Prediction of medial and lateral contact force of the knee joint during normal and turning gait after total knee replacement.

Science.gov (United States)

Purevsuren, Tserenchimed; Dorj, Ariunzaya; Kim, Kyungsoo; Kim, Yoon Hyuk

2016-04-01

The computational modeling approach has commonly been used to predict knee joint contact forces, muscle forces, and ligament loads during activities of daily living. Knowledge of these forces has several potential applications, for example, within design of equipment to protect the knee joint from injury and to plan adequate rehabilitation protocols, although clinical applications of computational models are still evolving and one of the limiting factors is model validation. The objective of this study was to extend previous modeling technique and to improve the validity of the model prediction using publicly available data set of the fifth "Grand Challenge Competition to Predict In Vivo Knee Loads." A two-stage modeling approach, which combines conventional inverse dynamic analysis (the first stage) with a multi-body subject-specific lower limb model (the second stage), was used to calculate medial and lateral compartment contact forces. The validation was performed by direct comparison of model predictions and experimental measurement of medial and lateral compartment contact forces during normal and turning gait. The model predictions of both medial and lateral contact forces showed strong correlations with experimental measurements in normal gait (r = 0.75 and 0.71) and in turning gait trials (r = 0.86 and 0.72), even though the current technique over-estimated medial compartment contact forces in swing phase. The correlation coefficient, Sprague and Geers metrics, and root mean squared error indicated that the lateral contact forces were predicted better than medial contact forces in comparison with the experimental measurements during both normal and turning gait trials. © IMechE 2016.

Neuropsychiatric effects of neurodegeneration of the medial vs. lateral ventral prefrontal cortex in humans

OpenAIRE

Huey, Edward D.; Lee, Seonjoo; Brickman, Adam M.; Manoochehri, Masood; Griffith, Erica; Devanand, D.P.; Stern, Yaakov; Grafman, Jordan

2015-01-01

Animal evidence suggests that a brain network involving the medial and rostral ventral prefrontal cortex (PFC) is central for threat response and arousal and a network involving the lateral and caudal PFC plays an important role in reward learning and behavioral control. In this study, we contrasted the neuropsychiatric effects of degeneration of the medial versus lateral PFC in 43 patients with Frontotemporal dementia and 11 patients with Corticobasal Syndrome using MRI, the Neuropsychiatric...

Autoshaping a leverpress in rats with lateral, medial, or complete septal lesions.

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Poplawsky, A; Phillips, C L

1986-05-01

Rats with either control operations or lateral, medial, or complete septal lesions received 600 trials of leverpress training using an autoshaping procedure, i.e., food delivery followed a 10 s illuminated lever presentation, or occurred immediately after a leverpress. Rats with complete septal lesions acquired the leverpress faster than controls and had more food-tray entries per minute during the first 100 trials than the other groups. Rats with lateral or medial septal lesions had leverpress and food-tray entries equivalent to controls. The facilitation of autoshaping a leverpress may partially be explained by the general increase in motor reactivity to stimuli found following septal lesions.

Impact of occupational mechanical exposures on risk of lateral and medial inguinal hernia requiring surgical repair

DEFF Research Database (Denmark)

Vad, Marie Vestergaard; Frost, Poul; Bay-Nielsen, Morten

2012-01-01

We undertook a register-based cohort study to evaluate exposure-response relations between cumulative occupational mechanical exposures, and risk of lateral and medial inguinal hernia repair.......We undertook a register-based cohort study to evaluate exposure-response relations between cumulative occupational mechanical exposures, and risk of lateral and medial inguinal hernia repair....

The use of MRI in the investigation of lateral meniscal tear post medial unicompartmental knee replacement

Directory of Open Access Journals (Sweden)

Sanil H. Ajwani, MBChB, BSc (Hons, MRCS

2015-06-01

Full Text Available The evaluation of lateral knee pain in patients with a medial unicompartmental knee replacement (UKR is complex. The native lateral compartment structures are prone to the same injuries as patients with normal knees. Historical reports of lateral meniscal injury post medial UKR have argued MRI evaluation is obsolete due to artefact caused by the prosthesis. We report a case of lateral meniscal injury in a patient two years after successful medial UKR. We identified the offending pathology via utilization of MRI scanners adopting metal artefact reduction sequences (MARS. The MARS MRI protocol helps clinicians accurately and non-invasively evaluate soft tissue structures in knees with metal prostheses. It also allows surgeons to accurately counsel patients and provides a higher degree of certainty in treating the pathology.

Relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index, and medial acetabular bone stock

International Nuclear Information System (INIS)

Werner, Clement M.L.; Copeland, Carol E.; Stromberg, Jeff; Turen, Clifford H.; Ruckstuhl, Thomas; Bouaicha, Samy

2011-01-01

Knowledge of acetabular anatomy is crucial for cup positioning in total hip replacement. Medial wall thickness of the acetabulum is known to correlate with the degree of developmental dysplasia of the hip (DDH). No data exist about the relationship of routinely used radiographic parameters such as Wiberg's lateral center edge angle (LCE-angle) or Lequesne's acetabular index (AI) with thickness of the medial acetabular wall in the general population. The aim of our study was to clarify the relationship between LCE, AI, and thickness of the medial acetabular wall. Measurements on plain radiographs (LCE and AI) and axial CT scans (quadrilateral plate acetabular distance QPAD) of 1,201 individuals (2,402 hips) were obtained using a PACS imaging program and statistical analyses were performed. The mean thickness of the medial acetabulum bone stock (QPAD) was 1.08 mm (95% CI: 1.05-1.10) with a range of 0.1 to 8.8 mm. For pathological values of either the LCE ( 12 ) the medial acetabular wall showed to be thicker than in radiological normal hips. The overall correlation between coxometric indices and medial acetabular was weak for LCE (r =-0.21. 95% CI [-0.25, -0.17]) and moderate for AI (r = 0.37, [0.33, 0.41]). We did not find a linear relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index and medial acetabular bone stock in radiological normal hips but medial acetabular wall thickness increases with dysplastic indices. (orig.)

Self-reported physical exposure association with medial and lateral epicondylitis incidence in a large longitudinal study.

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Descatha, Alexis; Dale, Ann Marie; Jaegers, Lisa; Herquelot, Eléonore; Evanoff, Bradley

2013-09-01

Although previous studies have related occupational exposure and epicondylitis, the evidence is moderate and mostly based on cross-sectional studies. Suspected physical exposures were tested over a 3-year period in a large longitudinal cohort study of workers in the USA. In a population-based study including a variety of industries, 1107 newly employed workers were examined; only workers without elbow symptoms at baseline were included. Baseline questionnaires collected information on personal characteristics and self-reported physical work exposures and psychosocial measures for the current or most recent job at 6 months. Epicondylitis (lateral and medial) was the main outcome, assessed at 36 months based on symptoms and physical examination (palpation or provocation test). Logistic models included the most relevant associated variables. Of 699 workers tested after 36 months who did not have elbow symptoms at baseline, 48 suffered from medial or lateral epicondylitis (6.9%), with 34 cases of lateral epicondylitis (4.9%), 30 cases of medial epicondylitis (4.3%) and 16 workers who had both. After adjusting for age, lack of social support and obesity, consistent associations were observed between self-reported wrist bending/twisting and forearm twisting/rotating/screwing motion and future cases of medial or lateral epicondylitis (ORs 2.8 (1.2 to 6.2) and 3.6 (1.2 to 11.0) in men and women, respectively). Self-reported physical exposures that implicate repetitive and extensive/prolonged wrist bend/twisting and forearm movements were associated with incident cases of lateral and medial epicondylitis in a large longitudinal study, although other studies are needed to better specify the exposures involved.

Lateral and medial ventral occipitotemporal regions interact during the recognition of images revealed from noise

Directory of Open Access Journals (Sweden)

Barbara eNordhjem

2016-01-01

Full Text Available Several studies suggest different functional roles for the medial and the lateral ventral sections in object recognition. Texture and surface information is processed in medial regions, while shape information is processed in lateral sections. This begs the question whether and how these functionally specialized sections interact with each other and with early visual cortex to facilitate object recognition. In the current research, we set out to answer this question. In an fMRI study, thirteen subjects viewed and recognized images of objects and animals that were gradually revealed from noise while their brains were being scanned. We applied dynamic causal modeling (DCM – a method to characterize network interactions – to determine the modulatory effect of object recognition on a network comprising the primary visual cortex (V1, the lingual gyrus (LG in medial ventral cortex and the lateral occipital cortex (LO. We found that object recognition modulated the bilateral connectivity between LG and LO. Moreover, the feed-forward connectivity from V1 to LG and LO was modulated, while there was no evidence for feedback from these regions to V1 during object recognition. In particular, the interaction between medial and lateral areas supports a framework in which visual recognition of objects is achieved by networked regions that integrate information on image statistics, scene content and shape – rather than by a single categorically specialized region – within the ventral visual cortex.

Patient-related risk factors for requiring surgical intervention following a failed injection for the treatment of medial and lateral epicondylitis.

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Degen, Ryan M; Cancienne, Jourdan M; Camp, Christopher L; Altchek, David W; Dines, Joshua S; Werner, Brian C

2017-11-01

To identify risk factors for failure of a therapeutic injection leading to operative management of both medial and lateral epicondylitis. A national database was used to query Medicare Standard Analytic Files from 2005-2012 for patients treated with therapeutic injections for medial or lateral epicondylitis using CPT codes for injections associated with corresponding ICD-9 diagnostic codes (726.31 and 726.32, respectively). Those who subsequently underwent surgical treatment following injection were identified. A multivariate binomial logistic regression analysis was utilized to evaluate patient-related risk factors for requiring surgery within 2 years after therapeutic injection. 1,837 patients received therapeutic injections for medial epicondylitis. 52 (2.8%) required ipsilateral surgery at a mean of 429 ± 28 days post-injection. Risk factors for requiring surgical intervention included age lateral epicondylitis. 201 (3.1%) required subsequent surgery at a mean of 383 ± 128 days' post-injection. Risk factors included age lateral epicondylitis is low (~3%). Risk factors for failing a therapeutic injection include age  30) for medial epicondylitis and age lateral epicondylitis. Patients with these identified risk factors presenting with medial or lateral epicondylitis should be cautioned that they carry a higher risk of subsequent surgical treatment. Therapeutic, III.

Clinical and radiological evaluation of the integrity of the medial and lateral collateral ligaments of the elbow in dogs

International Nuclear Information System (INIS)

Montavon, P.M.; Savoldelli, D.

1995-01-01

In most cases of luxation of the elbow closed reduction constitutes the therapy of choice. Clinical retrospective studies showed signs of arthrosis in 50 % of the cases treated with this therapy, and persisting medial instability after the reduction in more than 50 % of the cases. In the present study the biomechanics of both the medial and the lateral collateral ligaments were analysed after selective severing. Severing of the medial collateral ligament led to an average increase of 30 deg of the pronation with the presence of crepitus on the lateral aspect of the elbow during passive motion. The medial instability of the elbow could be evidenced both clinically and radiographically. Severing of the lateral collateral ligament resulted in an average increase of 15 deg of the supination. Neither palpation nor radiological examination showed any evidence of subluxation

Lateral Orbitofrontal Cortical Modulation on the Medial Prefrontal Cortex-Amygdala Pathway: Differential Regulation of Intra-Amygdala GABAA and GABAB Receptors.

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Chang, Chun-Hui

2017-07-01

The basolateral complex of the amygdala receives inputs from neocortical areas, including the medial prefrontal cortex and lateral orbitofrontal cortex. Earlier studies have shown that lateral orbitofrontal cortex activation exerts an inhibitory gating on medial prefrontal cortex-amygdala information flow. Here we examined the individual role of GABAA and GABAB receptors in this process. In vivo extracellular single-unit recordings were done in anesthetized rats. We searched amygdala neurons that fire in response to medial prefrontal cortex activation, tested lateral orbitofrontal cortex gating at different delays (lateral orbitofrontal cortex-medial prefrontal cortex delays: 25, 50, 100, 250, 500, and 1000 milliseconds), and examined differential contribution of GABAA and GABAB receptors with iontophoresis. Relative to baseline, lateral orbitofrontal cortex stimulation exerted an inhibitory modulatory gating on the medial prefrontal cortex-amygdala pathway and was effective up to a long delay of 500 ms (long-delay latencies at 100, 250, and 500 milliseconds). Moreover, blockade of intra-amygdala GABAA receptors with bicuculline abolished the lateral orbitofrontal cortex inhibitory gating at both short- (25 milliseconds) and long-delay (100 milliseconds) intervals, while blockade of GABAB receptors with saclofen reversed the inhibitory gating at long delay (100 milliseconds) only. Among the majority of the neurons examined (8 of 9), inactivation of either GABAA or GABAB receptors during baseline did not change evoked probability per se, suggesting that local feed-forward inhibitory mechanism is pathway specific. Our results suggest that the effect of lateral orbitofrontal cortex inhibitory modulatory gating was effective up to 500 milliseconds and that intra-amygdala GABAA and GABAB receptors differentially modulate the short- and long-delay lateral orbitofrontal cortex inhibitory gating on the medial prefrontal cortex-amygdala pathway. © The Author 2017

Combined medial and lateral anatomic ligament reconstruction for chronic rotational instability of the ankle.

Science.gov (United States)

Buchhorn, Tomas; Sabeti-Aschraf, Manuel; Dlaska, Constantin E; Wenzel, Florian; Graf, Alexandra; Ziai, Pejman

2011-12-01

This study aimed to extend knowledge on the arthroscopic evaluation of the unstable ankle joint and the outcome of ligament reconstruction on rotational instability. In contrast to previous studies, we investigated the combined repair of lateral and medial ligaments. Ninety-six patients underwent medial and lateral ligament reconstruction between 2006 and 2008, 81 of whom, with a mean age of 31.9 (range, 14 to 44) years, completed the 12-month followup and were therefore included in this study (Table 1). Clinical, radiographic, and concomitant arthroscopic examination was performed prior to the ligament stabilization. Postoperative followup included clinical and radiographic evaluation after 3, 6, and 12 months. Arthroscopy showed a lesion of the anterior fibulotalar ligament (AFTL), calcaneofibular ligament (CFL), and tibiocalcanear ligament (TCL) (Deep part of deltoid ligament complex) in 67 patients. An avulsion of the proximal insertion point of the ATTL was additionally found in 14 cases. Clinical results 3 months after surgery showed a significant increase in the AOFAS-Hindfoot Score as well as a significant decrease of the Visual Analogue-Scale for pain (VAS) (p ankle joint in most cases has an injury of the lateral ligaments and a component of the deltoid, the TCL, but rarely with a combined lesion of the TCL and the anterior tibiotalar ligament (ATTL) (Superficial part of deltoid ligament complex). The combined lateral and medial ligament reconstruction with an anchor technique had a good clinical outcome with high patient satisfaction with few complications.

Evaluation of medial and lateral meniscus thicknesses in early osteoarthritis of the knee with magnetic resonance imaging

International Nuclear Information System (INIS)

Bamac, B.; Ozdemir, S.; Colak, T.; Ozbek, A.; Sarisoy, Hasan T.; Akansel, G.

2006-01-01

To evaluate early changes occurring in both medial and lateral meniscus thickness from the knees of patients with osteoarthritis (Oa). We conducted this study in the Department of Anatomy and Division of Radiology, Faculty of Medicine, Klucel University, Klucel, Turkey during the period 2004 to 2005. In this study, we measured the thickness of the medial and lateral meniscus in a group of 36 (50 knees) consecutive patients with chronic knee pain, and clinical findings of early Oa, and 10 (20 knees) control subjects using MRI. The thickness of the posterior horn of the medial meniscus and anterior horn of the lateral meniscus were significantly higher in the Oa patients compared with the control subjects. This study showed that meniscal degeneration in early stage Oa is not evenly distributed in the knee. Thickening of the menisci in some areas may occur due to their own localization and biomechanics. (author)

Lateral and medial epicondylitis: role of occupational factors.

Science.gov (United States)

Shiri, Rahman; Viikari-Juntura, Eira

2011-02-01

Epicondylitis is a common upper-extremity musculoskeletal disorder. It is most common at the age of 40-60 years. Epicondylitis seems to affect women more frequently than men. Diagnosis of epicondylitis is clinical and based on symptoms and findings of physical examination. The prevalence of lateral epicondylitis in the general populations is approximately 1.0-1.3% in men and 1.1-4.0% in women and that of medial epicondylitis is nearly 0.3-0.6% in men and 0.3-1.1% in women. The incidence rate of medical consultations has been estimated at 0.3-1.1 for lateral and 0.1 for medial epicondylitis per year per 100 subjects of general practice populations. Of occupational risk factors, forceful activities, high force combined with high repetition or awkward posture and awkward postures are associated with epicondylitis. The number of studies is limited to work-related psychosocial factors and the effects are not as consistent as those of physical load factors. Topical non-steroidal anti-inflammatory drugs, corticosteroid injections and acupuncture provide short-term beneficial effects. Workload modification should be considered, especially in manually strenuous jobs. According to clinical case series, surgical treatment has shown fair to good results; however, the efficacy of surgical treatment has not been evaluated in randomised controlled trials. Poorer prognosis of epicondylitis has been reported for individuals with high level of physical strain at work, non-neutral wrist postures during work activity and for those with the condition on the dominant elbow. Modification of physical factors could reduce the risk or improve the prognosis of epicondylitis. Copyright © 2011 Elsevier Ltd. All rights reserved.

Automatic interpretation of F-18-FDG brain PET using artificial neural network: discrimination of medial and lateral temporal lobe epilepsy

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Lee, Jae Sung; Lee, Dong Soo; Kim, Seok Ki; Park, Kwang Suk; Lee, Sang Kun; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

2004-06-01

We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). We studied brain F-18-FDG PET images of 113 epilepsy patients surgically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptions (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 81 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier. Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE.

Automatic interpretation of F-18-FDG brain PET using artificial neural network: discrimination of medial and lateral temporal lobe epilepsy

International Nuclear Information System (INIS)

Lee, Jae Sung; Lee, Dong Soo; Kim, Seok Ki; Park, Kwang Suk; Lee, Sang Kun; Chung, June Key; Lee, Myung Chul

2004-01-01

We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). We studied brain F-18-FDG PET images of 113 epilepsy patients surgically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptions (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 81 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier. Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE

Medial unicompartmental knee arthroplasty improves congruence and restores joint space width of the lateral compartment.

Science.gov (United States)

Khamaisy, Saker; Zuiderbaan, Hendrik A; van der List, Jelle P; Nam, Denis; Pearle, Andrew D

2016-06-01

Osteoarthritic progression of the lateral compartment remains a leading indication for medial unicompartmental knee arthroplasty (UKA) revision. Therefore, the purpose of this study was to evaluate the alterations of the lateral compartment congruence and joint space width (JSW) following medial UKA. Retrospectively, lateral compartment congruence and JSW were evaluated in 174 knees (74 females, 85 males, mean age 65.5years; SD±10.1) preoperatively and six weeks postoperatively, and compared to 41 healthy knees (26 men, 15 women, mean age 33.7years; SD±6.4). Congruence (CI) was calculated using validated software that evaluates the geometric relationship between surfaces and calculates a congruence index (CI). JSW was measured on three sides (inner, middle, outer) by subdividing the lateral compartment into four quarters. The CI of the control group was 0.98 (SD±0.01). The preoperative CI was 0.88 (SD±0.01), which improved significantly to 0.93 (SD±0.03) postoperatively (pcongruence and restores the JSW of the lateral compartment. Copyright © 2016 Elsevier B.V. All rights reserved.

Dorso-medial and ventro-lateral functional specialization of the human retrosplenial complex in spatial updating and orienting.

Science.gov (United States)

Burles, Ford; Slone, Edward; Iaria, Giuseppe

2017-04-01

The retrosplenial complex is a region within the posterior cingulate cortex implicated in spatial navigation. Here, we investigated the functional specialization of this large and anatomically heterogeneous region using fMRI and resting-state functional connectivity combined with a spatial task with distinct phases of spatial 'updating' (i.e., integrating and maintaining object locations in memory during spatial displacement) and 'orienting' (i.e., recalling unseen locations from current position in space). Both spatial 'updating' and 'orienting' produced bilateral activity in the retrosplenial complex, among other areas. However, spatial 'updating' produced slightly greater activity in ventro-lateral portions, of the retrosplenial complex, whereas spatial 'orienting' produced greater activity in a more dorsal and medial portion of it (both regions localized along the parieto-occipital fissure). At rest, both ventro-lateral and dorso-medial subregions of the retrosplenial complex were functionally connected to the hippocampus and parahippocampus, regions both involved in spatial orientation and navigation. However, the ventro-lateral subregion of the retrosplenial complex displayed more positive functional connectivity with ventral occipital and temporal object recognition regions, whereas the dorso-medial subregion activity was more correlated to dorsal activity and frontal activity, as well as negatively correlated with more ventral parietal structures. These findings provide evidence for a dorso-medial to ventro-lateral functional specialization within the human retrosplenial complex that may shed more light on the complex neural mechanisms underlying spatial orientation and navigation in humans.

Results of isolated lateral retinacular reconstruction for iatrogenic medial patellar instability.

Science.gov (United States)

Sanchis-Alfonso, Vicente; Montesinos-Berry, Erik; Monllau, Joan Carles; Merchant, Alan C

2015-03-01

The aim of this study was to assess the outcomes of an isolated lateral retinaculum reconstruction for iatrogenic medial patellar instability (IMPI) in patients with continued pain after failed lateral retinacular release (LRR), including associated psychometric analysis. Pain was assessed using the visual analog scale (VAS) and disability was determined with the Lysholm scale. Psychological variables such as anxiety, depression, catastrophizing, and fear-of-movement beliefs were studied by using self-administered psychometric questionnaires. All 17 patients (13 women and 4 men) in this retrospective study had undergone LRR previously for anterior knee pain or lateral patellar instability. Four patients had undergone LRR plus proximal (Insall) realignment, and one had undergone LRR plus a medial tibial tubercle transfer. After their procedures, all had disabling symptoms. All patients underwent reconstructive surgery for IMPI. At a minimum follow-up of 2 years (range, 2 to 8 years), the mean preoperative VAS score was 7.6 (range, 5 to 9) and improved to 1.9 (range, 0 to 8) at the time of final follow-up (P surgery, 4 patients (24%) had the clinical criteria for depression, 10 (59%) had anxiety, 7 (41%) had "catastrophizing" ideas concerning pain, and all (100%) had kinesiophobia (fear of movement). After surgery, none of the patients had depression or anxiety, none had catastrophizing ideation, and only 53% had kinesiophobia. Reconstruction of the deep transverse layer of the lateral retinaculum (LR) using a central strip of the iliotibial band for IMPI in patients with continued pain after failed LRR can successfully treat these severely disabled patients. Level IV, therapeutic case series. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Reciprocal neural response within lateral and ventral medial prefrontal cortex during hot and cold reasoning.

Science.gov (United States)

Goel, Vinod; Dolan, Raymond J

2003-12-01

Logic is widely considered the basis of rationality. Logical choices, however, are often influenced by emotional responses, sometimes to our detriment, sometimes to our advantage. To understand the neural basis of emotionally neutral ("cold") and emotionally salient ("hot") reasoning we studied 19 volunteers using event-related fMRI, as they made logical judgments about arguments that varied in emotional saliency. Despite identical logical form and content categories across "hot" and "cold" reasoning conditions, lateral and ventral medial prefrontal cortex showed reciprocal response patterns as a function of emotional saliency of content. "Cold" reasoning trials resulted in enhanced activity in lateral/dorsal lateral prefrontal cortex (L/DLPFC) and suppression of activity in ventral medial prefrontal cortex (VMPFC). By contrast, "hot" reasoning trials resulted in enhanced activation in VMPFC and suppression of activation in L/DLPFC. This reciprocal engagement of L/DLPFC and VMPFC provides evidence for a dynamic neural system for reasoning, the configuration of which is strongly influenced by emotional saliency.

Medial release and lateral imbrication for intractable anterior knee pain: diagnostic process, technique, and results

Directory of Open Access Journals (Sweden)

Meldrum AR

2015-01-01

Full Text Available Alexander R Meldrum,1 Jeremy R Reed,2 Megan D Dash3 1Department of Surgery, Section of Orthopedic Surgery, University of Calgary, Calgary, AB, Canada; 2Department of Surgery, University of Saskatchewan College of Medicine, Regina, SK, Canada; 3Department of Family Medicine, College of Medicine, University of Saskatchewan, Regina, SK, Canada Purpose: To present two cases of intractable patellofemoral pain syndrome treated with a novel procedure, arthroscopic medial release, and lateral imbrication of the patellar retinaculum. Patients and methods: This case series presents the treatment of three knees in two patients (one bilateral in whom an all-inside arthroscopic medial release and lateral imbrication of the patellar retinaculum was performed. Subjective measurement of pain was the primary outcome measurement, and subjective patellofemoral instability was the secondary outcome measurement. Results: Subjectively the two patients had full resolution of their pain, without any patellofemoral instability. Conclusion: Medial release and lateral imbrication of the patellar retinaculum is a new surgical procedure that has been used in the treatment of intractable patellofemoral pain syndrome. This is the first report of its kind in the literature. While outcome measurements were less than ideal, the patients had positive outcomes, both functionally and in terms of pain. Keywords: anterior knee pain syndrome, chondromalacia patellae, runners knee, patellar chondropathy, patellofemoral dysfunction, patellofemoral tracking disorder

Reliability of a Seven-Segment Foot Model with Medial and Lateral Midfoot and Forefoot Segments During Walking Gait.

Science.gov (United States)

Cobb, Stephen C; Joshi, Mukta N; Pomeroy, Robin L

2016-12-01

In-vitro and invasive in-vivo studies have reported relatively independent motion in the medial and lateral forefoot segments during gait. However, most current surface-based models have not defined medial and lateral forefoot or midfoot segments. The purpose of the current study was to determine the reliability of a 7-segment foot model that includes medial and lateral midfoot and forefoot segments during walking gait. Three-dimensional positions of marker clusters located on the leg and 6 foot segments were tracked as 10 participants completed 5 walking trials. To examine the reliability of the foot model, coefficients of multiple correlation (CMC) were calculated across the trials for each participant. Three-dimensional stance time series and range of motion (ROM) during stance were also calculated for each functional articulation. CMCs for all of the functional articulations were ≥ 0.80. Overall, the rearfoot complex (leg-calcaneus segments) was the most reliable articulation and the medial midfoot complex (calcaneus-navicular segments) was the least reliable. With respect to ROM, reliability was greatest for plantarflexion/dorsiflexion and least for abduction/adduction. Further, the stance ROM and time-series patterns results between the current study and previous invasive in-vivo studies that have assessed actual bone motion were generally consistent.

Ensemble encoding of nociceptive stimulus intensity in the rat medial and lateral pain systems

Directory of Open Access Journals (Sweden)

Woodward Donald J

2011-08-01

Full Text Available Abstract Background The ability to encode noxious stimulus intensity is essential for the neural processing of pain perception. It is well accepted that the intensity information is transmitted within both sensory and affective pathways. However, it remains unclear what the encoding patterns are in the thalamocortical brain regions, and whether the dual pain systems share similar responsibility in intensity coding. Results Multichannel single-unit recordings were used to investigate the activity of individual neurons and neuronal ensembles in the rat brain following the application of noxious laser stimuli of increasing intensity to the hindpaw. Four brain regions were monitored, including two within the lateral sensory pain pathway, namely, the ventral posterior lateral thalamic nuclei and the primary somatosensory cortex, and two in the medial pathway, namely, the medial dorsal thalamic nuclei and the anterior cingulate cortex. Neuron number, firing rate, and ensemble spike count codings were examined in this study. Our results showed that the noxious laser stimulation evoked double-peak responses in all recorded brain regions. Significant correlations were found between the laser intensity and the number of responsive neurons, the firing rates, as well as the mass spike counts (MSCs. MSC coding was generally more efficient than the other two methods. Moreover, the coding capacities of neurons in the two pathways were comparable. Conclusion This study demonstrated the collective contribution of medial and lateral pathway neurons to the noxious intensity coding. Additionally, we provide evidence that ensemble spike count may be the most reliable method for coding pain intensity in the brain.

Differentiation of medial or lateral temporal lobe epilepsy by F-18-fluorodeoxyglucose positron emission tomography: comparative study with magnetic resonance imaging in 113 surgically and pathologically proven patients

International Nuclear Information System (INIS)

Lee, Dong Soo; Lee, Sang Kun; Chang, Ki Hyun; Chung, Chun Kee; Choi, Ki Young; Chung, June Key; Lee, Myung Chul

1999-01-01

As mesial temporal lobe epilepsy (TLE) shows hypometabolism of medial and lateral temporal lobe, we investigated whether symmetric uptake of F-18-FDG in medial temporal lobes can differentiate mesial from lateral TLE. In 113 patients (83 mesial TLE, 30 lateral TLE) who underwent anterior temporal lobectomy and/or corticectomy with good surgical outcome, we performed F-18-FDG PET and compared F-18-FDG uptake of medial and lateral temporal lobes. All the patients with mesial TLE had hippocampal sclerosis except one congenital abnormal hippocampus. Patients with lateral TLE revealed cerebromalacia, microdysgenesis, arteriovenous malformation, old contusion, and cortical dysplasia. Sensitivity of F-18-FDG PET and MR for mesial TLE was 84% (70/83) and 73% (62/83), respectively. Sensitivity of F-18-FDG PET and MR for lateral TLE was 90% (27/30) and 66% (20/30), respectively. Twelve patients were normal on F-18-FDG PET. 101 patients had hypometabolism of lateral temporal lobe. Among 88 patients who showed hypometabolism of medial temporal lobe as well as lateral temporal lobe, 70 were mesial TLE patients and 18 were lateral TLE on pathologic examination. Positive predictive value of medial temporal hypometabolism for mesial TLE was 80%. Among 13 patients who showed hypometabolism of only lateral temporal lobe, 4 were mesial TLE and 9 were lateral TLE. Positive predictive value of hypometabolism of lateral temporal lobe for the diagnosis of lateral TLE was 69% (9/ 13). Normal MR findings stood against medial TLE, whose negative predictive value was 66%. Lateral temporal lobe epilepsy should be suspected when there is decreased F-18-FDG uptake in lateral temporal lobe with normal uptake in medial temporal lobe

Current advances in the treatment of medial and lateral epicondylitis.

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Tarpada, Sandip P; Morris, Matthew T; Lian, Jayson; Rashidi, Sina

2018-03-01

Despite advances elucidating the causes of lateral and medial epicondylitis, the standard of care remains conservative management with NSAIDs, physical therapy, bracing, and rest. Scar tissue formation provoked by conservative management creates a tendon lacking the biomechanical properties and mechanical strength of normal tendon. The following review analyzes novel therapies to regenerate tendon and regain function in patients with epicondylitis. These treatments include PRP injection, BMAC, collagen-producing cell injection, and stem cell treatments. While these treatments are in early stages of investigation, they may warrant further consideration based on prospects of pain alleviation, function enhancement, and improved healing.

Relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index, and medial acetabular bone stock

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Werner, Clement M.L. [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland); University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Copeland, Carol E.; Stromberg, Jeff; Turen, Clifford H. [University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Ruckstuhl, Thomas; Bouaicha, Samy [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland)

2011-11-15

Knowledge of acetabular anatomy is crucial for cup positioning in total hip replacement. Medial wall thickness of the acetabulum is known to correlate with the degree of developmental dysplasia of the hip (DDH). No data exist about the relationship of routinely used radiographic parameters such as Wiberg's lateral center edge angle (LCE-angle) or Lequesne's acetabular index (AI) with thickness of the medial acetabular wall in the general population. The aim of our study was to clarify the relationship between LCE, AI, and thickness of the medial acetabular wall. Measurements on plain radiographs (LCE and AI) and axial CT scans (quadrilateral plate acetabular distance QPAD) of 1,201 individuals (2,402 hips) were obtained using a PACS imaging program and statistical analyses were performed. The mean thickness of the medial acetabulum bone stock (QPAD) was 1.08 mm (95% CI: 1.05-1.10) with a range of 0.1 to 8.8 mm. For pathological values of either the LCE (<20 ) or the AI (>12 ) the medial acetabular wall showed to be thicker than in radiological normal hips. The overall correlation between coxometric indices and medial acetabular was weak for LCE (r =-0.21. 95% CI [-0.25, -0.17]) and moderate for AI (r = 0.37, [0.33, 0.41]). We did not find a linear relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index and medial acetabular bone stock in radiological normal hips but medial acetabular wall thickness increases with dysplastic indices. (orig.)

Effectiveness of initial extracorporeal shock wave therapy on the newly diagnosed lateral or medial epicondylitis.

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Lee, Sang Seok; Kang, Sangkuk; Park, Noh Kyoung; Lee, Chan Woo; Song, Ho Sup; Sohn, Min Kyun; Cho, Kang Hee; Kim, Jung Hwan

2012-10-01

To evaluate the effectiveness of initial extracorporeal shock wave therapy (ESWT) for patients newly diagnosed with lateral or medial epicondylitis, compared to local steroid injection. An analysis was conducted of twenty-two patients who were newly confirmed as lateral or medial epicondylitis through medical history and physical examination. The ESWT group (n=12) was treated once a week for 3 weeks using low energy (0.06-0.12 mJ/mm(2), 2,000 shocks), while the local steroid injection group (n=10) was treated once with triamcinolone 10 mg mixed with 1% lidocaine solution. Nirschl score and 100 point score were assessed before and after the treatments of 1st, 2nd, 4th and 8th week. And Roles and Maudsley score was assessed one and eight weeks after the treatments. Both groups showed significant improvement in Nirschl score and 100 point score during the entire period. The local steroid injection group improved more in Nirschl score at the first week and in 100 point score at the first 2 weeks, compared to those of the ESWT group. But the proportion of excellent and good grades of Roles and Maudsley score in the ESWT group increased more than that of local steroid injection group by the final 8th week. The ESWT group improved as much as the local steroid injection group as treatment for medial and lateral epicondylitis. Therefore, ESWT can be a useful treatment option in patients for whom local steroid injection is difficult.

MORPHOMETRY OF THE ARTICULAR FACETS ON THE SUPERIOR, MEDIAL AND LATERAL SURFACES OF THE BODY OF TALUS AND ITS CLINICAL RELEVANCE

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Goda Jatin B, Patel Shailesh M, Parmar Ajay M, Agarwal GC

2015-07-01

Full Text Available Background: In the formation of Ankle joint, tibio-fibular mortice receives superior, medial and lateral articular surfaces of body of Talus. Because of very limited availability of the data on the Morphometry of the articular facets on the Body of the dry human tali, this study was undertaken. Aims: To prepare the database on the articular facets on the superior, medial and lateral surfaces of body of talus, to find if there is statistically significant difference between both the sides of measurements and to compare the results with the previous studies. Methods and Material: 40 Dry Human Tali (20 Right and 20 Left were measured with Digital vernier caliper for the following Measurements: On the Trochlear surface: Medial length, Central length, Lateral length, Anterior width, Central width, Posterior width. On the lateral triangular articular facet: Central height, Central width. On the coma shaped medial articular facet: Central height, Central width. Results: Mean values of Medial, Central and Lateral lengths were 31.02, 30.39 and 29.63mm on Right side and 31.79, 30.65 and 29.45mm on Left side. Mean Anterior, Central and Posterior widths were 28.87, 28.16 and 21.59mm on right side and 29.08, 27.54 and 21.78mm on left side. On the medial articular surface, mean central height was 11.93mm on the right side and 11.29mm on the left side, Mean central width was 27.94mm on the right side and 28.29mm on the left side. On the lateral articular surface, mean central height was 22.14mm on the right side and 22.63mm on the left side. Mean central width was 18.93mm on the right side and 18.99mm on the left side. There is no significant difference between right and left sides of measurements. Conclusion: The trochlear articular surface is wider in front, measurements of opposite talus bone can be used as a control during talus bone replacement surgery, it may help surgeons to plan pre-operatively the complex talar fracture surgeries, to design accurate

OPTIMAL SURGICAL MANAGEMENT OF HIGH VELOCITY POSTERIOR TIBIAL PLATEAU FRACTURE SUBLUXATIONS (DUPARC, REVISED CLASSIFICATION, GROUP – V: POSTERO - MEDIAL FRACTURE BY DIRECT, DORSAL APPROACH – A CHANGING TREND: A PROSPECTIVE STUDY

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Pardhasaradhi

2015-10-01

Full Text Available INTRODUCTION : High - energy tibial plateau fractures are infrequent and technically demanding to treat especially if those are shearing type, coronal plane, displaced fractures. The most widely used the Schatzker system of classification , [1] ( B ased on the AP radiograph is more than likely to miss postero - medial and postero - lateral shear fractures, best visible on the lateral, than the AP radiograph. These fractures have recently been characterised by two studies, highlighti ng their clinical relevance [ 2,3] and showing that less invasive surgery and indirect reduction techniques are often inadequate. Hohl described unicondylar c oronal plane splitting fractures of the medial tibial plateau, noted that these injuries be considered as fracture - dislocations. Connolly and others have suggested that the mechanism involved in this fracture pattern is one of knee flexion, varus, and inter nal rotation of the medial femoral condyle . [4,5,6 ] Consistent among these and other authors is that the occurrence of this fragment is relatively unusual and that the use of a posteriorly based exposure with direct fracture visualization, anatomic reductio n and absolute stability appears to result in satisfactory outcomes. Though variations of a postero - medial approach been previously described ( by Trickey et al and also by Burks et al.,, more recently, Lobenhoffer et al described direct posterior exposure , Wang et al described postero - medial approach and Luo et al. described the approach for the management of posterior bicondylar tibial plateau fractures . [7,8] These approaches have been used in isolation or as a dual - incision approach for treating tibial plateau fractures . [9,10,11,12,13,14, 15] PURPOSE : The purpose of this study is to describe this unfamiliar direct posterior surgical (Medial Gastrocnemius approach to a general orthopod, highlighting the relevant anatomy and presenting our experience using this approach in treating a

Tratamento cirúrgico da ginecomastia com pedículos lateral e medial

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Miguel Modolin

Full Text Available Ginecomastia é o aumento da mama masculina que pode acometer até 65% dos indivíduos deste sexo na fase infanto-puberal, compreendida entre 13 e 16 anos. Tem como principais causas hepatite ou cirrose hepática, carcinoma ou doenças inflamatórias pulmonares crônicas, carcinomas ou disfunções testiculares, tumores glandulares (pituitária, supra-renal, alterações dos níveis séricos de testosterona, síndromes genéticas (síndrome de Klinefelter, p.ex., uso de drogas como heroína, maconha ou anabolizantes e hanseníase. Podemos classificar a ginecomastia quanto ao volume, quanto aos tecidos que a compõem (gordurosa ou pseudoginecomastia, glandular e mista, ou quanto ao tratamento necessário para sua correção cirúrgica (pequena, moderada e grave. O tratamento das formas mais graves de ginecomastia é muito diferente daquele aplicado às formas mais suaves, pois nas formas graves, além da ressecção dos tecidos gorduroso e glandular, existe a necessidade de ressecção da pele em excesso e o reposicionamento do complexo aréolo-mamilar. O objetivo deste trabalho é descrever uma técnica cirúrgica específica para estes pacientes portadores de formas graves de ginecomastia, através de dois pedículos dermogordurosos, um lateral e um medial, com aproximadamente 2cm de espessura, mantendo assim a nutrição do complexo aréolo-mamilar. Esses pedículos são delimitados entre as bissetrizes dos quadrantes súpero-lateral e ínfero-lateral, e súpero-medial e ínfero-medial, tendo o mamilo como vértice. Na área de pele excessiva periareolar, obtida através do pinçamento interdigital, é realizada a desepidermização dos pedículos lateral e medial e ressecção de toda pele e tecido celular subcutâneo até a fáscia peitoral nas regiões superior e inferior aos pedículos; a síntese é realizada em dois planos, sendo periareolar a cicatriz resultante. Foram operados com esta técnica vinte pacientes com forma grave de

Biomechanical comparison of four double-row speed-bridging rotator cuff repair techniques with or without medial or lateral row enhancement.

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Pauly, Stephan; Fiebig, David; Kieser, Bettina; Albrecht, Bjoern; Schill, Alexander; Scheibel, Markus

2011-12-01

Biomechanical comparison of four different Speed-Bridge configurations with or without medial or lateral row reinforcement. Reinforcement of the knotless Speed-Bridge double-row repair technique with additional medial mattress- or lateral single-stitches was hypothesized to improve biomechanical repair stability at time zero. Controlled laboratory study: In 36 porcine fresh-frozen shoulders, the infraspinatus tendons were dissected and shoulders were randomized to four groups: (1) Speed-Bridge technique with single tendon perforation per anchor (STP); (2) Speed-Bridge technique with double tendon perforation per anchor (DTP); (3) Speed-Bridge technique with medial mattress-stitch reinforcement (MMS); (4) Speed-Bridge technique with lateral single-stitch reinforcement (LSS). All repairs were cyclically loaded from 10-60 N up to 10-200 N (20 N stepwise increase) using a material testing device. Forces at 3 and 5 mm gap formation, mode of failure and maximum load to failure were recorded. The MMS-technique with double tendon perforation showed significantly higher ultimate tensile strength (338.9 ± 90.0 N) than DTP (228.3 ± 99.9 N), LSS (188.9 ± 62.5 N) and STP-technique (122.2 ± 33.8 N). Furthermore, the MMS-technique provided increased maximal force resistance until 3 and 5 mm gap formation (3 mm: 77.8 ± 18.6 N; 5 mm: 113.3 ± 36.1 N) compared with LSS, DTP and STP (P row defect by tendon sawing first, then laterally. No anchor pullout occurred. Double tendon perforation per anchor and additional medial mattress stitches significantly enhance biomechanical construct stability at time zero in this ex vivo model when compared with the all-knotless Speed-Bridge rotator cuff repair.

Comparison of Two Methods for the Measurement of Medial and Lateral Metapodial Bones in Karagouniko Sheep (Ovis aries, L. 1758 and Hellenic Goat (Capra hircus, L. 1758

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Aris Pourlis

2014-01-01

Full Text Available The objective of this study was to compare the metapodial lengths of sheep and goats measured with a caliper with those measured using a 2-dimensional digital method. Complementarily, the lengths of medial and lateral metapodials in these species were compared. The limbs of 30 ewes and 30 goats were used. After preparation, the lateral and medial length of the metacarpals and metatarsals were measured twice with a caliper. Afterwards, each bone was scanned and the same lengths were digitally measured twice using commercial software. Data analysis revealed strong linear relationship between the two methods but the absolute relative deviation of the measurements with the caliper was significantly higher than those with the 2-dimensional method (P<0.05. All lengths measured with the caliper were significantly higher compared to those measured with the 2-dimensional method (P<0.05. In goats, the lateral length of both metacarpals and metatarsals was significantly higher than medial length (P<0.05; in sheep the lateral length was significantly higher compared to the medial one only in metatarsal bones (P<0.05. In conclusion, the 2-dimensional method is more accurate for the measurement of the metapodials’ length than the caliper and there is asymmetry between the medial and lateral metapodials in these species.

Different involvement of medial prefrontal cortex and dorso-lateral striatum in automatic and controlled processing of a future conditioned stimulus.

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Pérez-Díaz, Francisco; Díaz, Estrella; Sánchez, Natividad; Vargas, Juan Pedro; Pearce, John M; López, Juan Carlos

2017-01-01

Recent studies support the idea that stimulus processing in latent inhibition can vary during the course of preexposure. Controlled attentional mechanisms are said to be important in the early stages of preexposure, while in later stages animals adopt automatic processing of the stimulus to be used for conditioning. Given this distinction, it is possible that both types of processing are governed by different neural systems, affecting differentially the retrieval of information about the stimulus. In the present study we tested if a lesion to the dorso-lateral striatum or to the medial prefrontal cortex has a selective effect on exposure to the future conditioned stimulus (CS). With this aim, animals received different amounts of exposure to the future CS. The results showed that a lesion to the medial prefrontal cortex enhanced latent inhibition in animals receiving limited preexposure to the CS, but had no effect in animals receiving extended preexposure to the CS. The lesion of the dorso-lateral striatum produced a decrease in latent inhibition, but only in animals with an extended exposure to the future conditioned stimulus. These results suggest that the dorsal striatum and medial prefrontal cortex play essential roles in controlled and automatic processes. Automatic attentional processes appear to be impaired by a lesion to the dorso-lateral striatum and facilitated by a lesion to the prefrontal cortex.

Separate value comparison and learning mechanisms in macaque medial and lateral orbitofrontal cortex

OpenAIRE

Noonan, M. P.; Walton, M. E.; Behrens, T. E. J.; Sallet, J.; Buckley, M. J.; Rushworth, M. F. S.

2010-01-01

Uncertainty about the function of orbitofrontal cortex (OFC) in guiding decision-making may be a result of its medial (mOFC) and lateral (lOFC) divisions having distinct functions. Here we test the hypothesis that the mOFC is more concerned with reward-guided decision making, in contrast with the lOFC's role in reward-guided learning. Macaques performed three-armed bandit tasks and the effects of selective mOFC lesions were contrasted against lOFC lesions. First, we present analyses that make...

Comparison of Two Methods for the Measurement of Medial and Lateral Metapodial Bones in Karagouniko Sheep (Ovis aries, L. 1758) and Hellenic Goat (Capra hircus, L. 1758)

Science.gov (United States)

Pourlis, Aris; Chatzis, Theodoros; Katsoulos, Panagiotis

2014-01-01

The objective of this study was to compare the metapodial lengths of sheep and goats measured with a caliper with those measured using a 2-dimensional digital method. Complementarily, the lengths of medial and lateral metapodials in these species were compared. The limbs of 30 ewes and 30 goats were used. After preparation, the lateral and medial length of the metacarpals and metatarsals were measured twice with a caliper. Afterwards, each bone was scanned and the same lengths were digitally measured twice using commercial software. Data analysis revealed strong linear relationship between the two methods but the absolute relative deviation of the measurements with the caliper was significantly higher than those with the 2-dimensional method (P sheep the lateral length was significantly higher compared to the medial one only in metatarsal bones (P < 0.05). In conclusion, the 2-dimensional method is more accurate for the measurement of the metapodials' length than the caliper and there is asymmetry between the medial and lateral metapodials in these species. PMID:25530882

On framing effects in decision making: linking lateral versus medial orbitofrontal cortex activation to choice outcome processing.

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Windmann, Sabine; Kirsch, Peter; Mier, Daniela; Stark, Rudolf; Walter, Bertram; Güntürkün, Onur; Vaitl, Dieter

2006-07-01

Two correlates of outcome processing in the orbitofrontal cortex (OFC) have been proposed in the literature: One hypothesis suggests that the lateral/medial division relates to representation of outcome valence (negative vs. positive), and the other suggests that the medial OFC maintains steady stimulus-outcome associations, whereas the lateral OFC represents changing (unsteady) outcomes to prepare for response shifts. These two hypotheses were contrasted by comparing the original with the inverted version of the Iowa Gambling Task in an event-related functional magnetic resonance imaging experiment. Results showed (1) that (caudo) lateral OFC was indeed sensitive to the steadiness of the outcomes and not merely to outcome valence and (2) that the original and the inverted tasks, although both designed to measure sensitivity for future outcomes, were not equivalent as they enacted different behaviors and brain activation patterns. Results are interpreted in terms of Kahneman and Tversky's prospect theory suggesting that cognitions and decisions are biased differentially when probabilistic future rewards are weighed against consistent punishments relative to the opposite scenario [Kahneman, D., & Tversky, A. Choices, values, and frames. American Psychologist, 39, 341-350, 1984]. Specialized processing of unsteady rewards (involving caudolateral OFC) may have developed during evolution in support of goal-related thinking, prospective planning, and problem solving.

A lateral approach to the repair of propagating fractures of the medial condyle of the third metacarpal and metatarsal bone in 18 racehorses.

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Wright, Ian M; Smith, Matthew R W

2009-08-01

To report the technique, observations on fracture configurations and results of treatment by fixation lag screw following the fracture plane determined by an approach to the third metacarpal/metatarsal bone (MC3/MT3) that begins laterally over the metacarpo(metatarso)phalangeal joint and extends dorsally over the diaphysis of the bone. Case series. Thoroughbred horses (n=18) with propagating fractures of the medial condyle of MC3/MT3. Retrospective analysis of case records of horses with fractures of the medial condyle of MC3/MT3 that propagated sagittaly or in a spiral configuration into the diaphysis, repaired surgically under general anesthesia by screw fixation in lag fashion through a lateral approach with periosteal reflection. Fractures were readily identified at surgery, enabling screw fixation in lag fashion following the fracture plane. Fracture configurations varied and could be classified as sagittal and spiral fractures with fractures within each group generally following a similar course. All horses recovered relatively uneventfully from general anesthesia and surgery, and all fractures healed well. Thirteen horses returned to training; 5 subsequently raced. Repair of propagating sagittal and spiral fractures of the medial condyle of MC3/MT3 with diaphyseal involvement, through a lateral approach with periosteal reflection permits stable fixation with minimal complications. In this series there were no catastrophic failures. Fractures of the medial condyle of MC3/MT3 that propagate either sagittaly or in a spiral configuration into the diaphysis can be successfully repaired with screw fixation in lag fashion using a lateral approach with periosteal reflection.

The relationship of lateral anatomic structures to exiting guide pins during femoral tunnel preparation utilizing an accessory medial portal.

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Farrow, Lutul D; Parker, Richard D

2010-06-01

Anatomic reconstruction of the anterior cruciate ligament through an accessory medial portal has become increasingly popular. The purpose of this study is to describe the relationship of guide pin exit points to the lateral anatomic structures when preparing the anterior cruciate ligament femoral tunnel through an accessory medial portal. We utilized seven fresh frozen cadaveric knees. Utilizing an anteromedial approach, a guide wire was placed into the center of each bundle's footprint. Each guide wire was advanced through the lateral femoral cortex. The guide pins were passed at 90, 110, and 130 degrees of knee flexion. The distances from each guide pin to the closest relevant structures on the lateral side of the knee were measured. At 90 degrees the posterolateral bundle guide pin was closest to the lateral condyle articular cartilage (mean 5.4 +/- 2.2 mm) and gastrocnemius tendon (mean 5.7 +/- 2.1 mm). At 110 degrees the posterolateral bundle pin was closest to the gastrocnemius tendon (mean 4.5 +/- 3.4 mm). At 130 degrees the posterolateral bundle pin was closest to the gastrocnemius tendon (mean 7.2 +/- 5.5 mm) and lateral collateral ligament (mean 6.8 +/- 2.1 mm). At 90 degrees the anteromedial bundle guide pin was closest to the articular cartilage (mean 2.0 +/- 2.0 mm). At 110 degrees the anteromedial bundle pin was closest to the articular cartilage (mean 7.4 +/- 3.5 mm) and gastrocnemius tendon (mean 12.3 +/- 3.1 mm). At 130 degrees the AM bundle pin was closest to the gastrocnemius tendon (mean 8.2 +/- 3.2 mm) and LCL (mean 15.1 +/- 2.9 mm). Neither guide pin (anteromedial or posterolateral bundle) put the peroneal nerve at risk at any knee flexion angle. At low knee flexion angles the anteromedial and posterolateral bundle guide pins closely approximated multiple lateral structures when using an accessory medial arthroscopic portal. Utilizing higher flexion angles increases the margin of error when preparing both femoral tunnels. During preparation of

The Relationship between Chondromalacia Patella, Medial Meniscal Tear and Medial Periarticular Bursitis in Patients with Osteoarthritis.

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Resorlu, Mustafa; Doner, Davut; Karatag, Ozan; Toprak, Canan Akgun

2017-12-01

This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears. Radiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed all patients in terms of osteoarthritis, chondromalacia patella and medial meniscal tear. The second radiologist was blinded to these results and assessed the presence of bursitis in all patients. Mild osteoarthritis (grade I and II) was determined in 55 patients and severe osteoarthritis (grade III and IV) in 45 cases. At retropatellar cartilage evaluation, 25 patients were assessed as normal, while 29 patients were diagnosed with mild chondromalacia patella (grade I and II) and 46 with severe chondromalacia patella (grade III and IV). Medial meniscus tear was determined in 51 patients. Severe osteoarthritis and chondromalacia patella were positively correlated with meniscal tear (p chondromalacia patella (p = 0.023 and p = 0.479, respectively). Evaluation of lateral compartment bursae revealed lateral collateral ligament bursitis in 2 patients and iliotibial bursitis in 5 patients. We observed a greater prevalence of bursitis in the medial compartment of the knee in patients with severe osteoarthritis and medial meniscus tear.

Medial shoe-ground pressure and specific running injuries

DEFF Research Database (Denmark)

Brund, René B K; Rasmussen, Sten; Nielsen, Rasmus O

2017-01-01

pressure. Foot balance was categorized into those which presented a higher lateral shod pressure (LP) than medial pressure, and those which presented a higher medial shod pressure (MP) than lateral pressure during the stance phase. A time-to-event model was used to compare differences in incidence between...

[Application of lateral malleolus hook-plate in treatment of stage II supination-adduction type medial malleolus fracture].

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Chen, Yu; Zhang, Hui; Huang, Fuguo; Xiang, Zhuo; Fang, Yue; Liu, Lei; Cen, Shiqiang

2014-09-01

To investigate the application of lateral malleolus hook-plate for the treatment of stage II supination-adduction type medial malleolus fractures. Between January 2011 and June 2013, 21 patients with stage II supination-adduction type ankle fractures were treated with lateral malleolus hook-plate, including 12 males and 9 females with an average age of 55.5 years (range, 27-65 years). The injury causes were sprain in 17 cases and traffic accident in 4 cases. The mean time between injury and admission was 12.4 hours (range, 2-72 hours). The tibial distal medial articular surface collapse was found in 7 cases by CT examination and in 3 cases by X-ray film. Of 21 cases, there were 12 cases of low transverse fractures of lateral malleolus, 7 cases of short oblique fractures of lateral malleolus, and 2 cases of ankle joint lateral collateral ligament injury without fractures of lateral malleolus. After operation, the clinical outcome was evaluated according to the talus-leg angle, the recovery of Coin-sign continuity, inside-outside and top ankle gap, talus slope, American Orthopedic Foot and Ankle Society (AOFAS) score, Olerud-Molander score, Kofoed evaluation standards, and patient satisfaction. Seventeen cases were followed up 18.7 months on average (range, 12-25 months). Primary healing was obtained in 16 cases except 1 case of delayed healing. Fracture healed at an average of 14.6 weeks (range, 12-16 weeks). All cases achieved anatomical reduction, the continuity of Coin-sign, and consistency of inside and outside joint gap; no talus tilt occurred. There was no complication of reduction loss, loosening or breakage of internal fixation, or osteoarthritis during follow-up. The talus-leg angle of the affected side was significantly improved to (83.4 ± 1.8)° at 1 week after operation from preoperative (74.8 ± 7.1)° (t = 5.370, P = 0.000), but no significant difference was found when compared with normal side (83.8 ± 2.3)° (t = 0.676, P = 0.509). The AOFAS score

The Relationship between Chondromalacia Patella, Medial Meniscal Tear and Medial Periarticular Bursitis in Patients with Osteoarthritis

Science.gov (United States)

Doner, Davut; Karatag, Ozan; Toprak, Canan Akgun

2017-01-01

Abstract Background This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears. Patients and methods Radiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed all patients in terms of osteoarthritis, chondromalacia patella and medial meniscal tear. The second radiologist was blinded to these results and assessed the presence of bursitis in all patients. Results Mild osteoarthritis (grade I and II) was determined in 55 patients and severe osteoarthritis (grade III and IV) in 45 cases. At retropatellar cartilage evaluation, 25 patients were assessed as normal, while 29 patients were diagnosed with mild chondromalacia patella (grade I and II) and 46 with severe chondromalacia patella (grade III and IV). Medial meniscus tear was determined in 51 patients. Severe osteoarthritis and chondromalacia patella were positively correlated with meniscal tear (p chondromalacia patella (p = 0.023 and p = 0.479, respectively). Evaluation of lateral compartment bursae revealed lateral collateral ligament bursitis in 2 patients and iliotibial bursitis in 5 patients. Conclusions We observed a greater prevalence of bursitis in the medial compartment of the knee in patients with severe osteoarthritis and medial meniscus tear. PMID:29333118

Rostro-caudal and dorso-ventral gradients in medial and lateral prefrontal cortex during cognitive control of affective and cognitive interference.

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Rahm, Christoffer; Liberg, Benny; Wiberg-Kristoffersen, Maria; Aspelin, Peter; Msghina, Mussie

2013-04-01

Characterizing the anatomical substrates of major brain functions such as cognition and emotion is of utmost importance to the ongoing efforts of understanding the nature of psychiatric ailments and their potential treatment. The aim of our study was to investigate how the brain handles affective and cognitive interferences on cognitive processes. Functional magnetic resonance imaging investigation was performed on healthy individuals, comparing the brain oxygenation level dependent activation patterns during affective and cognitive counting Stroop tasks. The affective Stroop task activated rostral parts of medial prefrontal cortex (PFC) and rostral and ventral parts of lateral PFC, while cognitive Stroop activated caudal parts of medial PFC and caudal and dorsal parts of lateral PFC. Our findings suggest that the brain may handle affective and cognitive interference on cognitive processes differentially, with affective interference preferentially activating rostral and ventral PFC networks and cognitive interference activating caudal and dorsal PFC networks. © 2013 The Authors. Scandinavian Journal of Psychology © 2013 The Scandinavian Psychological Associations.

A study on MR images of the articular cartilage in medial-type osteoarthritis of the knee

International Nuclear Information System (INIS)

Miyazaki, Hiroyuki; Ishii, Yoshiaki; Hayashi, Mitsutoshi; Kotani, Akihiro

2001-01-01

Changes in the articular cartilage of 88 knees of 73 cases (age range 40-78) diagnosed clinically and radiologically as OA (osteoarthritis) were studied by obtaining fat-suppressed MR images of the knee. On 27 knees out of the 88, moreover, macroscopic observation was performed to make a comparative study between the directly-observed findings and MR findings. Fat-suppressed MR images were obtained sagittally by 3D-FLASH (fast low angle shot) sequence. The examined regions consisted of the following 4 sites; the medial condyle of the femur, its lateral condyle, the medial condyle of the tibia, and its lateral condyle. The revealed conditions of the cartilage were morphologically classified into 4 Stages. The evidence of cartilage defect on MR images was most frequently found at the medial condyle of the femur, with the medial condyle of the tibia, the lateral condyle of the femur, and the lateral condyle of the tibia following in a less frequent order. Fat-suppressed MRI's sensitivity to cartilage defect against macroscopy was 94.5%, specificity 95.4%, and accuracy 95.2%. MR imaging using fat-suppression can reveal cartilaginous degeneration and defect so well that this technique provides an important indication for selecting a proper method of treatment. (author)

Infraclavicular brachial plexus block: Comparison of posterior cord stimulation with lateral or medial cord stimulation, a prospective double blinded study

Directory of Open Access Journals (Sweden)

Dushyant Sharma

2013-01-01

Full Text Available Background: Infraclavicular approach to the brachial plexus sheath provides anesthesia for surgery on the distal arm, elbow, forearm, wrist, and hand. It has been found that evoked distal motor response or radial nerve-type motor response has influenced the success rate of single-injection infraclavicular brachial plexus block. Aim: We conducted this study to compare the extent and effectiveness of infraclavicular brachial plexus block achieved by injecting a local anesthetic drug after finding specific muscle action due to neural stimulator guided posterior cord stimulation and lateral cord/medial cord stimulation. Methods: After ethical committee approval, patients were randomly assigned to one of the two study groups of 30 patients each. In group 1, posterior cord stimulation was used and in group 2 lateral/medial cord stimulation was used for infraclavicular brachial plexus block. The extent of motor block and effectiveness of sensory block were assessed. Results: All four motor nerves that were selected for the extent of block were blocked in 23 cases (76.7% in group 1 and in 15 cases (50.0% in group 2 (P:0.032. The two groups did not differ significantly in the number of cases in which 0, 1, 2, and 3 nerves were blocked (P>0.05. In group 1, significantly lesser number of patients had pain on surgical manipulation compared with patients of group 2 (P:0.037. Conclusion: Stimulating the posterior cord guided by a nerve stimulator before local anesthetic injection is associated with greater extent of block (in the number of motor nerves blocked and effectiveness of block (in reporting no pain during the surgery than stimulation of either the lateral or medial cord.

Increased medial foot loading during drop jump in subjects with patellofemoral pain

DEFF Research Database (Denmark)

Rathleff, Michael S; Richter, Camilla; Brushøj, Christoffer

2014-01-01

PURPOSE: To compare medial-to-lateral plantar forces during drop jump and single leg squat in individuals with and without patellofemoral pain. METHODS: This cross-sectional study compared 23 young adults with patellofemoral pain to 20 age- and sex-matched controls without knee pain. The plantar...... pressure distribution was collected during drop jump and single leg squat using pressure-sensitive Pedar insoles, inserted into a standard flat shoe. The primary outcome was the medial-to-lateral force, quantified as the peak force under the medial forefoot as the percentage of force under the total...... forefoot during drop jump. Secondary outcomes included peak medial-to-lateral force during single leg squat and mean forces during drop jump and single leg squat. RESULTS: The primary outcome showed that individuals with patellofemoral pain had a 22 % higher medial-to-lateral peak force during drop jump...

The Neuro-Mechanical Processes That Underlie Goal-Directed Medio-Lateral APA during Gait Initiation.

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Honeine, Jean-Louis; Schieppati, Marco; Crisafulli, Oscar; Do, Manh-Cuong

2016-01-01

Gait initiation (GI) involves passing from bipedal to unipedal stance. It requires a rapid movement of the center of foot pressure (CoP) towards the future swing foot and of the center of mass (CoM) in the direction of the stance foot prior to the incoming step. This anticipatory postural adjustment (APA) allows disengaging the swing leg from the ground and establishing favorable conditions for stepping. This study aimed to describe the neuro-mechanical process that underlies the goal-directed medio-lateral (ML) APA. We hypothesized that controlled knee flexion of the stance leg contributes to the initial ML displacement of the CoP and to the calibration of the first step. Fourteen subjects initiated gait starting from three different initial stance widths of 15 cm (Small), 30 cm (Medium), and 45 cm (Large). Optoelectronic, force platform and electromyogram (EMG) measurements were performed. During APA, soleus activity diminished bilaterally, while tibialis anterior (TA) activity increased, more so in the stance leg than in the swing leg, and to a larger extent with increasing initial stance width. Knee flexion of the stance leg was observed during APA and correlated with the ML CoP displacement towards the swing leg. ML CoP and CoM displacements during APA increased with increasing stance width. The activity of stance-leg TA was correlated with the degree of knee flexion. Swing-leg tensor fasciae latae (TFL) was also active during APA. Across subjects, when stance-leg tibialis activity was low, TFL activity was large and vice versa. The modulation of the ML CoP position during APA allowed the gravity-driven torque to place the CoM just lateral to the stance foot during step execution. Accordingly, the gravity-driven torque, the ML CoM velocity during step execution, and the step width at foot contact (FC) were lower in the Small and greater in the Large condition. Consequently, the position of the stepping foot at FC remained close to the sagittal plane in all

Peak medial (but not lateral) hamstring activity is significantly lower during stance phase of running. An EMG investigation using a reduced gravity treadmill.

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Hansen, Clint; Einarson, Einar; Thomson, Athol; Whiteley, Rodney

2017-09-01

The hamstrings are seen to work during late swing phase (presumably to decelerate the extending shank) then during stance phase (presumably stabilizing the knee and contributing to horizontal force production during propulsion) of running. A better understanding of this hamstring activation during running may contribute to injury prevention and performance enhancement (targeting the specific role via specific contraction mode). Twenty active adult males underwent surface EMG recordings of their medial and lateral hamstrings while running on a reduced gravity treadmill. Participants underwent 36 different conditions for combinations of 50%-100% altering bodyweight (10% increments) & 6-16km/h (2km/h increments, i.e.: 36 conditions) for a minimum of 6 strides of each leg (maximum 32). EMG was normalized to the peak value seen for each individual during any stride in any trial to describe relative activation levels during gait. Increasing running speed effected greater increases in EMG for all muscles than did altering bodyweight. Peak EMG for the lateral hamstrings during running trials was similar for both swing and stance phase whereas the medial hamstrings showed an approximate 20% reduction during stance compared to swing phase. It is suggested that the lateral hamstrings work equally hard during swing and stance phase however the medial hamstrings are loaded slightly less every stance phase. Likely this helps explain the higher incidence of lateral hamstring injury. Hamstring injury prevention and rehabilitation programs incorporating running should consider running speed as more potent stimulus for increasing hamstring muscle activation than impact loading. Copyright © 2017 Elsevier B.V. All rights reserved.

Medial approach of ultrasound-guided costoclavicular plexus block and its effects on regional perfussion.

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Nieuwveld, D; Mojica, V; Herrera, A E; Pomés, J; Prats, A; Sala-Blanch, X

2017-04-01

Ultrasound-guided infraclavicular block in the costoclavicular space located between the clavicle and the first rib, reaches the secondary trunks when they are clustered together and lateral to the axillary artery. This block is most often performed through a lateral approach, the difficulty being finding the coracoid process an obstacle and guiding the needle towards the vessels and pleura. A medial approach, meaning from inside to outside, will avoid these structures. Traditionally the assessment of a successful block is through motor or sensitive responses but a sympathetic fibre block can also be evaluated measuring the changes in humeral artery blood flow, skin temperature and/or perfusion index. To describe the medial approach of the ultrasound-guided costoclavicular block evaluating its development by motor and sensitive response and measurement of sympathetic changes. Description of the technique and administration of 20ml of contrast in a fresh cadaver model, evaluating the distribution with CT-scan and sagittal sections of the anatomic piece. Subsequently in a clinical phase, including 11 patients, we evaluated the establishment of motor, sensitive and sympathetic blocks. We evaluated the sympathetic changes reflected by humeral artery blood flow, skin temperature and distal perfusion index. In the anatomical model the block was conducted without difficulties, showing an adequate periclavicular distribution of the contrast in the CT-scan and in sagittal sections, reaching the interscalenic space as far as the secondary trunks. Successful blocks were observed in 91% of patients after 25minutes. All the parameters reflecting sympathetic block increased significantly. The humeral artery blood flow showed an increase from 108 ± 86 to 188±141ml/min (P=.05), skin temperature from 32.1±2 to 32.8±9°C (P=.03) and perfusion index from 4±3 to 9±5 (P=.003). The medial approach of the ultrasound-guided costoclavicular block is anatomically feasible, with high

Absence of the musculocutaneous nerve with innervation of coracobrachialis, biceps brachii, brachialis and the lateral border of the forearm by branches from the lateral cord of the brachial plexus

Science.gov (United States)

NAKATANI, TOSHIO; TANAKA, SHIGENORI; MIZUKAMI, SHIGEKI

1997-01-01

Anomalies of the brachial plexus and its terminal branches are not uncommon. Variations in the course and branches of the musculocutaneous nerve have been noted (Clemente, 1985; Bergman et al. 1988) and its absence was reported by Le Minor (1990). Several anomalies were present in the left plexus of a 59-y-old Japanese man (Fig.). There were no anterior and posterior divisions of the middle trunk, although there were communications between the posterior, medial and lateral cords. The musculocutaneous nerve was absent (Le Minor, 1990) and the medial and lateral roots of the median nerve did not unite in the axillary fossa but in the upper arm about 5 cm distal to the lower border of latissimus dorsi (Adachi, 1928; Buch-Hansen, 1955). The hitherto unreported findings were branches arising directly from the lateral cord to supply coracobrachialis, both heads of biceps brachii and brachialis. The lateral cutaneous nerve of the forearm was derived from the lateral cord with a small contribution from the medial root of the median nerve. Since there were communications between the posterior cord (a continuation of the middle trunk) and the medial and lateral cords, it is theoretically possibly, but not proven, that the root values of branches innervating the flexor muscles of the arm and forearm and the skin of lateral border of the forearm were normal. PMID:9419004

Study of the lateral raise in foot wear for the management of medial compartment degenerative joint disease of knee

International Nuclear Information System (INIS)

Ahmad, A.; Manawar, A.

2014-01-01

A wide spread disease, which may lead the patient to severe outcomes e.g. pain, loss of joint motion, inflexibility and even disability, is Knee osteoarthritis (OA). It is most common among adults of older age and should not be ignored at all. Literature does not show any clear pathogenesis for occurrence of Knee OA, but most of the indications point toward biomechanical stresses which may influence the articular cartilage and sub chondral bone. Objective: The Aim of this study is to become aware of the effects of physical therapy with and without laterally raised footwear in the management of medial knee osteoarthritis. Methodology: We have used experimental comparative study in 35 patients which were randomly selected from Department of Physiotherapy, Fatima Memorial Hospital, Shadman, Lahore. The study consisted of 2 groups, Group I (Experimental Group): In experimental group, patients were treated with laterally raised foot wear and physical therapy both. Group II (Control Group): Whereas in control group patients were treated by physical therapy alone. Kellgren and Lawrence (KL) scale was used to assess radiograph of the knee joints after an anteroposterior weight-bearing standing. The assessment of disease in patients was done by using the Western Ontario and McMaster Universities (WOMAC) Index, Muscle flexibility, Muscle strengthening and Tolerance scales. Results: In group-I the mean age of patients observed was 59.52+-13.66 years and 65+-12.87 years in Group-II. In Group-I, 9 (52.9%) patients were males and 8 (47.1%) patients were females while in Group-II, 9 patients (50%) were male and 9 (50%) were female. In Group-I 2 (11.8%) patients used flat and open shoes, 6 (35.3%) used flat and close shoe, 3 (17.6%) patients used dress shoes and 2 (11.8%) used flat shoes. In Group-I, the frequency of patients wearing laterally raised foot wear in terms of duration was; 5 (29.4%) patients for 20 days, 4 (23.5%) for 24 days, 4 (23.5%) for 25 days, whilst 2 patients

The relationship between 3D bone architectural parameters and elastic moduli of three orthogonal directions predicted from finite elements analysis

International Nuclear Information System (INIS)

Park, Kwan Soo; Lee, Sam Sun; Huh, Kyung Hoe; Yi, Wan Jin; Heo, Min Suk; Choi, Soon Chul

2008-01-01

To investigate the relationship between 3D bone architectural parameters and direction-related elastic moduli of cancellous bone of mandibular condyle. Two micro-pigs (Micro-pigR, PWG Genetics Korea) were used. Each pig was about 12 months old and weighing around 44 kg. 31 cylindrical bone specimen were obtained from cancellous bone of condyles for 3D analysis and measured by micro-computed tomography. Six parameters were trabecular thickness (Tb.Th), bone specific surface (BS/BV), percent bone volume (BV/TV), structure model index (SMI), degree of anisotropy (DA) and 3-dimensional fractal dimension (3DFD). Elastic moduli of three orthogonal directions (superiorinferior (SI), medial-lateral (ML), andterior-posterior (AP) direction) were calculated through finite element analysis. Elastic modulus of superior-inferior direction was higher than those of other directions. Elastic moduli of 3 orthogonal directions showed different correlation with 3D architectural parameters. Elastic moduli of SI and ML directions showed significant strong to moderate correlation with BV/TV, SMI and 3DFD. Elastic modulus of cancellous bone of pig mandibular condyle was highest in the SI direction and it was supposed that the change into plate-like structure of trabeculae was mainly affected by increase of trabeculae of SI and ML directions.

Do MRI features at baseline predict radiographic joint space narrowing in the medial compartment of the osteoarthritic knee 2 years later?

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Madan-Sharma, Ruby; Kornaat, Peter R.; Bloem, Johannes L.; Watt, Iain [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Kloppenburg, Margreet; Botha-Scheepers, Stella A. [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Graverand, Marie-Pierre Hellio le [Pfizer Groton, Groton, CT (United States)

2008-09-15

The purpose of the study was to relate magnetic resonance imaging (MRI) features at baseline with radiographically determined joint space narrowing (JSN) in the medial compartment of the knee after 2 years in a group of patients with symptomatic osteoarthritis at multiple joint sites. MRI of the knee and standardized radiographs were obtained at baseline and after 2 years in 186 patients (81% female; aged 43-76 years; mean 60 years). MRI was analyzed for bone marrow lesions, cysts, osteophytes, hyaline cartilage defects, joint effusion, and meniscal pathology in the medial compartment. Radiographs were scored semiquantitatively for JSN in the medial tibiofemoral joint using the Osteoarthritis Research Society International (OARSI) atlas. Radiological progression was defined as {>=}1 grade increase. Associations between baseline magnetic resonance (MR) parameters and subsequent radiographic JSN changes were assessed using logistic regression. Relative risk (RR) was then calculated. Radiographic progression of JSN was observed in 17 (9.1%) of 186 patients. Eleven patients had a Kellgren and Lawrence (KL) score of {>=}2. A significant association was observed between all patients and meniscal tears (RR 3.57; confidence interval (CI) 1.08-10.0) and meniscal subluxation (RR 2.73; CI 1.20-5.41), between KL<2 and meniscal subluxation (RR 11.3; CI 2.49-29.49) and KL {>=} 2 and meniscus tears (RR 8.91; CI 1.13-22.84) and radiographic JSN 2 years later. Follow-up MR in 15 of 17 patients with progressive JSN showed only new meniscal abnormalities and no progression of cartilage loss. Meniscal pathology (tears and/or meniscal subluxation) was the only MRI parameter to be associated with subsequent radiographic progression of JSN in the medial tibiofemoral compartment on a radiograph 2 years later, as assessed by the OARSI score. (orig.)

Supinated forearm is correlated with the onset of medial epicondylitis in professional slalom water-skiers.

Science.gov (United States)

Rosa, Donato; Di Donato, Sigismondo Luca; Balato, Giovanni; D'Addona, Alessio; Schonauer, Fabrizio

2016-01-01

prolonged and laborious activities involving wrists and forearms has been long associated with the onset of epicondylitis. Slalom water-skiing can be included in this category. The purpose of the study is to analyse the correlation between the pronated or supinated position of forearms during water-skiing practice and the presence respectively of lateral and medial epicondylitis. sixty-six pro and semi-pro slalom water-skiers were enrolled in the study. A questionnaire was submitted to each athlete. Diagnosis of lateral or medial epicondylitis was made through anamnesis and clinical exam by an expert orthopaedic surgeon. Chi-squared were performed for categorical variables, and Mann-Whitney U test for continuous ones. from 116 upper limbs examined, we observed 15 (12.9%) cases of lateral epicondylitis, 30 (25.9%) cases of medial epicondylitis, 10 (8.6%) were affected by both lateral and medial epicondylitis. Lateral and medial epicondylitis were associated (95% C.I.=2,489-26,355; P=epicondylitis (95% C.I.=1,529-9,542; P=0.003). slalom water-skiing can be considered a high-risk sport for epicondylitis. In slalom water-skiers there is a correlation between development of lateral and medial epicondylitis in the same upper limb. Supinated position of forearms is strongly associated with the diagnosis of medial epicondylitis.

Endoscopic medial maxillectomy breaking new frontiers.

Science.gov (United States)

Mohanty, Sanjeev; Gopinath, M

2013-07-01

Endoscopy has changed the perspective of rhinologist towards the nose. It has revolutionised the surgical management of sinonasal disorders. Sinus surgeries were the first to get the benefit of endoscope. Gradually the domain of endoscopic surgery extended to the management of sino nasal tumours. Traditionally medial maxillectomy was performed through lateral rhinotomy or mid facial degloving approach. Endoscopic medial maxillectomy has been advocated by a number of authors in the management of benign sino-nasal tumours. We present our experience of endoscopic medial maxillectomy in the management of sinonasal pathologies.

Effects of laterally wedged insoles on symptoms and disease progression in medial knee osteoarthritis: a protocol for a randomised, double-blind, placebo controlled trial

Directory of Open Access Journals (Sweden)

Osborne Richard

2007-09-01

Full Text Available Abstract Background Whilst laterally wedged insoles, worn inside the shoes, are advocated as a simple, inexpensive, non-toxic self-administered intervention for knee osteoarthritis (OA, there is currently limited evidence to support their use. The aim of this randomised, double-blind controlled trial is to determine whether laterally wedges insoles lead to greater improvements in knee pain, physical function and health-related quality of life, and slower structural disease progression as well as being more cost-effective, than control flat insoles in people with medial knee OA. Methods/Design Two hundred participants with painful radiographic medial knee OA and varus malalignment will be recruited from the community and randomly allocated to lateral wedge or control insole groups using concealed allocation. Participants will be blinded as to which insole is considered therapeutic. Blinded follow up assessment will be conducted at 12 months after randomisation. The outcome measures are valid and reliable measures recommended for OA clinical trials. Questionnaires will assess changes in pain, physical function and health-related quality-of-life. Magnetic resonance imaging will measure changes in tibial cartilage volume. To evaluate cost-effectiveness, participants will record the use of all health-related treatments in a log-book returned to the assessor on a monthly basis. To test the effect of the intervention using an intention-to-treat analysis, linear regression modelling will be applied adjusting for baseline outcome values and other demographic characteristics. Discussion Results from this trial will contribute to the evidence regarding the effectiveness of laterally wedged insoles for the management of medial knee OA. Trial registration ACTR12605000503628; NCT00415259.

Endoscopic Medial Maxillectomy Breaking New Frontiers

OpenAIRE

Mohanty, Sanjeev; Gopinath, M.

2011-01-01

Endoscopy has changed the perspective of rhinologist towards the nose. It has revolutionised the surgical management of sinonasal disorders. Sinus surgeries were the first to get the benefit of endoscope. Gradually the domain of endoscopic surgery extended to the management of sino nasal tumours. Traditionally medial maxillectomy was performed through lateral rhinotomy or mid facial degloving approach. Endoscopic medial maxillectomy has been advocated by a number of authors in the management ...

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

Science.gov (United States)

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

2013-11-01

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

Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors

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Descatha, Alexis; Leclerc, Annette; Chastang, Jean-François; Roquelaure, Yves

2003-01-01

As medial epicondylitis has not been studied alone, we investigated its links between personal and occupational factors in repetitive work, and its course. 1757 workers were examined by an occupational health physician in 1993–94. 598 of them were re-examined three years later. Prevalence was between 4 and 5%, with annual incidence estimated at 1.5%. Forceful work was a risk factor for medial epicondylitis (OR 1.95 CI [1.15–3.32]), but not exposure to repetitive work (OR 1.11, CI [0.59–2.10]). Workers with medial epicondylitis had a significantly higher prevalence of other work-related upper-limb musculoskeletal disorders (WRMD). Risk factors differed for medial and lateral epicondylitis. The prognosis for medial epicondylitis in this population was good with a three-year recovery rate at 81%. Medial epicondylitis was clearly associated with forceful work and other upper-limb WRMD, and its prognosis was good. PMID:14506342

Lateral trunk lean and medializing the knee as gait strategies for knee osteoarthritis

NARCIS (Netherlands)

Gerbrands, T. A.; Pisters, M. F.; Theeven, P. J R; Verschueren, S.; Vanwanseele, B.

2017-01-01

Objective To determine (1) if Medial Thrust or Trunk Lean reduces the knee adduction moment (EKAM) the most during gait in patients with medial knee osteoarthritis, (2) if the best overall strategy is the most effective for each patient and (3) if these strategies affect ankle and hip kinetics.

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. Copyright © 2010 Wiley-Liss, Inc.

The medial prefrontal cortex-lateral entorhinal cortex circuit is essential for episodic-like memory and associative object-recognition.

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Chao, Owen Y; Huston, Joseph P; Li, Jay-Shake; Wang, An-Li; de Souza Silva, Maria A

2016-05-01

The prefrontal cortex directly projects to the lateral entorhinal cortex (LEC), an important substrate for engaging item-associated information and relaying the information to the hippocampus. Here we ask to what extent the communication between the prefrontal cortex and LEC is critically involved in the processing of episodic-like memory. We applied a disconnection procedure to test whether the interaction between the medial prefrontal cortex (mPFC) and LEC is essential for the expression of recognition memory. It was found that male rats that received unilateral NMDA lesions of the mPFC and LEC in the same hemisphere, exhibited intact episodic-like (what-where-when) and object-recognition memories. When these lesions were placed in the opposite hemispheres (disconnection), episodic-like and associative memories for object identity, location and context were impaired. However, the disconnection did not impair the components of episodic memory, namely memory for novel object (what), object place (where) and temporal order (when), per se. Thus, the present findings suggest that the mPFC and LEC are a critical part of a neural circuit that underlies episodic-like and associative object-recognition memory. © 2015 Wiley Periodicals, Inc.

Nirschl surgical technique for concomitant lateral and medial elbow tendinosis: a retrospective review of 53 elbows with a mean follow-up of 11.7 years.

Science.gov (United States)

Schipper, Oliver N; Dunn, Jonathan H; Ochiai, Derek H; Donovan, J Skye; Nirschl, Robert P

2011-05-01

Combined lateral elbow tendinosis (tennis elbow) and medial elbow tendinosis (golfer's elbow) can be a disabling condition that, if unresponsive to nonoperative treatments, may be effectively treated surgically. The authors are not aware of any study that reports the outcome of a combined operation for lateral and medial elbow tendinosis (country club elbow) performed in the same operative setting. Combined surgical treatment of country club elbow in the same operative setting has similar outcomes to those seen in the literature for single operative procedures. Case series; Level of evidence 4. Outcome measurements included the Numeric Pain Intensity Scale, the Nirschl tennis elbow scoring system, and the American Shoulder and Elbow Surgeons elbow form. Forty-eight patients (53 clinical elbows) were available by telephone, with a minimum time to follow-up of 5 years (range, 5-19 years; mean, 11.7 years). The average Nirschl tennis elbow score improved from 16.7 preoperatively to 70.8 postoperatively (P Elbow Surgeons elbow score improved from 45.2 to 90.4 (P tennis elbow score, results were rated excellent in 38 elbows, good in 7 elbows, fair in 5 elbows, and poor in 3 elbows, with 85% (45 of 53) good to excellent results. Patient satisfaction with the surgery averaged 8.7 out of 10. Of the 46 patients who played sports, 44 (96%) reported returning to their sports. When nonoperative treatment of lateral and medial elbow tendinosis fails, combined surgical intervention via the Nirschl operative techniques for country club elbow is highly effective, with results similar to those of single-sided intervention.

Transosseous-equivalent rotator cuff repair: a systematic review on the biomechanical importance of tying the medial row.

Science.gov (United States)

Mall, Nathan A; Lee, Andrew S; Chahal, Jaskarndip; Van Thiel, Geoffrey S; Romeo, Anthony A; Verma, Nikhil N; Cole, Brian J

2013-02-01

Double-row and transosseous-equivalent repair techniques have shown greater strength and improved healing than single-row techniques. The purpose of this study was to determine whether tying of the medial-row sutures provides added stability during biomechanical testing of a transosseous-equivalent rotator cuff repair. We performed a systematic review of studies directly comparing biomechanical differences. Five studies met the inclusion and exclusion criteria. Of the 5 studies, 4 showed improved biomechanical properties with tying the medial-row anchors before bringing the sutures laterally to the lateral-row anchors, whereas the remaining study showed no difference in contact pressure, mean failure load, or gap formation with a standard suture bridge with knots tied at the medial row compared with knotless repairs. The results of this systematic review and quantitative synthesis indicate that the biomechanical factors ultimate load, stiffness, gap formation, and contact area are significantly improved when medial knots are tied as part of a transosseous-equivalent suture bridge construct compared with knotless constructs. Further studies comparing the clinical healing rates and functional outcomes between medial knotted and knotless repair techniques are needed. This review indicates that biomechanical factors are improved when the medial row of a transosseous-equivalent rotator cuff is tied compared with a knotless repair. However, this has not been definitively proven to translate to improved healing rates clinically. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Role of pathophysiology of patellofemoral instability in the treatment of spontaneous medial patellofemoral subluxation: a case report

Directory of Open Access Journals (Sweden)

Doğruyol Dağhan

2010-05-01

Full Text Available Abstract Introduction Medial patellar subluxation is usually seen after lateral retinacular release. Spontaneous medial subluxation of the patella is a very rare condition. There are few reports in the literature on the pathophysiology of iatrogenic medial patellar subluxation. To our knowledge, there are no reports of the pathophysiology of non-iatrogenic medial patellar subluxation in the English literature. In this study we present a case of spontaneous medial patellar instability that is more prominent in extension during weight bearing. We also try to define the treatment protocol based on pathophsiology. Case presentation We report the case of a 21-year-old Turkish man with spontaneous medial patellar instability. He had suffered right knee pain, clicking and popping sensation in the affected knee for three months prior to presentation. Clinical examination demonstrated medial patellar subluxation that is more prominent in extension during the weight bearing phase of gait and while standing. Increased medial tilt was observed when the patella was stressed medially. Conventional anterior to posterior, lateral and Merchant radiographs did not reveal any abnormalities. After three months of physical therapy, our patient was still suffering from right knee pain which disturbed his gait pattern. Throughout the surgery, medial patellar translation was tested following the imbrication of lateral structures. He still had a medial patellar translation that was more than 50% of his patellar width. Patellotibial ligament augmentation using an iliotibial band flap was added. When examined after surgery, the alignment of the patella was effectively corrected. Conclusions Chronic imbalance between the strengths of vastus lateralis and vastus medialis results in secondary changes in passive ligamentous structures and causes additional instability. Physical therapy modalities that aim to strengthen the vastus lateralis might be sufficient for the

Usefulness of StereoEEG-based tailored surgery for medial temporal lobe epilepsy. Preliminary results in 11 patients.

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Kubota, Yuichi; Ochiai, Taku; Hori, Tomokatsu; Kawamata, Takakazu

2017-07-01

Surgical options for medial temporal lobe epilepsy (MTLE) include anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (SAH). Optimal criteria for choosing the appropriate surgical approach remain uncertain. This article reports 11 consecutive cases in which electrophysiological findings of stereoelectroencephalography (SEEG) were used to determine the optimal surgical approach. Eleven consecutive patients with MTLE underwent SEEG evaluation and were placed in either the medial or the medial+lateral group based on the findings. Patients in the medial group underwent SAH using the subtemporal approach, and patients in the medial+lateral group underwent SEEG-guided anterior temporal lobectomy. SEEG findings were also compared with other examinations including flumazenil (FMZ)-positron emission tomography (PET), fluorine-18 labeled fluorodeoxyglucose (FDG)-PET, and magnetoencephalography (MEG). Results were evaluated to determine which examinations most consistently identified the epileptogenic zone. Of the 11 cases, 4 patients were placed in the medial group, and 7 patients in the medial+lateral group. Of patients, 90.9% were classified in class I of the Engel Epilepsy Surgery Outcome Scale, while 72.7% were classified in class I by the International League Against Epilepsy (ILAE) system. Analyzed by group, 100% of the medial group experienced an Engel class I outcome in the medial group, compared to 85.7% in the medial+lateral group. SEEG findings were comparable with FDG-PET results (10 of 11, 91%). Tailored surgery guided by SEEG is an electrophysiologically feasible treatment for MTLE that can result in favorable outcomes. Although seizures are thought to originate in the medial temporal lobe in MTLE, it is important for involvement of the lateral temporal cortex to be also considered in some cases. Copyright © 2017. Published by Elsevier B.V.

Default network connectivity in medial temporal lobe amnesia.

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Hayes, Scott M; Salat, David H; Verfaellie, Mieke

2012-10-17

There is substantial overlap between the brain regions supporting episodic memory and the default network. However, in humans, the impact of bilateral medial temporal lobe (MTL) damage on a large-scale neural network such as the default mode network is unknown. To examine this issue, resting fMRI was performed with amnesic patients and control participants. Seed-based functional connectivity analyses revealed robust default network connectivity in amnesia in cortical default network regions such as medial prefrontal cortex, posterior medial cortex, and lateral parietal cortex, as well as evidence of connectivity to residual MTL tissue. Relative to control participants, decreased posterior cingulate cortex connectivity to MTL and increased connectivity to cortical default network regions including lateral parietal and medial prefrontal cortex were observed in amnesic patients. In contrast, somatomotor network connectivity was intact in amnesic patients, indicating that bilateral MTL lesions may selectively impact the default network. Changes in default network connectivity in amnesia were largely restricted to the MTL subsystem, providing preliminary support from MTL amnesic patients that the default network can be fractionated into functionally and structurally distinct components. To our knowledge, this is the first examination of the default network in amnesia.

A meta-analysis into the effect of lateral-wedged insoles with subtalar strapping versus traditional insoles in adults with medial knee osteoarthritis.

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L. Duvenhage

2011-02-01

Full Text Available To  systematically  identify,  collate,  and  analyze  the  current available evidence  for  the  effectiveness  of  lateral-wedged  insoles,  with subtalar strapping,  on  reducing  pain,  improving  function  and  improving  the femoral-tibial  angle  (FTA,  in  adults  with  medial  knee osteoarthritis compared to traditional insoles without subtalar strapping.Six computerised databases, namely Cochrane Library, CiNAHL, PEDro, BIOMED central,  PubMed  and  ScienceDirect  were  searched. The  included articles were  then  all  rated  using  the  PEDro  scale  to  determine  their meth-odological quality.  Homogeneous data were pooled in a meta-analysis using Review Manager (REVMAN software.  Where statistical pooling of the results was not possible, findings were summarised in narrative form. Three randomised controlled trials were selected for this review. The average PEDro score was 5.7. A meta-analysis demonstrated that lateral-wedged insoles with subtalar strapping significantly reduced pain in the short-term (p=0.004. The review found that lateral-wedge insoles with subtalar strapping significantly decreased pain in the short-term and seemed to have a positive effect on the FTA in the long-term, when compared to traditional insoles without  subtalar strapping. The lateral-wedge insole with subtalar strapping may provide a financially feasible adjunctive self-management treatment for knee OA and should be considered before invasive procedures such as surgery.

Dynamic balance deficits in individuals with chronic ankle instability compared to ankle sprain copers 1 year after a first-time lateral ankle sprain injury.

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Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

2016-04-01

To quantify the dynamic balance deficits that characterise a group with chronic ankle instability compared to lateral ankle sprain copers and non-injured controls using kinematic and kinetic outcomes. Forty-two participants with chronic ankle instability and twenty-eight lateral ankle sprain copers were initially recruited within 2 weeks of sustaining a first-time, acute lateral ankle sprain and required to attend our laboratory 1 year later to complete the current study protocol. An additional group of non-injured individuals were also recruited to act as a control group. All participants completed the anterior, posterior-lateral and posterior-medial reach directions of the star excursion balance test. Sagittal plane kinematics of the lower extremity and associated fractal dimension of the centre of pressure path were also acquired. Participants with chronic ankle instability displayed poorer performance in the anterior, posterior-medial and posterior-lateral reach directions compared with controls bilaterally, and in the posterior-lateral direction compared with lateral ankle sprain copers on their 'involved' limb only. These performance deficits in the posterior-lateral and posterior-medial directions were associated with reduced flexion and dorsiflexion displacements at the hip, knee and ankle at the point of maximum reach, and coincided with reduced complexity of the centre of pressure path. In comparison with lateral ankle sprain copers and controls, participants with chronic ankle instability were characterised by dynamic balance deficits as measured using the SEBT. This was attested to reduced sagittal plane motions at the hip, knee and ankle joints, and reduced capacity of the stance limb to avail of its supporting base. III.

Medial and Lateral Pectoral Nerve Block with Liposomal Bupivacaine for the Management of Postsurgical Pain after Submuscular Breast Augmentation

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David Leiman, MD

2014-12-01

Full Text Available Summary: This report describes an ultrasound-guided medial and lateral pectoralis nerve block using liposome bupivacaine, performed before the surgical incision, in a patient undergoing submuscular breast augmentation. The anatomic basis and technique are described. This procedure may be offered to patients undergoing submuscular insertion of a breast implant or tissue expander. Advancements in ultrasound guidance allow for more precise anatomic placement of local anesthetic agents. The injection technique used for this procedure resulted in complete relaxation of the pectoralis major, facilitating the surgical dissection and markedly diminishing postsurgical pain and muscle spasms.

Trochleoplasty and medial patellofemoral ligament reconstruction for recurrent patellar dislocation

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K Raghuveer Reddy

2012-01-01

Full Text Available We report a case of recurrent patellar dislocation with high-grade trochlear dysplasia which persisted despite two previous operations. We did a Dejour′s sulcus deepening trochleoplasty, medial patellofemoral ligament reconstruction, and lateral retinacular release. Trochleoplasty and medial patellofemoral ligament reconstruction is required in patients with high grade trochlear dysplasia.

Prediction of medial tibiofemoral compartment joint space loss progression using volumetric cartilage measurements: Data from the FNIH OA biomarkers consortium

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Hafezi-Nejad, Nima; Demehri, Shadpour [Johns Hopkins University School of Medicine, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Guermazi, Ali [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Roemer, Frank W. [University of Erlangen-Nuremberg, Department of Radiology, Erlangen (Germany); Hunter, David J. [Royal North Shore Hospital Sydney, Institute of Bone and Joint Research, Kolling Institute, University of Sydney, and Rheumatology Department, Sydney (Australia); Dam, Erik B. [Biomediq, Copenhagen (Denmark); Zikria, Bashir [Johns Hopkins University, Department of Orthopaedic Surgery, Baltimore, MD (United States); Kwoh, C.K. [University of Arizona, Division of Rheumatology and Clinical Immunology, Tucson, AZ (United States)

2017-02-15

Investigating the association between baseline cartilage volume measurements (and initial 24th month volume loss) with medial compartment Joint-Space-Loss (JSL) progression (>0.7 mm) during 24-48th months of study. Case and control cohorts (Biomarkers Consortium subset from the Osteoarthritis Initiative (OAI)) were defined as participants with (n=297) and without (n=303) medial JSL progression (during 24-48th months). Cartilage volume measurements (baseline and 24th month loss) were obtained at five knee plates (medial-tibial, lateral-tibial, medial-femoral, lateral-femoral and patellar), and standardized values were analysed. Multivariate logistic regression was used with adjustment for known confounders. Artificial-Neural-Network analysis was conducted by Multi-Layer-Perceptrons (MLPs) including baseline determinants, and baseline (1) and interval changes (2) in cartilage volumes. Larger baseline lateral-femoral cartilage volume was predictive of medial JSL (OR: 1.29 (1.01-1.64)). Greater initial 24th month lateral-femoral cartilage volume-loss (OR: 0.48 (0.27-0.84)) had protective effect on medial JSL during 24-48th months of study. Baseline and interval changes in lateral-femoral cartilage volume, were the most important estimators for medial JSL progression (importance values: 0.191(0.177-0.204), 0.218(0.207-0.228)) in the ANN analyses. Cartilage volumes (both at baseline and their change during the initial 24 months) in the lateral femoral plate were predictive of medial JSL progression. (orig.)

Clinical Comparison of Extensile Lateral Approach and Sinus Tarsi Approach Combined with Medial Distraction Technique for Intra-Articular Calcaneal Fractures.

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Zhou, Hai-Chao; Yu, Tao; Ren, Hao-Yang; Li, Bing; Chen, Kai; Zhao, You-Guang; Yang, Yun-Feng

2017-02-01

To study and compare the clinical outcomes of open reduction and internal fixation via extensile L-shape incision and limited open reduction via the sinus tarsi approach using the medial distraction technique for intra-articular calcaneal fractures. We performed a retrospective review of 65 intra-articular calcaneal fractures treated operatively between March 2012 and February 2015. Patients were divided into two groups: 28 were in the sinus tarsi approach group and 37 were in the extensile lateral approach group. All patients were asked to return for a research visit that included radiography and clinical evaluation. The postoperative function was evaluated using the ankle and hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and the visual analogue scale (VAS). No significant difference was found in demographics between the two groups. The corrected value of the calcaneal varus angle between the two groups is statistically significant (P articular calcaneal fractures could reduce the incidence of wound complications effectively, and the medial distraction technique is helpful for correcting the calcaneus varus deformity. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Meniscus maturation in the swine model: changes occurring along with anterior to posterior and medial to lateral aspect during growth

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Di Giancamillo, Alessia; Deponti, Daniela; Addis, Alessandro; Domeneghini, Cinzia; Peretti, Giuseppe M

2014-01-01

The meniscus plays important roles in knee function and mechanics and is characterized by a heterogeneous matrix composition. The changes in meniscus vascularization observed during growth suggest that the tissue-specific composition may be the result of a maturation process. This study has the aim to characterize the structural and biochemical variations that occur in the swine meniscus with age. To this purpose, menisci were collected from young and adult pigs and divided into different zones. In study 1, both lateral and medial menisci were divided into the anterior horn, the body and the posterior horn for the evaluation of glycosaminoglycans (GAGs), collagen 1 and 2 content. In study 2, the menisci were sectioned into the inner, the intermediate and the outer zones to determine the variations in the cell phenotype along with the inner–outer direction, through gene expression analysis. According to the results, the swine meniscus is characterized by an increasing enrichment in the cartilaginous component with age, with an increasing deposition in the anterior horn (GAGs and collagen 2; P meniscus maturation, suggesting a specific response of meniscal cells to the regional mechanical stimuli in the knee joint. PMID:25216283

Cartilage volume quantification with multi echo data image combination sequence in swine knee at 3.0 T MRI

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Zhang Lirong; Wang Dongqing; Wei Chuanshe; Ma Cong; Wang Dehang

2010-01-01

Objective: To investigate the accuracy and reproducibility of multi echo data imagine combination (MEDIC) sequence with water excitation at 3.0 T in swine knee cartilage. Methods: Sagittal MEDIC sequences (0.6 mm slice thickness, isotropic) were acquired twice at 3.0 T MRI in 30 swine knees. The knee cartilage was then removed and the volume was directly measured with water substitution method. The cartilage volume was also determined with a validated open source image software OsiriX by two observers (A and B). The cartilage volumes obtained by two methods were compared. The reproducibility of MEDIC for quantitative measurement was accessed by the root-mean-square (RMS) of variation coefficient. Interobserver and intraobserver precision errors were compared using a paired students t-test. The accuracy of MEDIC for quantitative measurement was determined by the random pairwise differences, systematic pairwise differences and the Pearson, correlation coefficients. Time of semiautomatic and manual segmentation were recorded. Results: Time was saved about 75% by using semiautomatic segmentation methods [(4.0± 1.5) min] versus manual segmentation [(16.0±0.9) min]. Interobserver precision errors (RMS CV% for paired analysis) between A and B for cartilage volume measurement were (2.66±0.82) ml and(2.61± 0.81) ml, t=0.24, P=0.81 (patella); (2.40±0.69) ml and (2.49±0.85) ml, t=-0.45, P=0.65 (medial femoral condyle); (2.28±0.74) ml and(2.41±0.78) ml, t=-0.66, P=0.51 (lateral femoral condyle); (3.43±1.28) ml and (3.51±1.08) ml, t=-0.26, P=0.79 (femora trochlea) with sagittal MEDIC. Intraobserver precision errors (RMS CV% for paired analysis) of observer A for the first and second cartilage volume measurement were (2.64±0.62) ml and (2.67±0.60) ml, t=-0.19, P=0.85 (patella); (2.43±0.60) ml and (2.39±0.59) ml, t=0.26, P=0.80 (medial femoral condyle); (2.26±0.56) ml and (2.30±0.57) ml, t=-0.27, P=0.78 (lateral femoral condyle); (3.40± 1.20) ml and (3.47±1

Laterality of radiographic osteoarthritis of the knee.

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Komatsu, Daigo; Ikeuchi, Kazuma; Kojima, Toshihisa; Takegami, Yasuhiko; Amano, Takafumi; Tsuboi, Masaki; Ishiguro, Naoki; Hasegawa, Yukiharu

2017-05-01

There are few reports of the laterality in radiological knee osteoarthritis (ROA). This study aimed to evaluate laterality in terms of the minimum joint space width (mJSW) and osteophyte areas (OFs) in a cross-sectorial general population screen and elucidate the association between laterality and risk of osteoarthritis. We enrolled 330 participants (mean age 64.6 years) and examined the presence of ROA (Kellgren-Lawrence grade ≧ 2) laterality in terms of the mJSW and OF on the medial tibia using auto-measuring software. Moreover, we examined the association between laterality and leg dominance. The right and left medial mJSWs were 4.02 ± 0.98 mm and 4.05 ± 1.01 mm, respectively, showing no laterality; the laterals were also similar. The participants who had osteophytes ≥1 mm 2 in the right, left, and bilateral knees were 15, 37, and 57 respectively, with osteophytes being significantly more common in the left knee. The OF was significantly larger in the left knee. Conversely, the medial and lateral mJSWs and OF did not differ according to leg dominance. The prevalence of ROA was higher and the OF was more pronounced in the left knee. However, the mJSW showed no laterality. Additionally, the mJSW and OF showed no differences according to leg dominance.

Effects on Subtalar Joint Stress Distribution After Cannulated Screw Insertion at Different Positions and Directions.

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Yuan, Cheng-song; Chen, Wan; Chen, Chen; Yang, Guang-hua; Hu, Chao; Tang, Kang-lai

2015-01-01

We investigated the effects on subtalar joint stress distribution after cannulated screw insertion at different positions and directions. After establishing a 3-dimensional geometric model of a normal subtalar joint, we analyzed the most ideal cannulated screw insertion position and approach for subtalar joint stress distribution and compared the differences in loading stress, antirotary strength, and anti-inversion/eversion strength among lateral-medial antiparallel screw insertion, traditional screw insertion, and ideal cannulated screw insertion. The screw insertion approach allowing the most uniform subtalar joint loading stress distribution was lateral screw insertion near the border of the talar neck plus medial screw insertion close to the ankle joint. For stress distribution uniformity, antirotary strength, and anti-inversion/eversion strength, lateral-medial antiparallel screw insertion was superior to traditional double-screw insertion. Compared with ideal cannulated screw insertion, slightly poorer stress distribution uniformity and better antirotary strength and anti-inversion/eversion strength were observed for lateral-medial antiparallel screw insertion. Traditional single-screw insertion was better than double-screw insertion for stress distribution uniformity but worse for anti-rotary strength and anti-inversion/eversion strength. Lateral-medial antiparallel screw insertion was slightly worse for stress distribution uniformity than was ideal cannulated screw insertion but superior to traditional screw insertion. It was better than both ideal cannulated screw insertion and traditional screw insertion for anti-rotary strength and anti-inversion/eversion strength. Lateral-medial antiparallel screw insertion is an approach with simple localization, convenient operation, and good safety. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Connections of the medial posterior parietal cortex (area 7m) in the monkey.

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Leichnetz, G R

2001-06-01

The afferent and efferent cortical and subcortical connections of the medial posterior parietal cortex (area 7m) were studied in cebus (Cebus apella) and macaque (Macaca fascicularis) monkeys using the retrograde and anterograde capabilities of the horseradish peroxidase (HRP) technique. The principal intraparietal corticocortical connections of area 7m in both cebus and macaque cases were with the ipsilateral medial bank of the intraparietal sulcus (MIP) and adjacent superior parietal lobule (area 5), inferior parietal lobule (area 7a), lateral bank of the IPS (area 7ip), caudal parietal operculum (PGop), dorsal bank of the caudal superior temporal sulcus (visual area MST), and medial prestriate cortex (including visual area PO and caudal medial lobule). Its principal frontal corticocortical connections were with the prefrontal cortex in the shoulder above the principal sulcus and the cortex in the shoulder above the superior ramus of the arcuate sulcus (SAS), the area purported to contain the smooth eye movement-related frontal eye field (FEFsem) in the cebus monkey by other investigators. There were moderate connections with the cortex in the rostral bank of the arcuate sulcus (purported to contain the saccade-related frontal eye field; FEFsac), supplementary eye field (SEF), and rostral dorsal premotor area (PMDr). Area 7m also had major connections with the cingulate cortex (area 23), particularly the ventral bank of the cingulate sulcus. The principal subcortical connections of area 7m were with the dorsal portion of the ventrolateral thalamic (VLc) nucleus, lateral posterior thalamic nucleus, lateral pulvinar, caudal mediodorsal thalamic nucleus and medial pulvinar, central lateral, central superior lateral, and central inferior intralaminar thalamic nuclei, dorsolateral caudate nucleus and putamen, middle region of the claustrum, nucleus of the diagonal band, zona incerta, pregeniculate nucleus, anterior and posterior pretectal nuclei, intermediate layer of

Severe Degeneration of the Medial Collateral Ligament in Hallux Valgus: A Histopathologic Study in 12 Consecutive Patients

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Prasitdumrong, Ittipol; Rungprai, Chamnanni; Reeboonlarb, Nitit; Poonpracha, Tara; Phisitkul, Phinit

2013-01-01

Objective To determine the degree and location of degenerative changes of the medial collateral ligament of the first metatarsophalangeal joint, using the lateral collateral ligament as a control, in patients undergoing hallux valgus correction. Materials and Methods A strip of medial and lateral collateral ligaments were biopsied from 12 consecutive patients (age 45 ± 4.8 years) with symptomatic hallux valgus. A blinded analysis of histopathology was performed by an experienced pathologist. Results The medial collateral ligament was significantly more degenerated compared to the lateral collateral ligament (x2 = 23.41, DF = 2, p hallux valgus correction. The Authors received no financial support for this study. PMID:24027461

Safety and surgical techniques of C1 lateral mass screws

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Kubo, Shinichiro; Kuroki, Hiroshi; Hanado, Shoji; Hamanaka, Hideaki; Inomata, Naoki; Kuroki, Shuji; Chosa, Etsuo

2010-01-01

The objectives of this study were to evaluate the proper insertion techniques of C1 lateral mass screws. Eighteen consecutive patients were examined after upper cervical fusion using twenty-nine C1 lateral mass screws. Screws were placed by three different techniques; Goel's technique (4), Tan's technique (20), Notching technique (5). Pre and post-operative CT scans with multiplanar reconstruction were used to detect cortical breaches and direction of screws. No transverse foramen and vertebral groove violation was found in CT scans. Three had breached superior articular facet of the atlas. However, the range of motion (R.O.M) of atlanto-occipital joints had not changed postoperatively. Theses screws were inserted with Tan's technique and two of three were directed medially. It is feasible to safely insert C1 lateral mass screws when correct insertion point and direction are considered preoperatively. However, care should be taken because screws can violate the atlanto-occipital joint especially with Tan's technique. (author)

Efficiency of Medial Rectus Advancement Surgery in Consecutive Exotropia

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Kemal Yar

2015-12-01

Full Text Available Purpose: To evaluate the efficiency of medial rectus advancement surgery in consecutive exotropia. Material and Methods: The study group consisted of 20 cases, 10 male, 10 female, who were diagnosed as consecutive exotropia and underwent surgery between 2008-2013 at Cukurova University Medical Faculty Ophthalmology Department. Records of the patients were investigated retrospectively. We evaluated best corrected visual acuity, existence of ambliopia, postoperative duration following the first surgery and applied surgical procedures. Postoperative deviation lower than 10 PD were assesed as successful. Mean follow up period was 29,8 +/- 21,36 (8-80 months, patients with inadequate follow up period were dismissed from the study group. Results: We only applied bilateral medial rectus advancement surgery to 6 and unilateral medial rectus advancement surgery to 5 patients and obtained intended surgical result in these 11 cases. The other patients underwent lateral rectus recession or/and medial rectus resection operations inorder to reach projected deviation degrees. Deviation was found to be 46,4+/-9,24 (40-70 PD in cases who only underwent advancement surgery and was 65,56 +/- 18,78 (40-90 PD in cases who underwent additional surgical procedure. 16 (%80 of the cases had hypermetropi various dioptries and 7 (%35 had ambliopia. Discussion: Consecutive exotropia can appear years after surgery and is an important late period complication. In this study achievement of %55 success with medial rectus advancement surgery indicates that this is a preferable procedure. But in wide angle deviations additional lateral rectus recession or/and medial rectus resection operations can be applied inorder to reach intended adjustment. Accurrate prediction of the propotion of advancement surgery and adjustment is not always possible because of intensive fybrosis in operated muscles and enviroment tissue. [Cukurova Med J 2015; 40(4.000: 707-713

Treatment of peroneal tendon dislocation and coexisting medial and lateral ligamentous laxity in the ankle joint.

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Ziai, Pejman; Sabeti-Aschraf, Manuel; Fehske, Kai; Dlaska, Constantin E; Funovics, Philipp; Wenzel, Florian; Graf, Alexandra; Buchhorn, Tomas

2011-06-01

Acute dislocation of the peroneal tendon is caused by massive combined flexion-torsion trauma supported by preexisting ligamentous laxity of the ankle joint. This study aimed to investigate the clinical outcome of combined treatment of peroneal tendon dislocation and lateral and medial ligamentous laxity. Between 2005 and 2007, forty-two patients with peroneal tendon dislocation and coexisting ligamentous laxity were treated. The superior extensor retinaculum was reconstructed using anchor technique and periosteal flap repair, whereas the preexisting ligamentous laxity with regard to the extensor inferior retinaculum was addressed using anchor reconstruction. All patients underwent arthroscopy prior to surgery. Thirty-eight of a total of 42 patients (aged 17-31) completed the 24-month follow-up. Clinical and arthroscopic examination was accomplished consistently by always the same two surgeons. Postoperative follow-up comprised clinical evaluation after 3, 6, 12 and 24 months. Clinical results showed a significant (Pankle joint following arthroscopy results in good clinical outcome and high patient satisfaction. Case series, Level IV.

The medial patellofemoral complex.

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Loeb, Alexander E; Tanaka, Miho J

2018-06-01

The purpose of this review is to describe the current understanding of the medial patellofemoral complex, including recent anatomic advances, evaluation of indications for reconstruction with concomitant pathology, and surgical reconstruction techniques. Recent advances in our understanding of MPFC anatomy have found that there are fibers that insert onto the deep quadriceps tendon as well as the patella, thus earning the name "medial patellofemoral complex" to allow for the variability in its anatomy. In MPFC reconstruction, anatomic origin and insertion points and appropriate graft length are critical to prevent overconstraint of the patellofemoral joint. The MPFC is a crucial soft tissue checkrein to lateral patellar translation, and its repair or reconstruction results in good restoration of patellofemoral stability. As our understanding of MPFC anatomy evolves, further studies are needed to apply its relevance in kinematics and surgical applications to its role in maintaining patellar stability.

The Use of Unilateral Pericranial Flaps for the Closure of Difficult Medial Orbital and Upper Lateral Nasal Defects.

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Newman, Jason; Costantino, Peter; Moche, Jason

2003-11-01

We present 3 cases in which a unilateral pericranial flap was used to repair defects in the medial orbital and upper lateral nasal areas. All three patients had undergone previous excision of malignant tumors from the upper septum and ethmoid areas. Postoperatively, they all received radiation and then developed wound breakdown with fistula formation, particularly in the area of the incisional site. All 3 patients had undergone previous unsuccessful repair of the fistula. Closure of such fistulas requires well-vascularized nonradiated tissue, which can be provided by a unilateral pericranial flap. This flap is flexible, thin, and well suited to the sinonasal area. Use of this flap avoids the need for a paramedian forehead or other musculocutaneous flap. Cosmetic results were excellent, and there have been no flap breakdowns or complications to date.

CT- and fluoroscopy-guided percutaneous discectomy for lumbar radiculopathy related to disc herniation: a comparative prospective study comparing lateral to medial herniated discs

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Amoretti, Nicolas; Huwart, Laurent; Marcy, Pierre-Yves [Centre Hospital-Universitaire de Nice, Department of Radiology, Hopital archet 2, Nice (France); Foti, Pauline [Centre Hospital-Universitaire de Nice, Department of Medical Statistics, Hopital archet 2, Nice (France); Hauger, Olivier [Centre Hospitalo-Universitaire de Bordeaux, Department of Radiology, Hopital Pellegrin, Bordeaux (France); Boileau, Pascal [Centre Hospital-Universitaire de Nice, Department of Orthopedic Surgery, Hopital archet 2, Nice (France)

2013-01-15

To evaluate and compare two groups of patients with sciatica due to intervertebral disc herniation with no neurologic deficit. The groups consisted of patients with intervertebral disc herniation in a medial location (group 1) and those in a lateral location (group 2). A total of 200 patients were included in the study and were followed for a minimum of 6 months. In our series, we treated 80 postero-lateral herniated discs (40% of cases), 46 postero-medial herniated discs (23%), and 74 foraminal herniated discs (37%). Level L3-L4 was treated in 30 cases (15%), L4-L5 in 98 cases (49%), and L5-S1 in 72 cases (36%). The procedure was performed under dual guidance: fluoroscopic and CT. A helical probe was activated. It penetrates the herniated disc and causes the pulpous material to be mechanically evacuated through the probe. All 200 patients were followed for a minimum of 6 months. In group 1, the patients had a mean pain score of 7.9 {+-} 2.5 VAS units (range 6-10 units) prior to intervention. This was reduced to 3.2 {+-} 2.1 VAS units (range 0-10 units) at 48 h follow-up and increased to 3.9 {+-} 1.2 VAS units (range 0-10 VAS units) at 1 month follow-up and further reduced to 2.7 {+-} 1.2 units (range 0-10 VAS units) at 6 month follow-up. In group 2, the patients had a mean pain score of 8.2 {+-} 3.2 VAS units (range 6-10 units) prior to intervention. This was reduced to 2.8 {+-} 1.5 VAS units (range 0-10 units) at 48 h follow-up and decreased to 1.5 {+-} 0.9 VAS units (range 0-10 units) at 1 month and further reduced to 1.1 {+-} 0.5 VAS units (range 0-10 units) at 6 months. Our study showed that results were more satisfactory for the hernia located laterally (postero-lateral, foraminal, and extra-foraminal) as compared to the hernia located posteromedially. (orig.)

Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty

Directory of Open Access Journals (Sweden)

José Roberto Tonelli Filho

Full Text Available ABSTRACT OBJECTIVE: To compare the clinical and radiological outcomes of conventional medial and lateral approaches for total knee replacement in the valgus osteoarthritic knee. METHODS: In this randomized controlled trial, 21 patients with valgus knee osteoarthritis were randomized to total knee replacement through medial or lateral approach. The primary outcome was radiographic patellar tilt. Secondary outcomes were visual analog scale of pain, postoperative levels of hemoglobin, and clinical aspect of the operative wound. RESULTS: There were no differences between the groups regarding other clinical variables. Mean lateral tilt of the patella was 3.1 degrees (SD ± 5.3 in the lateral approach group and 18 degrees (SD ± 10.2 in the medial approach group (p = 0.02. There were no differences regarding the secondary outcomes. CONCLUSION: Lateral approach provided better patellar tilt following total knee replacement in valgus osteoarthritic knee.

Medial shoe-ground pressure and specific running injuries: A 1-year prospective cohort study.

Science.gov (United States)

Brund, René B K; Rasmussen, Sten; Nielsen, Rasmus O; Kersting, Uwe G; Laessoe, Uffe; Voigt, Michael

2017-09-01

Achilles tendinitis, plantar fasciopathy and medial tibial stress syndrome injuries (APM-injuries) account for approximately 25% of the total number of running injuries amongst recreational runners. Reports on the association between static foot pronation and APM-injuries are contradictory. Possibly, dynamic measures of pronation may display a stronger relationship with the risk of APM-injuries. Therefore, the purpose of the present study was to investigate if running distance until the first APM-injury was dependent on the foot balance during stance phase in recreational male runners. Prospective cohort study. Foot balance for both feet was measured during treadmill running at the fastest possible 5000-m running pace in 79 healthy recreational male runners. Foot balance was calculated by dividing the average of medial pressure with the average of lateral pressure. Foot balance was categorized into those which presented a higher lateral shod pressure (LP) than medial pressure, and those which presented a higher medial shod pressure (MP) than lateral pressure during the stance phase. A time-to-event model was used to compare differences in incidence between foot balance groups. Compared with the LP-group (n=59), the proportion of APM-injuries was greater in the MP-group (n=99) after 1500km of running, resulting in a cumulative risk difference of 16%-points (95% CI=3%-point; 28%-point, p=0.011). Runners displaying a more medial pressure during stance phase at baseline sustained a greater amount of APM-injuries compared to those displaying a lateral shod pressure during stance phase. Prospective studies including a greater amount of runners are needed to confirm this relationship. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Damage to the medial motor system in stroke patients with motor neglect

Directory of Open Access Journals (Sweden)

Raffaella eMigliaccio

2014-06-01

Full Text Available Background and objectives. Motor neglect (MN is a clinically important condition whereby patients with unilateral brain lesions fail to move their contralateral limbs, despite normal muscle strength, reflexes, and sensation. MN has been associated with various lesion sites, including the parietal and frontal cortex, the internal capsule, the lenticulostriate nuclei, and the thalamus. In the present study, we explored the hypothesis that MN depends on a dysfunction of the medial motor system by performing a detailed anatomical analysis in four patients with MN.Methods. Ten patients participated in the study: four with MN, four with left visual neglect but without MN, and three patients with left hemiplegia without MN. We used specific scales for clinical and neuropsychological assessment. We drew the lesion borders directly onto the original brain images of each patient, and plotted the lesions on anatomical atlases for grey and white matter. Results. Lesion locations were highly heterogeneous in our MN patients, and included frontal and parietal sites, basal ganglia and white matter. The only consistently damaged structure across all MN patients was the cingulum bundle, a major pathway of the medial motor system important for motor initiative, and a key connection with limbic structures crucial for motivational aspects of actions. Three MN patients with additional damage to lateral fronto-parietal networks had also signs of contralesional visual neglect. The cingulum bundle was intact in all the control patients with visual neglect or hemiplegia.Conclusions. Cingulum damage may induce MN through unilateral dysfunction of the medial motor system. Additional lateral fronto-parietal dysfunction can result in the association with visual neglect.

Lymphangiogram of the pelvic limb in normal dogs with Lipiodol Ultra-Fluide

International Nuclear Information System (INIS)

Tachibana, F.; Nishikawa, T.; Kudo, T.; Otomo, K.; Koike, T.

1982-01-01

Lipiodol Ultra-Fluide (0.2 ml/kg) was injected directly into the lymphatic vessels of the pelvic limbs in 28 healthy adult mongrel dogs. The contrast medium appeared on the roentgenogram in the popliteal, lateral iliac, medial iliac, sacral and lumbar aortic lymph nodes (LN). It was also visible in the iliofemoral, superficial inguinal and cranial mediastinal LN in several dogs. It diffused from the popliteal into the sacral, medial iliac and lateral iliac LN to fill the cisterna chyli and thoracic duct system. The features of the popliteal, lateral iliac and lumbar aortic LN were shown in the lymphangiograms of all the animals. The incidence of the other LN was different. Depending on the incidence of these LN in the lymphangiogram, the pictures of the canine lymphatic system were classified into three types:(1) medial iliac and sacral LN were visible on both sides (16%);(2) one of these LN was not observed (36%);(3) medial iliac and/or sacral lymph node was not observed on both sides (48%). (author)

Differentiation of cryptogenic lateral from mesial temporal lobe epilepsy using regional asymmetric index of F-18-FDG PET

International Nuclear Information System (INIS)

Song, H. C.; Lee, D. S.; Lee, S. K.; Jeong, J. M.; Jeong, Z. K.; Lee, M. C.; Ko, C. S.

1997-01-01

We tried to find the possibility of utilization of F-18-FDG PET to differentiate lateral (neocortical) from mesial temporal lobe epilepsy(TLE) if we adopted quantitative comparison of regional metabolic activities using asymmetric index. We studied 22 pathologically proven mesial TLE(group C in Figure), and 27 lateral TLE patients. Lateral TLE patients were normal on MR(cryptogenic: 15; group A) or had structural lesions (12: group B). Asymmetric index (AI) was calculated as (ipsilateral -contralateral) / (ipsilateral + contralateral ) x 200. AI of medial lobe of cryptogenic lateral TLE was not decreased (-4.66.2, > 0.05) and AI of medial lobe of cryptogenic lateral TLE was not decreased (-4.66.2, >0.05) and AI of lateral lobe was decreased (-13.68.9). AI of medial and lateral lobes of mesial TLE was decreased (-3.44.7 and -16.58.9, respectively). AI of medial lobe of lesional lateral TLE was -7.39.1 (p<0.05 compared with mesial TEL). It was evident that lateral lobe of lesional lateral TLE had metabolic defect or decrease (AI: -21.410.4). While we could not find difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by AI quantitation. An AI value larger than -10 (cutoff: AI) predicted positively for lateral TLE(PPV:80%) and negatively for mesial TLE(NPV:77%). Asymmetry of metabolic activity in medial and not in lateral lobe of temporal lobe could give hints about whether the epileptogenic zones were mesial or lateral

Baseline Vitamin D Status is Predictive of Longitudinal Change in Tibial BMD in Knee Osteoarthritis (OA)

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With its lack of effective treatment and high prevalence, the public health impact of OA is substantial. Peri-articular bone in OA can be evaluated with the medial:lateral tibial BMD ratio (M:L BMD) obtained from dual x-ray absorptiometry (DXA). Higher M:L BMD is associated with medial OA features...

Segmental sensory disturbance in brain stem infarctions of the lateral lower pons and lateral medulla

International Nuclear Information System (INIS)

Matsumoto, Sadayuki; Yamasaki, Masahiro; Maya, Kiyomi; Imai, Terukuni; Okuda, Bungo.

1987-01-01

We reported on seven cases of brainstem infarctions of the lateral lower pons and lateral medulla, the sensory deficit manifested over the trunk or the leg namely segmental sensory disturbances. All patients showed dissociated sensory disturbance of pain and temperature with retained deep sensations except two cases in which touch was also slightly impaired. The sensory distribution was classified into two types. The first ''crossed type'', ipsilatral face and contralateral trunk and leg below the level was involved in 4 cases, and the second ''unilateral type'' contralateral face and trunk above the level in 3 cases. Clinico-anatomical evaluation was executed by MRI. Lesions were detected in the lateral lower pons in two cases and in the lateral medulla in one case. The location of lesions by MRI revealed more lateral lesions showed ''crossed type'' of segmental sensory disturbance and more medial lesions ''unilateral type''. It was shown that the segmental sensory disturbance could be explained by the partial involvement of the lateral spinothalamic tract, which is arranged with the fibers from the sacral segments most lateral. We considered it very important to differentiate the segmental sensory disturbance by brainstem lesion in practical clinical diagnosis. We also emphasize the type of segmental sensory disturbance could be a localizing sign in the lateral brainstem as such, ''crossed type'' indicating the lesion of the lateral portion and ''unilateral type'' the medial portion of the lateral lower brainstem. (author)

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

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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.)

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

International Nuclear Information System (INIS)

Khan, Nasir; Shepel, Michael; Leswick, David A.; Obaid, Haron

2014-01-01

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.)

TCDD alters medial epithelial cell differentiation during palatogenesis

International Nuclear Information System (INIS)

Abbott, B.D.; Birnbaum, L.S.

1989-01-01

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a widely distributed, persistent environmental contaminant that is teratogenic in mice, where it induces hydronephrosis and cleft palate. The incidence of clefting has been shown to be dose dependent after exposure on either gestation Day (GD) 10 or 12, although the embryo is more susceptible on GD 12. TCDD-exposed palatal shelves meet but do not fuse, and programmed cell death of the medial epithelial cells is inhibited. The mechanism of action through which TCDD alters the program of medial cell development has not been examined in earlier studies, and it is not known whether the mechanism is the same regardless of the dose or developmental stage of exposure. In this study, C57BL/6N mice, a strain sensitive to TCDD, were dosed orally on GD 10 or 12 with 0, 6, 12, 24, or 30 micrograms/kg body wt, in 10 ml corn oil/kg. Embryonic palatal shelves were examined on GD 14, 15, or 16. The degree of palatal closure, epithelial surface morphology, and cellular ultrastructure, the incorporation of [3H]TdR, the expression of EGF receptors, and the binding of 125I-EGF were assessed. After exposure on GD 10 or 12, TCDD altered the differentiation pathway of the medial epithelial cells. The palatal shelves were of normal size and overall morphology, but fusion of the medial epithelia of the opposing shelves did not occur. TCDD prevented programmed cell death of the medial peridermal cells. The expression of EGF receptors by medial cells continued through Day 16 and the receptors were able to bind ligand. The medial cells differentiated into a stratified, squamous, keratinizing epithelium. The shift in phenotype to an oral-like epithelium occurred after exposure on either GD 10 or 12. At the lower dose (6 micrograms/kg), fewer cleft palates were produced, but those shelves which did respond had a fully expressed shift in differentiation

CT- and fluoroscopy-guided percutaneous discectomy for lumbar radiculopathy related to disc herniation: a comparative prospective study comparing lateral to medial herniated discs

International Nuclear Information System (INIS)

Amoretti, Nicolas; Huwart, Laurent; Marcy, Pierre-Yves; Foti, Pauline; Hauger, Olivier; Boileau, Pascal

2013-01-01

To evaluate and compare two groups of patients with sciatica due to intervertebral disc herniation with no neurologic deficit. The groups consisted of patients with intervertebral disc herniation in a medial location (group 1) and those in a lateral location (group 2). A total of 200 patients were included in the study and were followed for a minimum of 6 months. In our series, we treated 80 postero-lateral herniated discs (40% of cases), 46 postero-medial herniated discs (23%), and 74 foraminal herniated discs (37%). Level L3-L4 was treated in 30 cases (15%), L4-L5 in 98 cases (49%), and L5-S1 in 72 cases (36%). The procedure was performed under dual guidance: fluoroscopic and CT. A helical probe was activated. It penetrates the herniated disc and causes the pulpous material to be mechanically evacuated through the probe. All 200 patients were followed for a minimum of 6 months. In group 1, the patients had a mean pain score of 7.9 ± 2.5 VAS units (range 6-10 units) prior to intervention. This was reduced to 3.2 ± 2.1 VAS units (range 0-10 units) at 48 h follow-up and increased to 3.9 ± 1.2 VAS units (range 0-10 VAS units) at 1 month follow-up and further reduced to 2.7 ± 1.2 units (range 0-10 VAS units) at 6 month follow-up. In group 2, the patients had a mean pain score of 8.2 ± 3.2 VAS units (range 6-10 units) prior to intervention. This was reduced to 2.8 ± 1.5 VAS units (range 0-10 units) at 48 h follow-up and decreased to 1.5 ± 0.9 VAS units (range 0-10 units) at 1 month and further reduced to 1.1 ± 0.5 VAS units (range 0-10 units) at 6 months. Our study showed that results were more satisfactory for the hernia located laterally (postero-lateral, foraminal, and extra-foraminal) as compared to the hernia located posteromedially. (orig.)

[Antero-medial incision of knee joint for the treatment of intercondylar fracture of femur].

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Yin, Zi-Fei; Sun, Bin-Feng; Yang, Xiao-Hai; Wang, Qing; Qian, Ping-Kang; Wu, Xiao-Feng; Xu, Feng

2017-12-25

To explore the clinical effect of antero-medial incision of knee joint in treating intercondylar fracture of femur. From September 2012 to March 2015, 24 patients with intercondylar fracture of femur were selected, including 17 males and 7 females, aged from 20 to 65 years old with an average of(38.3±9.5) years old. Among them, 12 cases were caused by traffic accident, 8 cases were caused by falling injury and 4 cases were caused by falling down. All patients were closed fractures. The time from injury to hospital was from 30 min to 8 h with an average of(2.2±0.3) h. According to AO classification, 4 cases were type B1, 3 type B2, 2 type B3, 5 type C1, 6 type C2 and 4 type C3. All patients were treated with antero-medial incision of knee joint. Operative time, blood loss and postoperative complications were observed and recovery of keen function was evaluated by Kolmert scoring. All patients were followed-up from 6 to 12 months with average of (9.0±1.7) months. Operative time ranged from 50 to 90 min with an average of (70.0±8.2) min; blood loss ranged from 90 to 400 ml with an average of (180±36) ml; negative pressure flow was from 30 to 90 ml, with an average of (50.0±7.1) ml. All fracture were healed at stage I without loosening of internal fixator, fracture nonunion, and deep vein thrombosis. According to Kolmert scoring, 16 patients got excellent result, 5 patients good and 3 fair. Antero-medial incision of knee joint in treating intercondylar fracture of femur, which has advantages of good fracture reduction, less injury of soft tissue and simple operation, could obtain good clinical results.

Bicarbonate-buffered ropivacaine-mepivacaine solution for medial caruncle anaesthesia.

Science.gov (United States)

Guerrier, Gilles; Boutboul, David; Chanat, Cédric; Samama, Charles Marc; Baillard, Christophe

2017-08-01

To compare self-reported pain during injection of plain versus alkalinised 0.75% ropivacaine-2% mepivacaine solution for anaesthesia performed at the medial caruncle site for eye surgery. This prospective, monocentric, double blind, randomised, controlled trial involved 40 consecutive patients who received either a standard local anaesthetic solution (0.75% ropivacaine 5ml and 2% mepivacaine 5ml with a pH of 5.9), or an alkalinised solution composed with a pH-adjusted solution of 7.0 through adjunction of 0.15mEq sodium bicarbonate per 10ml of the same mixture. Before anaesthesia, patients received intravenous midazolam (0.03mg/kg) to ease potential anxiety. During injection performed at the medial caruncle site, patients were asked to grade a pain VRS (0 to 10) for the injection using a verbal analogue scale. The primary end point was to investigate pain during injection of local anaesthetics. Anxiety levels before anaesthesia were low and similar for both groups. The mean pain score for the alkalinised group was significantly reduced compared to the control group (6 [25-75%, IQR 4-9] versus 3 [25-75%, IQR 1-5]; P=0.02; 95% CI for the difference in median pain scores [1.9-3.3]). Buffering local anaesthetics used in caruncular injection for eye surgery significantly reduces pain during injection. This simple strategy should be tested in routine clinical practice to improve patient satisfaction. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Atraumatic medial collateral ligament oedema in medial compartment knee osteoarthritis

International Nuclear Information System (INIS)

Bergin, D.; Keogh, C.; O'Connell, M.; Zoga, A.; Rowe, D.; Shah, B.; Eustace, S.

2002-01-01

Objective: To describe and determine the prevalence of atraumatic medial collateral oedema identified in patients with medial compartment osteoarthritis. Design and patients: Sixty patients, 30 patients with medial compartment knee osteoarthritis (Kellgren and Lawrence grade 2 to 4) and 30 age-matched patients with atraumatic knee pain without osteoarthritis, referred for MR imaging over a 2 year period were included in the study. In each case, severity of osteoarthritis was recorded on radiographs and correlated with the presence or absence of medial collateral ligament oedema at MR imaging. Results: Medial collateral oedema was identified in 27 of the 30 patients with osteoarthritis, of whom 14 had grade 1 oedema and 13 had grade 2 oedema compared with the presence of medial collateral ligament oedema (grade 1) in only two of the 30 control patients without osteoarthritis (P<<0.0001). Conclusion: Medial collateral oedema is common in patients with osteoarthritis in the absence of trauma. When identified, medial collateral ligament oedema should be considered to be a feature of osteoarthritis and should not be incorrectly attributed to an acute traumatic injury. (orig.)

Kinematic analysis of a televised medial ankle sprain

Directory of Open Access Journals (Sweden)

Francesca E. Wade

2018-04-01

Full Text Available Ankle sprains are one of the most prevalent athletic injuries. Prior work has investigated lateral ankle sprains, but research on generally more severe medial sprains is lacking. This case report performs a kinematic analysis using novel motion analysis methods on a non-contact medial ankle sprain. Peak eversion (50° occurred 0.2 seconds following ground contact, maximum velocity of 426°/s, while peak dorsiflexion (64° occurred with a greater maximum velocity (573°/s. The combination of dorsiflexion at ground contact and rapid eversion is associated with a non-contact eversion sprain. This study provides a quantitative analysis of the eversion ankle sprain injury mechanism. Keywords: Athletic injury, Biomechanics, Ankle injury, Kinematics

Changes in motor unit recruitment strategy during pain alters force direction.

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Tucker, Kylie J; Hodges, Paul W

2010-10-01

Motor unit (MU) recruitment is altered (decreased discharge rate and cessation of discharge in some units, and recruitment of new units) in force-matched contractions during pain compared to contractions performed before pain. As MU's within a motoneurone pool have different force direction properties we hypothesised that altered MU recruitment during experimental knee pain would change the force vector (total force (F(T)): amplitude and angle) generated by the quadriceps. Force was produced at two levels during 1 × 60-s and 3 × 10-s isometric contractions of knee extensors, and recorded by two force transducers at right angles. This enabled calculation of both F(E) (extension force) and F(T). MU recruitment was recorded from the medial and lateral vastii with four fine-wire electrodes. Pain was induced by hypertonic saline injection in the infra-patella fat pad. Nine subjects matched F(E) and six subjects also matched both medial and lateral forces (F(T)) before and during pain. Changes in MU discharge pattern (decreased discharge rate (Precruitment of new units) during pain were associated with a ∼5° change in absolute force angle. As force angle changed in both directions (left/right) for individual subjects with pain there was no change in average F(T) amplitude between conditions. When both medial and lateral forces were matched MU discharge rate decreased (Punits ceased firing or were newly recruited during pain. Change in motoneurone recruitment during pain alters direction of muscle force. This may be a strategy to avoid pain or protect the painful part. Copyright © 2010 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

Medial joint line bone bruising at MRI complicating acute ankle inversion injury: What is its clinical significance?

International Nuclear Information System (INIS)

Chan, V.O.; Moran, D.E.; Shine, S.; Eustace, S.J.

2013-01-01

Aim: To assess the incidence and clinical significance of medial joint line bone bruising following acute ankle inversion injury. Materials and methods: Forty-five patients who underwent ankle magnetic resonance imaging (MRI) within 2 weeks of acute ankle inversion injury were included in this prospective study. Integrity of the lateral collateral ligament complex, presence of medial joint line bone bruising, tibio-talar joint effusion, and soft-tissue swelling were documented. Clinical follow-up at 6 months was carried out to determine the impact of injury on length of time out of work, delay in return to normal walking, delay in return to sports activity, and persistence of medial joint line pain. Results: Thirty-seven patients had tears of the anterior talofibular ligament (ATFL). Twenty-six patients had medial joint line bone bruising with altered marrow signal at the medial aspect of the talus and congruent surface of the medial malleolus. A complete ATFL tear was seen in 92% of the patients with medial joint line bone bruising (p = 0.05). Patients with an ATFL tear and medial joint line bone bruising had a longer delay in return to normal walking (p = 0.0002), longer delay in return to sports activity (p = 0.0001), and persistent medial joint line pain (p = 0.0003). There was no statistically significant difference in outcome for the eight patients without ATFL tears. Conclusion: Medial joint line bone bruising following an acute ankle inversion injury was significantly associated with a complete ATFL tear, longer delay in the return to normal walking and sports activity, as well as persistent medial joint line pain. Its presence should prompt detailed assessment of the lateral collateral ligament complex, particularly the ATFL

Vertical and lateral forces when a permanent magnet above a superconductor traverses in arbitrary directions

Science.gov (United States)

Yang, Yong

2008-12-01

In an actual levitation system composed of high temperature superconductors (HTSs) and permanent magnets (PMs), the levitating bodies may traverse in arbitrary directions. Many previous researchers assumed that the levitating bodies moved in a vertical direction or a lateral direction in order to simplify the problem. In this paper, the vertical and lateral forces acting on the PM are calculated by the modified frozen-image method when a PM above an HTS traverses in arbitrary directions. In order to study the effects of the movement directions on the vertical and lateral forces, comparisons of the forces that act on a PM traversing in a tilted direction with those that act on a PM traversing in a vertical direction or a lateral direction have been presented.

Vertical and lateral forces when a permanent magnet above a superconductor traverses in arbitrary directions

Energy Technology Data Exchange (ETDEWEB)

Yang Yong [Key Laboratory of Applied Superconductivity, Chinese Academy of Sciences, Beijing 100190 (China); Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing 100190 (China)], E-mail: yy@mail.iee.ac.cn

2008-12-15

In an actual levitation system composed of high temperature superconductors (HTSs) and permanent magnets (PMs), the levitating bodies may traverse in arbitrary directions. Many previous researchers assumed that the levitating bodies moved in a vertical direction or a lateral direction in order to simplify the problem. In this paper, the vertical and lateral forces acting on the PM are calculated by the modified frozen-image method when a PM above an HTS traverses in arbitrary directions. In order to study the effects of the movement directions on the vertical and lateral forces, comparisons of the forces that act on a PM traversing in a tilted direction with those that act on a PM traversing in a vertical direction or a lateral direction have been presented.

Vertical and lateral forces when a permanent magnet above a superconductor traverses in arbitrary directions

International Nuclear Information System (INIS)

Yang Yong

2008-01-01

In an actual levitation system composed of high temperature superconductors (HTSs) and permanent magnets (PMs), the levitating bodies may traverse in arbitrary directions. Many previous researchers assumed that the levitating bodies moved in a vertical direction or a lateral direction in order to simplify the problem. In this paper, the vertical and lateral forces acting on the PM are calculated by the modified frozen-image method when a PM above an HTS traverses in arbitrary directions. In order to study the effects of the movement directions on the vertical and lateral forces, comparisons of the forces that act on a PM traversing in a tilted direction with those that act on a PM traversing in a vertical direction or a lateral direction have been presented.

Medial joint space widening of the ankle in displaced Tillaux and Triplane fractures in children.

Science.gov (United States)

Gourineni, Prasad; Gupta, Asheesh

2011-10-01

Tillaux and Triplane fractures occur in children predominantly from external rotation mechanism. We hypothesized that in displaced fractures, the talus would shift laterally along with the distal fibula and the distal tibial epiphyseal fragment increasing the medial joint space. Consecutive cases evaluated retrospectively. Level I and Level II centers. Twenty-two skeletally immature patients with 14 displaced Triplane fractures and eight displaced Tillaux fractures were evaluated for medial joint space widening. Measurement of fracture displacement and medial joint space widening before and after intervention. Thirteen Triplane and six Tillaux fractures (86%) showed medial space widening of 1 to 9 mm and equal to the amount of fracture displacement. Reduction of the fracture reduced the medial space to normal. There were no known complications. Medial space widening of the ankle may be a sign of ankle fracture displacement. Anatomic reduction of the fracture reduces the medial space and may improve the results in Tillaux and Triplane fractures.

CellML, SED-ML, and the Physiome Model Repository

OpenAIRE

Nickerson, David

2016-01-01

Invited presentation delivered at COMBINE 2016.CellML, SED-ML, and the Physiome Model Repository.David Nickerson, Auckland Bioengineering Institute, University of Auckland, New Zealand.CellML is an XML-based protocol for storing and exchanging computer-based mathematical models in an unambiguous, modular, and reusable manner. In addition to introducing CellML, in this presentation I will provide some of physiological examples that have help drive the development and adoption of CellML. I will...

Medial tibial “spackling” to lessen chronic medial tibial soft tissue irritation

Directory of Open Access Journals (Sweden)

J. Ryan Martin, MD

2016-09-01

Full Text Available We describe a unique, utilitarian reconstructive treatment option known as tibial “spackling” for chronic, localized medial joint line pain corresponding with progressive radiographic peripheral medial tibial bone loss beneath a well-fixed revision total knee arthroplasty tibial baseplate. It is believed that this localized pain is due to chronic irritation of the medial capsule and collateral ligament from the prominent medial edge of the tibial component. In the setting of failed nonoperative treatment, our experience with utilizing bone cement to reconstruct the medial tibial bone defect and create a smooth medial tibial surface has been successful in eliminating chronic medial soft tissue irritation.

GeoSciML and EarthResourceML Update, 2012

Science.gov (United States)

Richard, S. M.; Commissionthe Management; Application Inte, I.

2012-12-01

CGI Interoperability Working Group activities during 2012 include deployment of services using the GeoSciML-Portrayal schema, addition of new vocabularies to support properties added in version 3.0, improvements to server software for deploying services, introduction of EarthResourceML v.2 for mineral resources, and collaboration with the IUSS on a markup language for soils information. GeoSciML and EarthResourceML have been used as the basis for the INSPIRE Geology and Mineral Resources specifications respectively. GeoSciML-Portrayal is an OGC GML simple-feature application schema for presentation of geologic map unit, contact, and shear displacement structure (fault and ductile shear zone) descriptions in web map services. Use of standard vocabularies for geologic age and lithology enables map services using shared legends to achieve visual harmonization of maps provided by different services. New vocabularies have been added to the collection of CGI vocabularies provided to support interoperable GeoSciML services, and can be accessed through http://resource.geosciml.org. Concept URIs can be dereferenced to obtain SKOS rdf or html representations using the SISSVoc vocabulary service. New releases of the FOSS GeoServer application greatly improve support for complex XML feature schemas like GeoSciML, and the ArcGIS for INSPIRE extension implements similar complex feature support for ArcGIS Server. These improved server implementations greatly facilitate deploying GeoSciML services. EarthResourceML v2 adds features for information related to mining activities. SoilML provides an interchange format for soil material, soil profile, and terrain information. Work is underway to add GeoSciML to the portfolio of Open Geospatial Consortium (OGC) specifications.

A biomechanical analysis of point of failure during lateral-row tensioning in transosseous-equivalent rotator cuff repair.

Science.gov (United States)

Dierckman, Brian D; Goldstein, Jordan L; Hammond, Kyle E; Karas, Spero G

2012-01-01

The purpose of this study was to determine the maximum load and point of failure of the construct during tensioning of the lateral row of a transosseous-equivalent (TOE) rotator cuff repair. In 6 fresh-frozen human shoulders, a TOE rotator cuff repair was performed, with 1 suture from each medial anchor passed through the tendon and tied in a horizontal mattress pattern. One of 2 limbs from each of 2 medial anchors was pulled laterally over the tendon. After preparation of the lateral bone for anchor placement, the 2 limbs were passed through the polyether ether ketone (PEEK) eyelet of a knotless anchor and tied to a tensiometer. The lateral anchor was placed into the prepared bone tunnel but not fully seated. Tensioning of the lateral-row repair was simulated by pulling the tensiometer to tighten the suture limbs as they passed through the eyelet of the knotless anchor. The mode of failure and maximum tension were recorded. The procedure was then repeated for the second lateral-row anchor. The mean load to failure during lateral-row placement in the TOE model was 80.8 ± 21.0 N (median, 83 N; range, 27.2 to 115.8 N). There was no statistically significant difference between load to failure during lateral-row tensioning for the anterior and posterior anchors (P = .84). Each of the 12 constructs failed at the eyelet of the lateral anchor. Retrieval analysis showed no failure of the medial anchors, no medial suture cutout through the rotator cuff tendon, and no signs of gapping at the repair site. Our results suggest that the medial-row repair does not appear vulnerable during tensioning of the lateral row of a TOE rotator cuff repair with the implants tested. However, surgeons should exercise caution when tensioning the lateral row, especially when lateral-row anchors with PEEK eyelets are implemented. For this repair construct, the findings suggest that although the medial row is not vulnerable during lateral-row tensioning of a TOE rotator cuff repair, lateral

Complex Medial Meniscus Tears Are Associated With a Biconcave Medial Tibial Plateau.

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Barber, F Alan; Getelman, Mark H; Berry, Kathy L

2017-04-01

To determine whether an association exists between a biconcave medial tibial plateau and complex medial meniscus tears. A consecutive series of stable knees undergoing arthroscopy were evaluated retrospectively with the use of preoperative magnetic resonance imaging (MRI), radiographs, and arthroscopy documented by intraoperative videos. Investigators independently performed blinded reviews of the MRI or videos. Based on the arthroscopy findings, medial tibial plateaus were classified as either biconcave or not biconcave. A transverse coronal plane ridge, separating the front of the tibial plateau from the back near the inner margin of the posterior body of the medial meniscus, was defined as biconcave. The medial plateau slope was calculated with MRI sagittal views. General demographic information, body mass index, and arthroscopically confirmed knee pathology were recorded. A total of 179 consecutive knees were studied from July 2014 through August 2015; 49 (27.2%) biconcave medial tibial plateaus and 130 (72.8%) controls were identified at arthroscopy. Complex medial meniscus tears were found in 103. Patients with a biconcave medial tibial plateau were found to have more complex medial meniscus tears (69.4%) than those without a biconcavity (53.1%) (P = .049) despite having lower body mass index (P = .020). No difference in medial tibial plateau slope was observed for biconcavities involving both cartilage and bone, bone only, or an indeterminate group (P = .47). Biconcave medial tibial plateaus were present in 27.4% of a consecutive series of patients undergoing knee arthroscopy. A biconcave medial tibial plateau was more frequently associated with a complex medial meniscus tear. Level III, case-control study. Copyright © 2016 Arthroscopy Association of North America. All rights reserved.

Split hand muscle echo intensity index as a reliable imaging marker for differential diagnosis of amyotrophic lateral sclerosis.

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Seok, Hung Youl; Park, Jinseok; Kim, Yoo Hwan; Oh, Ki-Wook; Kim, Seung Hyun; Kim, Byung-Jo

2018-04-17

The objective of this study was to investigate the usefulness of muscle ultrasound in evaluating dissociated small hand muscle atrophy, termed 'split hand', and its feasibility in the diagnosis of amyotrophic lateral sclerosis (ALS). Forty-four patients with ALS, 18 normal subjects and 9 patients with other neuromuscular disorders were included in this study. The hand muscles were divided into three regions, the median-innervated lateral hand muscle group (ML), the ulnar-innervated lateral hand muscle (UL) and the ulnar-innervated medial hand muscle (UM), and the muscle echo intensity (EI) and compound muscle action potential (CMAP) were measured. We calculated the split hand index (SHI) using muscle EI (SHI mEI ) and CMAP (SHI CMAP ) for comparison among groups. The SHI was derived by dividing muscle EI (or CMAP) measured at the ML and UL by that measured at the UM. The SHI mEI was significantly higher in patients with ALS (51.7±28.3) than in normal controls (29.7±9.9) and disease controls with other neuromuscular disorders (36.5±7.3; Pdifferentiating ALS from other neuromuscular disorders and healthy controls. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Did Failure Occur Because of Medial Column Instability That Was Not Recognized, or Did It Develop After Surgery?

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Kadakia, Anish R; Kelikian, Armen S; Barbosa, Mauricio; Patel, Milap S

2017-09-01

Medial column instability is a primary deforming force in the setting of pes planovalgus deformity. Consideration for medial column stabilization only after correction of the hindfoot deformity may result in creating a rigid hindfoot, compromising clinical outcomes. Careful analysis of the lateral radiograph to determine whether the deformity is secondary to the medial column or true peritalar subluxation may allow superior outcomes. Iatrogenic creation of an excessively rigid medial column may lead to significant instability of the remaining joints in the short term and arthrosis in the long term. Medial column arthrodesis should be used selectively to correct gross instability. Copyright © 2017 Elsevier Inc. All rights reserved.

Medial vestibular connections with the hypocretin (orexin) system

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Horowitz, Seth S.; Blanchard, Jane; Morin, Lawrence P.

2005-01-01

The mammalian medial vestibular nucleus (MVe) receives input from all vestibular endorgans and provides extensive projections to the central nervous system. Recent studies have demonstrated projections from the MVe to the circadian rhythm system. In addition, there are known projections from the MVe to regions considered to be involved in sleep and arousal. In this study, afferent and efferent subcortical connectivity of the medial vestibular nucleus of the golden hamster (Mesocricetus auratus) was evaluated using cholera toxin subunit-B (retrograde), Phaseolus vulgaris leucoagglutinin (anterograde), and pseudorabies virus (transneuronal retrograde) tract-tracing techniques. The results demonstrate MVe connections with regions mediating visuomotor and postural control, as previously observed in other mammals. The data also identify extensive projections from the MVe to regions mediating arousal and sleep-related functions, most of which receive immunohistochemically identified projections from the lateral hypothalamic hypocretin (orexin) neurons. These include the locus coeruleus, dorsal and pedunculopontine tegmental nuclei, dorsal raphe, and lateral preoptic area. The MVe itself receives a projection from hypocretin cells. CTB tracing demonstrated reciprocal connections between the MVe and most brain areas receiving MVe efferents. Virus tracing confirmed and extended the MVe afferent connections identified with CTB and additionally demonstrated transneuronal connectivity with the suprachiasmatic nucleus and the medial habenular nucleus. These anatomical data indicate that the vestibular system has access to a broad array of neural functions not typically associated with visuomotor, balance, or equilibrium, and that the MVe is likely to receive information from many of the same regions to which it projects.

Influence of nerve growth factor on developing dorso-medial and ventro-lateral neurons of chick and mouse trigeminal ganglia.

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Davies, A; Lumsden, A

1983-01-01

Trigeminal ganglia have been removed from five, six, seven and eight day chick embryos and explants of the dorso-medial (DM) and ventro-lateral (VL) parts of the maxillomandibular lobe were grown in tissue culture. Quantitative methods were used to assess the influence of nerve growth factor (NGF) on fiber outgrowth from these explants. At all ages outgrowth from DM explants was significantly greater than from VL explants, the difference being most pronounced between the extreme DM and VL poles of the maxillomandibular lobe. These observations are interpreted as indicating the existence of two distinct populations of neurons in terms of their response to NGF rather than the consequence of the asynchronous differentiation and maturation of the VL and DM neurons. A similar study of 10, 11 and 12 day embryonic mouse trigeminal ganglia revealed no significant difference in neurite outgrowth between DM and VL regions grown in the presence or absence of NGF. Copyright © 1983. Published by Elsevier Ltd.

Numerical estimation of aircrafts' unsteady lateral-directional stability derivatives

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Maričić N.L.

2006-01-01

Full Text Available A technique for predicting steady and oscillatory aerodynamic loads on general configuration has been developed. The prediction is based on the Doublet-Lattice Method, Slender Body Theory and Method of Images. The chord and span wise loading on lifting surfaces and longitudinal bodies (in horizontal and vertical plane load distributions are determined. The configuration may be composed of an assemblage of lifting surfaces (with control surfaces and bodies (with circular cross sections and a longitudinal variation of radius. Loadings predicted by this method are used to calculate (estimate steady and unsteady (dynamic lateral-directional stability derivatives. The short outline of the used methods is given in [1], [2], [3], [4] and [5]. Applying the described methodology software DERIV is developed. The obtained results from DERIV are compared to NASTRAN examples HA21B and HA21D from [4]. In the first example (HA21B, the jet transport wing (BAH wing is steady rolling and lateral stability derivatives are determined. In the second example (HA21D, lateral-directional stability derivatives are calculated for forward- swept-wing (FSW airplane in antisymmetric quasi-steady maneuvers. Acceptable agreement is achieved comparing the results from [4] and DERIV.

Form of the compensatory stepping response to repeated laterally directed postural disturbances.

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Hurt, Christopher P; Rosenblatt, Noah J; Grabiner, Mark D

2011-10-01

A compensatory stepping response (CSR) is a common strategy to restore dynamic stability in response to a postural disturbance. Currently, few studies have investigated the CSR to laterally directed disturbances delivered to subjects during quiet standing. The purpose of this study was to characterize the CSR of younger adults following exposure to a series of similar laterally directed disturbances for which no instructions were given with regard to the recovery response. We hypothesized that in the absence of externally applied constraints to the recovery response, subjects would be equally as likely to perform a crossover step as a sidestep sequence (SSS). We further hypothesized that there would be an asymmetry in arm abduction that would be dependent on the disturbance direction. Finally, we were interested in characterizing the effect of practice on the CSR to repeated disturbances. Ten younger adults were exposed to thirty laterally directed platform disturbances that forced a stepping response. Subjects responded by primarily utilizing a SSS that differs from previously reported results. Further, five of the ten subjects utilized a different recovery response that was dependent on the direction of the disturbance (i.e., left or right). Greater arm abduction was characterized for the arm in the direction of the external disturbance in comparison with the contralateral arm. Lastly, subjects modified their recovery response to this task within 12 disturbances. Taken together, these results suggest that recovery responses to laterally directed disturbances can be quickly modified but can be quite variable between and within subjects.

A biomechanical comparison of 2 technical variations of double-row rotator cuff fixation: the importance of medial row knots.

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Busfield, Benjamin T; Glousman, Ronald E; McGarry, Michelle H; Tibone, James E; Lee, Thay Q

2008-05-01

Previous studies have shown comparable biomechanical properties of double-row fixation versus double-row fixation with a knotless lateral row. SutureBridge is a construct that secures the cuff with medial row mattress suture anchors and knotless lateral row fixation of the medial suture ends. Recent completely knotless constructs may lead to lesser clinical outcomes if the construct properties are compromised from lack of suture knots. A completely knotless construct without medial row knots will compromise the biomechanical properties in both cyclic and failure-testing parameters. Controlled laboratory study. Six matched pairs of cadaveric shoulders were randomized to 2 groups of double row fixation with SutureBridge: group 1 with medial row knots, and group 2 without medial row knots. The specimens were placed in a materials test system at 30 degrees of abduction. Cyclic testing to 180 N at 1 mm/sec for 30 cycles was performed, followed by tensile testing to failure at 1 mm/sec. Data included cyclic and failure data from the materials test system and gap data using a video digitizing system. All data from paired specimens were compared using paired Student t tests. Group 1 had a statistically significant difference (P row failure, whereas all group 1 specimens failed at the clamp. Although lateral row knotless fixation has been shown not to sacrifice structural integrity of this construct, the addition of a knotless medial row compromises the construct leading to greater gapping and failure at lower loads. This may raise concerns regarding recently marketed completely knotless double row constructs.

Comparison of fMRI BOLD response patterns by electrical stimulation of the ventroposterior complex and medial thalamus of the rat.

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Pai-Feng Yang

Full Text Available The objective of this study was to compare the functional connectivity of the lateral and medial thalamocortical pain pathways by investigating the blood oxygen level-dependent (BOLD activation patterns in the forebrain elicited by direct electrical stimulation of the ventroposterior (VP and medial (MT thalamus. An MRI-compatible stimulation electrode was implanted in the VP or MT of α-chloralose-anesthetized rats. Electrical stimulation was applied to the VP or MT at various intensities (50 µA to 300 µA and frequencies (1 Hz to 12 Hz. BOLD responses were analyzed in the ipsilateral forelimb region of the primary somatosensory cortex (iS1FL after VP stimulation and in the ipsilateral cingulate cortex (iCC after MT stimulation. When stimulating the VP, the strongest activation occurred at 3 Hz. The stimulation intensity threshold was 50 µA and the response rapidly peaked at 100 µA. When stimulating the MT, The optimal frequency for stimulation was 9 Hz or 12 Hz, the stimulation intensity threshold was 100 µA and we observed a graded increase in the BOLD response following the application of higher intensity stimuli. We also evaluated c-Fos expression following the application of a 200-µA stimulus. Ventroposterior thalamic stimulation elicited c-Fos-positivity in few cells in the iS1FL and caudate putamen (iCPu. Medial thalamic stimulation, however, produced numerous c-Fos-positive cells in the iCC and iCPu. The differential BOLD responses and c-Fos expressions elicited by VP and MT stimulation indicate differences in stimulus-response properties of the medial and lateral thalamic pain pathways.

Using VS30 to Estimate Station ML Adjustments (dML)

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Yong, A.; Herrick, J.; Cochran, E. S.; Andrews, J. R.; Yu, E.

2017-12-01

Currently, new seismic stations added to a regional seismic network cannot be used to calculate local or Richter magnitude (ML) until a revised region-wide amplitude decay function is developed. The new station must record a minimum number of local and regional events that meet specific amplitude requirements prior to re-calibration of the amplitude decay function. Therefore, there can be significant delay between when a new station starts contributing real-time waveform packets and when the data can be included in magnitude estimation. The station component adjustments (dML; Uhrhammer et al., 2011) are calculated after first inverting for a new regional amplitude decay function, constrained by the sum of dML for long-running stations. Here, we propose a method to calculate an initial dML using known or proxy values of seismic site conditions. For site conditions, we use the time-averaged shear-wave velocity (VS) of the upper 30 m (VS30). We solve for dML as described in Equation (1) by Uhrhammer et al. (2011): ML = log (A) - log A0 (r) + dML, where A is the maximum Wood and Anderson (1925) trace amplitude (mm), r is the distance (km), and dML is the station adjustment. Measured VS30 and estimated dML data are comprised of records from 887 horizontal components (east-west and north-south orientations) from 93 seismic monitoring stations in the California Integrated Seismic Network. VS30 values range from 202 m/s to 1464 m/s and dML range from -1.10 to 0.39. VS30 and dML exhibit a positive correlation coefficient (R = 0.72), indicating that as VS30 increases, dML increases. This implies that greater site amplification (i.e., lower VS30) results in smaller ML. When we restrict VS30 regional network ML estimates immediately without the need to wait until a minimum set of earthquake data has been recorded.

Human amnesia and the medial temporal lobe illuminated by neuropsychological and neurohistological findings for patient E.P.

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Insausti, Ricardo; Annese, Jacopo; Amaral, David G.; Squire, Larry R.

2013-01-01

We present neurohistological information for a case of bilateral, symmetrical damage to the medial temporal lobe and well-documented memory impairment. E.P. developed profound memory impairment at age 70 y and then was studied for 14 y He had no capacity for learning facts and events and had retrograde amnesia covering several decades. He also had a modest impairment of semantic knowledge. Neurohistological analysis revealed bilaterally symmetrical lesions of the medial temporal lobe that eliminated the temporal pole, the amygdala, the entorhinal cortex, the hippocampus, the perirhinal cortex, and rostral parahippocampal cortex. The lesion also extended laterally to involve the fusiform gyrus substantially. Last, the superior, inferior, and middle temporal gyri were atrophic, and subjacent white matter was gliotic. Several considerations indicate that E.P.’s severe memory impairment was caused by his medial temporal lesions, whereas his impaired semantic knowledge was caused by lateral temporal damage. His lateral temporal damage also may have contributed to his extensive retrograde amnesia. The findings illuminate the anatomical relationship between memory, perception, and semantic knowledge. PMID:23620517

The Prevalence of Medial Epicondylitis Among Patients With C6 and C7 Radiculopathy

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Lee, Aaron Taylor; Lee-Robinson, Ayse L.

2010-01-01

Background: Medial epicondylitis, or golfer’s/pitcher’s elbow, develops as a result of medial stress overload on the flexor muscles at the elbow and presents as pain at the medial epicondyle. Cervical radiculopathy has been associated with lateral epicondylitis, but few associations between the cervical spine and medial epicondylitis have been made. Researchers propose that there is an association, suggesting that the weakness and imbalance in the elbow flexor and extensor muscles from C6 and C7 radiculopathy allow for easy onset of medial epicondylitis. Hypothesis: Medial epicondylitis will present in over half the patients diagnosed with C6 and C7 radiculopathy. Methodology: A total of 102 patients initially presenting with upper extremity or neck symptoms were diagnosed with cervical radiculopathy. They were then examined for medial epicondylitis. Data were collected by referring to patient charts from February 2008 until June 2009. Results: Fifty-five patients were diagnosed with medial epicondylitis. Of these, 44 had C6 and C7 radiculopathy whereas 11 presented with just C6 radiculopathy. Conclusion: Medial epicondylitis presented with cervical radiculopathy in slightly more than half the patients. Weakening of the flexor carpi radialis and pronator teres and imbalance of the flexor and extensor muscles from the C6 and C7 radiculopathy allow for easy onset of medial epicondylitis. Patients with medial epicondylitis should be examined for C6 and C7 radiculopathy to ensure proper treatment. Physicians dealing with golfers, pitchers, or other patients with medial epicondylitis should be aware of the association between these 2 diagnoses to optimize care. PMID:23015956

Dissociating medial frontal and posterior cingulate activity during self-reflection.

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Johnson, Marcia K; Raye, Carol L; Mitchell, Karen J; Touryan, Sharon R; Greene, Erich J; Nolen-Hoeksema, Susan

2006-06-01

Motivationally significant agendas guide perception, thought and behaviour, helping one to define a 'self' and to regulate interactions with the environment. To investigate neural correlates of thinking about such agendas, we asked participants to think about their hopes and aspirations (promotion focus) or their duties and obligations (prevention focus) during functional magnetic resonance imaging and compared these self-reflection conditions with a distraction condition in which participants thought about non-self-relevant items. Self-reflection resulted in greater activity than distraction in dorsomedial frontal/anterior cingulate cortex and posterior cingulate cortex/precuneus, consistent with previous findings of activity in these areas during self-relevant thought. For additional medial areas, we report new evidence of a double dissociation of function between medial prefrontal/anterior cingulate cortex, which showed relatively greater activity to thinking about hopes and aspirations, and posterior cingulate cortex/precuneus, which showed relatively greater activity to thinking about duties and obligations. One possibility is that activity in medial prefrontal cortex is associated with instrumental or agentic self-reflection, whereas posterior medial cortex is associated with experiential self-reflection. Another, not necessarily mutually exclusive, possibility is that medial prefrontal cortex is associated with a more inward-directed focus, while posterior cingulate is associated with a more outward-directed, social or contextual focus.

KINESIO TAPING NÃO ALTERA A RELAÇÃO EMG ENTRE VASTO LATERAL E VASTO MEDIAL DURANTE MEIO-AGACHAMENTO

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Julio Cerca Serrão

Full Text Available RESUMO Introdução: Kinesio Taping é uma técnica realizada com aplicação de fitas elásticas sobre a pele, que se propõe a produzir determinados efeitos com fins de prevenção e tratamento das lesões musculoesqueléticas. No entanto, os meios pelos quais tais efeitos ocorrem continuam sendo investigados e discutidos, principalmente no que diz respeito à utilização no campo da reabilitação e do esporte. Objetivo: Analisar a relação da atividade eletromiográfica encontrada nos músculos vasto lateral (VL e vasto medial (VM em duas condições: sem aplicação de Kinesio Taping (GnKT e com aplicação de Kinesio Taping (GKT em uma população saudável, com experiência em treinamento de força. Métodos: Dezoito sujeitos do sexo masculino (idade: 28,1 ± 6,9 anos; massa corporal: 85,5 ± 8,3 kg; estatura: 179,5 ± 6,9 cm; comprimento de membro inferior: 97,0 ± 4,2 cm realizaram o exercício de meio-agachamento livre, com velocidade controlada, sem e com aplicação de Kinesio Taping. A relação foi verificada pela proporção de magnitude de ativação (VM/VL, utilizando-se os valores de root mean square (RMS. A sequência para realização dos exercícios nas condições mencionadas foi randomizada e balanceada. Resultados: Os valores encontrados para a razão VM/VL na situação GnKT foram de 83,96 ± 5,79% para VM e 84,13 ± 7,16% para VL. Já na situação GKT, 84,55 ± 16,97% para VM e 80,53 ± 9,20% para VL. Não foram observadas diferenças significativas nos valores de RMS para a relação VM/VL submetidos a aplicação de Kinesio Taping. Conclusão: A aplicação de Kinesio Taping não demonstrou influenciar a relação da atividade eletromiográfica entre os músculos vasto lateral e vasto medial durante a execução do exercício de meio-agachamento.

Lateral and medial prefrontal contributions to emotion generation by semantic elaboration during episodic encoding.

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Kaneda, Takumi; Shigemune, Yayoi; Tsukiura, Takashi

2017-02-01

Memories for emotion-laden stimuli are remembered more accurately than those for neutral stimuli. Although this enhancement reflects stimulus-driven modulation of memory by emotions, functional neuroimaging evidence of the interacting mechanisms between emotions generated by intentional processes, such as semantic elaboration, and memory is scarce. The present fMRI study investigated how encoding-related activation is modulated by emotions generated during the process of semantic elaboration. During encoding with fMRI, healthy young adults viewed neutral (target) pictures either passively or with semantic elaboration. In semantic elaboration, participants imagined background stories related to the pictures. Encoding trials with semantic elaboration were subdivided into conditions in which participants imagined negative, positive, or neutral stories. One week later, memories for target pictures were tested. In behavioral results, memories for target pictures were significantly enhanced by semantic elaboration, compared to passive viewing, and the memory enhancement was more remarkable when negative or positive stories were imagined. fMRI results demonstrated that activations in the left inferior frontal gyrus and dorsal medial prefrontal cortex (dmPFC) were greater during the encoding of target pictures with semantic elaboration than those with passive viewing, and that these activations further increased during encoding with semantic elaboration of emotional stories than of neutral stories. Functional connectivity between the left inferior frontal gyrus and dmPFC/hippocampus during encoding significantly predicted retrieval accuracies of memories encoded with self-generated emotional stories. These findings suggest that networks including the left inferior frontal region, dmPFC, and hippocampus could contribute to the modulation of memories encoded with the emotion generation.

Noradrenergic and GABAergic systems in the medial hypothalamus are activated during hypoglycemia

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Beverly, JL; De Vries, MG; Bouman, SD; Arseneau, LM

Noradrenergic and GABAergic systems in the medial hypothalamus influence plasma glucose and may be activated during glucoprivation. Microdialysis probes were placed into the ventromedial nucleus (VMH), lateral hypothalamus (LHA), and paraventricular nucleus (PVH) of male Sprague-Dawley rats to

Evaluation of the Talar Cartilage in Chronic Lateral Ankle Instability with Lateral Ligament Injury Using Biochemical T2* Mapping: Correlation with Clinical Symptoms.

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Hu, Yiwen; Tao, Hongyue; Qiao, Yang; Ma, Kui; Hua, Yinghui; Yan, Xu; Chen, Shuang

2018-06-19

This study aims to quantitatively compare T2* measurements of the talar cartilage between chronic lateral ankle instability (LAI) patients with lateral ligament injury and healthy volunteers, and to assess the association of T2* value with American Orthopedic Foot and Ankle Society (AOFAS) score. Nineteen consecutive patients with chronic LAI (LAI group) and 19 healthy individuals (control group) were enrolled. Biochemical magnetic resonance examination of the ankle was performed in all participants using three-dimensional gradient-echo T2* mapping. Total talar cartilage was divided into six subcompartments, including medial anterior (MA), central medial, medial posterior, lateral anterior, central lateral (LC), and lateral posterior regions. T2* values of respective cartilage areas were measured and compared between the two groups using Student t test. AOFAS scoring was performed for clinical evaluation. Then, the association of T2* value with AOFAS score was evaluated by Pearson correlation. The T2* values of total talar cartilage, as well as MA and LC cartilage compartments, in the chronic LAI group were significantly higher than control values (P T2* value of MA in the chronic LAI group was negatively correlated with AOFAS score (r =-0.8089, P T2* measurements. The clinical score correlates highly with T2* value of the MA cartilage compartment, indicating that MA may be the principal cartilage area conferring clinical symptoms. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Treatment of the lateral patellar luxation in toy poodles Tratamento da luxação lateral da patela em poodles toy

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João Guilherme Padilha Filho

2005-08-01

Full Text Available The purpose of this retrospective study was to report the occurrence of lateral patellar luxation in poodles. The animals were referred to the Orthopedics Service of the Veterinary Hospital, Faculdade de Ciências Agrárias e Veterinárias, - Jaboticabal Campus, São Paulo, Brazil, twelve client-owned poodles, seven females and five males poodles ranging in age from three to nine months. Clinical examination showed lameness, pain and deformities of the affected limbs. Surgical trochleoplasties were performed with medial retinacular overlap and medial tibial tuberosity transposition. The animals recovered their normal activity within a period of one to two weeks after surgery. Although this was a rarely occurring pathological condition in poodles, surgical repair was easy to execute because of its similarity to correction of medial patellar luxation. Lateral patellar luxation in small dogs is rare and, when present, is of congenital origin, at times progressing to marked functional impotence of the affected limbs.O objetivo deste estudo retrospectivo foi relatar a ocorrência de luxação lateral em poodles. Os animais foram encaminhados ao Serviço de Ortopedia do Hospital Veterinário da Faculdade de Ciências Agrárias e Veterinárias, Campus de Jaboticabal, SP/Brasil, doze poodles, sete fêmeas e cinco machos, com idades variando entre três a nove meses. Ao exame clínico, notaram-se sinais de dor, claudicação e deformidades físicas dos membros afetados. Realizaram-se procedimentos cirúrgicos de condroplastia com sobreposição medial de retalho do retináculo e a transposição medial da crista tibial. O retorno à função do membro afetado ocorreu em um período de uma a duas semanas de pós-cirúrgico. Apesar de ser condição patológica rara em poodles, a reconstituição cirúrgica foi de fácil execução pela similaridade desta com a correção para luxação medial de patela. A luxação lateral de patela é rara em cães de ra

The Modulation of Error Processing in the Medial Frontal Cortex by Transcranial Direct Current Stimulation

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Lisa Bellaïche

2013-01-01

Full Text Available Background. In order to prevent future errors, we constantly control our behavior for discrepancies between the expected (i.e., intended and the real action outcome and continuously adjust our behavior accordingly. Neurophysiological correlates of this action-monitoring process can be studied with event-related potentials (error-related negativity (ERN and error positivity (Pe originating from the medial prefrontal cortex (mPFC. Patients with neuropsychiatric diseases often show performance monitoring dysfunctions potentially caused by pathological changes of cortical excitability; therefore, a modulation of the underlying neuronal activity might be a valuable therapeutic tool. One technique which allows us to explore cortical modulation of neural networks is transcranial direct current stimulation (tDCS. Therefore, we tested the effect of medial-prefrontal tDCS on error-monitoring potentials in 48 healthy subjects randomly assigned to anodal, cathodal, or sham stimulation. Results. We found that cathodal stimulation attenuated Pe amplitudes compared to both anodal and sham stimulation, but no effect for the ERN. Conclusions. Our results indicate that cathodal tDCS over the mPFC results in an attenuated cortical excitability leading to decreased Pe amplitudes. We therefore conclude that tDCS has a neuromodulatory effect on error-monitoring systems suggesting a future approach to modify the sensitivity of corresponding neural networks in patients with action-monitoring deficits.

An electrocorticographic electrode array for simultaneous recording from medial, lateral, and intrasulcal surface of the cortex in macaque monkeys.

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Fukushima, Makoto; Saunders, Richard C; Mullarkey, Matthew; Doyle, Alexandra M; Mishkin, Mortimer; Fujii, Naotaka

2014-08-15

Electrocorticography (ECoG) permits recording electrical field potentials with high spatiotemporal resolution over a large part of the cerebral cortex. Application of chronically implanted ECoG arrays in animal models provides an opportunity to investigate global spatiotemporal neural patterns and functional connectivity systematically under various experimental conditions. Although ECoG is conventionally used to cover the gyral cortical surface, recent studies have shown the feasibility of intrasulcal ECoG recordings in macaque monkeys. Here we developed a new ECoG array to record neural activity simultaneously from much of the medial and lateral cortical surface of a single hemisphere, together with the supratemporal plane (STP) of the lateral sulcus in macaque monkeys. The ECoG array consisted of 256 electrodes for bipolar recording at 128 sites. We successfully implanted the ECoG array in the left hemisphere of three rhesus monkeys. The electrodes in the auditory and visual cortex detected robust event related potentials to auditory and visual stimuli, respectively. Bipolar recording from adjacent electrode pairs effectively eliminated chewing artifacts evident in monopolar recording, demonstrating the advantage of using the ECoG array under conditions that generate significant movement artifacts. Compared with bipolar ECoG arrays previously developed for macaque monkeys, this array significantly expands the number of cortical target areas in gyral and intralsulcal cortex. This new ECoG array provides an opportunity to investigate global network interactions among gyral and intrasulcal cortical areas. Published by Elsevier B.V.

Deep brain stimulation reveals a dissociation of consummatory and motivated behaviour in the medial and lateral nucleus accumbens shell of the rat.

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van der Plasse, Geoffrey; Schrama, Regina; van Seters, Sebastiaan P; Vanderschuren, Louk J M J; Westenberg, Herman G M

2012-01-01

Following the successful application of deep brain stimulation (DBS) in the treatment of Parkinson's disease and promising results in clinical trials for obsessive compulsive disorder and major depression, DBS is currently being tested in small patient-populations with eating disorders and addiction. However, in spite of its potential use in a broad spectrum of disorders, the mechanisms of action of DBS remain largely unclear and optimal neural targets for stimulation in several disorders have yet to be established. Thus, there is a great need to examine site-specific effects of DBS on a behavioural level and to understand how DBS may modulate pathological behaviour. In view of the possible application of DBS in the treatment of disorders characterized by impaired processing of reward and motivation, like addiction and eating disorders, we examined the effect of DBS of the nucleus accumbens (NAcc) on food-directed behavior. Rats were implanted with bilateral stimulation electrodes in one of three anatomically and functionally distinct sub-areas of the NAcc: the core, lateral shell (lShell) and medial shell (mShell). Subsequently, we studied the effects of DBS on food consumption, and the motivational and appetitive properties of food. The data revealed a functional dissociation between the lShell and mShell. DBS of the lShell reduced motivation to respond for sucrose under a progressive ratio schedule of reinforcement, mShell DBS, however, profoundly and selectively increased the intake of chow. DBS of the NAcc core did not alter any form of food-directed behavior studied. DBS of neither structure affected sucrose preference. These data indicate that the intake of chow and the motivation to work for palatable food can independently be modulated by DBS of subregions of the NAcc shell. As such, these findings provide important leads for the possible future application of DBS as a treatment for eating disorders such as anorexia nervosa.

Lateral luxation of the superficial digital flexor tendon from the calcaneal tuber in two horses

International Nuclear Information System (INIS)

Meagher, D.M.; Aldrete, A.V.

1989-01-01

Lateral luxation of the superficial digital flexor tendon from the calcaneal tuber occurs in horses as a result of tearing or rupture of the medial retinaculum of the tendon. This report describes the repair of this condition in 2 Thoroughbred race horses, using a surgical technique in which 2 cancellous bone screws were placed in the calcaneus lateral to the tendon, along with suturing the medial retinaculum

Communication between radial nerve and medial cutaneous nerve of forearm

Directory of Open Access Journals (Sweden)

R R Marathe

2010-01-01

Full Text Available Radial nerve is usually a branch of the posterior cord of the brachial plexus. It innervates triceps, anconeous, brachialis, brachioradialis, extensor carpi radialis longus muscles and gives the posterior cutaneous nerve of the arm, lower lateral cutaneous nerve of arm, posterior cutaneous nerve of forearm; without exhibiting any communication with the medial cutaneous nerve of forearm or any other nerve. We report communication between the radial nerve and medial cutaneous nerve of forearm on the left side in a 58-year-old male cadaver. The right sided structures were found to be normal. Neurosurgeons should keep such variations in mind while performing the surgeries of axilla and upper arm.

Treatment of recurrent patellar dislocation via knee arthroscopy combined with C-arm fluoroscopy and reconstruction of the medial patellofemoral ligament.

Science.gov (United States)

Li, Li; Wang, Hongbo; He, Yun; Si, Yu; Zhou, Hongyu; Wang, Xin

2018-06-01

Recurrent patellar dislocations were treated via knee arthroscopy combined with C-arm fluoroscopy, and reconstruction of the medial patellofemoral ligaments. Between October 2013 and March 2017, 52 cases of recurrent patellar dislocation [27 males and 25 females; age, 16-47 years (mean, 21.90 years)] were treated. Arthroscopic exploration was performed and patellofemoral joint cartilage injuries were repaired. It was subsequently determined whether it was necessary to release the lateral patellofemoral support belt. Pre-operative measurements were used to decide whether tibial tubercle osteotomy was required. Medial patellofemoral ligaments were reconstructed using autologous semitendinosus tendons. Smith and Nephew model 3.5 line anchors were used to double-anchor the medial patellofemoral margin. On the femoral side, the medial patellofemoral ligament was fixed using 7-cm, absorbable, interfacial compression screws. All cases were followed for 1-40 months (average, 21 months). The Q angle, tibial tuberosity trochlear groove distance, Insall-Salvati index, patellofemoral angle, lateral patellofemoral angle and lateral shift were evaluated on X-Ray images using the picture archiving and communication system. Subjective International Knee Documentation Committee (IKDC) knee joint functional scores and Lysholm scores were recorded. Post-operative fear was absent, and no patellar re-dislocation or re-fracture was noted during follow-up. At the end of follow-up, the patellofemoral angle (0.22±4.23°), lateral patellofemoral angle (3.44±1.30°), and lateral shift (0.36+0.14°) differed significantly from the pre-operative values (all, Ppatellofemoral ligament was effective.

Outside-In Deep Medial Collateral Ligament Release During Arthroscopic Medial Meniscus Surgery.

Science.gov (United States)

Todor, Adrian; Caterev, Sergiu; Nistor, Dan Viorel

2016-08-01

Arthroscopic partial medial meniscectomy is a very common orthopaedic procedure performed for symptomatic, irreparable meniscus tears. It is usually associated with a very good outcome and minimal complications. In some patients with tight medial compartment, the posterior horn of the medial meniscus can be difficult to visualize, and access in this area with instruments may be challenging. To increase the opening of the medial compartment, after valgus-extension stress position of the knee, different techniques of deep medial collateral ligament release have been described. The outside-in pie-crusting technique shown in this technical note has documented effectiveness and good outcomes with minimal or no morbidity.

Medial Canthoplasty Combined with Conjunctivodacryocystorhinostomy for the Treatment of Delayed Medial Telecanthal Deformity

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Hua Sun

2017-01-01

Conclusions: Medial canthoplasty combined with CDCR is an effective surgical method for treatment of patients with medial telecanthal deformity and lacrimal drainage system obstruction. The study indicates that medial canthoplasty combined with CDCR surgery rebuilds normal appearance of eyelid and contour of the medial canthus and successfully repairs the function of the lacrimal drainage system.

Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces

Science.gov (United States)

Gerus, Pauline; Sartori, Massimo; Besier, Thor F.; Fregly, Benjamin J.; Delp, Scott L.; Banks, Scott A.; Pandy, Marcus G.; D’Lima, Darryl D.; Lloyd, David G.

2013-01-01

Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model. PMID:24074941

Age-related differences in diffusion tensor indices and fiber architecture in the medial and lateral gastrocnemius.

Science.gov (United States)

Sinha, Usha; Csapo, Robert; Malis, Vadim; Xue, Yanjie; Sinha, Shantanu

2015-04-01

To investigate age related changes in diffusion tensor indices and fiber architecture of the medial and lateral gastrocnemius (MG and LG) muscles using diffusion tensor imaging (DTI). The lower leg of five young and five senior subjects was scanned at 3 Tesla and DTI indices extracted using three methods: region of interest, histogram, and tract based. Tracked fibers were automatically edited to ensure physiologically relevant tracks. Pennation angles were measured with respect to the deep and superficial aponeuroses of both muscles. The three methods provided internally consistent measures of the DTI indices (correlation coefficient in the range of 0.90-0.99). The primary, secondary, and tertiary eigenvalues in the MG and LG increased significantly in the senior cohort (P < 0.05), while the small increase in fractional anisotropy with age was not significant (MG/LG: P = 0.39/0.85; 95% confidence interval: [-0.059/-0.056, 0.116/0.064]). Fiber lengths of MG fibers originating distally were significantly decreased in seniors (P < 0.05) while pennation angles decreased with age in the MG and LG but this was not significant. Fiber atrophy and increased fibrosis have opposing effects on the diffusion indices resulting in a complicated dependence with aging. Fiber architectural changes could play a role in determining aging muscle function. © 2014 Wiley Periodicals, Inc.

Age Related Differences in Diffusion Tensor Indices and Fiber Architecture in the Medial and Lateral Gastrocnemius

Science.gov (United States)

Sinha, Usha; Csapo, Robert; Malis, Vadim; Xue, Yanjie; Sinha, Shantanu

2014-01-01

Purpose To investigate age related changes in diffusion tensor indices and fiber architecture of the medial and lateral gastrocnemius (MG and LG) muscles using diffusion tensor imaging (DTI). Materials and Methods The lower leg of five young and five senior subjects was scanned at 3T and DTI indices extracted using three methods: ROI, histogram and tract based. Tracked fibers were automatically edited to ensure physiologically relevant tracks. Pennation angles were measured with respect to the deep and superficial aponeuroses of both muscles. Results The three methods provided internally consistent measures of the DTI indices (correlation coefficient in the range of 0.90-0.99). The primary, secondary and tertiary eigenvalues in the MG and LG increased significantly in the senior cohort (p<0.05), while the small increase in fractional anisotropy (FA) with age was not significant (MG/LG: p=0.39/0.85; 95% CI:[ −0.059/-0.056, 0.116/0.064]). Fiber lengths of MG fibers originating distally were significantly decreased in seniors (p<0.05) while pennation angles decreased with age in the MG and LG but this was not significant. Conclusion Fiber atrophy and increased fibrosis have opposing effects on the diffusion indices resulting in a complicated dependence with aging. Fiber architectural changes could play a role in determining aging muscle function. PMID:24771672

[Mirror movement due to the medial frontal lobe lesion].

Science.gov (United States)

Takahashi, N; Kawamura, M; Hirayama, K

1995-01-01

We reported a case with acquired mirror movement in upper limbs due to the lesion of right medial frontal lobe including supplementary motor area, and also discussed a possible mechanism underlying it. A 59-year-old right-handed woman developed left hemiparesis caused by cerebral hemorrhage in the right frontoparietal lobe, on April 5, 1981. She had right hemiparesis and right hemianopsia due to cerebral hemorrhage in the left parieto-occipital lobe, 13 days later. As the patient was recovering from paresis, mirror movement appeared on upper limbs. The features of the mirror movement of this case are summarized as follows: (1) it appeared when using both proximal and distal region of upper limbs; (2) it appeared on left upper limb when the patient intended to move right upper limb or on right upper limb when intended to move left upper limb, while it appeared predominantly in the former; and (3) it was more remarkably found in habitual movement using gesture and pantomimic movement for the use of objects, and it was found in lower degree when actual object was used or when the patient tried to imitate the gesture of the examiner. The lesions in MRI were found in medial region of right frontal lobe (supplementary motor area, medial region of motor area, and cingulate gyrus), right medial parietal lobe, posterior region of right occipital lobe, and medial regions of left parietal and occipital lobes. There was no apparent abnormality in corpus callosum.(ABSTRACT TRUNCATED AT 250 WORDS)

Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience

Directory of Open Access Journals (Sweden)

Betina Bremer Hinckel

2016-02-01

Full Text Available ABSTRACT OBJECTIVE: To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. METHOD: The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM, apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10 and whether they would be prepared to go through this operation again. RESULTS: Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07. Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. CONCLUSION: Reconstruction of the

Injerto libre braquial medial Free medial arm graft

Directory of Open Access Journals (Sweden)

P. Martos Díaz

2007-12-01

Full Text Available Introducción. Entre las reconstrucciones de defectos titulares de cabeza y cuello, el injerto libre microvascularizado braquial medial no ha adquirido mucha popularidad debido a las variaciones anatómicas que se reflejan en la vascularización de éste. Nuestro objetivo es realizar una descripción de la anatomía y técnica quirúrgica, así como una revisión de la literatura describiendo las ventajas y desventajas de este tipo de injerto. Material y método. Presentamos el caso de una paciente con carcinoma epidermoide de mucosa yugal izquierda con afectación ganglionar ipsilateral. Se procedió a su resección con márgenes más disección cervical funcional. La reconstrucción del defecto se llevó a cabo mediante un injerto libre microvascularizado braquial medial de brazo izquierdo. Discusión. Pensamos que el injerto libre braquial medial de brazo se trata de una opción más segura a la hora de la reconstrucción de defectos cervicofaciales, aportando una serie de ventajas entre las que destacan: no sacrificio de una arteria terminal, cierre primario de la zona donante, mínimo defecto estético, y poseer una piel fina, elástica y sin vello.Introduction. Free medial microvascularized arm grafts have not become very popular for the reconstruction of head and neck defects due to anatomic variations in their vascularization. Our objective was to describe the anatomy and surgical technique and to review the literature on the advantages and disadvantages of free medial arm grafts. Material and methods. We report the case of a patient with squamous cell carcinoma of the left jugal mucosa with same-side lymph node involvement. The tumor was resected with margins and a functional cervical dissection was performed. The defect was reconstructed using a free medial microvascularized graft from the left arm. Discussion. We believe that free medial arm grafts are a safer option for the reconstruction of cervicofacial defects and that they offer

RED-ML

DEFF Research Database (Denmark)

Xiong, Heng; Liu, Dongbing; Li, Qiye

2017-01-01

using diverse RNA-seq datasets, we have developed a software tool, RED-ML: RNA Editing Detection based on Machine learning (pronounced as "red ML"). The input to RED-ML can be as simple as a single BAM file, while it can also take advantage of matched genomic variant information when available...... accurately detect novel RNA editing sites without relying on curated RNA editing databases. We have also made this tool freely available via GitHub . We have developed a highly accurate, speedy and general-purpose tool for RNA editing detection using RNA-seq data....... With the availability of RED-ML, it is now possible to conveniently make RNA editing a routine analysis of RNA-seq. We believe this can greatly benefit the RNA editing research community and has profound impact to accelerate our understanding of this intriguing posttranscriptional modification process....

Directional preference in dogs: Laterality and "pull of the north".

Science.gov (United States)

Adámková, Jana; Svoboda, Jan; Benediktová, Kateřina; Martini, Sabine; Nováková, Petra; Tůma, David; Kučerová, Michaela; Divišová, Michaela; Begall, Sabine; Hart, Vlastimil; Burda, Hynek

2017-01-01

Laterality is a well described phenomenon in domestic dogs. It was shown that dogs, under calm Earth's magnetic field conditions, when marking their home ranges, tend to head about north- or southwards and display thus magnetic alignment. The question arises whether magnetic alignment might be affected or even compromised by laterality and vice versa. We tested the preference of dogs to choose between two dishes with snacks that were placed left and right, in different compass directions (north and east, east and south, south and west or west and north) in front of them. Some dogs were right-lateral, some left-lateral but most of them were ambilateral. There was a preference for the dish placed north compared to the one placed east of the dog ("pull of the north"). This effect was highly significant in small and medium-sized breeds but not in larger breeds, highly significant in females, in older dogs, in lateralized dogs but less significant or not significant in males, younger dogs, or ambilateral dogs. Laterality and "pull of the north" are phenomena which should be considered in diverse tasks and behavioral tests with which dogs or other animals might be confronted. The interaction and possible conflict between lateralization and "pull of the north" might be also considered as a reason for shifted magnetic alignment observed in different animal species in different contexts.

Directional preference in dogs: Laterality and "pull of the north"

Science.gov (United States)

Adámková, Jana; Svoboda, Jan; Benediktová, Kateřina; Martini, Sabine; Nováková, Petra; Tůma, David; Kučerová, Michaela; Divišová, Michaela; Begall, Sabine; Hart, Vlastimil

2017-01-01

Laterality is a well described phenomenon in domestic dogs. It was shown that dogs, under calm Earth's magnetic field conditions, when marking their home ranges, tend to head about north- or southwards and display thus magnetic alignment. The question arises whether magnetic alignment might be affected or even compromised by laterality and vice versa. We tested the preference of dogs to choose between two dishes with snacks that were placed left and right, in different compass directions (north and east, east and south, south and west or west and north) in front of them. Some dogs were right-lateral, some left-lateral but most of them were ambilateral. There was a preference for the dish placed north compared to the one placed east of the dog ("pull of the north"). This effect was highly significant in small and medium-sized breeds but not in larger breeds, highly significant in females, in older dogs, in lateralized dogs but less significant or not significant in males, younger dogs, or ambilateral dogs. Laterality and “pull of the north” are phenomena which should be considered in diverse tasks and behavioral tests with which dogs or other animals might be confronted. The interaction and possible conflict between lateralization and "pull of the north" might be also considered as a reason for shifted magnetic alignment observed in different animal species in different contexts. PMID:28945773

Sex Differences and Laterality in Astrocyte Number and Complexity in the Adult Rat Medial Amygdala

Science.gov (United States)

JOHNSON, RYAN T.; BREEDLOVE, S. MARC; JORDAN, CYNTHIA L.

2008-01-01

The posterodorsal portion of the medial amygdala (MePD) is sexually dimorphic in several rodent species. In several other brain nuclei, astrocytes change morphology in response to steroid hormones. We visualized MePD astrocytes using glial-fibrillary acidic protein (GFAP) immunocytochemistry. We compared the number and process complexity of MePD astrocytes in adult wildtype male and female rats and testicular feminized mutant (TFM) male rats that lack functional androgen receptors (ARs) to determine whether MePD astrocytes are sexually differentiated and whether ARs have a role. Unbiased stereological methods revealed laterality and sex differences in MePD astrocyte number and complexity. The right MePD contained more astrocytes than the left in all three genotypes, and the number of astrocytes was also sexually differentiated in the right MePD, with males having more astrocytes than females. In contrast, the left MePD contained more complex astrocytes than did the right MePD in all three genotypes, and males had more complex astrocytes than females in this hemisphere. TFM males were comparable to wildtype females, having fewer astrocytes on the right and simpler astrocytes on the left than do wildtype males. Taken together, these results demonstrate that astrocytes are sexually dimorphic in the adult MePD and that the nature of the sex difference is hemisphere-dependent: a sex difference in astrocyte number in the right MePD and a sex difference in astrocyte complexity in the left MePD. Moreover, functional ARs appear to be critical in establishing these sex differences in MePD astrocyte morphology. PMID:18853427

Anatomical predisposition of the ankle joint for lateral sprain or lateral malleolar fracture evaluated by radiographic measurements.

Science.gov (United States)

Lee, Kyoung Min; Chung, Chin Youb; Sung, Ki Hyuk; Lee, SeungYeol; Kim, Tae Gyun; Choi, Young; Jung, Ki Jin; Kim, Yeon Ho; Koo, Seung Bum; Park, Moon Seok

2015-01-01

Injury mechanism and the amount of force are important factors determining whether a fracture or sprain occurs at the time of an ankle inversion injury. However, the anatomical differences between the ankle fracture and sprain have not been investigated sufficiently. This study was performed to investigate whether an anatomical predisposition of the ankle joint results in a lateral malleolar fracture or lateral ankle sprain. Two groups of consecutive patients, one with lateral malleolar fracture (274 patients, mean age 49.0 years) and the other with lateral ankle sprain (400 patients, mean age 38.4 years), were evaluated. Ankle radiographs were examined for 7 measures: distal tibial articular surface (DTAS) angle, bimalleolar tilt (BT), medial malleolar relative length (MMRL), lateral malleolar relative length (LMRL), medial malleolar slip angle (MMSA), anterior inclination of tibia (AI), and fibular position (FP). After an interobserver reliability test, the radiographic measurements were compared between the 2 groups. Linear regression analysis was performed to correct for age and sex effects between the groups. The fracture group and the sprain group showed significant differences in BT (P = .001), MMSA (P sprain groups showed a significant difference in BT (P = .001), MMRL (P ankle sprain group. Further 3-dimensional assessment of the bony structure and subsequent biomechanical studies are needed to elucidate the mechanism of injury according to the various types of ankle fractures and ankle sprain. Level III, retrospective comparative study. © The Author(s) 2014.

Effects of counteracting external valgus moment on lateral tibial cartilage contact conditions and tibial rotation.

Science.gov (United States)

Shriram, Duraisamy; Parween, Rizuwana; Lee, Yee Han Dave; Subburaj, Karupppasamy

2017-07-01

Knee osteoarthritis that prevalently occurs at the medial compartment is a progressive chronic disorder affecting the articular cartilage of the knee joint, and lead to loss of joint functionality. Valgus braces have been used as a treatment procedure to unload the medial compartment for patients with medial osteoarthritis. Valgus braces through the application of counteracting external valgus moment shift the load from medial compartment towards the lateral compartment. Previous biomechanical studies focused only on the changes in varus moments before and after wearing the brace. The objective of this study was to investigate the influence of opposing external valgus moment applied by knee braces on the lateral tibial cartilage contact conditions using a 3D finite element model of the knee joint. Finite element simulations were performed on the knee joint model without and with the application of opposing valgus moment to mimic the unbraced and braced conditions. Lateral tibial cartilage contact pressures and contact area, and tibial rotation (varus-valgus and internal-external) were estimated for the complete walking gait cycle. The opposing valgus moment increased the maximum contact pressure and contact area on the lateral tibial cartilage compared to the normal gait moment. A peak contact pressure of 8.2 MPa and maximum cartilage loaded area of 28% (loaded cartilage nodes) on the lateral cartilage with the application of external valgus moment were induced at 50% of the gait cycle. The results show that the use of opposing valgus moment may significantly increase the maximum contact pressures and contact area on the lateral tibial cartilage and increases the risk of articular cartilage damage on the lateral compartment.

Failed medial patellofemoral ligament reconstruction: Causes and surgical strategies

OpenAIRE

Sanchis-Alfonso, Vicente; Montesinos-Berry, Erik; Ramirez-Fuentes, Cristina; Leal Blanquet, Joan; Gelber, Pablo-Eduardo; Monllau García, Juan Carlos

2017-01-01

Patellar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament (MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed: (1) incorrect surgical ...

Effects of timing of signal indicating jump directions on knee biomechanics in jump-landing-jump tasks.

Science.gov (United States)

Stephenson, Mitchell L; Hinshaw, Taylour J; Wadley, Haley A; Zhu, Qin; Wilson, Margaret A; Byra, Mark; Dai, Boyi

2018-03-01

A variety of the available time to react (ATR) has been utilised to study knee biomechanics during reactive jump-landing tasks. The purpose was to quantify knee kinematics and kinetics during a jump-land-jump task of three possible directions as the ATR was reduced. Thirty-four recreational athletes performed 45 trials of a jump-land-jump task, during which the direction of the second jump (lateral, medial or vertical) was indicated before they initiated the first jump, the instant they initiated the first jump, 300 ms before landing, 150 ms before landing or at the instant of landing. Knee joint angles and moments close to the instant of landing were significantly different when the ATR was equal to or more than 300 ms before landing, but became similar when the ATR was 150 ms or 0 ms before landing. As the ATR was decreased, knee moments decreased for the medial jump direction, but increased for the lateral jump direction. When the ATR is shorter than an individual's reaction time, the movement pattern cannot be pre-planned before landing. Knee biomechanics are dependent on the timing of the signal and the subsequent jump direction. Precise control of timing and screening athletes with low ATR are suggested.

