Reasons for mini-implants failure: choosing installation site should be valued!

Directory of Open Access Journals (Sweden)

Alberto Consolaro

2014-04-01

Full Text Available Mini-implant loss is often associated with physical and mechanical aspects that result from choosing an inappropriate placement site. It is worth highlighting that: a Interdental alveolar bone crests are flexible and deformable. For this reason, they may not offer the ideal absolute anchorage. The more cervical the structures, the more delicate they are, thus offering less physical support for mini-implant placement; b Alveolar bone crests of triangular shape are more deformable, whereas those of rectangular shape are more flexible; c The bases of the alveolar processes of the maxilla and the mandible are not flexible, for this reason, they are more likely to receive mini-implants; d The more cervical a mini-implant is placed, the higher the risk of loss; the more apical a mini-implant is placed, the better its prognosis will be; e 3D evaluations play a major role in planning the use of mini-implants. Based on the aforementioned considerations, the hypotheses about mini-implant loss are as follows: 1 Deflection of maxillary and mandibular alveolar processes when mini-implants are more cervically placed; 2 Mini-implants placed too near the periodontal ligament, with normal intra-alveolar tooth movement; 3 Low bone density, low thickness and low alveolar bone volume; 4 Low alveolar cortical bone thickness; 5 Excessive pressure inducing trabecular bone microfracture; 6 Sites of higher anatomical weakness in the mandible and the maxilla; 7 Thicker gingival tissue not considered when choosing the mini-implant.

Arthroscopic suture anchor repair of the lateral ligament ankle complex: a cadaveric study.

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Giza, Eric; Shin, Edward C; Wong, Stephanie E; Acevedo, Jorge I; Mangone, Peter G; Olson, Kirstina; Anderson, Matthew J

2013-11-01

Operative treatment of mechanical ankle instability is indicated for patients with multiple sprains and continued episodes of instability. Open repair of the lateral ankle ligaments involves exposure of the attenuated ligaments and advancement back to their anatomic insertions on the fibula using bone tunnels or suture implants. Open and arthroscopic fixation are equal in strength to failure for anatomic Broström repair. Controlled laboratory study. Seven matched pairs of human cadaveric ankle specimens were randomized into 2 groups of anatomic Broström repair: open or arthroscopic. The calcaneofibular ligament and anterior talofibular ligament were excised from their origin on the fibula. In the open repair group, 2 suture anchors were used to reattach the ligaments to their anatomic origins. In the arthroscopic repair group, identical suture anchors were used for repair via an arthroscopic technique. The ligaments were cyclically loaded 20 times and then tested to failure. Torque to failure, degrees to failure, initial stiffness, and working stiffness were measured. A matched-pair analysis was performed. Power analysis of 0.8 demonstrated that 7 pairs needed to show a difference of 30%, with a 15% standard error at a significance level of α = .05. There was no difference in the degrees to failure, torque to failure, or stiffness for the repaired ligament complex. Nine of 14 specimens failed at the suture anchor. There is no statistical difference in strength or stiffness of a traditional open repair as compared with an arthroscopic anatomic repair of the lateral ligaments of the ankle. An arthroscopic technique can be considered for lateral ligament stabilization in patients with mild to moderate mechanical instability.

Percutaneous carpal tunnel release compared with mini-open release using ultrasonographic guidance for both techniques.

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Nakamichi, Ken-ichi; Tachibana, Shintaro; Yamamoto, Seizo; Ida, Masayoshi

2010-03-01

To compare the outcomes of percutaneous carpal tunnel release (PCTR) and mini-open carpal tunnel release (mini-OCTR) using ultrasonographic guidance for both techniques. We included 74 hands of 65 women with idiopathic carpal tunnel syndrome (age, 52-71 y; mean, 58 y). Thirty-five hands of 29 women had the PCTR (release with a device consisting of an angled blade, guide, and holder, along a line midway between the median nerve and ulnar artery (safe line) under ultrasonography (incision, 4 mm), and 39 hands of 36 women had the mini-OCTR (release along the safe line, distally under direct vision (incision, 1-1.5 cm) and proximally under ultrasonography, using a device consisting of a basket punch and outer tube. Assessments at 3, 6, 13, 26, 52, and 104 weeks showed no significant differences in neurologic recovery between the groups (p > .05). The PCTR group had significantly less pain, greater grip and key-pinch strengths, and better satisfaction scores at 3 and 6 weeks (p < .05), and less scar sensitivity at 3, 6, and 13 weeks (p < .05). There were no complications. The PCTR provides the same neurologic recovery as does the mini-OCTR. The former leads to less postoperative morbidity and earlier functional return and achievement of satisfaction. Therapeutic III. Copyright 2010. Published by Elsevier Inc.

[The mini-open Latarjet procedure for treatment of recurrent anterior instability of the shoulder].

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Pogorzelski, J; Beitzel, K; Imhoff, A B; Braun, S

2016-12-01

Shoulder stabilization. Symptomatic recurrent anterior shoulder instability combined with glenoid bone loss of approximately 20-35 % of the glenoid surface, engaging Hill-Sachs lesion and/or previously failed arthroscopic Bankart repair. In patients with a high risk of redislocation (contact sports) or irreparable soft tissue injury the Latarjet procedure can be considered as a first-line treatment. Contraindicated if arthroscopic Bankart repair is possible. Irreparable damage of subscapularis tendon. Bony defect >35 % of the glenoid that cannot be filled with coracoid bone block. Arbitrary shoulder dislocation. Young patients with open growth plates (relative contraindication). Mini-open deltopectoral approach of approximately 6 cm. Preparation of the coracoid process and the conjoined tendons. Osteotomy of the coracoid process at its base using a 90° sawblade. Split of the subscapularis tendon. Preparation of the glenoid defect and implantation of 2-3 suture anchors where appropriate. Drilling of two parallel holes through the coracoid process. Fixation of the bone block with cannulated screws at the anterior glenoid rim and refixation of the joint capsula, if necessary with the help of the suture anchors. Wound drainage and closure in layers. Intermittent immobilization in a sling for 6 weeks with limited abduction, flexion and external rotation. Sport-specific training after 3 months, over-head sports after 6 months. Since 2009 64 mini-open Latarjet procedures (61 patients) performed. In all, 9.4 % of patients suffered from persistent instability (dislocations and subluxations); only 1 patient needed revision surgery due to instability.

Kinematics of Different Components of the Posterolateral Corner of the Knee in the Lateral Collateral Ligament-intact State: A Human Cadaveric Study.

Science.gov (United States)

Domnick, Christoph; Frosch, Karl-Heinz; Raschke, Michael J; Vogel, Nils; Schulze, Martin; von Glahn, Mathias; Drenck, Tobias C; Herbort, Mirco

2017-10-01

To determine the static stabilizing effects of different anatomical structures of the posterolateral corner (PLC) of the knee in the lateral collateral ligament (LCL)-intact state. Thirteen fresh-frozen human cadaveric knees were dissected and tested using an industrial robot with an optical tracking system. Kinematics were determined for 134 N anterior/posterior loads, 10 N m valgus/varus loads, and 5 N m internal/external rotatory loads in 0°, 20°, 30°, 60°, and 90° of knee flexion. The PLC structures were dissected and consecutively released: (I) intact knee joint, (II) with released posterior cruciate ligament (PCL), (III) popliteomeniscal fibers, (IV) popliteofibular ligament, (V) arcuat and popliteotibial fibers, (VI) popliteus tendon (PLT), and (VII) LCL. Repeated-measures analysis of variance was performed with significance set at P < .05. After releasing the PCL, posterior tibial translation increased by 5.2 mm at 20° to 9.4 mm at 90° of joint flexion (P < .0001). A mild 1.8° varus instability was measured in 0° of flexion (P = .0017). After releasing the PLC structures, posterior tibial translation further increased by 2.9 mm at 20° to 5.9 mm at 90° of flexion (P < .05) and external rotation angle increased by 2.6° at 0° to 7.9° at 90° of flexion (P < .05, vs II). Varus stability did not decrease. Mild differences between states V and VI were found in 60° and 90° external rotation tests (2.1° and 3.1°; P < .05). The connecting ligaments/fibers to the PLT act as a primary static stabilizer against external rotatory loads and a secondary stabilizer against posterior tibial loads (when PCL is injured). After releasing these structures, most static stabilizing function of the intact PLT is lost. The PLC has no varus-stabilizing function in the LCL-intact knee. Anatomy and function of these structures for primary and secondary joint stability should be considered for clinical diagnostics and when performing surgery in

Comparison of Clinical and Radiologic Results of Mini-Open Transforaminal Lumbar Interbody Fusion and Extreme Lateral Interbody Fusion Indirect Decompression for Degenerative Lumbar Spondylolisthesis.

Science.gov (United States)

Kono, Yutaka; Gen, Hogaku; Sakuma, Yoshio; Koshika, Yasuhide

2018-04-01

Retrospective study. In this study, we compared the postoperative outcomes of extreme lateral interbody fusion (XLIF) indirect decompression with that of mini-open transforaminal lumbar interbody fusion (TLIF) in patients with lumbar degenerative spondylolisthesis. There are very few reports examining postoperative results of XLIF and minimally invasive TLIF for degenerative lumbar spondylolisthesis, and no reports comparing XLIF and mini-open TLIF. Forty patients who underwent 1-level spinal fusion, either by XLIF indirect decompression (X group, 20 patients) or by mini-open TLIF (T group, 20 patients), for treatment of lumbar degenerative spondylolisthesis were included in this study. Invasiveness of surgery was evaluated on the basis of surgery time, blood loss, hospitalization period, and perioperative complications. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), disc angle (DA), disc height (DH), and slipping length (SL) were evaluated before surgery, immediately after surgery, and at 12 months after surgery. Cross-sectional spinal canal area (CSA) was also measured before surgery and at 1 month after surgery. There was no significant difference between the groups in terms of surgery time or hospitalization period; however, X group showed a significant decrease in blood loss ( p X group ( p <0.05), and the changes in DA and SL were not significantly different between the two groups. The change in CSA was significantly greater in the T group ( p <0.001). Postoperative clinical results were equally favorable for both procedures; however, in comparison with mini-open TLIF, less blood loss and greater correction of DH were observed in XLIF.

MR imaging of the posterolateral corner of the knee

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Bolog, Nicolae [Emergency Hospital, Department of Radiology, Bucharest (Romania); Hodler, Juerg [Orthopaedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland)

2007-08-15

The posterolateral corner (PLC) is a complex functional unit, consisting of several structures, which is responsible for posterolateral stabilization. The PLC is not consistently defined in the literature. However, most descriptions include the popliteal tendon (PT), the lateral collateral ligament (LCL), the popliteofibular ligament (PFL) and the posterolateral capsule, which is reinforced by the arcuate ligament (AL) and the fabellofibular ligament (FFL). Knowledge of PLC anatomy, including its variations, and understanding of the biomechanics is important for correct diagnosis of PLC injuries. An overlooked PLC injury can result in chronic instability, chronic pain, and, eventually, in secondary osteoarthritis. Damage to the PLC also has an adverse effect on the outcome of cruciate ligament repair. Isolated lesions of the PLC are rare. PLC lesions are typically associated with injuries of the cruciate ligaments, the menisci, bone and soft tissue. In the acute phase, clinical findings can be difficult to interpret due to pain and swelling. Magnetic resonance (MR) imaging potentially demonstrates the entire spectrum of PLC injuries and associated lesions of the knee, including those that may be overlooked during clinical examination or arthroscopy. (orig.)

Kinematics of partial and total ruptures of the medial collateral ligament of the elbow

DEFF Research Database (Denmark)

Eygendaal, D; Olsen, Bo Sanderhoff; Jensen, Steen Lund

2000-01-01

In this study the kinematics of partial and total ruptures of the medial collateral ligament of the elbow are investigated. After selective transection of the medial collateral ligament of 8 osteoligamentous intact elbow preparations was performed, 3-dimensional measurements of angular displacement......, increase in medial joint opening, and translation of the radial head were examined during application of relevant stress. Increase in joint opening was significant only after complete transection of the anterior part of the medial collateral ligament was performed. The joint opening was detected during...... valgus and internal rotatory stress only. After partial transection of the anterior bundle of the medial collateral ligament was performed, there was an elbow laxity to valgus and internal rotatory force, which became significant after transection of 100% of the anterior bundle of the medial collateral...

Taman Mini Indonesia Indah sebagai Bagian dari Fenomena Taman Budaya Dunia

Directory of Open Access Journals (Sweden)

Anak Agung Ayu Wulandari

2012-10-01

Full Text Available Cultural display in an open space or known as cultural parks appears rapidly as a worldwide phenomenon. From the European model which has a strong educational value, to the Asian parks which not only has educational function, but also has recreational purposes. So many types and characteristics of these parks, researches give them different names, thodse are Open-air museums, Ethnographic Theme Parks or even Theme Parks. Taman Mini Indonesia Indah as a part of this phenomenon was built first and foremost for educational purposes, therefore Taman Mini can be considered as an open-air museum. However, since Taman Mini also has recreational purposes, others can argue that Taman Mini is a theme park. Qualitative method will be used for this research, through observation to Taman Mini Indonesia Indah, followed by extensive literature review. With these data along with a table which points out the distinction between museum and theme parks. It can  be concluded that Taman Mini is a Theme Park.   

[Effectiveness of arthroscopic treatment of anterior cruciate ligament tibial eminence avulsion fracture with non-absorbable suture fixation combined with mini-plate].

Science.gov (United States)

Wang, Suiyuan; Xiao, Yang; Tong, Zuoming; Li, Guiqiu; Jiang, Juhua; Yao, Jinghui; Wu, Zhiyong; Li, Tengfei; Wu, Qun

2013-09-01

To evaluate the surgical techniques and effectiveness of arthroscopic treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture with non-absorbable suture fixation combined with the miniplate. Between January 2009 and March 2012, 32 patients with ACL tibial eminence avulsion fractures were treated. There were 18 males and 14 females, aged 12-40 years (mean, 17.5 years). The injury causes included traffic accident injury in 15 cases, sport injury in 6 cases, and falling injury in 11 cases. The time from injury to operation ranged 7-18 days with an average of 9.5 days. Before operation, the results of Lachman test were all positive; the Lysholm score was 52.13 +/- 4.22 and the International Knee Documentation Committee (IKDC) score was 44.82 +/- 2.44. According to Meyers-McKeever classification criteria, there were 12 cases of type II and 20 cases of type III. After arthroscopic poking reduction of fracture, tibial eminence avulsion fractures were fixed with the Ethibond non-absorbable sutures bypass figure-of-eight tibial tunnel combined with the metacarpal and phalangeal mini-plate. Primary healing was obtained in all incisions; no joint infection or skin necrosis occurred after operation. All patients were followed up with an average time of 22.4 months (range, 12-50 months). The patients showed negative Lachman test at 12 weeks after operation. Except 3 patients having knee extension limitation at last follow-up, the knee extension range of motion (ROM) was normal in the other patients; the knee flexion ROM was normal in all patients. The Lysholm score and IKDC score were significantly improved to 94.19 +/- 0.93 and 94.35 +/- 1.22 at last follow-up, showing significant differences when compared with preoperative values (t = 55.080, P = 0.000; t = 101.715, P = 0.000). The arthroscopic treatment of ACL tibial eminence avulsion fracture with Ethibond non-absorbable suture fixation combined with mini-plate is an effective procedure with the

Poster - 23: Dosimetric Characterization and Transferability of an Accessory Mounted Mini-Beam Collimator

International Nuclear Information System (INIS)

Davis, William; Crewson, Cody; Alexander, Andrew; Cranmer-Sargison, Gavin; Kundapur, Vijayananda

2016-01-01

Objective: The dosimetric characterization of an accessory-mounted mini-beam collimator across three beam matched linear accelerators. Materials and Methods: Percent depth dose and profiles were measured for the open and mini-beam collimated fields. The average beam quality and peak-to-valley dose ratio (PVDR), the ratio of average peak dose to average valley dose, were obtained from these measurements. The open field relative output and the mini-beam collimator factor, the ratio of the mini-beam dose to open field dose at the beam center, were measured for square fields of side 2, 3, 4, and 5 cm. Mini-beam output as a function of collimator inclination angle relative to the central axis was also investigated. Results and Discussion: Beam quality for both the open and mini-beam collimated fields agreed across all linacs to within ±1.0%. The PVDR was found to vary by up to ±6.6% from the mean. For the 2, 3, and 4 cm fields the average open field relative output with respect to the 5 cm field was 0.874±0.4%, 0.921±0.3%, and 0.962±0.1%. The average collimator factors were 0.450±3.9%, 0.443±3.9%, 0.438±3.9%, and 0.434±3.9%. A decrease in collimator factor greater than 7% was found for an inclination angle change of 0.09°. Conclusion: The mini-beam collimator has revealed a difference between the three linacs not apparent in the open field data, yet transferability can still be attained through thorough dosimetric characterization.

Poster - 23: Dosimetric Characterization and Transferability of an Accessory Mounted Mini-Beam Collimator

Energy Technology Data Exchange (ETDEWEB)

Davis, William; Crewson, Cody; Alexander, Andrew; Cranmer-Sargison, Gavin; Kundapur, Vijayananda [University of Saskatchewan Department of Physics and engineering Physics, Saskatchewan Cancer Agency Department of Medical Physics, Saskatchewan Cancer Agency Department of Medical Physics, Saskatchewan Cancer Agency Department of Medical Physics, Saskatchewan Cancer Agency Department of Medical Physics (Canada)

2016-08-15

Objective: The dosimetric characterization of an accessory-mounted mini-beam collimator across three beam matched linear accelerators. Materials and Methods: Percent depth dose and profiles were measured for the open and mini-beam collimated fields. The average beam quality and peak-to-valley dose ratio (PVDR), the ratio of average peak dose to average valley dose, were obtained from these measurements. The open field relative output and the mini-beam collimator factor, the ratio of the mini-beam dose to open field dose at the beam center, were measured for square fields of side 2, 3, 4, and 5 cm. Mini-beam output as a function of collimator inclination angle relative to the central axis was also investigated. Results and Discussion: Beam quality for both the open and mini-beam collimated fields agreed across all linacs to within ±1.0%. The PVDR was found to vary by up to ±6.6% from the mean. For the 2, 3, and 4 cm fields the average open field relative output with respect to the 5 cm field was 0.874±0.4%, 0.921±0.3%, and 0.962±0.1%. The average collimator factors were 0.450±3.9%, 0.443±3.9%, 0.438±3.9%, and 0.434±3.9%. A decrease in collimator factor greater than 7% was found for an inclination angle change of 0.09°. Conclusion: The mini-beam collimator has revealed a difference between the three linacs not apparent in the open field data, yet transferability can still be attained through thorough dosimetric characterization.

Artificial phrenoesophageal ligament. An experimental study in dogs.

Science.gov (United States)

Sader, A A; Dantas, R O; Campos, A D; Evora, P R B

2016-01-01

This report deals with the preparation of a 'true' artificial phrenoesophageal ligament aimed at restoring effective anchoring of the esophagus to the diaphragm, keeping the esophagogastric sphincter in the abdomen. A total of 24 mongrel dogs were assigned to four groups: (i) Group I (n = 4): the esophageal diaphragm hiatus left wide open; (ii) Group II (n = 8): the anterolateral esophagus walls were attached to the diaphragm by the artificial ligament and the esophageal hiatus was left wide opened; (iii) Group III (n = 5): in addition to the use of the artificial ligament, the esophageal hiatus was narrowed with two retroesophageal stitches; (iv) Group IV (n = 7): the only procedure was the esophageal hiatus narrowing with two retroesophageal stitches. The phrenoesophagogastric connections were released, sparing the vagus nerves. Five animals of groups III and IV, which did not develop hiatal hernia, were submitted to esophageal manometry immediately before and 15 days after surgery. In group I, all animals developed huge sliding hiatal hernias. In group II, two dogs (25%) had a paraesophageal hernia between the two parts of the artificial ligament. In group III, neither sliding hiatal hernia nor paraesophageal hernia occurred. In group IV, two animals (28.6%) developed sliding esophageal hiatus hernia. Regarding esophageal manometry, postoperative significant difference between groups III and IV (P = 0.008) was observed. Thus, the artificial phrenoesophageal ligament maintained the esophagus firmly attached to the diaphragm in all animals and the esophagogastric sphincter pressure was significantly higher in this group. © 2015 International Society for Diseases of the Esophagus.

Tissue-engineered collateral ligament composite allografts for scapholunate ligament reconstruction: an experimental study.

Science.gov (United States)

Endress, Ryan; Woon, Colin Y L; Farnebo, Simon J; Behn, Anthony; Bronstein, Joel; Pham, Hung; Yan, Xinrui; Gambhir, Sanjiv S; Chang, James

2012-08-01

In patients with chronic scapholunate (SL) dissociation or dynamic instability, ligament repair is often not possible, and surgical reconstruction is indicated. The ideal graft ligament would recreate both anatomical and biomechanical properties of the dorsal scapholunate ligament (dorsal SLIL). The finger proximal interphalangeal joint (PIP joint) collateral ligament could possibly be a substitute ligament. We harvested human PIP joint collateral ligaments and SL ligaments from 15 cadaveric limbs. We recorded ligament length, width, and thickness, and measured the biomechanical properties (ultimate load, stiffness, and displacement to failure) of native dorsal SLIL, untreated collateral ligaments, decellularized collateral ligaments, and SL repairs with bone-collateral ligament-bone composite collateral ligament grafts. As proof of concept, we then reseeded decellularized bone-collateral ligament-bone composite grafts with green fluorescent protein-labeled adipo-derived mesenchymal stem cells and evaluated them histologically. There was no difference in ultimate load, stiffness, and displacement to failure among native dorsal SLIL, untreated and decellularized collateral ligaments, and SL repairs with tissue-engineered collateral ligament grafts. With pair-matched untreated and decellularized scaffolds, there was no difference in ultimate load or stiffness. However, decellularized ligaments revealed lower displacement to failure compared with untreated ligaments. There was no difference in displacement between decellularized ligaments and native dorsal SLIL. We successfully decellularized grafts with recently described techniques, and they could be similarly reseeded. Proximal interphalangeal joint collateral ligament-based bone-collateral ligament-bone composite allografts had biomechanical properties similar to those of native dorsal SLIL. Decellularization did not adversely affect material properties. These tissue-engineered grafts may offer surgeons another

Transcatheter closure, mini-invasive closure and open-heart surgical repair for treatment of perimembranous ventricular septal defects in children: a protocol for a network meta-analysis.

Science.gov (United States)

You, Tao; Yi, Kang; Ding, Zhao-Hong; Hou, Xiao-Dong; Liu, Xing-Guang; Wang, Xin-Kuan; Ge, Long; Tian, Jin-Hui

2017-06-21

Both transcatheter device closure and surgical repair are effective treatments with excellent midterm outcomes for perimembranous ventricular septal defects (pmVSDs) in children. The mini-invasive periventricular device occlusion technique has become prevalent in research and application, but evidence is limited for the assessment of transcatheter closure, mini-invasive closure and open-heart surgical repair. This study comprehensively compares the efficacy, safety and costs of transcatheter closure, mini-invasive closure and open-heart surgical repair for treatment of pmVSDs in children using Bayesian network meta-analysis. A systematic search will be performed using Chinese Biomedical Literature Database, China National Knowledge Infrastructure, PubMed, EMBASE.com and the Cochrane Central Register of Controlled Trials to include random controlled trials, prospective or retrospective cohort studies comparing the efficacy, safety and costs of transcatheter closure, mini-invasive closure and open-heart surgical repair. The risk of bias for the included prospective or retrospective cohort studies will be evaluated according to the risk of bias in non-randomised studies of interventions (ROBINS-I). For random controlled trials, we will use risk of bias tool from Cochrane Handbook version 5.1.0. A Bayesian network meta-analysis will be conducted using R-3.3.2 software. Ethical approval and patient consent are not required since this study is a network meta-analysis based on published trials. The results of this network meta-analysis will be submitted to a peer-reviewed journal for publication. CRD42016053352. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ligament Tissue Engineering

OpenAIRE

Khan, Wasim Sardar

2016-01-01

Ligaments are commonly injured in the knee joint, and have a poor capacity for healing due to their relative avascularity. Ligament reconstruction is well established for injuries such as anterior cruciate ligament rupture, however the use of autografts and allografts for ligament reconstruction are associated with complications, and outcomes are variable. Ligament tissue engineering using stem cells, growth factors and scaffolds is a novel technique that has the potential to provide an unlim...

[Ligament-controlled positioning of the knee prosthesis components].

Science.gov (United States)

Widmer, K-H; Zich, A

2015-04-01

There are at least two predominant goals in total knee replacement: first, the surgeon aims to achieve an optimal postoperative kinematic motion close to the patient's physiological range, and second, he aims for concurrent high ligament stability to establish pain-free movement for the entire range of motion. A number of prosthetic designs and surgical techniques have been developed in recent years to achieve both of these targets. This study presents another modified surgical procedure for total knee implantation. As in common practice the osteotomies are planned preoperatively, referencing well-defined bony landmarks, but their placement and orientation are also controlled intraoperatively in a stepwise sequence via ligamentous linkages. This method is open to all surgical approaches and can be applied for PCL-conserving or -sacrificing techniques. The anterior femoral osteotomy is carried out first, followed by the distal femoral osteotomy. Then, the extension gap is finalized by tensioning the ligaments and "top-down" referencing at the level of the tibial osteotomy, followed by finishing the flexion gap in the same way, except that the osteotomy of the posterior condyles is referenced in a "bottom-up" fashion. Hence, this technique relies on both bony and ligament-controlled procedures. Thus, it respects the modified ligamentous framework and drives the prosthetic components into the new ligamentous envelope. Further improvement may be achieved by additional control of the kinematics during surgery by applying modern computer navigation technology.

Ultrasonography of ankle ligaments

International Nuclear Information System (INIS)

Peetrons, P.A.; Silvestre, A.; Cohen, M.; Creteur, V.

2002-01-01

The lateral collateral ligament of the ankle is a complex of 3 ligaments: The anterior and posterior talofibular ligaments and the calcaneofibular ligament; these ligaments work together to support the lateral aspect of the ankle. The anterior talofibular (ATF) ligament (Fig. 1) runs from the anterior of the talus. The probe is placed in a slightly oblique position from the malleolus toward the forefoot. The ligament is hyperechoic when its fibres are perpendicular to the ultrasound beam (anisotropy artifact is present in ligaments as well as in tendons). It is approximately 2 mm thick and, during examination, must be straight and tight from one insertion point to the other, as seen in Fig. 2. The posterior talofibular (PTF) ligament, which runs from the posterior part of the malleolus to the posterior part of the talus, is difficult to see on US, being partially or sometimes completely hidden by the malleolus. The calcaneofibular ligament forms the middle portion of the lateral collateral ligament. It is tight between the inferior part of the lateral malleolus and the calcaneus, and runs in a slightly posterior oblique direction toward the heel (Fig. 3). The ligament lies on the deep surface of the fibular tendons, forming a hammock to fall deep on the calcaneus surface (Fig. 4). The calcaneofibular ligament is approximately 2-3 nun thick and is hyperechoic in the distal two-thirds only because of the obliquity of the proximal part. When examining this ligament, it is mandatory that the ankle be flexed dorsally; this stretches the ligament so that it can be seen clearly. (author)

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

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.

MRI appearance of surgically proven abnormal accessory anterior-inferior tibiofibular ligament (Bassett's ligament)

International Nuclear Information System (INIS)

Subhas, Naveen; Vinson, Emily N.; Cothran, R.L.; Helms, Clyde A.; Santangelo, James R.; Nunley, James A.

2008-01-01

A thickened accessory anterior-inferior tibiofibular ligament (Bassett's ligament) of the ankle can be a cause of ankle impingement. Its imaging appearance is not well described. The purpose of this study was to determine if the ligament could be identified on magnetic resonance imaging (MRI), to determine associated abnormalities, and to determine if MRI could be used to differentiate normal from abnormal. Eighteen patients with a preoperative ankle MRI and an abnormal Bassett's ligament reported at surgery were found retrospectively. A separate cohort of 18 patients was selected as a control population. The presence of Bassett's ligament and its thickness were noted. The integrity and appearance of the lateral ankle ligaments, talar dome cartilage, and anterolateral gutter were also noted. In 34 of the 36 cases (94%), Bassett's ligament was identified on MRI. The ligament was seen in all three imaging planes and most frequently in the axial plane. The mean thickness of the ligament in the surgically abnormal cases was 2.37 mm, compared with 1.87 mm in the control with a p value = 0.015 (t test). Nine of the 18 abnormal cases (50%) had talar dome cartilage lesions as a result of contact with the ligament at surgery, with only 3 cases of high-grade defects seen on MRI. Fourteen of the 18 abnormal cases (78%) had of synovitis or scarring in the lateral gutter at surgery, with only 5 cases with scarring seen on MRI. The anterior-inferior tibiofibular ligament was abnormal or torn in 8 of the 18 abnormal cases (44%) by MRI and confirmed in only 3 cases at surgery. Bassett's ligament can be routinely identified on MRI and was significantly thicker in patients who had it resected at surgery. An abnormal Bassett's ligament is often present in the setting of a normal anterior-inferior tibiofibular ligament. The cartilage abnormalities and synovitis associated with an abnormal Bassett's ligament are poorly detected by conventional MRI. (orig.)

The appearance of a lurking ligament in Laparoscopic Sleeve Gastrectomy; Posterior Gastric Ligament

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Mutlu Ünver

2017-03-01

Full Text Available Objective: The aim of this study was to demonstrate a lurking ligament and its various formation types and to mention the importance of this ligament in Laparoscopic sleeve gastrectomy Methods: One hundred and twelve patients had laparoscopic sleeve gastrectomy (LSG procedure in our clinic between March 2011 and September 2013. All procedures were performed with a standard operative technique. Only difference for the last 50 patients was to avoid the excessive dissection of posterior gastric wall. The existence of posterior gastric ligament was recorded and different types of posterior gastric ligament was demonstrated. Results: Posterior gastric ligament was observed in all of the cases in different formation types. Three types of ligament; complete, partial and skippy, was demonstrated. 53(47.3% of the patients had skippy, while 41 (36.6% had partial and 18 (16.1% had complete type of posterior gastric ligament. Conclusion: A ligament named as ‘posterior gastric ligament’ and its various forms were defined in the third dimensional plane of stomach. Posterior gastric ligament remains as the only structure in LSG for preventing the mobility and ability of the stomach to rotate. The excessive dissection of the posterior gastric ligament should be avoided to prevent complications such as kinking and volvulus

Entrepreneur and Establishment of a Mini Hotel in XiChang, China

OpenAIRE

Hu, Mingsong

2013-01-01

Mini Hotel, is a new hotel will be opened in China in this year. I and 4 of my friends will be the shareholders of this Mini Hotel. The hotel is planned to be operating from the autumn of 2013. Now, everything in this thesis is on process. The main objective of this thesis was to draft an effective approach to ensure this is a right plan which is worth to invest. By using benchmarking and SWOT analysis we defined the strength and weakness of this Mini Hotel business plan. This thesis will ...

CT appearance of pulmonary ligament

Energy Technology Data Exchange (ETDEWEB)

Im, Jung Gi; Han, Man Chung; Chin, Soo Yil [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1984-03-15

Pulmonary ligament consists of 2 serosal of pleura that connect the lower to the mediastinum. Author analyse and present CT appearance of pulmonary ligament of the 40 normal and abnormal patients on the basis of anatomic knowledge from the cross section of cadaver. Left pulmonary ligament is more frequency visualized than the right. The most important CT landmark in localizing pulmonary ligament is the esophagus where the ligament attaches on its lateral wall. Pitfalls in CT identification of pulmonary ligament are right phrenic nerve and right pericardiacophrenic vessels which emerge from lateral wall of the IVC and wall of the emphysematous bulla in the region of the pulmonary ligament.

CT appearance of pulmonary ligament

International Nuclear Information System (INIS)

Im, Jung Gi; Han, Man Chung; Chin, Soo Yil

1984-01-01

Pulmonary ligament consists of 2 serosal of pleura that connect the lower to the mediastinum. Author analyse and present CT appearance of pulmonary ligament of the 40 normal and abnormal patients on the basis of anatomic knowledge from the cross section of cadaver. Left pulmonary ligament is more frequency visualized than the right. The most important CT landmark in localizing pulmonary ligament is the esophagus where the ligament attaches on its lateral wall. Pitfalls in CT identification of pulmonary ligament are right phrenic nerve and right pericardiacophrenic vessels which emerge from lateral wall of the IVC and wall of the emphysematous bulla in the region of the pulmonary ligament

Chemical Concentrations in Field Mice from Open-Detonation Firing Sites TA-36 Minie and TA-39 Point 6 at Los Alamos National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Fresquez, Philip R. [Los Alamos National Laboratory

2011-01-01

Field mice (mostly Peromyscus spp.) were collected at two open-detonation (high explosive) firing sites - Minie at Technical Area (TA) 36 and Point 6 at TA-39 - at Los Alamos National Laboratory in August of 2010 and in February of 2011 for chemical analysis. Samples of whole body field mice from both sites were analyzed for target analyte list elements (mostly metals), dioxin/furans, polychlorinated biphenyl congeners, high explosives, and perchlorate. In addition, uranium isotopes were analyzed in a composite sample collected from TA-36 Minie. In general, all constituents, with the exception of lead at TA-39 Point 6, in whole body field mice samples collected from these two open-detonation firing sites were either not detected or they were detected below regional statistical reference levels (99% confidence level), biota dose screening levels, and/or soil ecological chemical screening levels. The amount of lead in field mice tissue collected from TA-39 Point 6 was higher than regional background, and some lead levels in the soil were higher than the ecological screening level for the field mouse; however, these levels are not expected to affect the viability of the populations over the site as a whole.

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

Development of Tissue-Engineered Ligaments: Elastin Promotes Regeneration of the Rabbit Medial Collateral Ligament.

Science.gov (United States)

Hirukawa, Masaki; Katayama, Shingo; Sato, Tatsuya; Yamada, Masayoshi; Kageyama, Satoshi; Unno, Hironori; Suzuki, Yoshiaki; Miura, Yoshihiro; Shiratsuchi, Eri; Hasegawa, Masahiro; Miyamoto, Keiichi; Horiuchi, Takashi

2017-12-21

When ligaments are injured, reconstructive surgery is sometimes required to restore function. Methods of reconstructive surgery include transplantation of an artificial ligament and autotransplantation of a tendon. However, these methods have limitations related to the strength of the bone-ligament insertion and biocompatibility of the transplanted tissue after surgery. Therefore, it is necessary to develop new reconstruction methods and pursue the development of artificial ligaments. Elastin is a major component of elastic fibers and ligaments. However, the role of elastin in ligament regeneration has not been described. Here, we developed a rabbit model of a medial collateral ligament (MCL) rupture and treated animal knees with exogenous elastin [100 µg/(0.5 mL·week)] for 6 or 12 weeks. Elastin treatment increased gene expression and protein content of collagen and elastin (gene expression, 6-fold and 42-fold, respectively; protein content, 1.6-fold and 1.9-fold, respectively), and also increased the elastic modulus of MCL increased with elastin treatment (2-fold) compared with the controls. Our data suggest that elastin is involved in the regeneration of damaged ligaments. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Macroscopic and microscopic analysis of the thumb carpometacarpal ligaments: a cadaveric study of ligament anatomy and histology.

Science.gov (United States)

Ladd, Amy L; Lee, Julia; Hagert, Elisabet

2012-08-15

Stability and mobility represent the paradoxical demands of the human thumb carpometacarpal joint, yet the structural origin of each functional demand is poorly defined. As many as sixteen and as few as four ligaments have been described as primary stabilizers, but controversy exists as to which ligaments are most important. We hypothesized that a comparative macroscopic and microscopic analysis of the ligaments of the thumb carpometacarpal joint would further define their role in joint stability. Thirty cadaveric hands (ten fresh-frozen and twenty embalmed) from nineteen cadavers (eight female and eleven male; average age at the time of death, seventy-six years) were dissected, and the supporting ligaments of the thumb carpometacarpal joint were identified. Ligament width, length, and thickness were recorded for morphometric analysis and were compared with use of the Student t test. The dorsal and volar ligaments were excised from the fresh-frozen specimens and were stained with use of a triple-staining immunofluorescent technique and underwent semiquantitative analysis of sensory innervation; half of these specimens were additionally analyzed for histomorphometric data. Mixed-effects linear regression was used to estimate differences between ligaments. Seven principal ligaments of the thumb carpometacarpal joint were identified: three dorsal deltoid-shaped ligaments (dorsal radial, dorsal central, posterior oblique), two volar ligaments (anterior oblique and ulnar collateral), and two ulnar ligaments (dorsal trapeziometacarpal and intermetacarpal). The dorsal ligaments were significantly thicker (p histologic appearance of capsular tissue with low cellularity. The dorsal deltoid ligament complex is uniformly stout and robust; this ligament complex is the thickest morphometrically, has the highest cellularity histologically, and shows the greatest degree of sensory nerve endings. The hypocellular anterior oblique ligament is thin, is variable in its location, and

Virtual laboratory of electrical mini-grids with distributed generation

International Nuclear Information System (INIS)

Menezes Ramos, Vanessa; Barros Galhardo, Marcos André; Oliveira Barbosa, Claudomiro Fábio de; Tavares Pinho, João

2015-01-01

This paper presents a computing tool called Virtual Laboratory de Minirredes (Virtual Laboratory of Mini-grids). Using the virtual environment of the developed tool, it is possible to make remote connection/disconnection of switches and loads (resistive, inductive, capacitive and non-linear) at strategic points of the electric mini-grid with hybrid distributed generation systems (solar photovoltaic-diesel). The mini-grid has a length of about 1 km and is installed in the test area of the Grupo de Estudios e Desenvolvimento de Alternativas Exergética (GEDAE) of the Universidade Federal do Pará, located in the city of Belém, Pará, Brazil. The developed tool has communication functions with electric parameters transducers and programmable logic controllers (PLCs). This communication enables the opening and closing of contactors, resulting in different settings for the mini-grid. In addition to that, based on the proposed configuration by the user, the real-time operation status of mini-grid is presented in a graphic interface (for example, monitored electric parameters, distributed generators connected, status of disconnected switches, etc.) and the acquired data is stored. The use of the computing tool also focuses on the construction of a database, in order to obtain knowledge about the mini-grid performance under various conditions that can be set, depending on the operational strategy adopted, based on the choice of the layout, loads and power sources used in the mini-grid. (full text)

Graft fixation in cruciate ligament reconstruction.

Science.gov (United States)

Brand, J; Weiler, A; Caborn, D N; Brown, C H; Johnson, D L

2000-01-01

Cruciate ligament reconstruction has progressed dramatically in the last 20 years. Anatomic placement of ligament substitutes has fostered rehabilitation efforts that stress immediate and full range of motion, immediate weightbearing, neuromuscular strength and coordination, and early return to athletic competition (3 months). This has placed extreme importance on secure graft fixation at the time of ligament reconstruction. Current ligament substitutes require a bony or soft tissue component to be fixed within a bone tunnel or on the periosteum at a distance from the normal ligament attachment site. Fixation devices have progressed from metal to biodegradable and from far to near-normal native ligament attachment sites. Ideally, the biomechanical properties of the entire graft construct would approach those of the native ligament and facilitate biologic incorporation of the graft. Fixation should be done at the normal anatomic attachment site of the native ligament (aperture fixation) and, over time, allow the biologic return of the histologic transition zone from ligament to fibrocartilage, to calcified fibrocartilage, to bone. The purpose of this article is to review current fixation devices and techniques in cruciate ligament surgery.

Extrinsic wrist ligaments: prevalence of injury by magnetic resonance imaging and association with intrinsic ligament tears.

Science.gov (United States)

Taneja, Atul K; Bredella, Miriam A; Chang, Connie Y; Joseph Simeone, F; Kattapuram, Susan V; Torriani, Martin

2013-01-01

The objective of this study was to determine the prevalence of extrinsic wrist ligament injury by magnetic resonance imaging and its association with intrinsic ligament tears. We reviewed conventional magnetic resonance images performed over a 5-year period from adult patients in the setting of wrist trauma. Two musculoskeletal radiologists examined the integrity of wrist ligaments and presence of bone abnormalities. In a cohort of 75 subjects, extrinsic ligament injury was present in 75%, with radiolunotriquetral being most frequently affected (45%). Intrinsic ligament injury was present in 60%. Almost half of subjects had combined intrinsic and extrinsic ligament injury. Bone abnormalities were seen in 69%. The rate of extrinsic injury was higher in subjects with bone injury (P = 0.008). There is high prevalence of extrinsic ligament injury in the setting of wrist trauma, especially in the presence of bone abnormalities, with combined injury of intrinsic and extrinsic ligaments in about half of cases.

Incarceration of the intermeniscal ligament in tibial eminence injury: a block to closed reduction identified using MRI

International Nuclear Information System (INIS)

Archibald-Seiffer, Noah; Jacobs, John; Zbojniewicz, Andrew; Shea, Kevin

2015-01-01

Tibial eminence fractures are a relatively uncommon injury, but most frequently occur in children and adolescents with open physes. Entrapment of the intermeniscal ligament or the meniscus itself can occur in the setting of a tibial eminence fracture and when present, poses a significant obstacle to successful closed or surgical reduction. Identification of these entrapped structures on preoperative imaging may be helpful to the physicians caring for these patients and assist with preoperative planning. We present a case of a 13-year-old male who sustained a tibial eminence fracture while playing football. Review by the orthopedic surgeon identified entrapment of the intermeniscal ligament. Subsequently, a closed reduction attempt under anesthesia prior to surgery was unsuccessful and arthroscopy was needed to remove the entrapped intermeniscal ligament and reduce the tibial eminence fracture. Pre-operative knowledge of entrapped soft tissue structures under the fracture plane, particularly the meniscus and intermeniscal ligament, provides the surgeon with valuable insight as to how to best counsel patients on the success of treatment options, how to best prepare for operative treatment, and can guide the surgeon during open reduction to maximize treatment success. (orig.)

Incarceration of the intermeniscal ligament in tibial eminence injury: a block to closed reduction identified using MRI

Energy Technology Data Exchange (ETDEWEB)

Archibald-Seiffer, Noah; Jacobs, John [University of Utah School of Medicine, Salt Lake City, UT (United States); Zbojniewicz, Andrew [University of Cincinnati Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Division of Pediatric Radiology, Cincinnati, OH (United States); Shea, Kevin [University of Utah School of Medicine, Salt Lake City, UT (United States); St. Luke' s Health System, Boise, ID (United States); St. Luke' s Sports Medicine, Boise, ID (United States)

2015-05-01

Tibial eminence fractures are a relatively uncommon injury, but most frequently occur in children and adolescents with open physes. Entrapment of the intermeniscal ligament or the meniscus itself can occur in the setting of a tibial eminence fracture and when present, poses a significant obstacle to successful closed or surgical reduction. Identification of these entrapped structures on preoperative imaging may be helpful to the physicians caring for these patients and assist with preoperative planning. We present a case of a 13-year-old male who sustained a tibial eminence fracture while playing football. Review by the orthopedic surgeon identified entrapment of the intermeniscal ligament. Subsequently, a closed reduction attempt under anesthesia prior to surgery was unsuccessful and arthroscopy was needed to remove the entrapped intermeniscal ligament and reduce the tibial eminence fracture. Pre-operative knowledge of entrapped soft tissue structures under the fracture plane, particularly the meniscus and intermeniscal ligament, provides the surgeon with valuable insight as to how to best counsel patients on the success of treatment options, how to best prepare for operative treatment, and can guide the surgeon during open reduction to maximize treatment success. (orig.)

Ankle ligament injuries

Directory of Open Access Journals (Sweden)

Per A.F.H. Renström

1998-06-01

Full Text Available Acute ankle ligament sprains are common injuries. The majority of these occur during athletic participation in the 15 to 35 year age range. Despite the frequency of the injury, diagnostic and treatment protocols have varied greatly. Lateral ligament complex injuries are by far the most common of the ankle sprains. Lateral ligament injuries typically occur during plantar flexion and inversion, which is the position of maximum stress on the anterotalofibular liagment (ATFL. For this reason, the ATFL is the most commonly torn ligament during an inversion injury. In more severe inversion injuries the calcaneofibular (CFL, posterotalofibular (PTFL and subtalar ligament can also be injured. Most acute lateral ankle ligament injuries recover quickly with nonoperative management. The treatment program, called "functional treatment," includes application of the RICE principle (rest, ice, compression, and elevation immediately after the injury, a short period of immobilization and protection with an elastic or inelastic tape or bandage, and early motion exercises followed by early weight bearing and neuromuscular ankle training. Proprioceptive training with a tilt board is commenced as soon as possible, usually after 3 to 4 weeks. The purpose is to improve the balance and neuromuscular control of the ankle. Sequelae after ankle ligament injuries are very common. As much as 10% to 30% of patients with a lateral ligament injury may have chronic symptoms. Symptoms usually include persistent synovitis or tendinitis, ankle stiffness, swelling, and pain, muscle weakness, and frequent giving-way. A well designed physical therapy program with peroneal strengthening and proprioceptive training, along with bracing and/or taping can alleviate instability problems in most patients. For cases of chronic instability that are refractory to bracing and external support, surgical treatment can be explored. If the chronic instability is associated with subtalar instability

A stress MRI of the shoulder for evaluation of ligamentous stabilizers in acute and chronic acromioclavicular joint instabilities.

Science.gov (United States)

Izadpanah, Kaywan; Winterer, Jan; Vicari, Marco; Jaeger, Martin; Maier, Dirk; Eisebraun, Leonie; Ute Will, Jutta; Kotter, Elmar; Langer, Mathias; Südkamp, Norbert P; Hennig, Jürgen; Weigel, Mathias

2013-06-01

To show the feasibility of a stress magnetic resonance imaging (MRI) as a new method for simultaneous evaluation of the morphology and the functional integrity of the acromioclavicular joint (ACJ) ligamentous stabilizers. MRI of four volunteers, 10 patients with acute, and six with chronic ACJ injuries was performed using a 0.25 T open MRI scanner. A 2D-proton-density and a 3D-gradient-echo sequence at rest and under 6.5 kg shoulder traction were performed. Comparative measurements of the coracoclavicular and the acromioclavicular distance were performed. Additionally, the conoid and trapezoid ligament lengths were measured with multiplanar reconstructions. MRI at rest correctly identified tears of the coracoclavicular and the acromioclavicular ligaments in eight patients suffering acute ACJ injuries. Stress application helped to distinguish between partial and complete coracoclavicular ligament tears in two cases. Insufficiency of the ACJ ligaments was present in all acute and chronic ACJ injuries. Stress application in chronic ACJ ligaments revealed isolated insufficiency of the conoid ligament in three cases and of the trapezoid ligament in one case. Combined insufficiency was present in two cases. Stress MRI facilitates simultaneous acquisition of morphologic and functional information of the ACJ stabilizers. In acute ACJ injuries it helps to distinguish between partial and complete ligament tears. In chronic ACJ injuries it provides functional information of the ligament regrinds. Copyright © 2012 Wiley Periodicals, Inc.

Rupture of the meniscofibular ligament

Directory of Open Access Journals (Sweden)

Poyanli Oguz

2010-05-01

Full Text Available Abstract The meniscofibular ligament is an anatomically defined ligament of the knee in humans. However, there are no data regarding the prognosis following injury to this ligament. Our case was a 42-year-old man who presented at our clinic with pain of the lateral side of his left knee. MRI of his left knee revealed the rupture of the meniscofibular ligament. The mechanism of injury was consistent with anatomical and mechanical studies of the meniscofibular ligament. The patient was treated conservatively for 1 year, but his pain did not resolve completely. A case series of patients with the same injury is required to establish an effective treatment for this rare injury.

Upside-down stomach – results of mini-invasive surgical therapy

Directory of Open Access Journals (Sweden)

Cestmir Neoral

2011-12-01

Full Text Available Aim: The authors evaluate the results of mini-invasive therapy in patients diagnosed with upside-down stomach. Material and methods: From 1998 to 2008, a total of 27 patients diagnosed with upside-down stomach were surgicallytreated at the 1st Department of Surgery, University Hospital Olomouc. Before the operation, patients wereexamined endoscopically and a barium swallow was performed. In all 27 patients (100%, the operation was performedelectively laparoscopically. The principle of the operation in all cases was reposition of the stomach into theabdominal cavity, resection of the hernial sac and hiatoplasty. In addition, in 15 patients (56% with reflux symptomsor endoscopic findings of reflux oesophagitis, fundoplication in Nissen’s modification was also performed. Fundopexywas indicated in 12 patients (44%. Results: In all patients (100%, the operation was performed mini-invasively; conversion to an open procedure wasnever necessary. In 3 cases (11%, the left pleural cavity was opened during the operation; this was treated by introducinga chest drain. The operation mortality in the patient set was zero; morbidity was 11%. A year after the operation,patients were re-examined, and follow-up endoscopy and barium swallow were performed. Conclusions: In all patients diagnosed with upside-down stomach, surgical treatment is indicated due to the risk ofdeveloping severe complications. Mini-invasive surgical therapy in the hands of an experienced surgeon is a safe procedurewhich offers patients all the benefits of mini-invasive therapy with promising short- and long-term results.

Close connections between open science and open-source software

Directory of Open Access Journals (Sweden)

YouHua Chen

2014-09-01

Full Text Available Open science is increasingly gaining attention in recent years. In this mini-review, we briefly discuss and summarize the reasons of introducing open science into academic publications for scientists. We argue that open-source software (like R and Python software can be the universal and important platforms for doing open science because of their appealing features: open source, easy-reading document, commonly used in various scientific disciplines like statistics, chemistry and biology. At last, the challenges and future perspectives of performing open science are discussed.

Role of tear location on outcomes of open primary repair of the anterior cruciate ligament: A systematic review of historical studies.

Science.gov (United States)

van der List, Jelle P; DiFelice, Gregory S

2017-10-01

The general opinion is that outcomes of open primary repair of the anterior cruciate ligament (ACL) in the historical literature were disappointing. Since good outcomes of primary repair of proximal tears have recently been reported, we aimed to assess the role of tear location on open primary repair outcomes in the historical literature. All studies reporting outcomes of open primary ACL repair published between the inception of PubMed, Embase and Cochrane and 2000 were identified. Studies were included if tear location was reported. Outcome scores, return to sports, stability examinations, failures and patient satisfaction were collected and reviewed in the total study cohort and in a subgroup of studies treating only proximal tears. Spearman correlation analysis was performed between the percentage of proximal tears in the studies and all outcomes. Twenty-nine studies were included reporting outcomes of open primary in 1457 patients of which 72% had proximal and 23% midsubstance tears. Mean age was 30years, 65% were males, and mean follow-up was 3.6years. Good outcomes were noted in the total cohort, and excellent outcomes were noted following repair of proximal tears. Positive correlation was found between the percentage proximal tears in the studies and percentage satisfied patients (p=0.010). Tear location seems to have played a role on the outcomes of open primary ACL repair. Outcomes of open primary repair in patients with proximal tears were excellent, which confirms there may be a potential role for primary repair as treatment for proximal ACL tears. Copyright © 2017 Elsevier B.V. All rights reserved.

CT of the pulmonary ligament

International Nuclear Information System (INIS)

Godwin, J.D.; Vock, P.; Osborne, D.R.

1983-01-01

Most computed tomographic (CT) scans of the chest show the inferior pulmonary ligament and an associated septum in the lower lobe, although CT descriptions of these structures have not been reported. Conventional radiography of the ligament has relied on indirect signs: the position of the lower lobe in the presence of pneumothorax or pleural effusion, soft-tissue peaks along the upper surface of the diaphragm, and the rare traumatic paramediastinal pneumatocele (attributed to air in the ligament). CT clarifies the anatomic relations of the ligament and alterations caused by pleural effusion and pneumothorax. The ligament is probably responsible for some long linear shadows at the lung bases, and CT helps to distinguish these from scars, walls of bullae, and normal structures such as the phrenic nerve and the interlobar fissures

CT of the pulmonary ligament

Energy Technology Data Exchange (ETDEWEB)

Godwin, J.D.; Vock, P.; Osborne, D.R.

1983-08-01

Most computed tomographic (CT) scans of the chest show the inferior pulmonary ligament and an associated septum in the lower lobe, although CT descriptions of these structures have not been reported. Conventional radiography of the ligament has relied on indirect signs: the position of the lower lobe in the presence of pneumothorax or pleural effusion, soft-tissue peaks along the upper surface of the diaphragm, and the rare traumatic paramediastinal pneumatocele (attributed to air in the ligament). CT clarifies the anatomic relations of the ligament and alterations caused by pleural effusion and pneumothorax. The ligament is probably responsible for some long linear shadows at the lung bases, and CT helps to distinguish these from scars, walls of bullae, and normal structures such as the phrenic nerve and the interlobar fissures.

Ulnar Collateral Ligament Injuries of the Thumb

Science.gov (United States)

McKeon, Kathleen E.; Gelberman, Richard H.; Calfee, Ryan P.

2013-01-01

Background: The clinical diagnosis of thumb ulnar collateral ligament disruption has been based on joint angulation during valgus stress testing. This report describes a definitive method of distinguishing between complete and partial ulnar collateral ligament injuries by quantifying translation of the proximal phalanx on the metacarpal head during valgus stress testing. Methods: Sixty-two cadaveric thumbs underwent standardized valgus stress testing under fluoroscopy with the ulnar collateral ligament intact, following an isolated release of the proper ulnar collateral ligament, and following a combined release of both the proper and the accessory ulnar collateral ligament (complete ulnar collateral ligament release). Following complete ulnar collateral ligament release, the final thirty-seven thumbs were also analyzed after the application of a valgus force sufficient to cause 45° of valgus angulation at the metacarpophalangeal joint to model more severe soft-tissue injury. Two independent reviewers measured coronal plane joint angulation (in degrees), ulnar joint line gap formation (in millimeters), and radial translation of the proximal phalanx on the metacarpal head (in millimeters) on digital fluoroscopic images that had been randomized. Results: Coronal angulation across the stressed metacarpophalangeal joint progressively increased through the stages of the testing protocol: ulnar collateral ligament intact (average [and standard deviation], 20° ± 8.1°), release of the proper ulnar collateral ligament (average, 23° ± 8.3°), and complete ulnar collateral ligament release (average, 30° ± 8.9°) (p collateral ligament release (5.7 ± 1.5 mm), to that following complete ulnar collateral ligament release (7.2 ± 1.5 mm) (p collateral ligament (1.6 ± 0.8 mm vs. 1.5 ± 0.9 mm in the intact state). There was a significant increase in translation following release of the complete ulnar collateral ligament complex (3.0 ± 0.9 mm; p collateral ligament

Bioreactor Design for Tendon/Ligament Engineering

OpenAIRE

Wang, Tao; Gardiner, Bruce S.; Lin, Zhen; Rubenson, Jonas; Kirk, Thomas B.; Wang, Allan; Xu, Jiake; Smith, David W.; Lloyd, David G.; Zheng, Ming H.

2012-01-01

Tendon and ligament injury is a worldwide health problem, but the treatment options remain limited. Tendon and ligament engineering might provide an alternative tissue source for the surgical replacement of injured tendon. A bioreactor provides a controllable environment enabling the systematic study of specific biological, biochemical, and biomechanical requirements to design and manufacture engineered tendon/ligament tissue. Furthermore, the tendon/ligament bioreactor system can provide a s...

Enhancing Application Performance Using Mini-Apps: Comparison of Hybrid Parallel Programming Paradigms

Science.gov (United States)

Lawson, Gary; Sosonkina, Masha; Baurle, Robert; Hammond, Dana

2017-01-01

In many fields, real-world applications for High Performance Computing have already been developed. For these applications to stay up-to-date, new parallel strategies must be explored to yield the best performance; however, restructuring or modifying a real-world application may be daunting depending on the size of the code. In this case, a mini-app may be employed to quickly explore such options without modifying the entire code. In this work, several mini-apps have been created to enhance a real-world application performance, namely the VULCAN code for complex flow analysis developed at the NASA Langley Research Center. These mini-apps explore hybrid parallel programming paradigms with Message Passing Interface (MPI) for distributed memory access and either Shared MPI (SMPI) or OpenMP for shared memory accesses. Performance testing shows that MPI+SMPI yields the best execution performance, while requiring the largest number of code changes. A maximum speedup of 23 was measured for MPI+SMPI, but only 11 was measured for MPI+OpenMP.

The BaBar Mini

International Nuclear Information System (INIS)

Brown, David N.

2003-01-01

BaBar has recently deployed a new event data format referred to as the Mini. The mini uses efficient packing and aggressive noise suppression to represent the average reconstructed BaBar event in under 7 KBytes. The Mini packs detector information into simple transient data objects, which are then aggregated into roughly 10 composite persistent objects per event. The Mini currently uses Objectivity persistence, and it is being ported to use Root persistence. The Mini contains enough information to support detailed detector studies, while remaining small and fast enough to be used directly in physics analysis. Mini output is customizable, allowing users to both truncate unnecessary content or add content, depending on their needs. The Mini has now replaced three older formats as the primary output of BaBar event reconstruction. A reduced form of the Mini will soon replace the physics analysis format as well, giving BaBar a single, flexible event data format covering all its needs

The BaBar mini

International Nuclear Information System (INIS)

Brown, David N.; BaBar Collaboration

2003-01-01

BaBar has recently deployed a new event data format referred to as the Mini. The mini uses efficient packing and aggressive noise suppression to represent the average reconstructed BaBar event in under 7 KBytes. The Mini packs detector information into simple transient data objects, which are then aggregated into roughly 10 composite persistent objects per event. The Mini currently uses Objectivity persistence, and it is being ported to use Root persistence. The Mini contains enough information to support detailed detector studies, while remaining small and fast enough to be used directly in physics analysis. Mini output is customizable, allowing users to both truncate unnecessary content or add content, depending on their needs. The Mini has now replaced three older formats as the primary output of BaBar event reconstruction. A reduced form of the Mini will soon replace the physics analysis format as well, giving BaBar a single, flexible event data format covering all its needs

Anatomic ligament consolidation of the superior acromioclavicular ligament and the coracoclavicular ligament complex after acute arthroscopically assisted double coracoclavicular bundle stabilization.

Science.gov (United States)

Jobmann, S; Buckup, J; Colcuc, C; Roessler, P P; Zimmermann, E; Schüttler, K F; Hoffmann, R; Welsch, F; Stein, T

2017-09-18

The consolidation of the acromioclavicular (AC) and coracoclavicular (CC) ligament complex after arthroscopically assisted stabilization of acute acromioclavicular joint (ACJ) separation is still under consideration. Fifty-five consecutive patients after arthroscopically assisted double-CC-bundle stabilization within 14 days after acute high-grade ACJ separation were studied prospectively. All patients were clinically analysed preoperatively (FU0) and post-operatively (FU1 = 6 months; FU2 = 12 months). The structural MRI assessments were performed at FU0 (injured ACJ) and at FU2 bilateral (radiologic control group) and assessed separately the ligament thickness and length at defined regions for the conoid, trapezoid and the superior AC ligament. Thirty-seven patients were assessed after 6.5 months and after 16.0 months. The 16-month MRI analysis revealed for all patients continuous ligament healing for the CC-complex and the superior AC ligament with in the average hypertrophic consolidation compared to the control side. Separate conoid and trapezoid strands (double-strand configuration) were detected in 27 of 37 (73%) patients, and a single-strand configuration was detected in 10 of 37 (27%) patients; both configurations showed similar CCD data. The ligament healing was not influenced by the point of surgery, age at surgery and heterotopic ossification. The clinical outcome was increased (FU0-FU2): Rowe, 47.7-97.0 pts.; TAFT, 3.9-10.6 pts.; NAS pain , 8.9-1.4 pts. (all P < 0.05). The arthroscopically assisted double-CC-bundle stabilization within 14 days after acute high-grade ACJ separation showed 16 months after surgery sufficient consolidations of the AC and double-CC ligament complex in 73%. III, Case series.

Bioreactor design for tendon/ligament engineering.

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Wang, Tao; Gardiner, Bruce S; Lin, Zhen; Rubenson, Jonas; Kirk, Thomas B; Wang, Allan; Xu, Jiake; Smith, David W; Lloyd, David G; Zheng, Ming H

2013-04-01

Tendon and ligament injury is a worldwide health problem, but the treatment options remain limited. Tendon and ligament engineering might provide an alternative tissue source for the surgical replacement of injured tendon. A bioreactor provides a controllable environment enabling the systematic study of specific biological, biochemical, and biomechanical requirements to design and manufacture engineered tendon/ligament tissue. Furthermore, the tendon/ligament bioreactor system can provide a suitable culture environment, which mimics the dynamics of the in vivo environment for tendon/ligament maturation. For clinical settings, bioreactors also have the advantages of less-contamination risk, high reproducibility of cell propagation by minimizing manual operation, and a consistent end product. In this review, we identify the key components, design preferences, and criteria that are required for the development of an ideal bioreactor for engineering tendons and ligaments.

Mini- or Less-open Sublay Operation (MILOS): A New Minimally Invasive Technique for the Extraperitoneal Mesh Repair of Incisional Hernias.

Science.gov (United States)

Reinpold, Wolfgang; Schröder, Michael; Berger, Cigdem; Nehls, Jennifer; Schröder, Alexander; Hukauf, Martin; Köckerling, Ferdinand; Bittner, Reinhard

2018-01-16

Improvement of ventral hernia repair. Despite the use of mesh and other recent improvements, the currently popular techniques of ventral hernia repair have specific disadvantages and risks. We developed the endoscopically assisted mini- or less-open sublay (MILOS) concept. The operation is performed transhernially via a small incision with light-holding laparoscopic instruments either under direct, or endoscopic visualization. An endoscopic light tube was developed to facilitate this approach (EndotorchTM Wolf Company). Each MILOS operation can be converted to standard total extraperitoneal gas endoscopy once an extraperitoneal space of at least 8 cm has been created. All MILOS operations were prospectively documented in the German Hernia registry with 1 year questionnaire follow-up. Propensity score matching of incisional hernia operations comparing the results of the MILOS operation with the laparoscopic intraperitoneal onlay mesh operation (IPOM) and open sublay repair from other German Hernia registry institutions was performed. Six hundred fifteen MILOS incisional hernia operations were included. Compared with laparoscopic IPOM incisional hernia operation, the MILOS repair is associated with significantly a fewer postoperative surgical complications (P advantages of open sublay and the laparoscopic IPOM repair.ClinicalTrials.gov Identifier NCT03133000.

The October 2014 United States Treasury bond flash crash and the contributory effect of mini flash crashes.

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Zachary S Levine

Full Text Available We investigate the causal uncertainty surrounding the flash crash in the U.S. Treasury bond market on October 15, 2014, and the unresolved concern that no clear link has been identified between the start of the flash crash at 9:33 and the opening of the U.S. equity market at 9:30. We consider the contributory effect of mini flash crashes in equity markets, and find that the number of equity mini flash crashes in the three-minute window between market open and the Treasury Flash Crash was 2.6 times larger than the number experienced in any other three-minute window in the prior ten weekdays. We argue that (a this statistically significant finding suggests that mini flash crashes in equity markets both predicted and contributed to the October 2014 U.S. Treasury Bond Flash Crash, and (b mini-flash crashes are important phenomena with negative externalities that deserve much greater scholarly attention.

The October 2014 United States Treasury bond flash crash and the contributory effect of mini flash crashes.

Science.gov (United States)

Levine, Zachary S; Hale, Scott A; Floridi, Luciano

2017-01-01

We investigate the causal uncertainty surrounding the flash crash in the U.S. Treasury bond market on October 15, 2014, and the unresolved concern that no clear link has been identified between the start of the flash crash at 9:33 and the opening of the U.S. equity market at 9:30. We consider the contributory effect of mini flash crashes in equity markets, and find that the number of equity mini flash crashes in the three-minute window between market open and the Treasury Flash Crash was 2.6 times larger than the number experienced in any other three-minute window in the prior ten weekdays. We argue that (a) this statistically significant finding suggests that mini flash crashes in equity markets both predicted and contributed to the October 2014 U.S. Treasury Bond Flash Crash, and (b) mini-flash crashes are important phenomena with negative externalities that deserve much greater scholarly attention.

Morphology of the dorsal and lateral calcaneocuboid ligaments.

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Dorn-Lange, Nadja V; Nauck, Tanja; Lohrer, Heinz; Arentz, Sabine; Konerding, Moritz A

2008-09-01

The dorsolateral calcaneocuboid ligaments have different configurations. In the literature they are only described as either the dorsal or lateral calcaneocuboid ligament. However, recent reconstructive surgical techniques may benefit from a better understanding of the anatomy. The aims of this study were to classify the morphology and attachments of the dorso-lateral calcaneocuboid ligaments and to determine their dimensions. The dorso-lateral aspects of the calcaneocuboid joint of 30 cadaver feet were dissected to expose the associated ligaments. Further, we evaluated possible bony landmarks of the calcaneus that could imply which shape or course the ligament would have in a specific individual. Our findings showed a wide variety of configurations in shape, number, and attachment sites. A constant dorsal ligament and an additional narrower lateral ligament was detectable in half of the cases. The majority of the dorso-lateral calcaneocuboid ligament-complex had an upward course and fanning out from proximal to distal. No bony predictor for the ligaments' shape or course was found. The dorso-lateral ligament-complex of the calcaneocuboid joint revealed a wide variety of configurations. Better understanding of the anatomy of these ligaments may aid in the anatomic reconstruction of these ligaments.

Lateral collateral ligament (image)

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The lateral collateral ligament connects the end of the femur (thigh) to the top of the fibula (the thin bone that runs next to the shin bone). The lateral collateral ligament provides stability against varus stress. Varus stress ...

Biomechanical implications of lumbar spinal ligament transection.

Science.gov (United States)

Von Forell, Gregory A; Bowden, Anton E

2014-11-01

Many lumbar spine surgeries either intentionally or inadvertently damage or transect spinal ligaments. The purpose of this work was to quantify the previously unknown biomechanical consequences of isolated spinal ligament transection on the remaining spinal ligaments (stress transfer), vertebrae (bone remodelling stimulus) and intervertebral discs (disc pressure) of the lumbar spine. A finite element model of the full lumbar spine was developed and validated against experimental data and tested in the primary modes of spinal motion in the intact condition. Once a ligament was removed, stress increased in the remaining spinal ligaments and changes occurred in vertebral strain energy, but disc pressure remained similar. All major biomechanical changes occurred at the same spinal level as the transected ligament, with minor changes at adjacent levels. This work demonstrates that iatrogenic damage to spinal ligaments disturbs the load sharing within the spinal ligament network and may induce significant clinically relevant changes in the spinal motion segment.

Image-anatomic research of the alar ligament

International Nuclear Information System (INIS)

Hao Caixian; Liu Jun; Jin Ying; Wang Jian; Zhong Jin; Wang Jinyue; Zhu Miao; Cheng Jinbao

2008-01-01

Objective: To detect position and morphous as well as coursing of the alar ligament, and to further investigate the sectional anatomy and CT and MRI imaging of the alar ligament. Methods: Twelve formalin fixed specimens including head and neck utilized, three of the twelve were observed in gross anatomy, nine of them were dissectioned. Fifty- one healthy volunteers from each group were selected to perform CT and MRI examination respectively. By combining gross and sectional anatomy. CT and MRI manifestations of the alar ligament were analyzed, the alar ligament width was measured. Results: Location and shape, as well as coursing of the alar ligament could be demonstrated clearly in gross and sectional anatomy. The transverse plane across the upper dens and the coronal plane by the middle dens were the optimal planes for demonstrating the alar ligament. The display ratio of the alar ligament was even 100% (51/51) in both images of CT and MRI. MRI had better advantages than CT in respect of demonstrating the alar ligament, PDWI (proton density weighted imaging, PDWI) is the most optimal sequence for the alar ligament. There were no significant differences of the alar ligament width between male and female and between the right and the left side (P>0.05). Conclusion: In combination with gross and sectional anatomy. CT and MRI could both provide an imageo-anatomic basis for diagnosis of the alar ligament trauma and malformation as well as infection. (authors)

Unilateral aplasia of both cruciate ligaments

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Liem Dennis

2010-02-01

Full Text Available Abstract Aplasia of both cruciate ligaments is a rare congenital disorder. A 28-year-old male presented with pain and the feeling of instability of his right knee after trauma. The provided MRI and previous arthroscopy reports did not indicate any abnormalities except cruciate ligament tears. He was referred to us for reconstruction of both cruciate ligaments. The patient again underwent arthroscopy which revealed a hypoplasia of the medial trochlea and an extremely narrow intercondylar notch. The tibia revealed a missing anterior cruciate ligament (ACL footprint and a single bump with a complete coverage with articular cartilage. There was no room for an ACL graft. A posterior cruciate ligament could not be identified. The procedure was ended since a ligament reconstruction did not appear reasonable. A significant notch plasty if not a partial resection of the condyles would have been necessary to implant a ligament graft. It is most likely that this would not lead to good knee stability. If the surgeon would have retrieved the contralateral hamstrings at the beginning of the planned ligament reconstruction a significant damage would have occurred to the patient. Even in seemingly clear diagnostic findings the arthroscopic surgeon should take this rare abdnormality into consideration and be familiar with the respective radiological findings. We refer the abnormal finding of only one tibial spine to as the "dromedar-sign" as opposed to the two (medial and a lateral tibial spines in a normal knee. This may be used as a hint for aplasia of the cruciate ligaments.

Minimally invasive instrumentation without fusion during posterior thoracic corpectomies: a comparison of percutaneously instrumented nonfused segments with open instrumented fused segments.

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Lau, Darryl; Chou, Dean

2017-07-01

OBJECTIVE During the mini-open posterior corpectomy, percutaneous instrumentation without fusion is performed above and below the corpectomy level. In this study, the authors' goal was to compare the perioperative and long-term implant failure rates of patients who underwent nonfused percutaneous instrumentation with those of patients who underwent traditional open instrumented fusion. METHODS Adult patients who underwent posterior thoracic corpectomies with cage reconstruction between 2009 and 2014 were identified. Patients who underwent mini-open corpectomy had percutaneous instrumentation without fusion, and patients who underwent open corpectomy had instrumented fusion above and below the corpectomy site. The authors compared perioperative outcomes and rates of implant failure requiring reoperation between the open (fused) and mini-open (unfused) groups. RESULTS A total of 75 patients were identified, and 53 patients (32 open and 21 mini-open) were available for followup. The mean patient age was 52.8 years, and 56.6% of patients were male. There were no significant differences in baseline variables between the 2 groups. The overall perioperative complication rate was 15.1%, and there was no significant difference between the open and mini-open groups (18.8% vs 9.5%; p = 0.359). The mean hospital stay was 10.5 days. The open group required a significantly longer stay than the mini-open group (12.8 vs 7.1 days; p open and mini-open groups at 6 months (3.1% vs 0.0%, p = 0.413), 1 year (10.7% vs 6.2%, p = 0.620), and 2 years (18.2% vs 8.3%, p = 0.438). The overall mean follow-up was 29.2 months. CONCLUSIONS These findings suggest that percutaneous instrumentation without fusion in mini-open transpedicular corpectomies offers similar implant failure and reoperation rates as open instrumented fusion as far out as 2 years of follow-up.

Sacroiliac part of the iliolumbar ligament

NARCIS (Netherlands)

Pool-Goudzwaard, A.L.; Kleinrensink, G.J.; Snijders, C.; Stoeckart, R.

1999-01-01

The iliolumbar ligament has been described as the most important ligament for restraining movement at the lumbosacral junction. In addition, it may play an important role in restraining movement in the sacroiliac joints. To help understand its presumed restraining effect, the anatomy of the ligament

Neck ligament strength is decreased following whiplash trauma

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Rubin Wolfgang

2006-12-01

Full Text Available Abstract Background Previous clinical studies have documented successful neck pain relief in whiplash patients using nerve block and radiofrequency ablation of facet joint afferents, including capsular ligament nerves. No previous study has documented injuries to the neck ligaments as determined by altered dynamic mechanical properties due to whiplash. The goal of the present study was to determine the dynamic mechanical properties of whiplash-exposed human cervical spine ligaments. Additionally, the present data were compared to previously reported control data. The ligaments included the anterior and posterior longitudinal, capsular, and interspinous and supraspinous ligaments, middle-third disc, and ligamentum flavum. Methods A total of 98 bone-ligament-bone specimens (C2–C3 to C7-T1 were prepared from six cervical spines following 3.5, 5, 6.5, and 8 g rear impacts and pre- and post-impact flexibility testing. The specimens were elongated to failure at a peak rate of 725 (SD 95 mm/s. Failure force, elongation, and energy absorbed, as well as stiffness were determined. The mechanical properties were statistically compared among ligaments, and to the control data (significance level: P Results For all whiplash-exposed ligaments, the average failure elongation exceeded the average physiological elongation. The highest average failure force of 204.6 N was observed in the ligamentum flavum, significantly greater than in middle-third disc and interspinous and supraspinous ligaments. The highest average failure elongation of 4.9 mm was observed in the interspinous and supraspinous ligaments, significantly greater than in the anterior longitudinal ligament, middle-third disc, and ligamentum flavum. The average energy absorbed ranged from 0.04 J by the middle-third disc to 0.44 J by the capsular ligament. The ligamentum flavum was the stiffest ligament, while the interspinous and supraspinous ligaments were most flexible. The whiplash

MR imaging of posttraumatic spinal ligament injury

International Nuclear Information System (INIS)

Pathria, M.N.; Emery, S.; Masaryk, T.J.; Wilber, R.G.; Bohlman, H.

1988-01-01

The accuracy of MR imaging in the detection of ligamentous injury was evaluated in 29 patients (24 male, five female) with spinal injury resulting in fractures (n=27), evidence of instability (n=11), or neurologic deficit (n=2). MR examinations were performed acutely (average, 7.5 days posttrauma) with T1- and T2-weighted imaging and were blindly evaluated. Subsequently, plain films (n=27), tomograms (n=10), and CT scans (n=22) were evaluated. Eighteen patients underwent surgery. Fourteen patients had torn ligaments as indicated by clinical and surgical findings. MR imaging demonstrated ligament damage in 13. One case imaged 40 days following trauma was not detected. No patients with intact ligaments had evidence of ligamentous damage on MR images. MR imaging demonstrated retropulsed fractures in six patients in whom the posterior longitudinal ligament was intact but displaced from the vertebra. MR imaging was more reliable than radiography and CT for detection of ligamentous injury, and T2- weighted sequences are essential in such cases

MR imaging of alar and transverse atlantal ligament injuries

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Echigoya, Naoki; Harata, Seiko; Ueyama, Kazumasa (Hirosaki Univ., Aomori (Japan). School of Medicine); Nakano, Keisuke

1992-06-01

Autopsy findings of ligaments of the upper cervical spine were compared with magnetic resonance imaging (MRI) findings. Ligaments were clearly shown as hypointensity on T1-weighted images and proton density images. Transverse images were useful in diagnosing alar and transverse atlantal ligament injuries. When there is a bilateral difference in the alar ligaments, ruptured ligament is suspected. Transverse ligament rupture was shown on interrupted hypointensity and as hyperintensity. MRI was capable of diagnosing alar ligament rupture in 8 of 11 patients, and transverse ligament rupture in all 3 patients. In 2 patients having Jefferson's fracture and injuried atlanoaxial subluxation encountered in the clinical practice, transverse ligament rupture was similarly observed as that in autopsy cases on MR images. Hyperintensity in the transverse ligament rupture area was seen even one year after injury. Injured transverse ligament was seen as swollen hyperintensity on sagittal images; and the hyperintensity was gradually decreased with the process of healing. (N.K.).

Deltoid ligament in acute ankle injury: MR imaging analysis

International Nuclear Information System (INIS)

Jeong, Min Sun; Choi, Yun Sun; Kim, Yun Jung; Jung, Yoon Young; Kim, Jin Su; Young, Ki Won

2014-01-01

To identify the pattern of deltoid ligament injury after acute ankle injury and the relationship between ankle fracture and deltoid ligament tear by magnetic resonance imaging (MRI). Thirty-six patients (32 male, and 4 female; mean age, 29.8 years) with acute deltoid ligament injury who had undergone MRI participated in this study. The deltoid ligament was classified as having 3 superficial and 2 deep components. An image analysis included the integrity and tear site of the deltoid ligament, and other associated injuries. Association between ankle fracture and deltoid ligament tear was assessed using Fisher's exact test (P < 0.05). Of the 36 patients, 21 (58.3 %) had tears in the superficial and deep deltoid ligaments, 6 (16.7 %) in the superficial ligaments only, and 4 (11.1 %) in the deep ligaments only. The most common tear site of the three components of the superficial deltoid and deep anterior tibiotalar ligaments was their proximal attachments (94 % and 91.7 % respectively), and that of the deep posterior tibiotalar ligament (pTTL) was its distal attachment (82.6 %). The common associated injuries were ankle fracture (63.9 %), syndesmosis tear (55.6 %), and lateral collateral ligament complex tear (44.4 %). All the components of the deltoid ligament were frequently torn in patients with ankle fractures (tibionavicular ligament, P = 0.009). The observed injury pattern of the deltoid ligament was complex and frequently associated with concomitant ankle pathology. The most common tear site of the superficial deltoid ligament was the medial malleolar attachment, whereas that of the deep pTTL was near its medial talar insertion. (orig.)

Functional tissue engineering of ligament healing

Directory of Open Access Journals (Sweden)

Hsu Shan-Ling

2010-05-01

Full Text Available Abstract Ligaments and tendons are dense connective tissues that are important in transmitting forces and facilitate joint articulation in the musculoskeletal system. Their injury frequency is high especially for those that are functional important, like the anterior cruciate ligament (ACL and medial collateral ligament (MCL of the knee as well as the glenohumeral ligaments and the rotator cuff tendons of the shoulder. Because the healing responses are different in these ligaments and tendons after injury, the consequences and treatments are tissue- and site-specific. In this review, we will elaborate on the injuries of the knee ligaments as well as using functional tissue engineering (FTE approaches to improve their healing. Specifically, the ACL of knee has limited capability to heal, and results of non-surgical management of its midsubstance rupture have been poor. Consequently, surgical reconstruction of the ACL is regularly performed to gain knee stability. However, the long-term results are not satisfactory besides the numerous complications accompanied with the surgeries. With the rapid development of FTE, there is a renewed interest in revisiting ACL healing. Approaches such as using growth factors, stem cells and scaffolds have been widely investigated. In this article, the biology of normal and healing ligaments is first reviewed, followed by a discussion on the issues related to the treatment of ACL injuries. Afterwards, current promising FTE methods are presented for the treatment of ligament injuries, including the use of growth factors, gene delivery, and cell therapy with a particular emphasis on the use of ECM bioscaffolds. The challenging areas are listed in the future direction that suggests where collection of energy could be placed in order to restore the injured ligaments and tendons structurally and functionally.

Deltoid ligament in acute ankle injury: MR imaging analysis

Energy Technology Data Exchange (ETDEWEB)

Jeong, Min Sun; Choi, Yun Sun; Kim, Yun Jung; Jung, Yoon Young [Eulji University, Department of Radiology, Eulji Hospital, Seoul (Korea, Republic of); Kim, Jin Su; Young, Ki Won [Eulji University, Department of Orthopedic Surgery, Eulji Hospital, Seoul (Korea, Republic of)

2014-05-15

To identify the pattern of deltoid ligament injury after acute ankle injury and the relationship between ankle fracture and deltoid ligament tear by magnetic resonance imaging (MRI). Thirty-six patients (32 male, and 4 female; mean age, 29.8 years) with acute deltoid ligament injury who had undergone MRI participated in this study. The deltoid ligament was classified as having 3 superficial and 2 deep components. An image analysis included the integrity and tear site of the deltoid ligament, and other associated injuries. Association between ankle fracture and deltoid ligament tear was assessed using Fisher's exact test (P < 0.05). Of the 36 patients, 21 (58.3 %) had tears in the superficial and deep deltoid ligaments, 6 (16.7 %) in the superficial ligaments only, and 4 (11.1 %) in the deep ligaments only. The most common tear site of the three components of the superficial deltoid and deep anterior tibiotalar ligaments was their proximal attachments (94 % and 91.7 % respectively), and that of the deep posterior tibiotalar ligament (pTTL) was its distal attachment (82.6 %). The common associated injuries were ankle fracture (63.9 %), syndesmosis tear (55.6 %), and lateral collateral ligament complex tear (44.4 %). All the components of the deltoid ligament were frequently torn in patients with ankle fractures (tibionavicular ligament, P = 0.009). The observed injury pattern of the deltoid ligament was complex and frequently associated with concomitant ankle pathology. The most common tear site of the superficial deltoid ligament was the medial malleolar attachment, whereas that of the deep pTTL was near its medial talar insertion. (orig.)

Radio sterilized human ligaments and their clinical application

International Nuclear Information System (INIS)

Luna Z, D.; Reyes F, M. L.; Diaz M, I.; Hernandez R, G.

2009-10-01

The ligaments are human tissues that are used in the transplantation area. A ligament is an anatomical structure in band form, composed by resistant fibers that connect the tissues that unite the bones with the articulations. In an articulation, the ligaments allow and facilitate the movement inside the natural anatomical directions, while it restricts those movements that are anatomically abnormal, impeding lesions that could arise of this type of movements. The kneecap ligament is a very important tissue in the knee mobility and of walking in the human beings. This ligament can injure it because of automobile accidents, for sport lesions or illnesses, and in many cases the only form of recovering the knee movement is carried out a transplant with the purpose of replacing the damage ligament by allo gen kneecap ligament processed in specialized Tissue Banks where the tissue is sterilized with gamma radiation of 60 Co at very low temperatures, obtaining high quality ligaments for clinical application in injured patients. The kneecap ligaments are processed in the Tissue Banks with a segment of kneecap bone, a segment of tibial bone, the contained ligament between both bones and in some cases a fraction of the quadriceps tendon. In this work is given a description of the selection method of the tissue that includes the donor's serologic control, the kneecap ligament processing in the Radio Sterilized Tissues Bank, its sterilization with gamma radiation of 60 Co, also it is indicated like the clinical application of the allo gen ligament was realized in a hasty patient and whose previous crossed ligament was injured. Finally the results are presented from the tissue obtaining until the clinical application of it is, and in this case is observed a favorable initial evolution of the transplantation patient. (Author)

A mini-sampler for welding aerosol mounted in close vicinity of the mouth/nose

International Nuclear Information System (INIS)

Liden, Goeran; Surakka, Jouni

2009-01-01

A small personal aerosol mini-sampler to be used inside modern welding visors has been developed. The main object of the mini-sampler has been to sample manganese. The sampler is based on commercially available 13 mm filter holders but modified to incorporate an inlet nozzle made of aluminium. The nominal flow rate of the mini-sampler is 0,75 l/min. The sampler is to be worn mounted on a headset, modified from professional microphone headsets. The headset mounting arrangement was accepted by the welders. The sampling bias of the mini sampler versus the IOM sampler depends on the coarseness of the sampled aerosol. At the lowest concentration ratio of the open-face 25 mm filter holder to the IOM sampler equal to 0,65, the bias of the mini sampler is approximately -26% versus the IOM. The RMS sampling bias of the mini sampler versus the IOM sampler for manganese is -4,6%. The inhalable fraction of welding aerosol mass consists only of 25-55% of welding fume. The rest of the mass is made up of spatter particles and grinding particles. For manganese generally more than 65% is found in the fume.

Chronic injuries of the cruciate ligaments

International Nuclear Information System (INIS)

Pricca, P.; Cecchini, A.; Vecchioni, G.; Mariani, P.M.; Tansini, A.; Ferrario, A.

1988-01-01

The high incidence of cruciate ligament injuries as a result of acute knee trauma with hemartrosis and abuse of diagnostic arthroscopies call for a suitable radiological imaging of the central pivot. Computed Arthrotomography (CAT) was used to examine the knee joint in 20 cases of clinically suspected chronic cruciate ligament injury. The images were correlated with arthroscopic and/or arthrotomic findings. Thirteen lesions of the anterior cruciate ligament (ACL) (65%) were found, plus 1 lesion of the posterior cruciate ligament (PCL) (5%), 2 associated lesions of ACL + PCL (10%), and 4 normal cases. Confirmation of pathology was available in all cases but one by arthroscopy and/or surgery. The central pivot diseases were classified as follows: absence, detachement, partial or complete tear. CAT findings of cruciate ligament injuries are emphasized and the role of the technique as compared to arthroscopy is discussed. CAT is useful in 3-D evaluation of central pivot and detection of different cruciate ligament injuries, with high sensitivity-specifity for ACL and high specifity-moderate sensitivity for PCL. In the evaluation of the chronic unstable knee, CAT is highly accurate and gives the surgeon useful information towards the planning of therapeutic procedures. CAT is almost non-invasive, well tolerated and easy to perform in out-patients, which make it a first-choice procedure in the screening of chronic ligament injuries

Anatomy of the ankle ligaments: a pictorial essay

NARCIS (Netherlands)

Golanó, Pau; Vega, Jordi; de Leeuw, Peter A. J.; Malagelada, Francesc; Manzanares, M. Cristina; Götzens, Víctor; van Dijk, C. Niek

2010-01-01

Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the

Anatomy of the ankle ligaments: a pictorial essay

NARCIS (Netherlands)

Golanó, Pau; Vega, Jordi; de Leeuw, Peter A. J.; Malagelada, Francesc; Manzanares, M. Cristina; Götzens, Víctor; van Dijk, C. Niek

2016-01-01

Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the

Tissue Engineering Strategies in Ligament Regeneration

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Caglar Yilgor

2012-01-01

Full Text Available Ligaments are dense fibrous connective tissues that connect bones to other bones and their injuries are frequently encountered in the clinic. The current clinical approaches in ligament repair and regeneration are limited to autografts, as the gold standard, and allografts. Both of these techniques have their own drawbacks that limit the success in clinical setting; therefore, new strategies are being developed in order to be able to solve the current problems of ligament grafting. Tissue engineering is a novel promising technique that aims to solve these problems, by producing viable artificial ligament substitutes in the laboratory conditions with the potential of transplantation to the patients with a high success rate. Direct cell and/or growth factor injection to the defect site is another current approach aiming to enhance the repair process of the native tissue. This review summarizes the current approaches in ligament tissue engineering strategies including the use of scaffolds, their modification techniques, as well as the use of bioreactors to achieve enhanced regeneration rates, while also discussing the advances in growth factor and cell therapy applications towards obtaining enhanced ligament regeneration.

Synthesis and characterization of polycaprolactone for anterior cruciate ligament regeneration

Energy Technology Data Exchange (ETDEWEB)

Gurlek, Ayse Cansu; Sevinc, Burcu; Bayrak, Ece; Erisken, Cevat, E-mail: cerisken@etu.edu.tr

2017-02-01

Anterior cruciate ligament (ACL) is the most frequently torn ligament in the knee, and complete healing is unlikely due to lack of vascularization. Current approaches for the treatment of ACL injuries include surgical interventions and grafting, however recent reports show that surgeries have 94% recurrency, and that repaired tissues are biomechanically inferior to the native tissue. These necessitate the need for new strategies for scar-free repair/regeneration of ACL injuries. Polycaprolactone (PCL) is a biodegradable and biocompatible synthetic polymer, which has been widely used in the connective tissue repair/regeneration attempts. Here, we report on the synthesis of PCL via ring opening polymerization using ε-caprolactone as the monomer, and ammonium heptamolybdate as a catalyst. The synthesized PCL was characterized using Fourier Transform Infrared Spectroscopy (FTIR) and Nuclear Magnetic Resonance (NMR) spectroscopy. It was then processed using electrospinning to form nanofiber-based scaffolds. These scaffolds were characterized in terms of surface as well as mechanical properties, and compared to the properties of commercially available PCL, and of native ACL tissue harvested from sheep. In addition, scaffolds fabricated with synthesized PCL were evaluated regarding their cell attachment capacity using human bone marrow mesenchymal stem cells (hBMSCs). Our findings demonstrated that the synthesized PCL is similar to its commercially available counterpart in terms of surface morphology and mechanical properties. In addition, fibrous scaffolds generated with electrospinning showed weaker mechanical properties visa vis native ACL tissue in terms of ultimate stress, and elastic modulus. Also, the synthesized PCL can accommodate cell attachment when tested with hBMSCs. Putting together, these observations reveal that the PCL synthesized in this study could be a good candidate as a biomaterial for ligament repair or regeneration. - Highlights: • Synthesis of

Synthesis and characterization of polycaprolactone for anterior cruciate ligament regeneration

International Nuclear Information System (INIS)

Gurlek, Ayse Cansu; Sevinc, Burcu; Bayrak, Ece; Erisken, Cevat

2017-01-01

Anterior cruciate ligament (ACL) is the most frequently torn ligament in the knee, and complete healing is unlikely due to lack of vascularization. Current approaches for the treatment of ACL injuries include surgical interventions and grafting, however recent reports show that surgeries have 94% recurrency, and that repaired tissues are biomechanically inferior to the native tissue. These necessitate the need for new strategies for scar-free repair/regeneration of ACL injuries. Polycaprolactone (PCL) is a biodegradable and biocompatible synthetic polymer, which has been widely used in the connective tissue repair/regeneration attempts. Here, we report on the synthesis of PCL via ring opening polymerization using ε-caprolactone as the monomer, and ammonium heptamolybdate as a catalyst. The synthesized PCL was characterized using Fourier Transform Infrared Spectroscopy (FTIR) and Nuclear Magnetic Resonance (NMR) spectroscopy. It was then processed using electrospinning to form nanofiber-based scaffolds. These scaffolds were characterized in terms of surface as well as mechanical properties, and compared to the properties of commercially available PCL, and of native ACL tissue harvested from sheep. In addition, scaffolds fabricated with synthesized PCL were evaluated regarding their cell attachment capacity using human bone marrow mesenchymal stem cells (hBMSCs). Our findings demonstrated that the synthesized PCL is similar to its commercially available counterpart in terms of surface morphology and mechanical properties. In addition, fibrous scaffolds generated with electrospinning showed weaker mechanical properties visa vis native ACL tissue in terms of ultimate stress, and elastic modulus. Also, the synthesized PCL can accommodate cell attachment when tested with hBMSCs. Putting together, these observations reveal that the PCL synthesized in this study could be a good candidate as a biomaterial for ligament repair or regeneration. - Highlights: • Synthesis of

Incorporating Inquiry into Upper-Level Homework Assignments: The Mini-Journal

Science.gov (United States)

Whittington, A. G.; Speck, A. K.; Witzig, S. B.; Abell, S. K.

2009-12-01

The U.S. National Science Education Standards provide guidelines for teaching science through inquiry, where students actively develop their understanding of science by combining scientific knowledge with reasoning and thinking skills. Inquiry activities include reading scientific literature, generating hypotheses, designing and carrying out investigations, interpreting data, and formulating conclusions. Inquiry-based instruction emphasizes questions, evidence, and explanation, the essential features of inquiry. As part of an NSF-funded project, “CUES: Connecting Undergraduates to the Enterprise of Science,” new inquiry-based homework materials were developed for two upper-level classes at the University of Missouri: Geochemistry (required for Geology majors), and Solar System Science (open to seniors and graduate students, co-taught and cross-listed between Geology and Physics & Astronomy). We engage students in inquiry-based learning by presenting homework exercises as “mini-journal” articles that follow the format of a scientific journal article, including a title, authors, abstract, introduction, methods, results, discussion and citations to peer-reviewed literature. The mini-journal provides a scaffold and serves as a springboard for students to develop and carry out their own follow-up investigation. They then present their findings in the form of their own mini-journal. Mini-journals replace traditional homework problem sets with a format that more directly reflects and encourages scientific practice. Students are engaged in inquiry-based homework which encompass doing, thinking, and communicating, while the minijournal allows the instructor to contain lines of inquiry within the limits posed by available resources. In the examples we present, research is conducted via spreadsheet modeling, where the students develop their own spreadsheets. The key differences between the old and new formats include (i) the active participation of the students in

Trends in Materials Science for Ligament Reconstruction.

Science.gov (United States)

Sava, Oana Roxana; Sava, Daniel Florin; Radulescu, Marius; Albu, Madalina Georgiana; Ficai, Denisa; Veloz-Castillo, Maria Fernanda; Mendez-Rojas, Miguel Angel; Ficai, Anton

2017-01-01

The number of ligament injuries increases every year and concomitantly the need for materials or systems that can reconstruct the ligament. Limitations imposed by autografts and allografts in ligament reconstruction together with the advances in materials science and biology have attracted a lot of interest for developing systems and materials for ligament replacement or reconstruction. This review intends to synthesize the major steps taken in the development of polymer-based materials for anterior cruciate ligament, their advantages and drawbacks and the results of different in vitro and in vivo tests. Until present, there is no successful polymer system for ligament reconstruction implanted in humans. The developing field of synthetic polymers for ligament reconstruction still has a lot of potential. In addition, several nano-structured materials, made of nanofibers or in the form of ceramic/polymeric nanocomposites, are attracting the interest of several groups due to their potential use as engineered scaffolds that mimic the native environment of cells, increasing the chances for tissue regeneration. Here, we review the last 15 years of literature in order to obtain a better understanding on the state-of-the-art that includes the usage of nano- and poly-meric materials for ligament reconstruction, and to draw perspectives on the future development of the field. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Status and headway of the clinical application of artificial ligaments

Directory of Open Access Journals (Sweden)

Tianwu Chen

2015-01-01

Full Text Available The authors first reviewed the history of clinical application of artificial ligaments. Then, the status of clinical application of artificial ligaments was detailed. Some artificial ligaments possessed comparable efficacy to, and fewer postoperative complications than, allografts and autografts in ligament reconstruction, especially for the anterior cruciate ligament. At the end, the authors focused on the development of two types of artificial ligaments: polyethylene glycol terephthalate artificial ligaments and tissue-engineered ligaments. In conclusion, owing to the advancements in surgical techniques, materials processing, and weaving methods, clinical application of some artificial ligaments so far has demonstrated good outcomes and will become a trend in the future.

The transverse ligament as a landmark for tibial sagittal insertions of the anterior cruciate ligament: a cadaveric study.

Science.gov (United States)

Kongcharoensombat, Wirat; Ochi, Mitsuo; Abouheif, Mohamed; Adachi, Nobuo; Ohkawa, Shingo; Kamei, Goki; Okuhara, Atushi; Shibuya, Hoyatoshi; Niimoto, Takuya; Nakasa, Tomoyuki; Nakamae, Atsuo; Deie, Masataka

2011-10-01

The purpose of this study was to determine the relation between the position of the transverse ligament, the anterior edge of the anterior cruciate ligament (ACL) tibial footprint, and the center of the ACL tibial insertion. We used arthroscopy for localization of the anatomic landmarks, followed by insertions of guide pins under direct visualization, and then the position of these guide pins was checked on plain lateral radiographs. The transverse ligament and the anterior aspect of the ACL tibial footprint were identified by arthroscopy in 20 unpaired cadaveric knees (10 left and 10 right). Guide pins were inserted with tibial ACL adapter drill guides under direct observation at the transverse ligament, the anterior aspect of the tibial footprint, and the center of tibial insertion of the ACL. Then, plain lateral radiographs of specimens were taken. The Amis and Jakob line was used to define the attachment of the ACL tibial insertion and the transverse ligament. A sagittal percentage of the location of the insertion point was determined and calculated from the anterior margin of the tibia in the anteroposterior direction. The transverse ligament averaged 21.20% ± 4.1%, the anterior edge of the ACL tibial insertion averaged 21.60% ± 4.0%, and the center of the ACL tibial insertion averaged 40.30% ± 4.8%. There were similar percent variations between the transverse ligament and the anterior edge of the ACL tibial insertion, with no significant difference between them (P = .38). Intraobserver and interobserver reliability was high, with small standard errors of measurement. This study shows that the transverse ligament coincides with the anterior edge of the ACL tibial footprint in the sagittal plane. The transverse ligament can be considered as a new landmark for tibial tunnel positioning during anatomic ACL reconstruction. Copyright © 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Ligament Tissue Engineering and Its Potential Role in Anterior Cruciate Ligament Reconstruction

OpenAIRE

Yates, E. W.; Rupani, A.; Foley, G. T.; Khan, W. S.; Cartmell, S.; Anand, S. J.

2011-01-01

Tissue engineering is an emerging discipline that combines the principle of science and engineering. It offers an unlimited source of natural tissue substitutes and by using appropriate cells, biomimetic scaffolds, and advanced bioreactors, it is possible that tissue engineering could be implemented in the repair and regeneration of tissue such as bone, cartilage, tendon, and ligament. Whilst repair and regeneration of ligament tissue has been demonstrated in animal studies, further research ...

Arthroscopic Lateral Ligament Repair Through Two Portals in Chronic Ankle Instability.

Science.gov (United States)

Batista, Jorge Pablo; Del Vecchio, Jorge Javier; Patthauer, Luciano; Ocampo, Manuel

2017-01-01

Injury to the lateral ligament complex of the ankle is one of the most common sports-related injury. Usually lateral ankle evolves with excellent clinical recovery with non surgical treatment, however, near about 30% develop a lateral chronic instability sequela. Several open and arthroscopic surgical techniques have been described to treat this medical condition. Of the 22 patients who were treated; 18 males and 4 females, and aged from 17-42 years (mean 28 years). All patients presented a history of more than three ankle sprains in the last two years and presented positive anterior drawer and talar tilt test of the ankle in the physical examination. We perform an anterior arthroscopy of the ankle in order to treat asociated disease and then we performed "All inside¨ lateral ligament repair through two portals (anteromedial and anterolateral) using an anchor knotless suture. Clinical outcome evaluations were performed at a mean follow up of 25 months. (R: 17-31). Overall results has been shown by means of the American Orthopaedic Foot and Ankle Society (AOFAS). Mean AOFAS scores improved from 63 points (range 52-77) preoperatively to 90 points (range 73-100) at final follow up. No recurrences of ankle instability were found in the cases presented. Several surgical procedures have been described during the last years in order to treat chronic ankle instability. ¨All inside¨ lateral ligament reconstruction presents lower local morbidity than open procedures with few complications. Moreover, it is a reproductible technique, with high clinical success rate, few complications and relatively quick return to sports activities. A high knowledge of the anatomic landmarks should be essential to avoid unwated injuries.

Open source identity management patterns and practices using OpenAM 10.x

CERN Document Server

Kenning, Waylon

2013-01-01

This is a Packt Mini in a tutorial format that provides multiple examples on Identity Management using OpenAM 10.x.Open Source Identity Management Patterns and Practices Using OpenAM 10.x is great for developers and architects who are new to Identity Management, and who want a brief overview of what's possible and how to quickly implement a prototype. It's assumed that you've had experience with web applications and some knowledge of Apache and Tomcat.

On the behavior of crack surface ligaments

International Nuclear Information System (INIS)

Nilsson, P.; Staahle, P.; Sundin, K.G.

1998-01-01

Small ligaments connecting the fracture surfaces just behind a moving crack front are assumed to exist under certain conditions. The ligaments are rapidly torn as the crack advances. Inelastic straining of such ligaments influences the energy balance in the fracture process. The rapid tearing of a single ligament is studied both numerically and experimentally. An elastic visco-plastic material model is adopted for finite-element calculations. The results show that relatively large amounts of energy are dissipated during the tearing process. Further, the energy needed to tear a ligament increases rapidly with increasing tearing rate. The computed behavior is partly verified in a few preliminary experiments. The implications for slow stable crack tip speeds during dynamic fracture are discussed. (orig.)

MRI of injuries of the lateral ankle ligaments

International Nuclear Information System (INIS)

Breitenseher, Martin

2011-01-01

The most frequent sport injury of the ankle is located in the lateral ankle ligaments. The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and stress radiography, allowing a fair diagnosis for the daily routine. For the direct visualization and precise diagnosis of the lateral ankle ligaments MRI provides the best answer. MRI is used with controlled positioning of the foot, correct angulation of sequenzes, and distinct analysis of MR findings. Sinus tarsi ligaments and ligaments of the distal syndesmosis should be included to the report. In selected patients MRI allows the best evaluation of the extent of the lateral ankle ligaments. MRI is the method of choice for combined osteochondral injuries and soft tissue lesions too. (orig.)

Evaluation of static and dynamic balance in athletes with anterior cruciate ligament injury – A controlled study

Directory of Open Access Journals (Sweden)

Tiago Lazzaretti Fernandes

Full Text Available OBJECTIVES: Anterior cruciate ligament injury leads to adaptive responses to maintain postural control. However, there is no consensus regarding whether leg dominance also affects postural control in athletes with anterior cruciate ligament injury. The purpose of this study was to evaluate dynamic and static postural control among athletes with and without anterior cruciate ligament injury to the dominant leg. METHODS: Twenty-eight athletes, twenty-one males and seven females aged 15-45 years, were allocated to one of two groups: the anterior cruciate ligament injury group (26±3 years or the control group without anterior cruciate ligament injury (25±6.5 years. All subjects performed one legged stance tests under eyes open and eyes closed conditions and squat and kick movement tests using a postural control protocol (AccuSwayPlus force platform, Massachusetts. The center of pressure displacement and speed were measured by the force platform. In addition, the distance traveled on the single-leg hop test was assessed as an objective measure of function. RESULTS: Significantly greater mediolateral sway was found under the eyes closed condition (p=0.04 and during squat movement (p=0.01 in the anterior cruciate ligament injury group than in the control group. Analysis of the single-leg hop test results showed no difference between the groups (p=0.73. CONCLUSION: Athletes with anterior cruciate ligament injury had greater mediolateral displacement of the center of pressure toward the dominant leg under the eyes closed condition and during squat movement compared to control athletes.

Minimally invasive mini open split-muscular percutaneous pedicle screw fixation of the thoracolumbar spine

Directory of Open Access Journals (Sweden)

Murat Ulutaş

2015-03-01

Full Text Available We prospectively assessed the feasibility and safety of a new percutaneous pedicle screw (PPS fixation technique for instrumentation of the thoracic and lumbar spine in this study. All patients were operated in the prone position under general anesthesia. A 6 to 8 cm midline skin incision was made and wide sub-cutaneous dissection was performed. The paravertebral muscles were first dissected subperiosteally into the midline incision of the fascia for lumbar microdiscectomy with transforaminal lumbar interbody fusion cage implantation. After the secondary paramedian incisions on the fascia, the PPSs were inserted via cleavage of the multifidus muscles directly into the pedicles under fluoroscopy visualization. A total of 35 patients underwent surgery with this new surgical technique. The control group for operative time, blood loss and analgesic usage consisted of 35 randomly selected cases from our department. The control group underwent surgery via conventional pedicle screw instrumentation with paramedian fusion. All patients in the minimal invasive surgery series were ambulatory with minimal pain on the first postoperative day. The operation time and blood loss and the postoperative analgesic consumption were significantly less with this new technique. In conclusion, the minimal invasive mini open split-muscular percutaneous pedicle screw fixation technique is safe and feasible. It can be performed via a short midline skin incision and can also be combined with interbody fusion, causing minimal pain without severe muscle damage.

Development of a Tissue-Engineered Artificial Ligament: Reconstruction of Injured Rabbit Medial Collateral Ligament With Elastin-Collagen and Ligament Cell Composite Artificial Ligament.

Science.gov (United States)

Hirukawa, Masaki; Katayama, Shingo; Sato, Tatsuya; Inoue, Kota; Niwa, Kosuke; Ito, Naoya; Hattori, Tetsuya; Hosoi, Takashi; Unno, Hironori; Suzuki, Yoshiaki; Hasegawa, Masahiro; Miyamoto, Keiichi; Horiuchi, Takashi

2018-04-16

Ligament reconstruction using a tissue-engineered artificial ligament (TEAL) requires regeneration of the ligament-bone junction such that fixation devices such as screws and end buttons do not have to be used. The objective of this study was to develop a TEAL consisting of elastin-coated polydioxanone (PDS) sutures covered with elastin and collagen fibers preseeded with ligament cells. In a pilot study, a ring-type PDS suture with a 2.5 mm (width) bone insertion was constructed with/without elastin coating (Ela-coat and Non-coat) and implanted into two bone tunnels, diameter 2.4 mm, in the rabbit tibia (6 cases each) to access the effect of elastin on the bond strength. PDS specimens taken together with the tibia at 6 weeks after implantation indicated growth of bone-like hard tissues around bone tunnels accompanied with narrowing of the tunnels in the Ela-coat group and not in the Non-coat group. The drawout load of the Ela-coat group was significantly higher (28.0 ± 15.1 N, n = 4) than that of the Non-coat group (7.6 ± 4.6 N, n = 5). These data can improve the mechanical bulk property of TEAL through extracellular matrix formation. To achieve this TEAL model, 4.5 × 10 6 ligament cells were seeded on elastin and collagen fibers (2.5 cm × 2.5 cm × 80 µm) prior to coil formation around the elastin-coated PDS core sutures having ball-shape ends with a diameter of 2.5 mm. Cell-seeded and cell-free TEALs were implanted across the femur and the tibia through bone tunnels with a diameter of 2.4 mm (6 cases each). There was no incidence of TEAL being pulled in 6 weeks. Regardless of the remarkable degradation of PDS observed in the cell-seeded group, both the elastic modulus and breaking load of the cell-seeded group (n = 3) were comparable to those of the sham-operation group (n = 8) (elastic modulus: 15.4 ± 1.3 MPa and 18.5 ± 5.7 MPa; breaking load: 73.0 ± 23.4 N and 104.8 ± 21.8 N, respectively) and higher than those

The spinoglenoid ligament. Anatomy, morphology, and histological findings.

Science.gov (United States)

Plancher, Kevin D; Peterson, Robert K; Johnston, Jack C; Luke, Timothy A

2005-02-01

Dysfunction of the distal branch of the suprascapular nerve has been reported in athletes involved in throwing or overhead sports. The consistent presence of a dynamic anatomic structure, the spinoglenoid ligament, overlying the nerve in the spinoglenoid notch may be a contributing factor to the dysfunction of this nerve. The purpose of this study was to report the anatomy, morphology, and histological characteristics of the spinoglenoid ligament. The spinoglenoid ligaments of fifty-eight fresh-frozen cadaver shoulders were dissected to evaluate their anatomic dimensions, histological characteristics, and relationship to the suprascapular nerve, the posterior part of the capsule, and the glenoid rim. The spinoglenoid ligament was harvested, with its insertions on the scapular spine and on the capsule and glenoid left intact, for the histological analysis. Dissection revealed that a spinoglenoid ligament was present in all specimens. The ligament was found to form an irregular quadrangular shape. On gross examination, the deep fibers of the ligament extended from the lateral aspect of the scapular spine to the posterior part of the glenoid and the superficial fibers blended with the posterior aspect of the shoulder capsule. Histological sections demonstrated Sharpey fibers inserting into bone at the scapular spine and blending with the posterior aspect of the shoulder capsule to insert into the posterior surface of the glenoid, findings that confirmed the ligamentous nature of this structure. This study revealed the presence of the spinoglenoid ligament in all of the shoulders that were examined, with some variation in the size of the ligament.

Psychometric properties of a sign language version of the Mini International Neuropsychiatric Interview (MINI).

Science.gov (United States)

Øhre, Beate; Saltnes, Hege; von Tetzchner, Stephen; Falkum, Erik

2014-05-22

There is a need for psychiatric assessment instruments that enable reliable diagnoses in persons with hearing loss who have sign language as their primary language. The objective of this study was to assess the validity of the Norwegian Sign Language (NSL) version of the Mini International Neuropsychiatric Interview (MINI). The MINI was translated into NSL. Forty-one signing patients consecutively referred to two specialised psychiatric units were assessed with a diagnostic interview by clinical experts and with the MINI. Inter-rater reliability was assessed with Cohen's kappa and "observed agreement". There was 65% agreement between MINI diagnoses and clinical expert diagnoses. Kappa values indicated fair to moderate agreement, and observed agreement was above 76% for all diagnoses. The MINI diagnosed more co-morbid conditions than did the clinical expert interview (mean diagnoses: 1.9 versus 1.2). Kappa values indicated moderate to substantial agreement, and "observed agreement" was above 88%. The NSL version performs similarly to other MINI versions and demonstrates adequate reliability and validity as a diagnostic instrument for assessing mental disorders in persons who have sign language as their primary and preferred language.

Psychometric properties of a sign language version of the Mini International Neuropsychiatric Interview (MINI)

Science.gov (United States)

2014-01-01

Background There is a need for psychiatric assessment instruments that enable reliable diagnoses in persons with hearing loss who have sign language as their primary language. The objective of this study was to assess the validity of the Norwegian Sign Language (NSL) version of the Mini International Neuropsychiatric Interview (MINI). Methods The MINI was translated into NSL. Forty-one signing patients consecutively referred to two specialised psychiatric units were assessed with a diagnostic interview by clinical experts and with the MINI. Inter-rater reliability was assessed with Cohen’s kappa and “observed agreement”. Results There was 65% agreement between MINI diagnoses and clinical expert diagnoses. Kappa values indicated fair to moderate agreement, and observed agreement was above 76% for all diagnoses. The MINI diagnosed more co-morbid conditions than did the clinical expert interview (mean diagnoses: 1.9 versus 1.2). Kappa values indicated moderate to substantial agreement, and “observed agreement” was above 88%. Conclusion The NSL version performs similarly to other MINI versions and demonstrates adequate reliability and validity as a diagnostic instrument for assessing mental disorders in persons who have sign language as their primary and preferred language. PMID:24886297

Tissue Engineering Strategies in Ligament Regeneration

OpenAIRE

Yilgor, Caglar; Yilgor Huri, Pinar; Huri, Gazi

2011-01-01

Ligaments are dense fibrous connective tissues that connect bones to other bones and their injuries are frequently encountered in the clinic. The current clinical approaches in ligament repair and regeneration are limited to autografts, as the gold standard, and allografts. Both of these techniques have their own drawbacks that limit the success in clinical setting; therefore, new strategies are being developed in order to be able to solve the current problems of ligament grafting. Tissue eng...

The Cruciate Ligaments in Total Knee Arthroplasty.

Science.gov (United States)

Parcells, Bertrand W; Tria, Alfred J

2016-01-01

The early knee replacements were hinge designs that ignored the ligaments of the knee and resurfaced the joint, allowing freedom of motion in a single plane. Advances in implant fixation paved the way for modern designs, including the posterior-stabilized (PS) total knee arthroplasty (TKA) that sacrifices both cruciate ligaments while substituting for the posterior cruciate ligament (PCL), and the cruciate-retaining (CR) TKA designs that sacrifice the anterior cruciate ligament but retain the PCL. The early bicruciate retaining (BCR) TKA designs suffered from loosening and early failures. Townley and Cartier designed BCR knees that had better clinical results but the surgical techniques were challenging.Kinematic studies suggest that normal motion relies on preservation of both cruciate ligaments. Unicompartmental knee arthroplasty retains all knee ligaments and closely matches normal motion, while PS and CR TKA deviate further from normal. The 15% to 20% dissatisfaction rate with current TKA has renewed interest in the BCR design. Replication of normal knee kinematics and proprioception may address some of the dissatisfaction.

Instrument-assisted cross-fiber massage accelerates knee ligament healing.

Science.gov (United States)

Loghmani, M Terry; Warden, Stuart J

2009-07-01

Controlled laboratory study. To investigate the effects of instrument-assisted cross-fiber massage (IACFM) on tissue-level healing of knee medial collateral ligament (MCL) injuries. Ligament injuries are common and significant clinical problems for which there are few established interventions. IACFM represents an intervention that may mediate tissue-level healing following ligament injury. Bilateral knee MCL injuries were created in 51 rodents, while 7 rodents were maintained as ligament-intact, control animals. IACFM was commenced 1 week following injury and introduced 3 sessions per week for 1 minute per session. IACFM was introduced unilaterally (IACFM-treated), with the contralateral, injured MCL serving as an internal control (nontreated). Thirty-one injured animals received 9 ACFM treatments, while the remaining 20 injured animals received 30 treatments. Ligament biomechanical properties and morphology were assessed at either 4 or 12 weeks postinjury. IACFM-treated ligaments were 43.1% stronger (P<.05), 39.7% stiffer (P<.01), and could absorb 57.1% more energy before failure (P<.05) than contralateral, injured, nontreated ligaments at 4 weeks postinjury. On histological and scanning electron microscopy assessment, IACFM-treated ligaments appeared to have improved collagen fiber bundle formation and orientation within the scar region than nontreated ligaments. There were minimal differences between IACFM-treated and contralateral, nontreated ligaments at 12 weeks postinjury, although IACFM-treated ligaments were 15.4% stiffer (P<.05). IACFM-accelerated ligament healing, possibly via favorable effects on collagen formation and organization, but had minimal effect on the final outcome of healing. These findings are clinically interesting, as there are few established interventions for ligament injuries, and IACFM is a simple and practical therapy technique. J Orthop Sports Phys Ther 2009;39(7):506-514, Epub 24 February 2009. doi:10.2519/jospt.2009.2997.

Posterior longitudinal ligament status in cervical spine bilateral facet dislocations

International Nuclear Information System (INIS)

Carrino, John A.; Manton, Geoffrey L.; Morrison, William B.; Flanders, Adam E.; Vaccaro, Alex R.; Schweitzer, Mark E.

2006-01-01

It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status. Retrospective case series. A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between various injury patterns and posterior longitudinal ligament status. The frequency of MRI abnormalities was: anterior longitudinal ligament disruption (26.7%), disc herniation or disruption (90%), posterior longitudinal ligament disruption (40%), facet fracture (63.3%) and disruption of the posterior column ligament complex (97%). There were no significant associations between injury to the posterior longitudinal ligament and other structures. Compared to surgical reports, MRI was accurate for determining the status for 24 of 26 ligaments (three of three anterior longitudinal ligament, seven of nine posterior longitudinal ligament, and 14 of 14 posterior column ligament complex) but generated false negatives in two instances (in both MRI showed an intact posterior longitudinal ligament that was torn at surgery). (orig.)

Whiplash causes increased laxity of cervical capsular ligament

Science.gov (United States)

Ivancic, Paul C.; Ito, Shigeki; Tominaga, Yasuhiro; Rubin, Wolfgang; Coe, Marcus P.; Ndu, Anthony B.; Carlson, Erik J.; Panjabi, Manohar M.

2009-01-01

Background Previous clinical studies have identified the cervical facet joint, including the capsular ligaments, as sources of pain in whiplash patients. The goal of this study was to determine whether whiplash caused increased capsular ligament laxity by applying quasi-static loading to whiplash-exposed and control capsular ligaments. Methods A total of 66 capsular ligament specimens (C2/3 to C7/T1) were prepared from 12 cervical spines (6 whiplash-exposed and 6 control). The whiplash-exposed spines had been previously rear impacted at a maximum peak T1 horizontal acceleration of 8 g. Capsular ligaments were elongated at 1 mm/s in increments of 0.05 mm until a tensile force of 5 N was achieved and subsequently returned to neutral position. Four pre-conditioning cycles were performed and data from the load phase of the fifth cycle were used for subsequent analyses. Ligament elongation was computed at tensile forces of 0, 0.25, 0.5, 0.75, 1.0, 2.5, and 5.0 N. Two factor, non-repeated measures ANOVA (Pwhiplash-exposed and control groups and between spinal levels. Findings Average elongation of the whiplash-exposed capsular ligaments was significantly greater than that of the control ligaments at tensile forces of 0 and 5 N. No significant differences between spinal levels were observed. Interpretation Capsular ligament injuries, in the form of increased laxity, may be one component perpetuating chronic pain and clinical instability in whiplash patients. PMID:17959284

Whiplash causes increased laxity of cervical capsular ligament.

Science.gov (United States)

Ivancic, Paul C; Ito, Shigeki; Tominaga, Yasuhiro; Rubin, Wolfgang; Coe, Marcus P; Ndu, Anthony B; Carlson, Erik J; Panjabi, Manohar M

2008-02-01

Previous clinical studies have identified the cervical facet joint, including the capsular ligaments, as sources of pain in whiplash patients. The goal of this study was to determine whether whiplash caused increased capsular ligament laxity by applying quasi-static loading to whiplash-exposed and control capsular ligaments. A total of 66 capsular ligament specimens (C2/3 to C7/T1) were prepared from 12 cervical spines (6 whiplash-exposed and 6 control). The whiplash-exposed spines had been previously rear impacted at a maximum peak T1 horizontal acceleration of 8 g. Capsular ligaments were elongated at 1mm/s in increments of 0.05 mm until a tensile force of 5 N was achieved and subsequently returned to neutral position. Four pre-conditioning cycles were performed and data from the load phase of the fifth cycle were used for subsequent analyses. Ligament elongation was computed at tensile forces of 0, 0.25, 0.5, 0.75, 1.0, 2.5, and 5.0 N. Two factor, non-repeated measures ANOVA (Pwhiplash-exposed and control groups and between spinal levels. Average elongation of the whiplash-exposed capsular ligaments was significantly greater than that of the control ligaments at tensile forces of 0 and 5 N. No significant differences between spinal levels were observed. Capsular ligament injuries, in the form of increased laxity, may be one component perpetuating chronic pain and clinical instability in whiplash patients.

Recruitment of knee joint ligaments

NARCIS (Netherlands)

Blankevoort, L.; Huiskes, H.W.J.; Lange, de A.

1991-01-01

On the basis of earlier reported data on the in vitro kinematics of passive knee-joint motions of four knee specimens, the length changes of ligament fiber bundles were determined by using the points of insertion on the tibia and femur. The kinematic data and the insertions of the ligaments were

Return of the mini

International Nuclear Information System (INIS)

Ashmore, C.

2001-01-01

Partly as a result of the contentious nature of some large hydroelectric schemes, and continuing deregulation on a global scale, the mini hydro systems are enjoying unprecedented growth. This article discusses the reasons for the increase in demand for mini hydro systems, and describes Alstom Power Hydro's new, integrated 'water-to-wire' renewable energy solution which is a modular system which integrates the hydro-turbine, generator and controls to provide a single optimised product called the Mini-Aqua. The Mini-Aqua can be supplied inside a turnkey package including all civil works. The company is also looking to the future with development of its Powerformer technology for smaller-scale, grid-connected applications

Consistência interna da versão em português do Mini-Inventário de Fobia Social (Mini-SPIN Internal consistency of the Portuguese version of the Mini-Social Phobia Inventory (Mini-SPIN

Directory of Open Access Journals (Sweden)

Gustavo J. Fonseca D'El Rey

2007-01-01

Full Text Available CONTEXTO: A fobia social é um grave transtorno de ansiedade que traz incapacitação e sofrimento. OBJETIVOS: Investigar a consistência interna da versão em português do Mini-Inventário de Fobia Social (Mini-SPIN. MÉTODOS: Foi realizado um estudo da consistência interna do Mini-SPIN em uma amostra de 206 estudantes universitários da cidade de São Paulo, SP. RESULTADOS: A consistência interna do instrumento, analisada pelo coeficiente alfa de Cronbach, foi de 0,81. CONCLUSÕES: Esses achados permitiram concluir que a versão em português do Mini-SPIN exibiu resultados de boa consistência interna, semelhantes aos da versão original em inglês.BACKGROUND: Social phobia is a severe anxiety disorder that brings disability and distress. OBJECTIVES: To investigate the internal consistency of the Portuguese version of the Mini-Social Phobia Inventory (Mini-SPIN. METHODS: We conducted a study of internal consistency of the Mini-SPIN in a sample of 206 college students of the city of São Paulo, SP. RESULTS: The internal consistency of the instrument, analyzed by Cronbach's alpha coefficient, was 0.81. CONCLUSIONS: These findings suggest that the Portuguese version of the Mini-SPIN has a good internal consistency, similar to those obtained with the original English version.

Posterior Cruciate Ligament Tibial Avulsion treated with Open Reduction and Internal Fixation through the Burks and Schaffer Approach

Directory of Open Access Journals (Sweden)

Khatri K

2015-07-01

Full Text Available Objective: To report functional outcome in Posterior Cruciate Ligament (PCL tibial avulsion fractures treated with open reduction and internal fixation through Burks and Schaffer approach. The patient specific functional outcome measures like IKDC grading together with objective grading with stress radiographs have rarely been used to assess PCL tibial avulsion fractures. Material and Methods: Twenty seven patients (21 males and 6 females were included in the study. The mean follow up duration was 22.30±6.82 months. They were assessed using international knee documentation committee (IKDC grades, Lysholm scoring and stress radiography. The injury severity scores (ISS of the patients were also recorded. Results: The mean Lysholm scores at the time of last follow up was 90.85±5.58. The IKDC grades achieved were normal in 20 patients, near normal in five and abnormal in two. The PCL laxity determined on active hamstring contraction stress radiography was grade I in 20 cases and grade II in seven cases. All patients had achieved bony union of tibial avulsion fractures at the time of last follow up. Statistically significant association was found between higher ISS and lower Lysholm scores. (t=3.455, p=0.0019. Good IKDC grades were associated with higher Lysholm scores (analysis of variance, F=32.51, p<.0001.There was no correlation between PCL laxity and functional outcome (t=.857, p =0.399. Conclusion: PCL tibial avulsion fractures treated through Burk and Schaffer approach with open reduction and internal fixation produces good results. The early rehabilitation without cast immobilisation prevents arthrofibrosis.

Ultrasonographic evaluation of normal extrinsic and intrinsic carpal ligaments: preliminary experience

International Nuclear Information System (INIS)

Boutry, Nathalie; Lapegue, Franck; Demondion, Xavier; Masi, Laetitia; Cotten, Anne; Claret, Antoine

2005-01-01

To determine normal anatomy of extrinsic and intrinsic carpal ligaments at ultrasonography (US). In the first part of the study, two musculoskeletal radiologists retrospectively reviewed in consensus the photographs of anatomic sections and dissections derived from 20 cadaveric wrists. This cadaveric study gave the two readers the opportunity to learn the anatomy and orientation of the various extrinsic and intrinsic carpal ligaments and, thus, to develop a US protocol to facilitate the recognition of each carpal ligament. In the second part of the study, these two radiologists prospectively and independently evaluated the visibility of extrinsic and intrinsic carpal ligaments in 30 wrists of volunteers, using the same US protocol. With regard to extrinsic carpal ligaments, the radioscaphocapitate ligament (partially visible, 38%; completely visible, 62%), the radiolunotriquetral ligament (partially visible, 27%; completely visible, 73%), the palmar ulnotriquetral ligament (partially visible, 12%; completely visible, 88%), and the dorsal radiotriquetral ligament (partially visible, 7%; completely visible, 93%) were visualized at US. The dorsal ulnotriquetral ligament (partially visible, 21%; completely visible, 74%), the ulnolunate ligament (partially visible, 5%; completely visible, 70%), and the radial collateral ligament (partially visible, 18%; completely visible, 12%) were more difficult to recognize. The radioscapholunate ligament was never seen. With regard to intrinsic carpal ligaments, the dorsal (partially visible, 11%; completely visible, 89%) and palmar (partially visible, 38%; completely visible, 62%) scaphotriquetral ligaments as well as the dorsal scapholunate ligament (partially visible, 3%; completely visible, 97%) were visualized at US. The dorsal lunotriquetral ligament (partially visible, 39%; completely visible, 61%) and the palmar scapholunate ligaments (partially visible, 12%; completely visible, 81%) were more difficult to recognize. US may

Graphic software ''MiniG'' for the Mini-6

International Nuclear Information System (INIS)

Zen, J.

1984-06-01

MiniG is a set of subprograms, written and aimed at being used in Fortran for graphic applications in nuclear physics (histograms or point clouds). It includes three representation modes of axis scales (linear, semi-log and squared root), five types of vectors and numerous graphic symbols for spectra representation with or without notation (circle, cross, arrow, triangle, spiral, etc.). It offers also the possibilities of the software ''Plot-10'' of Tektronix, and accept all the types of graphic terminals of SATD connected to Mini-6 [fr

Evaluation of Transsyndesmotic Fixation and Primary Deltoid Ligament Repair in Ankle Fractures With Suspected Combined Deltoid Ligament Injury.

Science.gov (United States)

Wu, Kai; Lin, Jian; Huang, Jianhua; Wang, Qiugen

2018-04-13

The present prospective study examined the utility of the intraoperative tap test/technique for distal tibiofibular syndesmosis in the diagnosis of deltoid ligament rupture and compared the outcomes of transsyndesmotic fixation to deltoid ligament repair with suture anchor. This diagnostic technique was performed in 59 ankle fractures with suspected deltoid ligament injury. The width of the medial clear space of 59 cases was evaluated to assess the sensitivity and specificity. Those with deltoid ligament rupture were randomly assigned to 2 groups and treated with deltoid ligament repair with a suture anchor or with syndesmosis screw fixation. All the patients were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, short-form 36-item questionnaire (SF-36), and visual analog scale (VAS). The tap test was positive in 53 cases. However, surgical exploration demonstrated that 51 cases (86.4%) had a combined deltoid ligament injury and fracture. The sensitivity and specificity of the tap test was 100.0% and 75.0%, respectively. Finally, 26 cases (96.3%) in the syndesmosis screw group and 22 (91.7%) in the deltoid repair group were followed up. No statistically significant differences were found in the AOFAS ankle-hindfoot scale score, SF-36 score, or VAS score between the 2 groups. The malreduction rate in the syndesmosis screw group was 34.6% and that in the deltoid repair group was 9.09%. The tap test is an intraoperative diagnostic method to use to evaluate for deltoid ligament injury. Deltoid ligament repair with a suture anchor had good functional and radiologic outcomes comparable to those with syndesmotic screw fixation but has a lower malreduction rate. We did not encounter the issue of internal fixation failure or implant removal. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

MR imaging features of chronically torn anterior cruciate ligament

International Nuclear Information System (INIS)

Niitsu, Mamoru; Kuramochi, Masashi; Ikeda, Kotaroh; Fukubayashi, Tohru; Anno, Izumi; Itai, Yuji

1995-01-01

Magnetic resonance (MR) images of 40 knee joints with arthroscopically proved chronic anterior cruciate ligament (ACL) tears were retrospectively evaluated. MRI demonstrated various features of chronic ACL tears: 19 knees revealed with no identifiable ligamentous structure, and 21 had residual ligamentous structures. These pseudoligaments, 14 discontinuous bands and seven continuous bands with elongation, were residual torn ligamentous fibers and/or synovial tissues. All the discontinuous bands were disrupted from the femoral attachment and were likely to traverse the lower intercondylar space. Six disrupted ligaments were attached to the lateral aspect of the posterior cruciate ligament (PCL). Coronal T2 * -weighted gradient echo images showed better delineation of the disrupted femoral attachment and adhesion to the PCL. A chronic ACL tear with minimal elongation or with PCL attachment at a higher position may occasionally be difficult to distinguish from an intact ligament. (author)

The fibre bundle anatomy of human cruciate ligaments

NARCIS (Netherlands)

Mommersteeg, T. J.; Kooloos, J. G.; Blankevoort, L.; Kauer, J. M.; Huiskes, R.; Roeling, F. Q.

1995-01-01

The cruciate ligaments of the knee consist of numerous fascicles, groups of which comprise fibre bundles. The stabilising function of these ligaments is established by changes in the lengths and orientations of the fascicles. Understanding the function of knee ligaments thus requires an

The medial collateral ligament of the elbow joint

DEFF Research Database (Denmark)

Floris, S; Olsen, Bo Sanderhoff; Dalstra, Michel

1998-01-01

Eighteen osteoligamentous elbow joint specimens were included in a study of the medial collateral ligament complex (MCL). The morphologic characteristics of the MCL were examined, and three-dimensional kinematic measurements were taken after selective ligament dissections were performed. On morph......Eighteen osteoligamentous elbow joint specimens were included in a study of the medial collateral ligament complex (MCL). The morphologic characteristics of the MCL were examined, and three-dimensional kinematic measurements were taken after selective ligament dissections were performed...

Lateral collateral ligament of the elbow joint

DEFF Research Database (Denmark)

Olsen, Bo Sanderhoff; Vaesel, M T; Søjbjerg, Jens Ole

1996-01-01

The structure and kinematics of the lateral collateral ligament of the elbow joint were investigated in 10 cadaveric specimens. The lateral collateral ligament was observed to be a distinct part of the lateral collateral ligament complex. It contains posterior fibers that pass through the annular....... Division of the posterolateral capsule caused no further laxity. Cutting the lateral collateral ligament induced a maximum laxity of 11.8 degrees at 110 degrees of flexion in forced varus and a maximum laxity of 20.6 degrees at 110 degrees of flexion in forced external rotation. The corresponding maximal...... posterior radial head translation was observed at 80 degrees to 100 degrees of flexion and was 5.7 mm in forced varus and 8.1 mm in forced external rotation. This study suggests the lateral collateral ligament to be an important stabilizer of the humeroulnar joint and the radial head in forced varus...

[Validation of the portuguese version of the Mini-Social Phobia Inventory (Mini-SPIN)].

Science.gov (United States)

D'El Rey, Gustavo José Fonseca; Matos, Cláudia Wilmor

2009-01-01

Social phobia (also known as social anxiety disorder) is a severe mental disorder that brings distress and disability. The aim of this study was validate to the Portuguese language the Mini-Social Phobia Inventory (Mini-SPIN) in a populational sample. We performed a discriminative validity study of the Mini-SPIN in a sample of 644 subjects (Mini-SPIN positive group: n = 218 and control/negative group: n = 426) of a study of anxiety disorders' prevalence in the city of Santo André-SP. The Portuguese version of the Mini-SPIN (with score of 6 points, suggested in the original English version) demonstrated a sensitivity of 95.0%, specificity of 80.3%, positive predictive value of 52.8%, negative predictive value of 98.6% and incorrect classification rate of 16.9%. With score of 7 points, was observed an increase in the specificity and positive predictive value (88.6% and 62.7%), while the sensitivity and negative predictive value (84.8% and 96.2%) remained high. The Portuguese version of the Mini-SPIN showed satisfactory psychometric qualities in terms of discriminative validity. In this study, the cut-off of 7, was considered to be the most suitable to screening of the generalized social phobia.

Tissue engineered devices for ligament repair, replacement and ...

African Journals Online (AJOL)

PRECIOUS

2009-12-29

Dec 29, 2009 ... These devices use a wide variety of materials and designs to replicate ligament mechanics and allow for new tissue regeneration. Key words: Anterior cruciate ligament (ACL), tissue engineering, cells, tensile, stress relaxation, polymer, allograft, xenograft. INTRODUCTION. The anterior cruciate ligament ...

Syndesmosis and deltoid ligament injuries in the athlete

NARCIS (Netherlands)

McCollum, Graham A.; van den Bekerom, Michel P. J.; Kerkhoffs, Gino M. M. J.; Calder, James D. F.; van Dijk, C. Niek

2013-01-01

Injury to the syndesmosis and deltoid ligament is less common than lateral ligament trauma but can lead to significant time away from sport and prolonged rehabilitation. This literature review will discuss both syndesmotic and deltoid ligament injuries without fracture in the professional athlete. A

P A Mini

Indian Academy of Sciences (India)

Home; Journals; Bulletin of Materials Science. P A Mini. Articles written in Bulletin of Materials Science. Volume 36 Issue 4 August 2013 pp 547-551. Composite supercapacitor electrodes made of activated carbon/PEDOT:PSS and activated carbon/doped PEDOT · T S Sonia P A Mini R Nandhini Kalluri Sujith Balakrishnan ...

Bioengineered anterior cruciate ligament

Science.gov (United States)

Martin, Ivan (Inventor); Altman, Gregory (Inventor); Kaplan, David (Inventor); Vunjak-Novakovic, Gordana (Inventor)

2001-01-01

The present invention provides a method for producing an anterior cruciate ligament ex vivo. The method comprises seeding pluripotent stem cells in a three dimensional matrix, anchoring the seeded matrix by attachment to two anchors, and culturing the cells within the matrix under conditions appropriate for cell growth and regeneration, while subjecting the matrix to one or more mechanical forces via movement of one or both of the attached anchors. Bone marrow stromal cells are preferably used as the pluripotent cells in the method. Suitable matrix materials are materials to which cells can adhere, such as a gel made from collagen type I. Suitable anchor materials are materials to which the matrix can attach, such as Goinopra coral and also demineralized bone. Optimally, the mechanical forces to which the matrix is subjected mimic mechanical stimuli experienced by an anterior cruciate ligament in vivo. This is accomplished by delivering the appropriate combination of tension, compression, torsion, and shear, to the matrix. The bioengineered ligament which is produced by this method is characterized by a cellular orientation and/or matrix crimp pattern in the direction of the applied mechanical forces, and also by the production of collagen type I, collagen type III, and fibronectin proteins along the axis of mechanical load produced by the mechanical forces. Optimally, the ligament produced has fiber bundles which are arranged into a helical organization. The method for producing an anterior cruciate ligament can be adapted to produce a wide range of tissue types ex vivo by adapting the anchor size and attachment sites to reflect the size of the specific type of tissue to be produced, and also adapting the specific combination of forces applied, to mimic the mechanical stimuli experienced in vivo by the specific type of tissue to be produced. The methods of the present invention can be further modified to incorporate other stimuli experienced in vivo by the

Validação da versão em português do Mini-Inventário de Fobia Social (Mini-SPIN) Validation of the portuguese version of the Mini-Social Phobia Inventory (Mini-SPIN)

OpenAIRE

Gustavo José Fonseca D'El Rey; Cláudia Wilmor Matos

2009-01-01

A fobia social (também conhecida como transtorno de ansiedade social) é um grave transtorno mental que traz sofrimento e incapacitação. O objetivo deste estudo foi validar para a língua portuguesa o Mini-Inventário de Fobia Social (Mini-SPIN) em uma amostra da população. Foi realizado um estudo da validade discriminativa do Mini-SPIN em uma amostra de 644 pessoas (grupo positivo para o Mini-SPIN: n = 218 e grupo controle/negativo: n = 426) de um estudo de prevalência de transtornos de ansieda...

Radiologic analysis of the medical collateral ligament rupture

International Nuclear Information System (INIS)

Cho, Chung Che; Lee, Chang Jun; Kim, Kun Sang; Park, Soo Soung

1979-01-01

The medical collateral ligament rupture is the most common injury involving the knee joint ligaments. The ruptured medical collateral ligaments of 73 cases with clinical and surgical confirmations were radiologically analyzed. The results were obtained as follows: 1. The most risky age for tearing of the medical collateral ligament was third to fifth decades (50 cases of male and 23 of females). 2. The most common cause of the medical collateral ligament rupture was traffic accident (82.2%). 3. The mean distance of medial knee joint space was 7.9 ± 2.0 mm on the normal side and 13.7 ± 4.2 mm on the affected side. 4. The mean degree of knee joint space was 10.1 ± 2.5 on the normal side and 14.7 ± 3.8 on the affected side. 5. The fibula was the bone fractured most frequently in association with the medial collateral ligament rupture (30.6%).

Anterolateral Ligament of the Knee Shows Variable Anatomy in Pediatric Specimens.

Science.gov (United States)

Shea, Kevin G; Milewski, Matthew D; Cannamela, Peter C; Ganley, Theodore J; Fabricant, Peter D; Terhune, Elizabeth B; Styhl, Alexandra C; Anderson, Allen F; Polousky, John D

2017-06-01

Anterior cruciate ligament (ACL) reconstruction failure rates are highest in youth athletes. The role of the anterolateral ligament in rotational knee stability is of increasing interest, and several centers are exploring combined ACL and anterolateral ligament reconstruction for these young patients. Literature on the anterolateral ligament of the knee is sparse in regard to the pediatric population. A single study on specimens younger than age 5 years demonstrated the presence of the anterolateral ligament in only one of eight specimens; therefore, much about the prevalence and anatomy of the anterolateral ligament in pediatric specimens remains unknown. We sought to (1) investigate the presence or absence of the anterolateral ligament in prepubescent anatomic specimens; (2) describe the anatomic relationship of the anterolateral ligament to the lateral collateral ligament; and (3) describe the anatomic relationship between the anterolateral ligament and the physis. Fourteen skeletally immature knee specimens (median age, 8 years; range, 7-11 years) were dissected (12 male, two female specimens). The posterolateral structures were identified in all specimens, including the lateral collateral ligament and popliteus tendon. The presence or absence of the anterolateral ligament was documented in each specimen, along with origin, insertion, and dimensions, when applicable. The relationship of the anterolateral ligament origin to the lateral collateral ligament origin was recorded. The anterolateral ligament was identified in nine of 14 specimens. The tibial attachment point was consistently located in the same region on the proximal tibia, between the fibular head and Gerdy's tubercle; however, the femoral origin of the anterolateral ligament showed considerable variation with respect to the lateral collateral ligament origin. The median femoral origin of the anterolateral ligament was 10 mm (first interquartile 6 mm, third interquartile 13) distal to the distal

Spray Modeling for Outwardly-Opening Hollow-Cone Injector

KAUST Repository

Sim, Jaeheon; Badra, Jihad; Elwardani, Ahmed Elsaid; Im, Hong G.

2016-01-01

linear instability sheet atomization (LISA) model was originally developed for pressure swirl hollow-cone injectors with moderate spray angle and toroidal ligament breakups. Therefore, it is not appropriate for the outwardly-opening injectors having wide

Round Ligament Varicosities During Pregnancy: Case Report

International Nuclear Information System (INIS)

Baek, Chang Kyu; Oh, Young Taik; Jung, Dae Chul

2011-01-01

There are various causes of a painful palpable mass in the groin during pregnancy. The differential diagnoses of an inguinal mass include hernia, lymphadenopathy, mesothelial cyst, cystic lymphangioma, neoplasms (lipoma, leiomyoma and sarcoma), endometriosis, embryonic remnants and round ligament varicosities. Among them, round ligament varicosities can be easily misdiagnosed as an inguinal hernia in a pregnant woman. These lesions should be managed conservatively because they resolve spontaneously during the postpartum period. Ultrasonography can help make the diagnosis of round ligament varicosities and so prevent unnecessary surgical intervention and the associated morbidity. Herein we report on a case of round ligament varicosities that presented during pregnancy and this condition was readily diagnosed via Doppler sonography

Round Ligament Varicosities During Pregnancy: Case Report

Energy Technology Data Exchange (ETDEWEB)

Baek, Chang Kyu; Oh, Young Taik; Jung, Dae Chul [Yonsei University Health System, Seoul (Korea, Republic of)

2011-12-15

There are various causes of a painful palpable mass in the groin during pregnancy. The differential diagnoses of an inguinal mass include hernia, lymphadenopathy, mesothelial cyst, cystic lymphangioma, neoplasms (lipoma, leiomyoma and sarcoma), endometriosis, embryonic remnants and round ligament varicosities. Among them, round ligament varicosities can be easily misdiagnosed as an inguinal hernia in a pregnant woman. These lesions should be managed conservatively because they resolve spontaneously during the postpartum period. Ultrasonography can help make the diagnosis of round ligament varicosities and so prevent unnecessary surgical intervention and the associated morbidity. Herein we report on a case of round ligament varicosities that presented during pregnancy and this condition was readily diagnosed via Doppler sonography

Anterior cruciate ligament tears: MRI versus arthroscopy

International Nuclear Information System (INIS)

Tosch, U.; Felix, R.; Schauwecker, W.; Dreithaler, B.

1992-01-01

Because of suspected rupture of the anterior cruciate ligament sixteen acute traumatised patients were investigated by MR and arthroscopy. The MR diagnosis of a lesion of the anterior cruciate ligament proved to be correct by arthroscopy in fifteen of sixteen cases. Diagnostic criteria for lesions of the anterior cruciate ligament were: increased signal intensity in T 1 - and T 2 weighted images, increased volume and discontinuity of ligamentous structures. Additional MR findings of meniscal tears were correct in three of four cases laterally and in four of four cases medially. Femoral cartilage lesions were correctly identified by MR in three cases. MR normal findings proved to be correct by arthroscopy in another five cases. (orig.) [de

[Clinical auxiliary diagnosis value of high frequency ultrasonographic measurements of the thickness of transverse carpal ligaments in carpal tunnel syndrome patients].

Science.gov (United States)

Xu, L; Chen, F M; Wang, L; Zhang, P X; Jiang, X R

2016-04-18

To evaluate the meaning and value of high-frequency ultrasound in the diagnosis of carpal tunnel syndrome (CTS). In this study, 48 patients (unilateral hand) with CTS were analyzed. The thickness of transverse carpal ligaments at the pisiform bone was measured using high-frequency ultrasound. Open carpal tunnel release procedure was performed in the 48 CTS patients, and the thickness of transverse carpal ligaments at the hamate hook bone measured using vernier caliper under direct vision. The accuracy of thickness of transverse carpal ligaments was evaluated using high-frequency ultrasound. high-frequency ultrasound measurement of thickness of transverse carpal ligaments at the hamate hook bone and pisiform bone, and determination of the diagnostic threshold measurement index using receiver operating characteristic (ROC) curve, sensitivity and specificity were performed and the correlation between the thickness of transverse carpal ligaments and nerve conduction study (NCS) analyzed. The thickness of transverse carpal ligaments in the CTS patients were (0.42±0.08) cm (high-frequency ultrasound) and (0.41±0.06) cm (operation) at hamate hook bone, and there was no significant difference between the two ways (t=0.672, P>0.05). The optimal cut-off value of the transverse carpal ligaments at hamate hook bone was 0.385 cm, the sensitivity 0.775, and the specificity 0.788. The optimal cut-off value of the transverse carpal ligaments at the pisiform bone was 0.315 cm, the sensitivity 0.950, and the specificity 1.000. The transverse carpal ligaments thickness and wrist-index finger sensory nerve conduction velocity (SCV), wrist-middle finger SCV showed a negative correlation. High frequency ultrasound measurements of thickness of transverse carpal ligaments is a valuable method for the diagnosis of CTS.

MiniCNT - A Tabletop Stellarator

Science.gov (United States)

Dugan, Chris; Pedersen, Thomas; Berkery, John

2006-10-01

MiniCNT is a scaled down version of the Columbia Non-Neutral Torus, a stellarator built to study confinement of non-neutral plasmas on magnetic surfaces. MiniCNT is a glass vacuum chamber capable of holding pressures six orders of magnitude below atmospheric pressure. Unlike CNT, in which plasmas are invisible, MiniCNT allows some collisions with neutrals, causing it to glow. Using two twelve-volt car batteries to power four magnetic coils, MiniCNT generates a 0.02 Tesla magnetic field. While CNT, being larger, is obviously more accurate, there are multiple benefits in MiniCNT. First, it is more flexible and can be adjusted to fit many scenarios easily. The car batteries can be switched for other power sources, the coils can be realigned, and the chamber can be pumped to various pressures of various gases. Also, it is visually accessible; while CNT has glass viewing ports and its plasma is dark, MiniCNT is made of glass and its plasma glows, allowing visualization of the magnetic surfaces.

Mini-Cog and Mini-Mental State Examination: agreement in a cross-sectional study with an elderly sample.

Science.gov (United States)

Costa, Diogo; Severo, Milton; Fraga, Sílvia; Barros, Henrique

2012-01-01

We aimed to compare the Mini-Mental State Examination (MMSE) with the Mini-Cog, measuring agreement in participants' classification, using a general population sample. Cross-sectional evaluation of 609 community dwellers aged ≥60 years was performed by trained interviewers. Cohen's kappa and 95% confidence intervals (CI) were calculated to assess overall agreement, and Cronbach alphas computed to assess reliability. Two-parameter Item Response Theory models (difficulty and discrimination parameters) were used to assess discrimination. Considering MMSE cut-point for scores Mini-Cog's cut-point score Mini-Cog Mini-Cog Mini-Cog's alpha was 0.2776. Co-calibration according to inherent ability is graphically presented. Agreement between scales seems fragile in our sample. The discriminative and reliability analysis suggests a better performance for subsets of the MMSE compared with the Mini-Cog. Usefulness of calibrated scores is discussed. Copyright © 2012 S. Karger AG, Basel.

Open capsular and ligament reconstruction with semitendinosus hamstring autograft successfully controls superior and posterior translation for type V acromioclavicular joint dislocation.

Science.gov (United States)

Garofalo, Raffaele; Ceccarelli, Enrico; Castagna, Alessandro; Calvisi, Vittorio; Flanagin, Brody; Conti, Marco; Krishnan, Sumant G

2017-07-01

Appropriate surgical management for type V complete acromioclavicular (AC) joint dislocation remains controversial. The purpose of this paper is to retrospectively report the clinical and radiographic outcomes of an open surgical technique consisting for AC joint ligamentous and capsular reconstruction using autologous hamstring tendon grafts and semi-permanent sutures. Between January 2005 and December 2011, 32 consecutive patients with symptomatic type V complete AC joint dislocation underwent surgical treatment using the same technique. The median time from injury to surgery was 45 days (range 24-90). The average median postoperative clinical and radiographic follow-up time was 30 months (range 24-33). Clinical outcomes measures included the ASES score, the visual analog score (VAS), and subjective patient satisfaction score. Minimum follow-up was 2 years. ASES score increased from a median of 38.2 ± 6.2 preoperative to 92.1 ± 4.7 postoperatively (p ≤ 0.05). The median VAS score improved from 62 mm (range 45-100 mm) preoperatively to 8 mm (range 0-20 mm) at final follow-up (p ≤ 0.05). No patient experienced pain or discomfort with either direct palpation of the AC joint or with cross-body adduction. Final radiographs demonstrated symmetric AC joint contour in 25/32 (78%) patients. Seven patients (22%) radiographically demonstrated superior translation of the distal clavicle relative to the superior margin of the acromion but less than 50% of the clavicular width. 30/32 patients (93%) were able to return to their pre-injury level of work and sports activities. This novel surgical technique using a free graft and braided suture for simultaneous coracoclavicular ligament and AC joint capsular reconstruction successfully controls superior and posterior translations after type V AC joint dislocation and minimizes the incidence of persistent postoperative AC joint subluxation. Retrospective case series, Level IV.

Meniscotibial (coronary) ligament tears

International Nuclear Information System (INIS)

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

1984-01-01

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

Tissue engineering of ligaments: a comparison of bone marrow stromal cells, anterior cruciate ligament, and skin fibroblasts as cell source.

Science.gov (United States)

Van Eijk, F; Saris, D B F; Riesle, J; Willems, W J; Van Blitterswijk, C A; Verbout, A J; Dhert, W J A

2004-01-01

Anterior cruciate ligament (ACL) reconstruction surgery still has important problems to overcome, such as "donor site morbidity" and the limited choice of grafts in revision surgery. Tissue engineering of ligaments may provide a solution for these problems. Little is known about the optimal cell source for tissue engineering of ligaments. The aim of this study is to determine the optimal cell source for tissue engineering of the anterior cruciate ligament. Bone marrow stromal cells (BMSCs), ACL, and skin fibroblasts were seeded onto a resorbable suture material [poly(L-lactide/glycolide) multifilaments] at five different seeding densities, and cultured for up to 12 days. All cell types tested attached to the suture material, proliferated, and synthesized extracellular matrix rich in collagen type I. On day 12 the scaffolds seeded with BMSCs showed the highest DNA content (p engineered ligament.

Injury patterns of the acromioclavicular ligament complex in acute acromioclavicular joint dislocations: a cross-sectional, fundamental study.

Science.gov (United States)

Maier, Dirk; Jaeger, Martin; Reising, Kilian; Feucht, Matthias J; Südkamp, Norbert P; Izadpanah, Kaywan

2016-09-06

Horizontal instability impairs clinical outcome following acute acromioclavicular joint (ACJ) reconstruction and may be caused by insufficient healing of the superior acromioclavicular ligament complex (ACLC). However, characteristics of acute ACLC injuries are poorly understood so far. Purposes of this study were to identify different ACLC tear types, assess type-specific prevalence and determine influencing cofactors. This prospective, cross-sectional study comprised 65 patients with acute-traumatic Rockwood-5 (n = 57) and Rockwood-4 (n = 8) injuries treated operatively by means of mini-open ACJ reduction and hook plate stabilization. Mean age at surgery was 38.2 years (range, 19-57 years). Standardized pre- and intraoperative evaluation included assessment of ACLC tear patterns and cofactors related to the articular disc, the deltoid-trapezoidal (DT) fascia and bony ACJ morphology. Articular disc size was quantified as 0 = absent, 1 = remnant, 2 = meniscoid and 3 = complete. All patients showed complete ruptures of the superior ACLC, which could be assigned to four different tear patterns. Clavicular-sided (AC-1) tears were observed in 46/65 (70.8 %), oblique (AC-2) tears in 12/65 (18.5 %), midportion (AC-3) tears in 3/65 (4.6 %) and acromial-sided (AC-4) tears in 4/65 (6.1 %) of cases. Articular disc size manifestation was significantly (P < .001) more pronounced in patients with AC-1 tears (1.89 ± 0.57) compared to patients with AC-2 tears (0.67 ± 0.89). Other cofactors did not influence ACLC tear patterns. ACLC dislocation with incarceration caused mechanical impediment to anatomical ACJ reduction in 14/65 (21.5 %) of cases including all Rockwood-4 dislocations. Avulsion "in continuity" was a consistent mode of failure of the DT fascia. Type-specific operative strategies enabled anatomical ACLC repair of all observed tear types. Acute ACLC injuries follow distinct tear patterns. There exist clavicular-sided (AC-1

MiniDraw

DEFF Research Database (Denmark)

2018-01-01

MiniDraw is a teaching-oriented 2D graphics direct manipulation framework in Java, inspired by JHotDraw. It is used in the book "Flexible, Reliable Software - using Patterns and Agile Development", by Henrik Bærbak Christensen, published by CRC Press 2010.......MiniDraw is a teaching-oriented 2D graphics direct manipulation framework in Java, inspired by JHotDraw. It is used in the book "Flexible, Reliable Software - using Patterns and Agile Development", by Henrik Bærbak Christensen, published by CRC Press 2010....

MRI assessment of mid-urethral ligament changes in female stress urinary incontinence

International Nuclear Information System (INIS)

Bai Mei; Liu Hongyi; Han Yue; Xu Guoping; Fang Ping; Zhao Yang; Li Jingjin

2012-01-01

Objective: To evaluate the MRI value in changes of mid-urethral ligament injury of female stress urinary incontinence (SUI). Methods: Comparison of MRI changes of mid-urethral ligament on 30 healthy female volunteers and 20 female SUI patients. Chi-square test was used to compare the form of SUI patient's mid-urethral support ligaments. Results: The female mid-urethral support ligaments were composed of 4 groups of ligaments, including the periurethral ligament and pubourethral ligaments (1 pair), and at both sides of the urethra's paraurethral ligaments (1 pair) and suburethral ligament lying dorsal urethra, connecting the urethra and pelvic arcus tendinous fasciae. In normal MRI, ligament was a thin strip and showed low signal on both T 1 WI and T 2 WI, T 2 WI sagittal and cross-section scan was the best combination to show the middle urethral support ligaments changes, with tension; 6 patients (20%) in the 30 patients normal control group could be seen tortuously and slack like around the urethra ligaments. Twenty SUI patients mid-urethral support ligaments were performance laxity or rupture,rates were 39% (47/120) and 42% (50/120) (χ 2 =43.191, P<0.05). On T 2 WI, the ligamentous laxity was floating,and loss tension, also could performance one side extension and thinner than the other side. The ligament rupture was performance of the signal interruption, ligament contracture and one end of ligament attachment points separation. Conclusion: MRI can objective effective evaluate the mid-urethral support ligaments' pathological changes in stress urinary incontinence patients. (authors)

Mini-grid Policy Tool-kit. Policy and business frameworks for successful mini-grid roll-outs

International Nuclear Information System (INIS)

Franz, Michael; Hayek, Niklas; Peterschmidt, Nico; Rohrer, Michael; Kondev, Bozhil; Adib, Rana; Cader, Catherina; Carter, Andrew; George, Peter; Gichungi, Henry; Hankins, Mark; Kappiah, Mahama; Mangwengwende, Simbarashe E.

2014-01-01

The Mini-grid Policy Tool-kit is for policy makers to navigate the mini-grid policy design process. It contains information on mini-grid operator models, the economics of mini-grids, and necessary policy and regulation that must be considered for successful implementation. The publication specifically focuses on Africa. Progress on extending the electricity grid in many countries has remained slow because of high costs of gird-extension and limited utility/state budgets for electrification. Mini-grids provide an affordable and cost-effective option to extend needed electricity services. Putting in place the right policy for min-grid deployment requires considerable effort but can yield significant improvement in electricity access rates as examples from Kenya, Senegal and Tanzania illustrate. The tool-kit is available in English, French and Portuguese

Characterization and role of the immune response during ligament healing

Science.gov (United States)

Chamberlain, Connie S.

Scar formation of ligaments after rupture remains a great challenge. Ligament healing involves a complex, coordinated series of events that form a neo-ligament, which is more disorganized and fibrotic in character than the native tissue. The repair process may extend from months to years, and the injured ligament never fully recovers its original mechanical properties. With little intrinsic healing potential, ruptures of the anterior cruciate ligament (ACL) are usually reconstructed. The "healed" tissues, however, do not regenerate native tissues or recapitulate their mechanical function. ACL grafts often lengthen (incidents range from 40-100%) and their strength can drop by ˜50% after remodeling. Reconstructed knees are often less stable and fail to restore normal joint kinematics. Our overall goal is to improve healing, making ligaments more regenerative. The first 2 studies characterized ligament healing in a spatial and temporal manner over 28 days. The experiments demonstrated creeping substitution and the potential role of the immune system to control the repair and/or regenerative process. From these studies, macrophages were identified as significant players during healing. Macrophages paralleled creeping substitution, were abundant within the healing ligament, and potentially played a destructive role via matrix phagocytosis. The role of macrophages during early ligament healing was then evaluated using liposome-encapsulated clodronate to inhibit phagocytosing macrophages. Clodronate attenuated the early infiltration of macrophages, resulting in delayed structural and functional healing. Macrophage re-infiltration into the wound resulted in continued ligament healing. These results suggested that early inhibition of phagocytosing macrophages is detrimental to ligament healing. The final experiment evaluated the effects of interleukin-4 on ligament healing. Interleukin-4 (IL-4) is reported to stimulate the Th2 lymphocyte/M2 macrophage pathway, reducing

Collateral Ligament Knee Injuries in Pediatric and Adolescent Athletes.

Science.gov (United States)

Kramer, Dennis E; Miller, Patricia E; Berrahou, Iman K; Yen, Yi-Meng; Heyworth, Benton E

2017-12-08

The majority of research on medial (MCL) and lateral (LCL) collateral ligament injuries has focused on adults and combined collateral/cruciate injuries. The purpose of this study was to determine characteristics associated with isolated collateral ligament injuries in adolescents, and assess timing for return to sports. Electronic medical records were queried to identify patients aged below 17 years who sustained a magnetic resonance imaging-confirmed isolated MCL or LCL injury over an 8-year period. Retrospective review then documented patient and injury characteristics and clinical course. General linear modeling was used to analyze risk factors for prolonged return to sports, continued pain or reinjury. Fifty-one knees (33 in males, 65%), mean age 13.8 years (range, 5 to 17), were identified, of which 40 (78%) had MCL injuries. Over half (29, 57%) of knees had an open distal femoral physis including all 5 bony avulsion injuries. Eleven (22%) had LCL injuries of which 3 (6%) had concurrent posterolateral corner injuries. Forty-two (82%) knees had injuries that occurred during sports. Eleven knees (28%) with MCL tears had a simultaneous patellar instability episode. Knee injuries that occurred during sports had 37% shorter recovery time (P=0.02). Eight knees (16%) experienced a reinjury and 12 (24%) were followed over an extended period of time for various knee issues. Football injuries were more likely to be grade 3 (P=0.03), and football and soccer accounted for all grade III injuries. The mean return to sports was 2.2 months, with grade III cases returning at 2.4 months, and 95% of cases within 4 months. Isolated collateral ligament injuries are rare in adolescent athletes. MCL injuries, one-quarter of which occurred in conjunction with patellar instability events, were 4 times more common than LCL injuries, one quarter of which have other posterolateral corner structures involved. Grade III injuries represent 20% to 25% of collateral ligament injuries and

Review of mini-clinical evaluation exercise (mini-CEX in a psychiatry clerkship

Directory of Open Access Journals (Sweden)

Meresh E

2018-04-01

Full Text Available Edwin Meresh,1 David Daniels,2 Aparna Sharma,1 Murali Rao,1 Kaushal Mehta,3 David Schilling1 1Department of Psychiatry and Behavioral Neurosciences, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA; 2Department of Psychiatry, Medstar Georgetown University Hospital, Washington, DC, USA; 3School of Public Health, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL USA Background: Direct observation of medical students with actual patients is important for the assessment of clinical skills including interviewing and counseling skills. This article describes medical students’ experience of mini-clinical evaluation exercise (mini-CEX during their clerkship in consultation psychiatry. Materials and methods: In our center during inpatient consultation psychiatry clerkship, all rotating students are expected to complete one mini-CEX assessment as part of their clinical training. We conducted retrospective analysis of mini-CEX ratings completed from 2013 to 2016. All evaluations took place at inpatient medical setting in patients admitted with medical conditions and psychiatric comorbidities. Results: A total of 113 evaluations were reviewed. The time examiner observed the interaction of a student with the patient was 14.24 minutes (mean, and the time spent in providing feedback to the student was 9.71 minutes. Complexity of problem was rated as low in 0.88% (n=1, moderate in 50.44% (n=57, and high in 48.67% (n=55. Highest ratings were for professionalism, similar to previous reports. Total score calculated by examiner showed no difference by the complexity of the patient; however, we observed a trend in higher counseling score for the high complexity group. Conclusion: Mini-CEX assessment during busy clerkship is feasible with good outcomes. Direct observation of medical trainees with actual patients is important for the assessment of performance-based clinical skills. Hospital psychiatry rotation

Psychometric properties of a sign language version of the Mini International Neuropsychiatric Interview (MINI)

OpenAIRE

Øhre, Beate; Saltnes, Hege; von Tetzchner, Stephen; Falkum, Erik

2014-01-01

Background There is a need for psychiatric assessment instruments that enable reliable diagnoses in persons with hearing loss who have sign language as their primary language. The objective of this study was to assess the validity of the Norwegian Sign Language (NSL) version of the Mini International Neuropsychiatric Interview (MINI). Methods The MINI was translated into NSL. Forty-one signing patients consecutively referred to two specialised psychiatric units were assessed with a diagnos...

Kinematic analysis of anterior cruciate ligament reconstruction in total knee arthroplasty

Science.gov (United States)

Liu, Hua-Wei; Ni, Ming; Zhang, Guo-Qiang; Li, Xiang; Chen, Hui; Zhang, Qiang; Chai, Wei; Zhou, Yong-Gang; Chen, Ji-Ying; Liu, Yu-Liang; Cheng, Cheng-Kung; Wang, Yan

2016-01-01

Background: This study aims to retain normal knee kinematics after knee replacement surgeries by reconstructing anterior cruciate ligament during total knee arthroplasty. Method: We use computational simulation tools to establish four dynamic knee models, including normal knee model, posterior cruciate ligament retaining knee model, posterior cruciate ligament substituting knee model, and anterior cruciate ligament reconstructing knee model. Our proposed method utilizes magnetic resonance images to reconstruct solid bones and attachments of ligaments, and assemble femoral and tibial components according representative literatures and operational specifications. Dynamic data of axial tibial rotation and femoral translation from full-extension to 135 were measured for analyzing the motion of knee models. Findings: The computational simulation results show that comparing with the posterior cruciate ligament retained knee model and the posterior cruciate ligament substituted knee model, reconstructing anterior cruciate ligament improves the posterior movement of the lateral condyle, medial condyle and tibial internal rotation through a full range of flexion. The maximum posterior translations of the lateral condyle, medial condyle and tibial internal rotation of the anterior cruciate ligament reconstructed knee are 15.3 mm, 4.6 mm and 20.6 at 135 of flexion. Interpretation: Reconstructing anterior cruciate ligament in total knee arthroplasty has been approved to be an more efficient way of maintaining normal knee kinematics comparing to posterior cruciate ligament retained and posterior cruciate ligament substituted total knee arthroplasty. PMID:27347334

iPad mini for dummies

CERN Document Server

Baig, Edward C

2014-01-01

Find out why the iPad mini has never been bigger This new edition of iPad mini For Dummies covers all the latest tips and tricks for getting an even bigger bang out of your iPad mini. Presented in full-color and written in the straightforward but fun language that has defined the For Dummies brand for more than twenty years, this friendly guide walks you through the multitouch interface, going online, getting connected, packing your iPad mini with apps, games, e-books, photos, music, and movies, synchronizing your data, texting with iMessage, working with Siri, importing pictures and launching

Validação da versão em português do Mini-Inventário de Fobia Social (Mini-SPIN Validation of the portuguese version of the Mini-Social Phobia Inventory (Mini-SPIN

Directory of Open Access Journals (Sweden)

Gustavo José Fonseca D'El Rey

2009-12-01

Full Text Available A fobia social (também conhecida como transtorno de ansiedade social é um grave transtorno mental que traz sofrimento e incapacitação. O objetivo deste estudo foi validar para a língua portuguesa o Mini-Inventário de Fobia Social (Mini-SPIN em uma amostra da população. Foi realizado um estudo da validade discriminativa do Mini-SPIN em uma amostra de 644 pessoas (grupo positivo para o Mini-SPIN: n = 218 e grupo controle/negativo: n = 426 de um estudo de prevalência de transtornos de ansiedade na cidade de Santo André (SP. A versão em português do Mini-SPIN (com escore de 6 pontos, sugerido na versão original em inglês demonstrou uma sensibilidade de 95,0%, especificidade de 80,3%, valor preditivo positivo de 52,8%, valor preditivo negativo de 98,6% e taxa de classificação incorreta de 16,9%. Com escores de 7 pontos, foi observado um aumento na especificidade e no valor preditivo positivo (88,6% e 62,7%, sendo que a sensibilidade e o valor preditivo negativo (84,8% e 96,2% mantiveram-se altos. A versão em português do Mini-SPIN apresentou qualidades psicométricas satisfatórias em termos de validade discriminativa. Neste estudo, o ponto de corte igual a 7 mostrou-se mais adequado para a identificação da fobia social generalizada.Social phobia (also known as social anxiety disorder is a severe mental disorder that brings distress and disability. The aim of this study was validate to the Portuguese language the Mini-Social Phobia Inventory (Mini-SPIN in a populational sample. We performed a discriminative validity study of the Mini-SPIN in a sample of 644 subjects (Mini-SPIN positive group: n = 218 and control/negative group: n = 426 of a study of anxiety disorders' prevalence in the city of Santo André-SP. The Portuguese version of the Mini-SPIN (with score of 6 points, suggested in the original English version demonstrated a sensitivity of 95.0%, specificity of 80.3%, positive predictive value of 52.8%, negative predictive

Anterolateral ligament abnormalities in patients with acute anterior cruciate ligament rupture are associated with lateral meniscal and osseous injuries

Energy Technology Data Exchange (ETDEWEB)

Dyck, Pieter van; Smet, Eline de; Gielen, Jan L.; Parizel, Paul M. [Antwerp University Hospital and University of Antwerp, Department of Radiology, Antwerp (Belgium); Clockaerts, Stefan [University College Hospitals, Department of Orthopaedics, London (United Kingdom); Vanhoenacker, Filip M. [Antwerp University Hospital and University of Antwerp, Department of Radiology, Antwerp (Belgium); Ghent University Hospital and University of Ghent, Department of Radiology, Ghent (Belgium); AZ St-Maarten, Department of Radiology, Antwerp (Belgium); Lambrecht, Valerie [Ghent University Hospital and University of Ghent, Department of Radiology, Ghent (Belgium); Wouters, Kristien [Antwerp University Hospital and University of Antwerp, Department of Biostatistics, Antwerp (Belgium)

2016-10-15

To determine the frequency of anterolateral ligament (ALL) injury in patients with acute anterior cruciate ligament (ACL) rupture and to analyse its associated injury patterns. Ninety patients with acute ACL rupture for which MRI was obtained within 8 weeks after the initial trauma were retrospectively identified. Two radiologists assessed the status of the ALL on MRI by consensus. The presence or absence of an ALL abnormality was compared with the existence of medial and lateral meniscal tears diagnosed during arthroscopy. Associated collateral ligament and osseous injuries were documented with MRI. Forty-one of 90 knees (46 %) demonstrated ALL abnormalities on MRI. Of 49 knees with intact ALL, 15 (31 %) had a torn lateral meniscus as compared to 25 torn lateral menisci in 41 knees (61 %) with abnormal ALL (p = 0.008). Collateral ligament (p ≤ 0.05) and osseous injuries (p = 0.0037) were more frequent and severe in ALL-injured as compared with ALL-intact knees. ALL injuries are fairly common in patients with acute ACL rupture and are statistically significantly associated with lateral meniscal, collateral ligament and osseous injuries. (orig.)

Thermographic and microscopic evaluation of LARS knee ligament tearing.

Science.gov (United States)

Pătraşcu, Jenel Marian; Amarandei, Mihaela; Kun, Karla Noemy; Borugă, Ovidiu; Totorean, Alina; Andor, Bogdan; Florescu, Sorin

2014-01-01

Damage to knee articular ligaments causes important functional problems and adversely affects particularly the stability of the knee joint. Several methods were developed in order to repair damage to the anterior cruciate ligament (ACL), which employ autografts, allografts, as well as synthetic ligaments. One such synthetic scaffold, the ligament advanced reinforcement system (LARS) synthetic ligament is made of non-absorbing polyethylene terephthalate fibers whose structure allow tissue ingrowths in the intra-articular part, improving the stability of the joint. The LARS ligament is nowadays widely used in modern knee surgery in the Europe, Canada, China or Japan. This paper evaluates LARS ligament from two perspectives. The first regards a study done by the Orthopedics Clinic II, Timisoara, Romania, which compared results obtained by employing two techniques of ACL repair - the Bone-Tendon-Bone (BTB) or LARS arthroscopic, intra-articular techniques. This study found that patients treated with the BTB technique presented with an IKDC score of 45.82±1.14 units preoperative, with increasing values in the first nine months after each implant post-surgical ligament restoration, reaching an average value of 75.92 ± 2.88 units postoperative. Patients treated with the LARS technique presented with an IKDC score of 43.64 ± 1.11 units preoperative, and a score of 77.32 ± 2.71 units postoperative. The second perspective describes the thermographic and microscopic analysis of an artificial knee ligament tearing or loosening. The objective of the study was to obtain information regarding the design of artificial ligaments in order to expand their lifespan and avoid complications such as recurring synovitis, osteoarthritis and trauma of the knee joint. Thermographic data has shown that tearing begins from the inside out, thus improving the inner design of the ligament would probably enhance its durability. An optical microscope was employed to obtain images of structural

[Studies on the mechanical properties of the knee ligament].

Science.gov (United States)

Kubotera, D

1987-04-01

To study mechanical properties of the knee ligaments, tension tests at various speeds were performed on the knee of a dog with only the collateral ligament. The results showed that the tensile force was greater in high speed than in low speed test. The difference may be caused in a viscous property of the ligament. The mechanical properties of ligaments can therefore be treated as those of viscoelastic materials and expressed by a modified Voigt model consisting of a non-linear spring element and a dash pot component. Observations regarding the ultrastructure of human knee ligaments using an electron scanning microscope revealed wavy bundles of collagen fiber connected with coarse fibers like network running in parallel with the long axis as the main structure. The above structure and properties were considered to be the decisive factors in the mechanical actions of the knee ligament.

Strain Distribution in the Anterior Inferior Tibiofibular Ligament, Posterior Inferior Tibiofibular Ligament, and Interosseous Membrane Using Digital Image Correlation.

Science.gov (United States)

Xu, Daorong; Wang, Yibei; Jiang, Chunyu; Fu, Maoqing; Li, Shiqi; Qian, Lei; Sun, Peidong; Ouyang, Jun

2018-05-01

Ligament repair and augmentation techniques can stabilize syndesmosis injuries. However, little is known about the mechanical behavior of syndesmotic ligaments. The aim of this study was to analyze full-field strain, strain trend under foot rotation, and subregional strain differences of the anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), and interosseous membrane (IOM). Eleven fresh-frozen lower limbs were dissected to expose the AITFL, PITFL, and IOM. The foot underwent rotation from 0° to 25° internal and 35° external, with 3 ankle positions (neutral, 15° dorsiflexion, and 25° plantarflexion) and a vertical load of 430 N. Ligament strain was recorded using digital image correlation. The mean strain on the AITFL with 35° external rotation was greater in the proximal portion compared with distal portion in the neutral position ( P = .009) and dorsiflexion ( P = .003). The mean strain in the tibial insertion and midsubstance near tibial insertion were greater when compared with other regions ( P = .018 and P = .009). The subregions of mean strain in the PITFL and IOM groups were not significantly different. The strain trend of AITFL, PITFL, and IOM showed common transformation, just when the foot was externally rotated. The findings of this study show that a significantly high strain was observed on the proximal part and the midsubstance near the Chaput tubercle of the AITFL when the ankle was externally rotated. All 3 ligaments resisted the torque in the syndesmosis by external rotation of the foot. This study allows for better understanding of the mechanical behavior of the syndesmosis ligaments, which could influence the repair technique and AITFL augmentation techniques.

Spurious RF signals emitted by mini-UAVs

NARCIS (Netherlands)

Schleijpen, R.; Voogt, V.; Zwamborn, P.; Oever, J. van den

2016-01-01

This paper presents experimental work on the detection of spurious RF emissions of mini Unmanned Aerial Vehicles (mini-UAV). Many recent events have shown that mini-UAVs can be considered as a potential threat for civil security. For this reason the detection of mini-UAVs has become of interest to

MRI of the lateral ankle ligaments: value of three-dimensional orientation

International Nuclear Information System (INIS)

Mayerhoefer, M.E.; Breitenseher, M.J.

2003-01-01

Purpose: To determine the three-dimensional orientation of the lateral ankle ligaments with MRI. Materials and Methods: Twenty healthy volunteers without previous injury to the ankle were included in the study. With the right ankle in the normal anatomic position stabilized in a splint, coronal T2-weighted spin-echo sequences (TSE) were obtained. The three-dimensional orientation was determined by placing paths through the ligaments and by measuring the angles between corresponding tangents and the three main imaging planes. Results: Using the calculated angles, full-length visualization of the lateral ligaments of the ankle was achieved. The angles deviating from the axial imaging plane were 18.0 degrees for the anterior talofibular ligament, 52.3 degrees for the calcaneofibular ligament and 28.2 degrees for the posterior talofibular ligament. Conclusion: MRI enables the exact determination of the three-dimensional orientation of the lateral ankle ligaments. Orienting the imaging planes according to the calculated angular deviation allows the full-length visualization of the ligaments and is the basis for optimal imaging of the lateral ankle ligaments. (orig.) [de

Comparison of conventional MRI and MR arthrography in the evaluation of wrist ligament tears: A preliminary experience

Science.gov (United States)

Pahwa, Shivani; Srivastava, Deep N; Sharma, Raju; Gamanagatti, Shivanand; Kotwal, Prakash P; Sharma, Vijay

2014-01-01

Aims: To compare conventional magnetic resonance imaging (MRI) and direct magnetic resonance (MR) arthrography in the evaluation of triangular fibrocartilage complex (TFCC) and intrinsic wrist ligament tears. Materials and Methods: T1-weighted, fat suppressed (FS) proton density plus T2-weighted (FS PD/T2), 3D multiple-echo data image combination (MEDIC) sequences and direct MR arthrography were performed in 53 patients with wrist pain. Images were evaluated for the presence and location of TFCC, scapholunate ligament (SLL) and lunatotriquetral ligament (LTL) tears, and imaging findings were compared with operative findings in 16 patients who underwent arthroscopy or open surgery (gold standard). Results: Sixteen patients underwent arthroscopy/open surgery: 12 TFCC tears were detected arthroscopically out of which 9 were detected on FS PD/T2 sequence, 10 on MEDIC sequence, and all 12 were detected on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in the detection of TFCC tears were 75%, 83.3%, and 100%, respectively. Out of the eight arthroscopically confirmed SLL tears, three tears were detected on FS PD/T2 sequence, five on MEDIC sequence, and all eight were visualized on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in detecting SLL tears were 37.5%, 62.5%, and 100%, respectively. One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography. The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively. Conclusions: MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears. PMID:25114389

Comparison of conventional MRI and MR arthrography in the evaluation of wrist ligament tears: A preliminary experience

Directory of Open Access Journals (Sweden)

Shivani Pahwa

2014-01-01

Full Text Available Aims: To compare conventional magnetic resonance imaging (MRI and direct magnetic resonance (MR arthrography in the evaluation of triangular fibrocartilage complex (TFCC and intrinsic wrist ligament tears. Materials and Methods: T1-weighted, fat suppressed (FS proton density plus T2-weighted (FS PD/T2, 3D multiple-echo data image combination (MEDIC sequences and direct MR arthrography were performed in 53 patients with wrist pain. Images were evaluated for the presence and location of TFCC, scapholunate ligament (SLL and lunatotriquetral ligament (LTL tears, and imaging findings were compared with operative findings in 16 patients who underwent arthroscopy or open surgery (gold standard. Results: Sixteen patients underwent arthroscopy/open surgery: 12 TFCC tears were detected arthroscopically out of which 9 were detected on FS PD/T2 sequence, 10 on MEDIC sequence, and all 12 were detected on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in the detection of TFCC tears were 75%, 83.3%, and 100%, respectively. Out of the eight arthroscopically confirmed SLL tears, three tears were detected on FS PD/T2 sequence, five on MEDIC sequence, and all eight were visualized on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in detecting SLL tears were 37.5%, 62.5%, and 100%, respectively. One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography. The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively. Conclusions: MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears.

Injury of the ankle joint ligaments

International Nuclear Information System (INIS)

Breitenseher, M.J.

2007-01-01

The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination and clinical stress tests. If the clinical stress test is positive, stress radiography can be performed. There is, however, no consensus about the usefulness of stress radiography in acute ankle sprain, and in particular about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today, magnetic resonance imaging (MRI) is not used in this area, although it does allow controlled positioning of the foot and defined section visualization of injured lateral collateral ankle ligaments. In acute and chronic sinus tarsi injuries, MRI forms the established basis for diagnostic imaging, and can provide a definitive answer in most cases. MRI is also the method of choice for chronic posttraumatic pain with anterolateral impingement after rupture of the anterior talofibular ligament. Generally, for the evaluation of acute ankle injuries, MRI has developed to be the most important second-step procedure when projection radiology is non-diagnostic. (orig.) [de

Anterior corpectomy via the mini-open, extreme lateral, transpsoas approach combined with short-segment posterior fixation for single-level traumatic lumbar burst fractures: analysis of health-related quality of life outcomes and patient satisfaction.

Science.gov (United States)

Theologis, Alexander A; Tabaraee, Ehsan; Toogood, Paul; Kennedy, Abbey; Birk, Harjus; McClellan, R Trigg; Pekmezci, Murat

2016-01-01

The authors present clinical outcome data and satisfaction of patients who underwent minimally invasive vertebral body corpectomy and cage placement via a mini-open, extreme lateral, transpsoas approach and posterior short-segment instrumentation for lumbar burst fractures. Patients with unstable lumbar burst fractures who underwent corpectomy and anterior column reconstruction via a mini-open, extreme lateral, transpsoas approach with short-segment posterior fixation were reviewed retrospectively. Demographic information, operative parameters, perioperative radiographic measurements, and complications were analyzed. Patient-reported outcome instruments (Oswestry Disability Index [ODI], 12-Item Short Form Health Survey [SF-12]) and an anterior scar-specific patient satisfaction questionnaire were recorded at the latest follow-up. Twelve patients (7 men, 5 women, average age 42 years, range 22-68 years) met the inclusion criteria. Lumbar corpectomies with anterior column support were performed (L-1, n = 8; L-2, n = 2; L-3, n = 2) and supplemented with short-segment posterior instrumentation (4 open, 8 percutaneous). Four patients had preoperative neurological deficits, all of which improved after surgery. No new neurological complications were noted. The anterior incision on average was 6.4 cm (range 5-8 cm) in length, caused mild pain and disability, and was aesthetically acceptable to the large majority of patients. Three patients required chest tube placement for pleural violation, and 1 patient required reoperation for cage subsidence/hardware failure. Average clinical follow-up was 38 months (range 16-68 months), and average radiographic follow-up was 37 months (range 6-68 months). Preoperative lumbar lordosis and focal lordosis were significantly improved/maintained after surgery. Patients were satisfied with their outcomes, had minimal/moderate disability (average ODI score 20, range 0-52), and had good physical (SF-12 physical component score 41.7% ± 10

Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia.

Science.gov (United States)

Wang, Chaoliang; Huang, Sufang; Wang, Yingzhen; Sun, Xuesheng; Zhu, Tao; Li, Qiang; Lin, Chu

2015-01-01

We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated by reconstruction of the acromioclavicular and coracoclavicular ligament using trapezius muscle fascia. Open reduction and internal fixation was performed using the clavicular hook plate in 12 patients with acute complete acromioclavicular joint dislocation, and the acromioclavicular and coracoclavicular ligaments were reconstructed using trapezius muscle fascia. Radiographic evaluations were conducted postoperatively. We evaluated the functional results with constant scoring system and radiological results at the final follow-up visit. The mean Constant score at the final follow-up visit was 91.67 (range, 81 to 100). The results were excellent in eight patients (66.7%) and good in four patients (33.3%). Three patients with scores from 80 to 90 had mild pain during activity, but this did not affect the range of motion of the shoulder. All patients have returned to their preoperative work without any limitations. Compared with the contralateral side, radiography showed anatomical reposition in the vertical plane in all cases. The hook-plate fixation with ligament reconstruction was successful in treating AC dislocations. The acromioclavicular and coracoclavicular ligament were reconstructed by trapezius muscle fascia that keep the distal clavicle stable both vertically and horizontally after type III injuries.

Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia

Directory of Open Access Journals (Sweden)

Wang Chaoliang

2015-01-01

Full Text Available We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated by reconstruction of the acromioclavicular and coracoclavicular ligament using trapezius muscle fascia. Open reduction and internal fixation was performed using the clavicular hook plate in 12 patients with acute complete acromioclavicular joint dislocation, and the acromioclavicular and coracoclavicular ligaments were reconstructed using trapezius muscle fascia. Radiographic evaluations were conducted postoperatively. We evaluated the functional results with constant scoring system and radiological results at the final follow-up visit. The mean Constant score at the final follow-up visit was 91.67 (range, 81 to 100. The results were excellent in eight patients (66.7% and good in four patients (33.3%. Three patients with scores from 80 to 90 had mild pain during activity, but this did not affect the range of motion of the shoulder. All patients have returned to their preoperative work without any limitations. Compared with the contralateral side, radiography showed anatomical reposition in the vertical plane in all cases. The hook-plate fixation with ligament reconstruction was successful in treating AC dislocations. The acromioclavicular and coracoclavicular ligament were reconstructed by trapezius muscle fascia that keep the distal clavicle stable both vertically and horizontally after type III injuries.

Stiffness of the ligaments of the human wrist joint

NARCIS (Netherlands)

Savelberg, H.H.C.M.; Kooloos, J.G.M.; Huiskes, H.W.J.; Kauer, J.M.G.

1992-01-01

The stiffnesses of the superficial ligaments of 14 human cadaver wrist joints have been determined. In these experiments the tested, fresh-frozen carpal joints are divided into a number of bone-ligament-bone complexes, which are loaded in a tensile testing machine at a rate of 66% of the ligaments'

Comparative histology of mouse, rat, and human pelvic ligaments.

Science.gov (United States)

Iwanaga, Ritsuko; Orlicky, David J; Arnett, Jameson; Guess, Marsha K; Hurt, K Joseph; Connell, Kathleen A

2016-11-01

The uterosacral (USL) and cardinal ligaments (CL) provide support to the uterus and pelvic organs, and the round ligaments (RL) maintain their position in the pelvis. In women with pelvic organ prolapse (POP), the connective tissue, smooth muscle, vasculature, and innervation of the pelvic support structures are altered. Rodents are commonly used animal models for POP research. However, the pelvic ligaments have not been defined in these animals. In this study, we hypothesized that the gross anatomy and histological composition of pelvic ligaments in rodents and humans are similar. We performed an extensive literature search for anatomical and histological descriptions of the pelvic support ligaments in rodents. We also performed anatomical dissections of the pelvis to define anatomical landmarks in relation to the ligaments. In addition, we identified the histological components of the pelvic ligaments and performed quantitative analysis of the smooth muscle bundles and connective tissue of the USL and RL. The anatomy of the USL, CL, and RL and their anatomical landmarks are similar in mice, rats, and humans. All species contain the same cellular components and have similar histological architecture. However, the cervical portion of the mouse USL and RL contain more smooth muscle and less connective tissue compared with rat and human ligaments. The pelvic support structures of rats and mice are anatomically and histologically similar to those of humans. We propose that both mice and rats are appropriate, cost-effective models for directed studies in POP research.

A Quantitative Study of the Relationship between the Distribution of Different Types of Collagen and the Mechanical Behavior of Rabbit Medial Collateral Ligaments

Science.gov (United States)

Wan, Chao; Hao, Zhixiu; Wen, Shizhu; Leng, Huijie

2014-01-01

The mechanical properties of ligaments are key contributors to the stability and function of musculoskeletal joints. Ligaments are generally composed of ground substance, collagen (mainly type I and III collagen), and minimal elastin fibers. However, no consensus has been reached about whether the distribution of different types of collagen correlates with the mechanical behaviors of ligaments. The main objective of this study was to determine whether the collagen type distribution is correlated with the mechanical properties of ligaments. Using axial tensile tests and picrosirius red staining-polarization observations, the mechanical behaviors and the ratios of the various types of collagen were investigated for twenty-four rabbit medial collateral ligaments from twenty-four rabbits of different ages, respectively. One-way analysis of variance was used in the comparison of the Young's modulus in the linear region of the stress-strain curves and the ratios of type I and III collagen for the specimens (the mid-substance specimens of the ligaments) with different ages. A multiple linear regression was performed using the collagen contents (the ratios of type I and III collagen) and the Young's modulus of the specimens. During the maturation of the ligaments, the type I collagen content increased, and the type III collagen content decreased. A significant and strong correlation () was identified by multiple linear regression between the collagen contents (i.e., the ratios of type I and type III collagen) and the mechanical properties of the specimens. The collagen content of ligaments might provide a new perspective for evaluating the linear modulus of global stress-strain curves for ligaments and open a new door for studying the mechanical behaviors and functions of connective tissues. PMID:25062068

MR imaging of the combined anterior and posterior cruciate ligament tears: focussing on the ratterns of injuries and associated findings

International Nuclear Information System (INIS)

Kwon, Seon Young; Choi, Chang Lak; Park, Dal Soo; Park, Eun Hee; Lee, Sang Ho; Song, Mun Kab; Lee, Kwang Won; Kwon, Soon Tae

1997-01-01

To evaluate the patterns of injuries and frequency of associated findings on MR imaging in patients with both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)tears;to compare the associated findings, as seen on MR imaging, in cases with both ACL and PCL tears with those with ACL or PCL tears. Ten patients with compbined ACL and PCL tears, 16 with ACL tears and 18 with PCL tears, all confirmed by arthroscopy or open surgery, were involved in this study. To identify the associated knee injuries, MR images were retrospectively evaluated. In ten patients with combined ACL and PCL tears, open surgery led to the identification of six complete ACL tears (60%), four partial ACL tears (40%), eitht complete PCL tears (80%) and two partial PCL tears (20%). Injuries associated with these combined tears, and revealed by MR imaging, comprised six medial collateral ligament injuries (60%), six lateral collateral ligament jnjuries (60%), five medial meniscal injuries (50%), three lateral meniscal injuries (30%), nine bony injuries (90%), two posterior capsular injuries (20%), and three popliteus muscle injuries (30%). The frequency of popliteus muscle injury was significantly different (p<0.05, Fisher's exact test) between the group with both ACL and PCL tears and that with ACL or PCL tears. Associated findings in patients with combined ACL and PCL tears are more frequent than in those with ACL or PCL tears. In cases involving combined ACL and PCL tears, associated findings-as seen on MR images-should thus be carefully examined

The sacroiliac part of the iliolumbar ligament

NARCIS (Netherlands)

A.L. Pool-Goudzwaard (Annelies); G.J. Kleinrensink (Gert Jan); C.J. Snijders (Chris); C.A. Entius; R. Stoeckart (Rob)

2001-01-01

textabstractThe iliolumbar ligament has been described as the most important ligament for restraining movement at the lumbosacral junction. In addition, it may play an important role in restraining movement in the sacroiliac joints. To help understand its presumed restraining

Psychometric Evaluation of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID).

Science.gov (United States)

Duncan, Laura; Georgiades, Kathy; Wang, Li; Van Lieshout, Ryan J; MacMillan, Harriet L; Ferro, Mark A; Lipman, Ellen L; Szatmari, Peter; Bennett, Kathryn; Kata, Anna; Janus, Magdalena; Boyle, Michael H

2017-12-04

The goals of the study were to examine test-retest reliability, informant agreement and convergent and discriminant validity of nine DSM-IV-TR psychiatric disorders classified by parent and youth versions of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Using samples drawn from the general population and child mental health outpatient clinics, 283 youth aged 9 to 18 years and their parents separately completed the MINI-KID with trained lay interviewers on two occasions 7 to 14 days apart. Test-retest reliability estimates based on kappa (κ) went from 0.33 to 0.79 across disorders, samples and informants. Parent-youth agreement on disorders was low (average κ = 0.20). Confirmatory factor analysis provided evidence supporting convergent and discriminant validity. The MINI-KID disorder classifications yielded estimates of test-retest reliability and validity comparable to other standardized diagnostic interviews in both general population and clinic samples. These findings, in addition to the brevity and low administration cost, make the MINI-KID a good candidate for use in epidemiological research and clinical practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Magnetic resonance imaging of ankle ligaments and tendon injuries

International Nuclear Information System (INIS)

Breitenseher, M.; Trattnig, S.; Kukla, C.; Daebler, C.; Helbich, T.; Haller, J.; Imhof, H.

1995-01-01

Today MRI allows evaluation of the integrity of injured ankle ligaments. The major difficulty in MRI is inconsistency in visualization by inadequate appreciation of the three-dimensional orientation of each ankle ligament. Using this technique, 52 patients with sprained ankles underwent MRI. The integrity of rupture of the collateral lateral ligaments was obtained in all 52 ankles. Full-lenght visualization is essential for evaluation of the ankle ligaments with MRI. In these 52 patients the angle of tilt on the stress X-ray was compared with the rate of MRI findings showing an injury affecting two ligaments. We found that none of the patients in whom the angle of lateral tilt was less than 5 had rupture of two laterial ligaments, while 32% of patients with angles of tilt of 6-14 and 42% of those with angles of tilt over 15 on stress X-ray had two ruptured lateral ligaments. The advantages of MRI are that it offers the best visualization of the extent of the tendon lesion. MRI, however, seems to be superior to US in detecting and quantifying lesions of the Achilles tendon. Therefore, MRI may be indicated in particularly difficult cases of tendons injuries in the foot. (orig.) [de

Voluntary enhanced cocontraction of hamstring muscles during open kinetic chain leg extension exercise: its potential unloading effect on the anterior cruciate ligament.

Science.gov (United States)

Biscarini, Andrea; Benvenuti, Paolo; Botti, Fabio M; Brunetti, Antonella; Brunetti, Orazio; Pettorossi, Vito E

2014-09-01

A number of research studies provide evidence that hamstring cocontraction during open kinetic chain knee extension exercises enhances tibiofemoral (TF) stability and reduces the strain on the anterior cruciate ligament. To determine the possible increase in hamstring muscle coactivation caused by a voluntary cocontraction effort during open kinetic chain leg-extension exercises, and to assess whether an intentional hamstring cocontraction can completely suppress the anterior TF shear force during these exercises. Descriptive laboratory study. Knee kinematics as well as electromyographic activity in the semitendinosus (ST), semimembranosus (SM), biceps femoris (BF), and quadriceps femoris muscles were measured in 20 healthy men during isotonic leg extension exercises with resistance (R) ranging from 10% to 80% of the 1-repetition maximum (1RM). The same exercises were also performed while the participants attempted to enhance hamstring coactivation through a voluntary cocontraction effort. The data served as input parameters for a model to calculate the shear and compressive TF forces in leg extension exercises for any set of coactivation patterns of the different hamstring muscles. For R≤ 40% 1RM, the peak coactivation levels obtained with intentional cocontraction (l) were significantly higher (P hamstring muscle, maximum level l was reached at R = 30% 1RM, corresponding to 9.2%, 10.5%, and 24.5% maximum voluntary isometric contraction (MVIC) for the BF, ST, and SM, respectively, whereas the ratio l/l 0 reached its maximum at R = 20% 1RM and was approximately 2, 3, and 4 for the BF, SM, and ST, respectively. The voluntary enhanced coactivation level l obtained for R≤ 30% 1RM completely suppressed the anterior TF shear force developed by the quadriceps during the exercise. In leg extension exercises with resistance R≤ 40% 1RM, coactivation of the BF, SM, and ST can be significantly enhanced (up to 2, 3, and 4 times, respectively) by a voluntary hamstring

Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

DEFF Research Database (Denmark)

Roemer, Frank W; Frobell, Richard; Lohmander, Stefan

2014-01-01

OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN...

[Conservative treatment using plasma rich in growth factors (PRGF) for injury to the ligamentous complex of the ankle].

Science.gov (United States)

Frei, R; Biosca, F E; Handl, M; Trc, T

2008-02-01

The authors describe the therapeutic utilization of separated/isolated autologous growth factors in semiconservative treatment of type III injury to the ankle ligamentous complex. Between October 2004 and March 2005 a group of 11 patients, two women and nine men, aged 18 to 41 (average, 25.09) years with acute injury to the lateral ligamentous complex of the ankle were treated by plasma rich in growth factors (PRGF) infiltration. On functional radiographic examination, the post-traumatic lateral opening of the tibiotalar intraarticular space was 17.45 degrees (range, 12.0-30.0; s = 5.68). The injured patients were clinically examined and standard forced inversion radiographs were made using topical anesthesia. Autologous PRGF activated with calcium chloride was used to infiltrate the injured tissues. The treatment was followed by immobilization of the joint and its subsequent rehabilitation. Clinical examination of injured tissues was carried out at 4 and 6 weeks of follow-up, using stability assessment tests and functional radiography of the ankle. Physical therapy included standard procedures, but faster regeneration of the soft tissues allowed for more exercises. The average time of healing was 5.18 weeks. Five patients showed no signs of instability at 4 weeks after therapy and could return to their previous sports activities. One patient had lateral ankle instability at 5 weeks and therefore the therapy continued with prolonged immobilization and then rehabilitation at a slower pace. The average lateral opening of the tibiotalar intra-articular space at 4 or 6 follow-up weeks was 4.73 degrees (range, 3.0 - 7.0; s = 1.19). At 6 weeks after therapy, 90.9% of the patients resumed their full sports activities. Ankle distortion with swelling, hematoma and pain, but with no radiographic findings of ligament lesions, is usually treated conservatively by ankle immobilization and early rehabilitation. When an injury to the fibular ankle ligaments occurs (i.e., opening

Arthroscopic repair of lateral ankle ligament complex by suture anchor.

Science.gov (United States)

Wang, Jingwei; Hua, Yinghui; Chen, Shiyi; Li, Hongyun; Zhang, Jian; Li, Yunxia

2014-06-01

Arthroscopic repair of the lateral ligament complex with suture anchors is increasingly used to treat chronic ankle instability (CAI). Our aims are (1) to analyze and evaluate the literature on arthroscopic suture anchor repair of the anterior talofibular ligament and (2) to conduct a systematic review of the clinical evidence on the reported outcomes and complications of treating CAI with this technique. We performed a systematic review of the literature using PubMed, Ovid, Elsevier ScienceDirect, Web of Science-Conference Proceedings Citation Index, and the Cochrane Database of Systematic Reviews from 1987 to September 2013. Clinical studies using the arthroscopic suture anchor technique to treat CAI were included. Outcome measures consisted of clinical assessment of postoperative ligament stability and complications. In addition, the methodologic quality of the included studies was assessed by use of the modified Coleman Methodology Score. After reviewing 371 studies, we identified 6 studies (5 retrospective case series and 1 prospective case series, all Level IV) that met the inclusion criteria, with a mean Coleman Methodology Score of 71.8 ± 7.52 (range, 63 to 82). In these studies 178 patients (179 ankles) underwent arthroscopic suture anchor repair of the anterior talofibular ligament with a mean follow-up period of 38.9 months (range, 6 to 117.6 months). All patients were reported to have subjective improvement of their ankle instability, with complications in 31 cases. Studies of arthroscopic suture anchor technique to treat CAI are sparse, with moderate mean methodologic quality. The included studies suggest that the arthroscopic technique is a feasible procedure to restore ankle stability; however, on the basis of our review, this technique seems to be associated with a relatively high complication rate. Extensive cadaveric studies, clinical trials, and comparative studies comparing arthroscopic and open repair should be performed in the future. Level

Anterior cruciate ligament-derived cells have high chondrogenic potential.

Science.gov (United States)

Furumatsu, Takayuki; Hachioji, Motomi; Saiga, Kenta; Takata, Naoki; Yokoyama, Yusuke; Ozaki, Toshifumi

2010-01-01

Anterior cruciate ligament (ACL)-derived cells have a character different from medial collateral ligament (MCL)-derived cells. However, the critical difference between ACL and MCL is still unclear in their healing potential and cellular response. The objective of this study was to investigate the mesenchymal differentiation property of each ligament-derived cell. Both ligament-derived cells differentiated into adipogenic, osteogenic, and chondrogenic lineages. In chondrogenesis, ACL-derived cells had the higher chondrogenic property than MCL-derived cells. The chondrogenic marker genes, Sox9 and alpha1(II) collagen (Col2a1), were induced faster in ACL-derived pellets than in MCL-derived pellets. Sox9 expression preceded the increase of Col2a1 in both pellet-cultured cells. However, the expression level of Sox9 and a ligament/tendon transcription factor Scleraxis did not parallel the increase of Col2a1 expression along with chondrogenic induction. The present study demonstrates that the balance between Sox9 and Scleraxis have an important role in the chondrogenic differentiation of ligament-derived cells. Copyright 2009 Elsevier Inc. All rights reserved.

Tissue engineering of ligaments for reconstructive surgery.

Science.gov (United States)

Hogan, MaCalus V; Kawakami, Yohei; Murawski, Christopher D; Fu, Freddie H

2015-05-01

The use of musculoskeletal bioengineering and regenerative medicine applications in orthopaedic surgery has continued to evolve. The aim of this systematic review was to address tissue-engineering strategies for knee ligament reconstruction. A systematic review of PubMed/Medline using the terms "knee AND ligament" AND "tissue engineering" OR "regenerative medicine" was performed. Two authors performed the search, independently assessed the studies for inclusion, and extracted the data for inclusion in the review. Both preclinical and clinical studies were reviewed, and the articles deemed most relevant were included in this article to provide relevant basic science and recent clinical translational knowledge concerning "tissue-engineering" strategies currently used in knee ligament reconstruction. A total of 224 articles were reviewed in our initial PubMed search. Non-English-language studies were excluded. Clinical and preclinical studies were identified, and those with a focus on knee ligament tissue-engineering strategies including stem cell-based therapies, growth factor administration, hybrid biomaterial, and scaffold development, as well as mechanical stimulation modalities, were reviewed. The body of knowledge surrounding tissue-engineering strategies for ligament reconstruction continues to expand. Presently, various tissue-engineering techniques have some potential advantages, including faster recovery, better ligamentization, and possibly, a reduction of recurrence. Preclinical research of these novel therapies continues to provide promising results. There remains a need for well-designed, high-powered comparative clinical studies to serve as a foundation for successful translation into the clinical setting going forward. Level IV, systematic review of Level IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

[Bone remodeling and modeling/mini-modeling.

Science.gov (United States)

Hasegawa, Tomoka; Amizuka, Norio

Modeling, adapting structures to loading by changing bone size and shapes, often takes place in bone of the fetal and developmental stages, while bone remodeling-replacement of old bone into new bone-is predominant in the adult stage. Modeling can be divided into macro-modeling(macroscopic modeling)and mini-modeling(microscopic modeling). In the cellular process of mini-modeling, unlike bone remodeling, bone lining cells, i.e., resting flattened osteoblasts covering bone surfaces will become active form of osteoblasts, and then, deposit new bone onto the old bone without mediating osteoclastic bone resorption. Among the drugs for osteoporotic treatment, eldecalcitol(a vitamin D3 analog)and teriparatide(human PTH[1-34])could show mini-modeling based bone formation. Histologically, mature, active form of osteoblasts are localized on the new bone induced by mini-modeling, however, only a few cell layer of preosteoblasts are formed over the newly-formed bone, and accordingly, few osteoclasts are present in the region of mini-modeling. In this review, histological characteristics of bone remodeling and modeling including mini-modeling will be introduced.

The MiniBooNE Detector

OpenAIRE

MiniBooNE Collaboration

2008-01-01

The MiniBooNE neutrino detector was designed and built to look for muon-neutrino to electron-neutrino oscillations in the mixing parameter space region where the LSND experiment reported a signal. The MiniBooNE experiment used a beam energy and baseline that were an order of magnitude larger than those of LSND so that the backgrounds and systematic errors would be completely different. This paper provides a detailed description of the design, function, and performance of the MiniBooNE detector.

A DNA mini-barcode for land plants.

Science.gov (United States)

Little, Damon P

2014-05-01

Small portions of the barcode region - mini-barcodes - may be used in place of full-length barcodes to overcome DNA degradation for samples with poor DNA preservation. 591,491,286 rbcL mini-barcode primer combinations were electronically evaluated for PCR universality, and two novel highly universal sets of priming sites were identified. Novel and published rbcL mini-barcode primers were evaluated for PCR amplification [determined with a validated electronic simulation (n = 2765) and empirically (n = 188)], Sanger sequence quality [determined empirically (n = 188)], and taxonomic discrimination [determined empirically (n = 30,472)]. PCR amplification for all mini-barcodes, as estimated by validated electronic simulation, was successful for 90.2-99.8% of species. Overall Sanger sequence quality for mini-barcodes was very low - the best mini-barcode tested produced sequences of adequate quality (B20 ≥ 0.5) for 74.5% of samples. The majority of mini-barcodes provide correct identifications of families in excess of 70.1% of the time. Discriminatory power noticeably decreased at lower taxonomic levels. At the species level, the discriminatory power of the best mini-barcode was less than 38.2%. For samples believed to contain DNA from only one species, an investigator should attempt to sequence, in decreasing order of utility and probability of success, mini-barcodes F (rbcL1/rbcLB), D (F52/R193) and K (F517/R604). For samples believed to contain DNA from more than one species, an investigator should amplify and sequence mini-barcode D (F52/R193). © 2013 John Wiley & Sons Ltd.

Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique

Directory of Open Access Journals (Sweden)

Gobezie Reuben

2009-01-01

Full Text Available Abstract Background Symptomatic Acromioclavicular (AC dislocations have historically been surgically treated with Coracoclavicular (CC ligament reconstruction with transfer of the Coracoacromial (CA ligament. Tensioning the CA ligament is the key to success. Methods Seventeen patients with chronic, symptomatic Type III AC joint or acute Type IV and V injuries were treated surgically. The distal clavicle was resected and stabilized with CC ligament reconstruction using the CA ligament. The CA ligament was passed into the medullary canal and tensioned, using a modified 'docking' technique. Average follow-up was 29 months (range 12–57. Results Postoperative ASES and pain significantly improved in all patients (p = 0.001. Radiographically, 16 (94% maintained reduction, and only 1 (6% had a recurrent dislocation when he returned to karate 3 months postoperatively. His ultimate clinical outcome was excellent. Conclusion The docking procedure allows for tensioning of the transferred CA ligament and healing of the ligament in an intramedullary bone tunnel. Excellent clinical results were achieved, decreasing the risk of recurrent distal clavicle instability.

[Application of silk-based tissue engineering scaffold for tendon / ligament regeneration].

Science.gov (United States)

Hu, Yejun; Le, Huihui; Jin, Zhangchu; Chen, Xiao; Yin, Zi; Shen, Weiliang; Ouyang, Hongwei

2016-03-01

Tendon/ligament injury is one of the most common impairments in sports medicine. The traditional treatments of damaged tissue repair are unsatisfactory, especially for athletes, due to lack of donor and immune rejection. The strategy of tissue engineering may break through these limitations, and bring new hopes to tendon/ligament repair, even regeneration. Silk is a kind of natural biomaterials, which has good biocompatibility, wide range of mechanical properties and tunable physical structures; so it could be applied as tendon/ligament tissue engineering scaffolds. The silk-based scaffold has robust mechanical properties; combined with other biological ingredients, it could increase the surface area, promote more cell adhesion and improve the biocompatibility. The potential clinical application of silk-based scaffold has been confirmed by in vivo studies on tendon/ligament repairing, such as anterior cruciate ligament, medial collateral ligament, achilles tendon and rotator cuff. To develop novel biomechanically stable and host integrated tissue engineered tendon/ligament needs more further micro and macro studies, combined with product development and clinical application, which will give new hope to patients with tendon/ligament injury.

Correlation between bone contusion and ligament, menisci injury of knee joint

International Nuclear Information System (INIS)

Zhang Lijuan; Li Pei; Tu Changzhuo; Wu Guangren; Qi Yuliang; Yan Xiaoqun

2004-01-01

Objective: To evaluate the correlation between bone contusion and ligament, meniscus injury of knee joint with MR imaging. Methods: Thirty-five patients with acute trauma of knee joint were studied retrospectively. All eases showed negative on X-ray and bone cont, -sion on MR imaging. Results: in all patients, ligament and meniscus injury were seen in 25 cases (71%), incorporate anterior cruciate ligament injury in 12 cases, posterior cruciate ligament in 6, tibial collateral ligament in 8 cases, fibular collateral ligament in 6 cases, medial meniscus tear in 4 cases, lateral meniscus tear in 5 cases, and hydrops in 29 cases. There were only 3 patients with ligament or meniscus injury but no bone contusion during the same period. Conclusion: It is necessary to check by MR for the patients with acute trauma of knee joint, who have clinical symptom such as ache, swelling, move un-freely showing bone contusion on MR Imaging but without any abnormality on X-ray in order to avoid failure in diagnosing injury of ligament and meniscus. (authors)

A real-time computational model for estimating kinematics of ankle ligaments.

Science.gov (United States)

Zhang, Mingming; Davies, T Claire; Zhang, Yanxin; Xie, Sheng Quan

2016-01-01

An accurate assessment of ankle ligament kinematics is crucial in understanding the injury mechanisms and can help to improve the treatment of an injured ankle, especially when used in conjunction with robot-assisted therapy. A number of computational models have been developed and validated for assessing the kinematics of ankle ligaments. However, few of them can do real-time assessment to allow for an input into robotic rehabilitation programs. An ankle computational model was proposed and validated to quantify the kinematics of ankle ligaments as the foot moves in real-time. This model consists of three bone segments with three rotational degrees of freedom (DOFs) and 12 ankle ligaments. This model uses inputs for three position variables that can be measured from sensors in many ankle robotic devices that detect postures within the foot-ankle environment and outputs the kinematics of ankle ligaments. Validation of this model in terms of ligament length and strain was conducted by comparing it with published data on cadaver anatomy and magnetic resonance imaging. The model based on ligament lengths and strains is in concurrence with those from the published studies but is sensitive to ligament attachment positions. This ankle computational model has the potential to be used in robot-assisted therapy for real-time assessment of ligament kinematics. The results provide information regarding the quantification of kinematics associated with ankle ligaments related to the disability level and can be used for optimizing the robotic training trajectory.

A quantitative study of the relationship between the distribution of different types of collagen and the mechanical behavior of rabbit medial collateral ligaments.

Science.gov (United States)

Wan, Chao; Hao, Zhixiu; Wen, Shizhu; Leng, Huijie

2014-01-01

The mechanical properties of ligaments are key contributors to the stability and function of musculoskeletal joints. Ligaments are generally composed of ground substance, collagen (mainly type I and III collagen), and minimal elastin fibers. However, no consensus has been reached about whether the distribution of different types of collagen correlates with the mechanical behaviors of ligaments. The main objective of this study was to determine whether the collagen type distribution is correlated with the mechanical properties of ligaments. Using axial tensile tests and picrosirius red staining-polarization observations, the mechanical behaviors and the ratios of the various types of collagen were investigated for twenty-four rabbit medial collateral ligaments from twenty-four rabbits of different ages, respectively. One-way analysis of variance was used in the comparison of the Young's modulus in the linear region of the stress-strain curves and the ratios of type I and III collagen for the specimens (the mid-substance specimens of the ligaments) with different ages. A multiple linear regression was performed using the collagen contents (the ratios of type I and III collagen) and the Young's modulus of the specimens. During the maturation of the ligaments, the type I collagen content increased, and the type III collagen content decreased. A significant and strong correlation (R2 = 0.839, P < 0.05) was identified by multiple linear regression between the collagen contents (i.e., the ratios of type I and type III collagen) and the mechanical properties of the specimens. The collagen content of ligaments might provide a new perspective for evaluating the linear modulus of global stress-strain curves for ligaments and open a new door for studying the mechanical behaviors and functions of connective tissues.

A quantitative study of the relationship between the distribution of different types of collagen and the mechanical behavior of rabbit medial collateral ligaments.

Directory of Open Access Journals (Sweden)

Chao Wan

Full Text Available The mechanical properties of ligaments are key contributors to the stability and function of musculoskeletal joints. Ligaments are generally composed of ground substance, collagen (mainly type I and III collagen, and minimal elastin fibers. However, no consensus has been reached about whether the distribution of different types of collagen correlates with the mechanical behaviors of ligaments. The main objective of this study was to determine whether the collagen type distribution is correlated with the mechanical properties of ligaments. Using axial tensile tests and picrosirius red staining-polarization observations, the mechanical behaviors and the ratios of the various types of collagen were investigated for twenty-four rabbit medial collateral ligaments from twenty-four rabbits of different ages, respectively. One-way analysis of variance was used in the comparison of the Young's modulus in the linear region of the stress-strain curves and the ratios of type I and III collagen for the specimens (the mid-substance specimens of the ligaments with different ages. A multiple linear regression was performed using the collagen contents (the ratios of type I and III collagen and the Young's modulus of the specimens. During the maturation of the ligaments, the type I collagen content increased, and the type III collagen content decreased. A significant and strong correlation (R2 = 0.839, P < 0.05 was identified by multiple linear regression between the collagen contents (i.e., the ratios of type I and type III collagen and the mechanical properties of the specimens. The collagen content of ligaments might provide a new perspective for evaluating the linear modulus of global stress-strain curves for ligaments and open a new door for studying the mechanical behaviors and functions of connective tissues.

Biomechanical Measures During Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury After Anterior Cruciate Ligament Reconstruction and Return to Sport

Science.gov (United States)

Paterno, Mark V.; Schmitt, Laura C.; Ford, Kevin R.; Rauh, Mitchell J.; Myer, Gregory D.; Huang, Bin; Hewett, Timothy E.

2016-01-01

Background Athletes who return to sport participation after anterior cruciate ligament reconstruction (ACLR) have a higher risk of a second anterior cruciate ligament injury (either reinjury or contralateral injury) compared with non–anterior cruciate ligament–injured athletes. Hypotheses Prospective measures of neuromuscular control and postural stability after ACLR will predict relative increased risk for a second anterior cruciate ligament injury. Study Design Cohort study (prognosis); Level of evidence, 2. Methods Fifty-six athletes underwent a prospective biomechanical screening after ACLR using 3-dimensional motion analysis during a drop vertical jump maneuver and postural stability assessment before return to pivoting and cutting sports. After the initial test session, each subject was followed for 12 months for occurrence of a second anterior cruciate ligament injury. Lower extremity joint kinematics, kinetics, and postural stability were assessed and analyzed. Analysis of variance and logistic regression were used to identify predictors of a second anterior cruciate ligament injury. Results Thirteen athletes suffered a subsequent second anterior cruciate ligament injury. Transverse plane hip kinetics and frontal plane knee kinematics during landing, sagittal plane knee moments at landing, and deficits in postural stability predicted a second injury in this population (C statistic = 0.94) with excellent sensitivity (0.92) and specificity (0.88). Specific predictive parameters included an increase in total frontal plane (valgus) movement, greater asymmetry in internal knee extensor moment at initial contact, and a deficit in single-leg postural stability of the involved limb, as measured by the Biodex stability system. Hip rotation moment independently predicted second anterior cruciate ligament injury (C = 0.81) with high sensitivity (0.77) and specificity (0.81). Conclusion Altered neuromuscular control of the hip and knee during a dynamic landing task

Common Types and Countermeasures of Ankle Ligament Injury ...

African Journals Online (AJOL)

2017-09-14

Sep 14, 2017 ... Objective: To analyze ankle ligament injury of basketball players caused during movement, summarize ... players with ankle ligament injury during basketball movement and admitted to different .... Road Success 2010;8:70. 5.

The MiniBooNE detector

International Nuclear Information System (INIS)

Aguilar-Arevalo, A.A.; Anderson, C.E.; Bartoszek, L.M.; Bazarko, A.O.; Brice, S.J.; Brown, B.C.; Bugel, L.; Cao, J.; Coney, L.; Conrad, J.M.; Cox, D.C.; Curioni, A.; Djurcic, Z.; Finley, D.A.; Fleming, B.T.; Ford, R.; Garcia, F.G.; Garvey, G.T.; Green, C.; Green, J.A.

2009-01-01

The MiniBooNE neutrino detector was designed and built to look for ν μ →ν e oscillations in the (sin 2 2θ,Δm 2 ) parameter space region where the LSND experiment reported a signal. The MiniBooNE experiment used a beam energy and baseline that were an order of magnitude larger than those of LSND so that the backgrounds and systematic errors would be completely different. This paper provides a detailed description of the design, function, and performance of the MiniBooNE detector.

Are Ducted Mini-Splits Worth It?

Energy Technology Data Exchange (ETDEWEB)

Winkler, Jonathan M [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Maguire, Jeffrey B [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Metzger, Cheryn E. [Pacific Northwest National Laboratory; Zhang, Jason [Pacific Northwest National Laboratory

2018-02-01

Ducted mini-split heat pumps are gaining popularity in some regions of the country due to their energy-efficient specifications and their ability to be hidden from sight. Although product and install costs are typically higher than the ductless mini-split heat pumps, this technology is well worth the premium for some homeowners who do not like to see an indoor unit in their living area. Due to the interest in this technology by local utilities and homeowners, the Bonneville Power Administration (BPA) has funded the Pacific Northwest National Laboratory (PNNL) and the National Renewable Energy Laboratory (NREL) to develop capabilities within the Building Energy Optimization (BEopt) tool to model ducted mini-split heat pumps. After the fundamental capabilities were added, energy-use results could be compared to other technologies that were already in BEopt, such as zonal electric resistance heat, central air source heat pumps, and ductless mini-split heat pumps. Each of these technologies was then compared using five prototype configurations in three different BPA heating zones to determine how the ducted mini-split technology would perform under different scenarios. The result of this project was a set of EnergyPlus models representing the various prototype configurations in each climate zone. Overall, the ducted mini-split heat pumps saved about 33-60% compared to zonal electric resistance heat (with window AC systems modeled in the summer). The results also showed that the ducted mini-split systems used about 4% more energy than the ductless mini-split systems, which saved about 37-64% compared to electric zonal heat (depending on the prototype and climate).

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

Science.gov (United States)

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

2017-01-01

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

Design guidelines for mini-roundabouts

CSIR Research Space (South Africa)

Emslie, I

1997-03-01

Full Text Available Guidelines for Traffic Calming. Concepts and principles relating to the use of mini-roundabouts as a form of intersection control and in the traffic calming context are discussed. Warrants for the implementation of mini-roundabouts and design standards...

MiniBooNE Oscillation Results

International Nuclear Information System (INIS)

Djurcic, Zelimir

2009-01-01

These proceedings summarize the MiniBooNE ν μ → ν e results, describe the first (bar ν) μ → (bar ν) e result, and current analysis effort with the NuMI neutrinos detected in the miniBooNE detector

Effects of Wii balance board exercises on balance after posterior cruciate ligament reconstruction.

Science.gov (United States)

Puh, Urška; Majcen, Nia; Hlebš, Sonja; Rugelj, Darja

2014-05-01

To establish the effects of training on Wii balance board (WBB) after posterior cruciate ligament (PCL) reconstruction on balance. Included patient injured her posterior cruciate ligament 22 months prior to the study. Training on WBB was performed 4 weeks, 6 times per week, 30-45 min per day. Center of pressure (CoP) sway during parallel and one-leg stance, and body weight distribution in parallel stance were measured. Additionally, measurements of joint range of motion and limb circumferences were taken before and after training. After training, the body weight was almost equally distributed on both legs. Decrease in CoP sway was most significant for one-leg stance with each leg on compliant surface with eyes open and closed. The knee joint range of motion increased and limb circumferences decreased. According to the results of this single case report, we might recommend the use of WBB for balance training after PCL reconstruction. Case series with no comparison group, Level IV.

A mini-invasive adductor magnus tendon transfer technique for medial patellofemoral ligament reconstruction: a technical note.

Science.gov (United States)

Sillanpää, Petri J; Mäenpää, Heikki M; Mattila, Ville M; Visuri, Tuomo; Pihlajamäki, Harri

2009-05-01

Patellar dislocations are associated with injuries to the medial patellofemoral ligament (MPFL). Several techniques for MPFL reconstruction have been recently published with some disadvantages involved, including large skin incisions and donor site morbidity. Arthroscopic stabilizing techniques carry the potential of inadequate restoration of MPFL function. We present a minimally invasive technique for MPFL reconstruction using adductor magnus tendon autograft. This technique is easily performed, safe, and provides a stabilizing effect equal to current MPFL reconstructions. Skin incision of only 3-4 cm is located at the level of the proximal half of the patella. After identifying the distal insertion of the adductor magnus tendon, a tendon harvester is introduced to harvest the medial two-thirds of the tendon, while the distal insertion is left intact. The adductor magnus tendon is cut at 12-14 cm from its distal insertion and transferred into the patellar medial margin. Two suture anchors are inserted through the same incision at the superomedial aspect of the patella in the anatomic MPFL origin. The graft is tightened at 30 degrees knee flexion. Aftercare includes 4 weeks of brace treatment with restricted range of motion.

Use of an all-suture anchor for re-creation of the anterior talofibular ligament: a case report.

Science.gov (United States)

Piraino, Jason A; Busch, Elliot L; Sansosti, Laura E; Pettineo, Steven J; Creech, Corine

2015-01-01

The lateral ankle ligament complex is typically injured during athletic activity caused by an inversion force on a plantar flexed foot. Numerous open surgical procedures to reconstruct the lateral ankle complex have been described. In contrast, we present a case report in which an all-suture anchor was used arthroscopically to re-create the anterior talofibular ligament in conjunction with ankle arthroscopy. A retrospective analysis of a 55-year-old male with a work-related inversion ankle sprain was performed with 14 months of follow-up. Objective and subjective assessments were obtained using range of motion measures, a strength assessment, and the Foot Function Index. An all-suture anchor was deployed through the anterolateral portal and secured in both the fibula and talus, re-creating the anterior talofibular ligament at its origin and insertion. Active range of motion physical therapy began at 2 weeks postoperatively. The patient started a neuromuscular re-education program at 5 weeks with minimal pain or discomfort. A return to full duty was achieved at 3 months postoperatively. To our knowledge, the use of an all-suture anchor has not been previously reported for lateral ankle complex re-creation. It is hoped that this approach to anterior talofibular ligament repair will decrease the incidence of complications and improve outcomes. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Kinematic analysis of anterior cruciate ligament reconstruction in total knee arthroplasty

OpenAIRE

Liu, Hua-Wei; Ni, Ming; Zhang, Guo-Qiang; Li, Xiang; Chen, Hui; Zhang, Qiang; Chai, Wei; Zhou, Yong-Gang; Chen, Ji-Ying; Liu, Yu-Liang; Cheng, Cheng-Kung; Wang, Yan

2016-01-01

Background: This study aims to retain normal knee kinematics after knee replacement surgeries by reconstructing anterior cruciate ligament during total knee arthroplasty. Method: We use computational simulation tools to establish four dynamic knee models, including normal knee model, posterior cruciate ligament retaining knee model, posterior cruciate ligament substituting knee model, and anterior cruciate ligament reconstructing knee model. Our proposed method utilizes magnetic resonance ima...

Anatomic deltoid ligament repair with anchor-to-post suture reinforcement: technique tip.

Science.gov (United States)

Lack, William; Phisitkul, Phinit; Femino, John E

2012-01-01

The deltoid ligament is the primary ligamentous stabilizer of the ankle joint. Both superficial and deep components of the ligament can be disrupted with a rotational ankle fracture, chronic ankle instability, or in late stage adult acquired flatfoot deformity. The role of deltoid ligament repair in these conditions has been limited and its contribution to arthritis is largely unknown. Neglect of the deltoid ligament in the treatment of ankle injuries may be due to difficulties in diagnosis and lack of an effective method for repair. Most acute repair techniques address the superficial deltoid ligament with direct end-to-end repair, fixation through bone tunnels, or suture anchor repair of avulsion injuries. Deep deltoid ligament repair has been described using direct end-to-end repair with sutures, as well as by autograft and allograft tendon reconstruction utilizing various techniques. Newer tenodesis techniques have been described for late reconstruction of both deep and superficial components in patients with stage 4 adult acquired flatfoot deformity. We describe a technique that provides anatomic ligament-to-bone repair of the superficial and deep bundles of the deltoid ligament while reducing the talus toward the medial malleolar facet of the tibiotalar joint with anchor-to-post reinforcement of the ligamentous repair. This technique may protect and allow the horizontally oriented fibers of the deep deltoid ligament to heal with the appropriate resting length while providing immediate stability of the construct.

Diagnostic validity Polish language version of the questionnaire MINI-KID (Mini International Neuropsychiatry Interview for Children and Adolescent).

Science.gov (United States)

Adamowska, Sylwia; Sylwia, Adamowska; Adamowski, Tomasz; Tomasz, Adamowski; Frydecka, Dorota; Dorota, Frydecka; Kiejna, Andrzej; Andrzej, Kiejna

2014-10-01

Since over forty years structuralized interviews for clinical and epidemiological research in child and adolescent psychiatry are being developed that should increase validity and reliability of diagnoses according to classification systems (DSM and ICD). The aim of the study is to assess the validity of the Polish version of MINI-KID (Mini International Neuropsychiatric Interview for Children and Adolescents) in comparison to clinical diagnosis made by a specialist in the field of child and adolescent psychiatry. There were 140 patients included in the study (93 boys, 66.4%, mean age 11.8±3.0 and 47 girls 33.5%, mean age 14.0±2.9). All the patients were diagnosed by the specialist in the field of child and adolescent psychiatry according to ICD-10 criteria and by the independent interviewer with the Polish version of MINI-KID (version 2.0, 2001). There was higher agreement between clinical diagnoses and diagnoses based on MINI-KID interview with respect to eating disorders and externalizing disorders (κ 0.43-0.56) and lower in internalizing disorders (κ 0.13-0.45). In the clinical interview, there was smaller number of diagnostic categories (maximum 3 diagnoses per one patient) in comparison to MINI-KID (maximum 10 diagnoses per one patient), and the smaller percentage of patients with one diagnosis (65,7%) in comparison to MINI-KID interview (72%). Our study has shown satisfactory validity parameters of MINI-KID questionnaire, promoting its use for clinical and epidemiological settings. The Mini International Neuropsychiatry Interview for Children and Adolescent (MINI-KID) is the first structuralized diagnostic interview for assessing mental status in children and adolescents, which has been translated into Polish language. Our validation study demonstrated satisfactory psychometric properties of the questionnaire, enabling its use in clinical practice and in research projects. Copyright © 2014 Elsevier Inc. All rights reserved.

Mini-Sniffer on Lakebed

Science.gov (United States)

1974-01-01

The original Mini-Sniffer on Rogers Dry Lake, adjacent to NASA's Flight Research Center, Edwards AFB. This version of the remotely-piloted vehicle had swept-back wings, tip rudders, nose canards, and an air breathing engine. The Mini-Sniffer was a remotely controlled, propeller-driven vehicle developed at the NASA Flight Research Center (which became the Dryden Flight Research Center, Edwards, California, in 1976) as a potential platform to sample the upper atmosphere for pollution. The vehicle, flown from 1975 to 1977, was one of the earliest attempts by NASA to develop an aircraft that could sense turbulence and measure natural and human-produced atmospheric pollutants at altitudes above 80,000 feet with a variable-load propeller that was never flight-tested. Three Mini-Sniffer vehicles were built. The number 1 Mini-Sniffer vehicle had swept wings with a span of 18 feet and canards on the nose. It flew 12 flights with the gas-powered engine at low altitudes of around 2,500 feet. The number 1 vehicle was then modified into version number 2 by removing the canards and wing rudders and adding wing tips and tail booms. Twenty flights were made with this version, up to altitudes of 20,000 feet. The number 3 vehicle had a longer fuselage, was lighter in weight, and was powered by the non-air-breathing hydrazine engine designed by NASA's Johnson Space Center in Houston, Texas. This version was designed to fly a 25-pound payload to an altitude of 70,000 feet for one hour or to climb to 90,000 feet and glide back. The number 3 Mini-Sniffer made one flight to 20,000 feet and was not flown again because of a hydrazine leak problem. All three versions used a pusher propeller to free the nose area for an atmospheric-sampling payload. At various times the Mini-Sniffer has been considered for exploration in the carbon dioxide atmosphere of the planet Mars, where the gravity (38 percent of that on Earth) would reduce the horsepower needed for flight.

Creep behaviour and creep mechanisms of normal and healing ligaments

Science.gov (United States)

Thornton, Gail Marilyn

Patients with knee ligament injuries often undergo ligament reconstructions to restore joint stability and, potentially, abate osteoarthritis. Careful literature review suggests that in 10% to 40% of these patients the graft tissue "stretches out". Some graft elongation is likely due to creep (increased elongation of tissue under repeated or sustained load). Quantifying creep behaviour and identifying creep mechanisms in both normal and healing ligaments is important for finding clinically relevant means to prevent creep. Ligament creep was accurately predicted using a novel yet simple structural model that incorporated both collagen fibre recruitment and fibre creep. Using the inverse stress relaxation function to model fibre creep in conjunction with fibre recruitment produced a superior prediction of ligament creep than that obtained from the inverse stress relaxation function alone. This implied mechanistic role of fibre recruitment during creep was supported using a new approach to quantify crimp patterns at stresses in the toe region (increasing stiffness) and linear region (constant stiffness) of the stress-strain curve. Ligament creep was relatively insensitive to increases in stress in the toe region; however, creep strain increased significantly when tested at the linear region stress. Concomitantly, fibre recruitment was evident at the toe region stresses; however, recruitment was limited at the linear region stress. Elevating the water content of normal ligament using phosphate buffered saline increased the creep response. Therefore, both water content and fibre recruitment are important mechanistic factors involved in creep of normal ligaments. Ligament scars had inferior creep behaviour compared to normal ligaments even after 14 weeks. In addition to inferior collagen properties affecting fibre recruitment and increased water content, increased glycosaminoglycan content and flaws in scar tissue were implicated as potential mechanisms of scar creep

Tissue engineering of ligaments : A comparison of bone marrow stromal cells, anterior cruciate ligament, and skin fibroblasts as cell source

NARCIS (Netherlands)

Van Eijk, F; Riesle, J; Willems, WJ; Van Blitterswijk, CA; Verbout, AJ; Dhert, WJA

Anterior cruciate ligament (ACL) reconstruction surgery still has important problems to overcome, such as "donor site morbidity" and the limited choice of grafts in revision surgery. Tissue engineering of ligaments may provide a solution for these problems. Little is known about the optimal cell

Mini-implant-supported Molar Distalization

Directory of Open Access Journals (Sweden)

Amit Goyal

2012-01-01

Full Text Available Temporary anchorage devices popularly called mini-implants or miniscrews are the latest addition to an orthodontist′s armamentarium. The following case report describes the treatment of a 16-year-old girl with a pleasant profile, moderate crowding and Angle′s Class II molar relationship. Maxillary molar distalization was planned and mini-implants were used to preserve the anterior anchorage. After 13 months of treatment, Class I molar and canine relation was achieved bilaterally and there was no anterior proclination. Thus, mini-implants provide a viable option to the clinician to carry out difficult tooth movements without any side effects.

Treatment of mandibular condyle fractures using a modified transparotid approach via the parotid mini-incision: experience with 31 cases.

Directory of Open Access Journals (Sweden)

Jun Shi

Full Text Available Surgery for mandibular condyle fractures must allow direct vision of the fracture, reduce surgical trauma and achieve reduction and fixation while avoiding facial nerve injury. This prospective study was conducted to introduce a new surgical approach for open reduction and internal fixation of mandibular condyle fractures using a modified transparotid approach via the parotid mini-incision, and surgical outcomes were evaluated. The modified transparotid approach via the parotid mini-incision was applied and rigid internal fixation using a small titanium plate was carried out for 36 mandibular condyle fractures in 31 cases. Postoperative follow-up of patients ranged from 3 to 26 months; in the first 3 months after surgery, outcomes for all patients were analyzed by evaluating the degree of mouth opening, occlusal relationship, facial nerve function and results of imaging studies. The occlusal relationships were excellent in all patients and none had symptoms of intraoperative ipsilateral facial nerve injury. The mean degree of mouth opening was 4.0 (maximum 4.8 cm, minimum 3.0 cm. No mandibular deviations were noted in any patient during mouth opening. CT showed complete anatomical reduction of the mandibular condyle fracture in all patients. The modified transparotid approach via the smaller, easily concealed parotid mini-incision is minimally invasive and achieves anatomical reduction and rigid internal fixation with a simplified procedure that directly exposes the fracture site. Study results showed that this procedure is safe and feasible for treating mandibular condyle fracture, and offers a short operative path, protection of the facial nerve and satisfactory aesthetic outcomes.

The Individual Features Of Indonesian-Chinese Mini-Novels

Directory of Open Access Journals (Sweden)

Ma Feng

2011-11-01

Full Text Available This article talks about mini-novels in the new period of Indonesian Chinese Literature. Through the overall developing trend of mini-novels’ corpuses, analyzes the individual creative features: firstly, the humor of Mo Mingmiao’s Mini-novels; secondly, the compassion of Xiao Xing’s Mini-novels; thirdly, Yuan Ni’s emotional sonata of The Lost Key-ring. By combination of themes and techniques of the three mini-novels corpuses, the article focuses on the analysis of three writers’ distinctive writing style.

Artificial ligamentous joints:Methods, materials and characteristics

OpenAIRE

Hockings, Nick; Iravani, Pejman; Bowen, Chris

2014-01-01

This paper presents a novel method for making ligamentous articulations for robots. Ligamentous joints are widely found in animals, but they have been of limited appli- cation in robotics due to lack of analogous synthetic materials. The method presented combines 3D printing, tow laying and thermoplastic welding which enables manufacturing of this type of structure.

Mini-Sniffer II in Flight

Science.gov (United States)

1976-01-01

This photograph shows the second Mini-Sniffer undergoing flight testing over Rogers Dry Lake in Edwards, California. This version of the Mini-Sniffer lacked the canard of the original version and had wing tips and tail booms added. The Mini-Sniffer was a remotely controlled, propeller-driven vehicle developed at the NASA Flight Research Center (which became the Dryden Flight Research Center, Edwards, California, in 1976) as a potential platform to sample the upper atmosphere for pollution. The vehicle, flown from 1975 to 1977, was one of the earliest attempts by NASA to develop an aircraft that could sense turbulence and measure natural and human-produced atmospheric pollutants at altitudes above 80,000 feet with a variable-load propeller that was never flight-tested. Three Mini-Sniffer vehicles were built. The number 1 Mini-Sniffer vehicle had swept wings with a span of 18 feet and canards on the nose. It flew 12 flights with the gas-powered engine at low altitudes of around 2,500 feet. The number 1 vehicle was then modified into version number 2 by removing the canards and wing rudders and adding wing tips and tail booms. Twenty flights were made with this version, up to altitudes of 20,000 feet. The number 3 vehicle had a longer fuselage, was lighter in weight, and was powered by the non-air-breathing hydrazine engine designed by NASA's Johnson Space Center in Houston, Texas. This version was designed to fly a 25-pound payload to an altitude of 70,000 feet for one hour or to climb to 90,000 feet and glide back. The number 3 Mini-Sniffer made one flight to 20,000 feet and was not flown again because of a hydrazine leak problem. All three versions used a pusher propeller to free the nose area for an atmospheric-sampling payload. At various times the Mini-Sniffer has been considered for exploration in the carbon dioxide atmosphere of the planet Mars, where the gravity (38 percent of that on Earth) would reduce the horsepower needed for flight.

Subfailure injury of the rabbit anterior cruciate ligament.

Science.gov (United States)

Panjabi, M M; Yoldas, E; Oxland, T R; Crisco, J J

1996-03-01

Ligamentous injuries range in severity from a simple sprain to a complete rupture. Although sprains occur more frequently than complete failures, only a few studies have investigated the phenomena of these subfailure injuries. The purpose of our study was to document the changes in the load-deformation curve until the failure point, after the ligament has been subjected to an 80% subfailure stretch. Thirteen paired fresh rabbit bone-anterior cruciate ligament-bone preparations were used. One of the pairs (control) was stretched until failure; the other (experimental) was first stretched to 80% of the failure deformation of the control and then stretched to failure. Comparisons were made between the load-deformation curves of the experimental and control specimens. The nonlinear load-deformation curves were characterized by eight parameters: failure load (Ffail), failure deformation (Dfail), energy until failure (Efail), deformations measured at 5, 10, 25, and 50% of the failure load (D5, D10, D25, and D50, respectively), and stiffness measured at 50% of the failure force (K50). There were no significant differences in the values for Ffail, Dfail, and Efail between the experimental and control ligaments (p > 0.33). In contrast, the deformation values were all larger for the experimental than the control ligaments (p > 0.01). The deformations D5, D10, D25, and D50 (mean +/- SD) for the control were 0.36 +/- 0.13, 0.49 +/- 0.23, 0.81 +/- 0.35, and 1.23 +/- 0.41 mm. The corresponding deformations for the experimental ligaments were, respectively, 209, 186, 153, and 130% of the control values. K50 was also greater for the experimental ligament (125.0 +/- 41.7 N/mm compared with 108.7 +/- 31.4 N/mm, p < 0.03). These findings indicate that even though the strength of the ligament did not change due to a subfailure injury, the shape of the load-displacement curve, especially at low loads, was significantly altered. Under the dynamic in vivo loading conditions of daily

Current Status of the MiniBooNE Experiment

OpenAIRE

Ray, H.; collaboration, for the MiniBooNE

2004-01-01

MiniBooNE is an experiment designed to refute or confirm the LSND anti-nu_mu -> anti-nu_e oscillation result. MiniBooNE will look for oscillations of nu_mu -> nu_e in a closed-box appearance analysis. MiniBooNE began collecting data in 2002, and is expected to continue data taking through 2005. Current MiniBooNE results are presented.

Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

NARCIS (Netherlands)

van Eijk, F.

2009-01-01

This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue

An osteogenesis/angiogenesis-stimulation artificial ligament for anterior cruciate ligament reconstruction.

Science.gov (United States)

Li, Hong; Li, Jinyan; Jiang, Jia; Lv, Fang; Chang, Jiang; Chen, Shiyi; Wu, Chengtie

2017-05-01

To solve the poor healing of polyethylene terephthalate (PET) artificial ligament in bone tunnel, copper-containing bioactive glass (Cu-BG) nanocoatings on PET artificial ligaments were successfully prepared by pulsed laser deposition (PLD). It was hypothesized that Cu-BG coated PET (Cu-BG/PET) grafts could enhance the in vitro osteogenic and angiogenic differentiation of rat bone marrow mesenchymal stem cells (rBMSCs) and in vivo graft-bone healing after anterior cruciate ligament (ACL) reconstruction in a goat model. Scanning electron microscope and EDS mapping analysis revealed that the prepared nanocoatings had uniform element distribution (Cu, Ca, Si and P) and nanostructure. The surface hydrophilicity of PET grafts was significantly improved after depositing Cu-BG nanocoatings. The in vitro study displayed that the Cu-BG/PET grafts supported the attachment and proliferation of rBMSCs, and significantly promoted the expression of HIF-1α gene, which up-regulated the osteogenesis-related genes (S100A10, BMP2, OCN) and angiogenesis-related genes (VEGF) in comparison with PET or BG coated PET (BG/PET) grafts which do not contain Cu element. Meanwhile, Cu-BG/PET grafts promoted the bone regeneration at the graft-host bone interface and decreased graft-bone interface width, thus enhancing the bonding strength as well as angiogenesis (as indicated by CD31 expression) in the goat model as compared with BG/PET and pure PET grafts. The study demonstrates that the Cu-containing biomaterials significantly promote osteogenesis and angiogenesis in the repair of bone defects of large animals and thus offering a promising method for ACL reconstruction by using Cu-containing nanobioglass modified PET grafts. It remains a significant challenge to develop an artificial graft with distinct osteogenetic/angiogenetic activity to enhance graft-bone healing for ligament reconstruction. To solve these problems, copper-containing bioactive glass (Cu-BG) nanocoatings on PET artificial

Advanced imaging of the scapholunate ligamentous complex

Energy Technology Data Exchange (ETDEWEB)

Shahabpour, Maryam; Maeseneer, Michel de; Boulet, Cedric; Mey, Johan de [Universitair Ziekenhuis Brussel (UZ Brussel), Department of Radiology, Brussels (Belgium); Staelens, Barbara; Scheerlinck, Thierry [Universitair Ziekenhuis Brussel (UZ Brussel), Department of Orthopaedics and Traumatology, Brussels (Belgium); Overstraeten, Luc van [Hand and Foot Surgery Unit (HFSU), Tournai (Belgium)

2015-12-15

The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The paper reviews the literature on imaging of radial-sided carpal ligaments with advanced computed tomographic arthrography (CTA) and magnetic resonance arthrography (MRA) to evaluate the scapholunate complex. Anatomy and pathology of the ligamentous complex are described and illustrated with CTA, MRA and corresponding arthroscopy. Sprains, mid-substance tears, avulsions and fibrous infiltrations of carpal ligaments could be identified on CTA and MRA images using 3D fat-saturated PD and 3D DESS (dual echo with steady-state precession) sequences with 0.5-mm-thick slices. Imaging signs of scapholunate complex pathology include: discontinuity, nonvisualization, changes in signal intensity, contrast extravasation (MRA), contour irregularity and waviness and periligamentous infiltration by edema, granulation tissue or fibrosis. Based on this preliminary experience, we believe that 3 T MRA using 3D sequences with 0.5-mm-thick slices and multiplanar reconstructions is capable to evaluate the scapholunate complex and could help to reduce the number of diagnostic arthroscopies. (orig.)

Telomere length of anterior crucial ligament after rupture

DEFF Research Database (Denmark)

Ponsot, Elodie; Langberg, Henning; Krogsgaard, Michael R

2011-01-01

The regeneration of ligaments following injury is a slow process compared to the healing of many other tissues and the underlying mechanisms remain unknown. The purpose of the study was to evaluate the proliferative potential of ligaments by assessing telomere length within three distinct parts...... of human anterior cruciate ligament (ACL) obtained during ACL reconstruction: the macroscopically injured proximal part and macroscopically noninjured mid- and distal portions in eight subjects (age 28 ± 8 years). The mean telomere length in ACL was within normal range of values usually reported for other...... tissues indicating that the endogenous machinery responsible for the proliferative potential of ligament is not implicated in its poor healing capacity. The three ACL parts showed similar mean TRF lengths (distal part: 11.5 ± 0.8 kbp, mid-portion: 11.8 ± 1.2 kbp, proximal part: 11.9 ± 1.6 kbp...

Quality Assurance Framework for Mini-Grids

Energy Technology Data Exchange (ETDEWEB)

Baring-Gould, Ian [National Renewable Energy Lab. (NREL), Golden, CO (United States); Burman, Kari [National Renewable Energy Lab. (NREL), Golden, CO (United States); Singh, Mohit [National Renewable Energy Lab. (NREL), Golden, CO (United States); Esterly, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mutiso, Rose [US Department of Energy, Washington, DC (United States); McGregor, Caroline [US Department of Energy, Washington, DC (United States)

2016-11-01

Providing clean and affordable energy services to the more than 1 billion people globally who lack access to electricity is a critical driver for poverty reduction, economic development, improved health, and social outcomes. More than 84% of populations without electricity are located in rural areas where traditional grid extension may not be cost-effective; therefore, distributed energy solutions such as mini-grids are critical. To address some of the root challenges of providing safe, quality, and financially viable mini-grid power systems to remote customers, the U.S. Department of Energy (DOE) teamed with the National Renewable Energy Laboratory (NREL) to develop a Quality Assurance Framework (QAF) for isolated mini-grids. The QAF for mini-grids aims to address some root challenges of providing safe, quality, and affordable power to remote customers via financially viable mini-grids through two key components: (1) Levels of service: Defines a standard set of tiers of end-user service and links them to technical parameters of power quality, power availability, and power reliability. These levels of service span the entire energy ladder, from basic energy service to high-quality, high-reliability, and high-availability service (often considered 'grid parity'); (2) Accountability and performance reporting framework: Provides a clear process of validating power delivery by providing trusted information to customers, funders, and/or regulators. The performance reporting protocol can also serve as a robust monitoring and evaluation tool for mini-grid operators and funding organizations. The QAF will provide a flexible alternative to rigid top-down standards for mini-grids in energy access contexts, outlining tiers of end-user service and linking them to relevant technical parameters. In addition, data generated through implementation of the QAF will provide the foundation for comparisons across projects, assessment of impacts, and greater confidence that

Percutaneous lateral ligament reconstruction with allograft for chronic lateral ankle instability.

Science.gov (United States)

Youn, Hyunkook; Kim, Yong Sang; Lee, Jongseok; Choi, Woo Jin; Lee, Jin Woo

2012-02-01

The majority of lateral ankle instability can be treated successfully with conservative method. However, if such treatments fail, surgical treatment should be considered. A wide variety of procedures have been introduced to treat chronic lateral ankle instability. The percutaneous method avoids dissection which is associated with open surgery and can lead to excessive morbidity. The purpose of this study was to evaluate the clinical and radiological outcomes of percutaneous lateral ligament reconstruction with an allograft in the treatment of chronic lateral ankle instability. Between October 2006 and April 2009, percutaneous lateral ligament reconstruction using an allograft was performed on 15 ankles in 13 patients for chronic lateral ankle instability. The patients included in this study satisfied at least one of the following criteria: a previously failed reconstruction of the ligament, severe ankle instability (more than 15 degrees of talar tilt, more than 10 mm of anterior drawer), general laxity of ligaments, body mass index (BMI) higher than 25. The mean followup period was 18.1 (range, 12 to 40) months. The grafted tendon was secured by double tenodeses at both the talus and calcaneus or triple tenodeses which included a fibular tenodesis. The clinical outcomes were evaluated with Visual Analogue Scale (VAS) for pain, Karlsson-Peterson ankle score, and patients' subjective satisfaction. The radiological results were evaluated using the varus tilting angle and the anterior displacement distance. The VAS improved from preoperative 3.7 ±2.2 to 1.6 ±1.3 at the last followup (p = 0.002). The Karlsson-Peterson ankle score increased from 54.2 ±8.8 to 80.9 ±7.2 (p = 0.001). Patients were satisfied in 13 cases (86.7%) with excellent or good results. Radiologically, the mean varus tilting angle was 15.5 ±4.4 degrees preoperatively and 7.3 ±3.6 at the last followup (p = 0.001). The anterior drawer distance was 10.1 ±3.3 mm preoperatively and 7.2 ±2.7 mm at

Model Documentation for the MiniCAM

Energy Technology Data Exchange (ETDEWEB)

Brenkert, Antoinette L.; Smith, Steven J.; Kim, Son H.; Pitcher, Hugh M.

2003-07-17

The MiniCAM, short for the Mini-Climate Assessment Model, is an integrated assessment model of moderate complexity focused on energy and agriculture sectors. The model produces emissions of greenhouse gases (carbon dioxide, methane and nitrous oxide) and other radiatively important substances such as sulfur dioxide. Through incorporation of the simple climate model MAGICC, the consequences of these emissions for climate change and sea-level rise can be examined. The MiniCAM is designed to be fast and flexible.

A Review on Biomechanics of Anterior Cruciate Ligament and Materials for Reconstruction

Science.gov (United States)

Marieswaran, M.; Jain, Ishita; Garg, Bhavuk; Sharma, Vijay

2018-01-01

The anterior cruciate ligament is one of the six ligaments in the human knee joint that provides stability during articulations. It is relatively prone to acute and chronic injuries as compared to other ligaments. Repair and self-healing of an injured anterior cruciate ligament are time-consuming processes. For personnel resuming an active sports life, surgical repair or replacement is essential. Untreated anterior cruciate ligament tear results frequently in osteoarthritis. Therefore, understanding of the biomechanics of injury and properties of the native ligament is crucial. An abridged summary of the prominent literature with a focus on key topics on kinematics and kinetics of the knee joint and various loads acting on the anterior cruciate ligament as a function of flexion angle is presented here with an emphasis on the gaps. Briefly, we also review mechanical characterization composition and anatomy of the anterior cruciate ligament as well as graft materials used for replacement/reconstruction surgeries. The key conclusions of this review are as follows: (a) the highest shear forces on the anterior cruciate ligament occur during hyperextension/low flexion angles of the knee joint; (b) the characterization of the anterior cruciate ligament at variable strain rates is critical to model a viscoelastic behavior; however, studies on human anterior cruciate ligament on variable strain rates are yet to be reported; (c) a significant disparity on maximum stress/strain pattern of the anterior cruciate ligament was observed in the earlier works; (d) nearly all synthetic grafts have been recalled from the market; and (e) bridge-enhanced repair developed by Murray is a promising technique for anterior cruciate ligament reconstruction, currently in clinical trials. It is important to note that full extension of the knee is not feasible in the case of most animals and hence the loading pattern of human ACL is different from animal models. Many of the published reviews on

Knee ligament injuries associated with long bone fractures

Directory of Open Access Journals (Sweden)

Kaseb M.H

2007-06-01

Full Text Available Background: Tibial and femoral fractures, commonly seen in emergency departments, may be associated with various knee ligament injuries. The aim of this study was to determine the prevalence of such fracture-associated knee ligament problems, with especial attention to rapid diagnosis. Methods: This study was carried out in patients with femoral or tibial fractures who were operated on in Imam Khomeini Medical Center from March 2003 to March 2005. All patients underwent surgical repair immediately after acute fracture, followed by a thorough knee examination. Patients with positive clinical findings were further evaluated using the stress view and arthroscopy. Results: We enrolled 470 cases in this study, of which 266 were tibial and 204 were femoral fractures. There were 404 men and 67 women, with an average age of tibial fracture patients was 34.5 and 44.6 years for those with femoral fractures. Of all fractures, 66% were due to car accidents, 16% to industrial accidents and 8% due to falling. The overall prevalence of ligament injuries in tibial fractures was as follows: 6.58% ACL tearing, 2.5% PCL, 21.95% MCL and 14.63% LCL. The overall prevalence of ligament injuries in femoral fractures was as follows: 6% ACL tearing, 3% PCL, 14% MCL and 8% LCL. Conclusion: The prevalence of ligament injuries of the knee was highest in distal femoral and tibial plateau fractures. It is prudent to perform a thorough knee examination once the fracture is stabilized in the operating room for the early detection of ligament injuries and prevention of further complications.

Mini-percutaneous nephrolithotomy for stones in anomalous-kidneys: a prospective study.

Science.gov (United States)

Khadgi, Sanjay; Shrestha, Babu; Ibrahim, Hamdy; Shrestha, Sunil; ElSheemy, Mohammed S; Al-Kandari, Ahmed M

2017-08-01

To evaluate safety and efficacy of minipercutaneous nephrolithotomy (Mini-PNL) in management of stones in different types of renal anomalies. Patients with stones ≥2 cm or SWL-resistant stones in anomalous-kidneys treated by Mini-PNL between March 2010 and September 2012 were included prospectively. Mini-PNL was done under regional anesthesia in prone position with fluoroscopic guidance through 18 Fr sheath using semirigid ureteroscope (8.5/11.5 Fr) and pneumatic lithotripter. All patients were followed-up for 2-3 years. Stone-free rate was defined as absence of residual fragments ≥2 mm. Student-T, Mann-Whitney, Chi square (χ 2 ), Fisher-exact, one way ANOVA or Kruskal-Wallis test were used for analysis. Mini-PNL was performed for 59 patients (20 horseshoe, 15 malrotated, 7 polycystic, 13 duplex and 4 ectopic pelvic-kidneys). Mean age was 40.18 ± 12.75 (14-78) years. Mean stone burden was 31.72 ± 21.43 (7.85-141.3) mm 2 . Two tracts were required in 7 (11.9 %) patients. Tubeless Mini-PNL with double-J insertion was performed in all patients except two. Operative time was 50.17 ± 18.73 (15-105) min. Hemoglobin loss was 0.44 ± 0.30 (0-1.4) g/dL. Complications were reported in 15 (25.4 %) patients. No pleural injury, sepsis, perinephric-collection or renal-pelvis perforation were reported. Stone-free rate was 89.8 % (converted to open-surgery in one patient, second-look PNL in two patients, auxiliary SWL in three patients). Stone-free rate improved to 98.3 % after retreatment and auxiliary SWL. Site of puncture was mostly upper calyceal in horseshoe-kidney (80 %), mid calyceal in polycystic-kidney (85.7 %) and lower calyceal in duplex-kidney (46.2 %). Punctures were also significantly infracostal in horseshoe-kidney (100 %) and supracostal in both duplex (53.8 %) and malrotated-kidneys (66.7 %). Mini-PNL is safe for management of stones in anomalous-kidney with SFR comparable to standard-PNL but with less complications.

Tissue engineered devices for ligament repair, replacement and ...

African Journals Online (AJOL)

potential, severe damage warrants surgical intervention including complete replacement. Ligaments are longitudinally arranged, complex tissues; the mechanical properties of ligaments are a direct result of their components and the arrangement of these components in the tissue. It is these mechanics that have made ...

Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

OpenAIRE

van Eijk, F.

2009-01-01

This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue engineering.

Common types and countermeasures of ankle ligament injury ...

African Journals Online (AJOL)

Objective: To analyze ankle ligament injury of basketball players caused during movement, summarize injury types, analyze the causes of injury, and put forward corresponding control measures. Methods: The author selected 3100 basketball players with ankle ligament injury during basketball movement and admitted to ...

Comparative transcriptional analysis of three human ligaments with distinct biomechanical properties

Science.gov (United States)

Lorda-Diez, Carlos I; Canga-Villegas, Ana; Cerezal, Luis; Plaza, Santiago; Hurlé, Juan M; García-Porrero, Juan A; Montero, Juan A

2013-01-01

One major aim of regenerative medicine targeting the musculoskeletal system is to provide complementary and/or alternative therapeutic approaches to current surgical therapies, often involving the removal and prosthetic substitution of damaged tissues such as ligaments. For these approaches to be successful, detailed information regarding the cellular and molecular composition of different musculoskeletal tissues is required. Ligaments have often been considered homogeneous tissues with common biomechanical properties. However, advances in tissue engineering research have highlighted the functional relevance of the organisational and compositional differences between ligament types, especially in those with higher risks of injury. The aim of this study was to provide information concerning the relative expression levels of a subset of key genes (including extracellular matrix components, transcription factors and growth factors) that confer functional identity to ligaments. We compared the transcriptomes of three representative human ligaments subjected to different biomechanical demands: the anterior cruciate ligament (ACL); the ligamentum teres of the hip (LT); and the iliofemoral ligament (IL). We revealed significant differences in the expression of type I collagen, elastin, fibromodulin, biglycan, transforming growth factor β1, transforming growth interacting factor 1, hypoxia-inducible factor 1-alpha and transforming growth factor β-induced gene between the IL and the other two ligaments. Thus, considerable molecular heterogeneity can exist between anatomically distinct ligaments with differing biomechanical demands. However, the LT and ACL were found to show remarkable molecular homology, suggesting common functional properties. This finding provides experimental support for the proposed role of the LT as a hip joint stabiliser in humans. PMID:24128114

Reconstructed and analyzed X-ray computed tomography data of investment-cast and additive-manufactured aluminum foam for visualizing ligament failure mechanisms and regions of contact during a compression test

Directory of Open Access Journals (Sweden)

Kristoffer E. Matheson

2018-02-01

Full Text Available Three stochastic open-cell aluminum foam samples were incrementally compressed and imaged using X-ray Computed Tomography (CT. One of the samples was created using conventional investment casting methods and the other two were replicas of the same foam that were made using laser powder bed fusion. The reconstructed CT data were then examined in Paraview to identify and highlight the types of failure of individual ligaments. The accompanying sets of Paraview state files and STL files highlight the different ligament failure modes incrementally during compression for each foam. Ligament failure was classified as either “Fracture” (red or “Collapse” (blue. Also, regions of neighboring ligaments that came into contact that were not originally touching were colored yellow. For further interpretation and discussion of the data, please refer to Matheson et al. (2017 [1].

Movimentação de molares inferiores ancorados em mini-parafusos Mandibular molar uprighting, using mini-screw as anchorage

Directory of Open Access Journals (Sweden)

Rosana Canteras Di Matteo

2005-08-01

Full Text Available Freqüentemente a movimentação ortodôntica exige recursos adicionais de ancoragem. Os mini-parafusos têm-se apresentado como uma possível solução. O propósito deste trabalho foi estabelecer um método para a verticalização de molares inferiores inclinados para mesial, utilizando ancoragem em mini-parafusos colocados na região de linha oblíqüa externa da mandíbula. Foram selecionados três pacientes entre 40 a 48 anos (dois do gênero feminino, um do gênero masculino, com molares inferiores inclinados para mesial e distalmente posicionados às áreas edêntulas. Os pacientes foram tratados ortodonticamente durante um período de 6 a 12 meses, com técnica ortodôntica MD3. Mini-parafusos de titânio foram colocados bilateralmente com anestesia local. Uma incisão sobre a linha oblíqüa externa da mandíbula, medindo aproximadamente 1 cm foi realizada em cada lado, distalmente aos molares inclinados. Após descolamento muco-periosteal, mini-parafusos foram implantados e foram realizadas suturas deixando suas cabeças exteriorizadas. Uma semana após a remoção das suturas, cargas ortodônticas (entre 150 a 200 gramas/força foram aplicadas através de forças elásticas. Verificamos que alguma inflamação foi observada ao redor dos mini-parafusos, mas foi controlada com procedimentos de higienização. O procedimento cirúrgico é simples, podendo ser realizado pelo ortodontista; as formas dimensionais dos mini-parafusos são adequadas e estes são de fácil remoção após uso. Concluímos que o uso de mini-parafusos representa uma alternativa efetiva de ancoragem ortodôntica na verticalização de molares inferiores.Tooth movement frequently requires additional anchorage resources. Mini-screws have been used as a possible solution to this matter. The purpose of this study was to establish a method of mandibular molar uprighting, using mini-screw as anchorage, positioned on the mandibular external oblique line, behind and

Calcification of the alar ligament of the cervical spine: imaging findings and clinical course

Energy Technology Data Exchange (ETDEWEB)

Kobayashi, Yuka; Mochida, J.; Toh, E. [Dept. of Orthopaedic Surgery, Tokai Univ., Isehara, Kanagawa (Japan); Saito, Ikuo; Matui, Sizuka [Dept. of Orthopaedic Surgery, Odawara Hospital, Printing Bureau, Ministry of Finance, Sakawa, Odawara, Kanagawa (Japan)

2001-05-01

Ligamentous calcification of the cervical spine has been reported in the yellow ligament, anterior and posterior longitudinal ligaments and interspinous ligament. Calcification in the upper cervical spine is rare, although some cases with calcification of the transverse ligament of the atlas have been reported. Two patients with calcification of the alar ligament with an unusual clinical presentation and course are described. Examination by tomography and computed tomography (CT) showed calcification of the alar ligament and the transverse ligament of the atlas. CT documented decreased calcification as symptoms resolved. There may be a role for CT in the search for calcifications in the upper cervical spine in patients presenting with neck pain and pharyngodynia if radiographs are normal. (orig.)

Calcification of the alar ligament of the cervical spine: imaging findings and clinical course

International Nuclear Information System (INIS)

Kobayashi, Yuka; Mochida, J.; Toh, E.; Saito, Ikuo; Matui, Sizuka

2001-01-01

Ligamentous calcification of the cervical spine has been reported in the yellow ligament, anterior and posterior longitudinal ligaments and interspinous ligament. Calcification in the upper cervical spine is rare, although some cases with calcification of the transverse ligament of the atlas have been reported. Two patients with calcification of the alar ligament with an unusual clinical presentation and course are described. Examination by tomography and computed tomography (CT) showed calcification of the alar ligament and the transverse ligament of the atlas. CT documented decreased calcification as symptoms resolved. There may be a role for CT in the search for calcifications in the upper cervical spine in patients presenting with neck pain and pharyngodynia if radiographs are normal. (orig.)

Psychological Aspects of Recovery Following Anterior Cruciate Ligament Reconstruction.

Science.gov (United States)

Christino, Melissa A; Fantry, Amanda J; Vopat, Bryan G

2015-08-01

Recovery following anterior cruciate ligament reconstruction is an arduous process that requires a significant mental and physical commitment to rehabilitation. Orthopaedic research in recent years has focused on optimizing anterior cruciate ligament surgical techniques; however, despite stable anterior cruciate ligament reconstructions, many athletes still never achieve their preinjury ability or even return to sport. Psychological factors associated with patient perceptions and functional outcomes following anterior cruciate ligament reconstruction are important to acknowledge and understand. Issues related to emotional disturbance, motivation, self-esteem, locus of control, and self-efficacy can have profound effects on patients' compliance, athletic identity, and readiness to return to sport. The psychological aspects of recovery play a critical role in functional outcomes, and a better understanding of these concepts is essential to optimize the treatment of patients undergoing anterior cruciate ligament reconstruction, particularly those who plan to return to sport. Identifying at-risk patients, encouraging a multidisciplinary approach to patient care, and providing early referral to a sports psychologist may improve patient outcomes and increase return-to-play rates among athletes. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

Anterolateral Ligament (ALL — Myth or Reality?

Directory of Open Access Journals (Sweden)

Roman Mihai

2017-05-01

Full Text Available Although the anterolateral ligament (ALL was described a long time ago, recent research shows a lot of interest regarding this structure. There is a high variability concerning its anatomy, especially its capsular/extracapsular situation and insertion sites. There is also some controversy about its ligamentous structure. It seems that it has a biomechanical role in restricting anterior tibial translation and internal rotation. The ALL complex seems to have a clinical significance, and a relationship with the pivot shift has been described. Although there are promising results recently, the surgical techniques of ALL reconstruction, in addition to anterior cruciate ligament reconstruction, have to be further investigated. A precise indication algorithm and patient selection criteria need to be established.

Standardization of the Korean version of Mini-Mental Adjustment to Cancer (K-Mini-MAC) scale: factor structure, reliability and validity.

Science.gov (United States)

Kang, Jee In; Chung, Hyun Cheol; Kim, Se Joo; Choi, Hye Jin; Ahn, Joong Bae; Jeung, Hei-Cheul; Namkoong, Kee

2008-06-01

Mental adjustment and coping affect the physical outcome and survival as well as quality of life in cancer patients. The Mini-Mental Adjustment to Cancer (Mini-MAC) scale is a new refined, economical and reliable self-rating instrument measuring cognitive and behavioral responses to cancer. The aim of this study was to evaluate the psychometric properties of the Mini-MAC in Korean cancer patients. A total of 208 cancer patients recruited from the Yonsei Cancer Center were assessed with the Mini-MAC and the Hospital Anxiety and Depression Scale (HADS). Principal component analysis with varimax rotation for the Korean version of Mini-MAC (K-Mini-MAC) confirmed four factors. Three had psychometric properties similar to Helpless-Hopeless (HH), Anxious Preoccupation (AP) and Cognitive Avoidance (CA) of the original Mini-MAC. A novel factor, named Positive Attitude, included items of both Fatalism (FA) and Fighting Spirit (FS) from the original version. The five subscales from the original version (AP, HH, FS, FA and CA) and Positive Attitude had acceptable internal reliabilities in our sample (Cronbach's alpha coefficient 0.50-0.86; correlation coefficient of test-retest 0.68-0.88). For the validity, significant interscale correlation was observed in the original five subscales and Positive Attitude. Each subscale including Positive Attitude was also significantly related to Depression and Anxiety of HADS. As a whole, the K-Mini-MAC was a reliable, valid and acceptable tool for Korean cancer patients. These findings can provide information about the cross-cultural validity of Mini-MAC scale's factor structure. Cultural differences were also discussed.

Occipital condyle fracture and ligament injury: imaging by CT

International Nuclear Information System (INIS)

Bloom, A.I.; Neeman, Z.; Floman, Y.; Gomori, J.; Bar-Ziv, J.

1996-01-01

The true incidence of fracture of the occipital condyles is unknown. It may be associated with instability at the craniocervical joint. CT is the modality of choice for the demonstration of these fractures, but its use for imaging of the associated ligament injury has not been reported. In order to demonstrate normal anatomy, occipital condyle fracture and ligament injury, and to estimate the incidence of this lesion, 21 children and young adults with high-energy blunt craniocervical injury were examined prospectively. Thin-slice, axial, contiguous, CT was performed from the base of C2 to above the foramen magnum. Bone and soft tissue windows and coronal, sagittal, and curvilinear 2D reconstructions were performed. Five occipital condyle fractures were identified in four patients (19 %), with demonstration of alar ligament injury in two cases and local hematoma in one. In four, artifacts or rotation precluded assessment of ligaments. In all remaining cases normal bone and ligament anatomy was demonstrated. Fracture of the occipital condyles following craniocervical injury is not uncommon in children and young adults. Normal bone and ligament anatomy and pathology can be safely and clearly demonstrated in seriously injured patients and others using this CT technique. Increased awareness of this entity and a low threshold for performing CT should avoid the potentially serious consequences of a missed diagnosis. (orig.). With 8 figs., 2 tabs

Marker of cemento-periodontal ligament junction associated with periodontal regeneration.

Science.gov (United States)

Hara, Ryohko; Wato, Masahiro; Tanaka, Akio

2005-06-01

The purpose of this study was to identify factors promoting formation of the cemento-periodontal ligament junction. Regeneration of the cemento-periodontal ligament junction is an important factor in recovery of the connective tissue attachment to the cementum and it is important to identify all specific substances that promote its formation. To clarify the substances involved in cemento-periodontal ligament junction formation, we produced a monoclonal antibody (mAb) to human cemento-periodontal ligament junction (designated as the anti-TAP mAb) and examined its immunostaining properties and reactive antigen. Hybridomas producing monoclonal antibody against human cemento-periodontal ligament junction antigens were established by fusing P3U1 mouse myeloma cells with spleen cells from BALB/c mice immunized with homogenized human cemento-periodontal ligament junction. The mAb, the anti-TAP mAb for cemento-periodontal ligament junction, was then isolated. The immunoglobulin class and light chain of the mAb were examined using an isotyping kit. Before immunostaining, antigen determination using an enzymatic method or heating was conducted. Human teeth, hard tissue-forming lesions, and animal tissues were immunostained by the anti-TAP mAb. The anti-TAP mAb was positive in human cemento-periodontal ligament junction and predentin but negative in all other human and animal tissues examined. In the cemento-osseous lesions, the anti-TAP mAb was positive in the peripheral area of the cementum and cementum-like hard tissues and not in the bone and bone-like tissues. The anti-TAP mAb showed IgM (kappa) and recognized phosphoprotein. The anti-TAP mAb is potentially useful for developing new agents promoting cementogenesis and periodontal regeneration.

Ultrasonographic assessment of the proximal digital annular ligament in the equine forelimb

International Nuclear Information System (INIS)

Dik, K.J.; Boroffka, S.; Stolk, P.

1994-01-01

Ultrasonography was used with 6 normal cadaver forelimbs of Dutch Warmblood horses to delineate the ultrasonographic anatomy of the palmar pastern region, with emphasis on the proximal digital annular ligament. Using a 5.5 MHz sector scanner, the thin proximal digital annular ligament was not visible on offset sonograms. Only if the digital sheath in the normal limb was distended was the distal border of this ligament outlined. In all normal limbs the palmarodistal thickness of the combined skin-proximal digital annular ligament layer in the mid-pastern region was 2 mm. The flexor tendons and distal sesamoidean ligaments were easily identified as hyperechoic structures. Distension of the digital sheath in the normal limbs clearly outlined the anechoic digital sheath pouches. In 4 lame horses ultrasonography aided the diagnosis of functional proximal digital annular ligament constriction. In all 4 diseased forelimbs ultrasonography demonstrated thickening of the skin-proximal digital annular ligament layer and distension of the digital sheath. In one of these limbs the distended digital sheath was also thickened. The flexor tendons and distal sesamoidean ligaments were normal. There was no radiographic evidence of additional bone or joint lesions

Ultrasonographic assessment of the proximal digital annular ligament in the equine forelimb.

Science.gov (United States)

Dik, K J; Boroffka, S; Stolk, P

1994-01-01

Ultrasonography was used with 6 normal cadaver forelimbs of Dutch Warmblood horses to delineate the ultrasonographic anatomy of the palmar pastern region, with emphasis on the proximal digital annular ligament. Using a 5.5 MHz sector scanner, the thin proximal digital annular ligament was not visible on offset sonograms. Only if the digital sheath in the normal limb was distended was the distal border of this ligament outlined. In all normal limbs the palmarodistal thickness of the combined skin-proximal digital annular ligament layer in the mid-pastern region was 2 mm. The flexor tendons and distal sesamoidean ligaments were easily identified as hyperechoic structures. Distension of the digital sheath in the normal limbs clearly outlined the anechoic digital sheath pouches. In 4 lame horses ultrasonography aided the diagnosis of functional proximal digital annular ligament constriction. In all 4 diseased forelimbs ultrasonography demonstrated thickening of the skin-proximal digital annular ligament layer and distension of the digital sheath. In one of these limbs the distended digital sheath was also thickened. The flexor tendons and distal sesamoidean ligaments were normal. There was no radiographic evidence of additional bone or joint lesions.

Postural stability in subjects with anterior cruciate ligament injury

OpenAIRE

Kolář, Miroslav

2011-01-01

6 Abstract Title: Postural stability in subjects with anterior cruciate ligament injury. Objectives: The aim of this thesis was to find out if the postural stability is differed in subjects with anterior cruciate ligament injury and in the control group after the "4 steps - one leg stance" test had been performed. Methods: This study compared a group with anterior cruciate ligament injury and a control group on the basis of the "4 steps - one leg stance" test. Methods of comparison and analys...

Radiographic Evaluation of Ankle Joint Stability After Calcaneofibular Ligament Elevation During Open Reduction and Internal Fixation of Calcaneus Fracture.

Science.gov (United States)

Wang, Chien-Shun; Tzeng, Yun-Hsuan; Lin, Chun-Cheng; Huang, Ching-Kuei; Chang, Ming-Chau; Chiang, Chao-Ching

2016-09-01

The aim of this prospective study was to evaluate the influence of sectioning the calcaneofibular ligament (CFL) during an extensile lateral approach during open reduction and internal fixation (ORIF) of calcaneal fractures on ankle joint stability. Forty-two patients with calcaneal fractures that received ORIF were included. Talar tilt stress and anterior drawer radiographs were performed on the operative and contralateral ankles 6 months postoperatively. The average degree of talar tilt on stress radiographs was 3.4 degrees (range, 0-12 degrees) on the operative side and 3.2 degrees (range, 0-14 degrees) on the contralateral side. The mean anterior drawer on stress radiographs of the CFL incised ankle was 6.1 mm (range, 2.4-11.8 mm) and on the contralateral ankle was 5.7 mm (range, 2.6-8.6 mm). There was no statistically significant difference of talar tilt and anterior drawer between the CFL incised side and the contralateral side (P = .658 and .302, respectively). The results suggest that sectioning of the CFL without any repair during ORIF of a calcaneal fracture does not have a negative effect on stability of the ankle. Repair of the CFL is, thus, probably not necessary following extended lateral approach for ORIF of calcaneal fractures. Level II, comparative study. © The Author(s) 2016.

Craniocervical junction in dogs revisited--new ligaments and confirmed presence of enthesis fibrocartilage.

Science.gov (United States)

Kupczynska, M; Wieladek, A; Janczyk, P

2012-06-01

The study was performed to investigate and to describe features of gross and microscopic morphology of craniocervical junction (CCJ) in dogs. Seventy mature dogs (38 females, 32 males) of different body weight, representing small, medium and large breeds of dolicho-, mesati-, and brachycephalic morphotype were dissected. Morphological details were localised using an operating microscope with integrated video channel. Occurrence and distribution of fibrocartilage in the ligaments from 10 dogs was analysed histologically. Three new pairs of ligaments were described and named: dorsal ligaments of atlas, cranial internal collateral ligaments of atlas, and caudal internal collateral ligaments of atlas. Several new findings in the course of the known ligaments were found relating to breed and body weight. For the first time enthesis fibrocartilage was identified in ligaments of CCJ in dogs. Sesamoidal fibrocartilage was identified in the transversal ligament of atlas in large dogs. The findings are discussed for clinical importance. Copyright © 2011 Elsevier Ltd. All rights reserved.

Open and Arthroscopic Surgical Treatment of Femoroacetabular Impingement

Directory of Open Access Journals (Sweden)

Benjamin D. Kuhns

2015-12-01

Full Text Available Femoroacetabular impingement (FAI is a common cause of hip pain, and when indicated, can be successfully managed through open surgery or hip arthroscopy. The goal of this review is to describe the different approaches to the surgical treatment of FAI. We present the indications, surgical technique, rehabilitation, and complications associated with (1 open hip dislocation, (2 reverse peri-acetabular osteotomy, (3 the direct anterior mini-open approach, and (4 arthroscopic surgery for femoroacetabular impingement.

Incidence and MRI characterization of the spectrum of posterolateral corner injuries occurring in association with ACL rupture

Energy Technology Data Exchange (ETDEWEB)

Frois Temponi, Eduardo [Hospital Madre Teresa, Belo Horizonte, Minas Gerais (Brazil); Honorio de Carvalho, Lucio Jr. [Hospital Madre Teresa, Belo Horizonte, Minas Gerais (Brazil); Universidade Federal de Minas Gerais, Departamento do Aparelho Locomotor, Faculdade de Medicina, Belo Horizonte, Minas Gerais (Brazil); Saithna, Adnan [Southport and Ormskirk Hospitals, Southport (United Kingdom); University of Liverpool, Department of Clinical Engineering, Liverpool (United Kingdom); Thaunat, Mathieu; Sonnery-Cottet, Bertrand [Centre Orthopedic Santy, FIFA Medical Center of Excellence, Ramsay-Generale de Sante, Hopital Prive Jean Mermoz, Lyon (France)

2017-08-15

To determine the incidence and MRI characteristics of the spectrum of posterolateral corner (PLC) injuries occurring in association with anterior cruciate ligament (ACL) rupture. We carried out a level IV, retrospective case series study. All patients clinically diagnosed with an ACL rupture between July 2015 and June 2016 who underwent MRI of the knee were included in the study. In addition to standard MRI knee reporting, emphasis was placed on identifying injury to the PLC and a description of involvement of these structures by two musculoskeletal radiologists. Association with PLC involvement was sought with concomitant injuries using correlation analysis and logistic regression. One hundred sixty-two patients with MRI following ACL rupture were evaluated. Thirty-two patients (19.7%) had an injury to at least one structure of the PLC, including the inferior popliteomeniscal fascicle (n = 28), arcuate ligament (n = 20), popliteus tendon (n = 20), superior popliteomeniscal fascicle (n = 18), lateral collateral ligament (n = 8), popliteofibular ligament (n = 7), biceps tendon (n = 4), iliotibial band (n = 3), and fabellofibular ligament (n = 1). Seventy-five percent of all patients with combined ACL and PLC injuries had bone contusions involving the lateral compartment of the knee. The presence of these contusions strongly correlated with superior popliteomeniscal fascicle lesions (p < 0.05). There was no correlation between injuries to other structures of the PLC and other intra-articular lesions. Missed injuries of the PLC lead to considerable morbidity. The relevance of this study is to highlight that these injuries occur more frequently than previously described and that an appropriate index of suspicion, clinical examination, and MRI are all required to reduce the risk of missed diagnoses. The results of this study support previous suggestions that the rate of concomitant PLC injury in the ACL-deficient knee is under-reported. The rate of combined injuries in

Tissue engineered devices for ligament repair, replacement and ...

African Journals Online (AJOL)

PRECIOUS

2009-12-29

Dec 29, 2009 ... These devices use a wide variety of materials and designs to replicate ligament ... other during the application of strain, leading to viscous dissipation of stress at low ... low strains without straining the collagen molecules and plastically ..... anterior cruciate ligament: current and future concepts. New York:.

Quality Assurance Framework for Mini-Grids

Energy Technology Data Exchange (ETDEWEB)

Esterly, Sean; Baring-Gould, Ian; Booth, Samuel

2017-05-04

To address the root challenges of providing quality power to remote consumers through financially viable mini-grids, the Global Lighting and Energy Access Partnership (Global LEAP) initiative of the Clean Energy Ministerial and the U.S. Department of Energy teamed with the National Renewable Energy Laboratory (NREL) and Power Africa to develop a Quality Assurance Framework (QAF) for isolated mini-grids. The framework addresses both alternating current (AC) and direct current (DC) mini-grids, and is applicable to renewable, fossil-fuel, and hybrid systems.

Ligament-bone interaction in a three-dimensional model of the knee

NARCIS (Netherlands)

Blankevoort, L.; Huiskes, H.W.J.

1991-01-01

In mathematical knee-joint models, the ligaments are usually represented by straight-line elements, connecting the insertions of the femur and tibia. Such a model may not be valid if a ligament is bent in its course over bony surfaces, particularly not if the resulting redirection of the ligament

Ligament-bone interaction in a three-dimensional model of the knee

NARCIS (Netherlands)

Blankevoort, L.; Huiskes, R.

1991-01-01

In mathematical knee-joint models, the ligaments are usually represented by straight-line elements, connecting the insertions of the femur and tibia. Such a model may not be valid if a ligament is bent in its course over bony-surfaces, particularly not if the resulting redirection of the ligament

A Review on Biomechanics of Anterior Cruciate Ligament and Materials for Reconstruction

Directory of Open Access Journals (Sweden)

M. Marieswaran

2018-01-01

Full Text Available The anterior cruciate ligament is one of the six ligaments in the human knee joint that provides stability during articulations. It is relatively prone to acute and chronic injuries as compared to other ligaments. Repair and self-healing of an injured anterior cruciate ligament are time-consuming processes. For personnel resuming an active sports life, surgical repair or replacement is essential. Untreated anterior cruciate ligament tear results frequently in osteoarthritis. Therefore, understanding of the biomechanics of injury and properties of the native ligament is crucial. An abridged summary of the prominent literature with a focus on key topics on kinematics and kinetics of the knee joint and various loads acting on the anterior cruciate ligament as a function of flexion angle is presented here with an emphasis on the gaps. Briefly, we also review mechanical characterization composition and anatomy of the anterior cruciate ligament as well as graft materials used for replacement/reconstruction surgeries. The key conclusions of this review are as follows: (a the highest shear forces on the anterior cruciate ligament occur during hyperextension/low flexion angles of the knee joint; (b the characterization of the anterior cruciate ligament at variable strain rates is critical to model a viscoelastic behavior; however, studies on human anterior cruciate ligament on variable strain rates are yet to be reported; (c a significant disparity on maximum stress/strain pattern of the anterior cruciate ligament was observed in the earlier works; (d nearly all synthetic grafts have been recalled from the market; and (e bridge-enhanced repair developed by Murray is a promising technique for anterior cruciate ligament reconstruction, currently in clinical trials. It is important to note that full extension of the knee is not feasible in the case of most animals and hence the loading pattern of human ACL is different from animal models. Many of the

Injuries of the lateral collateral ligaments of the ankle: assessment with MR imaging

Energy Technology Data Exchange (ETDEWEB)

Kreitner, K.F.; Ferber, A.; Grebe, P.; Thelen, M. [Department of Radiology, Johannes Gutenberg University Mainz (Germany); Runkel, M. [Department of Traumatologic and Reconstructive Surgery, Johannes Gutenberg University Mainz (Germany); Berger, S. [Department of Pediatric Surgery, Johannes Gutenberg University Mainz (Germany)

1999-04-01

The aim of this study was to evaluate the ability of MRI to display injuries of the lateral collateral ligamentous complex in patients with an acute ankle distorsion trauma. The MR examinations of 36 patients with ankle pain after ankle distorsion were evaluated retrospectively without knowledge of clinical history, outcome and/or operative findings. The examinations were performed on a 1.5-T whole-body imager using a flexible surface coil. The signs for ligamentous abnormality were as follows: complete or partial discontinuity, increased signal within, and irregularity and waviness of the ligament. The results were compared with operative findings in 18 patients with subsequent surgical repair. Eighteen patients with conservative therapy had a follow-up MR examination after 3 months. There was 1 sprain, 3 partial and 32 complete tears of the anterior talofibular ligament, and 5 sprains, 5 partial, and 7 complete tears of the calcaneofibular ligament. There were no lesions of the posterior talofibular ligament. Compared with surgery, MRI demonstrated in 18 of 18 cases the exact extent of anterior talofibular ligament injuries and underestimated the extent in 2 of 8 cases of calcaneofibular ligament injury. In patients with follow-up MRI after conservative therapy, a thickened band-like structure was found along the course of the injured ligament in 17 of 18 cases. The absence of ligament repair after conservative treatment was confirmed during operative revision in one case. The MRI technique allows for grading of the extent of injury of the lateral collateral ligamentous complex after acute ankle strain. It seems to be suitable for monitoring the healing process after conservative-functional treatment of ligament tears. (orig.) With 5 figs., 2 tabs., 26 refs.

Injuries of the lateral collateral ligaments of the ankle: assessment with MR imaging

International Nuclear Information System (INIS)

Kreitner, K.F.; Ferber, A.; Grebe, P.; Thelen, M.; Runkel, M.; Berger, S.

1999-01-01

The aim of this study was to evaluate the ability of MRI to display injuries of the lateral collateral ligamentous complex in patients with an acute ankle distorsion trauma. The MR examinations of 36 patients with ankle pain after ankle distorsion were evaluated retrospectively without knowledge of clinical history, outcome and/or operative findings. The examinations were performed on a 1.5-T whole-body imager using a flexible surface coil. The signs for ligamentous abnormality were as follows: complete or partial discontinuity, increased signal within, and irregularity and waviness of the ligament. The results were compared with operative findings in 18 patients with subsequent surgical repair. Eighteen patients with conservative therapy had a follow-up MR examination after 3 months. There was 1 sprain, 3 partial and 32 complete tears of the anterior talofibular ligament, and 5 sprains, 5 partial, and 7 complete tears of the calcaneofibular ligament. There were no lesions of the posterior talofibular ligament. Compared with surgery, MRI demonstrated in 18 of 18 cases the exact extent of anterior talofibular ligament injuries and underestimated the extent in 2 of 8 cases of calcaneofibular ligament injury. In patients with follow-up MRI after conservative therapy, a thickened band-like structure was found along the course of the injured ligament in 17 of 18 cases. The absence of ligament repair after conservative treatment was confirmed during operative revision in one case. The MRI technique allows for grading of the extent of injury of the lateral collateral ligamentous complex after acute ankle strain. It seems to be suitable for monitoring the healing process after conservative-functional treatment of ligament tears. (orig.)

MR imaging of normal extrinsic wrist ligaments using thin slices with clinical and surgical correlation

Energy Technology Data Exchange (ETDEWEB)

Shahabpour, M., E-mail: maryam.shahabpour@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); De Maeseneer, M., E-mail: michel.demaeseneer@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Pouders, C. [Department of Experimental Anatomy, Vrije Universiteit Brussel (Belgium); Van Overstraeten, L. [Department of Foot and Hand Surgery, Centre Hospitalier Regional de Wallonie Picarde, Tournai (Belgium); Ceuterick, P. [Department of Hand Surgery, Europa Ziekenhuizen, Brussels (Belgium); Fierens, Y. [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Goubau, J. [Department of Orthopaedic Surgery, UZ Brussel, Brussels (Belgium); De Mey, J. [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium)

2011-02-15

Eighty-nine MR examinations of the wrist were retrospectively analyzed. MRI results were compared with clinical findings and/or arthroscopy. Thin proton density and T2 weighted sequences and 3D DESS weighted sequences were applied on a 1.5 T scanner. On the palmar side three radiocarpal ligaments are recognized including the radioscaphocapitate, radiolunotriquetral, radioscapholunate, and midcarpal triquetroscaphoidal ligaments. Ulnocarpal ligaments include the ulnolunate ligament and the ulnotriquetral ligament. On the dorsal side three ligaments are recognized: the dorsal radiolunotriquetral, and the midcarpal triquetroscaphoidal and triquetro-trapezoido-trapezial. The collateral ligaments include the radial and ulnar collateral ligament. MR is a valuable technique in the assessment of the extrinsic and midcarpal ligaments. Depiction of the extrinsic ligaments can best be accomplished with coronal 3D DESS sequences and sagittal and transverse proton density and T2 weighted sequences with thin slices.

Anterior cruciate ligament repair - past, present and future.

Science.gov (United States)

Mahapatra, Piyush; Horriat, Saman; Anand, Bobby S

2018-06-15

This article provides a detailed narrative review on the history and current concepts surrounding ligamentous repair techniques in athletic patients. In particular, we will focus on the anterior cruciate ligament (ACL) as a case study in ligament injury and ligamentous repair techniques. PubMed (MEDLINE), EMBASE and Cochrane Library databases for papers relating to primary anterior cruciate ligament reconstruction were searched by all participating authors. All relevant historical papers were included for analysis. Additional searches of the same databases were made for papers relating to biological enhancement of ligament healing. The poor capacity of the ACL to heal is one of the main reasons why the current gold standard surgical treatment for an ACL injury in an athletic patient is ACL reconstruction with autograft from either the hamstrings or patella tendon. It is hypothesised that by preserving and repairing native tissues and negating the need for autograft that primary ACL repair may represent a key step change in the treatment of ACL injuries. The history of primary ACL repair will be discussed and the circumstances that led to the near-abandonment of primary ACL repair techniques will be reviewed. There has been a recent resurgence in interest with regards to primary ACL repair. Improvements in imaging now allow for identification of tear location, with femoral-sided injuries, being more suitable for repair. We will discuss in details strategies for improving the mechanical and biological environment in order to allow primary healing to occur. In particular, we will explain mechanical supplementation such as Internal Brace Ligament Augmentation and Dynamic Intraligamentary Stabilisation techniques. These are novel techniques that aim to protect the primary repair by providing a stabilising construct that connects the femur and the tibia, thus bridging the repair. In addition, biological supplementation is being investigated as an adjunct and we will

The Psychometrics of the Mini-K.

Science.gov (United States)

Richardson, George B; Chen, Ching-Chen; Dai, Chia-Liang; Brubaker, Michael D; Nedelec, Joseph L

2017-01-01

Many published studies have employed the Mini-K to measure a single fast-slow life history dimension. However, the internal structure of the Mini-K has not been determined and it is not clear that a single higher order K-factor fits the data. It is also not clear that the Mini-K is measurement invariant across groups such as the sexes. To establish the construct validity of K as well as the broader usefulness of applying life history theory to humans, it is crucial that these psychometric issues are addressed as a part of measure validation efforts. Here we report on three studies that used latent variable modeling and data drawn from two college student samples ( ns = 361 and 300) to elucidate the psychometrics of the Mini-K. We found that (a) the Mini-K had a six dimensional first-order structure, (b) the K-factor provided a parsimonious explanation of the associations among the lower order factors at no significant cost to fit, (c) the Mini-K measured the same K-factor across the sexes, (d) K-factor means did not have the same meaning across the sexes and thus the first-order factors should be used in studies of mean sex differences, and finally, (e) the K-factor was only associated with environment and aspects of mating competition in females. Implications and future directions for life history research are discussed.

MR imaging of posterior cruciate ligament injuries

Energy Technology Data Exchange (ETDEWEB)

Takahashi, Nobuyuki [Tsukuba Univ., Ibaraki (Japan). Hospital; Niitsu, Mamoru; Itai, Yuji; Sato, Motohiro; Kujiraoka, Yuka; Ikeda, Kotaro; Kanamori, Akihiro

2001-07-01

Posterior cruciate ligament (PCL) injuries are less frequent than anterior cruciate ligament (ACL) injuries, but are presumably more common than once thought. Thirty-nine patients with PCL injuries identified on MR images were studied. The criteria for PCL injury were complete tear, partial tear, and avulsion fracture. The approximate site of a partial tear was categorized as proximal, midsubstance, distal, or combination. Fourteen patients (35.9%) had complete tears of the PCL, 21 patients (53.8%) had partial tears, and four patients (10.3%) had avulsion fractures. A total of 12 patients (30.7%) had isolated PCL injuries, while the remaining 27 patients demonstrated evidence of other coexistent knee injuries, such as meniscal tears and ligamentous injuries. Of coexistent knee injuries, meniscal tears (18 patients, 46.2%) were most often seen. (author)

MR imaging of posterior cruciate ligament injuries

International Nuclear Information System (INIS)

Takahashi, Nobuyuki; Niitsu, Mamoru; Itai, Yuji; Sato, Motohiro; Kujiraoka, Yuka; Ikeda, Kotaro; Kanamori, Akihiro

2001-01-01

Posterior cruciate ligament (PCL) injuries are less frequent than anterior cruciate ligament (ACL) injuries, but are presumably more common than once thought. Thirty-nine patients with PCL injuries identified on MR images were studied. The criteria for PCL injury were complete tear, partial tear, and avulsion fracture. The approximate site of a partial tear was categorized as proximal, midsubstance, distal, or combination. Fourteen patients (35.9%) had complete tears of the PCL, 21 patients (53.8%) had partial tears, and four patients (10.3%) had avulsion fractures. A total of 12 patients (30.7%) had isolated PCL injuries, while the remaining 27 patients demonstrated evidence of other coexistent knee injuries, such as meniscal tears and ligamentous injuries. Of coexistent knee injuries, meniscal tears (18 patients, 46.2%) were most often seen. (author)

A simplistic analytical unit cell based model for the effective thermal conductivity of high porosity open-cell metal foams

International Nuclear Information System (INIS)

Yang, X H; Kuang, J J; Lu, T J; Han, F S; Kim, T

2013-01-01

We present a simplistic yet accurate analytical model for the effective thermal conductivity of high porosity open-cell metal foams saturated in a low conducting fluid (air). The model is derived analytically based on a realistic representative unit cell (a tetrakaidecahedron) under the assumption of one-dimensional heat conduction along highly tortuous-conducting ligaments at high porosity ranges (ε ⩾ 0.9). Good agreement with existing experimental data suggests that heat conduction along highly conducting and tortuous ligaments predominantly defines the effective thermal conductivity of open-cell metal foams with negligible conduction in parallel through the fluid phase. (paper)

Specialisation of extracellular matrix for function in tendons and ligaments

Science.gov (United States)

Birch, Helen L.; Thorpe, Chavaunne T.; Rumian, Adam P.

2013-01-01

Summary Tendons and ligaments are similar structures in terms of their composition, organisation and mechanical properties. The distinction between them stems from their anatomical location; tendons form a link between muscle and bone while ligaments link bones to bones. A range of overlapping functions can be assigned to tendon and ligaments and each structure has specific mechanical properties which appear to be suited for particular in vivo function. The extracellular matrix in tendon and ligament varies in accordance with function, providing appropriate mechanical properties. The most useful framework in which to consider extracellular matrix differences therefore is that of function rather than anatomical location. In this review we discuss what is known about the relationship between functional requirements, structural properties from molecular to gross level, cellular gene expression and matrix turnover. The relevance of this information is considered by reviewing clinical aspects of tendon and ligament repair and reconstructive procedures. PMID:23885341

Ex Vivo Growth of Bioengineered Ligaments and Other Tissues

Science.gov (United States)

Altman, Gregory; Kaplan, David L.; Martin, Ivan; Vunjak-Novakovic, Gordana

2005-01-01

A method of growing bioengineered tissues for use in surgical replacement of damaged anterior cruciate ligaments has been invented. An anterior cruciate ligament is one of two ligaments (the other being the posterior cruciate ligament) that cross in the middle of a knee joint and act to prevent the bones in the knee from sliding forward and backward relative to each other. Anterior cruciate ligaments are frequently torn in sports injuries and traffic accidents, resulting in pain and severe limitations on mobility. By making it possible to grow replacement anterior cruciate ligaments that structurally and functionally resemble natural ones more closely than do totally synthetic replacements, the method could create new opportunities for full or nearly full restoration of functionality in injured knees. The method is also adaptable to the growth of bioengineered replacements for other ligaments (e.g., other knee ligaments as well as those in the hands, wrists, and elbows) and to the production of tissues other than ligaments, including cartilage, bones, muscles, and blood vessels. The method is based on the finding that the histomorphological properties of a bioengineered tissue grown in vitro from pluripotent cells within a matrix are affected by the direct application of mechanical force to the matrix during growth generation. This finding provides important new insights into the relationships among mechanical stress, biochemical and cell-immobilization methods, and cell differentiation, and is applicable to the production of the variety of tissues mentioned above. Moreover, this finding can be generalized to nonmechanical (e.g., chemical and electromagnetic) stimuli that are experienced in vivo by tissues of interest and, hence, the method can be modified to incorporate such stimuli in the ex vivo growth of replacements for the various tissues mentioned above. In this method, a three-dimensional matrix made of a suitable material is seeded with pluripotent stem

Estrogen inhibits lysyl oxidase and decreases mechanical function in engineered ligaments.

Science.gov (United States)

Lee, Cassandra A; Lee-Barthel, Ann; Marquino, Louise; Sandoval, Natalie; Marcotte, George R; Baar, Keith

2015-05-15

Women are more likely to suffer an anterior cruciate ligament (ACL) rupture than men, and the incidence of ACL rupture in women rises with increasing estrogen levels. We used an engineered ligament model to determine how an acute rise in estrogen decreases the mechanical properties of ligaments. Using fibroblasts isolated from human ACLs from male or female donors, we engineered ligaments and determined that ligaments made from female ACL cells had more collagen and were equal in strength to those made from male ACL cells. We then treated engineered ligaments for 14 days with low (5 pg/ml), medium (50 pg/ml), or high (500 pg/ml) estrogen, corresponding to the range of in vivo serum estrogen concentrations and found that collagen within the grafts increased without a commensurate increase in mechanical strength. Mimicking the menstrual cycle, with 12 days of low estrogen followed by 2 days of physiologically high estrogen, resulted in a decrease in engineered ligament mechanical function with no change in the amount of collagen in the graft. The decrease in mechanical stiffness corresponded with a 61.7 and 76.9% decrease in the activity of collagen cross-linker lysyl oxidase with 24 and 48 h of high estrogen, respectively. Similarly, grafts treated with the lysyl oxidase inhibitor β-aminoproprionitrile (BAPN) for 24 h showed a significant decrease in ligament mechanical strength [control (CON) = 1.58 ± 0.06 N; BAPN = 1.06 ± 0.13 N] and stiffness (CON = 7.7 ± 0.46 MPa; BAPN = 6.1 ± 0.71 MPa) without changing overall collagen levels (CON = 396 ± 11.5 μg; BAPN = 382 ± 11.6 μg). Together, these data suggest that the rise in estrogen during the follicular phase decreases lysyl oxidase activity in our engineered ligament model and if this occurs in vivo may decrease the stiffness of ligaments and contribute to the elevated rate of ACL rupture in women. Copyright © 2015 the American Physiological Society.

Wrist ligament injuries: value of post-arthrography computed tomography

Energy Technology Data Exchange (ETDEWEB)

Theumann, N.; Schnyder, P.; Meuli, R. [Dept. of Diagnostic and Interventional Radiology, University Hospital, CHUV, Lausanne (Switzerland); Favarger, N. [Clinique Longeraie, Lausanne (Switzerland)

2001-02-01

Objective: To evaluate the use of post-arthrography high-resolution computed tomography in wrist ligament injuries.Design and patients: Thirty-six consecutive patients who had a history and clinical findings suggestive of ligamentous injuries of the wrist were prospectively studied. The findings of three-compartment arthrography and post-arthrography computed tomography (arthro-CT) were compared with those of arthroscopy. The evaluation concentrates on the detection and precise localization of ligament lesions in the triangular fibrocartilage (TFC), the scapholunate ligament (SLL) and the lunotriquetral ligament (LTL).Results: For TFC, SLL and LTL lesions, standard arthrography responded with a sensitivity and specificity of 85% and 100%, 85% and 100%, 80% and 100% respectively, while arthro-CT showed a sensitivity and specificity of 85% and 100%, 100% and 100%, 80% and 100% respectively. The precise localization of the lesions was possible only with arthro-CT.Conclusion: The sensitivity and specificity of standard arthrography and arthro-CT are similar, although the latter shows the site of tears or perforation with greater precision, while conventional arthrography demonstrates them indirectly. This precision is essential and may have clinical implications for the success of treatment procedures. (orig.)

Rigid immobilization alters matrix organization in the injured rat medial collateral ligament.

Science.gov (United States)

Padgett, L R; Dahners, L E

1992-11-01

The effects of mobilization on matrix reorganization and density after ligament injury were studied in rat medial collateral ligaments using scanning electron microscopy (SEM). Both medial collateral ligaments of 14 Sprague-Dawley rats were sharply incised transversely at their midpoint. A 1.14-mm threaded Kirschner wire was driven through the tibia and into the femur of the right leg (through the knee) to immobilize that knee at 90 degrees of flexion. Four additional rats were used as controls. The right medial collateral ligament of the control rats was exposed in the same manner as the experimental rats and the wound closed without damaging the ligament. Rats were sacrificed on the 7th and 14th days postinjury and the ligaments evaluated by SEM. The electron micrographs from this study demonstrated that early on, the tissue at the injury site is disorganized on a gross scale with large bundles of poorly organized matrix. Large "defects" were present between bundles in the substance of the ligament and appeared as holes in the ligament around the injury site. As healing progressed, the matrix in the mobilized specimens appeared to bridge the injury site more rapidly and completely with fewer "defects" and thus higher density than the immobilized specimens.

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.

Strengthening exercises for old cruciate ligament tears.

Science.gov (United States)

Tegner, Y; Lysholm, J; Lysholm, M; Gillquist, J

1986-04-01

Fifty-three consecutive patients with troublesome old cruciate ligament lesions underwent a 3-month thigh and calf muscle training program. Before training, the diagnosis was established by arthroscopy and clinical examination under anesthesia. Significant improvement in strength, performance, knee score, and activity level took place; the majority were improved and declined surgery. A period of strength training is recommended before the decision to undertake surgery for cruciate ligament injury.

Relationship between stress ankle radiographs and injured ligaments on MRI

International Nuclear Information System (INIS)

Lee, Kyoung Min; Chung, Chin Youb; Chung, Myung Ki; Won, Sung Hun; Lee, Seung Yeol; Park, Moon Seok; Kwon, Soon-Sun

2013-01-01

This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

Aetiology and pathogenesis of cranial cruciate ligament rupture in cats by histological examination.

Science.gov (United States)

Wessely, Marlis; Reese, Sven; Schnabl-Feichter, Eva

2017-06-01

Objectives The aim of this study was to examine histologically intact and ruptured cranial cruciate ligaments in cats, in order to evaluate whether degeneration is a prerequisite for rupture. Methods We performed a histological examination of 50 intact and 19 ruptured cranial cruciate ligaments in cadaver or client-owned cats, respectively, using light microscopy. Cats with stifle pathology were further divided into five age groups in order to investigate the relationship of changes in the ligament with lifespan. Cats with ruptured cranial cruciate ligaments were divided into two groups according to medical history (with presumed history of trauma or without any known history of trauma) in order to investigate the relationship of ligament rupture with a traumatic event. Data from 200 healthy cats were selected randomly and reviewed to make a statistical comparison of cats with and without cranial cruciate ligament rupture (reference group). Results On histological examination, the intact cranial cruciate ligaments showed basic parallel arrangement of the collagen fibres, with no relation to age. While cats of a more advanced age showed fibrocartilage in the middle of the cranial cruciate ligament - a likely physiological reaction to compression forces over the lifespan - degenerative changes within the fibrocartilage were absent in all cases, regardless of age or rupture status. Cats suffering from cranial cruciate ligament rupture without history of trauma were significantly older than cats in the reference group. Conclusions and relevance This study showed that differentiation of fibrocartilage in the middle of the cranial cruciate ligament is likely a physiological reaction to compressive forces and not a degenerative change associated with greater risk of rupture in advanced age. This finding in cats is distinct from the known decrease in differentiation of fibrocartilage in dogs with cranial cruciate ligament rupture. Furthermore, the histological examination

Effects of mechanical strain on human mesenchymal stem cells and ligament fibroblasts in a textured poly(L-lactide) scaffold for ligament tissue engineering.

Science.gov (United States)

Kreja, Ludwika; Liedert, Astrid; Schlenker, Heiter; Brenner, Rolf E; Fiedler, Jörg; Friemert, Benedikt; Dürselen, Lutz; Ignatius, Anita

2012-10-01

The purpose of this study was to prove the effect of cyclic uniaxial intermittent strain on the mRNA expression of ligament-specific marker genes in human mesenchymal stem cells (MSC) and anterior cruciate ligament-derived fibroblasts (ACL-fibroblasts) seeded onto a novel textured poly(L-lactide) scaffold (PLA scaffold). Cell-seeded scaffolds were mechanically stimulated by cyclic uniaxial stretching. The expression of ligament matrix gene markers: collagen types I and III, fibronectin, tenascin C and decorin, as well as the proteolytic enzymes matrix metalloproteinase MMP-1 and MMP-2 and their tissue specific inhibitors TIMP-1 and TIMP-2 was investigated by analysing the mRNA expression using reverse transcriptase polymerase chain reaction and related to the static control. In ACL-fibroblasts seeded on PLA, mechanical load induced up-regulation of collagen types I and III, fibronectin and tenascin C. No effect of mechanical stimulation on the expression of ligament marker genes was found in undifferentiated MSC seeded on PLA. The results indicated that the new textured PLA scaffold could transfer the mechanical load to the ACL-fibroblasts and improved their ligament phenotype. This scaffold might be suitable as a cell-carrying component of ACL prostheses.

Mini-Membrane Evaporator for Contingency Spacesuit Cooling

Science.gov (United States)

Makinen, Janice V.; Bue, Grant C.; Campbell, Colin; Petty, Brian; Craft, Jesse; Lynch, William; Wilkes, Robert; Vogel, Matthew

2015-01-01

The next-generation Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support System (PLSS) is integrating a number of new technologies to improve reliability and functionality. One of these improvements is the development of the Auxiliary Cooling Loop (ACL) for contingency crewmember cooling. The ACL is a completely redundant, independent cooling system that consists of a small evaporative cooler--the Mini Membrane Evaporator (Mini-ME), independent pump, independent feedwater assembly and independent Liquid Cooling Garment (LCG). The Mini-ME utilizes the same hollow fiber technology featured in the full-sized AEMU PLSS cooling device, the Spacesuit Water Membrane Evaporator (SWME), but Mini-ME occupies only approximately 25% of the volume of SWME, thereby providing only the necessary crewmember cooling in a contingency situation. The ACL provides a number of benefits when compared with the current EMU PLSS contingency cooling technology, which relies upon a Secondary Oxygen Vessel; contingency crewmember cooling can be provided for a longer period of time, more contingency situations can be accounted for, no reliance on a Secondary Oxygen Vessel (SOV) for contingency cooling--thereby allowing a reduction in SOV size and pressure, and the ACL can be recharged-allowing the AEMU PLSS to be reused, even after a contingency event. The first iteration of Mini-ME was developed and tested in-house. Mini-ME is currently packaged in AEMU PLSS 2.0, where it is being tested in environments and situations that are representative of potential future Extravehicular Activities (EVA's). The second iteration of Mini-ME, known as Mini-ME2, is currently being developed to offer more heat rejection capability. The development of this contingency evaporative cooling system will contribute to a more robust and comprehensive AEMU PLSS.

Role of periodontal ligament fibroblasts in osteoclastogenesis: a review

NARCIS (Netherlands)

Sokos, D.; Everts, V.; de Vries, T.J.

2015-01-01

During the last decade it has become clear that periodontal ligament fibroblasts may contribute to the in vitro differentiation of osteoclasts. We surveyed the current findings regarding their osteoclastogenesis potential. Periodontal ligament fibroblasts have the capacity to select and attract

Use of an extracapsular stabilization technique to repair cruciate ligament ruptures in two avian species.

Science.gov (United States)

Chinnadurai, Sathya K; Spodnick, Gary; Degernes, Laurel; DeVoe, Ryan S; Marcellin-Little, Denis J

2009-12-01

An extracapsular stabilization technique was used to repair cruciate ligament ruptures in a trumpeter hornbill (Bycanistes bucinator) and an African grey parrot (Psittacus erithacus). The hornbill demonstrated cranial drawer motion and severe rotational instability of the stifle from ruptures of the cranial and caudal cruciate ligaments and stifle joint capsule. The luxation was reduced, and the fibula was cranially transposed, in relation to the tibiotarsus, and anchored with 2 positive profile threaded acrylic pins. A lateral extracapsular stabilization was then performed. The African grey parrot had a traumatic stifle luxation, and an open reduction and a lateral extracapsular stabilization were performed. Both birds regained function of the affected leg by 1 month after surgery. Extracapsular stabilization allows motion of the stifle joint to be maintained during the postoperative recovery period, an advantage over rigid stabilization. Maintaining motion in the stifle joint facilitates physical therapy and can aid in full recovery after avian stifle injuries.

MINI-THESAURUS, Energy Data Base Subject Thesaurus Generator

International Nuclear Information System (INIS)

Paulk, J.W.

2003-01-01

1 - Description of program or function: MINI-THESAURUS allows the user to subset into highly-specialized 'mini-thesauri' the Energy Data Base (EDB) Subject Thesaurus, which contains the standard vocabulary of indexing terms (descriptors) developed and structured by the Office of Scientific and Technical Information (OSTI) for the building and maintenance of the U.S. Department of Energy (DOE) energy information databases. This structured vocabulary reflects the scope of DOE's research, development, and technological programs and encompasses terminology derived not only from the basic sciences but also from the areas of energy, conservation, safety, environmental impact, and regulation. Entire word blocks may be copied from the primary Subject Thesaurus, from another mini-thesaurus, or both, and subsequently modified through the addition of new terms, the deletion of existing terms, and changes to the internal relationships among the word blocks within the mini-thesaurus to create a new, special-purpose thesaurus. MINI-THESAURUS also provides the ability to copy the entire Subject Thesaurus and to treat the copy as a mini-thesaurus, thus allowing one to examine the effects of major changes to the thesaurus structure without having to modify the primary, on-line Thesaurus. The copy operation also optimizes the Subject Thesaurus structure. An interactive user having update privileges for a specific mini-thesaurus and access to the TeX and PostScript proprietary software can produce the mini-thesaurus in printed publication format. Once the mini-thesaurus has been published, periodic supplements may be generated based on date of entry or change maintained by the Thesaurus software. 2 Restrictions on the complexity of the problem: The system enforces the OSTI rules for Thesaurus development

Spurious RF signals emitted by mini-UAVs

Science.gov (United States)

Schleijpen, Ric (H. M. A.); Voogt, Vincent; Zwamborn, Peter; van den Oever, Jaap

2016-10-01

This paper presents experimental work on the detection of spurious RF emissions of mini Unmanned Aerial Vehicles (mini-UAV). Many recent events have shown that mini-UAVs can be considered as a potential threat for civil security. For this reason the detection of mini-UAVs has become of interest to the sensor community. The detection, classification and identification chain can take advantage of different sensor technologies. Apart from the signatures used by radar and electro-optical sensor systems, the UAV also emits RF signals. These RF signatures can be split in intentional signals for communication with the operator and un-intentional RF signals emitted by the UAV. These unintentional or spurious RF emissions are very weak but could be used to discriminate potential UAV detections from false alarms. The goal of this research was to assess the potential of exploiting spurious emissions in the classification and identification chain of mini-UAVs. It was already known that spurious signals are very weak, but the focus was on the question whether the emission pattern could be correlated to the behaviour of the UAV. In this paper experimental examples of spurious RF emission for different types of mini-UAVs and their correlation with the electronic circuits in the UAVs will be shown

Isolation and Characterization of Human Mesenchymal Stem Cells From Facet Joints and Interspinous Ligaments.

Science.gov (United States)

Kristjánsson, Baldur; Limthongkul, Worawat; Yingsakmongkol, Wicharn; Thantiworasit, Pattarawat; Jirathanathornnukul, Napaphat; Honsawek, Sittisak

2016-01-01

A descriptive in vitro study on isolation and differentiation of human mesenchymal stem cells (MSCs) derived from the facet joints and interspinous ligaments. To isolate cells from the facet joints and interspinous ligaments and investigate their surface marker profile and differentiation potentials. Lumbar spinal canal stenosis and ossification of the posterior longitudinal ligament are progressive conditions characterized by the hypertrophy and ossification of ligaments and joints within the spinal canal. MSCs are believed to play a role in the advancement of these diseases and the existence of MSCs has been demonstrated within the ligamentum flavum and posterior longitudinal ligament. The aim of this study was to investigate whether these cells could also be found within facet joints and interspinous ligaments. Samples were harvested from 10 patients undergoing spinal surgery. The MSCs from facet joints and interspinous ligaments were isolated using direct tissue explant technique. Cell surface antigen profilings were performed via flow cytometry. Their lineage differentiation potentials were analyzed. The facet joints and interspinous ligaments-derived MSCs have the tri-lineage potential to be differentiated into osteogenic, adipogenic, and chondrogenic cells under appropriate inductions. Flow cytometry analysis revealed both cell lines expressed MSCs markers. Both facet joints and interspinous ligaments-derived MSCs expressed marker genes for osteoblasts, adipocytes, and chondrocytes. The facet joints and interspinous ligaments may provide alternative sources of MSCs for tissue engineering applications. The facet joints and interspinous ligaments-derived MSCs are part of the microenvironment of the human ligaments of the spinal column and might play a crucial role in the development and progression of degenerative spine conditions.

The role of mechanical loading in ligament tissue engineering.

Science.gov (United States)

Benhardt, Hugh A; Cosgriff-Hernandez, Elizabeth M

2009-12-01

Tissue-engineered ligaments have received growing interest as a promising alternative for ligament reconstruction when traditional transplants are unavailable or fail. Mechanical stimulation was recently identified as a critical component in engineering load-bearing tissues. It is well established that living tissue responds to altered loads through endogenous changes in cellular behavior, tissue organization, and bulk mechanical properties. Without the appropriate biomechanical cues, new tissue formation lacks the necessary collagenous organization and alignment for sufficient load-bearing capacity. Therefore, tissue engineers utilize mechanical conditioning to guide tissue remodeling and improve the performance of ligament grafts. This review provides a comparative analysis of the response of ligament and tendon fibroblasts to mechanical loading in current bioreactor studies. The differential effect of mechanical stimulation on cellular processes such as protease production, matrix protein synthesis, and cell proliferation is examined in the context of tissue engineering design.

The Gore-Tex prosthetic ligament as a salvage procedure in deficient knees

NARCIS (Netherlands)

Roolker, W.; Patt, T. W.; van Dijk, C. N.; Vegter, M.; Marti, R. K.

2000-01-01

The purpose of this study was to evaluate the results of prosthetic ligament replacement of the anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) with the Gore-Tex polytetrafluorethyene prosthesis (W.L. Gore and Co., Flagstaff, Ariz. ) in 52 patients (54 knees). All patients

Allogeneic versus autologous derived cell sources for use in engineered bone-ligament-bone grafts in sheep anterior cruciate ligament repair.

Science.gov (United States)

Mahalingam, Vasudevan D; Behbahani-Nejad, Nilofar; Horine, Storm V; Olsen, Tyler J; Smietana, Michael J; Wojtys, Edward M; Wellik, Deneen M; Arruda, Ellen M; Larkin, Lisa M

2015-03-01

The use of autografts versus allografts for anterior cruciate ligament (ACL) reconstruction is controversial. The current popular options for ACL reconstruction are patellar tendon or hamstring autografts, yet advances in allograft technologies have made allogeneic grafts a favorable option for repair tissue. Despite this, the mismatched biomechanical properties and risk of osteoarthritis resulting from the current graft technologies have prompted the investigation of new tissue sources for ACL reconstruction. Previous work by our lab has demonstrated that tissue-engineered bone-ligament-bone (BLB) constructs generated from an allogeneic cell source develop structural and functional properties similar to those of native ACL and vascular and neural structures that exceed those of autologous patellar tendon grafts. In this study, we investigated the effectiveness of our tissue-engineered ligament constructs fabricated from autologous versus allogeneic cell sources. Our preliminary results demonstrate that 6 months postimplantation, our tissue-engineered auto- and allogeneic BLB grafts show similar histological and mechanical outcomes indicating that the autologous grafts are a viable option for ACL reconstruction. These data indicate that our tissue-engineered autologous ligament graft could be used in clinical situations where immune rejection and disease transmission may preclude allograft use.

Mini-Sniffer III on Lakebed

Science.gov (United States)

1976-01-01

The third remotely-piloted Mini-Sniffer research vehicle rests on the lakebed adjacent to the Dryden Flight Research Center, Edwards, California. This view shows the wing shape, hydrazine engine, and the tail booms. The Mini-Sniffer was a remotely controlled, propeller-driven vehicle developed at the NASA Flight Research Center (which became the Dryden Flight Research Center, Edwards, California, in 1976) as a potential platform to sample the upper atmosphere for pollution. The vehicle, flown from 1975 to 1977, was one of the earliest attempts by NASA to develop an aircraft that could sense turbulence and measure natural and human-produced atmospheric pollutants at altitudes above 80,000 feet with a variable-load propeller that was never flight-tested. Three Mini-Sniffer vehicles were built. The number 1 Mini-Sniffer vehicle had swept wings with a span of 18 feet and canards on the nose. It flew 12 flights with the gas-powered engine at low altitudes of around 2,500 feet. The number 1 vehicle was then modified into version number 2 by removing the canards and wing rudders and adding wing tips and tail booms. Twenty flights were made with this version, up to altitudes of 20,000 feet. The number 3 vehicle had a longer fuselage, was lighter in weight, and was powered by the non-air-breathing hydrazine engine designed by NASA's Johnson Space Center in Houston, Texas. This version was designed to fly a 25-pound payload to an altitude of 70,000 feet for one hour or to climb to 90,000 feet and glide back. The number 3 Mini-Sniffer made one flight to 20,000 feet and was not flown again because of a hydrazine leak problem. All three versions used a pusher propeller to free the nose area for an atmospheric-sampling payload. At various times the Mini-Sniffer has been considered for exploration in the carbon dioxide atmosphere of the planet Mars, where the gravity (38 percent of that on Earth) would reduce the horsepower needed for flight.

Feasibility of mini-tablets as a flexible drug delivery tool.

Science.gov (United States)

Mitra, Biplob; Chang, Jessica; Wu, Sy-Juen; Wolfe, Chad N; Ternik, Robert L; Gunter, Thomas Z; Victor, Michael C

2017-06-15

Mini-tablets have potential applications as a flexible drug delivery tool in addition to their generally perceived use as multi-particulates. That is, mini-tablets could provide flexibility in dose finding studies and/or allow for combination therapies in the clinic. Moreover, mini-tablets with well controlled quality attributes could be a prudent choice for administering solid dosage forms as a single unit or composite of multiple mini-tablets in patient populations with swallowing difficulties (e.g., pediatric and geriatric populations). This work demonstrated drug substance particle size and concentration ranges that achieve acceptable mini-tablet quality attributes for use as a single or composite dosage unit. Immediate release and orally disintegrating mini-tablet formulations with 30μm to 350μm (particle size d 90 ) acetaminophen and Compap™ L (90% acetaminophen) at concentrations equivalent to 6.7% and 26.7% acetaminophen were evaluated. Mini-tablets achieved acceptable weight variability, tensile strength, friability, and disintegration time at a reasonable solid fraction for each formulation. The content uniformity was acceptable for mini-tablets of 6.7% formulations with ≤170μm drug substance, mini-tablets of all 26.7% formulations, and composite dosage units containing five or more mini-tablets of any formulation. Results supported the manufacturing feasibility of quality mini-tablets, and their applicability as a flexible drug delivery tool. Copyright © 2017 Elsevier B.V. All rights reserved.

Biomechanical analysis of ankle ligamentous sprain injury cases from televised basketball games: Understanding when, how and why ligament failure occurs.

Science.gov (United States)

Panagiotakis, Emmanouil; Mok, Kam-Ming; Fong, Daniel Tik-Pui; Bull, Anthony M J

2017-12-01

Ankle sprains due to landing on an opponent's foot are common in basketball. There is no analysis to date that provides a quantification of this injury mechanism. The aim of this study was to quantify the kinematics of this specific injury mechanism and relate this to lateral ankle ligament biomechanics. Case series. The model-based image-matching technique was used to quantify calcaneo-fibular-talar kinematics during four ankle inversion sprain injury incidents in televised NBA basketball games. The four incidents follow the same injury pattern in which the players of interest step onto an opponent's foot with significant inversion and a diagnosed ankle injury. A geometric analysis was performed to calculate the in vivo ligament strains and strain rates for the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). Despite the controlled selection of cases, the results show that there are two distinct injury mechanisms: sudden inversion and internal rotation with low levels of plantarflexion; and a similar mechanism without internal rotation. The first of these mechanisms results in high ATFL and CFL strains, whereas the second of these strains the CFL in isolation. The injury mechanism combined with measures of the ligament injury in terms of percentage of strain to failure correlate directly with the severity of the injury quantified by return-to-sport. The opportunity to control excessive internal rotation through proprioceptive training and/or prophylactic footwear or bracing could be utilised to reduce the severity of common ankle injuries in basketball. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

CT anatomy of right phrenic nerve and pulmonary ligament

International Nuclear Information System (INIS)

Berkmen, Y.M.; Kazam, E.; Auh, Y.

1988-01-01

The relationship between the right phrenic nerve and the right pulmonary ligament was studied in eight cadavers and 100 computed tomographic (CT) examinations. The pulmonary ligament originates below the inferior pulmonary vein and is constantly posterior to the inferior vena cava. The lower end of the right phrenic nerve, on the other hand, descends over the lateral surface of the inferior vena cava, accompanied by the right cardiophrenic artery. The nerve spreads over the diaphragm within a thick parietal pleural fold, wrapped in a fatty tissue, and this should not be confused with pulmonary ligament on CT

In Vivo Study of Ligament-Bone Healing after Anterior Cruciate Ligament Reconstruction Using Autologous Tendons with Mesenchymal Stem Cells Affinity Peptide Conjugated Electrospun Nanofibrous Scaffold

Directory of Open Access Journals (Sweden)

Jingxian Zhu

2013-01-01

Full Text Available Electrospinning nanofibrous scaffold was commonly used in tissue regeneration recently. Nanofibers with specific topological characteristics were reported to be able to induce osteogenic differentiation of MSCs. In this in vivo study, autologous tendon grafts with lattice-like nanofibrous scaffold wrapping at two ends of autologous tendon were used to promote early stage of ligament-bone healing after rabbit ACL reconstruction. To utilize native MSCs from bone marrow, an MSCs specific affinity peptide E7 was conjugated to nanofibrous meshes. After 3 months, H-E assessment and specific staining of collagen type I, II, and III showed direct ligament-bone insertion with typical four zones (bone, calcified fibrocartilage, fibrocartilage, and ligament in bioactive scaffold reconstruction group. Diameters of bone tunnel were smaller in nanofibrous scaffold conjugated E7 peptide group than those in control group. The failure load of substitution complex also indicated a stronger ligament-bone insertion healing using bioactive scaffold. In conclusion, lattice-like nanofibrous scaffold with specific MSCs affinity peptide has great potential in promoting early stage of ligament-bone healing after ACL reconstruction.

Injuries to the Collateral Ligaments of the Metacarpophalangeal Joint of the Thumb, Including Simultaneous Combined Thumb Ulnar and Radial Collateral Ligament Injuries, in National Football League Athletes.

Science.gov (United States)

Werner, Brian C; Belkin, Nicole S; Kennelly, Steve; Weiss, Leigh; Barnes, Ronnie P; Rodeo, Scott A; Warren, Russell F; Hotchkiss, Robert N

2017-01-01

Thumb collateral ligament injuries occur frequently in the National Football League (NFL). In the general population or in recreational athletes, pure metacarpophalangeal (MCP) abduction or adduction mechanisms yield isolated ulnar collateral ligament (UCL) and radial collateral ligament (RCL) tears, respectively, while NFL athletes may sustain combined mechanism injury patterns. To evaluate the incidence of simultaneous combined thumb UCL and RCL tears among all thumb MCP collateral ligament injuries in NFL athletes on a single team. Case series; Level of evidence, 4. A retrospective review of all thumb injuries on a single NFL team from 1991 to 2014 was performed. All players with a thumb MCP collateral ligament injury were included. Collateral ligament injuries were confirmed by review of both physical examination findings and magnetic resonance imaging. Player demographics, surgical details, and return-to-play data were obtained from the team electronic medical record and surgeons' records. A total of 36 thumbs in 32 NFL players were included in the study, yielding an incidence of 1.6 thumb MCP collateral ligament injuries per year on a single NFL team. Of these, 9 thumbs (25%) had a simultaneous combined UCL and RCL tear injury pattern confirmed on both physical examination and MRI. The remaining 27 thumbs (75%) were isolated UCL injuries. All combined UCL/RCL injuries required surgery due to dysfunction from instability; 63.0% of isolated UCL injuries required surgical repair ( P = .032) due to continued pain and dysfunction from instability. Repair, when required, was delayed until the end of the season. All players with combined UCL/RCL injuries and isolated UCL injuries returned to play professional football the following season. Simultaneous combined thumb UCL and RCL tear is a previously undescribed injury pattern that occurred in 25% of thumb MCP collateral ligament injuries on a single NFL team over a 23-year period. All players with combined thumb UCL

Keratinocyte growth factor mRNA expression in periodontal ligament fibroblasts

DEFF Research Database (Denmark)

Dabelsteen, S; Wandall, H H; Grøn, B

1997-01-01

Keratinocyte growth factor (KGF) is a fibroblast growth factor which mediates epithelial growth and differentiation. KGF is expressed in subepithelial fibroblasts, but generally not in fibroblasts of deep connective tissue, such as fascia and ligaments. Here we demonstrate that KGF mRNA is expres......Keratinocyte growth factor (KGF) is a fibroblast growth factor which mediates epithelial growth and differentiation. KGF is expressed in subepithelial fibroblasts, but generally not in fibroblasts of deep connective tissue, such as fascia and ligaments. Here we demonstrate that KGF m......RNA is expressed in periodontal ligament fibroblasts, and that the expression is increased upon serum stimulation. Fibroblasts from human periodontal ligament, from buccal mucosa, from gingiva, and from skin were established from explants. Alkaline phosphatase activity was used as an indicator of the periodontal...

Results of computer assisted mini-incision subvastus approach for total knee arthroplasty.

Science.gov (United States)

Turajane, Thana; Larbpaiboonpong, Viroj; Kongtharvonskul, Jatupon; Maungsiri, Samart

2009-12-01

Mini-incision subvastus approach is soft tissue preservation of the knee. Advantages of the mini-incision subvastus approach included reduced blood loss, reduced pain, self rehabilitation and faster recovery. However, the improved visualization, component alignment, and more blood preservation have been debatable to achieve the better outcome and preventing early failure of the Total Knee Arthroplasty (TKA). The computer navigation has been introduced to improve alignment and blood loss. The purpose of this study was to evaluate the short term outcomes of the combination of computer assisted mini-incision subvastus approach for Total Knee Arthroplasty (CMS-TKA). A prospective case series of the initial 80 patients who underwent computer assisted mini-incision subvastus approach for CMS-TKA from January 2007 to October 2008 was carried out. The patients' conditions were classified into 2 groups, the simple OA knee (varus deformity was less than 15 degree, BMI was less than 20%, no associated deformities) and the complex deformity (varus deformity was more than 15 degrees, BMI more was than 20%, associated with flexion contractor). There were 59 patients in group 1 and 21 patients in group 2. Of the 80 knees, 38 were on the left and 42 on the right. The results of CMS-TKA [the mean (range)] in group 1: group 2 were respectively shown as the incision length [10.88 (8-13): 11.92 (10-14], the operation time [118 (111.88-125.12): 131 (119.29-143.71) minutes, lateral releases (0 in both groups), postoperative range of motion in flexion [94.5 (90-100): 95.25 (90-105) degree] and extension [1.75 (0-5): 1.5 (0-5) degree] Blood loss in 24 hours [489.09 (414.7-563.48): 520 (503.46-636.54) ml] and blood transfusion [1 (0-1) unit? in both groups], Tibiofemoral angle preoperative [Varus = 4 (varus 0-10): Varus = 17.14 (varus 15.7-18.5) degree, Tibiofemoral angle postoperative [Valgus = 1.38 (Valgus 0-4): Valgus = 2.85 (valgus 2.1-3.5) degree], Tibiofemoral angle outlier (85% both

Mini-marathon groups: psychological "first aid" following disasters.

Science.gov (United States)

Terr, L C

1992-01-01

Large group counseling sessions for soldiers following battle have been commonly used since World War II. The author conceptualizes and demonstrates how these mini-marathon sessions can be adapted to support all ages and types of civilians involved in disasters. Mini-marathons take about 3 hours and are divided into three sections: story sharing, symptom sharing, and suggestions for self-help, including sharing tales of heroism and survival. After an initial mini-marathon session, a second session may be held emphasizing creativity. The author also describes how mini-marathons can be adapted for therapists who will lead their own sessions.

Visualization of Penile Suspensory Ligamentous System Based on Visible Human Data Sets

Science.gov (United States)

Chen, Xianzhuo; Wu, Yi; Tao, Ling; Yan, Yan; Pang, Jun; Zhang, Shaoxiang; Li, Shirong

2017-01-01

Background The aim of this study was to use a three-dimensional (3D) visualization technology to illustrate and describe the anatomical features of the penile suspensory ligamentous system based on the Visible Human data sets and to explore the suspensory mechanism of the penis for the further improvement of the penis-lengthening surgery. Material/Methods Cross-sectional images retrieved from the first Chinese Visible Human (CVH-1), third Chinese Visible Human (CVH-3), and Visible Human Male (VHM) data sets were used to segment the suspensory ligamentous system and its adjacent structures. The magnetic resonance imaging (MRI) images of this system were studied and compared with those from the Visible Human data sets. The 3D models reconstructed from the Visible Human data sets were used to provide morphological features of the penile suspensory ligamentous system and its related structures. Results The fundiform ligament was a superficial, loose, fibro-fatty tissue which originated from Scarpa’s fascia superiorly and continued to the scrotal septum inferiorly. The suspensory ligament and arcuate pubic ligament were dense fibrous connective tissues which started from the pubic symphysis and terminated by attaching to the tunica albuginea of the corpora cavernosa. Furthermore, the arcuate pubic ligament attached to the inferior rami of the pubis laterally. Conclusions The 3D model based on Visible Human data sets can be used to clarify the anatomical features of the suspensory ligamentous system, thereby contributing to the improvement of penis-lengthening surgery. PMID:28530218

The use of mini-samples in palaeomagnetism

Science.gov (United States)

Böhnel, Harald; Michalk, Daniel; Nowaczyk, Norbert; Naranjo, Gildardo Gonzalez

2009-10-01

Rock cores of ~25 mm diameter are widely used in palaeomagnetism. Occasionally smaller diameters have been used as well which represents distinct advantages in terms of throughput, weight of equipment and core collections. How their orientation precision compares to 25 mm cores, however, has not been evaluated in detail before. Here we compare the site mean directions and their statistical parameters for 12 lava flows sampled with 25 mm cores (standard samples, typically 8 cores per site) and with 12 mm drill cores (mini-samples, typically 14 cores per site). The site-mean directions for both sample sizes appear to be indistinguishable in most cases. For the mini-samples, site dispersion parameters k on average are slightly lower than for the standard samples reflecting their larger orienting and measurement errors. Applying the Wilcoxon signed-rank test the probability that k or α95 have the same distribution for both sizes is acceptable only at the 17.4 or 66.3 per cent level, respectively. The larger mini-core numbers per site appears to outweigh the lower k values yielding also slightly smaller confidence limits α95. Further, both k and α95 are less variable for mini-samples than for standard size samples. This is interpreted also to result from the larger number of mini-samples per site, which better averages out the detrimental effect of undetected abnormal remanence directions. Sampling of volcanic rocks with mini-samples therefore does not present a disadvantage in terms of the overall obtainable uncertainty of site mean directions. Apart from this, mini-samples do present clear advantages during the field work, as about twice the number of drill cores can be recovered compared to 25 mm cores, and the sampled rock unit is then more widely covered, which reduces the contribution of natural random errors produced, for example, by fractures, cooling joints, and palaeofield inhomogeneities. Mini-samples may be processed faster in the laboratory, which is of

Review of the Nomenclature of the Retaining Ligaments of the Cheek: Frequently Confused Terminology

Directory of Open Access Journals (Sweden)

Yeui Seok Seo

2017-07-01

Full Text Available Since the time of its inception within facial anatomy, wide variability in the terminology as well as the location and extent of retaining ligaments has resulted in confusion over nomenclature. Confusion over nomenclature also arises with regard to the subcutaneous ligamentous attachments, and in the anatomic location and extent described, particularly for zygomatic and masseteric ligaments. Certain historical terms—McGregor’s patch, the platysma auricular ligament, parotid cutaneous ligament, platysma auricular fascia, temporoparotid fasica (Lore’s fascia, anterior platysma-cutaneous ligament, and platysma cutaneous ligament—delineate retaining ligaments of related anatomic structures that have been conceptualized in various ways. Confusion around the masseteric cutaneous ligaments arises from inconsistencies in their reported locations in the literature because the size and location of the parotid gland varies so much, and this affects the relationship between the parotid gland and the fascia of the masseter muscle. For the zygomatic ligaments, there is disagreement over how far they extend, with descriptions varying over whether they extend medially beyond the zygomaticus minor muscle. Even the ‘main’ zygomatic ligament’s denotation may vary depending on which subcutaneous plane is used as a reference for naming it. Recent popularity in procedures using threads or injectables has required not only an accurate understanding of the nomenclature of retaining ligaments, but also of their location and extent. The authors have here summarized each retaining ligament with a survey of the different nomenclature that has been introduced by different authors within the most commonly cited published papers.

Biomechanical properties of interosseous proximal carpal row ligaments.

Science.gov (United States)

Nikolopoulos, Fotios; Apergis, Emmanuel; Kefalas, Vassilios; Zoubos, Aristides; Soucacos, Panayiotis; Papagelopoulos, Panayiotis

2011-05-01

The Scapholunate (S-L) and Lunotriquetrum (L-Tr) ligaments have been extensively studied in the literature. A wide range of measurements has been reported for ultimate load and stiffness with different mechanical protocols. In this study, we examined the mechanical properties of both ligaments harvested from the same wrist. Fifteen fresh cadaver wrists were used to harvest eight S-L and four L-Tr. Testing was performed in quasi-static loading in a well defined direction for each ligament system. The ultimate load for S-L was 68-210 N with a mean value of 147 ± 54 N and a stiffness of 35.7 ± 9.6 N/mm. For L-Tr the ultimate load was 122-179 N with a mean value of 150 ± 24 N and a stiffness of 192 ± 60 N/mm. The two ligaments had nearly the same ultimate load, but the L-Tr had a higher stiffness (p = 0.05). These findings could be useful to assess the appropriate autologous autografts for reconstruction of the S-L and L-Tr. Copyright © 2010 Orthopaedic Research Society.

Anatomy and histology of the transverse humeral ligament.

Science.gov (United States)

Snow, Brian J; Narvy, Steven J; Omid, Reza; Atkinson, Roscoe D; Vangsness, C Thomas

2013-10-01

The classic literature describes the transverse humeral ligament (THL) as a distinct anatomic structure with a role in biceps tendon stability; however, recent literature suggests that it is not a distinct anatomic structure. The purpose of this study was to evaluate the gross and microscopic anatomy of the THL, including a specific investigation of the histology of this ligament. Thirty frozen, embalmed cadaveric specimens were dissected to determine the gross anatomy of the THL. Seven specimens were evaluated histologically for the presence of mechanoreceptors and free nerve endings. Two tissue layers were identified in the area described as the THL. In the deep layer, fibers of the subscapularis tendon were found to span the bicipital groove with contributions from the coracohumeral ligament and the supraspinatus tendon. Superficial to this layer was a fibrous fascial covering consisting of distinct bands of tissue. Neurohistology staining revealed the presence of free nerve endings but no mechanoreceptors. This study's findings demonstrate that the THL is a distinct structure continuous with the rotator cuff tendons and the coracohumeral ligament. The finding of free nerve endings in the THL suggests a potential role as a shoulder pain generator. Copyright 2013, SLACK Incorporated.

Sonography of injury of the ulnar collateral ligament of the elbow - initial experience

International Nuclear Information System (INIS)

Miller, Theodore T.; Adler, Ronald S.; Friedman, Lawrence

2004-01-01

The purpose of this study is to describe the sonographic appearance of injuries of the ulnar collateral ligament (UCL) of the elbow. Eight non-professional male baseball pitchers, ages 13-35 years, with medial elbow pain and clinical suspicion of ulnar collateral ligament injury, were referred for imaging. All eight underwent sonography of the affected and contralateral asymptomatic elbow, and six also underwent MR imaging. Neither valgus stress nor power Doppler was used during the sonographic examinations. Time from onset of symptoms to imaging was 1.5 weeks to 6 months. Three patients had surgical confirmation of their injuries, with time from imaging to surgery of 2 days to 9 months. In four patients, the UCL was ruptured, manifest sonographically in three cases as discontinuity of the normally hyperechoic ligament with anechoic fluid in the gap and in one case as non-visualization of the ligament with heterogeneous echogenicity in the expected location of the ligament. Two adolescent patients had avulsions of the UCL from the medial epicondyle, with sonographic demonstration of the avulsed echogenic bony fragment in both cases. One patient had a mild sprain, manifest as mild thickening and decreased echogenicity of the ligament sonographically compared with the contralateral normal elbow, with mild surrounding hypoechoic edema. The eighth patient had a small partial tear of the deep surface of the distal aspect of the ligament, visualized as a hypoechoic focus between the deep surface of the ligament and its ulnar attachment. Tears of the ulnar collateral ligament are manifested sonographically as non-visualization of the ligament or alteration of the normal morphology. (orig.)

The anatomy of the coracohumeral ligament and its relation to the subscapularis muscle.

Science.gov (United States)

Arai, Ryuzo; Nimura, Akimoto; Yamaguchi, Kumiko; Yoshimura, Hideya; Sugaya, Hiroyuki; Saji, Takahiko; Matsuda, Shuichi; Akita, Keiichi

2014-10-01

Only a few reports describe the extension of the coracohumeral ligament to the subscapularis muscle. The purposes of this study were to histo-anatomically examine the structure between the ligament and subscapularis and to discuss the function of the ligament. Nineteen intact embalmed shoulders were used. In 9 shoulders, the expansion of the ligament was anatomically observed, and in 6 of these 9, the muscular tissue of the supraspinatus and subscapularis was removed to carefully examine the attachments to the tendons of these muscles. Five shoulders were frozen and sagittally sectioned into 3-mm-thick slices. After observation, histologic analysis was performed on 3 of these shoulders. In the remaining 5 shoulders, the coracoid process was harvested to investigate the ligament origin. The coracohumeral ligament originated from the horizontal limb and base of the coracoid process and enveloped the cranial part of the subscapularis muscle. The superficial layer of the ligament covered a broad area of the anterior surface of the muscle. Laterally, it protruded between the long head of the biceps tendon and subscapularis and attached to the tendinous floor, which extended from the subscapularis insertion. Histologically, the ligament consisted of irregular and sparse fibers abundant in type III collagen. The coracohumeral ligament envelops the whole subscapularis muscle and insertion and seems to function as a kind of holder for the subscapularis and supraspinatus muscles. The ligament is composed of irregular and sparse fibers and contains relatively rich type III collagen, which would suggest flexibility. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

MRI features of the anterolateral ligament of the knee

International Nuclear Information System (INIS)

Taneja, Atul K.; Miranda, Frederico C.; Braga, Cesar A.P.; Hartmann, Luiz G.C.; Santos, Durval C.B.; Rosemberg, Laercio A.; Gill, Corey M.

2015-01-01

Evaluate the visibility and describe the anatomical features of the anterolateral ligament of the knee using MRI. Magnetic resonance imaging examinations of the knee were independently reviewed by two musculoskeletal radiologists and assessed for the visibility of the anterolateral ligament under direct cross-referencing of axial and coronal images as complete, partial, or non-visible. Distal insertion site (tibial, meniscal), distance to lateral tibial plateau, measurements (length, width, thickness), and associated imaging findings were also tabulated. Clinical and surgical records were also reviewed. Seventy MRI scans from 60 consecutive subjects were included in the study. Mean age was 40 years, body mass 74.9 kg, and height 1.72 m. The subject population was 53 % male, most of the knees were from the left side (51 %), and chronic pain was the main clinical symptom (40 %). Nine knees (13 %) had undergone previous surgery. The anterolateral ligament was identified in 51 % of the knees: completely visible in 11 % and partially visible in 40 %. In all visible cases, the distal insertion site was identified on the tibia, with a mean distance of 5.7 mm to the plateau. A completely visible ligament had a mean length of 33.2 mm, thickness of 5.6 mm, and width of 1.9 mm. Inter-observer agreement for ligament presence was significant (κ = 0.7). Statistical analyses showed a trend to be more visible in men, with a longer length compared with women. Magnetic resonance imaging clearly identifies the anterolateral ligament of the knee in slightly more than half of cases, being partially visible in most of them. In all cases, a tibial insertion is characterized. (orig.)

MRI features of the anterolateral ligament of the knee

Energy Technology Data Exchange (ETDEWEB)

Taneja, Atul K. [Hospital Israelita Albert Einstein, Musculoskeletal Radiology Division, Imaging Department, Sao Paulo, SP (Brazil); Hospital do Coracao (HCor), and Teleimagem, Musculoskeletal Imaging, Diagnostic Center, Sao Paulo, SP (Brazil); Miranda, Frederico C.; Braga, Cesar A.P.; Hartmann, Luiz G.C.; Santos, Durval C.B.; Rosemberg, Laercio A. [Hospital Israelita Albert Einstein, Musculoskeletal Radiology Division, Imaging Department, Sao Paulo, SP (Brazil); Gill, Corey M. [Department of Neurology and Cancer Center, Pappas Center for Neuro-Oncology, Boston, MA (United States)

2014-11-27

Evaluate the visibility and describe the anatomical features of the anterolateral ligament of the knee using MRI. Magnetic resonance imaging examinations of the knee were independently reviewed by two musculoskeletal radiologists and assessed for the visibility of the anterolateral ligament under direct cross-referencing of axial and coronal images as complete, partial, or non-visible. Distal insertion site (tibial, meniscal), distance to lateral tibial plateau, measurements (length, width, thickness), and associated imaging findings were also tabulated. Clinical and surgical records were also reviewed. Seventy MRI scans from 60 consecutive subjects were included in the study. Mean age was 40 years, body mass 74.9 kg, and height 1.72 m. The subject population was 53 % male, most of the knees were from the left side (51 %), and chronic pain was the main clinical symptom (40 %). Nine knees (13 %) had undergone previous surgery. The anterolateral ligament was identified in 51 % of the knees: completely visible in 11 % and partially visible in 40 %. In all visible cases, the distal insertion site was identified on the tibia, with a mean distance of 5.7 mm to the plateau. A completely visible ligament had a mean length of 33.2 mm, thickness of 5.6 mm, and width of 1.9 mm. Inter-observer agreement for ligament presence was significant (κ = 0.7). Statistical analyses showed a trend to be more visible in men, with a longer length compared with women. Magnetic resonance imaging clearly identifies the anterolateral ligament of the knee in slightly more than half of cases, being partially visible in most of them. In all cases, a tibial insertion is characterized. (orig.)

Three-dimensional anatomical analysis of ligamentous attachments of the second through fifth carpometacarpal joints

International Nuclear Information System (INIS)

Nanno, Mitsuhiko; Sawaizumi, Takuya; Horiguchi, Gen; Ito, Hiromoto

2007-01-01

The purpose of this study is to identify, measure, and show the anatomic locations and areas of specific ligamentous attachments and paths of the second through fifth carpometacarpal (CMC) joints on a three-dimensional (3-D) surface model. Ten fresh-frozen cadaver wrists were used to dissect and identify the second through fifth CMC ligaments. The ligamentous attachments and whole bone surfaces were digitized three-dimensionally, and their areas were calculated. The attachments of each ligament were represented in a model in which their surfaces, as seen on computed tomography (CT), were overlaid with a digitized 3-D surface, and they were also visually demonstrated with a specific color on 3-D images of the bones. A total of 9 dorsal and 9 volar CMC ligaments and 1 CMC interosseous ligament were identified in the second through fifth CMC joints. An intra-articular ligament between the third and fourth metacarpals (MCs) and the capitate and hamate was also identified. In addition, 5 dorsal and 5 volar intermetacarpal ligaments and 3 intermetacarpal interosseous ligaments were also identified in the second through fifth intermetacarpal joints. A previously undescribed volar intermetacarpal ligament was found located between the third, fourth, and fifth MC bases. The anatomic 3-D attachment sites of the second through fifth CMC ligaments were visually depicted qualitatively, and their areas were quantified. This study has improved the knowledge and understanding of the normal anatomy and its impact on the mechanics of the second through fifth CMC joints. This 3-D information should facilitate the accurate assessment of radiographic images and the treatment of various injuries seen in the second through fifth CMC joints when performing ligament reconstruction, repair, osteochondral grafting, and arthroscopy. (author)

Heat transfer and pressure drop characteristics of mini-fin structures

International Nuclear Information System (INIS)

Jiang Peixue; Xu Ruina

2007-01-01

Forced convection heat transfer of air and water in bronze and pure copper mini-fin structures and mini-channel structures was investigated experimentally. The mini-fin dimensions were 0.7 mm x 0.2 mm and 0.8 mm x 0.4 mm. The tests included both staggered diamond-shaped and in-line square mini-fin arrangements. The tests investigated the effects of structures, mini-fin dimensions and arrangement, test section materials, and fluid properties on the convection heat transfer and heat transfer enhancement. For the tested conditions, the convection heat transfer coefficient was increased 9-21 fold for water and 12-38 fold for air in the mini-fin structures compared with an empty plate channel. The friction factor and flow resistance in the mini-channel structures and the in-line square mini-fin arrangement were much less than in the staggered diamond-shaped mini-fin arrangement. For the small channel width, W c = 0.2 mm, the convection heat transfer with the in-line square array structure was more intense than with the staggered diamond-shaped structure, the mini-channel structure or the porous media. For the larger channel width, W c = 0.4 mm, the convection heat transfer in the staggered diamond-shaped array structure was more intense than in the others systems while the in-line square structure had the best overall thermal-hydraulic performance

Stress changes of lateral collateral ligament at different

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ZHONG Yan-lin

2011-04-01

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

Sonoanatomy and injection technique of the iliolumbar ligament.

LENUS (Irish Health Repository)

Harmon, Dominic

2012-01-31

BACKGROUND: The iliolumbar ligament plays an important biomechanic role in anchoring the spine to the pelvic ring and stabilizing the sacroiliac joint. Iliolumbar syndrome is a back pain condition caused by pathology of the iliolumbar ligament. History and physical examination are important in the assessment of back pain, but they lack sufficient specificity. Injection of small volumes of local anesthetic into the structure considered to be the source of the pain (i.e. the iliolumbar ligament) increases the specificity of the diagnostic workup. OBJECTIVE: To describe an ultrasound - guided technique for injecting the iliolumbar ligament. STUDY DESIGN: Case report based on knowledge of topographic anatomy and sonoanatomy. SETTING: Outpatient clinic. METHODS: A patient with a clinical picture suggestive of iliolumbar syndrome was selected. An ultrasound-guided injection of the iliolumbar ligament with local anesthetic was performed. We recorded the patient\\'s subjective assessment of pain and the change in range of movement and pain scores during provocative tests. RESULTS: Following the injection, the patient\\'s pain score decreased, provocation tests became negative, and the range of movement increased. LIMITATIONS: Case report. Target specificity and dispersion of local anesthetic spread not confirmed with an independent technique (i.e. magnetic resonance imaging). CONCLUSIONS: Ultrasound guidance allows the selective deposition of small volumes of local anesthetic into structures believed to cause soft tissue back pain and thus to confirm or exclude the working diagnosis. Further studies are needed to confirm our conclusions and to prove the clinical feasibility of this technique.

In vivo structural and cellular remodeling of engineered bone-ligament-bone constructs used for anterior cruciate ligament reconstruction in sheep.

Science.gov (United States)

Florida, Shelby E; VanDusen, Keith W; Mahalingam, Vasudevan D; Schlientz, Aleesa J; Wojtys, Edward M; Wellik, Deneen M; Larkin, Lisa M

2016-11-01

Anterior cruciate ligament (ACL) ruptures rank among the most prevalent and costly sports-related injuries. Current tendon grafts used for ACL reconstruction are limited by suboptimal biomechanical properties. We have addressed these issues by engineering multiphasic bone-ligament-bone (BLB) constructs that develop structural and mechanical properties similar to native ACL. The purpose of this study was to examine the acute remodeling process that occurs as the BLB grafts advance toward the adult ligament phenotype in vivo. Thus, we implanted BLB constructs fabricated from male cells into female host sheep and allowed 3, 7, 14, or 28 days (n = 4 at each time point) for recovery. To address whether or not graft-derived cells were even necessary, a subset of BLB constructs (n = 3) were acellularized, implanted, and allowed 28 days for recovery. At each recovery time point, the following histological analyses were performed: picrosirius red staining to assess collagen alignment and immunohistochemistry to assess both graft development and host immune response. Polymerase chain reaction (PCR) analysis, performed on every explanted BLB, was used to detect the presence of graft-derived male cells remaining in the constructs and/or migration into surrounding host tissue. The analysis of the PCR and histology samples revealed a rapid migration of host-derived macrophages and neutrophils into the graft at 3 days, followed by increased collagen density and alignment, vascularization, innervation, and near complete repopulation of the graft with host cells within 28 days. This study provides a greater understanding of the processes of ligament regeneration in our BLB constructs as they remodel toward the adult ligament phenotype.

Combined anterior and posterior cruciate ligaments avulsion from the tibial side in adult patient: case report

Directory of Open Access Journals (Sweden)

Marcos George de Souza Leao

2013-12-01

Full Text Available The authors describe a rare case of a 28-year-old male patient, victim of motorcycle crash, with direct impact on the right knee, who sustained a bicruciate ligament fracture avulsion from the tibial side, dislocated and with large dimensions, without associated ligamentary lesions; he has undergone surgical treatment - open reduction and internal fixation, of the avulsions, and the follow up was at least six months, presenting good outcome using the Tegner -Lysholm scale.

Mastication and the Postorbital Ligament: Dynamic Strain in Soft Tissues

Science.gov (United States)

Herring, Susan W.; Rafferty, Katherine L.; Liu, Zi Jun; Lemme, Michael

2011-01-01

Although the FEED database focuses on muscle activity patterns, it is equally suitable for other physiological recording and especially for synthesizing different types of information. The present contribution addresses the interaction between muscle activity and ligamentary stretch during mastication. The postorbital ligament is the thickened edge of a septum dividing the orbital contents from the temporal fossa and is continuous with the temporal fascia. As a tensile element, this fascial complex could support the zygomatic arch against the pull of the masseter muscle. An ossified postorbital bar has evolved repeatedly in mammals, enabling resistance to compression and shear in addition to tension. Although such ossification clearly reinforces the skull against muscle pull, the most accepted explanation is that it helps isolate the orbital contents from contractions of the temporalis muscle. However, it has never been demonstrated that the contraction of jaw muscles deforms the unossified ligament. We examined linear deformation of the postorbital ligament in minipigs, Sus scrofa, along with electromyography of the jaw muscles and an assessment of changes in pressure and shape in the temporalis. During chewing, the ligament elongated (average 0.9%, maximum 2.8%) in synchrony with the contraction of the elevator muscles of the jaw. Although the temporalis bulged outward and created substantial pressure against the braincase, the superficial fibers usually retracted caudally, away from the postorbital ligament. In anesthetized animals, stimulating either the temporalis or the masseter muscle in isolation usually elongated the ligament (average 0.4–0.7%). These results confirm that contraction of the masticatory muscles can potentially distort the orbital contents and further suggest that the postorbital ligament does function as a tension member resisting the pull of the masseter on the zygomatic arch. PMID:21593142

Cold experiments on ligament formation for blast furnace slag granulation

International Nuclear Information System (INIS)

Liu Junxiang; Yu Qingbo; Li Peng; Du Wenya

2012-01-01

Rotary cup atomization for molten slag granulation is an attractive alternative to water quenching. However, the mechanism of disintegration of molten slag must be assessed. In the present study, a glycerol/water mixture was substituted for molten slag, and the mechanism of ligament formation in a rotary cup was investigated using photos taken by a high-speed camera. The effects of the angular speed and inner depth of the rotary cup on ligament disintegration was investigated. The results showed that one state of disintegration may transform into another state as the angular speed of the rotary cup increases at a given liquid flow rate. During ligament formation, the number of ligaments increased with an increase in the angular speed of the rotary cup, and a decrease in the diameter of ligament and liquid drop was observed. Moreover, the initial point of disintegration of the ligament moved to the lip of the rotary cup as the angular speed increased. An equation describing the relationship between the diameter of the liquid drop and various factors was used to predict the diameter of the liquid drop. A rotary cup with an inner depth of 30 mm was the best choice for granulation. The results of the present study will be useful for designing devices used in molten slag granulation. - Highlights: ►The results can be used in the granulation of molten blast furnace slag. ► The three different states of disintegration occur as the angular speed of rotary cup increases. ► The mechanism of ligament disintegration is analyzed. ► Eq. can be used to predict the diameter of liquid drop. ► A rotary cup with an inner depth of 30 mm is optimal for granulation.

Study on the nuchal ligament ossification on lateral cephalometric radiograph

International Nuclear Information System (INIS)

An, Chang Hyeon

2009-01-01

The purpose of this study was to assess the prevalence and radiographic characteristics of the nuchal ligament ossification on lateral cephalometric radiographs in Koreans. I review and interpreted the lateral cephalometric radiographs from 4,558 patients (1,857 males and 2,701 females, age range from 2 to 79 years) who visited the Kyungpook National University Dental Hospital from January 1, 2008 to February 3, 2009. I grouped the shapes of nuchal ligament ossification as round, rod-like, and segmented shape. And localized the ossification as the involvement of anterior cervical vertebral body. The data were analyzed by using chi-squared test with two-tailed and at a 5% significance level. Among those who showed the nuchal ligament ossification, the mean age of the 143 males was 51.1 and that of the 97 females was 48.0 years. It was not observed completely below teens, and was observed 1% in twenties, 6.1% in thirties, 18.6% in forties, and 26.3% over fifties. It was significantly prevalent in older age group (P<0.01) and in males than females among the same age group (P<0.05). The shapes of nuchal ligament ossification were as follows in order of frequency : rod-like (49.2%), round (30.4%), and segmented (20.4%). The highest involvement of ossification was found at the level of C5 (67.9%), C4 (29.2%), C6 (22.9%), C3 (3.3%), C7 (2.9%), C2 (0.8%), and C1 (0.4%). The nuchal ligament ossifications on lateral cephalometric radiographs were showed as round, rodlike, or segmented shape. The nuchal ligament ossification is often observed after the age of 40 and is observed more frequently in males than females. The highest shape of nuchal ligament ossification was rod-like shape and the highest involvement of cervical spine was C5.

Design and characterization of a biodegradable composite scaffold for ligament tissue engineering.

Science.gov (United States)

Hayami, James W S; Surrao, Denver C; Waldman, Stephen D; Amsden, Brian G

2010-03-15

Herein we report on the development and characterization of a biodegradable composite scaffold for ligament tissue engineering based on the fundamental morphological features of the native ligament. An aligned fibrous component was used to mimic the fibrous collagen network and a hydrogel component to mimic the proteoglycan-water matrix of the ligament. The composite scaffold was constructed from cell-adherent, base-etched, electrospun poly(epsilon-caprolactone-co-D,L-lactide) (PCLDLLA) fibers embedded in a noncell-adherent photocrosslinked N-methacrylated glycol chitosan (MGC) hydrogel seeded with primary ligament fibroblasts. Base etching improved cellular adhesion to the PCLDLLA material. Cells within the MGC hydrogel remained viable (72 +/- 4%) during the 4-week culture period. Immunohistochemistry staining revealed ligament ECM markers collagen type I, collagen type III, and decorin organizing and accumulating along the PCLDLLA fibers within the composite scaffolds. On the basis of these results, it was determined that the composite scaffold design was a viable alternative to the current approaches used for ligament tissue engineering and merits further study. (c) 2009 Wiley Periodicals, Inc.

Mini-Split Heat Pumps Multifamily Retrofit Feasibility Study

Energy Technology Data Exchange (ETDEWEB)

Dentz, Jordan [ARIES Collaborative, New York, NY (United States); Podorson, David [ARIES Collaborative, New York, NY (United States); Varshney, Kapil [ARIES Collaborative, New York, NY (United States)

2014-05-01

Mini-split heat pumps can provide space heating and cooling in many climates and are relatively affordable. These and other features make them potentially suitable for retrofitting into multifamily buildings in cold climates to replace electric resistance heating or other outmoded heating systems. This report investigates the suitability of mini-split heat pumps for multifamily retrofits. Various technical and regulatory barriers are discussed and modeling was performed to compare long-term costs of substituting mini-splits for a variety of other heating and cooling options. A number of utility programs have retrofit mini-splits in both single family and multifamily residences. Two such multifamily programs are discussed in detail.

Functional regeneration of ligament-bone interface using a triphasic silk-based graft.

Science.gov (United States)

Li, Hongguo; Fan, Jiabing; Sun, Liguo; Liu, Xincheng; Cheng, Pengzhen; Fan, Hongbin

2016-11-01

The biodegradable silk-based scaffold with unique mechanical property and biocompatibility represents a favorable ligamentous graft for tissue-engineering anterior cruciate ligament (ACL) reconstruction. However, the low efficiency of ligament-bone interface restoration barriers the isotropic silk graft to common ACL therapeutics. To enhance the regeneration of the silk-mediated interface, we developed a specialized stratification approach implementing a sequential modification on isotropic silk to constitute a triphasic silk-based graft in which three regions respectively referring to ligament, cartilage and bone layers of interface were divided, followed by respective biomaterial coating. Furthermore, three types of cells including bone marrow mesenchymal stem cells (BMSCs), chondrocytes and osteoblasts were respectively seeded on the ligament, cartilage and bone region of the triphasic silk graft, and the cell/scaffold complex was rolled up as a multilayered graft mimicking the stratified structure of native ligament-bone interface. In vitro, the trilineage cells loaded on the triphasic silk scaffold revealed a high proliferative capacity as well as enhanced differentiation ability into their corresponding cell lineage. 24 weeks postoperatively after the construct was implanted to repair the ACL defect in rabbit model, the silk-based ligamentous graft exhibited the enhancement of osseointegration detected by a robust pullout force and formation of three-layered structure along with conspicuously corresponding matrix deposition via micro-CT and histological analysis. These findings potentially broaden the application of silk-based ligamentous graft for ACL reconstruction and further large animal study. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Treatment of complete acromioclavicular joint dislocation with transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament].

Science.gov (United States)

Dong, Wen-Wei; Shi, Zeng-Yuan; Liu, Zheng-Xin; Mao, Hai-Jiao

2015-04-01

To explore the operation methods and clinical effects of transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament in treating complete acromioclavicular joint dislocation. From January 2006 to June 2012,26 patients with acute complete acromioclavicular joint dislocation underwent surgery. Transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional clavical hoot plate and Kirschner wires fixation, were performed in all the patients. Among the patients, 18 patients were male and 8 patients were female, with an average age of 36.7 years old (ranged from 25 to 51 years). The duration from injury to operation was from 3 to 12 days with an average of 5 days. According to the Rockwood classification, 4 cases were grade III and 22 cases were grade V . Clinical manifestation included local swelling, tenderness with snapping, limitation of shoulder joint motion. In preoperative bilateral shoulder joint X-rays, the injured coracoclavicular distance was (16.2 ± 5.0) mm which was significantly wider than that of uninjured sides (7.6 ± 1.0) mm. Clinical results were evaluated according to X-rays and Constant-Murley score. All incisions obtained primary healing after operation without complication of infection, internal fixation breakage, redislocation. All the patients were followed up from 12 to 30 months with an average of 18 months. Kirschner wires and internal fixation plate were removed at 1 month and 8-10 months after operation, respectively. At final follow-up, the motion of shoulder joint recovered to normal and a no pain joint was obtained. According to Constant-Murley score, 24 cases got excellent results and 2 cases good. There was no significant difference after operation between the injured coracoclavicular distance and the uninjured contralateral side [(7.7 ± 1.2) mm vs (7.6 ± 1.0) mm), P > 0.05]. Transfer of the medial half of the coracoacromial ligament to

Development of mini-LIA and primary experiments

International Nuclear Information System (INIS)

Cheng Cheng; Liao Shuqing; Zheng Shuxin; Lin Yuzheng; Tang Chuanxiang; Jing Xiaobing; Mu Fan; Pan Haifeng; Zhang Kaizhi; Shi Jinshui; Deng Jianjun

2009-01-01

Mini-LIA is a miniature of a linear induction accelerator developed by China Academy of Engineering Physics and Tsinghua University in 2007. It has been constructed with a thermionic cathode in an electron injector and a metglas core in the induction accelerator cavities. A double-pulsed electron beam was produced for the first time in China on the Mini-LIA with a thermionic cathode in the electron gun and a metglas core in the induction accelerator cavities. A double-pulsed beam current of more than 1.1A was obtained on condition of 80 kV double-pulsed high voltage produced by pulsed power system supplying to the injector and accelerating modules. Some primary experiments for measuring the parameters of Mini-LIA has been performed, and some beam characterizations of Mini-LIA are presented. Further improvement is underway. (authors)

Radio sterilized human ligaments and their clinical application;Ligamentos humanos radioesterilizados y su aplicacion clinica

Energy Technology Data Exchange (ETDEWEB)

Luna Z, D.; Reyes F, M. L. [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico); Diaz M, I.; Hernandez R, G., E-mail: daniel.luna@inin.gob.m [Centro Estatal de Trasplantes del Estado de Mexico, Pablo Sidar No. 602, Col. Universidad, 50130 Toluca, Estado de Mexico (Mexico)

2009-10-15

The ligaments are human tissues that are used in the transplantation area. A ligament is an anatomical structure in band form, composed by resistant fibers that connect the tissues that unite the bones with the articulations. In an articulation, the ligaments allow and facilitate the movement inside the natural anatomical directions, while it restricts those movements that are anatomically abnormal, impeding lesions that could arise of this type of movements. The kneecap ligament is a very important tissue in the knee mobility and of walking in the human beings. This ligament can injure it because of automobile accidents, for sport lesions or illnesses, and in many cases the only form of recovering the knee movement is carried out a transplant with the purpose of replacing the damage ligament by allo gen kneecap ligament processed in specialized Tissue Banks where the tissue is sterilized with gamma radiation of {sup 60}Co at very low temperatures, obtaining high quality ligaments for clinical application in injured patients. The kneecap ligaments are processed in the Tissue Banks with a segment of kneecap bone, a segment of tibial bone, the contained ligament between both bones and in some cases a fraction of the quadriceps tendon. In this work is given a description of the selection method of the tissue that includes the donor's serologic control, the kneecap ligament processing in the Radio Sterilized Tissues Bank, its sterilization with gamma radiation of {sup 60}Co, also it is indicated like the clinical application of the allo gen ligament was realized in a hasty patient and whose previous crossed ligament was injured. Finally the results are presented from the tissue obtaining until the clinical application of it is, and in this case is observed a favorable initial evolution of the transplantation patient. (Author)

Mini lathe machine converted to CNC

Directory of Open Access Journals (Sweden)

Alexandru Morar

2012-06-01

Full Text Available This paper presents the adaptation of a mechanical mini-lathing machine to a computerized numerical control (CNC lathing machine. This machine is composed of a ASIST mini-lathe and a two-degrees-of-freedom XZ stage designed specifically for this application. The whole system is controlled from a PC using adequate CNC control software.

Ultra-mini PNL (UMP): Material, indications, technique, advantages and results.

Science.gov (United States)

Desai, Janak D

2017-01-01

Stone disease has afflicted mankind since centuries; records from ancient civilisations of India and Egypt have shown stones in human bodies. The scientific mind of humans has always made smart endeavours to remove the kidney stones. From large instruments made like the beaks of different animals and birds in 600 BC (Indian civilisation) to extremely sophisticated and miniaturised endoscopic intruments of today the human race has travelled a long way. The theme has always been to remove the stones with minimal morbidity and mortality and with minimum pain to the patient. The article takes you through the journey of instruments used in 600 BC until today. The story of instrumentation is a symbiosis of the medical minds along with engineering advances. The story of miniaturisation could not have moved further without the development of lasers, fiberoptics and sophisticated cameras. As the field stands today, we remove more complex stones by larger endoscopic intervention and smaller stones by miniaturised instruments. The article discusses all the merits and shortcomings of various techniques: from open surgery to standard PCNL to Mini PCNL to Ultra- Mini PCNL to Micro-PCNL.

Biofabrication of soft tissue templates for engineering the bone-ligament interface.

Science.gov (United States)

Harris, Ella; Liu, Yurong; Cunniffe, Grainne; Morrissey, David; Carroll, Simon; