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Sample records for lateral internal sphincterotomy

  1. Chronic anal fissures: Open lateral internal sphincterotomy result; a case series study

    Directory of Open Access Journals (Sweden)

    Abdulwahid M. Salih

    2017-03-01

    Conclusion: lateral sphincterotomy for internal anal sphincter, along, is the procedure of choice for management of CAF because it is effective and it can cure the disease in nearly all patients with good patient satisfaction.

  2. Botulinum toxin injection versus lateral internal sphincterotomy for chronic anal fissure: a meta-analysis of randomized control trials.

    Science.gov (United States)

    Chen, H-L; Woo, X-B; Wang, H-S; Lin, Y-J; Luo, H-X; Chen, Y-H; Chen, C-Q; Peng, J-S

    2014-08-01

    Although surgery is the gold standard treatment for anal fissure, the main concern remains its side effects and complications. Botulinum toxin injection and lateral internal sphincterotomy are technical options for patients suffering from chronic anal fissure. However, little is known about the efficacy of these two techniques. The aim of this meta-analysis was to compare the outcomes of botulinum toxin injection versus lateral internal sphincterotomy for chronic anal fissure. Original studies in English were searched from the MEDLINE database, PubMed, Web of Science, and the Cochrane Library database. Randomized control trials that compared botulinum toxin injection with lateral internal sphincterotomy were identified. Data were independently extracted for each study, and a meta-analysis was performed using fixed and random effects models. Four hundred and eighty-nine patients from seven trials met the inclusion criteria. Patients undergoing lateral internal sphincterotomy had a higher-healing and incontinence rate. No statistically significant differences were noted in total complications between botulinum toxin injection and lateral internal sphincterotomy. Patients treated with lateral internal sphincterotomy had a significantly lower recurrence rate than the patients treated with botulinum toxin injection. Our meta-analysis shows that lateral internal sphincterotomy was superior to botulinum toxin injection in terms of healing rate and lower recurrence rate. Botox, however, is safe associated with a lower rate of incontinence and could be used in certain situations. Further studies with a long-term follow-up are required to confirm our observations.

  3. The effect of lateral internal sphincterotomy on resting anal sphincter pressures

    OpenAIRE

    Peker, Kemal; YILMAZ, İsmayil; DEMİRYILMAZ, İsmail; İNAL, Abdullah; Işik, Arda

    2014-01-01

    Anal fissures are one of the most common proctologic disorders. This study aimed to investigate alterations in anal sphincteric resting pressures after lateral internal sphincterotomy, which was performed for chronic anal fissure treatment. Materials and methods: Fifty-six (68.3%) male and 26 (31.7%) female patients were included in this study. Patients complicated with fistula-in-ano, abscess, cancer, inflammatory bowel disease, dermatitis, poor general condition, allergy to any of the stan...

  4. Botulinum toxin injection versus lateral internal sphincterotomy in the treatment of chronic anal fissure: a non-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ulusoy Nefise B

    2004-03-01

    Full Text Available Abstract Background Although lateral internal sphincterotomy is the gold-standard treatment for chronic anal fissure, intrasphincteric injection of botulinum toxin seems to be a reliable new option. The aim of this non-randomized study is to compare the effect of lateral internal sphincterotomy and botulinum toxin injection treatments on the outcome and reduction of anal sphincter pressures in patients with chronic anal fissure. Methods Patients with chronic anal fissure were treated with either botulinum toxin injection or lateral internal sphincterotomy by their own choice. Maximal resting pressure and maximal squeeze pressure measurements were performed before and 2 weeks after treatments by anal manometry. Patients were followed for fissure relapse during 14 months. Results Twenty-one consecutive outpatients with posterior chronic anal fissure were enrolled. Eleven patients underwent surgery and ten patients received botulinum toxin injection treatment. Before the treatment, anal pressures were found to be similar in both groups. After the treatment, the maximal resting pressures were reduced from 104 ± 22 mmHg to 86 ± 15 mmHg in the surgery group (p 0.05 in the surgery group, and from 117 ± 62 mmHg to 76 ± 34 (p 0.05. There were no relapses during the 14 months of follow up. Conclusion Lateral internal sphincterotomy and botulinum toxin injection treatments both seem to be equally effective in the treatment of chronic anal fissure.

  5. Clinical and manometric evaluation of women with chronic anal fissure before and after internal subcutaneous lateral sphincterotomy

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    Silvana Marques e Silva

    2012-06-01

    Full Text Available OBJECTIVE: To evaluate clinical and manometric parameters of chronic anal fissure females undergoing lateral internal sphincterotomy (LIS. METHODS: A total of eight women with chronic anal fissure who underwent LIS were included in this study. The preoperative assessment was performed one week before surgery and included general and anorectal examination, anorectal manometry, and Jorge Wexner questionnaire. The post operative follow up was made every 15 days until complete healing. Jorge Wexner questionnaires and anorectal manometry were repeated at 1 month and 3 months after the surgery. Time to healing, manometric changes and complications were assessed. RESULTS: All patients had preoperative increased anal resting pressure. The resting pressures and anal canal length were significantly decreased 3 months after surgery. Patients' complaints of itching and bleeding were also reduced. Fissures healed in 7 patients and median healing time was 45 days. No complications were observed due to the procedure. One patient had transient incontinence to flatus. CONCLUSION: Lateral internal sphincterotomy provided clinical improvement and reduced resting pressure of the internal anal sphincter in women with chronic anal fissure.OBJETIVO: Avaliar a evolução clínica e manométrica de mulheres com fissura anal crônica submetidas à esfincterotomia lateral interna subcutânea. MÉTODOS: Estudo prospectivo com oito pacientes. A avaliação inicial foi realizada por meio de questionários, exame físico e manometria anorretal na semana anterior ao procedimento cirúrgico. Durante o período pós-operatório, as pacientes foram avaliadas clinicamente a cada 15 dias, até a cicatrização completa. Os questionários e a manometria anorretal foram repetidos 1 mês e 3 meses após a operação. Foi avaliado o tempo para cicatrização da fissura, as alterações manométricas e as complicações decorrentes do procedimento. RESULTADOS: Todas as pacientes

  6. Comparison of botox and lateral internal sphincterotomy treatment outcomes in chronic anal fissures

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    Tolga Dinç

    2014-03-01

    Full Text Available Objective: Both botox and lateral internal sfinkterotomi are treatment technics used in chronic anal fissure; provide the relaxation of anal sphincter and as a result of this, healing occurs. Aim of this study is to compare efficacy of botox and LIS treatment in chronic anal fissure and discussing with the literature. Methods: 60 of 66 patients who has chronic anal fissure, that we reached, treated but not healed with medical therapy, appealed to the Dr. Sami Ulus Hospital included the study. Gender, age, fissure localization, complaints (pain, bleeding, itching, constipation, complaint length, recurrences after treatment, continence conditions and complications of patients were registered. Results: Sixty patients were enrolled the study. Of the 60 patients; 38(63.3% were male and 22 (27.7% were female. Mean age of all patients was 35.93 ± 11.45 (21 -60. Pain was the common complaint of the all patients. 10 (32.3% recurrence were detected in botox treatment group (Group-I, only 1 (3.4% recurrence was in LIS group (Group-II. There was no complication as an incontinence in group-I but 3 cases with incontinence (10.39% were obtained in group-II. In the evaluation of these 3 cases by Cleveland Clinic Continence Scoring System, 2 cases classified as gas incontinence and 1 case as moderate fecal incontinence. Conclusion: Although botulinum toxin injection seen as an alternative treatment method with low complication rates such as incontinence, high recurrence is an important shortcoming of this technic. LIS performed by experienced surgeons remained the most popular treatment modality with low complication rates and great deal of healing success.

  7. Internal sphincterotomy versus topical nitroglycerin ointment for chronic anal fissure

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    Muhammad I. Aslam

    2014-01-01

    Conclusion: This quasi-experimental study demonstrates that open partial lateral internal sphincterotomy is superior to topical 0.2% nitroglycerin application in the treatment of chronic anal fissure, with good symptomatic relief, high rate of healing, fewer side effects, and a very low rate of early continence disturbances.

  8. COMPARATIVE STUDY OF LATERAL SPHINCTEROTOMY AND LATERAL SPHINCTEROTOMY WITH V-Y ADVANCEMENT FLAP IN TREATMENT OF CHRONIC ANAL FISSURE

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    S. Meenaa Saravanaperumaal

    2016-12-01

    Full Text Available BACKGROUND Anal fissure is an elongated ulcer in the long axis of lower anal canal. The most frequent site for anal fissure is midline posteriorly and followed by midline anteriorly. It causes severe pain during defecation and rectal bleeding that stain the tissue or streaks the stools. Chronic anal fissure has traditionally been treated by surgery, an effective and standard procedure that results in healing in 90-95% of cases. Lateral sphincterotomy heals chronic anal fissure in 90% of cases that is associated with incontinence to flatus and faeces. Anal advancement flaps was used to cover the chronic anal fissure. Using anal flaps to resurface chronic or recurrent anal fissure to promote wound healing and to assess the added advantage over lateral sphincterotomy in tissues of complete epithelialisation; time of relief of pain; persistent symptoms; patient satisfaction and quality of life. The aim of the study is to- 1. Compare the efficacy of lateral sphincterotomy against lateral sphincterotomy with V-Y advancement flap in treatment of chronic anal fissures. 2. Assess the added advantages of V-Y advancement flap in treatment of chronic anal fissure in terms of wound healing, time of relief of pain, persistent symptoms and patients’ satisfaction. 3. Compare the complications associated with procedures. MATERIALS AND METHODS A study of 50 patients was done. It included 26 females and 24 males. In that, lateral sphincterotomy alone was done in 25 patients and lateral sphincterotomy along with anal advancement flap was done in 25 patients. RESULTS In group A patients only lateral sphincterotomy done. In group B lateral sphincterotomy with anal advancement flap done. Anal advancement flap done by ‘v’ shaped flap formed of skin and subcutaneous tissue was elevated incontinuity with excised tissue to allow to cover the tissue defect. Flap should be broad based with adequate blood supply and avoid tension while suturing with 3-0 vicryl. A study

  9. Open lateral internal anal sphincterotomy under local anesthesia as the gold standard in the treatment of chronic anal fissures: A prospective clinical and manometric study Esfinterotomía lateral interna abierta con anestesia local como gold standard en el tratamiento de la fisura anal crónica: Estudio prospectivo clínico y manométrico a largo plazo

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    A. Sánchez Romero

    2004-12-01

    Full Text Available Background: chronic anal fissure is one of the most frequent proctological disorders in Western populations. Open lateral internal sphincterotomy is one of the therapeutic options accepted as the treatment of choice for chronic anal fissure, since it reduces the hypertonia of the internal anal sphincter (the main etiopathogenic mechanism of fissures, decreases anal pain, and allows the fissure to heal. Material and methods: we carried out a prospective study of 120 patients operated on for chronic anal fissure with open sphincterotomy under local anesthesia at our Proctology Outpatient Unit from 1998 to 2001. No preoperative studies, bowel preparation, or antibiotic prophylaxis were carried out. All patients were followed up after 1 week, 2 months, 6 months, and 1 year, and underwent an anal manometry before and after surgery. Results: early complications: 3 hematoma-ecchymosis of the wound (2.5%, 3 self-limited hemorrhage events (2.5%. No hemorrhoidal thrombosis, fistulas, or perianal abscesses occurred. Fissures recurred in nine patients (7.5% within one year. The initial rate of incontinence of 7.5% at two months dropped down to 5% at six months. The mean resting pressure (MRP in incontinent patients was lower than in continent patients (55±7 mmHg versus 80.7 ± 21 mmHg. The difference in mean squeeze pressure (MSP between incontinent patients and continent patients was not statistically significant. Conclusions: open sphincterotomy under local anesthesia has a long-term rate of healing and a morbidity rate similar to other techniques. It may therefore be considered an effective treatment for chronic anal fissure.Introducción: la fisura anal crónica sigue siendo uno de los problemas proctológicos más frecuentes e incapacitantes en la población occidental actual. La esfinterotomía lateral interna abierta es una de las opciones terapéuticas descritas y aceptadas como tratamiento de elección de la fisura anal crónica, ya que reduce la

  10. [Surgical treatment of anal stenosis following hemorrhoid surgery. Results of 150 combined mucosal advancement and internal sphincterotomy].

    Science.gov (United States)

    Carditello, Antonio; Milone, Antonino; Stilo, Francesco; Mollo, Francesco; Basile, Maurizio

    2002-01-01

    The aim of the study was to evaluate the efficacy of anoplasty by mucosal advancement combined with internal sphincterotomy for the treatment of iatrogenic anal stenosis. From January 1990 to December 2000, 149 patients with post-haemorrhoidectomy anal strictures underwent internal sphincterotomy and mucosal advancement flap anoplasty. Seventy-one percent of patients were operated on under local anaesthesia by perineal block according to Marti. In 90 percent of the patients, postoperative pain was mild. No significant complications were seen. The mean hospital stay was two days. Ninety-seven percent of patients were well satisfied with the surgical result one year after operation. Current surgical options for the treatment of post-haemorrhoidectomy anal stricture are reported and the advantages of mucosal advancement flap anoplasty outlined.

  11. Chronic anal fissure: new approaches to chemical sphincterotomy

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    Mohammad hassan Emami

    2008-06-01

    Full Text Available

    • An anal fissure is a split in the mucosa extending from the anal verge towards the dentate line. It currently affects 10% of patients attending proctology clinics. Recent studies have highlighted the role of increased internal anal sphincter pressure and decreased anodermal blood flow in the pathogenesis of chronic anal fissures. Acute fissures usually heal with conservative management. Fissures lasting greater than two months with features of chronicity, are unlikely to heal with conservative management. Lateral internal sphincterotomy has been the treatment of choice for chronic anal fissures. Because of the disability associated with surgery for healing anal fissure and the risk of incontinence, medical alternatives for surgery have been sought. Among different chemical agents, Glyceryl trinitrate (GTN has been shown to be the first line treatment for chronic anal fissure but the transient sphincteric relaxation effect of pharmacologic agents such as GTN, makes them less effective than surgery. Although we have different forms of GTN products, they do not show a long acting effect on relaxing and enhancing the perfusion of anal sphincter, because they are soon metabolized. Most difficulties with current usage of drugs are due to poor compliance of patients. It can be taken into consideration that new formulation and novel combination of GTN with other treatments, in slow releasing forms may lead to acceptable strategies in the management of chronic anal fissure. As authors’ experience in this field, other clinical trials on the drug combination and slow releasing formulations are warranted to generate new data on the subject.
    • Key word: chronic anal fissure, review, chemical sphincterotomy 

  12. Pancreatic sphincterotomy: Technique, indications, and complications

    Institute of Scientific and Technical Information of China (English)

    Jonathan M Buscaglia; Anthony N Kalloo

    2007-01-01

    Pancreatic sphincterotomy serves as the cornerstone of endoscopic therapy of the pancreas. Historically,its indications have been less well-defined than those of endoscopic biliary sphincterotomy, yet it plays a definite and useful role in diseases such as chronic pancreatitis and pancreatic-type sphincter of Oddi dysfunction. In the appropriate setting, it may be used as a single therapeutic maneuver, or in conjunction with other endoscopic techniques such as pancreatic stone extraction or stent placement. The current standard of practice utilizes two different methods of performing pancreatic sphincterotomy: a pull-type sphincterotome technique without prior stent placement, and a needleknife sphincterotome technique over an existing stent. The complications associated with pancreatic sphincterotomy are many, although acute pancreatitis appears to be the most common and the most serious of the early complications. As such, it continues to be reserved for those endoscopists who perform a relatively high-volume of therapeutic pancreaticobiliary endoscopic retrograde cholangio-pancreatography.

  13. Clinical Observation of Partial Internal Sphincterotomy Combined with Chinese Herbs in Anal Fissure%内括约肌部分切断术联合中药治疗肛裂疗效观察

    Institute of Scientific and Technical Information of China (English)

    方赤波; 林东华; 邓振辉; 叶惠花; 罗凯凡; 张惠芝

    2013-01-01

    目的:探讨肛门内括约肌部分切断术联合中药对肛裂的治疗效果。方法:肛裂患者80例,观察组(40例)予肛裂切除术与肛门内括约肌部分切断术,术后予中药治疗,对照组(40例)予肛裂切除术,术后常规处理,对比两组疗效。结果:两组患者全部治愈,均未发生肛门失禁等严重并发症,伤口愈合时间无显著差异(P>0.05);观察组术后VAS疼痛指数及止痛药用量均显著优于对照组(P0.05);the VAS pain index and painkillers dose in the observation group was significantly better than the control group (P<0.01). Conclusion:Partial internal sphincterotomy combined with Chinese herbs has curative effect in anal fissure.

  14. Post-endoscopic biliary sphincterotomy bleeding: an interventional radiology approach.

    LENUS (Irish Health Repository)

    Dunne, Ruth

    2013-12-01

    Endoscopic sphincterotomy is an integral component of endoscopic retrograde cholangiopancreatography. Post-sphincterotomy hemorrhage is a recognized complication. First line treatment involves a variety of endoscopic techniques performed at the time of sphincterotomy. If these are not successful, transcatheter arterial embolization or open surgical vessel ligation are therapeutic considerations.

  15. Selective Embolization for Post-Endoscopic Sphincterotomy Bleeding: Technical Aspects and Clinical Efficacy

    Energy Technology Data Exchange (ETDEWEB)

    So, Young Ho; Choi, Young Ho [Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung [Seoul National University Hospital, Seoul (Korea, Republic of); Song, Soon Young [Hanyang University Hospital, Seoul (Korea, Republic of)

    2012-01-15

    The objective of this study was to evaluate the technical aspects and clinical efficacy of selective embolization for post-endoscopic sphincterotomy bleeding. We reviewed the records of 10 patients (3%; M:F 6:4; mean age, 63.3 years) that underwent selective embolization for post-endoscopic sphincterotomy bleeding among 344 patients who received arteriography for nonvariceal upper gastrointestinal bleeding from 2000 to 2009. We analyzed the endoscopic procedure, onset of bleeding, underlying clinical condition, angiographic findings, interventional procedure, and outcomes in these patients. Among the 12 bleeding branches, primary success of hemostasis was achieved in 10 bleeding branches (83%). Secondary success occurred in two additional bleeding branches (100%) after repeated embolization. In 10 patients, post-endoscopic sphincterotomy bleedings were detected during the endoscopic procedure (n = 2, 20%) or later (n = 8, 80%), and the delay was from one to eight days (mean, 2.9 days; {+-} 2.3). Coagulopathy was observed in three patients. Eight patients had a single bleeding branch, whereas two patients had two branches. On the selective arteriography, bleeding branches originated from the posterior pancreaticoduodenal artery (n = 8, 67%) and anterior pancreaticoduodenal artery (n = 4, 33%), respectively. Superselection was achieved in four branches and the embolization was performed with n-butyl cyanoacrylate. The eight branches were embolized by combined use of coil, n-butyl cyanoacrylate, or Gelfoam. After the last embolization, there was no rebleeding or complication related to embolization. Selective embolization is technically feasible and an effective procedure for post-endoscopic sphincterotomy bleeding. In addition, the posterior pancreaticoduodenal artery is the main origin of the causative vessels of post-endoscopic sphincterotomy bleeding.

  16. Severe acute cholangitis after endoscopic sphincterotomy induced by barium examination: A case report

    Institute of Scientific and Technical Information of China (English)

    Zhen-Hai Zhang; Ya-Guang Wu; Cheng-Kun Qin; Zhong-Xue Su; Jian Xu; Guo-Zhe Xian; Shuo-DongWu

    2012-01-01

    Endoscopic sphincterotomy (EST) is considered as a possible etiological factor for severe cholangitis.We herein report a case of severe cholangitis after endoscopic sphincterotomy induced by barium examination.An adult male patient presented with epigastric pain was diagnosed as having choledocholithiasis by ultrasonography.EST was performed and the stone was completely cleaned.Barium examination was done 3d after EST and severe cholangitis appeared 4 h later.The patient was recovered after treated with tienam for 4 d.Barium examination may induce severe cholangitis in patients after EST,although rare,barium examination should be chosen cautiously.Cautions should be also used when EST is performed in patients younger than 50 years to avoid the damage to the sphincter of Oddi.

  17. Dermal flap advancement combined with conservative sphincterotomy in the treatment of chronic anal fissure.

    Science.gov (United States)

    Theodoropoulos, George E; Spiropoulos, Vasileios; Bramis, Konstantinos; Plastiras, Aris; Zografos, George

    2015-02-01

    Lateral internal sphincterotomy (LIS) is considered the surgical treatment of choice for chronic anal fissure (CAF). Flap techniques for fissure coverage have the advantage of primary wound healing, potentially providing better functional results and faster pain relief. The standard surgical strategy for CAF consisting of conventional LIS (CLIS) up to the dentate line was modified by "tailoring" the LIS to the apex of the CAF, but never greater than 1 cm, and by advancing a dermal flap for coverage of the CAF (LIS + flap) after fissurectomy. Thirty consecutive patients who underwent "LIS + flap" were compared with 32 patients who had been previously treated by CLIS. A modified, trapezoid-like Y-V flap from perianal skin was advanced into the CAF base. Pain at the first postoperative day, pain at defecation during the first week, postoperative use of analgesics, and time for patients' pain relief were significantly less at the "LIS + flap" group (P < 0.01). Objective healing was achieved faster (P < 0.01) and soiling episodes were less (P < 0.05) after "LIS + flap." The addition of a dermal flap after "conservative" LIS resulted in better healing and significantly less postoperative discomfort than the isolated application of CLIS.

  18. CLINICAL OBSERVATION ON TREATMENT OF ANAL FISSURE BY APPLYING SPHINCTEROTOMY WITH ACUPOTOM

    Institute of Scientific and Technical Information of China (English)

    段海涛; 沈瑞子; 阳建明; 温伟平; 邱仁斌

    2003-01-01

    Objective: To observe the therapeutic effect end features of acupotomy in the treatment of anal fis-sure. Methods: Seventy-six cases with anal fissure were randomly divided into two groups, namely, acupotomy groupin which 37 patients were treated by anal internal sphincterotomy with acupotomy, and conventional anal sphincteroto-my group (conventional group, n=39) that was treated by conventional amputation of the anal sphincter. Results: Af-ter treatment, twenty-six over 37 cases in acupotomy group recovered completely and the other 9 cases were improvedclinically, with the total effective rate being 94.59%. In conventional group, 27 over 39 cases recovered completelyand the other 11 cases were improved clinically. The total effective rate was 97.44%. There was no significant differ-ence in the curative rate between two groups. However, compared with those of conventional group, patients inacupotomy group had significantly less bleeding, earlier healing of fissure and less pain. Conclusion: The results sug-gest that acupotomy treatment of anal fissure with anal sphincterotomy is a better therapeutic technique with advantagesof easier manipulation, earlier healing and milder wound, less infectious complications end pain.

  19. Sphincterotomy plus large balloon dilation versus sphincterotomy alone for the extraction of complex lithiasis: a prospective analysis

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    Martín Alejandro Guidi

    2015-08-01

    Full Text Available Background and purpose: Mid-size sphincterotomy associated with large balloon dilation is an alternative to wide sphincterotomy to remove complex lithiases. However, which of the two techniques is most effective remains unclear. Hence, we conducted this study to compare both methods prospectively. Method: Since January 2012 until March 2014, 133 consecutive patients with complex stones were included. Group A underwent mid-size sphincterotomy associated with large balloon dilation and group B underwent wide sphincterotomy alone. Success rates were assessed for: Extraction of stones, ductal patency rate, the use of mechanical lithotripsy, dose, time and dose per radioscopy area as well as procedure-related complications. Results: Group A comprised 44 patients and group B comprised 69 patients. Overall success rate for extraction was 86.4% in group A and 70% in group B (p = 0.069. In giant lithiasis, effective extraction was 89.3% in group A and 58.6% in group B (p = 0.019. Use of mechanical lithotripsy was 15.9% and 30.4%, respectively (p = 0.142. Total radiotherapy dose was 39.8 mGy vs. 26.2 mGy, respectively (p = 0.134. Complications occurred in 6.8% and 5.5% of the procedures in each group, without significant differences among them (p = 0.856. Conclusion: Sphincterotomy plus large balloon dilation is more effective and equally safe than conventional sphincterotomy for the management of giant main bile duct lithiasis.

  20. Treatment of a duodenal perforation secondary to an endoscopic sphincterotomy with clips

    Institute of Scientific and Technical Information of China (English)

    Panagiotis Katsinelos; George Paroutoglou; Basilios Papaziogas; Athanasios Beltsis; Stavros Dimiropoulos; Konstantinos Atmatzidis

    2005-01-01

    Perforation is one of the most serious complications of endoscopic sphincterotomy (ES) necessitating immediate surgical intervention. We present a case of successful management of such a complication with endoclipping. A85-year-old woman developed duodenal perforation after ES. The perforation was identified early and its closure was achieved using three metallic clips in a single session.There was no procedure-related morbidity or complications and our patient was discharged from hospital 10 d later.Endoclipping of duodenal perforation induced by ES is a safe, effective and alternative to surgery treatment.

  1. A Comparison between External versus Internal Lateral Osteotomy in Rhinoplasty

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    M Hashemi

    2005-01-01

    Full Text Available Background: Lateral osteotomy is a major part of rhinoplasty for remodeling external facet of the nose and narrowing of nasal base and dorsum after removal of the hump. There are two techniques for lateral osteotomy known as external and internal. Each of these provide advantages and impose limitations. The purpose of our study was to compare the severity of postoperative edema and ecchymosis between internal and external osteotomy techniques. Methods: This study was designed as a clinical trial on 30 cases. With randomization, one side of the nasal bone was selected for internal approach, and the other side, for external approach. Then, on the 1st and 7th days after surgery, the patients were scored for the severity of edema and ecchymosis. Results: On the first day after surgery, not only edema, but also ecchymosis was lower with the external osteotomy than with the internal approach (P = 0.037, P = 0.002, respectively. The severity of ecchymosis, on the 7th postoperative day, was lower with the external approach, and the difference was significant (P = 0.011. The severity of both edema and ecchymosis on the first postoperative day was evaluated higher in females, with statistically significant differences (P = 0.05 for edema and P = 0.003 for ecchymosis. The extension of ecchymosis on the 7th postoperative day was higher in women (P = 0.05. There were no significant differences between the two approaches in medialization of the involved bones and no apparent asymmetries either. Conclusion: According to the results of this study, external osteotomy seems to be the approach of choice, provided that the surgeon has enough experience in doing it. Keywords: Rhinoplasty, Internal osteotomy, External osteotomy, Ecchymosis, Edema

  2. Safety advantage of endocut mode over endoscopic sphincterotomy for choledocholithiasis

    Institute of Scientific and Technical Information of China (English)

    Hirotada Akiho; Masahiro Matsumoto; Shingo Endo; Kazuhiko Nakamura; Yorinobu Sumida; Kazuya Akahoshi; Atsuhiko Murata; Jiro Ouchi; Yasuaki Motomura; Taisuke Toyomasu; Mitsuhide Kimura; Masaru Kubokawa

    2006-01-01

    AIM: To evaluate whether an automatically controlled cut system (endocut mode) could reduce the complication rate of endoscopic sphincterotomy (EST)and serum hyperamylasemia after EST compared to the conventional blended cut mode.METHODS: From January 2001 to October 2003, 134patients with choledocholithiasis were assigned to either endocut mode group or conventional blended cut mode group at the time of sphincterotomy. The two groups were retrospectively compared for the complications after EST and serum amylase level before and 24 h after the procedure.RESULTS: Of the 134 patients treated, 79 were assigned to conventional blended cut mode group and 55 to endocut mode group. There was no significant difference in age, sex, and serum amylase level before EST between the two groups. Complications were found in 5 patients of the endocut mode group (9%):hyperamylasemia (5 times higher than normal) in 4 and moderate pancreatitis in 1. Complications were found in 13 patients of the conventional blended cut mode group (16%): hyperamylasemia in 12 and moderate pancreatitis in 1. Serum amylase levels were elevated in both groups 24 h after EST (P<0.02). The average serum amylase level 24 h after EST in the conventional blended cut mode group was significantly higher than that in the endocut mode group (P< 0.05).CONCLUSION: Endocut mode offers a safety advantage over conventional blended cut mode for pancreatitis after EST by reducing hyperamylasemia.

  3. Systematic Biliary Sphincterotomy in Acute Gallstone Pancreatitis without Cholangitis?

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    Manley C Uy

    2009-11-01

    Full Text Available Drs. Shrode and Kahaleh [1] noted correctly that two out of the three mortalities in the early ERCP group of the Oria study [3] were not reported to be directly due to ERCP. However, it is worthwhile to take into consideration that one mortality was attributed to progressive respiratory failure despite early ERCP and sphincterotomy. Taking note that the incidence of severe and mild pancreatitis and other demographic and clinical characteristics were grossly the same in both groups, only one patient died in the early conservative group. Furthermore, both groups had the same number of patients undergoing surgery (45 early ERCP vs. 47 early conservative, respectively but nobody in the early conservative group died from biliary surgery as compared to the mortality in the early ERCP group which was attributed to elective biliary surgery. it was interesting that there was the absence of mortality in the early conservative group despite more complicated surgeries due to the larger number of patients necessitating transcystic ductal stone clearance and/or laparoscopic/open choledochotomy for main bile duct stones (one in the early ERCP vs. 19 in the early conservative management group. The large number of early conservative management patients with positive intraoperative cholangiography (40%, meaning persistent common bile duct stone, also raises doubts as to the need for early ERCP with sphincterotomy [3]. As to the study of Folsch et al. [4], although Drs. Shrode and Kahaleh [1] correctly noted that 22 patients in the early conservative management group required ERCP and that four patients died from cholecystitis and/or jaundice, they failed to note that there were fewer patients who died from respiratory and renal failure than in the early ERCP group. The two aforementioned organ failures are both possible complications of acute pancreatitis. This was in a background of the same demographic characteristics (including severity of pancreatitis [4

  4. Internal and external spatial attention examined with lateralized EEG power spectra.

    Science.gov (United States)

    Van der Lubbe, Rob H J; Bundt, Carsten; Abrahamse, Elger L

    2014-10-02

    Several authors argued that retrieval of an item from visual short term memory (internal spatial attention) and focusing attention on an externally presented item (external spatial attention) are similar. Part of the neuroimaging support for this view may be due to the employed experimental procedures. Furthermore, as internal spatial attention may have a more induced than evoked nature some effects may not have been visible in event related analyses of the electroencephalogram (EEG), which limits the possibility to demonstrate differences. In the current study, a colored frame cued which stimulus, one out of four presented in separate quadrants, required a response, which depended on the form of the cued stimulus (circle or square). Importantly, the frame occurred either before (precue), simultaneously with (simultaneous cue), or after the stimuli (postcue). The precue and simultaneous cue condition both concern external attention, while the postcue condition implies the involvement of internal spatial attention. Event-related lateralizations (ERLs), reflecting evoked effects, and lateralized power spectra (LPS), reflecting both evoked and induced effects, were determined. ERLs revealed a posterior contralateral negativity (PCN) only in the precue condition. LPS analyses on the raw EEG showed early increased contralateral theta power at posterior sites and later increased ipsilateral alpha power at occipito-temporal sites in all cue conditions. Responses were faster when the internally or externally attended location corresponded with the required response side than when not. These findings provide further support for the view that internal and external spatial attention share their underlying mechanism.

  5. Subciliary incision and lateral cantholysis in rigid internal fixation of zygomatic complex fractures

    Institute of Scientific and Technical Information of China (English)

    钟来平; 陈关福

    2004-01-01

    Objective: To introduce the technique of subciliary incision and lateral cantholysis with tri-dimension reduction and rigid internal fixation to treat zygomatic complex fractures.Methods: The subciliary incision and lateral cantholysis combined with tri-dimension reduction and rigid internal fixation of zygomatic complex fractures with titanium microplates were applied in 56 patients with zygomatic complex fractures. Another lateral eyebrow incision or sublabial incision was used to simplify the operation.Results: The postoperative follow-up period ranged from 6 months to 5 years. During the follow-up period, all the patients had satisfying postoperative results. All clinical symptoms disappeared except the numbness in the infraorbital region in 2 patients. In 94.6% patients no complications such as obvious scar, ectropion, entropion or blepharoedema were found, only 5.4% of the patients had slight ectropion 6 months after operation.Conclusions: The subciliary incision and lateral cantholysis have many advantages such as invisible scar,sufficient exposure, minimal injury, and few complications and combined with rigid internal fixation with titanium microplates this technique could be used as one of the routine operation methods to treat zygomatic complex fractures.

  6. Endoscopic sphincterotomy in the treatment of cholangiopancreatic diseases

    Institute of Scientific and Technical Information of China (English)

    Zhi-Hua Li; Min Chen; Ji-Kui Liu; Jun Ding; Jia-Hong Dong

    2005-01-01

    AIM: To investigate the therapeutic effect of endoscopicsphincterotomy (EST) in the treatment of choledocholithiasis and stenosing papillitis.METHODS: A total of 1 026 patients undergoing EST during July 1983 to May 2003 at the institute were retrospectively analyzed. Chronic pancreatitis was diagnosed in 63 (6.1%),cholecystolithiasis and choledocholithiasis in 549 (53.5%),stones in residual biliary duct in 249 (24.3%), stenosing papillitis in 228 (22.2%). In patients with simple stenosing papillitis, most incisions were within 0.5-1 cm in length. As for patients with chronic pancreatitis simultaneously, selective pancreatic sphincterotomy was performed, and incision was within 0.5-0.8 cm in length. For stones less than 1 cm, incision was from 1 to 1.5 cm, and for those larger than 1 cm, incision ranged from 1.5 to 3 cm. For stones more than 2 cm in diameter, detritus basket rather than simple incision was chosen. RESULTS: Of the 798 patients with choledocholithiasis, 764 (93.5%) had successful stone clearance, 215 (94.3%)out of 228 cases of stenosing papillitis were cured totally, while 63 had chronic pancreatitis developed from stenosing papillitis, 57 (90.1%) had sound remission of symptoms, though membranous stenosis emerged in 13 of 57 which was treated with balloon dilatation. After the operation, only 21 cases (2.1%) had complications such as severe pancreatitis and incision bleeding. None of the patients died.CONCLUSION: EST is an ideal surgical management with mini-invasion in the treatment of choledocholithiasis and stenosing papillitis.

  7. Reliability of forced internal rotation and active internal rotation to assess lateral instability of the biceps pulley

    Science.gov (United States)

    ARRIGONI, PAOLO; ROSE, GIACOMO DELLE; D’AMBROSI, RICCARDO; ROTUNDO, GIORGIO; CAMPAGNA, VINCENZO; PIRANI, PIERGIORGIO; PANASCÌ, MANLIO; PETRICCIOLI, DARIO; BERTONE, CELESTE; GRASSO, ANDREA; LATTE, CARMINE; COSTA, ALBERTO; VIOLA, GINO; DE GIORGI, SILVANA; PANELLA, ANTONELLO; PADUA, ROBERTO; BECCARINI, ALESSANDRO; SALCHER, BARBARA; OLIVIERI, MATTEO; MUGNAINI, MARCO; PANNONE, ANTONELLO; CEOLDO, CHIARA; LONGO, UMILE GIUSEPPE; DENARO, VINCENZO; CERCIELLO, SIMONE; PANNI, ALFREDO SCHIAVONE; AVANZI, PAOLO; ZORZI, CLAUDIO; RAGONE, VINCENZA; CASTAGNA, ALESSANDRO; RANDELLI, PIETRO

    2015-01-01

    Purpose the aim of this study was to investigate the relationship between positive painful forced internal rotation (FIR) and lateral pulley instability in the presence of a pre-diagnosed posterosuperior cuff tear. The same investigation was conducted for painful active internal rotation (AIR). Methods a multicenter prospective study was conducted in a series of patients scheduled to undergo arthroscopic posterosuperior cuff repair. Pain was assessed using a visual analog scale (VAS) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) was administered. The VAS score at rest, DASH score, and presence/absence of pain on FIR and AIR were recorded and their relationships with lesions of the lateral pulley, cuff tear patterns and shape of lesions were analyzed. Results the study population consisted of 115 patients (mean age: 55.1 years) recruited from 12 centers. The dominant arm was affected in 72 cases (62.6%). The average anteroposterior extension of the lesion was 1.61 cm. The mean preoperative VAS and DASH scores were 6.1 and 41.8, respectively. FIR and AIR were positive in 94 (81.7%) and 85 (73.9%) cases, respectively. The lateral pulley was compromised in 50 cases (43.4%). Cuff tears were partial articular in 35 patients (30.4%), complete in 61 (53%), and partial bursal in 19 (16.5%). No statistical correlation between positive FIR or AIR and lateral pulley lesions was detected. Positive FIR and AIR were statistically associated with complete lesions. Negative FIR was associated with the presence of partial articular tears. Conclusions painful FIR in the presence of a postero-superior cuff tear does not indicate lateral pulley instability. When a cuff tear is suspected, positive FIR and AIR are suggestive of full-thickness tear patterns while a negative FIR suggests a partial articular lesion. Level of evidence: level I, validating cohort study with good reference standards. PMID:26151035

  8. Endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy is safe and effective

    DEFF Research Database (Denmark)

    Jakobsen, Henrik Loft; Vilmann, Peter; Rosenberg, Jacob

    2011-01-01

    Management strategy for common bile duct (CBD) stones is controversial with several treatment options if stones in the CBD are recognized intraoperatively. The aim of this study was to report our experience with same-session combined endoscopic-laparoscopic treatment of gallbladder and CBD stones....... We retrospectively evaluated 31 patients with cholecystolithiasis and CBD stones undergoing same-session combined endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and endoscopic stone extraction and laparoscopic cholecystectomy. Same-session ERCP and sphincterotomy were...... pancreatitis postoperatively and no other morbidity or mortality. In conclusion, same-session ERCP with stone extraction and laparoscopic cholecystectomy seems to be a safe and effective treatment strategy for CBD stones....

  9. INTERMITTENT GALLSTONE ILEUS FOLLOWING ENDOSCOPIC BILIARY SPHINCTEROTOMY - A CASE-REPORT

    NARCIS (Netherlands)

    OSKAM, J; HEITBRINK, M; SCHATTENKERK, ME

    1993-01-01

    A 72-year-old woman presented with periods of colicky abdominal pain following endoscopic sphincterotomy and lithotripsy for choledocholithiasis. A diagnosis of intermittent gallstone ileus was made, while it appeared that a large gallstone, that was not removed from the common bile duct, obsructed

  10. INTERMITTENT GALLSTONE ILEUS FOLLOWING ENDOSCOPIC BILIARY SPHINCTEROTOMY - A CASE-REPORT

    NARCIS (Netherlands)

    OSKAM, J; HEITBRINK, M; SCHATTENKERK, ME

    1993-01-01

    A 72-year-old woman presented with periods of colicky abdominal pain following endoscopic sphincterotomy and lithotripsy for choledocholithiasis. A diagnosis of intermittent gallstone ileus was made, while it appeared that a large gallstone, that was not removed from the common bile duct, obsructed

  11. The Effect of Biliary Sphincterotomy on Serum Cholesterol Levels in Postcholecystectomy Patients: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Waleed M Alazmi

    2007-01-01

    Full Text Available BACKGROUND: Cholesterol, in the form of bile salts, is reabsorbed from the small intestine via the enterohepatic circulation. Biliary sphincterotomy increases the delivery of bile to the terminal ileum. If the absorptive capacity is exceeded, cholesterol excretion may increase, resulting in a decrease in serum cholesterol levels and improvement in serum lipid profiles.

  12. Santorinicele: secretin-enhanced magnetic resonance cholangiopancreatography findings before and after minor papilla sphincterotomy

    Energy Technology Data Exchange (ETDEWEB)

    Boninsegna, Enrico; Manfredi, Riccardo; Ventriglia, Anna; Negrelli, Riccardo; Pedrinolla, Beatrice; Mehrabi, Sara; Pozzi Mucelli, Roberto [University of Verona, Department of Radiology - Policlinico G.B. Rossi, Verona (Italy); Gabbrielli, Armando [University of Verona, Department of Medicine - Policlinico G.B. Rossi, Verona (Italy)

    2015-08-15

    To evaluate secretin-enhanced MRCP (S-MRCP) findings of patients with pancreas divisum and Santorinicele, before and after minor papilla sphincterotomy. S-MRCP examinations of 519 patients with suspected pancreatic disease were included. Size of the main pancreatic duct, presence and calibre of Santorinicele were evaluated. Duodenal filling was assessed on dynamic images. After sphincterotomy the same parameters and the clinical findings were re-evaluated. Pancreas divisum was depicted in 55/519 patients (11 %) by MRCP and an additional 26/519 by S-MRCP (total 81/519, 16 %). Santorinicele was detected in 7/81 patients (8.6 %) with pancreas divisum by MRCP and an additional 20/81 by S-MRCP (total 27/81, 33 %). Dorsal duct in patients with Santorinicele was significantly larger in the head compared with patients with only pancreas divisum (p < 0.01), in basal conditions (average 2.4 versus 1.9 mm) and after secretin administration (average 3.0 versus 2.4 mm). Duodenal filling was impaired in 11/27 patients (41 %) with Santorinicele. After sphincterotomy significant reduction in size of Santorinicele (-33 %) and dorsal duct (-17 %), increase of pancreatic juice and symptoms improvement were observed. Secretin administration increases the accuracy of MRCP in detecting Santorinicele and demonstrates the impaired duodenal filling. S-MRCP is useful to assess results of sphincterotomy. (orig.)

  13. Biliary ascariasis: an uncommon cause for recurrent biliary colic after biliary sphincterotomy and common bile duct stone removal.

    Science.gov (United States)

    Thandassery, Ragesh Babu; Jha, Ashish Kumar; Goenka, Mahesh Kumar

    2014-04-01

    Endoscopic retrograde cholangiography is the most commonly used technique for removal of common bile duct stones. Biliary sphincterotomy during the procedure facilitates stone retrieval from the common bile duct. However, sphincterotomy ablates the normal biliary sphincter mechanism. This facilitates duodeno-biliary reflex and can result in inward migration of luminal parasite into the biliary system. In areas where ascariasis is endemic there is an increased risk of biliary ascariasis in postbiliary sphincterotomy patients. We report an unusual case where a patient presented with recurrent biliary colic after cholecystectomy and common bile duct stone extraction and was diagnosed to have biliary ascariasis with the help of endoscopic ultrasound examination of the biliary system.

  14. Visible Perforating Lateral Osteotomy: Internal Perforating Technique with Wide Periosteal Dissection

    Directory of Open Access Journals (Sweden)

    Bong Il Rho

    2016-01-01

    Full Text Available There are two general categories of lateral osteotomy techniques—the external perforating method and the internal continuous method. Regardless of which technique is used, procedural effectiveness is hampered by limited visualization in the surgical field. Considering this point, we devised a new technique that involves using a wide subperiosteal dissection and internal perforation under direct visualization. Using an intranasal approach, whereby the visibility of the intended fracture line was maintained, enabled a greater degree of control, and in turn, results that were more precise, and thus predictable and reproducible. Traditionally, it has been taken as dogma that the periosteum must be preserved, considering the potential for dead space and bony instability; however, under sufficient visualization of the surgical field with an internal perforating method, complete osteotomy with fully preserved intranasal mucosa could be conducted exactly as intended. This intact mucosal lining compensates for the elevated periosteum. Compressive dressing and drainage through a Silastic angio-needle catheter enabled the elimination of dead space. Therefore, precise, reproducible, and predictable osteotomy minimizing the potential for associated complications such as ecchymosis, that is, bruising owing to hemorrhage, could be performed. In this article, we introduce a novel technique for lateral osteotomy with improved visualization.

  15. Internal hydration of a metal-transporting ATPase is controlled by membrane lateral pressure

    Energy Technology Data Exchange (ETDEWEB)

    Fahmy, Karim [Helmholtz-Zentrum Dresden-Rossendorf e.V., Dresden (Germany). Biophysics; Fischermeier, E. [Technische Univ. Dresden (Germany); Pospisil, P. [A.S.C. R., Prague (Czech Republic). J. Heyrovsky Inst. Physical Chemistry; Solioz, M. [Bern Univ. (Switzerland); Sayed, A.; Hof, M.

    2017-07-01

    The active transport of ions across biological mem branes requires their hydration shell to interact with the interior of membrane proteins. However, the influence of the external lipid phase on internal dielectric dynamics is hard to access by experiment. Using the octahelical transmembrane architecture of the copper-transporting P{sub 1B}-type ATPase from Legionella pneumophila (LpCopA) as a model structure, we have established the site-specific labeling of internal cysteines with a polarity-sensitive fluorophore. This enabled dipolar relaxation studies in a solubilized form of the protein and in its lipid-embedded state in nano-discs (NDs). Time-dependent fluorescence shifts revealed the site-specific hydration and dipole mobility around the conserved ion-binding motif. The spatial distribution of both features is shaped significantly and independently of each other by membrane lateral pressure.

  16. Effect of Endoscopic Sphincterotomy for Suspected Sphincter of Oddi Dysfunction on Pain-Related Disability Following Cholecystectomy

    Science.gov (United States)

    Cotton, Peter B.; Durkalski, Valerie; Romagnuolo, Joseph; Pauls, Qi; Fogel, Evan; Tarnasky, Paul; Aliperti, Giuseppe; Freeman, Martin; Kozarek, Richard; Jamidar, Priya; Wilcox, Mel; Serrano, Jose; Brawman-Mintzer, Olga; Elta, Grace; Mauldin, Patrick; Thornhill, Andre; Hawes, Robert; Wood-Williams, April; Orrell, Kyle; Drossman, Douglas; Robuck, Patricia

    2015-01-01

    IMPORTANCE Abdominal pain after cholecystectomy is common and may be attributed to sphincter of Oddi dysfunction. Management often involves endoscopic retrograde cholangiopancreatography (ERCP) with manometry and sphincterotomy. OBJECTIVE To determine whether endoscopic sphincterotomy reduces pain and whether sphincter manometric pressure is predictive of pain relief. DESIGN, SETTING, AND PATIENTS Multicenter, sham-controlled, randomized trial involving 214 patients with pain after cholecystectomy without significant abnormalities on imaging or laboratory studies, and no prior sphincter treatment or pancreatitis randomly assigned (August 6, 2008-March 23, 2012) to undergo sphincterotomy or sham therapy at 7 referral medical centers. One-year follow-up was blinded. The final follow-up visit was March 21, 2013. INTERVENTIONS After ERCP, patients were randomized 2:1 to sphincterotomy (n = 141) or sham (n = 73) irrespective of manometry findings. Those randomized to sphincterotomy with elevated pancreatic sphincter pressures were randomized again (1:1) to biliary or to both biliary and pancreatic sphincterotomies. Seventy-two were entered into an observational study with conventional ERCP managemeny. MAIN OUTCOMES AND MEASURES Success of treatment was defined as less than 6 days of disability due to pain in the prior 90 days both at months 9 and 12 after randomization, with no narcotic use and no further sphincter intervention. RESULTS Twenty-seven patients (37%; 95%CI, 25.9%-48.1%) in the sham treatment group vs 32 (23%; 95%CI, 15.8%-29.6%) in the sphincterotomy group experienced successful treatment (adjusted risk difference, −15.6%; 95% CI, −28.0% to −3.3%; P = .01). Of the patients with pancreatic sphincter hypertension, 14 (30%; 95% CI, 16.7%-42.9%) who underwent dual sphincterotomy and 10 (20%; 95% CI, 8.7%-30.5%) who underwent biliary sphincterotomy alone experienced successful treatment. Thirty-seven treated patients (26%; 95% CI,19%-34%) and 25 patients

  17. REVERSE ENGINEERING OF THE MITKOVIC TYPE INTERNAL FIXATOR FOR LATERAL TIBIAL PLATEAU

    Directory of Open Access Journals (Sweden)

    Nikola Vitković

    2015-12-01

    Full Text Available In orthopaedic surgery it is very important to use proper fixation techniques in the treatment of various medical conditions, i.e. bone fractures or other traumas. If an internal fixation method, such as plating, is required, it is possible to use Dynamic Compression Plates (DCP or Locking Compression Plates (LCP and their variants. For DCP implants it is important to match the patient's bone shape with the most possible accuracy, so that the most frequent implant bending is applied in the surgery. For LCP implants it is not so important to match the patient’s bone shape, but additional locking screw holes are required. To improve the geometrical accuracy and anatomical correctness of the shape of DCP and to improve the LCP geometric definition, new geometrical modelling methods for the Mitkovic type internal fixator for Lateral Tibia Plateau are developed and presented in this research. The presented results are quite promising; it can be concluded that these methods can be applied to the creation of geometrical models of internal fixator customized for the given patient or optimized for a group of patients with required geometrical accuracy and morphological correctness.

  18. Endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy is safe and effective

    DEFF Research Database (Denmark)

    Jakobsen, Henrik Loft; Vilmann, Peter; Rosenberg, Jacob

    2011-01-01

    performed in all patients, and stone extraction was successfully performed in 29 patients (93%) with 2 failures (7%) due to impacted stones. In 8 patients (26%), the laparoscopic procedure was converted to open cholecystectomy because of dense adhesions or unclear anatomy. Two patients (7%) developed mild......Management strategy for common bile duct (CBD) stones is controversial with several treatment options if stones in the CBD are recognized intraoperatively. The aim of this study was to report our experience with same-session combined endoscopic-laparoscopic treatment of gallbladder and CBD stones....... We retrospectively evaluated 31 patients with cholecystolithiasis and CBD stones undergoing same-session combined endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and endoscopic stone extraction and laparoscopic cholecystectomy. Same-session ERCP and sphincterotomy were...

  19. Evaluation of lateral resolution of scanning surface microscopy by total internal reflection with thermal lens effect.

    Science.gov (United States)

    Shimosaka, Takuya; Izako, Masakazu; Uchiyama, Katsumi; Hobo, Toshiyuki

    2003-06-01

    We have developed a novel method for in situ and non-destructive surface analyses, or a total internal reflection with thermal lens spectroscopy (TIR-TLS), which has sufficient sensitivity to monitor phenomena in thin films, such as lipid bilayers. In this study, we applied TIR-TLS to microscopy for surface analyses, and we experimentally obtained its lateral resolution using the edge of a chromium film made by a photolithography technique. The obtained resolution was 20 microm, which was 60% of the diameter of an excitation beam at the interface. The estimated resolution with a simple model agreed with the experimental one, and from this model, TIR-TLS microscopy has the same resolution as that of ordinary optical microscopy. The microscopy by TIR-TLS was applied to a sample whose contrast was too weak to be visually seen, and an image of the sample was obtained without any loss of resolution.

  20. Limited endoscopic sphincterotomy plus large balloon dilation for choledocholithiasis with periampullary diverticula

    Institute of Scientific and Technical Information of China (English)

    Hyung; Wook; Kim; Dae; Hwan; Kang; Cheol; Woong; Choi; Jong; Hwan; Park; Jin; Ho; Lee; Min; Dae; Kim; Il; Doo; Kim; Ki; Tae; Yoon; Mong; Cho; Ung; Bae; Jeon; Suk; Kim; Chang; Won; Kim; Jun; Woo; Lee

    2010-01-01

    AIM: To investigate the effectiveness and safety of limited endoscopic sphincterotomy (EST) plus large balloon dilation (LBD) for removing choledocholithiasis in patients with periampullary diverticula (PAD). METHODS: A total of 139 patients with common bile duct (CBD) stones were treated with LBD (10-20 mm balloon diameter) after limited EST. Of this total, 73 patients had PAD and 66 patients did not have PAD (controls). The results of stone removal and complications were retrospectively evaluated. RESULTS...

  1. Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.

    Science.gov (United States)

    Testoni, Pier Alberto; Mariani, Alberto; Aabakken, Lars; Arvanitakis, Marianna; Bories, Erwan; Costamagna, Guido; Devière, Jacques; Dinis-Ribeiro, Mario; Dumonceau, Jean-Marc; Giovannini, Marc; Gyokeres, Tibor; Hafner, Michael; Halttunen, Jorma; Hassan, Cesare; Lopes, Luis; Papanikolaou, Ioannis S; Tham, Tony C; Tringali, Andrea; van Hooft, Jeanin; Williams, Earl J

    2016-07-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It provides practical advice on how to achieve successful cannulation and sphincterotomy at minimum risk to the patient. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations 1 ESGE suggests that difficult biliary cannulation is defined by the presence of one or more of the following: more than 5 contacts with the papilla whilst attempting to cannulate; more than 5 minutes spent attempting to cannulate following visualization of the papilla; more than one unintended pancreatic duct cannulation or opacification (low quality evidence, weak recommendation). 2 ESGE recommends the guidewire-assisted technique for primary biliary cannulation, since it reduces the risk of post-ERCP pancreatitis (moderate quality evidence, strong recommendation). 3 ESGE recommends using pancreatic guidewire (PGW)-assisted biliary cannulation in patients where biliary cannulation is difficult and repeated unintentional access to the main pancreatic duct occurs (moderate quality evidence, strong recommendation). ESGE recommends attempting prophylactic pancreatic stenting in all patients with PGW-assisted attempts at biliary cannulation (moderate quality evidence, strong recommendation). 4 ESGE recommends needle-knife fistulotomy as the preferred technique for precutting (moderate quality evidence, strong recommendation). ESGE suggests that precutting should be used only by endoscopists who achieve selective biliary cannulation in more than 80 % of cases using standard cannulation techniques (low quality evidence, weak recommendation). When access to the pancreatic duct is easy to obtain, ESGE suggests placement of a pancreatic stent prior to precutting (moderate quality evidence, weak recommendation). 5 ESGE recommends that in patients with a small papilla

  2. Neuromyogenic properties of the internal anal sphincter: therapeutic rationale for anal fissures.

    Science.gov (United States)

    Bhardwaj, R; Vaizey, C J; Boulos, P B; Hoyle, C H

    2000-06-01

    Lateral sphincterotomy diminishes internal anal sphincter hypertonia and thereby reduces anal canal pressure. This improves anal mucosal blood flow and promotes the healing of anal fissures. However, sphincterotomy can be associated with long term disturbances of sphincter function. The optimal treatment for an anal fissure is to induce a temporary reduction of anal canal resting pressure to allow healing of the fissure without permanently disrupting normal sphincter function. Broader understanding of the intrinsic mechanisms controlling smooth muscle contraction has allowed pharmacological manipulation of anal sphincter tone. We performed an initial Medline literature search to identify all articles concerning "internal anal sphincter" and "anal fissures". This review is based on these articles and on additional publications obtained by manual cross referencing. Internal anal smooth muscle relaxation can be inhibited by stimulation of non-adrenergic non-cholinergic enteric neurones, parasympathetic muscarinic receptors, or sympathetic beta adrenoceptors, and by inhibition of calcium entry into the cell. Sphincter contraction depends on an increase in cytoplasmic calcium and is enhanced by sympathetic adrenergic stimulation. Currently, the most commonly used pharmacological agent in the treatment of anal fissures is topical glyceryl trinitrate, a nitric oxide donor. Alternative agents that exhibit a similar effect via membrane Ca2+ channels, muscarinic receptors, and alpha or beta adrenoceptors are also likely to have a therapeutic potential in treating anal fissures.

  3. Near-inertial internal Poincare waves in Lake Michigan: Seasonal variability and effects on lateral dispersion and turbulent mixing

    OpenAIRE

    Choi, Jun M

    2015-01-01

    A dominant physical process in stratified Lake Michigan is near-inertial internal Poincaré waves. The near-inertial internal Poincaré waves is described as locally quasi-uniform currents in the lateral direction, with vertically-sheared structures rotating clockwise at a near-inertial period. The goal of this dissertation is to investigate their seasonal variation and the potential roles on lateral dispersion and vertical mixing. ^ At this mid-lake location, the Poincaré wave is seen to descr...

  4. Associations between attachment-related symptoms and later psychological problems among international adoptees: results from the FinAdo study.

    Science.gov (United States)

    Elovainio, Marko; Raaska, Hanna; Sinkkonen, Jari; Mäkipää, Sanna; Lapinleimu, Helena

    2015-02-01

    We examined the associations between attachment-related symptoms (symptoms of reactive attachment disorder (RAD), symptoms of disinhibited social engagement disorder (DSED), and clinging) and later psychological problems among international adoptees. The study population comprised internationally adopted children (591 boys and 768 girls, 6-15 years) from the ongoing Finnish Adoption (FinAdo) study. Data were gathered with self-administered questionnaires both from adoptive parents and from adoptees aged over 9 years. Attachment-related symptoms were measured using of a short (8-item) questionnaire and later behavioral/emotional problems were assessed using the Child Behavior Checklist (CBCL) and the Five to Fifteen (FTF) scale for attention-deficit/hyperactivity disorder (ADHD) symptoms. RAD and DSED symptom subscales were associated with an increased risk of emotional and behavioral problems and ADHD. Especially the mixed type of attachment-related symptoms was strongly associated with later emotional and behavioral problems.

  5. Palliative care in amyotrophic lateral sclerosis: a review of current international guidelines and initiatives.

    LENUS (Irish Health Repository)

    Bede, Peter

    2011-04-01

    Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive neurodegenerative condition. Optimal management requires a palliative approach from diagnosis with emphasis on patient autonomy, dignity and quality of life.

  6. Internal Evaluation a Quarter-Century Later: A Conversation with Arnold J. Love

    Science.gov (United States)

    Volkov, Boris B.

    2011-01-01

    This chapter features a recent conversation with Dr. Arnold J. Love, a long-time proponent of internal evaluation and one of the most cited internal evaluation authors. In 1983, Love edited the first issue of "New Directions for Program Evaluation" on the topic of internal evaluation. He is the author of the book "Internal Evaluation: Building…

  7. An Analytical Approach for Deformation Shapes of a Cylindrical Shell with Internal Medium Subjected to Lateral Contact Explosive Loading

    Directory of Open Access Journals (Sweden)

    Xiangyu Li

    2015-01-01

    Full Text Available An experimental investigation on deformation shape of a cylindrical shell with internal medium subjected to lateral contact explosion was carried out briefly. Deformation shapes at different covered width of lateral explosive were recovered experimentally. Based on the experimental results, a corresponding analytical approach has been undertaken with rigid plastic hinge theory. In the analytical model, the cylindrical shell is divided into end-to-end rigid square bars. Deformation process of the cylindrical shell is described by using the translations and rotations of all rigid square bars. Expressions of the spring force, buckling moment, and deflection angle between adjacent rigid square bars are conducted theoretically. Given the structure parameters of the cylinder and the type of the lateral explosive charge, deformation processes and shapes are reported and discussed using the analytical approach. A good agreement has been obtained between calculated and experimental results, and thus the analytical approach can be considered as a valuable tool in understanding the deformation mechanism and predicting the deformation shapes of the cylindrical shell with internal medium subjected to lateral contact explosion. Finally, parametric studies are carried out to analyze the effects of deformation shape, including the covered width of the lateral explosive, explosive charge material, and distribution of initial velocity.

  8. Gallstone ileus following endoscopic retrograde cholangiopancreatography and sphincterotomy: a case report

    Directory of Open Access Journals (Sweden)

    Goyal Amit

    2008-11-01

    Full Text Available Abstract Introduction Gallstone ileus is a mechanical obstruction caused by the impaction of one or more gallstones within the lumen of any part of the gastrointestinal tract. Although the disorder is a rare cause of small bowel obstruction (1% to 2%, it has been reported to cause up to 25% of cases of non-strangulated small bowel obstruction in patients over 65 years of age. Case presentation We report a case of a 67-year-old woman who presented with gallstone ileus following endoscopic retrograde cholangiopancreatography and sphincterotomy for choledocholithiasis. She had a history of terminal ileum resection with ileocolic anastomosis for Crohn's disease. A 3 cm gallstone was found to be impacted just proximal to the previous ileocolic anastomosis. A second gallstone was found on digital examination of the proximal small bowel. Conclusion A gallstone may enter the gastrointestinal tract following endoscopic retrograde cholangiopancreatography and sphincterotomy and impact proximal to an anastomotic stricture as demonstrated here. The radiographic image of small bowel obstruction plus air in the biliary tree is a classic diagnostic finding. After stone extraction, the entire small bowel and colon should be digitally examined for further stones.

  9. Successful outcome of sphincterotomy and 7 French pigtail stent insertion in the management of post-cholecystectomy bile leaks.

    LENUS (Irish Health Repository)

    Donnellan, Fergal

    2009-06-01

    BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is widely used to manage post-cholecystectomy bile leaks. However, the best endoscopic intervention remains controversial. We investigated the success of a 7 French double pigtail stent following sphincterotomy in the management of such bile leaks. METHODS: Between July 1998 and June 2008, 48 patients were referred for ERCP for presumed post-cholecystectomy bile leaks. Leaks were confirmed at ERCP and managed by a combination of sphincterotomy and stent insertion unless contraindicated. RESULTS: Bile duct cannulation was successful in 44 (91.7%) patients. A leak of the cystic duct was demonstrated in 19 (43.2%) patients, the duct of Luschka in 11 (25.0%), and the common hepatic duct in 5 (11.4%). Complete transection of the common bile duct occurred in 4 patients. The remaining patients had no cholangiographic evidence of a leak. Sphincterotomy was performed in 34 patients. A 7 French double pigtail plastic stent was placed in all 35 patients with cholangiographic evidence of a bile leak. No bile leaks were demonstrated at a follow-up of 8-16 weeks and all stents were removed successfully. CONCLUSION: The combination of sphincterotomy and insertion of a 7 French double pigtail stent results in excellent outcomes in the management of post-cholecystectomy bile leaks.

  10. Duodenoscopic sphincterotomy for common bile duct stones in patients with gallbladder in situ.

    Science.gov (United States)

    Saraswat, V A; Kapur, B M; Vashisht, S; Tandon, R K

    1991-01-01

    Duodenoscopic sphincterotomy (DS) is a well established treatment for common bile duct (CBD) stones in post-cholecystectomy patients, but not in patients with gallbladder in situ. The main argument against the procedure in the latter set of patients has been that by performing it, one is leaving behind the diseased gallbladder which may require further treatment. We have, however, performed 60 DS in 49 patients with gallbladder in situ. The clinical picture of these patients was characterized by abdominal pain in 79.6%, jaundice in 91.8%, history of cholangitis in 46.9%, severe acute cholangitis at the time of DS in 28.6% and a major associated illness in 10.2% of them. Adequate sphincterotomy was performed in 91.8% of the patients with successful stone extractions in 93.3% and an overall CBD clearance in 85.7%. One patient (2%) with severe acute cholangitis, who had presented in a moribund state, died despite adequate DS. Three patients (6%) experienced an exacerbation of acute cholangitis after DS, two of them requiring emergency surgery. During subsequent follow-up, elective cholecystectomy was performed in 26 (54%) patients. Five additional patients are awaiting surgery. Seventeen (36%) patients continue to have their gallbladders in situ and over a mean follow-up period of 12.8 months (range, 4-32 mos) they have remained asymptomatic except for brief episodes of biliary pain in 2 patients. It is concluded that DS relieves the symptoms of CBD stones even in patients with gallbladders in situ and may suffice for patients who are frail, elderly and who have major associated illnesses.