Study on CT scanning technique of inferior horn of lateral ventricle

International Nuclear Information System (INIS)

Kakoi, Iwao; Okubo, Mitsuo; Nakamura, Sumio; Yoshinaga, Toshihiko; Shimono, Tetsuo

1984-01-01

It is said that temporal lobe epilepsy (TLE), one of the incurable epilepsies, results from the lesions of various structrues located in the medial and deep portion of the temporal lobe such as the hippocampus and amygdaloid nucleus. Routine CT scanning techniques cannot adequately delineate these structures in the assessment of TLE. The anatomical relationship between these medial temporal structures and the inferior horn of lateral ventricle which is lateral to them and easily identified by CT lead us to believe that the sections through the longitudinal plane of the inferior horn may clearly delineate them. The present experimental study was undertaken to develop the CT scan technique of the inferior horn of lateral ventricle, which results in the clear delineation of the region of the hippocampus and amygdaloid nucleus. As a result, A total of the 3-4 reversed axial 5 mm-thick section centered at 2.5 cm cephalad to the roof of the external auditory canal at a reversed 25 0 angle to ABL are adequate to delineate the inferior horn and the medial temporal structures. This scan technique is considered to be useful in the assessment of TLE. (author)

[SECOT consensus on medial femorotibial osteoarthritis].

Science.gov (United States)

Moreno, A; Silvestre, A; Carpintero, P

2013-01-01

A consensus, prepared by SECOT, is presented on the management of medial knee compartment osteoarthritis, in order to establish clinical criteria and recommendations directed at unifying the criteria in its management, dealing with the factors involved in the pathogenesis of medial femorotibial knee osteoarthritis, the usefulness of diagnostic imaging techniques, and the usefulness of arthroscopy. Conservative and surgical treatments are also analysed. The experts consulted showed a consensus (agreed or disagreed) in 65.8% of the items considered, leaving 14items where no consensus was found, which included the aetiopathogenesis of the osteoarthritis, the value of NMR in degenerative disease, the usefulness of COX-2 and the chondroprotective drugs, as well as on the ideal valgus tibial osteotomy technique. © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

Auditory conflict resolution correlates with medial-lateral frontal theta/alpha phase synchrony.

Science.gov (United States)

Huang, Samantha; Rossi, Stephanie; Hämäläinen, Matti; Ahveninen, Jyrki

2014-01-01

When multiple persons speak simultaneously, it may be difficult for the listener to direct attention to correct sound objects among conflicting ones. This could occur, for example, in an emergency situation in which one hears conflicting instructions and the loudest, instead of the wisest, voice prevails. Here, we used cortically-constrained oscillatory MEG/EEG estimates to examine how different brain regions, including caudal anterior cingulate (cACC) and dorsolateral prefrontal cortices (DLPFC), work together to resolve these kinds of auditory conflicts. During an auditory flanker interference task, subjects were presented with sound patterns consisting of three different voices, from three different directions (45° left, straight ahead, 45° right), sounding out either the letters "A" or "O". They were asked to discriminate which sound was presented centrally and ignore the flanking distracters that were phonetically either congruent (50%) or incongruent (50%) with the target. Our cortical MEG/EEG oscillatory estimates demonstrated a direct relationship between performance and brain activity, showing that efficient conflict resolution, as measured with reduced conflict-induced RT lags, is predicted by theta/alpha phase coupling between cACC and right lateral frontal cortex regions intersecting the right frontal eye fields (FEF) and DLPFC, as well as by increased pre-stimulus gamma (60-110 Hz) power in the left inferior fontal cortex. Notably, cACC connectivity patterns that correlated with behavioral conflict-resolution measures were found during both the pre-stimulus and the pre-response periods. Our data provide evidence that, instead of being only transiently activated upon conflict detection, cACC is involved in sustained engagement of attentional resources required for effective sound object selection performance.

Auditory conflict resolution correlates with medial-lateral frontal theta/alpha phase synchrony.

Directory of Open Access Journals (Sweden)

Samantha Huang

Full Text Available When multiple persons speak simultaneously, it may be difficult for the listener to direct attention to correct sound objects among conflicting ones. This could occur, for example, in an emergency situation in which one hears conflicting instructions and the loudest, instead of the wisest, voice prevails. Here, we used cortically-constrained oscillatory MEG/EEG estimates to examine how different brain regions, including caudal anterior cingulate (cACC and dorsolateral prefrontal cortices (DLPFC, work together to resolve these kinds of auditory conflicts. During an auditory flanker interference task, subjects were presented with sound patterns consisting of three different voices, from three different directions (45° left, straight ahead, 45° right, sounding out either the letters "A" or "O". They were asked to discriminate which sound was presented centrally and ignore the flanking distracters that were phonetically either congruent (50% or incongruent (50% with the target. Our cortical MEG/EEG oscillatory estimates demonstrated a direct relationship between performance and brain activity, showing that efficient conflict resolution, as measured with reduced conflict-induced RT lags, is predicted by theta/alpha phase coupling between cACC and right lateral frontal cortex regions intersecting the right frontal eye fields (FEF and DLPFC, as well as by increased pre-stimulus gamma (60-110 Hz power in the left inferior fontal cortex. Notably, cACC connectivity patterns that correlated with behavioral conflict-resolution measures were found during both the pre-stimulus and the pre-response periods. Our data provide evidence that, instead of being only transiently activated upon conflict detection, cACC is involved in sustained engagement of attentional resources required for effective sound object selection performance.

Role of an anatomically contoured plate and metal block for balanced stability between the implant and lateral hinge in open-wedge high-tibial osteotomy.

Science.gov (United States)

Jang, Young Woong; Lim, DoHyung; Seo, Hansol; Lee, Myung Chul; Lee, O-Sung; Lee, Yong Seuk

2018-07-01

Open-wedge high tibial osteotomy (OWHTO) is a well-established surgical option for medial compartment osteoarthritis of the varus knee. The initial strength of the fixation plate is critical for successful correction maintenance and healing of the osteotomy site. This study was conducted to verify if a newly designed anatomical plate (LCfit) improves the stability of both the medial implant and lateral hinge area, as well as to evaluate how the metal block contributes to both medial and lateral stability. A finite element (FE) tibial model was combined with TomoFix plate, a LCfit plate with and without a metal block. Data analysis was conducted to evaluate the balanced stability, which refers to the enforced lateral stability resulting from redistribution of overall stress. We assessed the balanced stability of the medial implant and lateral hinge area in three cases using the same Sawbones and loads using the tibia FE model. The LCfit plate reduced stress by 23.1% at the lateral hinge compared to the TomoFix plate (TomoFix vs. LCfit: 34.2 ± 23.3 MPa vs. 26.3 ± 17.5 MPa). The LCfit plate with a metal block reduced stress by 40.1% at the medial plate (210.1 ± 64.2 MPa vs. 125.8 ± 65.7 MPa) and by 31.2% (26.3 ± 17.5 MPa vs. 18.1 ± 12.1 MPa) at the lateral hinge area compared to the reduction using the LCfit plate without a metal block. The newly designed fixation system for OWHTO balanced the overall stress distribution and reduced stress at the lateral hinge area compared to that using a conventional fixation system. The addition of the metal block showed additional benefits for balanced stability between the medial implant and lateral hinge area. However, this conclusion could only be drawn using the FE model in this study. Therefore, further clinical studies are necessary to reveal the clinical effect of reduced lateral stress on the occurrence of the lateral hinge fracture and the biologic effect of the metal block on the

Deep brain stimulation reveals a dissociation of consummatory and motivated behaviour in the medial and lateral nucleus accumbens shell of the rat.

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Geoffrey van der Plasse

Full Text Available Following the successful application of deep brain stimulation (DBS in the treatment of Parkinson's disease and promising results in clinical trials for obsessive compulsive disorder and major depression, DBS is currently being tested in small patient-populations with eating disorders and addiction. However, in spite of its potential use in a broad spectrum of disorders, the mechanisms of action of DBS remain largely unclear and optimal neural targets for stimulation in several disorders have yet to be established. Thus, there is a great need to examine site-specific effects of DBS on a behavioural level and to understand how DBS may modulate pathological behaviour. In view of the possible application of DBS in the treatment of disorders characterized by impaired processing of reward and motivation, like addiction and eating disorders, we examined the effect of DBS of the nucleus accumbens (NAcc on food-directed behavior. Rats were implanted with bilateral stimulation electrodes in one of three anatomically and functionally distinct sub-areas of the NAcc: the core, lateral shell (lShell and medial shell (mShell. Subsequently, we studied the effects of DBS on food consumption, and the motivational and appetitive properties of food. The data revealed a functional dissociation between the lShell and mShell. DBS of the lShell reduced motivation to respond for sucrose under a progressive ratio schedule of reinforcement, mShell DBS, however, profoundly and selectively increased the intake of chow. DBS of the NAcc core did not alter any form of food-directed behavior studied. DBS of neither structure affected sucrose preference. These data indicate that the intake of chow and the motivation to work for palatable food can independently be modulated by DBS of subregions of the NAcc shell. As such, these findings provide important leads for the possible future application of DBS as a treatment for eating disorders such as anorexia nervosa.

Opening the medial tibiofemoral compartment by pie-crusting the superficial medial collateral ligament at its tibial insertion: a cadaver study.

Science.gov (United States)

Roussignol, X; Gauthe, R; Rahali, S; Mandereau, C; Courage, O; Duparc, F

2015-09-01

Arthroscopic treatment of tears in the middle and posterior parts of the medial meniscus can be difficult when the medial tibiofemoral compartment is tight. Passage of the instruments may damage the cartilage. The primary objective of this cadaver study was to perform an arthroscopic evaluation of medial tibiofemoral compartment opening after pie-crusting release (PCR) of the superficial medial collateral ligament (sMCL) at its distal insertion on the tibia. The secondary objective was to describe the anatomic relationships at the site of PCR (saphenous nerve, medial saphenous vein). We studied 10 cadaver knees with no history of invasive procedures. The femur was held in a vise with the knee flexed at 45°, and the medial aspect of the knee was dissected. PCR of the sMCL was performed under arthroscopic vision, in the anteroposterior direction, at the distal tibial insertion of the sMCL, along the lower edge of the tibial insertion of the semi-tendinosus tendon. Continuous 300-N valgus stress was applied to the ankle. Opening of the medial tibiofemoral compartment was measured arthroscopically using graduated palpation hooks after sequential PCR of the sMCL. The compartment opened by 1mm after release of the anterior third, 2.3mm after release of the anterior two-thirds, and 3.9mm after subtotal release. A femoral fracture occurred in 1 case, after completion of all measurements. Both the saphenous nerve and the medial saphenous vein were located at a distance from the PCR site in all 10 knees. PCR of the sMCL is chiefly described as a ligament-balancing method during total knee arthroplasty. This procedure is usually performed at the joint line, where it opens the compartment by 4-6mm at the most, with some degree of unpredictability. PCR of the sMCL at its distal tibial insertion provides gradual opening of the compartment, to a maximum value similar to that obtained with PCR at the joint space. The lower edge of the semi-tendinosus tendon is a valuable landmark

Optimal suture anchor direction in arthroscopic lateral ankle ligament repair.

Science.gov (United States)

Yoshimura, Ichiro; Hagio, Tomonobu; Noda, Masahiro; Kanazawa, Kazuki; Minokawa, So; Yamamoto, Takuaki

2017-05-26

In this study, the distance between the insertion point of the suture anchors and posterior surface of the fibula during arthroscopic lateral ankle ligament repair was investigated on computed tomography (CT) images. The hypothesis of this study was that there is an optimal insertional direction of the suture anchor to avoid anchor-related complications. One hundred eleven ankles of 98 patients who had undergone three-dimensional CT scans for foot or ankle disorders without deformity of the fibula were assessed (59 males, 52 females; median age 25.5 years; age range 12-78 years). The shortest distance from the insertion point of the suture anchor to the deepest point of the fossa/top of the convex aspect of the fibula was measured on the axial plane, tilting from the longitudinal axis of the fibula at 90°, 75°, 60°, and 45°. The distance from the insertion point of the suture anchor to the posterior surface of the fibula was also measured in a direction parallel to the sagittal plane of the lateral surface of the talus on the axial plane, tilting from the longitudinal axis of the fibula at 90°, 75°, 60°, and 45°. The posterior fossa was observed in all cases on the 90° and 75° images. The distance from the insertion point to the posterior surface of the fibula in the parallel direction was 15.0 ± 3.4 mm at 90°, 17.5 ± 3.2 mm at 75°, 21.7 ± 3.3 mm at 60°, and 25.7 ± 3.6 mm at 45°. The posterior points in the parallel direction were located on the posterior fossa in 36.0% of cases at 90°, in 12.6% at 75°, and in 0.0% at 60° and 45°. The suture anchor should be directed from anterior to posterior at an angle of <45° to the longitudinal axis of the fibula, parallel to the lateral surface of the talus, to avoid passing through the fibula. Cohort study, Level III.

Competitive swimmers with hypermobility have strength and fatigue deficits in shoulder medial rotation

DEFF Research Database (Denmark)

Liaghat, Behnam; Juul-Kristensen, Birgit; Frydendal, Thomas

2018-01-01

rotation (60°/s). Swimmers with GJHS showed significantly larger isokinetic fatigue at 180°/s (0.321 J/repetition; p = .010), and tendencies to lower levels of muscle activity in infraspinatus (20%, p = .066) and pectoralis major (34%, p = .092) at 60°/s during medial rotation. Young competitive swimmers...... rotations. Totally, 38 competitive swimmers (aged 13-17 years) participated, 19 were competitive swimmers with GJHS and 19 were age, sex and club matched swimmers without GJHS. Concentric isokinetic force in medial and lateral rotations were measured at 60°/s (5 repetitions) and 180°/s (10 repetitions...

Corrected direct force balance method for atomic force microscopy lateral force calibration

International Nuclear Information System (INIS)

Asay, David B.; Hsiao, Erik; Kim, Seong H.

2009-01-01

This paper reports corrections and improvements of the previously reported direct force balance method (DFBM) developed for lateral calibration of atomic force microscopy. The DFBM method employs the lateral force signal obtained during a force-distance measurement on a sloped surface and relates this signal to the applied load and the slope of the surface to determine the lateral calibration factor. In the original publication [Rev. Sci. Instrum. 77, 043903 (2006)], the tip-substrate contact was assumed to be pinned at the point of contact, i.e., no slip along the slope. In control experiments, the tip was found to slide along the slope during force-distance curve measurement. This paper presents the correct force balance for lateral force calibration.

[Influence of patellofemoral joint degeneration on outcome of medial unicompartmental knee arthroplasty].

Science.gov (United States)

Xu, B Y; Ji, B C; Guo, W T; Mu, W B; Cao, L

2017-06-01

Objective: To evaluate the influence of patellofemoral joint degeneration and pre-operative pain location on the outcome of medial Oxford unicompartmental knee arthroplasty (UKA). Methods: A total of 58 patients (58 knees) with medial Oxford UKA had been performed for medial osteoarthritis from March 2013 to July 2014 in Department of Orthopaedic Surgery at First Teaching Hospital of Xinjiang Medical University were retrospective reviewed. There were 24 males and 34 females, the age from 43 to 87 years with the mean age was 68.5 years. The mean body mass index was 25.2 kg/m(2) ranging from 19.7 to 31.5 kg/m(2). Patients were divided into anterior-medial pain group (35 knees), anterior knee pain group (17 knees) and general knee pain group (6 knees) according to pre-operative pain location. Pre-operative radiological statuses of the patellefemoral joint were defined by Ahlback system and divided into patellofemoral joint degeneration group (16 knees) and normal group (42 knees). Patients were also divided into medial patellofemoral degeneration group (20 knees), lateral patellofemoral degeneration group (12 knees) and normal group (26 knees) according to Altman scoring system. Outerbridge system was used intraoperatively and the patients were divided into patellofemoral joint degeneration group (21 knees) and normal group (37 knees). Pre- and post-operative outcomes were evaluated with Oxford Knee Score (OKS), Western Ontario and MacMaster (WOMAC) and patellofemoral score system of Lonner. T test and ANOVA were used to analyze the data. Results: The average duration of follow-up was 33 months (from 26 to 42 months). There were no patients had complications of infection, deep vein thrombosis, dislocation or loosing at the last follow-up. Compared to pre-operation, OKS (18.9±3.5 vs . 38.9±4.7, 19.3±4.2 vs . 39.6±4.6, 18.1±3.2 vs . 38.1±3.7)( t =5.64 to 7.08, all P patellofemoral joint degeneration group and normal group, the outcomes were the same according to

MORPHOMETRIC STUDY OF MEDIAL COLLATERAL LIGAMENTS OF ANKLE

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Neelu Prasad

2016-06-01

Full Text Available BACKGROUND The ankle joint is one of the most frequently injured joint. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. The talocrural joint is a major weight bearing joint of the body. The weight of the body is transmitted from the tibia and fibula to the talus which distributes the weight anteriorly and posteriorly within the foot. One sixth of the static load of the leg is carried by the fibula at the tibiofibular joint. These require a high degree of stability which is determined by the passive and dynamic factors. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. Conventionally, X-ray techniques have been used to diagnose ligament injuries. Magnetic resonance (MR imaging has opened new horizons in the diagnosis and treatment of many musculoskeletal diseases of the ankle and foot. It demonstrates abnormalities in the bones and soft tissues before they become evident at other imaging modalities. The anatomy of the deltoid ligament

Temporal and extra-temporal hypoperfusion in medial temporal lobe epilepsy evaluated by arterial-spin-labeling based MRI

International Nuclear Information System (INIS)

Shen Lianfang; Zhang Zhiqiang; Lu Guangming; Yuan Cuiping; Wang Zhengge; Wang Haoxue; Huang Wei; Wei Fangyuan; Chen Guanghui; Tan Qifu

2012-01-01

Objective: To evaluate the feasibility of the lateralization of unilateral medial temporal lobe epilepsy (mTLE) by using arterial-spin-labeling (ASL) based perfusion MR imaging and investigate the changes of perfusion in the regions related to mTLE network and the relationship between the perfusion and the clinical status. Methods: Twenty-five patients with left-sided and 23 with right-sided mTLE were enrolled, and 30 healthy volunteers were recruited. The cerebral blood flow (CBF) of related region was measured based on pulsed-ASL sequence on Siemens 3 T scanner. The CBF of the mTLE group were compared with that in the controls by using ANOVA analysis. The asymmetric indices of CBF in the medial temporal lobe were calculated as the lesion side compared with the normal side in matched region in mTLE group. Results: Compared with the volunteers, the patients with mTLE showed the decrease of CBF in the bilateral medial and lateral temporal, the frontal and parietal regions relating to the default-mode network and more serious in lesion side. The CBF values of the medial temporal lobe were negatively correlated with the epilepsy duration (r=-0.51, P<0.01). The asymmetric index of CBF as-0.01 has a 76.0% (19/25) sensitivity and a 78.3% (18/23) specificity to distinguish the lesion side. Conclusions: The decrease of CBF in the temporal and extra-temporal region by ASL-based MRI suggests the functional abnormalities in the network involved by mTLE. The ASL technique is a useful tool for lateralizing the unilateral mTLE. (authors)

[Effects of stimulation of dorso-medial area of nucleus facialis on respiration related units in ventro-lateral region of nucleus tractus solitaris in rabbits].

Science.gov (United States)

Gao, J X; Liu, L

1990-10-01

In urethane-anesthetized, vagotomized and paralyzed rabbits, effects of electrical stimulation of the dorso-medial area of the nucleus facialis (DMNF) on the respiration-related units (RRUs) in ventro-lateral region of nucleus tractus solitaris (VLNTS) were observed. The experimental results showed that during electrical stimulation of DMNF the majority of the inspiratory (I) neurons (64.4%) were increased in frequency and duration of discharge, some to a marked extent. During electrical stimulation of DMNF the expiratory neurons (35%) were decreased in their frequency and duration of discharge, some to a marked extent too. The responses of RRUs in ipsilateral and contralateral VLNTS to stimulation of DMNF was not statistically significant (P greater than 0.05). It is suggested that DMNF may have a facilitating effect on the inspiratory neurons and an inhibiting effect on the expiratory neurons in VLNTS.

Lateralization of eye use in cuttlefish: opposite direction for anti-predatory and predatory behaviors.

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Alexandra Kerstin Schnell

2016-12-01

Full Text Available Vertebrates with laterally placed eyes typically exhibit preferential eye use for ecological activities such as scanning for predators or prey. Processing visual information predominately through the left or right visual field has been associated with specialized function of the left and right brain. Lateralized vertebrates often share a general pattern of lateralized brain function at the population level, whereby the left hemisphere controls routine behaviors and the right hemisphere controls emergency responses. Recent studies have shown evidence of preferential eye use in some invertebrates, but whether the visual fields are predominately associated with specific ecological activities remains untested. We used the European common cuttlefish, Sepia officinalis, to investigate whether the visual field they use is the same, or different, during anti-predatory and predatory behavior. To test for lateralization of anti-predatory behavior, individual cuttlefish were placed in a new environment with opaque walls, thereby obliging them to choose which eye to orient away from the opaque wall to scan for potential predators (i.e. vigilant scanning. To test for lateralization of predatory behavior, individual cuttlefish were placed in the apex of an isosceles triangular arena and presented with two shrimp in opposite vertexes, thus requiring the cuttlefish to choose between attacking a prey item to the left or to the right of them. Cuttlefish were significantly more likely to favor the left visual field to scan for potential predators and the right visual field for prey attack. Moreover, individual cuttlefish that were leftward directed for vigilant scanning were predominately rightward directed for prey attack. Lateralized individuals also showed faster decision-making when presented with prey simultaneously. Cuttlefish appear to have opposite directions of lateralization for anti-predatory and predatory behavior, suggesting that there is functional

Lateralization of Eye Use in Cuttlefish: Opposite Direction for Anti-Predatory and Predatory Behaviors.

Science.gov (United States)

Schnell, Alexandra K; Hanlon, Roger T; Benkada, Aïcha; Jozet-Alves, Christelle

2016-01-01

Vertebrates with laterally placed eyes typically exhibit preferential eye use for ecological activities such as scanning for predators or prey. Processing visual information predominately through the left or right visual field has been associated with specialized function of the left and right brain. Lateralized vertebrates often share a general pattern of lateralized brain function at the population level, whereby the left hemisphere controls routine behaviors and the right hemisphere controls emergency responses. Recent studies have shown evidence of preferential eye use in some invertebrates, but whether the visual fields are predominately associated with specific ecological activities remains untested. We used the European common cuttlefish, Sepia officinalis , to investigate whether the visual field they use is the same, or different, during anti-predatory, and predatory behavior. To test for lateralization of anti-predatory behavior, individual cuttlefish were placed in a new environment with opaque walls, thereby obliging them to choose which eye to orient away from the opaque wall to scan for potential predators (i.e., vigilant scanning). To test for lateralization of predatory behavior, individual cuttlefish were placed in the apex of an isosceles triangular arena and presented with two shrimp in opposite vertexes, thus requiring the cuttlefish to choose between attacking a prey item to the left or to the right of them. Cuttlefish were significantly more likely to favor the left visual field to scan for potential predators and the right visual field for prey attack. Moreover, individual cuttlefish that were leftward directed for vigilant scanning were predominately rightward directed for prey attack. Lateralized individuals also showed faster decision-making when presented with prey simultaneously. Cuttlefish appear to have opposite directions of lateralization for anti-predatory and predatory behavior, suggesting that there is functional specialization of

THC alters alters morphology of neurons in medial prefrontal cortex, orbital prefrontal cortex, and nucleus accumbens and alters the ability of later experience to promote structural plasticity.

Science.gov (United States)

Kolb, Bryan; Li, Yilin; Robinson, Terry; Parker, Linda A

2018-03-01

Psychoactive drugs have the ability to alter the morphology of neuronal dendrites and spines and to influence later experience-dependent structural plasticity. If rats are given repeated injections of psychomotor stimulants (amphetamine, cocaine, nicotine) prior to being placed in complex environments, the drug experience interferes with the ability of the environment to increase dendritic arborization and spine density. Repeated exposure to Delta 9-Tetrahydrocannabinol (THC) changes the morphology of dendrites in medial prefrontal cortex (mPFC) and nucleus accumbens (NAcc). To determine if drugs other than psychomotor stimulants will also interfere with later experience-dependent structural plasticity we gave Long-Evans rats THC (0.5 mg/kg) or saline for 11 days before placing them in complex environments or standard laboratory caging for 90 days. Brains were subsequently processed for Golgi-Cox staining and analysis of dendritic morphology and spine density mPFC, orbital frontal cortex (OFC), and NAcc. THC altered both dendritic arborization and spine density in all three regions, and, like psychomotor stimulants, THC influenced the effect of later experience in complex environments to shape the structure of neurons in these three regions. We conclude that THC may therefore contribute to persistent behavioral and cognitive deficits associated with prolonged use of the drug. © 2017 Wiley Periodicals, Inc.

qcML

DEFF Research Database (Denmark)

Walzer, Mathias; Pernas, Lucia Espona; Nasso, Sara

2014-01-01

provide tools for the calculation of a wide range of quality metrics as well as a database format and interconversion tools, so that existing LIMS systems can easily add relational storage of the quality control data to their existing schema. We here describe the qcML specification, along with possible...... use cases and an illustrative example of the subsequent analysis possibilities. All information about qcML is available at http://code.google.com/p/qcml....

Anchor proximal migration in the medial patellofemoral ligament reconstruction in skeletally immature patients

Directory of Open Access Journals (Sweden)

Fabiano Kupczik

2013-09-01

Full Text Available The medial patellofemoral ligament (MPFL injury has been considered instrumental in lateral patellar instability after patellar dislocation. Consequently, the focus on the study of this ligament reconstruction has increased in recent years. The MPFL femoral anatomical origin point has great importance at the moment of reconstruction surgery, because a graft fixation in a non anatomical position may result in medial overload, medial subluxation of the patella or excessive tensioning of the graft with subsequent failure. In the pediatric population, the location of this point is highlighted by the presence of femoral physis. The literature is still controversial regarding the best placement of the graft. We describe two cases of skeletally immature patients in whom LPFM reconstruction was performed. The femoral fixation was through anchors that were placed above the physis. With the growth and development of the patients, the femoral origin point of the graft moved proximally, resulting in failure in these two cases.

Custom-Made Foot Orthoses Decrease Medial Foot Loading During Drop Jump in Individuals With Patellofemoral Pain

DEFF Research Database (Denmark)

Rathleff, Michael S; Richter, Camilla; Brushøj, Christoffer

2016-01-01

OBJECTIVE: To investigate the effect of foot orthoses on medial-to-lateral plantar forces during drop jump and single leg squat, and second, to explore the self-reported change in symptoms after 12 weeks of wearing the orthoses in individuals with patellofemoral pain (PFP). DESIGN: Cohort study...... with 12 weeks of follow-up. SETTING: Hospital setting. PARTICIPANTS: 23 adults with PFP. INTERVENTIONS: Custom-made foot orthoses. MAIN OUTCOME MEASURES: Foot loading (plantar pressure) was collected from the most painful side during drop jump and single leg squat using pressure sensitive Pedar insoles....... Primary outcome was the medial-to-lateral peak force under the forefoot during drop jump. The PFP syndrome severity score was used to measure self-reported improvement from baseline to follow-up. RESULTS: Orthoses were associated with a significant 2.9%-point (95% confidence intervals: 0.7-5.1) reduction...

SPHENOID SINUS (SS ANTERIOR MEDIAL TEMPORAL LOBE ENCEPHALOCELE (AMTLE WITH SPONTANEOUS CSF RHINORRHOEA : A CASE REPORT

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Laveena

2015-09-01

Full Text Available Cranial encephaloceles are the herniation of intracranial meninges and brain tissue through a defect in the cranium or skull base. These are rare conditions with an incidence of approximately 1 in 35,000 people, and are more common in the anterior cranial fossa than those in the middle one . 1,2 Temporal lobe herniation through a mid dle fossa defect into the lateral recess of the Sphenoid Sinus is even rarer than its medial representation. Intrasphenoidal encephaloceles are extremely rare findings 3 . Spontaneous, or primary, CSF fistula is a separate entity with no underlying cause of the CSF leak. Spontaneous CSF leaks are usually associated with a co - existing encephalocele of variable size 4 . We present a case of spontaneous CSF rhinorrhoea in a sphenoid sinus Anterior Medial Temporal lobe encephalocele herniating through a clinically silent lateral Craniopharyngeal canal.

The lateral-directional characteristics of a 74-degree Delta wing employing gothic planform vortex flaps

Science.gov (United States)

Grantz, A. C.

1984-01-01

The low speed lateral/directional characteristics of a generic 74 degree delta wing body configuration employing the latest generation, gothic planform vortex flaps was determined. Longitudinal effects are also presented. The data are compared with theoretical estimates from VORSTAB, an extension of the Quasi vortex lattice Method of Lan which empirically accounts for vortex breakdown effects in the calculation of longitudinal and lateral/directional aerodynamic characteristics. It is indicated that leading edge deflections of 30 and 40 degrees reduce the magnitude of the wing effective dihedral relative to the baseline for a specified angle of attack or lift coefficient. For angles of attack greater than 15 degrees, these flap deflections reduce the configuration directional stability despite improved vertical tail effectiveness. It is shown that asymmetric leading edge deflections are inferior to conventional ailerons in generating rolling moments. VORSTAB calculations provide coarse lateral/directional estimates at low to moderate angles of attack. The theory does not account for vortex flow induced, vertical tail effects.

Medial Condyle Fracture (Kilfoyle Type III of the Distal Humerus with Transient Fishtail Deformity after Surgery

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Motoki Sonohata

2017-01-01

Full Text Available A “Fishtail deformity” is one of the well-known complications following pediatric lateral condyle or supracondylar fractures of the humerus. We herein report a case of medial condyle fracture (Kilfoyle type III in an 11-year-old boy. He had a transient “fishtail deformity” of the trochlear groove after open reduction and internal fixation. As occurred in the current case, the bone remodeling and the improvement of ischemia of the trochlea after medial condyle fracture may be associated with the likelihood of recovery from transient “fishtail deformity.”

Fragmented medial coronoid process

International Nuclear Information System (INIS)

Juhasz, Cs.; Juhasz, T.

1997-01-01

Fragmented medial coronoid process: (FCP) is often considered to be part of the osteochondrosis dissecans complex, but trauma and growth discrepancies between the radius and ulna are proposed as causes. There is little to clinically differentiate FCP, from osteochondrosis dissecans (OCD) of the elbow. Pain on, flexion-extension of the elbow and lateral rotation of the paw is a little more consistent in FCP. Radiographic examination of the elbow is important despite the, fact that radiographic signs of the FCP are often nonspecific. Excessive osteoarthrosis and superimposition of the radial head and coronoid process make identification of the FCP difficult. Craniocaudal, flexed mediolateral and 25 degree craniocaudal-lateromedial views are necessary for diagnosis. Osteophyte production is more dramatic with FCP than with OCD and suggests therefore the occurrence of OCP in many cases. Although the detached process may be seen on any view, the oblique projection offers the least obstructed view. Exposure of the joint is identical to that for OCD, that means a medial approach with osteotomy of the epicondyle. In most cases the process is loose enough to be readily apparent, but in some it is necessary to exert force on the process in order to find the cleavage plane. It is necessary to remove the osteophytes as well and to inspect and irrigate the joint carefully to remove cartilage fragments before closure. Confinement is advisable for 4 weeks before returning the dog to normal activity. The outlook for function is good if the FCP is removed before secondary degenerative joint disease is well established

Growth of InP directly on Si by corrugated epitaxial lateral overgrowth

International Nuclear Information System (INIS)

Metaferia, Wondwosen; Kataria, Himanshu; Sun, Yan-Ting; Lourdudoss, Sebastian

2015-01-01

In an attempt to achieve an InP–Si heterointerface, a new and generic method, the corrugated epitaxial lateral overgrowth (CELOG) technique in a hydride vapor phase epitaxy reactor, was studied. An InP seed layer on Si (0 0 1) was patterned into closely spaced etched mesa stripes, revealing the Si surface in between them. The surface with the mesa stripes resembles a corrugated surface. The top and sidewalls of the mesa stripes were then covered by a SiO 2 mask after which the line openings on top of the mesa stripes were patterned. Growth of InP was performed on this corrugated surface. It is shown that growth of InP emerges selectively from the openings and not on the exposed silicon surface, but gradually spreads laterally to create a direct interface with the silicon, hence the name CELOG. We study the growth behavior using growth parameters. The lateral growth is bounded by high index boundary planes of {3 3 1} and {2 1 1}. The atomic arrangement of these planes, crystallographic orientation dependent dopant incorporation and gas phase supersaturation are shown to affect the extent of lateral growth. A lateral to vertical growth rate ratio as large as 3.6 is achieved. X-ray diffraction studies confirm substantial crystalline quality improvement of the CELOG InP compared to the InP seed layer. Transmission electron microscopy studies reveal the formation of a direct InP–Si heterointerface by CELOG without threading dislocations. While CELOG is shown to avoid dislocations that could arise due to the large lattice mismatch (8%) between InP and Si, staking faults could be seen in the layer. These are probably created by the surface roughness of the Si surface or SiO 2 mask which in turn would have been a consequence of the initial process treatments. The direct InP–Si heterointerface can find applications in high efficiency and cost-effective Si based III–V semiconductor multijunction solar cells and optoelectronics integration. (paper)

99mTc-HMPAO SPECT in dementia of the Alzheimer type. Hypoperfusion in the medial temporal region

International Nuclear Information System (INIS)

Nakamura, Yu; Kawakatsu, Shinobu; Shinohara, Masao; Nadaoka, Toshihide; Totsuka, Shiro; Komatani, Akio

1995-01-01

This study examined regional cerebral blood flow (rCBF) by single photon emission computed tomography (SPECT) using technetium 99m-hexamethyl-propyleneamineoxime and correlated the results with neuropsychological findings in 30 patients with dementia of the Alzheimer type (AT dementia). Ten healthy persons served as controls. The group of mild AT dementia exhibited a significant decrease in rCBF in the lower part of the right lateral frontal lobe and in the right parietal lobe. In the group of moderate AT dementia, the significant decrease in rCBF was noted in the lower part of the bilateral frontal lobes, the parietal part of the temporal lobe, the parietal lobe, and the medial temporal lobe. Factor analysis for neuropsychological test revealed three factors involved in rCBF. There was a significantly positive correlation between the factor responsible for memory and recall and rCBF in the left frontal lobe, the anterior part of the lateral temporal lobe, and the medial temporal lobe. These findings suggested that disturbance of the memory circuit may exist in the medial temporal lobe and others as pathophysiology of AT dementia. (N.K.)

The relationship between chondromalacia patella, medial meniscal tear and medial periarticular bursitis in patients with osteoarthritis

Directory of Open Access Journals (Sweden)

Resorlu Mustafa

2017-11-01

Full Text Available This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa in osteoarthritis, chondromalacia patella and medial meniscal tears.

Comparison of the insertion of the posterior horn of the lateral meniscus: discoid versus non-discoid.

Science.gov (United States)

Choi, Nam-Hong; Yang, Bong-Seok; Lee, Sang-Young; Lee, Chae-Chul; Lee, Chang-Yk; Victoroff, Brian N

2017-02-01

The purpose of this study was to compare the insertion sites of the posterior horn between discoid and non-discoid lateral meniscus using magnetic resonance imaging (MRI). Two hundred and twenty-seven patients who had MRI scans before surgery and underwent arthroscopy were enroled in this study. A coronal view showing the narrowest width of the midbody of the lateral meniscus was chosen to measure the widths of the entire tibial plateau and the midbody of the lateral meniscus. Considering the ratio of the meniscal width to the tibial plateau width, the patients were divided into non-discoid, incomplete discoid, and complete discoid groups. On a coronal view accurately showing the insertion of the posterior horn of the lateral meniscus, a distance between the peak of the lateral tibial eminence and the centre of the insertion of the posterior horn, and a width of the lateral tibial plateau between the lateral edge of the tibial plateau and the peak of the lateral tibial eminence were measured. The insertion centre of the posterior horn was located more medially in the incomplete and complete discoid groups than in the non-discoid group (p = 0.003, 0.010, respectively). When individual differences in the knee size were corrected, the insertion centre of the posterior horn in the incomplete discoid and complete discoid groups was located more medially than in the non-discoid group (p = 0.009, 0.003, respectively). The insertion centre of the posterior horn of the lateral meniscus is located more medially to the apex of the lateral tibial eminence in the discoid group than in the non-discoid group. This finding needs to be considered for an accurate position of the posterior horn of lateral meniscus during the lateral meniscal allograft transplantation. IV.

Impacts and limitations of medialization thyroplasty on swallowing function of patients with unilateral vocal fold paralysis.

Science.gov (United States)

Tateya, Ichiro; Hirano, Shigeru; Kishimoto, Yo; Suehiro, Atsushi; Kojima, Tsuyohi; Ohno, Satoshi; Ito, Juichi

2010-11-01

Medialization thyroplasty was effective in improving swallowing function as well as vocal function in most cases with unilateral vocal fold paralysis. The impact of medialization thryoplasty was insufficient for the case with severe atrophy and that in which the vocal fold was fixed in the lateral position. To evaluate the impacts and limitations of medialization thyroplasty on swallowing function of the patients with unilateral vocal fold paralysis. Eight cases (mean age 68.5 years) with unilateral vocal fold paralysis chiefly complaining of swallowing disturbance were studied. All patients underwent thyroplasty type I. The causes of the paralysis were lung cancer in four cases, esophageal cancer in one case, aortic aneurysm in one case, subarachnoid hemorrhage in one case, and unknown in one case. Subjective swallowing function score, maximum phonation time (MPT), mean flow rate (MFR), amplitude perturbation quotient (APQ), and pitch perturbation quotient (PPQ) were examined pre- and postoperatively. The swallowing score improved in all except two cases. However, bilateral thryoplasty was necessary for the case with severe vocal fold atrophy and arytenoid adduction was needed for the case in which the vocal fold was fixed in the lateral position. The swallowing score, MPT, and MFR showed significant improvement after surgery.

Effects of supine, prone, and lateral positions on cardiovascular and renal variables in humans

DEFF Research Database (Denmark)

Pump, Bettina; Talleruphuus, Ulrik; Christensen, Niels Juel

2002-01-01

The hypothesis was tested that changing the direction of the transverse gravitational stress in horizontal humans modulates cardiovascular and renal variables. On different study days, 14 healthy males were placed for 6 h in either the horizontal supine or prone position following 3 h of being...... supine. Eight of the subjects were in addition investigated in the horizontal left lateral position. Compared with supine, the prone position slightly increased free water clearance (349 +/- 38 vs. 447 +/- 39 ml/6 h, P = 0.05) and urine output (1,387 +/- 55 vs. 1,533 +/- 52 ml/6 h, P = 0...

High-Alpha Research Vehicle Lateral-Directional Control Law Description, Analyses, and Simulation Results

Science.gov (United States)

Davidson, John B.; Murphy, Patrick C.; Lallman, Frederick J.; Hoffler, Keith D.; Bacon, Barton J.

1998-01-01

This report contains a description of a lateral-directional control law designed for the NASA High-Alpha Research Vehicle (HARV). The HARV is a F/A-18 aircraft modified to include a research flight computer, spin chute, and thrust-vectoring in the pitch and yaw axes. Two separate design tools, CRAFT and Pseudo Controls, were integrated to synthesize the lateral-directional control law. This report contains a description of the lateral-directional control law, analyses, and nonlinear simulation (batch and piloted) results. Linear analysis results include closed-loop eigenvalues, stability margins, robustness to changes in various plant parameters, and servo-elastic frequency responses. Step time responses from nonlinear batch simulation are presented and compared to design guidelines. Piloted simulation task scenarios, task guidelines, and pilot subjective ratings for the various maneuvers are discussed. Linear analysis shows that the control law meets the stability margin guidelines and is robust to stability and control parameter changes. Nonlinear batch simulation analysis shows the control law exhibits good performance and meets most of the design guidelines over the entire range of angle-of-attack. This control law (designated NASA-1A) was flight tested during the Summer of 1994 at NASA Dryden Flight Research Center.

Irreducible lateral dislocation of the elbow.

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Chhaparwal M

1997-01-01

Full Text Available A rare case of an irreducible post-traumatic lateral dislocation of elbow is presented. The mechanism of injury was fall on a flexed elbow with trauma on its medial aspect resulting in pronation of the forearm. At open reduction, the brachialis muscle was in the form of a tight band which prevented reduction. The ulnar nerve was entrapped in the joint.

Twenty-degree-tilt radiography for evaluation of lateral humeral condylar fracture in children

International Nuclear Information System (INIS)

Imada, Hideaki; Tanaka, Ryuji; Itoh, Yohei; Kishi, Kazuhiko

2010-01-01

To investigate the efficacy of '20 -tilt anteroposterior (A-P) radiography' in the assessment of lateral condylar fractures of the distal humerus. Eighteen children with lateral humeral condylar fractures were studied. Every child underwent conventional A-P and lateral radiography, and six children underwent multi-detector computed tomography (MDCT). For the investigation of 20 -tilt radiography, ten children with lateral humeral condylar fractures had conventional and 20 -tilt A-P and lateral radiography both preoperatively and postoperatively. Fragment dislocation was measured at the lateral and medial margins of the fracture on both the conventional A-P and 20 -tilt A-P radiographs. The lateral condylar fragment was triangular and was most prominent posteriorly. The fracture line was typically tilted approximately 20 to a reference line perpendicular to the long axis of the humerus in the lateral view. The extent of dislocation at the lateral and medial margins of the fracture site by 20 -tilt A-P radiography (9.3 ± 3.6 mm and 5.6 ± 2.5 mm) was significantly wider than that measured by the conventional method (6.8 ± 4.1 mm and 2.0 ± 1.5 mm), which may influence treatment. Twenty-degree-tilt A-P radiography may more precisely demonstrate fragment dislocation than standard radiographs and may influence patient treatment. (orig.)

Traumatic posterior root tear of the medial meniscus in patients with severe medial instability of the knee.

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Ra, Ho Jong; Ha, Jeong Ku; Jang, Ho Su; Kim, Jin Goo

2015-10-01

To examine the incidence and diagnostic rate of traumatic medial meniscus posterior root tear associated with severe medial instability and to evaluate the effectiveness of pullout repair. From 2007 to 2011, 51 patients who underwent operation due to multiple ligament injuries including medial collateral ligament rupture were reviewed retrospectively. The International Knee Documentation Committee (IKDC) subjective and Lysholm score were evaluated pre- and postoperatively. Postoperative magnetic resonance imaging (MRI) was performed, and if indicated, a second-look arthroscopic examination was conducted. Fourteen out of 51 patients were associated with severe medial instability. Seven patients were diagnosed with traumatic medial meniscus posterior root tear and underwent arthroscopic pullout repair. Five of them were missed at initial diagnosis using MRI. In seven patients, the mean Lysholm and IKDC subjective scores improved from 74.6 ± 10.3 and 47.6 ± 7.3 to 93.0 ± 3.7 and 91.6 ± 2.6, respectively. All showed complete healing of meniscus root on follow-up MRI and second-look arthroscopy. Medial meniscus posterior root tear may occur in severe medial instability from trauma. It is a common mistake that surgeons may not notice on the diagnosis of those injuries using MRI. Therefore, a high index of suspicion is required for the diagnosis of medial meniscus posterior root tear in this type of injuries. The traumatic medial meniscus posterior root tear could be healed successfully using arthroscopic pullout repair technique. The possibility of the medial meniscus posterior root tear should be considered in severe medial instability and arthroscopic pullout repair can be an effective option for treatment. Case series with no comparison group, Level IV.

Modulating Phonation Through Alteration of Vocal Fold Medial Surface Contour

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Mau, Ted; Muhlestein, Joseph; Callahan, Sean; Chan, Roger W.

2012-01-01

Objectives 1. To test whether alteration of the vocal fold medial surface contour can improve phonation. 2. To demonstrate that implant material properties affect vibration even when implant is deep to the vocal fold lamina propria. Study Design Induced phonation of excised human larynges. Methods Thirteen larynges were harvested within 24 hours post-mortem. Phonation threshold pressure (PTP) and flow (PTF) were measured before and after vocal fold injections using either calcium hydroxylapatite (CaHA) or hyaluronic acid (HA). Small-volume injections (median 0.0625 mL) were targeted to the infero-medial aspect of the thyroarytenoid (TA) muscle. Implant locations were assessed histologically. Results The effect of implantation on PTP was material-dependent. CaHA tended to increase PTP, whereas HA tended to decrease PTP (Wilcoxon test P = 0.00013 for onset). In contrast, the effect of implantation on PTF was similar, with both materials tending to decrease PTF (P = 0.16 for onset). Histology confirmed implant presence in the inferior half of the vocal fold vertical thickness. Conclusions Taken together, these data suggested the implants may have altered the vocal fold medial surface contour, potentially resulting in a less convergent or more rectangular glottal geometry as a means to improve phonation. An implant with a closer viscoelastic match to vocal fold cover is desirable for this purpose, as material properties can affect vibration even when the implant is not placed within the lamina propria. This result is consistent with theoretical predictions and implies greater need for surgical precision in implant placement and care in material selection. PMID:22865592

[Lateral column lengthening osteotomy of calcaneus].

Science.gov (United States)

Hintermann, B

2015-08-01

Lengthening of the lateral column for adduction of forefoot and restoration of the medial arch. Stabilization of the ankle joint complex. Supple flatfoot deformity (posterior tibial tendon dysfunction stage II). Instability of the medial ankle joint complex (superficial deltoid and spring ligament). Posttraumatic valgus and pronation deformity of the foot. Rigid flatfoot deformity (posterior tibial tendon dysfunction stage III and IV). Talocalcaneal and naviculocalcaneal coalition. Osteoarthritis of calcaneocuboid joint. Exposition of calcaneus at sinus tarsi. Osteotomy through sinus tarsi and widening until desired correction of the foot is achieved. Insertion of bone graft. Screw fixation. Immobilization in a cast for 6 weeks. Weight-bearing as tolerated from the beginning. In the majority of cases, part of hindfoot reconstruction. Reliable and stable correction. Safe procedure with few complications.

Arthroscopic partial medial meniscectomy

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Dašić Žarko

2011-01-01

Full Text Available Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62% vertical complete bucket handle lesions, 19 (8.92% vertical incomplete lesions, 18 (8.45% longitudinal tears, 35 (16.43% oblique tears, 18 (8.45% complex degenerative lesions, 17 (7.98% radial lesions and 28 (13.14% horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49% of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57% patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93% patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.

Association of medial meniscal extrusion with medial tibial osteophyte distance detected by T2 mapping MRI in patients with early-stage knee osteoarthritis.

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Hada, Shinnosuke; Ishijima, Muneaki; Kaneko, Haruka; Kinoshita, Mayuko; Liu, Lizu; Sadatsuki, Ryo; Futami, Ippei; Yusup, Anwajan; Takamura, Tomohiro; Arita, Hitoshi; Shiozawa, Jun; Aoki, Takako; Takazawa, Yuji; Ikeda, Hiroshi; Aoki, Shigeki; Kurosawa, Hisashi; Okada, Yasunori; Kaneko, Kazuo

2017-09-12

Medial meniscal extrusion (MME) is associated with progression of medial knee osteoarthritis (OA), but no or little information is available for relationships between MME and osteophytes, which are found in cartilage and bone parts. Because of the limitation in detectability of the cartilage part of osteophytes by radiography or conventional magnetic resonance imaging (MRI), the rate of development and size of osteophytes appear to have been underestimated. Because T2 mapping MRI may enable us to evaluate the cartilage part of osteophytes, we aimed to examine the association between MME and OA-related changes, including osteophytes, by using conventional and T2 mapping MRI. Patients with early-stage knee OA (n = 50) were examined. MRI-detected OA-related changes, in addition to MME, were evaluated according to the Whole-Organ Magnetic Resonance Imaging Score. T2 values of the medial meniscus and osteophytes were measured on T2 mapping images. Osteophytes surgically removed from patients with end-stage knee OA were histologically analyzed and compared with findings derived by radiography and MRI. Medial side osteophytes were detected by T2 mapping MRI in 98% of patients with early-stage knee OA, although the detection rate was 48% by conventional MRI and 40% by radiography. Among the OA-related changes, medial tibial osteophyte distance was most closely associated with MME, as determined by multiple logistic regression analysis, in the patients with early-stage knee OA (β = 0.711, p T2 values of the medial meniscus were directly correlated with MME in patients with early-stage knee OA, who showed ≥ 3 mm of MME (r = 0.58, p = 0.003). The accuracy of osteophyte evaluation by T2 mapping MRI was confirmed by histological analysis of the osteophytes removed from patients with end-stage knee OA. Our study demonstrates that medial tibial osteophyte evaluated by T2 mapping MRI is frequently observed in the patients with early-stage knee OA, showing

Evaluation of medial patellofemoral ligament tears after acute lateral patellar dislocation: comparison of high-frequency ultrasound and MR

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Zhang, Guang-Ying; Ding, Hong-Yu [Shandong University, Department of Ultrasonography, Qianfoshan Hospital, Jinan (China); Zheng, Lei; Sun, Bai-Sheng [Chinese People' s Armed Police Force, Department of Radiology, Shandong Provincial Corps Hospital, Jinan (China); Li, En-Miao [Jinan Third People' s Hospital, Department of Ultrasonography, Jinan (China); Shi, Hao [Shandong University, Department of Radiology, Qianfoshan Hospital, Jinan (China)

2015-01-15

The purpose of this study was to compare the diagnostic performance of high-frequency ultrasound with MR in the evaluation of medial patellofemoral ligament (MPFL) lesions after acute lateral patellar dislocation (LPD). High-frequency ultrasound and MR images were prospectively obtained in 97 consecutive patients with acute LPD. Images were acquired using standardised protocols and were independently evaluated by two radiologists. The MPFL was assessed at three sites (patellar insertion, femoral attachment, and mid-substance) for signs of injury. Of a total of 291 sites in 97 MPFLs, 127 showed proven MPFL tear at surgery, including 51 sites of complete tear and 76 sites of partial tear. In a site-based analysis, the sensitivity, specificity, and accuracy of high-frequency ultrasound was 90.8 %, 96.3 %, and 94.6 %, respectively, for partial MPFL tear and 86.3 %, 96.3 %, and 94 %, respectively, for complete tear. For MR, the sensitivity, specificity, and accuracy was 81.6 %, 95.7 %, and 91.3 %, respectively, for partial MPFL tear and 80.4 %, 95.7 %, and 92.1 %, respectively, for complete tear. There was no statistical difference between high-frequency ultrasound and MR in the assessment of partial (P = 0.1, 0.777, 0.155) or complete (P = 0.425, 0.777, 0.449) MPFL lesions. Interobserver agreement was very good for high-frequency ultrasound and good for MR. Data suggest that high-frequency ultrasound and MR have similar diagnostic performance in the evaluation of MPFL lesions after acute LPD. (orig.)

Central projections of gustatory receptor neurons in the medial and the lateral sensilla styloconica of Helicoverpa armigera larvae.

Directory of Open Access Journals (Sweden)

Qing-Bo Tang

Full Text Available Food selection behavior of lepidopteran larvae is predominantly governed by the activation of taste neurons present in two sensilla styloconica located on the galea of the maxilla. In this study, we present the ultrastructure of the sensilla styloconica and the central projection pattern of their associated receptor neurons in larvae of the heliothine moth, Helicoverpa armigera. By means of light microscopy and scanning electron microscopy, the previous findings of two morphologically fairly similar sensilla comprising a socketed conic tip inserted into a large peg were confirmed. However, the peg size of the medial sensillum was found to be significantly bigger than that of the lateral sensillum. The sensory neurons derived from each sensillum styloconicum were mapped separately using anterograde staining experiments combined with confocal laser-scanning microscopy. For determining the afferents' target regions relative to each other, we reconstructed the labeled axons and placed them into a common reference framework. The sensory axons from both sensilla projected via the ipsilateral maxillary nerve to the suboesophageal ganglion and further through the ipsilateral circumoesophageal connective to the brain. In the suboesophageal ganglion, the sensory projections targeted two areas of the ipsilateral maxillary neuropil, one located in the ventrolateral neuromere and the other adjacent to the neuromere midline. In the brain, the axon terminals targeted the dorso-anterior area of the ipsilateral tritocerebrum. As confirmed by the three-dimensional reconstructions, the target regions of the neural projections originating from each of the two sensilla styloconica were identical.

Central projections of gustatory receptor neurons in the medial and the lateral sensilla styloconica of Helicoverpa armigera larvae.

Science.gov (United States)

Tang, Qing-Bo; Zhan, Huan; Cao, Huan; Berg, Bente G; Yan, Feng-Ming; Zhao, Xin-Cheng

2014-01-01

Food selection behavior of lepidopteran larvae is predominantly governed by the activation of taste neurons present in two sensilla styloconica located on the galea of the maxilla. In this study, we present the ultrastructure of the sensilla styloconica and the central projection pattern of their associated receptor neurons in larvae of the heliothine moth, Helicoverpa armigera. By means of light microscopy and scanning electron microscopy, the previous findings of two morphologically fairly similar sensilla comprising a socketed conic tip inserted into a large peg were confirmed. However, the peg size of the medial sensillum was found to be significantly bigger than that of the lateral sensillum. The sensory neurons derived from each sensillum styloconicum were mapped separately using anterograde staining experiments combined with confocal laser-scanning microscopy. For determining the afferents' target regions relative to each other, we reconstructed the labeled axons and placed them into a common reference framework. The sensory axons from both sensilla projected via the ipsilateral maxillary nerve to the suboesophageal ganglion and further through the ipsilateral circumoesophageal connective to the brain. In the suboesophageal ganglion, the sensory projections targeted two areas of the ipsilateral maxillary neuropil, one located in the ventrolateral neuromere and the other adjacent to the neuromere midline. In the brain, the axon terminals targeted the dorso-anterior area of the ipsilateral tritocerebrum. As confirmed by the three-dimensional reconstructions, the target regions of the neural projections originating from each of the two sensilla styloconica were identical.

Evaluation of medial patellofemoral ligament tears after acute lateral patellar dislocation: comparison of high-frequency ultrasound and MR

International Nuclear Information System (INIS)

Zhang, Guang-Ying; Ding, Hong-Yu; Zheng, Lei; Sun, Bai-Sheng; Li, En-Miao; Shi, Hao

2015-01-01

The purpose of this study was to compare the diagnostic performance of high-frequency ultrasound with MR in the evaluation of medial patellofemoral ligament (MPFL) lesions after acute lateral patellar dislocation (LPD). High-frequency ultrasound and MR images were prospectively obtained in 97 consecutive patients with acute LPD. Images were acquired using standardised protocols and were independently evaluated by two radiologists. The MPFL was assessed at three sites (patellar insertion, femoral attachment, and mid-substance) for signs of injury. Of a total of 291 sites in 97 MPFLs, 127 showed proven MPFL tear at surgery, including 51 sites of complete tear and 76 sites of partial tear. In a site-based analysis, the sensitivity, specificity, and accuracy of high-frequency ultrasound was 90.8 %, 96.3 %, and 94.6 %, respectively, for partial MPFL tear and 86.3 %, 96.3 %, and 94 %, respectively, for complete tear. For MR, the sensitivity, specificity, and accuracy was 81.6 %, 95.7 %, and 91.3 %, respectively, for partial MPFL tear and 80.4 %, 95.7 %, and 92.1 %, respectively, for complete tear. There was no statistical difference between high-frequency ultrasound and MR in the assessment of partial (P = 0.1, 0.777, 0.155) or complete (P = 0.425, 0.777, 0.449) MPFL lesions. Interobserver agreement was very good for high-frequency ultrasound and good for MR. Data suggest that high-frequency ultrasound and MR have similar diagnostic performance in the evaluation of MPFL lesions after acute LPD. (orig.)

Radiographic evaluation of the canine elbow joint with special reference to the medial humeral condyle and the medial coronoid process

International Nuclear Information System (INIS)

Voorhout, G.; Hazewinkel, H.A.W.

1987-01-01

The results of radiographic examination of clinically affected elbow joints in 14 young, large-breed dogs, including standard and oblique projections and linear tomography, were compared with the findings of medial arthrotomy. Radiographs revealed arthrosis (13 dogs), osteochondrosis of the medial humeral condyle (2 dogs), fragmentation of the medial coronoid process (5 dogs), and a combination of osteochondrosis of the medial humeral condyle and fragmentation of the medial coronoid process (2 dogs). In one dog fissures in the medial coronoid process and in another dog a linear radiopacity along the articular surface of the medial coronoid process were found. In three dogs both medial humeral condyle and medial coronoid process appeared normal. The radiographic findings were confirmed during surgery in 11 dogs. Cartilage erosion of the medial humeral condyle in two dogs and of the medial coronoid process in one dog had not resulted in radiographically visible abnormalities. Radiographic examination of the elbow joints in young, large-breed dogs should include standard mediolateral and craniocaudal projections, a mediolateral projection with the joint maximally extended and the leg supinated 15°, and a craniolateral-to-caudomedial projection

Acute Medial Plantar Fascia Tear.

Science.gov (United States)

Pascoe, Stephanie C; Mazzola, Timothy J

2016-06-01

A 32-year-old man who participated in competitive soccer came to physical therapy via direct access for a chief complaint of plantar foot pain. The clinical examination findings and mechanism of injury raised a concern for a plantar fascia tear, so the patient was referred to the physician and magnetic resonance imaging was obtained. The magnetic resonance image confirmed a high-grade, partial-thickness, proximal plantar fascia tear with localized edema at the location of the medial band. J Orthop Sports Phys Ther 2016;46(6):495. doi:10.2519/jospt.2016.0409.

Medial thalamic 18-FDG uptake following inescapable shock correlates with subsequent learned helpless behavior

International Nuclear Information System (INIS)

Mirrione, M.M.; Schulz, D.; Dewey, S.L.; Henn, F.A.

2009-01-01

The learned helplessness paradigm has been repeatedly shown to correlate with neurobiological aspects of depression in humans. In this model, rodents are exposed inescapable foot-shock in order to reveal susceptibility to escape deficit, defined as 'learned helplessness' (LH). Few methods are available to probe the neurobiological aspects underlying the differences in susceptibility in the living animal, thus far being limited to studies examining regional neurochemical changes with microdialysis. With the widespread implementation of small animal neuroimaging methods, including positron emission tomography (PET), it is now possible to explore the living brain on a systems level to define regional changes that may correlate with vulnerability to stress. In this study, 12 wild type Sprague-Dawley rats were exposed to 40 minutes of inescapable foot-shock followed by metabolic imaging using 2-deoxy-2[ 18 F]fluoro-D-glucose (18-FDG) 1 hour later. The escape test was performed on these rats 48 hours later (to accommodate radiotracer decay), where they were given the opportunity to press a lever to shut off the shock. A region of interest (ROI) analysis was used to investigate potential correlations (Pearson Regression Coefficients) between regional 18-FDG uptake following inescapable shock and subsequent learned helpless behavior (time to finish the test; number of successful lever presses within 20 seconds of shock onset). ROI analysis revealed a significant positive correlation between time to finish and 18-FDG uptake, and a negative correlation between lever presses and uptake, in the medial thalamic area (p=0.033, p=0.036). This ROI included the paraventricular thalamus, mediodorsal thalamus, and the habenula. In an effort to account for possible spillover artifact, the posterior thalamic area (including ventral medial and lateral portions) was also evaluated but did not reveal significant correlations (p=0.870, p=0.897). No other significant correlations were found

Management of Medial Collateral Ligament Injury During Primary Total Knee Arthroplasty: A Systematic Review

Directory of Open Access Journals (Sweden)

Paul Della Torre, MD

2014-07-01

Full Text Available Medial collateral ligament injury during primary total knee arthroplasty is a recognised complication potentially resulting in valgus instability, suboptimal patient outcomes and a higher rate of revision or reoperation. Options for management include primary repair with or without augmentation, reconstruction or immediate conversion to prosthesis with greater constraint, in conjunction with various postoperative rehabilitation protocols. Inconsistent recommendations throughout the orthopaedic literature have made the approach to managing this complication problematic. The objective of this study was to review the available literature to date comparing intraoperative and postoperative management options for primary total knee arthroplasty complicated by recognised injury to the medial collateral ligament. This systematic literature review was prospectively registered with PROSPERO (#CRD42014008866 and performed in accordance with PRISMA guidelines including a PRISMA flow diagram. Five articles satisfied the inclusion criteria. Each was a retrospective, observational cohort or case series with small numbers reported, inconsistent methodology and incompletely reported outcomes. Four of the five studies managing medial collateral ligament injury during total knee arthroplasty (47/84 patients with direct repair with or without autograft augmentation reported good outcomes with no revision or reoperation required for symptomatic instability over a follow-up period of 16 months to almost 8 years. The fifth study with a follow-up to 10 years and a high rate of conversion to unlinked semi constrained total knee arthroplasty implant (30/37 patients reported a greater incidence of revision due to instability, in patients in whom the medial collateral ligament injury was directly repaired without added constraint. Overall balance of evidence is in favour of satisfactory outcomes without symptomatic instability following direct repair with or without

Lateral incisor root resorption and active orthodontic treatment in the early mixed dentition.

Science.gov (United States)

Amlani, M S; Inocencio, F; Hatibovic-Kofman, S

2007-12-01

To evaluate the presence of root resorption in the lateral incisor after active orthodontic treatment in the early mixed dentition. Twenty-six children treated at the Children's Clinic of the Schulich School of Medicine and Dentistry at the University of Western Ontario were examined radiographically for lateral incisors root resorption before and after early active treatment to align upper incisors (2 x 4 appliance). In addition, canine inclinations to the midline and to the long axis of the lateral incisor as well as the most medial position of the canine crown were measured as potential risk factors for root resorption. 8% (4) of the lateral incisors exhibited root resorption and the mean crown-to-root ratio of these teeth was significantly higher than that for lateral incisors not exhibiting root resorption. Similarly, mean canine inclinations to the midline and to the long axis of the lateral incisor were also significantly higher for the root resorption group. No association could be found between the most medial position of the canine crown and root resorption in the lateral incisor. This study showed that active orthodontic treatment in the early mixed dentition does not increase the risk for root resorption in the lateral incisors as long as the clinician takes into consideration canine inclinations and their potential effect on root resorption. Limitations inherent to radiographic assessment are acknowledged.

Polymorphic New World monkeys with more than three M/L cone types

Science.gov (United States)

Jacobs, Gerald H.; Deegan, Jess F.

2005-10-01

Most New World (platyrrhine) monkeys have M/L cone photopigment polymorphisms that map directly into individual variations in visual sensitivity and color vision. We used electroretinogram flicker photometry to examine M/L cone photopigments in the New World monkey Callicebus moloch (the dusky Titi). Like other New World monkeys, this species has an M/L cone photopigment polymorphism that reflects the presence of X-chromosome opsin gene alleles. However, unlike other platyrrhines in which three M/L photopigments are typical, Callicebus has a total of five M/L cone photopigments. The peak sensitivity values for these pigments extend across the range from 530 to 562 nm. The result is an enhanced array of potential color vision phenotypes in this species.

Foot medial longitudinal-arch deformation during quiet standing and gait in subjects with medial tibial stress syndrome

DEFF Research Database (Denmark)

Bandholm, Thomas Quaade; Boysen, Lisbeth; Haugaard, Stine

2008-01-01

The objective of this study was to investigate (1) if subjects with medial tibial stress syndrome demonstrate increased navicular drop and medial longitudinal-arch deformation during quiet standing and gait compared with healthy subjects, and (2) the relationship between medial longitudinal-arch ...

Treatment of subtotal medial rectus myectomy complicating functional endoscopic sinus surgery.

Science.gov (United States)

Trotter, W L; Kaw, P; Meyer, D R; Simon, J W

2000-08-01

During the past 2 decades, the introduction of functional endoscopic sinus surgery (FESS) has dramatically improved the treatment of sinus disorders. However, a variety of orbital complications have been reported, including optic nerve damage, hemorrhage, infection, compromise of the lacrimal drainage apparatus, and strabismus. At least 10 cases have reported damage to the medial rectus muscle. (1-8) Treatment options for such patients have been limited, especially because most are adults at risk for anterior segment ischemia after transposition of vertical rectus muscles. We describe 2 patients whose medial rectus myectomies were repaired by using nonabsorbable "hang-back" sutures in combination with a botulinum toxin (Botox) injection of the antagonist lateral rectus muscle. Good primary position alignment was achieved in both patients, and one patient was able to regain binocular function. We recommend this surgical approach, especially in patients at increased risk for anterior segment ischemia.

Medial prefrontal aberrations in major depressive disorder revealed by cytoarchitectonically informed voxel-based morphometry

Science.gov (United States)

Bludau, Sebastian; Bzdok, Danilo; Gruber, Oliver; Kohn, Nils; Riedl, Valentin; Sorg, Christian; Palomero-Gallagher, Nicola; Müller, Veronika I.; Hoffstaedter, Felix; Amunts, Katrin; Eickhoff, Simon B.

2017-01-01

Objective The heterogeneous human frontal pole has been identified as a node in the dysfunctional network of major depressive disorder. The contribution of the medial (socio-affective) versus lateral (cognitive) frontal pole to major depression pathogenesis is currently unclear. The present study performs morphometric comparison of the microstructurally informed subdivisions of human frontal pole between depressed patients and controls using both uni- and multivariate statistics. Methods Multi-site voxel- and region-based morphometric MRI analysis of 73 depressed patients and 73 matched controls without psychiatric history. Frontal pole volume was first compared between depressed patients and controls by subdivision-wise classical morphometric analysis. In a second approach, frontal pole volume was compared by subdivision-naive multivariate searchlight analysis based on support vector machines. Results Subdivision-wise morphometric analysis found a significantly smaller medial frontal pole in depressed patients with a negative correlation of disease severity and duration. Histologically uninformed multivariate voxel-wise statistics provided converging evidence for structural aberrations specific to the microstructurally defined medial area of the frontal pole in depressed patients. Conclusions Across disparate methods, we demonstrated subregion specificity in the left medial frontal pole volume in depressed patients. Indeed, the frontal pole was shown to structurally and functionally connect to other key regions in major depression pathology like the anterior cingulate cortex and the amygdala via the uncinate fasciculus. Present and previous findings consolidate the left medial portion of the frontal pole as particularly altered in major depression. PMID:26621569

The far lateral transpontomedullary sulcus approach to pontine cavernous malformations: technical report and surgical results.

Science.gov (United States)

Abla, Adib A; Benet, Arnau; Lawton, Michael T

2014-09-01

Pontine cavernous malformations (CMs) located on a peripheral pontine surface or the fourth ventricular floor are resectable lesions, but those deep within the pons away from a pial surface are typically observed. However, the anterior bulge of the pons formed by the brachium pontis creates a unique entry point for access to deep pontine lesions from below, working upward through the pontomedullary sulcus. We developed a transpontomedullary sulcus (TPMS) approach to these lesions. The TPMS approach used the far lateral craniotomy and upper vagoaccessory triangle to define the surgical corridor. The entry point was above the olive, lateral to the pyramidal tracts and cranial nerve (CN) VI, above the preolivary sulcus and CN XII, and medial to CNs VII and VIII and CNs IX through XI. Four patients underwent this approach. All presented with hemorrhage and CN VI palsies. All pontine CMs were resected completely. Three patients were improved or unchanged, with good outcomes (modified Rankin Scale score ≤2) in all patients. The central pons remains difficult territory to access, and new surgical corridors are needed. The bulging underbelly of the pons allows access to pontine lesions deep to the pial surface from below. The far lateral TPMS approach is a novel and more direct alternative to the retrosigmoid transmiddle cerebellar peduncle approach. Unlike the retrosigmoid approach, the TPMS approach requires minimal parenchymal transgression and uses a brainstem entry point medial to most lower CNs. Favorable results demonstrate the feasibility of resecting pontine CMs that might have been previously deemed unresectable.

MR imaging of the anatomy of the anterior horn of the medial meniscus.

Science.gov (United States)

De Coninck, Tineke; Vanrietvelde, Frederik; Seynaeve, Patrick; Verdonk, Peter; Verstraete, Koenraad

2017-04-01

Background In cadaveric and arthroscopic studies different insertion locations of the anterior horn of the medial meniscus (AHMM) have been described. Purpose To investigate if the different insertion locations of the AHMM, as described in cadaveric studies, can be determined on magnetic resonance imaging (MRI). Material and Methods MR images of 100 patients without meniscal tears on MRI were retrospectively evaluated. Two observers classified the AHMM insertion based on its position relative to the anterior tibial edge and the medial tibial spine. The association between AHMM insertion and tibial plateau slope, meniscal radial displacement, and anterior intermeniscal ligament (AIL) presence was investigated. Results The AHMM inserted posterior to the anterior tibial edge in 93 knees and anterior to the tibial edge in seven knees (= type III). Of the 93 knees with AHMM insertion posterior to the anterior tibial edge, 63 inserted lateral to the medial tibial spine (= type I) and 30 medial (= type II). The AHMMs inserting anterior to the tibial edge had a significantly ( P  0.05). A strong inter- and intra-observer agreement was observed. Conclusion Three different bony insertion locations of the AHMM, as described in cadaveric studies, could be identified on MRI. All AHMMs inserting anterior to the tibial edge displayed an AIL. Whether there is a clinical correlation with these insertion patterns remains unclear.

Clinical and radiographic features, treatment and outcome in 15 horses with fracture of the medial aspect of the patella

International Nuclear Information System (INIS)

Dyson, S.; Wright, I.; Kold, S.; Vatistas, N.

1992-01-01

A sagittal fracture of the medial aspect of the patella was identified in 15 horses, 2 of which had been kicked and 12 of which had hit a fixed fence while jumping. Eight horses showed concurrent fragmentation of the base of the patella, and 2 had sustained a concurrent fracture of the distal end of the lateral trochlear ridge of the femur. A cranioproximal-craniodistal oblique radiographic view was essential to identify the site of the medial patellar fracture and to determine its configuration. Fourteen horses were treated by surgical removal of the medial patellar fracture fragment(s). Of 12 horses (83%) without evidence of pre-existing degenerative joint disease, 10 were treated successfully with return to full athletic function

Fixator-assisted medial tibial plateau elevation to treat severe Blount's disease: outcomes at maturity.

Science.gov (United States)

Fitoussi, F; Ilharreborde, B; Lefevre, Y; Souchet, P; Presedo, A; Mazda, K; Penneçot, G F

2011-04-01

Severe forms of Blount's disease may be associated with medial tibial plateau (MTP) depression. Management should then take account of joint congruence, laxity, limb axis, torsional abnomality, leg length discrepancy (LLD) and eventual recurrence history. Eight knees (six patients) were managed in a single step comprising MTP elevation osteotomy, lateral epiphysiodesis and proximal tibia osteotomy to correct varus and rotational deformity. Fixation was achieved using an Ilizarov external fixator. Mean age was 10.5 years. Mean hip-knee-ankle (HKA) angle was 151°; distal femoral varus, 94°; metaphyseal-diaphyseal angle (MDA), 27°; and angle of depression of the medial tibial plateau (ADMTP), 42°. Predicted residual proximal tibial growth was 2.6 cm. At a mean 48 months' follow-up, results were good in six cases, medium in one and poor (due to incomplete lateral epiphysiodesis) in one. Mean lateral tibial torsion was 9° and final LLD 11 mm. Weight-bearing was resumed at 2 months, and the fixator was removed at 5.5 months postoperatively. At end of follow-up, mean HKA angle was 179.6°, MDA 7.3° and ADMTP 5.4°. This technically demanding procedure gave satisfactory results in terms of axes and congruence; longer term assessment remains needed. Level IV. Retrospective study. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Medial subtalar dislocation: Case report

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Manojlović Radovan

2010-01-01

Full Text Available Introduction. Subtalar dislocation (SI is a term that refers to an injury in which there is dislocation of the talonavicular and talocalcanear joint, although the tibiotalar joint is intact. Case Outline. A case of medial subtalar dislocation as a result of basketball injury, so-called 'basketball foot', is presented. Closed reposition in i.v. anaesthesia was performed with the patient in supine position and a knee flexed at 90 degrees. Longitudinal manual traction in line of deformity was carried out in plantar flexion. The reposition continued with abduction and eversion simultaneously increasing dorsiflexion. It was made in the first attempt and completed instantly. Rehabilitation was initiated after 5 weeks of immobilization. One year after the injury, the functional outcome was excellent with full range of motion and the patient was symptom-free. For better interpretation of roentgenogram, bone model of subtalar dislocation was made using the cadaver bone. Conclusion. Although the treatment of such injury is usually successful, diagnosis can be difficult because it is a rare injury, and moreover, X-ray of the injury can be confusing due to superposition of bones. Radiograms revealed superposition of the calcaneus, tarsal and metatarsal bones which was radiographically visualized in the anterior-posterior projection as one osseous block inward from the talus, and on the lateral view as in an osteal block below the tibial bone. Prompt recognition of these injuries followed by proper, delicately closed reduction under anaesthesia is crucial for achieving a good functional result in case of medial subtalar dislocation.

White cell labeling: 20 ML VS 4 ML of blood volume-case reports

International Nuclear Information System (INIS)

Imam, S.K.

1998-01-01

Full text: Some times, it becomes difficult to draw 20 mL blood from a patient with bad veins. On two occasions, we could collect only about 4 mL of blood, that too with a great deal of struggle, and then we carried out the routine labelling procedure. A labelling efficiency of 98.2% and 95.6% was achieved. The white cell scan was negative in one patient, but positive in the next one. In a third patient, a comparison of labelling efficiency was done between 5 and 20 mLs of blood volumes separately and the results were found to be identical, 98.5% and 98.4%, respectively. As we have achieved the usual pattern of white cell scan with as low as 4-5 mL of blood, it appears that enough number of white cells is present even in the 4-5 mL of blood that is capable of generating a white cell scan and so, it seems rational to reduce the blood volume from 20 mL to 4 or 5 mL. However, further studies are warranted before adopting this modification. The procedure appears to carry the following advantages: ease of blood collection, handling and re-injection and less risk to the patient

Comparison of the Calcaneal Pitch Angle and Modified Projection Area Per Length Squared Method for Medial Longitudinal Arch Evaluation of the Foot

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Esat Kıter2

2012-12-01

Full Text Available Objective: To compare the calcaneal pitch angle (CPA values measured on direct lateral radiographs of feet, and the modified projection area per length squared (PAL, which was calculated as a new method for the evaluation of the medial longitudinal arch (MLA of the foot.Material and Methods: Direct lateral radiographs of patients who had weightbearing feet radiographies for any reason except trauma were retrospectively obtained from the archives. Direct lateral radiographs of the feet were printed and a transparent sheet was placed on it. A straight line was drawn between the most plantar process of the calcaneus and the head of the first metatarsal bone for the calculation of the PAL of the MLA. Two semilunar arcs were drawn upon this straight line. PAL1 and PAL2 were estimated using a point-counting technique. The CPA, lateral talo-calcaneal angles (LTCA, and talo-first metatarsal angles (TFMA were measured. The correlations between PAL1, PAL2 of right and left feet and CPA, LTCA, and TFMA were explored.Results: Fifty patients (27 females, 23 males with a mean age of 40.12 (4-78 years were evaluated. Significant correlations were detected between PAL1, PAL2 and CPA, and TFMA for both right and left feet (p<0.05. Conclusion: A significant correlation was detected between the modified PAL method as a new technique and the standard CPA method for MLA evaluation. The PAL method is suggested as a simple and practical method for MLA evaluation.

Can medio-lateral baseplate position and load sharing induce asymptomatic local bone resorption of the proximal tibia? A finite element study

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Wong Pius

2009-07-01

Full Text Available Abstract Background Asymptomatic local bone resorption of the tibia under the baseplate can occasionally be observed after total knee arthroplasty (TKA. Its occurrence is not well documented, and so far no explanation is available. We report the incidence of this finding in our practice, and investigate whether it can be attributed to specific mechanical factors. Methods The postoperative radiographs of 500 consecutive TKA patients were analyzed to determine the occurrence of local medial bone resorption under the baseplate. Based on these cases, a 3D FE model was developed. Cemented and cementless technique, seven positions of the baseplate and eleven load sharing conditions were considered. The average VonMises stress was evaluated in the bone-baseplate interface, and the medial and lateral periprosthetic region. Results Sixteen cases with local bone resorption were identified. In each, bone loss became apparent at 3 months post-op and did not increase after one year. None of these cases were symptomatic and infection screening was negative for all. The FE analysis demonstrated an influence of baseplate positioning, and also of load sharing, on stresses. The average stress in the medial periprosthetic region showed a non linear decrease when the prosthetic baseplate was shifted laterally. Shifting the component medially increased the stress on the medial periprosthetic region, but did not significantly unload the lateral side. The presence of a cement layer decreases the stresses. Conclusion Local bone resorption of the proximal tibia can occur after TKA and might be attributed to a stress shielding effect. This FE study shows that the medial periprosthetic region of the tibia is more sensitive than the lateral region to mediolateral positioning of the baseplate. Medial cortical support of the tibial baseplate is important for normal stress transfer to the underlying bone. The absence of medial cortical support of the tibial baseplate may lead

Head tilt produced by hemilabyrinthectomy does not depend on the direct vestibulospinal tracts.

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Fukushima, K; Fukushima, J; Kato, M

1988-01-01

Head tilt is one of the most characteristic and enduring symptoms produced by hemilabyrinthectomy and is compensated by the central nervous system with time. In order to study the central mechanisms of compensation of the head tilt, it is first necessary to understand how it is produced. However, its mechanism remains unknown. Experiments were performed in cats to examine whether the direct vestibulocollic pathways are responsible for the head tilt, as suggested by some authors. Hemilabyrinthectomies produced a characteristic head tilt in cats in which the medial and/or one lateral vestibulospinal tracts (VSTs) had been interrupted. The lesions of the medial VST did not influence the preexisting head tilt produced by hemilabyrinthectomies. These results suggest that the head tilt produced by hemilabyrinthectomies does not depend on the activity of the VSTs.

UMAPRM: Uniformly sampling the medial axis

KAUST Repository

Yeh, Hsin-Yi Cindy

2014-05-01

© 2014 IEEE. Maintaining clearance, or distance from obstacles, is a vital component of successful motion planning algorithms. Maintaining high clearance often creates safer paths for robots. Contemporary sampling-based planning algorithms That utilize The medial axis, or The set of all points equidistant To Two or more obstacles, produce higher clearance paths. However, They are biased heavily Toward certain portions of The medial axis, sometimes ignoring parts critical To planning, e.g., specific Types of narrow passages. We introduce Uniform Medial Axis Probabilistic RoadMap (UMAPRM), a novel planning variant That generates samples uniformly on The medial axis of The free portion of Cspace. We Theoretically analyze The distribution generated by UMAPRM and show its uniformity. Our results show That UMAPRM\\'s distribution of samples along The medial axis is not only uniform but also preferable To other medial axis samplers in certain planning problems. We demonstrate That UMAPRM has negligible computational overhead over other sampling Techniques and can solve problems The others could not, e.g., a bug Trap. Finally, we demonstrate UMAPRM successfully generates higher clearance paths in The examples.

The relationship between chondromalacia patella, medial meniscal tear and medial periarticular bursitis in patients with osteoarthritis

OpenAIRE

Resorlu Mustafa; Doner Davut; Karatag Ozan; Toprak Canan Akgun

2017-01-01

Abstract Background This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears. Patients and methods Radiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed al...

Magnetic Resonance Imaging based Cartilage Loss in Painful Contra-Lateral Knees with and without Radiographic Joint Space Narrowing – Data from the Osteoarthritis Initiative (OAI)

Science.gov (United States)

Eckstein, Felix; Benichou, Olivier; Wirth, Wolfgang; Nelson, David R; Maschek, Susanne; Hudelmaier, Martin; Kwoh, C. Kent; Guermazi, Ali; Hunter, David

2010-01-01

Objective Magnetic resonance imaging (MRI) was used to assess whether knees with advanced radiographic disease (medial joint space narrowing = mJSN) encounter greater longitudinal cartilage loss than contra-lateral knees with earlier disease (no or less mJSN). Methods Participants were selected from 2678 cases in the Osteoarthritis Initiative, based on exhibition of bilateral pain, BMI>25, mJSN in one knee, no or less mJSN in the contra-lateral knee, and no lateral JSN in both knees. 80 participants (age 60.6±9.1 yrs) fulfilled these criteria. Medial tibial and femoral cartilage morphology was analyzed from baseline and 1-year follow-up sagittal DESSwe 3 Tesla MRI of both knees, by experienced readers blinded to the timepoint and mJSN status. Results Knees with more radiographic mJSN displayed greater medial cartilage loss (-80 μm), assessed by MRI, than contra-lateral knees with less mJSN (-57μm). The difference reached statistical significance in participants with mJSN grade 2 or 3 (p=0.005 to p=0.08), but not in participants with mJSN grade 1 (p=0.28 to 0.98). In knees with more mJSN, cartilage loss increased with higher grades of mJSN (p=0.003 in the medial femur). Knees with mJSN grade 2 or 3 displayed greater cartilage loss in the weight-bearing medial femur than in the posterior femur or in the medial tibia (p=0.048). Conclusion Knees with advanced mJSN displayed greater cartilage loss than contra-lateral knees with less mJSN. These data suggest that radiography can be used to stratify fast structural progressors, and that MRI cartilage thickness loss is more pronounced at advanced radiographic disease stage. PMID:19714595

A systematic review and meta-analysis into the effect of lateral wedge arch support insoles for reducing knee joint load in patients with medial knee osteoarthritis

Science.gov (United States)

Xing, Fei; Lu, Bin; Kuang, Ming-jie; Wang, Ying; Zhao, Yun-long; Zhao, Jie; Sun, Lei; Wang, Yan; Ma, Jian-xiong; Ma, Xin-long

2017-01-01

Abstract Objective: The aim of this study was to evaluate the immediate effects of lateral wedge arch support insoles (LWAS) on reducing the knee joint load in patients with medial knee osteoarthritis (OA) compared with an appropriate control. Methods: Databases including Medline, EMBASE, Web of Science, Wiley Online Library, Cochrane library, and Google Scholar were searched with no limits on study date or language, from the earliest available date to October 31, 2016. The included studies had to have the aim of reducing knee load and have an appropriate control. The main measured values were the first and second peak external knee adduction moments (EKAM) and the knee adduction angular impulse (KAAI). The random-effects model was used for analyzing the eligible studies. Results: Nine studies met the inclusion criteria with a total of 356 participants of whom 337 received LWAS treatment. The risk of methodological bias scores (quality index) ranged from 21 to 27 of 32. Treatment with LWAS resulted in statistically significant reductions in the first peak EKAM (P = .005), the second peak EKAM (P = .01), and the KAAI (P = .03). However, among trials in which the control treatment was control shoes, the LWAS showed no associations on the first peak EKAM (P = .10) or the KAAI (P =  .06); among trials in which the control treatment was neutral insoles, the LWAS showed no associations on the second peak EKAM (P = .21) or the KAAI (P = .23). At the same time, the LWAS showed no statistically significant reduction on the first peak EKAM (P = .39) when compared with flat insoles. Conclusion: Although meta-analysis outcomes of all studies indicated statistically significant associations between LWAS and reductions of the first peak EKAM, second peak EKAM and KAAI in people with medial knee OA while walking, different results existed in subgroups using various control conditions for comparison. These findings do not support the use of LWAS

Glutamate co-transmission from developing medial nucleus of the trapezoid body - Lateral superior olive synapses is cochlear dependent in kanamycin-treated rats

Energy Technology Data Exchange (ETDEWEB)

Lee, Jae Ho [Institute of Tissue Regeneration Engineering (ITREN), Dankook University, San 29, Anseo-dong, Cheonan-si, Chungnam 330-714 (Korea, Republic of); Pradhan, Jonu [Department of Nanobio Medical Science, Dankook University, San 29, Anseo-dong, Cheonan-si, Chungnam 330-714 (Korea, Republic of); Maskey, Dhiraj; Park, Ki Sup [Department of Anatomy, College of Medicine, Dankook University, San 29, Anseo-dong, Cheonan-si, Chungnam 330-714 (Korea, Republic of); Hong, Sung Hwa [Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul 135-710 (Korea, Republic of); Suh, Myung-Whan [Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Dankook University, San 29, Anseo-dong, Cheonan-si, Chungnam 330-714 (Korea, Republic of); Kim, Myeung Ju, E-mail: mjukim99@dankook.ac.kr [Department of Anatomy, College of Medicine, Dankook University, San 29, Anseo-dong, Cheonan-si, Chungnam 330-714 (Korea, Republic of); Ahn, Seung Cheol, E-mail: ansil67@hanmail.net [Department of Physiology, College of Medicine, Dankook University, San 29, Anseo-dong, Cheonan-si, Chungnam 330-714 (Korea, Republic of)

2011-02-11

Research highlights: {yields} Glutamate co-transmission is enhanced in kanamycin-treated rats. {yields} VGLUT3 expression is increased in kanamycin-treated rats. {yields} GlyR expression is decreased in kanamycin-treated rats. {yields} GlyR, VGLUT3 expression patterns are asymmetric in unilaterally cochlear ablated rat. -- Abstract: Cochlear dependency of glutamate co-transmission at the medial nucleus of the trapezoid body (MNTB) - the lateral superior olive (LSO) synapses was investigated using developing rats treated with high dose kanamycin. Rats were treated with kanamycin from postnatal day (P) 3 to P8. A scanning electron microscopic study on P9 demonstrated partial cochlear hair cell damage. A whole cell voltage clamp experiment demonstrated the increased glutamatergic portion of postsynaptic currents (PSCs) elicited by MNTB stimulation in P9-P11 kanamycin-treated rats. The enhanced VGLUT3 immunoreactivities (IRs) in kanamycin-treated rats and asymmetric VGLUT3 IRs in the LSO of unilaterally cochlear ablated rats supported the electrophysiologic data. Taken together, it is concluded that glutamate co-transmission is cochlear-dependent and enhanced glutamate co-transmission in kanamycin-treated rats is induced by partial cochlear damage.

Combined effects of knee brace, laterally wedged insoles and toe-in gait on knee adduction moment and balance in moderate medial knee osteoarthritis patients.

Science.gov (United States)

Khan, Saad Jawaid; Khan, Soobia Saad; Usman, Juliana; Mokhtar, Abdul Halim; Abu Osman, Noor Azuan

2018-03-01

To test the hypothesis that toe-in gait (TI) will further reduce first peak (Knee Adduction Moment) KAM and decrease balance when combined with a knee brace (KB) and laterally wedged insoles (LWI) in medial knee osteoarthritis (kOA) patients. Twenty patients with bilateral symptomatic medial kOA. 4-point leverage-based KB, full-length LWI with 5° inclination and toe-in gait (TI). First and second peak knee adduction moment (fKAM and sKAM respectively), balance and pain. The fKAM and sKAM were determined from 3-dimensional gait analysis with six randomized conditions: (1) N (without any intervention), (2) KB, (3) KB + TI, (4) LWI, (5) LWI + TI, (6) KB + LWI + TI. Balance was assessed by Biodex Balance System using three stability settings, (i) Static (ii) Moderate dynamic setting for fall risk (FR12) and (iii) High dynamic setting for fall risk (FR8). The reduction in fKAM and sKAM was greatest (19.75% and 12%) when TI was combined with KB and LWI respectively. No change in balance was observed when TI combined with KB, and LWI and when used concurrently with both the orthosis at static and FR12 conditions. Significant balance reduction was found at FR8 for KB + TI (22.22%), and KB + LWI + TI (35.71%). Pain increased significantly for KB (258%), KB + TI (305%), LWI + TI (210%) and KB + LWI + TI (316%). LWI showed no effect on pain. There is a synergistic effect of TI when combined with KB and LWI concurrently in sKAM reduction. However, the concurrent use of TI, KB and LWI decreases balance and pain as assessed on a highly dynamic platform. Copyright © 2018 Elsevier B.V. All rights reserved.

Adaptability of the Immature Ocular Motor Control System: Unilateral IGF-1 Medial Rectus Treatment.

Science.gov (United States)

Willoughby, Christy L; Fleuriet, Jérome; Walton, Mark M; Mustari, Michael J; McLoon, Linda K

2015-06-01

Unilateral treatment with sustained release IGF-1 to one medial rectus muscle in infant monkeys was performed to test the hypothesis that strabismus would develop as a result of changes in extraocular muscles during the critical period of development of binocularity. Sustained release IGF-1 pellets were implanted unilaterally on one medial rectus muscle in normal infant monkeys during the first 2 weeks of life. Eye position was monitored using standard photographic methods. After 3 months of treatment, myofiber and neuromuscular size, myosin composition, and innervation density were quantified in all rectus muscles and compared to those in age-matched controls. Sustained unilateral IGF-1 treatments resulted in strabismus for all treated subjects; 3 of the 4 subjects had a clinically significant strabismus of more than 10°. Both the treated medial rectus and the untreated ipsilateral antagonist lateral rectus muscles had significantly larger myofibers. No adaptation in myofiber size occurred in the contralateral functionally yoked lateral rectus or in myosin composition, neuromuscular junction size, or nerve density. Sustained unilateral IGF-1 treatment to extraocular muscles during the sensitive period of development of orthotropic eye alignment and binocularity was sufficient to disturb ocular motor development, resulting in strabismus in infant monkeys. This could be due to altering fusion of gaze during the early sensitive period. Serial measurements of eye alignment suggested the IGF-1-treated infants received insufficient coordinated binocular experience, preventing the establishment of normal eye alignment. Our results uniquely suggest that abnormal signaling by the extraocular muscles may be a cause of strabismus.

Usefulness of a Lateral Thoracodorsal Flap after Breast Conserving Surgery in Laterally Located Breast Cancer

Directory of Open Access Journals (Sweden)

Jung Dug Yang

2013-07-01

Full Text Available BackgroundBreast-conserving surgery is widely accepted as an appropriate method in breast cancer, and the lateral thoracodorsal flap provides a simple, reliable technique, especially when a mass is located in the lateral breast. This study describes the usefulness of a lateral thoracodorsal flap after breast conserving surgery in laterally located breast cancer.MethodsFrom September 2008 to February 2013, a lateral thoracodorsal flap was used in 20 patients with laterally located breast cancer treated at our institution. The technique involves a local medially based, wedge shaped, fasciocutaneous transposition flap from the lateral region of the thoracic area. Overall satisfaction and aesthetic satisfaction surveys were conducted with the patients during a 6-month postoperative follow-up period. Aesthetic results in terms of breast shape and symmetry were evaluated by plastic surgeons.ResultsThe average specimen weight was 76.8 g. The locations of the masses were the upper lateral quadrant (n=15, the lower lateral quadrant (n=2, and the central lateral area (n=3. Complications developed in four of the cases, partial flap necrosis in one, wound dehiscence in one, and fat necrosis in two. The majority of the patients were satisfied with their cosmetic outcomes.ConclusionsPartial breast reconstruction using a lateral thoracodorsal flap is well matched with breast color and texture, and the surgery is less aggressive than other techniques with few complications. Therefore, the lateral thoracodorsal flap can be a useful, reliable technique in correcting breast deformity after breast conserving surgery, especially in laterally located breast cancer.

Usefulness of a Lateral Thoracodorsal Flap after Breast Conserving Surgery in Laterally Located Breast Cancer

Directory of Open Access Journals (Sweden)

Ho Yong Park

2013-07-01

Full Text Available Background Breast-conserving surgery is widely accepted as an appropriate method in breast cancer, and the lateral thoracodorsal flap provides a simple, reliable technique, especially when a mass is located in the lateral breast. This study describes the usefulness of a lateral thoracodorsal flap after breast conserving surgery in laterally located breast cancer.Methods From September 2008 to February 2013, a lateral thoracodorsal flap was used in 20 patients with laterally located breast cancer treated at our institution. The technique involves a local medially based, wedge shaped, fasciocutaneous transposition flap from the lateral region of the thoracic area. Overall satisfaction and aesthetic satisfaction surveys were conducted with the patients during a 6-month postoperative follow-up period. Aesthetic results in terms of breast shape and symmetry were evaluated by plastic surgeons.Results The average specimen weight was 76.8 g. The locations of the masses were the upper lateral quadrant (n=15, the lower lateral quadrant (n=2, and the central lateral area (n=3. Complications developed in four of the cases, partial flap necrosis in one, wound dehiscence in one, and fat necrosis in two. The majority of the patients were satisfied with their cosmetic outcomes.Conclusions Partial breast reconstruction using a lateral thoracodorsal flap is well matched with breast color and texture, and the surgery is less aggressive than other techniques with few complications. Therefore, the lateral thoracodorsal flap can be a useful, reliable technique in correcting breast deformity after breast conserving surgery, especially in laterally located breast cancer.

Influence of Concurrent Finger Movements on Transcranial Direct Current Stimulation (tDCS)-Induced Aftereffects.

Science.gov (United States)

Shirota, Yuichiro; Terney, Daniella; Antal, Andrea; Paulus, Walter

2017-01-01

Transcranial direct current stimulation (tDCS) has been reported to have bidirectional influence on the amplitude of motor-evoked potentials (MEPs) in resting participants in a polarity-specific manner: anodal tDCS increased and cathodal tDCS decreased them. More recently, the effects of tDCS have been shown to depend on a number of additional factors. We investigated whether a small variety of movements involving target and non-target muscles could differentially modify the efficacy of tDCS. MEPs were elicited from the right first dorsal interosseous muscle, defined as the target muscle, by single pulse transcranial magnetic stimulation (TMS) over the primary motor cortex (M1). During M1 tDCS, which lasted for 10 min applying anodal, cathodal, or sham condition, the participants were instructed to squeeze a ball with their right hand (Task 1), to move their right index finger only in the medial (Task 2), in the lateral direction (Task 3), or in medial and lateral direction alternatively (Task 4). Anodal tDCS reduced MEP amplitudes measured in Task 1 and Task 2, but to a lesser extent in the latter. In Task 3, anodal tDCS led to greater MEP amplitudes than cathodal stimulation. Alternating movements resulted in no effect of tDCS on MEP amplitude (Task 4). The results are congruent with the current notion that the aftereffects of tDCS are highly variable relying on a number of factors including the type of movements executed during stimulation.

Medial structure generation for registration of anatomical structures

DEFF Research Database (Denmark)

Vera, Sergio; Gil, Debora; Kjer, Hans Martin

2017-01-01

structures. Methods for generation of medial structures, however, are prone to the generation of medial artifacts (spurious branches) that traditionally need to be pruned before the medial structure can be used for further computations. The act of pruning can affect main sections of the medial surface......Medial structures (skeletons and medial manifolds) have shown capacity to describe shape in a compact way. In the field of medical imaging, they have been employed to enrich the description of organ anatomy, to improve segmentation, or to describe the organ position in relation to surrounding...

The jmzQuantML programming interface and validator for the mzQuantML data standard.

Science.gov (United States)

Qi, Da; Krishna, Ritesh; Jones, Andrew R

2014-03-01

The mzQuantML standard from the HUPO Proteomics Standards Initiative has recently been released, capturing quantitative data about peptides and proteins, following analysis of MS data. We present a Java application programming interface (API) for mzQuantML called jmzQuantML. The API provides robust bridges between Java classes and elements in mzQuantML files and allows random access to any part of the file. The API provides read and write capabilities, and is designed to be embedded in other software packages, enabling mzQuantML support to be added to proteomics software tools (http://code.google.com/p/jmzquantml/). The mzQuantML standard is designed around a multilevel validation system to ensure that files are structurally and semantically correct for different proteomics quantitative techniques. In this article, we also describe a Java software tool (http://code.google.com/p/mzquantml-validator/) for validating mzQuantML files, which is a formal part of the data standard. © 2014 The Authors. Proteomics published by Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Rheo: Japanese sound art interrogating digital mediality

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Vandsø Anette

2014-12-01

Full Text Available The article asks in what way the Japanese sound artist, Ryoichi Kurokawa’s audiovisual installation, Rheo: 5 Horisonz (2010, is “digital.” Using professor Lars Elleström’s concept of “mediality,” the main claim in this article is that Rheo not only uses digital technology but also interrogates digital mediality as such. This argument is pursued in an analysis of Rheo that draws in various descriptions of digital media by N. Catherine Hayles, Lev Manovic, Bolter, and Grusin among other. The article will show how the critical potential in Rheo is directed both towards digital media as a language (Meyrowitz (or a place for representation and towards the digital as a milieu (Meyrowitz or as our culture (Gere. The overall goal of the article is not just analyse this singular art work, but also to show how such a sound art work can contribute to our understanding of our own contemporary culture as a digital culture.

The effect of autologous platelet rich plasma in treatment lateral epicondylitis

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İsmail Ağır

2011-03-01

Full Text Available Lateral epicondylitis (tennis elbow is the most commonly diagnosed cause of lateral elbow pain. The aim of this study was to compare the effect of single dose corticosteroid and autologous platelet rich plasma (PRP injection in the treatment of tennis elbow.Materials and methods: The 15 elbow of 15 patients (6 male and 9 female was included in the study, who applied to our clinic with lateral elbow pain and diagnosed as lateral epicondylitis. A single dose of 0,5 ml Bethametasone and 0,5 ml Prilocaine mixture was applied to first group and single dose 1 ml autologous PRP was locally applied to the second group.Results: In the early follow-ups the results of corticosteroid group were better than latter follow-ups, however in PRP group the results were worst in early follow-ups but better results were obtained in later follow-ups according to Verhaar scoring system.Conclusion: According to our results, the beneficial effects of PRP injection in lateral epicondylitis increases over time but further studies with more patients and longer follow up durations should done in order to more clarified this subject.

jmzML, an open-source Java API for mzML, the PSI standard for MS data.

Science.gov (United States)

Côté, Richard G; Reisinger, Florian; Martens, Lennart

2010-04-01

We here present jmzML, a Java API for the Proteomics Standards Initiative mzML data standard. Based on the Java Architecture for XML Binding and XPath-based XML indexer random-access XML parser, jmzML can handle arbitrarily large files in minimal memory, allowing easy and efficient processing of mzML files using the Java programming language. jmzML also automatically resolves internal XML references on-the-fly. The library (which includes a viewer) can be downloaded from http://jmzml.googlecode.com.

Lateral and Anterior Thalamic Lesions Impair Independent Memory Systems

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Mitchell, Anna S.; Dalrymple-Alford, John C.

2006-01-01

Damage to the medial region of the thalamus, both in clinical cases (e.g., patients with infarcts or the Korsakoff's syndrome) and animal lesion models, is associated with variable amnesic deficits. Some studies suggest that many of these memory deficits rely on the presence of lateral thalamic lesions (LT) that include the intralaminar nuclei,…

Plantar Fascia Release Through a Single Lateral Incision in the Operative Management of a Cavovarus Foot: A Cadaver Model Analysis of the Operative Technique.

Science.gov (United States)

Kiskaddon, Eric M; Meeks, Brett D; Roberts, Joseph G; Laughlin, Richard T

2018-04-04

Plantar fascia release and calcaneal slide osteotomy are often components of the surgical management for cavovarus deformities of the foot. In this setting, plantar fascia release has traditionally been performed through an incision over the medial calcaneal tuberosity, and the calcaneal osteotomy through a lateral incision. Two separate incisions can potentially increase the operative time and morbidity. The purpose of the present study was threefold: to describe the operative technique, use cadaveric dissection to analyze whether a full release of the plantar fascia was possible through the lateral incision, and examine the proximity of the medial neurovascular structures to both the plantar fascia release and calcaneal slide osteotomy when performed together. In our cadaveric dissections, we found that full release of the plantar fascia is possible through the lateral incision with no obvious damage to the medial neurovascular structures. We also found that the calcaneal branch of the tibial nerve reliably crossed the osteotomy in all specimens. We have concluded that both the plantar fascia release and the calcaneal osteotomy can be safely performed through a lateral incision, if care is taken when completing the calcaneal osteotomy to ensure that the medial neurovascular structures remain uninjured. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Bidirectional Control of Anxiety-Related Behaviors in Mice: Role of Inputs Arising from the Ventral Hippocampus to the Lateral Septum and Medial Prefrontal Cortex.

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Parfitt, Gustavo Morrone; Nguyen, Robin; Bang, Jee Yoon; Aqrabawi, Afif J; Tran, Matthew M; Seo, D Kanghoon; Richards, Blake A; Kim, Jun Chul

2017-07-01

Anxiety is an adaptive response to potentially threatening situations. Exaggerated and uncontrolled anxiety responses become maladaptive and lead to anxiety disorders. Anxiety is shaped by a network of forebrain structures, including the hippocampus, septum, and prefrontal cortex. In particular, neural inputs arising from the ventral hippocampus (vHPC) to the lateral septum (LS) and medial prefrontal cortex (mPFC) are thought to serve as principal components of the anxiety circuit. However, the role of vHPC-to-LS and vHPC-to-mPFC signals in anxiety is unclear, as no study has directly compared their behavioral contribution at circuit level. We targeted LS-projecting vHPC cells and mPFC-projecting vHPC cells by injecting the retrogradely propagating canine adenovirus encoding Cre recombinase into the LS or mPFC, and injecting a Cre-responsive AAV (AAV8-hSyn-FLEX-hM3D or hM4D) into the vHPC. Consequences of manipulating these neurons were examined in well-established tests of anxiety. Chemogenetic manipulation of LS-projecting vHPC cells led to bidirectional changes in anxiety: activation of LS-projecting vHPC cells decreased anxiety whereas inhibition of these cells produced opposite anxiety-promoting effects. The observed anxiety-reducing function of LS-projecting cells was in contrast with the function of mPFC-projecting cells, which promoted anxiety. In addition, double retrograde tracing demonstrated that LS- and mPFC-projecting cells represent two largely anatomically distinct cell groups. Altogether, our findings suggest that the vHPC houses discrete populations of cells that either promote or suppress anxiety through differences in their projection targets. Disruption of the intricate balance in the activity of these two neuron populations may drive inappropriate behavioral responses seen in anxiety disorders.

Investigation of high-alpha lateral-directional control power requirements for high-performance aircraft

Science.gov (United States)

Foster, John V.; Ross, Holly M.; Ashley, Patrick A.

1993-01-01

Designers of the next-generation fighter and attack airplanes are faced with the requirements of good high angle-of-attack maneuverability as well as efficient high speed cruise capability with low radar cross section (RCS) characteristics. As a result, they are challenged with the task of making critical design trades to achieve the desired levels of maneuverability and performance. This task has highlighted the need for comprehensive, flight-validated lateral-directional control power design guidelines for high angles of attack. A joint NASA/U.S. Navy study has been initiated to address this need and to investigate the complex flight dynamics characteristics and controls requirements for high angle-of-attack lateral-directional maneuvering. A multi-year research program is underway which includes groundbased piloted simulation and flight validation. This paper will give a status update of this program that will include a program overview, description of test methodology and preliminary results.

Comparison of dynamic postural stability scores between athletes with and without chronic ankle instability during lateral jump landing.

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Shiravi, Zeinab; Shadmehr, Azadeh; Moghadam, Saeed Talebian; Moghadam, Behrouz Attarbashi

2017-01-01

Many ankle injuries occur while participating in sports that require jumping and landing such as basketball, volleyball and soccer. Most recent studies have investigated dynamic postural stability of patients with chronic ankle instability after landing from a forward jump. The present study aimed to investigate the dynamic postural stability of the athletes who suffer from chronic ankle sprain while landing from a lateral jump. Twelve athletes with self-reported unilateral chronic ankle instability (4 females and 8 males) and 12 matched controls (3 females and 9 males) voluntarily participated in the study. Dynamic postural stability index and its directional indices were measured while performing lateral jump landing test. No differences were found between athletes with and without chronic ankle instability during our landing protocol by means of the dynamic postural stability index and its directional indices. Findings showed that in each group, medial/lateral stability index is significantly higher than anterior/posterior and vertical stability indexes. Findings showed that dynamic postural stability was not significantly different between the two groups. Future studies should examine chronic ankle instability patients with more severe disabilities and expose them to more challenging dynamic balance conditions to further explore postural stability. IIIa.

Medial Position and Counterclockwise Rotation of the Parietal Scalp Hair-Whorl as a Possible Indicator for Non-Right-Handedness

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Heinrich Schmidt

2008-01-01

Full Text Available The objective of our study was to assess the association between position and swirling direction of the parietal whorl (PW and handedness. In 519 patients of a pediatric practice, PWs were located and the swirling direction determined. Of those patients, handedness could be specified in 217. The right-sided PW (n = 347; 70.8% and the clockwise (CW swirling type (n = 411; 83.9% of all participants were predominant in children with one PW. Non-right-handedness (NRH was found in 40 (18.4%. Medial position of the whorl per se increases the chance for NRH, indifferent of the swirling direction. In patients with counterclockwise (CCW swirling, the chance of NRH increased 3.5-fold for the right-sided, 5.4-fold for the left-sided, and 12.9-fold for the medial-positioned whorl. We conclude that NRH is associated with the position (medial! and the swirling direction (CCW! of the PW.

A Population of Projection Neurons that Inhibits the Lateral Horn but Excites the Antennal Lobe through Chemical Synapses in Drosophila

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Kazumichi Shimizu

2017-05-01

Full Text Available In the insect olfactory system, odor information is transferred from the antennal lobe (AL to higher brain areas by projection neurons (PNs in multiple AL tracts (ALTs. In several species, one of the ALTs, the mediolateral ALT (mlALT, contains some GABAergic PNs; in the Drosophila brain, the great majority of ventral PNs (vPNs are GABAergic and project through this tract to the lateral horn (LH. Most excitatory PNs (ePNs, project through the medial ALT (mALT to the mushroom body (MB and the LH. Recent studies have shown that GABAergic vPNs play inhibitory roles at their axon terminals in the LH. However, little is known about the properties and functions of vPNs at their dendritic branches in the AL. Here, we used optogenetic and patch clamp techniques to investigate the functional roles of vPNs in the AL. Surprisingly, our results show that specific activation of vPNs reliably elicits strong excitatory postsynaptic potentials (EPSPs in ePNs. Moreover, the connections between vPNs and ePNs are mediated by direct chemical synapses. Neither pulses of GABA, nor pharmagological, or genetic blockade of GABAergic transmission gave results consistent with the involvement of GABA in vPN-ePN excitatory transmission. These unexpected results suggest new roles for the vPN population in olfactory information processing.

Snapping Knee Caused by Medial Meniscal Cyst

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Tsuyoshi Ohishi

2014-01-01

Full Text Available Snapping phenomenon around the medial aspect of the knee is rare. We present this case of snapping knee caused by the sartorius muscle over a large medial meniscal cyst in a 66-year-old female. Magnetic resonance images demonstrated a large medial meniscal cyst with a horizontal tear of the medial meniscus. Arthroscopic cyst decompression with limited meniscectomy resulted in the disappearance of snapping, and no recurrence of the cyst was observed during a 2-year follow-up period.

A Systematic Review of Clinical Functional Outcomes After Medial Stabilized Versus Non-Medial Stabilized Total Knee Joint Replacement

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Tony Young

2018-04-01

Full Text Available Background Medial stabilized total knee joint replacement (TKJR construct is designed to closely replicate the kinematics of the knee. Little is known regarding comparison of clinical functional outcomes of patients utilising validated patient reported outcome measures (PROM after medial stabilized TKJR and other construct designs.PurposeTo perform a systematic review of the available literature related to the assessment of clinical functional outcomes following a TKJR employing a medial stabilized construct design.MethodsThe review was performed with a Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA algorithm. The literature search was performed using variouscombinations of keywords. The statistical analysis was completed using Review Manager (RevMan, Version 5.3.ResultsIn the nineteen unique studies identified, there were 2,448 medial stabilized TKJRs implanted in 2,195 participants, there were 1,777 TKJRs with non-medial stabilized design constructs implanted in 1,734 subjects. The final mean Knee Society Score (KSS value in the medial stabilized group was 89.92 compared to 90.76 in the non-medial stabilized group, with the final KSS mean value difference between the two groups was statistically significant and favored the non-medial stabilized group (SMD 0.21; 95% CI: 0.01 to 0.41; p = 004. The mean difference in the final WOMAC values between the two groups was also statistically significant and favored the medial stabilized group (SMD: −0.27; 95% CI: −0.47 to −0.07; p = 0.009. Moderate to high values (I2 of heterogeneity were observed during the statistical comparison of these functional outcomes.ConclusionBased on the small number of studies with appropriate statistical analysis, we are unable to reach a clear conclusion in the clinical performance of medial stabilized knee replacement construct.Level of EvidenceLevel II

Arthroscopic meniscectomy in medial compartment osteoarthritis of the knee

International Nuclear Information System (INIS)

Noguchi, Joji; Shimoyama, Gishichiro; Shinozaki, Toshiro; Nagata, Kensei

2007-01-01

The purpose of this research is to evaluate the results of arthroscopic meniscectomy in medial compartment osteoarthritis of the knee. The operation was performed on 25 knee joints (8 male, 17 female) with the mean age of 67 years. The mean period of follow-up was 19 months. Clinical results were more or less excellent, but radiological assessment suggested slight osteoarthritic changes. In addition, two cases progressed to subchondral bone collapse. Of 12 cases which had no bone marrow edema on MRI before surgery, six (50%) cases showed it at follow-up. These findings suggest a possible relationship between arthroscopic meniscectomy and later appearance of osteonecrosis in some cases. (author)

Anisotropic Margin Expansions in 6 Anatomic Directions for Oropharyngeal Image Guided Radiation Therapy

International Nuclear Information System (INIS)

Yock, Adam D.; Garden, Adam S.; Court, Laurence E.; Beadle, Beth M.; Zhang, Lifei; Dong, Lei

2013-01-01

Purpose: The purpose of this work was to determine the expansions in 6 anatomic directions that produced optimal margins considering nonrigid setup errors and tissue deformation for patients receiving image-guided radiation therapy (IGRT) of the oropharynx. Methods and Materials: For 20 patients who had received IGRT to the head and neck, we deformably registered each patient's daily images acquired with a computed tomography (CT)-on-rails system to his or her planning CT. By use of the resulting vector fields, the positions of volume elements within the clinical target volume (CTV) (target voxels) or within a 1-cm shell surrounding the CTV (normal tissue voxels) on the planning CT were identified on each daily CT. We generated a total of 15,625 margins by dilating the CTV by 1, 2, 3, 4, or 5 mm in the posterior, anterior, lateral, medial, inferior, and superior directions. The optimal margins were those that minimized the relative volume of normal tissue voxels positioned within the margin while satisfying 1 of 4 geometric target coverage criteria and 1 of 3 population criteria. Results: Each pair of geometric target coverage and population criteria resulted in a unique, anisotropic, optimal margin. The optimal margin expansions ranged in magnitude from 1 to 5 mm depending on the anatomic direction of the expansion and on the geometric target coverage and population criteria. Typically, the expansions were largest in the medial direction, were smallest in the lateral direction, and increased with the demand of the criteria. The anisotropic margin resulting from the optimal set of expansions always included less normal tissue than did any isotropic margin that satisfied the same pair of criteria. Conclusions: We demonstrated the potential of anisotropic margins to reduce normal tissue exposure without compromising target coverage in IGRT to the head and neck

Magnetic resonance imaging signs of iliotibial band friction in patients with isolated medial compartment osteoarthritis of the knee

International Nuclear Information System (INIS)

Vasilevska, Violeta; Szeimies, Ulrike; Staebler, Axel

2009-01-01

The purpose of this retrospective study was to assess the frequency of magnetic resonance imaging (MRI) signs of iliotibial band friction (ITBF) in patients with advanced medial compartment knee osteoarthritis. Proton density-weighted (PDw) fat-saturated (fatsat) MR images (1.5 T, slice thickness (SL) 2.5-3 mm, eight-channel phased array coil) of 128 patients with isolated advanced osteoarthritis of the medial knee compartment and complete or subtotal (>80%) loss of cartilage were evaluated. There were 41 men and 87 women. Mean age was 63 years, range 34-89 years. The control group consisted of 94 patients with medial meniscus degeneration without cartilage loss (56 men and 38 women, mean age 50 years, range 16-89 years). MRI signs of ITBF were evaluated in both groups [poorly defined abnormalities of signal intensity and localized fluid collection lateral, distal or proximal to the lateral epicondyle; signal intensity abnormalities superficial to or deep by the iliotibial band (ITB)]. Transverse images were evaluated separately. Consensus evaluation using all imaging planes was performed. Of 128 patients with osteoarthritis, 95 had moderate or advanced MRI signs of ITBF (74.2%). Eighty-nine patients (69.5%) had advanced degeneration of the meniscus. In the control group, 26 of 94 patients had only moderate MRI signs of ITBF. There was a statistically significant difference between both groups for the presence of MR signs of ITBF (P ≤ 0.01). MRI signs of ITBF were frequently present in patients with severe medial compartment osteoarthritis of the knee. Joint space narrowing with varus knee deformity may be a cause of ITBF. Level 4 (Historic, non-randomized, retrospective, cohort study with a control group) (orig.)

Magnetic resonance imaging signs of iliotibial band friction in patients with isolated medial compartment osteoarthritis of the knee

Energy Technology Data Exchange (ETDEWEB)

Vasilevska, Violeta [University Surgical Clinic ' St. Naum Ohridski' , Skopje (Macedonia (The Former Yugoslav Republic of)); Szeimies, Ulrike; Staebler, Axel [Radiology in Muenchen Harlaching, Orthopedic Clinic Harlaching, Munich (Germany)

2009-09-15

The purpose of this retrospective study was to assess the frequency of magnetic resonance imaging (MRI) signs of iliotibial band friction (ITBF) in patients with advanced medial compartment knee osteoarthritis. Proton density-weighted (PDw) fat-saturated (fatsat) MR images (1.5 T, slice thickness (SL) 2.5-3 mm, eight-channel phased array coil) of 128 patients with isolated advanced osteoarthritis of the medial knee compartment and complete or subtotal (>80%) loss of cartilage were evaluated. There were 41 men and 87 women. Mean age was 63 years, range 34-89 years. The control group consisted of 94 patients with medial meniscus degeneration without cartilage loss (56 men and 38 women, mean age 50 years, range 16-89 years). MRI signs of ITBF were evaluated in both groups [poorly defined abnormalities of signal intensity and localized fluid collection lateral, distal or proximal to the lateral epicondyle; signal intensity abnormalities superficial to or deep by the iliotibial band (ITB)]. Transverse images were evaluated separately. Consensus evaluation using all imaging planes was performed. Of 128 patients with osteoarthritis, 95 had moderate or advanced MRI signs of ITBF (74.2%). Eighty-nine patients (69.5%) had advanced degeneration of the meniscus. In the control group, 26 of 94 patients had only moderate MRI signs of ITBF. There was a statistically significant difference between both groups for the presence of MR signs of ITBF (P {<=} 0.01). MRI signs of ITBF were frequently present in patients with severe medial compartment osteoarthritis of the knee. Joint space narrowing with varus knee deformity may be a cause of ITBF. Level 4 (Historic, non-randomized, retrospective, cohort study with a control group) (orig.)

Prx1 and Prx2 cooperatively regulate the morphogenesis of the medial region of the mandibular process

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Balic, Anamaria; Adams, Douglas; Mina, Mina

2009-01-01

Mice lacking both Prx1 and Prx2 display severe abnormalities in the mandible. Our analysis showed that complete loss of Prx gene products leads to growth abnormalities in the mandibular processes evident as early as E10.5 associated with changes in the survival of the mesenchyme in the medial region. Changes in the gene expression in the medial and lateral regions were related to gradual loss of a subpopulation of mesenchyme in the medial region expressing eHand. Our analysis also showed that Prx gene products are required for the initiation and maintenance of chondrogenesis and terminal differentiation of the chondrocytes in the caudal and rostral ends of Meckel’s cartilage. The fusion of the mandibular processes in the Prx1/Prx2 double mutants is caused by accelerated ossification. These observations together show that during mandibular morphogenesis Prx gene products play multiple roles including the cell survival, the region-specific terminal differentiation of Meckelian chondrocytes and osteogenesis. PMID:19777594

An isolated dorso-medial dislocation of navicular bone: A case report.

Science.gov (United States)

Singh, Varun Kumar; Kashyap, Abhishek; Vargaonkar, Gauresh; Kumar, Ramesh

2015-03-01

An isolated dislocation of tarsal navicular is extremely rare injury. Usually it is associated with fracture of navicular itself or other tarsal bones of foot along with disruption of medial or lateral column of foot. Mechanism of injury is complex but usually a severe abduction force is required to produce such injury in a planter flexed foot. A 30 year old male presented with isolated navicular dislocation. Management required open reduction and fixation with k-wires. These injuries have specific complications including avascular necrosis of navicular and post-traumatic arthritis.

Medial cortex activity, self-reflection and depression.

Science.gov (United States)

Johnson, Marcia K; Nolen-Hoeksema, Susan; Mitchell, Karen J; Levin, Yael

2009-12-01

Using functional magnetic resonance imaging, we investigated neural activity associated with self-reflection in depressed [current major depressive episode (MDE)] and healthy control participants, focusing on medial cortex areas previously shown to be associated with self-reflection. Both the MDE and healthy control groups showed greater activity in anterior medial cortex (medial frontal gyrus, anterior cingulate gyrus) when cued to think about hopes and aspirations compared with duties and obligations, and greater activity in posterior medial cortex (precuneus, posterior cingulate) when cued to think about duties and obligations (Experiment 1). However, the MDE group showed less activity than controls in the same area of medial frontal cortex when self-referential cues were more ambiguous with respect to valence (Experiment 2), and less deactivation in a non-self-referential condition in both experiments. Furthermore, individual differences in rumination were positively correlated with activity in both anterior and posterior medial cortex during non-self-referential conditions. These results provide converging evidence for a dissociation of anterior and posterior medial cortex depending on the focus of self-relevant thought. They also provide neural evidence consistent with behavioral findings that depression is associated with disruption of positively valenced thoughts in response to ambiguous cues, and difficulty disengaging from self-reflection when it is appropriate to do so.

MRI of discoid lateral meniscus

International Nuclear Information System (INIS)

Araki, Yutaka; Ootani, Masatoshi; Furukawa, Tomoaki; Yamamoto, Tadatsuka; Tomoda, Kaname; Tsukaguchi, Isao; Mitomo, Masanori.

1991-01-01

We retrospectively reviewed the MR examinations of 10 patients (17 knees) with surgically documented discoid lateral meniscus of the knee joint. As MRI of the knee is being used more often, the criteria for diagnosis of this entity with MRI need to be established. We tried to define MRI criteria for the detection of discoid menisci by performing numerical measurements of MR images on a display screen. The transverse diameter of the midbody of a discoid lateral meniscus averaged 21.9 mm (normal control: 8.6 mm), and its proportion to the transverse width of the tibia averaged 29.4% (normal control: 12.0%). The measurable difference in height between the discoid and the medial meniscus was negligible. The number of sagittal sections on which the anterior and posterior horns connected varied from two to five in cases of discoid lateral meniscus, and from zero to two in normal controls. Among these parameters, the transverse diameter and its proportion of the transverse width of the tibia proved to be the most reliable. We concluded that a discoid meniscus is indicated if a transverse diameter of a lateral meniscus exceeds 15 mm (proportion to the tibia: 20%). (author)

Dissociation between unconscious motor response facilitation and conflict in medial frontal areas.

Science.gov (United States)

D'Ostilio, Kevin; Garraux, Gaëtan

2012-01-01

Masked prime tasks have shown that sensory information that has not been consciously perceived can nevertheless modulate behavior. The neuronal correlates of behavioral manifestations of visuomotor priming remain debated, particularly with respect to the distribution and direction (i.e. increase or decrease) of activity changes in medial frontal areas. Here, we predicted that these discrepant results could be accounted for by two automatic and unconscious processes embedded in this task: response conflict and facilitation. We used event-related functional magnetic resonance imaging (fMRI), as 24 healthy participants had to respond, as fast as possible, to a target arrow presented immediately after a subliminal masked prime arrow. There were three experimental conditions defined by the prime-target relationship: compatible, incompatible, and neutral. The classical visuomotor priming effect was reproduced, with relatively longer reaction times (RTs) in incompatible trials. Longer RTs in incompatible than in neutral trials were specifically associated with stronger blood oxygen level-dependent (BOLD) activity in a conflict-related network comprising the anterior cingulate cortex and right frontal associative areas. Motor response facilitation as shown by shorter RTs in compatible than in neutral trials was associated with reduced activation in a motor preparation network including the medial and lateral premotor cortices, as a result of the repetition suppression of the fMRI BOLD signal. The present results provide new insights into automatic and unconscious visuomotor priming processes, suggesting an involvement of either a cognitive or motor network, depending on the prime-target relationship. © 2012 The Authors. European Journal of Neuroscience © 2012 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

Pressure plate analysis of toe-heel and medio-lateral hoof balance at the walk and trot in sound sport horses.

Science.gov (United States)

Oosterlinck, M; Hardeman, L C; van der Meij, B R; Veraa, S; van der Kolk, J H; Wijnberg, I D; Pille, F; Back, W

2013-12-01

Empirically, equine distal limb lameness is often linked to hoof imbalance. To objectively quantify dynamic toe-heel and medio-lateral hoof balance of the vertical ground reaction force in sound sport horses, seven Royal Dutch Sport Horses were led at the walk and trot over a dynamically calibrated pressure plate. Forelimb hoof prints were divided into a toe and heel region and a medial and lateral zone. Toe-heel and medio-lateral hoof balance of the vertical ground reaction force were calculated throughout the stance. Toe-heel balance was highly symmetrical between contralateral limbs at both gaits. At the walk, medio-lateral balance of both forelimbs presented higher loading in the lateral part of the hoof throughout the stance. However, at the trot, left medio-lateral balance presented higher loading of the medial part of the hoof at impact, whereas the right limb showed higher loading of the lateral part of the hoof in all horses, and both limbs presented increased lateral loading at the end of the stance. This study provides objective data for toe-heel and medio-lateral hoof balance in sound sport horses. Copyright © 2013 Elsevier Ltd. All rights reserved.

Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle

International Nuclear Information System (INIS)

Melloni, Pietro; Valls, Rafael; Yuguero, Mariano; Saez, Amparo

2004-01-01

We report a case of a mucoid degeneration of the anterior cruciate ligament (ACL) that produced osseous erosion of the medial aspect of the lateral femoral condyle. The MRI findings and differential diagnosis are discussed. (orig.)

Medial gastrocnemius myoelectric control of a robotic ankle exoskeleton.

Science.gov (United States)

Kinnaird, Catherine R; Ferris, Daniel P

2009-02-01

A previous study from our laboratory showed that when soleus electromyography was used to control the amount of plantar flexion assistance from a robotic ankle exoskeleton, subjects significantly reduced their soleus activity to quickly return to normal gait kinematics. We speculated that subjects were primarily responding to the local mechanical assistance of the exoskeleton rather than directly attempting to reduce exoskeleton mechanical power via decreases in soleus activity. To test this observation we studied ten healthy subjects walking on a treadmill at 1.25 m/s while wearing a robotic exoskeleton proportionally controlled by medial gastrocnemius activation. We hypothesized that subjects would primarily decrease soleus activity due to its synergistic mechanics with the exoskeleton. Subjects decreased medial gastrocnemius recruitment by 12% ( p exoskeleton (soleus). These findings indicate that anatomical morphology needs to be considered carefully when designing software and hardware for robotic exoskeletons.

Processing of spatial and non-spatial information in rats with lesions of the medial and lateral entorhinal cortex: Environmental complexity matters.

Science.gov (United States)

Rodo, Christophe; Sargolini, Francesca; Save, Etienne

2017-03-01

The entorhinal-hippocampal circuitry has been suggested to play an important role in episodic memory but the contribution of the entorhinal cortex remains elusive. Predominant theories propose that the medial entorhinal cortex (MEC) processes spatial information whereas the lateral entorhinal cortex (LEC) processes non spatial information. A recent study using an object exploration task has suggested that the involvement of the MEC and LEC spatial and non-spatial information processing could be modulated by the amount of information to be processed, i.e. environmental complexity. To address this hypothesis we used an object exploration task in which rats with excitotoxic lesions of the MEC and LEC had to detect spatial and non-spatial novelty among a set of objects and we varied environmental complexity by decreasing the number of objects or amount of object diversity. Reducing diversity resulted in restored ability to process spatial and non-spatial information in MEC and LEC groups, respectively. Reducing the number of objects yielded restored ability to process non-spatial information in the LEC group but not the ability to process spatial information in the MEC group. The findings indicate that the MEC and LEC are not strictly necessary for spatial and non-spatial processing but that their involvement depends on the complexity of the information to be processed. Copyright © 2016 Elsevier B.V. All rights reserved.

Striatal dopamine D2 receptor availability predicts the thalamic and medial prefrontal responses to reward in cocaine abusers three years later

International Nuclear Information System (INIS)

Asensio, S.; Goldstein, R.; Romero, M.J.; Romero, F.J.; Wong, C.T.; Alia-Klein, N.; Tomasi, D.; Wang, G.-J.; Telang, F.; Volkow, N.D.; Goldstein, R.Z.

2010-01-01

Low levels of dopamine (DA) D2 receptor availability at a resting baseline have been previously reported in drug addicted individuals and have been associated with reduced ventral and dorsal prefrontal metabolism. The reduction in DA D2 receptor availability along with the reduced ventral frontal metabolism is thought to underlie compromised sensitivity to nondrug reward, a core characteristic of drug addiction. We therefore hypothesized that variability in DA D2 receptor availability at baseline will covary with dynamic responses to monetary reward in addicted individuals. Striatal DA D2 receptor availability was measured with ( 11 C)raclopride and positron emission tomography and response to monetary reward was measured (an average of three years later) with functional magnetic resonance imaging in seven cocaine-addicted individuals. Results show that low DA D2 receptor availability in the dorsal striatum was associated with decreased thalamic response to monetary reward; while low availability in ventral striatum was associated with increased medial prefrontal (Brodmann Area 6/8/32) response to monetary reward. These preliminary results, that need to be replicated in larger sample sizes and validated with healthy controls, suggest that resting striatal DA D2 receptor availability predicts variability in functional responses to a nondrug reinforcer (money) in prefrontal cortex, implicated in behavioral monitoring, and in thalamus, implicated in conditioned responses and expectation, in cocaine-addicted individuals.

Striatal dopamine D2 receptor availability predicts the thalamic and medial prefrontal responses to reward in cocaine abusers three years later

Energy Technology Data Exchange (ETDEWEB)

Asensio, S.; Goldstein, R.; Asensio, S.; Romero, M.J.; Romero, F.J.; Wong, C.T.; Alia-Klein, N.; Tomasi, D.; Wang, G.-J.; Telang, F..; Volkow, N.D.; Goldstein, R.Z.

2010-05-01

Low levels of dopamine (DA) D2 receptor availability at a resting baseline have been previously reported in drug addicted individuals and have been associated with reduced ventral and dorsal prefrontal metabolism. The reduction in DA D2 receptor availability along with the reduced ventral frontal metabolism is thought to underlie compromised sensitivity to nondrug reward, a core characteristic of drug addiction. We therefore hypothesized that variability in DA D2 receptor availability at baseline will covary with dynamic responses to monetary reward in addicted individuals. Striatal DA D2 receptor availability was measured with [{sup 11}C]raclopride and positron emission tomography and response to monetary reward was measured (an average of three years later) with functional magnetic resonance imaging in seven cocaine-addicted individuals. Results show that low DA D2 receptor availability in the dorsal striatum was associated with decreased thalamic response to monetary reward; while low availability in ventral striatum was associated with increased medial prefrontal (Brodmann Area 6/8/32) response to monetary reward. These preliminary results, that need to be replicated in larger sample sizes and validated with healthy controls, suggest that resting striatal DA D2 receptor availability predicts variability in functional responses to a nondrug reinforcer (money) in prefrontal cortex, implicated in behavioral monitoring, and in thalamus, implicated in conditioned responses and expectation, in cocaine-addicted individuals.

Differential roles for medial prefrontal and medial temporal cortices in schema-dependent encoding: from congruent to incongruent.

Science.gov (United States)

van Kesteren, Marlieke T R; Beul, Sarah F; Takashima, Atsuko; Henson, Richard N; Ruiter, Dirk J; Fernández, Guillén

2013-10-01

Information that is congruent with prior knowledge is generally remembered better than incongruent information. This effect of congruency on memory has been attributed to a facilitatory influence of activated schemas on memory encoding and consolidation processes, and hypothesised to reflect a shift between processing in medial temporal lobes (MTL) towards processing in medial prefrontal cortex (mPFC). To investigate this shift, we used functional magnetic resonance imaging (fMRI) to compare brain activity during paired-associate encoding across three levels of subjective congruency of the association with prior knowledge. Participants indicated how congruent they found an object-scene pair during scanning, and were tested on item and associative recognition memory for these associations one day later. Behaviourally, we found a monotonic increase in memory performance with increasing congruency for both item and associative memory. Moreover, as hypothesised, encoding-related activity in mPFC increased linearly with increasing congruency, whereas MTL showed the opposite pattern of increasing encoding-related activity with decreasing congruency. Additionally, mPFC showed increased functional connectivity with a region in the ventral visual stream, presumably related to the binding of visual representations. These results support predictions made by a recent neuroscientific framework concerning the effects of schema on memory. Specifically, our findings show that enhanced memory for more congruent information is mediated by the mPFC, which is hypothesised to guide integration of new information into a pre-existing schema represented in cortical areas, while memory for more incongruent information relies instead on automatic encoding of arbitrary associations by the MTL. © 2013 Elsevier Ltd. All rights reserved.

[SPECIFIC DIAGNOSTIC SIGNIFICANCE OF "RIPPLE SIGN" OF MEDIAL FEMORAL CONDYLE UNDER ARTHROSCOPE IN MEDIAL LONGITUDINAL MENISCAL TEARS].

Science.gov (United States)

Ren Shiyou; Sun, Limang; Chen, Guofei; Jiang, Changqing; Zhang, Xintao; Zhang Wentao

2015-01-01

To investigate the reliability of the "ripple sign" on the upper surface of the medial femoral condyle in the diagnosis of medial longitudinal meniscal tears under arthroscope. Between June 2013 and June 2014, 56 patients with knee injuries were included. There were 35 males and 21 females with an average age of 22.2 years (range, 12-38 years). The causes of injury were sports in 40 cases, falling in 10 cases, and traffic accident in 6 cases. The injury was located at the left knee in 22 cases and at the right knee in 34 cases. The disease duration was 10-40 days (mean, 20.2 days). Of 56 patients, 15 cases had simple medial meniscal injury; 41 cases had combined injuries, including anterior cruciate ligament injury in 38 cases, posterior cruciate ligament injury in 2 cases, and patellar dislocation in 1 case. The "ripple sign" was observed under arthroscope before operation. Repair of medial meniscal injury and reconstruction of cruciate ligament were performed. The positive "ripple sign" was seen under arthroscope in all patients, who were diagnosed to have longitudinal meniscal tears, including 23 cases of mild "ripple sign" , 28 cases of moderate "ripple sign", and 5 cases of severe "ripple sign". The "ripple sign" on the upper surface of the medial femoral condyle is a reliable diagnostic evidence of medial longitudinal meniscal tears.

Relationships between the center of pressure and the movements of the ankle and knee joints during the stance phase in patients with severe medial knee osteoarthritis.

Science.gov (United States)

Fukaya, Takashi; Mutsuzaki, Hirotaka; Okubo, Tomoyuki; Mori, Koichi; Wadano, Yasuyoshi

2016-08-01

The knee joint movement during the stance phase is affected by altered ankle movement and the center of pressure (COP). However the relationships between changes in the center of pressure (COP) and the altered kinematics and kinetics of the ankle and knee joints in patients with osteoarthritis (OA) of the knee are not well understood. The purpose of this study was to determine the relationships between changes in the COP and the altered kinematic and kinetic variables in ankle and knee joints during the stance phase in patients with medial knee OA. Fourteen patients with knee OA (21 knees) and healthy subjects were assessed by gait analysis using an eight-camera motion analysis system to record forward and lateral shifts in the COP and the angle and net internal moments of the knee and ankle joint. Spearman rank-correlation coefficients were used to determine the relationship between these results. In knees with medial OA, lateral shifts in the COP were correlated with knee flexion angle. Lateral shifts in the COP were correlated with the second peak of the knee extensor moment and correlated with the knee abductor moment. In patients with medial knee OA, lateral shifts in the COP were negatively correlated with the kinematic and kinetic variables in the sagittal plane of the knee joints. Controlling such lateral shifts in the COP may thus be an effective intervention for mechanical loads on the knee during the stance phase in patients with knee OA. Copyright © 2016 Elsevier B.V. All rights reserved.

Multiple running speed signals in medial entorhinal cortex

Science.gov (United States)

Hinman, James R.; Brandon, Mark P.; Climer, Jason R.; Chapman, G. William; Hasselmo, Michael E.

2016-01-01

Grid cells in medial entorhinal cortex (MEC) can be modeled using oscillatory interference or attractor dynamic mechanisms that perform path integration, a computation requiring information about running direction and speed. The two classes of computational models often use either an oscillatory frequency or a firing rate that increases as a function of running speed. Yet it is currently not known whether these are two manifestations of the same speed signal or dissociable signals with potentially different anatomical substrates. We examined coding of running speed in MEC and identified these two speed signals to be independent of each other within individual neurons. The medial septum (MS) is strongly linked to locomotor behavior and removal of MS input resulted in strengthening of the firing rate speed signal, while decreasing the strength of the oscillatory speed signal. Thus two speed signals are present in MEC that are differentially affected by disrupted MS input. PMID:27427460

Quantitative analysis of the difference between an intact complete discoid lateral meniscus and a torn complete discoid meniscus on MR imaging: a feasibility study for a new classification

International Nuclear Information System (INIS)

Lee, Mi Hee; Choi, Sang-Hee; Woo, Sook Young

2010-01-01

To determine the quantitative difference between an intact complete discoid lateral meniscus (CDLM) and a torn CDLM on MR imaging. Between May 2005 to November 2009, 137 patients with a CDLM (107 intact CDLM and 30 torn CDLM) and 92 patients with a normal meniscus were included in this study. The evaluated parameters were the height of the posterior horn of the lateral and medial menisci on the sagittal images and their ratio as assessed by two observers twice at an interval of 1 month. Each parameter was analyzed based on the Kruskal Wallis test, and the analysis using the mixed model. Intraclass correlation coefficient (ICC) was used to determine the interobserver reliabilities at session 2. The mean heights of the posterior horn of the lateral and medial menisci on the sagittal images for an intact CDLM, a torn CLDM, and a normal meniscus were 6.5, 7.3, 5.7 and 6.6, 6.4, 6.7 mm at session 1, respectively. The mean heights of the posterior horn of the lateral and medial menisci on the sagittal images for an intact CDLM, a torn CDLM, and a normal meniscus for both observers were 6.5, 7.2, 5.7 and 6.6, 6.3, 6.8 mm at session 2, respectively. The ratio of the height of the lateral to the height of the medial meniscus for an intact CDLM at both sessions for both observers was 1.0. The ratios were 1.2 and 0.8 for a torn CDLM and for a normal meniscus, respectively, at both sessions for observer 1. The ratios were 1.2 and 0.9 for a torn CDLM and for a normal meniscus, respectively, at session 2 for observer 2. The heights of the posterior horn of the lateral meniscus on the sagittal images and the ratios of the heights of the lateral to the medial menisci in all three groups were statistically significantly different for both sessions (p < 0.0001). The interobserver ICCs for each parameter of both an intact CDLM and a torn CDLM at session 2 showed high correlations (p < 0.0001). The height of the lateral meniscus and the ratio of the height of the lateral to the height

Rostro-Caudal Organization of Connectivity between Cingulate Motor Areas and Lateral Frontal Regions

Directory of Open Access Journals (Sweden)

Kep Kee Loh

2018-01-01

Full Text Available According to contemporary views, the lateral frontal cortex is organized along a rostro-caudal functional axis with increasingly complex cognitive/behavioral control implemented rostrally, and increasingly detailed motor control implemented caudally. Whether the medial frontal cortex follows the same organization remains to be elucidated. To address this issue, the functional connectivity of the 3 cingulate motor areas (CMAs in the human brain with the lateral frontal cortex was investigated. First, the CMAs and their representations of hand, tongue, and eye movements were mapped via task-related functional magnetic resonance imaging (fMRI. Second, using resting-state fMRI, their functional connectivity with lateral prefrontal and lateral motor cortical regions of interest (ROIs were examined. Importantly, the above analyses were conducted at the single-subject level to account for variability in individual cingulate morphology. The results demonstrated a rostro-caudal functional organization of the CMAs in the human brain that parallels that in the lateral frontal cortex: the rostral CMA has stronger functional connectivity with prefrontal regions and weaker connectivity with motor regions; conversely, the more caudal CMAs have weaker prefrontal and stronger motor connectivity. Connectivity patterns of the hand, tongue and eye representations within the CMAs are consistent with that of their parent CMAs. The parallel rostral-to-caudal functional organization observed in the medial and lateral frontal cortex could likely contribute to different hierarchies of cognitive-motor control.

Patellar dislocations in children, adolescents and adults: A comparative MRI study of medial patellofemoral ligament injury patterns and trochlear groove anatomy

International Nuclear Information System (INIS)

Balcarek, Peter; Walde, Tim Alexander; Frosch, Stephan; Schuettrumpf, Jan P.; Wachowski, Martin M.; Stuermer, Klaus M.; Frosch, Karl-Heinz

2011-01-01

Purpose: The first aim was to compare medial patellofemoral ligament injury patterns in children and adolescents after first-time lateral patellar dislocations with the injury patterns in adults. The second aim was to evaluate the trochlear groove anatomy at different developmental stages of the growing knee joint. Materials and methods: Knee magnetic resonance (MR) images were collected from 22 patients after first-time patellar dislocations. The patients were aged 14.2 years (a range of 11-15 years). The injury pattern of the medial patellofemoral ligament was analysed, and trochlear dysplasia was evaluated with regard to sulcus angle, trochlear depth and trochlear asymmetry. The control data consisted of MR images from 21 adult patients who were treated for first-time lateral patellar dislocation. Results: After patellar dislocation, injury to the medial patellofemoral ligament was found in 90.2% of the children and in 100% of the adult patients. Injury patterns of the medial patellofemoral ligament were similar between the study group and the control group with regard to injury at the patellar attachment site (Type I), to the midsubstance (Type II) and to injury at the femoral origin (Type III) (all p > 0.05). Combined lesions (Type IV) were significantly less frequently observed in adults when compared to the study group (p = 0.02). The magnitude of trochlear dysplasia was similar in children, adolescents and adults with regard to all three of the measured parameter-values (all p > 0.05). In addition, the articular cartilage had a significant effect on the distal femur geometry in both paediatrics and adults. Conclusion: First, the data from our study indicated that the paediatric medial patellofemoral ligament injury patterns, as seen on MR images, were similar to those in adults. Second, the trochlear groove anatomy and the magnitude of trochlear dysplasia, respectively, did not differ between adults and paediatrics with patellar instability. Thus

Patellar dislocations in children, adolescents and adults: A comparative MRI study of medial patellofemoral ligament injury patterns and trochlear groove anatomy

Energy Technology Data Exchange (ETDEWEB)

Balcarek, Peter, E-mail: peter.balcarek@med.uni-goettingen.de [Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, 37075 Goettingen (Germany); Walde, Tim Alexander; Frosch, Stephan; Schuettrumpf, Jan P.; Wachowski, Martin M.; Stuermer, Klaus M. [Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, 37075 Goettingen (Germany); Frosch, Karl-Heinz [Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Hamburg (Germany)

2011-09-15

Purpose: The first aim was to compare medial patellofemoral ligament injury patterns in children and adolescents after first-time lateral patellar dislocations with the injury patterns in adults. The second aim was to evaluate the trochlear groove anatomy at different developmental stages of the growing knee joint. Materials and methods: Knee magnetic resonance (MR) images were collected from 22 patients after first-time patellar dislocations. The patients were aged 14.2 years (a range of 11-15 years). The injury pattern of the medial patellofemoral ligament was analysed, and trochlear dysplasia was evaluated with regard to sulcus angle, trochlear depth and trochlear asymmetry. The control data consisted of MR images from 21 adult patients who were treated for first-time lateral patellar dislocation. Results: After patellar dislocation, injury to the medial patellofemoral ligament was found in 90.2% of the children and in 100% of the adult patients. Injury patterns of the medial patellofemoral ligament were similar between the study group and the control group with regard to injury at the patellar attachment site (Type I), to the midsubstance (Type II) and to injury at the femoral origin (Type III) (all p > 0.05). Combined lesions (Type IV) were significantly less frequently observed in adults when compared to the study group (p = 0.02). The magnitude of trochlear dysplasia was similar in children, adolescents and adults with regard to all three of the measured parameter-values (all p > 0.05). In addition, the articular cartilage had a significant effect on the distal femur geometry in both paediatrics and adults. Conclusion: First, the data from our study indicated that the paediatric medial patellofemoral ligament injury patterns, as seen on MR images, were similar to those in adults. Second, the trochlear groove anatomy and the magnitude of trochlear dysplasia, respectively, did not differ between adults and paediatrics with patellar instability. Thus

Treatment of Medial Malleolus or Pure Deltoid Ligament Injury in Patients with Supination-External Rotation Type IV Ankle Fractures.

Science.gov (United States)

Wang, Xu; Zhang, Chao; Yin, Jian-Wen; Wang, Chen; Huang, Jia-Zhang; Ma, Xin; Wang, Cheng-Wei; Wang, Xue

2017-02-01

To investigate the effect of internal fixation on postoperative ankle function in patients with supination-external rotation type IV ankle fractures, including medial malleolus fractures and deltoid ligament injury. Between January 2012 and June 2014, patients with medial structure injuries were enrolled in this study and assigned to the medial malleolus fracture group or the deltoid ligament group. The surgical procedures for the two groups were documented. The follow-up endpoint was the time point when the steel plate or screw was removed from the lateral ankle. The Olerud-Molander ankle scoring system was used to assess ankle function. A total of 84 patients with supination-external rotation type IV ankle fractures had complete medical records and were included in this study. The average age of the patients was 44.16 years (range, 15-75). The patient sample included 39 males and 45 females. Overall, 49 patients (19 males and 30 females) suffered a medial malleolus fracture. The average age of these patients was 40.20 years (range, 15-75). Patients with a posterior malleolar fracture fragment >25% of the articular surface accounted for 81.6% (40 patients) of these patients. Overall, 35 patients (20 males and 15 females) experienced a deltoid ligament injury. The average age of these patients was 44.21 years (range, 17-73). Patients with a posterior malleolar fracture fragment >25% of the articular surface accounted for 11.5% (four patients) of these patients. Open reduction was performed in patients with medial malleolus fractures, and two 4.0-mm cannulated screws were used to fixate the posterior malleolus and the medial malleolus. The suture-anchor technique was used to repair the ligaments in patients with deltoid ligament injuries. The follow-up endpoint was the time point when the steel plate and screws were removed from the lateral ankle in patients. The average follow-up period was 13.4 months (range, 11-17). The Olerud-Molander ankle scoring system was

In vivo tibiofemoral cartilage-to-cartilage contact area of females with medial osteoarthritis under acute loading using MRI.

Science.gov (United States)

Shin, Choongsoo S; Souza, Richard B; Kumar, Deepak; Link, Thomas M; Wyman, Bradley T; Majumdar, Sharmila

2011-12-01

To investigate the effect of acute loading on in vivo tibiofemoral contact area changes in both compartments, and to determine whether in vivo tibiofemoral contact area differs between subjects with medial knee osteoarthritis (OA) and healthy controls. Ten subjects with medial knee OA (KL3) and 11 control subjects (KL0) were tested. Coronal three-dimensional spoiled gradient-recalled (3D-SPGR) and T(2) -weighted fast spin-echo FSE magnetic resonance imaging (MRI) of the knee were acquired under both unloaded and loaded conditions. Tibiofemoral cartilage contact areas were measured using image-based 3D models. Tibiofemoral contact areas in both compartments significantly increased under loading (P contact area in the medial compartment was significantly larger than in the lateral compartment (P contact area was significantly larger in KL3 subjects than KL0 subjects, both at unloaded and loaded conditions (P Contact areas measured from 3D-SPGR and T(2) -weighted FSE images were strongly correlated (r = 0.904). Females with medial OA increased tibiofemoral contact area in the medial compartment compared to healthy subjects under both unloaded and loaded conditions. The contact area data presented in this study may provide a quantitative reference for further cartilage contact biomechanics such as contact stress analysis and cartilage biomechanical function difference between osteoarthritic and healthy knees. Copyright © 2011 Wiley Periodicals, Inc.

Oxytocin mediates rodent social memory within the lateral septum and the medial amygdala depending on the relevance of the social stimulus: male juvenile versus female adult conspecifics.

Science.gov (United States)

Lukas, Michael; Toth, Iulia; Veenema, Alexa H; Neumann, Inga D

2013-06-01

Brain oxytocin (OXT) plays an important role in short-term social memory in laboratory rodents. Here we monitored local release of OXT and its functional involvement in the maintenance and retrieval of social memory during the social discrimination test. We further assessed, if the local effects of OXT within the medial amygdala (MeA) and lateral septum (LS) on social discrimination abilities were dependent on the biological relevance of the social stimulus, thus comparing male juvenile versus adult female conspecifics. OXT release was increased in the LS of male rats during the retrieval, but not during the acquisition or maintenance, of social memory for male juvenile stimuli. Blockade of OXT activity by intracerebroventricular (ICV) administration of a specific OXT receptor antagonist (OXTR-A, rats: 0.75 μg/5 μl, mice: 2 μg/2 μl) immediately after acquisition of social memory impaired the maintenance of social memory, and consequently discrimination abilities during retrieval of social memory. In contrast, ICV OXTR-A was without effect when administered 20 min prior to retrieval of social memory in both species. Non-social memory measured in the object discrimination test was not affected by ICV OXTR-A in male mice, indicating that brain OXT is mainly required for memory formation in a social context. The biological relevance of the social stimulus seems to importantly determine social memory abilities, as male rats recognized a previously encountered female adult stimulus for at least 2h (versus 60 min for male juveniles), with a region-dependent contribution of endogenous OXT; while bilateral administration of OXTR-A into the MeA (0.1 μg/1 μl) impaired social memory for adult females only, administration of OXTR-A into the LS via retrodialysis (10 μg/ml, 1.0 μl/min) impaired social memory for both male juveniles and female adults. Overall, these results indicate that brain OXT is a critical mediator of social memory in male rodents and that, depending

Historical Review of Uncommanded Lateral-Directional Motions at Transonic Conditions

Science.gov (United States)

Chambers, Joseph R.; Hall, Robert M.

2003-01-01

This paper presents the results of a survey of past experiences with uncommanded lateral-directional motions at transonic speeds during specific military aircraft programs. The effort was undertaken to provide qualitative and quantitative information on past airplane programs that might be of use to the participants in the joint NASA/Navy/Air Force Abrupt Wing Stall (AWS) Program. The AWS Program was initiated because of the experiences of the F/A-l8E/F development program, during which unexpected, severe wing-drop motions were encountered by preproduction aircraft at transonic conditions. These motions were judged to be significantly degrading to the primary mission requirements of the aircraft. Although the problem was subsequently solved for the production version of the F/A-l8E/F, a high-level review panel emphasized the poor understanding of such phenomena and issued a strong recommendation to: "Initiate a national research effort to thoroughly and systematically study the wing drop phenomena." A comprehensive, cooperative NASA/Navy/Air Force AWS Program was designed to respond to provide the required technology requirements. As part of the AWS Program, a work element was directed at a historical review of wing-drop experiences in past aircraft development programs at high subsonic and transonic speeds. In particular, information was requested regarding: specific aircraft configurations that exhibited uncommanded motions and the nature of the motions; geometric characteristics of the air- planes; flight conditions involved in occurrences; relevant data, including wind-tunnel, computational, and flight sources; figures of merit used for analyses; and approaches used to alleviate the problem. An attempt was also made to summarize some of the more important lessons learned from past experiences, and to recommend specific research efforts. In addition to providing technical information to assist the AWS research objectives, the study produced fundamental

Repair of Medial Patellofemoral, Ligament Improves Patellar, Tracking in Total Knee Replacement.

Science.gov (United States)

Meneghini, R Michael; Ziemba-Davis, Mary; Smits, Shelly; Bicos, James

2015-11-01

The medial patellofemoral ligament (MPFL) is essential to maintain patella stability; however, its role in total knee replacement (TKR) has not been studied. Forty-six consecutive TKRs in 40 patients were reviewed. Standard closure was performed in 29 TKRs. The MPFL was isolated and anatomically re-approximated in 17 subsequent TKRs. Blinded radiographic evaluation of patellar tilt and subluxation was performed preoperatively and 4 months postoperatively. Despite greater preoperative lateral tilt, the MPFL repair group demonstrated greater correction in patellar tilt compared with the standard closure group (p = 0.02). Patellar tracking also was optimized in the MPFL group, despite equivalent preoperative lateral patellar subluxation in the two groups. Simple repair of the MPFL at arthrotomy closure appears to optimize patellar stability radiographically and may improve long-term results by minimizing patellar complications and wear.

Lateralized EEG components with direction information for the preparation of saccades versus finger movements

NARCIS (Netherlands)

van der Lubbe, Robert Henricus Johannes; Wauschkuhn, Bernd; Wascher, Edmund; Niehoff, Torsten; Kömpf, Detlef; Verleger, Rolf

2000-01-01

During preparation of horizontal saccades in humans, several lateralized (relative to saccade direction), event-related EEG components occur that have been interpreted as reflecting activity of frontal and parietal eye fields. We investigated to what degree these components are specific to saccade

Isolated Medial Rectus Nuclear Palsy as a Rare Presentation of Midbrain Infarction.

Science.gov (United States)

Al-Sofiani, Mohammed; Lee Kwen, Peterkin

2015-10-08

Diplopia is a common subjective complaint that can be the first manifestation of a serious pathology. Here, we report a rare case of midbrain infarction involving the lateral subnucleus of the oculomotor nuclear complex presenting as diplopia, with no other stroke manifestations. An 83-year-old right-handed white man with past medical history of diabetes mellitus, hypertension, dyslipidemia, and coronary artery disease presented to the emergency department (ED) with diplopia and unsteadiness. Two days prior to admission, the patient woke up with constant horizontal diplopia and unsteadiness, which limited his daily activities and led to a fall at home. He denied any weakness, clumsiness, nausea, vomiting, photophobia, fever, or chills. Ocular exam showed a disconjugate gaze at rest, weakness of the left medial rectus muscle, impaired convergence test, and bilateral 3-mm reactive pupils. The diplopia resolved by closing either eye. The remaining extraocular muscles and other cranial nerves were normal. There was no nystagmus, ptosis, or visual field deficit. Sensation, muscle tone, and strength were normal in all extremities. Magnetic resonance imaging (MRI) of the brain revealed a tiny focus of restricted diffusion in the left posterior lateral midbrain. A thorough history and physical examination is essential to diagnose and manage diplopia. Isolated extraocular palsy is usually thought to be caused by orbital lesions or muscular diseases. Here, we report a case of midbrain infarction manifested as isolated medial rectus palsy.

jqcML: an open-source java API for mass spectrometry quality control data in the qcML format.

Science.gov (United States)

Bittremieux, Wout; Kelchtermans, Pieter; Valkenborg, Dirk; Martens, Lennart; Laukens, Kris

2014-07-03

The awareness that systematic quality control is an essential factor to enable the growth of proteomics into a mature analytical discipline has increased over the past few years. To this aim, a controlled vocabulary and document structure have recently been proposed by Walzer et al. to store and disseminate quality-control metrics for mass-spectrometry-based proteomics experiments, called qcML. To facilitate the adoption of this standardized quality control routine, we introduce jqcML, a Java application programming interface (API) for the qcML data format. First, jqcML provides a complete object model to represent qcML data. Second, jqcML provides the ability to read, write, and work in a uniform manner with qcML data from different sources, including the XML-based qcML file format and the relational database qcDB. Interaction with the XML-based file format is obtained through the Java Architecture for XML Binding (JAXB), while generic database functionality is obtained by the Java Persistence API (JPA). jqcML is released as open-source software under the permissive Apache 2.0 license and can be downloaded from https://bitbucket.org/proteinspector/jqcml .

A randomized comparison between neurostimulation and ultrasound-guided lateral femoral cutaneous nerve block.

Science.gov (United States)

Gupta, Gaurav; Radhakrishna, Mohan; Tamblyn, Isaac; Tran, D Q; Besemann, Markus; Thonnagith, Atikun; Elgueta, Maria Francisca; Robitaille, Marie Eve; Finlayson, Roderick J

2017-01-01

This prospective, randomized trial compared neurostimulation (NS) and ultrasound (US) guided lateral femoral cutaneous nerve (LFCN) block. We hypothesized that US would result in a shorter total anesthesia-related time (sum of performance and onset times). Twenty-one volunteers were enrolled. The right lower limb was randomized to an NS- or US-guided LFCN block. The alternate technique was employed for the left lower limb. With NS, paresthesias were sought in the lateral thigh at a stimulatory threshold of 0.6 mA (pulse width=0.3 ms; frequency=2 Hz) or lower. With US, local anesthetic was deposited under the inguinal ligament, ventral to the iliopsoas muscle. In both groups, 5 mL of lidocaine 2% were used to anesthetize the nerve. During the procedure of the block, the performance time and number of needle passes were recorded. Subsequently, a blinded observer assessed sensory block in the lateral thigh every minute until 20 minutes. Success was defined as loss of pinprick sensation at a point midway between the anterior superior iliac spine and the lateral knee line. The blinded observer also assessed the areas of sensory block in the anterior, medial, lateral, and posterior aspects of the thigh and mapped this distribution onto a corresponding grid. Both modalities provided comparable success rates (76.2%-95.2%), performance times (162.1 to 231.3 seconds), onset times (300.0 to 307.5 seconds) and total anesthesia related-times (480.1 to 554.0 seconds). However US required fewer needle passes (3.2±2.9 vs 9.5±12.2; P=.009). There were no intergroup differences in terms of the distribution of the anesthetized cutaneous areas. However considerable variability was encountered between individuals and between the 2 sides of a same subject. The most common areas of sensory loss included the central lateral two-eighths anteriorly and the central antero-inferior three-eighths laterally. Ultrasound guidance and NS provide similar success rates and total anesthesia

OpenML : An R package to connect to the machine learning platform OpenML

NARCIS (Netherlands)

Casalicchio, G.; Bossek, J.; Lang, M.; Kirchhoff, D.; Kerschke, P.; Hofner, B.; Seibold, H.; Vanschoren, J.; Bischl, B.

2017-01-01

OpenML is an online machine learning platform where researchers can easily share data, machine learning tasks and experiments as well as organize them online to work and collaborate more efficiently. In this paper, we present an R package to interface with the OpenML platform and illustrate its

In defence of transpalatal, transpalatal-circumaxillary (transpterygopalatine) and transpalatal-circumaxillary-sublabial approaches to lateral extensions of juvenile nasopharyngeal angiofibroma.

Science.gov (United States)

Mishra, A; Mishra, S C; Verma, V; Singh, H P; Kumar, S; Tripathi, A M; Patel, B; Singh, V

2016-05-01

Juvenile nasopharyngeal angiofibroma often presents with lateral extensions. In countries with limited resources, selection of a cost-effective and least morbid surgical approach for complete excision is challenging. Sixty-three patients with juvenile nasopharyngeal angiofibroma, with lateral extensions, underwent transpalatal, transpalatal-circumaxillary (transpterygopalatine) or transpalatal-circumaxillary-sublabial approaches for resection. Clinico-radiological characteristics, tumour volume and intra-operative bleeding were recorded. The transpalatal approach was suitable for extensions involving medial part of pterygopalatine fossa; transpalatal-circumaxillary for extensions involving complete pterygopalatine fossa, with or without partial infratemporal fossa; and transpalatal-circumaxillary-sublabial for extensions involving complete infratemporal fossa, even cheek or temporal fossa up to zygomatic arch. Haemorrhage was greatest with the transpalatal-circumaxillary-sublabial approach, followed by transpalatal approach and transpalatal-circumaxillary approach (1212, 950 and 777 ml respectively). Tumour size (volume) was greatest with the transpalatal-circumaxillary approach, followed by transpalatal-circumaxillary-sublabial approach and transpalatal approach (40, 34 and 29 mm3). There was recurrence in three cases and residual disease in two cases. Long-term morbidity included small palatal perforation (n = 1), trismus (n = 1) and atrophic rhinitis (n = 2). These modified techniques, performed with endoscopic assistance under hypotensive anaesthesia, without embolisation, offer a superior option over other open procedures with regard to morbidity and recurrences.

Role of the medial medullary reticular formation in relaying vestibular signals to the diaphragm and abdominal muscles

Science.gov (United States)

Mori, R. L.; Bergsman, A. E.; Holmes, M. J.; Yates, B. J.

2001-01-01

Changes in posture can affect the resting length of respiratory muscles, requiring alterations in the activity of these muscles if ventilation is to be unaffected. Recent studies have shown that the vestibular system contributes to altering respiratory muscle activity during movement and changes in posture. Furthermore, anatomical studies have demonstrated that many bulbospinal neurons in the medial medullary reticular formation (MRF) provide inputs to phrenic and abdominal motoneurons; because this region of the reticular formation receives substantial vestibular and other movement-related input, it seems likely that medial medullary reticulospinal neurons could adjust the activity of respiratory motoneurons during postural alterations. The objective of the present study was to determine whether functional lesions of the MRF affect inspiratory and expiratory muscle responses to activation of the vestibular system. Lidocaine or muscimol injections into the MRF produced a large increase in diaphragm and abdominal muscle responses to vestibular stimulation. These vestibulo-respiratory responses were eliminated following subsequent chemical blockade of descending pathways in the lateral medulla. However, inactivation of pathways coursing through the lateral medulla eliminated excitatory, but not inhibitory, components of vestibulo-respiratory responses. The simplest explanation for these data is that MRF neurons that receive input from the vestibular nuclei make inhibitory connections with diaphragm and abdominal motoneurons, whereas a pathway that courses laterally in the caudal medulla provides excitatory vestibular inputs to these motoneurons.

Clinical Results of Surgically Treated Medial Humeral Epicondylar Apophyseal Avulsion Injury in Children and Adolescent.

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Ruban Raj Joshi

2014-12-01

years (SD=2.3. Fifteen (75% dominant elbows were injured in our study and 12(60% elbows had an associated elbow dislocation. On examination in operating room post anaesthesia, all of the elbow injuries revealed some degree of valgus instability. All of our patients(n=20 showed good to excellent results in the MAYO elbow performance score (MEPS. Radiographically, union was achieved in all cases. Three patients developed postoperative ulnar nerve neuropraxia, all recovered at time of final follow up. One patient developed mild lateral heterotrophic ossification but did not require any additional surgical intervention. Conclusion: Our results suggest that open reduction internal fixation of displaced medial epicondyle fractures leads to satisfactory motion and function. A valgus stress test in operating room can reveal the true nature of joint instability that can warrant operative stabilization of medial epicondylar injuries.

Medial collateral ligament healing one year after a concurrent medial collateral ligament and anterior cruciate ligament injury: an interdisciplinary study in rabbits.

Science.gov (United States)

Yamaji, T; Levine, R E; Woo, S L; Niyibizi, C; Kavalkovich, K W; Weaver-Green, C M

1996-03-01

The optimal treatment for concurrent injuries to the medial collateral and anterior cruciate ligaments has not been determined, despite numerous clinical and laboratory studies. The objective of this study was to examine the effect of surgical repair of the medial collateral ligament on its biomechanical and biochemical properties 52 weeks after such injuries. In the left knee of 12 skeletally mature New Zealand White rabbits, the medial collateral ligament was torn and the anterior cruciate ligament was transected and then reconstructed. This is an experimental model previously developed in our laboratory. In six rabbits, the torn ends of the medial collateral ligament were repaired, and in the remaining six rabbits, the ligament was not repaired. Fifty-two weeks after injury, we examined varus-valgus and anterior-posterior knee stability; structural properties of the femur-medial collateral ligament-tibia complex; and mechanical properties, collagen content, and mature collagen crosslinking of the medial collateral ligament. We could not detect significant differences between repair and nonrepair groups for any biomechanical or biochemical property. Our data support clinical findings that when the medial collateral and anterior cruciate ligaments are injured concurrently and the anterior cruciate ligament is reconstructed, conservative treatment of the ruptured medial collateral ligament can result in successful healing.

Effects of Lateral Heel Wedges and Lateral Forefoot Wedge on the Knee Adduction Moment in Healthy Male Students

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Fatemeh Shamsi

2012-01-01

Full Text Available Objective: Lateral wedged insoles have been designed to decrease the force applied on the medial knee compartment. The aim of this study was to assess the effects of laterally wedged insoles regarding to the placement of the wedge under the sole (under the heel or under the forefoot on the knee adduction moment and the ground reaction forces. Material & Methods: In this pretest-posttest study, three-dimensional gait analysis was performed on 20 healthy men between 18-30 years old. Knee adduction moment and ground reaction forces were compared among following three types of insoles: a flat insole, a 6˚ laterally inclined heel wedged insole and a 6˚ laterally- inclined forefoot wedged insole. Results: there was no difference between three conditions (flat insole (9.72±1.501, lateral heel wedge (9.866±2.141 and lateral forefoot wedge (9.952±1.986 in peak knee adduction moment (P>0.05. Ground reaction forces and spatiotemporal parameters of gait were not affected by any types of these insoles (P>0.05. Conclusion: Based on the current finding, placement of the lateral wedge under the sole, that is, under the heel or under the forefoot has no effect on the efficacy of these insoles on the adduction moment of the knee and ground reaction forces.

Kinematic change of the meniscus and the tibiofemoral joint space in asymptomatic volunteers using a wide bore 3T closed MRI system

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Kim, Eugene; Kim, Yeo Ju; Kim, Mi Young; Cho, Soon Gu [Inha University Hospital, Department of Radiology, Choong-gu, Incheon (Korea, Republic of); Cha, Jang Gyu [Soonchunhyang University Hospital, Department of Radiology, Bucheon (Korea, Republic of); Lee, Dae Hyung [Inha University Hospital, Clinical Trail Center, Incheon (Korea, Republic of); Kim, Ryuh Sup [Inha University Hospital, Department of Orthopedic Surgery, Incheon (Korea, Republic of)

2015-10-15

To evaluate kinematic changes in menisci and tibiofemoral joint spaces in extension and flexion using asymptomatic volunteers using a wide-bore 3-T closed MRI system. Twenty-two knees from asymptomatic volunteers were examined in knee extension and flexion using a 3-T MRI (sagittal 2D FSE T2-weighted sequence and sagittal 3D isotropic FSE proton density-weighted cube sequence). The meniscal positions, meniscal floating and flounce were evaluated. The widths of the medial and lateral tibiofemoral joint spaces and coronal tibiofemoral angles were measured. In the anteroposterior direction, meniscal extrusion was most frequently seen in the anterior horn of the medial menisci (100 %) in extensions (maximum 6.04 mm). Most of the menisci moved significantly to the posterior side from extension to flexion. The anteroposterior meniscal movement was the greatest for the anterior horn of the medial meniscus and least for the posterior horn of the medial meniscus. In the mediolateral direction, meniscal extrusion was seen in 52 % of the medial menisci in extensions (maximum 1.91 mm) and 29 % of lateral menisci in flexions (maximum 2.36 mm). From the extension to flexion, all medial and lateral menisci moved significantly to the lateral side. Meniscal floating was frequently observed in the posterior horn of medial menisci in extension. Meniscal flounce was frequently seen in lateral menisci in flexion with a widened lateral tibiofemoral joint space gap. The coronal tibiofemoral angle showed medial wedging in flexion, but not in extension. Wide-bore 3-T closed MRI revealed significant kinematic changes in the menisci and tibiofemoral joint spaces in asymptomatic volunteers. (orig.)

Intra-articular Entrapment of Medial Epicondyle Fracture Fragment in Elbow Joint Dislocation Causing Ulnar Neuropraxia: A Case Report

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Syed J

2017-03-01

Full Text Available Traumatic elbow dislocations in children are rare but most of them are complex dislocations, and in such dislocations, medial humerus epicondyle fractureis the most common associated injury. Fracture incarceration in the elbow joint occurs in 5-18% of medial humerus epicondyle fractures but ulnar neuropraxia is very rare. Open reduction internal fixation is indicated in medial humerus epicondyle fracture with fracture incarceration, ulnar neuropraxia, marked instability or open fracture. Operative treatment options include fragment excision and sutures, closed or open reduction and Kirschner wire fixation, open reduction and suture fixation, open reduction and smooth pin fixation, and open reduction and screw fixation. However, ulnar nerve transposition is debatable as good outcome had been reported with and without nerve transposition. We report a case of a 13-year old boy, who presented with right elbow dislocation and intra-articular entrapment of medial humerus epicondyle fracture fragment, complicated with sensory ulnar neuropraxia, following a fall onto his right outstretched hand in a motor vehicle accident. The elbow joint was reduced using close manipulative reduction but the fracture fragment remained entrapped post-reduction. The patient then underwent open reduction and screw fixation of the medial humerus epicondyle fracture without ulnar nerve transposition. He had good functional outcome six weeks after surgical intervention, with complete recovery of ulnar neuropraxia six months later. Currently, he is doing well at school and is active with his sporting activity.

ML 3.1 developer's guide.

Energy Technology Data Exchange (ETDEWEB)

Sala, Marzio; Hu, Jonathan Joseph (Sandia National Laboratories, Livermore, CA); Tuminaro, Raymond Stephen (Sandia National Laboratories, Livermore, CA)

2004-05-01

ML development was started in 1997 by Ray Tuminaro and Charles Tong. Currently, there are several full- and part-time developers. The kernel of ML is written in ANSI C, and there is a rich C++ interface for Trilinos users and developers. ML can be customized to run geometric and algebraic multigrid; it can solve a scalar or a vector equation (with constant number of equations per grid node), and it can solve a form of Maxwell's equations. For a general introduction to ML and its applications, we refer to the Users Guide [SHT04], and to the ML web site, http://software.sandia.gov/ml.

Concurrent patellar fracture and lateral collateral ligament avulsion as a result of trauma in three horses.

Science.gov (United States)

McLellan, Jonathan; Plevin, Sarah; Taylor, Elizabeth

2012-05-15

3 horses were evaluated because of lameness and swelling of the stifle joint subsequent to trauma. All horses had characteristic clinical signs of stifle joint pain and effusion. A medial patellar fracture and lateral collateral ligament avulsion fracture were visible ultrasonographically in each. Radiography, including standard as well as flexed lateromedial, cranioproximal-craniodistal oblique (skyline patellar), and laterally stressed caudocranial views, revealed similar findings. Arthroscopic surgery to remove the patellar fracture was attempted in 1 horse with severe desmitis of the lateral collateral ligament; it remained lame afterward. The other 2 horses, with less severe collateral ligament damage, were managed conservatively and returned to athletic use, despite the lack of surgical intervention to repair the patellar fractures. Special radiographic views were necessary for diagnosis of medial patellar fracture and lateral collateral ligament avulsion fracture in the 3 horses. Ultrasonographic findings pertaining to the collateral ligament may be prognostically important in such situations. The severity of a fracture involving ligament avulsion may be the limiting factor in horses with this combined injury, and this factor should be considered prior to attempting surgical correction of patellar fractures.

Loss of lateral prefrontal cortex control in food-directed attention and goal-directed food choice in obesity.

Science.gov (United States)

Janssen, Lieneke K; Duif, Iris; van Loon, Ilke; Wegman, Joost; de Vries, Jeanne H M; Cools, Roshan; Aarts, Esther

2017-02-01

Loss of lateral prefrontal cortex (lPFC)-mediated attentional control may explain the automatic tendency to eat in the face of food. Here, we investigate the neurocognitive mechanism underlying attentional bias to food words and its association with obesity using a food Stroop task. We tested 76 healthy human subjects with a wide body mass index (BMI) range (19-35kg/m 2 ) using fMRI. As a measure of obesity we calculated individual obesity scores based on BMI, waist circumference and waist-to-hip ratio using principal component analyses. To investigate the automatic tendency to overeat directly, the same subjects performed a separate behavioral outcome devaluation task measuring the degree of goal-directed versus automatic food choices. We observed that increased obesity scores were associated with diminished lPFC responses during food attentional bias. This was accompanied by decreased goal-directed control of food choices following outcome devaluation. Together these findings suggest that deficient control of both food-directed attention and choice may contribute to obesity, particularly given our obesogenic environment with food cues everywhere, and the choice to ignore or indulge despite satiety. Copyright © 2016 Elsevier Inc. All rights reserved.

Atypically thick and high location of the Wrisberg ligament in patients with a complete lateral discoid meniscus

International Nuclear Information System (INIS)

Kim, Eun Young; Choi, Sang-Hee; Kwon, Jong Won; Ahn, Jin Hwan

2008-01-01

The purpose of this study was to document the relationship between a discoid lateral meniscus and a thickened Wrisberg ligament with a higher location on the medial femoral condyle. Between July 2002 and February 2006, 100 consecutive patients who had a complete lateral discoid meniscus and another 100 patients without a discoid lateral meniscus (control group) were included. Two radiologists retrospectively reviewed all of the magnetic resonance images, paying particular attention to the presence and thickness of the Wrisberg ligament and the location of the attachment of the Wrisberg ligament to the medial femoral condyle (types I, II, or III). We assumed that type I Wrisberg ligaments had a higher location. All 141 patients had a Wrisberg ligament (71%). There were 73 patients (73%) in the discoid group and 68 patients (68%) in the non-discoid group. The mean thickness of the Wrisberg ligament in the patients in the discoid and non-discoid groups was 2.1 mm (range, 0.4-4.7 mm; median, 2.1 mm) and 1.6 mm (range, 0.4-4.5 mm; median, 1.3 mm), respectively. The Wrisberg ligaments of the discoid group were thicker than the non-discoid group (p=0.0002). The Wrisberg ligament was attached to the upper part of the medial femoral condyle in the discoid group more often than in the non-discoid group (p<0.0001). (orig.)

Typing of MRI in medial meniscus degeneration in relation to radiological grade in medial compartmental osteoarthritis of the knee

Energy Technology Data Exchange (ETDEWEB)

Nagata, Nobuhito; Koshino, Tomihisa; Saito, Tomoyuki; Sakai, Naotaka; Takagi, Toshitaka; Takeuchi, Ryohei [Yokohama City Univ. (Japan). School of Medicine

1998-10-01

The advancement of degeneration of 50 medial menisci in patients with medial compartmental osteoarthritic knees (OA) were evaluated with magnetic resonance imaging (MRI). The average age of the patients was 66.6 years (range, 39 to 86). According to a radiographical grading system, 6 knees were classified as Grade 1, 24 as Grade 2, 16 as Grade 3, and 4 as Grade 4. The extent and the location of a high intensity region in MRI were observed in 3 parts of the meniscus, namely, the anterior, middle and posterior part. In Grade 1, no high intensity region was observed in 3 knees, and a high intensity region was observed only in the posterior part in 2 knees. A high intensity region was observed from the medial to the posterior part in 13 knees, and only in the posterior part in 10 knees of Grade 2; from the medial to the posterior part in 12 knees, and only in the posterior part in 3 knees of Grade 3, and from the anterior to the posterior part in 2 knees of Grade 4. The shape of the high intensity region in the medial meniscus was classified into 5 types, as follows: Type 1, there was no high intensity region; Type 2, the high intensity region was observed to be restricted within the meniscus; Type 3, the high intensity region resembled a horizontal tear; Type 4, the high intensity region was observed as all of the medial joint space without a marginal area; Type 5, the high intensity region was observed as all of the medial joint space. In Grade 1, 3 knees were classified as Type 1, and 2 knees as Type 2; in Grade 2, 7 knees as Type 2, and 13 knees as Type 3, and 4 knees into Type 4; in Grade 3, 6 knees as Type 3, and 7 knees as Type 4; and in Grade 4, 2 knees as Type 4, and 2 knees as Type 5. These findings might suggest that the degeneration of medial meniscus in the medial type of OA was accelerated by mechanical stress due to varus deformity. (author)

Typing of MRI in medial meniscus degeneration in relation to radiological grade in medial compartmental osteoarthritis of the knee

International Nuclear Information System (INIS)

Nagata, Nobuhito; Koshino, Tomihisa; Saito, Tomoyuki; Sakai, Naotaka; Takagi, Toshitaka; Takeuchi, Ryohei

1998-01-01

The advancement of degeneration of 50 medial menisci in patients with medial compartmental osteoarthritic knees (OA) were evaluated with magnetic resonance imaging (MRI). The average age of the patients was 66.6 years (range, 39 to 86). According to a radiographical grading system, 6 knees were classified as Grade 1, 24 as Grade 2, 16 as Grade 3, and 4 as Grade 4. The extent and the location of a high intensity region in MRI were observed in 3 parts of the meniscus, namely, the anterior, middle and posterior part. In Grade 1, no high intensity region was observed in 3 knees, and a high intensity region was observed only in the posterior part in 2 knees. A high intensity region was observed from the medial to the posterior part in 13 knees, and only in the posterior part in 10 knees of Grade 2; from the medial to the posterior part in 12 knees, and only in the posterior part in 3 knees of Grade 3, and from the anterior to the posterior part in 2 knees of Grade 4. The shape of the high intensity region in the medial meniscus was classified into 5 types, as follows: Type 1, there was no high intensity region; Type 2, the high intensity region was observed to be restricted within the meniscus; Type 3, the high intensity region resembled a horizontal tear; Type 4, the high intensity region was observed as all of the medial joint space without a marginal area; Type 5, the high intensity region was observed as all of the medial joint space. In Grade 1, 3 knees were classified as Type 1, and 2 knees as Type 2; in Grade 2, 7 knees as Type 2, and 13 knees as Type 3, and 4 knees into Type 4; in Grade 3, 6 knees as Type 3, and 7 knees as Type 4; and in Grade 4, 2 knees as Type 4, and 2 knees as Type 5. These findings might suggest that the degeneration of medial meniscus in the medial type of OA was accelerated by mechanical stress due to varus deformity. (author)

COHORT STUDY OF DISPLACED SUPRACONDYLAR FRACTURE TREATED IN TERTIARY CARE INSTITUTE IN PONDICHERY WITH RADIOLOGICAL ASSISTANCE WITH MEDIAL ‘K’ WIRE FIRST FROM 2008-2016

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Aravindan Kalamegam

2017-10-01

Full Text Available BACKGROUND Supracondylar fracture in children when it is displaced, it is very difficult to reduce the fracture. That too after reduction, maintaining the reduction is very difficult. While reducing the fracture in closed reduction with lateral pinning first the result is not predictably good. Cross pinning will be giving mechanically stable fixation than lateral pinning alone. Lateral pinning alone imparts less rotational stability of fracture. Our aim of study is to prevent rotational instability by putting medial pinning first by avoiding the ulnar nerve injury using radiological assistance followed by lateral pinning. MATERIALS AND METHODS One hundred and six cases of displaced supracondylar fracture were included in study. The mean age of the patient was 7 yrs. (3-12 yrs., the male and female patient ratio was 72:34 and left side was involved in 63 patients whereas right side in 43 patients. The most common mode of trauma was fall from height on outstretched hand with elbow in extension. All the 106 patients were consecutively admitted. Patient had extension type of injury with 63 patients had Gartland type III fracture and 43 had Gartland type II fracture. Posteromedial displacement was noted in 63 patients whereas posterolateral displacement noted in 43 patients. In all cases, medial K wire was first inserted after closed reduction, then after stabilising the fractured rotation using image guidance. Lateral K-wire was removed on 3 weeks (21 days and follow up was done at 6 weeks and 12 weeks when they were evaluated according to Flynn’s criteria. RESULTS Results were graded according to Flynn’s criteria. CONCLUSION Medial K wire technique provides stable fixation and rotational stability has been correlated according to this technique.

Method of segmenting inferior horns of lateral ventricles using active contour models

International Nuclear Information System (INIS)

Hattori, Masumi; Koyama, Shuji; Kodera, Yoshie

2007-01-01

Recent research has suggested that the measurement of regional atrophy in the structure of the medial temporal lobe is a promising way to discriminate Alzheimer-type dementia patients from healthy control subjects. There are some reports that the inferior horns of the lateral ventricles are expanded by atrophying the structure of the medial temporal lobe. We developed a technique to automatically detect the region of the inferior horns of the lateral ventricles by gray-level thresholding and morphological processing. However, there were some incorrect regions in this method. Accordingly, we proposed a technique for which active contour models (ACM) were used. Our ACM incorporates the improved edge-based image and the external constraint to improve convergence and to reduce its dependence on initial estimation. In this study, we present the details of an algorithm that traces the contours of the inferior horns of the lateral ventricles and its performance relative to manual methods. The average degree of correspondence between the extract region and manual trace was measured in 30 inferior horns of 15 subjects. The average degree of correspondence of the proposed method was about 4% higher than that of the conventional method. These results suggest that the proposed method is more accurate than the conventional method. (author)

mzML2ISA & nmrML2ISA: generating enriched ISA-Tab metadata files from metabolomics XML data.

Science.gov (United States)

Larralde, Martin; Lawson, Thomas N; Weber, Ralf J M; Moreno, Pablo; Haug, Kenneth; Rocca-Serra, Philippe; Viant, Mark R; Steinbeck, Christoph; Salek, Reza M

2017-08-15

Submission to the MetaboLights repository for metabolomics data currently places the burden of reporting instrument and acquisition parameters in ISA-Tab format on users, who have to do it manually, a process that is time consuming and prone to user input error. Since the large majority of these parameters are embedded in instrument raw data files, an opportunity exists to capture this metadata more accurately. Here we report a set of Python packages that can automatically generate ISA-Tab metadata file stubs from raw XML metabolomics data files. The parsing packages are separated into mzML2ISA (encompassing mzML and imzML formats) and nmrML2ISA (nmrML format only). Overall, the use of mzML2ISA & nmrML2ISA reduces the time needed to capture metadata substantially (capturing 90% of metadata on assay and sample levels), is much less prone to user input errors, improves compliance with minimum information reporting guidelines and facilitates more finely grained data exploration and querying of datasets. mzML2ISA & nmrML2ISA are available under version 3 of the GNU General Public Licence at https://github.com/ISA-tools. Documentation is available from http://2isa.readthedocs.io/en/latest/. reza.salek@ebi.ac.uk or isatools@googlegroups.com. Supplementary data are available at Bioinformatics online. © The Author(s) 2017. Published by Oxford University Press.

Vocal fold injection medialization laryngoplasty.

Science.gov (United States)

Modi, Vikash K

2012-01-01

Unilateral vocal fold paralysis (UVFP) can cause glottic insufficiency that can result in hoarseness, chronic cough, dysphagia, and/or aspiration. In rare circumstances, UVFP can cause airway obstruction necessitating a tracheostomy. The treatment options for UVFP include observation, speech therapy, vocal fold injection medialization laryngoplasty, thyroplasty, and laryngeal reinnervation. In this chapter, the author will discuss the technique of vocal fold injection for medialization of a UVFP. Copyright © 2012 S. Karger AG, Basel.

Assessment of postural stability in overweight and obese middle-aged women

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Zuzana Kováčiková

2014-09-01

Full Text Available Background: Obesity and overweight are defined as abnormal or excessive fat accumulation and are associated with balance disorders. Objective: To assess the postural stability in a natural stance in overweight and obese women based on center of pressure (CoP velocity in the anterior-posterior (AP and medial-lateral (ML directions. Methods: A total of 102 women categorized according to body mass index into normal weight, overweight and obese categories underwent a measurement of quiet standing with their eyes open (EO and with their eyes closed (EC. Postural stability was assessed with a force platform. The mean CoP velocity was evaluated in both directions. Results: In the AP direction under EO conditions, obese women swayed significantly faster than normal weight women (1.01 cm/s and 0.80 cm/s. In the ML direction, a higher CoP velocity was observed in normal weight women than in obese women (0.52 cm/s and 0.41 cm/s. Under EC conditions in the AP direction, obese women swayed significantly faster than normal weight women (1.29 cm/s and 0.97 cm/s. In the ML direction, a higher CoP velocity was observed in normal weight women than in obese women (0.65 cm/s and 0.48 cm/s. Conclusions: Results suggest a negative impact of obesity on postural stability in the AP direction. In the ML direction, obese women were more stable than normal weight women, probably due to enlargement of the support base in a natural stance.

MR imaging of medial collateral ligament injury and associated internal knee joint injury

International Nuclear Information System (INIS)

Lim, Chae Ha; Lee, Sun Kyoung; Lim, Dong Hun; Kim, Young Sook; Byun, Ju Nam; Kim, Young Chul; Oh, Jae Hee

1996-01-01

To assess the value of MR imaging in the diagnosis of medial collateral ligament injury of the knee, we used MR imaging to evaluate the characteristic findings in MCL tears and the frequency of associated knee joint injury. We retrospectively reviewed 26 patients within four weeks of MCL injury, analysed MR findings and correlated them with surgical findings. We evaluated discontinuity, heterogeneous signal intensity of MCL, thin band- like low signal intensity at MCL, facial edema, loss of clear demarcation of adjacent fat also combined bone injury, meniscus injury and other ligament injury. Complete MCL tears were present in 14 patients and partial tears in 12. Complete tears showed discontinuity of MCL, fascial edema and loss of clear demarcation from adjacent fat in 11 patients(79%);proximal MCL tears are more common than distal tears. Partial tears showed thin band-like low signal intensity within MCL, fascial edema and loss of clear demarcation from adjacent fat in seven patients (58%);all patient s with MCL injury showed fascial edema;in 12 patients there was loss of clear demarcation from adjacent fat. We could not, however, distinguish between complete tears and partial tears when MCL showed heterogeneous high signal intensity. Combined bone injury in MCL tears was found in eight patients(62%);the most common sites of this were the lateral femoral condyle and lateral tibial plateau. There was associated injury involving other ligaments(ACL:50%;PCL:27%). Combined meniscus injury in MCL tears was present in 17 patients and the most common meniscus site(50%) is the posterior horn of the medial meniscus. Complete MCL tears showed discontinuity of MCL and partial tears showed a thin band-like low signal intensity within MCL. All patients with MCL injury showed fascial edema, and loss of clear demarcation from adjacent fat. Various other injuries combine with MCL tears. MR imaging is therefore useful in the evaluation of medial collateral ligament injury and

TIBIAL PLATEAU PROXIMAL AND DISTAL BONE BEHAVE SIMILARLY: BOTH ARE ASSOCIATED WITH FEATURES OF KNEE OSTEOARTHRITIS

Science.gov (United States)

There is a growing imperative to understand how changes in peri-articular bone relate to pathological progression of knee osteoarthritis (KOA). Peri-articular bone density can be measured using dual x-ray absorptiometry (DXA). The medial:lateral tibial BMD ratio (M:L BMD) is associated with MRI and...

Bereitschaftspotentials recorded from the lateral part of the superior frontal gyrus in humans.

Science.gov (United States)

Ohara, Shinji; Ikeda, Akio; Matsuhashi, Masao; Satow, Takeshi; Kunieda, Takeharu; Mikuni, Nobuhiro; Baba, Koichi; Mihara, Tadahiro; Miyamoto, Susumu; Shibasaki, Hiroshi

2006-05-15

To demonstrate the Bereitschaftspotentials (BPs) over the high lateral convexity in the superior frontal gyrus, movement-related cortical potentials with respect to the middle finger extension were recorded in seven patients with refractory epilepsy who underwent subdural implantation of platinum electrode grids and/or strips covering the high lateral frontal convexity. In two out of the seven patients, BPs were recorded from the electrodes placed on the superior frontal gyrus in the vicinity of the border between the medial and lateral frontal lobes, which were distinct from those recorded from the primary sensorimotor cortex. The results suggest the possible contribution of either the lateral dorsal non-primary motor area or the SMA to the generation of the BPs.

Isolated partial tear and partial avulsion of the medial head of gastrocnemius tendon presenting as posterior medial knee pain

OpenAIRE

Watura, Christopher; Ward, Anthony; Harries, William

2010-01-01

We present a case of medial head of gastrocnemius tendon tear. The type of injury widely reported in the literature is tear of the medial head of gastrocnemius muscle or ‘tennis leg’. We previously reported an isolated partial tear and longitudinal split of the tendon to the medial head of gastrocnemius at its musculotendinous junction. The case we now present has notable differences; the tear was interstitial and at the proximal (femoral attachment) part of the tendon, the patient’s symptoms...

Lateral radiography of the knee with single-leg standing

International Nuclear Information System (INIS)

Ohmori, Kan; Sugawara, Tsuyoshi; Murakami, Katsuyoshi; Kirinai, Mikio; Fujiwara, Junichi; Oikawa, Takumi; Matsumura, Yutaka; Sugawara, Tsukasa

2002-01-01

The purpose of this investigation was to accomplish reproducible radiography of single-leg standing lateral radiography of the knee by adjusting lateral rotation using a ruler to measure foot position. After preliminary assessment of three-dimensional CT of the knees of normal volunteers, the best adjustment of external rotation was estimated. A ruler was made for use in adjusting the angle of knee rotation by measuring foot rotation. Based on the foot rotation measured by this ruler, the positioning of radiography was adjusted to correct rotation. Rotation was estimated by the distance between the posterior edges of the lateral and medial femoral condyles. Fifteen-degree and 17.5-degree rotations were used for correction. Correction of rotation was 17 degrees on average. This helped not only to correct external rotation in the initial radiography but also to correct rotation for repeat radiography. Our method is quantitative and highly reproducible, and it increases the success rate of lateral knee radiography. (author)

Allelism of Genes in the Ml-a locus

DEFF Research Database (Denmark)

Giese, Nanna Henriette; Jensen, Hans Peter; Jørgensen, Jørgen Helms

1980-01-01

Seven barley lines or varieties, each with a different gene at the Ml-a locus for resistance to Erysiphe graminis were intercrossed. Progeny testing of the F2s using two different fungal isolates per cross provided evidence that there are two or more loci in the Ml-a region. Apparent recombinants...... were also screened for recombination between the Hor1 and Hor2 loci which are situated either side of the Ml-a locus. The cross between Ricardo and Iso42R (Rupee) yielded one possible recombinant, with Ml-a3 and Ml-a(Rul) in the coupling phase; other recombinants had wild-type genes in the coupling...... phase. Iso20R, derived from Hordeum spontaneum 'H204', carrying Ml-a6, had an additional gene, in close coupling with Ml-a6, tentatively named Ml-aSp2 or Reglv, causing an intermediate infection type with isolate EmA30. It is suggested that Ml-a(Ar) in Emir and Ml-a(Rul), shown to differ from other Ml...

Magnetic resonance imaging of bilateral lateral congenital dislocations of unossified patellae

International Nuclear Information System (INIS)

Calisir, Cuneyt; Yilmaz, Oguzhan; Inan, Ulukan

2006-01-01

We describe our experience using magnetic resonance imaging (MRI) to evaluate the unossified dislocated cartilaginous patella in a 6-year-old male patient with restricted extension and flexion deformity of both knees. MRI is used widely in the visualization of cartilage since it can show cartilage directly. In addition, FS FLASH 3D sequence has recently been accepted as a suitable sequence in the evaluation of hyaline cartilage. MRI makes it possible to evaluate ligamentous, tendinous, muscular, and cartilaginous structures as well as the abnormalities related to them. We applied this technique in our case and found it very effective in locating the unossified dislocated cartilaginous patella. We also observed structural changes such as bilateral lateral displacement of short quadriceps tendon inserting into diminutive patella, insertion of bilateral patellar tendons into anterolateral tibia, and a stretching of the medial collateral ligament associated with valgus stress. (orig.)

Magnetic resonance imaging of bilateral lateral congenital dislocations of unossified patellae

Energy Technology Data Exchange (ETDEWEB)

Calisir, Cuneyt; Yilmaz, Oguzhan [Osmangazi University, Medical Faculty, Department of Radiology, Eskisehir (Turkey); Inan, Ulukan [Osmangazi University, Medical Faculty, Department of Orthopaedic and Trauma Surgery, Eskisehir (Turkey)

2006-06-15

We describe our experience using magnetic resonance imaging (MRI) to evaluate the unossified dislocated cartilaginous patella in a 6-year-old male patient with restricted extension and flexion deformity of both knees. MRI is used widely in the visualization of cartilage since it can show cartilage directly. In addition, FS FLASH 3D sequence has recently been accepted as a suitable sequence in the evaluation of hyaline cartilage. MRI makes it possible to evaluate ligamentous, tendinous, muscular, and cartilaginous structures as well as the abnormalities related to them. We applied this technique in our case and found it very effective in locating the unossified dislocated cartilaginous patella. We also observed structural changes such as bilateral lateral displacement of short quadriceps tendon inserting into diminutive patella, insertion of bilateral patellar tendons into anterolateral tibia, and a stretching of the medial collateral ligament associated with valgus stress. (orig.)

Fragmentation of the medial malleolus of dogs with and without tarsal osteochondrosis

International Nuclear Information System (INIS)

Newell, S.M.; Mahaffey, M.B.; Aron, D.N.

1994-01-01

Fragmentation of the medial malleolus of the tibia was found radiographically in 5 canine tarsi which did not have evidence of osteochondrosis of the medial trochlear ridge. An additional 5 tarsi were found where both medial malleolar fragmentation and osteochondrosis of the medial trochlear ridge were present. Radiographic evidence of degenerative joint disease was present in 3 of 5 dogs with medial malleolar fragmentation alone, and 5 of 5 dogs with medial malleolar fragmentation and medial trochlear ridge osteochondrosis. Eight of the 9 dogs were Rottweilers. Considering the sites of occurrence of osteochondrosis in other species, the authors propose that medial malleolar fragmentation could be secondary to osteochondrosis of the medial malleolus. Osteochondrosis of the medial malleolus has not been previously reported in dogs. Histological examination of the medial malleolar fragmentation was unavailable because surgery was not performed, therefore the hypothesis that the medial malleolar fragmentation is due to osteochondrosis was not proven

Optimal combinations for detection of prostate cancer: systematic sextant and laterally directed biopsies versus systematic sextant and color Doppler-targeted biopsies.

Science.gov (United States)

Kravchick, Sergey; Cytron, Shmuel; Peled, Ronit; London, Daniel; Sibi, Yosef; Ben-Dor, David

2004-02-01

To determine the accuracy of different combinations of biopsies in detecting prostate cancer. The standard sextant protocol for obtaining prostate biopsy underestimates the presence of prostate cancer. Conversely, an increased cancer detection rate has been obtained with additional laterally directed biopsies. The results of the studies dedicated to transrectal color Doppler (CD) sonography have shown that it might detect neoplastic lesions with no corresponding gray-scale abnormality. A total of 120 consecutive patients underwent sextant biopsy with additional biopsy cores taken from the lateral peripheral zone (four to six cores, depending on the prostate volume) and CD-guided biopsy. The sensitivity of laterally directed, CD-guided, and different combinations of biopsies was compared. Various patient, clinical, and pathologic factors were compared, and multivariate analysis was performed to assess the strongest predictor of cancer detection. Cancer was detected in 43 (35.8%) of 120 patients. The combination of sextant biopsy with laterally directed cores gained sensitivity to 56.6% compared with 67.4% obtained in the regimen that combined sextant and CD-guided biopsy. The CD regimen detected cancer in 11 additional patients. However, the differences in the detection rates of these combinations were not statistically significant (P = 0.797). The results of multivariate analysis showed that sextant biopsy and laterally directed cores were the strongest predictors of cancer detection (odds ratio 8.356 versus 49.282; 95% confidence interval 1.698 to 41.114 versus 10.508 to 231.130). The regimen that included sextant and CD-guided biopsy was the most sensitive. However, only standard sextant and laterally directed biopsies were statistically significant predictors of cancer detection on biopsy.

Lateral organisation in nineteenth-century studio photographs is influenced by the direction of writing: a comparison of Iranian and Spanish photographs.

Science.gov (United States)

Pérez González, Carmen

2012-01-01

The direction of reading has been found to have a significant effect upon aesthetic preference, with left-to-right readers showing a preference for stimuli with a rightward directionality while right-to-left readers prefer stimuli with a leftward directionality. This study looks at a large set of posed, studio photographs to study the cultural interaction between direction of reading and lateral organisation, comparing a corpus of 735 nineteenth-century photographs from Iran (right-to-left reading) with a similar corpus of 898 photographs from Spain (left-to-right readers). Five separate types of composition were studied: linear ordering, usually by height; couples; individuals posing by a chair; individuals posing by a table; and portraits. Lateral preferences were found for all five types of photograph, with the lateral organisation of Iranian photographs being the reverse of that in the Spanish photographs. These data provide support for the influence of direction of reading upon aesthetic organisation in naturalistically produced photographs.

Biomechanical Performance of Medial Row Suture Placement Relative to the Musculotendinous Junction in Transosseous Equivalent Suture Bridge Double-Row Rotator Cuff Repair.

Science.gov (United States)

Virk, Mandeep S; Bruce, Benjamin; Hussey, Kristen E; Thomas, Jacqueline M; Luthringer, Tyler A; Shewman, Elizabeth F; Wang, Vincent M; Verma, Nikhil N; Romeo, Anthony A; Cole, Brian J

2017-02-01

To compare the biomechanical performance of medial row suture placement relative to the musculotendinous junction (MTJ) in a cadaveric transosseous equivalent suture bridge (TOE-SB) double-row (DR) rotator cuff repair (RCR) model. A TOE-SB DR technique was used to reattach experimentally created supraspinatus tendon tears in 9 pairs of human cadaveric shoulders. The medial row sutures were passed either near the MTJ (MTJ group) or 10 mm lateral to the MTJ (rotator cuff tendon [RCT] group). After the supraspinatus repair, the specimens underwent cyclic loading and load to failure tests. The localized displacement of the markers affixed to the tendon surface was measured with an optical tracking system. The MTJ group showed a significantly higher (P = .03) medial row failure (5/9; 3 during cyclic testing and 2 during load to failure testing) compared with the RCT group (0/9). The mean number of cycles completed during cyclic testing was lower in the MTJ group (77) compared with the RCT group (100; P = .07) because 3 specimens failed in the MTJ group during cyclic loading. There were no significant differences between the 2 study groups with respect to biomechanical properties during the load to failure testing. In a cadaveric TOE-SB DR RCR model, medial row sutures through the MTJ results in a significantly higher rate of medial row failure. In rotator cuff tears with tendon tissue loss, passage of medial row sutures through the MTJ should be avoided in a TOE-SB RCR technique because of the risk of medial row failure. Copyright © 2016. Published by Elsevier Inc.

Functional results after external vocal fold medialization thyroplasty with the titanium vocal fold medialization implant.

Science.gov (United States)

Schneider, Berit; Denk, Doris-Maria; Bigenzahn, Wolfgang

2003-04-01

A persistent insufficiency of glottal closure is mostly a consequence of a unilateral vocal fold movement impairment. It can also be caused by vocal fold atrophy or scarring processes with regular bilateral respiratory vocal fold function. Because of consequential voice, breathing, and swallowing impairments, a functional surgical treatment is required. The goal of the study was to outline the functional results after medialization thyroplasty with the titanium vocal fold medialization implant according to Friedrich. In the period of 1999 to 2001, an external vocal fold medialization using the titanium implant was performed on 28 patients (12 women and 16 men). The patients were in the age range of 19 to 84 years. Twenty-two patients had a paralysis of the left-side vocal fold, and six patients, of the right-side vocal fold. Detailed functional examinations were executed on all patients before and after the surgery: perceptive voice sound analysis according to the "roughness, breathiness, and hoarseness" method, judgment of the s/z ratio and voice dysfunction index, voice range profile measurements, videostroboscopy, and pulmonary function tests. In case of dysphagia/aspiration, videofluoroscopy of swallowing was also performed. The respective data were statistically analyzed (paired t test, Wilcoxon-test). All patients reported on improvement of voice, swallowing, and breathing functions postoperatively. Videostroboscopy revealed an almost complete glottal closure after surgery in all of the patients. All voice-related parameters showed a significant improvement. An increase of the laryngeal resistance by the medialization procedure could be excluded by analysis of the pulmonary function test. The results confirm the external medialization of the vocal folds as an adequate method in the therapy of voice, swallowing, and breathing impairment attributable to an insufficient glottal closure. The titanium implant offers, apart from good tissue tolerability, the

Historical Review of Uncommanded Lateral-Directional Motions At Transonic Conditions (Invited)

Science.gov (United States)

Chambers, Joseph R.; Hall, Robert M.

2003-01-01

This paper presents the results of a survey of past experiences with uncommanded lateral-directional motions at transonic speeds during specific military aircraft programs. The effort was undertaken to provide qualitative and quantitative information on past airplane programs that might be of use to the participants in the joint NASA/Navy/Air Force Abrupt Wing Stall (AWS) Program. The AWS Program was initiated because of the experiences of the F/A-18E/F development program, during which unexpected, severe wing-drop motions were encountered by preproduction aircraft at transonic conditions. These motions were judged to be significantly degrading to the primary mission requirements of the aircraft. Although the problem was subsequently solved for the production version of the F/A-l8E/F, a high-level review panel emphasized the poor understanding of such phenomena and issued a strong recommendation to: Initiate a national research effort to thoroughly and systematically study the wing drop phenomena. A comprehensive, cooperative NASA/Navy/Air Force AWS Program was designed to respond to provide the required technology requirements. As part of the AWS Program, a work element was directed at a historical review of wing-drop experiences in past aircraft development programs at high subsonic and transonic speeds. In particular, information was requested regarding: specific aircraft configurations that exhibited uncommanded motions and the nature of the motions; geometric characteristics of the air- planes; flight conditions involved in occurrences; relevant data, including wind-tunnel, computational, and flight sources; figures of merit used for analyses; and approaches used to alleviate the problem. An attempt was also made to summarize some of the more important lessons learned from past experiences, and to recommend specific research efforts. In addition to providing technical information to assist the AWS research objectives, the study produced fundamental information

Intra-articular sodium hyaluronate 2 mL versus physiological saline 20 mL versus physiological saline 2 mL for painful knee osteoarthritis: a randomized clinical trial

DEFF Research Database (Denmark)

Lundsgaard, C.; Dufour, N.; Fallentin, E.

2008-01-01

, Knee Injury and Osteoarthritis Outcome Score (KOOS), Osteoarthritis Research Society International (OARSI) criteria, and global assessment of the patient's condition. Results: The mean age of the patients was 69.4 years; 55% were women. The effects of hyaluronate 2 mL, physiological saline 20 m......Objective: Methodological constraints weaken previous evidence on intra-articular viscosupplementation and physiological saline distention for osteoarthritis. We conducted a randomized, patient- and observer-blind trial to evaluate these interventions in patients with painful knee osteoarthritis....... Methods: We centrally randomized 251 patients with knee ostcoarthritis to four weekly intra-articular injections of sodium hyaluronate 2 mL (Hyalgan(R) 10.3 mg/mL) versus physiological saline 20 mL (distention) versus physiological saline 2 mL (placebo) and followed patients for 26 weeks. Inclusion...

Medial Occipital Lobe Hyperperfusion Identified by Arterial Spin-Labeling: A Poor Prognostic Sign in Patients with Hypoxic-Ischemic Encephalopathy.

Science.gov (United States)

de Havenon, A; Sultan-Qurraie, A; Tirschwell, D; Cohen, W; Majersik, J; Andre, J B

2015-12-01

Hypoxic-ischemic encephalopathy carries an uncertain prognosis. We sought to retrospectively assess the prognostic value of arterial spin-labeling MR imaging in 22 adult patients diagnosed with hypoxic-ischemic encephalopathy. Quantitative CBF maps were generated from the M0 map, and arterial spin-labeling data on a per-voxel basis were regionally interrogated via visual inspection and ROI placement. Hyperperfusion was defined as regional increases in CBF of >20% (relative to global CBF) and/or >100 mL/100 g/min. Eleven of 22 patients had prominent bilateral medial occipital lobe hyperperfusion, all of whom died before hospital discharge. One patient who had nondistinct arterial spin-labeling hyperperfusion and restricted diffusion survived. Medial occipital lobe hyperperfusion is a distinctive pattern that merits prospective investigation in a cohort of patients with moderate hypoxic-ischemic encephalopathy to determine its predictive ability in patients with a higher likelihood of survival. © 2015 by American Journal of Neuroradiology.

Stimulation of the medial amygdala enhances medial preoptic dopamine release: implications for male rat sexual behavior.

Science.gov (United States)

Dominguez, J M; Hull, E M

2001-11-02

Increased dopamine (DA) in the medial preoptic area (MPOA) facilitates male sexual behavior. A major source of innervation to the MPOA is the medial amygdala (MeA). We now report that chemical stimulation of the MeA enhanced levels of extracellular MPOA DA in anesthetized male rats. These results suggest that DA activity in the MPOA can be regulated by input from the MeA to the MPOA.

Cellular properties of principal neurons in the rat entorhinal cortex. I. The lateral entorhinal cortex

NARCIS (Netherlands)

Canto, C.B.; Witter, M.P.

2012-01-01

The lateral entorhinal cortex (LEC) provides a major cortical input to the hippocampal formation, equaling that of the medial entorhinal cortex (MEC). To understand the functional contributions made by LEC, basic knowledge of individual neurons, in the context of the intrinsic network, is needed.

libNeuroML and PyLEMS: using Python to combine procedural and declarative modeling approaches in computational neuroscience.

Science.gov (United States)

Vella, Michael; Cannon, Robert C; Crook, Sharon; Davison, Andrew P; Ganapathy, Gautham; Robinson, Hugh P C; Silver, R Angus; Gleeson, Padraig

2014-01-01

NeuroML is an XML-based model description language, which provides a powerful common data format for defining and exchanging models of neurons and neuronal networks. In the latest version of NeuroML, the structure and behavior of ion channel, synapse, cell, and network model descriptions are based on underlying definitions provided in LEMS, a domain-independent language for expressing hierarchical mathematical models of physical entities. While declarative approaches for describing models have led to greater exchange of model elements among software tools in computational neuroscience, a frequent criticism of XML-based languages is that they are difficult to work with directly. Here we describe two Application Programming Interfaces (APIs) written in Python (http://www.python.org), which simplify the process of developing and modifying models expressed in NeuroML and LEMS. The libNeuroML API provides a Python object model with a direct mapping to all NeuroML concepts defined by the NeuroML Schema, which facilitates reading and writing the XML equivalents. In addition, it offers a memory-efficient, array-based internal representation, which is useful for handling large-scale connectomics data. The libNeuroML API also includes support for performing common operations that are required when working with NeuroML documents. Access to the LEMS data model is provided by the PyLEMS API, which provides a Python implementation of the LEMS language, including the ability to simulate most models expressed in LEMS. Together, libNeuroML and PyLEMS provide a comprehensive solution for interacting with NeuroML models in a Python environment.

libNeuroML and PyLEMS: using Python to combine imperative and declarative modelling approaches in computational neuroscience

Directory of Open Access Journals (Sweden)

Michael eVella

2014-04-01

Full Text Available NeuroML is an XML-based model description language, which provides a powerful common data format for defining and exchanging models of neurons and neuronal networks. In the latest version of NeuroML, the structure and behavior of ion channel, synapse, cell,and network model descriptions are based on underlying definitions provided in LEMS, a domain-independent language for expressing hierarchical mathematical models of physical entities. While declarative approaches for describing models have led to greater exchange of model elements among software tools in computational neuroscience, a frequent criticism of XML-based languages is that they are difficult to work with directly. Here we describe two APIs (Application Programming Interfaces written in Python (http://www.python.org, which simplify the process of developing and modifying models expressed in NeuroML and LEMS. The libNeuroML API provides a Python object model with a direct mapping to all NeuroML concepts defined by the NeuroML Schema, which facilitates reading and writing the XML equivalents. In addition, it offers a memory-efficient, array-based internal representation, which is useful for handling large-scale connectomics data. The libNeuroML API also includes support for performing common operations that are required when working with NeuroML documents. Access to the LEMS data model is provided by the PyLEMS API, which provides a Python implementation of the LEMS language, including the ability to simulate most models expressed in LEMS. Together, libNeuroML and PyLEMS provide a comprehensive solution for interacting with NeuroML models in a Python environment.

MPS and ML

Science.gov (United States)

... individuals about MPS and ML, the National MPS Society has created a central location for more information on MPS. Click here to go to the MPS Library. Share Tweet Our Mission The National MPS Society exists to cure, support and advocate for MPS ...

An in vitro analysis of medial structures and a medial soft tissue reconstruction in a constrained condylar total knee arthroplasty.

Science.gov (United States)

Athwal, Kiron K; El Daou, Hadi; Inderhaug, Eivind; Manning, William; Davies, Andrew J; Deehan, David J; Amis, Andrew A

2017-08-01

The aim of this study was to quantify the medial soft tissue contributions to stability following constrained condylar (CC) total knee arthroplasty (TKA) and determine whether a medial reconstruction could restore stability to a soft tissue-deficient, CC-TKA knee. Eight cadaveric knees were mounted in a robotic system and tested at 0°, 30°, 60°, and 90° of flexion with ±50 N anterior-posterior force, ±8 Nm varus-valgus, and ±5 Nm internal-external torque. The deep and superficial medial collateral ligaments (dMCL, sMCL) and posteromedial capsule (PMC) were transected and their relative contributions to stabilising the applied loads were quantified. After complete medial soft tissue transection, a reconstruction using a semitendinosus tendon graft was performed, and the effect on kinematic behaviour under equivocal conditions was measured. In the CC-TKA knee, the sMCL was the major medial restraint in anterior drawer, internal-external, and valgus rotation. No significant differences were found between the rotational laxities of the reconstructed knee to the pre-deficient state for the arc of motion examined. The relative contribution of the reconstruction was higher in valgus rotation at 60° than the sMCL; otherwise, the contribution of the reconstruction was similar to that of the sMCL. There is contention whether a CC-TKA can function with medial deficiency or more constraint is required. This work has shown that a CC-TKA may not provide enough stability with an absent sMCL. However, in such cases, combining the CC-TKA with a medial soft tissue reconstruction may be considered as an alternative to a hinged implant.

Infarcts presenting with a combination of medial medullary and posterior inferior cerebellar artery syndromes.

Science.gov (United States)

Lee, Hyung; Baik, Seung Kug

2004-09-15

Cerebellar and medial medullary infarctions are well-known vertebrobasilar stroke syndromes. However, their development in a patient with distal vertebral artery occlusion has not been previously reported. A 49-year-old man with longstanding hypertension suddenly developed vertigo, right-sided Horner syndrome, and left-sided weakness. An MRI of the brain showed acute infarcts in the right inferior cerebellum (posterior inferior cerebellar artery territory) and the right upper medial medulla (direct penetrating branches of vertebral artery). Magnetic resonance angiogram showed occlusion of the distal vertebral artery on the right side. Atherothrombotic occlusion of the distal vertebral artery may cause this unusual combination of vertebrobasilar stroke.

Clinical and Radiological Evaluation of the Radius-Ulna- Humerus Joint in Police Dogs in the City of Concepción, Chile

Directory of Open Access Journals (Sweden)

Álvaro Luzio Quiroga

2014-06-01

Full Text Available Objective: To assess the elbow joint in police dogs through a clinical orthopedic exam and a radiological exam. Fifteen dogs were studied (13 males and 2 females between the ages of 3 and 10 that perform police work in Concepción, Chile. Method: Individuals were subjected to a general and orthopedic physical examination focused on the elbow joint, and then a radiological study was carried out, in which both elbows were assessed through 4 projections including an extended medial lateral (ML, craniocaudal (CrCa, medial lateral flexed at 45º (ML 45º flex and craniolateral-caudomedial oblique (Cr15° LCdMO, in order to establish the appearance of osteoarticular disorders. Results: Only 2 dogs showed clinical signs (13.33 % in which pain and crepitation were observed through palpation and manipulation of the joint; 8 individuals showed radiological signs (53.33 %. The most common signs were osteophytes (40 %, sclerosis (20 %, joint incongruity (20 %, unevenness between radius and ulna (20 %, absence of the medial coronoid process of the ulna (6.67 % and unbound anconeus process (6.67 %. Conclusion: This study showed a low correlation between the presence of clinical signs and the presence of radiological signs (r: 0.327.

Lateralization of functional magnetic resonance imaging (fMRI) activation in the auditory pathway of patients with lateralized tinnitus

Energy Technology Data Exchange (ETDEWEB)

Smits, Marion [Erasmus MC - University Medical Center Rotterdam, Department of Radiology, Hs 224, Rotterdam (Netherlands); Kovacs, Silvia; Peeters, Ronald R; Hecke, Paul van; Sunaert, Stefan [University Hospitals of the Catholic University Leuven, Department of Radiology, Leuven (Belgium); Ridder, Dirk de [University of Antwerp, Department of Neurosurgery, Edegem (Belgium)

2007-08-15

Tinnitus is hypothesized to be an auditory phantom phenomenon resulting from spontaneous neuronal activity somewhere along the auditory pathway. We performed fMRI of the entire auditory pathway, including the inferior colliculus (IC), the medial geniculate body (MGB) and the auditory cortex (AC), in 42 patients with tinnitus and 10 healthy volunteers to assess lateralization of fMRI activation. Subjects were scanned on a 3T MRI scanner. A T2*-weighted EPI silent gap sequence was used during the stimulation paradigm, which consisted of a blocked design of 12 epochs in which music presented binaurally through headphones, which was switched on and off for periods of 50 s. Using SPM2 software, single subject and group statistical parametric maps were calculated. Lateralization of activation was assessed qualitatively and quantitatively. Tinnitus was lateralized in 35 patients (83%, 13 right-sided and 22 left-sided). Significant signal change (P{sub corrected} < 0.05) was found bilaterally in the primary and secondary AC, the IC and the MGB. Signal change was symmetrical in patients with bilateral tinnitus. In patients with lateralized tinnitus, fMRI activation was lateralized towards the side of perceived tinnitus in the primary AC and IC in patients with right-sided tinnitus, and in the MGB in patients with left-sided tinnitus. In healthy volunteers, activation in the primary AC was left-lateralized. Our paradigm adequately visualized the auditory pathways in tinnitus patients. In lateralized tinnitus fMRI activation was also lateralized, supporting the hypothesis that tinnitus is an auditory phantom phenomenon. (orig.)

Lateralization of functional magnetic resonance imaging (fMRI) activation in the auditory pathway of patients with lateralized tinnitus

International Nuclear Information System (INIS)

Smits, Marion; Kovacs, Silvia; Peeters, Ronald R.; Hecke, Paul van; Sunaert, Stefan; Ridder, Dirk de

2007-01-01

Tinnitus is hypothesized to be an auditory phantom phenomenon resulting from spontaneous neuronal activity somewhere along the auditory pathway. We performed fMRI of the entire auditory pathway, including the inferior colliculus (IC), the medial geniculate body (MGB) and the auditory cortex (AC), in 42 patients with tinnitus and 10 healthy volunteers to assess lateralization of fMRI activation. Subjects were scanned on a 3T MRI scanner. A T2*-weighted EPI silent gap sequence was used during the stimulation paradigm, which consisted of a blocked design of 12 epochs in which music presented binaurally through headphones, which was switched on and off for periods of 50 s. Using SPM2 software, single subject and group statistical parametric maps were calculated. Lateralization of activation was assessed qualitatively and quantitatively. Tinnitus was lateralized in 35 patients (83%, 13 right-sided and 22 left-sided). Significant signal change (P corrected < 0.05) was found bilaterally in the primary and secondary AC, the IC and the MGB. Signal change was symmetrical in patients with bilateral tinnitus. In patients with lateralized tinnitus, fMRI activation was lateralized towards the side of perceived tinnitus in the primary AC and IC in patients with right-sided tinnitus, and in the MGB in patients with left-sided tinnitus. In healthy volunteers, activation in the primary AC was left-lateralized. Our paradigm adequately visualized the auditory pathways in tinnitus patients. In lateralized tinnitus fMRI activation was also lateralized, supporting the hypothesis that tinnitus is an auditory phantom phenomenon. (orig.)

The XBabelPhish MAGE-ML and XML translator.

Science.gov (United States)

Maier, Don; Wymore, Farrell; Sherlock, Gavin; Ball, Catherine A

2008-01-18

MAGE-ML has been promoted as a standard format for describing microarray experiments and the data they produce. Two characteristics of the MAGE-ML format compromise its use as a universal standard: First, MAGE-ML files are exceptionally large - too large to be easily read by most people, and often too large to be read by most software programs. Second, the MAGE-ML standard permits many ways of representing the same information. As a result, different producers of MAGE-ML create different documents describing the same experiment and its data. Recognizing all the variants is an unwieldy software engineering task, resulting in software packages that can read and process MAGE-ML from some, but not all producers. This Tower of MAGE-ML Babel bars the unencumbered exchange of microarray experiment descriptions couched in MAGE-ML. We have developed XBabelPhish - an XQuery-based technology for translating one MAGE-ML variant into another. XBabelPhish's use is not restricted to translating MAGE-ML documents. It can transform XML files independent of their DTD, XML schema, or semantic content. Moreover, it is designed to work on very large (> 200 Mb.) files, which are common in the world of MAGE-ML. XBabelPhish provides a way to inter-translate MAGE-ML variants for improved interchange of microarray experiment information. More generally, it can be used to transform most XML files, including very large ones that exceed the capacity of most XML tools.

The difference of contrast effects of myelography in normal dogs: Comparison of iohexol (180 mgI/ml), iohexol (240 mgI/ml) and iotrolan (240 mgI/ml)

International Nuclear Information System (INIS)

Shimizu, J.; Yamada, K.; Kishimoto, M.; Iwasaki, T.; Miyake, Y.

2008-01-01

The contrast effects of three different contrast media preparations (iohexol 180 mgI/ml, iohexol 240 mgI/ml and iotrolan 240 mgI/ml) in conventional and CT myelography were compared. Three beagle dogs were used and the study employed a cross-over method (total of 9) for each contrast media. The result of CT myelography showed that the contrast effect of iohexol (180 mgI/ml), which had low viscosity, was highest in cranial sites, and the contrast effect of high-viscosity iotrolan (240 mgI/ml) was highest in caudal sites 5 min after injection of the contrast media preparations. This shows that the diffusion of contrast media preparations in the subarachnoid space is influenced by viscosity. The results of conventional myelography also showed that the diffusion of contrast media preparations is influenced by viscosity. Therefore, it is important to identify the location of spinal lesions in veterinary practice, and low viscosity contrast medium preparation with wide spread contrast effects is considered suitable for myelography

New Fpg probe chemistry for direct detection of recombinase polymerase amplification on lateral flow strips.

Science.gov (United States)

Powell, Michael L; Bowler, Frank R; Martinez, Aurore J; Greenwood, Catherine J; Armes, Niall; Piepenburg, Olaf

2018-02-15

Rapid, cost-effective and sensitive detection of nucleic acids has the ability to improve upon current practices employed for pathogen detection in diagnosis of infectious disease and food testing. Furthermore, if assay complexity can be reduced, nucleic acid amplification tests could be deployed in resource-limited and home use scenarios. In this study, we developed a novel Fpg (Formamidopyrimidine DNA glycosylase) probe chemistry, which allows lateral flow detection of amplification in undiluted recombinase polymerase amplification (RPA) reactions. The prototype nucleic acid lateral flow chemistry was applied to a human genomic target (rs1207445), Campylobacter jejuni 16S rDNA and two genetic markers of the important food pathogen E. coli O157:H7. All four assays have an analytical sensitivity between 10 and 100 copies DNA per amplification. Furthermore, the assay is performed with fewer hands-on steps than using the current RPA Nfo lateral flow method as dilution of amplicon is not required for lateral flow analysis. Due to the simplicity of the workflow, we believe that the lateral flow chemistry for direct detection could be readily adapted to a cost-effective single-use consumable, ideal for use in non-laboratory settings. Copyright © 2017. Published by Elsevier Inc.

QuakeML 2.0: Recent developments

Science.gov (United States)

Euchner, Fabian; Kästli, Philipp; Heiniger, Lukas; Saul, Joachim; Schorlemmer, Danijel; Clinton, John

2016-04-01

QuakeML is a community-backed data model for seismic event parameter description. Its current version 1.2, released in 2013, has become the gold standard for parametric data dissemination at seismological data centers, and has been adopted as an FDSN standard. It is supported by several popular software products and data services, such as FDSN event web services, QuakePy, and SeisComP3. Work on the successor version 2.0 is under way since 2015. The scope of QuakeML has been expanded beyond event parameter description. Thanks to a modular architecture, many thematic packages have been added, which cover peak ground motion, site and station characterization, hydraulic parameters of borehole injection processes, and macroseismics. The first three packages can be considered near final and implementations of program codes and SQL databases are in productive use at various institutions. A public community review process has been initiated in order to turn them into community-approved standards. The most recent addition is a package for single station quake location, which allows a detailed probabilistic description of event parameters recorded at a single station. This package adds some information elements such as angle of incidence, frequency-dependent phase picks, and dispersion relations. The package containing common data types has been extended with a generic type for probability density functions. While on Earth, single station methods are niche applications, they are of prominent interest in planetary seismology, e.g., the NASA InSight mission to Mars. So far, QuakeML is lacking a description of seismic instrumentation (inventory). There are two existing standards of younger age (FDSN StationXML and SeisComP3 Inventory XML). We discuss their respective strengths, differences, and how they could be combined into an inventory package for QuakeML, thus allowing full interoperability with other QuakeML data types. QuakeML is accompanied by QuakePy, a Python package

Arthroscopic treatment of symptomatic type D medial plica

OpenAIRE

Uysal, Mustafa; Asik, Mehmet; Akpinar, Sercan; Ciftci, Feyyaz; Cesur, Necip; Tandogan, Reha N.

2007-01-01

We aimed to review the results of subtotal arthroscopic resection of symptomatic type D medial plica. We retrospectively evaluated 23 knees with symptomatic type D medial plica in 22 patients without other intra-articular pathology. All patients complained of chronic knee pain that had not been alleviated by medical treatment or physical therapy. In only three (13%) of the patients studied was the plica diagnosed pre-operatively with magnetic resonance imaging. The type D medial plicae in our...

Voxel-based morphometry (VBM) based assessment of gray matter loss in medial temporal lobe epilepsy; comparison with FDG PET

International Nuclear Information System (INIS)

Kang, Hye Jin; Lee, Ho Young; Lee, Jae Sung; Kang, Eun Joo; Lee, Sang Gun; Chang, Kee Hyun; Lee, Dong Soo

2004-01-01

The aims of this study were to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphometry (VBM) analysis for lateralizing epileptogenic zones in medial temporal lobe epilepsy (mTLE). The findings were compared with fluorodeoxyglucose positron emission tomography (FDG PET). MR T1-weighted images of 12 left mTLE and 11 right mTLE patients were compared with those of 37 normal controls. Images were transformed to standard MNI space and averaged in order to create study-specific brain template. Each image was normalized to this local template and brain tissues were segmented. Modulation VBM analysis was performed in order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was performed using statistical parametric mapping software (SPM99). FDG PET images were compared with those of 22 normal controls using SPM. Gray matter volume was significantly reduced in the left amygdala and hippocampus in left mTLE. In addition, volume of cerebellum, anterior cingulate, and fusiform gyrus in both sides and left insula was reduced. In right mTLE, volume was reduced significantly in right hippocampus. In contrast, FDG uptake was decreased in broad areas of left or right temporal lobes in left TLE and right TLE, respectively. Gray matter loss was found in the ipsilateral hippocampus by modulation VBM analysis in medial temporal lobe epilepsy. This VBM analysis might be useful in lateralizing the epileptogenic zones in medial temporal lobe epilepsy, while SPM analysis of FDG PET disclosed hypometabolic epileptogenic zones

Voxel-based morphometry (VBM) based assessment of gray matter loss in medial temporal lobe epilepsy; comparison with FDG PET

Energy Technology Data Exchange (ETDEWEB)

Kang, Hye Jin; Lee, Ho Young; Lee, Jae Sung; Kang, Eun Joo; Lee, Sang Gun; Chang, Kee Hyun; Lee, Dong Soo [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

2004-02-01

The aims of this study were to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphometry (VBM) analysis for lateralizing epileptogenic zones in medial temporal lobe epilepsy (mTLE). The findings were compared with fluorodeoxyglucose positron emission tomography (FDG PET). MR T1-weighted images of 12 left mTLE and 11 right mTLE patients were compared with those of 37 normal controls. Images were transformed to standard MNI space and averaged in order to create study-specific brain template. Each image was normalized to this local template and brain tissues were segmented. Modulation VBM analysis was performed in order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was performed using statistical parametric mapping software (SPM99). FDG PET images were compared with those of 22 normal controls using SPM. Gray matter volume was significantly reduced in the left amygdala and hippocampus in left mTLE. In addition, volume of cerebellum, anterior cingulate, and fusiform gyrus in both sides and left insula was reduced. In right mTLE, volume was reduced significantly in right hippocampus. In contrast, FDG uptake was decreased in broad areas of left or right temporal lobes in left TLE and right TLE, respectively. Gray matter loss was found in the ipsilateral hippocampus by modulation VBM analysis in medial temporal lobe epilepsy. This VBM analysis might be useful in lateralizing the epileptogenic zones in medial temporal lobe epilepsy, while SPM analysis of FDG PET disclosed hypometabolic epileptogenic zones.

Relationship between the medial longitudinal arch and the thoracic and lumbar curvatures with the static and dynamic stability in obese females

Directory of Open Access Journals (Sweden)

Abbas Rahimi

2012-07-01

Full Text Available Background and Aim: Reviewing the literature reveals a possible correlation between the obesity and the potential foot, spine and stability problems. Investigating the important parameters affecting the balance of obese people and prevention from falling are of high importance to reduce the resulting expenditures. This study aimed to assess the acts and the counter acts between the medial longitudinal arch (MLA and the thoracic and lumbar curvatures with the static and dynamic stability in obese females. Materials and Methods: Twenty eight obese females (age= 25±8 years old, BMI=37±4 and twenty nine non-obese females (age= 23±4 years old, BMI=23±3 were recruited in this case-control study with the cross-sectional technique. The MLA, spinal curve angles and the static or dynamic balance index of the subjects were measured using the navicular drop, flexible ruler and Biodex balance system tools, respectively. The static balance test was carried out using a modified Clinical Test of Sensory Interaction and Balance (CTSIB test in both the open and closed eyes while the subjects stood on their dominant legs. The order of the dynamic and static tests was selected randomly.Results: The findings of this study showed that in closed eye condition, most changes happened between the global Stability Index (SI and BMI; while in open eye condition, most changes occurred between the lateral-medial stability index and BMI (r=0.5. Also during an open eye condition, a moderate correlation was found between the navicular drop and lateral-medial stability index (r=0.05. In closed eyes condition, no significant changes were found between the SI and lumbar lordosis (r=0.0004; while a weak correlation was found between the thoracic curve angle and lateral-medial stability index (r=0.04.Conclusion: The dynamic stability is not only correlated to their BMI, but is highly dependent on their foot curvature types and slightly on their thoracic curve angle. Abdominal

The Distal Humerus Axial View: Assessment of Displacement in Medial Epicondyle Fractures.

Science.gov (United States)

Souder, Christopher D; Farnsworth, Christine L; McNeil, Natalie P; Bomar, James D; Edmonds, Eric W

2015-01-01

The assessment and treatment of childhood medial epicondyle humerus fractures continues to be associated with significant debate. Several studies demonstrate that standard radiographic views are unable to accurately portray the true displacement. Without reliable ways to assess the amount of displacement, how can we debate treatment and outcomes? This study introduces a novel imaging technique for the evaluation of medial epicondyle fractures. An osteotomy of a cadaveric humerus was performed to simulate a medial epicondyle fracture. Plain radiographs were obtained with the fracture fragment displaced anteriorly in 2-mm increments between 0 and 18 mm. Anteroposterior (AP), internal oblique (IR), lateral (LAT), and distal humerus axial (AXIAL) views were performed. Axial images were obtained by positioning the central ray above the shoulder at 15 to 20 degrees from the long axis of the humerus, centered on the distal humerus. Displacement (mm) was measured by 7 orthopaedic surgeons on digital radiographs. At 10 mm displacement, AP views underestimated displacement by 5.5±0.6 mm and IR views underestimated by 3.8±2.1 mm. On LAT views, readers were not able to visualize fragments with displacement. Displacement ≥10 mm from LAT views was overestimated by 1 reader by up to 4.6 mm and underestimated by others by up to 18.0 mm. AXIAL images more closely estimated the true amount of displacement, with a mean 1.5±1.1 mm error in measurement for displacement and a mean 0.8±0.7 mm error for displacements of ≥10 mm. AXIAL measurements correlated strongly with the actual displacement (r=0.998, Pdisplacement of medial epicondyle humerus fractures. The newly described AXIAL projection more accurately and reliably demonstrated the true displacement while reducing the need for advanced imaging such as computed tomography. This simple view can be easily obtained at a clinic visit, enhancing the surgeon's ability to determine the true displacement.

Centralization of extruded medial meniscus delays cartilage degeneration in rats.

Science.gov (United States)

Ozeki, Nobutake; Muneta, Takeshi; Kawabata, Kenichi; Koga, Hideyuki; Nakagawa, Yusuke; Saito, Ryusuke; Udo, Mio; Yanagisawa, Katsuaki; Ohara, Toshiyuki; Mochizuki, Tomoyuki; Tsuji, Kunikazu; Saito, Tomoyuki; Sekiya, Ichiro

2017-05-01

Meniscus extrusion often observed in knee osteoarthritis has a strong correlation with the progression of cartilage degeneration and symptom in the patients. We recently reported a novel procedure "arthroscopic centralization" in which the capsule was sutured to the edge of the tibial plateau to reduce meniscus extrusion in the human knee. However, there is no animal model to study the efficacy of this procedure. The purposes of this study were [1] to establish a model of centralization for the extruded medial meniscus in a rat model; and [2] to investigate the chondroprotective effect of this procedure. Medial meniscus extrusion was induced by the release of the anterior synovial capsule and the transection of the meniscotibial ligament. Centralization was performed by the pulled-out suture technique. Alternatively, control rats had only the medial meniscus extrusion surgery. Medial meniscus extrusion was evaluated by micro-CT and macroscopic findings. Cartilage degeneration of the medial tibial plateau was evaluated macroscopically and histologically. By micro-CT analysis, the medial meniscus extrusion was significantly improved in the centralization group in comparison to the extrusion group throughout the study. Both macroscopically and histologically, the cartilage lesion of the medial tibial plateau was prevented in the centralization group but was apparent in the control group. We developed medial meniscus extrusion in a rat model, and centralization of the extruded medial meniscus by the pull-out suture technique improved the medial meniscus extrusion and delayed cartilage degeneration, though the effect was limited. Centralization is a promising treatment to prevent the progression of osteoarthritis. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

CLAS App ML

NARCIS (Netherlands)

Maher, Bridget; Hartkopf, Kathleen; Stieger, Lina; Schroeder, Hanna; Sopka, Sasa; Orrego, Carola; Drachsler, Hendrik

2014-01-01

This is a multi-language (ML) update of the CLAS App original design by Bridget Maher from the School of Medicine at University College Cork, Ireland. The current version has an improve counting mechanism and has been translated from English to Spanish, Catalan and German languages within the

Required coefficient of friction in the anteroposterior and mediolateral direction during turning at different walking speeds.

Science.gov (United States)

Yamaguchi, Takeshi; Suzuki, Akito; Hokkirigawa, Kazuo

2017-01-01

This study investigated the required coefficient of friction (RCOF) and the tangent of center of mass (COM)-center of pressure (COP) angle in the mediolateral (ML) and anteroposterior (AP) directions during turning at different walking speeds. Sixteen healthy young adults (8 males and 8 females) participated in this study. The participants were instructed to conduct trials of straight walking and 90° step and spin turns to the right at each of three self-selected speeds (slow, normal, and fast). The ML and AP directions during turning gait were defined using the orientation of the pelvis to construct a body-fixed reference frame. The RCOF values and COM-COP angle tangent in the ML direction during turning at weight acceptance phase were higher than those during straight walking, and those values increased with increasing walking speed. The ML component of the RCOF and COM-COP tangent values during weight acceptance for step turns were higher than those for spin turns. The mean centripetal force during turning tended to increase with an increase in walking speed and had a strong positive correlation with the RCOF values in the ML direction (R = 0.97 during the weight acceptance phase; R = 0.95 during the push-off phase). Therefore, turning, particularly step turn, is likely to cause lateral slip at weight acceptance because of the increased centripetal force compared with straight walking. Future work should test at-risk population and compare with the present results.

Required coefficient of friction in the anteroposterior and mediolateral direction during turning at different walking speeds.

Directory of Open Access Journals (Sweden)

Takeshi Yamaguchi

Full Text Available This study investigated the required coefficient of friction (RCOF and the tangent of center of mass (COM-center of pressure (COP angle in the mediolateral (ML and anteroposterior (AP directions during turning at different walking speeds. Sixteen healthy young adults (8 males and 8 females participated in this study. The participants were instructed to conduct trials of straight walking and 90° step and spin turns to the right at each of three self-selected speeds (slow, normal, and fast. The ML and AP directions during turning gait were defined using the orientation of the pelvis to construct a body-fixed reference frame. The RCOF values and COM-COP angle tangent in the ML direction during turning at weight acceptance phase were higher than those during straight walking, and those values increased with increasing walking speed. The ML component of the RCOF and COM-COP tangent values during weight acceptance for step turns were higher than those for spin turns. The mean centripetal force during turning tended to increase with an increase in walking speed and had a strong positive correlation with the RCOF values in the ML direction (R = 0.97 during the weight acceptance phase; R = 0.95 during the push-off phase. Therefore, turning, particularly step turn, is likely to cause lateral slip at weight acceptance because of the increased centripetal force compared with straight walking. Future work should test at-risk population and compare with the present results.

Radiological assessment of cervical lateral mass screw angulations in Asian patients

Directory of Open Access Journals (Sweden)

Mariapan Sureisen

2011-01-01

Full Text Available Background: Various lateral mass screw fixation methods have been described in the literature with various levels of safety in relation to the anterior neurovascular structures. This study was designed to radiologically determine the minimum lateral angulations of the screw to avoid penetration of the vertebral artery canalusing three of the most common techniques: Roy-Camille, An, and Magerl. Materials and Methods: Sixty normal cervical CT scans were reviewed. A minimum lateral angulation of a 3.5 mm lateral mass screw which was required to avoid penetration of the vertebral artery canal at each level of vertebra were measured. Results: The mean lateral angulations of the lateral mass screws (with 95% confidence interval to avoid vertebral artery canal penetration, in relation to the starting point at the midpoint (Roy-Camille, 1 mm medial (An, and 2 mm medial (Magerl to the midpoint of lateral mass were 6.8° (range, 6.3-7.4°, 10.3° (range, 9.8-10.8°, and 14.1° (range, 13.6-14.6° at C3 vertebrae; 6.8° (range, 6.2-7.5°, 10.7° (range, 10.0-11.5°, and 14.1° (range, 13.4-14.8° at C4 vertebrae; 6.6° (range, 6.0-7.2°, 10.1° (range, 9.3-10.8°, and 13.5° (range, 12.8-14.3° at C5 vertebrae and 7.6° (range, 6.9-8.3°, 10.9° (range, 10.3-11.6°, and 14.3° (range, 13.7-15.0° at C6 vertebrae. The recommended lateral angulations for Roy-Camille, Magerl, and An are 10°, 25°,and 30°, respectively. Statistically, there is a higher risk of vertebral foramen violation with the Roy-Camille technique at C3, C4 and C6 levels, P < 0.05. Conclusions: Magerl and An techniques have a wide margin of safety. Caution should be practised with Roy-Camille′s technique at C3, C4, and C6 levels to avoid vertebral vessels injury in Asian population.

Absorption kinetics of two highly concentrated preparations of growth hormone: 12 IU/ml compared to 56 IU/ml

DEFF Research Database (Denmark)

Laursen, Torben; Susgaard, Søren; Jensen, Flemming Steen

1994-01-01

was to compare the relative bioavailability of two highly concentrated (12 IU/ml versus 56 IU/ml) formulations of biosynthetic human growth hormone administered subcutaneously. After pretreatment with growth hormone for at least four weeks, nine growth hormone deficient patients with a mean age of 26.2 years......AbstractSend to: Pharmacol Toxicol. 1994 Jan;74(1):54-7. Absorption kinetics of two highly concentrated preparations of growth hormone: 12 IU/ml compared to 56 IU/ml. Laursen T1, Susgaard S, Jensen FS, Jørgensen JO, Christiansen JS. Author information Abstract The purpose of this study...... (range 17-43) were studied two times in a randomized design, the two studies being separated by at least one week. At the start of each study period (7 p.m.), growth hormone was injected subcutaneously in a dosage of 3 IU/m2. The 12 IU/ml preparation of growth hormone was administered on one occasion...

Unruptured medial paraclinoid internal carotid artery aneurysm embedded within symptomatic nonfunctioning pituitary giant adenoma: A high-risk comorbid pathology in transsphenoidal surgery and its countermeasures

Directory of Open Access Journals (Sweden)

Taiki Saito, M.D.

2017-12-01

Conclusions: This case conveys three important lessons about TSS: 1 coil embolization will manage a medial paraclinoid ICA-An as a sufficient preoperative procedure for TSS; 2 a medial paraclinoid ICA-An can appear directly under the sellar floor as an apparent extradural aneurysm; and; 3 surgeons should take great care in procedures near a coil-embolized medial paraclinoid ICA-An because the aneurysmal wall can be thin to the point of transparency.

Steroidogenic factor 1 directs programs regulating diet-induced thermogenesis and leptin action in the ventral medial hypothalamic nucleus

Science.gov (United States)

The transcription factor steroidogenic factor 1 (SF-1) is exclusively expressed in the brain in the ventral medial hypothalamic nucleus (VMH) and is required for the development of this nucleus. However, the physiological importance of transcriptional programs regulated by SF-1 in the VMH is not wel...

Medial Entorhinal Grid Cells and Head Direction Cells Rotate with a T-Maze More Often During Less Recently Experienced Rotations

Science.gov (United States)

Gupta, Kishan; Beer, Nathan J.; Keller, Lauren A.; Hasselmo, Michael E.

2014-01-01

Prior studies of head direction (HD) cells indicate strong landmark control over the preferred firing direction of these cells, with few studies exhibiting shifts away from local reference frames over time. We recorded spiking activity of grid and HD cells in the medial entorhinal cortex of rats, testing correlations of local environmental cues with the spatial tuning curves of these cells' firing fields as animals performed continuous spatial alternation on a T-maze that shared the boundaries of an open-field arena. The environment was rotated into configurations the animal had either seen or not seen in the past recording week. Tuning curves of both cell types demonstrated commensurate shifts of tuning with T-maze rotations during less recent rotations, more so than recent rotations. This strongly suggests that animals are shifting their reference frame away from the local environmental cues over time, learning to use a different reference frame more likely reliant on distal or idiothetic cues. In addition, grid fields demonstrated varying levels of “fragmentation” on the T-maze. The propensity for fragmentation does not depend on grid spacing and grid score, nor animal trajectory, indicating the cognitive treatment of environmental subcompartments is likely driven by task demands. PMID:23382518

Comparative study of induction of labour with Foley’s catheter inflated to 30 mL versus 60 mL

OpenAIRE

Indira I; Latha G; Lakshmi Narayanamma V

2016-01-01

Background: The ripeness of the cervix is an important determinant of the success of induction of labour. One of the mechanical methods of cervical ripening is the use of a transcervical Foley catheter. In this study we compared the efficacy in induction of labour of two insufflation volumes of Foley catheter bulb 30 mL and 60mL. Methods: This was a randomized, single-blind study conducted in 100 women, randomly allocated to the 30 mL group (n=50) and 60 mL group (n=50). Foley’s cath...

Differential roles for medial prefrontal and medial temporal cortices in schema-dependent encoding: From congruent to incongruent

OpenAIRE

Kesteren, M.T.R. van; Beul, S.F.; Takashima, A.; Henson, R.N.; Ruiter, D.J.

2013-01-01

Information that is congruent with prior knowledge is generally remembered better than incongruent information. This effect of congruency on memory has been attributed to a facilitatory influence of activated schemas on memory encoding and consolidation processes, and hypothesised to reflect a shift between processing in medial temporal lobes (MTL) towards processing in medial prefrontal cortex (mPFC). To investigate this shift, we used functional magnetic resonance imaging (fMRI) to compare ...

Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella

International Nuclear Information System (INIS)

Zhang, Guang-ying; Ding, Hong-yu; Zheng, Lei; Ji, Bing-jun; Shi, Hao; Feng, Yan

2017-01-01

To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. (orig.)

Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella

Energy Technology Data Exchange (ETDEWEB)

Zhang, Guang-ying; Ding, Hong-yu [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Ultrasonography, Jinan (China); Zheng, Lei; Ji, Bing-jun [Shandong Provincial Corps Hospital of Chinese People' s Armed Police Force, Department of Radiology, Jinan (China); Shi, Hao [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Radiology, Jinan (China); Feng, Yan [Affiliated Hospital of Binzhou Medical College, Department of Radiology, Binzhou (China)

2017-03-15

To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. (orig.)

The alien hand sign. Localization, lateralization and recovery.

Science.gov (United States)

Goldberg, G; Bloom, K K

1990-10-01

The alien hand sign was first described by Brion and Jedynak as a "feeling of estrangement between the patient and one of his hands." The affected hand frequently shows a grasp reflex and an instinctive grasp reaction as well as elements of what Denny-Brown referred to as a "magnetic apraxia" associated with frontal lobe damage. Most notably, however, the affected hand is observed to perform apparently purposive behaviors that are perceived as being outside the volitional control of the patient. The patients interpret the behavior of their own affected limb as being controlled by an external agent. They do not feel that they are initiating or controlling the behavior of the hand and often express dismay at the hand's "extravolitional" activity. The patients attempt to control behavior of the alien hand with the unimpaired hand by forcibly restraining the affected limb, an act that may be termed "self-restriction." In this paper, we report an additional four cases of alien hand sign in right-handed subjects: two involving the right hand and two involving the left hand. In each case, the clinical findings were associated with extensive unilateral damage of the medial frontal cortex of the hemisphere contralateral to the affected hand. Furthermore, the alien movement gradually disappears over the course of 6-12 months after the stroke. These clinical case studies are presented and discussed in the context of the "dual premotoer systems hypothesis," an anatomicophysiological model that proposes that action is organized by two separate but interactive premotor brain systems corresponding to evolutionarily defined medial and lateral cortical moieties. It is hypothesized that the alien mode behavior results from unconstrained activity of the lateral premotor system in the damaged hemisphere. The residual volitional control in the limb occurs through the activity of the intact medial premotor system of the ipsilateral hemisphere. Recovery may occur through extension of

Description of the sodium loop ML-3

International Nuclear Information System (INIS)

Torre, de la M.; Melches, I; Lapena, J.; Martinez, T.A.; Miguel, de D.; Duran, F.

1979-01-01

The sodium loop ML-3 is described. The main objective of this facility is to obtain mechanical property data for LMFBR materials in creep and low cycle fatigue testing in flowing sodium. ML-3 includes 10 test stations for creep and two for fatigue. It is possible to operate simultaneously at three different temperature levels. The maximum operating temperature is 650 deg C at flow velocities up to 5 m/s. The ML-3 loop has been located in a manner that permits the fill/dump tank cover gas and security systems to be shared with an earlier circuit, the ML-1. (author)

Bilateral lesions of the medial frontal cortex disrupt recognition of social hierarchy during antiphonal communication in naked mole-rats (Heterocephalus glaber).

Science.gov (United States)

Yosida, Shigeto; Okanoya, Kazuo

2012-02-01

Generation of the motor patterns of emotional sounds in mammals occurs in the periaqueductal gray matter of the midbrain and is not directly controlled by the cortex. The medial frontal cortex indirectly controls vocalizations, based on the recognition of social context. We examined whether the medial frontal cortex was responsible for antiphonal vocalization, or turn-taking, in naked mole-rats. In normal turn-taking, naked mole-rats vocalize more frequently to dominant individuals than to subordinate ones. Bilateral lesions of the medial frontal cortex disrupted differentiation of call rates to the stimulus animals, which had varied social relationships to the subject. However, medial frontal cortex lesions did not affect either the acoustic properties of the vocalizations or the timing of the vocal exchanges. This suggests that the medial frontal cortex may be involved in social cognition or decision making during turn-taking, while other regions of the brain regulate when animals vocalize and the vocalizations themselves.

Cartilage Delamination Flap Mimicking a Torn Medial Meniscus

Directory of Open Access Journals (Sweden)

Gan Zhi-Wei Jonathan

2016-01-01

Full Text Available We report a case of a chondral delamination lesion due to medial parapatellar plica friction syndrome involving the medial femoral condyle. This mimicked a torn medial meniscus in clinical and radiological presentation. Arthroscopy revealed a chondral delamination flap, which was debrided. Diagnosis of chondral lesions in the knee can be challenging. Clinical examination and MRI have good accuracy for diagnosis and should be used in tandem. Early diagnosis and treatment of chondral lesions are important to prevent progression to early osteoarthritis.

Chronic hyperglycemia increases the risk of lateral epicondylitis: the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS).

Science.gov (United States)

Otoshi, Kenichi; Takegami, Misa; Sekiguchi, Miho; Onishi, Yoshihiro; Yamazaki, Shin; Otani, Koji; Shishido, Hiroaki; Fukuhara, Shunichi; Kikuchi, Shinichi; Konno, Shinichi

2015-01-01

Although humeral epicondylitis is a common health problem, there have been no reports that describe its prevalence in Japanese general population, and relatively little is known about its etiology and associated risk factors. This study aimed to clarify the prevalence of humeral epicondilitis in Japanese general population, and investigate the associated risk factors using the data from a cross-sectional study of the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS). A total of 1,777 participants who participated in health checkups conducted at rural area in Japan in 2010 were enrolled. The prevalence of lateral and medial epicondylitis was investigated. Logistic regression models were performed to examine the relationship between lateral epicondylitis and correlated factors such as occupational status, smoking and alcohol preferences, and medical characteristics. The overall prevalence of lateral and medial epicondylitis was 2.5 % and 0.3 %, respectively. A shortened version of the disabilities of the arm, shoulder and hand (The QuickDASH) score was significantly higher in subjects with lateral epicondylitis than in those without (15.0 ± 12.7 vs 8.5 ± 11.1). Subjects with definite chronic hyperglycemia (HbA1c ≥ 6.5) showed a 3.37-times higher risk of lateral epicondylitis than those with favorable glycemic control (HbA1c lateral epicondylitis. Lateral epicondylitis influences activities of daily living. Chronic hyperglycemia might be one of the risk factor for lateral epicondylitis. Chronic hyperglycemia is significantly associated with lateral epicondylitis.

Lateral-directional aerodynamic characteristics of light, twin-engine, propeller driven airplanes

Science.gov (United States)

Wolowicz, C. H.; Yancey, R. B.

1972-01-01

Analytical procedures and design data for predicting the lateral-directional static and dynamic stability and control characteristics of light, twin engine, propeller driven airplanes for propeller-off and power-on conditions are reported. Although the consideration of power effects is limited to twin engine airplanes, the propeller-off considerations are applicable to single engine airplanes as well. The procedures are applied to a twin engine, propeller driven, semi-low-wing airplane in the clean configuration through the linear lift range. The calculated derivative characteristics are compared with wind tunnel and flight data. Included in the calculated characteristics are the spiral mode, roll mode, and Dutch roll mode over the speed range of the airplane.

Medial branch neurotomy in low back pain

International Nuclear Information System (INIS)

Masala, Salvatore; Mammucari, Matteo; Simonetti, Giovanni; Nano, Giovanni; Marcia, Stefano

2012-01-01

This study aimed to assess the effectiveness of pulsed radiofrequency medial branch dorsal ramus neurotomy in patients with facet joint syndrome. From January 2008 to April 2010, 92 patients with facet joint syndrome diagnosed by strict inclusion criteria and controlled diagnostic blocks undergone medial branch neurotomy. We did not exclude patients with failed back surgery syndrome (FBSS). Electrodes (20G) with 5-mm active tip were placed under fluoroscopy guide parallel to medial branch. Patients were followed up by physical examination and by Visual Analog Scale and Oswestry Disability Index at 1, 6, and 12 months. In all cases, pain improvement was statistically significant and so quality of life. Three non-FBSS patients had to undergo a second neurotomy because of non-satisfactory pain decrease. Complications were reported in no case. Medial branch radiofrequency neurotomy has confirmed its well-established effectiveness in pain and quality of life improvement as long as strict inclusion criteria be fulfilled and nerve ablation be accomplished by parallel electrode positioning. This statement can be extended also to FBSS patients. (orig.)

Medial branch neurotomy in low back pain

Energy Technology Data Exchange (ETDEWEB)

Masala, Salvatore; Mammucari, Matteo; Simonetti, Giovanni [Interventional Radiology and Radiotherapy University ' ' Tor Vergata' ' , Department of Diagnostic and Molecular Imaging, Rome (Italy); Nano, Giovanni [Interventional Radiology and Radiotherapy University ' ' Tor Vergata' ' , Department of Diagnostic and Molecular Imaging, Rome (Italy); University ' ' Tor Vergata' ' , Department of Radiology, Rome (Italy); Marcia, Stefano [S. Giovanni di Dio Hospital, Department of Diagnostic and Molecular Imaging, Cagliari (Italy)

2012-07-15

This study aimed to assess the effectiveness of pulsed radiofrequency medial branch dorsal ramus neurotomy in patients with facet joint syndrome. From January 2008 to April 2010, 92 patients with facet joint syndrome diagnosed by strict inclusion criteria and controlled diagnostic blocks undergone medial branch neurotomy. We did not exclude patients with failed back surgery syndrome (FBSS). Electrodes (20G) with 5-mm active tip were placed under fluoroscopy guide parallel to medial branch. Patients were followed up by physical examination and by Visual Analog Scale and Oswestry Disability Index at 1, 6, and 12 months. In all cases, pain improvement was statistically significant and so quality of life. Three non-FBSS patients had to undergo a second neurotomy because of non-satisfactory pain decrease. Complications were reported in no case. Medial branch radiofrequency neurotomy has confirmed its well-established effectiveness in pain and quality of life improvement as long as strict inclusion criteria be fulfilled and nerve ablation be accomplished by parallel electrode positioning. This statement can be extended also to FBSS patients. (orig.)

Patterned Arrays of Functional Lateral Heterostructures via Sequential Template-Directed Printing.

Science.gov (United States)

Li, Yifan; Su, Meng; Li, Zheng; Huang, Zhandong; Li, Fengyu; Pan, Qi; Ren, Wanjie; Hu, Xiaotian; Song, Yanlin

2018-04-30

The precise integration of microscale dots and lines with controllable interfacing connections is highly important for the fabrication of functional devices. To date, the solution-processible methods are used to fabricate the heterogeneous micropatterns for different materials. However, for increasingly miniaturized and multifunctional devices, it is extremely challenging to engineer the uncertain kinetics of a solution on the microstructures surfaces, resulting in uncontrollable interface connections and poor device performance. Here, a sequential template-directed printing process is demonstrated for the fabrication of arrayed microdots connected by microwires through the regulation of the Rayleigh-Taylor instability of material solution or suspension. Flexibility in the control of fluidic behaviors can realize precise interface connection between the micropatterns, including the microwires traversing, overlapping or connecting the microdots. Moreover, various morphologies such as circular, rhombic, or star-shaped microdots as well as straight, broken or curved microwires can be achieved. The lateral heterostructure printed with two different quantum dots displays bright dichromatic photoluminescence. The ammonia gas sensor printed by polyaniline and silver nanoparticles exhibits a rapid response time. This strategy can construct heterostructures in a facile manner by eliminating the uncertainty of the multimaterials interface connection, which will be promising for the development of novel lateral functional devices. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: 'SCOPEX', a randomised control trial protocol

DEFF Research Database (Denmark)

Hall, Michelle; Hinman, Rana S; Wrigley, Tim V

2012-01-01

Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential...... to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have...

Medial stabilized and posterior stabilized TKA affect patellofemoral kinematics and retropatellar pressure distribution differently.

Science.gov (United States)

Glogaza, Alexander; Schröder, Christian; Woiczinski, Matthias; Müller, Peter; Jansson, Volkmar; Steinbrück, Arnd

2018-06-01

Patellofemoral kinematics and retropatellar pressure distribution change after total knee arthroplasty (TKA). It was hypothesized that different TKA designs will show altered retropatellar pressure distribution patterns and different patellofemoral kinematics according to their design characteristics. Twelve fresh-frozen knee specimens were tested dynamically in a knee rig. Each specimen was measured native, after TKA with a posterior stabilized design (PS) and after TKA with a medial stabilized design (MS). Retropatellar pressure distribution was measured using a pressure sensitive foil which was subdivided into three areas (lateral and medial facet and patellar ridge). Patellofemoral kinematics were measured by an ultrasonic-based three-dimensional motion system (Zebris CMS20, Isny Germany). Significant changes in patellofemoral kinematics and retropatellar pressure distribution were found in both TKA types when compared to the native situation. Mean retropatellar contact areas were significantly smaller after TKA (native: 241.1 ± 75.6 mm 2 , MS: 197.7 ± 74.5 mm 2 , PS: 181.2 ± 56.7 mm 2 , native vs. MS p patellofemoral kinematics were found in both TKA designs when compared to the native knee during flexion and extension with a more medial patella tracking. Patellofemoral kinematics and retropatellar pressure change after TKA in different manner depending on the type of TKA used. Surgeons should be aware of influencing the risks of patellofermoral complications by the choice of the prosthesis design.

Natural history of medial clavicle fractures.

Science.gov (United States)

Salipas, Andrew; Kimmel, Lara A; Edwards, Elton R; Rakhra, Sandeep; Moaveni, Afshin Kamali

2016-10-01

Fractures of the medial third of the clavicle comprise less than 3% of all clavicle fractures. The natural history and optimal management of these rare injuries are unknown. The aim of our study is to describe the demographics, management and outcomes of patients with medial clavicle fractures treated at a Level 1 Trauma Centre. A retrospective review was conducted of patients presenting to our institution between January 2008 and March 2013 with a medial third clavicle fracture. Clinical and radiographic data were recorded including mechanism of injury, fracture pattern and displacement, associated injuries, management and complications. Functional outcomes were assessed using the Glasgow Outcome Scale Extended (GOS-E) scores from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR). Shoulder outcomes were assessed using two patient reported outcomes scores, the American Shoulder and Elbow Society Score (ASES) and the Subjective Shoulder Value (SSV). Sixty eight medial clavicle fractures in 68 patients were evaluated. The majority of patients were male (n=53), with a median age of 53.5 years (interquartile range (IQR) 37.5-74.5 years). The most common mechanism of injury was motor vehicle accident (n=28). The in-hospital mortality rate was 4.4%. The fracture pattern was almost equally distributed between extra articular (n=35) and intra-articular (n=33). Fifty-five fractures (80.9%) had minimal or no displacement. Associated injuries were predominantly thoracic (n=31). All fractures were initially managed non-operatively, with a broad arm sling. Delayed operative fixation was performed for painful atrophic delayed union in two patients (2.9%). Both patients were under 65 years of age and had a severely displaced fracture of the medial clavicle. One intra-operative vascular complication was seen, with no adverse long-term outcome. Follow-up was obtained in 85.0% of the surviving cohort at an average of three years post injury (range 1-6 years). The mean ASES

Desempenho de idosos brasileiros no teste de deglutição de 100 ml de água Performance of Brazilian elderly on the 100 ml water swallowing test

Directory of Open Access Journals (Sweden)

Graziela Maria Martins Moreira

2012-03-01

Full Text Available OBJETIVO: Comparar o desempenho de idosos brasileiros, residentes em uma instituição de longa permanência, no teste de deglutição de 100 ml de água com os resultados obtidos em idosos ingleses. MÉTODOS: Dezoito idosos residentes numa instituição de longa permanência, considerados normais para a função de deglutição (13 mulheres e cinco homens, com idade média de 83,46 anos foram solicitados a beber 100 ml de água de um copo plástico, reproduzindo o estudo inglês. O avaliador observou lateralmente o número de goles, tempo gasto e intercorrências, gerando três índices: volume por deglutição (ml, tempo por deglutição (s e capacidade de deglutição (ml/s. RESULTADOS: A capacidade de deglutição para homens foi menor do que a das mulheres, divergindo do estudo original. O tempo médio de cada deglutição e o volume médio por deglutição foi semelhante para ambos os gêneros. CONCLUSÃO: A capacidade de deglutição em idosos é inferior à de adultos normais, indicando lentificação da deglutição. A diferença entre gêneros encontrada no estudo original não foi reproduzida, entretanto nossa amostra foi mais idosa.PURPOSE: To compare the performance of Brazilian elderly patients living in a long-term care facility on the 100 ml water swallowing test with the results obtained with British elderly. METHODS: Eighteen elderly subjects (13 women and five men, mean age 83.46, residents in a long-term care facility and considered normal regarding the swallowing function, were selected to take part in this study. As in a British study, they were laterally observed by the examiner while swallowing 100 ml of water from a plastic cup. The examiner observed the number of sips, the time taken, and complications during the test, which generated the following indices: volume per swallow (ml, time per swallow (s, and swallowing capacity (ml/s. RESULTS: The elderly men had lower swallowing capacity than the women in the research

Diguanylate cyclase activity of the Mycobacterium leprae T cell antigen ML1419c.

Science.gov (United States)

Rotcheewaphan, Suwatchareeporn; Belisle, John T; Webb, Kristofor J; Kim, Hee-Jin; Spencer, John S; Borlee, Bradley R

2016-09-01

The second messenger, bis-(3',5')-cyclic dimeric guanosine monophosphate (cyclic di-GMP), is involved in the control of multiple bacterial phenotypes, including those that impact host-pathogen interactions. Bioinformatics analyses predicted that Mycobacterium leprae, an obligate intracellular bacterium and the causative agent of leprosy, encodes three active diguanylate cyclases. In contrast, the related pathogen Mycobacterium tuberculosis encodes only a single diguanylate cyclase. One of the M. leprae unique diguanylate cyclases (ML1419c) was previously shown to be produced early during the course of leprosy. Thus, functional analysis of ML1419c was performed. The gene encoding ML1419c was cloned and expressed in Pseudomonas aeruginosa PAO1 to allow for assessment of cyclic di-GMP production and cyclic di-GMP-mediated phenotypes. Phenotypic studies revealed that ml1419c expression altered colony morphology, motility and biofilm formation of P. aeruginosa PAO1 in a manner consistent with increased cyclic di-GMP production. Direct measurement of cyclic di-GMP levels by liquid chromatography-mass spectrometry confirmed that ml1419c expression increased cyclic di-GMP production in P. aeruginosa PAO1 cultures in comparison to the vector control. The observed phenotypes and increased levels of cyclic di-GMP detected in P. aeruginosa expressing ml1419c could be abrogated by mutation of the active site in ML1419c. These studies demonstrated that ML1419c of M. leprae functions as diguanylate cyclase to synthesize cyclic di-GMP. Thus, this protein was renamed DgcA (Diguanylate cyclase A). These results also demonstrated the ability to use P. aeruginosa as a heterologous host for characterizing the function of proteins involved in the cyclic di-GMP pathway of a pathogen refractory to in vitro growth, M. leprae.

The association between scalp hair-whorl direction, handedness and hemispheric language dominance: is there a common genetic basis of lateralization?

Science.gov (United States)

Jansen, Andreas; Lohmann, Hubertus; Scharfe, Stefanie; Sehlmeyer, Christina; Deppe, Michael; Knecht, Stefan

2007-04-01

The hemispheres of the human brain are functionally asymmetric. The left hemisphere tends to be dominant for language and superior in the control of manual dexterity. The mechanisms underlying these asymmetries are not known. Genetic as well as environmental factors are discussed. Recently, atypical anticlockwise hair-whorl direction has been related to an increased probability for non-right-handedness and atypical hemispheric language dominance. These findings are fascinating and important since hair-whorl direction is a structural marker of lateralization and could provide a readily observable anatomical clue to functional brain lateralization. Based on data on handedness and hair-whorl direction, Amar Klar proposed a genetic model ("random-recessive model") in that a single gene with two alleles controls both handedness and hair-whorl orientation (Klar, A.J.S., 2003. Human handedness and scalp hair-whorl direction develop from a common genetic mechanism. Genetics 165, 269-276). The present study was designed to further investigate the relationship between scalp hair-whorl direction with handedness and hemispheric language dominance. 1212 subjects were investigated for scalp hair-whorl direction and handedness. Additionally, we determined hemispheric language dominance (as assessed by a word generation task) in a subgroup of 212 subjects using functional transcranial Doppler sonography (fTCD). As for the single attributes - hair-whorl direction, handedness, and language dominance - we reproduced previously published results. However, we found no association between hair-whorl direction and either language dominance or handedness. These results strongly argue against a common genetic basis of handedness or language lateralization with scalp hair-whorl direction. Inspection of hair patterns will not help us to determine language dominance.

QualityML: a dictionary for quality metadata encoding

Science.gov (United States)

Ninyerola, Miquel; Sevillano, Eva; Serral, Ivette; Pons, Xavier; Zabala, Alaitz; Bastin, Lucy; Masó, Joan

2014-05-01

The scenario of rapidly growing geodata catalogues requires tools focused on facilitate users the choice of products. Having quality fields populated in metadata allow the users to rank and then select the best fit-for-purpose products. In this direction, we have developed the QualityML (http://qualityml.geoviqua.org), a dictionary that contains hierarchically structured concepts to precisely define and relate quality levels: from quality classes to quality measurements. Generically, a quality element is the path that goes from the higher level (quality class) to the lowest levels (statistics or quality metrics). This path is used to encode quality of datasets in the corresponding metadata schemas. The benefits of having encoded quality, in the case of data producers, are related with improvements in their product discovery and better transmission of their characteristics. In the case of data users, particularly decision-makers, they would find quality and uncertainty measures to take the best decisions as well as perform dataset intercomparison. Also it allows other components (such as visualization, discovery, or comparison tools) to be quality-aware and interoperable. On one hand, the QualityML is a profile of the ISO geospatial metadata standards providing a set of rules for precisely documenting quality indicator parameters that is structured in 6 levels. On the other hand, QualityML includes semantics and vocabularies for the quality concepts. Whenever possible, if uses statistic expressions from the UncertML dictionary (http://www.uncertml.org) encoding. However it also extends UncertML to provide list of alternative metrics that are commonly used to quantify quality. A specific example, based on a temperature dataset, is shown below. The annual mean temperature map has been validated with independent in-situ measurements to obtain a global error of 0.5 ° C. Level 0: Quality class (e.g., Thematic accuracy) Level 1: Quality indicator (e.g., Quantitative

[New varieties of lateral metatarsophalangeal dislocations of the great toe].

Science.gov (United States)

Bousselmame, N; Rachid, K; Lazrak, K; Galuia, F; Taobane, H; Moulay, I

2001-04-01

We report seven cases of traumatic dislocation of the great toe, detailing the anatomy, the mechanism of injury and the radiographic diagnosis. We propose an additional classification based on three hereto unreported cases. Between october 1994 and october 1997, we treated seven patients with traumatic dislocation of the first metatarso-phalangeal joint of the great toe. There were six men and one woman, mean age 35 years (range 24 - 44 years). Dislocation was caused by motor vehicle accidents in four cases and by falls in three. Diagnosis was made on anteroposterior, lateral and medial oblique radiographs. According to Jahss' classification, there was one type I and three type IIB dislocations. There was also one open lateral dislocation and two dorsomedial dislocations. Only these dorsomedial dislocations required open reduction, done via a dorsal approach. Mean follow-up was 17.5 months (range 9 - 24 months) in six cases. One patient was lost to follow-up. The outcome was good in six cases and poor in one (dorsomedial dislocation). Dislocation of the first metatarso-phalangeal joint of the great toe is an uncommon injury. In 1980, Jahss reported two cases and reviewed three others described in the literature. He proposed three types of dislocation based on the feasibility of closed reduction (type I, II and IIB). In 1991, Copeland and Kanat reported a unique case in which there was an association of IIA and IIB lesions. They proposed an addition to the classification (type IIC). In 1994, Garcia Mata et al. reported another case which had not been described by Jahss and proposed another addition. All dislocations reported to date have been sagittal dislocations. Pathological alteration of the collateral ligaments has not been previously reported. In our experience, we have seen one case of open lateral dislocation due, at surgical exploration, to medial ligament rupture and two cases of dorsomedial dislocation due, at surgical exploration, to lateral ligament

The effect of different depths of medial heel skive on plantar pressures

Directory of Open Access Journals (Sweden)

Bonanno Daniel R

2012-08-01

Full Text Available Abstract Background Foot orthoses are often used to treat lower limb injuries associated with excessive pronation. There are many orthotic modifications available for this purpose, with one being the medial heel skive. However, empirical evidence for the mechanical effects of the medial heel skive modification is limited. This study aimed to evaluate the effect that different depths of medial heel skive have on plantar pressures. Methods Thirty healthy adults (mean age 24 years, range 18–46 with a flat-arched or pronated foot posture and no current foot pain or deformity participated in this study. Using the in-shoe pedar-X® system, plantar pressure data were collected for the rearfoot, midfoot and forefoot while participants walked along an 8 metre walkway wearing a standardised shoe. Experimental conditions included a customised foot orthosis with the following 4 orthotic modifications: (i no medial heel skive, (ii a 2 mm medial heel skive, (iii a 4 mm medial heel skive and (iv a 6 mm medial heel skive. Results Compared to the foot orthosis with no medial heel skive, statistically significant increases in peak pressure were observed at the medial rearfoot – there was a 15% increase (p = 0.001 with the 4 mm skive and a 29% increase (p  Conclusions This study found that a medial heel skive of 4 mm or 6 mm increases peak pressure under the medial rearfoot in asymptomatic adults with a flat-arched or pronated foot posture. Plantar pressures at the midfoot and forefoot were not altered by a medial heel skive of 2, 4 or 6 mm. These findings provide some evidence for the effects of the medial heel skive orthotic modification.

SU-E-T-81: A Study On Correlation Between Gamma Analysis for Midline and Lateralized Tumors Using VMAT

International Nuclear Information System (INIS)

Kumar, Syam; Anjana

2015-01-01

Purpose: To evaluate the fluence for the midline and lateralized tumors for VMAT technique using 2D seven29 detector array combined with the Octavius phantom. Methods: 60 cases that are already being treated with volumetric modulated arc therapy (VMAT) have selected for this study. This includes tumors situated at the medial and lateral. Medial refers to the tumor situated at the midline of the body and lateral means toward the side or away from the midline of the body. Verification plans were created for each treatment plan in Varian Eclipse treatment planning system (version10, Varian medical systems, Palo Alto,CA) with the 2D Seven29 detector array and the Octavius phantom(PTW, Freiburg, Germany). Measurements were performed on a Varian Clinac 2100 iX, linear accelerator equipped with a millennium 120 leaf collimator. Analysis was done by comparing the fluence measured for the tumors situated on the midline and tumors situated laterally. Results: Fluence measured for all the delivered plans were analyzed using Verisoft software (PTW, Freiburg, Germany). The gamma pass percentage for midline tumors were found to be higher compared with the lateralized ones. The standard deviation between gamma values for midline and lateralized tumors is 2.18 and 3.5 respectively. Also the standard deviation between the point doses for midline and lateralized tumors is 0.38 and 0.29 respectively. The average gamma passing rate for midline tumors is 96.55% and for lateralized tumors are 94.94% for 3%DD and 3mm DTA criteria. From the T test, it was found that there is no significant difference between the gamma pass percentage between midline and lateralized tumors with p value of 0.28. Conclusion: There is no particular correlation found in the gamma pass criteria for midline and lateralized tumors

QuakeML - An XML Schema for Seismology

Science.gov (United States)

Wyss, A.; Schorlemmer, D.; Maraini, S.; Baer, M.; Wiemer, S.

2004-12-01

We propose an extensible format-definition for seismic data (QuakeML). Sharing data and seismic information efficiently is one of the most important issues for research and observational seismology in the future. The eXtensible Markup Language (XML) is playing an increasingly important role in the exchange of a variety of data. Due to its extensible definition capabilities, its wide acceptance and the existing large number of utilities and libraries for XML, a structured representation of various types of seismological data should in our opinion be developed by defining a 'QuakeML' standard. Here we present the QuakeML definitions for parameter databases and further efforts, e.g. a central QuakeML catalog database and a web portal for exchanging codes and stylesheets.

Medial prefrontal cortex dopamine controls the persistent storage of aversive memories

Science.gov (United States)

Gonzalez, María C.; Kramar, Cecilia P.; Tomaiuolo, Micol; Katche, Cynthia; Weisstaub, Noelia; Cammarota, Martín; Medina, Jorge H.

2014-01-01

Medial prefrontal cortex (mPFC) is essential for initial memory processing and expression but its involvement in persistent memory storage has seldom been studied. Using the hippocampus dependent inhibitory avoidance learning task and the hippocampus-independent conditioned taste aversion paradigm together with specific dopamine receptor agonists and antagonists we found that persistence but not formation of long-term aversive memories requires dopamine D1/D5 receptors activation in mPFC immediately after training and, depending on the task, between 6 and 12 h later. Our results indicate that besides its well-known participation in retrieval and early consolidation, mPFC also modulates the endurance of long-lasting aversive memories regardless of whether formation of the aversive mnemonic trace requires the participation of the hippocampus. PMID:25506318

Two-View Gravity Stress Imaging Protocol for Nondisplaced Type II Supination External Rotation Ankle Fractures: Introducing the Gravity Stress Cross-Table Lateral View.

Science.gov (United States)

Boffeli, Troy J; Collier, Rachel C; Gervais, Samuel J

Assessing ankle stability in nondisplaced Lauge-Hansen supination external rotation type II injuries requires stress imaging. Gravity stress mortise imaging is routinely used as an alternative to manual stress imaging to assess deltoid integrity with the goal of differentiating type II from type IV injuries in cases without a posterior or medial fracture. A type II injury with a nondisplaced fibula fracture is typically treated with cast immobilization, and a type IV injury is considered unstable and often requires operative repair. The present case series (two patients) highlights a standardized 2-view gravity stress imaging protocol and introduces the gravity stress cross-table lateral view. The gravity stress cross-table lateral view provides a more thorough evaluation of the posterior malleolus owing to the slight external rotation and posteriorly directed stress. External rotation also creates less bony overlap between the tibia and fibula, allowing for better visualization of the fibula fracture. Gravity stress imaging confirmed medial-sided injury in both cases, confirming the presence of supination external rotation type IV or bimalleolar equivalent fractures. Open reduction and internal fixation was performed, and both patients achieved radiographic union. No further treatment was required at 21 and 33 months postoperatively. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Direct activation of EXPANSIN14 by LBD18 in the gene regulatory network of lateral root formation in Arabidopsis.

Science.gov (United States)

Kim, Jungmook; Lee, Han Woo

2013-02-01

Root system architecture is important for plants to adapt to a changing environment. The major determinant of the root system is lateral roots originating from the primary root. The developmental process of lateral root formation can be divided into priming, initiation, primordium development and the emergence of lateral roots, and is well characterized in Arabidopsis. The hormone auxin plays a critical role in lateral root development, and several auxin response modules involving AUXIN RESPONSE FACTORS (ARFs), transcriptional regulators of auxin-regulated genes and Aux/IAA, negative regulators of ARFs, regulate lateral root formation. The LATERAL ORGAN BOUNDARIES DOMAIN/ASYMMETRIC LEAVES2-LIKE (LBD/ASL) gene family encodes a unique class of transcription factors harbouring a conserved plant-specific lateral organ boundary domain and plays a role in lateral organ development of plants including lateral root formation. In our previous study, we showed that LBD18 stimulates lateral root formation in combination with LBD16 downstream of ARF7 and ARF19 during the auxin response. We have recently demonstrated that LBD18 activates expression of EXP14, a gene encoding the cell-wall loosening factor, by directly binding to the EXP14 promoter to promote lateral root emergence. Here we present the molecular function of LBD18 and its gene regulatory network during lateral root formation.

Proceedings ML Family/OCaml Users and Developers workshops

OpenAIRE

Kiselyov, Oleg; Garrigue, Jacques

2015-01-01

This volume collects the extended versions of selected papers originally presented at the two ACM SIGPLAN workshops: ML Family Workshop 2014 and OCaml 2014. Both were affiliated with ICFP 2014 and took place on two consecutive days, on September 4 and 5, 2014 in Gothenburg, Sweden. The ML Family workshop aims to recognize the entire extended family of ML and ML-like languages: languages that are Higher-order, Typed, Inferred, and Strict. It provides the forum to discuss common issues, both pr...

Successful Treatment of Gluteal Pain from Obturator Internus Tendinitis and Bursitis with Ultrasound-Guided Injection.

Science.gov (United States)

Chen, Boqing; Rispoli, Leia; Stitik, Todd; Leong, Michelle

2017-10-01

This case report describes what the authors believe is the first case of a patient with obturator internus tendinitis and bursitis successfully treated with a corticosteroid injection using a trans-tendinous lateral to medial approach. The patient presented with right gluteal pain not relieved by physical therapy or right hip and ischial bursa corticosteroid injections. Pelvic and lumbar spine MRIs and EMG/NCS findings were unremarkable. Physical examination demonstrated tenderness to palpation at the right middle lower gluteal region. Ultrasound imaging with sonopalpation identified the maximal local tender point as the right obturator internus muscle and/or its underlying bursa. A 22-gauge 3.5-inch needle was inserted in-plane to the transducer and longitudinal to the obturator internus from a lateral to medial direction, an approach previously described in cadavers. The obturator internus tendon sheath and bursa were injected with 2.5 ml of 0.5% lidocaine combined with 10 mg of triamcinolone. The patient reported immediate complete relief of pain with continued relief at 2 and 6 months post-injection. This case report demonstrates an injection of the obturator internus tendon sheath and bursa using a trans-tendinous approach, which may be successful for treatment of patients presenting with persistent gluteal pain from obturator internus tendinitis and bursitis.

Mapping hemispheric symmetries, relative asymmetries, and absolute asymmetries underlying the auditory laterality effect.

Science.gov (United States)

Westerhausen, René; Kompus, Kristiina; Hugdahl, Kenneth

2014-01-01

Functional hemispheric differences for speech and language processing have been traditionally studied by using verbal dichotic-listening paradigms. The commonly observed right-ear preference for the report of dichotically presented syllables is taken to reflect the left hemispheric dominance for speech processing. However, the results of recent functional imaging studies also show that both hemispheres - not only the left - are engaged by dichotic listening, suggesting a more complex relationship between behavioral laterality and functional hemispheric activation asymmetries. In order to more closely examine the hemispheric differences underlying dichotic-listening performance, we report an analysis of functional magnetic resonance imaging (fMRI) data of 104 right-handed subjects, for the first time combining an interhemispheric difference and conjunction analysis. This approach allowed for a distinction of homotopic brain regions which showed symmetrical (i.e., brain region significantly activated in both hemispheres and no activation difference between the hemispheres), relative asymmetrical (i.e., activated in both hemispheres but significantly stronger in one than the other hemisphere), and absolute asymmetrical activation patterns (i.e., activated only in one hemisphere and this activation is significantly stronger than in the other hemisphere). Symmetrical activation was found in large clusters encompassing temporal, parietal, inferior frontal, and medial superior frontal regions. Relative and absolute left-ward asymmetries were found in the posterior superior temporal gyrus, located adjacent to symmetrically activated areas, and creating a lateral-medial gradient from symmetrical towards absolute asymmetrical activation within the peri-Sylvian region. Absolute leftward asymmetry was also found in the post-central and medial superior frontal gyri, while rightward asymmetries were found in middle temporal and middle frontal gyri. We conclude that dichotic

Various vibration modes in a silicon ring resonator driven by p–n diode actuators formed in the lateral direction

Science.gov (United States)

Tsushima, Takafumi; Asahi, Yoichi; Tanigawa, Hiroshi; Furutsuka, Takashi; Suzuki, Kenichiro

2018-06-01

In this paper, we describe p–n diode actuators that are formed in the lateral direction on resonators. Because previously reported p–n diode actuators, which were driven by a force parallel to the electrostatic force induced in a p–n diode, were fabricated in the perpendicular direction to the surface, the fabrication process to satisfy the requirement of realizing a p–n junction set in the middle of the plate thickness has been difficult. The resonators in this work are driven by p–n diodes formed in the lateral direction, making the process easy. We have fabricated a silicon ring resonator that has in-plane vibration using p–n–p and n–p–n diode actuators formed in the lateral direction. First, we consider a space charge model that can sufficiently accurately describe the force induced in p–n diode actuators and compare it with the capacitance model used in most computer simulations. Then, we show that multiplying the vibration amplitude calculated by computer simulation by the modification coefficient of 4/3 provides the vibration amplitude in the p–n diode actuators. Good agreement of the theory with experimental results of the in-plane vibration measured for silicon ring resonators is obtained. The computer simulation is very useful for evaluating various vibration modes in resonators driven by the p–n diode actuators. The small amplitude of the p–n diode actuator measured in this work is expected to increase greatly with increased doping of the actuator.

ML at ATLAS&CMS : setting the stage

CERN Multimedia

CERN. Geneva

2015-01-01

In the early days of the LHC the canonical problems of classification and regression were mostly addressed using simple cut-based techniques. Today, ML techniques (some already pioneered in pre-LHC or non collider experiments) play a fundamental role in the toolbox of any experimentalist. The talk will introduce, through a representative collection of examples, the problems addressed with ML techniques at the LHC. The goal of the talk is to set the stage for a constructive discussion with non-HEP ML practitioners, focusing on the specificities of HEP applications.

Myosin light chain kinase regulates synaptic plasticity and fear learning in the lateral amygdala.

Science.gov (United States)

Lamprecht, R; Margulies, D S; Farb, C R; Hou, M; Johnson, L R; LeDoux, J E

2006-01-01

Learning and memory depend on signaling molecules that affect synaptic efficacy. The cytoskeleton has been implicated in regulating synaptic transmission but its role in learning and memory is poorly understood. Fear learning depends on plasticity in the lateral nucleus of the amygdala. We therefore examined whether the cytoskeletal-regulatory protein, myosin light chain kinase, might contribute to fear learning in the rat lateral amygdala. Microinjection of ML-7, a specific inhibitor of myosin light chain kinase, into the lateral nucleus of the amygdala before fear conditioning, but not immediately afterward, enhanced both short-term memory and long-term memory, suggesting that myosin light chain kinase is involved specifically in memory acquisition rather than in posttraining consolidation of memory. Myosin light chain kinase inhibitor had no effect on memory retrieval. Furthermore, ML-7 had no effect on behavior when the training stimuli were presented in a non-associative manner. Anatomical studies showed that myosin light chain kinase is present in cells throughout lateral nucleus of the amygdala and is localized to dendritic shafts and spines that are postsynaptic to the projections from the auditory thalamus to lateral nucleus of the amygdala, a pathway specifically implicated in fear learning. Inhibition of myosin light chain kinase enhanced long-term potentiation, a physiological model of learning, in the auditory thalamic pathway to the lateral nucleus of the amygdala. When ML-7 was applied without associative tetanic stimulation it had no effect on synaptic responses in lateral nucleus of the amygdala. Thus, myosin light chain kinase activity in lateral nucleus of the amygdala appears to normally suppress synaptic plasticity in the circuits underlying fear learning, suggesting that myosin light chain kinase may help prevent the acquisition of irrelevant fears. Impairment of this mechanism could contribute to pathological fear learning.

Differential efferent projections of the anterior, posteroventral and posterodorsal subdivisions of the medial amygdala in mice

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Cecília ePardo-Bellver

2012-08-01

Full Text Available The medial amygdaloid nucleus (Me is a key structure in the control of sociosexual behaviour in mice. It receives direct projections from the main and accessory olfactory bulbs, as well as an important hormonal input. To better understand its behavioural role, in this work we investigate the structures receiving information from the Me, by analysing the efferent projections from its anterior (MeA, posterodorsal (MePD and posteroventral (MePV subdivisions, using anterograde neuronal tracing with biotinylated and tetrametylrhodamine-conjugated dextranamines.The Me is strongly interconnected with the rest of the chemosensory amygdala, but shows only moderate projections to the central nucleus and light projections to the associative nuclei of the basolateral amygdaloid complex. In addition, the MeA originates a strong feedback projection to the deep mitral cell layer of the accessory olfactory bulb, whereas the MePV projects to its granule cell layer. The medial amygdaloid nucleus (especially the MeA has also moderate projections to different olfactory structures, including the piriform cortex. The densest outputs of the Me target the bed nucleus of the stria terminalis (BST and the hypothalamus. The MeA and MePV project to key structures of the circuit involved in the defensive response against predators (medial posterointermediate BST, anterior hypothalamic area, dorsomedial aspect of the ventromedial hypothalamic nucleus, although less dense projections also innervate reproductive-related nuclei. In contrast, the MePD projects mainly to structures that control reproductive behaviours (medial posteromedial BST, medial preoptic nucleus, and ventrolateral aspect of the ventromedial hypothalamic nucleus, although less dense projections to defensive-related nuclei also exist. These results confirm and extend previous results in other rodents and suggest that the medial amygdala is anatomically and functionally compartmentalized.

Intrinsic factors associated with medial tibial stress syndrome in ...

African Journals Online (AJOL)

Intrinsic factors associated with medial tibial stress syndrome in athletes: A large case-control study. ... Medial tibial stress syndrome (MTSS) is the most common lower-leg injury in athletes, and is thought to be caused by ... from 32 Countries:.

Ultrastructure of medial rectus muscles in patients with intermittent exotropia.

Science.gov (United States)

Yao, J; Wang, X; Ren, H; Liu, G; Lu, P

2016-01-01

PURPOSE To study the ultrastructure of the medial rectus in patients with intermittent exotropia at different ages.PATIENTS AND METHODS The medial recti were harvested surgically from 20 patients with intermittent exotropia. Patients were divided into adolescent (age18 years, n=10). The normal control group included five patients without strabismus and undergoing eye enucleation. Hematoxylin and eosin staining and transmission electron microscopy were used to visualize the medial recti. Western blot was used to determine the levels of myosin and actin.RESULTS Varying fiber thickness, atrophy, and misalignment of the medial recti were visualized under optical microscope in patients with exotropia. Electron microscopy revealed sarcomere destruction, myofilament disintegration, unclear dark and light bands, collagen proliferation, and fibrosis. The adolescent group manifested significantly higher levels of myosin and actin than the adult group (Pstronger contraction of the medial recti compared with older patients. Our findings suggest that childhood was the appropriate time for surgery as the benefit of the intervention was better than in adulthood.

Subquadratic medial-axis approximation in $\\mathbb{R}^3$

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Christian Scheffer

2015-09-01

Full Text Available We present an algorithm that approximates the medial axis of a smooth manifold in $\\mathbb{R}^3$ which is given by a sufficiently dense point sample. The resulting, non-discrete approximation is shown to converge to the medial axis as the sampling density approaches infinity. While all previous algorithms guaranteeing convergence have a running time quadratic in the size $n$ of the point sample, we achieve a running time of at most $\\mathcal{O}(n\\log^3 n$. While there is no subquadratic upper bound on the output complexity of previous algorithms for non-discrete medial axis approximation, the output of our algorithm is guaranteed to be of linear size.

Postoperative analgesic efficacy of ultrasound-guided ilioinguinal-iliohypogastric nerve block compared with medial transverse abdominis plane block in inguinal hernia repair: A prospective, randomised trial.

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Bhatia, Nidhi; Sen, Indu Mohini; Mandal, Banashree; Batra, Ankita

2018-03-29

Analgesic efficacy of ultrasound-guided transverse abdominis plane block, administered a little more medially, just close to the origin of the transverse abdominis muscle has not yet been investigated in patients undergoing unilateral inguinal hernia repair. We hypothesised that medial transverse abdominis plane block would provide comparable postoperative analgesia to ilioinguinal-iliohypogastric nerve block in inguinal hernia repair patients. This prospective, randomised trial was conducted in 50 ASA I and II male patients≥18 years of age. Patients were randomised into two groups to receive either pre-incisional ipsilateral ultrasound-guided ilioinguinal-iliohypogastric nerve block or medial transverse abdominis plane block, with 0.3ml/kg of 0.25% bupivacaine. Our primary objective was postoperative 24-hour analgesic consumption and secondary outcomes included pain scores, time to first request for rescue analgesic and side effects, if any, in the postoperative period. There was no significant difference in the total postoperative analgesic consumption [group I: 66.04mg; group II: 68.33mg (P value 0.908)]. Time to first request for rescue analgesic was delayed, though statistically non-significant (P value 0.326), following medial transverse abdominis plane block, with excellent pain relief seen in 58.3% patients as opposed to 45.8% patients in ilioinguinal-iliohypogastric nerve block group. Medial transverse abdominis plane block being a novel, simple and easily performed procedure can serve as an useful alternative to ilioinguinal-iliohypogastric nerve block for providing postoperative pain relief in inguinal hernia repair patients. Copyright © 2018 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Intrinsic and Extrinsic Contributions to Seated Balance in the Sagittal and Coronal Planes: Implications for Trunk Control After Spinal Cord Injury.

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Audu, Musa L; Triolo, Ronald J

2015-08-01

The contributions of intrinsic (passive) and extrinsic (active) properties of the human trunk, in terms of the simultaneous actions about the hip and spinal joints, to the control of sagittal and coronal seated balance were examined. Able-bodied (ABD) and spinal-cord-injured (SCI) volunteers sat on a moving platform which underwent small amplitude perturbations in the anterior-posterior (AP) and medial-lateral (ML) directions while changes to trunk orientation were measured. A linear parametric model that related platform movement to trunk angle was fit to the experimental data by identifying model parameters in the time domain. The results showed that spinal cord injury leads to a systematic reduction in the extrinsic characteristics, while most of the intrinsic characteristics were rarely affected. In both SCI and ABD individuals, passive characteristics alone were not enough to maintain seated balance. Passive stiffness in the ML direction was almost 3 times that in the AP direction, making more extrinsic mechanisms necessary for balance in the latter direction. Proportional and derivative terms of the extrinsic model made the largest contribution to the overall output from the active system, implying that a simple proportional plus derivative (PD) controller structure will suffice for restoring seated balance after spinal cord injury.

Gender differences of the morphology of the distal femur and proximal tibia in a Korean population.

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Lim, Hong-Chul; Bae, Ji-Hoon; Yoon, Ji-Yeol; Kim, Seung-Ju; Kim, Jae-Gyoon; Lee, Jae-Moon

2013-01-01

We conducted this study to determine whether the sizes of distal femurs and proximal tibiae in Korean men and women are different, and to assess suitability of the sizes of prostheses currently used in Korea. We performed morphological analysis of proximal tibia and distal femur on 115 patients (56 male, 59 female) using MRI to investigate a gender difference. Tibial mediolateral dimension (tMAP), tibial medial anteroposterior dimension (tMAP), tibial lateral anteroposterior dimension (tLAP) femoral mediolateral dimension (fML), femoral medial anteroposterior dimension (fMAP), and femoral lateral anteroposterior dimension (fLAP) were measured. The ratio of tMAP and tLAP to tML (plateau aspect ratio, tAP/tML×100%), and that of fMAP and fLAP to fML (condylar aspect ratio, fAP/fML×100%) were calculated. The measurements were compared with the similar dimensions of four total knee implants currently used. The tML and tAP lengths showed a significant gender difference (PtMAP/tML) revealed a significant difference between male (0.74±0.05) and female (0.68±0.04, P<0.05). For morphotype of distal femur, males were found to have significantly large values (P<0.05) in the parameters, except for fLAP. With regards to the ratio of the ML width to the AP length, the women showed a narrower ML width than the men. Both genders were distributed within the range of the dimensions of the prostheses currently used prostheses. Korean population revealed that women have smaller dimensions than male counterparts. In both genders, a relatively small size of prostheses matches distal femur and proximal tibia better among the implants currently used in Korea. Copyright © 2012 Elsevier B.V. All rights reserved.

Mapping directionality specific volume changes using tensor based morphometry: an application to the study of gyrogenesis and lateralization of the human fetal brain.

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Rajagopalan, Vidya; Scott, Julia; Habas, Piotr A; Kim, Kio; Rousseau, Francois; Glenn, Orit A; Barkovich, A James; Studholme, Colin

2012-11-01

Tensor based morphometry (TBM) is a powerful approach to analyze local structural changes in brain anatomy. However, conventional scalar TBM methods do not completely capture all direction specific volume changes required to model complex changes such as those during brain growth. In this paper, we describe novel TBM descriptors for studying direction-specific changes in a subject population which can be used in conjunction with scalar TBM to analyze local patterns in directionality of volume change during brain development. We also extend the methodology to provide a new approach to mapping directional asymmetry in deformation tensors associated with the emergence of structural asymmetry in the developing brain. We illustrate the use of these methods by studying developmental patterns in the human fetal brain, in vivo. Results show that fetal brain development exhibits a distinct spatial pattern of anisotropic growth. The most significant changes in the directionality of growth occur in the cortical plate at major sulci. Our analysis also detected directional growth asymmetry in the peri-Sylvian region and the medial frontal lobe of the fetal brain. Copyright © 2012 Elsevier Inc. All rights reserved.

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

DEFF Research Database (Denmark)

Allpass, Maja; Miles, James Edward

2015-01-01

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

Model-driven Service Engineering with SoaML

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Elvesæter, Brian; Carrez, Cyril; Mohagheghi, Parastoo; Berre, Arne-Jørgen; Johnsen, Svein G.; Solberg, Arnor

This chapter presents a model-driven service engineering (MDSE) methodology that uses OMG MDA specifications such as BMM, BPMN and SoaML to identify and specify services within a service-oriented architecture. The methodology takes advantage of business modelling practices and provides a guide to service modelling with SoaML. The presentation is case-driven and illuminated using the telecommunication example. The chapter focuses in particular on the use of the SoaML modelling language as a means for expressing service specifications that are aligned with business models and can be realized in different platform technologies.

The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: 'SCOPEX', a randomised control trial protocol.

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Hall, Michelle; Hinman, Rana S; Wrigley, Tim V; Roos, Ewa M; Hodges, Paul W; Staples, Margaret; Bennell, Kim L

2012-11-27

Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have recently undergone a partial medial meniscectomy. 62 people aged 30-50 years who have undergone an arthroscopic partial medial meniscectomy within the previous 3 to 12 months will be recruited and randomly assigned to a neuromuscular exercise or control group using concealed allocation. The neuromuscular exercise group will attend 8 supervised exercise sessions with a physiotherapist and will perform 6 exercises at home, at least 3 times per week for 12 weeks. The control group will not receive the neuromuscular training program. Blinded assessment will be performed at baseline and immediately following the 12-week intervention. The primary outcomes are change in the peak external knee adduction moment measured by 3-dimensional analysis during normal paced walking and one-leg rise. Secondary outcomes include the change in peak external knee adduction moment during fast pace walking and one-leg hop and change in the knee adduction moment impulse during walking, one-leg rise and one-leg hop, knee and hip muscle strength, electromyographic muscle activation patterns, objective measures of physical function, as well as self-reported measures of physical function and symptoms and additional biomechanical parameters. The findings from this trial will provide evidence regarding the effect of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee

A clinical evaluation of alternative fixation techniques for medial malleolus fractures.

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Barnes, Hayley; Cannada, Lisa K; Watson, J Tracy

2014-09-01

Medial malleolus fractures have traditionally been managed using partially threaded screws and/or Kirschner wire fixation. Using these conventional techniques, a non-union rate of as high as 20% has been reported. In addition too many patients complaining of prominent hardware as a source of pain post-fixation. This study was designed to assess the outcomes of medial malleolar fixation using a headless compression screw in terms of union rate, the need for hardware removal, and pain over the hardware site. Saint Louis University and Mercy Medical Center, Level 1 Trauma Centers, St. Louis, MO. After IRB approval, we used billing records to identify all patients with ankle fractures involving the medial malleolus. Medical records and radiographs were reviewed to identify patients with medial malleolar fractures treated with headless compression screw fixation. Our inclusion criteria included follow-up until full weight bearing and a healed fracture. Follow-up clinical records and radiographs were reviewed to determine union, complication rate and perception of pain over the site of medial malleolus fixation. Sixty-four ankles were fixed via headless compression screws and 44 had adequate follow-up for additional evaluation. Seven patients had isolated medial malleolar fractures, 23 patients had bimalleolar fractures, and 14 patients had trimalleolar fractures. One patient (2%) required hardware removal due to cellulitis. One patient (2%) had a delayed union, which healed without additional intervention. Ten patients (23%) reported mild discomfort to palpation over the medial malleolus. The median follow-up was 35 weeks (range: 12-208 weeks). There were no screw removals for painful hardware and no cases of non-union. Headless compression screws provide effective compression of medial malleolus fractures and result in good clinical outcomes. The headless compression screw is a beneficial alternative to the conventional methods of medial malleolus fixation. Copyright �

TENS to the Lateral Aspect of the Knees During Stance Attenuates Postural Sway in Young Adults

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Yocheved Laufer

2007-01-01

Full Text Available Somatosensory input is known to be essential for postural control. The present study examined the effects on postural sway of sensory input delivered via transcutaneous electrical nerve stimulation (TENS applied to the knees during stance. Electrodes from a dual-channel portable TENS unit were adhered to the skin overlying the lateral and medial aspect of both knees of 20 young healthy volunteers (mean age 24.0 years, standard deviation 4.0. Postural sway parameters were obtained during static bipedal stance with an AMTI force platform. Four stimulation conditions were tested with eyes open and with eyes closed: no TENS; TENS applied bilaterally; and TENS applied to either the right or the left knee. Participants underwent two eight-trial blocks, with each trial lasting 30 seconds. The order of conditions was randomized for each participant. Stimulation consisted of a biphasic symmetrical stimulus delivered at the sensory detection level, with a pulse duration of 200μsec and a pulse frequency of 100Hz. The application of TENS induced significant reductions in mean sway velocity and in the medio-lateral dispersion of the center of pressure, with no corresponding effect on the anterior-posterior dispersion. These findings suggest that electrical stimulation delivered at the sensory detection level to the lateral aspects of the knees may be effective in improving balance control, and that this effect may be directionally specific.

Reliability of internal oblique elbow radiographs for measuring displacement of medial epicondyle humerus fractures: a cadaveric study.

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Gottschalk, Hilton P; Bastrom, Tracey P; Edmonds, Eric W

2013-01-01

Standard elbow radiographs (AP and lateral views) are not accurate enough to measure true displacement of medial epicondyle fractures of the humerus. The amount of perceived displacement has been used to determine treatment options. This study assesses the utility of internal oblique radiographs for measurement of true displacement in these fractures. A medial epicondyle fracture was created in a cadaveric specimen. Displacement of the fragment (mm) was set at 5, 10, and 15 in line with the vector of the flexor pronator mass. The fragment was sutured temporarily in place. Radiographs were obtained at 0 (AP), 15, 30, 45, 60, 75, and 90 degrees (lateral) of internal rotation, with the elbow in set positions of flexion. This was done with and without radio-opaque markers placed on the fragment and fracture bed. The 45 and 60 degrees internal oblique radiographs were then presented to 5 separate reviewers (of different levels of training) to evaluate intraobserver and interobserver agreement. Change in elbow position did not affect the perceived displacement (P=0.82) with excellent intraobserver reliability (intraclass correlation coefficient range, 0.979 to 0.988) and interobserver agreement of 0.953. The intraclass correlation coefficient for intraobserver reliability on 45 degrees internal oblique films for all groups ranged from 0.985 to 0.998, with interobserver agreement of 0.953. For predicting displacement, the observers were 60% accurate in predicting the true displacement on the 45 degrees internal oblique films and only 35% accurate using the 60 degrees internal oblique view. Standardizing to a 45 degrees internal oblique radiograph of the elbow (regardless of elbow flexion) can augment the treating surgeon's ability to determine true displacement. At this degree of rotation, the measured number can be multiplied by 1.4 to better estimate displacement. The addition of a 45 degrees internal oblique radiograph in medial humeral epicondyle fractures has good

Evaluation of set-up deviations during the irradiation of patients suffering from breast cancer treated with two different techniques

International Nuclear Information System (INIS)

KukoIowicz, Pawel Franciszek; Debrowski, Andrzej; Gut, Piotr; Chmielewski, Leszek; Wieczorek, Andrzej; Kedzierawski, Piotr

2005-01-01

Purpose: To compare reproducibility of set-up for two different treatment techniques for external irradiation of the breast. Methods and materials: In total, the analysis comprised 56 pairs of portal and simulator films for 14 consecutive patients treated following breast conserving therapy and 98 pairs of portal and simulator films for 20 consecutive patients treated after mastectomy. For the first group the tangential field technique (TF technique) was used, for the second the inverse hockey stick technique (IHS technique). Evaluation of the treatment reproducibility was performed in terms of systematic and random error calculated for the whole groups, comparison of set-up accuracy by means of comparison of cumulative distribution of the length of the displacement vector. Results: In the IHS and TF techniques for medial and lateral fields, displacement larger than 5 mm occurred in 28.3, 15.8 and 25.4%, respectively. For the IHS technique, the systematic errors for lateral and cranial-caudal direction were 1.9 and 1.7 mm, respectively (1 SD), the random errors for lateral and cranial-caudal direction were 2.0 and 2.5 mm. For the TF technique, the systematic errors for ventral-dorsal and cranial-caudal direction were 2.6 and 1.3 mm for medial field and 3.7 and 0.7 mm for lateral fields, respectively, the random errors for lateral and cranial-caudal direction were 2.2 and 1.0 mm for medial field and 2.9 and 1.1 for lateral field, respectively. Rotations were negligible in the IHS technique. For the TF technique the systematic and random components amounted to about 2.0 degrees (1 SD). Conclusions: Both the inverse hockey stick and standard tangential techniques showed good reproducibility of patients' set-up with respect to cranial-caudal direction. For the TF technique, the accuracy should be improved for the medial field with respect to the ventral-dorsal direction

Modified tension band wiring of medial malleolar ankle fractures.

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Georgiadis, G M; White, D B

1995-02-01

Twenty-two displaced medial malleolar ankle fractures that were treated surgically using the modified tension band method of Cleak and Dawson were retrospectively reviewed at an average follow-up of 25 months. The technique involves the use of a screw to anchor a figure-of-eight wire. There were no malreductions and all fractures healed. Problems with the technique included technical errors with hardware placement, medial ankle pain, and asymptomatic wire migration. Despite this, modified tension band wiring remains an acceptable method for fixation of selected displaced medial malleolar fractures. It is especially suited for small fracture fragments and osteoporotic bone.

Bucket handle tears of the medial meniscus: meniscal intrusion rather than meniscal extrusion

International Nuclear Information System (INIS)

Schlossberg, S.; Umans, H.; Flusser, G.; DiFelice, G.S.; Lerer, D.B.

2007-01-01

To determine the frequency of medial meniscal extrusion (MME) versus ''medial meniscal intrusion'' in the setting of bucket handle tears. Images were evaluated for previously reported risk factors for MME, including: medial meniscal root tear, radial tear, degenerative joint disease and joint effusion. Forty-one consecutive cases of bucket handle tear of the medial meniscus were reviewed by consensus by two musculoskeletal radiologists. Imaging was performed using a 1.5 GE Signa MR unit. Patient age, gender, medial meniscal root integrity, MME, medial meniscal intrusion, degenerative joint disease, effusion and anterior cruciate ligament (ACL) tear were recorded. Thirteen females and 27 males (age 12-62 years, median=30 years) were affected; one had bucket handle tear of each knee. Effusion was small in 13, moderate in 9 and large in 18. Degenerative joint disease was mild in three, moderate in two and severe in one. 26 ACL tears included three partial and three chronic. Medial meniscal root tear was complete in one case and partial thickness in two. None of the 40 cases with an intact or partially torn medial meniscal root demonstrated MME. MME of 3.1 mm was seen in the only full-thickness medial meniscal root tear, along with chronic ACL tear, moderate degenerative joint disease and large effusion. Medial meniscal intrusion of the central bucket handle fragment into the intercondylar notch was present in all 41 cases. Given an intact medial meniscal root in the setting of a ''pure'' bucket handle tear, there is no MME. (orig.)

Failed medial patellofemoral ligament reconstruction: Causes and surgical strategies

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Sanchis-Alfonso, Vicente; Montesinos-Berry, Erik; Ramirez-Fuentes, Cristina; Leal-Blanquet, Joan; Gelber, Pablo E; Monllau, Joan Carles

2017-01-01

Patellar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament (MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed: (1) incorrect surgical indication or inappropriate surgical technique/patient selection; (2) a technical error; and (3) an incorrect assessment of the concomitant risk factors for instability. An understanding of the anatomy and biomechanics of the MPFL and cautiousness with the imaging techniques while favoring clinical over radiological findings and the use of common sense to determine the adequate surgical technique for each particular case, are critical to minimizing MPFL surgery failure. Additionally, our approach to dealing with failure after primary MPFL reconstruction is also presented. PMID:28251062

The medial tibial stress syndrome. A cause of shin splints.

Science.gov (United States)

Mubarak, S J; Gould, R N; Lee, Y F; Schmidt, D A; Hargens, A R

1982-01-01

The medial tibial stress syndrome is a symptom complex seen in athletes who complain of exercise-induced pain along the distal posterior-medial aspect of the tibia. Intramuscular pressures within the posterior compartments of the leg were measured in 12 patients with this disorder. These pressures were not elevated and therefore this syndrome is a not a compartment syndrome. Available information suggests that the medial tibial stress syndrome most likely represents a periostitis at this location of the leg.

MicroRNA Profiling in the Medial and Lateral Habenula of Rats Exposed to the Learned Helplessness Paradigm: Candidate Biomarkers for Susceptibility and Resilience to Inescapable Shock.

Science.gov (United States)

Svenningsen, Katrine; Venø, Morten T; Henningsen, Kim; Mallien, Anne S; Jensen, Line; Christensen, Trine; Kjems, Jørgen; Vollmayr, Barbara; Wiborg, Ove

2016-01-01

Depression is a highly heterogeneous disorder presumably caused by a combination of several factors ultimately causing the pathological condition. The genetic liability model of depression is likely to be of polygenic heterogeneity. miRNAs can regulate multiple genes simultaneously and therefore are candidates that align with this model. The habenula has been linked to depression in both clinical and animal studies, shifting interest towards this region as a neural substrate in depression. The goal of the present study was to search for alterations in miRNA expression levels in the medial and lateral habenula of rats exposed to the learned helplessness (LH) rat model of depression. Ten miRNAs showed significant alterations associating with their response to the LH paradigm. Of these, six and four miRNAs were significantly regulated in the MHb and LHb, respectively. In the MHb we identified miR-490, miR-291a-3p, MiR-467a, miR-216a, miR-18b, and miR-302a. In the LHb miR-543, miR-367, miR-467c, and miR-760-5p were significantly regulated. A target gene analysis showed that several of the target genes are involved in MAPK signaling, neutrophin signaling, and ErbB signaling, indicating that neurotransmission is affected in the habenula as a consequence of exposure to the LH paradigm.

Fratura extra-articular da extremidade medial da clavícula associada à luxação acromioclavicular tipo IV: relato de caso Extra-articular fracture of the medial end of the clavicle associated with type IV acromioclavicular dislocation: case report

Directory of Open Access Journals (Sweden)

Mário Chaves Correa

2011-10-01

Full Text Available Ocorrendo isoladamente, as fraturas da clavícula e as luxações acromioclaviculares são lesões muito comuns. A combinação de uma luxação acromioclavicular e de uma fratura do terço lateral da clavícula não é rara. Entretanto, existem muito poucos casos descritos de luxações acromioclaviculares associadas a fraturas do terço médio da clavícula; aquelas associadas a fraturas do terço medial são ainda mais raras. Nós reportamos o caso de um indivíduo adulto do sexo masculino que sofreu uma luxação acromioclavicular (tipo IV associada a uma fratura extra-articular desviada da extremidade medial da clavícula (grupo 3 de Almann em um acidente ciclístico. O paciente foi tratado na fase aguda com redução aberta e fixação interna das duas lesões. Na avaliação clínica, 12 meses após a cirurgia, o paciente apresentava-se assintomático, com mobilidade ativa e passiva completa, força e resistência normais e simetria das cinturas escapulares. As radiografias e a tomografia computadorizada tridimensional mostravam subluxação posterossuperior persistente da articulação acromioclavicular e consolidação anatômica da fratura clavicular.Fractures of the clavicle and acromioclavicular dislocations are very common injuries when they occur separately. The combination of an acromioclavicular dislocation and a fracture of the lateral third of the clavicle is not rare. However, there are very few reported cases of acromioclavicular dislocations associated with fractures of the middle third of the clavicle; those associated with fractures of the medial third are even rarer. We report the case of an adult male who suffered an acromioclavicular dislocation (type IV associated with a displaced extra-articular fracture of the medial end of the clavicle (Almann group 3 in a cycling accident. The patient was treated during the acute phase with open reduction and internal fixation of the two lesions. At the clinical evaluation 12

Long-Term Synaptic Changes in Two Input Pathways into the Lateral Nucleus of the Amygdala Underlie Fear Extinction

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Park, Junchol; Choi, June-Seek

2010-01-01

Plasticity in two input pathways into the lateral nucleus of the amygdala (LA), the medial prefrontal cortex (mPFC) and the sensory thalamus, have been suggested to underlie extinction, suppression of a previously acquired conditioned response (CR) following repeated presentations of the conditioned stimulus (CS). However, little is known about…

A new surgical technique for traumatic dislocation of posterior tibial tendon with avulsion fracture of medial malleolus.

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Jeong, Soon-Taek; Hwang, Sun-Chul; Kim, Dong-Hee; Nam, Dae-Cheol

2015-01-01

We introduce a case of traumatic dislocation of the posterior tibial tendon with avulsion fracture of the medial malleolus in a 52-year-old female patient who was treated surgically with periosteal flap and suture anchor fixation. Based in the posteromedial ridge of the distal tibia, a quadrilateral periosteal flap was created and folded over the tendon, followed by fixation on the lateral aspect of the groove by use of multiple suture anchors. Clinical and radiological findings 25 months postoperatively showed well-preserved function of the ankle joint with stable tendon gliding.

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

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Li, Xiaodi; Wang, Yuzhou

2014-04-01

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

The Anatomic Midpoint of the Attachment of the Medial Patellofemoral Complex.

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Tanaka, Miho J; Voss, Andreas; Fulkerson, John P

2016-07-20

The medial patellofemoral ligament varies in attachment of its fibers to the patella and vastus intermedius tendon. Our aim was to identify and describe its anatomic midpoint. To account for the variability of the attachment site, we refer to it as the medial patellofemoral complex. Using AutoCAD software, we identified the midpoint of the medial patellofemoral complex attachment on photographs of 31 cadaveric knee dissections. The midpoint was referenced relative to the superior articular surface of the patella (P1) and was described in terms of the percentage of the patellar articular length distal to this point. A second point, at the junction of the medial border of the vastus intermedius tendon with the superior articular border of the patella, was identified (P2). The distances of the midpoint to P1 and P2 were calculated and were compared using paired t tests. Twenty-five images had appropriate quality and landmarks for digital analysis. The midpoint of the medial patellofemoral complex was located a mean (and standard deviation) of 2.3% ± 15.8% of the patellar articular length distal to the superior pole and was at or proximal to P1 in 12 knees. In all knees, the midpoint was at or proximal to P2. After exclusion of 2 knees with vastus intermedius tendon attachments only, the medial patellofemoral complex midpoint was closer to P2 (5.3% ± 8.6% of the patellar articular length) than to P1 (9.3% ± 8.5% of the patellar articular length) (p = 0.06). The midpoint of the medial patellofemoral complex was 2.3% of the articular length distal to the superior pole of the patella. Additionally, we describe an anatomic landmark at the junction of the medial border of the vastus intermedius tendon and the articular border of the patella that approximates the midpoint of this complex. Our study shows that the anatomic midpoint of the attachment of the medial patellofemoral complex is proximal to the junction of the medial vastus intermedius tendon and the articular

Role for the Ventral Posterior Medial/Posterior Lateral Thalamus and Anterior Cingulate Cortex in Affective/Motivation Pain Induced by Varicella Zoster Virus

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Phillip R. Kramer

2017-10-01

Full Text Available Varicella zoster virus (VZV infects the face and can result in chronic, debilitating pain. The mechanism for this pain is unknown and current treatment is often not effective, thus investigations into the pain pathway become vital. Pain itself is multidimensional, consisting of sensory and affective experiences. One of the primary brain substrates for transmitting sensory signals in the face is the ventral posterior medial/posterior lateral thalamus (VPM/VPL. In addition, the anterior cingulate cortex (ACC has been shown to be vital in the affective experience of pain, so investigating both of these areas in freely behaving animals was completed to address the role of the brain in VZV-induced pain. Our lab has developed a place escape avoidance paradigm (PEAP to measure VZV-induced affective pain in the orofacial region of the rat. Using this assay as a measure of the affective pain experience a significant response was observed after VZV injection into the whisker pad and after VZV infusion into the trigeminal ganglion. Local field potentials (LFPs are the summed electrical current from a group of neurons. LFP in both the VPM/VPL and ACC was attenuated in VZV injected rats after inhibition of neuronal activity. This inhibition of VPM/VPL neurons was accomplished using a designer receptor exclusively activated by a designer drug (DREADD. Immunostaining showed that cells within the VPM/VPL expressed thalamic glutamatergic vesicle transporter-2, NeuN and DREADD suggesting inhibition occurred primarily in excitable neurons. From these results we conclude: (1 that VZV associated pain does not involve a mechanism exclusive to the peripheral nerve terminals, and (2 can be controlled, in part, by excitatory neurons within the VPM/VPL that potentially modulate the affective experience by altering activity in the ACC.

Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study

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Haichao Zhou

2017-01-01

Full Text Available Purpose. To investigate the effect of cuboid osteotomy lateral column lengthening (LCL for the correction of stage II B adult-acquired flatfoot deformity in cadaver. Methods. Six cadaver specimens were loaded to 350 N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1 intact foot, (2 flatfoot, and (3 cuboid osteotomy LCL (2, 3, 4, and 5 mm. Results. Compared with the flatfoot model, the LCLs showed significant correction of talonavicular coverage on anteroposterior radiographs and talus-first metatarsal angle on both anteroposterior and lateral radiographs (p<.05. Compared with the intact foot, the above angles of the LCLs showed no significant difference except the 2 mm LCL. In terms of forefoot pressure, medial pressure of the 2 mm LCL (p=.044 and lateral pressure of the 3, 4, and 5 mm LCLs showed statistical differences (p<.05, but lateral pressure of the 3 mm LCL was not more than the intact foot as compared to the 4 and 5 mm LCLs, which was less than medial pressure. Conclusion. Cuboid osteotomy LCL procedure avoids damage to subtalar joint and has a good effect on correction of stage II B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers.

Postural control and functional balance in individuals with diabetic peripheral neuropathy

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Ana Claudia de Souza Fortaleza

2013-04-01

Full Text Available Diabetic Peripheral Neuropathy (DPN brings on reduced somatosensation, which can lead to changes in postural control. The objective of this study was to evaluate postural control in a standing position and in different conditions, as well as functional balance in individuals with DPN, make the correlation between the results obtained from the postural control assessment with the values from the functional balance test and compare the results obtained in the neuropathy group with those of the control group, checking for possible differences between the evaluation conditions of both groups. The study included 13 women with DPN (NG and 17 non-diabetic women (CG. Postural control assessment was performed by kinemetry in the following conditions: eyes opened (EO, eyes closed (EC, and semi-tandem (ST. The data was processed in MATLAB and the following variables were generated: mean amplitude of oscillation (MAO in the anterior-posterior (AP and medial-lateral (ML direction; and average speed of oscillation (ASO in AP and ML direction. Functional balance was assessed by the Timed Up and Go Test. There was significant difference between the groups (p≤0.005 in MAO-AP EO and EC, MAO-ML EC and ST, and ASO-ML ST. There were differences between the conditions EO and ST (p≤0.005 and EC and ST (p≤0.005 for the variables MAO-ML and ASO-ML with greater damage to the NG, which also had a lower functional balance (p=0.001. ML instability was positively correlated with functional imbalance. The results show a change in the postural control system in the DPN, which could lead these individuals to a higher risk for falls and functional impairment.

Deficits in medio-lateral balance control and the implications for falls in individuals with multiple sclerosis.

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Morrison, S; Rynders, C A; Sosnoff, J J

2016-09-01

A major health concern faced by individuals with Multiple Sclerosis (MS) is the heightened risk of falling. Reasons for this increased risk can often be traced back to declines in neurophysiological mechanisms underlying balance control and/or muscular strength. The aim of this study was to assess differences between persons with MS and age-matched healthy adults in regards to their falls risk, strength, reactions and directional control of balance. Twenty-two persons with multiple sclerosis (mean age 56.3±8.9 years) and 22 age-matched healthy adults (mean age 59.1±7.1 years) participated in the study. Assessments of falls risk, balance, fear of falling, lower limb strength, and reaction time were performed. Balance control was assessed under four conditions where the combined effects of vision (eyes open/closed) and standing surface (firm/pliable surface) were evaluated. Results demonstrated that, in comparison to healthy older adults, persons with MS had a significantly higher falls risk, slower reaction times, and weaker lower- limb strength. For balance, persons with MS exhibited greater overall COP motion in both the medio-lateral (ML) and anterior-posterior (AP) directions compared to older adults. Additionally, during more challenging balance conditions, persons from the MS group exhibited greater ML motion compared to sway in the AP direction. Overall, the results confirm that persons with MS are often at a heightened risk of falling, due to the multitude of neuromuscular changes brought about by this disease process. However, the increased ML sway for the MS group could reflect a decreased ability to control side-to-side motion in comparison to controlling AP sway. Copyright © 2016 Elsevier B.V. All rights reserved.

Radiographic anatomy of the medial coronoid process of dogs

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Miyabayashi, T.; Takiguchi, M.; Schrader, S.C.; Biller, D.S.

1995-01-01

Mediolateral, flexed mediolateral, mediocaudal-laterocranial 15 degrees oblique (extended and supinated mediolateral), and craniolateral-caudomedial 20 degrees to 30 degrees oblique radiographs of 16 elbow-joint specimens were produced to study the radiographic anatomy of the medial coronoid process. On the mediolateral view, the cranial point of the coronoid process was at the level of the distal one-third of the radial epiphysis. Degree of superimposition of the proximal radius and ulna determined how the medial coronoid process was projected on the radiographs. Mediocaudal-laterocranial oblique radiographs best showed the cranial outline of the medial coronoid process with moderate superimposition of the proximal radius and ulna

The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: ‘SCOPEX’ a randomised control trial protocol

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2012-01-01

Background Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have recently undergone a partial medial meniscectomy. Methods/design 62 people aged 30–50 years who have undergone an arthroscopic partial medial meniscectomy within the previous 3 to 12 months will be recruited and randomly assigned to a neuromuscular exercise or control group using concealed allocation. The neuromuscular exercise group will attend 8 supervised exercise sessions with a physiotherapist and will perform 6 exercises at home, at least 3 times per week for 12 weeks. The control group will not receive the neuromuscular training program. Blinded assessment will be performed at baseline and immediately following the 12-week intervention. The primary outcomes are change in the peak external knee adduction moment measured by 3-dimensional analysis during normal paced walking and one-leg rise. Secondary outcomes include the change in peak external knee adduction moment during fast pace walking and one-leg hop and change in the knee adduction moment impulse during walking, one-leg rise and one-leg hop, knee and hip muscle strength, electromyographic muscle activation patterns, objective measures of physical function, as well as self-reported measures of physical function and symptoms and additional biomechanical parameters. Discussion The findings from this trial will provide evidence regarding the effect of a home-based, physiotherapist

The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: ‘SCOPEX’ a randomised control trial protocol

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Hall Michelle

2012-11-01

Full Text Available Abstract Background Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have recently undergone a partial medial meniscectomy. Methods/design 62 people aged 30–50 years who have undergone an arthroscopic partial medial meniscectomy within the previous 3 to 12 months will be recruited and randomly assigned to a neuromuscular exercise or control group using concealed allocation. The neuromuscular exercise group will attend 8 supervised exercise sessions with a physiotherapist and will perform 6 exercises at home, at least 3 times per week for 12 weeks. The control group will not receive the neuromuscular training program. Blinded assessment will be performed at baseline and immediately following the 12-week intervention. The primary outcomes are change in the peak external knee adduction moment measured by 3-dimensional analysis during normal paced walking and one-leg rise. Secondary outcomes include the change in peak external knee adduction moment during fast pace walking and one-leg hop and change in the knee adduction moment impulse during walking, one-leg rise and one-leg hop, knee and hip muscle strength, electromyographic muscle activation patterns, objective measures of physical function, as well as self-reported measures of physical function and symptoms and additional biomechanical parameters. Discussion The findings from this trial will provide evidence regarding the effect of a home

The mechanical benefit of medial support screws in locking plating of proximal humerus fractures.

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Wen Zhang

Full Text Available BACKGROUND: The purpose of this study was to evaluate the biomechanical advantages of medial support screws (MSSs in the locking proximal humeral plate for treating proximal humerus fractures. METHODS: Thirty synthetic left humeri were randomly divided into 3 subgroups to establish two-part surgical neck fracture models of proximal humerus. All fractures were fixed with a locking proximal humerus plate. Group A was fixed with medial cortical support and no MSSs; Group B was fixed with 3 MSSs but without medial cortical support; Group C was fixed with neither medial cortical support nor MSSs. Axial compression, torsional stiffness, shear stiffness, and failure tests were performed. RESULTS: Constructs with medial support from cortical bone showed statistically higher axial and shear stiffness than other subgroups examined (P<0.0001. When the proximal humerus was not supported by medial cortical bone, locking plating with medial support screws exhibited higher axial and torsional stiffness than locking plating without medial support screws (P ≤ 0.0207. Specimens with medial cortical bone failed primarily by fracture of the humeral shaft or humeral head. Specimens without medial cortical bone support failed primarily by significant plate bending at the fracture site followed by humeral head collapse or humeral head fracture. CONCLUSIONS: Anatomic reduction with medial cortical support was the stiffest construct after a simulated two-part fracture. Significant biomechanical benefits of MSSs in locking plating of proximal humerus fractures were identified. The reconstruction of the medial column support for proximal humerus fractures helps to enhance mechanical stability of the humeral head and prevent implant failure.

Comparison of postural stability between injured and uninjured ballet dancers.

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Lin, Cheng-Feng; Lee, I-Jung; Liao, Jung-Hsien; Wu, Hong-Wen; Su, Fong-Chin

2011-06-01

Ballet movements require a limited base of support; thus, ballet dancers require a high level of postural control. However, postural stability in ballet dancers is still unclear and needs to be understood. To evaluate ballet dancers' postural stability in performing single-leg standing, the en pointe task, and the first and fifth positions and to determine differences in task performance among healthy nondancers, healthy dancers, and dancers with ankle sprains. Controlled laboratory study. Injured dancers, uninjured dancers, and nondancers were recruited for this study (N = 33 age-matched participants; n= 11 per group). The tasks tested were single-leg standing with eyes open and closed, first position, fifth position, and en pointe. Center of pressure parameters were calculated from the ground-reaction force collected with 1 force plate. Analysis of variance was used to assess the differences of center of pressure parameters among 3 groups in single-leg standing; independent t test was used to examine the differences of center of pressure parameters between injured and uninjured dancers. During single-leg standing, injured dancers had significantly greater maximum displacement in the medial-lateral direction and total trajectory of center of pressure, compared with the uninjured dancers and nondancers. During the first and fifth positions, the injured dancers demonstrated significantly greater standard deviation of center of pressure position in the medial-lateral and anterior-posterior directions, compared with the uninjured dancers. During en pointe, the injured dancers had significantly greater maximum displacement in the medial-lateral direction and the anterior-posterior direction, compared with the uninjured dancers. The injured and uninjured dancers demonstrated differences in postural stability in the medial-lateral direction during single-leg standing and the ballet postures. Although the injured dancers received ballet training, their postural stability

Raman spectroscopy imaging reveals interplay between atherosclerosis and medial calcification in the human aorta

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You, Amanda Y. F.; Bergholt, Mads S.; St-Pierre, Jean-Philippe; Kit-Anan, Worrapong; Pence, Isaac J.; Chester, Adrian H.; Yacoub, Magdi H.; Bertazzo, Sergio; Stevens, Molly M.

2017-01-01

Medial calcification in the human aorta accumulates during aging and is known to be aggravated in several diseases. Atherosclerosis, another major cause of cardiovascular calcification, shares some common aggravators. However, the mechanisms of cardiovascular calcification remain poorly understood. To elucidate the relationship between medial aortic calcification and atherosclerosis, we characterized the cross-sectional distributions of the predominant minerals in aortic tissue, apatite and whitlockite, and the associated extracellular matrix. We also compared the cellular changes between atherosclerotic and nonatherosclerotic human aortic tissues. This was achieved through the development of Raman spectroscopy imaging methods that adapted algorithms to distinguish between the major biomolecules present within these tissues. We present a relationship between apatite, cholesterol, and triglyceride in atherosclerosis, with the relative amount of all molecules concurrently increased in the atherosclerotic plaque. Further, the increase in apatite was disproportionately large in relation to whitlockite in the aortic media directly underlying a plaque, indicating that apatite is more pathologically significant in atherosclerosis-aggravated medial calcification. We also discovered a reduction of β-carotene in the whole aortic intima, including a plaque in atherosclerotic aortic tissues compared to nonatherosclerotic tissues. This unprecedented biomolecular characterization of the aortic tissue furthers our understanding of pathological and physiological cardiovascular calcification events in humans. PMID:29226241

[Application of pie-crusting the medial collateral ligament release in arthroscopic surgery for posterior horn of 
medial meniscus in knee joint].

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Zhu, Weihong; Tang, Qi; Liao, Lele; Li, Ding; Yang, Yang; Chen, You

2017-09-28

To explore the effectiveness and safety of pie-crusting the medial collateral ligament release (MCL) in treating posterior horn of medial meniscus (PHMM) tear in tight medial tibiofemoral compartment of knee joint.
 Methods: Thirty-two consecutive patients with PHMM tear in tight medial tibiofemoral compartment of knee joint were admitted to our department from January, 2013 to December, 2014. All patients were performed pie-crusting the MCL release at its tibial insertion with 18-gauge intravenous needle. All patients were evaluated by valgus stress test and bilateral valgus stress radiograph at postoperative 1st day, 4th week and 12th week. Visual Analogue Scales (VAS), Lysholm scores, Tegner scores and International Knee Documentation Committee (IKDC) scores were recorded at the 1st, 3th, 6th month follow-up, then follow-up every 6 months.
 Results: The mean follow-up was 28 (24-36) months. All cases were negative in valgus stress test. MCL rupture, femoral fracture, articular cartilage lesion and neurovascular injury were not found at the last follow-up. The median medial joint space width of affected side and unaffected side for valgus stress radiographs were 6.8 mm and 4.3 mm (P0.05) at the 12th week, respectively. VAS scores was changed from 4.5±1.5 preoperatively to 1.7±1.0 at the final follow-up (t=16.561, Pjoint.

jmzIdentML API: A Java interface to the mzIdentML standard for peptide and protein identification data.

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Reisinger, Florian; Krishna, Ritesh; Ghali, Fawaz; Ríos, Daniel; Hermjakob, Henning; Vizcaíno, Juan Antonio; Jones, Andrew R

2012-03-01

We present a Java application programming interface (API), jmzIdentML, for the Human Proteome Organisation (HUPO) Proteomics Standards Initiative (PSI) mzIdentML standard for peptide and protein identification data. The API combines the power of Java Architecture of XML Binding (JAXB) and an XPath-based random-access indexer to allow a fast and efficient mapping of extensible markup language (XML) elements to Java objects. The internal references in the mzIdentML files are resolved in an on-demand manner, where the whole file is accessed as a random-access swap file, and only the relevant piece of XMLis selected for mapping to its corresponding Java object. The APIis highly efficient in its memory usage and can handle files of arbitrary sizes. The APIfollows the official release of the mzIdentML (version 1.1) specifications and is available in the public domain under a permissive licence at http://www.code.google.com/p/jmzidentml/. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Selection of appropriate medial branch of the optic tract by fibres of ventral retinal origin during development and in regeneration: an autoradiographic study in Xenopus

International Nuclear Information System (INIS)

Straznicky, C.; Gaze, R.M.; Horder, T.J.

1979-01-01

The formation of the branches of the optic tract has been studied with the use of [ 3 H] -proline autoradiography, during development and during regeneration of the optic nerve in Xenopus with one compound ventral (VV) eye made by the embryonic fusion of two ventral eye fragments. The formation of the optic pathway was abnormal in that the lateral branch failed to develop, suggesting that fibres from a VV retina selectively entered the tectum via the medial branch during development. Three months after section of the optic nerve of a VV eye, regenerated fibres were present both in the contralateral and ipsilateral tecta. On the ipsilateral side regenerated fibres entered the tectum via the medial branch only. Retinal fibres entered the contralateral tectum through both branches in some animals and through the medial branch only in others. It is concluded that mechanical factors alone are insufficient to explain the phenomenon of selection of the appropriate medial branch fibres of ventral retinal origin either during development or in regeneration. Some form of fibre-substrate interaction seems to be necessary; and this ability of fibres from a VV eye to take the path appropriate for ventral retina argues strongly that the VV eye is not a regulated system in terms of cell specificities. 8author)

Pathways for the direct extension of malignant pleural mesothelioma into peritoneal cavity. Assessment using computed tomography (CT) and magnetic resonance imaging (MRI)

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Nakano, Takashi; Inoue, Yasushi; Iida, Shinichiro; Tonomura, Atsushi; Miyake, Mitsutomi; Togawa, Naoki; Hada, Toshikazu [Hyogo Coll. of Medicine, Nishinomiya (Japan); Chahinian, A.P.

2000-01-01

We investigated pathways for the direct extension of malignant pleural mesothelioma into peritoneal cavity using CT and MRI, and compared the radiographic findings with the corresponding gross pathologic features at thoracotomy or autopsy to make sure an accurate radiologic assessment. Three different pathways could be recognized ; direct invasion of diaphragmatic muscle to penetrate into peritoneal cavity, direct contiguous extension along the descending aorta into retroperitoneum through the aortic hiatus, and extension from the medial and lateral arcuate ligaments into retroperitoneum along the psoas major muscle and quadratus lumbrum muscle. MRI could evaluate a diaphragmatic muscle invasion and differentiate it from transdiaphragmatic extension. Irregularity of the infradiaphragmatic fat tissue in T1-weighted image was a reliable indicator of transdiaphragmatic extension. MRI is of value in assessing diaphragmatic involvement in patients with malignant pleural mesothelioma. (author)

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.

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Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D; Hirsch, Joshua A

2017-01-01

Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design: Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives: To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results: The results showed direct

Adductor Canal Block With 10 mL Versus 30 mL Local Anesthetics and Quadriceps Strength