neuropathic pain is poorly understood. We aimed to elucidate the regulation of spinal lipids in response to neuropathic peripheral nerve injury in mice by utilizing matrix-assisted laser desorption/ionization imaging mass spectrometry, which allows visualization of lipid distribution within the cord. We found that arachidonic acid (AA containing [PC(diacyl-16:0/20:4+K]+ was increased temporarily at superficial ipsilateral dorsal horn seven days after spared nerve injury (SNI. The spatiotemporal changes in lipid concentration resembled microglia activation as defined by ionized calcium binding adaptor molecule 1 (Iba1 immunohistochemistry. Suppression of microglial function through minocycline administration resulted in attenuation of hypersensitivity and reduces [PC(diacyl-16:0/20:4+K]+ elevation in the spinal dorsal horn. These data suggested that AA containing [PC(diacyl-16:0/20:4+K]+ is related to hypersensitivity evoked by SNI and implicate microglial cell activation in this lipid production.

  7. Urinothorax—An Underdiagnosed Cause of Acute Dyspnea: Report of a Bilateral and of an Ipsilateral Urinothorax Case

    Directory of Open Access Journals (Sweden)

    Leonidas Laskaridis

    2012-01-01

    Full Text Available Urinothorax (UT is a rare and often undiagnosed condition, defined as the presence of urine in the pleural cavity due to the retroperitoneal leakage of urine accumulation, known as urinoma, into the pleural space. UT usually is a transudative pleural effusion that presents in patients with obstructive uropathy and it may occur following surgical procedures in the ureter or kidney such as ESWL, PCNL, and URS. Its diagnosis requires a high degree of clinical suspicion since the respiratory symptoms tend to be absent or mild and the urological signs tend to dominate. However, UT may rarely present with severe and acute dyspnea as well. The objectives of this study are to describe two new cases of this rare entity, a bilateral case and an ipsilateral case focusing on the side that occurs according to the affected renal insult, and to alert the physicians to include UT in their differential diagnosis of pleural effusions especially in patients with recent urinary tract disorders.

  8. A comparative study of standard intensity-modulated radiotherapy and RapidArc planning techniques for ipsilateral and bilateral head and neck irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Pursley, Jennifer, E-mail: jpursley@mgh.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, MA (United States); Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Damato, Antonio L.; Czerminska, Maria A.; Margalit, Danielle N. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, MA (United States); Sher, David J. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, MA (United States); Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX (United States); Tishler, Roy B. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, MA (United States)

    2017-04-01

    The purpose of this study was to investigate class solutions using RapidArc volumetric-modulated arc therapy (VMAT) planning for ipsilateral and bilateral head and neck (H&N) irradiation, and to compare dosimetric results with intensity-modulated radiotherapy (IMRT) plans. A total of 14 patients who received ipsilateral and 10 patients who received bilateral head and neck irradiation were retrospectively replanned with several volumetric-modulated arc therapy techniques. For ipsilateral neck irradiation, the volumetric-modulated arc therapy techniques included two 360° arcs, two 360° arcs with avoidance sectors around the contralateral parotid, two 260° or 270° arcs, and two 210° arcs. For bilateral neck irradiation, the volumetric-modulated arc therapy techniques included two 360° arcs, two 360° arcs with avoidance sectors around the shoulders, and 3 arcs. All patients had a sliding-window-delivery intensity-modulated radiotherapy plan that was used as the benchmark for dosimetric comparison. For ipsilateral neck irradiation, a volumetric-modulated arc therapy technique using two 360° arcs with avoidance sectors around the contralateral parotid was dosimetrically comparable to intensity-modulated radiotherapy, with improved conformity (conformity index = 1.22 vs 1.36, p < 0.04) and lower contralateral parotid mean dose (5.6 vs 6.8 Gy, p < 0.03). For bilateral neck irradiation, 3-arc volumetric-modulated arc therapy techniques were dosimetrically comparable to intensity-modulated radiotherapy while also avoiding irradiation through the shoulders. All volumetric-modulated arc therapy techniques required fewer monitor units than sliding-window intensity-modulated radiotherapy to deliver treatment, with an average reduction of 35% for ipsilateral plans and 67% for bilateral plans. Thus, for ipsilateral head and neck irradiation a volumetric-modulated arc therapy technique using two 360° arcs with avoidance sectors around the contralateral parotid is

  9. Probing the Effects and Mechanisms of Electroacupuncture at Ipsilateral or Contralateral ST36-ST37 Acupoints on CFA-induced Inflammatory Pain.

    Science.gov (United States)

    Lu, Kung-Wen; Hsu, Chao-Kuei; Hsieh, Ching-Liang; Yang, Jun; Lin, Yi-Wen

    2016-02-24

    Transient receptor potential vanilloid 1 (TRPV1) and associated signaling pathways have been reported to be increased in inflammatory pain signaling. There are accumulating evidences surrounding the therapeutic effect of electroacupuncture (EA). EA can reliably attenuate the increase of TRPV1 in mouse inflammatory pain models with unclear signaling mechanisms. Moreover, the difference in the clinical therapeutic effects between using the contralateral and ipsilateral acupoints has been rarely studied. We found that inflammatory pain, which was induced by injecting the complete Freund's adjuvant (CFA), (2.14 ± 0.1, p CFA injection; this expression can be further attenuated significantly in EA treatment. TRPV1 and associated signaling pathways can be prevented in TRPV1 knockout mice, suggesting that TRPV1 knockout mice are resistant to inflammatory pain. Through this study, we have increased the understanding of the mechanism that both ipsilateral and contralateral EA might alter TRPV1 and associated signaling pathways to reduce inflammatory pain.

  10. The human dorsal premotor cortex facilitates the excitability of ipsilateral primary motor cortex via a short latency cortico-cortical route

    DEFF Research Database (Denmark)

    Groppa, Sergiu; Schlaak, Boris H; Münchau, Alexander

    2012-01-01

    In non-human primates, invasive tracing and electrostimulation studies have identified strong ipsilateral cortico-cortical connections between dorsal premotor- (PMd) and the primary motor cortex (M1(HAND) ). Here, we applied dual-site transcranial magnetic stimulation (dsTMS) to left PMd and M1......(HAND) through specifically designed minicoils to selectively probe ipsilateral PMd-to-M1(HAND) connectivity in humans. A suprathreshold test stimulus (TS) was applied to M1(HAND) producing a motor evoked potential (MEP) of about 0.5 mV in the relaxed right first dorsal interosseus muscle (FDI......) facilitation did not change as a function of CS intensity. Even at higher intensities, the CS alone failed to elicit a MEP or a cortical silent period in the pre-activated FDI, excluding a direct spread of excitation from PMd to M1(HAND). No MEP facilitation was present while CS was applied rostrally over...

  11. Ipsilateral Breast Tumor Relapse: Local Recurrence Versus New Primary Tumor and the Effect of Whole-Breast Radiotherapy on the Rate of New Primaries

    International Nuclear Information System (INIS)

    Gujral, Dorothy M.; Sumo, Georges; Owen, John R.; Ashton, Anita; Bliss, Judith M.; Haviland, Joanne; Yarnold, John R.

    2011-01-01

    Purpose: The justification for partial breast radiotherapy after breast conservation surgery assumes that ipsilateral breast tumor relapses (IBTR) outside the index quadrant are mostly new primary (NP) tumors that develop despite radiotherapy. We tested the hypothesis that whole-breast radiotherapy (WBRT) is ineffective in preventing NP by comparing development rates in irradiated and contralateral breasts after tumor excision and WBRT. Methods and Materials: We retrospectively reviewed 1,410 women with breast cancer who were entered into a prospective randomized trial of radiotherapy fractionation and monitored annually for ipsilateral breast tumor relapses (IBTR) and contralateral breast cancer (CLBC). Cases of IBTR were classified into local recurrence (LR) or NP tumors based on location and histology and were subdivided as definite or likely depending on clinical data. Rates of ipsilateral NP and CLBC were compared over a 15-year period of follow-up. Results: At a median follow-up of 10.1 years, there were 150 documented cases of IBTR: 118 (79%) cases were definite or likely LR; 27 (18%) cases were definite or likely NP; and 5 (3%) cases could not be classified. There were 71 cases of CLBC. The crude proportion of definite-plus-likely NP was 1.9% (27/1,410) patients compared with 5% (71/1,410) CLBC patients. Cumulative incidence rates at 5, 10, and 15 years were 0.8%, 2.0%, and 3.5%, respectively, for definite-plus-likely NP and 2.4%, 5.8%, and 7.9%, respectively for CLBC, suggesting a difference in the rates of NP and CLBC. Conclusions: This analysis suggests that WBRT reduces the rate of ipsilateral NP tumors. The late presentation of NP has implications for the reporting of trials that are testing partial breast radiotherapy.

  12. Electrical Stimulation of Motor Cortex in the Uninjured Hemisphere after Chronic Unilateral Injury Promotes Recovery of Skilled Locomotion through Ipsilateral Control

    OpenAIRE

    Carmel, Jason B.; Kimura, Hiroki; Martin, John H.

    2014-01-01

    Partial injury to the corticospinal tract (CST) causes sprouting of intact axons at their targets, and this sprouting correlates with functional improvement. Electrical stimulation of motor cortex augments sprouting of intact CST axons and promotes functional recovery when applied soon after injury. We hypothesized that electrical stimulation of motor cortex in the intact hemisphere after chronic lesion of the CST in the other hemisphere would restore function through ipsilateral control. To ...

  13. Decreased ipsilateral [123I]iododexetimide binding to cortical muscarinic receptors in unilaterally 6-hydroxydopamine lesioned rats

    International Nuclear Information System (INIS)

    Knol, Remco J.J.; Bruin, Kora de; Opmeer, Brent; Voorn, Pieter; Jonker, Allert J.; Eck-Smit, Berthe L.F. van; Booij, Jan

    2014-01-01

    Introduction: Dysfunction of the cholinergic neurotransmitter system is present in Parkinson’s disease, Parkinson’s disease related dementia and dementia with Lewy bodies, and is thought to contribute to cognitive deficits in these patients. In vivo imaging of the cholinergic system in these diseases may be of value to monitor central cholinergic disturbances and to select cases in which treatment with cholinesterase inhibitors could be beneficial. The muscarinic receptor tracer [ 123 I]iododexetimide, predominantly reflecting M 1 receptor binding, may be an appropriate tool for imaging of the cholinergic system by means of SPECT. In this study, we used [ 123 I]iododexetimide to study the effects of a 6-hydroxydopamine lesion (an animal model of Parkinson’s disease) on the muscarinic receptor availability in the rat brain. Methods: Rats (n = 5) were injected in vivo at 10–13 days after a confirmed unilateral 6-hydroxydopamine lesion. Muscarinic receptor availability was measured bilaterally in multiple brain areas on storage phosphor images by region of interest analysis. Results: Autoradiography revealed a consistent and statistically significant lower [ 123 I]iododexetimide binding in all examined neocortical areas on the ipsilateral side of the lesion as compared to the contralateral side. In hippocampal and subcortical areas, such asymmetry was not detected. Conclusions: This study suggests that evaluation of muscarinic receptor availability in dopamine depleted brains using [ 123 I]iododexetimide is feasible. We conclude that 6-hydroxydopamine lesions induce a decrease of neocortical muscarinic receptor availability. We hypothesize that this arises from down regulation of muscarinic postsynaptic M 1 receptors due to hyperactivation of the cortical cholinergic system in response to dopamine depletion. Advances in knowledge: In rats, dopamine depletion provokes a decrease in neocortical muscarinic receptor availability, which is evaluable by [ 123 I

  14. Contralateral acupuncture versus ipsilateral acupuncture in the rehabilitation of post-stroke hemiplegic patients: a systematic review

    Directory of Open Access Journals (Sweden)

    Lee Hyangsook

    2010-07-01

    Full Text Available Abstract Background Contralateral acupuncture (CAT involves inserting needles in the meridian on the side opposite the disease location and is often used in post-stroke rehabilitation. The aim of this systematic review is to summarize and critically evaluate the evidence for and against the effectiveness of CAT for post-stroke rehabilitation as compared to ipsilateral acupuncture (IAT. Methods Seventeen databases were searched from their inceptions through June 2010. Prospective clinical trials were included if CAT was tested as the sole treatment or as an adjunct to other treatments for post-stroke rehabilitation and compared to IAT. Results Eight randomized clinical trials (RCTs met our inclusion criteria. Four of them reported favorable effects of CAT compared to IAT for at least one outcome. A meta-analysis showed superior effects of CAT compared to IAT on recovery rate (n = 361; risk ratio (RR, 1.12; 95% confidence intervals (CIs, 1.04 to 1.22, P = 0.005. Subgroup analysis also showed favorable effects of using CAT on patients with cerebral infarction (n = 261; RR, 1.15; 95% CIs, 1.04 to 1.27, P = 0.006. Further analysis including patients with cerebral infarction and intracranial hemorrhage, however, failed to show these advantages (n = 100; RR, 1.11; 95% CIs, 0.85 to 1.46, P = 0.43. Conclusion The results of our systematic review and meta-analysis suggest that there is limited evidence for CAT being superior to IAT in the treatment of cerebral infarction. The total number of RCTs included in our analysis was low, however, and the RCTs included had a high risk of bias. Future RCTs appear to be warranted.

  15. Study of cerebral blood flow and oxygen utilization in the edematous area and ipsilateral hemispheric gray matter using positron emission tomography in brain tumors

    International Nuclear Information System (INIS)

    Ikeda, Yusuke

    1990-01-01

    We measured the cerebral blood flow and oxygen utilization of the peritumoral white matter and ipsilateral hemispheric gray matter in 50 patients with brain tumors using Positron Emission Tomography (PET). The intraaxial tumors consisted of 34 cases (25 of gliomas, 6 of metastatic tumors, and 3 others), white the extraaxial tumors (all of meningiomas) were 16 cases. The cases were divided into 2 groups on the basis of the Xray CT scan findings. The cases of Edema (+) group showed moderate or large peritumoral edema in the white matter on the Xray CT scan, while Edema (-) group showed no or small edema. The method of PET study was the 15 O steady state inhalation technique by Frackoviak's method. ROIs (region of interest) were set on the peritumoral white matter and the ipsilateral hemispheric gray matter, and the mean CBF, OEF and CMRO2 values of the white and gray matter were calculated. In the Edema (+) group, the mean values of blood flow and oxygen utilization were low in the peritumoral white matter, and there were no obvious differences of values between intra and extraaxial tumors. But, the values in the ipsilateral hemispheric gray matter of intraaxial tumors were lower than those of extraaxial tumor. In the Edema (-) group, the mean values were almost normal in the white and gray matter, and there were no differences between intra and extraaxial tumors. The consideration about significance of the above stated results was discussed added with literature. (author)

  16. Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses.

    Science.gov (United States)

    Cousty, M; Tricaud, C; De Beauregard, T; Picandet, V; Bizon-Mercier, C; Tessier, C

    2016-01-09

    The objective of the study was to evaluate the effect of ligation of the ipsilateral common carotid artery (CCA) combined with various antimycotic treatments for the prevention of epistaxis in horses with guttural pouch mycosis. For each case, ipsilateral ligation of the CCA was performed, followed by application of various topical medications under endoscopic guidance. Frequency and number of treatments, outcome and recurrence of haemorrhage were retrospectively recorded. Twenty-four horses were included. Topical medication was administered by detachment of the diphtheric membrane and spraying (n=16) or by intralesional injection directly in the plaques using a transendoscopic needle (n=8). Epistaxis recurred in five horses (20.8 per cent), causing death of four horses (16.6 per cent). The mean number of treatments was 6.3±4.0 (range 2-14) for all topical treatments. Ligation of the ipsilateral CCA and topical medication carries a fair prognosis for avoidance of recurrent episodes of epistaxis, but fatal haemorrhage can occur. Removal of the fungal plaque and topical treatment of the underlying lesion appeared to speed up resolution of the mycotic mucosal lesions. The described technique is a salvage procedure when financial or technical constraints prevent the use of transarterial catheter occlusion techniques. British Veterinary Association.

  17. Myofascial involvement of supra- and infraspinatus muscles contributes to ipsilateral shoulder pain after muscle-sparing thoracotomy and video-assisted thoracic surgery.

    Science.gov (United States)

    Ohmori, Aki; Iranami, Hiroshi; Fujii, Keisuke; Yamazaki, Akinori; Doko, Yukari

    2013-12-01

    This study examined the hypothesis that ipsilateral upper extremity elevation for muscle-sparing thoracotomy procedures contributes to the postoperative shoulder pain. Prospective observational study. Medical center. ASA physical status 1-2 patients undergoing elective lung surgeries including pneumonectomy, lobectomy, and segmentectomy performed through either the anterolateral approach or video-assisted thoracotomy surgery. Postoperative observation of ipsilateral shoulder pain. Postoperative examinations of sites of shoulder pain (clavicle, anterior, lateral,or posterior aspect of acromion, posterior neck, supraspinatus, infraspinatus, and these entire areas) with or without trigger points, visual analog scale score of wound pain, and requested counts of analgesics. The number of patients who suffered from postoperative shoulder pain was 37 of 70 (52.9%). Demographic data, anterolateral/VATS ratio, VAS scores, and requested counts of rescue analgesics requirement were similar in the groups of patients with and without postoperative shoulder pain. The segmentectomy caused a significantly higher incidence of postoperative shoulder pain compared with other procedures (p shoulder pain showed defined trigger points in their painful areas. These results supported the hypothesis that myofascial involvement contributed, to some extent, to shoulder pain after muscle-sparing thoracotomy with ipsilateral upper extremity elevation. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Probing the Effects and Mechanisms of Electroacupuncture at Ipsilateral or Contralateral ST36–ST37 Acupoints on CFA-induced Inflammatory Pain

    Science.gov (United States)

    Lu, Kung-Wen; Hsu, Chao-Kuei; Hsieh, Ching-Liang; Yang, Jun; Lin, Yi-Wen

    2016-01-01

    Transient receptor potential vanilloid 1 (TRPV1) and associated signaling pathways have been reported to be increased in inflammatory pain signaling. There are accumulating evidences surrounding the therapeutic effect of electroacupuncture (EA). EA can reliably attenuate the increase of TRPV1 in mouse inflammatory pain models with unclear signaling mechanisms. Moreover, the difference in the clinical therapeutic effects between using the contralateral and ipsilateral acupoints has been rarely studied. We found that inflammatory pain, which was induced by injecting the complete Freund’s adjuvant (CFA), (2.14 ± 0.1, p < 0.05, n = 8) can be alleviated after EA treatment at either ipsilateral (3.91 ± 0.21, p < 0.05, n = 8) or contralateral acupoints (3.79 ± 0.25, p < 0.05, n = 8). EA may also reduce nociceptive Nav sodium currents in dorsal root ganglion (DRG) neurons. The expression of TRPV1 and associated signaling pathways notably increased after the CFA injection; this expression can be further attenuated significantly in EA treatment. TRPV1 and associated signaling pathways can be prevented in TRPV1 knockout mice, suggesting that TRPV1 knockout mice are resistant to inflammatory pain. Through this study, we have increased the understanding of the mechanism that both ipsilateral and contralateral EA might alter TRPV1 and associated signaling pathways to reduce inflammatory pain. PMID:26906464

  19. Metastatic carcinoma in the cervical lymph nodes from an unknown primary site: results of bilateral neck plus mucosal irradiation vs. ipsilateral neck irradiation

    International Nuclear Information System (INIS)

    Reddy, Sarada P.; Marks, James E.

    1997-01-01

    Purpose: To compare the outcome for patients with squamous cell carcinoma of cervical lymph nodes metastatic from an unknown primary site who were irradiated to both sides of the neck and potential mucosal sites with opposed photon beams, and for those irradiated to the ipsilateral side of the neck alone with an electron beam. Methods and Materials: Fifty-two patients with squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary site were irradiated by two different methods. Thirty-six were irradiated with a bilateral technique (BT), i.e., to both sides of the neck, including the naso-oro-hypopharyngeal mucosa, and 16 were irradiated with an electron beam (EB) to the ipsilateral side of the neck alone. Twenty patients of the BT group and 11 of the EB group had cervical lymph node dissections, and the remaining 21 patients had lymph node biopsies, prior to radiotherapy. Results: Tumor control in the ipsilateral side of the neck did not differ for either radiation technique, but was significantly higher after lymph node dissection than after biopsy (90 vs. 48%; p = 0.0004). Control of subclinical metastases in the contralateral cervical lymph nodes was higher for patients irradiated with BT than for patients irradiated with EB (86 vs. 56%; p 0.03). The occult primary was later discovered in 8% of the patients in the BT group and 44% of the EB group (p = 0.0005). The disease-free survival rate at 5 years for patients who had lymph node dissection prior to irradiation was 61%, and was 37% for those who had biopsy (p = 0.05). Only 20% of patients who subsequently developed an occult primary were salvaged and survived for 5 years after salvage treatment. Conclusion: Bilateral neck and mucosal irradiation is superior to ipsilateral neck irradiation in preventing contralateral cervical lymph node metastases and the subsequent appearance of an occult primary cancer. Both techniques combined with cervical lymph node dissection were equally effective

  20. Acromioclavicular Joint Dislocation with Ipsilateral Mid Third Clavicle, Mid Shaft Humerus and Coracoid Process Fracture - A Case Report.

    Science.gov (United States)

    Sharma, Naveen; Mandloi, Avinash; Agrawal, Ashish; Singh, Shailendra

    2016-01-01

    The clavicle, humerus and acromioclavicular (AC) joint separately are very commonly involved in traumatic injuries around the shoulder. Acromioclavicular joint dislocation with distal clavicle fracture is a well recognized entity in clinical practice. AC joint dislocation with mid shaft clavicle fracture is uncommon and only few cases have been reported in literature. However, to the best of our knowledge, this is the first case report to describe an acromioclavicular dislocation with ipsilateral mid shaft clavicle, mid shaft humerus and coracoid process fracture. Fractures of the humerus and clavicle along with the acromioclavicular joint dislocation were fixed at the same setting. A 65-year-old male met with a high velocity road traffic accident. Plain radiographs showed displaced mid third clavicle fracture with acromioclavicular joint dislocation with mid shaft humerus fracture. Surgical fixation was planned for humerus with interlocking nail, clavicle with locking plate and acromioclavicular joint with reconstruction of coracoclavicular ligaments. Intraoperatively, coracoid process was found to have a comminuted fracture. The operative plan had to be changed on table as coracoclavicular fixation was not possible. So acromioclavicular joint fixation was done using tension band wiring and the coracoclavicular ligament was repaired using a 2-0 ethibond. The comminuted coracoid fracture was managed conservatively. K wires were removed at 6 weeks. Early mobilization was started. In acromioclavicular joint injuries, clavicle must be evaluated for any injury. Although it is more commonly associated with distal clavicle fractures, it can be associated with middle third clavicle fractures. As plain radiographs, AP view are most of the times insufficient for viewing integrity of coracoid process, either special views like Stryker notch or CT scan may help in diagnosing such concealed injuries. When associated with fractures of the humerus and clavicle, anatomical

  1. Different mechanisms of contralateral- or ipsilateral-acupuncture to modulate the brain activity in patients with unilateral chronic shoulder pain: a pilot fMRI study

    Directory of Open Access Journals (Sweden)

    Zhang S

    2018-03-01

    Full Text Available Shuai Zhang,1,* Xu Wang,2,* Chao-Qun Yan,1 Shang-Qing Hu,3 Jian-Wei Huo,4 Zhong-Yan Wang,4 Ping Zhou,1 Chun-Hong Liu,1 Cun-Zhi Liu3 1Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Dongcheng District, Beijing, 2School of Life Sciences, Beijing University of Chinese Medicine, Chaoyang District, Beijing, 3Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Fengtai District, Beijing, 4Department of Medical Imaging, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Dongcheng District, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Chronic shoulder pain (CSP is a common disease causing pain and functional limitation, which is highly prevalent and has substantial negative effects on the quality of life. Acupuncture has gained popularity and has been accepted gradually by many countries because it can successfully treat patients with chronic pain, but the specific brain mechanisms under acupuncture treatment for CSP remain unclear. Therefore, in this study, we aimed to 1 compare the clinical effects between acupuncture at the contralateral and ipsilateral Tiaokou (ST 38 point in patients with unilateral shoulder pain and 2 explore how contralateral- and ipsilateral-acupuncture modulates the regional homogeneity (ReHo of patients with CSP.Patients and methods: This was a pilot functional magnetic resonance imaging (fMRI trial. Twenty-four patients with CSP were recruited and randomized to the contralateral acupuncture group (contra-group and the ipsilateral acupuncture group (ipsi-group. All patients completed resting-state functional magnetic resonance imaging (fMRI scans before and after acupuncture treatment. Shoulder pain intensity (visual analog scale [VAS] and shoulder joint function (Constant–Murley score [CMS] were used

  2. Ipsilateral feeding-specific circuits between the nucleus accumbens shell and the lateral hypothalamus: regulation by glutamate and GABA receptor subtypes.

    Science.gov (United States)

    Urstadt, Kevin R; Kally, Peter; Zaidi, Sana F; Stanley, B Glenn

    2013-04-01

    The nucleus accumbens shell (AcbSh) and the lateral hypothalamus (LH) are both involved in the control of food intake. Activation of GABA(A) receptors or blockade of AMPA and kainate receptors within the AcbSh induces feeding, as does blockade of GABA(A) receptors or activation of NMDA receptors in the LH. Further, evidence suggests that feeding induced via the AcbSh can be suppressed by LH inhibition. However, it is unclear if this suppression is specific to feeding. Adult male Sprague-Dawley rats with 3 intracranial guide cannulas, one unilaterally into the AcbSh and two bilaterally into the LH, were used to explore this issue. DNQX (1.25 μg) or muscimol (100 ng) infused into the AcbSh unilaterally elicited feeding, and this elicited intake was suppressed by bilateral LH injection of d-AP5 (2 μg) or muscimol (25 ng). The effectiveness of d-AP5 or muscimol infusion into either the LH site ipsilateral or contralateral to the AcbSh injection was compared. Ipsilateral LH injection of d-AP5 or muscimol was significantly more effective than contralateral injection in suppressing food intake initiated by AcbSh injection of DNQX or muscimol. These results add to the prior evidence that inhibition of the LH through pharmacological modulation of NMDA or GABA(A) receptors specifically suppresses feeding initiated by AcbSh inhibition, and that these two regions communicate via an ipsilateral circuit to specifically regulate feeding. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Expansion of the ipsilateral visual corticotectal projection in hamsters subjected to partial lesions of the visual cortex during infancy: anatomical experiments

    International Nuclear Information System (INIS)

    Rhoades, R.W.