  11. Management of choledocholithiasis: Comparison between laparoscopic common bile duct exploration and intraoperative endoscopic sphincterotomy

    Institute of Scientific and Technical Information of China (English)

    Qi Wei; Jian-Guo Wang; Li-Bo Li; Jun-Da Li

    2003-01-01

    AIM: Choledocholithiasis is present in 5 to 10 percent of patients who have cholelithiasis. Tn the area of laparoscopic cholecystectomy (LC), laparoscopic common bile duct exploration (LCBDE) and intraoperative endoscopic sphincterotomy (IOES) have been used to treat choledocholithiasis. The purpose of this study was to compare the clinical outcomes and hospital costs of LCBDE with IOES.METHODS: Between November 1999 and October 2002,patients with choledocholithiasis undergoing LC plus LCBDE (Group A, n=45) were retrospectively compared to those undergoing LC plus IOES (Group B, n=57) at a single institution.RESULTS: Ductal stone clearance rates were equivalent for the two groups (88 % versus 89 %, P=0.436). The conversion rate was higher for Group B (8.8 % versus 4.4 %,P=0.381), as was the morbidity (12.3 % versus 6.7 %,P=0.336). There were no other significant differences between the two groups. The complications were mainly related to endoscopic sphincterotomy (ES), and the hospital costs were significantly increased in this subset of Group B (median, 23 910 versus 14 955 RMB yuan, P=0.03). Although hospital stay was longer in Group A (median, 7 versus 6 days,P=0.041), the patients in Group A had a significantly decreased cost of hospitalization compared with those in Group B (median, L1 362 versus 15 466 RMB yuan, P=0.000).CONCLUSION: The results demonstrate equivalent ductal stone clearance rates for the two groups. LCBDE management appears safer, and is associated with a significantly decreased hospital cost. The findings suggest LCBDE for choledocholithiasis is a better option.

  12. Study of Lateral Misalignment Tolerance of a Symmetric Free-Space Optical Link for Intra International Space Station Communication

    Science.gov (United States)

    Tedder, Sarah A.; Schoenholz, Bryan; Suddath, Shannon N.

    2016-01-01

    This paper describes the study of lateral misalignment tolerance of a symmetric high-rate free-space optical link (FSOL) for use between International Space Station (ISS) payload sites and the main cabin. The link will enable gigabit per second (Gbps) transmission of data, which is up to three orders of magnitude greater than the current capabilities. This application includes 10-20 meter links and requires minimum size, weight, and power (SWaP). The optical power must not present an eye hazard and must be easily integrated into the existing ISS infrastructure. On the ISS, rapid thermal changes and astronaut movement will cause flexure of the structure which will potentially misalign the free space transmit and receive optics 9 cm laterally and 0.2 degrees angularly. If this misalignment is not accounted for, a loss of the link or degradation of link performance will occur. Power measurements were collected to better understand the effect of various system design parameters on lateral misalignment. Parameters that were varied include: the type of small form pluggable (SFP) transceivers, type of fiber, and transmitted power level. A potential solution was identified that can reach the lateral misalignment tolerance (decenter span) required to create an FSOL on the ISS by using 105 m core fibers, a duplex SFP, two channels of light, and two fiber amplifiers.

  13. Later Leaders in Education: Hazel Flannery Gabbard--Specialist in International Education.

    Science.gov (United States)

    Blackwood, Paul E.

    1993-01-01

    This biography of Hazel Flannery Gabbard discusses her organization of nursery school centers in Rochester, New York; her work as an education specialist in the U.S. Office of Education; her cooperation with national organizations; and her international education activities. (SM)

  14. Condylar position on the lateral individualized corrected tomography in internal derangement of temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keun Min; Hwang, Eui Hwan; Lee, Sang Rae [College of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    2002-06-15

    To examine the possible relationship between condylar position and disk displacement in the temporomandibular joint. 79 temporomandibular joints in 40 patients having temporomandibular disorders were classified into three categories: no disk displacement (NDD), disk displacement with reduction (DDWR), and disk displacement without reduction (DDWOR). Disk positions were assessed from clinical and MRI findings. The relationship between the three categories and condylar positions was evaluated using lateral individualized corrected tomography. Clinical findings regarding the relationship between condyle and disk positions having anterior, centric, and posterior positions were 27%, 27%, and 46%, respectively, in NDD, 43%, 17%, and 40%, respectively, in DDWR, and 44%, 22%, and 34%, respectively, in DDWOR. There were no significant differences in condylar positions between each of the groups (P>0.05). In the relationship between condyle and disk positions with MRI findings, anterior, centric, and posterior positions were 38%, 38%, and 24%, respectively, in NDD, 29%, 21%, and 50%, respectively, in DDWR, and 44%, 9%, and 47% respectively, in DDWOR. There were significant differences in the condylar positions when MRI was utilized (P<0.05). There was a significant correlation between the condyle and disk positions with MRI findings on lateral individualized corrected tomography.

  15. Influence of hooks and a lag screw on internal fixation plates for lateral malleolar fracture: a biomechanical and ergonomic study.

    Science.gov (United States)

    Sakai, Rina; Uchino, Masataka; Yoneo, Terumasa; Ohtaki, Yasuaki; Minehara, Hiroaki; Matsuura, Terumasa; Gomi, Tsutomu; Ujihira, Masanobu

    2017-02-23

    For internal fixation of AO classification Type B lateral malleolar fracture, insertion of lag screws into the fracture plane and fixation with a one-third tubular plate as a neutralization plate are the standard treatment procedures. The one-third tubular plate is processed to a hook shape and hung on the distal end of the fibula. In this study, to compare the function of the hook and lag screws of a one-third tubular plate and LCP for osteosynthesis of lateral malleolar fracture, mechanical indices of internal fixation were compared among the one-third tubular plates with lag screws with and without the hook and a locking compression plate. As mechanical tests, a compression test was performed in which compression in the bone axis direction produced by supporting the body weight was simulated, and a torsion test was performed in which external rotation of the bone axis caused by plantar flexion of the ankle joint was simulated. Muscle strength during walking and the force and torque acting on the ankle and knee joints were determined using inverse dynamic analysis. Finite element analysis was performed to analyze the function of hooks and lag screws. The joint reaction force determined by inverse dynamic analysis was adopted as the loading condition of finite element analysis. A stiffness equivalent to that of healthy bone could be achieved by all three internal fixations. It was clarified that the presence of the hook does not make a difference in stiffness. Displacement of the one-third tubular plate was small regardless of the presence or absence of the hook compared with those of locking compression plates. The presence of the hook did not make any difference in stiffness, suggesting that active preparation of the hook is unnecessary. We also clarified that lag screws inhibit displacement.

  16. Protective Factors Interrupting the Continuity from School Bullying to Later Internalizing and Externalizing Problems: A Systematic Review of Prospective Longitudinal Studies

    Science.gov (United States)

    Ttofi, Maria M.; Bowes, Lucy; Farrington, David P.; Lösel, Friedrich

    2014-01-01

    A systematic review is presented, based on prospective longitudinal studies, on protective factors that interrupt the continuity from bullying perpetration at school to externalizing problem behaviors later in life; and from bullying victimization to later internalizing problems. Some common factors were established, which seem to interrupt the…

  17. A mapping review of international guidance on the management and care of amyotrophic lateral sclerosis (ALS).

    Science.gov (United States)

    Janssens, Astrid I W A; Ruytings, Marijke; Al-Chalabi, Ammar; Chio, Adriano; Hardiman, Orla; Mcdermott, Christopher J; Meyer, Thomas; Mora, Gabriele; Van Damme, Philip; Van Den Berg, Leonard H; Vanhaecht, Kris; Winkler, Andrea S; Sermeus, Walter

    2016-01-01

    Management of ALS is suboptimal. Consequently, quality improvement interventions are needed to improve ALS care. An evidence-based insight into how patients should be managed is essential when developing quality improvement interventions. Therefore, this study aimed to map, categorize and summarize international guidance on the management and care of ALS and to identify gaps in this guidance by means of a mapping review. Literature was searched for clinical practice guidelines, quality indicators and evidence-based clinical summaries. A content analysis and meta-synthesis of the included literature was performed. Interventions and outcomes used in the management and care of ALS were identified and categorized. Furthermore, the amount of guidance underpinning these interventions and outcomes was analysed. Six clinical practice guidelines, one set of quality indicators and three evidence-based clinical summaries were identified. The results demonstrated that certain domains in ALS care, mainly disease-specific domains such as breathing and swallowing, are extensively addressed in the literature whereas other subjects, such as care coordination, receive little attention. In conclusion, this mapping review provides a scientific basis for targeting and developing the clinical content of a quality improvement intervention for the management of ALS.

  18. LATE OPEN REDUCTION AND INTERNAL FIXATION FOR FRACTURES OF LATERAL CONDYLE OF HUMERUS IN CHILDREN: A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Ajay

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : Neglected fracture of the lateral condyle of distal humerus in children is very common. Patients with non union of the lateral condylar fracture have pain, instability or a progressive cubitus valgus deformity, condylar prominence. A neglected displaced lateral humeral condyle fracture remains a difficult problem to treat. The bone ends become indistinct and soft tissue becomes contracted; making anatomic reduction difficult. Moreover a n attempt to mobilize the fragment by stripping the soft tissues may lead to avascular necrosis. Several authors have recommended operative treatment for such patients, while others do not recommend operative intervention because stiff elbow and AVN are th e usual outcomes. The present study was undertaken to assess the results of open reduction and internal fixation in neglected lateral humeral condyle fracture in children. MATERIAL AND METHODS : This is a prospective study carried out between November 2008 and July 2011 in the department of orthopedics at Teerthanker Mahaveer Medical College and research centre, Moradabad. Eighteen patients (14M:4F with an average age of 7.3years (range 5.5 to 14 years who had lateral humeral condyle fracture and reporte d 3 or more weeks after sustaining injury, were included in the study. The fractures were classified according to the Jacobs system. All patients were operated using the lateral approach and fixation was done using K wire or screw with or without bone graf ting. The results were graded as excellent, good, fair or poor according to the modified criteria of Agarwal et al. RESULTS : There were 14 males and 4 females with a mean age of 7 years and 3 months (range 4 - 14 years. Among the nine (50% patients who pr esented between 5 to 8 weeks after injury, the results were excellent in 3, good in 4, fair in 1 and poor in 1 patient. Excellent to good results were seen in all the five (27% patients presenting between 3 - 5 weeks of injury. Among

  19. Prior minimal endoscopic sphincterotomy to prevent pancreatitis related to endoscopic balloon sphincteroplasty

    Science.gov (United States)

    Kanazawa, Ryo; Sai, Jin Kan; Ito, Tomoyasu; Miura, Hiroko; Ishii, Shigeto; Saito, Hiroaki; Tomishima, Ko; Shimizu, Ryo; Sato, Koki; Hayashi, Manabu; Watanabe, Sumio; Shiina, Shuichiro

    2016-01-01

    AIM To investigate the efficacy of prior minimal endoscopic sphincterotomy (EST) to prevent pancreatitis related to endoscopic balloon sphincteroplasty (EBS). METHODS After bile duct access was gained and cholangiogram confirmed the presence of stones pancreatitis and the difference in serum amylase level after the procedure were examined and compared with those associated with 8-mm EBS alone in 32 patients of historical control (control group). RESULTS One hundred and five patients were included in the EST-EBS group, and complete stone removal was accomplished in all of them. The difference in serum amylase level after the procedure was - 25.0 (217.9) IU/L in the EST-EBS group and this value was significantly lower than the 365.5 (576.3) IU/L observed in the control group (P pancreatitis was 0% (0/105) in the EST-EBS group and 15.6% (5/32) in the control group (P pancreatitis related to EBS.

  20. Late Complications following Endoscopic Sphincterotomy for Choledocholithiasis: A Swedish Population-Based Study

    Directory of Open Access Journals (Sweden)

    A. Langerth

    2014-01-01

    Full Text Available In order to assess the risk of long-term complications following endoscopic sphincterotomy (ES for common bile duct stones (CBDS, we conducted a cohort study. The study included 1,113 patients who underwent ES for CBDS in six different hospitals in central Sweden between 1977 and 1990. Through the use of the Swedish population registry, each patient was assigned five population-based controls matched for sex and age. Linkage to the Inpatient Registry yielded information on morbidity and mortality for the patients as well as for the controls. After one year of washout, there were 964 patients available for follow-up. The mean age was 70.6 years, 57% were women, and the mean length of follow-up was 8.9 years. The patients’ overall morbidity was significantly higher and we observed a tendency towards increased mortality as well. Recurrent CBDS was diagnosed in 4.1% of the patients. Acute cholangitis with a hazard ratio (HR of 36 (95%CI 11–119.4 was associated with recurrent CBDS in 39% of the patients. HR for acute pancreatitis was 6.2 (95%CI 3.4–11.3 and only one patient had CBDS at the same time. In conclusion, we consider acute pancreatitis and cholangitis both as probable long-term complications after ES.

  1. Treating delayed endoscopic sphincterotomy-induced bleeding: Epinephrine injection with or without thermotherapy

    Institute of Scientific and Technical Information of China (English)

    Yung-Kuan Tsou; Cheng-Hui Lin; Nai-Jen Liu; Jui-Hsiang Tang; Kai-Feng Sung; Chi-Liang Cheng

    2009-01-01

    AIM: To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed postendoscopic sphincterotomy (ES) bleeding. METHODS: Cases with delayed post-ES bleeding undergoing epinephrine injection alone (epinephrine injection group, n = 26) or epinephrine combined with thermotherapy (combination therapy group, n = 33) in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements were: initial endoscopic hemostasis, rebleeding, complications, requirement of angiographic embolization or surgery, requirement for blood transfusion, and mortality. RESULTS: The initial hemostatic efficacy was 96.2% for epinephrine injection alone and 100% for combination therapy ( P = 0.44). There were four patients with re-bleeding in each group (16.0% vs 12.1%, P = 0.72). There was only one complication of pancreatitis from the combination therapy group. Three patients (11.5%) in the epinephrine injection group and one patient (3%) in the combination therapy group required angiographic embolization or surgery ( P = 0.31). The total number of blood transfusions was not significantly different between the two groups (3.5 ± 4.6 U vs 3.5 ± 4.5 U, P = 0.94). There was no bleeding-related death in either group. CONCLUSION: Epinephrine injection alone is as effective as epinephrine injection combined with thermotherapy for the management of delayed post- ES bleeding.

  2. Stability of right visual field advantage in an international lateralized lexical decision task irrespective of participants' sex, handedness or bilingualism.

    Science.gov (United States)

    Willemin, Julie; Hausmann, Markus; Brysbaert, Marc; Dael, Nele; Chmetz, Florian; Fioravera, Asia; Gieruc, Kamila; Mohr, Christine

    2016-01-18

    In lateralized lexical decision tasks (LDTs), accuracy is higher and reaction times (RTs) are faster for right visual field (RVF) than left visual field (LVF) presentations. Visual field differences are thought to demonstrate the left hemisphere's (LH) dominance for language. The use of different tasks and words between studies and languages make direct comparisons difficult. We performed a lateralized LDT for which we selected four to six letter words that are used in three languages of Switzerland (French, German, and Italian) and English and Dutch. We accounted for the potential moderating roles of sex, handedness and multilingualism (early acquisition versus late acquisition of at least one second language). One hundred participants were tested at a French-speaking University in Switzerland. All performed a French vocabulary knowledge task [Brysbaert ( 2013 ). Lextale_FR a fast, free, and efficient test to measure language proficiency in French. Psychologica Belgica, 53(1), 23-27. Retrieved from http://hdl.handle.net/1854/LU-4373981]. Results showed a RVF over LVF advantage (accuracy, RTs and signal detection theory measures) for all groups, that is, irrespective of participants' sex, handedness and how many languages they spoke. We observed, however, that enhanced vocabulary knowledge related to a right hemisphere shift in early bilinguals and a LH shift in late bilinguals. We discuss how the current observations can inform future studies suitable for the validation of the current task using an "international" vocabulary.

  3. Endoscopic sphincterotomy and risk of cholangiocarcinoma: a population-based cohort study in Finland and Sweden

    Science.gov (United States)

    Strömberg, Cecilia; Böckelman, Camilla; Song, Huan; Ye, Weimin; Pukkala, Eero; Haglund, Caj; Nilsson, Magnus

    2016-01-01

    Background and study aims: Elevated long-term risk of cholangiocarcinoma is reported after endoscopic sphincterotomy (ES), but in a previous study we found a trend towards a decreased risk. The aim of this study was to evaluate the association in a larger cohort with a longer follow-up. Patients and methods: Data concerning all patients having had an inpatient endoscopic retrograde cholangiopancreatography (ERCP) were collected from the hospital discharge registries of Finland and Sweden. Incident cases of malignancy were identified through linkage to the nationwide Cancer Registries. Patients with a diagnosis of malignancy, before or within 2 years of the ERCP, were excluded. The cohorts were followed until a diagnosis of malignancy, death or emigration, or end of follow-up (end of 2010). The relative risk of malignancy was calculated as standardized incidence ratio (SIR) compared with the general population, inherently adjusting for age, gender, and calendar year of follow-up. Results: A total of 69 925 patients undergoing ERCP from 1976 through 2008 were included in the pooled cohort. ES was performed in 40 193 subjects. The risk of malignancy was elevated in the total cohort (SIR = 2.3; 95 % confidence interval [CI] 2.1 – 2.5) irrespective of whether ES was performed or not. The SIRs diminished with duration of follow-up. Conclusions: We found an elevated risk of malignancy both in the bile ducts alone and in the bile ducts, liver or pancreas together, after ERCP. The risk was the same, regardless of whether ES had been performed or not, so ES was unlikely to be the cause, and a common carcinogenic exposure previous to the ERCP procedure, possibly ductal gallstone disease, was more likely.

  4. Composition of common bile duct stones in Chinese patients during and after endoscopic sphincterotomy

    Institute of Scientific and Technical Information of China (English)

    Wei-Lun Tsai; Kwok-Hung Lai; Chiun-Ku Lin; Hoi-Hung Chan; Ching-Chu Lo; Ping-I Hsu; Wen-Chi Chen; Jin-Shiung Cheng; Gin-Ho Lo

    2005-01-01

    AIM: Endoscopic sphincterotomy (ES) is a well-established therapeutic modality for the removal of common bile duct (CBD) stones. After ES there are still around 10% of patients that experience recurrent CBD stones. The aim of this study is to investigate the composition of CBD stones before and after ES and its clinical significance in Chinese patients.METHODS: From January 1996 to December 2003, 735Veterans General Hospital and stone specimens from 266patients were sent for analysis. Seventy-five patients had recurrent CBD stones and stone specimens from 44patients were sent for analysis. The composition of the stones was analyzed by infrared (IR) spectrometry and they were classified as cholesterol or bilirubinate stones according to the predominant composition. Clinical data were analyzed.RESULTS: In the initial 266 stone samples, 217 (82%)were bilirubinate stones, 42 (16%) were cholesterol stones,3 were calcium carbonate stones, 4 were mixed cholesterol and bilirubinate stones. Patients with bilirubinate stones were significantly older than patients with cholesterol stones (66±13 years vs 56±17 years, P= 0.001). In the 44 recurrent stone samples, 38 (86%) were bilirubinate stones, 3 (7%) were cholesterol stones, and 3 were mixed cholesterol and bilirubinate stones. In 27 patients, bothinitial and recurrent stone specimens can be obtained,23 patients had bilirubinate stones initially and 2 became cholesterol stones in the recurrent attack. In the four patients with initial cholesterol stones, three patients had bilirubinate stones and one patient had a cholesterol stone in the recurrent attack.CONCLUSION: Bilirubinate stone is the predominant composition of initial or recurrent CBD stone in Chinese patients. The composition of CBD stones may be different from initial stones after ES.

  5. Cholecystectomy and sphincterotomy in patients with mild acute biliary pancreatitis in Sweden 1988 - 2003: a nationwide register study

    Directory of Open Access Journals (Sweden)

    Stenlund Hans C

    2009-10-01

    Full Text Available Abstract Background Gallstones represent the most common cause of acute pancreatitis in Sweden. Epidemiological data concerning timing of cholecystectomy and sphincterotomy in patients with first attack of mild acute biliary pancreatitis (MABP are scarce. Our aim was to analyse readmissions for biliary disease, cholecystectomy within one year, and mortality within 90 days of index admission for MABP. Methods Hospital discharge and death certificate data were linked for patients with first attack acute pancreatitis in Sweden 1988-2003. Mortality was calculated as case fatality rate (CFR and standardized mortality ratio (SMR. MABP was defined as acute pancreatitis of biliary aetiology without mortality during an index stay of 10 days or shorter. Patients were analysed according to four different treatment policies: Cholecystectomy during index stay (group 1, no cholecystectomy during index stay but within 30 days of index admission (group 2, sphincterotomy but not cholecystectomy within 30 days of index admission (group 3, and neither cholecystectomy nor sphincterotomy within 30 days of index admission (group 4. Results Of 11636 patients with acute biliary pancreatitis, 8631 patients (74% met the criteria for MABP. After exclusion of those with cholecystectomy or sphincterotomy during the year before index admission (N = 212, 8419 patients with MABP remained for analysis. Patients in group 1 and 2 were significantly younger than patients in group 3 and 4. Length of index stay differed significantly between the groups, from 4 (3-6 days, (representing median, 25 and 75 percentiles in group 2 to 7 (5-8 days in groups 1. In group 1, 4.9% of patients were readmitted at least once for biliary disease within one year after index admission, compared to 100% in group 2, 62.5% in group 3, and 76.3% in group 4. One year after index admission, 30.8% of patients in group 3 and 47.7% of patients in group 4 had undergone cholecystectomy. SMR did not differ

  6. Effects Comparison between Endoscopic Papillary Large Balloon Dilatation and Endoscopic Sphincterotomy for Common Bile Duct Stone Removal

    Directory of Open Access Journals (Sweden)

    Yandong Guo

    2015-01-01

    Full Text Available Endoscopic sphincterotomy (EST is a treatment of choice for stone extraction and is now most frequently used. The study was to compare the efficacy of endoscopic papillary large balloon dilatation (EPLBD and endoscopic sphincterotomy (EST for common bile duct stone removal. Trials comparing the effects between EPLBD and EST treatment were searched according to the study protocol. Overall stone removal rate, complete removal rate in 1st session, treatment duration, mechanical lithotripsy using rate, and overall complication rate were compared using risk ratio (RR and mean difference (MD and their 95% confidence interval (CI via RevMan 5.2 software. For overall stone removal rate, two therapies showed similar effect, but EPLBD showed better overall stone removal rate for stone >10 mm in diameter. For complete stone removal rate in 1st session, no difference was found, even for those with stone >10 mm in diameter; EPLBD showed longer treatment duration, higher mechanical lithotripsy using rate obvious overall complications rate, and more serious bleeding, whereas there were no significant differences for perforation, hyperamylasemia, pancreatitis, and cholecystitis/cholangitis. EPLBD showed better efficacy in certain conditions compared to EST, however with shortcomings, such as more duration, higher mechanical lithotripsy using rate, more serious overall complications rate, and bleeding.

  7. Sphincterotomy with endoscopic biliary drainage for severe acute cholangitis: a meta-analysis

    Science.gov (United States)

    Sawas, Tarek; Arwani, Noura; Al Halabi, Shadi; Vargo, John

    2017-01-01

    Aims To investigate the role of endoscopic sphincterotomy (ES) with endoscopic biliary drainage (EBD) in acute severe obstructive cholangitis management by performing a meta-analysis of controlled trials. Method We searched PubMed and Embase for controlled studies that compared endoscopic drainage with ES versus Non-ES in acute obstructive cholangitis. Two reviewers selected the studies and extracted the data. Disagreement was addressed by a third reviewer. Heterogeneity of the studies was analyzed by Cochran’s Q statistics. A Mantel–Haenszel risk ratio was calculated utilizing a random effects model. Results Four controlled studies met our inclusion criteria with 392 participants (201 ES, 191 Non-ES). The outcomes were drainage insertion success rate, drainage effectiveness, post drainage pancreatitis, bleeding, procedure duration, perforation, cholecystitis, and 30-day mortality. Drainage insertion success rate was identical in both groups (RR: 1.00, 95 %CI% 0.96 – 1.04). Effective drainage was not significantly different (RR: 1.11, 95 %CI 0.73 – 1.7). There was no significant difference in the incidence of pancreatitis post EBD between the ES and Non-ES groups at 3 % and 4 %, respectively (RR: 0.73, 95 %CI 0.24 – 2.27). However, there was a significant increase in post EBD bleeding with ES compared to Non-ES (RR: 8.58, 95 %CI 2.03 – 36.34). Thirty-day mortality was similar between ES and Non-ES groups at 0.7 % and 1 %, respectively (RR: 0.5, 95 %CI 0.05 – 5.28). Conclusion Our findings show that EBD without ES is an effective drainage technique and carries less risk for post procedure bleeding. Patients who are critically ill and have coagulopathy should be spared from undergoing ES in the acute phase. PMID:28229129

  8. Lateral Mixing

    Science.gov (United States)

    2012-11-08

    being made on their analysis. A process we became very curious about was the separation of tendrils of warm salty water from the north wall figure 7...structure, and to remove the effect of internal waves by mapping this structure onto isopycnals. This has been very successful in elucidating lateral...we passed through the same water on multiple passes, and that changes in the horizontal structure of the water mas should be readily apparent from

  9. Endoscopic sphincterotomy for common bile duct calculi in patients with gall bladder in situ considered unfit for surgery.

    Science.gov (United States)

    Davidson, B R; Neoptolemos, J P; Carr-Locke, D L

    1988-01-01

    Endoscopic sphincterotomy (ES) was attempted in 106 patients with common bile duct (CBD) calculi and gall bladders present, who were considered unfit for surgery on the grounds of age and frailty alone (35%) and/or the presence of major medical problems (65%). Endoscopic sphincterotomy was successful in 105 patients (99%). Early ES related complications occurred in 21 patients (19.8%). Twelve hospital deaths occurred (11.3%), although this was due to biliary causes in only five (4.7%) and one of these was moribund on admission. Complications were more frequent in those in whom initial ES did not clear the common bile duct (30.4%) compared with those in whom this was (11.7%; p = 0.0164). The mortality was also greater in patients in whom there was no ERCP proof of CBD clearance (p = 0.01) unless operated upon. Twelve patients developed gall bladder complications (11.3%) including five with empyema (4.7%). Analysis of clinical, haematological, and biochemical factors together with ERCP findings showed that the only factor which had any value in predicting gall bladder complications was pre-existing cholangitis. The present series was compared with another using ES as a definitive procedure, and with a surgical series. Although there were significant differences in outcome, differences with respect to medical risk factors and the incidence of complications of CBD stones (jaundice, cholangitis, and acute pancreatitis) were striking. Further analysis of these factors may allow a clearer definition of patients most likely to benefit from either ES or surgery.

  10. Endodontic treatment of a maxillary lateral incisor with a perforating internal resorption by using cone beam computed tomography as a diagnostic aid: a case report.

    Science.gov (United States)

    Takita, Toshiya; Tsurumachi, Tamotsu; Ogiso, Bunnai

    2011-10-01

    This case report presents the endodontic treatment of a maxillary right lateral incisor with a perforating internal resorption in a 50-year-old woman. Radiographically, internal resorption appears as a fairly uniform, radiolucent enlargement of the pulp canal and distortion of the original root canal outline. The use of cone beam computed tomography can help the clinician in making a confirmatory diagnosis and determining the treatment plan before undertaking the actual treatment. After cleaning the root canal space and the resorptive defect by mechanic instrumentation, irrigation, and interim calcium hydroxide dressing, the apical third canal was filled with a gutta-percha point by lateral condensation. The resorptive defect was filled with mineral trioxide aggregate. Follow-up radiographs at 3 years showed adequate repair of the resorption, and the tooth remained asymptomatic.

  11. Safety of immediate endoscopic sphincterotomy in acutesuppurative cholangitis caused by choledocholithiasis

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    AIM To examine the safety of immediate endoscopicsphincterotomy (EST) in patients with acute suppurativecholangitis (ASC) caused by choledocholithiasis, ascompared with elective EST.METHODS: Patients with ASC due to choledocholithiasiswere allocated to two groups: Those who underwent ESTimmediately and those who underwent EBD followed byEST 1 wk later because they were under anticoagulanttherapy, had a coagulopathy (international normalizedratio 〉 1.3, partial thromboplastin time greater thantwice that of control), or had a platelet count 〈 50000× 103/μL. One of four trainees [200-400 cases of endoscopicretrograde cholangiopancreatography (ERCP)]supervised by a specialist (〉 10000 cases of ERCP)performed the procedures. The success and complicationrates associated with EST in each group were examined.RESULTS: Of the 87 patients with ASC, 59 were in theimmediate EST group and 28 in the elective EST group.EST was successful in all patients in both groups. Therewere no complications associated with EST in either groupof patients, although white blood cell count, C-reactive protein, total bilirubin, and serum concentrations of liverenzymes just before EST were significantly higher in theimmediate EST group than in the elective EST group.CONCLUSION: Immediate EST can be as safe as electiveEST for patients with ASC associated with choledocholithiasisprovided they are not under anticoagulanttherapy, or donot have a coagulopathy or a platelet count 〈 50000 ×103/μL. Moreover, the procedure was safely performed by atrainee under the supervision of an experienced specialist.

  12. Open reduction and internal fixation for displaced supracondylar fractures of the humerus in children with crossed K-wires via lateral approach

    Directory of Open Access Journals (Sweden)

    Hussain Shahid

    2014-06-01

    Full Text Available Objective:To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondylar fractures of the humerus in children. Methods: We prospectively followed 52 children who presented with Gartland type 3 displaced supracondylar fractures of the humerus and were managed by open reduction and internal fixation with crossed K-wires via lateral approach.There were 37 male and 15 female patients; average age was 7.39 years. The most common mechanism of trauma was fall while playing (n=23, followed by fall from height (n=20, road traffic accidents (n=5 and fall from standing height (n=2. In 2 cases, mode of injury was not available. The mean follow-up was 12 months and patients were assessed according to Flynn’s criteria. Results:Lateral approach provided an excellent view of the lateral column between two nervous planes and enabled an anatomical reduction in all cases. Immobilizing the elbow at 90 degrees or more of flexion was not needed after cross K-wire fixation. Majority of patients regained full range of motion within 6 weeks of pin removal. Two patients had postoperative ulnar nerve injuries that resolved after pin removal. The common late complication of cubitus varus was not seen in any patient. Delayed presentation to the emergency department, repeated manipulations by bone setters and massage with edible oil were responsible for stiffness in 5 patients. Superficial pin tract infection was noted in 5 patients that resolved with dressings and antibiotics. No deep infection occurred. A detailed clinical examination and radiographic analysis was done at final follow-up. They included measurement of carrying angle and range of movements of both operated and normal sides, and radiographs of both upper limbs for comparison. According to Flynn’s criteria, 90.4% patients showed satisfactory results.Conclusion:Lateral approach for open reduction and internal fixation of the

  13. One-Step Transpapillary Balloon Dilation under Cap-Fitted Endoscopy without a Preceding Sphincterotomy for the Removal of Bile Duct Stones in Billroth II Gastrectomy.

    Science.gov (United States)

    Lee, Tae Hoon; Hwang, Jae Chul; Choi, Hyun Jong; Moon, Jong Ho; Cho, Young Deok; Yoo, Byung Moo; Park, Sang-Heum; Kim, Jin Hong; Kim, Sun-Joo

    2012-01-01

    Endoscopic sphincterotomy may be limited in Billroth II gastrectomy because of difficulty in orientating the duodenoscope and sphincterotome as a result of altered anatomy. This study was planned to investigate the efficacy and safety of endoscopic transpapillary large balloon dilation (EPBD) without preceding sphincterotomy for removal of large CBD stones in Billroth II gastrectomy. Between March 2010 and February 2011, one-step EPBD under cap-fitted forward-viewing endoscopy was performed in patients who had undergone Billroth II gastrectomy at two tertiary referral centers. Main outcome measurements were successful duct clearance and EPBD-related complications. Successful access to major duodenal papilla was performed in 13 patients, but successful selective CBD cannulation was achieved in 12 patients (92.3%). Median maximum transverse stone size was 11.5 mm (10 to 14 mm). The mean number of stones was 2 (1-5). The median CBD diameter was 15 mm (12 to 19 mm). Mean procedure time from successful biliary access to complete stone removal was 17.8 min. Complete duct clearance was achieved in all patients. Four patients (33.3%) needed one more session of ERCP for removal of remnant stones. Asymptomatic hyperamylasemia in two patients and minor bleeding in another occurred. Without preceding sphincterotomy, one-step EPBD (≥10 mm) under cap-fitted forward-viewing endoscopy may be safe and effective for the removal of large stones (≥10 mm) with CBD dilatation in Billroth II gastrectomy.

  14. Sexual dimorphism of the lateral angle of the internal auditory canal and its potential for sex estimation of burned human skeletal remains.

    Science.gov (United States)

    Gonçalves, David; Thompson, Tim J U; Cunha, Eugénia

    2015-09-01

    The potential of the petrous bone for sex estimation has been recurrently investigated in the past because it is very resilient and therefore tends to preserve rather well. The sexual dimorphism of the lateral angle of the internal auditory canal was investigated in two samples of cremated Portuguese individuals in order to assess its usefulness for sex estimation in burned remains. These comprised the cremated petrous bones from fleshed cadavers (N = 54) and from dry and disarticulated bones (N = 36). Although differences between males and females were more patent in the sample of skeletons, none presented a very significant sexual dimorphism, thus precluding any attempt of sex estimation. This may have been the result of a difficult application of the method and of a differential impact of heat-induced warping which is known to be less frequent in cremains from dry skeletons. Results suggest that the lateral angle method cannot be applied to burned human skeletal remains.

  15. Open reduction and internal fixation for displaced supracondylar fractures of the humerus in children with crossed K-wires via lateral approach

    Institute of Scientific and Technical Information of China (English)

    Shahid Hussain; Manzoor Ahmad; Tufail Muzaffar

    2014-01-01

    Objective:To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondylar fractures of the humerus in children.Methods:We prospectively followed 52 children who presented with Gartland type 3 displaced supracondylar fractures of the humerus and were managed by open reduction and internal fixation with crossed K-wires via lateral approach.There were 37 male and 15 female patients; average age was 7.39 years.The most common mechanism of trauma was fall while playing (n=23),followed by fall from height (n=20),road traffic accidents (n=5) and fall from standing height (n=2).In 2 cases,mode of injury was not available.The mean follow-up was 12 months and patients were assessed according to Flynn's criteria.Results:Lateral approach provided an excellent view of the lateral column between two nervous planes and enabled an anatomical reduction in all cases.Immobilizing the elbow at 90 degrees or more of flexion was not needed after cross K-wire fixation.Majority of patients regained full range of motion within 6 weeks of pin removal.Two patients had postoperative ulnar nerve injuries that resolved after pin removal.The common late complication of cubitus varus was not seen in any patient.Delayed presentation to the emergency department,repeated manipulations by bone setters and massage with edible oil were responsible for stiffness in 5 patients.Superficial pin tract infection was noted in 5 patients that resolved with dressings and antibiotics.No deep infection occurred.A detailed clinical examination and radiographic analysis was done at final follow-up.They included measurement of carrying angle and range of movements of both operated and normal sides,and radiographs of both upper limbs for comparison.According to Flynn's criteria,90.4% patients showed satisfactory results.Conclusion:Lateral approach for open reduction and internal fixation of the widely-displaced supracondylar fracture of

  16. Chernobylsk: twenty years later, the international system of nuclear civil liability; Tchernobyl: 20 ans apres, le systeme international de responsabilite civile nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Lahorgue, M.B. [Poitiers Univ., 86 (France)

    2006-06-15

    The International system of nuclear civil liability is based on two international treaties: the Paris convention (24.07.1960) and the Brussels convention (31.01.1963), with a time limit for ratification in each concerned country at 30.10.1968. The Paris convention treats compensation and transfrontier problems, the amount of compensation is limited, the Brussels convention specifies the financial system of compensation. The Vienna system under the IAEA auspices gives minimal norms of financial protection against damages and stood in may 1963 thirty three parties signed it. Hungary, Poland, Lithuania, Romania, Armenia, czech republic, Estonia, Bulgaria, Slovakia, Latvia, Ukraine, Belarus, Moldavia have joined the Vienna convention, then the Russian Federation that had signed the Convention in 1996 became member in august 2005. New elements appear such measures of remedial action or measures of prevention of reduction of nuclear damages are included, the new protocol increases the geographical area by taking into account the maritime areas because of the evolution of the international sea law. The transport needs specific contracts between parties, the only case of exoneration is the armed conflicts, civil war, insurrection. The time of loss of right comes from ten years to thirty years, for deaths and body damages, the others types of damages stay fixed at ten years. The most important revision is about the limit financial amount for the nuclear operator that is increased and the calculation of methods of funding for each contracting party is tackled. In fact it appears that more important funds will be available to make compensation for a more important number of victims. The revised system guarantees that the liability chain will never be broken. (N.C.)

  17. [Our viewpoints on Deqi in the later ages after birth of classical works "The Yellow Emperor's Internal Classic" and "Canon of Difficult Medical Problems"].

    Science.gov (United States)

    Hao, Jie; Zhu, Jiang; Zhang, Peng; Xin, Si-Yuan; Qi, Dan-Dan; Hu, Ni-Juan; Lin, Chi; Wang, Pei; Zhao, Min-Yi; Hu, Shang-Qing; Wu, Gui-Wen

    2015-04-01

    In our previous paper, we analyzed "Deqi" in book Huangdi Neijing (The Yellow Emperor's Internal Classic) and Nanjing (Canon of Difficult Medical Problems) from "Zhishen"(Treating mentality) and Tiaoqi (Regulating qi). In the present paper, the authors discuss the connotations of "Deqi" and related events in the later ages of the abovementioned two classic books to the later stage of the Qing Dynasty when involves about 20 classical works as Zhenjiu Dacheng ( The Great Compendium of Acupuncture and Moxibustion), Zhenjing Zhinan (Guide to the classics of Acupuncture), Zhenjiu Daquan (A Complete Works of Acupuncture and Moxibustion) etc. from 1) close association between "Deqi" and patients' mental activity; 2) how to wait for arrival of qi if the needling does not induce "Deqi" for the time being; 3) how to identify "qi-arrival" and then, performing suitable manipulations; 4) Deqi and shallow- or deep-needling; 5) putting more emphasis on patients' feeling and reactions, rather than the practitioners perception beneath the needle which is described in book Huangdi Neijing; and 6) not withdrawing the acupuncture needles if qi does not arrive. Generally, in the later ages, the connotations of Deqi are enriched greatly.

  18. The protection of Canfranc Internation Railway Sattion against natural risks. Analysis and evaluation of its effectiveness 100 years later.

    Science.gov (United States)

    Fabregas, S.; Hurtado, R.; Mintegui, J.

    2012-04-01

    In the late XIXth century and early XXth century, the international railway station in Canfranc "Los Arañones" is built in the Central Pyrenees of Huesca in Spain, along the border between France and Spain. Just after starting the construction of the huge station (250 m long), it was found that natural hazards such as flash floods, landslides, falling blocks and avalanches affected it and compromised the safety of users and infrastructures.Quickly, hydrological restoration works were carried out along "Los Arañones" gorgers basins to reduce joint residual risks. Longitudinal and transversal dams for floods, a large reforestation work to prevent against falling blocks, erosion, flooding and regarding avalanches stone walls were built, as well as benches of grit, snow rakes, and "empty dams", which were created as experimental structures to dissipate the energy of the avalanche in the track zone and wich do not exist anywhere else in the world. All the works were carried out mainly by hand, with materials such as stone, cement and iron. Over 2,500,000 holes were made for planting more than 15 different species of trees, and more than 400,000 tons of stone were moved to build more than 12 different kinds of control measures.It is essential to emphasize the empirical nature of these works and Canfranc's function as a "laboratory or field tests", with most of its structures still effective 100 years after its construction. The works involved about 30% of the total cost of the station in the early XX century. Nowadays to have an "equivalent protection" with the current technology, around 100 million euro should be invested. It is also necessary to validate the current effectiveness of such works, its maintenance task and the protective role of the forest.

  19. Endoscopic papillary large balloon dilation for the management of recurrent difficult bile duct stones after previous endoscopic sphincterotomy.

    Science.gov (United States)

    Yoon, Hyung Geun; Moon, Jong Ho; Choi, Hyun Jong; Kim, Dong Choon; Kang, Myung Soo; Lee, Tae Hoon; Cha, Sang-Woo; Cho, Young Deok; Park, Sang-Heum; Kim, Sun-Joo

    2014-03-01

    Endoscopic management of recurrent bile duct stones after endoscopic sphincterotomy (EST) is effective and safe. However, repeat EST for extension of a previous EST for recurrent bile duct stones may involve substantial risk. The aim of the present study was to evaluate the safety and efficacy of endoscopic papillary large balloon dilation (EPLBD) without repeat EST for recurrent difficult bile duct stones after previous EST. From January 2006 to October 2010, a total of 52 patients were enrolled; all had undergone EPLBD (balloon diameter: 12-20 mm) to remove recurrent difficult bile duct stones after previous EST. In all patients, stone removal had failed with conventional methods using a basket and/or balloon. The size of the balloon for EPLBD was selected to fit the diameter of the common bile duct or the largest stone. The median interval between initial EST and stone recurrence was 2.2 years (range 1-10). Median diameters of thelargest stone and balloon were 20.1 mm (range 12-40) and 14.7 mm (range 12-20), respectively. Complete stone removal was achieved in all patients (100%). The median number of endoscopic retrograde cholangiopancreatography sessions needed for complete stone removal was 1.6 (range 1-3). Additional lithotripsy was required in 16 patients (30.7%). No procedure-related complications were documented, with the exception of four cases of asymptomatic hyperamylasemia. The recurrence rate of CBD stones after bile duct clearance was 17.3% (9/52) during the follow-up period (mean 27.0 ± 14.1 months). EPLBD without repeat EST is effective and relatively safe for the extraction of recurrent difficult bile duct stones after previous EST. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

  20. Long-term follow-up of common bile duct diameter after endoscopic sphincterotomy in patients with common bile duct stones.

    Science.gov (United States)

    Kolahdoozan, Shadi; Sotoudehmanesh, Rasoul; Khatibian, Morteza; Ali-Asgari, Ali; Shahraeeni, Shadi; Zeinali, Fatemeh

    2010-01-01

    To determine the time to normalization of common bile duct (CBD) diameter after endoscopic sphincterotomy and stone extraction in patients with choledocholithiasis. Patients with CBD dilation due to choledocholithiasis were enrolled. CBD diameter was measured by transabdominal ultrasonography before, and repeated after one, three, six and twelve months after endoscopic sphincterotomy and stone extraction, until normalization of CBD diameter. Of 115 cases enrolled over a 36-month period, CBD diameter reversed to normal in 71 (61.7%) patients after one month. Of the remaining 44 patients, CBD diameter reversed to normal in 36 patients (including 3 in whom repeat ERCP revealed choledocholithiasis) at the end of three months. CBD diameter had not reversed to normal diameter in 8 (18.2%) patients; none of these patients had symptoms. Two of them had asymptomatic dilated CBD after 6 months with no abnormal liver function tests (LFT); the duct reversed to normal at the last follow-up (month 12). Asymptomatic CBD dilation may persist in a minority of patients (18% at the end of 3 months) after removal of CBD stones. A dilated CBD can be attributed to retained choledocholithiasis within the first month, if it is associated with symptoms and abnormal LFT.

  1. Endoscopic sphincterotomy in patients with stenosis of ampulla of Vater: Three-year follow-up of exocrine pancreatic function and clinical symptoms

    Institute of Scientific and Technical Information of China (English)

    Nils Ewald; Axel Michael Marzeion; Reinhard Georg Bretzel; Hans Ulrich Kloer; Philip Daniel Hardt

    2007-01-01

    AIM: To investigate retrospectively the long-term effect of endoscopic sphincterotomy (ES) including exocrine pancreatic function in patients with stenosis of ampulla of Vater.METHODS: After diagnostic endoscopic retrograde cholangiopancreatography (ERCP) and ES because of stenosis of the ampulla of Vater (SOD Type I), follow-up examinations were performed in 60 patients (mean follow-up time 37.7 mo). Patients were asked about clinical signs and symptoms at present and before intervention using a standard questionnaire. Before and after ES exocrine pancreatic function was assessed by determination of immunoreactive fecal elastase 1. Serum enzymes indicating cholestasis as well as serum lipase and amylase were measured.RESULTS: Eighty percent of patients reported an improvement in their general condition after ES. The fecal elastase 1 concentrations (FEC) in all patients increased significantly after ES. This effect was even more marked in patients with pathologically low concentrations (< 200 ng/g) of fecal elastase prior to ES. The levels of serum lipase and amylase as well as serum alcaline phosphatase (AP) and gamma-glutamyltranspeptidase (GGT) decreased significantly after ES.CONCLUSION: The results of this study demonstrate that patients with stenosis of the ampulla of Vater can be successfully treated with endoscopic sphincterotomy. The positive effect is not only indicated by sustained improvement of clinical symptoms and cholestasis but also by improvement of exocrine pancreatic function.

  2. Endoclip therapy of post-sphincterotomy bleeding using a transparent cap-fitted forward-viewing gastroscope.

    Science.gov (United States)

    Chon, Hyung Ku; Kim, Tae Hyeon

    2017-07-01

    The incidence of post-endoscopic sphincterotomy (ES) bleeding is reportedly 2.0-5.0 %. Among various hemostatic methods, endoclip therapy is an effective modality in gastrointestinal bleeding. However, endoclip application for post-ES hemorrhage has not been widely studied, partly because of the difficulty in placing of clips using a duodenoscope. A cap-fitted forward-viewing gastroscope can easily visualize the major papilla and overcome the technical difficulty in applying endoclips. We aimed to determine the efficacy and safety of endoclips for the treatment of post-ES hemorrhage using a cap-fitted forward-viewing gastroscope. From January 2011 to December 2015, a total of 1448 endoscopic retrograde cholangiopancreatography procedures with ES were retrospectively assessed and followed-up. Patients with post-ES hemorrhage who did not respond to balloon compression or to spray or injection of a diluted epinephrine solution at the bleeding focus underwent endoclip therapy using a cap-fitted forward-viewing gastroscope. Bleeding patterns (oozing, pulsatile, and exposed vessel) were recorded. ES-induced uncontrolled hemorrhage occurred in 57 patients (3.93 %). The mean age was 68.9 ± 14.5 years, and the sex ratio (male/female) was 37 (64.9 %):20 (35.1 %) in 57 patients. Of the 57 cases of hemorrhage, early uncontrolled and delayed hemorrhage occurred in 45 (3.1 %) and 12 (0.82 %), respectively. Visible bleeding patterns following ES were: 50 oozing (57.7 %), 6 pulsatile (10.5 %), and 1 exposed vessel (1.8 %). Hemostasis was achieved by endoclipping using a cap-fitted forward-viewing gastroscope in 57 of 57 patients (100 %). The median number of clips used was 1.8 (range 1-3). No evidence of further bleeding or procedure-related complications was seen. We concluded that endoclip application using a cap-fitted forward-viewing gastroscope is feasible and safe and may be an effective technique for the treatment and/or prevention of post-ES hemorrhage.

  3. Nonverbal cognitive development in children with cochlear implants: relationship between the Mullen Scales of Early Learning and later performance on the Leiter International Performance Scales-Revised.

    Science.gov (United States)

    Caudle, Susan E; Katzenstein, Jennifer M; Oghalai, John S; Lin, Jerry; Caudle, Donald D

    2014-02-01

    Methodologically, longitudinal assessment of cognitive development in young children has proven difficult because few measures span infancy through school age. This matter is further complicated when the child presents with a sensory deficit such as hearing loss. Few measures are validated in this population, and children who are evaluated for cochlear implantation are often reevaluated annually. The authors sought to evaluate the predictive validity of subscales of the Mullen Scales of Early Learning (MSEL) on Leiter International Performance Scales-Revised (LIPS-R) Full-Scale IQ scores. To further elucidate the relationship of these two measures, comparisons were also made with the Vineland Adaptive Behavior Scale-Second Edition (VABS), which provides a measure of adaptive functioning across the life span. Participants included 35 children (14 female, 21 male) who were evaluated both as part of the precandidacy process for cochlear implantation using the MSEL and VABS and following implantation with the LIPS-R and VABS. Hierarchical linear regression revealed that the MSEL Visual Reception subdomain score significantly predicted 52% of the variance in LIPS-R Full-Scale IQ scores at follow-up, F(1, 34) = 35.80, p < .0001, R (2) = .52, β = .72. This result suggests that the Visual Reception subscale offers predictive validity of later LIPS-R Full-Scale IQ scores. The VABS was also significantly correlated with cognitive variables at each time point.

  4. Lateral Concepts

    Directory of Open Access Journals (Sweden)

    Christopher Gad

    2016-06-01

    Full Text Available This essay discusses the complex relation between the knowledges and practices of the researcher and his/her informants in terms of lateral concepts. The starting point is that it is not the prerogative of the (STS scholar to conceptualize the world; all our “informants” do it too. This creates the possibility of enriching our own conceptual repertoires by letting them be inflected by the concepts of those we study. In a broad sense, the lateral means that there is a many-to-many relation between domains of knowledge and practice. However, each specific case of the lateral is necessarily immanent to a particular empirical setting and form of inquiry. In this sense lateral concepts are radically empirical since it locates concepts within the field. To clarify the meaning and stakes of lateral concepts, we first make a contrast between lateral anthropology and Latour’s notion of infra-reflexivity. We end with a brief illustration and discussion of how lateral conceptualization can re-orient STS modes of inquiry, and why this matters.

  5. Force Display and Bi-Lateral Master-Slave Control with an Internal Model under the Consideration of Human Cross-Over Model

    Science.gov (United States)

    Kawahata, Nagakatsu; Nishizawa, Masanori; Itoh, Youichirou; Yoshida, Hiroaki

    Human behavior for controlling machines is quite adaptive but restrictive in gain, phase, frequency bandwidth and so on. It is often assumed by a cross-over model especially for compensatory tracking task. Force display system is increasingly important in robotics, remote manipulations, machine handling and etc. The control system design for force display and/or bi-lateral master-slave manipulator is not so easy because of gain limits, mechanical vibration, human-induced oscillation and others. Proposed is a control system design for force display and/or bi-lateral master-slave manipulator based on model-following control under the concept of human crossover model in compensatory tracking. Experimental results are also shown for an actual force display device designed by the proposed method.

  6. Gender moderates the relationship between childhood abuse and internalizing and substance use disorders later in life: a cross-sectional analysis

    OpenAIRE

    Meng, Xiangfei; D’Arcy, Carl

    2016-01-01

    Background Although some studies examined the moderating role of gender in the relationship between childhood maltreatment and mental disorders later in life, a number of them examined the effects of only one or two types of maltreatment on an individual mental disorder, for instance, depression, substance use. It is of considerable clinical and theoretical importance to have in-depth understanding what roles of different types of childhood abuse play out in a wide range of mental disorders a...

  7. POST TRAUMATIC INSTABILITY OF SUB - AXIAL CERVICAL SPINE - REDUCTION AND INTERNAL FIXATION BY LATERAL MASS SCREWS : A LONG TERM FOLLOW - UP STUDY

    Directory of Open Access Journals (Sweden)

    Godagu

    2015-10-01

    Full Text Available AIM: We present here the clinical results of 24 patients who were operated for cervical instability following trauma by lateral mass fixation at our institution between July 2010 and Dec 2013 and to assess the stability of the construct at 2yr follow - up study. MATERIALS AND METHODS: Between July 2010 and Dec 2013 a total of 24 pts. Were operated by lateral mass fixation for cervical spine instability following trauma to subaxial cervical spine between C3 - C6. Presenting with posterior element injury like facet locking and subluxation injuries were included in the study. Al l these patients were evaluated postoperatively for neurologic improvement , complications and Results were analyzed. RESULTS: A total of 104 screws were placed in to the lateral masses during the study. There were 8(33.3% deaths in this series not related to the surgical procedure. There were no immediate complications related to the procedure. There was no evidence of neurovascular injury either during the procedure or immediately following the surgery. There was CSF leak in one case of badly traumatized cord injury during the procedure. Neurological improvement was seen in 13(81.2% out of surviving 16 cases of trauma at the end of 3m to the extent of self - ambulation and the rest three did not show any improvement and remained quadriplegic. CONCLUSION: In this study we report good long term stability achieved by the lateral mass fixation with rods and screws with least morbidity and the safety of the procedure compared to other methods of posterier elements fixations. Both Roy Camille and Magerl technique can be followed for screw placement, where in Magerl technique has slight advantage of avoiding the nerve root injury and a longer screw can be placed to achieve a good bony purchase. Over all it is very safe and efficacious procedure in the hands of an ex perienced surgeon

  8. Endoscopic Papillary Large Balloon Dilatation Without Sphincterotomy for the Treatment of Large Common Bile Duct Stone: Long-Term Outcomes at a Single Center.

    Science.gov (United States)

    Park, Jin-Seok; Jeong, Seok; Bang, Byung Wook; Kang, Ae Ra; Lee, Don Haeng

    2016-10-01

    Endoscopic papillary large balloon dilatation (EPLBD) without endoscopic sphincterotomy (EST) is an accepted, simplified endoscopic technique for large common bile duct (CBD) stone removal. However, little is known about the long-term outcomes of this technique. The purpose of this study was to evaluate the long-term outcomes of EPLBD without EST for the treatment of large CBD stones. This retrospective study of EPLBD without EST for a large CBD stone was conducted between June 2005 and October 2010. A total of 128 patients with a large CBD stone were included. The primary outcome measurement was complete CBD stone removal after EPLBD. Clinical data obtained from medical records were analyzed. The overall complete stone removal rate was 94.5 %. Mechanical lithotripsy was needed in 18 (14.1 %) patients. Post-procedural pancreatitis and asymptomatic hyperamylasemia occurred in 1 (0.8 %) and 11 (8.6 %) patients, respectively. One (0.8 %) patient experienced minor bleeding. The rate of stone recurrence was 13.1 %, and median time to stone recurrence was 600 days (range 144-2284 days). Over a half (64.3 %) of stone recurrences occurred during the 2 years following stone removal. Recurrence tended to be more frequent in patients with a large CBD diameter and in patients requiring multiple endoscopic sessions for complete CBD stone retrieval. EPLBD without EST may be safe and effective in patients with a large bile duct stone.

  9. Gender moderates the relationship between childhood abuse and internalizing and substance use disorders later in life: a cross-sectional analysis.

    Science.gov (United States)

    Meng, Xiangfei; D'Arcy, Carl

    2016-11-15

    Although some studies examined the moderating role of gender in the relationship between childhood maltreatment and mental disorders later in life, a number of them examined the effects of only one or two types of maltreatment on an individual mental disorder, for instance, depression, substance use. It is of considerable clinical and theoretical importance to have in-depth understanding what roles of different types of childhood abuse play out in a wide range of mental disorders among women and men using well accepted instruments measuring abuse and mental disorders. The present study aimed to examine this issue using a large nationally representative population sample to explore the gender effect of different types of childhood abuse in mental disorders, and assess the moderating role of gender in the abuse-mental disorder relationship. Using data from the Canadian Community Health Survey 2012: Mental Health we sought to answer this question. Respondents with information on childhood maltreatment prior to age 16 were selected (N = 23, 395). We found: i) strong associations between childhood abuse frequency and gender; ii) significant differences between men and women in terms of mental disorders; iii) strong associations between childhood abuse and mental disorders; and, iv) gender moderated the role of childhood abuse history on adulthood mental disorders. Females with a history of sexual abuse and/or exposure to interpersonal violence were at a greater risk of alcohol abuse or dependence later in life. Intervention should occur as early as possible, and should help female victims of childhood sexual abuse and/or exposure to interpersonal violence, and their families to build more constructive ways to effectively reduce the negative affects of these experiences. Recognition of the moderating role of gender on the relationship between childhood abuse history and mental disorders later in life may aid clinicians and researchers in providing optimal health

  10. 内镜下乳头括约肌切开术后出血治疗方法%Treatment of Post-endoscopic Sphincterotomy Bleeding

    Institute of Scientific and Technical Information of China (English)

    陈男男; 张学彦

    2016-01-01

    In recent years,endoscopic technique has become a basic procedure for the diagnosis and treatment of biliary and pancreatic diseases,thus the procedure-related complications of ERCP and endoscopic sphincterotomy(EST) become prominent day by day. Post-EST bleeding is one of the most serious complications of the procedure,and its first line treatment involves a variety of endoscopic techniques,such as epinephrine or fibrin glue local injection,electric coagulation and heat probe,clamps and covered metal stents. If these are not successful,transcatheter arterial embolization or surgical operation should be considered. In this article,the above-mentioned treatment modalities of post-EST bleeding were reviewed.%近年来,胆胰疾病的诊治越来越多地依赖于内镜技术,ERCP 和内镜下乳头括约肌切开术(EST)相关并发症的问题日渐凸显。术后出血为 EST 的严重并发症之一,其一线治疗包括各种内镜下操作,如肾上腺素或纤维蛋白胶注射止血、电凝或热探头止血、钛夹止血、覆膜支架置入等,如内镜治疗失败,可考虑行经导管动脉栓塞或外科手术治疗。本文就上述 EST 术后出血的治疗方法作一综述。

  11. Safety and efficacy of minimal biliary sphincterotomy with papillary balloon dilation (m-EBS+EPBD) in patients using clopidogrel or anticoagulation

    Science.gov (United States)

    Mok, Shaffer R. S.; Arif, Murtaza; Diehl, David L; Khara, Harshit S; Ho, Henry C; Elfant, Adam B

    2017-01-01

    Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (EBS) or endoscopic papillary balloon dilation (EPBD) are common techniques of biliary decompression. Potential risks include gastrointestinal hemorrhage, which can be increased by antiplatelet agents, anticoagulants (AC) and/or novel oral anticoagulants (NOACs) (ie. apixaban, dabigatran and rivaroxaban). The study aim is to evaluate the safety/efficacy of an alternative technique, minimal-EBS plus EPBD (m-EBS + EPBD), in individuals for whom clopidogrel, AC, and/or NOACs cannot be interrupted due to high cardiovascular or thromboembolic risk. Patients and methods Patients undergoing m-EBS + EPBD while taking clopidogrel and/or AC were retrospectively evaluated at two United States tertiary care centers for efficacy, GIB and procedure-related, cardiovascular and thromboembolic adverse events (AE). Results Ninety-five patients were identified [55 = clopidogrel and 45 = AC (31.1 % NOACs)]. The main indication for ERCP was choledocholithiasis (34 %). 100 % clinical improvement and 97.9 % endoscopic success were found. The incidence of AE was 5.3 %. There was a 4.2 % incidence of gastrointestinal hemorrhage (2 cases requiring endoscopic intervention). Both severe gastrointestinal hemorrhages also experienced the cases of post-ERCP pancreatitis, and 2 /3 of cholangitis (all aspirin + AC). There was 1cardiovascular event (non-ST elevation myocardial infarction), and no thromboembolic events. Conclusions Minimal-EBS + EPBD is an effective and safe therapy with an incidence of gastrointestinal hemorrhage of 4.2 %, (2.1 % requiring endoscopic intervention), for patients on clopidogrel and/or AC, with a high risk for cardiovascular/thromboembolic events. PMID:28337485

  12. Severe acute pancreatitis: clinical findings and therapeutic tools in Internal Medicine practice

    Directory of Open Access Journals (Sweden)

    Generoso Uomo

    2013-04-01

    Full Text Available BACKGROUND Recent advances in pathophysiology and therapeutic measures suggest that patients suffering from acute pancreatitis (AP should undergo an early evaluation and treatment in Internal Medicine wards. Severe AP, usually associated with pancreatic necrosis and peripancreatic fluid collections, may be frequently complicated by distant organ(s involvement. RESULTS The dreadful multi-organ failure may occur as an early event (during the first week of the disease or in association with the infection of pancreatic necrosis in a later stage. So, during the clinical outcome, physicians may be compelled to counteract cardio-circulatory, pulmonary, renal, hepatic, haematological and hydro-electrolytic complex derangements. Arterial hypotension and shock may be consequence of hypovolemia and/or hearth failure or septic shock syndrome. Pleural effusions are frequent in the early phase of the disease as well as pulmonary densifications and renal insufficiency. Urinary, pulmonary, and biliary infections may intervene during all phases of the disease whereas pancreatic necrosis and fluid collections infections are more frequent after the second week of hospitalization. Prognostic evaluation should be obtained by simple and precise scoring system such as the modified Marshall score and CT-scan severity index. CONCLUSIONS Treatment must be initiated as soon as possible with special focusing on fluid and nutritional supplementation, pain control, cardio-respiratory support, antiproteases and antibiotics. Invasive procedures such as endoscopic sphincterotomy in biliary AP with cholangitis and/or obstruction and percutaneous drainage should be utilized in specific cases. Surgical necrosectomy is mandatory in patients with documented infection of pancreatic necrosis.

  13. Nonverbal Cognitive Development in Children With Cochlear Implants: Relationship Between the Mullen Scales of Early Learning and Later Performance on the Leiter International Performance Scales–Revised

    Science.gov (United States)

    Caudle, Susan E.; Katzenstein, Jennifer M.; Oghalai, John S.; Lin, Jerry; Caudle, Donald D.

    2013-01-01

    Methodologically, longitudinal assessment of cognitive development in young children has proven difficult because few measures span infancy through school age. This matter is further complicated when the child presents with a sensory deficit such as hearing loss. Few measures are validated in this population, and children who are evaluated for cochlear implantation are often reevaluated annually. The authors sought to evaluate the predictive validity of subscales of the Mullen Scales of Early Learning (MSEL) on Leiter International Performance Scales–Revised (LIPS-R) Full-Scale IQ scores. To further elucidate the relationship of these two measures, comparisons were also made with the Vineland Adaptive Behavior Scale–Second Edition (VABS), which provides a measure of adaptive functioning across the life span. Participants included 35 children (14 female, 21 male) who were evaluated both as part of the precandidacy process for cochlear implantation using the MSEL and VABS and following implantation with the LIPS-R and VABS. Hierarchical linear regression revealed that the MSEL Visual Reception subdomain score significantly predicted 52% of the variance in LIPS-R Full-Scale IQ scores at follow-up, F(1, 34) = 35.80, p VABS was also significantly correlated with cognitive variables at each time point. PMID:22353228

  14. Wind tunnel test of the 0.015-scale Rockwell International space shuttle vehicle orbiter in the Ames 6 by 6 foot supersonic wind tunnel. [to determine longitudinal and lateral-directional characteristics

    Science.gov (United States)

    Milam, M. D.; Dziubala, T. J.