    1981-01-01

    Electrophysiological methods were employed to determine whether or not partial visual cortical lesions in neonatal (7--11-day) hamster produced large scotomas in the cortical visual representation. In cases where such scotomas were present electrophoretic deposits of radioactive amino acids in the visually responsive ''cortical remnant'' of the damaged hemisphere resulted in labelling throughout the lower portion of the stratum griseum superficiale and the stratum opticum of the ipsilateral superior colliculus. No differential labeling of the part of the colliculus which was topographically matched with the remaining visual representation in the cortical remnant was observed. In normal hamsters relatively localized, visual cortical deposits of radioactive amino acids resulted in superficial layer labeling only in portions of the colliculus which corresponded to the locus of the cortical deposit. In a similar fashion, small lesions at physiologically defined loci in the cortical remnant produced degeneration throughout most of the superficial tectal laminae, but a more restricted ''focus'' of denser degeneration was also visible in these cases. The position of this focus in the colliculus for a given cortical lesion varied with the nature of the visual map in the cortical remnant. In several additional neonatally brain-damaged hamsters large lesions of the visual cortex in the intact hemisphere were combined with radioactive amino acid deposits in the cortical remnant to determine whether or not axons from the crossed corticocollicular pathway previously demonstrated in such hamsters were intermingled with fibers from the ipsilateral corticotectal projection. In alternate sections processed for autoradiography or by the Fink-Heimer ('67) method autoradiographic label and degeneration argyrophilia were both observed in the medical part of the colliculus ipsilateral to the neonatal cortical lesion

  4. Anterior cingulate cortex is crucial for contra- but not ipsi-lateral electro-acupuncture in the formalin-induced inflammatory pain model of rats

    Directory of Open Access Journals (Sweden)

    Xing Guo-Gang

    2011-08-01

    Full Text Available Abstract Acupuncture and electro-acupuncture (EA are now widely used to treat disorders like pain. We and others have shown previously that current frequency, intensity and treatment duration all significantly influence the anti-nociceptive effects of EA. There is evidence that stimulating sites also affect the antinociception, with EA applied ipsilaterally to the pain site being more effective under some pain states but contralateral EA under others. It was recently reported that local adenosine A1 receptors were responsible for ipsilateral acupuncture, but what mechanisms specifically mediate the anti-nociceptive effects of contralateral acupuncture or EA remains unclear. In the present study, we applied 100 Hz EA on the ipsi- or contra-lateral side of rats with inflammatory pain induced by intra-plantar injection of formalin, and reported distinct anti-nociceptive effects and mechanisms between them. Both ipsi- and contra-lateral EA reduced the paw lifting time in the second phase of the formalin test and attenuated formalin-induced conditioned place aversion. Contralateral EA had an additional effect of reducing paw licking time, suggesting a supraspinal mechanism. Lesions of rostral anterior cingulate cortex (ACC completely abolished the anti-nociceptive effects of contra- but not ipsi-lateral EA. These findings were not lateralized effects, since injection of formalin into the left or right hind paws produced similar results. Overall, these results demonstrated distinct anti-nociceptive effects and mechanisms between different stimulating sides and implied the necessity of finding the best stimulating protocols for different pain states.

  5. Short communication: Development of the first follicular wave dominant follicle on the ovary ipsilateral to the corpus luteum is associated with decreased conception rate in dairy cattle.

    Science.gov (United States)

    Miura, R; Haneda, S; Kayano, M; Matsui, M

    2015-01-01

    In this study, we examined the effect of the locations of the first-wave dominant follicle (DF) and corpus luteum (CL) on fertility. In total, 350 artificial insemination (AI) procedures were conducted (lactating dairy cows: n=238, dairy heifers: n=112). Ovulation was confirmed 24 h after AI. The locations of the first-wave DF and CL were examined 5 to 9d after AI using rectal palpation or transrectal ultrasonography. Lactating dairy cows and dairy heifers were divided into 2 groups: (1) the ipsilateral group (IG), in which the DF was ipsilateral to the CL; and (2) the contralateral group (CG), in which the DF was contralateral to the CL. Pregnancy was diagnosed using transrectal ultrasonography 40d after AI. Conception rates were 54.0% in all cattle: 48.9% in lactating dairy cows, and 58.9% in dairy heifers. The incidence of the first-wave DF location did not differ between IG and CG (all cattle: 184 vs. 166; lactating cows: 129 vs. 109; heifers: 55 vs. 57 for IG vs. CG). Conception rates were lower in IG than in CG (all cattle: 40.2 vs. 69.3%; lactating dairy cows: 38.0 vs. 67.0%; dairy heifers: 45.5 vs. 73.7%, for IG vs. CG). Conception rate was not affected by season or live weight in heifers and lactating cows. In addition, days in milk at AI, milk production, body condition score, and parity did not affect conception in lactating cows. In summary, development of the first-wave DF in the ovary ipsilateral to the CL was associated with reduced conception rates in both lactating cows and heifers. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  6. Three-dimensional vascular mapping of the breast by using contrast-enhanced MRI: association of unilateral increased vascularity with ipsilateral breast cancer.

    Science.gov (United States)

    Orgüç, Şebnem; Başara, Işıl; Coşkun, Teoman; Pekindil, Gökhan

    2012-01-01

    We aimed to retrospectively compare three-dimensional vascular maps of both breasts obtained by dynamic magnetic resonance imaging (MRI) and determine the association of one-sided vascular prominence with ipsilateral breast cancer. MRI was performed using gadolinium in 194 cases. Two readers scored vascular density using maximum intensity projections (MIPs). Dynamic fat-saturated T1-weighted gradientecho MIPs were acquired. Two readers evaluated the MIPs, and vessels greater than 2 mm in diameter and longer than 3 cm were counted. The difference in vessel numbers detected in the two breasts determined the score. A total of 54 patients had malignant lesions (prevalence, 28%), including invasive ductal carcinoma (n=40), invasive mixed ductal-lobular carcinoma (n=5), invasive lobular carcinoma (n=3), ductal carcinoma in situ (n=3), mucinous carcinoma (n=1), medullary carcinoma (n=1), and leukemic metastasis (n=1). In 62 patients, there were benign lesions (fibroadenomas, fibrocysts), and four patients had inflammation (granulomatous mastitis in two patients, breast tuberculosis in two patients). There were 78 normal cases. When a difference of at least two vessels was scored as vascular asymmetry, the sensitivity, specificity, positive likelihood ratio (+LR), and negative (-LR) of unilaterally increased vascularity associated with ipsilateral malignancy were 69%, 92%, 8.72, and 0.34, respectively. When four infection and three post-operative cases with vascular asymmetry were excluded; prevalence, specificity, and +LR increased to 29%, 97%, and 22.8, respectively, with the same sensitivity and -LR. Differences in mean vascularity scores were evaluated with regard to tumor size. T1 and T2 tumors were not significantly different from each other. The mean score of T3 tumors differed significantly from T1 and T2 tumors. MRI vascular mapping is an effective method for determining breast tissue vascularization. Ipsilateral increased vascularity was commonly associated with

  7. Concomitant posterior hip dislocation, ipsilateral intertrochanteric- and proximal tibial- fractures with popliteal artery injury: a challenging trauma mélange

    Directory of Open Access Journals (Sweden)

    Pranit N. Chotai

    2015-12-01

    Full Text Available Constellation of ipsilateral posterior hip dislocation, intertrochanteric- and proximal tibial fracture with popliteal artery injury is rare. Management of this presentation is challenging. A motor vehicle accident victim presented with these injuries, but without any initial signs of vascular compromise. Popliteal artery injury was diagnosed intra-operatively and repaired. This was followed by external fixation of tibial fracture, open reduction of dislocated hip and internal fixation of intertrochanteric fracture. Patient regained bilateral complete weight bearing and returned to pre-accident activity level. Apt surgical management including early repair of vascular injury in such a trauma mélange allows for a positive postoperative outcome.

  8. Catheter-directed thrombolysis for acute iliofemoral deep vein thrombosis via the ipsilateral great saphenous vein approach: a comparative clinical study

    International Nuclear Information System (INIS)

    Su Haobo; Gu Jianping; Lou Wensheng; He Xu; Chen Liang; Chen Guoping; Song Jinhua; Wang Tao

    2011-01-01

    Objective: To investigate prospectively the feasibility and clinical value of catheterization via the ipsilateral great saphenous vein in catheter-directed thrombolysis (CDT) for acute iliofemoral deep vein thrombosis (IFVT) by a comparative study. Methods: The prospective study included 93 cases of IFVT proved by venography. All patients were divided into three groups randomly. In group A, 31 patients received CDT via the ipsilateral great saphenous vein. In group B, 27 patients received CDT via the ipsilateral popliteal vein. In group C, 35 patients received anterograde thrombolysis via an ipsilateral dorsalis pedis vein. Urokinase was adopted as the thrombolytic agent in all cases. The assessment of the curative effect include therapeutic effective rate, rate of edema reduction and venous patency which were observed according to the clinical symptoms and the follow-up venograms obtained 5 days after thrombolysis. The time and comfort scores of procedures was recorded and compared between group A and B using two independent samples t test. The rate of edema reduction and venous patency were assessed using analysis of variance (LSD method). Therapeutic effective rate and complication rate were assessed using Chi-square test. Results: The total effective rate of the three groups were 90.3% (28/31), 92.6% (25/27) and 68.6% (24/35) respectively. The limbs edema reduction rate were (83.5±21.1)%, (82.4±20.1)%, and (67.0±23.3)% respectively (F= 6.059, P=0.003). The venous patency rate after thrombolysis were (61.2±20.2)%, (55.7±20.5)%, and (44.2±23.6)% respectively. There was no significant difference between group A and B in therapeutic effective rate (χ 2 =0.09, P=0.759), rate of edema reduction (P=0.822) and venous patency (P=0.343) . There was a significant difference statistically in therapeutic effective rate (χ 2 =4.65, P=0.031), rate of edema reduction (P=0.002) and venous patency (P=0.002) between group A and C. Compared with group A and B, the

  9. Case of pregnancy in two cows with unicorn horn of the uterus either by artificial insemination at ipsilateral or embryo transfer at contralateral corpus luteum in the ovary.

    Science.gov (United States)

    Moriyama, C; Kobayashi, I; Tani, M; Oishi, T; Kajisa, M; Horii, Y; Kamimura, S

    2008-06-01

    Two Holstein heifers and a cow were diagnosed with White Heifer Disease by ultrasonography. Case 1 was a 14 month-old heifer with aplasia of both sides of the uterine horn. In case 2, a primiparous cow and case 3, an 18 month-old heifer, both showed aplasia of the right uterine horn. Case 2 became pregnant by artificial insemination at ipsilateral ovulatory follicle and corpus luteum in the left ovary, while case 3 became pregnant by embryo transfer at 7 days after oestrus with contralateral corpus luteum in the right ovary.

  10. Ipsilateral Traumatic Posterior Hip Dislocation, Posterior Wall and Transverse Acetabular Fracture with Trochanteric Fracture in an adult: Report of First Case

    Directory of Open Access Journals (Sweden)

    Skand Sinha

    2013-10-01

    Full Text Available Introduction: Posterior dislocation of the hip joint with associated acetabular and intertrochanteric fracture is a complex injury. Early recognition, prompt and stable reduction is needed of successful outcome. Case Report: 45 year old male patient presented with posterior dislocation of the hip with transverse fracture with posterior wall fracture of acetabulam and intertrochanteric fracture on the ipsilateral side. The complex fracture geometry was confirmed by CT scan. The patient was successfully managed by open reduction and internal fixation of intertrochanteric fracture was achieved with dynamic hip screw (DHS plate fixation followed by fixation of acetabular fracture with reconstruction plate. Conclusion: Hip dislocation combined with acetabular fracture is an uncommon injury; this article presents a unique case of posterior wall and transverse fractures of ipsilateral acetabulum with intertrochanteric fracture in a patient who sustained traumatic posterior hip dislocation. Early surgical intervention is important for satisfactory outcomes of such complex fracture-dislocation injuries. Keywords: Hip dislocation; acetabular fractures; intertrochanteric fracture; operative treatment.

  11. Effects of training programs based on ipsilateral voluntary and stimulated contractions on muscle strength and monopedal postural control of the contralateral limb.

    Science.gov (United States)

    Kadri, Mohamed Abdelhafid; Noé, Frederic; Nouar, Merbouha Boulahbel; Paillard, Thierry

    2017-09-01

    To compare the effects of unilateral strength training by stimulated and voluntary contractions on muscle strength and monopedal postural control of the contralateral limb. 36 non-active healthy male subjects were recruited and split randomly into three groups. Two groups of 12 subjects took part in a strength-training program (3 sessions a week over 8 weeks) comprising 43 contractions of the quadriceps femoris of the ipsilateral limb (at 20% of the MVC). One group carried out voluntary contractions exclusively (VOL group), while the other group benefited exclusively from electro-induced contractions (NMES group). The other 12 subjects formed the control (CON) group. Assessments of MVC and monopedal postural control in static and dynamic postural tasks were performed with the ipsilateral (ISPI) and contralateral (CONTRA) limbs before (PRE) and after (POST) completion of the training program. After the training program, the MVC of the IPSI and CONTRA limbs increased similarly for both experimental groups (VOL and NMES). There were no significant improvements of monopedal postural control for the IPSI or CONTRA limbs in either the VOL or NMES experimental group. No change was observed for the CON group over the protocol period. The purposed training program with NMES vs VOL contractions induced strength gains but did not permit any improvement of contralateral monopedal postural control in healthy young subjects. This has potential for therapeutic application and allows clinicians to focus their training programs on dynamic and poly-articular exercises to improve the postural control in young subjects.

  12. Re-evaluation of Ipsilateral Radiation for T1-T2N0-N2b Tonsil Carcinoma at the Princess Margaret Hospital in the Human Papillomavirus Era, 25 Years Later

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Shao Hui, E-mail: shaohui.huang@rmp.uhn.on.ca [Department of Radiation Oncology, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Waldron, John [Department of Radiation Oncology, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Department of Otolaryngology—Head & Neck Surgery, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Bratman, Scott V. [Department of Radiation Oncology, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Su, Jie [Department of Biostatistics, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Kim, John; Bayley, Andrew; Cho, John; Giuliani, Meredith; Hope, Andrew; Ringash, Jolie [Department of Radiation Oncology, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Hansen, Aaron [Division of Medical Oncology, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Almeida, John R. de; Goldstein, David [Department of Otolaryngology—Head & Neck Surgery, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Perez-Ordonez, Bayardo; Weinreb, Ilan [Department of Pathology, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Tong, Li [Department of Radiation Oncology, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Xu, Wei [Department of Biostatistics, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); O' Sullivan, Brian [Department of Radiation Oncology, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Department of Otolaryngology—Head & Neck Surgery, The Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada)

    2017-05-01

    Purpose: To report the outcome of ipsilateral radiation therapy (RT) in human papillomavirus (HPV)-positive (HPV+) patients and HPV-negative (HPV−) patients with T1-T2N0-N2b tonsillar cancer treated 25 years after our initial historical cohort. Methods and Materials: Patients with T1-T2N0-N2b tonsillar cancer who received ipsilateral RT or bilateral RT between 1999 and 2014 were reviewed. Overall survival (OS), local control (LC), regional control (RC), and grade 3 to 4 late toxicity (LT) were compared between ipsilateral RT and bilateral RT within HPV+ and HPV− patients, separately. Results: HPV status was ascertained in 379/427 (88%) consecutive patients (ipsilateral RT: 62 HPV+, 34 HPV−; bilateral RT: 240 HPV+ 240, 41 HPV−). The proportion of ipsilateral RT by N category for HPV+ and HPV− patients were as follows: N0: 24/37 (65%) versus 28/48 (74%); N1: 21/49 (43%) versus 4/9 (44%); N2a: 10/39 (26%) versus 1/4 (25%); and N2b: 7/177 (4%) versus 1/24 (4%), respectively. Of the patients receiving ipsilateral RT, 94/96 (98%) were treated with RT alone. The median follow-up time was 5.03 years. The respective 5-year rates of OS, LC, RC, and LT were similar between ipsilateral RT and bilateral RT for the HPV+ patients (OS: 89% vs 87%, P=.55; LC: 97% vs 98%, P=.65; RC: 98% vs 97%, P=.27; LT: 17% vs 12%, P=.83) and HPV− patients (OS: 63% vs 48%, P=.27; LC: 90% vs 80%, P=.19; RC: 94% vs 83%, P=.14; LT: 15% vs 22%, P=.36). Of the 96 patients receiving ipsilateral RT, contralateral neck failure (CNF) occurred in 1/52 HPV+ patients and 1/34 HPV− patients. The 5-year CNF rates were 2% (95% CI: 1-9) (HPV+: 2% [0-14]; HPV−: 3% [0-21], P=.66). Five local failures (2 HPV+; 3 HPV−) and no distant failures were seen. The 5-year rates of LC, RC, and LT were 97% versus 90% (P=.24), 98% versus 94% (P=.25), and 18% versus 15% (P=.75) for the HPV+ and HPV− cohorts, respectively. Osteoradionecrosis occurred in 9 patients: 6/47 (13%) treated with conventional RT

  13. Re-evaluation of Ipsilateral Radiation for T1-T2N0-N2b Tonsil Carcinoma at the Princess Margaret Hospital in the Human Papillomavirus Era, 25 Years Later

    International Nuclear Information System (INIS)

    Huang, Shao Hui; Waldron, John; Bratman, Scott V.; Su, Jie; Kim, John; Bayley, Andrew; Cho, John; Giuliani, Meredith; Hope, Andrew; Ringash, Jolie; Hansen, Aaron; Almeida, John R. de; Goldstein, David; Perez-Ordonez, Bayardo; Weinreb, Ilan; Tong, Li; Xu, Wei; O'Sullivan, Brian

    2017-01-01

    Purpose: To report the outcome of ipsilateral radiation therapy (RT) in human papillomavirus (HPV)-positive (HPV+) patients and HPV-negative (HPV−) patients with T1-T2N0-N2b tonsillar cancer treated 25 years after our initial historical cohort. Methods and Materials: Patients with T1-T2N0-N2b tonsillar cancer who received ipsilateral RT or bilateral RT between 1999 and 2014 were reviewed. Overall survival (OS), local control (LC), regional control (RC), and grade 3 to 4 late toxicity (LT) were compared between ipsilateral RT and bilateral RT within HPV+ and HPV− patients, separately. Results: HPV status was ascertained in 379/427 (88%) consecutive patients (ipsilateral RT: 62 HPV+, 34 HPV−; bilateral RT: 240 HPV+ 240, 41 HPV−). The proportion of ipsilateral RT by N category for HPV+ and HPV− patients were as follows: N0: 24/37 (65%) versus 28/48 (74%); N1: 21/49 (43%) versus 4/9 (44%); N2a: 10/39 (26%) versus 1/4 (25%); and N2b: 7/177 (4%) versus 1/24 (4%), respectively. Of the patients receiving ipsilateral RT, 94/96 (98%) were treated with RT alone. The median follow-up time was 5.03 years. The respective 5-year rates of OS, LC, RC, and LT were similar between ipsilateral RT and bilateral RT for the HPV+ patients (OS: 89% vs 87%, P=.55; LC: 97% vs 98%, P=.65; RC: 98% vs 97%, P=.27; LT: 17% vs 12%, P=.83) and HPV− patients (OS: 63% vs 48%, P=.27; LC: 90% vs 80%, P=.19; RC: 94% vs 83%, P=.14; LT: 15% vs 22%, P=.36). Of the 96 patients receiving ipsilateral RT, contralateral neck failure (CNF) occurred in 1/52 HPV+ patients and 1/34 HPV− patients. The 5-year CNF rates were 2% (95% CI: 1-9) (HPV+: 2% [0-14]; HPV−: 3% [0-21], P=.66). Five local failures (2 HPV+; 3 HPV−) and no distant failures were seen. The 5-year rates of LC, RC, and LT were 97% versus 90% (P=.24), 98% versus 94% (P=.25), and 18% versus 15% (P=.75) for the HPV+ and HPV− cohorts, respectively. Osteoradionecrosis occurred in 9 patients: 6/47 (13%) treated with conventional RT

  14. Foxg1 regulates retinal axon pathfinding by repressing an ipsilateral program in nasal retina and by causing optic chiasm cells to exert a net axonal growth-promoting activity.

    Science.gov (United States)

    Tian, Natasha M; Pratt, Thomas; Price, David J

    2008-12-01

    Mammalian binocular vision relies on the divergence of retinal ganglion cell axons at the optic chiasm, with strictly controlled numbers projecting contralaterally and ipsilaterally. In mouse, contralateral projections arise from the entire retina, whereas ipsilateral projections arise from ventrotemporal retina. We investigate how development of these patterns of projection is regulated by the contralateral determinant Foxg1, a forkhead box transcription factor expressed in nasal retina and at the chiasm. In nasal retina, loss of Foxg1 causes increased numbers of ipsilateral projections and ectopic expression of the ipsilateral determinants Zic2, Ephb1 and Foxd1, indicating that nasal retina is competent to express an ipsilateral program that is normally suppressed by Foxg1. Using co-cultures that combine Foxg1-expressing with Foxg1-null retinal explants and chiasm cells, we provide functional evidence that Foxg1 promotes contralateral projections through actions in nasal retina, and that in chiasm cells, Foxg1 is required for the generation of a hitherto unrecognized activity supporting RGC axon growth.

  15. Early diagnosis of Parkinson's disease: neurospect by trodat-1Tc99m, dopamine transporter marker

    International Nuclear Information System (INIS)

    Mena, Ismael; Diaz, Fernando; Gomez, Ariel

    2001-01-01

    Information: We have recently preliminarily reported that NeuroSPECT (NSP) of the Dopamine Transporter (DAT) is a highly sensitive method for early diagnosis of Parkinson disease (27). Objectives: To evaluate the sensitivity of NSP of DAT in patients with de novo hemiparkinsonism and compare the contralateral Vs ipsilateral to the symptomatic side results and also Vs. normal controls, in order to assess the sensitivity to detect pre symptomatic and symptomatic impairment of concentration of DAT (Au)

  16. True recurrence vs. new primary ipsilateral breast tumor relapse: An analysis of clinical and pathologic differences and their implications in natural history, prognoses, and therapeutic management

    International Nuclear Information System (INIS)

    Smith, Tanya E.; Lee, Daesung; Turner, Bruce C.; Carter, Darryl; Haffty, Bruce G.

    2000-01-01

    Purpose: The purpose of this study was to classify all ipsilateral breast tumor relapses (IBTR) in patients treated with conservative surgery and radiation therapy (CS+RT) as either new primary tumors (NP) or true local recurrences (TR) and to assess the prognostic and therapeutic implications of this classification. Methods and Materials: Of the 1152 patients who have been treated at Yale-New Haven Hospital before 1990, 136 patients have experienced IBTR as their primary site of failure. These relapses were classified as either NP or TR. Specifically, patients were classified as NP if the recurrence was distinctly different from the primary tumor with respect to the histologic subtype, the recurrence location was in a different location, or if the flow cytometry changed from aneuploid to diploid. This information was determined by a detailed review of each patient's hospital and/or radiotherapy record, mammograms, and pathologic reports. Results: As of 2/99, with a mean follow-up of 14.2 years, the overall ipsilateral breast relapse-free rate for all 1152 patients was 86% at 10 years. Using the classification scheme outlined above, 60 patient relapses were classified as TR, 70 were classified as NP and 6 were unable to be classified. NP patients had a longer mean time to breast relapse than TR patients (7.3 years vs. 3.7 years, p < 0.0001) and were significantly younger than TR patients (48.9 years vs. 54.5 years, p < 0.01). Patients developed both TR and NP at similar rates until approximately 8 years, when TR rates stabilized but NP rates continued to rise. By 15 years following original diagnosis, the TR rate was 6.8% compared to 13.1% for NP. Of the patients who had been previously tested for BRCA1/2 mutations, 17% (8/52) had deleterious mutations. It is noteworthy that all patients with deleterious mutations had new primary IBTR, while patients without deleterious mutations had both TR and NP (p = 0.06). Ploidy was evenly distributed between TR and NP but NP

  17. Elbow dislocation with ipsilateral fracture of the distal radius associated with a brachial artery injury: A new pathological condition of traumatic origin.

    Science.gov (United States)

    Trigo Lahoz, L; Lamas Gomez, C; Sarasquete Reiriz, J; de Caso Rodriguez, J; Proubasta Renart, I

    Elbow dislocation associated with ipsilateral fracture of the distal radius and a brachial artery injury is an uncommon traumatic entity. The two references of this injury combination appeared in 2015, although both authors did not realise that they were the first two cases published in the medical literature. Although mentioned in the text of the articles, no mention was made of the fracture of the distal radius in the titles. The purpose of this paper is to present three cases with this new traumatic pathological entity, explaining its pathogenetic mechanism, the treatment used, and the results obtained. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Ipsilateral dislocation of the radial head associated with fracture of distal end of the radius: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Gupta Vinay

    2013-06-01

    Full Text Available 【Abstract】Dislocation of the radial head in adults is uncommon. A simultaneous dislocation of the radial head and fracture of the ipsilateral distal end of radius with no other associated injuries is extremely rare. As far as we know, such an injury after an unusual mode of injury has been seldom reported in the English literature. We report such a case without any associated injuries or comorbidity. Closed reduction was performed within two hours after injury and results were satisfactory. Immobilisation was continued for 3 weeks. Gradual mobilisation was started after removal of the plaster under the supervision of a physiotherapist. At 6 months’ follow-up, the patient had no residual pain at the elbow with full flexion & extension. Almost full supination with a restriction of last 10 degrees of pronation was achieved. There was no evidence of instability of the elbow. Key words: Radial heads; Dislocations; Radius fractures

  19. Congenital seminal vesicle cyst accompanying with ipsilateral renal agenesis in an adolescent patient: A pediatric radiologist approach to Zinner’s syndrome

    Directory of Open Access Journals (Sweden)

    Mehmet Burak Özkan

    2015-12-01

    Full Text Available A fifteen-year-old boy who had complaints of left sided pelvic pain with known ipsilateral left renal agenesia was referred to pediatric radiology department. Incidentally, his sonography examination revealed a dilated tubular structure located in the retro-vesicular region from cephalic to prostate. Contrast enhanced pelvic MRI showed a huge seminal vesicle cyst which is over 6 cm without a mass effect near the aspect border of the prostate and bladder. The patient was diagnosed with Zinner syndrome. The patient doesn’t have new complaint with no definite increase in the diameter of the cyst. In this case presentation we are discussing the Zinner syndrome’s imaging findings from a pediatric radiologist approach with a brief review of the literature.

  20. Ipsilateral vascularised ulnar transposition autograft for limb-sparing surgery of the distal radius in 2 dogs with osteosarcoma : clinical communication

    Directory of Open Access Journals (Sweden)

    G.S. Irvine-Smith

    2006-06-01

    Full Text Available Canine osteosarcoma is the most commonly diagnosed primary bone tumour in the dog, affecting mainly large and giant breed dogs with the predilection site being the metaphysis of long bones, specifically the distal radius, proximal humerus, distal femur and proximal tibia and fibula. Treatment options are either palliative or curative intent therapy, the latter limb amputation or limb-sparing surgery together with chemotherapy. This article describes the use of an ipsilateral vascularised ulnar transposition autograft as well as chemotherapy in 2 dogs with osteosarcoma of the distal radius. Both dogs showed minimal complications with the technique and both survived over 381 days following the surgery. Complications seen were loosening of the screws and osteomyelitis. The procedure was well tolerated with excellent limb use. This technique is indicated for use in cases with small tumour size that have not broken through the bone cortex.

  1. Is the ipsilateral cortex surrounding the lesion or the non-injured contralateral cortex important for motor recovery in rats with photochemically induced cortical lesions?

    Science.gov (United States)

    Takata, Kotaro; Yamauchi, Hideki; Tatsuno, Hisashi; Hashimoto, Keiji; Abo, Masahiro

    2006-01-01

    To determine whether the ipsilateral cortex surrounding the lesion or the non-injured contralateral cortex is important for motor recovery after brain damage in the photochemically initiated thrombosis (PIT) model. We induced PIT in the sensorimotor cortex in rats and examined the recovery of motor function using the beam-walking test. In 24 rats, the right sensorimotor cortex was lesioned after 2 days of training for the beam-walking test (group 1). After 10 days, PIT was induced in the left sensorimotor cortex. Eight additional rats (group 2) received 2 days training in beam walking, then underwent the beam-walking test to evaluate function. After 10 days of testing, the left sensorimotor cortex was lesioned and recovery was monitored by the beam-walking test for 8 days. In group 1 animals, left hindlimb function caused by a right sensorimotor cortex lesion recovered within 10 days after the operation. Right hindlimb function caused by the left-side lesion recovered within 6 days. In group 2, right hindlimb function caused by induction of the left-side lesion after a total of 12 days of beam-walking training and testing recovered within 6 days as with the double PIT model. The training effect may be relevant to reorganization and neuromodulation. Motor recovery patterns did not indicate whether motor recovery was dependent on the ipsilateral cortex surrounding the lesion or the cortex of the contralateral side. The results emphasize the need for selection of appropriate programs tailored to the area of cortical damage in order to enhance motor functional recovery in this model. Copyright 2006 S. Karger AG, Basel.

  2. Stent-induced flow disturbances in the ipsilateral external carotid artery following internal carotid artery stenting: a temporary cause of jaw claudication.

    Science.gov (United States)

    Giurgea, Georgiana-Aura; Haumer, Markus; Mlekusch, Irene; Sabeti-Sandor, Schila; Dick, Petra; Schillinger, Martin; Minar, Erich; Mlekusch, Wolfgang

    2017-07-01

    We hypothesize that stenting of the internal carotid artery can immediately impede blood flow to the external carotid artery by either plaque shift or stent coverage of the ostium, and thereby cause ischemic symptoms like ipsilateral jaw claudication. Thirty-three patients with high-grade asymptomatic stenosis of the internal carotid artery who underwent endovascular treatment were examined by ultrasound of the external carotid artery and performed an exercise test by chewing chewing gum synchronously to an electronic metronome for 3 min. Tests were performed before, the day after, and 1 week after the stenting procedure. Claudication time was defined as the timespan until occurrence of pain of the masseter muscle and/or chewing dyssynchrony to the metronome for more than 15 s. Ten patients with an isolated, atherosclerotic stenosis of the external carotid artery served as controls. A significantly reduced claudication time (in seconds) was recorded in patients who underwent carotid artery stenting compared to baseline values; median 89 (interquartile range, IQR, 57 to 124) vs. median 180 (IQR 153 to 180; p external carotid artery into faster or slower as 200 cm/sec, the effect was even accentuated. Stenting values showed improvement 1 week after but did not return to baseline levels. No respective changes were found in controls. Stenting of the internal carotid artery lead to ipsilateral flow deterioration at the external carotid artery resulting in temporary jaw claudication. This impairment attenuated over the time and was significantly reduced after 1 week.

  3. Excitability of the motor cortex ipsilateral to the moving body side depends on spatio-temporal task complexity and hemispheric specialization.

    Directory of Open Access Journals (Sweden)

    Femke E van den Berg

    Full Text Available Unilateral movements are mainly controlled by the contralateral hemisphere, even though the primary motor cortex ipsilateral (M1(ipsi to the moving body side can undergo task-related changes of activity as well. Here we used transcranial magnetic stimulation (TMS to investigate whether representations of the wrist flexor (FCR and extensor (ECR in M1(ipsi would be modulated when unilateral rhythmical wrist movements were executed in isolation or in the context of a simple or difficult hand-foot coordination pattern, and whether this modulation would differ for the left versus right hemisphere. We found that M1(ipsi facilitation of the resting ECR and FCR mirrored the activation of the moving wrist such that facilitation was higher when the homologous muscle was activated during the cyclical movement. We showed that this ipsilateral facilitation increased significantly when the wrist movements were performed in the context of demanding hand-foot coordination tasks whereas foot movements alone influenced the hand representation of M1(ipsi only slightly. Our data revealed a clear hemispheric asymmetry such that MEP responses were significantly larger when elicited in the left M1(ipsi than in the right. In experiment 2, we tested whether the modulations of M1(ipsi facilitation, caused by performing different coordination tasks with the left versus right body sides, could be explained by changes in short intracortical inhibition (SICI. We found that SICI was increasingly reduced for a complex coordination pattern as compared to rest, but only in the right M1(ipsi. We argue that our results might reflect the stronger involvement of the left versus right hemisphere in performing demanding motor tasks.

  4. Repeated administration of the monoamine reuptake inhibitor BTS 74 398 induces ipsilateral circling in the 6-hydroxydopamine lesioned rat without sensitizing motor behaviours.

    Science.gov (United States)

    Lane, E L; Cheetham, S C; Jenner, P

    2005-01-01

    BTS 74 398 (1-[1-(3,4-dichlorophenyl)cyclobutyl]-2-(3-diaminethylaminopropylthio)ethanone monocitrate) is a monoamine reuptake inhibitor that reverses motor deficits in MPTP-treated (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) common marmosets without provoking established dyskinesia. However, it is not known whether BTS 74 398 primes the basal ganglia for dyskinesia induction. In this study, the ability of BTS 74 398 to sensitize 6-hydroxydopamine (6-OHDA)-lesioned rats for the production of abnormal motor behaviours and the induction of striatal DeltaFosB were determined in comparison with l-3,4-dihydroxyphenylalanine methyl ester (L-dopa). Acute administration of BTS 74 398 induced a dose-dependent ipsilateral circling response in unilaterally 6-OHDA-lesioned rats whereas L-dopa produced dose-dependent contraversive rotation. The ipsilateral circling response to BTS 74 398 did not alter during 21 days of administration. In contrast, L-dopa treatment for 21 days caused a marked increase in rotational response. Repeated administration of both L-dopa and BTS 74 398 increased general motor activity and stereotypic behaviour. In L-dopa-treated rats, orolingual, locomotive, forelimb and axial abnormal movements developed whereas BTS 74 398 produced only locomotion with a side bias but no other abnormal movements. Sensitization of circling responses and the development of abnormal movements in 6-OHDA-lesioned rats have been associated with the potential of dopaminergic drugs to induce dyskinesia. Furthermore, striatal DeltaFosB immunoreactivity, shown to correlate with dyskinesia induction, was increased by L-dopa but was unaffected by repeated BTS 74 398 administration. The lack of such changes following repeated BTS 74 398 treatment suggests that it may be an effective antiparkinsonian therapy that is unlikely to produce involuntary movements.

  5. Radiation Transport

    Energy Technology Data Exchange (ETDEWEB)

    Urbatsch, Todd James [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-06-15

    We present an overview of radiation transport, covering terminology, blackbody raditation, opacities, Boltzmann transport theory, approximations to the transport equation. Next we introduce several transport methods. We present a section on Caseology, observing transport boundary layers. We briefly broach topics of software development, including verification and validation, and we close with a section on high energy-density experiments that highlight and support radiation transport.

  6. Chamber transport

    International Nuclear Information System (INIS)

    Olson, Craig L.

    2001-01-01

    Heavy ion beam transport through the containment chamber plays a crucial role in all heavy ion fusion (HIF) scenarios. Here, several parameters are used to characterize the operating space for HIF beams; transport modes are assessed in relation to evolving target/accelerator requirements; results of recent relevant experiments and simulations of HIF transport are summarized; and relevant instabilities are reviewed. All transport options still exist, including (1) vacuum ballistic transport, (2) neutralized ballistic transport, and (3) channel-like transport. Presently, the European HIF program favors vacuum ballistic transport, while the US HIF program favors neutralized ballistic transport with channel-like transport as an alternate approach. Further transport research is needed to clearly guide selection of the most attractive, integrated HIF system

  7. Ipsilateral corticotectal projections from the primary, premotor and supplementary motor cortical areas in adult macaque monkeys: a quantitative anterograde tracing study

    Science.gov (United States)

    Fregosi, Michela; Rouiller, Eric M.

    2018-01-01

    The corticotectal projection from cortical motor areas is one of several descending pathways involved in the indirect control of spinal motoneurons. In non-human primates, previous studies reported that cortical projections to the superior colliculus originated from the premotor cortex and the primary motor cortex, whereas no projection originated from the supplementary motor area. The aim of the present study was to investigate and compare the properties of corticotectal projections originating from these three cortical motor areas in intact adult macaques (n=9). The anterograde tracer BDA was injected into one of these cortical areas in each animal. Individual axonal boutons, both en passant and terminaux, were charted and counted in the different layers of the ipsilateral superior colliculus. The data confirmed the presence of strong corticotectal projections from the premotor cortex. A new observation was that strong corticotectal projections were also found to originate from the supplementary motor area (its proper division). The corticotectal projection from the primary motor cortex was quantitatively less strong than that from either the premotor or supplementary motor areas. The corticotectal projection from each motor area was directed mainly to the deep layer of the superior colliculus, although its intermediate layer was also a consistent target of fairly dense terminations. The strong corticotectal projections from non-primary motor areas are in position to influence the preparation and planning of voluntary movements. PMID:28921678

  8. Bimodal Modulation of Ipsilateral Spinal-Coeruleo-Spinal Pathway in CRPS: A Novel Model for Explaining Different Clinical Features of the Syndrome.

    Science.gov (United States)

    Carcamo, Cesar R

    2015-08-01

    The objective is to present a hypothesis to explain the sensory, autonomic, and motor disturbances associated with complex regional pain syndrome (CRPS) syndrome. The author reviewed the available and relevant literature, which was supplemented with research on experimental animal models, with a focus on how they may translate into humans, particularly in areas about pathophysiologic mechanisms of CRPS. We propose that different CRPS subtypes may result from facilitative or inhibitory influences exerted by the spinal-coeruleo-spinal pathway in three sites at the spinal cord: the dorsal horn (DH), intermediolateral cell column (IML) and ventral horn (VH). A facilitatory influence over DH may have a pronociceptive effect that explains exacerbated pain, sensory disturbances, and spreading sensitization and neuroinflammation. Conversely, a facilitatory influence over preganglionic neurons located in IML cell column may increase sympathetic outflow with peripheral vasoconstriction, which leads to cold skin, ipsilateral limb ischaemia, and sympathetically maintained pain (SMP). For patients presenting with these symptoms, a descending inhibitory influence would be predicted to result in decreased sympathetic outflow and warm skin, as well as impairment of peripheral vasoconstrictor reflexes. Finally, a descending inhibitory influence over VH could explain muscle weakness and decreased active range of motion, while also facilitating motor reflexes, tremor and dystonia. The proposed model provides a mechanistically based diagnostic scheme for classifying and explaining the sensory, autonomic and motor disturbances associated with CRPS syndrome. Wiley Periodicals, Inc.

  9. Monomorphic Epithelial Proliferations of the Breast: A Possible Precursor Lesion Associated With Ipsilateral Breast Failure After Breast Conserving Therapy in Patients With Negative Lumpectomy Margins

    International Nuclear Information System (INIS)

    Goldstein, Neal S.; Kestin, Larry L.; Vicini, Frank A.

    2011-01-01

    Background: It is generally believed that ipsilateral breast failures (IBFs) after breast-conserving therapy (BCT) develop from incompletely eradicated carcinoma. We previously suggested that monomorphic epithelial proliferations (MEPs) in the breast may be a pool of partially transformed clones from which breast carcinomas can arise and that radiation therapy (RT) may also reduce the risk of IBF by eradicating MEPs. We examined salvage mastectomy specimens in patients experiencing an IBF to define the relationship between MEPs and IBFs and an additional potential mechanism for IBF risk reduction by RT. Methods and Materials: The location, number, and distribution of radiation changes and MEPs relative to 51 IBFs were mapped in salvage mastectomy specimens from BCT patients with adequately excised, initial carcinomas (negative lumpectomy margins). Results: All 51 salvage mastectomies had diffuse, late radiation changes. None had active fibrocystic lesions. MEPs were predominantly located in the immediate vicinity of the IBFs. A mean of 39% of MEP cases were located within the IBF, 46% were located within 2 cm of the IBF, and 14% were 2-3 cm from the IBF. Conclusions: MEPs appear to be a pool of partially transformed precursor lesions that can give rise to ductal carcinoma in situ and invasive carcinomas (CAs). Many IBFs may arise from MEPs that reemerge after RT. Radiation may also reduce IBF risk after BCT (including in patients with negative margins) by primarily eradicating MEPs.

  10. Transport phenomena

    International Nuclear Information System (INIS)

    Kirczenow, G.; Marro, J.

    1974-01-01

    Some simple remarks on the basis of transport theory. - Entropy, dynamics and scattering theory. - Response, relaxation and fluctuation. - Fluctuating hydrodynamics and renormalization of susceptibilities and transport coefficients. - Irreversibility of the transport equations. - Ergodic theory and statistical mechanics. - Correlation functions in Heisenberg magnets. - On the Enskog hard-sphere kinetic eqquation and the transport phenomena of dense simple gases. - What can one learn from Lorentz models. - Conductivity in a magnetic field. - Transport properties in gases in presence of external fields. - Transport properties of dilute gases with internal structure. (orig.) [de

  11. Breast-conserving surgery in locally advanced breast cancer submitted to neoadjuvant chemotherapy. Safety and effectiveness based on ipsilateral breast tumor recurrence and long-term follow-up

    Directory of Open Access Journals (Sweden)

    Guilherme Freire Angotti Carrara

    Full Text Available OBJECTIVE: To evaluate ipsilateral breast tumor recurrence after breast-conserving surgery for locally advanced breast cancer. METHODS: A retrospective observational cohort study was performed in patients with locally advanced breast cancer submitted to breast-conserving surgery after neoadjuvant chemotherapy based on an adriamycin-cyclophosphamide-paclitaxel regimen. We evaluated the clinical, pathologic, immunohistochemistry, and surgical factors that contribute to ipsilateral breast tumor recurrence and locoregional recurrence. A Kaplan-Meier analysis and Cox model were used to evaluate the main factors related to disease-free survival. RESULTS: Of the 449 patients who received neoadjuvant chemotherapy, 98 underwent breast-conserving surgery. The average diameter of the tumors was 5.3 cm, and 87.2% reached a size of up to 3 cm. Moreover, 86.7% were classified as clinical stage III, 74.5% had T3-T4 tumors, 80.5% had N1-N2 axilla, and 89.8% had invasive ductal carcinoma. A pathologic complete response was observed in 27.6% of the tumors, and 100.0% of samples had free margins. The 5-year actuarial overall survival rate was 81.2%, and the mean follow-up was 72.8 months. The rates of ipsilateral breast tumor recurrence and locoregional recurrence were 11.2% and 15.3%, respectively. Multifocal morphology response was the only factor related to ipsilateral breast tumor recurrence disease-free survival (p=0.04. A multivariate analysis showed that the pathologic response evaluation criteria in solid tumors (RECIST-breast cutoff was the only factor related to locoregional recurrence disease-free survival (p=0.01. CONCLUSIONS: Breast-conserving surgery is a safe and effective therapy for selected locally advanced breast tumors.

  12. Neurotransmitter transporters

    DEFF Research Database (Denmark)

    Gether, Ulrik; Andersen, Peter H; Larsson, Orla M

    2006-01-01

    The concentration of neurotransmitters in the extracellular space is tightly controlled by distinct classes of membrane transport proteins. This review focuses on the molecular function of two major classes of neurotransmitter transporter that are present in the cell membrane of neurons and....... Recent research has provided substantial insight into the structure and function of these transporters. In particular, the recent crystallizations of bacterial homologs are of the utmost importance, enabling the first reliable structural models of the mammalian neurotransmitter transporters...

  13. Bloqueio dos nervos tibial e fibular comum em fossa poplítea com punção única utilizando o estimulador percutâneo de nervos: considerações anatômicas e descrição ultrassonográfica

    OpenAIRE

    Rangel, Viviane de Oliveira; Carvalho, Raphael de Almeida; Mandim, Beatriz Lemos da Silva; Alves, Rodrigo Rodrigues; Ruzi, Roberto Araújo; Fonseca, Neuber Martins da

    2011-01-01

    JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios de nervos periféricos têm ganhado popularidade nas últimas duas décadas, tornando-se crescente opção anestésica para a cirurgia de membros. Este estudo propõe uma técnica de abordagem dos nervos tibial e fibular comum na fossa poplítea por punção única e utilizando o estimulador percutâneo de nervos, considerando a correlação com estudo anatômico e ultrassonográfico. MÉTODO: Estudo prospectivo, observacional e aleatório realizado com 28 paci...

  14. Validation of the Web-Based IBTR! 2.0 Nomogram to Predict for Ipsilateral Breast Tumor Recurrence After Breast-Conserving Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kindts, Isabelle, E-mail: Isabelle.kindts@uzleuven.be [Department of Oncology, KU Leuven - University of Leuven, Leuven (Belgium); Department of Radiation Oncology, University Hospitals Leuven, Leuven (Belgium); Laenen, Annouschka [Leuven Biostatistics and Statistical Bioinformatics Center (L-Biostat), KU Leuven - University of Leuven, Leuven (Belgium); Peeters, Stephanie; Janssen, Hilde; Depuydt, Tom [Department of Oncology, KU Leuven - University of Leuven, Leuven (Belgium); Department of Radiation Oncology, University Hospitals Leuven, Leuven (Belgium); Nevelsteen, Ines [Department of Oncology, KU Leuven - University of Leuven, Leuven (Belgium); Department of Surgical Oncology, University Hospitals Leuven, Leuven (Belgium); Van Limbergen, Erik; Weltens, Caroline [Department of Oncology, KU Leuven - University of Leuven, Leuven (Belgium); Department of Radiation Oncology, University Hospitals Leuven, Leuven (Belgium)

    2016-08-01

    Purpose: To evaluate the IBTR! 2.0 nomogram, which predicts 10-year ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy with and without radiation therapy for breast cancer, by using a large, external, and independent cancer center database. Methods and Materials: We retrospectively identified 1898 breast cancer cases, treated with breast-conserving therapy and radiation therapy at the University Hospital Leuven from 2000 to 2007, with requisite data for the nomogram variables. Clinicopathologic factors were assessed. Two definitions of IBTR were considered where simultaneous regional or distant recurrence were either censored (conform IBTR! 2.0) or included as event. Validity of the prediction algorithm was tested in terms of discrimination and calibration. Discrimination was assessed by the concordance probability estimate and Harrell's concordance index. The mean predicted and observed 10-year estimates were compared for the entire cohort and for 4 risk groups predefined by nomogram-predicted IBTR risks, and a calibration plot was drawn. Results: Median follow-up was 10.9 years. The 10-year IBTR rates were 1.3% and 2.1%, according to the 2 definitions of IBTR. The validation cohort differed from the development cohort with respect to the administration of hormonal therapy, surgical section margins, lymphovascular invasion, and tumor size. In univariable analysis, younger age (P=.002) and a positive nodal status (P=.048) were significantly associated with IBTR, with a trend for the omission of hormonal therapy (P=.061). The concordance probability estimate and concordance index varied between 0.57 and 0.67 for the 2 definitions of IBTR. In all 4 risk groups the model overestimated the IBTR risk. In particular, between the lowest-risk groups a limited differentiation was suggested by the calibration plot. Conclusions: The IBTR! 2.0 predictive model for IBTR in breast cancer patients shows substandard discriminative ability, with an

  15. Validation of a Web-Based Tool to Predict the Ipsilateral Breast Tumor Recurrence (IBTR! 2.0) after Breast-Conserving Therapy for Korean Patients.

    Science.gov (United States)

    Jung, Seung Pil; Hur, Sung Mo; Lee, Se Kyung; Kim, Sangmin; Choi, Min-Young; Bae, Soo Youn; Kim, Jiyoung; Kim, Min Kuk; Kil, Won Ho; Choe, Jun-Ho; Kim, Jung-Han; Kim, Jee Soo; Nam, Seok Jin; Bae, Jeoung Won; Lee, Jeong Eon

    2013-03-01

    IBTR! 2.0 is a web-based nomogram that predicts the 10-year ipsilateral breast tumor recurrence (IBTR) rate after breast-conserving therapy. We validated this nomogram in Korean patients. The nomogram was tested for 520 Korean patients, who underwent breast-conserving surgery followed by radiation therapy. Predicted and observed 10-year outcomes were compared for the entire cohort and for each group, predefined by nomogram-predicted risks: group 1, 10%. In overall patients, the overall 10 year predicted and observed estimates of IBTR were 5.22% and 5.70% (p=0.68). In group 1, (n=124), the predicted and observed estimates were 2.25% and 1.80% (p=0.73), in group 2 (n=177), 3.95% and 3.90% (p=0.97), in group 3 (n=181), 7.14% and 8.80% (p=0.42), and in group 4 (n=38), 11.66% and 14.90% (p=0.73), respectively. In a previous validation of this nomogram based on American patients, nomogram-predicted IBTR rates were overestimated in the high-risk subgroup. However, our results based on Korean patients showed that the observed IBTR was higher than the predicted estimates in groups 3 and 4. This difference may arise from ethnic differences, as well as from the methods used to detect IBTR and the healthcare environment. IBTR! 2.0 may be considered as an acceptable nomogram in Korean patients with low- to moderate-risk of in-breast recurrence. Before widespread use of this nomogram, the IBTR! 2.0 needs a larger validation study and continuous modification.

  16. Validation of the Web-Based IBTR! 2.0 Nomogram to Predict for Ipsilateral Breast Tumor Recurrence After Breast-Conserving Therapy.

    Science.gov (United States)

    Kindts, Isabelle; Laenen, Annouschka; Peeters, Stephanie; Janssen, Hilde; Depuydt, Tom; Nevelsteen, Ines; Van Limbergen, Erik; Weltens, Caroline

    2016-08-01

    To evaluate the IBTR! 2.0 nomogram, which predicts 10-year ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy with and without radiation therapy for breast cancer, by using a large, external, and independent cancer center database. We retrospectively identified 1898 breast cancer cases, treated with breast-conserving therapy and radiation therapy at the University Hospital Leuven from 2000 to 2007, with requisite data for the nomogram variables. Clinicopathologic factors were assessed. Two definitions of IBTR were considered where simultaneous regional or distant recurrence were either censored (conform IBTR! 2.0) or included as event. Validity of the prediction algorithm was tested in terms of discrimination and calibration. Discrimination was assessed by the concordance probability estimate and Harrell's concordance index. The mean predicted and observed 10-year estimates were compared for the entire cohort and for 4 risk groups predefined by nomogram-predicted IBTR risks, and a calibration plot was drawn. Median follow-up was 10.9 years. The 10-year IBTR rates were 1.3% and 2.1%, according to the 2 definitions of IBTR. The validation cohort differed from the development cohort with respect to the administration of hormonal therapy, surgical section margins, lymphovascular invasion, and tumor size. In univariable analysis, younger age (P=.002) and a positive nodal status (P=.048) were significantly associated with IBTR, with a trend for the omission of hormonal therapy (P=.061). The concordance probability estimate and concordance index varied between 0.57 and 0.67 for the 2 definitions of IBTR. In all 4 risk groups the model overestimated the IBTR risk. In particular, between the lowest-risk groups a limited differentiation was suggested by the calibration plot. The IBTR! 2.0 predictive model for IBTR in breast cancer patients shows substandard discriminative ability, with an overestimation of the risk in all subgroups. Copyright

  17. Validation of the Web-Based IBTR! 2.0 Nomogram to Predict for Ipsilateral Breast Tumor Recurrence After Breast-Conserving Therapy

    International Nuclear Information System (INIS)

    Kindts, Isabelle; Laenen, Annouschka; Peeters, Stephanie; Janssen, Hilde; Depuydt, Tom; Nevelsteen, Ines; Van Limbergen, Erik; Weltens, Caroline

    2016-01-01

    Purpose: To evaluate the IBTR! 2.0 nomogram, which predicts 10-year ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy with and without radiation therapy for breast cancer, by using a large, external, and independent cancer center database. Methods and Materials: We retrospectively identified 1898 breast cancer cases, treated with breast-conserving therapy and radiation therapy at the University Hospital Leuven from 2000 to 2007, with requisite data for the nomogram variables. Clinicopathologic factors were assessed. Two definitions of IBTR were considered where simultaneous regional or distant recurrence were either censored (conform IBTR! 2.0) or included as event. Validity of the prediction algorithm was tested in terms of discrimination and calibration. Discrimination was assessed by the concordance probability estimate and Harrell's concordance index. The mean predicted and observed 10-year estimates were compared for the entire cohort and for 4 risk groups predefined by nomogram-predicted IBTR risks, and a calibration plot was drawn. Results: Median follow-up was 10.9 years. The 10-year IBTR rates were 1.3% and 2.1%, according to the 2 definitions of IBTR. The validation cohort differed from the development cohort with respect to the administration of hormonal therapy, surgical section margins, lymphovascular invasion, and tumor size. In univariable analysis, younger age (P=.002) and a positive nodal status (P=.048) were significantly associated with IBTR, with a trend for the omission of hormonal therapy (P=.061). The concordance probability estimate and concordance index varied between 0.57 and 0.67 for the 2 definitions of IBTR. In all 4 risk groups the model overestimated the IBTR risk. In particular, between the lowest-risk groups a limited differentiation was suggested by the calibration plot. Conclusions: The IBTR! 2.0 predictive model for IBTR in breast cancer patients shows substandard discriminative ability, with an

  18. Ipsilateral breast tumor recurrence after breast conservation therapy: Outcomes of salvage mastectomy vs. salvage breast-conserving surgery and prognostic factors for salvage breast preservation

    International Nuclear Information System (INIS)

    Alpert, Tracy E.; Kuerer, Henry M.; Arthur, Douglas W.; Lannin, Donald R.; Haffty, Bruce G.

    2005-01-01

    Purpose: To compare outcomes of salvage mastectomy (SM) and salvage breast-conserving surgery (SBCS) and study the feasibility of SBCS. Methods and Materials: Of 2,038 patients treated with breast-conserving therapy at Yale-New Haven Hospital before 1999, 166 sustained an ipsilateral breast tumor recurrence (IBTR). Outcomes and prognostic factors of patients treated with SM or SBCS were compared. Patients were considered amenable to SBCS if the recurrence was localized on mammogram and physical examination, and had pathologic size <3 cm, confined to the biopsy site, without skin or lymphovascular invasion, and with ≤3 positive nodes. Results: Of the 146 patients definitively managed at IBTR, surgery was SM (n = 116) or SBCS (n 30). The median length of follow-up after IBTR was 13.8 years. The SM and SBCS cohorts had no significant differences, except at IBTR the SM cohort had a greater tumor size (p = 0.049). Of the SM cohort, 65.5% were considered appropriate for SBCS, and a localized relapse was predicted by estrogen-receptor positive, diploid, and detection of recurrence by mammogram. Multicentric disease correlated with BRCA1/2 mutation, estrogen-receptor negative, lymph node positive at relapse, and detection of recurrence by physical examination. Survival after IBTR was 64.5% at 10 years, with no significant difference between SM (65.7%) and SBCS (58.0%). Only 2 patients in the SBCS cohort subsequently had a second IBTR, and were salvaged with mastectomy. Conclusions: While mastectomy is considered the standard surgical salvage of IBTR, SBCS is feasible and prognostic factors are related to favorable tumor biology and early detection. Patients with BRCA1/2 germline mutations may be less appropriate for SBCS, as multicentric disease was more prevalent. Patients who underwent SBCS had comparable outcomes as those who underwent SM, but remain at continued risk for IBTR. A prospective trial evaluating repeat lumpectomy and partial breast reirradiation is

  19. Peroneal nerve palsy due to compartment syndrome after facial plastic surgery Paralisia de nervo fibular devido a síndrome compartimental após cirurgia plástica da face

    Directory of Open Access Journals (Sweden)

    Clécio O. Godeiro-Júnior

    2007-09-01

    índrome compartimental crônica. Ele fazia uso de anabolizantes e venlafaxina, não relatado no início do quadro, e a agitação poderia ser explicada por uma síndrome serotoninérgia desencadeada pela interação deste último medicamento e haloperidol. A rabdomiólise secundária a estes eventos causou edema e isquemia nos compartimentos anteriores de ambos os membros inferiores, levando a uma compressão secundária do nervo fibular. O caso em questão ilustra a importância do diagnóstico precoce da síndrome compartimental pois, caso contrário, mesmo com fasciotomia, uma complicação permanente devido à compressão de nervos periféricos pode se estabelecer.

  20. Sustainable Transportation

    DEFF Research Database (Denmark)

    Hall, Ralph P.; Gudmundsson, Henrik; Marsden, Greg

    2014-01-01

    The transportation system is the backbone of economic and social progress and the means by which humans access goods and services and connect with one another. Yet, as the scale of transportation activities has grown worldwide, so too have the negative environmental, social, and economic impacts...... that relate to the construction and maintenance of transportation infrastructure and the operation or use of the different transportation modes. The concept of sustainable transportation emerged in response to these concerns as part of the broader notion of sustainable development. Given the transportation...... sector’s significant contribution to global challenges such as climate change, it is often said that sustainable development cannot be achieved without sustainable transportation....

  1. Effect of nerve activity on transport of nerve growth factor and dopamine β-hydroxylase antibodies in sympathetic neurones

    International Nuclear Information System (INIS)

    Lees, G.; Chubb, I.; Freeman, C.; Geffen, L.; Rush, R.

    1981-01-01

    The effect of nerve activity on the uptake and retrograde transport of nerve growth factor (NGF) and dopamine β-hydroxylase (DBH) antibodies was studied by injecting 125 I-labelled NGF and anti-DBH into the anterior eye chamber of guinea-pigs. Decentralization of the ipsilateral superior cervical ganglion (SCG) had no significant effect on the retrograde transport of either NGF or anti-DBH. Phenoxybenzamine produced a 50% increase in anti-DBH but not NGF accumulation and this effect was prevented by prior decentralization. This demonstrates that NGF is taken up independently of the retrieval of synaptic vesicle components. (Auth.)

  2. The value of radiotherapy in breast cancer patients with isolated ipsilateral supraclavicular lymph node metastasis without distant metastases at diagnosis: a retrospective analysis of Chinese patients

    Directory of Open Access Journals (Sweden)

    Wu SG

    2014-02-01

    Full Text Available San-Gang Wu,1,* Jia-Yuan Sun,2,* Juan Zhou,3,* Feng-Yan Li,2 Qin Lin,1 Huan-Xin Lin,2 Zhen-Yu He2 1Xiamen Cancer Center, Department of Radiation Oncology, the First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China; 2Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People’s Republic of China; 3Xiamen Cancer Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China *These authors contributed equally to this work Background: The purpose of this study was to investigate the prognosis of ipsilateral supraclavicular lymph node metastasis (ISLM without evidence of distant metastases at diagnosis in Chinese women with breast cancer and to elucidate the clinical value of adjuvant radiotherapy. Methods: We performed a retrospective analysis of clinical data for 39 patients with ISLM from breast cancer without distant metastasis at diagnosis. Combined modality therapy, consisting of neoadjuvant chemotherapy, surgery, and adjuvant chemotherapy with or without adjuvant radiotherapy, was offered to the patients. Results: The patients in this study accounted for 1% of all breast cancer patients treated during the same time period. The median follow-up was 35 months. The 5-year locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival (DFS, and overall survival (OS were 57.3%, 42.3%, 34.4%, and 46.2%, respectively. Twenty-three patients received postoperative adjuvant radiotherapy. However, there was no significant difference in the 3- and 5-year locoregional recurrence-free survival (P=0.693, ISLM-free recurrence (P=0.964, distant metastasis-free survival (P=0.964, DFS (P=0.234, and OS (P=0.329 rates between the groups of patients who received or did not receive adjuvant radiotherapy

  3. Nuclear transport

    International Nuclear Information System (INIS)

    Anon.

    2003-01-01

    During january and february 2003, a unique event concerning nuclear transport was reported and rated 1 on the INES scale. This event concerns the absence of a maintenance operation on a shipping cask. This shipping cask was used for several years for nuclear transport inside La-hague site before being re-assigned to transport on public thoroughfare. The re-assignment of the cask should have been preceded and conditioned by a maintenance operation whose purpose is to check the efficiency of its radiation shield. During this period 2 on-site inspections concerning the transport of nuclear materials were performed. (A.C.)

  4. Ocean transportation

    National Research Council Canada - National Science Library

    Frankel, Ernst G; Marcus, Henry S

    1973-01-01

    .... This analysis starts with a review of ocean transportation demand and supply including projections of ship capacity demand and world shipbuilding capacity under various economic and political assumptions...

  5. Neutron transport

    International Nuclear Information System (INIS)

    Berthoud, Georges; Ducros, Gerard; Feron, Damien; Guerin, Yannick; Latge, Christian; Limoge, Yves; Santarini, Gerard; Seiler, Jean-Marie; Vernaz, Etienne; Coste-Delclaux, Mireille; M'Backe Diop, Cheikh; Nicolas, Anne; Andrieux, Catherine; Archier, Pascal; Baudron, Anne-Marie; Bernard, David; Biaise, Patrick; Blanc-Tranchant, Patrick; Bonin, Bernard; Bouland, Olivier; Bourganel, Stephane; Calvin, Christophe; Chiron, Maurice; Damian, Frederic; Dumonteil, Eric; Fausser, Clement; Fougeras, Philippe; Gabriel, Franck; Gagnier, Emmanuel; Gallo, Daniele; Hudelot, Jean-Pascal; Hugot, Francois-Xavier; Dat Huynh, Tan; Jouanne, Cedric; Lautard, Jean-Jacques; Laye, Frederic; Lee, Yi-Kang; Lenain, Richard; Leray, Sylvie; Litaize, Olivier; Magnaud, Christine; Malvagi, Fausto; Mijuin, Dominique; Mounier, Claude; Naury, Sylvie; Nicolas, Anne; Noguere, Gilles; Palau, Jean-Marc; Le Pallec, Jean-Charles; Peneliau, Yannick; Petit, Odile; Poinot-Salanon, Christine; Raepsaet, Xavier; Reuss, Paul; Richebois, Edwige; Roque, Benedicte; Royer, Eric; Saint-Jean, Cyrille de; Santamarina, Alain; Serot, Olivier; Soldevila, Michel; Tommasi, Jean; Trama, Jean-Christophe; Tsilanizara, Aime; Behar, Christophe; Provitina, Olivier; Lecomte, Michael; Forestier, Alain; Bender, Alexandra; Parisot, Jean-Francois; Finot, Pierre

    2013-10-01

    This bibliographical note presents a reference book which addresses the study of neutron transport in matter, the study of conditions for a chain reaction and the study of modifications of matter composition due to nuclear reactions. This book presents the main nuclear data, their measurement, assessment and processing, and the spallation. It proposes an overview of methods applied for the study of neutron transport: basic equations and their derived forms, deterministic methods and Monte Carlo method of resolution of the Boltzmann equation, methods of resolution of generalized Bateman equations, methods of time resolution of space kinetics coupled equations. It presents the main calculation codes, discusses the qualification and experimental aspects, and gives an overview of neutron transport applications: neutron transport calculation of reactors, neutron transport coupled with other disciplines, physics of fuel cycle, criticality

  6. Hybrid treatment of tandem, common carotid/innominate artery and ipsilateral carotid bifurcation stenoses by simultaneous, retrograde proximal stenting and eversion carotid endarterectomy: Preliminary results of a case series.

    Science.gov (United States)

    Illuminati, Giulio; Pizzardi, Giulia; Pasqua, Rocco; Frezzotti, Francesca; Palumbo, Piergaspare; Macrina, Francesco; Calio', Francesco

    2018-04-01

    Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses. The proximal stenosis involved the left proximal CCA in 4 patients, the proximal innominate artery in 2 patients and the right CCA in one patient. The procedure was performed under general anesthesia in a conventional operating room equipped with a mobile C-arm. A covered, balloon expandable stent was deployed over the proximal stenosis via a 6-F sheath directly introduced into the proximal CCA through the obliquely transected carotid bulb. After removing the sheath, debris were flushed through the carotid bulb and eversion CEA completed the procedure. Study endpoints were: postoperative stroke/mortality rate, cardiac mortality and morbidity, peripheral nerve injury, cervical hematoma, overall late survival, freedom from ipsilateral stroke and patency of arterial reconstruction. No postoperative mortality or neurologic morbidity was observed in any patient. Cervical hematomas and peripheral nerve injuries were likewise absent. At a mean follow-up of 18 months, all the patients were alive, free from neurologic events of new onset and free from restenosis. Combined proximal stenting and eversion CEA for tandem lesions seems a valid treatment, with the advantages of eversion CEA over other techniques of carotid bifurcation

  7. Assessment of DNA methylation profiling and copy number variation as indications of clonal relationship in ipsilateral and contralateral breast cancers to distinguish recurrent breast cancer from a second primary tumour

    International Nuclear Information System (INIS)

    Huang, Katie T.; Mikeska, Thomas; Li, Jason; Takano, Elena A.; Millar, Ewan K A; Graham, Peter H.; Boyle, Samantha E.; Campbell, Ian G.; Speed, Terence P.; Dobrovic, Alexander; Fox, Stephen B.

    2015-01-01

    Patients with breast cancer have an increased risk of developing subsequent breast cancers. It is important to distinguish whether these tumours are de novo or recurrences of the primary tumour in order to guide the appropriate therapy. Our aim was to investigate the use of DNA methylation profiling and array comparative genomic hybridization (aCGH) to determine whether the second tumour is clonally related to the first tumour. Methylation-sensitive high-resolution melting was used to screen promoter methylation in a panel of 13 genes reported as methylated in breast cancer (RASSF1A, TWIST1, APC, WIF1, MGMT, MAL, CDH13, RARβ, BRCA1, CDH1, CDKN2A, TP73, and GSTP1) in 29 tumour pairs (16 ipsilateral and 13 contralateral). Using the methylation profile of these genes, we employed a Bayesian and an empirical statistical approach to estimate clonal relationship. Copy number alterations were analysed using aCGH on the same set of tumour pairs. There is a higher probability of the second tumour being recurrent in ipsilateral tumours compared with contralateral tumours (38 % versus 8 %; p <0.05) based on the methylation profile. Using previously reported recurrence rates as Bayesian prior probabilities, we classified 69 % of ipsilateral and 15 % of contralateral tumours as recurrent. The inferred clonal relationship results of the tumour pairs were generally concordant between methylation profiling and aCGH. Our results show that DNA methylation profiling as well as aCGH have potential as diagnostic tools in improving the clinical decisions to differentiate recurrences from a second de novo tumour. The online version of this article (doi:10.1186/s12885-015-1676-0) contains supplementary material, which is available to authorized users

  8. Animal Transports

    Directory of Open Access Journals (Sweden)

    Diana Ludrovcová

    2016-08-01

    Full Text Available Purpose and Originality: The research is aimed to the animal transports issue, from two points of view – first is the animal cruelty and second is the policy and economic consideration. The goal is to acquaint the readers with the transports risks and its cruelty and evaluation of the economic, political aspects for he involved countries. The study is oriented on more points of view, what is rare in works with a similar theme. Method: This paper examines many issues and examinations from different authors and subsequently summarized the findings with authors own knowledge to one expanded unit. Results: Results proves, that livestock transports have negative impact on animal´s health, environment. Number of transported animals is rising every year. Society: Research familiarize the society with the animal transports, cruelty against animals during them, and influence of transports on some countries, their economy, policy. People get better informed and can form their own opinion on this topic. They may start acting, undertaking some steps to improve the present situation, what could help a lot to animals and environment. Limitations / further research: Future research could show progress and improvement of transports, quality of food supply and economics.

  9. Ocean transportation

    National Research Council Canada - National Science Library

    Frankel, Ernst G; Marcus, Henry S

    1973-01-01

    .... The discussion of technology considers the ocean transportation system as a whole, and the composite subsystems such as hull, outfit, propulsion, cargo handling, automation, and control and interface technology...

  10. Ocean transportation

    National Research Council Canada - National Science Library

    Frankel, Ernst G; Marcus, Henry S

    1973-01-01

    .... In ocean transportation economics we present investment and operating costs as well as the results of a study of financing of shipping. Similarly, a discussion of government aid to shipping is presented.

  11. Nicaragua - Transportation

    Data.gov (United States)

    Millennium Challenge Corporation — The evaluation examines impacts of the Transportation Project in three ways. First, we calculate economic rates of return associated with reduced user costs for each...

  12. Sediment Transport

    DEFF Research Database (Denmark)

    Liu, Zhou

    Flow and sediment transport are important in relation to several engineering topics, e.g. erosion around structures, backfilling of dredged channels and nearshore morphological change. The purpose of the present book is to describe both the basic hydrodynamics and the basic sediment transport...... mechanics. Chapter 1 deals with fundamentals in fluid mechanics with emphasis on bed shear stress by currents, while chapter 3 discusses wave boundary layer theory. They are both written with a view to sediment transport. Sediment transport in rivers, cross-shore and longshore are dealt with in chapters 2......, 4 and 5, respectively. It is not the intention of the book to give a broad review of the literature on this very wide topic. The book tries to pick up information which is of engineering importance. An obstacle to the study of sedimentation is the scale effect in model tests. Whenever small...

  13. RF transport

    International Nuclear Information System (INIS)

    Choroba, Stefan

    2013-01-01

    This paper deals with the techniques of transport of high-power radiofrequency (RF) power from a RF power source to the cavities of an accelerator. Since the theory of electromagnetic waves in waveguides and of waveguide components is very well explained in a number of excellent text books it will limit itself on special waveguide distributions and on a number of, although not complete list of, special problems which sometimes occur in RF power transportation systems. (author)

  14. Public transport

    OpenAIRE

    Lethbridge, Jane

    2008-01-01

    Public transport plays an essential role in enabling people from low income and other disadvantaged groups to access employment and services. It also contributes to the development of social networks and social capital, by helping people to visit friends and relatives and take part in community and other social activities. Public policy makers have begun to recognise that adequate public transport provision can play an important role in reducing social exclusion. [Taken from introductory para...

  15. Ipsilateral testicular necrosis and atrophy after 1,080-degree torsion of the spermatic cord in rats Necrose e atrofia do testículo ipsilateral após torção de 1080 graus do cordão espermático em ratos

    Directory of Open Access Journals (Sweden)

    Frederico Ramalho Romero

    2009-04-01

    Full Text Available PURPOSE: To assess the incidence of testicular necrosis/atrophy immediately after 1 to 4 hours of 1,080-degree torsion of the spermatic cord, and 60 days after detorsion of the spermatic cord. METHODS: 42 rats were divided in 7 groups. Except for the control group, surgical torsion of the right spermatic cord was performed in all groups (T0. After 1, 2, or 4 hours of torsion, each group underwent either ipsilateral orchiectomy (groups OT1, OT2, and OT4, or detorsion of the spermatic cord and observation for 60 days (groups DT1, DT2, and DT4, before they were evaluated for the presence of testicular necrosis/atrophy. RESULTS: Only one rat (5.5% in groups OT1, OT2, and OT4 had testicular necrosis, in comparison with six rats (33.3% in groups DT1, DT2, and DT4 (p=0.04. The incidence of testicular necrosis/atrophy was not different between subgroups T1, T2, and T4, and the control group (p>0.05. There was, however, a tendency toward greater incidence of necrosis/atrophy in the rats in group DT4. CONCLUSION: The incidence of testicular necrosis/atrophy immediately after 1 to 4 hours of 1,080-degree torsion of the spermatic cord is 5.5%, in comparison with 33.3% sixty days after detorsion of the spermatic cord.OBJETIVO: Avaliar a incidência de necrose/atrofia testicular imediatamente após 1 a 4 horas de torção de 1080 graus do cordão espermático e 60 dias após a destorção do cordão espermático. MÉTODOS: 42 ratos foram separados em 7 grupos. Exceto para o grupo controle, todos os animais foram submetidos à torção operatória do cordão espermático direito (T0. Após 1, 2 ou 4 horas de torção, cada grupo foi submetido a orquiectomia ipsilateral (grupos OT1, OT2 e OT4, ou destorção do cordão espermático e observação por 60 dias (grupos DT1, DT2 e DT4, antes de serem avaliados para a presença de necrose/atrofia testicular. RESULTADOS: Somente um rato (5,5% nos grupos OT1, OT2 e OT4 apresentou necrose testicular em comparação com

  16. Orbital transport

    International Nuclear Information System (INIS)

    Oertel, H. Jr.; Koerner, H.

    1993-01-01

    The Third Aerospace Symposium in Braunschweig presented, for the first time, the possibility of bringing together the classical disciplines of aerospace engineering and the natural science disciplines of meteorology and air chemistry in a european setting. In this way, aspects of environmental impact on the atmosphere could be examined quantitatively. An essential finding of the european conference, is the unrestricted agreement of the experts that the given launch frequencies of the present orbital transport result in a negligible amount of pollutants being released in the atmosphere. The symposium does, however, call attention to the increasing need to consider the effect of orbital and atmospheric environmental impact of a future increase in launch frequencies of orbital transport in connection with future space stations. The Third Aerospace Symposium, 'Orbital Transport, Technical, Meteorological and Chemical Aspects', constituted a first forum of discussion for engineers and scientists. Questions of new orbital transport technologies and their environmental impact were to be discussed towards a first consensus. Through the 34 reports and articles, the general problems of space transportation and environmental protection were addressed, as well as particular aspects of high temperatures during reentry in the atmosphere of the earth, precision navigation of flight vehicles or flow behavior and air chemistry in the stratosphere. (orig./CT). 342 figs

  17. Botulinum toxin's axonal transport from periphery to the spinal cord.

    Science.gov (United States)

    Matak, Ivica; Riederer, Peter; Lacković, Zdravko

    2012-07-01

    Axonal transport of enzymatically active botulinum toxin A (BTX-A) from periphery to the CNS has been described in facial and trigeminal nerve, leading to cleavage of synaptosomal-associated protein 25 (SNAP-25) in central nuclei. Aim of present study was to examine the existence of axonal transport of peripherally applied BTX-A to spinal cord via sciatic nerve. We employed BTX-A-cleaved SNAP-25 immunohistochemistry of lumbar spinal cord after intramuscular and subcutaneous hind limb injections, and intraneural BTX-A sciatic nerve injections. Truncated SNAP-25 in ipsilateral spinal cord ventral horns and dorsal horns appeared after single peripheral BTX-A administrations, even at low intramuscular dose applied (5 U/kg). Cleaved SNAP-25 appearance in the spinal cord after BTX-A injection into the sciatic nerve was prevented by proximal intrasciatic injection of colchicine (5 mM, 2 μl). Cleaved SNAP-25 in ventral horn, using choline-acetyltransferase (ChAT) double labeling, was localized within cholinergic neurons. These results extend the recent findings on BTX-A retrograde axonal transport in facial and trigeminal nerve. Appearance of truncated SNAP-25 in spinal cord following low-dose peripheral BTX-A suggest that the axonal transport of BTX-A occurs commonly following peripheral application. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Travel and transport

    DEFF Research Database (Denmark)

    Bill, Jan; Roesdahl, Else

    2007-01-01

    On the interrelationship between travel, transport and society; on land transport, sea and river transport, and on winter transport;  on the related technologies and their developments......On the interrelationship between travel, transport and society; on land transport, sea and river transport, and on winter transport;  on the related technologies and their developments...

  19. Transport system

    NARCIS (Netherlands)

    Drenth, K.F.

    1999-01-01

    The transport system comprises at least one road surface (2) and at least one vehicle (4) on wheels (6). The road surface (2) has a substantially bowl-shaped cross section and the vehicle (4) is designed so that the wheels (6) run directly on the road surface (2) while the road surface (2) acts as a

  20. Optimal transport

    CERN Document Server

    Eckmann, B

    2008-01-01

    At the close of the 1980s, the independent contributions of Yann Brenier, Mike Cullen and John Mather launched a revolution in the venerable field of optimal transport founded by G Monge in the 18th century, which has made breathtaking forays into various other domains of mathematics ever since. The author presents a broad overview of this area.

  1. Nuclear transport

    International Nuclear Information System (INIS)

    Anon.

    2001-01-01

    Here is given the decree (2001/1199) of the 10. of december 2001 relative to the passing of safety rules concerning the maritime transport of spent fuels, plutonium and high-level radioactive wastes contained in packages. (O.M.)

  2. Transport fuel

    DEFF Research Database (Denmark)

    Ronsse, Frederik; Jørgensen, Henning; Schüßler, Ingmar

    2014-01-01

    Worldwide, the use of transport fuel derived from biomass increased four-fold between 2003 and 2012. Mainly based on food resources, these conventional biofuels did not achieve the expected emission savings and contributed to higher prices for food commod - ities, especially maize and oilseeds...

  3. Combined SCI and TBI: recovery of forelimb function after unilateral cervical spinal cord injury (SCI) is retarded by contralateral traumatic brain injury (TBI), and ipsilateral TBI balances the effects of SCI on paw placement.

    Science.gov (United States)

    Inoue, Tomoo; Lin, Amity; Ma, Xiaokui; McKenna, Stephen L; Creasey, Graham H; Manley, Geoffrey T; Ferguson, Adam R; Bresnahan, Jacqueline C; Beattie, Michael S

    2013-10-01

    A significant proportion (estimates range from 16 to 74%) of patients with spinal cord injury (SCI) have concomitant traumatic brain injury (TBI), and the combination often produces difficulties in planning and implementing rehabilitation strategies and drug therapies. For example, many of the drugs used to treat SCI may interfere with cognitive rehabilitation, and conversely drugs that are used to control seizures in TBI patients may undermine locomotor recovery after SCI. The current paper presents an experimental animal model for combined SCI and TBI to help drive mechanistic studies of dual diagnosis. Rats received a unilateral SCI (75 kdyn) at C5 vertebral level, a unilateral TBI (2.0 mm depth, 4.0 m/s velocity impact on the forelimb sensori-motor cortex), or both SCI+TBI. TBI was placed either contralateral or ipsilateral to the SCI. Behavioral recovery was examined using paw placement in a cylinder, grooming, open field locomotion, and the IBB cereal eating test. Over 6weeks, in the paw placement test, SCI+contralateral TBI produced a profound deficit that failed to recover, but SCI+ipsilateral TBI increased the relative use of the paw on the SCI side. In the grooming test, SCI+contralateral TBI produced worse recovery than either lesion alone even though contralateral TBI alone produced no observable deficit. In the IBB forelimb test, SCI+contralateral TBI revealed a severe deficit that recovered in 3 weeks. For open field locomotion, SCI alone or in combination with TBI resulted in an initial deficit that recovered in 2 weeks. Thus, TBI and SCI affected forelimb function differently depending upon the test, reflecting different neural substrates underlying, for example, exploratory paw placement and stereotyped grooming. Concurrent SCI and TBI had significantly different effects on outcomes and recovery, depending upon laterality of the two lesions. Recovery of function after cervical SCI was retarded by the addition of a moderate TBI in the contralateral

  4. Nuclear transport

    International Nuclear Information System (INIS)

    Anon.

    2002-01-01

    During September and October 2001, 1 event has been reported and classified at the first level of the INES scale. This incident concerns the violation of the European regulation that imposes to any driver of radioactive matter of being the holder of a certificate asserting that he attended a special training. During this period, 13 in-site inspections have been made in places related to nuclear transport. (A.C.)

  5. Motor Skills Training Enhances α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid Receptor Subunit mRNA Expression in the Ipsilateral Sensorimotor Cortex and Striatum of Rats Following Intracerebral Hemorrhage.

    Science.gov (United States)

    Tamakoshi, Keigo; Ishida, Kazuto; Kawanaka, Kentaro; Takamatsu, Yasuyuki; Tamaki, Hiroyuki

    2017-10-01

    We investigated the effects of acrobatic training (AT) on expression of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) subunits in the sensorimotor cortex and striatum after intracerebral hemorrhage (ICH). Male Wistar rats were divided into 4 groups: ICH without AT (ICH), ICH with AT (ICH + AT), sham operation without AT (SHAM), and sham operation with AT (SHAM + AT). ICH was induced by collagenase injection into the left striatum. The ICH + AT group performed 5 acrobatic tasks daily on days 4-28 post ICH. Forelimb sensorimotor function was evaluated using the forelimb placing test. On days 14 and 29, mRNA expression levels of AMPAR subunits GluR1-4 were measured by real-time reverse transcription-polymerase chain reaction. Forelimb placing test scores were significantly higher in the ICH + AT group than in the ICH group. Expression levels of all AMPAR subunit mRNAs were significantly higher in the ipsilateral sensorimotor cortex of rats in the ICH + AT group than in that of rats in the ICH group on day 29. GluR3 and GluR4 expression levels were reduced in the ipsilateral striatum of rats in the ICH group compared with that of rats in the SHAM group on day 14. These changes may play a critical role in motor skills training-induced recovery after ICH. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. Michigan transportation facts & figures : public transportation

    Science.gov (United States)

    2002-08-16

    This on-line document is part of a series, Transportation Facts & Figures, by the Michigan Department of Transportation (MDOT). The Public Transit section of Transportation Facts & Figures cover such topics as intercity bus service, intercity rail se...

  7. Analysis of transport administrators and sustainable transport ...

    African Journals Online (AJOL)

    Analysis of transport administrators and sustainable transport development in Lagos, Ogun and Oyo States, Nigeria. ... A good transportation system planning and management is considered vital for ... EMAIL FULL TEXT EMAIL FULL TEXT

  8. Transporter Classification Database (TCDB)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Transporter Classification Database details a comprehensive classification system for membrane transport proteins known as the Transporter Classification (TC)...

  9. Energy transport

    International Nuclear Information System (INIS)

    Anon.

    1982-01-01

    The measurement of primary interaction cross sections and the incorporation of these data into Monte Carlo calculations provide detailed information about the initial spatial distribution of absorbed dose. Our theoretical energy transport studies have focused on the use of this information to predict the evolution of chemical species formed as a result of the energy deposition. This effort has led to a stochastic approach to diffusion kinetics that can account for the influence of track structure on the yield of free radicals in the radiolysis of water. Fluorescence studies with pulsed alpha particle and proton beams provided the first experimental test of our stochastic model of tract structure effects. Our experimental studies use time-resolved emission spectroscopy to investigate the mechanism of energy transport in nonpolar liquids. Studies of the concentration dependence of time-resolved emission from solutions of benzene in cyclohexane also show the importance of using low benzene concentrations to minimize the influence of benzene dimers on the emission kinetics

  10. National transportation statistics 2011

    Science.gov (United States)

    2011-04-01

    Compiled and published by the U.S. Department of Transportation's Bureau of Transportation Statistics : (BTS), National Transportation Statistics presents information on the U.S. transportation system, including : its physical components, safety reco...

  11. National Transportation Statistics 2008

    Science.gov (United States)

    2009-01-08

    Compiled and published by the U.S. Department of Transportations Bureau of Transportation Statistics (BTS), National Transportation Statistics presents information on the U.S. transportation system, including its physical components, safety record...

  12. State Transportation Statistics 2012

    Science.gov (United States)

    2013-08-15

    The Bureau of Transportation Statistics (BTS), a part of the U.S. Department of Transportation's (USDOT) Research and Innovative Technology Administration (RITA), presents State Transportation Statistics 2012, a statistical profile of transportation ...

  13. National Transportation Statistics 2009

    Science.gov (United States)

    2010-01-21

    Compiled and published by the U.S. Department of Transportation's Bureau of Transportation Statistics (BTS), National Transportation Statistics presents information on the U.S. transportation system, including its physical components, safety record, ...

  14. State Transportation Statistics 2014

    Science.gov (United States)

    2014-12-15

    The Bureau of Transportation Statistics (BTS) presents State Transportation Statistics 2014, a statistical profile of transportation in the 50 states and the District of Columbia. This is the 12th annual edition of State Transportation Statistics, a ...

  15. Transport of radioactive substances

    International Nuclear Information System (INIS)

    2014-12-01

    The report on the transport of radioactive substances covers the following topics: facts on radioactive materials transport, safety of the transport of radioactive substances, legal regulations and guidelines: a multiform but consistent system, transport of nuclear fuels, safety during the transport of nuclear fuel, future transport of spent fuel elements and high-level radioactive wastes in Germany.

  16. The pattern and extent of retrograde transsynaptic transport of WGA-Alexa 488 in the phrenic motor system is dependent upon the site of application.

    Science.gov (United States)

    Goshgarian, Harry G; Buttry, Janelle L

    2014-01-30

    The first aim of the study was to determine if WGA-Alexa 488 would undergo retrograde transsynaptic transport in the phrenic motor system as we have shown with WGA-HRP in a previous study. The advantage of using WGA-Alexa 488 is that labeled neurons could be isolated and analyzed for intracellular molecular mechanisms without exposing tissue sections to chemicals for histochemical staining. The second aim of the study was to investigate the pattern and extent of labeling that occurs when WGA-Alexa 488 is applied to the cervical phrenic nerve as compared to intradiaphragmatic injection. After injecting the hemidiaphragm ipsilateral to a C2 spinal cord hemisection, WGA-Alexa 488 presumably diffused to the contralateral hemidiaphragm and labeled the phrenic nuclei bilaterally. In all animals with hemidiaphragmatic injection, the rostral ventral respiratory group (rVRG) was also labeled bilaterally in the medulla. Thus, injection of WGA-Alexa 488 into the diaphragm results in retrograde transsynaptic transport in the phrenic motor system. After applying WGA-Alexa 488 to the ipsilateral intact cervical phrenic nerve in both C2 hemisected rats and rats with a sham hemisection, only ipsilateral phrenic neurons were labeled; there was no labeling of the rVRG or any other center in the medulla. These results suggest that WGA-Alexa 488 must be applied in the vicinity of the phrenic myoneural junction where there is a high concentration of WGA receptors in order for transsynaptic transport to occur. The present study provides investigators with a new tool to study plasticity in the respiratory system after spinal cord injury. Copyright © 2013. Published by Elsevier B.V.

  17. Chemical transport reactions

    CERN Document Server

    Schäfer, Harald

    2013-01-01

    Chemical Transport Reactions focuses on the processes and reactions involved in the transport of solid or liquid substances to form vapor phase reaction products. The publication first offers information on experimental and theoretical principles and the transport of solid substances and its special applications. Discussions focus on calculation of the transport effect of heterogeneous equilibria for a gas motion between equilibrium spaces; transport effect and the thermodynamic quantities of the transport reaction; separation and purification of substances by means of material transport; and

  18. Beam transport

    International Nuclear Information System (INIS)

    1988-01-01

    Considerable experience has now been gained with the various beam transport lines, and a number of minor changes have been made to improve the ease of operation. These include: replacement of certain little-used slits by profile monitors (harps or scanners); relocation of steering magnets, closer to diagnostic harps or profile scanners; installation of a scanner inside the isocentric neutron therapy system; and conversion of a 2-doublet quadrupole telescope (on the neutron therapy beamline) to a 2-triplet telescope. The beam-swinger project has been delayed by very late delivery of the magnet iron to the manufacturer, but is now progressing smoothly. The K=600 spectrometer magnets have now been delivered and are being assembled for field mapping. The x,y-table with its associated mapping equipment is complete, together with the driver software. One of the experimental areas has been dedicated to the production of collimated neutron beams and has been equipped with a bending magnet and beam dump, together with steel collimators fixed at 4 degrees intervals from 0 degrees to 16 degrees. Changes to the target cooling and shielding system for isotope production have led to a request for much smaller beam spot sizes on target, and preparations have been made for rearrangement of the isotope beamline to permit installation of quadrupole triplets on the three beamlines after the switching magnet. A practical system of quadrupoles for matching beam properties to the spectrometer has been designed. 6 figs

  19. Plant Transporter Identification

    DEFF Research Database (Denmark)

    Larsen, Bo

    Membrane transport proteins (transporters) play a critical role for numerous biological processes, by controlling the movements of ions and molecules in and out of cells. In plants, transporters thus function as gatekeepers between the plant and its surrounding environment and between organs......, tissues, cells and intracellular compartments. Since plants are highly compartmentalized organisms with complex transportation infrastructures, they consequently have many transporters. However, the vast majority of predicted transporters have not yet been experimentally verified to have transport...... activity. This project contains a review of the implemented methods, which have led to plant transporter identification, and present our progress on creating a high-throughput functional genomics transporter identification platform....

  20. Transport of Radioactive Materials

    International Nuclear Information System (INIS)

    2001-01-01

    This address overviews the following aspects: concepts on transport of radioactive materials, quantities used to limit the transport, packages, types of packages, labeling, index transport calculation, tags, labeling, vehicle's requirements and documents required to authorize transportation. These requirements are considered in the regulation of transport of radioactive material that is in drafting step

  1. Transportation and the environment.

    NARCIS (Netherlands)

    Banister, D.; Anderton, K.; Bonilla, D.; Givoni, M.; Schwanen, T.

    2011-01-01

    The growth of CO2-intensive transport, mobility and the impact of transport on the environment are reviewed. The recent global exponential growth in transport is unsustainable and must end unless the transport sector can decarbonize. The paper examines solutions for low-carbon transport systems; the

  2. Effectiveness of postoperative radiotherapy in patients with small oral and oropharyngeal squamous cell carcinoma and concomitant ipsilateral singular cervical lymph node metastasis (pN1). A meta-analysis

    International Nuclear Information System (INIS)

    Moergel, Maximilian; Meurer, Philipp; Al-Nawas, Bilal; Wendt, Thomas G.

    2011-01-01

    The positive effect of radiation therapy for patients with advanced oropharyngeal squamous cell carcinoma (OSCC) has been substantially verified. The present work investigated whether a meta-analysis of current data is able to evaluate the effectiveness of postoperative radiotherapy (PORT) in patients with small OSCC (pT1, pT2) and a single ipsilateral lymph node metastasis (pN1). The meta-analysis comprises randomized and non-randomized studies. High-risk tumors were excluded and defined by size ≥ pT3/pT4, lymph node involvement ≥ pN2, or presence of additional histological risk factors, e.g., involved positive resection margins, extra nodal spread of the disease, or lymphangiosis carcinomatosa. The primary outcome analyzed mortality between the different treatment arms. Only one prospective randomized clinical trial and six retrospective observational studies were adequate for evaluation. Descriptive analysis revealed a marginally higher mortality in the irradiation group (44% vs. 34%). In contrast, a forest plot presentation of two of seven studies with and without events in the control and therapy arms presented an advantage for the irradiation group with the limitation of large heterogeneity and a lack of statistical significance. Present data are poor and exhibit limited internal and external validity; thus, direct comparison was not possible with the eligible studies. Therefore, a meta-analysis of present data may not serve as the basis for a general treatment recommendation but underlines the need of prospective, randomized, controlled clinical trials. (orig.)

  3. Teste de identificação de sentenças sintéticas com mensagem competitiva ipsilateral pediátrico: revisão narrativa sobre a sua aplicabilidade

    Directory of Open Access Journals (Sweden)

    Fernanda Freitas Vellozo

    2015-10-01

    Full Text Available Resumo: O Processamento auditivo é a capacidade que o sistema nervoso tem para usar a informação que chega pela audição. As habilidades auditivas são necessárias para que haja o processamento das informações. Testes comportamentais são utilizados para avaliar desordens do processamento auditivo, como o Teste de Identificação de Sentenças Sintéticas com Mensagem Competitiva Ipsilateral Pediátrico (PSI, que avalia a habilidade de figura-fundo para sons verbais. Trata-se de uma revisão narrativa que objetiva identificar a aplicabilidade do teste PSI, nos últimos dez anos. Uma busca nas bases de dados: Lilacs, PubMed, Medline, IBCS e SciELO foi realizada, utilizando-se como descritores: percepção auditiva, testes auditivos, transtorno da percepção auditiva ,audição, compreensão, combinados com a palavra PSI. Foram encontrados 52 artigos, sendo selecionados, lidos na íntegra e analisados, apenas, oito artigos. Pôde-se observar grande variabilidade em sua aplicação, demonstrando ser uma eficaz ferramenta de avaliação do processamento auditivo em diferentes populações e faixas etárias.

  4. Comparative study on the analgesic effect of acute ipsilateral shoulder pain after open thoracotomy between preoperative ultrasound guided suprascapular nerve block (SNB) and intraoperative phrenic nerve infiltration (PNI) in cancer lung patients.

    Science.gov (United States)

    Elfokery, Bassel M; Tawfic, Sahar A; Abdelrahman, Abdelrahman M; Abbas, Dina N; Abdelghaffar, Ikramy M

    2018-03-01

    Acute ipsilateral shoulder pain (ISP) is a common complaint in patients after thoracotomy. The incidence ranges from 21% to 97%. Unfortunately, clinical studies did not put enough focus on ISP post thoracic surgery. This study was designed to compare the effectiveness of suprascapular nerve block (SNB) and phrenic nerve infiltration (PNI) for controlling ISP. One hundred and thirty-five lung cancer patients (135) scheduled for open-lung surgery were randomly allocated into three equal groups; control group: received thoracic epidural with general anesthesia, suprascapular group: (SNB) one hour before the operation with 10 ml bupivacaine plus thoracic epidural with general anesthesia and phrenic nerve group: (PNI) was performed by the operating surgeon with 10 ml bupivacaine plus thoracic epidural with general anesthesia. The visual analogue score (VAS) of ISP, rescue of ketorolac for break through shoulder pain, peak expiratory flow rate (PEFR) and arterial blood gases were measured every 6 h postoperatively for 48 h. The VAS, rescue doses of ketorolc and PEFR were significantly lower in the phrenic nerve group (P-value 0.05). PNI is more effective than SNB for ISP. Production and hosting by Elsevier B.V.

  5. Transportation librarian's toolkit

    Science.gov (United States)

    2007-12-01

    The Transportation Librarians Toolkit is a product of the Transportation Library Connectivity pooled fund study, TPF- 5(105), a collaborative, grass-roots effort by transportation libraries to enhance information accessibility and professional expert...

  6. Advanced Transportation Institute 2008.

    Science.gov (United States)

    2009-02-01

    The seventh version of the Advanced Transportation Institute (ATI-08) was conducted in 2008 to encourage high school students to pursue careers in the field of transportation engineering. The University Transportation Center for Alabama partnered wit...

  7. Advanced Transportation Institute 2009.

    Science.gov (United States)

    2009-09-01

    The eighth version of the Advanced Transportation Institute (ATI-09) was conducted in 2009 to encourage high school students to pursue careers in the field of transportation engineering. The University Transportation Center for Alabama partnered with...

  8. Innovative Technologies in Transportation

    Science.gov (United States)

    2004-12-01

    An historical overview of the transportation infrastructure of the United States and Texas is provided. Data for trends in transportation is analyzed and projections for the future are postulated. A survey of current technologies in transportation is...

  9. State Transportation Statistics 2010

    Science.gov (United States)

    2011-09-14

    The Bureau of Transportation Statistics (BTS), a part of DOTs Research and Innovative Technology Administration (RITA), presents State Transportation Statistics 2010, a statistical profile of transportation in the 50 states and the District of Col...

  10. State transportation statistics 2009

    Science.gov (United States)

    2009-01-01

    The Bureau of Transportation Statistics (BTS), a part of DOTs Research and : Innovative Technology Administration (RITA), presents State Transportation : Statistics 2009, a statistical profile of transportation in the 50 states and the : District ...

  11. State Transportation Statistics 2011

    Science.gov (United States)

    2012-08-08

    The Bureau of Transportation Statistics (BTS), a part of DOTs Research and Innovative Technology Administration (RITA), presents State Transportation Statistics 2011, a statistical profile of transportation in the 50 states and the District of Col...

  12. State Transportation Statistics 2013

    Science.gov (United States)

    2014-09-19

    The Bureau of Transportation Statistics (BTS), a part of the U.S. Department of Transportations (USDOT) Research and Innovative Technology Administration (RITA), presents State Transportation Statistics 2013, a statistical profile of transportatio...

  13. Smart Growth and Transportation

    Science.gov (United States)

    Describes the relationship between smart growth and transportation, focusing smart and sustainable street design, transit-oriented development, parking management, sustainable transportation planning, and related resources.

  14. Neoclassical transport in NCSX

    International Nuclear Information System (INIS)

    Mikkelsen, D.R.; Zarnstorff, M.C.; Beidler, C.D.; Maassberg, H.; Houlberg, W.A.; Spong, D.A.; Tribaldos, V.

    2003-01-01

    Methods for calculating neoclassical transport in the National Compact Stellarator Experiment (NCSX) are discussed, with particular attention to developing computationally inexpensive predictions of neoclassical transport. (orig.)

  15. Journal of transportation engineering

    National Research Council Canada - National Science Library

    1983-01-01

    The Journal of Transportation Engineering contains technical and professional articles on the planning, design, construction, maintenance, and operation of air, highway, rail, and urban transportation...

  16. Transportation Industry 2004

    National Research Council Canada - National Science Library

    Miller, Evan; Kathir, Nathan; Brogan, Dennis M

    2004-01-01

    .... Because the defense sector relies on commercial transportation for both peacetime activities and for power projection, senior military leaders must understand the global transportation industry...

  17. Saxton Transportation Operations Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Saxton Transportation Operations Laboratory (Saxton Laboratory) is a state-of-the-art facility for conducting transportation operations research. The laboratory...

  18. Recurrence and mortality according to Estrogen Receptor status for breast cancer patients undergoing conservative surgery. Ipsilateral breast tumour recurrence dynamics provides clues for tumour biology within the residual breast

    International Nuclear Information System (INIS)

    Demicheli, Romano; Ardoino, Ilaria; Boracchi, Patrizia; Coradini, Danila; Agresti, Roberto; Ferraris, Cristina; Gennaro, Massimiliano; Hrushesky, William JM; Biganzoli, Elia

    2010-01-01

    the study was designed to determine how tumour hormone receptor status affects the subsequent pattern over time (dynamics) of breast cancer recurrence and death following conservative primary breast cancer resection. Time span from primary resection until both first recurrence and death were considered among 2825 patients undergoing conservative surgery with or without breast radiotherapy. The hazard rates for ipsilateral breast tumour recurrence (IBTR), distant metastasis (DM) and mortality throughout 10 years of follow-up were assessed. DM dynamics displays the same bimodal pattern (first early peak at about 24 months, second late peak at the sixth-seventh year) for both estrogen receptor (ER) positive (P) and negative (N) tumours and for all local treatments and metastatic sites. The hazard rates for IBTR maintain the bimodal pattern for ERP and ERN tumours; however, each IBTR recurrence peak for ERP tumours is delayed in comparison to the corresponding timing of recurrence peaks for ERN tumours. Mortality dynamics is markedly different for ERP and ERN tumours with more early deaths among patients with ERN than among patients with ERP primary tumours. DM dynamics is not influenced by the extent of conservative primary tumour resection and is similar for both ER phenotypes across different metastatic sites, suggesting similar mechanisms for tumour development at distant sites despite apparently different microenvironments. The IBTR risk peak delay observed in ERP tumours is an exception to the common recurrence risk rhythm. This suggests that the microenvironment within the residual breast tissue may enforce more stringent constraints upon ERP breast tumour cell growth than other tissues, prolonging the latency of IBTR. This local environment is, however, apparently less constraining to ERN cells, as IBTR dynamics is similar to the corresponding recurrence dynamics among other distant tissues

  19. Systematic lymphadenectomy versus sampling of ipsilateral mediastinal lymph-nodes during lobectomy for non-small-cell lung cancer: a systematic review of randomized trials and a meta-analysis.

    Science.gov (United States)

    Mokhles, Sahar; Macbeth, Fergus; Treasure, Tom; Younes, Riad N; Rintoul, Robert C; Fiorentino, Francesca; Bogers, Ad J J C; Takkenberg, Johanna J M

    2017-06-01

    To re-examine the evidence for recommendations for complete dissection versus sampling of ipsilateral mediastinal lymph nodes during lobectomy for cancer. We searched for randomized trials of systematic mediastinal lymphadenectomy versus mediastinal sampling. We performed a textual analysis of the authors' own starting assumptions and conclusion. We analysed the trial designs and risk of bias. We extracted data on early mortality, perioperative complications, overall survival, local recurrence and distant recurrence for meta-analysis. We found five randomized controlled trials recruiting 1980 patients spanning 1989-2007. The expressed starting position in 3/5 studies was a conviction that systematic dissection was effective. Long-term survival was better with lymphadenectomy compared with sampling (Hazard Ratio 0.78; 95% CI 0.69-0.89) as was perioperative survival (Odds Ratio 0.59; 95% CI 0.25-1.36, non-significant). But there was an overall high risk of bias and a lack of intention to treat analysis. There were higher rates (non-significant) of perioperative complications including bleeding, chylothorax and recurrent nerve palsy with lymphadenectomy. The high risk of bias in these trials makes the overall conclusion insecure. The finding of clinically important surgically related morbidities but lower perioperative mortality with lymphadenectomy seems inconsistent. The multiple variables in patients, cancers and available treatments suggest that large pragmatic multicentre trials, testing currently available strategies, are the best way to find out which are more effective. The number of patients affected with lung cancer makes trials feasible. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. Modelling freight transport

    NARCIS (Netherlands)

    Tavasszy, L.A.; Jong, G. de

    2014-01-01

    Freight Transport Modelling is a unique new reference book that provides insight into the state-of-the-art of freight modelling. Focusing on models used to support public transport policy analysis, Freight Transport Modelling systematically introduces the latest freight transport modelling

  1. Transport of radioactive materials

    International Nuclear Information System (INIS)

    2013-01-01

    This ninth chapter presents de CNEN-NE--5.01 norm 'Transport of radioactive material'; the specifications of the radioactive materials for transport; the tests of the packages; the requests for controlling the transport and the responsibilities during the transport of radioactive material

  2. Ipsilateral masking between acoustic and electric stimulations.

    Science.gov (United States)

    Lin, Payton; Turner, Christopher W; Gantz, Bruce J; Djalilian, Hamid R; Zeng, Fan-Gang

    2011-08-01

    Residual acoustic hearing can be preserved in the same ear following cochlear implantation with minimally traumatic surgical techniques and short-electrode arrays. The combined electric-acoustic stimulation significantly improves cochlear implant performance, particularly speech recognition in noise. The present study measures simultaneous masking by electric pulses on acoustic pure tones, or vice versa, to investigate electric-acoustic interactions and their underlying psychophysical mechanisms. Six subjects, with acoustic hearing preserved at low frequencies in their implanted ear, participated in the study. One subject had a fully inserted 24 mm Nucleus Freedom array and five subjects had Iowa/Nucleus hybrid implants that were only 10 mm in length. Electric masking data of the long-electrode subject showed that stimulation from the most apical electrodes produced threshold elevations over 10 dB for 500, 625, and 750 Hz probe tones, but no elevation for 125 and 250 Hz tones. On the contrary, electric stimulation did not produce any electric masking in the short-electrode subjects. In the acoustic masking experiment, 125-750 Hz pure tones were used to acoustically mask electric stimulation. The acoustic masking results showed that, independent of pure tone frequency, both long- and short-electrode subjects showed threshold elevations at apical and basal electrodes. The present results can be interpreted in terms of underlying physiological mechanisms related to either place-dependent peripheral masking or place-independent central masking.

  3. Circumcaval Ureter with Synchronous Ipsilateral Transitional Cell ...

    African Journals Online (AJOL)

    mn

    flank pain and gross hematuria of one year's duration. Clinical examination was unremarkable apart from ... ry tract stasis and a J- or fish-hook deformity of the ureter as it passes behind the inferior vena cava (IVC). ... Patients usually present with right flank pain and discomfort, which can be intermittent, dull or aching6.

  4. Circumcaval ureter with synchronous ipsilateral transitional cell ...

    African Journals Online (AJOL)

    We report a case of concomitant transitional cell carcinoma (TCC) in a circumcaval ureter and invasive bladder cancer. The diagnosis was based on the findings of excretory urography (IVU) and contrast-enhanced computed tomography (CT). IVU showed a typical J-shaped deformity in the dilated right proximal ureteric ...

  5. Water-transporting proteins

    DEFF Research Database (Denmark)

    Zeuthen, Thomas

    2010-01-01

    . In the K(+)/Cl(-) and the Na(+)/K(+)/2Cl(-) cotransporters, water is entirely cotransported, while water transport in glucose uniporters and Na(+)-coupled transporters of nutrients and neurotransmitters takes place by both osmosis and cotransport. The molecular mechanism behind cotransport of water...... transport. Epithelial water transport is energized by the movements of ions, but how the coupling takes place is uncertain. All epithelia can transport water uphill against an osmotic gradient, which is hard to explain by simple osmosis. Furthermore, genetic removal of aquaporins has not given support...... to osmosis as the exclusive mode of transport. Water cotransport can explain the coupling between ion and water transport, a major fraction of transepithelial water transport and uphill water transport. Aquaporins enhance water transport by utilizing osmotic gradients and cause the osmolarity...

  6. Blood Sample Transportation by Pneumatic Transportation Systems

    DEFF Research Database (Denmark)

    Nybo, Mads; Lund, Merete E; Titlestad, Kjell

    2018-01-01

    BACKGROUND: Pneumatic transportation systems (PTSs) are increasingly used for transportation of blood samples to the core laboratory. Many studies have investigated the impact of these systems on different types of analyses, but to elucidate whether PTSs in general are safe for transportation...... analysis, and the hemolysis index). CONCLUSIONS: Owing to their high degree of heterogeneity, the retrieved studies were unable to supply evidence for the safety of using PTSs for blood sample transportation. In consequence, laboratories need to measure and document the actual acceleration forces...

  7. Magnetic type transportation system

    International Nuclear Information System (INIS)

    Kobama, Masao.

    1981-01-01

    Purpose: To enable automatic transportation of nuclear substances with optional setting for the transportation distance, even for a long distance, facilitating the automation of the transportation and decreasing the space for the installation of a direction converging section of the transporting path. Constitution: A transporting vehicle having a pair of permanent magnets or ferromagnetic bodies mounted with a predetermined gap to each other along the transporting direction is provided in the transporting path including a bent direction change section for transporting specimens such as nuclear materials, and a plurality of driving vehicles having permanent magnets or ferromagnetic bodies for magnetically attracting the transporting vehicle from outside of the transporting path are arranged to the outside of the transporting path. At least one of the driving vehicles is made to run along the transporting direction of the transporting path by a driving mechanism incorporating running section such as an endless chain to drive the transportation vehicle, and the transporting vehicle is successively driven by each of the driving mechanisms. (Kawakami, Y.)

  8. Transportation Technology: Rail Transport and Logistics

    Science.gov (United States)

    Lang, Aaron B.

    2011-01-01

    Transportation can simply be defined as the movement of goods, services, and people from one location to another. Without an efficient means to transport goods from place to place, the economy would be nothing like it is today. Throughout the history of the United States, American railroads have paved the way toward creating a nation of great…

  9. Information disclosure on transport

    International Nuclear Information System (INIS)

    Kubo, M.

    1998-01-01

    In Japan, the transport of nuclear fuel materials strictly meets the above international convention and domestic regulations as well. Information on the transport of nuclear fuel materials within the country and between the country and foreign countries is treated carefully. Nuclear fuel materials are categorized for transport and are physically protected accordingly. Certain transportation information is treated with special precautions, including prior arrangements among sender, recipient and carrier, and prior agreement between entities subject to the jurisdiction and regulation of supplier and recipient countries. In the case of international transport, this information includes specifying time, place and procedures for transferring transport and responsibility. (O.M.)

  10. Secure Transportation Management

    International Nuclear Information System (INIS)

    Gibbs, P. W.

    2014-01-01

    Secure Transport Management Course (STMC) course provides managers with information related to procedures and equipment used to successfully transport special nuclear material. This workshop outlines these procedures and reinforces the information presented with the aid of numerous practical examples. The course focuses on understanding the regulatory framework for secure transportation of special nuclear materials, identifying the insider and outsider threat(s) to secure transportation, organization of a secure transportation unit, management and supervision of secure transportation units, equipment and facilities required, training and qualification needed.

  11. Monte Carlo Transport for Electron Thermal Transport

    Science.gov (United States)

    Chenhall, Jeffrey; Cao, Duc; Moses, Gregory

    2015-11-01

    The iSNB (implicit Schurtz Nicolai Busquet multigroup electron thermal transport method of Cao et al. is adapted into a Monte Carlo transport method in order to better model the effects of non-local behavior. The end goal is a hybrid transport-diffusion method that combines Monte Carlo Transport with a discrete diffusion Monte Carlo (DDMC). The hybrid method will combine the efficiency of a diffusion method in short mean free path regions with the accuracy of a transport method in long mean free path regions. The Monte Carlo nature of the approach allows the algorithm to be massively parallelized. Work to date on the method will be presented. This work was supported by Sandia National Laboratory - Albuquerque and the University of Rochester Laboratory for Laser Energetics.

  12. Dosimetric analysis of the brachial plexus among patients with breast cancer treated with post-mastectomy radiotherapy to the ipsilateral supraclavicular area: report of 3 cases of radiation-induced brachial plexus neuropathy

    International Nuclear Information System (INIS)

    Wu, San-Gang; Huang, Si-Juan; Zhou, Juan; Sun, Jia-Yuan; Guo, Han; Li, Feng-Yan; Lin, Qin; Lin, Huan-Xin; He, Zhen-Yu

    2014-01-01

    The purpose of this study was to evaluate the brachial plexus (BP) dose of postmastectomy radiotherapy (PMRT) to the ipsilateral supraclavicular (ISCL) area, and report the characteristics of radiation-induced brachial plexus neuropathy (RIBPN). The BP dose of 31 patients who received adjuvant PMRT to the ISCL area and chest wall using three-dimensional conformal radiotherapy (3DCRT) and the records of 3 patients with RIBPN were retrospectively analyzed based on the standardized Radiation Therapy Oncology Group-endorsed guidelines. The total dose to the ISCL area and chest wall was 50 Gy in 25 fractions. Patients with a higher number of removed lymph nodes (RLNs) had a higher risk of RIBPN (hazard ratio [HR]: 1.189, 95% confidence interval [CI]: 1.005-1.406, p = 0.044). In 31 patients treated with 3DCRT, the mean dose to the BP without irradiation to the ISCL area was significantly less than that with irradiation to the ISCL area (0.97 ± 0.20 vs. 44.39 ± 4.13 Gy, t = 136.75, p <0.001). In the 3DCRT plans with irradiation to the ISCL area and chest wall, the maximum dose to the BP was negatively correlated with age (r = −0.40, p = 0.026), body mass index (BMI) (r = −0.44, p = 0.014), and body weight (r = −0.45, p = 0.011). Symptoms of the 3 patients with RIBPN occurred 37–65 months after radiotherapy, and included progressive upper extremity numbness, pain, and motor disturbance. After treatment, 1 patient was stable, and the other 2 patients’ symptoms worsened. The incidence of RIBPN was higher in patients with a higher number of RLNs after PMRT. The dose to the BP is primarily from irradiation of the ISCL area, and is higher in slim and young patients. Prevention should be the main focus of managing RIBPN, and the BP should be considered an organ-at-risk when designing a radiotherapy plan for the ISCL area

  13. Sustainable Transportation and Health

    Directory of Open Access Journals (Sweden)

    Norbert Mundorf

    2018-03-01

    Full Text Available We are experiencing a shift in thinking about Transportation and Mobility, which makes this Special Issue on Sustainable Transportation and Health in the International Journal of Environmental Research and Public Health especially timely.[...

  14. Arizona transportation history.

    Science.gov (United States)

    2011-12-01

    The Arizona transportation history project was conceived in anticipation of Arizonas centennial, which will be : celebrated in 2012. Following approval of the Arizona Centennial Plan in 2007, the Arizona Department of : Transportation (ADOT) recog...

  15. Department of Transportation

    Science.gov (United States)

    ... of Drone Integration Pilot Program MEET THE SECRETARY TRANSPORTATION TUESDAY FEATURED NEWS The Briefing Room Connect With ... Carriers - Get a DOT Number Find Your State Transportation Department 5 Star Automobile Crash Test Ratings Office ...

  16. Transportation Management Workshop: Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-01

    This report is a compilation of discussions presented at the Transportation Management Workshop held in Gaithersburg, Maryland. Topics include waste packaging, personnel training, robotics, transportation routing, certification, containers, and waste classification.

  17. TRANSPORTATION ECONOMIC TRENDS 2017

    Science.gov (United States)

    2018-01-05

    The report has eight chapters: - Chapter 1 introduces the Transportation Services Index, a monthly summary of freight and passenger movement. - Chapter 2 explains what transportation contributes to the American economy. - Chapter 3 examines the costs...

  18. Oxygen transport membrane

    DEFF Research Database (Denmark)

    2015-01-01

    The present invention relates to a novel composite oxygen transport membrane as well as its preparation and uses thereof.......The present invention relates to a novel composite oxygen transport membrane as well as its preparation and uses thereof....

  19. Transport not as others

    International Nuclear Information System (INIS)

    Gruhier, Fabien.

    1979-01-01

    Transport of radioactive materials will increase with the development of nuclear power station. Problems arising are examined. Some examples of past accidents are given. Thermal and impact tests of containers and categories of transport are recalled [fr

  20. Transportation Management Workshop: Proceedings

    International Nuclear Information System (INIS)

    1993-01-01

    This report is a compilation of discussions presented at the Transportation Management Workshop held in Gaithersburg, Maryland. Topics include waste packaging, personnel training, robotics, transportation routing, certification, containers, and waste classification

  1. National transportation statistics 2010

    Science.gov (United States)

    2010-01-01

    National Transportation Statistics presents statistics on the U.S. transportation system, including its physical components, safety record, economic performance, the human and natural environment, and national security. This is a large online documen...

  2. Transportation Services Index

    Data.gov (United States)

    Department of Transportation — The TSI is a monthly measure of the volume of services performed by the for-hire transportation sector. The index covers the activities of for-hire freight carriers,...

  3. Transport of MOX fuel

    International Nuclear Information System (INIS)

    Porter, I.R.; Carr, M.

    1997-01-01

    The regulatory framework which governs the transport of MOX fuel is set out, including packages, transport modes and security requirements. Technical requirements for the packages are reviewed and BNFL's experience in plutonium and MOX fuel transport is described. The safety of such operations and the public perception of safety are described and the question of gaining public acceptance for MOX fuel transport is addressed. The paper concludes by emphasising the need for proactive programmes to improve the public acceptance of these operations. (Author)

  4. Radioactive materials transport

    International Nuclear Information System (INIS)

    Talbi, B.

    1996-01-01

    The development of peaceful applications of nuclear energy results in the increase of transport operations of radioactive materials. Therefore strong regulations on transport of radioactive materials turns out to be a necessity in Tunisia. This report presents the different axes of regulations which include the means of transport involved, the radiation protection of the carriers, the technical criteria of security in transport, the emergency measures in case of accidents and penalties in case of infringement. (TEC). 12 refs., 1 fig

  5. TRANSPORTATION INFORMATION CLEARINGHOUSE

    OpenAIRE

    Allen, Karin; Dijohn, Joseph; Misek, Shamus

    2005-01-01

    The Transportation Information Clearinghouse (TIC) Project was the result of collaboration among the Regional Transportation Authority, the Workforce Boards of Metropolitan Chicago and the Urban Transportation Center (UTC) at the University of Illinois at Chicago (UIC). The primary objective of the project was to identify privatelyprovided, employer-based, non-traditional transportation services in operation as well as specific information about these services in order for employers, Workforc...

  6. Transport statistics 1995

    CSIR Research Space (South Africa)

    De Haan, ML

    1996-04-01

    Full Text Available This publication contains information on all major modes of transport in South Africa. The transport sector is placed in perspective relative to the macro economy and a number of important transport indicators are given. The document also contains...

  7. Transports of radioactive materials

    International Nuclear Information System (INIS)

    Sousselier, Yves

    1982-01-01

    Transport safety depends on the packaging, and the degree of safety must be adapted to the potential hazards of the substance carried. The various kinds of packagings and their strength are examined and the transport of irradiated fuels from the safety angle is taken as example and a comparison is made with the transport of conventional dangerous substances [fr

  8. Transport of radioactive materials

    International Nuclear Information System (INIS)

    Lenail, B.

    1984-01-01

    Transport of radioactive materials is dependent of transport regulations. In practice integrated doses for personnel during transport are very low but are more important during loading or unloading a facility (reactor, plant, laboratory, ...). Risks occur also if packagings are used outside specifications. Recommendations to avoid these risks are given [fr

  9. Transportation in African Development.

    Science.gov (United States)

    Altschul, Robert D.

    1980-01-01

    Examines the structure, role, and needs of Africa's national and intracontinental transportation system. Characteristics of rail, water, road, and air transportation are examined. The conclusion is that high investment in transportation systems is essential to the development process. (Author/KC)

  10. Competing Transport Networks

    NARCIS (Netherlands)

    M.J. van der Leij (Marco)

    2003-01-01

    textabstractIn a circular city model, I consider network design and pricing decisions for a single fast transport connection that faces competition from a slower but better accessible transport mode. To access the fast transport network individuals have to make complementary trips by slow mode. This

  11. NATURAL GAS TRANSPORTATION

    OpenAIRE

    Stanis³aw Brzeziñski

    2007-01-01

    In the paper, Author presents chosen aspects of natural gas transportation within global market. Natural gas transportation is a technicaly complicated and economicly expensive process; in infrastructure construction and activities costs. The paper also considers last and proposed initiatives in natural gas transportation.

  12. Assessing Sensitiveness to Transport

    DEFF Research Database (Denmark)

    Lieb, Christoph; Suter, Stefan; Sánchez, Alfredo

    Summary The EU-project ASSET (ASessing SEnsitiveness to Transport) aims at developing and implementing a concise concept to assess transport sensitive areas (TSA) in a European context, i.e. areas in which transport leads to more serious impacts than in other areas. The aim of work package 2 (WP2...

  13. fibular osteosynthesis of neglected femoral neck fracture in a young

    African Journals Online (AJOL)

    As soon as a diagnosis of non-displaced fracture of his right hip was made he discharged himself ... in dogs that cortical grafts provided structural support to the necrotic femoral head preventing its collapse ... possibility of future osteoarthritis of the index hip and the need for regular follow-up. In conclusion, the use of ...

  14. Road Transport Entrepreneurs and Road Transportation Revolution ...

    African Journals Online (AJOL)

    Toshiba

    upon a massive road-building programme throughout the colony. The rapid expansion ..... transportation problems of his textile customers and palm produce producers and ... unflinching loyalty and solidarity with their illustrious son, General.

  15. Transportation and public health.

    Science.gov (United States)

    Litman, Todd

    2013-01-01

    This article investigates various ways that transportation policy and planning decisions affect public health and better ways to incorporate public health objectives into transport planning. Conventional planning tends to consider some public health impacts, such as crash risk and pollution emissions measured per vehicle-kilometer, but generally ignores health problems resulting from less active transport (reduced walking and cycling activity) and the additional crashes and pollution caused by increased vehicle mileage. As a result, transport agencies tend to undervalue strategies that increase transport system diversity and reduce vehicle travel. This article identifies various win-win strategies that can help improve public health and other planning objectives.

  16. Convective transport in tokamaks

    International Nuclear Information System (INIS)

    D'Ippolito, D.A.; Myra, J.R.; Russell, D.A.; Krasheninnikov, S.I.; Pigarov, A.Yu.; Yu, G.Q.; Xu, X.Q.; Nevins, W.M.

    2005-01-01

    Scrape-off-layer (SOL) convection in fusion experiments appears to be a universal phenomenon that can 'short-circuit' the divertor in some cases. The theory of 'blob' transport provides a simple and robust physical paradigm for studying convective transport. This paper summarizes recent advances in the theory of blob transport and its comparison with 2D and 3D computer simulations. We also discuss the common physical basis relating radial transport of blobs, pellets, and ELMs and a new blob regime that may lead to a connection between blob transport and the density limit. (author)

  17. Theory of contributon transport

    International Nuclear Information System (INIS)

    Painter, J.W.; Gerstl, S.A.W.; Pomraning, G.C.

    1980-10-01

    A general discussion of the physics of contributon transport is presented. To facilitate this discussion, a Boltzmann-like transport equation for contributons is obtained, and special contributon cross sections are defined. However, the main goal of this study is to identify contributon transport equations and investigate possible deterministic solution techniques. Four approaches to the deterministic solution of the contributon transport problem are investigated. These approaches are an attempt to exploit certain attractive properties of the contributon flux, psi = phi phi + , where phi and phi + are the solutions to the forward and adjoint Boltzmann transport equations

  18. Transportation Business Plan

    International Nuclear Information System (INIS)

    1986-01-01

    The Transportation Business Plan is a step in the process of procuring the transportation system. It sets the context for business strategy decisions by providing pertinent background information, describing the legislation and policies governing transportation under the NWPA, and describing requirements of the transportation system. Included in the document are strategies for procuring shipping casks and transportation support services. In the spirit of the NWPA directive to utilize the private sector to the maximum extent possible, opportunities for business ventures are obvious throughout the system development cycle

  19. Transportation safety training

    International Nuclear Information System (INIS)

    Jones, E.

    1990-01-01

    Over the past 25 years extensive federal legislation involving the handling and transport of hazardous materials/waste has been passed that has resulted in numerous overlapping regulations administered and enforced by different federal agencies. The handling and transport of hazardous materials/waste involves a significant number of workers who are subject to a varying degree of risk should an accident occur during handling or transport. Effective transportation training can help workers address these risks and mitigate them, and at the same time enable ORNL to comply with the federal regulations concerning the transport of hazardous materials/waste. This presentation will outline how the Environmental and Health Protection Division's Technical Resources and Training Section at the Oak Ridge National Laboratory, working with transportation and waste disposal personnel, have developed and implemented a comprehensive transportation safety training program to meet the needs of our workers while satisfying appropriate federal regulations. 8 refs., 3 tabs

  20. Transportation System Requirements Document

    International Nuclear Information System (INIS)

    1993-09-01

    This Transportation System Requirements Document (Trans-SRD) describes the functions to be performed by and the technical requirements for the Transportation System to transport spent nuclear fuel (SNF) and high-level radioactive waste (HLW) from Purchaser and Producer sites to a Civilian Radioactive Waste Management System (CRWMS) site, and between CRWMS sites. The purpose of this document is to define the system-level requirements for Transportation consistent with the CRWMS Requirement Document (CRD). These requirements include design and operations requirements to the extent they impact on the development of the physical segments of Transportation. The document also presents an overall description of Transportation, its functions, its segments, and the requirements allocated to the segments and the system-level interfaces with Transportation. The interface identification and description are published in the CRWMS Interface Specification

  1. TRANSPORT/HANDLING REQUESTS

    CERN Multimedia

    Groupe ST/HM

    2002-01-01

    A new EDH document entitled 'Transport/Handling Request' will be in operation as of Monday, 11th February 2002, when the corresponding icon will be accessible from the EDH desktop, together with the application instructions. This EDH form will replace the paper-format transport/handling request form for all activities involving the transport of equipment and materials. However, the paper form will still be used for all vehicle-hire requests. The introduction of the EDH transport/handling request form is accompanied by the establishment of the following time limits for the various services concerned: 24 hours for the removal of office items, 48 hours for the transport of heavy items (of up to 6 metric tons and of standard road width), 5 working days for a crane operation, extra-heavy transport operation or complete removal, 5 working days for all transport operations relating to LHC installation. ST/HM Group, Logistics Section Tel: 72672 - 72202

  2. Transport of radioactive substances; Der Transport radioaktiver Stoffe

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-12-15

    The report on the transport of radioactive substances covers the following topics: facts on radioactive materials transport, safety of the transport of radioactive substances, legal regulations and guidelines: a multiform but consistent system, transport of nuclear fuels, safety during the transport of nuclear fuel, future transport of spent fuel elements and high-level radioactive wastes in Germany.

  3. Stochastic models of intracellular transport

    KAUST Repository

    Bressloff, Paul C.; Newby, Jay M.

    2013-01-01

    mechanisms for intracellular transport: passive diffusion and motor-driven active transport. Diffusive transport can be formulated in terms of the motion of an overdamped Brownian particle. On the other hand, active transport requires chemical energy, usually

  4. Modelling of transport phenomena

    International Nuclear Information System (INIS)

    Itoh, Kimitaka; Itoh, Sanae; Fukuyama, Atsushi.

    1993-09-01

    In this review article, we discuss key features of the transport phenomena and theoretical modelling to understand them. Experimental observations have revealed the nature of anomalous transport, i.e., the enhancement of the transport coefficients by the gradients of the plasma profiles, the pinch phenomena, the radial profile of the anomalous transport coefficients, the variation of the transport among the Bohm diffusion, Pseudo-classical confinement, L-mode and variety of improved confinement modes, and the sudden jumps such as L-H transition. Starting from the formalism of the transport matrix, the modelling based on the low frequency instabilities are reviewed. Theoretical results in the range of drift wave frequency are examined. Problems in theories based on the quasilinear and mixing-length estimates lead to the renewal of the turbulence theory, and the physics picture of the self-sustained turbulence is discussed. The theory of transport using the fluid equation of plasma is developed, showing that the new approach is very promising in explaining abovementioned characteristics of anomalous transport in both L-mode and improved confinement plasmas. The interference of the fluxes is the key to construct the physics basis of the bifurcation theory for the L-H transition. The present status of theories on the mechanisms of improved confinement is discussed. Modelling on the nonlocal nature of transport is briefly discussed. Finally, the impact of the anomalous transport on disruptive phenomena is also described. (author) 95 refs

  5. Transport, energy and environment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-01

    Transportation demands a large and increasing share of total energy consumption in Europe. At the same time many European countries are facing difficult decisions in achieving their long term environmental goals. Therefore energy policy, environmental policy and transport policy should be seen and discussed in a common perspective. In particular the relative contribution from the transport sector and the energy sector involves a number of important and difficult issues. The aim of the conference was to bring together economists, scientists, manufactures, energy planners, transport planners, and decision makers in order to discuss the importance of the transport sector in relation to energy demand and long term environmental goals. General conference sessions covered. Trends in Transport Energy Demand and Environmental constraints, Technological Development and New Transport Systems, Lifestyle Changes and the Transport Sector, Megacities: Solutions to the Transport and Air Pollution Problems, Effectiveness of Public Policies, Transport and Energy sector, and Methods, Models and Data. The conference took place at Hotel Marienlyst, Elsinore, Denmark and attracted wide interest. The participants represented 14 different countries covering international organisations, ministries, universities, research centres, consulting firms, industry etc. (EG)

  6. Resultados do tratamento das fraturas da diáfise do fêmur ipsilaterais às do colo ou transtrocantérica Outcomes in treatment of diaphiseal femur fractures ipsilateral to the neck or transtrocanteric fracture

    Directory of Open Access Journals (Sweden)

    Nelson Astur Neto

    2010-01-01

    Full Text Available OBJETIVO: Avaliação radiográfica, funcional e das complicações do tratamento cirúrgico das fraturas diafisárias do fêmur associadas à fratura transtrocantérica ou do colo do mesmo fêmur. MÉTODOS: De 2002 a 2007 foram tratados 17 pacientes. Eram masculinos 88% e a idade média foi de 31 anos e três meses. Dez (59% apresentavam associação com fratura do colo do fêmur e sete (41% com a fratura transtrocantérica. Foram avaliados a dor residual e a amplitude de movimento articular do quadril e joelho, a consolidação radiográfica e o tipo de implante utilizado, pela avaliação atual e retrospectivamente pelo prontuário, com um seguimento médio de 48 meses. RESULTADOS: Todas as fraturas transtrocantéricas evoluíram para consolidação sem deformidade residual. Das fraturas do colo, três (30% apresentaram retardo da consolidação, e duas consolidaram em varo. Dois pacientes apresentaram retardo de consolidação da fratura diafisária. Todas as fraturas associadas trans-diáfise apresentaram resultado funcional excelente ou bom. Das associadas colo-diáfise, sete (70% apresentaram resultado funcional excelente ou bom, dois regular e um ruim. CONCLUSÃO: As fraturas associadas da diáfise do fêmur com fratura transtrocantérica apresentaram melhor resultado radiográfico e funcional com menos complicações que a associação da fratura diafisária com a fratura do colo do fêmurOBJECTIVE: To perform a radiographic and functional evaluation of the complications of diaphyseal fractures of the femur associated with ipsilateral fractures of the trochanter or the neck of the femur. METHODS: From 2002 to 2007, seventeen patients were treated, of which 88% were men, with a mean age of thirty-one years and three months. Ten (59% had associated fractures of the femoral neck and seven (41% had associated trochanteric fractures. The final range of motion of the hip and knee, the radiographic fracture consolidation, and the type of

  7. Energy policy in transport and transport policy

    International Nuclear Information System (INIS)

    Van Dender, Kurt

    2009-01-01

    Explanations for, and indirect evidence of, imperfections in the market for private passenger vehicle fuel economy suggest there is a reasonable case for combining fuel economy standards and fuel or carbon taxes to contribute to an energy policy that aims to reduce greenhouse gas emissions and improve energy security. Estimates of key elasticities, including the rebound effect, indicate that the positive and negative side-effects of fuel economy measures on transport activities and external costs are limited. However, an energy policy for transport does not replace a transport policy that aims to manage the main transport externalities including congestion and local pollution. Conventional marginal cost estimates and standard cost-benefit reasoning suggest that policies that address congestion and local pollution likely bring benefits at least as large as those from fuel economy measures. But the large uncertainty on the possible effects of greenhouse gas emissions constitutes a strong challenge for standard cost-benefit reasoning. Emerging results from methods to cope with this uncertainty suggest that policies to stimulate the widespread adoption of low-carbon technologies in transport are justified.

  8. Energy policy in transport and transport policy

    Energy Technology Data Exchange (ETDEWEB)

    Van Dender, Kurt [Joint Transport Research Centre of the International Transport Forum and the OECD, 2 rue Andre Pascale, F-75775 Paris Cedex 16 (France)

    2009-10-15

    Explanations for, and indirect evidence of, imperfections in the market for private passenger vehicle fuel economy suggest there is a reasonable case for combining fuel economy standards and fuel or carbon taxes to contribute to an energy policy that aims to reduce greenhouse gas emissions and improve energy security. Estimates of key elasticities, including the rebound effect, indicate that the positive and negative side-effects of fuel economy measures on transport activities and external costs are limited. However, an energy policy for transport does not replace a transport policy that aims to manage the main transport externalities including congestion and local pollution. Conventional marginal cost estimates and standard cost-benefit reasoning suggest that policies that address congestion and local pollution likely bring benefits at least as large as those from fuel economy measures. But the large uncertainty on the possible effects of greenhouse gas emissions constitutes a strong challenge for standard cost-benefit reasoning. Emerging results from methods to cope with this uncertainty suggest that policies to stimulate the widespread adoption of low-carbon technologies in transport are justified. (author)

  9. EBS Radionuclide Transport Abstraction

    International Nuclear Information System (INIS)

    J. Prouty

    2006-01-01

    The purpose of this report is to develop and analyze the engineered barrier system (EBS) radionuclide transport abstraction model, consistent with Level I and Level II model validation, as identified in Technical Work Plan for: Near-Field Environment and Transport: Engineered Barrier System: Radionuclide Transport Abstraction Model Report Integration (BSC 2005 [DIRS 173617]). The EBS radionuclide transport abstraction (or EBS RT Abstraction) is the conceptual model used in the total system performance assessment (TSPA) to determine the rate of radionuclide releases from the EBS to the unsaturated zone (UZ). The EBS RT Abstraction conceptual model consists of two main components: a flow model and a transport model. Both models are developed mathematically from first principles in order to show explicitly what assumptions, simplifications, and approximations are incorporated into the models used in the TSPA. The flow model defines the pathways for water flow in the EBS and specifies how the flow rate is computed in each pathway. Input to this model includes the seepage flux into a drift. The seepage flux is potentially split by the drip shield, with some (or all) of the flux being diverted by the drip shield and some passing through breaches in the drip shield that might result from corrosion or seismic damage. The flux through drip shield breaches is potentially split by the waste package, with some (or all) of the flux being diverted by the waste package and some passing through waste package breaches that might result from corrosion or seismic damage. Neither the drip shield nor the waste package survives an igneous intrusion, so the flux splitting submodel is not used in the igneous scenario class. The flow model is validated in an independent model validation technical review. The drip shield and waste package flux splitting algorithms are developed and validated using experimental data. The transport model considers advective transport and diffusive transport

  10. EBS Radionuclide Transport Abstraction

    Energy Technology Data Exchange (ETDEWEB)

    J. Prouty

    2006-07-14

    The purpose of this report is to develop and analyze the engineered barrier system (EBS) radionuclide transport abstraction model, consistent with Level I and Level II model validation, as identified in Technical Work Plan for: Near-Field Environment and Transport: Engineered Barrier System: Radionuclide Transport Abstraction Model Report Integration (BSC 2005 [DIRS 173617]). The EBS radionuclide transport abstraction (or EBS RT Abstraction) is the conceptual model used in the total system performance assessment (TSPA) to determine the rate of radionuclide releases from the EBS to the unsaturated zone (UZ). The EBS RT Abstraction conceptual model consists of two main components: a flow model and a transport model. Both models are developed mathematically from first principles in order to show explicitly what assumptions, simplifications, and approximations are incorporated into the models used in the TSPA. The flow model defines the pathways for water flow in the EBS and specifies how the flow rate is computed in each pathway. Input to this model includes the seepage flux into a drift. The seepage flux is potentially split by the drip shield, with some (or all) of the flux being diverted by the drip shield and some passing through breaches in the drip shield that might result from corrosion or seismic damage. The flux through drip shield breaches is potentially split by the waste package, with some (or all) of the flux being diverted by the waste package and some passing through waste package breaches that might result from corrosion or seismic damage. Neither the drip shield nor the waste package survives an igneous intrusion, so the flux splitting submodel is not used in the igneous scenario class. The flow model is validated in an independent model validation technical review. The drip shield and waste package flux splitting algorithms are developed and validated using experimental data. The transport model considers advective transport and diffusive transport

  11. Transportation: Grade 8. Cluster IV.

    Science.gov (United States)

    Calhoun, Olivia H.

    A curriculum guide for grade 8, the document is devoted to the occupational cluster "Transportation." It is divided into five units: surface transportation, interstate transportation, air transportation, water transportation, and subterranean transportation (the Metro). Each unit is introduced by a statement of the topic, the unit's…

  12. Efeitos da fadiga muscular induzida por exercícios no tempo de reação muscular dos fibulares em indivíduos sadios Efectos de la fatiga muscular inducida por ejercicios sobre el tiempo de reacción muscular peronea en individuos sanos Effects of the exercise-induced muscular fatigue on the time of muscular reaction of the fibularis in healthy individuals

    Directory of Open Access Journals (Sweden)

    Bruno Araújo Rego Santos Silva

    2006-04-01

    Full Text Available A fadiga muscular (FM é um fenômeno comum nas atividades esportivas e diárias, resultando numa piora da performance motora. Ela é considerada um dos fatores causadores de lesões músculo-esqueléticas. A entorse de tornozelo é um exemplo: a FM afetaria tanto o sistema aferente quanto o eferente. Vários estudos têm analisado a influência da FM no controle neuromuscular (CNM; entretanto, existe pouca pesquisa sobre essa influência na velocidade de reação dos músculos. O objetivo deste estudo foi verificar os efeitos da FM no tempo de reação muscular (TRM dos músculos fibulares, que são os primeiros a responder a um estresse em inversão do tornozelo. Foram estudados 14 indivíduos saudáveis masculinos (idade: 20-35 anos, que tiveram seus TRM avaliados por meio de eletromiografia (EMG de superfície. O início da atividade muscular foi definido como a média de repouso + 3x o desvio-padrão (DP. O TRM dos fibulares foi mensurado após uma inversão súbita de 20º realizada numa plataforma. A inversão súbita foi realizada antes e depois da fadiga muscular, que foi induzida por exercícios localizados dos fibulares até a exaustão. Os resultados mostraram que houve um aumento significativo do tempo de reação muscular após a fadiga (p La fatiga muscular (FM es un fenómeno común en las actividades diarias, produciendo un empeoramiento de la actuación. Se la considera una de las causas de factores lesionantes musculares de esqueleto. El esguince del tobillo es un ejemplo: La FM afectaría tanto el sistema aferente cuanto el eferente. Varios estudios han estado analizando la influencia de FM en el comando neuromuscular (CNM, sin embargo, la existen pocas investigaciones sobre la influencia en la velocidad de reacción de los músculos. El objetivo de ese estudio era verificar los efectos de FM en el tiempo de reacción muscular (TRM de los músculos peroneos, que son los primeros en responder a una tensión en la inversi

  13. Transport Energy Efficiency

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    Transport is the sector with the highest final energy consumption and, without any significant policy changes, is forecast to remain so. In 2008, the IEA published 25 energy efficiency recommendations, among which four are for the transport sector. The recommendations focus on road transport and include policies on improving tyre energy efficiency, fuel economy standards for both light-duty vehicles and heavy-duty vehicles, and eco-driving. Implementation of the recommendations has been weaker in the transport sector than others. This paper updates the progress that has been made in implementing the transport energy efficiency recommendations in IEA countries since March 2009. Many countries have in the last year moved from 'planning to implement' to 'implementation underway', but none have fully implemented all transport energy efficiency recommendations. The IEA calls therefore for full and immediate implementation of the recommendations.

  14. Transportation Emissions: some basics

    DEFF Research Database (Denmark)

    Kontovas, Christos A.; Psaraftis, Harilaos N.

    2016-01-01

    transportation and especially carbon dioxide emissions are at the center stage of discussion by the world community through various international treaties, such as the Kyoto Protocol. The transportation sector also emits non-CO2 pollutants that have important effects on air quality, climate, and public health......Transportation is the backbone of international trade and a key engine driving globalization. However, there is growing concern that the Earth’s atmospheric composition is being altered by human activities, including transportation, which can lead to climate change. Air pollution from....... The main purpose of this chapter is to introduce some basic concepts that are relevant in the quest of green transportation logistics. First, we present the basics of estimating emissions from transportation activities, the current statistics and future trends, as well as the total impact of air emissions...

  15. Astrocytic GABA Transporters

    DEFF Research Database (Denmark)

    Schousboe, Arne; Wellendorph, Petrine; Frølund, Bente

    2017-01-01

    , and several of these compounds have been shown to exhibit pronounced anticonvulsant activity in a variety of animal seizure models. As proof of concept of the validity of this drug development approach, one GABA-transport inhibitor, tiagabine, has been developed as a clinically active antiepileptic drug......Inactivation of GABA-mediated neurotransmission is achieved by high-affinity transporters located at both GABAergic neurons and the surrounding astrocytes. Early studies of the pharmacological properties of neuronal and glial GABA transporters suggested that different types of transporters might...... be expressed in the two cell types, and such a scenario was confirmed by the cloning of four distinctly different GABA transporters from a number of different species. These GABA-transport entities have been extensively characterized using a large number of GABA analogues of restricted conformation...

  16. Transport of radioactive wastes

    International Nuclear Information System (INIS)

    Stuller, C.

    2003-01-01

    In this article author describes the system of transport and processing of radioactive wastes from nuclear power of Slovenske elektrarne, plc. It is realized the assurance of transport of liquid and solid radioactive wastes to processing links from places of their formation, or of preliminary storage and consistent transports of treated radioactive wastes fixed in cement matrix of fibre-concrete container into Rebublic storage of radioactive wastes in Mochovce

  17. Transport of radioactive materials

    International Nuclear Information System (INIS)

    1991-07-01

    The purpose of this Norm is to establish, relating to the TRANSPORT OF RADIOACTIVE MATERIALS, safety and radiological protection requirements to ensure an adequate control level of the eventual exposure of persons, properties and environment to the ionizing radiation comprising: specifications on radioactive materials for transport; package type selection; specification of the package design and acceptance test requirements; arrangements relating to the transport itself; administrative requirements and responsibilities. (author)

  18. Radioactive material air transportation

    International Nuclear Information System (INIS)

    Pader y Terry, Claudio Cosme

    2002-01-01

    As function of the high aggregated value, safety regulations and the useful life time, the air transportation has been used more regularly because is fast, reliable, and by giving great security to the cargo. Based on the International Atomic Energy Agency (IAEA), the IATA (International Air Transportation Association) has reproduced in his dangerous goods manual (Dangerous Goods Regulations - DGR IATA), the regulation for the radioactive material air transportation. Those documents support this presentation

  19. Handling and Transport Problems

    Energy Technology Data Exchange (ETDEWEB)

    Pomarola, J. [Head of Technical Section, Atomic Energy Commission, Saclay (France); Savouyaud, J. [Head of Electro-Mechanical Sub-Division, Atomic Energy Commission, Saclay (France)

    1960-07-01

    Arrangements for special or dangerous transport operations by road arising out of the activities of the Atomic Energy Commission are made by the Works and Installations Division which acts in concert with the Monitoring and Protection Division (MPD) whenever radioactive substances or appliances are involved. In view of the risk of irradiation and contamination entailed in handling and transporting radioactive substances, including waste, a specialized transport and storage team has been formed as a complement to the emergency and decontamination teams.

  20. Transport Nuclear Liability Insurance

    International Nuclear Information System (INIS)

    Folens, M.

    2006-01-01

    Although transport of nuclear substances represents only a very small part of the global transport of dangerous goods, it takes place every day all over the world and it is part of our daily life. Transport of nuclear material takes also place at every stage of the nuclear fuel cycle; radioactive materials are carried out all over the world by all major modes of transport: sea, air, road and rail. Despite the large number of nuclear transports, they are not considered as posing a serious risk. A major nuclear incident is almost always associated with the operating of fixed installations such as nuclear power plants; just think about Three Mile Island and Chernobyl. This perception is strengthened by the absence so far of serious accidents in the nuclear transport sector and this finding is in fact proof of the very safe conditions of nuclear transport. But accidents can never be excluded entirely and in some cases damages could be as large as those caused by fixed installations. This means that protection of the interests of possible victims should also be covered in a correct way. That is why the special nuclear liability regime has also been developed to cover damage caused by a nuclear transport accident. As stated by Patrick Reyners, the prime motivation for originally adopting a special nuclear regime was the harmonisation of national legislation and that nowhere more than in the field of international transport operations is such harmonisation felt desirable . The international legal regime has been developed along two tracks, one based on the mode of transport and the other based on the notion of dangerous goods. The linkage between those two tracks is of permanent concern and the mode of transport is the key element to determine which international instrument should be applicable. The purpose of this paper is to briefly introduce the financial security provided by the insurance industry to cover the international nuclear liability regime for nuclear

  1. Freight transport and intermodality

    OpenAIRE

    Barbero Mañanes, Eduardo

    2010-01-01

    During recent decades, there has been very substantial growth in the freight transport sector. Freight transport is increasing faster than the economy or passenger transport. Demand is increasing more rapidly than supply and is resulting in environmental and social problems. Increasing congestion, too, is affecting efficient and reliable freight distribution, and consequently having a deleterious effect on local economies. Intermodality is therefore needed to make better use of alternative mo...

  2. Climate Change and Transportation

    OpenAIRE

    Yevdokimov, Yuri

    2010-01-01

    As stated at the beginning of this chapter, the relationship between transportation and climate is two-directional. Based on our statistical analysis performed for Canada, we can make some general conclusions about this relationship. On the one hand, transportation is one of the largest contributors to GHG emissions which, in turn, cause various changes in climate. On the other hand, these climate changes negatively affect transportation in terms of its infrastructure and operations. Therefor...

  3. Transport barriers in plasmas

    International Nuclear Information System (INIS)

    Caldas, I L; Szezech, J D Jr; Kroetz, T; Marcus, F A; Roberto, M; Viana, R L; Lopes, S R

    2012-01-01

    We discuss the creation of transport barriers in magnetically confined plasmas with non monotonic equilibrium radial profiles. These barriers reduce the transport in the shearless region (i.e., where the twist condition does not hold). For the chaotic motion of particles in an equilibrium electric field with a nonmonotonic radial profile, perturbed by electrostatic waves, we show that a nontwist transport barrier can be created in the plasma by modifying the electric field radial profile. We also show non twist barriers in chaotic magnetic field line transport in the plasma near to the tokamak wall with resonant modes due to electric currents in external coils.

  4. Urban transportation projects conceptualised:

    DEFF Research Database (Denmark)

    Pineda, Andres Felipe Valderrama

    is straightforward: transportation projects transform cities. The paradoxical reality thus is that a problem that has been traditionally conceptualized in technical terms (transportation engineering, transportation economics, planning theory, traffic engineering, urban planning, etc.), has tremendous consequences...... operation when discussing transportation projects in big cities. The tradition of Science and Technology Studies might have provided some clues. In the following paper we discuss the most prominent aspects of some theories in STS in order to understand and conceptualize the cases of Bogotá and Copenhagen...

  5. WASTE PACKAGE TRANSPORTER DESIGN

    International Nuclear Information System (INIS)

    Weddle, D.C.; Novotny, R.; Cron, J.

    1998-01-01

    The purpose of this Design Analysis is to develop preliminary design of the waste package transporter used for waste package (WP) transport and related functions in the subsurface repository. This analysis refines the conceptual design that was started in Phase I of the Viability Assessment. This analysis supports the development of a reliable emplacement concept and a retrieval concept for license application design. The scope of this analysis includes the following activities: (1) Assess features of the transporter design and evaluate alternative design solutions for mechanical components. (2) Develop mechanical equipment details for the transporter. (3) Prepare a preliminary structural evaluation for the transporter. (4) Identify and recommend the equipment design for waste package transport and related functions. (5) Investigate transport equipment interface tolerances. This analysis supports the development of the waste package transporter for the transport, emplacement, and retrieval of packaged radioactive waste forms in the subsurface repository. Once the waste containers are closed and accepted, the packaged radioactive waste forms are termed waste packages (WP). This terminology was finalized as this analysis neared completion; therefore, the term disposal container is used in several references (i.e., the System Description Document (SDD)) (Ref. 5.6). In this analysis and the applicable reference documents, the term ''disposal container'' is synonymous with ''waste package''

  6. WASTE PACKAGE TRANSPORTER DESIGN

    Energy Technology Data Exchange (ETDEWEB)

    D.C. Weddle; R. Novotny; J. Cron

    1998-09-23

    The purpose of this Design Analysis is to develop preliminary design of the waste package transporter used for waste package (WP) transport and related functions in the subsurface repository. This analysis refines the conceptual design that was started in Phase I of the Viability Assessment. This analysis supports the development of a reliable emplacement concept and a retrieval concept for license application design. The scope of this analysis includes the following activities: (1) Assess features of the transporter design and evaluate alternative design solutions for mechanical components. (2) Develop mechanical equipment details for the transporter. (3) Prepare a preliminary structural evaluation for the transporter. (4) Identify and recommend the equipment design for waste package transport and related functions. (5) Investigate transport equipment interface tolerances. This analysis supports the development of the waste package transporter for the transport, emplacement, and retrieval of packaged radioactive waste forms in the subsurface repository. Once the waste containers are closed and accepted, the packaged radioactive waste forms are termed waste packages (WP). This terminology was finalized as this analysis neared completion; therefore, the term disposal container is used in several references (i.e., the System Description Document (SDD)) (Ref. 5.6). In this analysis and the applicable reference documents, the term ''disposal container'' is synonymous with ''waste package''.

  7. EUROPEAN MARITIME TRANSPORT POLICY

    Directory of Open Access Journals (Sweden)

    Jerzy Kujawa

    2014-03-01

    Full Text Available The article describes the common EU policy on maritime transport, which comprises almost 80% of the volume of external trade of the Union and about 40% of internal transport needs. The first part of the paper presents the origins of the common maritime transport policy and the difficulties encountered during its initial formation. Subsequently, the evolution of the concepts of the policy and its current shape is discussed. The final, substantial part of the article describes the main aims and directions of the EU maritime transport policy and includes an evaluation of the effects of the policy.

  8. Intelligent Freigth Transport Systems

    DEFF Research Database (Denmark)

    Overø, Helene Martine; Larsen, Allan; Røpke, Stefan

    2009-01-01

    is to enhance the efficiency and lower the environmental impact in freight transport. In this paper, a pilot project involving real-time waste collection at a Danish waste collection company is described, and a solution approach is proposed. The problem corresponds to the dynamic version of the waste collection......The Danish innovation project entitled “Intelligent Freight Transport Systems” aims at developing prototype systems integrating public intelligent transport systems (ITS) with the technology in vehicles and equipment as well as the IT-systems at various transport companies. The objective...

  9. Moisture Transport in Wood

    DEFF Research Database (Denmark)

    Astrup, Thomas; Hansen, Kurt Kielsgaard; Hoffmeyer, Preben

    2005-01-01

    Modelling of moisture transport in wood is of great importance as most mechanical and physical properties of wood depend on moisture content. Moisture transport in porous materials is often described by Ficks second law, but several observations indicate that this does not apply very well to wood....... Recently at the Technical University of Denmark, Department of Civil Engineering, a new model for moisture transport in wood has been developed. The model divides the transport into two phases, namely water vapour in the cell lumens and bound water in the cell walls....

  10. UZ Colloid Transport Model

    International Nuclear Information System (INIS)

    McGraw, M.

    2000-01-01

    The UZ Colloid Transport model development plan states that the objective of this Analysis/Model Report (AMR) is to document the development of a model for simulating unsaturated colloid transport. This objective includes the following: (1) use of a process level model to evaluate the potential mechanisms for colloid transport at Yucca Mountain; (2) Provide ranges of parameters for significant colloid transport processes to Performance Assessment (PA) for the unsaturated zone (UZ); (3) Provide a basis for development of an abstracted model for use in PA calculations

  11. Heavy transport problems

    International Nuclear Information System (INIS)

    Haas, K.F.

    1975-01-01

    Assuming that very often a long transport route from the factory of the manufacturer to the provided site has to be reckoned with, in general only transport with a ship is possible. As each site is only called by a certain steamship line, at a very early stage of planning the nuclear power plant the possibilities and capacities of the lines and means of transportation under discussion should be investigated. In planning the unloading equipment at the site, due consideration should be given to the fact that at a later time this equipment should also be suitable for the transport of heavy components and spent fuel assemblies. (orig.) [de

  12. Heme transport and erythropoiesis

    Science.gov (United States)

    Yuan, Xiaojing; Fleming, Mark D.; Hamza, Iqbal

    2013-01-01

    In humans, systemic heme homeostasis is achieved via coordinated regulation of heme synthesis, transport and degradation. Although the heme biosynthesis and degradation pathways have been well characterized, the pathways for heme trafficking and incorporation into hemoproteins remains poorly understood. In the past few years, researchers have exploited genetic, cellular and biochemical tools, to identify heme transporters and, in the process, reveal unexpected functions for this elusive group of proteins. However, given the complexity of heme trafficking pathways, current knowledge of heme transporters is fragmented and sometimes contradictory. This review seeks to focus on recent studies on heme transporters with specific emphasis on their functions during erythropoiesis. PMID:23415705

  13. Hopping transport in solids

    CERN Document Server

    Pollak, M

    1991-01-01

    The hopping process, which differs substantially from conventional transport processes in crystals, is the central process in the transport phenomena discussed in this book. Throughout the book the term ``hopping'' is defined as the inelastic tunneling transfer of an electron between two localized electronic states centered at different locations. Such processes do not occur in conventional electronic transport in solids, since localized states are not compatible with the translational symmetry of crystals.The rapid growth of interest in hopping transport has followed in the footsteps of the

  14. Innominate Vein Stenosis in Association with Ipsilateral Hyperdynamic Brachiobasilic Fistula Causing Ipsilateral Limb and Hemifacial Swelling.

    Science.gov (United States)

    Narendra, J B; Sreenivas, J; Karthikeyan, V S; Nagaraja, N H

    2017-01-01

    A 34-year-old hypertensive woman with a hyperdynamic, left brachiobasilic dialysis fistula presented with a long history of throbbing in her head and swelling of the left side of the face. Tight stenosis of left brachiocephalic vein was found to be causing retrograde flow into the left jugular vein which normalized after dilatation and stenting with resolution of all the symptoms and patient is asymptomatic for 1 year.

  15. Canadian pipeline transportation system : transportation assessment

    International Nuclear Information System (INIS)

    2009-07-01

    In addition to regulating the construction and operation of 70,000 km of oil and natural gas pipelines in Canada, the National Energy Board (NEB) regulates the trade of natural gas, oil and natural gas liquids. This report provided an assessment of the Canadian hydrocarbon transportation system in relation to its ability to provide a robust energy infrastructure. Data was collected from NEB-regulated pipeline companies and a range of publicly available sources to determine if adequate pipeline capacity is in place to transport products to consumers. The NEB also used throughput and capacity information received from pipeline operators as well as members of the investment community. The study examined price differentials compared with firm service tolls for transportation paths, as well as capacity utilization on pipelines and the degree of apportionment on major oil pipelines. This review indicated that in general, the Canadian pipeline transportation system continues to work effectively, with adequate pipeline capacity in place to move products to consumers who need them. 9 tabs., 30 figs., 3 appendices.

  16. Passenger transport research

    CSIR Research Space (South Africa)

    Mokonyama, Mathetha T

    2008-03-01

    Full Text Available In South Africa, airport and airline services epitomise what many would like to see in everyday public transport. The CSIR investigates what it will take to provide a commercial public transport service in South Africa which resembles commercial air...

  17. Bronchial mucus transport

    NARCIS (Netherlands)

    van der Schans, Cees P.

    Effective clearance of inhaled particles requires mucus production and continuous mucus transport from the lower airways to the oropharynx. Mucus production takes place mainly in the peripheral airways. Mucus transport is achieved by the action of the ciliated cells that cover the inner surface of

  18. Biofuels for sustainable transportation

    Energy Technology Data Exchange (ETDEWEB)

    Neufeld, S.

    2000-05-23

    Biomass is an attractive energy source, and transportation fuels made from biomass offer a number of benefits. Developing the technology to produce and use biofuels will create transportation fuel options that can positively impact the national energy security, the economy, and the environment. Biofuels include ethanol, methanol, biodiesel, biocrude, and methane.

  19. Emissions of road transport

    International Nuclear Information System (INIS)

    Maekelae, K.; Tuominen, A.

    2001-01-01

    Information on the emissions and energy consumption of different vehicles per transported amount of goods has up to last years been minimal. The unit emissions mean the amount of harmful compounds in the flue gases of a vehicle per service, time or energy unit. National three-year MOBILE 2-research program, started in 1999, determines the unit emissions of all the traffic sectors in Finland. VTT Building and Transport mainly carry out the research, but the Institute of Transportation Engineering of the Tampere University of Technology (TTKK) is responsible for a part of the research. The objective of the project is to create common rules for the determination of unit emissions values, and to determine the best possible values for Finnish conditions. Unit emission data is mainly needed for evaluation of the environmental impacts of production plants and other activities containing transportation of commodities. At the web sites of VTT Building and Transport there are about 60 pages of text and tables (about 4000 values) on unit emissions. The URL of the pages is http://www.vtt.fi/rte/projects/lipastoe/index.htm. These web pages present data on all the transportation sectors (road, railroad, water and air transportation), most of the materials concerning road transportation. Following compounds and values are included: CO, HC, NO x , particulates, SO 2 , CO 2 and energy consumption. Methane and nitrous oxide emissions values have also been presented

  20. Trajectory structures and transport

    International Nuclear Information System (INIS)

    Vlad, Madalina; Spineanu, Florin

    2004-01-01

    The special problem of transport in two-dimensional divergence-free stochastic velocity fields is studied by developing a statistical approach, the nested subensemble method. The nonlinear process of trapping determined by such fields generates trajectory structures whose statistical characteristics are determined. These structures strongly influence the transport

  1. Porters and neurotransmitter transporters

    NARCIS (Netherlands)

    Nelson, Nathan; Lill, H

    1994-01-01

    Uptake of neurotransmitters involves multiple transporters acting in different brain locations under different physiological conditions. The vesicular transporters are driven by a proton-motive force generated by a V-ATPase and their substrates are taken up via proton/substrate exchange. The plasma

  2. Nuclear materials transportation

    International Nuclear Information System (INIS)

    Ushakov, B.A.

    1986-01-01

    Various methods of nuclear materials transportation at different stages of the fuel cycle (U 3 O 8 , UF 6 production enrichment, fuel element manufacturing, storage) are considered. The advantages and drawbacks of railway, automobile, maritime and air transport are analyzed. Some types of containers are characterized

  3. Human peptide transporters

    DEFF Research Database (Denmark)

    Nielsen, Carsten Uhd; Brodin, Birger; Jørgensen, Flemming Steen

    2002-01-01

    Peptide transporters are epithelial solute carriers. Their functional role has been characterised in the small intestine and proximal tubules, where they are involved in absorption of dietary peptides and peptide reabsorption, respectively. Currently, two peptide transporters, PepT1 and PepT2, wh...

  4. Transport of plutonium nitrate

    International Nuclear Information System (INIS)

    1982-02-01

    This leaflet discusses the subject under the headings: why do we need plutonium; why must we transport it; what action is carried out; how is it moved; what are the risks. The transport of the material in specially designed containers, from Dounreay in Caithness by road and sea to Sellafield in Cumbria, is described. (U.K.)

  5. Electronic transport properties

    International Nuclear Information System (INIS)

    Young, W.H.

    1985-01-01

    The theory of the electron transport properties of liquid alkali metals is described. Conductivity coefficients, Boltzmann theory, Ziman theory, alkali form factors, Ziman theory and alkalis, Faber-Ziman alloy theory, Faber-Ziman theory and alkali-alkali methods, status of Ziman theory, and other transport properties, are all discussed. (UK)

  6. Transport and Sustainability

    DEFF Research Database (Denmark)

    Jørgensen, Kaj

    1997-01-01

    Ph.D. study of the scope for sustainable transport in Denmark, and particularly of the role of the motor vehicle in this context. The distribution of groceries is used as case study of the introduction of the motor vehicle in Denmark, concluding that this has resulted in increases of the transport...

  7. Macropores and macropore transport

    DEFF Research Database (Denmark)

    Iversen, Bo Vangsø; Lamandé, Mathieu; Torp, Søren Bent

    2012-01-01

    Preferential transport of water through soil macropores is a governing process in the facilitated transport of strongly sorbing compounds. The aim of this study was to investigate the relationships between macropore density and the hydraulic conductivity of the soil and to test the sampling...

  8. Transport in the Nordic countries

    International Nuclear Information System (INIS)

    Gustafsson, B.; Pettersson, S.; Vilkamo, S.

    1989-01-01

    Transport of radioactive material from different fields of operation is well advanced in the Nordic countries: waste from the medical sector, industry, research, and now in increasing amounts from reactor operation, including spent fuel. In the future, waste from decommissioning will also be transported. This report gives the amount of radioactive waste material to be transported in the Nordic countries. Transport routes, transport containers, and transport systems are described. Legislations and transport regulatins are discussed. (author)

  9. Planning Public Transport

    DEFF Research Database (Denmark)

    Andersen, Jonas Lohmann Elkjær; Landex, Alex

    2009-01-01

    This good practice guide is composed for the master course 13120 Public Transport Planning held at the Department of Transport, Technical University of Denmark. It is intended to use as guide in the different planning aspects and assignments of the course. Since the course is about the planning...... of new public transport infrastructure this guide also focuses on the planning of new infrastructure. Furthermore, the new infrastructure in the course is expected to be a light rail and even though this guide aims at being general for public transport some of the issues evidently become more relevant...... will enable a capability for planning both bus and rail. The guide is build as a full sketch investigation of a new public transport project ranging chronological from project clarification to physical and timetable planning to traffic modeling and project appraisal. The same steps that are expected...

  10. Porters and neurotransmitter transporters.

    Science.gov (United States)

    Nelson, N; Lill, H

    1994-11-01

    Uptake of neurotransmitters involves multiple transporters acting in different brain locations under different physiological conditions. The vesicular transporters are driven by a proton-motive force generated by a V-ATPase and their substrates are taken up via proton/substrate exchange. The plasma membrane transporters are driven by an electrochemical gradient of sodium generated by a Na+/K(+)-ATPase. Two distinct families of transporters were identified in this group. One cotransports sodium with glutamate and other amino acids and requires additionally an outwardly directed potassium gradient. The second cotransports sodium, chloride and a variety of neurotransmitters, including gamma-aminobutyric acid (GABA), glycine and monoamines. Genes and cDNA encoding several members of the latter family have been cloned and studied in detail. The structure and function as well as the evolutionary relationships among these neurotransmitter transporters are discussed.

  11. Fuel transporting device

    International Nuclear Information System (INIS)

    Shiratori, Hirozo.

    1979-01-01

    Purpose: In a liquid-metal cooled reactor, to reduce the waiting time of fuel handling apparatuses and shorten the fuel exchange time. Constitution: A fuel transporting machine is arranged between a reactor vessel and an out-pile storage tank, thereby dividing the transportation line of the pot for contracting fuel and transporting the same. By assuming such a construction, the flow of fuel transportation which has heretofore been carried out through fuel transportation pipes is not limited to one direction but the take-out of fuels from the reactor and the take-in thereof from the storage tank can be carried out constantly, and much time is not required for fuel exchange. (Kamimura, M.)

  12. Fuelling tomorrow's transport

    International Nuclear Information System (INIS)

    Cadwallader, S.; Donovan, N.

    1995-11-01

    Fuelling Tomorrow's Transport provides a thorough analysis of key industry trends; developments in technology, fuel use and efficiency; environmental and legislative constraints; and company and governmental policy. It discusses in detail the changes facing the transport industry and analyses how the various technological, political and economic developments will affect the industry into the next century. Key issues addressed include: current and future fuel use in road, marine and aviation transport; growth in the transport sector and the impact on the oil market; likely scenarios for future transport fuelling; the latest developments in alternative fuels and engines, including electricity, natural gas, nuclear power and liquid hydrogen, and the commercial feasibility of these technologies; government policy and current and proposed legislative and fiscal incentives for the development and take-up of alternative fuels and engines; the driving force of the environmental debate; the current research and development programmes of individual companies; and the commercial openings offered by these developments. (author)

  13. Transport, environment and sustainability

    DEFF Research Database (Denmark)

    Joumard, Robert; Gudmundsson, Henrik; Kehagia, Fotini

    2010-01-01

    This report is the final report of the action COST 356 'EST - Towards the definition of a measurable environmentally sustainable transport'. It tries to answer the following questions: How can environmental impacts of transport be measured? How can measurements be transformed into operational...... indicators? How can several indicators be jointly considered? And how can indicators be used in planning and decision making? Firstly we provide definition of 'indicator of environmental sustainability in transport'. The functions, strengths and weaknesses of indicators as measurement tools, and as decision...... support tools are discussed. We define what "environmental sustainability in transport" may mean through the transport system, the concepts of sustainable development and of environment. The concept of 'chain of causality' between a source and a final target is developed, as a common reference...

  14. Logistic innovations in transport

    Directory of Open Access Journals (Sweden)

    Mirosław Antonowicz

    2014-03-01

    Full Text Available Introduction: The article discusses the issue of logistic innovations in transport. The essentials of logistic innovations in transport together with some examples of specific innovations are presented. The role of the client's needs in transport innovations is indicated. The most vital postulates affecting the innovativeness of shipping companies and derived from the author's experience as well as scholarly publications, are time, safety, reliability as well as comprehensiveness of service offer. Following the analysis of the issue, and on the grounds of Kaizen's and Lean's method, the concept of continuous innovations is suggested as very useful for the development of transport. The potential of clusters as the source of logistic innovations in transport is emphasised. Methods: The discussion of the issue was preceded by the author's analysis of written sources on innovativeness, the evaluation of ratings of innovativeness as well as the analysis of rewarded innovative solutions in transport subsequent to the businesses participation in the programme of innovative solutions in transport. The role of innovation practical business operations is argued following the analysis of some strategic documents such as: 2011 White Paper and the Strategy for the Development of Transport by 2020 adopted by the Polish government in 2013. Aim: The aim of the article is to present the role and significance of the issue of logistic innovations in transport and to cite instances of practical solutions implemented by shipping companies, the solutions which resulted in measurable effects. Following the author's observation of the instances of innovative solutions as well as his analysis of the ratings of innovativeness, the article aims to present the conclusions as for the specific kinds of activities which are indispensable to foster innovativeness in transport. Conclusions: The conclusions derived from the author's analyses and observations show that logistic

  15. Transportation Consumer Education Curriculum Guide.

    Science.gov (United States)

    Finn, Peter; And Others

    Materials in this curriculum guide represent a selection of the major transportation consumer topics and ideas and are designed to set the stage for more intensive transportation consumer education curriculum development and teacher efforts. (Eleven manuals covering the four transportation topics of public transportation, transportation and the…

  16. Children and transportation

    Energy Technology Data Exchange (ETDEWEB)

    Anon

    2003-12-09

    This issue of the 'Sustainable Transportation Monitor', published by the Centre for Sustainable Transportation located in Mississauga, Ontario, reports on key findings from a project involving children and transportation in the Halton and Peel regions of Ontario, recently completed by the Centre. Excerpts from the report summarized in this issue include data on children's travel in Halton and Peel, and a discussion on possible contribution of transport practices to the growing incidence of obesity among Canadian children. Results of the study indicate that until about age 18, travel by children on schooldays is dominated by the journey to and from school. School bus is the choice of 28 per cent, and passenger car by 23 per cent among 11-to-14- year-olds; the share of travel by car is larger for older young people and also likely larger among 6-to-10-year-olds. Physical inactivity has been highlighted as the contributing factor to excess body weight and obesity in this, and other studies. Data collected for this study corroborates the findings of other studies by showing a positive correlation between obesity and transport energy use in 18 affluent countries, suggesting that a high level of use of motorized transport contributes to inactivity and body weight gain. Several alternate means of transportation, with the potential to combat obesity, are proposed. 46 refs.

  17. Canadian hydrocarbon transportation system : transportation assessment

    International Nuclear Information System (INIS)

    2006-06-01

    This document provided an assessment of the Canadian hydrocarbon transportation system. In addition to regulating the construction and operation of Canada's 45,000 km of pipeline that cross international and provincial borders, Canada's National Energy Board (NEB) regulates the trade of natural gas, oil and natural gas liquids. The ability of pipelines to delivery this energy is critical to the country's economic prosperity. The pipeline system includes large-diameter, cross-country, high-pressure natural gas pipelines, low-pressure crude oil and oil products pipelines and small-diameter pipelines. In order to assess the hydrocarbon transportation system, staff at the NEB collected data from pipeline companies and a range of publicly available sources. The Board also held discussions with members of the investment community regarding capital markets and emerging issues. The assessment focused largely on evaluating whether Canadians benefit from an efficient energy infrastructure and markets. The safety and environmental integrity of the pipeline system was also evaluated. The current adequacy of pipeline capacity was assessed based on price differentials compared with firm service tolls for major transportation paths; capacity utilization on pipelines; and, the degree of apportionment on major oil pipelines. The NEB concluded that the Canadian hydrocarbon transportation system is working effectively, with an adequate capacity in place on existing natural gas pipelines, but with a tight capacity on oil pipelines. It was noted that shippers continue to indicate that they are reasonably satisfied with the services provided by pipeline companies and that the NEB-regulated pipeline companies are financially stable. 14 refs, 11 tabs., 28 figs., 4 appendices

  18. Transports and environment; Transports et environnements

    Energy Technology Data Exchange (ETDEWEB)

    Anon,

    2004-07-01

    In the framework of the greenhouse gases reduction, this study proposes many advices to control the fuel consumption of the vehicles and to change habits in the transportation sector. It presents also the alternatives to the pollutant today vehicles in the domain of the vehicles and buses fuels but also the new motors. Many Internet addresses are provided to complete the presentation. (A.L.B.)

  19. Transport of hazardous goods

    International Nuclear Information System (INIS)

    1989-01-01

    The course 'Transport of hazardous goods' was held in Berlin in November 1988 in cooperation with the Bundesanstalt fuer Materialforschung und -pruefung. From all lecturs, two are recorded separately: 'Safety of tank trucks - requirements on the tank, development possibiities of active and passive safety' and 'Requirements on the transport of radioactive materials - possible derivations for other hazardous goods'. The other lectures deal with hazardous goods law, requirements on packinging, risk assessment, railroad transport, hazardous goods road network, insurance matters, EC regulations, and waste tourism. (HSCH) [de

  20. TRANSPORTATION SYSTEM REQUIREMENTS DOCUMENT

    International Nuclear Information System (INIS)

    2004-01-01

    This document establishes the Transportation system requirements for the U.S. Department of Energy's (DOE's) Civilian Radioactive Waste Management System (CRWMS). These requirements are derived from the Civilian Radioactive Waste Management System Requirements Document (CRD). The Transportation System Requirements Document (TSRD) was developed in accordance with LP-3.1Q-OCRWM, Preparation, Review, and Approval of Office of National Transportation Level-2 Baseline Requirements. As illustrated in Figure 1, the TSRD forms a part of the DOE Office of Civilian Radioactive Waste Management (OCRWM) Technical Baseline

  1. Transport in stellarators

    International Nuclear Information System (INIS)

    Maassberg, H.; Brakel, R.; Burhenn, R.; Gasparino, U.; Grigull, P.; Kick, M.; Kuehner, G.; Ringler, H.; Sardei, F.; Stroth, U.; Weller, A.

    1993-01-01

    The local electron and ion heat transport as well as the particle and impurity transport properties in stellarators are reviewed. In this context, neoclassical theory is used as a guideline for the comparison of the experimental results of the quite different confinement concepts. At sufficiently high temperatures depending on the specific magnetic configuration, neoclassical predictions are confirmed by experimental findings. The confinement properties in the LMFP collisionality regime are discussed with respect to the next stellarator generation, for which at higher temperatures the neoclassical transport is expected to become more important. (orig.)

  2. CNG transport opportunities

    International Nuclear Information System (INIS)

    Anon

    2000-01-01

    The recent announcement by the Australian Government of funding for a dramatic increase in supply infrastructure for Compressed Natural Gas (CNG) powered vehicles has shored up predictions that natural gas will achieve a thirty-fold increase in its share of the Australian transport energy market by 2015. This projection, would put sales of natural gas for transport fuel in the year 2014/15 at about 10% of current retail sales across the nation. In the general transport sector, the lower particulate and noise pollution, compared with diesel-powered vehicles, is a significant advantage

  3. Means of Transport

    DEFF Research Database (Denmark)

    Balle, Søren Hattesen

    The car is probably one of the most central signifiers of modern scientific and technological progress. Not only did its introduction in early 20th century America quite literally move scientific progress into the street, it also provided its increasing number of users with new and technologically....... According to film theorist Julian Smith, the automobile has been just as much “embraced … as a form of emotional transport, the state or condition of being transported by ecstasy” as “perceived as a mode of transportation in the primary and ordinary sense of the word.” This paper analyses the ways in which...

  4. Transport Coefficients of Fluids

    CERN Document Server

    Eu, Byung Chan

    2006-01-01

    Until recently the formal statistical mechanical approach offered no practicable method for computing the transport coefficients of liquids, and so most practitioners had to resort to empirical fitting formulas. This has now changed, as demonstrated in this innovative monograph. The author presents and applies new methods based on statistical mechanics for calculating the transport coefficients of simple and complex liquids over wide ranges of density and temperature. These molecular theories enable the transport coefficients to be calculated in terms of equilibrium thermodynamic properties, and the results are shown to account satisfactorily for experimental observations, including even the non-Newtonian behavior of fluids far from equilibrium.

  5. EBS Radionuclide Transport Abstraction

    Energy Technology Data Exchange (ETDEWEB)

    J.D. Schreiber

    2005-08-25

    The purpose of this report is to develop and analyze the engineered barrier system (EBS) radionuclide transport abstraction model, consistent with Level I and Level II model validation, as identified in ''Technical Work Plan for: Near-Field Environment and Transport: Engineered Barrier System: Radionuclide Transport Abstraction Model Report Integration'' (BSC 2005 [DIRS 173617]). The EBS radionuclide transport abstraction (or EBS RT Abstraction) is the conceptual model used in the total system performance assessment for the license application (TSPA-LA) to determine the rate of radionuclide releases from the EBS to the unsaturated zone (UZ). The EBS RT Abstraction conceptual model consists of two main components: a flow model and a transport model. Both models are developed mathematically from first principles in order to show explicitly what assumptions, simplifications, and approximations are incorporated into the models used in the TSPA-LA. The flow model defines the pathways for water flow in the EBS and specifies how the flow rate is computed in each pathway. Input to this model includes the seepage flux into a drift. The seepage flux is potentially split by the drip shield, with some (or all) of the flux being diverted by the drip shield and some passing through breaches in the drip shield that might result from corrosion or seismic damage. The flux through drip shield breaches is potentially split by the waste package, with some (or all) of the flux being diverted by the waste package and some passing through waste package breaches that might result from corrosion or seismic damage. Neither the drip shield nor the waste package survives an igneous intrusion, so the flux splitting submodel is not used in the igneous scenario class. The flow model is validated in an independent model validation technical review. The drip shield and waste package flux splitting algorithms are developed and validated using experimental data. The transport

  6. EBS Radionuclide Transport Abstraction

    International Nuclear Information System (INIS)

    J.D. Schreiber

    2005-01-01

    The purpose of this report is to develop and analyze the engineered barrier system (EBS) radionuclide transport abstraction model, consistent with Level I and Level II model validation, as identified in ''Technical Work Plan for: Near-Field Environment and Transport: Engineered Barrier System: Radionuclide Transport Abstraction Model Report Integration'' (BSC 2005 [DIRS 173617]). The EBS radionuclide transport abstraction (or EBS RT Abstraction) is the conceptual model used in the total system performance assessment for the license application (TSPA-LA) to determine the rate of radionuclide releases from the EBS to the unsaturated zone (UZ). The EBS RT Abstraction conceptual model consists of two main components: a flow model and a transport model. Both models are developed mathematically from first principles in order to show explicitly what assumptions, simplifications, and approximations are incorporated into the models used in the TSPA-LA. The flow model defines the pathways for water flow in the EBS and specifies how the flow rate is computed in each pathway. Input to this model includes the seepage flux into a drift. The seepage flux is potentially split by the drip shield, with some (or all) of the flux being diverted by the drip shield and some passing through breaches in the drip shield that might result from corrosion or seismic damage. The flux through drip shield breaches is potentially split by the waste package, with some (or all) of the flux being diverted by the waste package and some passing through waste package breaches that might result from corrosion or seismic damage. Neither the drip shield nor the waste package survives an igneous intrusion, so the flux splitting submodel is not used in the igneous scenario class. The flow model is validated in an independent model validation technical review. The drip shield and waste package flux splitting algorithms are developed and validated using experimental data. The transport model considers

  7. NJ transportation fact book, 2007

    Science.gov (United States)

    2010-01-01

    The New Jersey Transportation Fact Book 2006-07 presents information about the New Jersey Department of Transportation : and other agencies that provide transportation services in New Jersey. We hope it will prove helpful.

  8. National Transportation Atlas Databases : 2013.

    Science.gov (United States)

    2013-01-01

    The National Transportation Atlas Databases 2013 (NTAD2013) is a set of nationwide geographic datasets of transportation facilities, transportation networks, associated infrastructure, and other political and administrative entities. These datasets i...

  9. National Transportation Atlas Databases : 2015.

    Science.gov (United States)

    2015-01-01

    The National Transportation Atlas Databases 2015 (NTAD2015) is a set of nationwide geographic datasets of transportation facilities, transportation networks, associated infrastructure, and other political and administrative entities. These datasets i...

  10. National Transportation Atlas Databases : 2012.

    Science.gov (United States)

    2012-01-01

    The National Transportation Atlas Databases 2012 (NTAD2012) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  11. National Transportation Atlas Databases : 2011.

    Science.gov (United States)

    2011-01-01

    The National Transportation Atlas Databases 2011 (NTAD2011) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  12. National Transportation Atlas Databases : 2009.

    Science.gov (United States)

    2009-01-01

    The National Transportation Atlas Databases 2009 (NTAD2009) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  13. National Transportation Atlas Databases : 2014.

    Science.gov (United States)

    2014-01-01

    The National Transportation Atlas Databases 2014 (NTAD2014) is a set of nationwide geographic datasets of transportation facilities, transportation networks, associated infrastructure, and other political and administrative entities. These datasets i...

  14. National Transportation Atlas Databases : 2010.

    Science.gov (United States)

    2010-01-01

    The National Transportation Atlas Databases 2010 (NTAD2010) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  15. Development of Indian passenger transport

    Energy Technology Data Exchange (ETDEWEB)

    Ramanathan, R. [Indira Ghandi Institute of Development Research, Mumbai (India)

    1998-05-01

    The Indian transport sector has been studied using logistic substitution. The share of rail transport is declining, while road and air transport are increasing. These developments are not desirable from an energy-efficiency perspective. (author)

  16. Transportation statistics annual report 2010

    Science.gov (United States)

    2011-01-01

    The Transportation Statistics Annual Report (TSAR) presents data and information compiled by the Bureau of Transportation Statistics (BTS), a component of the U.S. Department of Transportations (USDOTs) Research and Innovative Technology Admini...

  17. Transportation statistics annual report 2009

    Science.gov (United States)

    2009-01-01

    The Transportation Statistics Annual Report (TSAR) presents data and information selected by the Bureau of Transportation Statistics (BTS), a component of the U.S. Department of Transportation's (USDOT's) Research and Innovative Technology Administra...

  18. Pocket Guide to Transportation 2012

    Science.gov (United States)

    2012-01-01

    The Bureau of Transportation Statistics (BTS) of the Research and Innovative Technology Administration produces the Pocket Guide to Transportation as a compact resource that provides snapshots of the U.S. transportation system and highlights major tr...

  19. Pocket Guide to Transportation 2018

    Science.gov (United States)

    2018-01-01

    The 2018 BTS Pocket Guide to Transportation is a quick reference guide that provides transportation statistics at your fingertips. It provides key information and highlights major trends on the U.S. transportation system. This year features a new and...

  20. Accident resistant transport container

    Science.gov (United States)

    Anderson, J.A.; Cole, K.K.

    The invention relates to a container for the safe air transport of plutonium having several intermediate wood layers and a load spreader intermediate an inner container and an outer shell for mitigation of shock during a hypothetical accident.

  1. Molecular electronic junction transport

    DEFF Research Database (Denmark)

    Solomon, Gemma C.; Herrmann, Carmen; Ratner, Mark

    2012-01-01

    Whenasinglemolecule,oracollectionofmolecules,isplacedbetween two electrodes and voltage is applied, one has a molecular transport junction. We discuss such junctions, their properties, their description, and some of their applications. The discussion is qualitative rather than quantitative, and f...

  2. Transportation energy data book

    Science.gov (United States)

    2009-01-01

    The Transportation Energy Data Book: Edition 28 is a statistical compendium prepared and : published by Oak Ridge National Laboratory (ORNL) under contract with the U.S. Department of : Energy, Office of Energy Efficiency and Renewable Energy, Vehicl...

  3. Interfacial transport phenomena

    CERN Document Server

    Slattery, John C; Oh, Eun-Suok

    2007-01-01

    Revised and updated extensively from the previous editionDiscusses transport phenomena at common lines or three-phase lines of contactProvides a comprehensive summary about the extensions of continuum mechanics to the nanoscale.

  4. Transport of radioactive materials

    International Nuclear Information System (INIS)

    1988-07-01

    The norm which establishes the requirements of radiation protection and safety related to the transport of radioactive materials, aiming to keep a suitable control level of eventual exposure of personnels, materials and environment of ionizing radiation, including: specifications on radioactive materials for transport, selection of package type; specification of requirements of the design and assays of acceptance of packages; disposal related to the transport; and liability and administrative requirements, are presented. This norm is applied to: truckage, water carriage and air service; design, fabrication, assays and mantenaince of packages; preparation, despatching, handling, loading storage in transition and reception in the ultimate storage of packages; and transport of void packages which have been contained radioactive materials. (M.C.K.) [pt

  5. Transport and the environment

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, C; Jennings, T

    1976-01-01

    This book examines the impact of transport operations on the environment. Noise, air pollution, vibration, accidents, delays caused by slow-moving vehicles, road wear, visual intrusion, the severance of communities--all these social costs of transport are studied, together with policies that might reduce them. The difficulties in measuring costs and benefits and the value judgments that may guide transport policy are reviewed. Specific problems examined include the journey to work, traffic-free shopping streets, urban motor-ways, and inter-change depots for goods vehicles. The role of central and local government is considered, particular attention being given to methods of allowing for environmental benefits when planning new transport investment; the implications of EEC policy are also noted.

  6. Transportation Network Topologies

    Science.gov (United States)

    Alexandrov, Natalia (Editor)

    2004-01-01

    The existing U.S. hub-and-spoke air transportation system is reaching saturation. Major aspects of the current system, such as capacity, safety, mobility, customer satisfaction, security, communications, and ecological effects, require improvements. The changing dynamics - increased presence of general aviation, unmanned autonomous vehicles, military aircraft in civil airspace as part of homeland defense - contributes to growing complexity of airspace. The system has proven remarkably resistant to change. NASA Langley Research Center and the National Institute of Aerospace conducted a workshop on Transportation Network Topologies on 9-10 December 2003 in Williamsburg, Virginia. The workshop aimed to examine the feasibility of traditional methods for complex system analysis and design as well as potential novel alternatives in application to transportation systems, identify state-of-the-art models and methods, conduct gap analysis, and thus to lay a foundation for establishing a focused research program in complex systems applied to air transportation.

  7. Modelling Ballast Water Transport

    Digital Repository Service at National Institute of Oceanography (India)

    Jayakumar, S.; Babu, M.T.; Vethamony, P.

    Ballast water discharges in the coastal environs have caused a great concern over the recent periods as they account for transporting marine organisms from one part of the world to the other. The movement of discharged ballast water as well...

  8. Transportation Industry 2004

    National Research Council Canada - National Science Library

    Miller, Evan; Kathir, Nathan; Brogan, Dennis M

    2004-01-01

    ... and the environment in which the private sector operates. They must also assess the role of government in determining transportation policy, as federal, state, and local agencies regulate every mode of this industry. While the U.S...

  9. Transportation Security Administration

    Science.gov (United States)

    ... content Official website of the Department of Homeland Security Transportation Security Administration A - Z Index Blog What Can I ... Search form Search the Site Main menu Travel Security Screening Special Procedures TSA Pre✓® Passenger Support Travel ...

  10. Remote controlled transport device

    International Nuclear Information System (INIS)

    Nakahira, Masataka; Oka, Kiyoshi; Ito, Akira; Tada, Eisuke; Sato, Masaki

    1998-01-01

    The present invention provides a device for transporting equipments for maintenance and parts between a maintenance port and a facility for maintenance by remote control in a radioactive material handling facility such as a nuclear power plant. Namely, a power supply bus bar is disposed along a transferring path in order to supply power to a transporting means, and is divided into every region having a predetermined length. Each of the power supply bus bar regions is controlled for the power supply by a control device. Accordingly, the transporting means can be moved and driven successively being independent on every power supply bus bar region. Accordingly, a plurality of transporting means can be operated independently in a transferring path without laying around power cables and control signal cables. (I.S.)

  11. Active transport and heat.

    Science.gov (United States)

    Tait, Peter W

    2011-07-01

    Increasing heat may impede peoples' ability to be active outdoors thus limiting active transport options. Co-benefits from mitigation of and adaptation to global warming should not be assumed but need to be actively designed into strategies.

  12. Transportation and Tourism

    Science.gov (United States)

    2012-08-01

    This project explored the link between transportation and tourism in Texas. A session on transit and tourism was organized and conducted as part of the 2012 Texas Transit Conference. Speakers at the session described public transit services oriented ...

  13. Risicobeheersing transport diervoeders

    NARCIS (Netherlands)

    Meijer, G.A.L.; Houwers, H.W.J.; Ipema, A.H.; Boekhoff, M.

    2007-01-01

    Welke knelpunten en oplossingsrichtingen bestaan in de praktijk van het transport diervoeders met betrekking tot de implementatie van de diervoederhygiëneverordening, toegespitst op informatievoorziening over wettelijke en bovenwettelijke eisen, naleving, controle en handhaving?

  14. Offsite transportation hazards assessment

    International Nuclear Information System (INIS)

    Burnside, M.E.

    1997-01-01

    This report documents the emergency preparedness Hazards Assessment for the offsite transportation of hazardous material from the Hanford Site. The assessment is required by the US Department of Energy (DOE) Order 151.1. Offsite transportation accidents are categorized using the DOE system to assist communication within the DOE and assure that appropriate assistance is provided to the people in charge at the scene. The assistance will initially include information about the load and the potential hazards. Local authorities will use the information to protect the public following a transportation accident. This Hazards Assessment will focus on the material being transported from the Hanford Site. Shipments coming to Hanford are the responsibility of the shipper and the carrier and, therefore, are not included in this Hazards Assessment, unless the DOE elects to be the shipper of record

  15. Manpower and Transportation Planning

    NARCIS (Netherlands)

    Lai, S.W.

    2014-01-01

    This thesis studies three routing and scheduling problems arising in manpower and transportation planning. These problems are rooted in real applications, and carry interesting characteristics. By exploiting the structures of the problems, this thesis provides effective mathematical models and

  16. Energy and transportation(*

    Directory of Open Access Journals (Sweden)

    Hermans J.

    2015-01-01

    Full Text Available Transportation takes a considerable and increasing fraction of the energy use worldwide, and more than half the oil consumption. By far the largest part is used by cars powered by internal combustion engines. The advantage of using internal combustion engines is that the energy density of liquid fuels is extremely high. The disadvantage is that gasoline and diesel engines have a poor performance: 20 to 25% only. How does this compare with electric cars? What are the alternative transportation systems and their efficiencies anyway? In this lecture we analyse the efficiency of various transport systems, using elementary physics principles. We will look at cars, buses, trains and TGVs, ships and aircraft. In addition, the efficiency of human powered vehicles will be considered. New and promising developments in the field of Intelligent Transportation Systems, like Cooperative Adaptive Cruise Control, are also discussed.

  17. MANAGEMENT OF TOURISM TRANSPORT

    Directory of Open Access Journals (Sweden)

    Gabriela Cecilia STĂNCIULESCU

    2016-06-01

    Full Text Available Undoubtedly, the relevance of transport activities in relation to tourism activities is essential, because it is extremely important and necessary to offer feasible information about tourism services to help consumer to choose the mode of travel to destinations ideal holiday. The methods used in the development of this hypothesis were explanation, exemplification (brief presentation of each mode of transport comparison etc. Analyzing the current situation of national, European and World Wide tourism transportation, the paper proposes practical applications able to explain that the conduct of economic activities as an integral part of the sector of trade and services within a national economy, would not be possible without the involvement of transport, whether by road, rail and air and naval. The results of the analysis are perfectly applicable offering guests the opportunity to reach the most remote corners of the world in a short time, high degree of comfort and affordable price.

  18. Crew Transportation Operations Standards

    Science.gov (United States)

    Mango, Edward J.; Pearson, Don J. (Compiler)

    2013-01-01

    The Crew Transportation Operations Standards contains descriptions of ground and flight operations processes and specifications and the criteria which will be used to evaluate the acceptability of Commercial Providers' proposed processes and specifications.

  19. Accident resistant transport container

    International Nuclear Information System (INIS)

    Andersen, J.A.; Cole, J.K.

    1980-01-01

    The invention relates to a container for the safe air transport of plutonium having several intermediate wood layers and a load spreader intermediate an inner container and an outer shell for mitigation of shock during a hypothetical accident

  20. Cooperative Transport Planning

    NARCIS (Netherlands)

    Zutt, J.; De Weerdt, M.M.

    2000-01-01

    To test and compare different forms of cooperative planning algorithms developed in the CABS project we use a generic simulator called MARS. Examples in the transportation sector are implemented in this simulator.