    1973-01-01

    Experimental investigations were performed in a 6- by 6-Foot Supersonic wind tunnel on a 0.015-scale model of the Rockwell International space shuttle vehicle (SSV) 2A orbiter. The purpose of the test was to investigate the longitudinal and lateral-directional characteristics of the vehicle. In addition, hinge moments were measured on the rudder and elevons. Buffet onset was investigated using wing trailing edge pressures and a strain gauge instrumented panel mounted in the wing. The model was tested through a Mach range from 0.6 to 2.0 at a constant unit Reynolds number of 2.5 million. Pitch runs were made at angles of attack from minus 2 deg to +26 deg with beta = 0 deg and 5 deg; yaw runs were made in the range from minus 5 deg to 10 deg of sideslip at angles of attack of 0 deg and 10 deg. Static pressures were measured at the fuselage base and the trailing edges of the wing and rudder. Boundary layer transition was fixed for some runs using distributed roughness strips.

  15. The Effect Observation of International Obstetric Service Mode to Reduce the Lateral Episiotomy Rate%国际产科服务模式降低会阴侧切率的效果观察

    Institute of Scientific and Technical Information of China (English)

    刘火姐; 曾小惠

    2014-01-01

    Objective:To explore the effect of international obstetric service mode to promote natural delivery, reduce the rate of lateral episiotomy. Method:Selected from October 2012 to October 2013 in the author’s hospital natural birth of 636 cases of primipara as observation group, using the international obstetric service mode, in the condition of no protection of perineum out fetal childbirth. Selected from October 2011 to September 2012 in the author’s hospital natural birth of 528 cases of primipara as control group, routine nursing in obstetrics and gynecology textbooks, adopt the method of traditional protection of perineum for delivery.Result:Maternal episiotomy rate of observation group was obviously lower than the control group, the difference was statistically significant (P0.05).Conclusion:Promote international obstetric service mode, reduce medical intervention, to reduce the episiotomy rate, promote natural delivery, reduce puerpera childbirth pain and sufferings, thus improve the quality of obstetrics.%目的:探讨国际产科服务模式对促进自然分娩、降低会阴侧切率的效果。方法:选取2012年10月-2013年10月于笔者所在医院自然分娩的636例初产妇作为观察组,运用国际产科服务模式,在无保护会阴状态下分娩出胎儿;选取2011年10月-2012年9月于笔者所在医院自然分娩的528例初产妇作为对照组,按妇产科教科书常规护理,采用传统的方法保护会阴进行接产。结果:观察组产妇的会阴侧切率明显低于对照组,差异有统计学意义(P0.05)。结论:推广国际产科服务模式,减少医疗干预、降低会阴侧切率,促进自然分娩,减轻产妇分娩痛苦,从而提高产科质量。

  16. Tennis Elbow (Lateral Epicondylitis)

    Science.gov (United States)

    .org Tennis Elbow (Lateral Epicondylitis) Page ( 1 ) Tennis elbow, or lateral epicondyliti s, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause ...

  17. Cause of the duodenal perforation due to endoscopic sphincterotomy: an analysis of 24 cases%内窥镜括约肌切开并发十二指肠穿孔24例分析

    Institute of Scientific and Technical Information of China (English)

    赵玉元

    2009-01-01

    目的 分析内窥镜括约肌切开后并发十二指肠穿孔24例的病因以及探讨预防这种并发症的方法.方法 回顾分析近4年作者所在地区5家医院因胆道疾病施行EST治疗致十二指肠穿孔24例.结果 保守治疗成功7例,手术治疗存活6例,死亡11例,死亡率达45.83%.结论 内窥镜括约肌切开术后并发十二指肠穿孔的发生率<1%,这种并发症一旦发生,死亡率甚高(该组为45.83%),咎其原因为EST手术指征掌握不当,操作人员训练不够等,应高度注意预防这种并发症的发生.%Objective To analyze the cause of the duodenal perforation due to endoscopic sphincterotomy (EST) and explore the methods to prevent this condition. Methods A total of 24 pa-tients with bile duct disease underwent EST and complicated duodenal perforation at our hospital and other 4 hospitals in last 4 years were retrospectively reviewed. Result Thirteen patients were treated by medicine and 6 of them died. For the 11 patients treated by operation, 5 of them died. The total mortality was 45.83%. Conclusion The incidence of duodenal perforation is <1% after the endo-scopic sphincterotomy. In case of such complications, the mortality is high. Improper operation indi-cation of EST, inadequate training of operators etc. are the reasons for it. More attention should be paid to the prevention of such complications.

  18. Diamond heteroepitaxial lateral overgrowth

    Science.gov (United States)

    Tang, Yung-Hsiu

    This dissertation describes improvements in the growth of single crystal diamond by microwave plasma-assisted chemical vapor deposition (CVD). Heteroepitaxial (001) diamond was grown on 1 cm. 2 a-plane sapphiresubstrates using an epitaxial (001) Ir thin-film as a buffer layer. Low-energy ion bombardment of the Ir layer, a process known as bias-enhanced nucleation, is a key step in achieving a high density of diamond nuclei. Bias conditions were optimized to form uniformly-high nucleation densities across the substrates, which led to well-coalesced diamond thin films after short growth times. Epitaxial lateral overgrowth (ELO) was used as a means of decreasing diamond internal stress by impeding the propagation of threading dislocations into the growing material. Its use in diamond growth requires adaptation to the aggressive chemical and thermal environment of the hydrogen plasma in a CVD reactor. Three ELO variants were developed. The most successful utilized a gold (Au) mask prepared by vacuum evaporation onto the surface of a thin heteroepitaxial diamond layer. The Au mask pattern, a series of parallel stripes on the micrometer scale, was produced by standard lift-off photolithography. When diamond overgrows the mask, dislocations are largely confined to the substrate. Differing degrees of confinement were studied by varying the stripe geometry and orientation. Significant improvement in diamond quality was found in the overgrown regions, as evidenced by reduction of the Raman scattering linewidth. The Au layer was found to remain intact during diamond overgrowth and did not chemically bond with the diamond surface. Besides impeding the propagation of threading dislocations, it was discovered that the thermally-induced stress in the CVD diamond was significantly reduced as a result of the ductile Au layer. Cracking and delamination of the diamond from the substrate was mostly eliminated. When diamond was grown to thicknesses above 0.1 mm it was found that

  19. Clinical implications of endoscopic sphincterotomy in preventing recurrence of acute biliary pancreatitis%EST对预防急性胆源性胰腺炎复发的临床价值

    Institute of Scientific and Technical Information of China (English)

    周鸣清; 陈欣然; 陆仁达

    2007-01-01

    目的 探讨内镜下乳头括约肌切开(endoscopic sphincterotomy,EST)对预防急性胆源性胰腺炎(acute biliary pancreatitis,ABP)复发的临床价值.方法 将临床治愈的296例ABP患者分为EST治疗组(n=119)和非EST对照组(n=177).将两组患者进一步分为胆囊切除组和非胆囊切除组.随访所有ABP患者,比较两组复发率有无显著差异.结果 两组ABP患者平均随访时间32±14月;15例失访,随访率94.9%.EST治疗组(11/113)的复发率明显低于非EST治疗组(75/168),差异有显著性(P<0.01);胆囊切除虽然能降低ABP的复发率,但其差异无显著性地(P>0.05).结论 应用EST技术治疗ABP,可预防ABP的再次发作.

  20. Amyotrophic Lateral Sclerosis (ALS)

    Science.gov (United States)

    ... ALS Neurons' broken machinery piles up in ALS Esclerosis Lateral Amiotrófica Dormant viral genes may awaken to ... Dementia Information Page Multifocal Motor Neuropathy Information Page Multiple Sclerosis Information Page Muscular Dystrophy Information Page Myasthenia ...

  1. Amyotrophic lateral sclerosis (ALS)

    Science.gov (United States)

    Lou Gehrig disease; ALS; Upper and lower motor neuron disease; Motor neuron disease ... 98. Shaw PJ. Amyotrophic lateral sclerosis and other motor neuron diseases. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  2. Biliary sphincterotomy dilation for the extraction of difficult common bile duct stones Dilatación de la esfinterotomía biliar para la extracción de coledocolitiasis difíciles

    Directory of Open Access Journals (Sweden)

    J. García-Cano

    2009-08-01

    Full Text Available Background and aim: endoscopic retrograde cholangiopancreatography (ERCP with biliary sphincterotomy (BS is the usual method for extracting common bile duct stones. However, following BS and by means of extraction balloons and Dormia baskets a complete bile duct clearance cannot be achieved in all cases. We present a study on the impact that hydrostatic balloon dilation of a previous BS (BSD may have in the extraction rate of choledocholithiasis. Patients and methods: a prospective study which included 91 consecutive patients diagnosed with choledocholithiasis who underwent ERCP. For stone removal, extraction balloons and Dormia baskets were used, and when necessary BSD was employed. Results: complete bile duct clearance was achieved in 86/91 (94.5% patients. BSD was used in 30 (33% cases. In these cases, extraction was complete in 29/30 (97%; 23 (76% patients in the BSD group had anatomic difficulties or bleeding disorders. The most frequently used hydrostatic balloon diameter was 15 mm (60%. There were 7 (7.6% complications: two self-limited hemorrhage episodes in the BSD group and one episode of cholangitis, one of pancreatitis, and three of bleeding in the group in which BSD was not used. Conclusions: BSD is a very valuable tool for extracting common bile duct stones. In our experience, there has been an increase in the extraction rate from 73% (Rev Esp Enferm Dig 2002; 94: 340-50 to 94.5% (p = 0.0001, OR 0.1, CI 0.05-0.45, with no increase in complications.

  3. Laterally loaded masonry

    DEFF Research Database (Denmark)

    Raun Gottfredsen, F.

    In this thesis results from experiments on mortar joints and masonry as well as methods of calculation of strength and deformation of laterally loaded masonry are presented. The strength and deformation capacity of mortar joints have been determined from experiments involving a constant compressive...... stress and increasing shear. The results show a transition to pure friction as the cohesion is gradually destroyed. An interface model of a mortar joint that can take into account this aspect has been developed. Laterally loaded masonry panels have also been tested and it is found to be characteristic...

  4. Lateral Thinking of Prospective Teachers

    Science.gov (United States)

    Lawrence, A. S. Arul; Xavier, S. Amaladoss

    2013-01-01

    Edward de Bono who invented the term "lateral thinking" in 1967 is the pioneer of lateral thinking. Lateral thinking is concerned with the generation of new ideas. Liberation from old ideas and the stimulation of new ones are twin aspects of lateral thinking. Lateral thinking is a creative skills from which all people can benefit…

  5. Onset dominance in lateralization.

    Science.gov (United States)

    Freyman, R L; Zurek, P M; Balakrishnan, U; Chiang, Y C

    1997-03-01

    Saberi and Perrott [Acustica 81, 272-275 (1995)] found that the in-head lateralization of a relatively long-duration pulse train could be controlled by the interaural delay of the single pulse pair that occurs at onset. The present study examined this further, using an acoustic pointer measure of lateralization, with stimulus manipulations designed to determine conditions under which lateralization was consistent with the interaural onset delay. The present stimuli were wideband pulse trains, noise-burst trains, and inharmonic complexes, 250 ms in duration, chosen for the ease with which interaural delays and correlations of select temporal segments of the stimulus could be manipulated. The stimulus factors studied were the periodicity of the ongoing part of the signal as well as the multiplicity and ambiguity of interaural delays. The results, in general, showed that the interaural onset delay controlled lateralization when the steady state binaural cues were relatively weak, either because the spectral components were only sparsely distributed across frequency or because the interaural time delays were ambiguous. Onset dominance can be disrupted by sudden stimulus changes within the train, and several examples of such changes are described. Individual subjects showed strong left-right asymmetries in onset effectiveness. The results have implications for understanding how onset and ongoing interaural delay cues contribute to the location estimates formed by the binaural auditory system.

  6. Laterality and reproductive indices.

    Science.gov (United States)

    Kalichman, Leonid; Kobyliansky, Eugene

    2008-01-01

    Several previous studies support the association between manual dominance and age at menarche or age at menopause. The aim of the present study was to estimate the association between indices of laterality and reproductive indices. The studied sample comprised 650 Chuvashian women aged 18 to 80 years (mean, 46.9; SD = 16.2). The independent-sample t test was used to compare the age at menarche or age at menopause between individuals with right or left dominance of handedness, dominant eye, hand clasping, and arm folding. No significant differences in age at menarche or age at menopause between women with right and left dominance in any of the studied laterality indices were found. This is the first study that simultaneously evaluates the association between dominance in four laterality indices (handedness, dominant eye, hand clasping, and arm folding) and two reproductive indices (age at menarche and age at menopause). Result of our study do not support the hypothesis of a possible association between handedness (and other indices of laterality) and an early age at menarche or age at natural menopause.

  7. Lateral Attitude Change.

    Science.gov (United States)

    Glaser, Tina; Dickel, Nina; Liersch, Benjamin; Rees, Jonas; Süssenbach, Philipp; Bohner, Gerd

    2015-08-01

    The authors propose a framework distinguishing two types of lateral attitude change (LAC): (a) generalization effects, where attitude change toward a focal object transfers to related objects, and (b) displacement effects, where only related attitudes change but the focal attitude does not change. They bring together examples of LAC from various domains of research, outline the conditions and underlying processes of each type of LAC, and develop a theoretical framework that enables researchers to study LAC more systematically in the future. Compared with established theories of attitude change, the LAC framework focuses on lateral instead of focal attitude change and encompasses both generalization and displacement. Novel predictions and designs for studying LAC are presented.

  8. Treatment of lateral epicondylitis.

    Science.gov (United States)

    Johnson, Greg W; Cadwallader, Kara; Scheffel, Scot B; Epperly, Ted D

    2007-09-15

    Lateral epicondylitis is a common overuse syndrome of the extensor tendons of the forearm. It is sometimes called tennis elbow, although it can occur with many activities. The condition affects men and women equally and is more common in persons 40 years or older. Despite the prevalence of lateral epicondylitis and the numerous treatment strategies available, relatively few high-quality clinical trials support many of these treatment options; watchful waiting is a reasonable option. Topical nonsteroidal anti-inflammatory drugs, corticosteroid injections, ultrasonography, and iontophoresis with nonsteroidal anti-inflammatory drugs appear to provide short-term benefits. Use of an inelastic, nonarticular, proximal forearm strap (tennis elbow brace) may improve function during daily activities. Progressive resistance exercises may confer modest intermediate-term results. Evidence is mixed on oral nonsteroidal antiinflammatory drugs, mobilization, and acupuncture. Patients with refractory symptoms may benefit from surgical intervention. Extracorporeal shock wave therapy, laser treatment, and electromagnetic field therapy do not appear to be effective.

  9. [Lateral lumbar disk herniation].

    Science.gov (United States)

    Deburge, A; Barre, E; Guigui, P

    A retrospective study of 41 lateral discal hernias observed between 1984 and 1991 were studied among the 1080 discal hernias treated during this period. CT scan, performed in all cases, distinguished several different types of hernia: foramen hernias (26), extraforamen hernias (12), mixed forms (5) associated with canal component (11). Thirteen disco scans were required. Nucleolysis was performed in 24 patients (58%) and surgical treatment was the first intention choice in 17 (41%). Outcome, evaluated with a function score developed in the unit were good in the 17 surgery cases (100%). In the nucleolysis patients results were good or excellent in 13, average in 4, and poor in 7. Five of the nucleolysis failures were later operated leading to good results in 3, average in 1 and no change in 1. Indications for surgery are more frequent in this type of discal hernia and results in our surgical series were better than those for chemonucleolysis.

  10. The lateral angle revisited

    DEFF Research Database (Denmark)

    Morgan, Jeannie; Lynnerup, Niels; Hoppa, R.D.

    2013-01-01

    measurements taken from computed tomography (CT) scans. Previous reports have observed that the lateral angle size in females is significantly larger than in males. The method was applied to an independent series of 77 postmortem CT scans (42 males, 35 females) to validate its accuracy and reliability...... method appears to be of minimal practical use in forensic anthropology and archeology. © 2013 American Academy of Forensic Sciences....

  11. Lateral Elbow Tendinopathy

    Science.gov (United States)

    Bhabra, Gev; Wang, Allan; Ebert, Jay R.; Edwards, Peter; Zheng, Monica; Zheng, Ming H.

    2016-01-01

    Lateral elbow tendinopathy, commonly known as tennis elbow, is a condition that can cause significant functional impairment in working-age patients. The term tendinopathy is used to describe chronic overuse tendon disorders encompassing a group of pathologies, a spectrum of disease. This review details the pathophysiology of tendinopathy and tendon healing as an introduction for a system grading the severity of tendinopathy, with each of the 4 grades displaying distinct histopathological features. Currently, there are a large number of nonoperative treatments available for lateral elbow tendinopathy, with little guidance as to when and how to use them. In fact, an appraisal of the clinical trials, systematic reviews, and meta-analyses studying these treatment modalities reveals that no single treatment reliably achieves outstanding results. This may be due in part to the majority of clinical studies to date including all patients with chronic tendinopathy rather than attempting to categorize patients according to the severity of disease. We relate the pathophysiology of the different grades of tendinopathy to the basic science principles that underpin the mechanisms of action of the nonoperative treatments available to propose a treatment algorithm guiding the management of lateral elbow tendinopathy depending on severity. We believe that this system will be useful both in clinical practice and for the future investigation of the efficacy of treatments. PMID:27833925

  12. Origin and lateral migration of linear dunes in the Qaidam Basin of NW China revealed by dune sediments, internal structures, and optically stimulated luminescence ages, with implications for linear dunes on Titan: discussion

    Science.gov (United States)

    Rubin, David M.; Rubin, Alan M.

    2013-01-01

    Zhou et al. (2012) proposed that longitudinal dunes in the Qaidam Basin, China, formed like yardangs: by erosion into sediment that was not deposited by those dunes. Because erosion occurs on the upwind flanks of most migrating dunes (Rubin and Hunter, 1982, 1985), the key to demonstrating a yardang-like origin is to show that the dunes did not deposit the strata that they contain. Zhou et al. made this argument by proposing that: (1) The dunes have not deposited cross-strata in the past 810 yr. (2) Cross-bedding within the dunes was not deposited by the dunes on the present-day land surface, but rather by older dunes that had a different morphology. (3) The present dunes are a later generation, “most likely of erosional origin similar to yardangs with orientations controlled by strikes of joints,” (p. 1147). (4) Rates of deflation in the dune field have been extremely high for the past 810–2440 yr. This commentary reviews these conclusions, reviews contradictory observations, and considers alternative interpretations.

  13. Lateral angle: a method for sexing using the petrous bone

    DEFF Research Database (Denmark)

    Norén, Anna; Lynnerup, Niels; Czarnetzki, Alfred

    2005-01-01

    We report on the results of applying the so-called lateral angle method for sex determination on skeletal remains. The lateral angle denotes the angle of the internal auditory canal in relation to the medial surface of the petrous part of the temporal bone. The method involves making a small cast...

  14. The lateral line microcosmos.

    Science.gov (United States)

    Ghysen, Alain; Dambly-Chaudière, Christine

    2007-09-01

    The lateral-line system is a simple sensory system comprising a number of discrete sense organs, the neuromasts, distributed over the body of fish and amphibians in species-specific patterns. Its development involves fundamental biological processes such as long-range cell migration, planar cell polarity, regeneration, and post-embryonic remodeling. These aspects have been extensively studied in amphibians by experimental embryologists, but it is only recently that the genetic bases of this development have been explored in zebrafish. This review discusses progress made over the past few years in this field.

  15. Model to Design Drip Hose Lateral Line

    Science.gov (United States)

    Ludwig, Rafael; Cury Saad, João Carlos

    2014-05-01

    Introduction The design criterion for non-pressure compensating drip hose is normally to have 10% of flow variation (Δq) in the lateral line, corresponding to 20% of head pressure variation (ΔH). Longer lateral lines in drip irrigation systems using conventional drippers provide cost reduction, but it is necessary to obtain to the uniformity of irrigation [1]. The use of Δq higher levels can provide longer lateral lines. [4] proposes the use of a 30% Δq and he found that this value resulted in distribution uniformity over 80%. [1] considered it is possible to extend the lateral line length using two emitters spacing in different section. He assumed that the spacing changing point would be at 40% of the total length, because this is approximately the location of the average flow according with [2]. [3] found that, for practical purposes, the average pressure is located at 40% of the length of the lateral line and that until this point it has already consumed 75% of total pressure head loss (hf ). In this case, the challenge for designers is getting longer lateral lines with high values of uniformity. Objective The objective of this study was to develop a model to design longer lateral lines using non-pressure compensating drip hose. Using the developed model, the hypotheses to be evaluated were: a) the use of two different spacing between emitters in the same lateral line allows longer length; b) it is possible to get longer lateral lines using high values of pressure variation in the lateral lines since the distribution uniformity stays below allowable limits. Methodology A computer program was developed in Delphi® based on the model developed and it is able to design lateral lines in level using non-pressure compensating drip hose. The input data are: desired distribution uniformity (DU); initial and final pressure in the lateral line; coefficients of relationship between emitter discharge and pressure head; hose internal diameter; pipe cross-sectional area

  16. Creativity in later life.

    Science.gov (United States)

    Price, K A; Tinker, A M

    2014-08-01

    The ageing population presents significant challenges for the provision of social and health services. Strategies are needed to enable older people to cope within a society ill prepared for the impacts of these demographic changes. The ability to be creative may be one such strategy. This review outlines the relevant literature and examines current public health policy related to creativity in old age with the aim of highlighting some important issues. As well as looking at the benefits and negative aspects of creative activity in later life they are considered in the context of the theory of "successful ageing". Creative activity plays an important role in the lives of older people promoting social interaction, providing cognitive stimulation and giving a sense of self-worth. Furthermore, it is shown to be useful as a tool in the multi-disciplinary treatment of health problems common in later life such as depression and dementia. There are a number of initiatives to encourage older people to participate in creative activities such as arts-based projects which may range from visual arts to dance to music to intergenerational initiatives. However, participation shows geographical variation and often the responsibility of provision falls to voluntary organisations. Overall, the literature presented suggests that creative activity could be a useful tool for individuals and society. However, further research is needed to establish the key factors which contribute to patterns of improved health and well-being, as well as to explore ways to improve access to services.

  17. Brainmining emotive lateral solutions

    Directory of Open Access Journals (Sweden)

    Theodore Scaltsas

    2016-07-01

    Full Text Available BrainMining is a theory of creative thinking that shows how we should exploit the mind’s spontaneous natural disposition to use old solutions to address new problems – our Anchoring Cognitive Bias. BrainMining develops a simple and straightforward method to transform recalcitrant problems into types of problems which we have solved before, and then apply an old type of solution to them. The transformation makes the thinking lateral by matching up disparate types of problem and solution. It emphasises the role of emotive judgements that the agent makes, when she discerns whether a change of the values or the emotions and feelings in a situation, which would expand the space of solutions available for the problem at hand, would be acceptable or appropriate in the situation. A lateral solution for an intractable problem is thus spontaneously brainmined from the agent’s old solutions, to solve a transformed version of the intractable problem, possibly involving changes in the value system or the emotional profile of the situation, which the agent judges, emotively, will be acceptable, and even appropriate in the circumstances.

  18. Lateral Lumbar Interbody Fusion

    Science.gov (United States)

    Hughes, Alexander; Girardi, Federico; Sama, Andrew; Lebl, Darren; Cammisa, Frank

    2015-01-01

    The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular. LLIF is currently being utilized for a variety of pathologies including but not limited to adult de novo lumbar scoliosis, central and foraminal stenosis, spondylolisthesis, and adjacent segment degeneration. Although early clinical outcomes have been good, the potential for significant neurological and vascular vertebral endplate complications exists. Nevertheless, LLIF is a promising technique with the potential to more effectively treat complex adult de novo scoliosis and achieve predictable fusion while avoiding the complications of traditional anterior surgery and posterior interbody techniques. PMID:26713134

  19. INTEGRAL three years later

    CERN Document Server

    Foschini, L; Malaguti, G

    2005-01-01

    The ESA INTErnational Gamma-Ray Astrophyisics Laboratory (INTEGRAL) is composed of two main instruments (IBIS and SPI) for the gamma-ray astrophysics (20 keV - 10 MeV), plus two monitors (JEM-X and OMC) for X-ray and optical counterparts. It was launched on October 17th, 2002, from the Baikonur cosmodrome (Kazakhstan) and it will be active at least up to 2008. A selection of its main scientific contributions obtained to date are presented.

  20. An update of the International Joint Commission's 1998 report, unsafe dams? seven years later what has changed? a report to the Governments of the United States and Canada

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-03-15

    In February 1998, the International Joint Commission of Canada and the United States (IJC) submitted a report to the governments of the United States and Canada on the safety of dams and dykes that are directly subject to IJC Orders. One of the report's conclusions was that some regulated facilities that are under IJC Orders at the border are not subject to comprehensive government safety inspections and that oversight by governments was unsatisfactory. In early 2004, the IJC asked the owners of regulated facilities to update information furnished for the 1998 report, including information on safety inspections and emergency action plans, governmental oversight of inspections, inundation maps, security protocols and any other information concerning safety and security. In addition, the IJC asked for the assistance of its boards to provide information on steps that have been taken since 1998 to ensure the safety and security of these structures. Relevant federal, state and provincial government agencies were also requested to provide additional information regarding safety, security and governmental oversight of structures listed in the 1998 report. This document provided a summary of the information received pursuant to these requests as well as information from several other consultation processes. The report made several recommendations including that the governments take appropriate steps to ensure the safety and security of facilities at the border, particularly for those that are not regulated by the IJC. It was suggested that more United States federal funding be provided to Maine and Minnesota to increase the frequency of inspections. 2 tabs., 3 appendices.

  1. Epicondilite lateral do cotovelo

    OpenAIRE

    Cohen,Marcio; Motta Filho,Geraldo da Rocha

    2012-01-01

    A epicondilite lateral, também conhecida como cotovelo do tenista, é uma condição comum que acomete de 1 a 3% da população. O termo epicondilite sugere inflamação, embora a análise histológica tecidual não demonstre um processo inflamatório. A estrutura acometida com mais frequência é a origem do tendão extensor radial curto do carpo e o mecanismo de lesão está associado à sua sobrecarga. O tratamento incruento é o de escolha e inclui: repouso, fisioterapia, infiltração com cortisona ou plasm...

  2. Vitiligo Lateral Lower Lip

    Directory of Open Access Journals (Sweden)

    Sahoo Antaryami

    2002-01-01

    Full Text Available Vitiligo characteristically affecting the lateral lower lip (LLL is a common presentation in South Orissa. This type of lesion has rarely been described in literature. One hundred eighteen such cases were studied during the period from October 1999 to September, 2000. LLL vitiligo constituted 16.39% of all vitiligo patients. Both sexes were affected equally. The peak age of onset was in the 2nd decade, mean duration of illness 21.46 months. Fifty six patients had unilateral lesion (38 on the left and 18 on the right. Among the 62 patients having bilateral lesions, the onset was more frequent on the left (38 than either the right (8 or both sides together (16. All the patients were right handed. Association with local factors like infection, trauma, cheilitis, FDE etc were associated in 38.98% of cases, but systemic or autoimmune diseases were not associated. Positive family history was found in 22% of cases.

  3. Lateral conduction infrared photodetector

    Science.gov (United States)

    Kim, Jin K.; Carroll, Malcolm S.

    2011-09-20

    A photodetector for detecting infrared light in a wavelength range of 3-25 .mu.m is disclosed. The photodetector has a mesa structure formed from semiconductor layers which include a type-II superlattice formed of alternating layers of InAs and In.sub.xGa.sub.1-xSb with 0.ltoreq.x.ltoreq.0.5. Impurity doped regions are formed on sidewalls of the mesa structure to provide for a lateral conduction of photo-generated carriers which can provide an increased carrier mobility and a reduced surface recombination. An optional bias electrode can be used in the photodetector to control and vary a cut-off wavelength or a depletion width therein. The photodetector can be formed as a single-color or multi-color device, and can also be used to form a focal plane array which is compatible with conventional read-out integrated circuits.

  4. Lateral Thinking and Technology Education.

    Science.gov (United States)

    Waks, Shlomo

    1997-01-01

    Presents an analysis of technology education and its relevance to lateral thinking. Discusses prospects for utilizing technology education as a platform and a contextual domain for nurturing lateral thinking. Argues that technology education is an appropriate environment for developing complementary incorporation of vertical and lateral thinking.…

  5. [Lateral lumbar disk hernia].

    Science.gov (United States)

    Monod, A; Desmoineaux, P; Deburge, A

    1990-01-01

    Lateral lumbar disc herniations (L.D.H.) develop in the foramen, and compress the nerve root against the overlying vertebral pedicle. In our study of L.D.H. from the clinical, radiographical, and therapeutical aspects, we reviewed 23 cases selected from the 590 patients treated for discal herniation from 1984 to 1987. The frequency of L.D.H. in this series was 3.8 per cent. The clinical pattern brings out some suggestive signs of L.D.H. (frequency of cruralgia, a seldom very positive Lasegue's test, the paucity of spinal signs, non impulsive pain). Saccoradiculography and discography rarely evidenced the L.D.H.. The T.D.M. was the investigation of choice on condition that it was correctly used. When the image was doubtful, disco-CT confirmation should be proceeded too. This latter method of investigation enabled the possibility of sequestration to be explored. 14 patients were treated by chemonucleolysis, with 9 successful outcomes. The 5 failures were cases where chemonucleolysis should not have been indicated, mainly due to associated osseous stenosis. 9 patients underwent immediate surgery with good results in each case.

  6. Amyotrophic lateral sclerosis: update

    Directory of Open Access Journals (Sweden)

    Zapata-Zapata, Carlos Hugo

    2016-04-01

    Full Text Available Amyotrophic lateral sclerosis is a neurodegenerative disease with devastating consequences for the patient and his/her family. Its etiology is still not clear. In about 10 % of the patients there is a hereditary pattern of the disease. Worldwide, prevalence ranges from 2 to 11 cases per 100,000 people. Age of presentation varies from 58 to 63 years for sporadic cases, and from 47 to 52 years for the familial ones. Concerning gender, there is a slight preference for males. Clinical manifestations include signs of upper and lower motor neurons, damage in limbs and bulbar muscles, and, in some patients, frontotemporal cognitive dysfunction. Diagnosis is essentially clinical supported by neurophysiological studies, such as needle electromyography, which is the most important test for early diagnosis. There is no cure, but riluzol has proven to delay the use of mechanical ventilation and to slightly prolong survival. Consequently, management is based on support measures, such as those related to nutrition and ventilatory function, in addition to control of the motor and non-motor symptoms of the disease.

  7. Identificação trans-operatória do óstio do Wirsung após a papilo-esfincterotomia Intra-operatory identification of the ostium of Wirsung's pancreatic duct after sphincterotomy

    Directory of Open Access Journals (Sweden)

    A.L. da Silva

    1999-04-01

    Full Text Available OBJETIVO: Contribuir para o achado do óstio de Wirsung durante a técnica da papilo-esfincteroplastia, prevenindo a pancreatite aguda pós-operatória. CASUÍSTICA E MÉTODO: Foram estudados 27 pacientes submetidos a papilo-esfincteroplastia por coledocolitíase com ou sem odite. Após a papilo-esfincterotomia (PET terapêutica, por via duodenal, realizou-se estudo da localização do óstio do ducto de Wirsung. A PET transforma a ampola de Vater em um triângulo isósceles, cujas medidas foram obtidas através de compasso. Utilizando-as, o óstio do Wirsung poderá ser facilmente identificado e cateterizado no trans-operatório, antes de se fazer a sutura muco-mucosa da papila seccionada. RESULTADOS: O óstio geralmente é encontrado medialmente na metade esquerda do triângulo e a uma distância média de 0,19cm a 0,25cm acima da base do triângulo, considerando-se a ausência ou presença de inflamação, respectivamente. CONCLUSÃO: A determinação transoperatória das distâncias padronizadas neste estudo, permite a detecção e cateterização segura do óstio do Wirsung na presença ou não de odite.PURPOSE: The aim of this study is to suggest a feasible method to find the ostium of the Wirsung's duct during sphincteroplasty of the Vater's papilla, in order to avoid post-operative complications such as acute pancreatitis. PATIENTS AND METHODS: A total of 27 patients were submitted to sphincteroplasty for choledocolithiasis with or without Odditis. After therapeutic papillotomy and sphincterotomy through the duodenun, the location of the ostium of the Wirsung's duct was determined and studied. After papillotomy, the Vater's papilla becomes an isosceles triangle and its measurements were made with a compass. Thereby the ostium of Wirsung's duct was easily detected and a catheter was inserted before the suture of the mucosa of the papilla. RESULTS: The ostium was generally found medially, on the left side of the triangle, 0.19cm to 0.25cm

  8. LATERAL SURVIVAL: AN OT ACCOUNT

    Directory of Open Access Journals (Sweden)

    Moira Yip

    2004-12-01

    Full Text Available When laterals are the targets of phonological processes, laterality may or may not survive. In a fixed feature geometry, [lateral] should be lost if its superordinate node is eliminated by either the spreading of a neighbouring node, or by coda neutralization. So if [lateral] is under Coronal (Blevins 1994, it should be lost under Place assimilation, and if [lateral] is under Sonorant Voicing (Rice & Avery 1991 it should be lost by rules that spread voicing. Yet in some languages lateral survives such spreading intact. Facts like these argue against a universal attachment of [lateral] under either Coronal or Sonorant Voicing, and in favour of an account in terms of markedness constraints on feature-co-occurrence (Padgett 2000. The core of an OT account is that IFIDENTLAT is ranked above whatever causes neutralization, such as SHARE-F or *CODAF. laterality will survive. If these rankings are reversed, we derive languages in which laterality is lost. The other significant factor is markedness. High-ranked feature co-occurrence constraints like *LATDORSAL can block spreading from affecting laterals at all.

  9. Amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Leigh P Nigel

    2009-02-01

    Full Text Available Abstract Amyotrophic lateral sclerosis (ALS is a neurodegenerative disease characterised by progressive muscular paralysis reflecting degeneration of motor neurones in the primary motor cortex, corticospinal tracts, brainstem and spinal cord. Incidence (average 1.89 per 100,000/year and prevalence (average 5.2 per100,000 are relatively uniform in Western countries, although foci of higher frequency occur in the Western Pacific. The mean age of onset for sporadic ALS is about 60 years. Overall, there is a slight male prevalence (M:F ratio~1.5:1. Approximately two thirds of patients with typical ALS have a spinal form of the disease (limb onset and present with symptoms related to focal muscle weakness and wasting, where the symptoms may start either distally or proximally in the upper and lower limbs. Gradually, spasticity may develop in the weakened atrophic limbs, affecting manual dexterity and gait. Patients with bulbar onset ALS usually present with dysarthria and dysphagia for solid or liquids, and limbs symptoms can develop almost simultaneously with bulbar symptoms, and in the vast majority of cases will occur within 1–2 years. Paralysis is progressive and leads to death due to respiratory failure within 2–3 years for bulbar onset cases and 3–5 years for limb onset ALS cases. Most ALS cases are sporadic but 5–10% of cases are familial, and of these 20% have a mutation of the SOD1 gene and about 2–5% have mutations of the TARDBP (TDP-43 gene. Two percent of apparently sporadic patients have SOD1 mutations, and TARDBP mutations also occur in sporadic cases. The diagnosis is based on clinical history, examination, electromyography, and exclusion of 'ALS-mimics' (e.g. cervical spondylotic myelopathies, multifocal motor neuropathy, Kennedy's disease by appropriate investigations. The pathological hallmarks comprise loss of motor neurones with intraneuronal ubiquitin-immunoreactive inclusions in upper motor neurones and TDP-43

  10. Turbine airfoil with laterally extending snubber having internal cooling system

    Science.gov (United States)

    Scribner, Carmen Andrew; Messmann, Stephen John; Marsh, Jan H.

    2016-09-06

    A turbine airfoil usable in a turbine engine and having at least one snubber with a snubber cooling system positioned therein and in communication with an airfoil cooling system is disclosed. The snubber may extend from the outer housing of the airfoil toward an adjacent turbine airfoil positioned within a row of airfoils. The snubber cooling system may include an inner cooling channel separated from an outer cooling channel by an inner wall. The inner wall may include a plurality of impingement cooling orifices that direct impingement fluid against an outer wall defining the outer cooling channel. In one embodiment, the cooling fluids may be exhausted from the snubber, and in another embodiment, the cooling fluids may be returned to the airfoil cooling system. Flow guides may be positioned in the outer cooling channel, which may reduce cross-flow by the impingement orifices, thereby increasing effectiveness.

  11. Lateral shear-moraines and lateral marginal-moraines of palaeo-ice streams

    Science.gov (United States)

    Batchelor, C. L.; Dowdeswell, J. A.

    2016-11-01

    An understanding of the nature of sedimentation at ice-stream lateral margins is important in reconstructing the dynamics of former ice sheets and modelling the mechanisms by which sediment is transported beneath contemporary ice streams. Theories of the formation of ice-stream lateral moraines (ISLMs) have hitherto been based on a relatively limited number of terrestrial and marine examples. Here, an inventory of ISLMs is compiled from available studies, together with independent analysis of seismic-reflection and bathymetric datasets. The locations and dimensions of 70 ISLMs, alongside a synthesis of their key architectural and geomorphic characteristics, are presented. Two different types of ISLMs are identified. Type 1 ISLMs are up to 3.5 km wide and 60 m thick. They maintain a constant width, thickness and cross-sectional shape along their length. Type 1 ISLMs are interpreted and referred to as ice-stream lateral shear-moraines that form subglacially in the shear zone between ice streams and slower-flowing regions of an ice sheet. In contrast, Type 2 ISLMs are up to 50 km wide and 300 m thick. They are only identified close to the shelf break in the marine environment. Type 2 ISLMs exhibit an increase in width and thickness along their length and their distal slopes become steeper in a seaward direction. They contain internal dipping reflections that indicate sediment progradation away from the former ice stream. Type 2 ISLMs are interpreted and referred to as ice-stream lateral marginal-moraines that were formed at the lateral boundary between ice streams and seafloor terrain that was free of grounded ice. We suggest that, using bathymetric images and acoustic profiles, it is possible to differentiate between ice-stream lateral shear-moraines and lateral marginal-moraines in the geological record. This distinction is important for understanding the mechanisms of sediment transfer beneath ice streams and for making inferences about the conditions that existed

  12. 内镜下侧方入路单椎体内固定治疗胸腰椎压缩性骨折的解剖学研究%Anatomical study of only injured vertebrae internal fixation through lateral approach by endoscope to treat thoracolumbar vertebral compression fracture

    Institute of Scientific and Technical Information of China (English)

    李际才; 刘平均; 刘君华; 贺用礼; 毛炳焱; 王文聪; 晏平华; 丁原; 胡志喜

    2012-01-01

      目的探讨内镜下侧方入路单椎体内固定术治疗胸腰椎压缩性骨折在应用解剖上的可行性。方法随机选取12具脊柱胸腰段保存完整的成人尸体标本,垂直于矢状面将克氏针钻入T11-L4椎体侧方中央,观察脊神经的走行方向、冠状面上各克氏针与其后方经过的上位脊神经的距离、胸腰段椎体节段血管在椎体侧方的走行位置、椎体高度、椎体后缘与腔静脉、主动脉的距离,测量椎体侧方手术安全区。结果冠状面上T10-L3脊神经均走行于下位椎体侧方中线(克氏针)的后方,胸腰段椎体节段性血管紧贴椎体侧方自内上斜向外下走向,本手术路径无法避开,胸腰椎侧方存在手术安全区,左侧手术区较右侧更安全。结论内镜下侧方入路单椎体内固定治疗胸腰椎压缩性骨折在解剖学上是可行性的。%  Objective To investigate the feasibility of treatment thoracolumbar vertebral compression fracture by endoscopic lateral approach which only injured vertebrae internal fixated. Methods Select 12 thoracolumbar vertebrae with adult corpses specimens randomly, perpendicular to the vertical plane a gram needle drilling into the T11-L4 vertebral body side in central, observe the nerve way of T10-L3, coronary face every gram its rear after superior needle of the distance and chest pairs of vertebral segment lumbar blood vessels in the vertebral body side walk line position, thoracolumbar vertebral height, after vertebral bodies flanges and vena cava, aortic distance, calculation vertebral lateral surgical area safety. Results Coronary face T10-L3 nerve walking on lateral vertebral bodies under a line(gram needle) rear, segment artery of thoracolumbar vertebrae cling to the body, this surgery path can't avoid it, vertebral lateral side being security operation window, the left is right safety. Conclusion Minimal invasion through lateral approach by endoscopic treatment

  13. A Pascalian lateral drift sensor

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, H., E-mail: hendrik.jansen@desy.de

    2016-09-21

    A novel concept of a layer-wise produced semiconductor sensor for precise particle tracking is proposed herein. In contrast to common semiconductor sensors, local regions with increased doping concentration deep in the bulk termed charge guides increase the lateral drift of free charges on their way to the read-out electrode. This lateral drift enables charge sharing independent of the incident position of the traversing particle. With a regular grid of charge guides the lateral charge distribution resembles a normalised Pascal's triangle for particles that are stopped in depths lower than the depth of the first layer of the charge guides. For minimum ionising particles a sum of binomial distributions describes the lateral charge distribution. This concept decouples the achievable sensor resolution from the pitch size as the characteristic length is replaced by the lateral distance of the charge guides.

  14. A Pascalian lateral drift sensor

    Science.gov (United States)

    Jansen, H.

    2016-09-01

    A novel concept of a layer-wise produced semiconductor sensor for precise particle tracking is proposed herein. In contrast to common semiconductor sensors, local regions with increased doping concentration deep in the bulk termed charge guides increase the lateral drift of free charges on their way to the read-out electrode. This lateral drift enables charge sharing independent of the incident position of the traversing particle. With a regular grid of charge guides the lateral charge distribution resembles a normalised Pascal's triangle for particles that are stopped in depths lower than the depth of the first layer of the charge guides. For minimum ionising particles a sum of binomial distributions describes the lateral charge distribution. This concept decouples the achievable sensor resolution from the pitch size as the characteristic length is replaced by the lateral distance of the charge guides.

  15. Comparison of therapeutic effects between open reduction and internal fixation with conventional plate via L-shaped lateral approach and internal fixation with percutaneous plate using a sinus tarsi approach in treatment of calcaneal fractures%经跗骨窦切口插入钢板与经外侧L形切口钢板内固定治疗跟骨骨折临床疗效的比较

    Institute of Scientific and Technical Information of China (English)

    夏胜利; 王秀会; 陆耀刚; 王惠中; 王子平

    2012-01-01

    Objective To compare therapeutic effects between open reduction and internal fixation with conventional plate via L-shaped lateral approach and internal fixation with percutaneous plate using a sinus tarsi approach in the treatment of calcaneal fractures. Methods All of 108 patients (117 feet) of displaced intra—articular calcaneal fractures were randomly divided into two groups: minimally invasive treatment group with 59 cases (64 feet) and conventional treatment group with 49 cases (53 feet).Results All patients were followed up for 8 to 28 months (mean 19 months).Lateral roentgenograms showed satisfactory restoration of the calcaneal height,width,length,Bohlers angle and Gissanes angle after operation in all patients.Early wound complications occurred postoperatively in 8 feet in conventional treatment group, while no feet developed wound complication in invasive treatment group. Maryland foot score demonstrated excellent results achieved in 49 feet, good in 11, fair in 4 in minimally invasive treatment group with the excellent and good rates of 93.8%, and excellent results in 31 feet, good in 15 feet, fair in 7 feet in conventional treatment group with the excellent and good rates of 86.8%, with significant difference found between two groups (P <0.01). Conclusion Compared with conventional surgical methods of treatment of displaced intra—articular calcaneal fractures, sinus tarsi approach for the reduction and internal fixation with percutaneous plate not only significantly reduces operative time and achieves satisfactory clinical therapeutic effects, but also effectively avoids postoperative complications.%目的 比较经跗骨窦切口插入钢板内固定与经外侧L形切口复位钢板内固定治疗跟骨骨折的临床疗效.方法 108例(117足)跟骨关节内骨折被随机分为微创及常规治疗组,微创治疗组59例(64足)采用经跗骨窦切口插入钢板内固定,常规治疗组49例(53足)采用外侧L

  16. Comparison of open choledocholithotomy with endoscopic sphincterotomy%开腹胆总管切开取石术与内镜下十二指肠乳头括约肌切开取石术的比较

    Institute of Scientific and Technical Information of China (English)

    张鹏; 赵景明; 张忠涛

    2011-01-01

    目的 比较开腹胆总管切开取石术与内镜下十二指肠乳头括约肌切开取石术(EST)两者治疗胆总管结石的疗效与费用。方法 收集北京友谊医院及北京积水潭医院2002年至2009年符合入选条件(年龄在20~75岁之间,术前经影像学检查证实为单纯胆总管结石,既往无胆道手术及EST病史,无严重全身合并症)的胆总管结石病例共177例,按其治疗方式分为开腹手术组和EST组。其中开腹手术组62例,EST组11 5例。比较两组患者性别组成、年龄、ASA分级、术前有无症状及症状持续时间、术前有无合并症,以上指标差异均无统计学意义。统计两组患者手术时间、出血量、取出结石的情况、术后恢复排气时间及腹痛持续时间、术后并发症的情况、住院时间及费用、残余结石发生率,对统计结果进行比较。结果开腹组手术时间为50~300 min(M=110)、出血量10~300 ml(M=60)、术后恢复排气时间24~96 h(M=48)、腹痛持续时间0~96 h(M=48)、住院时间8~70 d(M=21)、围手术期高淀粉酶血症发生率8.1%、手术费546~2498元(M=1503.2);EST组手术时间为10~120 min(M=25)、出血量2~40 ml(M=10)、术后恢复排气时间1~48 h(M=3)、腹痛持续时间0~144 h(M=0)、住院时间5~56 d(M=17)、围手术期高淀粉酶血症发生率40%、手术费2028~5728元(M=2028)。以上差异均有统计学意义。结论EST手术时间短,出血量少,术后恢复排气时间短,腹痛持续时间短,住院时间短;但围手术期高淀粉酶血症发生率及手术费高于开腹手术。%Objective To compare the efficacy and health economics between open choledocholithotomy and endoscopic sphincterotomy (EST) these two operations on patients with choledocholithiasis. Methods 177 patients (aged 20-75 yrs, with simple choledocholithiasis on medical imaging,who had not been treated with either biliary tract surgery or EST

  17. What causes amyotrophic lateral sclerosis?

    Science.gov (United States)

    Martin, Sarah; Al Khleifat, Ahmad; Al-Chalabi, Ammar

    2017-01-01

    Amyotrophic lateral sclerosis is a neurodegenerative disease predominantly affecting upper and lower motor neurons, resulting in progressive paralysis and death from respiratory failure within 2 to 3 years. The peak age of onset is 55 to 70 years, with a male predominance. The causes of amyotrophic lateral sclerosis are only partly known, but they include some environmental risk factors as well as several genes that have been identified as harbouring disease-associated variation. Here we review the nature, epidemiology, genetic associations, and environmental exposures associated with amyotrophic lateral sclerosis. PMID:28408982

  18. What causes amyotrophic lateral sclerosis?

    Science.gov (United States)

    Martin, Sarah; Al Khleifat, Ahmad; Al-Chalabi, Ammar

    2017-01-01

    Amyotrophic lateral sclerosis is a neurodegenerative disease predominantly affecting upper and lower motor neurons, resulting in progressive paralysis and death from respiratory failure within 2 to 3 years. The peak age of onset is 55 to 70 years, with a male predominance. The causes of amyotrophic lateral sclerosis are only partly known, but they include some environmental risk factors as well as several genes that have been identified as harbouring disease-associated variation. Here we review the nature, epidemiology, genetic associations, and environmental exposures associated with amyotrophic lateral sclerosis.

  19. Diagnosing and treating lateral epicondylitis.

    OpenAIRE

    1994-01-01

    Lateral epicondylitis is often encountered in primary care. Although its diagnosis can be fairly straightforward, its treatment is often difficult. This review examines the epidemiology, pathophysiology, and clinical presentation of tennis elbow. Management options are discussed.

  20. Lateral inhibition during nociceptive processing

    DEFF Research Database (Denmark)

    Quevedo, Alexandre S.; Mørch, Carsten Dahl; Andersen, Ole Kæseler

    2017-01-01

    of skin. Thus, the stimulation of the skin region between the endpoints of the lines appears to produce inhibition. These findings indicate that lateral inhibition limits spatial summation of pain and is an intrinsic component of nociceptive information processing. Disruption of such lateral inhibition......Spatial summation of pain is the increase of perceived intensity that occurs as the stimulated area increases. Spatial summation of pain is sub-additive in that increasing the stimulus area produces a disproportionately small increase in the perceived intensity of pain. A possible explanation...... for sub-additive summation may be that convergent excitatory information is modulated by lateral inhibition. To test the hypothesis that lateral inhibition may limit spatial summation of pain, we delivered different patterns of noxious thermal stimuli to the abdomens of 15 subjects using a computer...

  1. Lateral gene transfer, rearrangement, reconciliation

    NARCIS (Netherlands)

    Patterson, M.D.; Szollosi, G.; Daubin, V.; Tannier, E.

    2013-01-01

    Background. Models of ancestral gene order reconstruction have progressively integrated different evolutionary patterns and processes such as unequal gene content, gene duplications, and implicitly sequence evolution via reconciled gene trees. These models have so far ignored lateral gene transfer,

  2. Cerebral Laterality and Verbal Processes

    Science.gov (United States)

    Sherman, Jay L.; And Others

    1976-01-01

    Research suggests that we process information by way of two distinct and functionally separate coding systems. Their location, somewhat dependent on cerebral laterality, varies in right- and left-handed persons. Tests this dual coding model. (Editor/RK)

  3. Lateral Asymmetries in Human Evolution

    OpenAIRE

    John L. Bradshaw; Nettleton, Norman C.

    1989-01-01

    Lateral asymmetries are not confined to humans. Palaeozoic trilobites and calcichordates are now known to have been asymmetrical; song control in passerines is vested in the left cerebral hemisphere; learning which is lateralized to the left forebrain of chicks includes imprinting, visual discrimination learning and auditory habituation, while responses to novelty, attack and copulation are activated by the right; in rats the right hemisphere is involved in emotional behavior and spatial disc...

  4. CT navigated lateral interbody fusion.

    Science.gov (United States)

    Drazin, Doniel; Liu, John C; Acosta, Frank L

    2013-10-01

    Lateral interbody fusion techniques are heavily reliant on fluoroscopy for retractor docking and graft placement, which expose both the patient and surgeon to high doses of radiation. Use of image-guided technologies with CT-based images, however, can eliminate this radiation exposure for the surgeon. We describe the surgical technique of performing lateral lumbar interbody fusion using CT navigation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Optineurin and amyotrophic lateral sclerosis.

    Science.gov (United States)

    Maruyama, Hirofumi; Kawakami, Hideshi

    2013-07-01

    Amyotrophic lateral sclerosis is a devastating disease, and thus it is important to identify the causative gene and resolve the mechanism of the disease. We identified optineurin as a causative gene for amyotrophic lateral sclerosis. We found three types of mutations: a homozygous deletion of exon 5, a homozygous Q398X nonsense mutation and a heterozygous E478G missense mutation within its ubiquitin-binding domain. Optineurin negatively regulates the tumor necrosis factor-α-induced activation of nuclear factor kappa B. Nonsense and missense mutations abolished this function. Mutations related to amyotrophic lateral sclerosis also negated the inhibition of interferon regulatory factor-3. The missense mutation showed a cyotoplasmic distribution different from that of the wild type. There are no specific clinical symptoms related to optineurin. However, severe brain atrophy was detected in patients with homozygous deletion. Neuropathologically, an E478G patient showed transactive response DNA-binding protein of 43 kDa-positive neuronal intracytoplasmic inclusions in the spinal and medullary motor neurons. Furthermore, Golgi fragmentation was identified in 73% of this patient's anterior horn cells. In addition, optineurin is colocalized with fused in sarcoma in the basophilic inclusions of amyotrophic lateral sclerosis with fused in sarcoma mutations, and in basophilic inclusion body disease. These findings strongly suggest that optineurin is involved in the pathogenesis of amyotrophic lateral sclerosis.

  6. 外侧锁定板与内侧支持接骨板联合治疗C2及C3型股骨髁间骨折%Internal Fixation of Femoral Intercondylar Fracture with Lateral Locking Plate and Medial Buttress Plate

    Institute of Scientific and Technical Information of China (English)

    周建刚; 孟维春; 曹骏敏; 蒋臻欢

    2011-01-01

    Objective:To investigate the clinical effects of the treatment of type C2 and C3 femoral intercondylar fractures using locking plate and buttress plate. MethodS:From 2007 to 2010,18 cases of femoral intercondylar fractures were treated with lateral locking plates and medial buttress plates. According to Osteosynthe stfragen (AO) fracture classification, the fractures were classified as type C2 in 12 cases and type C3 in 6 cases. Medial and lateral approaches were used in the operation. After reduction,buttress plates were placed medially and locking plates were inserted laterally. There was no additional external fixation device postoperatively. Results: All the cases were followed up for an average of 8. 3 months and they all got bony union in 12-22 weeks. According to the criteria of Lysholm Knee Score, the result was as follows: 8 excellent, 8 good and 2 fair. The excellent and good rate was 89%. Conclusions: Open reduction and internal fixation with locking and buttress plates in the treatment of type C2 and C3 femoral intercondylar fracture has the advantage of a low rate complication, stable fixation and rapid bone union,and presents good clinical outcome.%目的:探讨外侧锁定板结合内侧支持接骨板治疗股骨髁间C2及C3型骨折的可行性.方法:采用外侧锁定板结合内侧支持接骨板治疗股骨髁间骨折患者18例.按AO分型:C2型12例,C3型6例,手术均采用内、外侧联合入路,骨折解剖复位后分别在外侧放置髁支持钢板,内侧放置普通钢板固定,术后不予外固定.结果:所有患者获得随访,平均随访时间为8.3个月,骨折均愈合,愈合时间12~22周.膝关节功能Lysholm评分:优8例,良8例,可2例,优良率为89%.结论:切开复位外侧锁定板结合内侧支持接骨板内固定治疗C2及C3股骨髁间型骨折并发症少、固定牢固、骨折愈合快,能获得良好的临床效果.

  7. Lateral epicondylitis of the elbow.

    Science.gov (United States)

    Tosti, Rick; Jennings, John; Sewards, J Milo

    2013-04-01

    Lateral epicondylitis, or "tennis elbow," is a common musculotendinous degenerative disorder of the extensor origin at the lateral humeral epicondyle. Repetitive occupational or athletic activities involving wrist extension and supination are thought to be causative. The typical symptoms include lateral elbow pain, pain with wrist extension, and weakened grip strength. The diagnosis is made clinically through history and physical examination; however, a thorough understanding of the differential diagnosis is imperative to prevent unnecessary testing and therapies. Most patients improve with nonoperative measures, such as activity modification, physical therapy, and injections. A small percentage of patients will require surgical release of the extensor carpi radialis brevis tendon. Common methods of release may be performed via percutaneous, arthroscopic, or open approaches.

  8. Later Zhou Sejong's Cultural Policy

    Institute of Scientific and Technical Information of China (English)

    PAN Qing

    2015-01-01

    Sejong wanted to stabilize the control. He paid attention to strengthen cultural enlightenment and implement cultural policy from educating people, choosing capable person, repairing history, limiting Buddhism, respecting Confucianism and other aspects. The wind of literature rise gradually. It is conducive to research the developmental trajectory of Later Zhou Dynasty.

  9. Lateral inhibition during nociceptive processing.

    Science.gov (United States)

    Quevedo, Alexandre S; Mørch, Carsten Dahl; Andersen, Ole K; Coghill, Robert C

    2017-06-01

    Spatial summation of pain (SSP) is the increase of perceived intensity that occurs as the stimulated area increases. Spatial summation of pain is subadditive in that increasing the stimulus area produces a disproportionately small increase in the perceived intensity of pain. A possible explanation for subadditive summation may be that convergent excitatory information is modulated by lateral inhibition. To test the hypothesis that lateral inhibition may limit SSP, we delivered different patterns of noxious thermal stimuli to the abdomens of 15 subjects using a computer-controlled CO2 laser. Lines (5 mm wide) of variable lengths (4, 8 cm) were compared with 2-point stimuli delivered at the same position/separation as the length of lines. When compared with one-point control stimuli, 2-point stimulus patterns produced statistically significant SSP, while no such summation was detected during line stimulus patterns. Direct comparison of pain intensity evoked by 2-point pattern stimuli with line pattern stimuli revealed that 2-point patterns were perceived as significantly more painful, despite the fact that the 2-point pattern stimulated far smaller areas of skin. Thus, the stimulation of the skin region between the endpoints of the lines appears to produce inhibition. These findings indicate that lateral inhibition limits SSP and is an intrinsic component of nociceptive information processing. Disruption of such lateral inhibition may contribute substantially to the radiation of some types of chronic pain.

  10. Pollute first, clean up later?

    NARCIS (Netherlands)

    Azadi, Hossein; Verheijke, Gijs; Witlox, Frank

    2011-01-01

    There is a growing concern with regard to sustainability in emerging economies like China. The Chinese growth is characterized by a strategy which is known as "pollute first, clean up later". Here we show that based on this strategy, the pollution alarm can often be postponed by a tremendous economi

  11. Early Adolescent Affect Predicts Later Life Outcomes.

    Science.gov (United States)

    Kansky, Jessica; Allen, Joseph P; Diener, Ed

    2016-07-01

    Subjective well-being as a predictor for later behavior and health has highlighted its relationship to health, work performance, and social relationships. However, the majority of such studies neglect the developmental nature of well-being in contributing to important changes across the transition to adulthood. To examine the potential role of subjective well-being as a long-term predictor of critical life outcomes, we examined indicators of positive and negative affect at age 14 as predictors of relationship, adjustment, self-worth, and career outcomes a decade later at ages 23 to 25, controlling for family income and gender. We utilised multi-informant methods including reports from the target participant, close friends, and romantic partners in a demographically diverse community sample of 184 participants. Early adolescent positive affect predicted fewer relationship problems (less self-reported and partner-reported conflict, and greater friendship attachment as rated by close peers) and healthy adjustment to adulthood (lower levels of depression, anxiety, and loneliness). It also predicted positive work functioning (higher levels of career satisfaction and job competence) and increased self-worth. Negative affect did not significantly predict any of these important life outcomes. In addition to predicting desirable mean levels of later outcomes, early positive affect predicted beneficial changes across time in many outcomes. The findings extend early research on the beneficial outcomes of subjective well-being by having an earlier assessment of well-being, including informant reports in measuring a large variety of outcome variables, and by extending the findings to a lower socioeconomic group of a diverse and younger sample. The results highlight the importance of considering positive affect as an important component of subjective well-being distinct from negative affect. © 2016 The International Association of Applied Psychology.

  12. Diabetic kidney disease:Act now or pay later

    Institute of Scientific and Technical Information of China (English)

    Robert C Atkins; Paul Zimmet

    2009-01-01

    @@ For the 2010 International Society of Nephrology/International Federation of Kidney Foundations World Kidney Day Steering Committee~* ( RA ) and the International Diabetes Federation (PZ) World Kidney Day 11 March 2010: we must act on diabetic kidney disease In 2003, the International Society of Nephrology and the International Diabetes Federation launched a booklet called " Diabetes in the Kidney: Time to act"~([1]) to highlight the global pandemic of type 2 diabetes and diabetic kidney disease. It aimed to alert governments, health organisations, providers, doctors and patients to the increasing health and socio-economic problems due to diabetic kidney disease and its sequelae, end stage kidney disease requiring dialysis and cardiovascular death. Seven years later, the same message has become even more urgent.

  13. 空心钉克氏针内固定治疗儿童陈旧性肱骨外髁骨折近期疗效观察%Short-term effect of cannulated screw with K-wires used as internal fixation in management of pediatric neglected humeral lateral condylar fractures

    Institute of Scientific and Technical Information of China (English)

    易新成; 鲍琨; 陈博昌

    2014-01-01

    目的:探讨空心钉克氏针内固定手术治疗儿童陈旧性肱骨外髁骨折的临床疗效。方法回顾性分析2009年10月至2012年12月我们收治并获完整随访的的11例肱骨外髁陈旧性骨折患儿临床资料,其中男9例,女2例,年龄2岁1个月至6岁4个月,平均4岁5个月。患儿受伤至手术时间为30~90 d,平均52 d。受伤初期按Milch分型,MilchⅠ型4例,MilchⅡ型7例,肘关节功能有不同程度受限。患儿均切开复位后用1枚空心钉外加2枚交叉克氏针内固定治疗。术后随访观察骨折愈合时间及并发症情况,术后1年采用Dhillon评分值和Baumann角评定疗效。结果所有患儿术后均获12~34个月(平均22.7个月)随访。均在术后6~8周获骨性愈合。术后1年按照Dhillon评分标准,10例为优,1例为良,优良率100%,术前患侧肘关节活动弧度平均为90.5°±27.3°,术后1年时平均为129.1°±11.8°,二者差异有统计学意义(t=6.527,P=0.000)。术后1年所有患儿Baumann角均在正常范围(68°~80°),平均74.3°±4.2°。无一例发生术后感染、骨折延迟愈合、畸形愈合、骨不连、肘内外翻、肱骨小头缺血坏死、医源性血管神经损伤等并发症。结论切开复位后采用1枚空心钉外加2枚交叉克氏针内固定治疗儿童陈旧性肱骨外髁骨折可达到复位满意、内固定稳定和良好的近期疗效,并发症少。%Objetive To discuss the short-term effect of cannulated screw with K-wires used as internal fixation in management of pediatric neglected humeral lateral condylar fractures. Methods The clinical data of 1 1 cases with neglected humeral lateral condylar fracture were analyzed retrospectively.from October 2009 to December 2012.There were 9 boys and 2 girls,aged from 2 years and 1month to 6 year and 4 months old (aver-age,4 years and 5 months).The duration of initially trauma to surgery ranged

  14. Craving creativity in later life

    DEFF Research Database (Denmark)

    Fristrup, Tine

    2013-01-01

    but it also raises questions as to what constitutes a ‘good’ and ‘active’ life in all societies. The conflicting aspect of the discursive battlefield on active ageing constitutes a fight for authority: Who has the ‘right’ to define the meaning of being ‘active’ and how can ‘activity’ be identified? ‘Active......’ is to be understood according to the interpretations available in different knowledge perspectives in order to discipline the future knowledge production of ageing and control the processes of subjectification in later life as the disciplining of ‘Population Ageing’: Becoming a subject to active ageing. Dominant...... discourses on ‘active ageing’ are challenged by the focus of museums and archives on using heritage and participatory arts as an arena to performAGE in later life by craving creativity as a notion of age and opportunity....

  15. Laterally Loaded Piles in Clay

    DEFF Research Database (Denmark)

    Christensen, Helle; Niewald, Gitte

    1992-01-01

    The ultimate lateral resistance of a pile element moved horizontally can be analyzed by the theory of plasticity. At a certain depth the movements around the pile are purely horizontal and upper bound solutions can be estimated theoretically under undrained circumstances. Model tests...... in the laboratory show ultimate resistances close to the estimated limits and p - y curves close to curves based on test results from full-scale piles. Rough and smooth piles with circular and square cross sections are investigated....

  16. Internal and International Corruption

    Directory of Open Access Journals (Sweden)

    Dr.Sc. Mario Antinucci

    2015-06-01

    Full Text Available This subject, whence the name of this paper originates from, must be addressed with courage and intellectual integrity by all of us, the different parts of the civil society, the public institutions, the entrepreneurs and the legal professionals, the youth and the new generations. All the public policies of the European governments share the belief of a direct correlation between the criminal density connected to corruption of States political and economic protagonists and the lack of availability of investments on young talents, new generations, both in the entrepreneurial and in the professional fields. In most Member States, anticorruption policies have gained an increased prominence in government agendas and the financial crisis has drawn attention to the integrity and accountability of policy-makers. Most Member States that are currently in serious financial difficulties have acknowledged the seriousness of issues related to corruption and have created (or are planning anticorruption programs in order to deal with the risks deriving from this issue and with the diversion of public funds. In some Member States, the economic adjustment programs provide for explicit obligations related to anti-corruption policies. Even when not formally connected to adjustment programs, anticorruption policies complement the adjustment measures, especially in those countries in which corruption is a serious issue.  During the European Semester of economic policy coordination, recommendations for efficiently fighting corruption have been laid out; Among the most vulnerable sectors, urban development and building projects are certainly very exposed to corruption risks and to infiltration of internal and transnational organized crime.

  17. Direct lateral maneuvers in hawkmoths

    Directory of Open Access Journals (Sweden)

    Jeremy S. M. Greeter

    2016-01-01

    Full Text Available We used videography to investigate direct lateral maneuvers, i.e. ‘sideslips’, of the hawkmoth Manduca sexta. M. sexta sideslip by rolling their entire body and wings to reorient their net force vector. During sideslip they increase net aerodynamic force by flapping with greater amplitude, (in both wing elevation and sweep, allowing them to continue to support body weight while rolled. To execute the roll maneuver we observed in sideslips, they use an asymmetric wing stroke; increasing the pitch of the roll-contralateral wing pair, while decreasing that of the roll-ipsilateral pair. They also increase the wing sweep amplitude of, and decrease the elevation amplitude of, the contralateral wing pair relative to the ipsilateral pair. The roll maneuver unfolds in a stairstep manner, with orientation changing more during downstroke than upstroke. This is due to smaller upstroke wing pitch angle asymmetries as well as increased upstroke flapping counter-torque from left-right differences in global reference frame wing velocity about the moth's roll axis. Rolls are also opposed by stabilizing aerodynamic moments from lateral motion, such that rightward roll velocity will be opposed by rightward motion. Computational modeling using blade-element approaches confirm the plausibility of a causal linkage between the previously mentioned wing kinematics and roll/sideslip. Model results also predict high degrees of axial and lateral damping. On the time scale of whole and half wing strokes, left-right wing pair asymmetries directly relate to the first, but not second, derivative of roll. Collectively, these results strongly support a roll-based sideslip with a high degree of roll damping in M. sexta.

  18. Clinical Neurogenetics: Amyotrophic Lateral Sclerosis

    Science.gov (United States)

    Harms, Matthew B.; Baloh, Robert H.

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease, about which our understanding is expanding rapidly as its genetic causes are uncovered. The pace of new gene discovery over the last 5 years has accelerated, providing new insights into the pathogenesis of disease and highlighting biological pathways for target for therapeutic development. This article reviews our current understanding of the heritability of ALS, provides an overview of each of the major ALS genes, highlighting their phenotypic characteristics and frequencies as a guide for clinicians evaluating patients with ALS. PMID:24176417

  19. Detecting lateral genetic material transfer

    CERN Document Server

    Calderón, C; Mireles, V; Miramontes, P

    2012-01-01

    The bioinformatical methods to detect lateral gene transfer events are mainly based on functional coding DNA characteristics. In this paper, we propose the use of DNA traits not depending on protein coding requirements. We introduce several semilocal variables that depend on DNA primary sequence and that reflect thermodynamic as well as physico-chemical magnitudes that are able to tell apart the genome of different organisms. After combining these variables in a neural classificator, we obtain results whose power of resolution go as far as to detect the exchange of genomic material between bacteria that are phylogenetically close.

  20. Craving creativity in later life

    DEFF Research Database (Denmark)

    Fristrup, Tine

    2013-01-01

    The societal norms of ageing and old age are changing in society today, due to demographic changes that favour a pedagogicalization of society, focusing on the management of human resources throughout the entire lifespan. The discourse on active ageing mot only reveals ‘better’ ways of ageing......’ is to be understood according to the interpretations available in different knowledge perspectives in order to discipline the future knowledge production of ageing and control the processes of subjectification in later life as the disciplining of ‘Population Ageing’: Becoming a subject to active ageing. Dominant...

  1. Diagnosis of amyotrophic lateral sclerosis.

    Science.gov (United States)

    Rowland, L P

    1998-10-01

    This review of the differential diagnosis of amyotrophic lateral sclerosis focuses on two themes. The first is practical, how to establish the diagnosis based primarily on clinical findings buttressed by electrodiagnosis. The main considerations are multifocal motor neuropathy and cervical spondylotic myelopathy. The second theme is the relationship of motor neuron disease to other conditions, including benign fasciculation (Denny-Brown, Foley syndrome), paraneoplastic syndromes, lymphoproliferative disease, radiation damage, monomelic amyotrophy (Hirayama syndrome), as well as an association with parkinsonism, dementia and multisystem disorders of the central nervous system.

  2. Lateral Thoracic Maningocele : Anaesthetic Implications

    Directory of Open Access Journals (Sweden)

    Nazeer Ahmed K

    2008-12-01

    Full Text Available Meningomyelocele is a broad term representing herniation of extracranial contents through a congenital defect in the vertebral column. If only cerebrospinal fluid (CSF and meninges herniate, it is termed as a meningocele. A meningoencephalocele is herniation of neural elements along with meninges. Anaesthetic challenges in management of thoracic meningomyelocele include securing the airway with intubation in lateral or supine position, intraoperative prone position with its associated complications and accurate assessment of blood loss and prevention of hypothermia. We report a case of a thoracic meningocele posted for resection and discuss its anaesthetic implications

  3. International arbejdsdeling

    DEFF Research Database (Denmark)

    Henten, Anders

    1998-01-01

    Article dealing with the implications of informátion and communication technologies on the international division of labour.......Article dealing with the implications of informátion and communication technologies on the international division of labour....

  4. Internal Bleeding

    Science.gov (United States)

    ... in Paralyzed Monkeys Additional Content Medical News Internal Bleeding By Amy H. Kaji, MD, PhD, Associate Professor, ... Emergency First Aid Priorities Cardiac Arrest Choking Internal Bleeding Wounds Soft-Tissue Injuries Severed or Constricted Limbs ...

  5. Lateral facilitation--no effect on the target noise level.

    Science.gov (United States)

    Katkov, Mikhail; Sagi, Dov

    2010-11-23

    The detection threshold of a centrally placed Gabor target is reduced in the presence of aligned high-contrast Gabor patches that are optimally spaced from the target (Polat & Sagi, 1993). Here we determined whether threshold reduction is due to signal enhancement or to decreased signal response variability (internal noise), using a recently developed analysis for a Signal Detection Theory (SDT)-based contrast-identification paradigm (Katkov, Tsodyks, & Sagi, 2007a). We found that flankers did not affect internal noise, but instead caused increased target response when collinear with it, in agreement with the lateral facilitation effect. Based on these results, we concluded that lateral facilitation can be explained by signal enhancement only, and that uncertainty-based models do not provide a satisfactory description of the data.

  6. Lateral interactions and enhanced adsorption

    Science.gov (United States)

    Rikvold, Per Arne; Deakin, Mark R.

    1991-06-01

    We extend earlier work on the effects of lateral adsorbate-adsorbate interactions in systems with two different adsorbate species to consider in detail enhanced adsorption phenomena. We give a detailed explanation of the enhancement mechanism for a lattice-gas model in thermodynamic equilibrium, and provide explicit quantitative criteria which must be satisfied by the effective lateral interactions in systems exhibiting strong, intermediate, or weak enhancement behavior. It is the examination and understanding of the topological details of the ground-state and phase diagrams of the model that allow the formulation of these criteria. The theoretically obtained criteria are supported by precise numerical calculations (transfer-matrix with strip width six) of adsorption isotherms for a three-state lattice-gas model with nearest-neighbor interactions on a triangular lattice. The applicability of this theoretical framework is illustrated by an analysis of experimental adsorption isotherms for the electrochemical adsorption of naphthalene on copper and n-decylamine on nickel, previously obtained by Bockris et al. As suggested by Damaskin et al. we attribute the potential dependence of the organic coverage to the influence of coadsorbed hydrogen. We find that nonlinear least-squares fits of numerical lattice-gas isotherms to the experimental data produce good agreement between the experimental and numerical adsorption isotherms, as well as effective lattice-gas interaction energies consistent with independent estimates from the literature.

  7. Epicondilite lateral do cotovelo Lateral epicondylitis of the elbow

    Directory of Open Access Journals (Sweden)

    Marcio Cohen

    2012-01-01

    Full Text Available A epicondilite lateral, também conhecida como cotovelo do tenista, é uma condição comum que acomete de 1 a 3% da população. O termo epicondilite sugere inflamação, embora a análise histológica tecidual não demonstre um processo inflamatório. A estrutura acometida com mais frequência é a origem do tendão extensor radial curto do carpo e o mecanismo de lesão está associado à sua sobrecarga. O tratamento incruento é o de escolha e inclui: repouso, fisioterapia, infiltração com cortisona ou plasma rico em plaquetas e a utilização de imobilização específica. O tratamento cirúrgico é recomendado quando persistem impotência funcional e dor. Tanto a técnica cirúrgica aberta quanto a artroscópica com ressecção da área tendinosa degenerada apresenta bons resultados na literatura.Lateral epicondylitis, also known as tennis elbow, is a common condition that is estimated to affect 1% to 3% of the population. The word epicondylitis suggests inflammation, although histological analysis on the tissue fails to show any inflammatory process. The structure most commonly affected is the origin of the tendon of the extensor carpi radialis brevis and the mechanism of injury is associated with overloading. Nonsurgical treatment is the preferred method, and this includes rest, physiotherapy, cortisone infiltration, platelet-rich plasma injections and use of specific immobilization. Surgical treatment is recommended when functional disability and pain persist. Both the open and the arthroscopic surgical technique with resection of the degenerated tendon tissue present good results in the literature.

  8. Lateral Violence in Nursing Survey: Instrument Development and Validation

    Directory of Open Access Journals (Sweden)

    Lynne S. Nemeth

    2017-07-01

    Full Text Available An examination of the psychometric properties of the Lateral Violence in Nursing Survey (LVNS, an instrument previously developed to measure the perceived incidence and severity of lateral violence (LV in the nursing workplace, was carried out. Conceptual clustering and principal components analysis were used with survey responses from 663 registered nurses and ancillary nursing staff in a southeastern tertiary care medical center. Where appropriate, Cronbach’s alpha (α evaluated internal consistency. The prevalence/severity of lateral violence items constitute two distinct subscales (LV by self and others with Cronbach’s alpha of 0.74 and 0.86, respectively. The items asking about potential causes of LV are unidimensional and internally consistent (alpha = 0.77 but there is no conceptually coherent theme underlying the various causes. Respondents rating a potential LV cause as “major” scored higher on both prevalence/severity subscales than those rating it a “minor” cause or not a cause. Subsets of items on the LVNS are internally reliable, supporting construct validity. Revisions of the original LVNS instrument will improve its use in future work.

  9. LATERAL EPICONDYLITIS OF THE ELBOW.

    Science.gov (United States)

    Cohen, Marcio; da Rocha Motta Filho, Geraldo

    2012-01-01

    Lateral epicondylitis, also known as tennis elbow, is a common condition that is estimated to affect 1% to 3% of the population. The word epicondylitis suggests inflammation, although histological analysis on the tissue fails to show any inflammatory process. The structure most commonly affected is the origin of the tendon of the extensor carpi radialis brevis and the mechanism of injury is associated with overloading. Nonsurgical treatment is the preferred method, and this includes rest, physiotherapy, cortisone infiltration, platelet-rich plasma injections and use of specific immobilization. Surgical treatment is recommended when functional disability and pain persist. Both the open and the arthroscopic surgical technique with resection of the degenerated tendon tissue present good results in the literature.

  10. Relativism in Feyerabend's later writings.

    Science.gov (United States)

    Kusch, Martin

    2016-06-01

    This paper reconstructs, and distinguishes between, Feyerabend's different forms of relativism in his later writings. Science in a Free Society remains close to familiar forms of relativism, while, at the same time, developing an original but under-argued form of political relativism, and rejecting "conversion" models of cultural exchange. Farewell to Reason moves away from common renderings of relativism, and develops a range of different new forms. Central here are links between relativism, skepticism and infallibilism. In the last six years of his life, Feyerabend often criticizes a peculiar radical form of relativism that arguably no-one has ever proposed or defended. In the same context, Feyerabend sketches an "ontological" form of relativism. It combines "Kantian humility", metaphysical pluralism and constructivism.

  11. Internal Poverty and Teen Pregnancy.

    Science.gov (United States)

    Young, Tamera M.; Martin Sue S.; Young, Michael E.; Ting, Ling

    2001-01-01

    Examined selected predictor variables from baseline 1988 wave of data, taken from the National Education Longitudinal Study, in relation to pregnancy status. Results indicated statistically significant difference in locus of control between those females who became pregnant later in adolescence (external) and those who did not (internal).…

  12. AXIS侧板钢板螺钉内固定系统对下颈椎骨折脱位后颈髓功能恢复作用%Effect of AXIS lateral mass screw- plate internal fixation system on functional recovery of spinal cord in fracture of lower cervical vertebrae

    Institute of Scientific and Technical Information of China (English)

    昌耘冰; 尹庆水; 夏虹; 吴增晖; 徐国洲; 张余; 权日; 章凯

    2003-01-01

    AIM:To evaluate the methods and results of the AXIS lateral mass screw- plate system in the treating of lower cervical spine injury.METHODS:29 cases of lower cervical vertebrae injury were fixed with AXIS system.All of them were followed- up for more than 1 year.RESULTS:All cases had a good bone union without malformation.We found no complication of the injury to the vertebral arteries or nerves.There was no loosening of the plate and screw. CONCLUSION:AXIS lateral mass screw- plate system has the characteristic of stable,simple and safe and is suitable for the treatment of lower cervical spine injury.

  13. Acupuncture for Lateral Epicondylitis: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Hongzhi Tang

    2015-01-01

    Full Text Available Objective. This systematic review aimed to assess the effectiveness and safety of acupuncture for lateral epicondylitis (LE. Methods. Seven databases and the WHO International Clinical Trials Registry Platform Search Portal were searched to identify relevant studies. The data were extracted and assessed by two independent authors, and Review Manager Software (V.5.3 was used for data synthesis with effect estimate presented as standard mean difference (SMD and mean difference (MD with a 95% confidence interval. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE was used to assess the level of evidence. Results. Four RCTs with 309 participants were included with poor methodological quality. Participants who received acupuncture and acupuncture plus moxibustion with material insulation were likely to have an improvement in elbow functional status and/or myodynamia. The overall quality rated by GRADE was from very low to low. Two studies reported that the needle pain would be the main reason for the dropout. Conclusion. For the small number of included studies with poor methodological quality, no firm conclusion can be drawn regarding the effect of acupuncture of elbow functional status and myodynamia for LE. This trial is registered with CRD42015016199.

  14. Hemispheric Laterality in Music and Math

    Science.gov (United States)

    Szirony, Gary Michael; Burgin, John S.; Pearson, L. Carolyn

    2008-01-01

    Hemispheric laterality may be a useful concept in teaching, learning, training, and in understanding more about human development. To address this issue, a measure of hemispheric laterality was compared to musical and mathematical ability. The Human Information Processing Survey (HIPS) instrument, designed to measure hemispheric laterality, was…

  15. Lateral violence in the perioperative setting.

    Science.gov (United States)

    Bigony, Lorraine; Lipke, Tammy G; Lundberg, Ashley; McGraw, Carrie A; Pagac, Gretchen L; Rogers, Anne

    2009-04-01

    Lateral violence is disruptive, bullying, intimidating, or unsettling behavior that occurs between nurses in the workplace. The perioperative setting fosters lateral violence because of the inherent stress of performing surgery; high patient acuity; a shortage of experienced personnel; work demands; and the restriction and isolation of the OR, which allows negative behaviors to be concealed more easily. Lateral violence affects nurses' health and well-being and their ability to care for patients. Interventions to reduce lateral violence include empowerment of staff members and zero tolerance for lateral violence.

  16. International skatteret

    DEFF Research Database (Denmark)

    Winther-Sørensen, Niels; Wittendorff, Jens

    1996-01-01

    De seneste 6 måneders udvikling indenfor international skatteret beskrives. NW-S har skrevet artiklens afsnit om udvalgte afgørelser og om EU-skatteret.......De seneste 6 måneders udvikling indenfor international skatteret beskrives. NW-S har skrevet artiklens afsnit om udvalgte afgørelser og om EU-skatteret....

  17. International indsats

    DEFF Research Database (Denmark)

    Sachs, Therese

    En analyse af Beredskabsstyrelsens internationale engagement og muligheder for international indsats fremover. Forslag til struktur logistisk og materielt samt til udvikling af personel-kompetencer......En analyse af Beredskabsstyrelsens internationale engagement og muligheder for international indsats fremover. Forslag til struktur logistisk og materielt samt til udvikling af personel-kompetencer...

  18. International Curriculums.

    Science.gov (United States)

    Neal, Larry L.

    This workshop presentation on international curriculums in the field of parks, recreation, leisure, cultural services, and travel/tourism comments that the literature is replete with articles addressing what the field is about, but not about curriculum issues, models, and structure. It reports an international survey of 12 college educators…

  19. International Specialization

    DEFF Research Database (Denmark)

    Kleindienst, Ingo; Geisler Asmussen, Christian; Hutzschenreuter, Thomas;

    2012-01-01

    Whether and how international diversification and cross-border arbitrage affects firm performance remains one of the major unresolved research questions in the strategy and international business literatures. We propose that knowing how much a firm has internationally diversified tells us very...... little about performance implications, if we do not know, and do not ask, how the firm has diversified. Therefore, building on the two broad arguments of operating flexibility and location-specific commitment, we develop a theoretical framework that focuses on the extent to which a firm's international...... arbitrage strategy is characterized by specialization versus replication and argue that these different strategies may have differential impact on profitability and risk reduction. Developing a sophisticated measure of international specialization and using a unique panel data set of 92 German MNEs to test...

  20. International Specialization

    DEFF Research Database (Denmark)

    Kleindienst, Ingo; Geisler Asmussen, Christian; Hutzschenreuter, Thomas

    2012-01-01

    Whether and how international diversification and cross-border arbitrage affects firm performance remains one of the major unresolved research questions in the strategy and international business literatures. We propose that knowing how much a firm has internationally diversified tells us very...... little about performance implications, if we do not know, and do not ask, how the firm has diversified. Therefore, building on the two broad arguments of operating flexibility and location-specific commitment, we develop a theoretical framework that focuses on the extent to which a firm's international...... arbitrage strategy is characterized by specialization versus replication and argue that these different strategies may have differential impact on profitability and risk reduction. Developing a sophisticated measure of international specialization and using a unique panel data set of 92 German MNEs to test...

  1. International Relations:

    DEFF Research Database (Denmark)

    This is the textbook for the Open University module International Relations: Continuity and Change in Global Politics. Instead of leading with a succession of theoretical 'isms', the module structures its presentation of the subject around six teaching ‘blocks’, each of which explores a dilemma......: Flat or uneven? Change and transformation in the international system • Block 3: Just or unjust? Intervention and inequality in the international system • Block 4: Top-down or bottom-up? Governance in the international system • Block 5: Secure or insecure? Pursuing security in the international system...... • Block 6: Continuity or change in global politics? Each block introduces new IR theories through discussions of the substantive dilemmas and adds in a layered way levels of analysis and conceptual complexity....

  2. The Later Wittgenstein and the Later Husserl on Language

    Directory of Open Access Journals (Sweden)

    Paul Ricoeur

    2014-07-01

    Full Text Available This article presents an edited version of lectures given by Paul Ricœur at Johns Hopkins University in April 1966. Ricœur offers a comparative analysis of Wittgenstein’s and Husserl’s late works, taking the problem of language as the common ground of investigation for these two central figures of phenomenology and analytic philosophy. Ricœur develops his study in two parts. The first part considers Husserl’s approach to language after the Logical Investigations and concentrates on Formal and Transcendental Logic; leaving a transcendental reflection on language behind it re-examines a phenomenological conception, according to which the sphere of logic is not separable from that of experience. The main focus of the second part is Wittgenstein’s later philosophy as it moved on from the conception of an isomorphic relation between language and the world, as set out in the picture theory in the Tractatus Logico-Philosophicus, to the more pragmatic notion of a language-game in the Philosophical Investigations. In order to get beyond the irrevocable differences between the two philosophies and the unresolved theoretical issues on both sides, Ricœur suggests turning to a semiological paradigm based on the Saussurean distinction between “language” and “speaking.” Keywords: Analytic Philosophy, Husserl, Phenomenology, Semiology, Wittgenstein.Résumé Cet article est une version éditée de conférences données par Paul Ricœur à la Johns Hopkins University en avril 1966. Ricœur propose une analyse comparée des dernières œuvres de Wittgenstein et Husserl, avec le problème du langage comme sol commun d’investigations pour ces deux figures centrales de la phénoménologie et la philosophie analytique. Cette analyse de Ricœur se joue à travers deux parties. La première partie revient sur l'approche du langage chez Husserl depuis Recherches logiques avec une attention particulière aux développements de Logique formelle et

  3. The 25th International Meteor Conference

    Science.gov (United States)

    Roggemans, Paul

    2006-08-01

    Since the founding of the International Meteor Organization, the International Meteor Conferences guaranteed the vital personal contacts between its members. In recent years IMCs were sometimes assumed to have started with IMO. However, the IMCs grew out of a much older initiative, the Meteor Seminars that started in 1979, later also called International Meteor Weekends. These events played a crucial role in the making of the IMO. The 2006 IMC in Roden, the Netherlands later this year is in fact a jubilee edition as it is the 25th edition since the very beginning in 1979!

  4. International Health

    Science.gov (United States)

    ... create refugee populations with immediate and long-term health problems. Some of the major diseases currently affecting ... also an international problem which can affect people's health. Many countries and health organizations are working together ...

  5. International Reports.

    Science.gov (United States)

    Valauskas, Edward J.; Stowe, Jennifer L.; Haycock, Ken; Dodd, Frances

    1998-01-01

    Presents three reports: International Federation of Library Associations and Institutions; Special Libraries Association; and Canadian library trends, focusing on information technology and access to information and rights and examining provincial libraries and library education. (PEN)

  6. Juris International

    CERN Document Server

    A database on international trade law aimed at lawyers and legal counsel in developing and transition economies. Juris International is a multilingual collection (English, Spanish, and French) of legal information on international trade. Juris International aims to facilitate and reduce the work involved in research for business lawyers, advisers and in-house counsel, and state organizations in developing nd transition economies, by providing access to texts which have often been difficult to obtain. Its objective is to gather a large quantity of basic information at one site (favoring complete legal texts), without the need to send for the information, and consequently without excessive communication costs for users who d benefit from an efficient and cheap telecommunications network.

  7. Internal education

    OpenAIRE

    Anita Zagorc

    2016-01-01

    Research Question (RQ): The importance of internal trainings in an organization. Purpose: The purpose of research is to examine and present internal trainings in an organization and their contribution to greater success of an organization. The paper studies employee training in a company, how the organization itself looks after its employees during training, how trainings contribute to further development of organization and the advancement of knowledge for successful operation of organi...

  8. Effect Observation of Laparoscopic Cholecystectomy Combined with Endoscopic Sphincterotomy in Treatment of Cholelithiasis Complicated by Choledochal Stricture End or Thin Choledocholith%腹腔镜胆囊切除术联合十二指肠镜下乳头切开术治疗胆石症合并胆总管末端狭窄或细径胆总管结石效果观察

    Institute of Scientific and Technical Information of China (English)

    汪海; 王怀志; 魏从光; 宋永庆; 谢景军

    2015-01-01

    Objective To investigate the clinical effect of laparoscopic cholecystectomy ( LC) combined with en-doscopic sphincterotomy ( EST) in treatment of cholelithiasis complicated by choledochal stricture end or thin choledocho-lith. Methods A total of 87 patients with cholelithiasis complicated by choledochal stricture end or thin choledocholith admitted during July 2008 and July 2013 were divided into observation group ( n=45 ) and control group ( n=42 ) ac-cording to the therapy methods. The control group was given conventional open surgery, while the observation group was given LC combined with EST. The removed stones condition, intraoperative bleeding volume, operation time, hospital stay, postoperative complications and calculus recurrence in the two groups were observed and compared. The level chan-ges of direct bilirubin, white blood cell count, alanine transarninase (ALT) and C-reactive protein on postoperative 3rd and 7th d in the two groups were also observed and compared. Results All the stones were cleared, and no stone was left in the two groups. Compared with those in the control group, less intraoperative bleeding volume, shorter operation time and hospital stay were found in observation group, and the differences were statistically significant (P 0. 05 ). Conclusion The laparoscopic cholecystectomy combined with endoscopic sphincterotomy in treatment of cholelithiasis complicated by choledochal stricture end or thin choledocholith has a higher stone clearance rate, shorter operation time and hospital stay and less intraoperative bleeding volume. It has quicker digestion of postoperative obstructive jaundice and recovery of liver function with less inflammatory response.%目的:研究胆石症合并胆总管末端狭窄或细径胆总管结石患者应用腹腔镜胆囊切除术( laparoscopic cholecystectomy, LC)联合十二指肠镜下乳头切开术( endoscopic sphincterotomy, EST)治疗的临床效果。方法选择武警河南总队医院2008年7

  9. Variation of the Lateral Sacral Artery in relation to Sciatic Neuropathy

    Directory of Open Access Journals (Sweden)

    Waseem Al Talalwah

    2014-01-01

    Full Text Available The lateral sacral artery usually originates from the posterior trunk of the internal iliac artery. The current study of 342 specimens from 171 cadavers (79 male, 92 female investigated the origin and course of the lateral sacral artery. It was observed to arise from the posterior trunk in 79.1%. Occasionally it originated from the anterior trunk that occurred in 1%. It arose from the sciatic artery in 8.8%, from the superior gluteal artery in 16.8%, and from the inferior gluteal artery in 5.4%. Conversely, the lateral sacral artery is congenital absence in 0.3%. In addition, the lateral sacral artery was single, double, triple, and quadruple in 77.2%, 19.8%, 2.3%, and 0.3%, respectively. Consequently, variability of the lateral sacral artery origin is due to vascular demand as the lateral sacral artery plexus does arise from the earlier trunk development. With variability of the lateral sacral artery origin, there is a variability of the sciatic nerve supply. Knowing the variability of origins, surgeons have to avoid prolonged ligation of the internal iliac artery or its posterior trunk during surgical procedures which may lead to sciatic neuropathy. Therefore, the lateral sacral artery origin, course, and branches are important for clinicians to improve their knowledge and patient management.

  10. Vehicle lateral dynamics stabilization using active suspension

    Directory of Open Access Journals (Sweden)

    Drobný V.

    2008-12-01

    Full Text Available The paper deals with the investigation of active nonlinear suspension control in order to stabilize the lateral vehicle motion in similar way as systems like ESP do. The lateral stabilization of vehicle based on braking forces can be alternatively provided by the different setting of suspension forces. The basis of this control is the nonlinear property of the tyres. The vehicle has at least four wheels and it gives one or more redundant vertical forces that can be used for the different distribution of vertical suspension forces in such a way that resulting lateral and/or longitudinal forces create the required correction moment for lateral dynamic vehicle stabilization.

  11. Acoustic reflex patterns in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Canale, Andrea; Albera, Roberto; Lacilla, Michelangelo; Canosa, Antonio; Albera, Andrea; Sacco, Francesca; Chiò, Adriano; Calvo, Andrea

    2017-02-01

    The aim of the study is to investigate acoustic reflex testing in amyotrophic lateral sclerosis patients. Amplitude, latency, and rise time of stapedial reflex were recorded for 500 and 1000 Hz contralateral stimulus. Statistical analysis was performed by the Wilcoxon test and the level of significance was set at 5 %. Fifty-one amyotrophic lateral sclerosis patients and ten sex- and age-matched control subjects were studied. Patients were further divided in two groups: amyotrophic lateral sclerosis-bulbar (38 cases, with bulbar signs at evaluation) and amyotrophic lateral sclerosis-spinal (13 cases, without bulbar signs at evaluation). Stapedial reflex was present in all patients. There was a statistically significant difference in the mean amplitude, latency, and rise time between the amyotrophic lateral sclerosis patients as compared with the controls. Amplitude was lower in both the amyotrophic lateral sclerosis-bulbar and the amyotrophic lateral sclerosis-spinal patients than in the controls (p amyotrophic lateral sclerosis cases with bulbar signs and, moreover, suggesting a possible subclinical involvement of the stapedial motor neuron even in amyotrophic lateral sclerosis-spinal patients. Amplitude and rise time seem to be good sensitive parameters for investigating subclinical bulbar involvement.

  12. Lateral human-structure interaction on footbridges

    DEFF Research Database (Denmark)

    Ingólfsson, Einar Thór; Georgakis, Christos; Ricciardelli, Francesco

    2010-01-01

    In recent years, several high-profile footbridges have suffered from unexpected excessive pedestrian-induced lateral vibrations. There is a commonly accepted view that the synchronisation of pedestrians to the lateral movement of a structure is necessary for the onset of a form of instability which....... The tests reveal that synchronisation is not a pre-condition for the development of large amplitude lateral vibrations on footbridges, as walking frequencies and phase angles remain largely unaffected by lateral motion at most frequencies and amplitudes. Instead, large amplitude vibrations are the result...

  13. Efficacy analysis of endoscopic sphincterotomy plus endoscopic papillary balloon dilation for remove of common bile duct stons%内镜下乳头小切开联合球囊扩张治疗胆总管结石临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    闫方博; 张健康

    2014-01-01

    Objective To explore the effectiveness and safety of endoscopic sphincterotomy(EST)plus endoscopic pap-illary balloon dilation (EPBD) for the removal of common bile duct stones. Methods One hundred patients who re-ceived endoscopic retrograde pancreatic angiography(ERCP)in the first hospital of shanxi medical university from June 2012 to March 2014 were randomly divided into EST group and ESBD group. ESBD group in advance nipples small in-cision after balloon expansion; EST group used normal operation. The successful rate of stone clear-ance,operation time,the rate of mechanical lithotripsy and related complications were observed.Results After one time,all stones were removed one time from 46 cases(92%) assigned EST and 48 cases(96%) assigned EPBD(P>0.05); Mechanical lithotripsy was used to fragment stones 8 cases(16%) in EST group and 2 cases(4%) in ESBD group(P0.05); Average operation time,respectively (45.3±13.0) min and (30.5±9.2) min(P0.05);使用机械碎石分别有8例(16%)和2例(4%),差异有统计学意义(P0.05);两组平均操作时间分别为(45.3±13.0)min和(30.5±9.2)min,差异有统计学意义(P<0.05)。结论内镜下乳头括<肌小切开联合球囊扩张术取石成功率及术后并发症发生率与常规括<肌切开术相当,但平均操作时间及使用机械碎石的机率与EST相比较低,是治疗胆总管结石安全、有效的方法。

  14. Vannevar Bush: Fifty Years Later

    Science.gov (United States)

    Lagowski, J. J.

    1995-12-01

    It is ironic that the 50th anniversary year of Vannevar Bush's Report to President Truman entitled "Science the Endless Frontier", which put into motion the eminently successful current system of education of scientists in this country occurs at a time when serious questions are being asked about the usefulness of that very system. Bush viewed his proposal to establish a national research foundation (later to be called the National Science Foundation) as a "social compact." Judgment of scientific merit would be delegated to expert peers in return for scientific progress, which would ultimately benefit the nation in terms of scientific needs--military security, economic productivity, and enhanced quality of life. Bush wanted the funding of basic research intertwined with training, and preferred to use universities for this purpose rather than industrial or national labs. Bush viewed college and university scientists as teachers and investigators. He believed university-based research would uniquely encourage and engage the next generation of scientists as no other institutional arrangement could. Bush did not trust industry's commitment to basic research, an instinct that proved prophetic. The academic reserve of scientists (PhD's in training and postdoctoral students) that existed before World War II, and upon which the United States could draw for its needs, which were primarily associated with defense efforts, was probably one of the defining factors in Bush's suggested strategy. Currently, that reserve of talent has gotten so large that it is the obvious throttle in the pipeline slowing the continued development of the university research enterprise. Since 1977, the rate at which we have trained new scientists exceeds an average of 4% annually. Since 1987, the "science work force"--PhD's--has grown at three times the rate of the general labor supply. Temporary positions for postdoctoral scientists have grown even faster (over 5% per year since 1989). To compound

  15. [Identification of internal fistolous orifice: evolution of methylene blue technique with a mini-probe].

    Science.gov (United States)

    Gaj, F; Andreuccetti, J; Trecca, A; Crispino, P

    2012-01-01

    Often perianal fistulas can be difficult typing and traditional anatomical classifications do not help the surgeon in accurate diagnosis of the fistula as an outpatient procedure and therefore does not allow a timely surgical currettage. The aim of our study was to introduce in the management of anal fistulas performed on an outpatient injection with methylene blue of the fistula through a small polyethylene catheter in order to detect in real time the internal opening of the fistula and drive so the next currettage surgery. A total of 50 consecutive patients 21 female and 29 male, relating to our clinic with symptoms suggestive of colon proctology perianal fistula, aged between 36 and 69 years were selected for our study. After running the news-gathering medical history, physical examination, digital examination through examination anoscope, using a polyethylene catheter in a small scale, of methylene blue was injected through the external fistula orifice looking inside the spreading of liquid. Subsequently, the patient was started on specillazione currettage and possible surgery. 62 outpatients were treated intramural fistulas, diagnosed with the injection technique with methylene blue running always probing and practiced a wide dish made of the mucosa, submucosa and circular muscle layer of the internal drainage with sphincterotomy. In particular, the technique injection of methylene blue was sufficient to diagnose 42 out of 62 cases examined (67.7%). In the remaining 20 cases it was necessary to integrate diagnosis with MRI-defecates on the complexity of fistulas (10 horseshoe, 6 trans sphincteric and 4 intersphincteric. Methylene blue injection is a low-cost screening technique, simple to perform on an outpatient basis and in the case of suprasphincteric fistulas also a simple diagnostic technique is sufficient to allow the closure of the fistula.

  16. Septins and the lateral compartmentalization of eukaryotic membranes.

    Science.gov (United States)

    Caudron, Fabrice; Barral, Yves

    2009-04-01

    Eukaryotic cells from neurons and epithelial cells to unicellular fungi frequently rely on cellular appendages such as axons, dendritic spines, cilia, and buds for their biology. The emergence and differentiation of these appendages depend on the formation of lateral diffusion barriers at their bases to insulate their membranes from the rest of the cell. Here, we review recent progress regarding the molecular mechanisms and functions of such barriers. This overview underlines the importance and conservation of septin-dependent diffusion barriers, which coordinately compartmentalize both plasmatic and internal membranes. We discuss their role in memory establishment and the control of cellular aging.

  17. Rondeau Seminars amalgamated mid-sagittal (lateral) cephalometric analysis.

    Science.gov (United States)

    Palencar, Adrian J

    2014-01-01

    The author presents a comprehensive International Association for Orthodontics--Rondeau Seminars Amalgamated Mid-sagittal (Lateral) Cephalometric Analysis. Norms on the Cephalometric Data Sheet are age and gender specific for the Caucasian population and the postings are color coded for visual attraction. If the patient is ofa different ethnic group, the Norms should be adjusted accordingly. This Cephalometric Analysis is comprised often Sections, in alphabetical order and twenty nine Factors. The author expanded Rondeau Seminars Cephalometric Analysis by only six Factors, thus fulfilling the requirement for the case presentation for the Fellow of the IAO and the Diplomate ofthe IBO.

  18. Lateral epicondylitis: review of injection therapies.

    Science.gov (United States)

    Judson, Christopher H; Wolf, Jennifer Moriatis

    2013-10-01

    Lateral epicondylitis has several different treatment methods, with no single agreed upon therapy. This article summarizes the current literature on injection therapies for lateral epicondylitis. Glucocorticoid, botulinum toxin, autologous blood, platelet-rich plasma, hyaluronic acid, polidocanol, glycosaminoglycan, and prolotherapy injections are discussed.

  19. Introduction to Single Piles under Lateral Loading

    DEFF Research Database (Denmark)

    Augustesen, Anders; Ibsen, Lars Bo

    The purpose of this chapter is to give a short introduction to single piles subjected to lateral loading. First, the observed behaviour of laterally loaded piles is described, i.e. the effects of loading conditions, installation procedure, pile type etc. on pile behaviour are presented (section 1...

  20. Sensor data fusion for lateral safe applications

    NARCIS (Netherlands)

    Amditis, A; Floudas, N.; Polychronopoulos, A.; Bank, D.; Broek, B. van den; Oechsle, F.

    2006-01-01

    This paper describes the algorithms that are being developed for the perception layer of the PReVENT subproject LATERAL SAFE. These algorithms aim at achieving a reliable representation of the objects and their kinematics, present at the lateral and rear field of the ego-vehicle. The work presented

  1. Plasticity and function of cerebral lateralization

    NARCIS (Netherlands)

    Lust, J.M.

    2011-01-01

    Lateralization refers to the division of labour between the hemispheres. The studies presented in this thesis addressed the developmental plasticity and function of cerebral lateralization. The access to an unique dataset of prenatal testosterone (pT) levels and the use of fTCD to measure individual

  2. Sensor data fusion for lateral safe applications

    NARCIS (Netherlands)

    Amditis, A; Floudas, N.; Polychronopoulos, A.; Bank, D.; Broek, B. van den; Oechsle, F.

    2006-01-01

    This paper describes the algorithms that are being developed for the perception layer of the PReVENT subproject LATERAL SAFE. These algorithms aim at achieving a reliable representation of the objects and their kinematics, present at the lateral and rear field of the ego-vehicle. The work presented

  3. Lateral interception II : Predicting hand movements

    NARCIS (Netherlands)

    Michaels, CF; Jacobs, DM; Bongers, RM

    2006-01-01

    D. M. Jacobs and C. F. Michaels (2006) concluded that aspects of hand movements in lateral catching were predicted by the ratio of lateral optical velocity to expansion velocity. Their conclusions were based partly on a modified version of the required velocity model of catching (C. E. Peper, R. J.

  4. Naphthyl azomesogens with lateral chloro groups†

    Indian Academy of Sciences (India)

    A K Prajapati; H M Pandya; N L Bonde

    2004-06-01

    A homologous series of azomesogens, 2"-[4-(4'--alkoxybenzoyloxy)-2-chlorophenylazo] naphthalenes, with lateral chloro groups was synthesised. All the homologues synthesized exhibit enantiotropic nematic mesophase. The mesomorphic properties of the present series are compared with other structurally related series to evaluate the effect of lateral chloro group and its position on mesomorphism.

  5. Herniographic appearance of the lateral inguinal fossa

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Kesek, P.

    Herniography frequently reveals clinically undetected groin hernia. Thereby herniography contributes to the clinical work-up in patients with obscure groin pain. However, the distinction between clinically important and unimportant abnormalities within the lateral inguinal fossa can be difficult. This study was therefore designed in order to elucidate the herniographic appearance of the lateral inguinal fossa in patients with obscure groin pain. Herniographic findings were compared with laterality of the patients' symptoms. The lateral umbilical fold was visible in only 47% of the groins. A triangular shaped outpouching from the lateral inguinal fossa and a patent processus vaginalis were found with equal frequency on the left and right side. They were five times as frequent in men as in women. Their presence did not correlate with laterality of the patients' symptoms. Indirect hernias were almost twice as common on the symptomatic side as compared with the asymptomatic side. On the left side they were found twice as often in men as in women while there was no significant sex difference on the right side. Our results show that neither a patent processus vaginalis nor a triangular outpouching from the lateral inguinal fossa correlate with the laterality of the patients' symptoms while true indirect hernias do.

  6. An international biodiversity observation year.

    Science.gov (United States)

    Wall; Adams; Mooney; Boxshall; Dobson; Nakashizuka

    2001-01-01

    The International Geophysical Year (IGY), which took place between July 1957 and December 1958, helped us to rethink the world. At a time when there was a major paradigm shift in our understanding of the physical world, the international collaboration of the IGY helped to reset the discipline. The International Biodiversity Observation Year (IBOY) is now occurring at a time when our dependence on, and understanding of, biodiversity is being acknowledged as a paradigm shift in our present view of the world. Although the benefits of IGY were initially intellectual with practical effects remaining unknown until many years later, the benefits of greater knowledge of biodiversity will support efforts towards sustainability and affect the quality of life, both now and in the future. By providing the framework for international collaborations between scientists involved in every aspect of life on Earth, IBOY has the potential to redefine our current understanding of biodiversity in a manner similar to how IGY helped redefine the geophysical world.

  7. Rhinoplasty: the lateral crura-alar ring.

    Science.gov (United States)

    Daniel, Rollin K; Palhazi, Peter; Gerbault, Olivier; Kosins, Aaron M

    2014-05-01

    Rhinoplasty surgeons routinely excise or incise the lateral crura despite nostril rim retraction, bossa, and collapse. Given recent emphasis on preserving the lateral crura, a review of the lateral crura's anatomy is warranted. The authors quantify specific anatomical aspects of the lateral crura in cadavers and clinical patients. This was a 2-part investigation, consisting of a prospective clinical measurement study of 40 consecutive rhinoplasty patients (all women) and 20 fresh cadaver dissections (13 males, 1 female). In the clinical phase, the alar cartilages were photographed intraoperatively and alar position (ie, orientation), axis, and width were measured. Cadaver dissections concentrated on parts of the lateral crura (alar cartilages and alar ring) that were inaccessible clinically. Average clinical patient age was 28 years (range, 14-51 years). Average cadaver age was 74 (range, 57-88 years). Clinically, the distance of the lateral crura from the mid-nostril point averaged 5.9 mm, and the cephalic orientation averaged 43.6 degrees. The most frequent configuration of the axis was smooth-straight in the horizontal axis and a cephalic border higher than the caudal border in the vertical axis. Maximal lateral crura width averaged 10.1 mm. In the cadavers, average lateral crural dimensions were 23.4 mm long, 6.4 mm wide at the domal notch, 11.1 mm wide at the so-designated turning point (TP), and 0.5 mm thickness. The accessory cartilage chain was present in all dissections. The lateral crura-alar ring was present in all dissections as a circular ring continuing around toward the anterior nasal spine but not abutting the pyriform. The lateral crura (1) begins at the domal notch and ends at the accessory cartilages, (2) exhibits a distinct TP from the caudal border, (3) has distinct horizontal and vertical vectors, and (4) should have a caudal border higher than the cephalic border. Alar malposition may be associated with position, orientation, or configuration.

  8. Interne evalueringer

    DEFF Research Database (Denmark)

    Hansson, Finn

    Det er en gennemgående tese i denne undersøgelse af interne evalueringer, at en af de vigtigste kendetegn ved den New Public Management -dominerede udvikling af den offentlige sektors reguleringspolitik, som Danmark såvel som en række andre OECD lande har gennemlevet, er en omfattende brug af alle...

  9. Transparency International

    NARCIS (Netherlands)

    Hulten, van M. (Michel)

    2009-01-01

    Established in 1993, Transparency International (TI) defines itself as “the global civil society organization leading the fight against corruption, that brings people together in a powerful worldwide coalition to end the devastating impact of corruption on men, women and children around the wo

  10. International Business

    NARCIS (Netherlands)

    Anne van Delft

    2011-01-01

    Internationalisation is the expansion of a firms operations to foreign markets and includes not only import and export but also foreign direct investments and international cooperation. Today’s globalising economy has resulted in a growing number of small and medium enterprises (SMEs) undertaking

  11. International Entomology

    Science.gov (United States)

    Pests and diseases of plants in agriculture are a shared international problem. Yet some of the very places that pest invaders come from often lack the institutional structure and organization necessary to help in understanding the biology of the pest or disease. Strengthening entomology by stimulat...

  12. International Reports.

    Science.gov (United States)

    Tabb, Winston; Bender, David R.; Haycock, Ken; Horodyski, John

    2001-01-01

    Includes three annual reports: one from the International Federation of Library Associations and Institutions, the Special Libraries Association, and a report on innovations in Canadian libraries that discusses electronic initiatives, partnerships, books and publishing, school libraries, national issues, local challenges, and funding. (LRW)

  13. Ascott International

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    "Heart-to-Heart" Charity Event for Hearing-Impaired Children in Beijing On June 12, Ascott International North China held a "heart-to-heart" charity event for hearing-impaired children in the Heritage Room at the Ascott Beijing.

  14. Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance.

    Science.gov (United States)

    Stensby, J Derek; Baker, Jonathan C; Fox, Michael G

    2016-02-01

    The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries.

  15. Delayed Operative Management of Fractures of the Lateral Condyle of the Humerus in Children

    Directory of Open Access Journals (Sweden)

    Shabir AD

    2015-03-01

    Full Text Available Purpose; Delayed presentation of lateral condylar fractures of the humerus is relatively common in the developing regions of the world. These fractures are difficult to manage because of the displacement and fibrosis around the condylar fragment secondary to the delay. There is a paucity of literature concerning the management of these fractures. An oft repeated finding is the requirement of extensive dissection around the fragment for proper reduction. The purpose of this study was to assess the efficacy of surgical management of lateral condylar fractures with delayed presentation. Methods; We assessed the results of lateral condylar fracture fixation in 20 cases with delayed presentation. Results; The lateral condylar fractures in patients with a delayed presentation can be managed surgically with good results. Conclusions; Open reduction and internal fixation should continue to be the method of choice for the management of lateral condylar fractures which report late for management.

  16. Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance

    Energy Technology Data Exchange (ETDEWEB)

    Stensby, J.D. [University of Virginia, Department of Radiology and Medical Imaging, 1218 Lee Street, Box 800170, Charlottesville, VA (United States); Mallinckrodt Institute of Radiology, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO (United States); Baker, Jonathan C. [Mallinckrodt Institute of Radiology, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO (United States); Fox, Michael G. [University of Virginia, Department of Radiology and Medical Imaging, 1218 Lee Street, Box 800170, Charlottesville, VA (United States)

    2016-02-15

    The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries. (orig.)

  17. Olfactory coding in the honeybee lateral horn.

    Science.gov (United States)

    Roussel, Edith; Carcaud, Julie; Combe, Maud; Giurfa, Martin; Sandoz, Jean-Christophe

    2014-03-03

    Olfactory systems dynamically encode odor information in the nervous system. Insects constitute a well-established model for the study of the neural processes underlying olfactory perception. In insects, odors are detected by sensory neurons located in the antennae, whose axons project to a primary processing center, the antennal lobe. There, the olfactory message is reshaped and further conveyed to higher-order centers, the mushroom bodies and the lateral horn. Previous work has intensively analyzed the principles of olfactory processing in the antennal lobe and in the mushroom bodies. However, how the lateral horn participates in olfactory coding remains comparatively more enigmatic. We studied odor representation at the input to the lateral horn of the honeybee, a social insect that relies on both floral odors for foraging and pheromones for social communication. Using in vivo calcium imaging, we show consistent neural activity in the honeybee lateral horn upon stimulation with both floral volatiles and social pheromones. Recordings reveal odor-specific maps in this brain region as stimulations with the same odorant elicit more similar spatial activity patterns than stimulations with different odorants. Odor-similarity relationships are mostly conserved between antennal lobe and lateral horn, so that odor maps recorded in the lateral horn allow predicting bees' behavioral responses to floral odorants. In addition, a clear segregation of odorants based on pheromone type is found in both structures. The lateral horn thus contains an odor-specific map with distinct representations for the different bee pheromones, a prerequisite for eliciting specific behaviors.

  18. Augmentation of lateral tarsorrhaphy in lagophthalmos.

    Science.gov (United States)

    Nemet, Arie Y

    2014-08-01

    Lagophthalmos, the inability to close the eyelids completely, is a serious condition caused by orbicularis oculi muscle paresis or paralysis. The standard lateral tarsorrhaphy may leave the eye open with corneal exposure. In those cases, we suggest that better approximation of the upper and lower eyelids will be achieved when the lower lid is retracted laterally and the upper lid medially. This yields satisfactory closure of the eyelids. I report herein four patients who were successfully treated with permanent lateral tarsorrhaphy with this approximation of the upper and lower eyelids with effective, satisfactory outcomes.

  19. Liver International

    OpenAIRE

    Quarantini, Lucas de Castro [UNIFESP; Rodrigo A Bressan; Galvão, Amanda; Neves, Susana Batista; Raymundo PARANÁ

    2007-01-01

    p. 1098-1102 Objective: Evaluate the incidence of mental disorders using pegylated interferon plus ribavirin retreatment in nonresponder hepatitis C virus-infected patients. Method: The Mini-International Neuropsychiatric Interview (MINI) was used to evaluate 30 hepatitis C virus-infected interferon-nonresponder patients at baseline and following 4, 12 and 24 weeks of pegylated interferon retreatment. Results: During the pegylated interferon/ribavirin retreatment, 5(16.6%) patient...

  20. Teaching International Law: Concepts in International Relations

    Science.gov (United States)

    Starbird, Caroline; Pettit, Jenny; Singleton, Laurel

    2004-01-01

    This book is designed to introduce students to public international law. Topics covered include international public organizations, such as the United Nations and World Trade Organization, international courts, international human rights law, international trade law, and international environmental law. The goal of each study is to examine how…

  1. Coping with Mood Changes Later in Life

    Science.gov (United States)

    ... of Personal Stories Peers Celebrating Art Peers Celebrating Music Be Vocal Support Group Locator DBSA In-Person ... or adjust your medication can prevent more costly interventions later. back to top What can I do ...

  2. The laterality effect: myth or truth?

    Science.gov (United States)

    Cohen Kadosh, Roi

    2008-03-01

    Tzelgov and colleagues [Tzelgov, J., Meyer, J., and Henik, A. (1992). Automatic and intentional processing of numerical information. Journal of Experimental Psychology: Learning, Memory and Cognition, 18, 166-179.], offered the existence of the laterality effect as a post-hoc explanation for their results. According to this effect, numbers are classified automatically as small/large versus a standard point under autonomous processing of numerical information. However, the genuinity of the laterality effect was never examined, or was confounded with the numerical distance effect. In the current study, I controlled the numerical distance effect and observed that the laterality effect does exist, and affects the processing of automatic numerical information. The current results suggest that the laterality effect should be taken into account when using paradigms that require automatic numerical processing such as Stroop-like or priming tasks.

  3. Medial and Lateral Plantar Nerve Entrapment

    Science.gov (United States)

    ... Foot Problems Overview of Foot Problems Achilles Tendon Bursitis Achilles Tendon Enthesopathy Bunion Corns and Calluses Damage ... the Foot Freiberg Disease Hammer Toe Inferior Calcaneal Bursitis Medial and Lateral Plantar Nerve Entrapment Metatarsal Joint ...

  4. Lateral power transistors in integrated circuits

    CERN Document Server

    Erlbacher, Tobias

    2014-01-01

    This book details and compares recent advancements in the development of novel lateral power transistors (LDMOS devices) for integrated circuits in power electronic applications. It includes the state-of-the-art concept of double-acting RESURF topologies.

  5. The National Report--Five Years Later.

    Science.gov (United States)

    Stewart, Bob R.; And Others

    1993-01-01

    Six theme articles assess the impact five years later of the National Academy of Sciences report, "Understanding Agriculture." Topics discussed include strategic planning, agricultural education's mission, teacher education, policy research needs, and agricultural literacy. (SK)

  6. [Internal migration].

    Science.gov (United States)

    Borisovna, L

    1991-06-01

    Very few studies have been conducted that truly permit explanation of internal migration and it repercussions on social and economic structure. It is clear however that a profound knowledge of the determinants and consequences of internal migration will be required as a basis for economic policy decisions that advance the goal of improving the level of living of the population. the basic supposition of most studies of the relationship of population and development is that socioeconomic development conditions demographic dynamics. The process of development in Mexico, which can be characterized by great heterogeneity, consequently produces great regional disparities. At the national level various studies have estimated the volume of internal migration in Mexico, but they have usually been limited to interstate migration because the main source of data, the census, is classified by states. But given the great heterogeneity within states in all the elements related to internal migration, it is clear that studies of internal migration within states are also needed. Such studies are almost nonexistent because of their technical difficulty. National level studies show that interstate migration increased significantly between 1940-80. The proportion of Mexicans living outside their states of birth increased by 558% in those years, compared to the 342% increase in the total Mexican population. Although Puebla has a high rate of increase, migration has kept it below Mexico's national growth rate. Migration between Puebla and other states and within Puebla has led to an increasing unevenness of spatial distribution. Between 1970-80, 57 of Puebla's municipios had growth rates above the state average of 2.8%/year, 6 had growth rates equal to the average, and 129 had growth rates that were below the average but not negative. 25 states with negative growth rates that were considered strongly expulsive. In 1980, 51.7% of the population was concentrated in the 57 municipios

  7. Lateral sacral lipomyelomeningocele : a rare anomaly.

    Directory of Open Access Journals (Sweden)

    Shetty D

    2002-04-01

    Full Text Available Lateral sacral lipomyelomeningocele is a rare spinal developmental anomaly. In the case under report, the fat attached to the neural placode was blending with the gluteal fat externally. The cord was tethered at this level. Multiple bony anomalies and diastematomyelia were associated findings. A case of lateral sacral lipomyelomeningocele with excellent imaging detail provided by the multiplanar magnetic resonance (MR scan is reported.

  8. C-reactive protein and later preeclampsia

    DEFF Research Database (Denmark)

    Rebelo, Fernanda; Schlüssel, Michael M; Vaz, Juliana S;

    2013-01-01

    This study aims to determine whether high C-reactive protein (CRP) concentration during pregnancy is associated with later preeclampsia and whether weight status (BMI) is a potential modifier of the relation between CRP and preeclampsia.......This study aims to determine whether high C-reactive protein (CRP) concentration during pregnancy is associated with later preeclampsia and whether weight status (BMI) is a potential modifier of the relation between CRP and preeclampsia....

  9. Brain and behavioural lateralization in invertebrates.

    Directory of Open Access Journals (Sweden)

    Elisa eFrasnelli

    2013-12-01

    Full Text Available Traditionally, only humans were thought to exhibit brain and behavioural asymmetries, but several studies have revealed that most vertebrates are also lateralized. Recently, evidence of left-right asymmetries in invertebrates has begun to emerge, suggesting that lateralization of the nervous system may be a feature of simpler brains as well as more complex ones. Here I present some examples in invertebrates of sensory and motor asymmetries, as well as asymmetries in the nervous system. I illustrate two cases where an asymmetric brain is crucial for the development of some cognitive abilities. The first case is the nematode C. elegans, which has asymmetric odour sensory neurons and taste perception neurons. In this worm left/right asymmetries are responsible for the sensing of a substantial number of salt ions, and lateralized responses to salt allow the worm to discriminate between distinct salt ions. The second case is the fruit fly D. melanogaster, where the presence of asymmetry in a particular structure of the brain is important in the formation or retrieval of long-term memory. Moreover, I distinguish two distinct patterns of lateralization that occur in both vertebrates and invertebrates: individual-level and population-level lateralization. Theoretical models on the evolution of lateralization suggest that the alignment of lateralization at the population level may have evolved as an evolutionary stable strategy in which individually-asymmetrical organisms must coordinate their behaviour with that of other asymmetrical organisms. This implies that lateralization at the population-level is more likely to have evolved in social rather than in solitary species. I evaluate this new hypothesis with specific focus on insects showing different level of sociality. In particular, I present a series of studies on antennal asymmetries in honeybees and other related species of bees, showing how insects may be extremely useful to test evolutionary

  10. Lateral epicondylitis: a review of the literature.

    Science.gov (United States)

    Waseem, Mohd; Nuhmani, S; Ram, C S; Sachin, Yadav

    2012-01-01

    Lateral epicondylitis (Tennis Elbow) is the most frequent type of myotendinosis and can be responsible for substantial pain and loss of function of the affected limb. Muscular biomechanics characteristics and equipment are important in preventing the conditions. This article present on overview of the current knowledge on lateral Epicondylitis and focuses on Etiology, Diagnosis and treatment strategies, conservative treatment are discussed and recent surgical techniques are outlined. This information should assist health care practitioners who treat patients with this disorder.

  11. Lateral shear interferometry with holo shear lens

    Science.gov (United States)

    Joenathan, C.; Mohanty, R. K.; Sirohi, R. S.

    1984-12-01

    A simple method for obtaining lateral shear using holo shear lenses (HSL) has been discussed. This simple device which produces lateral shears in the orthogonal directions has been used for lens testing. The holo shear lens is placed at or near the focus of the lens to be tested. It has also been shown that HSL can be used in speckle shear interferometry as it performs both the functions of shearing and imaging.

  12. Laterality enhances cognition in Australian parrots.

    Science.gov (United States)

    Magat, Maria; Brown, Culum

    2009-12-01

    Cerebral lateralization refers to the division of information processing in either hemisphere of the brain and is a ubiquitous trait among vertebrates and invertebrates. Given its widespread occurrence, it is likely that cerebral lateralization confers a fitness advantage. It has been hypothesized that this advantage takes the form of enhanced cognitive function, potentially via a dual processing mechanism whereby each hemisphere can be used to process specific types of information without contralateral interference. Here, we examined the influence of lateralization on problem solving by Australian parrots. The first task, a pebble-seed discrimination test, was designed for small parrot species that feed predominately on small seeds, which do not require any significant manipulation with the foot prior to ingestion. The second task, a string-pull problem, was designed for larger bodied species that regularly use their feet to manipulate food objects. In both cases, strongly lateralized individuals (those showing significant foot and eye biases) outperformed less strongly lateralized individuals, and this relationship was substantially stronger in the more demanding task. These results suggest that cerebral lateralization is a ubiquitous trait among Australian parrots and conveys a significant foraging advantage. Our results provide strong support for the enhanced cognitive function hypothesis.

  13. Displacing lateral meniscus masquerading as patella dislocation.

    Science.gov (United States)

    Arendt, Elizabeth A; Fontboté, Cristián A; Rohr, Sara R

    2014-10-01

    To alert the treating clinician to an uncommon knee meniscal condition that often masquerades as a more common patella condition. Retrospective chart review of a series of cases was undertaken. A series of 12 knees in 11 patients were referred to an orthopaedic surgeon with a diagnosis of recurrent lateral patella dislocation. Three knees had undergone patella realignment surgery with continuance of symptoms. Eight patients had prior magnetic resonance images read as no meniscal pathology and no acute patella/patella retinacular injury. All patients presented for a consult with a similar history. Under anaesthesia, all knees had a stable patella as judged by physical examination. At the time of surgery, six patients had a frank tear in the lateral meniscus, all of which were readily displaceable. Six knees showed a displaceable lateral meniscus with attenuation but not a visible frank tear. Ten menisci were treated with repair, and two knees underwent partial lateral meniscectomies. Patient follow-up of minimally 18 months revealed no further episodes of "knee-cap dislocation" or symptoms of catching and locking. The clinician treating a patient with a history of a knee locking in flexion should have a high index of suspicion for a lateral meniscus tear or an unstable hypermobile lateral meniscus, despite patient report of perceived patella movement. History of symptoms occurring in knee flexion and attention to patella physical examination should be key factors in this diagnostic conundrum. Retrospective chart review, Level IV.

  14. International Exchanges

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    On October 12,2015,Mr.Zhu Rui,CPAPD Secretary General,chaired informal discussions with U.S.young experts and scholars on arms control and non-proliferation.The two sides exchanged views on international arms control,disarmament,non-proliferation and nuclear security,etc.During October 12 to 16,2015,at the invitation of the CPAPD,a four-member delegation from the Vietnam Peace Committee headed by its Vice-President Ms.Nguyen Thi Hoang Van

  15. EFFECTIVENESS OF MEDIAL TO LATERAL TAPING WITH EXERCISE PROGRAMME IN SUBJECTS WITH LATERAL EPICONDYLITIS

    Directory of Open Access Journals (Sweden)

    Bhavana Dattaram Desai

    2014-09-01

    Full Text Available Background: Medial to lateral tapping and exercise programme has been found to be effective in Lateral epicondylitis. The purpose to find the combined effect of Medial to lateral tapping with exercise programme for subjects with lateral epicondylitis on pain intensity and functional ability. Method: An experimental study design, selected 40 subjects with Lateral epicondylitis randomized 20 subjects each into Study and Control group. Control group received only exercise programme while study group received combined medial to lateral tapping with exercise programme thrice a week for 4 weeks. Pain intensity was measured using Visual analogue scale and functional ability was measured using Patient Rated Tennis Elbow Evaluation questionnaire before and after 4 weeks of treatment. Results: When the post-intervention means were compared between Study and Control group after 4 weeks of treatment found statistically significant difference in the improvement in outcomes measures in means of VAS and PRTEE before and after intervention within the groups. Conclusion: It is concluded that the Medial to lateral tapping with exercise programme is more effective than the exercise programme in reduction of pain and improve functional abilities for subjects with Lateral epicondylitis. Key Words: Lateral epicondylitis, Medial to lateral tapping, Exercise programme, Pain, Functional ability, Tennis Elbow.

  16. Association of Lateral Crural Overlay Technique With Strength of the Lower Lateral Cartilages.

    Science.gov (United States)

    Insalaco, Louis; Rashes, Emma R; Rubin, Samuel J; Spiegel, Jeffrey H

    2017-07-06

    The lateral crural overlay technique is a powerful technique for altering nasal tip projection and rotation. By overlapping and thus shortening the lateral crura, the nasal tip is shortened and rotated upward, thus decreasing projection and increasing rotation. There is no data to show the association of this technique with the strength of the lower lateral cartilage. Strengthening of the lower lateral cartilages would presumably lead to resistance to external nasal valve collapse and improved airway. In this cadaver study, we set out to determine the differences in the strength and resilience of the lateral crura after performing lateral crural overlay using 2 different techniques. Seven individual lower lateral cartilages were harvested from 6 cadavers for analysis. Each of the 7 cartilages was included sequentially in 3 test groups in the following order: a preprocedure group (preP), a postprocedure group (postP) in which the lateral crural overlay technique was performed, and a postprocedure with glue group (postPG) in which cyanoacrylate glue was added to the postP cartilages to simulate cartilage healing. A force gauge was used to measure the force required to deflect the lower lateral cartilages distances from 1 to 6 mm. Differences measured in newtons (N) for strength and resilience of lateral crura between the preP, postP, and postPG groups. A statistically significant increase in lower lateral cartilage resilience was noted between the preP and postPG groups at all distances of tip deflection (1 mm, 0.20 vs 0.70 N; P overlay technique affords increased strength and resilience to the lateral crura of the lower lateral cartilages, which should in turn decrease the likelihood of external nasal valve collapse postoperatively. NA.

  17. Ultrasonographic findings of lateral epicondylitis of humerus

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Hyuk; Ha, Doo Heo [Pundang CHA Univ., Seongnam (Korea, Republic of)

    2002-03-01

    To evaluate the ultrasonographic findings of lateral epicondylitis and their relationship with clinical outcome. The findings of ultrasonographic examinations of eighteen elbow joints in 15 patients (M:F=5:10; age:38-65(mean, 47.6) years) with lateral epicondylitis were reviewed. Two patients underwent surgery, two were not treated, and the remaining 11 were treated conservatively. Symptomatic improvement was noted 1 week after conservative treatment in two cases, at 2 weeks in five cases, at 3 weeks in three cases, and at 5 weeks in one case. With patients in the 90 degree flexed elbow position and in a supinated wrist, weexamined the extensor carpi radialis brevis (ECRB) tendon around the lateral epicondyle using ultrasound equipment with a 7-11 MHz linear transducer. The findings were assessed in terms of swelling of the tendon, changes in its echotexture, the presence of calcification of cystic degeneration, loss of the hypoechoic band between the tendon and bony cortex of the lateral epicondyle, cortical irregularity of the lateral epicondyle, and fluid collection around the tendon. Any relationships between each ultrasonographic finding and the treatment interval after which symptomatic improvement was noted were evaluated. In the 18 joints, change was heterogeneous hypoechogenicity in 13, and heterogeneous mixed echogenicity in three. Other ultrasonographic findings were swelling of the tendon in ten cases, loss of the hypoechoic band in 14, cortical irregularity in five, calcification in four, cystic degeneration in nine, and fluid collection around the tendon in four. In patients treated conservatively, there was no statistically significant difference between each ultrasonographic finding and the treatment interval after which symptomatic improvement was noted. Ultrasonography can be used to assess changes in the ECRB tendon and lateral epicondyle occurring in lateral epicondylitis, but fails to provide information on the rapidity of symptomatic

  18. Internal education

    Directory of Open Access Journals (Sweden)

    Anita Zagorc

    2016-09-01

    Full Text Available Research Question (RQ: The importance of internal trainings in an organization. Purpose: The purpose of research is to examine and present internal trainings in an organization and their contribution to greater success of an organization. The paper studies employee training in a company, how the organization itself looks after its employees during training, how trainings contribute to further development of organization and the advancement of knowledge for successful operation of organization. Method: How to achieve the purpose of research, used methods and theoretical approach. Results: Specific examples and opinions of employees. Results show the importance of trainings for an organization. We can see that all employees are fairly motivated and ready to participate in trainings and can adapt to changing business environment very well. The results demonstrate that all trainings in the organization are very important and welcome. Only with continuous learning, the organization can be successful and survive in the market despite strong competition. Organization: Trainings are designed for all employees inside an organization. Different employees participate in trainings in a different way as all trainings are divided into certain work and fields that are important for each individual or department in an organization. Society: Trainings have an impact on the whole organization by contributing to its development. Originality: The originality of study is what was new in the research, what is the value and originality of research. Limitations/Future Research: Research was limited to a small number of sources.

  19. Language lateralization shifts with learning by adults.

    Science.gov (United States)

    Plante, Elena; Almryde, Kyle; Patterson, Dianne K; Vance, Christopher J; Asbjørnsen, Arve E

    2015-05-01

    For the majority of the population, language is a left-hemisphere lateralized function. During childhood, a pattern of increasing left lateralization for language has been described in brain imaging studies, suggesting that this trait develops. This development could reflect change due to brain maturation or change due to skill acquisition, given that children acquire and refine language skills as they mature. We test the possibility that skill acquisition, independent of age-associated maturation can result in shifts in language lateralization in classic language cortex. We imaged adults exposed to an unfamiliar language during three successive fMRI scans. Participants were then asked to identify specific words embedded in Norwegian sentences. Exposure to these sentences, relative to complex tones, resulted in consistent activation in the left and right superior temporal gyrus. Activation in this region became increasingly left-lateralized with repeated exposure to the unfamiliar language. These results demonstrate that shifts in lateralization can be produced in the short term within a learning context, independent of maturation.

  20. Lateral laryngopharyngeal diverticulum: anatomical and videofluoroscopic study

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Milton Melciades Barbosa [Universidade Federal do Rio de Janeiro ICB/CCS/UFRJ, Laboratorio de Motilidade Digestiva e Imagem, S. F1-008, Departamento de Anatomia, Rio de Janeiro (Brazil); Koch, Hilton Augusto [Universidade Federal do Rio de Janeiro ICB/CCS/UFRJ, Departamento de Radiologia, Rio de Janeiro (Brazil)

    2005-07-01

    The aims were to characterize the anatomical region where the lateral laryngopharyngeal protrusion occurs and to define if this protrusion is a normal or a pathological entity. This protrusion was observed on frontal contrasted radiographs as an addition image on the upper portion of the laryngopharynx. We carried out a plane-by-plane qualitative anatomical study through macroscopic and mesoscopic surgical dissection on 12 pieces and analyzed through a videofluoroscopic method on frontal incidence the pharyngeal phase of the swallowing process of 33 patients who had a lateral laryngopharyngeal protrusion. The anatomical study allowed us to identify the morphological characteristics that configure the high portion of the piriform recess as a weak anatomical point. The videofluoroscopic study allowed us to observe the laryngopharyngeal protrusion and its relation to pharyngeal repletion of the contrast medium. All kinds of the observed protrusions could be classified as ''lateral laryngopharyngeal diverticula.'' The lateral diverticula were more frequent in older people. These lateral protrusions can be found on one or both sides, usually with a small volume, without sex or side prevalence. This formation is probably a sign of a pharyngeal transference difficulty associated with a deficient tissue resistance in the weak anatomical point of the high portion of the piriform recess. (orig.)

  1. Pedestrian-induced lateral forces on footbridges

    DEFF Research Database (Denmark)

    Ingólfsson, Einar Thór; Georgakis, Christos T.; Jönsson, Jeppe

    2011-01-01

    This paper investigates the phenomenon of excessive pedestrian-induced lateral vibrations as observed on several high-profile footbridges. The vibrations are a consequence of human-structure interaction, in which the forces generated by the pedestrians depend strongly on the vibration of the unde...... amplitude lateral vibrations are the results of correlated pedestrian forces in the form of negative damping, with amplitudes that depend on the relationship between the step frequency and the frequency of the lateral movement.......This paper investigates the phenomenon of excessive pedestrian-induced lateral vibrations as observed on several high-profile footbridges. The vibrations are a consequence of human-structure interaction, in which the forces generated by the pedestrians depend strongly on the vibration...... motion at varying combinations of frequencies (0.33-1.07 Hz) and amplitudes (4.5-48 mm). The component of the pedestrian-induced force which is caused by the laterally moving surface is herewith quantified through equivalent velocity and acceleration proportional coefficients. It is shown that large...

  2. Pedestrian-induced lateral forces on footbridges

    DEFF Research Database (Denmark)

    Ingolfsson, Einar Thor; Georgakis, Christos T.; Jönsson, Jeppe

    2012-01-01

    This paper investigates the phenomenon of excessive pedestrian-induced lateral vibrations as observed on several high-profile footbridges. The vibrations are a consequence of human-structure interaction, in which the forces generated by the pedestrians depend strongly on the vibration of the unde...... amplitude lateral vibrations are the results of correlated pedestrian forces in the form of negative damping, with amplitudes that depend on the relationship between the step frequency and the frequency of the lateral movement.......This paper investigates the phenomenon of excessive pedestrian-induced lateral vibrations as observed on several high-profile footbridges. The vibrations are a consequence of human-structure interaction, in which the forces generated by the pedestrians depend strongly on the vibration...... motion at varying combinations of frequencies (0.33-1.07 Hz) and amplitudes (4.5-48 mm). The component of the pedestrian-induced force which is caused by the laterally moving surface is herewith quantified through equivalent velocity and acceleration proportional coefficients. It is shown that large...

  3. Femoral rotation unpredictably affects radiographic anatomical lateral distal femoral angle measurements

    DEFF Research Database (Denmark)

    Miles, James Edward

    2016-01-01

    Objective: To describe the effects of internal and external femoral rotation on radiographic measurements of the anatomical lateral distal femoral angle (a-LDFA) using two methods for defining the anatomical proximal femoral axis (a-PFA). Methods: Digital radiographs were obtained of 14 right fem...

  4. Assessment and analysis of human laterality for manipulation and communication using the Rennes Laterality Questionnaire

    Science.gov (United States)

    Barbu, Stéphanie; Blois-Heulin, Catherine

    2017-01-01

    Despite significant scientific advances, the nature of the left-hemispheric systems involved in language (speech and gesture) and manual actions is still unclear. To date, investigations of human laterality focused mainly on non-communication functions. Although gestural laterality data have been published for infants and children, relatively little is known about laterality of human gestural communication. This study investigated human laterality in depth considering non-communication manipulation actions and various gesture types involving hands, feet, face and ears. We constructed an online laterality questionnaire including 60 items related to daily activities. We collected 317 594 item responses by 5904 randomly selected participants. The highest percentages of strong left-lateralized (6.76%) and strong right-lateralized participants (75.19%) were for manipulation actions. The highest percentages of mixed left-lateralized (12.30%) and ambidextrous (50.23%) participants were found for head-related gestures. The highest percentage of mixed right-lateralized participants (55.33%) was found for auditory gestures. Every behavioural category showed a significant population-level right-side bias. More precisely, participants were predominantly right-lateralized for non-communication manual actions, for visual iconic, visual symbolic, visual deictic (with and without speech), tactile and auditory manual gestures as well as for podial and head-related gestures. Our findings support previous studies reporting that humans have left-brain predominance for gestures and complex motor activities such as tool-use. Our study shows that the Rennes Laterality Questionnaire is a useful research instrument to assess and analyse human laterality for both manipulation and communication functions. PMID:28878966

  5. EAS thermal neutron lateral and temporal distributions

    CERN Document Server

    Stenkin, Yu V; Petrukhin, A A; Shchegolev, O B; Stepanov, V I; Volchenko, V I; Yashin, I I; Zadeba, E A

    2015-01-01

    A novel type of EAS array (PRISMA-32) has been constructed on the base of NEVOD-DECOR experiment (MEPhI,Moscow) and is now taking data. It consists of 32 specially designed scintillator en-detectors able to measure two main EAS components: hadrons (n) and electrons (e). First results on thermal neutron lateral as well as temporal distributions are presented. Obtained exponential neutron lateral distributions are consistent with that expected for normal hadron production with exponential transverse momentum distribution. As there are no other experimental data on thermal neutron distributions and so, to compare results with other measurements, we additionally obtained electron lateral distribution function (using the same detectors) and compared it with NKG - function. Recorded neutron temporal distributions are very close to that obtained with data of our previous prototypes.

  6. Lateral meniscal cyst causing common peroneal palsy

    Energy Technology Data Exchange (ETDEWEB)

    Jowett, Andrew J.L.; Johnston, Jaquie F.A. [Royal Melbourne Hospital, Department of Orthopaedic Surgery, Level 7, Melbourne, Victoria (Australia); Gaillard, Francesco; Anderson, Suzanne E. [Royal Melbourne Hospital, Department of Radiology, Melbourne, Victoria (Australia)

    2008-04-15

    Lateral meniscal cysts are relatively common, but only in rare instances do they cause common peroneal nerve irritation. There are, we believe, no cases reported in which both the sensory and motor functions of the nerve have been compromised. We present a case of a lateral meniscal cyst that became palpable and led to symptoms of numbness and weakness in the distribution of the common peroneal nerve. The MRI findings were of an oblique tear of the lateral meniscus with an associated multiloculated meniscal cyst that coursed behind the biceps tendon before encroaching on the common peroneal nerve. Surgical resection confirmed the tract as located on the MRI and histology confirmed the mass to be a synovial cyst. Resection of the cyst and arthroscopic excision of the meniscal tear led to resolution of the symptoms in 3 months. (orig.)

  7. Anisotropic permeability in deterministic lateral displacement arrays

    CERN Document Server

    Vernekar, Rohan; Loutherback, Kevin; Morton, Keith; Inglis, David

    2016-01-01

    We investigate anisotropic permeability of microfluidic deterministic lateral displacement (DLD) arrays. A DLD array can achieve high-resolution bimodal size-based separation of micro-particles, including bioparticles such as cells. Correct operation requires that the fluid flow remains at a fixed angle with respect to the periodic obstacle array. We show via experiments and lattice-Boltzmann simulations that subtle array design features cause anisotropic permeability. The anisotropy, which indicates the array's intrinsic tendency to induce an undesired lateral pressure gradient, can lead to off-axis flows and therefore local changes in the critical separation size. Thus, particle trajectories can become unpredictable and the device useless for the desired separation duty. We show that for circular posts the rotated-square layout, unlike the parallelogram layout, does not suffer from anisotropy and is the preferred geometry. Furthermore, anisotropy becomes severe for arrays with unequal axial and lateral gaps...

  8. Bucket foundations under lateral cyclic loading

    DEFF Research Database (Denmark)

    Foglia, Aligi

    -competitive in the energy market. This thesis addresses issues concerning monopod bucket foundations in the hope of providing tools and ideas that could be used to optimize the design of this sub-structure. The work is focussed on the behaviour of bucket foundations under lateral cyclic loading. Other related......To enable a prosperous development of offshore wind energy, economically feasible technologies must be developed. The monopod bucket foundation is likely to become a cost-effective sub-structure for offshore wind turbines and has the potential to make offshore wind more cost...... and propaedeutic topics, such as bucket foundations under transient lateral loading and under monotonic lateral loading, are also investigated. All the scientific work is fundamentally based on small-scale experimental tests of bucket foundations in dense water-saturated sand. The most important scientific...

  9. Pedestrian-induced lateral vibrations of footbridges

    DEFF Research Database (Denmark)

    Ingólfsson, Einar Thór; Georgakis, Christos T.; Jönsson, Jeppe

    2012-01-01

    The earliest scientific descriptions of excessive pedestrian-induced lateral vibrations are dated back to the 1970s, but it was not until the beginning of the new millennium that bridge engineers fully comprehended the potential negative effect of pedestrian crowds on long-span footbridges....... Following the unexpected serviceability failures of Paris’ Solférino and London’s Millennium footbridges in 1999 and 2000, a new tract of research was initiated, focused on understanding the phenomenon which has become known as Synchronous Lateral Excitation (SLE). In this paper, a comprehensive review...... of studies related to pedestrian-induced lateral vibrations of footbridges is provided, primarily focusing on studies published within the last decade. Research in this field can generally be split into three categories; (i) fullscale testing of existing bridges subject to crowd loading, (ii) laboratory...

  10. Amyotrophic Lateral Sclerosis: A Historical Perspective.

    Science.gov (United States)

    Katz, Jonathan S; Dimachkie, Mazen M; Barohn, Richard J

    2015-11-01

    This article looks back in time to see where the foundational basis for the understanding of amyotrophic lateral sclerosis originated. This foundation was created primarily in France by Jean-Martin Charcot and his fellow countrymen and disciples, along with key contributions from early clinicians in England and Germany. The early work on amyotrophic lateral sclerosis provides a useful foundation for today's clinicians with respect to tying together genetic and biologic aspects of the disorder that have been discovered over the past few decades.

  11. Dermatomal sensory manifestations in lateral medullary infarction.

    Science.gov (United States)

    Hongo, Hiroki; Tanaka, Yasutaka; Shimada, Yoshiaki; Tanaka, Ryota; Hattori, Nobutaka; Urabe, Takao

    2014-01-01

    A 61-year-old man who experienced a sudden onset of unstable gait followed by nuchal pain was admitted to our department. The neurologic examination revealed right-sided limb ataxia, right partial ptosis, and decreased sensation to 50% of the normal side to pinprick and temperature stimuli on the left side below the level of the T-6 dermatome. A lateral medullary infarction caused by spontaneous vertebral artery dissection was diagnosed by magnetic resonance imaging and computed tomography angiography. In conclusion, lateral medullary infarction is an important entity to consider in the differential diagnosis of dermatomal sensory manifestations.

  12. Plasmonic lateral forces on chiral spheres

    CERN Document Server

    Canaguier-Durand, Antoine

    2015-01-01

    We show that the optical force exerted on a finite size chiral sphere by a surface plasmon mode has a component along a direction perpendicular to the plasmon linear momentum. We reveal how this chiral lateral force, pointing in opposite directions for opposite enantiomers, stems from an angular-to-linear crossed momentum transfer involving the plasmon transverse spin angular momentum density and mediated by the chirality of the sphere. Our multipolar approach allows us discussing the inclusion of the recoil term in the force on a small sphere taken in the dipolar limit and observing sign inversions of the lateral chiral force when the size of the sphere increases.

  13. Reversible transinsular herniation of the lateral ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Holodny, Andrei I. [UMDNJ-New Jersey Medical School, Department of Radiology, Newark, NJ (United States); Memorial Sloan Kettering Cancer Center, The Department of Radiology, New York, NY (United States); Gor, Devang M.; Thaver, Hussain; Millian, Brian R. [UMDNJ-New Jersey Medical School, Department of Radiology, Newark, NJ (United States)

    2004-11-01

    We present a 7-year-old boy, with a history of neonatal intraventricular hemorrhage, leading to hydrocephalus with multiple shunt revisions. The current presentation of shunt failure and resultant hydrocephalus was complicated by herniation of the trigone of the lateral ventricle into the posterior fossa. Despite the dramatic radiological appearance, this herniation of the lateral ventricle was not accompanied by any additional clinical signs or symptoms other than those usually attributed to hydrocephalus. Following successful shunt revision, the patient returned to his baseline clinically with the trigone reverting back to its normal position. We also present a second companion case. (orig.)

  14. Bone suture and lateral sinus lift surgery

    Directory of Open Access Journals (Sweden)

    Amin Rahpeyma

    2015-01-01

    Full Text Available Bone suture in lateral sinus lift has four indications. Three of them depend on creating a hole in the lateral maxillary sinus wall above the antrostomy window for securing the elevated medial maxillary sinus membrane to manage perforated Schneiderian membrane. Covering the buccal antrostomy window with the buccal fat pad (BFP for better nourishment of the inserted graft and as an alternative for bone tags in fixation of collagen membrane has been reported previously. A new indication for firmly anchoring the BFP to the medial maxillary sinus wall as the last resort for the management of perforated Schneiderian membrane is explained in this article.

  15. Tonoplast aquaporins facilitate lateral root emergence

    DEFF Research Database (Denmark)

    Reinhardt, Hagen; Hachez, Charles; Bienert, Manuela Désirée

    2016-01-01

    that, in Arabidopsis (Arabidopsis thaliana), the highly abundant tonoplast AQP isoforms AtTIP1;1, AtTIP1;2, and AtTIP2;1 facilitate the emergence of new lateral root primordia (LRPs). The number of lateral roots was strongly reduced in the triple tip mutant, whereas the single, double, and triple tip...... could be fully rescued by expressing AtTIP2;1 under its native promoter. We conclude that TIP isoforms allow the spatial and temporal fine-tuning of cellular water transport, which is critically required during the highly regulated process of LRP morphogenesis and emergence....

  16. Pedestrian-induced lateral vibrations of footbridges

    DEFF Research Database (Denmark)

    Ingólfsson, Einar Thór

    The dissertation investigates the phenomenon of excessive pedestrian-induced lateral vibrations as observed on several high-profile footbridges. In particular, the temporary closures of both Paris’ Solferino Bridge (1999) and the London Millennium Bridge (2000) have led to an understanding...... for modelling of pedestrian-induced lateral vibrations. It is shown that the modal response of a footbridge subject to a pedestrian crowd is sensitive to the selection of the pacing rate distribution within the group, the magnitude of ambient loads and the total duration of the load event. The selection...

  17. Parametric resonance of flexible footbridges under crowd-induced lateral excitation

    Science.gov (United States)

    Piccardo, Giuseppe; Tubino, Federica

    2008-03-01

    The excessive lateral sway motion caused by crowds walking across footbridges has attracted great public attention in the past few years. Three possible mechanisms responsible for such lateral vibrations have been investigated in the literature: direct resonance, dynamic interaction, and internal resonance. In this paper, starting from a critical review of the mechanisms proposed in the literature, a parametric excitation mechanism is analyzed, based on a forcing model whose amplitude is a function of deck oscillations. A stability criterion is identified, depending on the ratio between the structural and excitation frequencies, on the ratio of the structural and pedestrian masses, and on the structural damping. The proposed mechanism can be achieved for very flexible footbridges, with a lateral natural frequency around 0.5 Hz, corresponding to a half of the lateral walking frequency. This situation can occur in modern structures, such as in the case of the London Millennium Footbridge.

  18. Increasing lateral tibial slope: is there an association with articular cartilage changes in the knee?

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Nasir; Shepel, Michael; Leswick, David A.; Obaid, Haron [University of Saskatchewan, Department of Medical Imaging, Royal University Hospital, and College of Medicine, Saskatoon, Saskatchewan (Canada)

    2014-04-15

    The geometry of the lateral tibial slope (LTS) plays an important role in the overall biomechanics of the knee. Through this study, we aim to assess the impact of LTS on cartilage degeneration in the knee. A retrospective analysis of 93 knee MRI scans (1.5 T or 3 T) for patients aged 20-45 years with no history of trauma or knee surgery, and absence of internal derangement. The LTS was calculated using the circle method. Chondropathy was graded from 0 (normal) to 3 (severe). Linear regression analysis was used for statistical analysis (p < 0.05). In our cohort of patients, a statistically significant association was seen between increasing LTS and worsening cartilage degenerative changes in the medial patellar articular surface and the lateral tibial articular surface (p < 0.05). There was no statistically significant association between increasing LTS and worsening chondropathy of the lateral patellar, medial trochlea, lateral trochlea, medial femoral, lateral femoral, and medial tibial articular surfaces. Our results show a statistically significant association between increasing LTS and worsening cartilage degenerative changes in the medial patella and the lateral tibial plateau. We speculate that increased LTS may result in increased femoral glide over the lateral tibial plateau with subsequent increased external rotation of the femur predisposing to patellofemoral articular changes. Future arthroscopic studies are needed to further confirm our findings. (orig.)

  19. Reflections on Dead Theory in International Relations

    Science.gov (United States)

    Thakur, Vineet

    2016-01-01

    In this short autobiographical essay, I trace my journey in the discipline of International Relations. While entering the discipline, I, along with a host of my classmates, were enamoured by the exciting possibilities of thinking theoretically. Almost a decade later, those promises look bleak. From the perspective of a student in the discipline, I…

  20. Lateral rectus muscle disinsertion and reattachment to the lateral orbital wall

    OpenAIRE

    Morad, Y.; KOWAL, L.; Scott, A B

    2005-01-01

    Background/aims: Surgical correction of ocular alignment in patients with third cranial nerve paralysis is challenging, as the unopposed lateral rectus muscle often pulls the eye back to exotropia following surgery. The authors present a simple surgical approach to overcome this difficulty. This approach is also applicable to removal of unwanted overactivity of the lateral rectus in Duane syndrome.

  1. 国际金融危机后民生科技促进中国经济转型研究——模型与实证%Later the International Financial Crisis the Research of People's Livelihood Science and Technology to Promote China's Economic Transformation——Model and Empiricism

    Institute of Scientific and Technical Information of China (English)

    苏玉娟

    2012-01-01

    全球性经济危机往往是推动重大科技创新及催生新产业的契机和动力.2008年国际金融危机后,以解决民生问题为己任的民生科技越来越得到发达国家和发展中国家的重视.民生科技作为当代科学技术发展的新领域,它通过引起科技结构、生产要素结构、市场结构、产业结构的变革,解决中国目前面临的经济危机和生态危机,实现中国经济从依靠出口拉动的外向型经济,向依靠投资、消费拉动的内向型经济转型,从粗放型的经济发展方式,向节能、环保、低碳、安全和健康的经济发展方式转变,从工业经济形态向民生经济形态转变.%The global economic crisis is the opportunity and motivation of a major technological innovation and new industry. In 2008 the international financial crisis, the science of people's livelihood mission has been attention to the developed and developing countries, as new areas of science and technology, people's livelihood science and technology changes the structures of science and technology, factors, markets, industries, solves China's current economic and ecological crisis, realizes the transformation of China's economy from reliance on export led export oriented economy to rely on investment and consumer driven, inward looking economy, from the extensive mode of economic development to energy conservation, environmental protection, low carbon, secure and healthy economic development mode, from industrial economic structures to the livelihood and economic patterns.

  2. Eye and head turning indicates cerebral lateralization.

    Science.gov (United States)

    Kinsbourne, M

    1972-05-05

    When solving verbal problems, right-handed people usually turn head and eyes to the right, whereas with numerical and spatial problems, these people look up and left. Left-handed people differ in all these respects. The results suggest that the direction in which people look while thinking reflects the lateralization of the underlying cerebral activity.

  3. [Upper lateral incisor with 2 canals].

    Science.gov (United States)

    Fabra Campos, H

    1991-01-01

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

  4. Traces of disease in amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    Verstraete, E.

    2012-01-01

    Amyotrophic lateral sclerosis (ALS) is a progressive disease of the motor system involving both upper motor neurons in the brain and lower motor neurons in the spinal cord. Patients suffer from progressive wasting and weakness of limb, bulbar and respiratory muscles. Onset and disease course in ALS

  5. Immune system alterations in amyotrophic lateral sclerosis

    DEFF Research Database (Denmark)

    Hovden, H; Frederiksen, J L; Pedersen, S W

    2013-01-01

    Amyotrophic lateral sclerosis is a disease of which the underlying cause and pathogenesis are unknown. Cumulatative data clearly indicates an active participation by the immune system in the disease. An increasingly recognized theory suggests a non-cell autonomous mechanism, meaning that multiple...

  6. Lateral root organogenesis - from cell to organ.

    Science.gov (United States)

    Benková, Eva; Bielach, Agnieszka

    2010-12-01

    Unlike locomotive organisms capable of actively approaching essential resources, sessile plants must efficiently exploit their habitat for water and nutrients. This involves root-mediated underground interactions allowing plants to adapt to soils of diverse qualities. The root system of plants is a dynamic structure that modulates primary root growth and root branching by continuous integration of environmental inputs, such as nutrition availability, soil aeration, humidity, or salinity. Root branching is an extremely flexible means to rapidly adjust the overall surface of the root system and plants have evolved efficient control mechanisms, including, firstly initiation, when and where to start lateral root formation; secondly lateral root primordia organogenesis, during which the development of primordia can be arrested for a certain time; and thirdly lateral root emergence. Our review will focus on the most recent advances in understanding the molecular mechanisms involved in the regulation of lateral root initiation and organogenesis with the main focus on root system of the model plant Arabidopsis thaliana. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. Lateral pressure profiles in lipid monolayers

    NARCIS (Netherlands)

    Baoukina, Svetlana; Marrink, Siewert J.; Tieleman, D. Peter

    2010-01-01

    We have used molecular dynamics simulations with coarse-grained and atomistic models to study the lateral pressure profiles in lipid monolayers. We first consider simple oil/air and oil/water interfaces, and then proceed to lipid monolayers at air/water and oil/water interfaces. The results are qual

  8. Dynamic extensor brace for lateral epicondylitis.

    NARCIS (Netherlands)

    Faes, M.; Akker, B. van den; Lint, J.A. de; Kooloos, J.G.M.; Hopman, M.T.E.

    2006-01-01

    Lateral epicondylitis (tennis elbow) is a common, often disabling ailment. Based on the failure of current therapies, a new dynamic extensor brace has been developed. In this study, the effects of application of this brace for 3 months on the most important and disabling symptoms of patients with la

  9. Lateral Transpsoas Fusion: Indications and Outcomes

    Directory of Open Access Journals (Sweden)

    Vishal C. Patel

    2012-01-01

    Full Text Available Spinal fusion historically has been used extensively, and, recently, the lateral transpsoas approach to the thoracic and lumbar spine has become an increasingly common method to achieve fusion. Recent literature on this approach has elucidated its advantage over more traditional anterior and posterior approaches, which include a smaller tissue dissection, potentially lower blood loss, no need for an access surgeon, and a shorter hospital stay. Indications for the procedure have now expanded to include degenerative disc disease, spinal stenosis, degenerative scoliosis, nonunion, trauma, infection, and low-grade spondylolisthesis. Lateral interbody fusion has a similar if not lower rate of complications compared to traditional anterior and posterior approaches to interbody fusion. However, lateral interbody fusion has unique complications that include transient neurologic symptoms, motor deficits, and neural injuries that range from 1 to 60% in the literature. Additional studies are required to further evaluate and monitor the short- and long-term safety, efficacy, outcomes, and complications of lateral transpsoas procedures.

  10. Sweet food preference in amyotrophic lateral sclerosis

    OpenAIRE

    Turner, M; Talbot, K

    2017-01-01

    An elderly female developed anarthria with prominent emotionality over an 18 month period prior to specialist neurological assessment. Although tongue electromyography (EMG) was normal, corticobulbar signs were consistent with amyotrophic lateral sclerosis (ALS), a pattern which in the absence of functional impairment outside of speech and swallowing, is appropriately termed progressive bulbar palsy

  11. Lateral junction dynamics lead the way out.

    Science.gov (United States)

    Behrndt, Martin; Heisenberg, Carl-Philipp

    2014-02-01

    Epithelial cell layers need to be tightly regulated to maintain their integrity and correct function. Cell integration into epithelial sheets is now shown to depend on the N-WASP-regulated stabilization of cortical F-actin, which generates distinct patterns of apical-lateral contractility at E-cadherin-based cell-cell junctions.

  12. MEPHISTO spectromicroscope reaches 20 nm lateral resolution

    Science.gov (United States)

    De Stasio, Gelsomina; Perfetti, Luca; Gilbert, B.; Fauchoux, O.; Capozi, M.; Perfetti, P.; Margaritondo, G.; Tonner, B. P.

    1999-03-01

    The recently described tests of the synchrotron imaging photoelectron spectromicroscope MEPHISTO (Microscope à Emission de PHotoélectrons par Illumination Synchrotronique de Type Onduleur) were complemented by further resolution improvements and tests, which brought the lateral resolution down to 20 nm. Images and line plot profiles demonstrate such performance.

  13. Lateral Eye Movement Behavior in Children.

    Science.gov (United States)

    Reynolds, Cecil R.; Kaufman, Alan S.

    1980-01-01

    The conjugate lateral eye movement phenomenon was investigated for 52 children aged 2 through 10 using both spatial and verbal-analytic questions. The phenomenon was observed in 50 subjects and appeared well-established by age 3 1/2. Some interesting developmental findings and discrepancies with the results of adult studies are noted. (Author/SJL)

  14. Liponeurocytoma of the Left Lateral Ventricle

    Directory of Open Access Journals (Sweden)

    Ahmet BEKAR

    2009-09-01

    Full Text Available Liponeurocytoma has been recognized recently as a distinct clinicopathological entity by the World Health Organization. Although there are few cases described in the literature it has been accepted as a benign lesion. Here we present a 55-year-old woman with a supratentorial intraventricular liponeurocytoma of the left lateral ventricle.

  15. Laparoscopic versus open left lateral segmentectomy

    Directory of Open Access Journals (Sweden)

    Rela Mohamed

    2009-09-01

    Full Text Available Abstract Background Laparoscopic liver surgery is becoming increasingly common. This cohort study was designed to directly compare perioperative outcomes of the left lateral segmentectomy via laparoscopic and open approach. Methods Between 2002 and 2006 43 left lateral segmentectomies were performed at King's College Hospital. Those excluded from analysis included previous liver resections, polycystic liver disease, liver cirrhosis and synchronous operations. Of 20 patients analysed, laparoscopic (n = 10 were compared with open left lateral segmentectomy (n = 10. Both groups had similar patient characteristics. Results Morbidity rates were similar with no wound or chest infection in either group. The conversion rate was 10% (1/10. There was no difference in operating time between the groups (median time 220 minutes versus 179 minutes, p = 0.315. Surgical margins for all lesions were clear. Less postoperative opiate analgesics were required in the laparoscopic group (median 2 days versus 5 days, p = 0.005. The median postoperative in-hospital stay was less in the laparoscopic group (6 days vs 9 days, p = 0.005. There was no mortality. Conclusion Laparoscopic left lateral segmentectomy is safe and feasible. Laparoscopic patients may benefit from requiring less postoperative opiate analgesia and a shorter post-operative in-hospital stay.

  16. Motorcycle state estimation for lateral dynamics

    NARCIS (Netherlands)

    Teerhuis, A.P.; Jansen, S.T.H.

    2012-01-01

    The motorcycle lean (or roll) angle development is one of the main characteristics of motorcycle lateral dynamics. Control of motorcycle motions requires an accurate assessment of this quantity and for safety applications also the risk of sliding needs to be considered. Direct measurement of the rol

  17. Laterality and Directional Preferences in Preschool Children.

    Science.gov (United States)

    Tan, Lesley E.

    1982-01-01

    Directional preference for horizontal hand movements was investigated in 49 right- and 49 left-handed four-year-olds using three drawing tests. Directionality for more complex perceptual-motor tasks has a different basis than directionality for simple tasks; such directionality is established at a later age but only for the right hand. (Author/CM)

  18. Quantifying lateral tissue heterogeneities in hadron therapy.

    Science.gov (United States)

    Pflugfelder, D; Wilkens, J J; Szymanowski, H; Oelfke, U

    2007-04-01

    In radiotherapy with scanned particle beams, tissue heterogeneities lateral to the beam direction are problematic in two ways: they pose a challenge to dose calculation algorithms, and they lead to a high sensitivity to setup errors. In order to quantify and avoid these problems, a heterogeneity number H(i) as a method to quantify lateral tissue heterogeneities of single beam spot i is introduced. To evaluate this new concept, two kinds of potential errors were investigated for single beam spots: First, the dose calculation error has been obtained by comparing the dose distribution computed by a simple pencil beam algorithm to more accurate Monte Carlo simulations. The resulting error is clearly correlated with H(i). Second, the analysis of the sensitivity to setup errors of single beam spots also showed a dependence on H(i). From this data it is concluded that H(i) can be used as a criterion to assess the risks of a compromised delivered dose due to lateral tissue heterogeneities. Furthermore, a method how to incorporate this information into the inverse planning process for intensity modulated proton therapy is presented. By suppressing beam spots with a high value of H(i), the unfavorable impact of lateral tissue heterogeneities can be reduced, leading to treatment plans which are more robust to dose calculation errors of the pencil beam algorithm. Additional possibilities to use the information of H(i) are outlined in the discussion.

  19. Clinical psychology and amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Francesco Pagnini

    2010-07-01

    Full Text Available Amyotrophic Lateral Sclerosis is a fatal and progressive disease, characterized by progressive muscles weakness, with consequent loss of physical capacities. Psychologists can play an important role in ALS care, by providing clinical activities in every step of the disease, including support and counseling activities directed to patients, their caregivers and to physicians.

  20. Service differentiation through selective lateral transshipments

    NARCIS (Netherlands)

    Alvarez, E.M.; Heijden, van der M.C.; Vliegen, I.M.H.; Zijm, W.H.M.

    2014-01-01

    We consider a multi-item spare parts problem with multiple warehouses and two customer classes, where lateral transshipments are used as a differentiation tool. Specifically, premium requests that cannot be met from stock at their preferred warehouse may be satisfied from stock at other warehouses (

  1. iPS Cells 10 Years Later.

    Science.gov (United States)

    2016-09-08

    In 2006, Takahashi and Yamanaka reported the breakthrough discovery of induction of pluripotent stem cells from fibroblasts by a combination of defined factors. Ten years later, Cell editor João Monteiro brings together Shinya Yamanaka and Hans Schöler, one the original reviewers of the landmark study, to revisit the history behind the paper and its long-lasting legacy.

  2. Progress in clinical diagnosis of amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    YANG Qiong

    2012-06-01

    Full Text Available Amyotrophic lateral sclerosis (ALS is a fatal neurodegenerative disease, mainly involving the pyramidal tract, brain stem and spinal cord anterior horn cells, manifests as progressive muscle atrophy, weakness and cramps, as well as cognitive impairment, and may overlap with frontotemporal dementia. ALS is familial in 5% of cases, whose clinical manifestations are similar to sporadic. The diagnosis is made mainly based on clinical manifestations, using internationally recognized consensus standard, after rule out conditions that can mimic ALS. Genetic testing provides a new way to accelerate the diagnostic process for early intervention. Part of the gene mutations are associated with specific phenotypes. According to this, prognosis assessment and genetic counseling are able to carry out.

  3. Thomson Reuters to release Book Citation Index later this year

    Science.gov (United States)

    Aldred, Maxine

    2011-08-01

    Thomson Reuters will launch its new Book Citation Index later this year. Projected to include 25,000 volumes from major publishers and university presses in science, social science, and the humanities, the Book Citation Index will cover scholarly books (both series and nonseries) that present original research or literature reviews. The current effort regarding the science section is focused on books published from 2005 to the present. AGU has sent copies of its catalog for inclusion in the Book Citation Index, but the final selection will be made by Thomson Reuters, using its internal selection criteria, which may be found at http://wokinfo.com/wok/media/pdf/BKCI-SelectionEssay_web.pdf.

  4. Sap flow measurements of lateral tree roots in agroforestry systems.

    Science.gov (United States)

    Lott, J. E.; Khan, A. A. H.; Ong, C. K.; Black, C. R.

    1996-01-01

    Successful extension of agroforestry to areas of the semi-arid tropics where deep reserves of water exist requires that the tree species be complementary to the associated crops in their use of water within the crop rooting zone. However, it is difficult to identify trees suitable for dryland agroforestry because most existing techniques for determining water uptake by roots cannot distinguish between absorption by tree and crop roots. We describe a method for measuring sap flow through lateral roots using constant temperature heat balance gauges, and the application of this method in a study of complementarity of water use in agroforestry systems containing Grevillea robusta A. Cunn. Sap flow gauges were attached to the trunks and roots of Grevillea with minimum disturbance to the soil. Thermal energy emanating from the soil adversely affected the accuracy of sap flow gauges attached to the roots, with the result that the uncorrected values were up to eightfold greater than the true water uptake determined gravimetrically. This overestimation was eliminated by using a calibration method in which nonconducting excised root segments, with sap flow gauges attached, were placed adjacent to the live roots. The power consumption and temperature differentials of the excised roots were used to correct for external sources and internal losses of heat within the paired live root. The fraction of the total sap flow through individual trees supplied by the lateral roots varied greatly between trees of similar canopy size. Excision of all lateral roots, except for one to which a heat balance gauge was attached, did not significantly increase sap flow through the intact root, suggesting that it was functioning at near maximum capacity.

  5. Lateral organic photodetectors for imaging applications

    Science.gov (United States)

    Shafique, Umar; Karim, Karim S.

    2011-03-01

    Organic semiconductor detectors have always been in active research interest of researchers due to its low fabrication cost. Vertical organic detectors have been studied in the past but not much of the works have been done on lateral organic detectors. The lateral design has an advantage over the vertical design that it is easy to fabricate and can be easily integrated with the backplane TFT imager circuit. Integrating an organic photodetectors with TFT imager can improve the over all sensitivity of the imager. However the lateral design limits the fill-factor. Here in our work we propose a new bilayered lateral organic photodetectors with Copper-Phthalocyanine (CUPC) as top and Perylene- Tetracarboxylic Bis- Benzimidazole (PTCBI) as the bottom layer organic material. The bottom organic semiconductor layer work as both, charge transport layer and photon absorption layer. The top and bottom layer provides and heterojunction a potential gradient enough to separate the photo generated excitons in to electrons and holes. The incident photons are absorbed in the two layers active layers giving an exciton. These excitons see a potential barrier at the CUPC-PTCBI heterojunction and separated into holes and electrons. The separated electrons are directed by the external applied electric field and thus give a increase in photocurrent. Lateral organic photodetectors are simple to design and have low dark current. The photo-response of these photo detectors is observed approximately three orders higher in magnitude compare able to its dark response. The dual layer has an advantage of tuning the devices for different absorption wavelengths and were observed more stable comparable to vertical devices.

  6. Surgeon's view of the skull base from the lateral approach.

    Science.gov (United States)

    Goldenberg, R A

    1984-12-01

    This paper presents the surgical anatomy of the skull base and infratemporal fossa. The information has been derived from the author's own experience in surgical and cadaver dissection, standard anatomical references, and selected experience of other skull base surgeons. Because the lateral approach has become the utilitarian method of exposure, the intricate detailed anatomy is demonstrated from this view at five levels of dissection, so the surgeon may gain a practical understanding of the surgical relationship of critical structures. Consistent anatomical landmarks can be used by the surgeon in the location of these critical structures. The styloid process, sphenoidal spine, and middle meningeal artery identify the internal carotid artery as it enters the carotid canal. The bony or fibrous septum that divides the jugular foramen into neural and vascular compartments may be used to better identify nerves IX, X, and XI. The zygomatic root is useful for location of the middle fossa dura. The lateral pterygoid plate leads directly to the foramen ovale. The increased precision of dissection permitted by use of the microscope requires an increased level of knowledge of anatomical structures in this area. It is hoped that the information presented in this paper will assist surgeons in the meticulous and thorough removal of skull base tumors and in the preservation of neural and vascular structures that are presently being sacrificed.

  7. Lateral bias of agonistic responses to mirror images and morphological asymmetry in the Siamese fighting fish (Betta splendens).

    Science.gov (United States)

    Takeuchi, Yuichi; Hori, Michio; Myint, Omar; Kohda, Masanori

    2010-03-17

    Behavioural laterality (e.g., during social interactions) is often observed at the individual level in lower vertebrates such as fish, whereas population-level laterality is observed in many higher vertebrates. Population-level laterality can be explained mainly by internal factors (e.g., cerebral lateralization), whereas little is known about the behavioural mechanisms underlying individual-level laterality. Recently, it was revealed that many fish have asymmetrical body morphology, but the relationship between asymmetric morphology and social behaviours has been rarely examined. Here we report the relationship between lateralized eye use during aggressive displays (e.g., body posture) of male Siamese fighting fish, Betta splendens, toward their own mirror image and morphological asymmetry. Of 25 males, five exhibited significantly more leftward eye use during left displays, and eight males exhibited predominantly rightward eye use during right displays. Morphological measurement results for the craniovertebral angle and opercular area showed that the craniovertebral angle and opercular area displayed antisymmetry and fluctuating asymmetry, respectively. We found that lateralized eye use during agonistic responses by each fish was associated with the craniovertebral angle, but not with operculum size; lefties (left-curved body) showed mainly left eye use (during left-side displays), and righties (right-curved body) demonstrated the opposite. We suggest that antisymmetric morphologies, such as head incline, are potentially useful for studying the association between cerebral lateralization and individual laterality of behavioural responses. Further, we propose that in fish, morphological asymmetry is related to laterality in various behaviours.

  8. Measuring acetabular component position on lateral radiographs - ischio-lateral method.

    Science.gov (United States)

    Pulos, Nicholas; Tiberi Iii, John V; Schmalzried, Thomas P

    2011-01-01

    The standard method for the evaluation of arthritis and postoperative assessment of arthroplasty treatment is observation and measurement from plain films, using the flm edge for orientation. A more recent employment of an anatomical landmark, the ischial tuberosity, has come into use as orientation for evaluation and is called the ischio-lateral method. In this study, the use of this method was evaluated as a first report to the literature on acetabular component measurement using a skeletal reference with lateral radiographs. Postoperative radiographs of 52 hips, with at least three true lateral radiographs taken at different time periods, were analyzed. Component position was measured with the historical method (using the flm edge for orientation) and with the new method using the ischio-lateral method. The mean standard deviation (SD) for the historical approach was 3.7° and for the ischio-lateral method, 2.2° (p historical method, 19 (36.5%) hips had a SD greater than ± 4°, compared to six hips (11.5%) with the ischio-lateral method. By using a skeletal reference, the ischio-lateral method provides a more consistent measurement of acetabular component position. The high intra-class correlation coefficients for both intra- and inter-observer reliability indicate that the angle measured with this simple method, which employs no further technology, increased time, or cost, is consistent and reproducible for multiple observers.

  9. 77 FR 64462 - Conference on International Trade Issues Facing U.S. Machinery Manufacturing Industries

    Science.gov (United States)

    2012-10-22

    ... Conference on International Trade Issues Facing U.S. Machinery Manufacturing Industries AGENCY: Manufacturing... December 4, 2012 the Office of Transportation and Machinery will hold a one-day conference on bi-lateral and multi-lateral international trade issues impacting the U.S. machinery manufacturing...

  10. Lateral cephalometric radiograph versus lateral nasopharyngeal radiograph for quantitative evaluation of nasopharyngeal airway space

    Directory of Open Access Journals (Sweden)

    Suelen Cristina da Costa Pereira

    2014-08-01

    Full Text Available OBJECTIVE: This study compared lateral radiographs of the nasopharynx (LN and lateral cephalometric radiographs (LC used to assess nasopharyngeal airway space in children. MATERIAL AND METHODS: One examiner measured the nasopharyngeal space of 15 oral breathing patients aged between 5 and 11 years old by using LN and LC. Both assessments were made twice with a 15-day interval in between. Intergroup comparison was performed with t-tests (P < 0.05. RESULTS: Comparison between LN and LC measurements showed no significant differences. CONCLUSION: Lateral cephalometric radiograph is an acceptable method used to assess nasopharyngeal airway space.

  11. Reflection tomography in laterally varying media

    Energy Technology Data Exchange (ETDEWEB)

    Carrion, Phillip M.; Boehm, Gualtiero; Vesnaver, Aldo

    1993-12-31

    In this paper, we will discuss a separate reconstruction of lateral velocity gradients and reflection interfaces using the method of reflection tomography. We will be limited by inversion of traveltimes. As it is known such inversion may suffer from a significant drawback: ambiguity. This ambiguity is referred to as depth/velocity ambiguity which is especially notable in the case of non-vertical angles of propagation. In tomographic experiments this ambiguity is suppressed by finite angular aperture. The next problem is non-uniqueness. It will be shown that the lateral gradients of velocity and the depths to the reflection points can be uniquely recovered from surface seismic data in the reflection tomography experiments. Reflection data inversion is done via an optimization process which can be formulated either in the physical space of seismic velocities or in the dual space of Lagrangian multipliers. We compare both methods and show the advantages of the dual transform. (author). 4 refs., 8 figs

  12. Later Wittgenstein and the Philosophy of Religion

    DEFF Research Database (Denmark)

    Hansen, Stig Børsen

    2010-01-01

    This article sets out by distinguishing Wittgenstein’s own views in the philosophy of religion from a school of thought in the philosophy of religion that relies on later Wittgenstein’s philosophy of language. After a survey of distinguishing features of Wittgenstein’s later philosophy, the third...... section explores Wittgenstein’s treatment of Frazer’s account of magic among primitive peoples. The following section offers an account of Wittgensteinian philosophy of religion, including the use of the notions of a language game and superstition. I conclude by criticizing a very influential argument...... of Wittgenstein’s to the effect that the meaning of words like ‘belief’ and ‘object’ varies from context to context without having any one thing in common....

  13. Lateral force transmission between human tendon fascicles

    DEFF Research Database (Denmark)

    Haraldsson, Bjarki T; Aagaard, Per; Qvortrup, Klaus

    2008-01-01

    Whether adjacent collagen fascicles transmit force in parallel is unknown. The purpose of the present study was to examine the magnitude of lateral force transmission between adjacent collagen fascicles from the human patellar and Achilles tendon. From each sample two adjacent strands of fascicles...... in the patellar and Achilles tendon fascicles, respectively. A decline in stiffness of 39% and 60% from cycle 1 to cycle 2, and of 93% and 100% from cycle 2 to cycle 3 was observed in the patellar and Achilles tendon fascicles, respectively. The present data demonstrate that lateral force transmission between...... adjacent collagen fascicles in human tendons is small or negligible, suggesting that tendon fascicles largely act as independent structures and that force transmission principally takes place within the individual fascicles....

  14. LATERAL SINUS THROMBOSIS IN OTOLOGY: A REVIEW

    Directory of Open Access Journals (Sweden)

    B Visavanatha

    2010-09-01

    Full Text Available Lateral sinus thrombosis (LST is usually occurs as a complication of middle ear infection .The involvement of lateral sinus during the course of ear infection was a well known complication in preantibiotic days .The decrease in the incidence of LST is due to the introduction of broad-spectrum antibiotics, early diagnosis and surgical treatment. Now, it is a rare complication of otitis media and poses a serious threat that warrants immediate medical and surgical treatment. The classical clinical picture is often changed by previous antibiotic therapy. An awareness of this rare potentially devastating condition and its varied presentations is necessary for early diagnosis and treatment. LST can also occur after head injury.

  15. Customized MFM probes with high lateral resolution

    Directory of Open Access Journals (Sweden)

    Óscar Iglesias-Freire

    2016-07-01

    Full Text Available Magnetic force microscopy (MFM is a widely used technique for magnetic imaging. Besides its advantages such as the high spatial resolution and the easy use in the characterization of relevant applied materials, the main handicaps of the technique are the lack of control over the tip stray field and poor lateral resolution when working under standard conditions. In this work, we present a convenient route to prepare high-performance MFM probes with sub-10 nm (sub-25 nm topographic (magnetic lateral resolution by following an easy and quick low-cost approach. This allows one to not only customize the tip stray field, avoiding tip-induced changes in the sample magnetization, but also to optimize MFM imaging in vacuum (or liquid media by choosing tips mounted on hard (or soft cantilevers, a technology that is currently not available on the market.

  16. Early Taste Experiences and Later Food Choices

    Directory of Open Access Journals (Sweden)

    Valentina De Cosmi

    2017-02-01

    Full Text Available Background. Nutrition in early life is increasingly considered to be an important factor influencing later health. Food preferences are formed in infancy, are tracked into childhood and beyond, and complementary feeding practices are crucial to prevent obesity later in life. Methods. Through a literature search strategy, we have investigated the role of breastfeeding, of complementary feeding, and the parental and sociocultural factors which contribute to set food preferences early in life. Results. Children are predisposed to prefer high-energy, -sugar, and -salt foods, and in pre-school age to reject new foods (food neophobia. While genetically determined individual differences exist, repeated offering of foods can modify innate preferences. Conclusions. Starting in the prenatal period, a varied exposure through amniotic fluid and repeated experiences with novel flavors during breastfeeding and complementary feeding increase children’s willingness to try new foods within a positive social environment.

  17. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Directory of Open Access Journals (Sweden)

    Angélica Castro Pimentel

    2016-01-01

    Full Text Available Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics.

  18. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Science.gov (United States)

    Sanches, Marco Antonio; Ramalho, Gabriel Cardoso; Manzi, Marcello Roberto

    2016-01-01

    Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics. PMID:27433360

  19. Handedness and Lateralization of the Brain

    Directory of Open Access Journals (Sweden)

    Shohreh Teimournezhad

    2011-01-01

    Full Text Available

    The present study is a review of the key concepts in relation to the nature of handedness and in line with that, the phenomenon of brain lateralization. To this end, a number of articles have been overviewed and the critical concepts such as handedness and its main features, the theoretical bases for this phenomenon, the nature and functions of lateralization, and the relationship between these two concepts have been shed light on for a better understanding. Finally, the general differences between the left-handers vs. right-handers have been drawn into consideration.

  20. Motorcycle state estimation for lateral dynamics

    Science.gov (United States)

    Teerhuis, A. P.; Jansen, S. T. H.

    2012-08-01

    The motorcycle lean (or roll) angle development is one of the main characteristics of motorcycle lateral dynamics. Control of motorcycle motions requires an accurate assessment of this quantity and for safety applications also the risk of sliding needs to be considered. Direct measurement of the roll angle and tyre slip is not available; therefore, a method of model-based estimation is developed to estimate the state of a motorcycle. This paper investigates the feasibility of such a motorcycle state estimator (MCSE). A simplified analytic model of a motorcycle is developed by comparison to an extended multi-body model of the motorcycle, designed in Matlab/SimMechanics. The analytic model is used inside an extended Kalman filter. Experimental results of an instrumented Yamaha FJR1300 motorcycle show that the MCSE is a feasible concept for obtaining signals related to the lateral dynamics of the motorcycle.

  1. Tonoplast Aquaporins Facilitate Lateral Root Emergence.

    Science.gov (United States)

    Reinhardt, Hagen; Hachez, Charles; Bienert, Manuela Désirée; Beebo, Azeez; Swarup, Kamal; Voß, Ute; Bouhidel, Karim; Frigerio, Lorenzo; Schjoerring, Jan K; Bennett, Malcolm J; Chaumont, Francois

    2016-03-01

    Aquaporins (AQPs) are water channels allowing fast and passive diffusion of water across cell membranes. It was hypothesized that AQPs contribute to cell elongation processes by allowing water influx across the plasma membrane and the tonoplast to maintain adequate turgor pressure. Here, we report that, in Arabidopsis (Arabidopsis thaliana), the highly abundant tonoplast AQP isoforms AtTIP1;1, AtTIP1;2, and AtTIP2;1 facilitate the emergence of new lateral root primordia (LRPs). The number of lateral roots was strongly reduced in the triple tip mutant, whereas the single, double, and triple tip mutants showed no or minor reduction in growth of the main root. This phenotype was due to the retardation of LRP emergence. Live cell imaging revealed that tight spatiotemporal control of TIP abundance in the tonoplast of the different LRP cells is pivotal to mediating this developmental process. While lateral root emergence is correlated to a reduction of AtTIP1;1 and AtTIP1;2 protein levels in LRPs, expression of AtTIP2;1 is specifically needed in a restricted cell population at the base, then later at the flanks, of developing LRPs. Interestingly, the LRP emergence phenotype of the triple tip mutants could be fully rescued by expressing AtTIP2;1 under its native promoter. We conclude that TIP isoforms allow the spatial and temporal fine-tuning of cellular water transport, which is critically required during the highly regulated process of LRP morphogenesis and emergence.

  2. Lateral Modes in Quantum Cascade Lasers

    Directory of Open Access Journals (Sweden)

    Gregory C. Dente

    2016-03-01

    Full Text Available We will examine the waveguide mode losses in ridge-guided quantum cascade lasers. Our analysis illustrates how the low-loss mode for broad-ridge quantum cascade lasers (QCLs can be a higher-order lateral waveguide mode that maximizes the feedback from the sloped ridge-wall regions. The results are in excellent agreement with the near- and far-field data taken on broad-ridge-guided quantum cascade lasers processed with sloped ridge walls.

  3. Arthroscopic treatment for chronic lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVE: To report the clinical and functional results from arthroscopic release of the short radial extensor of the carpus (SREC in patients with chronic lateral epicondylitis that was refractory to conservative treatment. METHODS: Over the period from January 2012 to November 2013, 15 patients underwent arthroscopic treatment. The surgical technique used was the one described by Romeo and Cohen, based on anatomical studies on cadavers. The inclusion criteria were that the patients needed to present lateral epicondylitis and that conservative treatment (analgesics, anti-inflammatory agents, corticoid infiltration or physiotherapy had failed over a period of more than six months. The patients were evaluated based on the elbow functional score of the Mayo Clinic, Nirschl's staging system and a visual analog scale (VAS for pain. RESULTS: A total of 15 patients (9 men and 6 women were included. The mean Mayo elbow functional score after the operation was 95 (ranging from 90 to 100. The pain VAS improved from a mean of 9.2 before the operation to 0.64 after the operation. On Nirschl's scale, the patients presented an improvement from a mean of 6.5 before the operation to approximately one. There were significant differences from before to after the surgery for the three functional scores used ( p 0.05. CONCLUSION: Arthroscopic treatment for lateral epicondylitis was shown to be a safe and effective therapeutic option when appropriately indicated and performed, in refractory cases of chronic lateral epicondylitis. It also allowed excellent viewing of the joint space for diagnosing and treating associated pathological conditions, with a minimally invasive procedure.

  4. Impaired Sacculocollic Reflex in Lateral Medullary Infarction

    OpenAIRE

    Seonhye eKim; Hyo-Jung eKim; Ji Soo eKim

    2011-01-01

    Objective: The aim of this study was to determine saccular dysfunction by measuring cervical vestibular-evoked myogenic potentials (cVEMP) and to correlate abnormality of cVEMP with results of other vestibular function tests in lateral medullary infarction (LMI). Methods: We recorded cVEMP in 21 patients with LMI documented on MRI. cVEMP was induced by a short tone burst and was recorded in contracting sternocleidomastoid muscle while patients turned their heads forcefully to the contralatera...

  5. Evaluation and management of amyotrophic lateral sclerosis.

    Science.gov (United States)

    Valadi, Nojan

    2015-06-01

    Motor neuron diseases can cause progressive impairment of voluntary muscles of movement, respiration, speech, and swallowing. This review discusses the most common motor neuron disease, amyotrophic lateral sclerosis (ALS). It reviews the evaluation, diagnosis, and management of ALS, and its epidemiology, pathophysiology, and management. A coordinated approach by the primary care physician and neurologist is necessary with a focus on treatment options, durable medical equipment needs, and end-of-life discussions. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. The management of amyotrophic lateral sclerosis.

    LENUS (Irish Health Repository)

    Phukan, Julie

    2009-02-01

    The terms amyotrophic lateral sclerosis (ALS) or motor neuron disease (MND) refer to a condition characterized by motor system degeneration with relative preservation of other pathways. Although there have been advances in symptomatic treatment, ALS remains an incurable condition. Advances in ALS management prolong survival but simultaneously raise challenging ethical dilemmas for physicians, patients and their families. Here, we review current practice in the management of ALS including pharmacological treatment, nutritional management, respiratory care, and evolving strategies in the management of cognitive impairment.

  7. Lateral elbow tendinopathy: Evidence of physiotherapy management

    OpenAIRE

    2016-01-01

    Lateral elbow tendinopathy (LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the management of LET. The optimal protocol of exercise programme is still unknown. The effectiveness of the exercise programme is low when it is applied as monotherapy. Therefore, exercise programme is combined with other physiotherapy modalities such as soft tissue techniques, ext...

  8. Grey Literature in Energy: 5 Years Later

    OpenAIRE

    Cutler, Deborah E. (OSTI-DOE); GreyNet, Grey Literature Network Service

    2004-01-01

    At GL'99, the Department of Energy's Office of Scientific and Technical Information (DOE OSTI) presented a paper titled "Grey Literature in Energy: a Shifting Paradigm". Five years later, the paradigm continues to shift, less radically than the change from paper and microfiche to electronic, but with significant benefit to users worldwide. OSTI's efforts continue this shift, moving even further away from the connotation of "grey" as meaning "hard to get" literature. Along with its domestic an...

  9. Lateral angle and cranial base sexual dimorphism

    DEFF Research Database (Denmark)

    Duquesnel Mana, Mathilde; Adalian, Pascal; Lynnerup, Niels

    2016-01-01

    SUMMARY: Previous studies have yielded very different results in sex estimation based on measurements of the lateral angle (LA) of the temporal bone. The purpose of this study was to, first, investigate if the bad results obtained by the LA method could be due to the methodology and then, second......, to examine sexual dimorphism in the relationship between the lateral angle and cranial base shape. The lateral angle method was tested using a forensic sample of 102 CT scans of the head with known sex. We measured the angle using two methods: measurements directly on the CT slide, the method usually applied...... the direct measurements. The mean angle was greater in females (48.2° ± 7.2°) than in males (45.38° ±8.06°) but the difference was not significant (t-test, p = 0.063). A statistically significant difference in cranial base shape existed between the two sexes, but the results also demonstrated a major overlap...

  10. Clinical neurorestorative progress in amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Chen L

    2015-08-01

    Full Text Available Lin Chen,1,2,5 Hongyun Huang,3 Haitao Xi,4,5 Gengsheng Mao3 1Medical Center, Tsinghua University, 2Tsinghua University Yuquan Hospital, 3General Hospital of Chinese People's Armed Police Forces, 4Beijing Rehabilitation Hospital of Capital Medical University, 5Beijing Hongtianji Neuroscience Academy, Beijing, People’s Republic of China Abstract: Amyotrophic lateral sclerosis is a progressive and fatal neurodegenerative disease characterized by progressive paralysis and motor neuron death. In addition to symptomatic managements such as ventilation and nutritional support, neurorestorative therapies have demonstrated anti-neurodegenerative potential and may improve quality of life for patients. Currently, clinical neurorestorative strategies include pharmacological management (granulocyte colony stimulating factor, neuromodulatory intervention (repetitive transcranial magnetic and cortical stimulation, cell transplantation (bone marrow stromal cells, olfactory ensheathing cells, granulocyte colony stimulating factor-mobilized peripheral blood stromal cells, hematopoietic stem and progenitor cells, neural stem/progenitor cells, CD133+ cells and CD34+ cells, bioengineering and tissue engineering therapy, and combined neurorehabilitative treatment. In this review, we describe the latest progress in clinical neurorestorative management of amyotrophic lateral sclerosis and discuss the underlying evidence base. Keywords: amyotrophic lateral sclerosis, neurorestorative treatment, cell transplantation, clinical trial

  11. Lateral interactions and non-equilibrium in surface kinetics

    Science.gov (United States)

    Menzel, Dietrich

    2016-08-01

    Work modelling reactions between surface species frequently use Langmuir kinetics, assuming that the layer is in internal equilibrium, and that the chemical potential of adsorbates corresponds to that of an ideal gas. Coverage dependences of reacting species and of site blocking are usually treated with simple power law coverage dependences (linear in the simplest case), neglecting that lateral interactions are strong in adsorbate and co-adsorbate layers which may influence kinetics considerably. My research group has in the past investigated many co-adsorbate systems and simple reactions in them. We have collected a number of examples where strong deviations from simple coverage dependences exist, in blocking, promoting, and selecting reactions. Interactions can range from those between next neighbors to larger distances, and can be quite complex. In addition, internal equilibrium in the layer as well as equilibrium distributions over product degrees of freedom can be violated. The latter effect leads to non-equipartition of energy over molecular degrees of freedom (for products) or non-equal response to those of reactants. While such behavior can usually be described by dynamic or kinetic models, the deeper reasons require detailed theoretical analysis. Here, a selection of such cases is reviewed to exemplify these points.

  12. Maxillary lateral incisors with two canals and two separate curved roots

    Directory of Open Access Journals (Sweden)

    Ajit George Mohan

    2012-01-01

    Full Text Available Variation in the roots and root canal anatomy seems to be the norm rather than an exception. For a successful endodontic treatment, a clinician should have a thorough knowledge of the internal and external dental anatomy and its variations. Maxillary lateral incisors usually exhibit single canal with a single root. In this case, clinical examination and radiographs clearly demonstrates the presence of two root canals with two separate curved roots. This case report emphasizes the need for attention during endodontic management of maxillary lateral incisors.

  13. Recalcitrant Lateral Premalleolar Bursitis of the Ankle Associated with Lateral Ankle Instability

    Directory of Open Access Journals (Sweden)

    Masashi Naito

    2017-01-01

    Full Text Available Lateral premalleolar bursitis of the ankle is a rarely reported disorder in the English literature although it is not uncommon in Asian countries where people commonly sit on their feet. Here, we present the case of a 66-year-old woman with recalcitrant lateral premalleolar bursitis associated with lateral ankle instability which was successfully treated with surgical resection of the bursa and repair of the anterior talofibular ligament. Operative findings revealed a communication between the bursa and articular cavity of the ankle joint via the sheath of the extensor digitorum longus tendon, which was considered to act as a check valve leading to a large and recalcitrant bursitis. This report provides a novel concept about the etiology of recalcitrant lateral premalleolar bursitis of the ankle.

  14. Endoscopic balloon sphincter dilation vs.sphincterotomy for common bile duct stones: a Meta analysis%内镜下乳头球囊扩张术对比乳头括约肌切开术治疗胆总管结石的Meta分析

    Institute of Scientific and Technical Information of China (English)

    鲁超; 锁涛; 付亮; 张钰; 宋陆军

    2013-01-01

    目的 对比内镜下乳头球囊扩张术(EPBD)与内镜乳头括约肌切开术(EST)治疗胆总管结石的利与弊.方法 检索Cochrane Library、Embase、Medline、Pubmed、CBM、CNKI、VIP和万方数据库,没有语言限制.纳入从1983年1月到2012年9月间发表的比较EPBD与EST治疗胆总管结石的临床随机对照实验,并对其进行了质量学评价,最后用RevMan 5.1软件进行Meta分析.结果 18个临床随机对照实验符合研究标准(2385个研究对象).在第一次成功取石率、总成功取石率、穿孔、长期胆管炎发生率等方面EPBD与EST结果类似.EPBD有更高的危险发生胰腺炎(RR=1.99,95% CI:1.41 ~2.81)和重症胰腺炎(RR =4.68,95% CI:1.36~ 16.11),需要机械碎石的概率更高(RR=1.31,95%CI:1.14~ 1.50).相反的是,EPBD不但有明显低的出血率(RR=0.14,95% CI:0.06 ~0.34),而且长期结石复发(RR =0.67,95% CI:0.47~0.96),长期胆囊炎(RR =0.38,95% CI:0.19 ~0.76)和总的长期并发症(RR =0.52,95% CI:0.40 ~0.67)发生率更低.结论 考虑出血、结石复发或长期并发症的话,相对于EST,EPBD治疗胆总管结石是更好的选择;但后者胰腺炎尤其是重症胰腺炎的发生率更高.%Objective To compare the pros and cons of endoscopic papillary balloon dilation (EPBD) with those of endoscopic sphincterotomy (EST) in the treatment of common bile duct stones.Methods We searched The Cochrane library,Medline,Pubmed,Embase,CBM,CNKI,VIP and Wan Fang database in any language.RCTs that compared EPBD with EST for the removal of common bile duct stones were included from January 1983 to September 2012 and qualities of the trials were evaluated.Statistic analyses were carried out using RevMan 5.1 software.Results A total of 18 randomized trials with 2385 participants met our inclusion criteria.EPBD compared with EST resulted in similar outcomes with regards to stone removal on 1 st attempt,overall stone removal,perforation,total short

  15. Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation.

    Science.gov (United States)

    Kotnis, Nikhil A; Chiavaras, Mary M; Harish, Srinivasan

    2012-04-01

    The diagnosis of lateral epicondylitis is often straightforward and can be made on the basis of clinical findings. However, radiological assessment is valuable where the clinical picture is less clear or where symptoms are refractory to treatment. Demographics, aspects of clinical history, or certain physical signs may suggest an alternate diagnosis. Knowledge of the typical clinical presentation and imaging findings of lateral epicondylitis, in addition to other potential causes of lateral elbow pain, is necessary. These include entrapment of the posterior interosseous and lateral antebrachial cutaneous nerves, posterolateral rotatory instability, posterolateral plica syndrome, Panner's disease, osteochondritis dissecans of the capitellum, radiocapitellar overload syndrome, occult fractures and chondral-osseous impaction injuries, and radiocapitellar arthritis. Knowledge of these potential masquerades of lateral epicondylitis and their characteristic clinical and imaging features is essential for accurate diagnosis. The goal of this review is to provide an approach to the imaging of lateral elbow pain, discussing the relevant anatomy, various causes, and discriminating factors, which will allow for an accurate diagnosis.

  16. Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kotnis, Nikhil A. [McMaster University, Departments of Radiology, Hamilton, ON (Canada); Sheffield Teaching Hospitals, Department of Medical Physics and Medical Imaging, Sheffield (United Kingdom); Chiavaras, Mary M. [McMaster University, Departments of Radiology, Hamilton, ON (Canada); Harish, Srinivasan [McMaster University, Departments of Radiology, Hamilton, ON (Canada); St. Joseph' s Healthcare, Department of Diagnostic Imaging, Hamilton, ON (Canada)

    2012-04-15

    The diagnosis of lateral epicondylitis is often straightforward and can be made on the basis of clinical findings. However, radiological assessment is valuable where the clinical picture is less clear or where symptoms are refractory to treatment. Demographics, aspects of clinical history, or certain physical signs may suggest an alternate diagnosis. Knowledge of the typical clinical presentation and imaging findings of lateral epicondylitis, in addition to other potential causes of lateral elbow pain, is necessary. These include entrapment of the posterior interosseous and lateral antebrachial cutaneous nerves, posterolateral rotatory instability, posterolateral plica syndrome, Panner's disease, osteochondritis dissecans of the capitellum, radiocapitellar overload syndrome, occult fractures and chondral-osseous impaction injuries, and radiocapitellar arthritis. Knowledge of these potential masquerades of lateral epicondylitis and their characteristic clinical and imaging features is essential for accurate diagnosis. The goal of this review is to provide an approach to the imaging of lateral elbow pain, discussing the relevant anatomy, various causes, and discriminating factors, which will allow for an accurate diagnosis. (orig.)

  17. Stress changes of lateral collateral ligament at different

    Directory of Open Access Journals (Sweden)

    ZHONG Yan-lin

    2011-04-01

    Full Text Available 【Abstract】 Objective: To create a 3-dimensional finite element model of knee ligaments and to analyse the stress changes of lateral collateral ligament (LCL with or without displaced movements at different knee flexion conditions. Methods: A four-major-ligament contained knee specimen from an adult died of skull injury was prepared for CT scanning with the detectable ligament insertion footprints, locations and orientations precisely marked in advance. The CT scanning images were converted to a 3-dimensional model of the knee with the 3-dimensional reconstruction technique and transformed into finite element model by the software of ANSYS. The model was validated using experimental and numerical results obtained by other scientists. The natural stress changes of LCL at five different knee flexion angles (0°, 30°, 60°, 90°, 120° and under various motions of anterior-posterior tibial translation, tibial varus rotation and internal-external tibial rotation were measured. Results: The maximum stress reached to 87%-113% versus natural stress in varus motion at early 30° of knee flexions. The stress values were smaller than the peak value of natural stress at 0° (knee full extension when knee bending was over 60° of flexion in anterior-posterior tibial translation and internal-external rotation. Conclusion: LCL is vulnerable to varus motion in almost all knee bending positions and susceptible to anterior- posterior tibial translation or internal-external rotation at early 30° of knee flexions. Key words: Knee joint; Collateral ligaments; Finite element analysis

  18. ANALYSIS AND DESIGN OF A MICROIRRIGATION LATERAL

    Directory of Open Access Journals (Sweden)

    Lakhdar ZELLA

    2006-10-01

    Full Text Available Micro-irrigation systems are methods of applying water, nutrients and chemicals directly to the plant root area at a controllable rate, which allows maximum results and minimum use of water and energy. For these reasons, microirrigation systems are developed in arid countries with insuffi ciency water resources. It has expanded to many countries engaging in modern agricultural practices due to relatively high agricultural outputs and low energy expenses. For micro-irrigation to be profi table, system design’s must be based on precise calculations and rigorous management. The precision with which micro-irrigation lateral and network’s are designed is of fundamental importance to system operation, the uniformity of distribution of water and fertilizer, and the consumption of energy. The computation model presented in this paper is based on equations of mass and energy conservation within an elemental control volume on the lateral. Considering the variation of the out-fl ow regime leads to an algebraic, coupled and non-linear equation system whose resolution is based on the numeric methods to a defective analytic approach. In this work, the control volume method was selected due to its simplicity. A program of computation has been developed for this and applied to a lateral for the fi rst time. Results from this simple model are precise and are similar to those from other validated models. Precision design increase effi ciency of water and fertilizer distribution. This method can be applied to the design of micro-irrigation lateral’s or network’s.

  19. Quantifying Disease Progression in Amyotrophic Lateral Sclerosis

    Science.gov (United States)

    Simon, Neil G; Turner, Martin R; Vucic, Steve; Al-Chalabi, Ammar; Shefner, Jeremy; Lomen-Hoerth, Catherine; Kiernan, Matthew C

    2014-01-01

    Amyotrophic lateral sclerosis (ALS) exhibits characteristic variability of onset and rate of disease progression, with inherent clinical heterogeneity making disease quantitation difficult. Recent advances in understanding pathogenic mechanisms linked to the development of ALS impose an increasing need to develop strategies to predict and more objectively measure disease progression. This review explores phenotypic and genetic determinants of disease progression in ALS, and examines established and evolving biomarkers that may contribute to robust measurement in longitudinal clinical studies. With targeted neuroprotective strategies on the horizon, developing efficiencies in clinical trial design may facilitate timely entry of novel treatments into the clinic. PMID:25223628

  20. Lateral dynamic features of a railway vehicle

    DEFF Research Database (Denmark)

    Gao, Xue-jun; True, Hans; Li, Ying-hui

    2016-01-01

    The lateral dynamic features of a railway vehicle are investigated using two similar wheel/rail contact models: the Vermeulen-Johnson and the Shen-Hedrick-Elkins models. The symmetric/asymmetric bifurcation behaviour and chaotic motions of the railway vehicle are investigated in great detail...... by varying the speed and using the resultant bifurcation diagram' method. It is found that multiple solution branches exist and they can lead to more steady states in the dynamic behaviour of the railway vehicle. The coexistence of multiple steady states can lead to jumps in the amplitude of oscillations...

  1. Trigemino-abducens synkinesis after lateral orbitotomy.

    Science.gov (United States)

    Park, Kyung-Ah; Oh, Sei Yeul

    2013-01-01

    A 30-year-old man underwent lateral orbitotomy with removal of dermoid cyst in the right orbit. One month after operation, the patient started to experience double vision. He had 25 prism diopters of esotropia in primary gaze with marked limitation of abduction in the right eye. Seven months after the operation, he developed synkinetic movement of the eye when clenching his teeth. He could abduct his right eye while gritting his teeth. This is the fourth reported case of trigemino-abducens synkinesis and the first reported case without brain trauma.

  2. Lateral elbow tendinopathy: Evidence of physiotherapy management

    Science.gov (United States)

    Dimitrios, Stasinopoulos

    2016-01-01

    Lateral elbow tendinopathy (LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the management of LET. The optimal protocol of exercise programme is still unknown. The effectiveness of the exercise programme is low when it is applied as monotherapy. Therefore, exercise programme is combined with other physiotherapy modalities such as soft tissue techniques, external support, acupuncture, manual therapy and electrotherapy, in the treatment of LET. Future research is needed to determine which treatment strategy combined with exercise programme will provide the best results in LET rehabilitation. PMID:27622145

  3. The changing scene of amyotrophic lateral sclerosis.

    Science.gov (United States)

    Robberecht, Wim; Philips, Thomas

    2013-04-01

    Several recent breakthroughs have provided notable insights into the pathogenesis of amyotrophic lateral sclerosis (ALS), with some even shifting our thinking about this neurodegenerative disease and raising the question as to whether this disorder is a proteinopathy, a ribonucleopathy or both. In addition, these breakthroughs have revealed mechanistic links between ALS and frontotemporal dementia, as well as between ALS and other neurodegenerative diseases, such as the cerebellar atrophies, myotonic dystrophy and inclusion body myositis. Here, we summarize the new findings in ALS research, discuss what they have taught us about this disease and examine issues that are still outstanding.

  4. MR imaging of amyotrophic lateral sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Oba, Hiroshi; Monzawa, Shuichi (Yamanashi Medical College, Nakakoma (Japan). Hospital); Araki, Tsutomu (and others)

    1992-04-01

    Magnetic resonance imaging (MR imaging) provides a sensitive method for mapping the normal and pathological distribution of iron in the brain. High field strength MR imaging (1.5 T) was used to evaluate eight patients with amyotrophic lateral sclerosis (ALS) and 49 neurological normal control patients. All eight ALS patients showed decreased signal intensity in the motor cortex on T2-weighted images, while only one of the normal control patients showed this finding. The results suggested that the decreased signal intensity in the motor cortex in ALS was caused by the deposition of iron in this area. (author).

  5. Stem cell therapy for amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Zhijuan Mao

    2015-01-01

    Full Text Available Amyotrophic lateral sclerosis (ALS is a fatal neurodegenerative disorder characterized by the loss of motor neurons. Currently, no effective therapy is available to treat ALS, except for Riluzole, which has only limited clinical benefits. Stem-cell-based therapy has been intensively and extensively studied as a potential novel treatment strategy for ALS and has been shown to be effective, at least to some extent. In this article, we will review the current state of research on the use of stem cell therapy in the treatment of ALS and discuss the most promising stem cells for the treatment of ALS.

  6. STRAIN ANALYSIS OF LATERAL EXTRUSION PROCESS

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    The strain distribution of equal-cross section lateral extrusion(ECSLE) has been simulated by finite element method. Considering the effect of friction and the width of sample, the simulation results are very close to the reality. The simulated results showed that, around the corner of die, the strain is distributed by sharp layers, and the gradient of the layers is very large, which means that the deformation is just plane shear deformation; the larger the width of sample or the smaller the friction, the more uniform the strain distribution is.

  7. Monopod bucket foundations under cyclic lateral loading

    OpenAIRE

    Foglia, Aligi; Ibsen, Lars Bo

    2014-01-01

    The monopod bucket foundation can be a cost-reducing sub-structure for offshore wind turbines. To avoid problems during the turbine operation, the long-term effect of cyclic loading must be considered in the design of the foundation. In this paper a 1g testing rig is adopted to extend the knowledge on bucket foundations under lateral cyclic loading. The test setup is described in detail and a comprehensive experimental campaign is presented. The foundation is subjected to cyclic overturning m...

  8. Psychotherapists and the clergy: Fifty years later.

    Science.gov (United States)

    Spiegelman, J M

    1984-03-01

    Jung's two powerful articles on psychotherapy and the clergy, written in 1928 and 1932. are looked at from the vantage point of fifty years later and the author's experience in conducting analysis with many people from both vocations. He notes that relatively few people achieve the kind of integration of the ego that Jung writes about-an essentially religious experience-wherein the center of their existence now gravitates about the Self. Yet Jung's work and views have had a profound effect on spiritually inclined people of all ages. The predictions of Jung's articles, regarding therapy, the dissemination of pyschology to the masses, and other issues are examined.

  9. Dynamics of laterally confined marine ice sheets

    OpenAIRE

    Kowal, Katarzyna N.; Pegler, Samuel S.; Worster, M. Grae

    2016-01-01

    This is the author accepted manuscript. The final version is available from Cambridge University Press via http://dx.doi.org/10.1017/jfm.2016.37 We present an experimental and theoretical study of the dynamics of laterally confined marine ice sheets in the natural limit in which the long, narrow channel into which they flow is wider than the depth of the ice. A marine ice sheet comprises a grounded ice sheet in contact with bedrock that floats away from the bedrock at a ‘grounding line’ t...

  10. Pemphigus vulgaris and amyotrophic lateral sclerosis

    Science.gov (United States)

    Mokhtari, Fatemeh; Matin, Marzieh; Rajati, Fatemeh

    2016-01-01

    Pemphigus vulgaris (PV) is an autoimmune bullous and erosive mucocutaneous disease. Rarely, it occurs in patients with other autoimmune disease. The relation between PV and neurological disorders is unclear and needs to be more studied. Here, we report a case of amyotrophic lateral sclerosis (ALS), followed by dermatologic involvement. Histopathological evidence and direct immunofluorescence are consistent with PV. Systemic corticosteroid and azathioprine were effective in the treatment of mucocutaneous lesions. PV seems to be accidentally associated with ALS. Expression of major histocompatibility complex Class II in autoimmune disease and production of autoantibodies have been proposed to describe the association of PV with ALS. PMID:28163728

  11. Community College Internal Auditors: Internal Audit Guidebook.

    Science.gov (United States)

    Jones, Ronna; And Others

    This guidebook includes information compiled by the "Audit Manual" committee of Community College Internal Auditors (CCIA) from several California community college districts regarding their internal auditing practices. The first section of the guidebook discusses the purpose of internal audits, indicating that audits assist members of…

  12. Health evaluation of the 2nd International "Quit and Win" Antinicotine Campaign participants ten years later.

    Science.gov (United States)

    Kowalska, Alina; Stelmach, Włodzimierz; Krakowiak, Jan; Rzeźnicki, Adam; Pikala, Małgorzata; Dziankowska-Zaborszczyk, Elzbieta; Drygas, Wojciech

    2008-01-01

    Smoking is one of the most often noticed types of negative behaviour among the Poles. In the work, the results of the health evaluation are presented of the participants of the 'Quit and Win' competition ten years after making a decision to refrain from smoking, also the dependency between this evaluation and behaviour connected with smoking among the people living in big cities and small towns and villages was analysed. Among the 648 respondents, majority, which is 302 people (46.6%) evaluated their health as good, 236 (36.4%) as average, and 76 of the questioned (11.7%) as very good, 29 people (4.5%) as bad, and 5 of the questioned (0.8%) as very bad. The respondents most often evaluated negatively their health in the group of the still smoking living in the big cities, and the least often in the group of the non-smokers living in small towns and villages.

  13. Infant Brain Development and Vulnerability to Later Internalizing Difficulties: The Generation R Study

    Science.gov (United States)

    Herba, Catherine M.; Roza, Sabine J.; Govaert, Paul; van Rossum, Joram; Hofman, Albert; Jaddoe, Vincent; Verhulst, Frank C.; Tiemeier, Henning

    2010-01-01

    Objective: Although clinical studies have demonstrated smaller subcortical volumes in structures such as the amygdala, hippocampus, caudate nucleus, and thalamus in adults and adolescents with depressive disorders and anxiety, no study has assessed such structures in babies, long before the development of the disorders. This study examined whether…

  14. the Analysis of Coupled Lateral Torsional Vibrations

    Directory of Open Access Journals (Sweden)

    Tomasz Szolc

    2000-01-01

    Full Text Available In the paper, dynamic investigations of the rotor shaft systems are performed by means of the discrete-continuous mechanical models. In these models the rotor shaft segments are represented by the rotating cylindrical flexurally and torsionally deformable continuous viscoelastic elements. These elements are mutually connected according to the structure of the real system in the form of a stepped shaft which is suspended on concentrated inertial viscoelastic supports of linear or non-linear characteristics. At appropriate shaft crosssections, by means of massless membranes, there are attached rigid rings representing rotors, disks, gears, flywheels and others. The proposed model enables us to investigate coupled linear or non-linear lateral torsional Vibrations of the rotating systems in steady-state and transient operating conditions. As demonstrative examples, for the steam turbo-compressor under coupled lateral torsional vibrations, the transient response due to a blade falling out from the turbine rotor as well as the steady-state response in the form of parametric resonance caused by residual unbalances are presented.

  15. Autologus Blood Injection for Recurrent Lateral Epicondylitis

    Directory of Open Access Journals (Sweden)

    M. Dehghani, M.D.

    2007-09-01

    Full Text Available Background and purpose: Tennis elbow is a common complaint. Several treatment strategies, such as corticosteroid injections and physical terapy and braces have been described with no predictable efficacy. The purpose of this study was to evaluate prospectively the result of refractory lateral epicondylitis with autologus blood injections.Materials and Methods: Twenty two patients with lateral epicondylitis were injected with 2 mL of autologous blood under the extensor carpi radialis brevis. All patients had failed the two previous non surgical treatments including all or combination of physical therapy, splintinge, non steroidal anti-inflammatory medication and prior steroid injection. The patients were evaluated with patient-rated Tennis Elbow Evaluation (PRTEE.Results: The average fallow-up period was 7.3 months (range, 4-10mo. After autologus blood injection, the average pain score decreased from 43.7 to 9.1 (P-value < 0.001. The average functional score decreased from 42.4 to 10.1 (P-value <0.001.Conclusion: On the basis of this study, this minimally invasive treatment advocates refractory Tennis elbow.

  16. Mirror movements in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Wittstock, Mathias; Meister, Steffanie; Walter, Uwe; Benecke, Reiner; Wolters, Alexander

    2011-11-01

    Amyotrophic lateral sclerosis (ALS) is a progressive motor syndrome with clinical evidence of upper and lower motor neuron dysfunction. Mirror movements (MM) in ALS have been reported and attributed to a disturbed transcallosal inhibition (TI). Hence, occurrence of MM in ALS might be explained by involvement of transcallosal projecting fibre tracts into the degenerative process of the motor system. Twenty-six consecutive ALS patients were studied by clinical investigation of MM and by transcranial magnetic stimulation testing of TI using evaluation of the ipsilateral silent period. MM were observed in 39% of ALS patients. There was a significant correlation between the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) and occurrence of MM (correlation coefficient -0.315; p = 0.044). In conclusion, all MM patients had pathological TI at least in one hemisphere, which indicates involvement of transcallosally projecting output neurons in ALS patients, which in turn may be an early feature of the disease process with the potential of a diagnostic biomarker.

  17. Lateral weathering gradients in glaciated catchments

    Science.gov (United States)

    McGuire, K. J.; Bailey, S. W.; Ross, D. S.; Strahm, B. D.; Schreiber, M. E.

    2016-12-01

    Mineral dissolution and the distribution of weathering products are fundamental processes that drive development and habitability of the Earth's critical zone; yet, the spatial configuration of these processes in some systems is not well understood. Feedbacks between hydrologic flows and weathering fluxes are necessary to understanding how the critical zone develops. In upland glaciated catchments of the northeastern USA, primary mineral dissolution and the distribution of weathering products are spatially distinct and predictable over short distances. Hillslopes, where shallow soils force lateral hydrologic fluxes through accumulated organic matter, produce downslope gradients in mineral depletion, weathering product accumulation, soil development, and solute chemistry. We propose that linked gradients in hydrologic flow paths, soil depth, and vegetation lead to predictable differences in the location and extent of mineral dissolution in regolith (soil, subsoil, and rock fragments) and bedrock, and that headwater catchments within the upland glaciated northeast show a common architecture across hillslopes as a result. Examples of these patterns and processes will be illustrated using observations from the Hubbard Brook Experimental Forest in New Hampshire where laterally distinct soils with strong morphological and biogeochemical gradients have been documented. Patterns in mineral depletion and product accumulation are essential in predicting how ecosystems will respond to stresses, disturbance, and management.

  18. Amyotrophic lateral sclerosis: one or multiple causes?

    Directory of Open Access Journals (Sweden)

    Aline Furtado Bastos

    2011-04-01

    Full Text Available The Amyotrophic lateral sclerosis (ALS is the most common form of motor neuron disease in the adulthood, and it is characterized by rapid and progressive compromise of the upper and lower motor neurons. The majority of the cases of ALS are classified as sporadic and, until now, a specific cause for these cases still is unknown. To present the different hypotheses on the etiology of ALS. It was carried out a search in the databases: Bireme, Scielo and Pubmed, in the period of 1987 to 2011, using the following keywords: Amyotrophic lateral sclerosis, motor neuron disease, etiology, causes and epidemiology and its similar in Portuguese and Spanish. It did not have consensus as regards the etiology of ALS. Researches demonstrates evidences as regards intoxication by heavy metals, environmental and occupational causes, genetic mutations (superoxide dismutase 1, certain viral infections and the accomplishment of vigorous physical activity for the development of the disease. There is still no consensus regarding the involved factors in the etiology of ALS. In this way, new research about these etiologies are necessary, for a better approach of the patients, promoting preventive programs for the disease and improving the quality of life of the patients.

  19. Laterally extended endopelvic resection (LEER)--principles and practice.

    Science.gov (United States)

    Höckel, Michael

    2008-11-01

    Exenteration has been used for the last 6 decades, mainly to treat cancers of the lower and middle female genital tract in the irradiated pelvis. New ablative techniques based on developmentally derived surgical anatomy termed laterally extended endopelvic resection (LEER) aim to increase the curative resection rate, even of tumors extending to and fixed to the pelvic side wall. LEER is performed as a combination of at least two of the following procedures: total mesorectal excision, total mesometrial resection, and total mesovesical resection. In cases of lateral tumor fixation, the inclusion of pelvic side wall and floor muscles, such as the obturator internus muscle and pubococcygeus, iliococcygeus and coccygeus muscles, and eventually of the internal iliac vessel system assures the completeness of the multicompartmental resection. One hundred patients with locally advanced (n=25) and recurrent (n=75) gynecologic tumors have been treated with these new procedures. In 76 patients, the tumors were fixed to the pelvic side wall. Two patients with advanced age and extensive comorbidity died during the early postoperative period. Moderate and severe treatment-related morbidity was 70%, mainly due to compromised healing of irradiated tissue and the performance of complex reconstructions. At a median follow-up period of 30 months (range, 1-136 months), 5-year recurrence-free and disease-specific overall survival probabilities are 62% (95% CI, 52-72%) and 55% (95% CI, 43-67%), respectively. LEER has significant potential to salvage selected patients with locally advanced and recurrent gynecologic malignancies, including those with pelvic side wall disease, traditionally not considered for surgical therapy.

  20. Lü Shengrong Competes Internationally

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    Little-known by her Chinese compatriots but wellknown in the international sports world, L(?) Shengrong,president of the International Badminton Federation (IBF) and member of the International Olympic Committee (IOC), has had a legendary career.

  1. MONJU AS AN INTERNATIONAL ASSET: INTERNATIONAL ASSISTANCE AND COOPERATION

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, G.; Wisner, R.S.; Stuart, R.

    2004-10-06

    The role of the fast breeder reactor prototype Monju has expanded to meet the challenges of the 21st century. Today instead of being merely a demonstration of an economical, safe, environmentally responsible source of energy, as originally designed, it has also the capability to be transformed into a unique International Irradiations Test Facility. The potential for Monju's role in the Generation IV nuclear energy systems development, and fast reactor research and development area is clear. Its incomparable fast neutron spectrum density will be a major interest not only for Sodium Fast Reactor but for all the Generation IV concepts. As Monju's potential future role is laid out, plans for future tests can be made. Tests of advanced fuels and materials in support of the Advanced Fuel Cycle Initiative, as well as Minor Actinide Burning can be envisaged. Tests planned on transmutation of minor actinides have the objectives of an industrial demonstration of the reduction of toxic wastes and the stewardship burden of the long-lived wastes. Tests and demonstrations carried out at Monju will provide a bridge from existing Generation III fast reactor systems, now in the later stages of their projected operational lifetimes, to Generation IV nuclear energy systems. The JNC founded the International Cooperation and Technology Development Center and the International Research Fellowship program to facilitate this international effort. The Center exists specifically to formulate and perform projects ensuring the maximum technical benefit from Monju. The staff includes physicists, engineers and nuclear industry leaders from around the world. Research Fellowships center is based on several technical areas: advanced instrumentation, inspection techniques, plant reliability and safety, nucleonics, sodium handling technologies, irradiation and experiment management and coordination and advanced post-irradiation examination capabilities and techniques. This paper describes

  2. Hypoadiponectinemia in overweight children contributes to a negative metabolic risk profile 6 years later

    DEFF Research Database (Denmark)

    Kynde, Iben; Heitmann, Berit L; Bygbjerg, Ib C;

    2009-01-01

    -density lipoprotein cholesterol ratio, serum triglycerides, systolic blood pressure, and the reciprocal value of fitness (maximum watts per kilogram). Overweight was defined using international classification of body mass index cutoff points for children. Plasma adiponectin, leptin, interleukin-8, and hepatocyte...... adiponectin at baseline was inversely associated with metabolic risk score 6 years later (P = .04). In childhood, both hypoadiponectinemia and hyperleptinemia accompany a negative metabolic risk profile. In addition, circulating plasma adiponectin may be a useful biomarker to identify overweight children...

  3. Lateral sacral artery supply to an intramedullary arteriovenous fistula at the conus medullaris

    Energy Technology Data Exchange (ETDEWEB)

    Mochizuki, T.; Nemoto, Y.; Inoue, Y.; Tashiro, T. (Osaka City Univ. Medical School (Japan). Dept. of Radiology); Sakanaka, H. (Osaka City Univ. Medical School (Japan). Dept. of Orthopedics)

    1991-10-01

    In this 25-year-old woman, severe low back pain, flaccid paraparesis, sensory disturbance of both legs and sphincter dysfunction resulted from an intramedullary conal arteriovenous malformation fed by an anterior spinal artery arising from the left sixth intercostal artery and by the left lateral sacral artery, a branch of the left internal iliac artery. Magnetic resonance (MR) images showed low signal (flow void) within an intramedullary mass that expanded the conus from T12 to L1. (orig./GDG).

  4. Potential Prognostic Benefit of Lateral Pelvic Node Dissection for Rectal Cancer Located Below the Peritoneal Reflection

    Science.gov (United States)

    Ueno, Hideki; Mochizuki, Hidetaka; Hashiguchi, Yojiro; Ishiguro, Megumi; Miyoshi, Masayoshi; Kajiwara, Yoshiki; Sato, Taichi; Shimazaki, Hideyuki; Hase, Kazuo

    2007-01-01

    Objective: To identify the parameters related to the effective selection of patients who could receive prognostic benefit from lateral pelvic node dissection. Background: Accurate preoperative diagnosis of lateral nodal involvement (LNI) remains difficult, and the indications for lateral lymph node dissection have been controversial. Patients and Methods: A total of 244 consecutive patients who underwent potentially curative surgery with lateral dissection for advanced lower rectal cancer (1985–2000) were reviewed. Patients were stratified into groups based on various parameters, and the therapeutic value index for survival benefit was compared among groups. The therapeutic index of lateral dissection was calculated by multiplying the frequency of metastasis to the lateral area and the cancer-related 5-year survival rate of patients with metastasis to the lateral area, irrespective of metastasis to other areas (mesorectal, superior rectal artery [SRA], and inferior mesenteric artery [IMA] areas). Results: LNI was observed in 41 patients (17%); and 88% of them had nodal involvement in the region along the internal iliac/pudendal artery or in the obturator region (“vulnerable field”). The cancer-related 5-year survival rate among the patients with LNI was 42%; the therapeutic index for lateral dissection was calculated as 7.0 patients, which was much higher than that of lymphadenectomy of the SRA area (1.6 patients) and the IMA area (0.4 patients), and almost comparable to that of lymphadenectomy of the upward mesorectal area (6.9 patients). Although it was possible to select groups at high and low risk for LNI based on several parameters related to tumor aggressiveness, such as tumor differentiation in biopsy specimens, the therapeutic value index was not significantly different between these groups. Unlike these parameters, the diameter of the largest lymph node in the “vulnerable field,” which was positively correlated with the rate of LNI but irrelevant

  5. Decision-Tree Formulation With Order-1 Lateral Execution

    Science.gov (United States)

    James, Mark

    2007-01-01

    A compact symbolic formulation enables mapping of an arbitrarily complex decision tree of a certain type into a highly computationally efficient multidimensional software object. The type of decision trees to which this formulation applies is that known in the art as the Boolean class of balanced decision trees. Parallel lateral slices of an object created by means of this formulation can be executed in constant time considerably less time than would otherwise be required. Decision trees of various forms are incorporated into almost all large software systems. A decision tree is a way of hierarchically solving a problem, proceeding through a set of true/false responses to a conclusion. By definition, a decision tree has a tree-like structure, wherein each internal node denotes a test on an attribute, each branch from an internal node represents an outcome of a test, and leaf nodes represent classes or class distributions that, in turn represent possible conclusions. The drawback of decision trees is that execution of them can be computationally expensive (and, hence, time-consuming) because each non-leaf node must be examined to determine whether to progress deeper into a tree structure or to examine an alternative. The present formulation was conceived as an efficient means of representing a decision tree and executing it in as little time as possible. The formulation involves the use of a set of symbolic algorithms to transform a decision tree into a multi-dimensional object, the rank of which equals the number of lateral non-leaf nodes. The tree can then be executed in constant time by means of an order-one table lookup. The sequence of operations performed by the algorithms is summarized as follows: 1. Determination of whether the tree under consideration can be encoded by means of this formulation. 2. Extraction of decision variables. 3. Symbolic optimization of the decision tree to minimize its form. 4. Expansion and transformation of all nested conjunctive

  6. Centrifuge modelling of lateral displacement of buried pipelines; Modelagem fisica centrifuga de flambagem lateral de dutos

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Jose Renato Moreira da Silva de; Almeida, Marcio de Souza Soares de; Marques, Maria Esther Soares; Almeida, Maria Cascao Ferreira de [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia (COPPE); Costa, Alvaro Maia da [PETROBRAS, Rio de Janeiro, RJ (Brazil). Centro de Pesquisas (CENPES)

    2003-07-01

    This work discusses soil-structure interaction applied to the buckling phenomena of buried pipelines subjected to heated oil flow. A set of physical modelling tests on lateral buckling of pipelines buried on soft clay is presented using COPPE/UFRJ geotechnical centrifuge. A 1:30 pipeline model was moved side ward through a soft clay layer during centrifuge flight, varying the burial depth, in order to simulate the lateral buckling in plane strain condition. The results show different behaviour concerning horizontal and vertical forces measured at pipeline level due to soil reaction. (author)

  7. Surveying your internal customers.

    Science.gov (United States)

    Weir, V L

    1998-06-01

    Internal customers often are overlooked when business techniques are applied. By applying common external customer satisfaction survey techniques to internal business functions, one hospital identified areas for improvement.

  8. Primary lateral sclerosis mimicking atypical parkinsonism

    DEFF Research Database (Denmark)

    Norlinah, Ibrahim M; Bhatia, Kailash P; Østergaard, Karen

    2007-01-01

    Primary lateral sclerosis (PLS), the upper motor neurone variant of motor neurone disease, is characterized by progressive spinal or bulbar spasticity with minimal motor weakness. Rarely, PLS may present with clinical features resembling parkinsonism resulting in occasional misdiagnosis as one...... of the atypical parkinsonian syndromes. Here we describe five patients initially referred with a diagnosis of levodopa-unresponsive atypical parkinsonism (n = 4) or primary progressive multiple sclerosis (n = 1), but subsequently found to have features consistent with PLS instead. Onset age varied from 49 to 67...... included emotional lability (n = 5) and cognitive impairment involving frontal subcortical systems (n = 1). In conclusion, these cases represent a subgroup of PLS patients in whom pyramidal slowness may be mistaken for akinesia, and spasticity misconstrued as rigidity, leading to an erroneous diagnosis...

  9. Therapeutic neuroprotective agents for amyotrophic lateral sclerosis

    Science.gov (United States)

    Pandya, Rachna S.; Zhu, Haining; Li, Wei; Bowser, Robert; Friedlander, Robert M.

    2014-01-01

    Amyotrophic lateral sclerosis (ALS) is a fatal chronic neurodegenerative disease whose hallmark is proteinaceous, ubiquitinated, cytoplasmic inclusions in motor neurons and surrounding cells. Multiple mechanisms proposed as responsible for ALS pathogenesis include dysfunction of protein degradation, glutamate excitotoxicity, mitochondrial dysfunction, apoptosis, oxidative stress, and inflammation. It is therefore essential to gain a better understanding of the underlying disease etiology and search for neuroprotective agents that might delay disease onset, slow progression, prolong survival, and ultimately reduce the burden of disease. Because riluzole, the only Food and Drug Administration (FDA)-approved treatment, prolongs the ALS patient’s life by only 3 months, new therapeutic agents are urgently needed. In this review, we focus on studies of various small pharmacological compounds targeting the proposed pathogenic mechanisms of ALS and discuss their impact on disease progression. PMID:23864030

  10. Amyotrophic lateral sclerosis: update and new developments

    Science.gov (United States)

    Pratt, Ashley J; Getzoff, Elizabeth D; Perry, J Jefferson P

    2012-01-01

    Amyotrophic lateral sclerosis (ALS) is the most common form of motor neuron disease. It is typically characterized by adult-onset degeneration of the upper and lower motor neurons, and is usually fatal within a few years of onset. A subset of ALS patients has an inherited form of the disease, and a few of the known mutant genes identified in familial cases have also been found in sporadic forms of ALS. Precisely how the diverse ALS-linked gene products dictate the course of the disease, resulting in compromised voluntary muscular ability, is not entirely known. This review addresses the major advances that are being made in our understanding of the molecular mechanisms giving rise to the disease, which may eventually translate into new treatment options. PMID:23019386

  11. A comprehensive review of amyotrophic lateral sclerosis

    Science.gov (United States)

    Zarei, Sara; Carr, Karen; Reiley, Luz; Diaz, Kelvin; Guerra, Orleiquis; Altamirano, Pablo Fernandez; Pagani, Wilfredo; Lodin, Daud; Orozco, Gloria; Chinea, Angel

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is a late-onset fatal neurodegenerative disease affecting motor neurons with an incidence of about 1/100,000. Most ALS cases are sporadic, but 5–10% of the cases are familial ALS. Both sporadic and familial ALS (FALS) are associated with degeneration of cortical and spinal motor neurons. The etiology of ALS remains unknown. However, mutations of superoxide dismutase 1 have been known as the most common cause of FALS. In this study, we provide a comprehensive review of ALS. We cover all aspects of the disease including epidemiology, comorbidities, environmental risk factor, molecular mechanism, genetic factors, symptoms, diagnostic, treatment, and even the available supplement and management of ALS. This will provide the reader with an advantage of receiving a broad range of information about the disease. PMID:26629397

  12. Motoneuron firing in amyotrophic lateral sclerosis (ALS

    Directory of Open Access Journals (Sweden)

    Mamede eDe Carvalho

    2014-09-01

    Full Text Available Amyotrophic lateral sclerosis is an inexorably progressive neurodegenerative disorder involving the classical motor system and the frontal effector brain, causing muscular weakness and atrophy, with variable upper motor neuron signs and often an associated fronto-temporal dementia. The physiological disturbance consequent on the motor system degeneration is beginning to be well understood. In this review we describe aspects of the motor cortical, neuronal and lower motor neuron dysfunction. We show how studies of the changes in the pattern of motor unit firing help delineate the underlying pathophysiological disturbance as the disease progresses. Such studies are beginning to illuminate the underlying disordered pathophysiological processes in the disease, and are important in designing new approaches to therapy and especially for clinical trials.

  13. Dichotic listening CV lateralization and developmental dyslexia.

    Science.gov (United States)

    Martínez, J A; Sánchez, E

    1999-08-01

    The present study was carried out on a sample of 125 right-handed boys who are described as follows: 50 boys with dyslexia, 50 controls of a similar age, and 25 controls according to reading level. Using an objective procedure based on regression, we selected three subgroups from among the poor readers: children with difficulties in the lexical pathway (surface dyslexics), children with difficulties in the sublexical pathway (phonological dyslexics), and children with problems in both pathways (mixed dyslexics). When the performances of these children on a dichotic listening task with CV syllables as stimuli were compared, it was found that although the children with dyslexia obtained lower lateralization indices than did the controls, the differences were only clearly significant when the most severe cases of phonological dyslexia were selected.

  14. Exchange coupling between laterally adjacent nanomagnets

    Science.gov (United States)

    Dey, H.; Csaba, G.; Bernstein, G. H.; Porod, W.

    2016-09-01

    We experimentally demonstrate exchange-coupling between laterally adjacent nanomagnets. Our results show that two neighboring nanomagnets that are each antiferromagnetically exchange-coupled to a common ferromagnetic bottom layer can be brought into strong ferromagnetic interaction. Simulations show that interlayer exchange coupling effectively promotes ferromagnetic alignment between the two nanomagnets, as opposed to antiferromagnetic alignment due to dipole-coupling. In order to experimentally demonstrate the proposed scheme, we fabricated arrays of pairs of elongated, single-domain nanomagnets. Magnetic force microscopy measurements show that most of the pairs are ferromagnetically ordered. The results are in agreement with micromagnetic simulations. The presented scheme can achieve coupling strengths that are significantly stronger than dipole coupling, potentially enabling far-reaching applications in Nanomagnet Logic, spin-wave devices and three-dimensional storage and computing.

  15. Amyotrophic lateral sclerosis associated with pregnancy.

    Directory of Open Access Journals (Sweden)

    Tyagi A

    2001-10-01

    Full Text Available Amyotrophic lateral sclerosis (ALS is the most common, progressive motor neurone disease but is rare in the obstetric population. Only 4 cases have been described in the English literature since 1975. We describe a 29 year old woman who presented with ataxia, lower limb weakness and dysarthria 4 weeks after the birth of her first child. The symptoms had onset during the pregnancy but had not been considered remarkable. There were clinical features of upper and lower motor neurone involvement without any sensory loss. MRI of brain and spine was normal. CSF analysis was negative. EMG studies confirmed the presence of widespread anterior horn cell dysfunction compatible with ALS. The patient was commenced on Riluzole and has progressed clinically, at 12 months post diagnosis.

  16. Lateral hypothalamic circuits for feeding and reward.

    Science.gov (United States)

    Stuber, Garret D; Wise, Roy A

    2016-02-01

    In experiments conducted over 60 years ago, the lateral hypothalamic area (LHA) was identified as a critical neuroanatomical substrate for motivated behavior. Electrical stimulation of the LHA induces voracious feeding even in well-fed animals. In the absence of food, animals will work tirelessly, often lever-pressing thousands of times per hour, for electrical stimulation at the same site that provokes feeding, drinking and other species-typical motivated behaviors. Here we review the classic findings from electrical stimulation studies and integrate them with more recent work that has used contemporary circuit-based approaches to study the LHA. We identify specific anatomically and molecularly defined LHA elements that integrate diverse information arising from cortical, extended amygdala and basal forebrain networks to ultimately generate a highly specified and invigorated behavioral state conveyed via LHA projections to downstream reward and feeding-specific circuits.

  17. Large-scale lateral nanowire arrays nanogenerators

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhong L; Xu, Chen; Qin, Yong; Zhu, Guang; Yang, Rusen; Hu, Youfan; Zhang, Yan

    2014-01-07

    In a method of making a generating device, a plurality of spaced apart elongated seen members are deposited onto a surface of a flexible non-conductive substrate. An elongated conductive layer is applied to a top surface and a first side of each seed member, thereby leaving an exposed second side opposite the first side. A plurality of elongated piezoelectric nanostructures is grown laterally from the second side of each seed layer. A second conductive material is deposited onto the substrate adjacent each elongated first conductive layer so as to be soupled the distal end of each of the plurality of elongated piezoelectric nanostructures. The second conductive material is selected so as to form a Schottky barrier between the second conductive material and the distal end of each of the plurality of elongated piezoelectric nanostructures and so as to form an electrical contact with the first conductive layer.

  18. Predicting masking release of lateralized speech

    DEFF Research Database (Denmark)

    Chabot-Leclerc, Alexandre; MacDonald, Ewen; Dau, Torsten

    2016-01-01

    al., 2013, J. Acoust. Soc. Am. 130], which uses a short-term equalization-cancellation process to model binaural unmasking. In the conditions where informational masking (IM) was involved, the predicted SRTs were lower than the measured values because the model is blind to confusions experienced......Locsei et al. (2015) [Speech in Noise Workshop, Copenhagen, 46] measured ˝ speech reception thresholds (SRTs) in anechoic conditions where the target speech and the maskers were lateralized using interaural time delays. The maskers were speech-shaped noise (SSN) and reversed babble with 2, 4, or 8...... talkers. For a given interferer type, the number of maskers presented on the target’s side was varied, such that none, some, or all maskers were presented on the same side as the target. In general, SRTs did not vary significantly when at least one masker was presented on the same side as the target...

  19. Dysarthria in amyotrophic lateral sclerosis: A review.

    Science.gov (United States)

    Tomik, Barbara; Guiloff, Roberto J

    2010-01-01

    Dysarthria is a motor disorder of speech characterized by abnormalities of the articulation and intelligibility of speech. Phonation and the rate of facial movements may also be affected. Understanding the nature and course of dysarthria in amyotrophic lateral sclerosis (ALS) is important because loss of communication prevents patients from participating in many activities, may lead to social isolation, and reduces the quality of life. The goal of management of dysarthria in ALS patients is to optimize communication effectiveness for as long as possible. The information about dysarthria in ALS is dispersed in physiological, pathological, speech therapy, otorhinolaringological and neurological publications. This review summarizes the current state of knowledge on the clinical features, differential diagnosis, pathophysiology, investigations and management of dysarthria in ALS patients. There is a need to compare the different methods used to assess dysarthria and for controlled clinical trials to assess therapeutic strategies.

  20. Analysis of flexible structures under lateral impact

    Energy Technology Data Exchange (ETDEWEB)

    Ramirez, D. F. [Paul C. Kizzo and Associates Inc., Seismic Structural Group, Oakland, CA 94612 (United States); Razavi, H. [AREVA Inc., Civil Seismic Group, San Jose, CA 95119 (United States)

    2012-07-01

    Three methods for analysis of flexible structures under lateral impact are presented. The first proposed method (Method A) consists of: (1) modifying an available deceleration on a rigid target with conservation principles to account for structural flexibility; and (2) transient nonlinear analysis of the structure with the corrected forcing function. The second proposed method (Method B) is similar to Method A in obtaining the forcing function but it solves the equations of motion of an idealized two-degree-of-freedom system instead of directly using conservation principles. The last method simply provides the maximum force in the structure using the conservation of energy and linear momentum. A coupled simulation is also performed in LS-DYNA and compared against the proposed methods. A case study is presented to illustrate the applicability of all three methods and the LS-DYNA simulation. (authors)

  1. [Amyotrophic lateral sclerosis and respiratory insufficiency].

    Science.gov (United States)

    Siirala, Waltteri; Korpela, Jaana; Vuori, Arno; Saaresranta, Tarja; Olkkola, Klaus T; Aantaa, Riku

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is a disease causing degeneration of motor neurons, without any curative treatment. The most common cause of death is respiratory arrest due to atrophy of the respiratory musculature. ALS-associated respiratory insufficiency differs in mechanism from the more common causes of dyspnea, such as diseases of pulmonary or cardiac origin. Recognizing the respiratory insufficiency can be challenging for a clinician. It should be possible to predict the development of respiratory insufficiency in order to avoid leaving the treatment decisions concerning respiratory insufficiency to emergency services. Noninvasive ventilatory support can be used to alleviate the patient's dyspnea. It is actually recommended as the first-line treatment of ALS-associated respiratory insufficiency.

  2. Amyotrophic lateral sclerosis associated with pregnancy.

    LENUS (Irish Health Repository)

    Tyagi, A

    2012-02-03

    Amyotrophic lateral sclerosis (ALS) is the most common, progressive motor neurone disease but is rare in the obstetric population. Only 4 cases have been described in the English literature since 1975. We describe a 29 year old woman who presented with ataxia, lower limb weakness and dysarthria 4 weeks after the birth of her first child. The symptoms had onset during the pregnancy but had not been considered remarkable. There were clinical features of upper and lower motor neurone involvement without any sensory loss. MRI of brain and spine was normal. CSF analysis was negative. EMG studies confirmed the presence of widespread anterior horn cell dysfunction compatible with ALS. The patient was commenced on Riluzole and has progressed clinically, at 12 months post diagnosis.

  3. A comprehensive review of amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Sara Zarei

    2015-01-01

    Full Text Available Amyotrophic lateral sclerosis (ALS is a late-onset fatal neurodegenerative disease affecting motor neurons with an incidence of about 1/100,000. Most ALS cases are sporadic, but 5-10% of the cases are familial ALS. Both sporadic and familial ALS (FALS are associated with degeneration of cortical and spinal motor neurons. The etiology of ALS remains unknown. However, mutations of superoxide dismutase 1 have been known as the most common cause of FALS. In this study, we provide a comprehensive review of ALS. We cover all aspects of the disease including epidemiology, comorbidities, environmental risk factor, molecular mechanism, genetic factors, symptoms, diagnostic, treatment, and even the available supplement and management of ALS. This will provide the reader with an advantage of receiving a broad range of information about the disease.

  4. [Dysphagia with lateral medullary infarction (Wallenberg's syndrome)].

    Science.gov (United States)

    Oshima, Fumiko

    2011-11-01

    Dysphagia after lateral medullary infarction (LMI) is common. The dysphagia of LMI is dynamically characterized by a failure in triggering of the pharyngeal-phase swallowing movements, reduced output, and lack of coordination (swallowing pattern abnormality). Based on accurate evaluation, we can select suitable rehabilitative approaches for individual patients, including respiratory therapy, food modification, postural changes, and oral care. We focused on the absence of upper esophageal sphincter (UES) opening of the unaffected side of the medullae. The movement pattern was defined as failure of bolus passage through the intact side of the UES, occurring at least once during the videofluorographic evaluation of each individual. Three abnormal patterns of UES opening were classified. The passage pattern abnormality shows the failure of the stereotyped motor sequence. For severe cases, it is necessary to consider long-term treatment, including botulinum toxin injection or surgery to prevent aspiration and adequate nutritional management.

  5. EAS-BUAP: Lateral Distribution and Performance

    Science.gov (United States)

    Salazar, H.; Martinez, O.; Cotzomi, J.; Moreno, E.; Aguilar, S.; Villaseñor, L.

    2003-07-01

    We describe the operation and performance of the first stage of the EAS-UAP extensive air shower array, as a detector of very high energy cosmic rays (Eo > 1014eV) after one year of operation. The array is located at the Campus of Puebla University, 2200 m above sea level. It consists of 10 liquid scintillator detectors, each with an active surface of 1 m2 and a detector spacing of 20 m in a square grid. One Auger Water Cherenkov detector is also included as part of the array. In this report we discuss the stability, the calibration and lateral distribution function reconstruction capabilities of the detector array. We also present the analysis of the shower size spectrum. In addition, the main characteristics of this array allow us to use it as an educational and training facility.

  6. Management of patients with amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Andrea Calvo

    2008-09-01

    Full Text Available Amyotrophic lateral sclerosis (ALS is a progressive, fatal, neurodegenerative disease caused by the degeneration of motor neurons. We report a case of a 45-years-old patient with ALS to underline difficulties and challenges in ALS management. Even though ALS remains fatal, several advances have been made in improving the consequences of this disease: symptomatic treatments have an important role in controlling sialorrhea, bronchial secretions, pseudobulbar emotional lability, cramps, spasticity, depression and anxiety, insomnia and pain. An adequate management of ALS should be multidisciplinar, involving not only the neurologist, but also family physicians and many other specialists, such as pulmonologist, rehabilitation medicine physician, speech therapist, dietitian and psychologist. The multidisciplinary approach should be aimed at relieving specific problems associated with the disability of single patients and improving their quality of life.

  7. Electrodiagnosis in persons with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Joyce, Nanette C; Carter, Gregory T

    2013-05-01

    Electrophysiology remains an important tool in the evaluation of patients presenting with signs and symptoms of motor neuron disease. The electrodiagnostic study should include peripheral nerve conduction studies and needle electromyography to both exclude treatable disease and gather evidence regarding a diagnosis of amyotrophic lateral sclerosis (ALS). The recent changes in the revised El Escorial criteria, recommended by the Awaji-shima consensus group, have increased the diagnostic significance of fasciculation potentials to equal that of fibrillation and positive sharp-wave potentials in the needle electromyography examination of patients suspected of having ALS. In addition, electrophysiologic evidence is now considered equivalent to clinical signs and symptoms in reaching a diagnostic certainty of ALS. These changes, strategies for the design, and implementation of an effective electrodiagnostic evaluation, in addition to electrophysiologic techniques and their relationship to the evaluation of a patient with ALS, are reviewed and discussed.

  8. Numerical methods of microirrigation lateral design

    Directory of Open Access Journals (Sweden)

    Kettab A.

    2002-01-01

    Full Text Available The present work contributes to the hydraulic analysis of the lateral microirrigation by using the numerical methods: the control volumes method “CVM” and the Runge-Kutta method “RK4”. These methods are relatively simple to manipulate and agree to the use of the partial differential equations of the first order. The CVM method warrants to follow the hydraulic phenomenon step by step and facilitates iterative development; whereas, the RK4 method is used in the integration and the solution of the differential equations system. The risk of divergence, as the slowness of the computation is avoided by the recourse to the interpolation using the polynomial of Lagrange in order to accelerate the convergence toward the solution. The models of calculation used have the advantage to be simple, fast, precise, and allow their extension to large microirrigation network.

  9. Lateral pupil alignment tolerance in peripheral refractometry.

    Science.gov (United States)

    Fedtke, Cathleen; Ehrmann, Klaus; Ho, Arthur; Holden, Brien A

    2011-05-01

    To investigate the tolerance to lateral pupil misalignment in peripheral refraction compared with central refraction. A Shin-Nippon NVision-K5001 open-view auto-refractor was used to measure central and peripheral refraction (30° temporal and 30° nasal visual field) of the right eyes of 10 emmetropic and 10 myopic participants. At each of the three fixation angles, five readings were recorded for each of the following alignment positions relative to pupil center: centrally aligned, 1 and 2 mm temporally aligned, and 1 and 2 mm nasally aligned. For central fixation, increasing dealignment from pupil center produced a quadratic decrease (r ≥ 0.98, p < 0.04) in the refractive power vectors M and J180 which, when interpolated, reached clinical significance (i.e., ≥ 0.25 diopter for M and ≥ 0.125 diopter for J180 and J45) for an alignment error of 0.79 mm or greater. M and J180 as measured in the 30° temporal and 30° nasal visual field led to a significant linear correlation (r ≥ 0.94, p < 0.02) as pupil dealignment gradually changed from temporal to nasal. As determined from regression analysis, a pupil alignment error of 0.20 mm or greater would introduce errors in M and J180 that are clinically significant. Tolerance to lateral pupil alignment error decreases strongly in the periphery compared with the greater tolerance in central refraction. Thus, precise alignment of the entrance pupil with the instrument axis is critical for accurate and reliable peripheral refraction.

  10. Risk factors for amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Ingre C

    2015-02-01

    Full Text Available Caroline Ingre,1 Per M Roos,2 Fredrik Piehl,1 Freya Kamel,3 Fang Fang4 1Department of Clinical Neuroscience, 2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; 3Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA; 4Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Abstract: Amyotrophic lateral sclerosis (ALS is the most common motor neuron disease. It is typically fatal within 2–5 years of symptom onset. The incidence of ALS is largely uniform across most parts of the world, but an increasing ALS incidence during the last decades has been suggested. Although recent genetic studies have substantially improved our understanding of the causes of ALS, especially familial ALS, an important role of non-genetic factors in ALS is recognized and needs further study. In this review, we briefly discuss several major genetic contributors to ALS identified to date, followed by a more focused discussion on the most commonly examined non-genetic risk factors for ALS. We first review factors related to lifestyle choices, including smoking, intake of antioxidants, physical fitness, body mass index, and physical exercise, followed by factors related to occupational and environmental exposures, including electromagnetic fields, metals, pesticides, β-methylamino-L-alanine, and viral infection. Potential links between ALS and other medical conditions, including head trauma, metabolic diseases, cancer, and inflammatory diseases, are also discussed. Finally, we outline several future directions aiming to more efficiently examine the role of non-genetic risk factors in ALS. Keywords: amyotrophic lateral sclerosis, risk factors, genetics, lifestyle, environment

  11. GENETIC FACTORS ASSOCIATED WITH AMYOTROPHIC LATERAL SCLEROSIS

    Directory of Open Access Journals (Sweden)

    Katarina Vrabec

    2015-10-01

    Full Text Available Amyotrophic lateral sclerosis (ALS is a rare complex neurodegenerative disease characterized by degeneration of motor neurons in the cerebral cortex, brainstem and spinal cord. The disease mainly occurs in adults, typically between 50. and 60. years and presents with symptoms like muscular weakness, atrophy and later on paralysis which lead to death due to respiratory failure within 2-5 years from onset and remains incurable. The symptoms typically start in the muscles of arms or legs (spinal onset or bulbary (bulbar onset. Most ALS cases are sporadic although about 5% are familiar. Genetic factors contribute to the disease in sporadic form as well as in familial form. Mutations have been found in 116 genes among which SOD1, TARDBP, FUS and C9ORF72 are represented in highest frequencies. Besides those four genes we are also describing 13 other genes involved in the disease process. Oligogenic model has been proposed for ALS that considers mutations in two or more genes in one patient. We emphasize the convergence between hereditary and sporadic form, which are clinically inseparable, and other neurodegenerative diseases that share with ALS genetic and clinical characteristics. Because about 2/3 of familial cases and only about 11% of sporadic cases are explained by mutations the research have been aimed at discovering new candidate genes using  genome –wide association studies and at the epigenetic causes of the disease. We have recently completed the first representative genetic analysis of patients with ALS in Slovenia and research on methylation and microRNAs is currently in progress.

  12. Early Pavlovian conditioning impairs later Pavlovian conditioning.

    Science.gov (United States)

    Lariviere, N A; Spear, N E

    1996-11-01

    Four experiments tested the effects in the rat of very early experience with stimuli to be used later for Pavlovian conditioning. Beginning on postnatal Day 12, prior to the development of substantial detection and effective perception of visual and auditory stimuli, rats were given five daily experiences with either lights or tones and a footshock known to be an effective unconditioned stimulus at these ages. Twenty-four hours after the last of these experiences, pairings of either the light or tone and the unconditioned stimulus were given with parameters established to yield a moderate degree of conditioning in untreated preweanlings (Experiment 1). Experiment 2 determined that early experience with paired or unpaired presentations of either the light or tone and the unconditioned stimulus resulted in a failure to condition to these same lights or tones on postnatal Day 17, although nontreated pups from the same litters conditioned quite effectively. Experiment 3 determined that this early conditioning experience with either paired or unpaired presentations of the lights or tones and the unconditioned stimulus yielded impaired conditioning on postnatal Day 17 in the alternative sensory modality as well, although again nontreated siblings conditioned quite effectively. Experiment 4 replicated the results of each of Experiments 2 and 3 and determined in addition that despite the impairment in conditioning that resulted from early paired or unpaired experience with the stimuli of conditioning, early experience with the individual stimuli of conditioning-with only the CS, the US, or the context-did not result in a similar impairment in conditioning. Although the results were unexpected, they may be understood in part in terms of intersensory competition during development, and there is precedent in the literature for similar interfering effects of early learning on later learning in a variety of species.

  13. Terapia manual en epicondalgia lateral (revisión sistemática Manual therapy in lateral epicondylalgia (systematic review

    Directory of Open Access Journals (Sweden)

    R.A. Aguilera Eguía

    2009-03-01

    rehabilitation is based on clinical experience and on the treatment of the physical limitations found during the clinical examination. The main physical limitation in LE is lack of grip strength due to pain, leading to motor function impairment. Multiple treatments have been proposed in the literature (complementary therapies, physiotherapy, drug treatment, manual therapy, surgery but most are lacking an evidence base to support their use. The aim of the present study was to select the clinical interventions in manual therapy with the highest level of evidence for the treatment of LE. A search was made of Pubmed, Cochcrane, National Guideline Clearinghouse, NHS Guidelines Finder, and CMA infobase for meta-analyses, randomized clinical trials and clinical trials. To evaluate the internal validity of each of the selected studies, the Physiotherapy Evidence Database (PEDro scale was applied and the level of evidence was subsequently classified according to the scale of the Centre for Evidence-Based Medicine in Oxford. One randomized clinical trial and one randomized pilot study met the inclusion and exclusion criteria. There is level 1B evidence with level A recommendation for the use of the lateral glide and wrist manipulation techniques for the treatment of chronic unilateral epicondylalgia.

  14. Collaboration enhances later individual memory for emotional material

    NARCIS (Netherlands)

    Bärthel, Gwennis A; Wessel, Ineke; Huntjens, Rafaële J C; Verwoerd, Johan

    2017-01-01

    Research on collaborative remembering suggests that collaboration hampers group memory (i.e., collaborative inhibition), yet enhances later individual memory. Studies examining collaborative effects on memory for emotional stimuli are scarce, especially concerning later individual memory. In the

  15. Epigenesis of behavioural lateralization in humans and other animals

    NARCIS (Netherlands)

    Schaafsma, S. M.; Riedstra, B. J.; Pfannkuche, K. A.; Bouma, A.; Groothuis, T. G. G.

    2009-01-01

    Despite several decades of research, the epigenesis of behavioural and brain lateralization is still elusive, although its knowledge is important in understanding developmental plasticity, function and evolution of lateralization, and its relationship with developmental disorders. Over the last deca

  16. Review on Mutation in Lateral Root of Rice

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xia; ZHANG Da; HAO Zaibin

    2011-01-01

    Rice roots include seminal roots, adventitious roots, lateral roots and root hairs, At present, progresses in the research of rice roots have been achieved in many aspects, such as root morphology, root activity, root reaction to various environmental factors as a contribution of root growth and rice yield, the relationship between root growth and stems/leaves/flowers/rice, genetic laws of root characters, etc. However, there are very few researches on lateral root mutant. This paper reviewed progresses of the lateral root mutant of rice from the perspectives of phytomorphology to plant physiology and biochemistry to the gene mapping, consisting of mechanism of developing lateral root of rice, gene cloning and functional analysis of lateral root development, the relationship between auxin and lateral roots, agronomic traits of lateral roots mutant, structure and morphology of root hairs, gravity anomaly of root, redox metabolism and proteomics researches of the mutation in lateral root of rice.

  17. JPRS Report, Soviet Union, International Affairs.

    Science.gov (United States)

    2007-11-02

    Shchekin, a pensioner from.Lyskovo City, asks: Why is Article 12 of the International Pact of Civil and Political Rights and Article 13 of the General...go, but they could cut my pension , and quite considerably. And so he came here much later. There you have so to speak if you please a specific...scientific production association, Sistema . Specialists and managers of metrology services and scientists coordinated their actions in the creation and

  18. Childhood laterality and adult schizophrenia spectrum disorders: a prospective investigation

    DEFF Research Database (Denmark)

    Schiffman, Jason; Pestle, Sarah; Mednick, Sara

    2005-01-01

    Left or mixed-handedness, footedness, and eye dominance are thought to indicate abnormalities in lateralization related to schizophrenia. Increased left or mixed-dominance in schizophrenia suggests possible hemispheric abnormalities associated with the disorder. A related body of research suggests...... that some indications of lateralization abnormalities may be evident prior to the onset of schizophrenia, suggesting that disruptions in lateralization are inherent to the developmental course of the disorder. We attempted to replicate and extend upon findings indicating differences in lateralization...

  19. Adsorption kinetics of laterally and polarly flagellated Vibrio.

    OpenAIRE

    Belas, M R; Colwell, R.R.

    1982-01-01

    The adsorption of laterally and polarly flagellated bacteria to chitin was measured, and from the data obtained, a modified Langmuir adsorption isotherm was derived. Results indicated that the adsorption of laterally flagellated Vibrio parahaemolyticus follows the Langmuir adsorption isotherm, a type of adsorption referred to as surface saturation kinetics, when conditions are favorable for the production of lateral flagella. When conditions were not favorable for the production of lateral fl...

  20. The International Criminal Court

    DEFF Research Database (Denmark)

    Damgaard, Ciara Therése

    This article considers whether acts of international terrorism can and should be prosecuted before the International Criminal Court as crimes against humanity.......This article considers whether acts of international terrorism can and should be prosecuted before the International Criminal Court as crimes against humanity....

  1. International Engagement Strategy

    Science.gov (United States)

    2017-06-14

    INTERNATIONAL ENGAGEMENT STRATEGY STATEMENT OF PURPOSE The U.S. Department of Homeland Security (DHS) Science and Technology Directorate (S&T... International Engagement Strategy is intended to establish clear goals and objectives to guide S&T’s international cooperative research, development... International Engagement Strategy, the 2015 White House National Security Strategy, the 2014 Quadrennial Homeland Security Review, and the DHS Fiscal

  2. The Internal Audit Outsourcing

    Directory of Open Access Journals (Sweden)

    Grzegorz Gołębiowski

    2010-06-01

    Full Text Available The article explores an issue of the internal audit outsourcing. It indicates the differences between internal audit, outsourcing and cosourcing of this service as well as their advantages and disadvantages. Drawing from the research on internal audit outsourcing the recent market trends were identified as well as motivations for choosing different forms of internal auditing.

  3. Neural correlates of cognitive set shifting in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Lange, Florian; Lange, Christian; Joop, Max; Seer, Caroline; Dengler, Reinhard; Kopp, Bruno; Petri, Susanne

    2016-12-01

    Amyotrophic lateral sclerosis (ALS) has been associated with executive dysfunction, particularly in the domain of cognitive set shifting. In a recent event-related potential (ERP) study, shifting-related cortical activity on a complex set-shifting paradigm was found to be attenuated in patients with ALS. Here, we investigated whether this ERP change could also be observed in a simplified set-shifting task adapted for potential clinical use, and in ALS patients without overt cognitive impairment. Twenty-six patients and 28 matched healthy controls (HC) completed a set-shifting paradigm involving two task rules and explicit task cues. Cue-locked ERPs were analyzed. ALS patients and HC did not differ in response latency or accuracy. In HC, cues that required shifting task rules elicited more positive parietal ERP waveforms than cues that signaled a rule repetition. This shifting-related amplitude modulation was absent in patients with ALS. The attenuation of ERP activity in ALS patients remained significant when participants with possible cognitive impairment were excluded. Electrophysiological measures can detect ALS-related changes in the neural substrates of set shifting even when these changes do not become apparent in neuropsychological assessment. These findings illustrate the potential utility of ERPs as indicators of cognitive change in ALS. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  4. Laterally assembled nanowires for ultrathin broadband solar absorbers.

    Science.gov (United States)

    Song, Kyung-Deok; Kempa, Thomas J; Park, Hong-Gyu; Kim, Sun-Kyung

    2014-05-05

    We studied optical resonances in laterally oriented Si nanowire arrays by conducting finite-difference time-domain simulations. Localized Fabry-Perot and whispering-gallery modes are supported within the cross section of each nanowire in the array and result in broadband light absorption. Comparison of a nanowire array with a single nanowire shows that the current density (J(SC)) is preserved for a range of nanowire morphologies. The J(SC) of a nanowire array depends on the spacing of its constituent nanowires, which indicates that both diffraction and optical antenna effects contribute to light absorption. Furthermore, a vertically stacked nanowire array exhibits significantly enhanced light absorption because of the emergence of coupled cavity-waveguide modes and the mitigation of a screening effect. With the assumption of unity internal quantum efficiency, the J(SC) of an 800-nm-thick cross-stacked nanowire array is 14.0 mA/cm², which yields a ~60% enhancement compared with an equivalent bulk film absorber. These numerical results underpin a rational design strategy for ultrathin solar absorbers based on assembled nanowire cavities.

  5. Individual performance and leader's laterality in interactive contests.

    Science.gov (United States)

    Mukherjee, Satyam

    2017-05-01

    Left-handedness is known to provide an intrinsic and tactical advantage at top level in many sports involving interactive contests. Again, most of the renowned leaders of the world are known to have been left-handed. Leadership plays an important role in politics, sports and mentorship. In this paper we show that Cricket captains who bat left-handed have a strategic advantage over the right-handed captains in One Day International (ODI) and Test matches. The present study involving 46 left-handed captains and 148 right-handed captains in ODI matches, reveal a strong relation between leader's laterality and team member performance, demonstrating the critical importance of left-handedness and successful leadership. The odds for superior batting performance in an ODI match under left-handed captains are 89% higher than the odds under right-handed captains. Our study shows that left-handed captains are more successful in extracting superior performance from the batsmen and bowlers in ODI and Test matches; perhaps indicating left-handed leaders are better motivators as leaders when compared to right-handed captains.

  6. The Relationship Between Lateral Dominance and Divergent Cognitive Thought.

    Science.gov (United States)

    Williams, Barbara B.

    This study was designed to explore the relationship of lateral dominance to divergent cognitive thought. According to the screening results of the Harris Tests of Lateral Dominance, 36 subjects ranging from 9-12 years were divided equally into three groups of left, right, and mixed lateral dominance. In order to measure divergent cognitive…

  7. Sex Differences in Cerebral Laterality of Language and Visuospatial Processing

    Science.gov (United States)

    Clements, A. M.; Rimrodt, S. L.; Abel, J. R.; Blankner, J. G.; Mostofsky, S. H.; Pekar, J. J.; Denckla, M. B.; Cutting, L. E.

    2006-01-01

    Sex differences on language and visuospatial tasks are of great interest, with differences in hemispheric laterality hypothesized to exist between males and females. Some functional imaging studies examining sex differences have shown that males are more left lateralized on language tasks and females are more right lateralized on visuospatial…

  8. Is performance better when brain functions are typically lateralized?

    NARCIS (Netherlands)

    Geuze, Reint; Zickert, Nele; Beking, Tess; Groothuis, Antonius

    2014-01-01

    Lateralization refers to the dominant involvement of one homologous region of the brain over the other in functional task performance. Direction and strength of lateralization depend on the functional task. It is well known that language is lateralized to the left hemisphere, even in most left-hande

  9. Anatomical Knee Variants in Discoid Lateral Meniscal Tears

    Science.gov (United States)

    Chen, Xu-Xu; Li, Jian; Wang, Tao; Zhao, Yang; Kang, Hui

    2017-01-01

    Background: Discoid lateral meniscus was a common meniscal dysplasia and was predisposed to tear. There were some anatomical knee variants in patients with discoid lateral meniscus. The aim of this study was to analyze the relationship between anatomical knee variants and discoid lateral meniscal tears. Methods: There were totally 125 cases of discoid lateral meniscus enrolled in this study from February 2008 to December 2013. Eighty-seven patients who underwent arthroscopic surgery for right torn discoid lateral meniscus were enrolled in the torn group. An additional 38 patients who were incidentally identified as having intact discoid lateral menisci on magnetic resonance imaging (MRI) findings were included in the control group. All patients were evaluated for anatomical knee variants on plain radiographs, including lateral joint space distance, height of the lateral tibial spine, height of the fibular head, obliquity of the lateral tibial plateau, squaring of the lateral femoral condyle, cupping of the lateral tibial plateau, lateral femoral condylar notch, and condylar cutoff sign. The relationship between anatomical variants and meniscal tear was evaluated. These anatomical variants in cases with complete discoid meniscus were also compared with those in cases with incomplete discoid meniscus. Results: There were no significant differences between the two groups in lateral joint space distance (P = 0.528), height of the lateral tibial spine (P = 0.927), height of the fibular head (P = 0.684), obliquity of the lateral tibial plateau (P = 0.672), and the positive rates of squaring of the lateral femoral condyle (P = 0.665), cupping of the lateral tibial plateau (P = 0.239), and lateral femoral condylar notch (P = 0.624). The condylar cutoff sign was significantly different between the two groups, with the prominence ratio in the torn group being smaller than that in the control group (0.74 ± 0.11 vs. 0.81 ± 0.04, P = 0.049). With the decision value of the

  10. Age at first childbirth and later poverty.

    Science.gov (United States)

    Moore, K A; Myers, D E; Morrison, D R; Nord, C W; Brown, B; Edmonston, B

    1993-01-01

    A linear structural equation model is used in this research study in order to estimate the simultaneous effects of age at first birth on a woman's subsequent socioeconomic conditions and related outcomes after the age of 27 years. Estimation was accomplished with a variant of Amemiya's principle and a feasible generalized least squares estimator. Analysis involved examination of the bivariate relationship between age at first birth and poverty at age 27 years for Blacks, Hispanics, and Whites, followed by structural equation models for each racial group and then analysis of the total and indirect effects of age at first birth on poverty. Poverty is measured as the ratio of family income to the poverty threshold. Findings indicate that the association between early childbearing and poverty at the age of 27 years is very strong. Young women with educated parents and women with reading materials in their home before the age of 14 years achieved more schooling. When these effects were controlled, being raised by both parents and having more siblings were only associated with more schooling among Whites. Rural Blacks and Whites completed more schooling than rural Hispanics. Blacks in poor states had lower educational attainment. Age at first birth was only significant among Hispanics. First birth was delayed by 1.26 years among Blacks, 0.88 years among Whites, and 0.98 years among Hispanics for having an additional year of schooling. Delaying marriage had the strongest effect among Whites. Delayed childbearing among Blacks was predicted by having fewer siblings, being raised by both parents, and later menstruation. Earlier White childbearing was associated with women from larger families and women with larger ideal family sizes. Hispanic women raised by both parents was associated with delayed childbearing. Findings confirm that age at first birth was associated for all racial groups with poverty. Age at first birth affected educational attainment of Hispanics and age

  11. Efferent connections from the lateral hypothalamic region and the lateral preoptic area to the hypothalamic paraventricular nucleus of the rat

    DEFF Research Database (Denmark)

    Larsen, P J; Hay-Schmidt, Anders; Mikkelsen, J D

    1994-01-01

    area within the lateral hypothalamic region that consistently innervated magnocellular perikarya of the PVN. Finally, all areas of the lateral hypothalamic region contributed substantially to fibres terminating in the perinuclear shell of the PVN. These results demonstrate that anatomically distinct...

  12. 26 CFR 1.101-4 - Payment of life insurance proceeds at a date later than death.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Payment of life insurance proceeds at a date... Income § 1.101-4 Payment of life insurance proceeds at a date later than death. (a) In general. (1)(i... those to which section 101(c) applies) received under a life insurance contract and paid by reason...

  13. Lateral Scapular Slide Test and Scapular Mobility in Volleyball Players

    Science.gov (United States)

    Ozunlu, Nihan; Tekeli, Hatice; Baltaci, Gul

    2011-01-01

    Context: The stability of the scapula in relation to the entire moving upper extremity is the key in the throwing sequence. The importance of scapular positioning in volleyball players has been well documented in the literature, but no one has compared scapular positioning between volleyball players and sedentary people. Objective: To compare measurements of scapular mobility obtained using the lateral scapular slide test between volleyball players and sedentary participants without shoulder impairments and to compare changes in scapular mobility in players according to the number of years of sport participation. Design: Cross-sectional study. Setting: University research laboratory. Patients or Other Participants: A total of 121 people at a single university volunteered. Of these, 67 were sedentary (age = 24.3 ± 2.34 years, height = 1.69 ± 0.09 m, mass = 65.1 ± 11.91 kg); 54 were volleyball players from 4 professional teams and were separated into 2 groups according to their years of sport participation. The first group was named young players (n = 31; age = 17.7 ± 2.58 years, height = 1.83 ± 0.10 m, mass = 68.3 ± 12.21 kg, sport participation ≤ 9 years), and the second group was named old players (n = 23; age = 26.9 ± 3.39 years, height = 1.95 ± 4.38 m, mass = 90.7 ± 5.75 kg, sport participation ≥ 10 years). Main Outcome Measure(s): Study participants completed a rating scale for pain and a questionnaire about demographic and shoulder problems. One assessor performed the lateral scapular slide test and additional flexibility measurements around the shoulder girdle. Flexibility (external rotation, internal rotation) and scapular position (1, 2, 3) were compared among groups (young players, old players, sedentary people) and between sides (dominant, nondominant). Results: In sedentary participants, we found differences for position 1 (t66 = 3.327, P = .002), position 2 (t66 = 2.491, P = .004), position 3 (t66 = 2.512, P = .006), and internal rotation

  14. Implicit Recognition Based on Lateralized Perceptual Fluency

    Directory of Open Access Journals (Sweden)

    Iliana M. Vargas

    2012-02-01

    Full Text Available In some circumstances, accurate recognition of repeated images in an explicit memory test is driven by implicit memory. We propose that this “implicit recognition” results from perceptual fluency that influences responding without awareness of memory retrieval. Here we examined whether recognition would vary if images appeared in the same or different visual hemifield during learning and testing. Kaleidoscope images were briefly presented left or right of fixation during divided-attention encoding. Presentation in the same visual hemifield at test produced higher recognition accuracy than presentation in the opposite visual hemifield, but only for guess responses. These correct guesses likely reflect a contribution from implicit recognition, given that when the stimulated visual hemifield was the same at study and test, recognition accuracy was higher for guess responses than for responses with any level of confidence. The dramatic difference in guessing accuracy as a function of lateralized perceptual overlap between study and test suggests that implicit recognition arises from memory storage in visual cortical networks that mediate repetition-induced fluency increments.

  15. Molecular Motor Proteins and Amyotrophic Lateral Sclerosis

    Directory of Open Access Journals (Sweden)

    Manal Farg

    2011-12-01

    Full Text Available Amyotrophic lateral sclerosis (ALS is a neurodegenerative disorder affecting motor neurons in the brain, brainstem and spinal cord, which is characterized by motor dysfunction, muscle dystrophy and progressive paralysis. Both inherited and sporadic forms of ALS share common pathological features, however, the initial trigger of neurodegeneration remains unknown. Motor neurons are uniquely targeted by ubiquitously expressed proteins in ALS but the reason for this selectively vulnerability is unclear. However motor neurons have unique characteristics such as very long axons, large cell bodies and high energetic metabolism, therefore placing high demands on cellular transport processes. Defects in cellular trafficking are now widely reported in ALS, including dysfunction to the molecular motors dynein and kinesin. Abnormalities to dynein in particular are linked to ALS, and defects in dynein-mediated axonal transport processes have been reported as one of the earliest pathologies in transgenic SOD1 mice. Furthermore, dynein is very highly expressed in neurons and neurons are particularly sensitive to dynein dysfunction. Hence, unravelling cellular transport processes mediated by molecular motor proteins may help shed light on motor neuron loss in ALS.

  16. Controversies and priorities in amyotrophic lateral sclerosis

    Science.gov (United States)

    Turner, Martin R; Hardiman, Orla; Benatar, Michael; Brooks, Benjamin R; Chio, Adriano; de Carvalho, Mamede; Ince, Paul G; Lin, Cindy; Miller, Robert G; Mitsumoto, Hiroshi; Nicholson, Garth; Ravits, John; Shaw, Pamela J; Swash, Michael; Talbot, Kevin; Traynor, Bryan J; den Berg, Leonard H Van; Veldink, Jan H; Vucic, Steve; Kiernan, Matthew C

    2015-01-01

    Summary Two decades after the discovery that 20% of familial amyotrophic lateral sclerosis (ALS) cases were linked to mutations in the superoxide dismutase-1 (SOD1) gene, a substantial proportion of the remainder of cases of familial ALS have now been traced to an expansion of the intronic hexanucleotide repeat sequence in C9orf72. This breakthrough provides an opportunity to re-evaluate longstanding concepts regarding the cause and natural history of ALS, coming soon after the pathological unification of ALS with frontotemporal dementia through a shared pathological signature of cytoplasmic inclusions of the ubiquitinated protein TDP-43. However, with profound clinical, prognostic, neuropathological, and now genetic heterogeneity, the concept of ALS as one disease appears increasingly untenable. This background calls for the development of a more sophisticated taxonomy, and an appreciation of ALS as the breakdown of a wider network rather than a discrete vulnerable population of specialised motor neurons. Identification of C9orf72 repeat expansions in patients without a family history of ALS challenges the traditional division between familial and sporadic disease. By contrast, the 90% of apparently sporadic cases and incomplete penetrance of several genes linked to familial cases suggest that at least some forms of ALS arise from the interplay of multiple genes, poorly understood developmental, environmental, and age-related factors, as well as stochastic events. PMID:23415570

  17. Redox Regulation in Amyotrophic Lateral Sclerosis

    Science.gov (United States)

    Parakh, Sonam; Spencer, Damian M.; Halloran, Mark A.; Soo, Kai Y.; Atkin, Julie D.

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that results from the death of upper and lower motor neurons. Due to a lack of effective treatment, it is imperative to understand the underlying mechanisms and processes involved in disease progression. Regulations in cellular reduction/oxidation (redox) processes are being increasingly implicated in disease. Here we discuss the possible involvement of redox dysregulation in the pathophysiology of ALS, either as a cause of cellular abnormalities or a consequence. We focus on its possible role in oxidative stress, protein misfolding, glutamate excitotoxicity, lipid peroxidation and cholesterol esterification, mitochondrial dysfunction, impaired axonal transport and neurofilament aggregation, autophagic stress, and endoplasmic reticulum (ER) stress. We also speculate that an ER chaperone protein disulphide isomerase (PDI) could play a key role in this dysregulation. PDI is essential for normal protein folding by oxidation and reduction of disulphide bonds, and hence any disruption to this process may have consequences for motor neurons. Addressing the mechanism underlying redox regulation and dysregulation may therefore help to unravel the molecular mechanism involved in ALS. PMID:23533690

  18. Risk factors for amyotrophic lateral sclerosis

    Science.gov (United States)

    Ingre, Caroline; Roos, Per M; Piehl, Fredrik; Kamel, Freya; Fang, Fang

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease. It is typically fatal within 2–5 years of symptom onset. The incidence of ALS is largely uniform across most parts of the world, but an increasing ALS incidence during the last decades has been suggested. Although recent genetic studies have substantially improved our understanding of the causes of ALS, especially familial ALS, an important role of non-genetic factors in ALS is recognized and needs further study. In this review, we briefly discuss several major genetic contributors to ALS identified to date, followed by a more focused discussion on the most commonly examined non-genetic risk factors for ALS. We first review factors related to lifestyle choices, including smoking, intake of antioxidants, physical fitness, body mass index, and physical exercise, followed by factors related to occupational and environmental exposures, including electromagnetic fields, metals, pesticides, β-methylamino-L-alanine, and viral infection. Potential links between ALS and other medical conditions, including head trauma, metabolic diseases, cancer, and inflammatory diseases, are also discussed. Finally, we outline several future directions aiming to more efficiently examine the role of non-genetic risk factors in ALS. PMID:25709501

  19. Later first marriage and marital success.

    Science.gov (United States)

    Glenn, Norval D; Uecker, Jeremy E; Love, Robert W B

    2010-09-01

    The research reported here used measures of marital success based on both marital survival and marital quality to assess how well first marriages entered at relatively late ages fare in comparison with those entered younger. Analysis of data from five American data sets indicated that the later marriages fare very well in survival but rather poorly in quality. The greatest indicated likelihood of being in an intact marriage of the highest quality is among those who married at ages 22-25, net of the estimated effects of time since first marriage and several variables that might commonly affect age at marriage and marital outcomes. The negative relationship beyond the early to mid-twenties between age at marriage and marital success is likely to be at least partially spurious, and thus it would be premature to conclude that the optimal time for first marriage for most persons is ages 22-25. However, the findings do suggest that most persons have little or nothing to gain in the way of marital success by deliberately postponing marriage beyond the mid-twenties.

  20. Redox Regulation in Amyotrophic Lateral Sclerosis

    Directory of Open Access Journals (Sweden)

    Sonam Parakh

    2013-01-01

    Full Text Available Amyotrophic lateral sclerosis (ALS is a neurodegenerative disease that results from the death of upper and lower motor neurons. Due to a lack of effective treatment, it is imperative to understand the underlying mechanisms and processes involved in disease progression. Regulations in cellular reduction/oxidation (redox processes are being increasingly implicated in disease. Here we discuss the possible involvement of redox dysregulation in the pathophysiology of ALS, either as a cause of cellular abnormalities or a consequence. We focus on its possible role in oxidative stress, protein misfolding, glutamate excitotoxicity, lipid peroxidation and cholesterol esterification, mitochondrial dysfunction, impaired axonal transport and neurofilament aggregation, autophagic stress, and endoplasmic reticulum (ER stress. We also speculate that an ER chaperone protein disulphide isomerase (PDI could play a key role in this dysregulation. PDI is essential for normal protein folding by oxidation and reduction of disulphide bonds, and hence any disruption to this process may have consequences for motor neurons. Addressing the mechanism underlying redox regulation and dysregulation may therefore help to unravel the molecular mechanism involved in ALS.

  1. Redox regulation in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Parakh, Sonam; Spencer, Damian M; Halloran, Mark A; Soo, Kai Y; Atkin, Julie D

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that results from the death of upper and lower motor neurons. Due to a lack of effective treatment, it is imperative to understand the underlying mechanisms and processes involved in disease progression. Regulations in cellular reduction/oxidation (redox) processes are being increasingly implicated in disease. Here we discuss the possible involvement of redox dysregulation in the pathophysiology of ALS, either as a cause of cellular abnormalities or a consequence. We focus on its possible role in oxidative stress, protein misfolding, glutamate excitotoxicity, lipid peroxidation and cholesterol esterification, mitochondrial dysfunction, impaired axonal transport and neurofilament aggregation, autophagic stress, and endoplasmic reticulum (ER) stress. We also speculate that an ER chaperone protein disulphide isomerase (PDI) could play a key role in this dysregulation. PDI is essential for normal protein folding by oxidation and reduction of disulphide bonds, and hence any disruption to this process may have consequences for motor neurons. Addressing the mechanism underlying redox regulation and dysregulation may therefore help to unravel the molecular mechanism involved in ALS.

  2. Takotsubo cardiomyopathy in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Choi, Seok-Jin; Hong, Yoon-Ho; Shin, Je-Young; Yoon, Byung-Nam; Sohn, Sung-Yeon; Park, Chan Soon; Sung, Jung-Joon

    2017-04-15

    To investigate the frequency, features, and prognosis of takotsubo cardiomyopathy (TTC) in patients with amyotrophic lateral sclerosis (ALS). We reviewed detailed clinical, laboratory, and cardiovascular data from 64 ALS patients (38 men and 26 women) who underwent echocardiographic evaluation for various reasons at a single referral center between January 2011 and December 2015. TTC was diagnosed in 9 ALS patients (4 men and 5 women). Mean age was 61.3years (range 55-71years), and median disease duration was 51.5months (range 18-134months). All patients were bulbar or cervical onset, and were at advanced stages of ALS when TTC was diagnosed. Acute exacerbation of dyspnea was an invariable presentation, and chest discomfort mimicking acute coronary syndrome was present in 2 patients. Six patients had significant hypotension requiring intravenous fluid challenge and inotropic support. Three patients showed altered mentality, and 2 of them suffered cardiopulmonary arrest. TTC should be suspected in ALS patients presenting with acute exacerbation of dyspnea and chest discomfort, particularly at advanced stages of the disease. This study highlights the need for proper evaluation and management of cardiac dysfunction in ALS. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Narrative discourse deficits in amyotrophic lateral sclerosis

    Science.gov (United States)

    Menaged, Anna; Olm, Christopher; McMillan, Corey T.; Boller, Ashley; Irwin, David J.; McCluskey, Leo; Elman, Lauren; Grossman, Murray

    2014-01-01

    Objective: We examined narrative discourse in amyotrophic lateral sclerosis (ALS) to assess the role of executive functioning in support of language and the neuroanatomical basis for such support. Methods: We analyzed a semistructured speech sample in 26 patients with ALS and 19 healthy seniors for narrative discourse features of coherence. Regression analyses related a measure of discourse coherence (“local connectedness”) to gray matter atrophy and reduced white matter fractional anisotropy. Results: Patients with ALS were impaired relative to controls on measures of discourse adequacy, including local connectedness and maintenance of the theme. These discourse measures were related to measures of executive functioning but not to motor functioning. Regressions related local connectedness to gray matter atrophy in ventral and dorsal prefrontal regions and to reduced fractional anisotropy in white matter tracts mediating projections between prefrontal regions. Conclusion: Patients with ALS exhibit deficits in their ability to organize narrative discourse. These deficits appear to be related in part to executive limitations. Consistent with the hypothesis that ALS is a multisystem disorder, this deficit is related to disease in prefrontal regions. PMID:24991038

  4. Implicit recognition based on lateralized perceptual fluency.

    Science.gov (United States)

    Vargas, Iliana M; Voss, Joel L; Paller, Ken A

    2012-02-06

    In some circumstances, accurate recognition of repeated images in an explicit memory test is driven by implicit memory. We propose that this "implicit recognition" results from perceptual fluency that influences responding without awareness of memory retrieval. Here we examined whether recognition would vary if images appeared in the same or different visual hemifield during learning and testing. Kaleidoscope images were briefly presented left or right of fixation during divided-attention encoding. Presentation in the same visual hemifield at test produced higher recognition accuracy than presentation in the opposite visual hemifield, but only for guess responses. These correct guesses likely reflect a contribution from implicit recognition, given that when the stimulated visual hemifield was the same at study and test, recognition accuracy was higher for guess responses than for responses with any level of confidence. The dramatic difference in guessing accuracy as a function of lateralized perceptual overlap between study and test suggests that implicit recognition arises from memory storage in visual cortical networks that mediate repetition-induced fluency increments.

  5. Hesseling: ’n eeu later

    Directory of Open Access Journals (Sweden)

    F. Ponelis

    1999-05-01

    Full Text Available Hesseling: a century laterThe Dutch linguist D.C. Hesseling was a pioneer of creole studies. The first evidence of Hesseling's interest in language contact and creole languages was his publications on Afrikaans. Hesseling formulated the core of his approach to the origin of Afrikaans in an 1897 article and greatly elaborated his ideas on the subject in the book Het Afrikaansch, published in 1899. This was the first truly scientific study of Afrikaans.Hesseling placed emergent Afrikaans within the colonial Dutch contact situation. In his wide-ranging and penetrating sociohistórical analysis of the seventeenth-century language contact situation at the Cape, Hesseling discounted the impact of either Koi or French and German on emergent Afrikaans. He singled out the creole Portuguese introduced by slaves as the main factor in the formation of Afrikaans from colloquial seventeenthcentury Dutch. Some of the issues raised by Hesseling have been hotly disputed, but his approach has remained at the centre of the discourse on Afrikaans historical linguistics.Hesseling's involvement in the diachrony of early Afrikaans was partly stimulated by his passionate interest in the language politics of the emergent Afrikaans standard language. He was the very first linguist of stature to argue for the standardisation of Afrikaans. Moreover, his ideas on the viability of Afrikaans as a local standard language in competition with both English and Dutch have been borne out, though they had been discounted within contemporary Afrikaner Nationalist discourse.

  6. Epidemiologic correlates of sporadic amyotrophic lateral sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Armon, C.; Kurland, L.T.; Daube, J.R.; O' Brien, P.C. (Department of Neurology, Mayo Clinic, Rochester, MN (USA))

    1991-07-01

    The authors evaluated 74 selected patients with amyotrophic lateral sclerosis (ALS) and 201 matched controls for risk factors for ALS by a case-control design and a sequential questionnaire/interview technique to quantitate biographic data. They analyzed occupational and recreational data only for 47 male patients and 47 corresponding patient controls; data for women were insufficient. They used nonparametric analyses to evaluate five primary comparisons of ALS patients with controls: (1) more hard physical labor, p not significant (NS); (2) greater frequency of neurodegenerative disease in family members, p NS; (3) greater exposure to lead, p less than 0.05; (4) more years lived in a rural community, p NS; and (5) more trauma or major surgery, p NS. Men with ALS had worked more frequently at blue-collar jobs (although not a statistically significant difference, p = 0.10) and at welding or soldering (p less than 0.01). These results suggest that there may be an association between ALS in men and exposure to lead vapor. The limited nature of the association favors a multifactorial etiologic mechanism of ALS.

  7. Motoneuron afterhyperpolarisation duration in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Piotrkiewicz, Maria; Hausmanowa-Petrusewicz, Irena

    2011-06-01

    Motor unit (MU) potentials were registered from 20 ALS patients and 13 age-matched control individuals during isometric constant force contractions of brachial biceps (BB). The registered signals were decomposed into single MU potential trains. The estimates of duration of the afterhyperpolarisation (AHP) in MNs, derived from the interspike interval variability, was compared between ALS patients (124 MNs) and control subjects (111 MNs) and no significant differences were encountered. However, the relationship between TI and age for patients appeared to be qualitatively different from that of the control group. The dependence of patients' AHPs on relative force deficit (RFD), which quantified muscle involvement, was more specific. For RFDs below 30%, the AHP estimate was significantly lower than control values and then increased thereafter with increasing RFDs. Moreover, firing rates of patients with the smallest RFDs were significantly higher while firing rates of patients with the greatest RFDs were significantly lower than control values. The AHP shortening in the early stages of muscle impairment is consistent with the decrease in firing threshold of ‘fast' MNs found in spinal cord slices from neonatal SOD1 mice. The later elongation of the AHP may be caused by the higher vulnerability of ‘fast' MNs to degeneration and by the influence of reinnervation. Our results are comparable to what has been observed in acute experiments in animal models, providing a bridge between animal and clinical research that may be relevant for identification of mechanism(s) underlying neurodegeneration in ALS.

  8. The epidemiology of amyotrophic lateral sclerosis.

    Science.gov (United States)

    Talbott, E O; Malek, A M; Lacomis, D

    2016-01-01

    Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease in adults and is characterized by neurodegeneration of motor neurons in the brain and spinal cord. The incidence of ALS is approximately 1-2.6 cases per 100 000 persons annually, whereas the prevalence is approximately 6 cases per 100 000. The average age of onset of ALS is currently 58-60 years and the average survival from onset to death is 3-4 years. Between October 19, 2010 and December 31, 2011, there were an estimated 12 187 prevalent cases diagnosed with definite ALS in the USA alone. Sporadic ALS (90-95%) constitutes the large majority of cases, while the remaining 5-10% are hereditary and termed familial ALS. Sporadic ALS is suspected to involve genetic susceptibility to environmental risk factors. The purpose of this review is to present a clinical overview of ALS and provide an epidemiologic summary of personal and environmental risk factors shown to be related to the risk of disease. A discussion of the most recent research initiatives is also included. © 2016 Elsevier B.V. All rights reserved.

  9. Human brain : biochemical lateralization in normal subjects.

    Directory of Open Access Journals (Sweden)

    Jayasundar R

    2002-07-01

    Full Text Available Chemical asymmetries in normal human brain were studied using the non-invasive technique of volume localized proton magnetic resonance spectroscopy (MRS. The technique of STEAM was used to acquire water-suppressed proton spectra from 8 ml voxels placed in bilaterally symmetrical positions in the two hemispheres of the brain. One hundred and sixty eight right-handed male volunteers were studied for six different regions in the brain (n=28, for each region. Parietal, occipital, temporal, frontal, thalamus and cerebellum regions were studied. The focus was on metabolites such as N-acetyl aspartate (NAA, creatine/phosphocreatine (Cr/PCr and choline (Cho containing compounds. Ratios of the peak areas were calculated for them. Quantitation of the metabolites were carried for data on 18 volunteers. Significant interhemispheric differences in the distribution of metabolites were observed for all the regions studied. There were statistically significant differences on right and left side for the metabolite ratios in all the regions studied. The study has shown the existence of significant lateralization in the distribution of proton MR visible metabolites for all the regions studied.

  10. Lateral load pattern in pushover analysis

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    The seismic capacity curves of three types of buildings including frame, frame-shear wall and shear wall obtained by pushover analysis under different lateral load patterns are compared with those from nonlinear time history analysis. Based on the numerical results obtained a two-phase load pattern: an inverted triangle(first mode)load pattern until the base shear force reaches β times its maximum value,Vmax, followed by a(x/H)α form, here β and α being some coefficients depending on the type of the structures considered, is proposed in the paper, which can provide excellent approximation of the seismic capacity curve for low-to-mid-rise shear type buildings. Furthermore, it is shown both the two-phase load pattern proposed and the invariant uniform pattern can be used for low-to-mid-rise shear-bending type and low-rise bending type of buildings. No suitable load patterns have been found for high-rise buildings.

  11. Respiratory exercise in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Pinto, Susana; Swash, Michael; de Carvalho, Mamede

    2012-01-01

    We have evaluated the potential role of respiratory exercise by implementing specific inspiratory muscle training in a selected population of early-affected amyotrophic lateral sclerosis (ALS) patients. We studied 26 patients with ALS with normal respiratory function using two groups of patients in a parallel, control-group, randomized, delayed-start design. Patients in the first group (G1) started the active inspiratory exercise programme at entry and were followed for eight months, while the second group (G2) of patients followed a placebo exercise programme for the first four months and then active exercise for the second four-month period. The primary outcome measure was the ALSFRS. Respiratory tests, neurophysiological measurements, fatigue and quality of life scales were secondary outcomes. Analysis of covariance was used to compare changes between and within groups. Results showed that there was no significant difference between the two patient groups. Within-group analysis suggested that inspiratory exercise promotes a transient improvement in the respiratory subscore and in the maximal voluntary ventilation, peak expiratory flow, and sniff inspiratory pressure. In conclusion, there was no clear positive or negative outcome of the respiratory exercise protocol we have proposed, but we cannot rule out a minor positive effect. Exercise regimes merit more detailed clinical evaluation in ALS.

  12. Decoupled echo state networks with lateral inhibition.

    Science.gov (United States)

    Xue, Yanbo; Yang, Le; Haykin, Simon

    2007-04-01

    Building on some prior work, in this paper we describe a novel structure termed the decoupled echo state network (DESN) involving the use of lateral inhibition. Two low-complexity implementation schemes, namely, the DESN with reservoir prediction (DESN + RP) and DESN with maximum available information (DESN + MaxInfo), are developed: (1) In the multiple superimposed oscillator (MSO) problem, DESN + MaxInfo exhibits three important attributes: lower generalization mean-square error (MSE), better robustness with respect to the random generation of reservoir weight matrix and feedback connections, and robustness to variations in the sparseness of reservoir weight matrix, compared to DESN + RP. (2) For a noiseless nonlinear prediction task, DESN + RP outperforms the DESN + MaxInfo and single reservoir-based ESN approach in terms of lower prediction MSE and better robustness to a change in the number of inputs and sparsity of the reservoir weight matrix. Finally, in a real-life prediction task using noisy sea clutter data, both schemes exhibit higher prediction accuracy and successful design ratio than a conventional ESN with a single reservoir.

  13. Lateral shift in one-dimensional quasiperiodic chiral photonic crystal

    Energy Technology Data Exchange (ETDEWEB)

    Da, Jian, E-mail: dajian521@sina.com [Department of Information Engineering, Huaian Senior Vocational and Technical School, Feiyao road, Huaian 223005, Jiangsu Province (China); Mo, Qi, E-mail: moqiyueyang@163.com [School of Software, Yunnan University, Cuihu Bai Road, Kunming City, Yunnan Province 650091 (China); Cheng, Yaokun [Department of Information Engineering, Huaian Senior Vocational and Technical School, Feiyao road, Huaian 223005, Jiangsu Province (China); Liu, Taixiang [Taishan Vocational College of Nursing, Shandong Province 271000 (China)

    2015-02-01

    We investigate the lateral shift of a one-dimensional quasiperiodic photonic crystal consisting of chiral and conventional dielectric materials. The effect of structural irregularity on lateral shift is evaluated by stationary-phase approach. Our results show that the lateral shift can be modulated by varying the structural irregularity in quasiperiodic structure. Besides, the position of peak in lateral shift spectrum stays sensitive to the chiral factor of chiral materials. In comparison with that of periodic structure, quasiperiodic structure provides an extra degree of freedom to manipulate the lateral shift.

  14. Pavlov at home and abroad: His role in international physiology.

    Science.gov (United States)

    Tansey, E M

    2006-04-30

    Contemporary science is conducted internationally. This is a comparatively recent phenomenon that developed during the last century, most notably after the second world war. During the first half of the twentieth century, however, I P Pavlov became the first major international physiologist, travelling widely and contributing to major scientific meetings around the world. This paper records and assesses Pavlov's international role, with an especial focus on the International Congresses of Physiology, set in the dynamic context of his domestic position in Imperial Russia and later in the Soviet Union.

  15. International bowel function extended spinal cord injury data set

    DEFF Research Database (Denmark)

    Krogh, K; Perkash, I; Stiens, S A;

    2008-01-01

    STUDY DESIGN: International expert working group.Objective:To develop an International Bowel Function Extended Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of an extended amount of information on bowel function. SETTING: Working group...... consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS). METHODS: A draft prepared by the working group was reviewed by Executive Committee of the International SCI Standards and Data Sets and later by the ISCoS Scientific Committee...

  16. International bowel function basic spinal cord injury data set

    DEFF Research Database (Denmark)

    Krogh, K; Perkash, I; Stiens, S A;

    2008-01-01

    STUDY DESIGN: International expert working group. OBJECTIVE: To develop an International Bowel Function Basic Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on bowel function in daily practice or in research....... SETTING: Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS). METHODS: A draft prepared by the working group was reviewed by Executive Committee of the International SCI Standards and Data Sets, and later by ISCo...

  17. The 'Nature' of International Relations

    DEFF Research Database (Denmark)

    Corry, Olaf

    2017-01-01

    The discipline of IR is beginning to grapple with how nature is a condition for, and increasingly and object of, international politics. This chapter narrates how IR actually began with features of the natural world at its heart, then narrowed this down to human nature, before losing sight...... of it almost entirely – only to rediscover it years later as ‘the environment’. A recent revival of realist geopolitics brings geography back in, but misses the environmental angle as well as the Anthropocene idea that due to human influence nature is now more dynamic, more prone to harm and in some ways more...... threatening than before. To theorise a non-anthropocentric IR, one way forward is to develop concepts that integrate the human with the non-human, as some post-human and ‘new materialist’ approaches do. Another strategy is to maintain an analytical distinction between the social and the natural...

  18. Lateral Thoracic Osteoplastic Rib-Sparing Technique Used for Lateral Spine Surgery: Technical Note.

    Science.gov (United States)

    Moisi, Marc; Fisahn, Christian; Tubbs, R Shane; Page, Jeni; Rice, Richard; Paulson, David; Kazemi, Noojan; Hanscom, David; Oskouian, Rod J

    2016-07-05

    Of patients who have undergone lateral approaches to the thoracic spine, surgical site postoperative pain appears to be greater among those who have undergone transection and removal of a rib segment than those who have not. Therefore, techniques that conserve anatomical position and minimize tissue disruption would theoretically result in less pain and a quicker recovery. Herein, we describe a rib-sparing osteoplastic technique used when rib segments need to be displaced in order to create an unobscured corridor to the operative target. Our approach minimizes soft tissue disruption and restores the anatomical function of the rib. Based on our experience, these patients report less pain, mobilize earlier, and are discharged sooner than those who have had rib segments sacrificed as part of a lateral approach to the spine.

  19. Lateral Thoracic Osteoplastic Rib-Sparing Technique Used for Lateral Spine Surgery: Technical Note

    Science.gov (United States)

    Fisahn, Christian; Tubbs, R. Shane; Page, Jeni; Rice, Richard; Paulson, David; Kazemi, Noojan; Hanscom, David; Oskouian, Rod J

    2016-01-01

    Of patients who have undergone lateral approaches to the thoracic spine, surgical site postoperative pain appears to be greater among those who have undergone transection and removal of a rib segment than those who have not. Therefore, techniques that conserve anatomical position and minimize tissue disruption would theoretically result in less pain and a quicker recovery. Herein, we describe a rib-sparing osteoplastic technique used when rib segments need to be displaced in order to create an unobscured corridor to the operative target. Our approach minimizes soft tissue disruption and restores the anatomical function of the rib. Based on our experience, these patients report less pain, mobilize earlier, and are discharged sooner than those who have had rib segments sacrificed as part of a lateral approach to the spine. PMID:27551648

  20. Anatomy of the lateral antebrachial cutaneous nerve in relation to the lateral epicondyle and cephalic vein.

    Science.gov (United States)

    Wongkerdsook, Wachara; Agthong, Sithiporn; Amarase, Chavarin; Yotnuengnit, Pattarapol; Huanmanop, Thanasil; Chentanez, Vilai

    2011-01-01

    The lateral antebrachial cutaneous nerve (LACN) is the terminal sensory branch of the musculocutaneous nerve supplying the lateral aspect of forearm. Because of its close proximity to the biceps brachii tendon (BBT), the lateral epicondyle (LE), and the cephalic vein (CV), surgery and venipuncture in the cubital fossa can injure the LACN. Measurement data regarding the relative anatomy of LACN are scarce. We, therefore, dissected 96 upper extremities from 26 males and 22 females to expose the LACN in the cubital fossa and forearm. The LACN consistently emerged from the lateral margin of BBT. It then pierced the deep fascia distal to the interepicondylar line (IEL) in 84.4% with mean distances of 1.8 ± 1.1 and 1.2 ± 0.9 cm (male and female, respectively). At the level of IEL, the LACN in all cases was medial to the LE (5.9 ± 1.1 cm male and 5.2 ± 0.9 cm female). Two types of branching were observed: single trunk (78.1%) and bifurcation (21.9%). Asymmetry in the branching pattern was observed in 6 males and 1 female. Concerning the relationship to the CV, the LACN ran medially within 1 cm at the level of IEL in 78.7%. Moreover, in 10 specimens, the LACN was directly beneath the CV. In the forearm, the LACN tends to course medial to the CV. Significant differences in the measurement data between genders but not sides were found in some parameters. These data are important for avoiding LACN injury and locating the LACN during relevant medical procedures.

  1. Models of international entrepreneurship

    DEFF Research Database (Denmark)

    Rask, Morten; Servais, Per

    2012-01-01

    on International Entrepreneurship, and specifically but not exclusively, International New Ventures (INVs). The three resulting ‘meta-models’ depict the activities and loci of such firms (Figure 1), the motivating factors that give rise to such firms (Figure 2) and their growth modalities and strategies (Figure 3......The purpose with this article is to review models used to describe and explain the establishment and development of international new ventures in order to investigate how and why international new ventures are established and developed. This article attempts an integration of extant theory......). These models reflect the merger of entrepreneurship and international business into the field of international entrepreneurship. Managers in international entrepreneurial firms and students in international business and entrepreneurship can use the models as framework for understanding international...

  2. Models of international entrepreneurship

    DEFF Research Database (Denmark)

    Rask, Morten; Servais, Per

    2012-01-01

    ). These models reflect the merger of entrepreneurship and international business into the field of international entrepreneurship. Managers in international entrepreneurial firms and students in international business and entrepreneurship can use the models as framework for understanding international......The purpose with this article is to review models used to describe and explain the establishment and development of international new ventures in order to investigate how and why international new ventures are established and developed. This article attempts an integration of extant theory...... on International Entrepreneurship, and specifically but not exclusively, International New Ventures (INVs). The three resulting ‘meta-models’ depict the activities and loci of such firms (Figure 1), the motivating factors that give rise to such firms (Figure 2) and their growth modalities and strategies (Figure 3...

  3. Differential lateralization for words and faces: category or psychophysics?

    Science.gov (United States)

    Mercure, Evelyne; Dick, Frederic; Halit, Hanife; Kaufman, Jordy; Johnson, Mark H

    2008-11-01

    This set of three experiments assessed the influence of different psychophysical factors on the lateralization of the N170 event-related potential (ERP) component to words and faces. In all experiments, words elicited a left-lateralized N170, whereas faces elicited a right-lateralized or nonlateralized N170 depending on presentation conditions. Experiment 1 showed that lateralization for words (but not for faces) was influenced by spatial frequency. Experiment 2 showed that stimulus presentation time influenced N170 lateralization independently of spatial frequency composition. Finally, Experiment 3 showed that stimulus size and resolution did not influence N170 lateralization, but did influence N170 amplitude, albeit differentially for words and faces. These findings suggest that differential lateralization for words and faces, at least as measured by the N170, is influenced by spatial frequency (words), stimulus presentation time, and category.

  4. Surgical endodontic management of infected lateral canals of maxillary incisors

    Science.gov (United States)

    2015-01-01

    This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment. PMID:25671217

  5. Changes in lateral abdominal muscles' thickness immediately after the abdominal drawing-in maneuver and maximum expiration.

    Science.gov (United States)

    Ishida, Hiroshi; Watanabe, Susumu

    2013-04-01

    All lateral abdominal muscles contract more strongly during maximum expiration than during the abdominal drawing-in maneuver (ADIM). However, little is known about which of the lateral abdominal muscles is activated during maximum expiration. Thus, the purpose of this study is to quantify changes in the thickness of the lateral abdominal muscles immediately after the ADIM and maximum expiration. The thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles was measured by ultrasound imaging in 30 healthy men before and after the ADIM and maximum expiration. After the ADIM, there was no significant change in the thickness of the lateral abdominal muscles. After maximum expiration, the thickness of the TrA muscle significantly increased, and there was no significant change in the thickness of the IO and EO muscles. Thus, maximum expiration may be an effective method for TrA, rather than IO and EO, muscle training.

  6. A description of the lumbar interfascial triangle and its relation with the lateral raphe: anatomical constituents of load transfer through the lateral margin of the thoracolumbar fascia.

    Science.gov (United States)

    Schuenke, M D; Vleeming, A; Van Hoof, T; Willard, F H

    2012-12-01

    Movement and stability of the lumbosacral region is contingent on the balance of forces distributed through the myofascial planes associated with the thoracolumbar fascia (TLF). This structure is located at the common intersection of several extremity muscles (e.g. latissimus dorsi and gluteus maximus), as well as hypaxial (e.g. ventral trunk muscles) and epaxial (paraspinal) muscles. The mechanical properties of the fascial constituents establish the parameters guiding the dynamic interaction of muscle groups that stabilize the lumbosacral spine. Understanding the construction of this complex myofascial junction is fundamental to biomechanical analysis and implementation of effective rehabilitation in individuals with low back and pelvic girdle pain. Therefore, the main objectives of this study were to describe the anatomy of the lateral margin of the TLF, and specifically the interface between the fascial sheath surrounding the paraspinal muscles and the aponeurosis of the transversus abdominis (TA) and internal oblique (IO) muscles. The lateral margin of the TLF was exposed via serial reduction dissections from anterior and posterior approaches. Axial sections (cadaveric and magnetic resonance imaging) were examined to characterize the region between the TA and IO aponeurosis and the paraspinal muscles. It is confirmed that the paraspinal muscles are enveloped by a continuous paraspinal retinacular sheath (PRS), formed by the deep lamina of the posterior layer of the TLF. The PRS extends from the spinous process to transverse process, and is distinct from both the superficial lamina of the posterior layer and middle layer of the TLF. As the aponeurosis approaches the lateral border of the PRS, it appears to separate into two distinct laminae, which join the anterior and posterior walls of the PRS. This configuration creates a previously undescribed fat-filled lumbar interfascial triangle situated along the lateral border of the paraspinal muscles from the 12th

  7. A description of the lumbar interfascial triangle and its relation with the lateral raphe: anatomical constituents of load transfer through the lateral margin of the thoracolumbar fascia

    Science.gov (United States)

    Schuenke, M D; Vleeming, A; Van Hoof, T; Willard, F H

    2012-01-01

    Movement and stability of the lumbosacral region is contingent on the balance of forces distributed through the myofascial planes associated with the thoracolumbar fascia (TLF). This structure is located at the common intersection of several extremity muscles (e.g. latissimus dorsi and gluteus maximus), as well as hypaxial (e.g. ventral trunk muscles) and epaxial (paraspinal) muscles. The mechanical properties of the fascial constituents establish the parameters guiding the dynamic interaction of muscle groups that stabilize the lumbosacral spine. Understanding the construction of this complex myofascial junction is fundamental to biomechanical analysis and implementation of effective rehabilitation in individuals with low back and pelvic girdle pain. Therefore, the main objectives of this study were to describe the anatomy of the lateral margin of the TLF, and specifically the interface between the fascial sheath surrounding the paraspinal muscles and the aponeurosis of the transversus abdominis (TA) and internal oblique (IO) muscles. The lateral margin of the TLF was exposed via serial reduction dissections from anterior and posterior approaches. Axial sections (cadaveric and magnetic resonance imaging) were examined to characterize the region between the TA and IO aponeurosis and the paraspinal muscles. It is confirmed that the paraspinal muscles are enveloped by a continuous paraspinal retinacular sheath (PRS), formed by the deep lamina of the posterior layer of the TLF. The PRS extends from the spinous process to transverse process, and is distinct from both the superficial lamina of the posterior layer and middle layer of the TLF. As the aponeurosis approaches the lateral border of the PRS, it appears to separate into two distinct laminae, which join the anterior and posterior walls of the PRS. This configuration creates a previously undescribed fat-filled lumbar interfascial triangle situated along the lateral border of the paraspinal muscles from the 12th

  8. Internal septorhinoplasty technique.

    Science.gov (United States)

    Waite, Peter D

    2012-02-01

    The internal septorhinoplasty was the standard operating procedure until the popularity of the external or open rhinoplasty technique. The internal technique of the rhinoplasty should be in the armamentarium of every cosmetic surgeon. There will always be indications for both internal and external rhinoplasty. The advantages of the internal technique are several. Rhinoplasty should be treatment planned based on the individual diagnosis. With experience, most surgeons find the internal rhinoplasty to be successful and extremely rewarding. A simple internal rhinoplasty will produce a good result and satisfied patients.

  9. Amyotrophic lateral sclerosis causes small fiber pathology.

    Science.gov (United States)

    Dalla Bella, E; Lombardi, R; Porretta-Serapiglia, C; Ciano, C; Gellera, C; Pensato, V; Cazzato, D; Lauria, G

    2016-02-01

    Our aim was to address the correlation between small fiber loss and amyotrophic lateral sclerosis (ALS) for disease onset, phenotype, genotype, duration, severity and sensory findings. Consecutive patients referred for suspected ALS were screened. Exclusion criteria were possible ALS and previous diagnosis or known risk factors for small fiber neuropathies. A sural nerve conduction study (NCS) was bilaterally recorded. The ALS functional rating scale revised was administered and loss of functions were calculated using the Milano-Torino staging (MITOS) system. Sensory symptoms and signs were recorded. Genetic analysis was performed by the next-generation sequencing approach. Skin biopsy was performed at the distal leg and intraepidermal nerve fiber (IENF) density was quantified in three non-consecutive sections following published guidelines. Findings were referred to age- and sex-adjusted normative values. Fifty-seven patients including six with facial onset sensory and motor neuronopathy (FOSMN) were enrolled. Eight (15.7%) pure ALS patients and five (83%) FOSMN patients complained of sensory disturbances with different distributions. Sural NCS was normal in all except two patients. IENF density was reduced in 75.4% of pure ALS and 50% of FOSMN patients, without correlation with any disease features. IENF density was similarly reduced in bulbar (78.5%), flail limb (87.5%), pyramidal (100%), and spinal (68.2%) onset, as well as in genetic (83.3%) and sporadic (82%) ALS. There was no correlation with genotype, disease duration and severity. Intraepidermal nerve fiber loss is a feature of most ALS patients. It does not correlate with onset, phenotype, course and severity of the disease, and cannot be considered a clinical or prognostic biomarker. © 2016 EAN.

  10. Lateral asymmetry of voluntary attention orienting

    Directory of Open Access Journals (Sweden)

    B.A. Castro-Barros

    2010-08-01

    Full Text Available We recently demonstrated that automatic attention favors the right side of space and, in the present study, we investigated whether voluntary attention also favors this side. Six reaction time experiments were conducted. In each experiment, 12 new 18-25-year-old male right-handed individuals were tested. In Experiments 1, 2, 3 (a, b and 4 (a, b, tasks with increasing attentional demands were used. In Experiments 1, 2, 3a, and 4a, attention was oriented to one or both sides by means of a central spatially informative visual cue. A left or right side visual target appeared 100, 300, or 500 ms later. Attentional effects were observed in the four experiments. In Experiments 2, 3a and 4a, these effects were greater when the cue indicated the right side than when it indicated the left side (respectively: 16 ± 10 and 44 ± 6 ms, P = 0.015, for stimulus onset asynchrony of 500 ms in Experiment 2; 38 ± 10 and 70 ± 7 ms, P = 0.011, for Experiment 3a, and 23 ± 11 and 61 ± 10 ms, P = 0.009, for Experiment 4a. In Experiments 3b and 4b, the central cue pointed to both sides and was said to be non-relevant for task performance. In these experiments right and left reaction times did not differ. The most conservative interpretation of the present findings is that voluntary attention orienting favors the right side of space, particularly when a difficult task has to be performed.

  11. Rodent Models of Amyotrophic Lateral Sclerosis.

    Science.gov (United States)

    Philips, Thomas; Rothstein, Jeffrey D

    2015-06-01

    Amyotrophic Lateral Sclerosis (ALS) is a motor neuron disease affecting upper and lower motor neurons in the central nervous system. Patients with ALS develop extensive muscle wasting and atrophy leading to paralysis and death 3 to 5 years after disease onset. The condition may be familial (fALS 10%) or sporadic ALS (sALS, 90%). The large majority of fALS cases are due to genetic mutations in the Superoxide dismutase 1 gene (SOD1, 15% of fALS) and repeat nucleotide expansions in the gene encoding C9ORF72 (∼ 40% to 50% of fALS and ∼ 10% of sALS). Studies suggest that ALS is mediated through aberrant protein homeostasis (i.e., ER stress and autophagy) and/or changes in RNA processing (as in all non-SOD1-mediated ALS). In all of these cases, animal models suggest that the disorder is mediated non-cell autonomously, i.e., not only motor neurons are involved, but glial cells including microglia, astrocytes, and oligodendrocytes, and other neuronal subpopulations are also implicated in the pathogenesis. Provided in this unit is a review of ALS rodent models, including discussion of their relative advantages and disadvantages. Emphasis is placed on correlating the model phenotype with the human condition and the utility of the model for defining the disease process. Information is also presented on RNA processing studies in ALS research, with particular emphasis on the newest ALS rodent models. Copyright © 2013 John Wiley & Sons, Inc. All rights reserved.

  12. High content analysis in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Rinaldi, Federica; Motti, Dario; Ferraiuolo, Laura; Kaspar, Brian K

    2017-04-01

    Amyotrophic lateral sclerosis (ALS) is a devastating disease characterized by the progressive loss of motor neurons. Neurons, astrocytes, oligodendrocytes and microglial cells all undergo pathological modifications in the onset and progression of ALS. A number of genes involved in the etiopathology of the disease have been identified, but a complete understanding of the molecular mechanisms of ALS has yet to be determined. Currently, people affected by ALS have a life expectancy of only two to five years from diagnosis. The search for a treatment has been slow and mostly unsuccessful, leaving patients in desperate need of better therapies. Until recently, most pre-clinical studies utilized the available ALS animal models. In the past years, the development of new protocols for isolation of patient cells and differentiation into relevant cell types has provided new tools to model ALS, potentially more relevant to the disease itself as they directly come from patients. The use of stem cells is showing promise to facilitate ALS research by expanding our understanding of the disease and help to identify potential new therapeutic targets and therapies to help patients. Advancements in high content analysis (HCA) have the power to contribute to move ALS research forward by combining automated image acquisition along with digital image analysis. With modern HCA machines it is possible, in a period of just a few hours, to observe changes in morphology and survival of cells, under the stimulation of hundreds, if not thousands of drugs and compounds. In this article, we will summarize the major molecular and cellular hallmarks of ALS, describe the advancements provided by the in vitro models developed in the last few years, and review the studies that have applied HCA to the ALS field to date. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Coping with anxiety in later life.

    Science.gov (United States)

    Frazier, Leslie D; Waid, Lisa D; Fincke, Candy

    2002-12-01

    The goal of this study was to determine how older adults cope with three forms of anxiety, and potential avenues for applied interventions. Although the findings shed light on some interesting findings with potential psychosocial applications, several limitations need to be noted. First, this study was based on two assumptions. The assumption, based on earlier work (Carver et al., 1989; Lazarus & Folkman, 1984; Zeidner & Saklofske, 1996), that certain coping strategies are more effective than others, and an assumption of the direction of influence in which anxiety is a precursor of coping strategies. Because this was an exploratory study, the research questions did not directly test these assumptions. Second, this study is correlational in nature. Therefore, conclusions cannot be drawn about the causality of these associations. Third, as with any self-report data and self-selected sample, one needs to interpret the findings with caution. Similarly, for the purposes of the study, a non-clinical sample of older adults was examined using three distinct conceptualizations of anxiety. Suggestions for future research include: Replication of this study using a multidimensional measure of anxiety appropriate for clinical samples. A longitudinal replication of this study identifying patterns of coping that facilitate adjustment over time. Finally, a more general purpose of this study was to focus attention on a neglected issue in gerontology--the experience of anxietY in later life (Frazier & Waid, 1999; Gatz, 1995; Rabins, 1992; Shamoian, 1991; Sheikh, 1992; Smyer, 1995; Stanley & Beck, 1998), and, most importantly, the role of gerontological nurses in early assessment and intervention for successful treatment of anxiety in older adults.

  14. Lateral malleolus hook plate for comminuted Weber A and B fractures: A retrospective study

    Directory of Open Access Journals (Sweden)

    Fang Zhenhua

    2013-01-01

    Full Text Available Background: The goal of managing the comminuted fracture of lateral malleolus is to restore length, rotation and alignment which might be more challenging with extensive comminution around the area of the distal tip. The common osteosynthesis techniques such as the one-third tubular plate, tension band wiring, K-wires, screws, or intramedullary nail may be insufficient in cases with a comminuted lateral malleolus. The anatomical hook plate is an alternative implant in such cases. We present our results of the comminuted lateral malleolar fractures (Weber A, B, managed by open reduction and internal fixation (ORIF with an anatomical hook plate of lateral malleolus (Königsee Implant Company, Germany. Materials and Methods: We retrospectively reviewed 20 patients of comminuted fracture of distal lateral malleolus between 2008 and 2010. There were 12 males and 8 females, right side was involved in 18 patients and left in 2. The mean age was 51.9 years (range 18-75 years. The fractures were categorized by Denis-Weber classification type A (n=1, B1 (n=1, B2 (n=13 and B3 (n=5. Nineteen cases were of closed injury and one of open injury (Gustilo Anderson type II. These patients underwent ORIF with a lateral malleolus anatomical hook plate. Followup including radiographs and clinical examinations were performed. The American Orthopedic Foot and Ankle Society (AOFAS ankle hindfoot scores were documented at followups. Results: The mean followup was 21.4 months (range 16-27 months. The average AOFAS score was 94.3 (range 78-100 points. A stable anatomic reduction and bony union were obtained in all the cases. The average time was 3.1 months (range 2.5-4 months. Four cases had complications like posttraumatic osteoarthritis, hardware impingement and superficial wound infection. Conclusion: A reasonably good stability can be obtained in distal most comminuted fractures of lateral malleolus with a lateral malleolus anatomical hook plate. We believe this

  15. The dragonfly splint: a new disposable device designed to prevent both medial and lateral turbinate synechiae after sinonasal surgery.

    Science.gov (United States)

    Mantovani, Mario; Rinaldi, Vittorio; Torretta, Sara; Sigismund, Paolo Enrico; Cappadona, Maurizio; Minetti, Andrea; Pignataro, Lorenzo

    2014-03-01

    Periturbinal adhesions are among the most frequent and challenging complications of sinonasal surgery. Endonasal paraseptal splints have proved to be very efficient in preventing "medial synechiae," that is, adhesions located between the medial faces of the middle/inferior turbinates and the septum. However, none of these devices for guiding mucosal healing can prevent "lateral synechiae" (adhesions between the lateral face of the middle turbinate and the lateral nasal wall) inside the middle meatal cleft, which is a very critical area for the physiology of the anterior sinus system. For this reason, if followed by the formation of lateral synechiae, the surgical maneuvers used to treat sinus diseases could paradoxically become a cause of persistent functional impairment and lead to iatrogenic sinusitis or mucocele.We describe our preliminary experience with a new endonasal splint called "Dragonfly" (because of its shape), which has been designed to prevent both medial and lateral postsurgical synechiae. This device has a long lateral wing designed to separate the mucosal surfaces of the middle meatal/ethmoid cavities and prevent adhesions during the postoperative process of healing. The device must be kept in situ for 3 to 4 weeks to permit the re-epithelialization of the internal nasal surfaces. Our experience shows that the splints are well tolerated and highly efficient, preventing both medial and lateral synechiae in 100% of cases. A randomized controlled study has now been started to confirm these positive preliminary findings in a larger patient population.

  16. Behavior of Pile Group with Elevated Cap Subjected to Cyclic Lateral Loads

    Institute of Scientific and Technical Information of China (English)

    陈云敏; 顾明; 陈仁朋; 孔令刚; 张浙杭; 边学成

    2015-01-01

    The pile group with elevated cap is widely used as foundation of offshore structures such as turbines, power transmission towers and bridge piers, and understanding its behavior under cyclic lateral loads induced by waves, tide water and winds, is of great importance to designing. A large-scale model test on 3×3 pile group with elevated cap subjected to cyclic lateral loads was performed in saturated silts. The preparation and implementation of the test is presented. Steel pipes with the outer diameter of 114 mm, thickness of 4.5 mm, and length of 6 m were employed as model piles. The pile group was cyclic loaded in a multi-stage sequence with the lateral displacement controlled. In addition, a single pile test was also conducted at the same site for comparison. The displacement of the pile cap, the internal forces of individual piles, and the horizontal stiffness of the pile group are presented and discussed in detail. The results indicate that the lateral cyclic loads have a greater impact on pile group than that on a single pile, and give rise to the significant plastic strain in the soil around piles. The lateral loads carried by each row of piles within the group would be redistributed with loading cycles. The lateral stiffness of the pile group decreases gradually with cycles and broadly presents three different degradation patterns in the test. Significant axial forces were measured out in some piles within the group, owing to the strong restraint provided by the cap, and finally lead to a large settlement of the pile group. These findings can be referred for foundation designing of offshore structures.

  17. Behavior of pile group with elevated cap subjected to cyclic lateral loads

    Science.gov (United States)

    Chen, Yun-min; Gu, Ming; Chen, Ren-peng; Kong, Ling-gang; Zhang, Zhe-hang; Bian, Xue-cheng

    2015-06-01

    The pile group with elevated cap is widely used as foundation of offshore structures such as turbines, power transmission towers and bridge piers, and understanding its behavior under cyclic lateral loads induced by waves, tide water and winds, is of great importance to designing. A large-scale model test on 3×3 pile group with elevated cap subjected to cyclic lateral loads was performed in saturated silts. The preparation and implementation of the test is presented. Steel pipes with the outer diameter of 114 mm, thickness of 4.5 mm, and length of 6 m were employed as model piles. The pile group was cyclic loaded in a multi-stage sequence with the lateral displacement controlled. In addition, a single pile test was also conducted at the same site for comparison. The displacement of the pile cap, the internal forces of individual piles, and the horizontal stiffness of the pile group are presented and discussed in detail. The results indicate that the lateral cyclic loads have a greater impact on pile group than that on a single pile, and give rise to the significant plastic strain in the soil around piles. The lateral loads carried by each row of piles within the group would be redistributed with loading cycles. The lateral stiffness of the pile group decreases gradually with cycles and broadly presents three different degradation patterns in the test. Significant axial forces were measured out in some piles within the group, owing to the strong restraint provided by the cap, and finally lead to a large settlement of the pile group. These findings can be referred for foundation designing of offshore structures.

  18. Does cerebral lateralization develop? A study using functional transcranial Doppler ultrasound assessing lateralization for language production and visuospatial memory.

    Science.gov (United States)

    Groen, Margriet A; Whitehouse, Andrew J O; Badcock, Nicholas A; Bishop, Dorothy V M

    2012-05-01

    In the majority of people, language production is lateralized to the left cerebral hemisphere and visuospatial skills to the right. However, questions remain as to when, how, and why humans arrive at this division of labor. In this study, we assessed cerebral lateralization for language production and for visuospatial memory using functional transcranial Doppler ultrasound in a group of 60 typically developing children between the ages of six and 16 years. The typical pattern of left-lateralized activation for language production and right-lateralized activation for visuospatial memory was found in the majority of the children (58%). No age-related change in direction or strength of lateralization was found for language production. In contrast, the strength of lateralization (independent of direction) for visuospatial memory function continued to increase with age. In addition, boys showed a trend for stronger right-hemisphere lateralization for visuospatial memory than girls, but there was no gender effect on language laterality. We tested whether having language and visuospatial functions in the same hemisphere was associated with poor cognitive performance and found no evidence for this "functional crowding" hypothesis. We did, however, find that children with left-lateralized language production had higher vocabulary and nonword reading age-adjusted standard scores than other children, regardless of the laterality of visuospatial memory. Thus, a link between language function and left-hemisphere lateralization exists, and cannot be explained in terms of maturational change.

  19. Characterization of the exradin A18 chamber ionization according to the IEC70631 standards. This work aims at the characterization of the Exradin model (Standard Imaging) A18 ionization chamber, according to the international standard IEC 607311. Intends to use the camera Exradin A18 for the quality control of a linear accelerator VARIAN model TrueBeam with capacity to produce beams of photons of high energy, unfiltered flatter (in later FFF) with high dose absorbed by pulse rate, why is verified, according to the mentioned standard IEC 60731, even under conditions of high dose absorbed by pulse rate, the efficiency of ion collection from this camera is within tolerances; Caracterizacion de la camara de ionizacion exradin A18 segun el estandar IEC70631. Estudio para haces de fotones sin filtro aplanador

    Energy Technology Data Exchange (ETDEWEB)

    Onses Segarra, A.; Puxeu Vaque, J.; Sancho Kolster, I.; Lizuain Arroyo, M. C.; Picon Olmos, C.

    2013-07-01

    This work aims at the characterization of the Exradin model (Standard Imaging) A18 ionization chamber, according to the international standard IEC 607311. Intends to use the camera Exradin A18 for the quality control of a linear accelerator VARIAN model TrueBeam with capacity to produce beams of photons of high energy, unfiltered flatter (in later FFF) with high dose absorbed by pulse rate, why is verified, according to the mentioned standard IEC 60731, even under conditions of high dose absorbed by pulse rate, the efficiency of ion collection from this camera is within tolerances. (Author)

  20. Association between the Brain Laterality, Gender and Birth Season

    Directory of Open Access Journals (Sweden)

    A Baghdasarians

    2008-08-01

    Full Text Available Objective: in recent years different hypotheses with respect to the formation of cerebral laterality were proposed. Some of the researchers claim that cerebral dominance and laterality are determined by genetic factors, just as the case with eye color and blood type. However, another group states that in addition to genetic factors, environmental factors, too, have a remarkable role in hemispheric dominance and lateral dominance. Hence, the present research was designed to study the relationship between 1- lateral dominance and birth season 2- lateral dominance and gender. "n "nMethod:1355(girls and boys fifth graders from the 19 educational regions of Tehran were selected using multi stage cluster sampling in the 2003-2004 school year. Coren lateral preference and personal information questionnaire were applied. "nResults:The following results were obtained at the level of ل=0.05 and probability of 95%. There were significant association between lateral dominance and birth season, between lateral dominance and gender, between ambidexterity and birth season, between non-genetic sinistrality and birth season, between dexterality and gender, between ambidexterity and gender, between genetic sinistrality and gender. There were no significant associations between dexterality and birth season, genetic sinistrality and birth season, between non-genetic sinistrality and gender. "nConclusion: The gestational environmental factors can have significant effect on the formation of lateral dominance and cerebral laterality.

  1. Penetration and lateral diffusion characteristics of polycrystalline graphene barriers

    Science.gov (United States)

    Yoon, Taeshik; Mun, Jeong Hun; Cho, Byung Jin; Kim, Taek-Soo

    2013-12-01

    We report penetration and lateral diffusion behavior of environmental molecules on synthesized polycrystalline graphene. Penetration occurs through graphene grain boundaries resulting in local oxidation. However, when the penetrated molecules diffuse laterally, the oxidation region will expand. Therefore, we measured the lateral diffusion rate along the graphene-copper interface for the first time by the environment-assisted crack growth test. It is clearly shown that the lateral diffusion is suppressed due to the high van der Waals interaction. Finally, we employed bilayer graphene for a perfect diffusion barrier facilitated by decreased defect density and increased lateral diffusion path.We report penetration and lateral diffusion behavior of environmental molecules on synthesized polycrystalline graphene. Penetration occurs through graphene grain boundaries resulting in local oxidation. However, when the penetrated molecules diffuse laterally, the oxidation region will expand. Therefore, we measured the lateral diffusion rate along the graphene-copper interface for the first time by the environment-assisted crack growth test. It is clearly shown that the lateral diffusion is suppressed due to the high van der Waals interaction. Finally, we employed bilayer graphene for a perfect diffusion barrier facilitated by decreased defect density and increased lateral diffusion path. Electronic supplementary information (ESI) available. See DOI: 10.1039/c3nr03849a

  2. International diversification and Microfinance

    NARCIS (Netherlands)

    Galema, Rients; Lensink, Robert; Spierdijk, Laura

    2011-01-01

    International commercial banks, institutional investors, and private investors have become increasingly interested in financing microfinance institutions (MFIs). This paper investigates whether adding microfinance funds to a portfolio of risky international assets yields diversification gains. By us

  3. Training for International Operations.

    Science.gov (United States)

    Lowe, Judy

    1980-01-01

    As many corporations widen their scope to international markets, there arises a need for specialized management development. To be effective in an international environment, a manager requires linguistic, social, and communication skills, functional expertise, and familiarity with cultural differences. (SK)

  4. International Transplant Nurses Society

    Science.gov (United States)

    ... The Mission of ITNS The International Transplant Nurses Society is committed to the promotion of excellence in ... 20-1589538 Copyright © 2006 - 2014 International Transplant Nurses Society (ITNS). No materials, including graphics, may be reused, ...

  5. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, Mohammad Akbar Hosain

    2014-12-04

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green\\'s function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green\\'s function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green\\'s function and renders the higher order internal multiple image for display on a display device.

  6. What Defines an International Criminal Court?

    DEFF Research Database (Denmark)

    Kjeldgaard-Pedersen, Astrid

    2015-01-01

    that only criminal tribunals deriving their authority from international law should be labelled ‘international’, while the term ‘national criminal court’ should apply to tribunals set up under national law. This terminology would underline that issues concerning jurisdiction and applicable law must......Since the post-World War II tribunals, only few scholars have attempted to draw a definitional distinction between international and national criminal courts. Remarkable exceptions include Robert Woetzel, who in 1962 categorized criminal courts according to ‘the involvement of the international...... community’, and Sarah Williams, who 50 years later relied on the same factor in her definitions of ‘hybrid’ and ‘internationalized’ criminal tribunals. Through examples of rulings by the Special Court for Sierra Leone and the Extraordinary Chambers in the Courts of Cambodia, this article will demonstrate...

  7. The Evolution of Lateralized Brain Circuits

    Directory of Open Access Journals (Sweden)

    Michael C. Corballis

    2017-06-01

    Full Text Available In the vast clade of animals known as the bilateria, cerebral and behavioral asymmetries emerge against the backdrop of bilateral symmetry, with a functional trade-off between the two. Asymmetries can lead to more efficient processing and packaging of internal structures, but at the expense of efficient adaptation to a natural world without systematic left-right bias. Asymmetries may arise through the fissioning of ancestral structures that are largely symmetrical, creating new circuits. In humans these may include asymmetrical adaptations to language and manufacture, and as one or other hemisphere gains dominance for functions that were previously represented bilaterally. This is best illustrated in the evolution of such functions as language and tool manufacture in humans, which may derive from the mirror-neuron system in primates, but similar principles probably apply to the many other asymmetries now evident in a wide range of animals. Asymmetries arise in largely independent manner with multi-genetic sources, rather than as a single over-riding principle.

  8. The Evolution of Lateralized Brain Circuits.

    Science.gov (United States)

    Corballis, Michael C

    2017-01-01

    In the vast clade of animals known as the bilateria, cerebral and behavioral asymmetries emerge against the backdrop of bilateral symmetry, with a functional trade-off between the two. Asymmetries can lead to more efficient processing and packaging of internal structures, but at the expense of efficient adaptation to a natural world without systematic left-right bias. Asymmetries may arise through the fissioning of ancestral structures that are largely symmetrical, creating new circuits. In humans these may include asymmetrical adaptations to language and manufacture, and as one or other hemisphere gains dominance for functions that were previously represented bilaterally. This is best illustrated in the evolution of such functions as language and tool manufacture in humans, which may derive from the mirror-neuron system in primates, but similar principles probably apply to the many other asymmetries now evident in a wide range of animals. Asymmetries arise in largely independent manner with multi-genetic sources, rather than as a single over-riding principle.

  9. Lateral abdominal wall hematoma as a rare complication after carotid artery stenting: a case report

    Directory of Open Access Journals (Sweden)

    Satomi Jyunichiro

    2009-11-01

    Full Text Available Abstract Abdominal wall hematoma is a rare and life-threatening complication after carotid artery stenting (CAS, but it can occur when activated clotting time is prolonged. We report a right lateral abdominal wall hematoma caused by rupture of the superficial circumflex iliac artery after CAS in a 72-year-old man with severe stenosis of the origin of the right internal carotid artery. We performed CAS for the targeted lesion while activated clotting time exceeded 300 seconds. After 2 hours, he complained of right lateral abdominal pain. Abdominal computed tomography revealed an extensive hematoma in the right lateral abdominal wall. Activated clotting time was 180 seconds at this point. Seven hours later, he developed hypotension and hemoglobin level dropped to 11.3 g/dl. Subsequent computed tomography showed enlargement of the hematoma. Emergent selective angiography of the external iliac artery revealed active bleeding from the right superficial circumflex iliac artery. Transcatheter arterial embolization with Gelfoam and microcoils was performed successfully. With more CAS procedures being performed, it is important for endovascular surgeons and radiologists to consider the possibility of abdominal wall hematoma in this situation.

  10. The alar rim flap: a novel technique to manage malpositioned lateral crura.

    Science.gov (United States)

    Kemaloğlu, Cemal Alper; Altıparmak, Mehmet

    2015-11-01

    Alar cartilage malposition is a common anatomic variation in which the axis of the lateral crus lies cephalically and may be parallel to the cephalic septum. Malposition of the lateral crura may produce inward collapse of the alae that is observable on deep inspiration. The authors performed the alar rim flap technique to treat patients with alar malposition and assessed functional and aesthetic outcomes. Twelve patients who underwent primary open rhinoplasty with the alar rim flap technique were evaluated in a prospective study. A 2- or 3-mm caudal portion of the lateral crus was elevated from the underlying mucosa, pulled caudally, and extended with a cartilage graft. This extension of the alar rim flap was placed through the pyriform aperture for additional support. Patients completed pre- and postoperative questionnaires addressing nasal obstruction and underwent paranasal computed tomography. Patients received follow-up for an average of 16 months (range, 8-27 months). Patients with alar cartilage malposition and external valve insufficiency experienced aesthetic and functional improvements after rhinoplasty with the alar rim flap technique. No patients developed alar rim collapse or flap displacement. The alar rim flap technique is effective for the correction of malpositioned lateral crura and external valve insufficiency. Because this technique does not damage the scroll area, disruption of the internal valve area is avoided. 4 Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  11. National and International Views.

    Science.gov (United States)

    Kilgour, David

    1992-01-01

    Discusses Canadian government policy dealing with internal matters of party politics and international questions of human rights. Describes the political situation in Burma as an oppressive military regime. Urges the Canadian government to take a firmer stand to influence the international community against tolerating regimes that are guilty of…

  12. Improving Internal Communication.

    Science.gov (United States)

    Bonus, Thaddeus, Ed.

    Guidelines for developing the internal communications of colleges and universities, researching internal communication needs, and increasing information flow through traditional and nontraditional media are provided in 11 articles. Titles and authors include the following: "Work for an Open Internal Communication Policy" (Thaddeus Bonus); "Five…

  13. CHINA INTERNATIONAL PUBLISHING GROUP

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The China International Publishing Group (CIPG) specializes in international communications. Its operationsencompass reporting, editing, translation, publishing, printing, distribution, and the Internet. It incorporates sevenpublishing companies, five magazines and 19 periodicals, published in over 20 languages. The ChinaInternational Book Trading Corporation, another group facet, distributes all of these to over 180 countries and

  14. Differential bilingual laterality: mythical monster found in Wales.

    Science.gov (United States)

    Evans, Judith; Workman, Lance; Mayer, Peter; Crowley, Kevin

    2002-11-01

    Paradis (1992) likens studies of bilingual laterality to reported sightings of the Loch Ness Monster, in that although some studies claim differential laterality much conflicting research evidence does not-and like the mythical Scottish monster, what reason have we to suspect that any such phenomenon might exist? This study reexamines differential bilingual laterality using four groups of English-Welsh bilinguals which differ in their age of acquisition and in their environment of acquisition. Using a split visual field paradigm we present evidence which, supports the notion of greater right hemisphere processing in a later learned language. Our findings also suggest the pattern of lateralization in bilinguals is strongly affected by the specific language environment during development such that the shift toward greater right hemisphere involvement for the later learned language will be more pronounced in individuals which are brought up in areas where that language is not regularly heard.

  15. Maximizing aesthetics in lateral-tension abdominoplasty and body lifts.

    Science.gov (United States)

    Lockwood, Ted E

    2004-10-01

    The high-lateral-tension abdominoplasty addresses the practical and theoretic faults of standard abdominoplasty design. Key features include limited direct undermining, increased lateral skin resection with highest-tension wound closure along lateral limbs, two-layer superficial fascial system repair, and significant truncal liposuction when needed. The high-lateral-tension design limits the unfavorable features of standard abdominoplasty and produces balanced natural aesthetic contours. The high-lateral-tension abdominoplasty is the foundation for treatment of more generalized relaxation problems in the circumferential trunk and thighs. For more significant thigh laxity and buttock ptosis, the lateral-tension abdominoplasty is combined with the transverse thigh/buttock lift to produce the lower body lift #2.

  16. An in vitro model to investigate filling of lateral canals.

    Science.gov (United States)

    Venturi, Mauro; Di Lenarda, Roberto; Prati, Carlo; Breschi, Lorenzo

    2005-12-01

    Aims of this work were to examine lateral canals in extracted teeth, to propose a new technique to produce artificial lateral canals, and to compare two obturation techniques. Cleared roots were examined to record measure and shape of lateral canals. Artificial lateral canals were prepared on human demineralized teeth before final clearing. Specimens were divided in two groups: canals of group 1 were filled with Schilder's technique, canals of group 2 were filled with vertical compaction with apical backfilling. Stereomicroscopic analysis of lateral canal filling revealed lower filling rates in apical canals compared to coronal ones and higher filling rates with "vertical compaction with apical backfilling" compared to Schilder's group. The tested procedure appears to be a reliable technique to obtain standardized lateral canals and to compare filling procedures.

  17. Artificial lateral line with biomimetic neuromasts to emulate fish sensing

    Energy Technology Data Exchange (ETDEWEB)

    Yang Yingchen; Chen Nannan; Tucker, Craig; Hu Huan; Liu Chang [Department of Mechanical Engineering, Northwestern University, Evanston, IL 60208 (United States); Nguyen, Nam; Lockwood, Michael; Jones, Douglas L [Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801 (United States); Bleckmann, Horst, E-mail: changliu@northwestern.ed, E-mail: dl-jones@uiuc.ed [Institut fuer Zoologie, Universitaet Bonn, Poppelsdorfer Schloss, D-53115 Bonn (Germany)

    2010-03-15

    Hydrodynamic imaging using the lateral line plays a critical role in fish behavior. To engineer such a biologically inspired sensing system, we developed an artificial lateral line using MEMS (microelectromechanical system) technology and explored its localization capability. Arrays of biomimetic neuromasts constituted an artificial lateral line wrapped around a cylinder. A beamforming algorithm further enabled the artificial lateral line to image real-world hydrodynamic events in a 3D domain. We demonstrate that the artificial lateral line system can accurately localize an artificial dipole source and a natural tail-flicking crayfish under various conditions. The artificial lateral line provides a new sense to man-made underwater vehicles and marine robots so that they can sense like fish.

  18. Image Restoration Phase-Filtering Lateral Superresolution Confocal Microscopy

    Institute of Scientific and Technical Information of China (English)

    ZHAO Wei-Qian; QIU Li-Rong; CHEN Shan-Shan; FENG Zheng-De

    2006-01-01

    @@ Image restoration phase-filtering lateral superresolution confocal microscopy, a new approach, is proposed to achieve lateral superresolution using a confocal microscope. This approach uses a lateral superresolution pupil filter to preliminarily improve its lateral resolution and uses a single-image superresolution restoration technique based on a maximum likelihood estimate to further improve its lateral resolution. The new approach has the advantages of a low cost and the remarkable superresolution effect without excessive system complexity. Experiments indicate that the proposed approach can improve the lateral resolution of a confocal microscope from 0.3μm to less than 0.1 μm when λ = 632.8 nm and NA =0.85.

  19. Analysis of lateral stability of I-section aluminum beams

    Institute of Scientific and Technical Information of China (English)

    CHENG Ming; SHI Yongjiu; WANG Yuanqing

    2006-01-01

    This paper focuses on the lateral buckling of laterally-unrestrained aluminum beams subjected to a concentrated, uniformly loading and pure-bending action. The design methods of lateral stability of aluminum beams in the current codes are discussed. The influence of material property on the lateral buckling of aluminum beams is investigated with finite element analysis (FEA) methods. Some numerical examples are given, and the results from current codes are compared with the FEA solutions. The design method on lateral stability of steel beams specified in the Chinese standard GB 50017-2003 is modified to calibrate the stability factors of aluminum beams according to the European code, British code, and American code, and the modified method is verified by FEA results. Through comparison with the available test results, the modified design method for overall stability of aluminum bending members is proposed in this paper and proved applicable in the design of lateral stability of aluminum beams.

  20. Measurement of Laterally Induced Optical Forces at the Nanoscale

    CERN Document Server

    Huang, Fei; Wickramasinghe, Hemanta Kumar

    2016-01-01

    We demonstrate the measurement of laterally induced optical forces using an Atomic Force Microscope (AFM). The lateral electric field distribution between a gold coated AFM probe and a nano-aperture in a gold film is mapped by measuring the lateral optical force between the apex of the AFM probe and the nano-aperture. Torsional eigenmodes of an AFM cantilever probe were used to detect the laterally induced optical forces. We engineered the cantilever shape using a focused ion beam to enhance the torsional eigenmode resonance. The measured lateral optical force agrees well with simulations. This technique can be extended to simultaneously detect both lateral and longitudinal optical forces at the nanoscale by using an AFM cantilever as a multichannel detector. This will enable simultaneous Photon Induced Force Microscopy (PIFM) detection of molecular responses with different incident field polarizations. The technique can be implemented on both cantilever and tuning fork based AFMs.

  1. Childhood laterality and adult schizophrenia spectrum disorders: a prospective investigation

    DEFF Research Database (Denmark)

    Schiffman, Jason; Pestle, Sarah; Mednick, Sara;

    2005-01-01

    Left or mixed-handedness, footedness, and eye dominance are thought to indicate abnormalities in lateralization related to schizophrenia. Increased left or mixed-dominance in schizophrenia suggests possible hemispheric abnormalities associated with the disorder. A related body of research suggests...... that some indications of lateralization abnormalities may be evident prior to the onset of schizophrenia, suggesting that disruptions in lateralization are inherent to the developmental course of the disorder. We attempted to replicate and extend upon findings indicating differences in lateralization...... between children who later developed a schizophrenia spectrum disorder (n = 26) and those who did not develop a schizophrenia spectrum disorder (n = 216), among a high-risk and control, longitudinal sample. The rate of left or mixed-footedness, eye dominance, and any anomalous lateralization...

  2. Laterality enhances numerical skills in the guppy, Poecilia reticulata

    Directory of Open Access Journals (Sweden)

    Marco eDadda

    2015-10-01

    Full Text Available It has been hypothesized that cerebral lateralization can significantly enhance cognition and that this was one of the primary selective forces shaping its wide-spread evolution amongst vertebrate taxa. Here we tested this hypothesis by examining the link between cerebral lateralization and numerical discrimination. Guppies, Poecilia reticulata, were sorted into left, right and non-lateralized groups using a standard mirror test and their numerical discrimination abilities tested in both natural shoal choice and abstract contexts. Our results show that strongly lateralized guppies have enhanced numerical abilities compared to non-lateralized guppies irrespective of context. These data provide further credence to the notion that cerebral lateralization can enhance cognitive efficiency

  3. Deep transverse friction massage for treating lateral elbow or lateral knee tendinitis.

    Science.gov (United States)

    Loew, Laurianne M; Brosseau, Lucie; Tugwell, Peter; Wells, George A; Welch, Vivian; Shea, Beverley; Poitras, Stephane; De Angelis, Gino; Rahman, Prinon

    2014-11-08

    Background Deep transverse friction massage, one of several physical therapy interventions suggested for the management of tendinitis pain, was first demonstrated in the 1930s by Dr James Cyriax, a renowned orthopedic surgeon in England. Its goal is to prevent abnormal fibrous adhesions and abnormal scarring. This is an update of a Cochrane review first published in 2001.Objectives To assess the benefits and harms of deep transverse friction massage for treating lateral elbow or lateral knee tendinitis.Search methods We searched the following electronic databases: the specialized central registry of the Cochrane Field of Physical and Related Therapies,the Cochrane Central Register of Controlled Trials (CENTRAL),MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Clinicaltrials.gov, and the Physiotherapy Evidence Database (PEDro), up until July 2014. The reference lists of these trials were consulted for additional studies.Selection criteria All randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing deep transverse friction massage with control or other active interventions for study participants with two eligible types of tendinitis (ie, extensor carpi radialis tendinitis (lateral elbow tendinitis, tennis elbow or lateral epicondylitis or lateralis epicondylitis humeri) and iliotibial band friction syndrome (lateral knee tendinitis)) were selected. Only studies published in English and French languages were included.Data collection and analysis Two review authors independently assessed the studies on the basis of inclusion and exclusion criteria. Results of individual trials were extracted from the included study using extraction forms prepared by two independent review authors before the review was begun.Data were cross-checked by a third review author. Risk of bias of the included studies was assessed using the "Risk of bias"tool of The Cochrane Collaboration. A pooled analysis was performed using

  4. Enhanced performance of methamphetamine lateral flow cassettes using an electronic lateral flow reader.

    Science.gov (United States)

    Smith, Jerome P; Sammons, Deborah L; Robertson, Shirley A; Snawder, John E

    2015-01-01

    Surface contamination from methamphetamine in meth labs continues to be a problem. We had previously developed a lateral flow assay cassette for field detection of methamphetamine contamination that is commercially available and has been used by a number of groups to assess contamination. This cassette uses the complete disappearance of the test line as an end point for detection of 50 ng/100 cm2 of methamphetamine contamination for surface sampling with cotton swabs. In the present study, we further evaluate the response of the cassettes using an electronic lateral flow reader to measure the intensities of the test and control lines. The cassettes were capable of detecting 0.25 ng/ml for calibration solutions. For 100 cm2 ceramic tiles that were spiked with methamphetamine and wiped with cotton-tipped wooden swabs wetted in assay/sampling buffer, 1 ng/tile was detected using the reader. Semi-quantitative results can be produced over the range 0-10 ng/ml for calibration solutions and 0-25 ng/tile for spiked tiles using either a 4-parameter logistic fit of test line intensity versus concentration or spiked mass or the ratio of the control line to the test line intensity fit to concentration or spiked mass. Recovery from the tiles was determined to be about 30% using the fitted curves. Comparison of the control line to the test line was also examined as a possible visual detection end point and it was found that the control line became more intense than the test line at 0.5 to 1 ng/ml for calibration solutions or 1 to 2 ng/tile for spiked tiles. Thus the lateral flow cassettes for methamphetamine have the potential to produce more sensitive semi-quantitative results if an electronic lateral flow reader is used and can be more sensitive for detection if the comparison of the control line to the test line is used as the visual end point.

  5. The 'hidden work' of a hospital neurologist: 1000 consults later.

    LENUS (Irish Health Repository)

    Ali, E

    2012-02-01

    BACKGROUND: A new Web-based, internal neurology referral service was introduced in our department to expedite inpatient review for other departments and to allow assessment of the impact of neurology consults on patient care throughout the hospital, especially in the emergency department (ED). The results of the analysis of the first 1000 referrals using the new system are presented. Methods: An intranet referral system was designed by the consultant neurologists. The previous method of referral was by handwritten letter. The electronic template included \\'drop-down\\' menus and mandatory fields to help guide referring teams. An outcome section is completed by the neurology team. Results: An average of 17 referrals was seen weekly. Seventy-seven per cent were seen within 24 h of referral. A consultant neurologist saw 87% of the referrals directly; 13% were first seen by a registrar and later discussed with a consultant. Forty per cent were seen in the ED of which a one-third of the patients were discharged following assessment. The most common reason for referral was seizure(s) or an episode of collapse (28%). Patients presenting with stroke\\/transient ischaemic attack represented 13.5%, and 12.5% presented with headaches. The management of 79% of referred cases was deemed to have been significantly changed after neurology review. Discussion: The introduction of a neurology consultant-designed and consultant-led intranet referral service has greatly enhanced the delivery of the consult service to patients in our hospital. This referral system contributes significantly to hospital efficiency and to access for patients to specialist assessment.

  6. Is early measles vaccination better than later measles vaccination?

    Science.gov (United States)

    Aaby, Peter; Martins, Cesário L; Ravn, Henrik; Rodrigues, Amabelia; Whittle, Hilton C; Benn, Christine S

    2015-01-01

    WHO recommends delaying measles vaccination (MV) until maternal antibody has waned. However, early MV may improve child survival by reducing mortality from conditions other than measles infection. We tested whether early MV improves child survival compared with later MV. We found 43 studies comparing measles-vaccinated and measles-unvaccinated children; however, only 16 studies had specific information that MV had been provided at 4-13 months of age, many before 9 months of age. In the 10 best studies (4 randomized trials and 6 observational studies) control children did not receive MV during follow-up. In eight of these studies the vaccine efficacy against death (VED) was 60% or more. In four studies with information on MV provided both before and after 12 months of age, the all-cause mortality reduction was significantly larger for children vaccinated in infancy (VED=74%; 95% CI 51-86%) than for children vaccinated after 12 months of age (VED=29%; CI 8-46%). Prevention of measles explained little of the reduction in mortality. In five studies with information on measles infection, VED was 67% (51-78%) and when measles deaths were excluded, VED was only reduced to 65% (47-77%). One natural experiment compared MV at 4-8 months versus MV at 9-11 months of age and found significantly lower all-cause mortality with early vaccination, the difference being 39% (8-60%). Child mortality may be reduced if MV is given earlier than currently recommended by international organizations.

  7. Extra flat, flexible and disposable endoscope for lateral imaging

    Science.gov (United States)

    Basset, G.; Marinov, D.; Hofer, C.; Cattaneo, S.; Volet, P.; Gallinet, B.; Schnieper, M.; Ferrini, R.

    2016-03-01

    We present an innovative disposable endoscope based on extra flat flexible polymer slabs used as multimode waveguides. The waveguides are compatible with low-cost roll-to-roll production technologies and can be easily customized by patterning, coating and printing techniques according to the specifications of the target application. In order to couple the light (i.e. the illumination beam and the imaging beam) in and out of the waveguide, diffractive subwavelength gratings are used. These nano-scale optical structures enable an efficient and controlled light trapping by total internal reflection, thus minimizing the distortion effects generated by the rough edges. Nano-patterning is obtained using established techniques (i.e. hot embossing and/or UV casting) that are compatible with industrial roll-to-roll production lines or plastic injection molding. Unique features of these innovative endoscopes are i) the achievable very thin form that can be reduced to thicknesses below 200 μm, ii) the ability to record lateral images with respect to the endoscope direction, iii) the ability to image samples (e.g. tissues, tiny objects) in direct contact with the polymer slab, with a minimum imaging distance equal to zero, and iv) the access to high volume fabrication techniques that can enable the production of low-cost disposable endoscopes. A possible device implementation is demonstrated and tested, which consists of a flat line-scanning endoscope enabling the acquisition of 1D images in monochromatic illumination and the reconstruction of 2D images by scanning. Images taken with such a disposable endoscope are discussed and the related technological constraints such as manufacturing tolerances, image distortion, scattered light and signal to noise ratio are further described. Finally, advantages and disadvantages with respect to other endoscopic techniques will be discussed, thus demonstrating the potential of this innovative approach for endoscopic applications in very

  8. Investigation of human hair fibers using lateral force microscopy.

    Science.gov (United States)

    McMullen, R L; Kelty, S P

    2001-01-01

    Atomic force microscopy (AFM) and lateral force microscopy (LFM) were used to investigate the morphologic and surface changes associated with various surface modifications to human hair. These included extraction with a series of solvents, bleaching, and treatment with a cationic copolymer. The study assessed the ability of these techniques to distinguish the changes in surface properties, including morphology and friction coefficient, as manifested in changes brought about by the indicated surface modifications. While topographic morphology can easily be investigated with contact AFM. LFM offers an additional tool for probing the surface distribution of oils and waxes. The removal of surface lipids from the fiber surface was accomplished using soxhlet extraction with t-butanol and n-hexane, while the free internal lipids (within the fiber structure) were removed by extraction with a mixture of chloroform and methanol (70:30, v/v). In addition, the surface of hair was modified with the cationic polymer, co(vinyl pyrrolidone-methacrylamidopropyl trimethylammonium chloride [PVP/MAPTAC]), and its distribution on the surface was monitored. Ambient AFM and LFM studies of surface modified and native fibers clearly indicate that when investigated as a function of tip loading force, the different modifications result in changes of the friction coefficient, which increase in this order: native, bleached, solvent extracted, and polymer-treated hair. Friction images show surface variations that are interpreted as areas of varying lipid film coverage. In addition, topographic images of the fibers show the presence of small pores, which become increasingly prevalent upon solvent extraction.

  9. Mechanical and neuromuscular changes with lateral trunk lean gait modifications.

    Science.gov (United States)

    Robbins, Shawn M; Teoli, Anthony; Preuss, Richard A

    2016-09-01

    Lateral trunk lean (LTL) is a proposed intervention for knee osteoarthritis but increased muscular demands have not been considered. The objective was to compare lower extremity and trunk muscle activation and joint mechanics between normal and increased LTL gait in healthy adults. Participants (n=20, mean age 22 years) were examined under two gait conditions: normal and increased LTL. A motion capture system and force plates sampled at 100 and 2000Hz respectively were used to determine joint angles and external moments including LTL angle and external knee adduction moment (KAM). Surface electromyography, sampled at 2000Hz, measured activation of six trunk/hip muscles bilaterally. Peak LTL angle, peak KAM, gait speed, and mean values from electromyography waveforms were compared between normal and LTL conditions using paired t-tests or 2-way analysis of variance. There was a significant (p<0.05) increase in peak LTL angle, decrease in first but not second peak KAM, and decrease in gait speed during LTL gait. There were significant (p<0.01) increases in external oblique and iliocostalis muscle activation during LTL gait. There was no change in activation for internal oblique, rectus abdominis, longissimus, and gluteus medius. LTL gait decreased early/mid-stance KAM demonstrating its ability to decrease medial compartment knee loading. Increases in external oblique and iliocostalis activation were present but small to moderate in size and unlikely to lead to short term injury. Longitudinal studies should evaluate the effectiveness of increased LTL for knee osteoarthritis and if the increase in muscular demands leads to negative long term side effects.

  10. Internal stress in children and parental attitude to dental treatment with passive restraint

    National Research Council Canada - National Science Library

    Tsuchihashi, Natsumi; Uehara, Naoko; Takagi, Yuzo; Miwa, Zenzo; Sugimoto, Kumiko

    2012-01-01

      PURPOSE: The purpose of this study was to examine the internal stress in uncooperative children treated under passive restraint and the changes of it in later treatments under cooperative condition with no need of restraint...

  11. Internal stress in children and parental attitude to dental treatment with passive restraint

    National Research Council Canada - National Science Library

    Tsuchihashi, Natsumi; Uehara, Naoko; Takagi, Yuzo; Miwa, Zenzo; Sugimoto, Kumiko

    2012-01-01

    PURPOSE: The purpose of this study was to examine the internal stress in uncooperative children treated under passive restraint and the changes of it in later treatments under cooperative condition with no need of restraint...

  12. Medio-lateral entry pin versus lateral entry pin for displaced pediatric supracondylar fractures: A comparative, prospective study

    Directory of Open Access Journals (Sweden)

    Manoj Kandel

    2016-01-01

    Full Text Available Background & Objectives: Supracondylar fracture is one of the commonest fractures in children. Although the technique of pinning is controversial, percutaneous medio-lateral entry pinning is theoretically considered more stable biomechanical construct. The drawback of this method is injury to ulnar nerve which is not encountered in only lateral entry pinning.Materials & Methods: This was a prospective, comparative and observational study done in 60 patients which was alternately divided into two groups. The first group (A underwent medio-lateral entry pinning and the second group (B underwent lateral entry pinning. They were followed for 24 weeks and the outcome was assessed using Flynn’s criteria.Results: At twenty-four weeks, the mean loss of range of motion of elbow in medio-lateral pinning group was 3.70 degrees (SD±1.93 and that in lateral pinning group was 4.23 degrees (SD ±1.38. The mean loss in carrying angle at twenty-four weeks in medio-lateral group was 2.93 degrees (SD±2.19 and that in lateral group was 4.17 (SD±2.24. There were 2 (6.67% cases of iatrogenic ulnar nerve injury in medio-lateral pinning group. Out of thirty patients, in medio-lateral pinning group, 25 had excellent results, 5 had good results and none had fair or poor results. While out of 30 patients in lateral pinning group, 23 had excellent results, 7 had good results and none had fair or poor results.Conclusion: There is no significant difference in outcome in terms of loss of carrying angle and range of motion between the medio-lateral pinning group and the lateral pinning group at the end of 6 months.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 28-31

  13. Calibration and removal of lateral chromatic aberration in images

    OpenAIRE

    Mallon, John; Whelan, Paul F.

    2007-01-01

    This paper addresses the problem of compensating for lateral chromatic aberration in digital images through colour plane realignment. Two main contributions are made: the derivation of a model for lateral chromatic aberration in images, and the subsequent calibration of this model from a single view of a chess pattern. These advances lead to a practical and accurate alternative for the compensation of lateral chromatic aberrations. Experimental results validate the proposed models and calibra...

  14. Effects of a continuous lateral turning device on pressure relief

    OpenAIRE

    Do, Nam Ho; Kim, Deog Young; Kim, Jung-Hoon; Choi, Jong Hyun; Joo, So Young; Kang, Na Kyung; Baek, Yoon Su

    2016-01-01

    [Purpose] The purpose of this study was to examine the pressure-relieving effects of a continuous lateral turning device on common pressure ulcer sites. [Subjects] Twenty-four healthy adults participated. [Methods] The design of our continuous lateral turning device was motivated by the need for an adequate pressure-relieving device for immobile and/or elderly people. The procedure of manual repositioning is embodied in our continuous lateral turning device. The interface pressure and time we...

  15. Revisiting the relationship between hand preference and lateral eye movement

    OpenAIRE

    Indiwar Misra; Damodar Suar; Manas K. Mandal

    2010-01-01

    The study examines the relationship between hand preference and conjugate lateral eye movements. The sample comprised of 224 persons. The hand preference was assessed using a handedness inventory. Conjugate lateral eye movements were elicited in response to verbal and spatial questions among left-, mixed- and right-handers. The left- and mixed-handers exhibit significantly greater number of conjugate lateral eye movements than the right-handers. On the verbal task, right-handers exhibit right...

  16. Toxic shock syndrome post open reduction and Kirschner wire fixation of a humeral lateral condyle fracture.

    Science.gov (United States)

    Chan, Yuen; Selvaratnam, Veenesh; Garg, Neeraj

    2015-08-11

    Use of Kirschner wires (K-wires) is the most common method of fracture stabilisation in lateral condyle fracture fixation in children. We report a case of toxic shock syndrome (TSS) following an open reduction and internal fixation using K-wires for a humeral lateral condyle fracture in a 5-year-old girl. TSS is a toxin-mediated multisystem illness. It typically presents with shock and it is most often attributed to toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. It can lead to multiorgan failure and, ultimately, death. It is important to be aware of TSS, as it can present within any setting. Patients often have non-specific symptoms and their condition can worsen rapidly. TSS postorthopaedic surgery is rare; however, due to the serious nature of this disease, it is important to promptly recognise and diagnose TSS, and to ensure appropriate treatment is started without delay.

  17. Windows® Internals

    CERN Document Server

    Russinovich, Mark E; Ionescu, Alex

    2009-01-01

    See how the core components of the Windows operating system work behind the scenes-guided by a team of internationally renowned internals experts. Fully updated for Windows Server 2008 and Windows Vista, this classic guide delivers key architectural insights on system design, debugging, performance, and support-along with hands-on experiments to experience Windows internal behavior firsthand.Delve inside Windows architecture and internals:Understand how the core system and management mechanisms work-from the object manager to services to the registryExplore internal system data structures usin

  18. Neurology and international organizations.

    Science.gov (United States)

    Mateen, Farrah J

    2013-07-23

    A growing number of international stakeholders are engaged with neurologic diseases. This article provides a brief overview of important international stakeholders in the practice of neurology, including global disease-specific programs, United Nations agencies, governmental agencies with international influence, nongovernmental organizations, international professional organizations, large private donors, private-public partnerships, commercial interests, armed forces, and universities and colleges. The continued engagement of neurologists is essential for the growing number of international organizations that can and should incorporate neurologic disease into their global agendas.

  19. Large-area, laterally-grown epitaxial semiconductor layers

    Energy Technology Data Exchange (ETDEWEB)

    Han, Jung; Song, Jie; Chen, Danti

    2017-07-18

    Structures and methods for confined lateral-guided growth of a large-area semiconductor layer on an insulating layer are described. The semiconductor layer may be formed by heteroepitaxial growth from a selective growth area in a vertically-confined, lateral-growth guiding structure. Lateral-growth guiding structures may be formed in arrays over a region of a substrate, so as to cover a majority of the substrate region with laterally-grown epitaxial semiconductor tiles. Quality regions of low-defect, stress-free GaN may be grown on silicon.

  20. Lateral resonances in initial stressed 1-3 piezocomposites

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-yan; SHEN Ya-peng; YIN Guan-sheng

    2007-01-01

    A theoretical analysis of the lateral resonances in 1-3 piezocomposites with poling initial stress is conducted using the Bloch wave theory. Based on the linear piezoelectricity theory, theoretical formulations that include initial stress for the propagation of acoustic plane waves are made. Numerical calculations are performed to study the effects of the initial stress on the lateral mode frequencies and the stop band. It is found that lateral mode frequencies increase with the piezoelectricity of the piezocomposites,but decrease with the poling initial stress. The influence of the initial shear stress on the lateral mode frequencies is minimal, and can thus be neglected.

  1. Effect of Acupotomy Therapy on Lateral Epicondylitis Diagnosed by Ultrasonography

    Directory of Open Access Journals (Sweden)

    Lim Nara

    2011-06-01

    Full Text Available Purpose: This observation was to report the clinical effects of acupotomy in treating lateral epicondylitis. Methods: Three patients diagnosed with lateral epicondylitis were treated with acupotomy. Two were male and one was female. The improvement of symptom were evaluated by visual analog scale (VAS and self-consciousness symptoms of Cozen test. Results: After one treatments, patient's chief complaint and the pain near the lateral epicondyle while cozen test were notably improved. Conclusions: This study demonstrates that oriental medical treatment with acuputomy therapy has significant effect in improving symptoms of lateral epicondylitis. As though we had not wide experienced in this treatment, more research is needed.

  2. Functional brain laterality for sequential movements: Impact of transient practice

    Institute of Scientific and Technical Information of China (English)

    ZHU Yihong; DONG Zongwang; WENG Xuchu; CHEN Yizhang

    2005-01-01

    The impact of learning on brain functional laterality has not been systematically investigated. We employed an event-related functional magnetic resonance imaging combined with a delayed sequential movement task to investigate brain activation pattern and laterality during a transient practice in 12 subjects. Both hemispheres, involving motor areas and posterior parietal cortex, were engaged during motor preparation and execution, with larger activation volume in the left hemisphere than in the right. Activation volume in these regions significantly decreased after a transient practice, with more reduction in the right hemisphere resulting increase in left lateralization. The theoretical implications of these findings are discussed in relation to the physiological significance of brain functional laterality.

  3. On possible linguistic correlates to brain lateralization

    Directory of Open Access Journals (Sweden)

    Tania Kouteva/Kuteva

    2014-04-01

    phenomena and brain lateralization. More precisely, on the basis of substantial neurolinguistic research it is argued that novel speech is represented in the left hemisphere, whereas formulaic speech is modulated by a subcortical right hemisphere circuit. Within the framework of Discourse Grammar (Heine et al. 2013 it is argued that there is a similar correlation between two domains of grammar, namely Sentence Grammar and Thetical Grammar: Aphasic patients and other persons with left hemisphere damage appear to draw mainly on linguistic expressions within the domain of Thetical Grammar; persons with right hemisphere damage, by contrast, use primarily Sentence Grammar as their main domain of structuring speech (Heine et al. 2014. While arriving at similar conclusions, there are a few differences between these two frameworks. In particular, the dual process model relies on the distinction between novel and formulaic speech as its main parameter, while in the framework of Discourse Grammar it is distinctions in the functions and the syntactic and prosodic independence of linguistic units that are most central. The present paper argues that such differences can be accounted for with reference to the differential role played by the situation of discourse in linguistic communication.

  4. Comparison of Kinematics and Tibiofemoral Contact Pressures for Native and Transplanted Lateral Menisci

    Science.gov (United States)

    McCulloch, Patrick C.; Dolce, Donald; Jones, Hugh L.; Gale, Andrea; Hogen, Michael G.; Alder, Jason; Palmer, Jeremiah E.; Noble, Philip C.

    2016-01-01

    Background: Lateral meniscus transplantation is a proven treatment option for the meniscus-deficient knee, yet little is known about meniscal kinematics, strain, and tibiofemoral contact pressure changes after transplantation or the effect of altered root position in lateral meniscus transplantation. Purpose: To compare the native lateral meniscal kinematics, strain, and tibiofemoral contact pressures to a best-case scenario meniscus transplant with perfectly matched size and position and to determine how sensitive these factors are to subtle changes in shape and position by using a nonanatomic meniscus transplant position. Study Design: Controlled laboratory study. Methods: The lateral menisci of 8 cadaveric knees were circumferentially implanted with radiopaque spherical markers. They were mounted to a testing apparatus applying muscle and ground-reaction forces. The meniscus was evaluated at 0°, 30°, 90°, and 115° of knee flexion using Roentgen stereophotogrammetric analysis (RSA), with a pressure sensor affixed to the lateral tibial plateau. Measurements were recorded for 3 states: the native lateral meniscus, an anatomic autograft transplant, and a nonanatomic autograft transplant with an anteriorized posterior root position. Results: After transplantation, there was less posterior displacement in both the anatomic and nonanatomic transplant states compared with the native meniscus, but this was not significant. The largest lateral translation in the native state was 2.38 ± 1.58 mm at the anterolateral region from 0° to 90°, which was increased to 3.28 ± 1.39 mm (P = .25) and 3.12 ± 1.18 mm (P = .30) in the anatomic and nonanatomic transplant states, respectively. Internal deformations of the transplant states were more constrained, suggesting less compliance. The native meniscus distributed load over 223 mm2, while both the anatomic (160 mm2) and nonanatomic (102 mm2) states concentrated pressure anteriorly to the tibial plateau centroid. Conclusion

  5. Orbitotomía lateral mediante abordaje temporal Lateral orbitotomy using a temporal approach

    Directory of Open Access Journals (Sweden)

    H. Herencia Nieto

    2005-12-01

    Full Text Available La orbitotomía lateral sigue siendo en el momento actual la técnica quirúrgica de elección para la biopsia o extirpación de lesiones intraorbitarias laterales al nervio óptico, la biopsia del propio nervio óptico y la extirpación de la glándula lacrimal. Se han descrito múltiples incisiones cutáneas para llevar a cabo esta intervención; la más frecuentemente empleada por el momento es la incisión palpebral, que discurre a nivel de alguna arruga del párpado superior. Aunque los resultados obtenidos con esta incisión suelen ser aceptables, no está exenta de complicaciones, ni estéticas ni funcionales. Por esto, en los últimos años han ido apareciendo nuevas incisiones que intentan evitar estas complicaciones. Entre estas nuevas vías de abordaje a la pared lateral de la órbita se encuentra la incisión temporal. En los últimos 3 años, se ha intervenido en nuestro servicio a cuatro pacientes para llevar a cabo biopsia o extirpación de masas intraorbitarias mediante orbitotomía lateral, siempre a través de una incisión temporal. En todos los casos esta incisión permitió una amplia exposición del campo quirúrgico y la cómoda realización de la intervención, obteniéndose resultados estéticos y funcionales excelentes, y sin ninguna secuela ni complicación permanente. La complicación específica más frecuente de esta incisión es la paresia de la rama frontal del nervio facial. Una técnica de disección cuidadosa suele ser suficiente para evitarla. Todo esto hace que esta incisión, tal y como la describimos aquí, sea de elección para llevar a cabo la orbitotomía lateral, constituyendo en nuestro criterio una alternativa perfectamente válida y a tener en cuenta frente a las incisiones «clásicas», a las que llega a superar en muchos aspectos.The lateral orbitotomy it still the surgical technique of choice for biopsies or the removal of intraorbital lesions that are lateral to the optic nerve, for biopsies of

  6. Lack of consensus on the role of endoscopic retrograde cholangiography in acute biliary pancreatitis in published meta-analyses and guidelines: a systematic review

    NARCIS (Netherlands)

    Geenen, E.J.M. van; Santvoort, H.C. van; Besselink, M.G.; Peet, D.L. van der; Erpecum, K.J. van; Fockens, P.; Mulder, C.J.; Bruno, M.J.

    2013-01-01

    OBJECTIVES: Several randomized controlled trials studied the role of endoscopic retrograde cholangiopancreaticography (ERCP) and endoscopic sphincterotomy (ES) in acute biliary pancreatitis (ABP). No study assessed whether these trials resulted in international consensus in published meta-analyses a

  7. MRI of paraventricular white matter lesions in amyotrophic lateral sclerosis. Analysis by diffusion-weighted images

    Energy Technology Data Exchange (ETDEWEB)

    Segawa, Fuminori; Kinoshita, Masao (Toho Univ., Tokyo (Japan). Ohashi Hospital); Kishibayashi, Jun; Kamada, Kazuhiko; Sunohara, Nobuhiko

    1994-09-01

    Magnetic resonance images in some cases of amyotrophic lateral sclerosis (ALS) revealed abnormal signals in both the paraventriculer white matter and in the posterior limbs of the internal capsule. We examined T[sub 2]- and diffusion-weighted MR images of these lesions in 18 cases of ALS. There were symmetrical high-signal areas in the posterior limbs of the internal capsule in all of the cases. The high-signal areas in the internal capsule corresponded to the pyramidal tracts in the anatomical atlas by Talairach. In 5 of the cases of ALS, T[sub 2]-weighted MR images showed discrete paraventricular white matter lesions as well. The mean age of the ALS patients with paraventricular white matter lesions was higher than that of the ALS patients without such lesions. Proton densities calculated from the conventional MR images were higher in both the capsular and paraventricular lesions. The diffusion coefficients perpendicular to the pyramidal tract in the internal capsular lesions were within the normal range, where as the diffusion coefficients in the paraventricular lesions were increased in all directions. Thus, diffusion anisotropy was lost in the paraventricular lesions. These findings are similar to those observed in the white matter lesions of cerebro-vascular origin. As a result, the pathology of the paraventricular lesions in ALS was confirmed to be different from that of the internal capsular lesions. (author).

  8. Coronal patellar osteotomy of the external facet combined with the release of the lateral retinaculum improves the clinical outcomes of isolated lateral release in lateral knee compartment syndrome.

    Science.gov (United States)

    Rosales-Varo, A P; Roda-Murillo, O; Prados-Olleta, N; García-Espona, M A

    2016-01-01

    To describe a novel coronal osteotomy of the external facet of the patella, and to evaluate if the outcomes of the treatment of lateral knee compartment syndrome (LKCS) with this osteotomy, combined with the release of the external lateral retinaculum, are better than the isolated lateral retinacular release. A prospective study with a 2 year follow up that included 70 patients diagnosed with LKCS, distributed into 2 groups. The first group included 50 patients on whom the lateral retinacular release combined with osteotomy was performed, and a second group on whom an isolated retinacular release was performed. Measurements were made using the Werner functional scale before the surgery and at 3, 12, and 24 months follow-up. There were significant differences in the overall functional state between the two groups after the surgery (better in the osteotomy group at all the intervals, Posteotomy technique, combined with lateral retinacular release, significantly improves the pain and the functional scale score of patients with LKCS after 2 years of follow-up, to a greater extent than isolated lateral retinacular release, including those in which there was evidence of degenerative signs. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Defining the lateral and accessory views of the patella: an anatomic and radiographic study with implications for fracture treatment.

    Science.gov (United States)

    Berkes, Marschall B; Little, Milton T M; Pardee, Nadine C; Lazaro, Lionel E; Helfet, David L; Lorich, Dean G

    2013-12-01

    The majority of orthopaedic surgeons rely on a lateral fluoroscopic image to assess reduction during patella fracture osteosynthesis. However, a comprehensive radiographic description of the lateral view of the patella has not been performed previously, and no accessory views to better visualize specific anatomic features have been developed. The purpose of this study was to provide a detailed anatomic description of all radiographic features of the true lateral of the patella, describe reproducible accessory views for assessing specific features of the patella, and demonstrate their utility in a fracture model. Twelve cadaver knee specimens free of patellofemoral pathology were used, and imaging was performed using standard C-arm fluoroscopy. For each specimen, a true lateral radiographic projection of the patella was obtained and distinct features were noted. Next, an arthrotomy was made and steel wire was contoured and fixed to various anatomic regions of the patella so as to obliterate the radiographic densities on the true lateral projection, thus confirming their anatomic correlation. Ideal views of the lateral and medial facets themselves were determined using radiographic markers and varying amounts of internal or external rotation of the specimen. Last, a transverse osteotomy was created in each patella and the ability of the true lateral and accessory views to detect malreduction was assessed. The true lateral projection of the patella was obtained with the limb in neutral alignment. Constant radiographic features of the lateral view of the patella include the articular tangent, a secondary articular density of variable length, and a dorsal cortical density. The articular tangent was produced by the central ridge between the medial and lateral facets in all specimens. The secondary articular density was created by a confluence of the edge of the lateral and edge of the medial facets in 5 patellas, a confluence of the edge of the lateral facet and the

  10. Influence of inlet and bulk noise on Rayleigh-Bénard convection with lateral flow.

    Science.gov (United States)

    Jung, D; Lücke, M; Szprynger, A

    2001-05-01

    Spatiotemporal properties of convective fluctuations and of their correlations are investigated theoretically in the vicinity of the threshold for onset of convection in the presence of a lateral through-flow using the full linearized equations of fluctuating hydrodynamics. The effect of external forcing by inlet boundary conditions on the downstream evolution of convective fields is separated from the effect of internal bulk thermal forcing with the use of spatial Laplace transformations. They show how the spatial variation of fluctuations and of their correlations are governed by the six spatial characteristic exponents of the field equations.

  11. Examining External and Internal Poverty as Antecedents of Teen Pregnancy

    Science.gov (United States)

    Young, Tamera; Turner, Jean; Denny, George; Young, Michael

    2004-01-01

    Objectives: To identify antecedents of teen pregnancy. Methods: Data from the National Education Longitudinal Study were analyzed. This data set allowed us to identify eighth-grade antecedents of teen pregnancy/childbearing. Results: The variables that were found to be most predictive of later pregnancy were reflective of internal poverty (locus…

  12. The mammalian gene function resource: The International Knockout Mouse Consortium

    NARCIS (Netherlands)

    A. Bradley (Allan); K. Anastassiadis (Konstantinos); A. Ayadi (Abdelkader); J.F. Battey (James); C. Bell (Cindy); M.-C. Birling (Marie-Christine); J. Bottomley (Joanna); S.D.M. Brown (Steve); F. Bürger (Friederike); C.J. Bult (Carol); W. Bushell (Wendy); F.S. Collins (Francis); C. Desaintes (Christian); B. Doe (Brendan); E. Aris (Economides); J.T. Eppig (Janan); R.H. Finnell (Richard); C. Fletcher (Colin); M. Fray (Martin); D. Frendewey (David); R.H. Friedel (Roland); F.G. Grosveld (Frank); J. Hansen; Y. Hérault (Yann); G. Hicks (Geoffrey); A. Hörlein (Andreas); C. Houghton (Catherine); M. Hrabé De Angelis (Martin); D. Huylebroeck (Danny); V. Iyer (Vivek); P.J. de Jong (Pieter); J.A. Kadin (James); C. Kaloff (Cornelia); K. Kennedy (Karen); M. Koutsourakis (Manousos); K.C. Kent Lloyd (K.); S. Marschall (Susan); J. Mason (Jeremy); C. McKerlie (Colin); M.P. McLeod (Michael); H. von Melchner (Harald); M. Moore (Matt); A.O. Mujica (Alejandro); A. Nagy (Andras); M. Nefedov (Mikhail); L.M. Nutter (Lauryl); G. Pavlovic (Guillaume); J.L. Peterson (Jane); I. Pollock; R. Ramirez-Solis (Ramiro); D.E. Rancourt (Derrick); M. Raspa (Marcello); J.E. Remacle (Jacques); M. Ringwald (Martin); B. Rosen (Barry); N. Rosenthal (Nadia); J. Rossant (Janet); P. Ruiz Noppinger (Patricia); S. Ryder; J.Z. Schick (Joel Zupicich); F. Schnütgen (Frank); C.J. Schofield (Christopher); C. Seisenberger (Claudia); M. Selloum (Mohammed); E.M. Simpson (Elizabeth); W.C. Skarnes (William); D. Smedley (Damian); W.L. Stanford (William); A. Francis Stewart (A.); K. Stone (Kevin); K. Swan (Kate); H. Tadepally (Hamsa); J.L. Teboul (Jean Louis); G.P. Tocchini-Valentini (Glauco); D. Valenzuela (David); A.P. West (Anthony); K.-I. Yamamura (Ken-Ichi); Y. Yoshinaga (Yuko); M. Wurst (Martin)

    2012-01-01

    textabstractIn 2007, the International Knockout Mouse Consortium (IKMC) made the ambitious promise to generate mutations in virtually every protein-coding gene of the mouse genome in a concerted worldwide action. Now, 5 years later, the IKMC members have developed highthroughput gene trapping and, i

  13. The mammalian gene function resource: The International Knockout Mouse Consortium

    NARCIS (Netherlands)

    A. Bradley (Allan); K. Anastassiadis (Konstantinos); A. Ayadi (Abdelkader); J.F. Battey (James); C. Bell (Cindy); M.-C. Birling (Marie-Christine); J. Bottomley (Joanna); S.D.M. Brown (Steve); F. Bürger (Friederike); C.J. Bult (Carol); W. Bushell (Wendy); F.S. Collins (Francis); C. Desaintes (Christian); B. Doe (Brendan); E. Aris (Economides); J.T. Eppig (Janan); R.H. Finnell (Richard); C. Fletcher (Colin); M. Fray (Martin); D. Frendewey (David); R.H. Friedel (Roland); F.G. Grosveld (Frank); J. Hansen; Y. Hérault (Yann); G. Hicks (Geoffrey); A. Hörlein (Andreas); C. Houghton (Catherine); M. Hrabé De Angelis (Martin); D. Huylebroeck (Danny); V. Iyer (Vivek); P.J. de Jong (Pieter); J.A. Kadin (James); C. Kaloff (Cornelia); K. Kennedy (Karen); M. Koutsourakis (Manousos); K.C. Kent Lloyd (K.); S. Marschall (Susan); J. Mason (Jeremy); C. McKerlie (Colin); M.P. McLeod (Michael); H. von Melchner (Harald); M. Moore (Matt); A.O. Mujica (Alejandro); A. Nagy (Andras); M. Nefedov (Mikhail); L.M. Nutter (Lauryl); G. Pavlovic (Guillaume); J.L. Peterson (Jane); I. Pollock; R. Ramirez-Solis (Ramiro); D.E. Rancourt (Derrick); M. Raspa (Marcello); J.E. Remacle (Jacques); M. Ringwald (Martin); B. Rosen (Barry); N. Rosenthal (Nadia); J. Rossant (Janet); P. Ruiz Noppinger (Patricia); S. Ryder; J.Z. Schick (Joel Zupicich); F. Schnütgen (Frank); C.J. Schofield (Christopher); C. Seisenberger (Claudia); M. Selloum (Mohammed); E.M. Simpson (Elizabeth); W.C. Skarnes (William); D. Smedley (Damian); W.L. Stanford (William); A. Francis Stewart (A.); K. Stone (Kevin); K. Swan (Kate); H. Tadepally (Hamsa); J.L. Teboul (Jean Louis); G.P. Tocchini-Valentini (Glauco); D. Valenzuela (David); A.P. West (Anthony); K.-I. Yamamura (Ken-Ichi); Y. Yoshinaga (Yuko); M. Wurst (Martin)

    2012-01-01

    textabstractIn 2007, the International Knockout Mouse Consortium (IKMC) made the ambitious promise to generate mutations in virtually every protein-coding gene of the mouse genome in a concerted worldwide action. Now, 5 years later, the IKMC members have developed highthroughput gene trapping and,

  14. CNPC makes major breakthrough in array lateral logging technology

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    On October 12, 2011, the array lateral logging tool independently developed by CNPC Well Logging Company was successfully put to use at two production wells at Changqing Oilfield, obtaining high quality logging information. CNPC becomes the second company after Schlumberger in the world to master the array lateral logging technology, which can effectively identify layers as thin as 0.3 meter.

  15. Dynamic interplay between adhesive and lateral E-cadherin dimers

    DEFF Research Database (Denmark)

    Klingelhöfer, Jörg; Laur, Oscar Y; Troyanovsky, Regina B;

    2002-01-01

    M. The disappearance of adhesive dimers was counterbalanced by an increase in Trp156-dependent lateral dimers. Increasing the calcium concentration to a normal level rapidly restored the original balance between adhesive and lateral dimers. We also present evidence that E-cadherin dimers in vivo have a short lifetime...

  16. The influence of sex hormones on brain lateralization : Research Programme

    NARCIS (Netherlands)

    Beking, Tess; Geuze, Reint; Groothuis, Antonius

    2015-01-01

    Between and within sexes individuals differ in lateralization of brain and behaviour that might affect cognitive performance. There is long standing debate to what extent variation in lateralization is due to variation in early or late exposure to sex hormones. We will use two unique data sets to te

  17. LATERAL CEPHALOMETRIC RADIOGRAPHY FOR EVALUATION OF UPPER AIRWAY

    Directory of Open Access Journals (Sweden)

    Miesje Karmiati Purwanegara

    2015-06-01

    Full Text Available The influenced of respiration to dentocraniofacial growth and development is still controversial. The accurate radiologic examination is important factor for proper diagnosis. Deviation of upper airway (i.e. nasopharynx, oropharymx and nasal cavity could be evaluated by lateral and anteroposterior cephalometric projection technique. This paper explains several methods to evaluate upper respiratory tract by lateral radiograph.

  18. Design and fabrication process for artificial lateral line flow sensors

    NARCIS (Netherlands)

    Izadi, N.; Verlaat, Bas; Berenschot, Johan W.; Wiegerink, Remco J.; de Boer, Meint J.; Mogdans, Joachim; Krijnen, Gijsbertus J.M.

    2008-01-01

    In fish the lateral line is a sensory organ used to perceive water movement in the surrounding environment to localize prey or predators, to avoid obstacles, for schooling and more. The lateral line consists of many mechanoreceptors called neuromast which consist of groups of hair cells covered by a

  19. The Evolution of Lateralization in Group Hunting Sailfish

    DEFF Research Database (Denmark)

    Kurvers, Ralf H J M; Krause, Stefan; Viblanc, Paul E

    2017-01-01

    of a lack of population-level lateralization. Our results present a novel benefit of group hunting: by alternating attacks, individual-level attack lateralization can evolve, without the negative consequences of individual-level predictability. More generally, our results suggest that group hunting...... in predators might provide more suitable conditions for the evolution of strategy diversity compared to solitary life....

  20. Fascial deformation in the lateral elbow region: A conceptual approach

    NARCIS (Netherlands)

    R. Stoeckart (Rob); A. Vleeming (Andry); J.L. Simons; R.P. van Helvoirt (R.); C.J. Snijders (Chris)

    1991-01-01

    markdownabstractAbstract In embalmed preparations, the antebrachial fascia in the lateral elbow region is shown to be deformed by load application to the triceps muscle. From this fascia, muscles arise which are primarily concerned with the extension of wrist and fingers. In the case of lateral ep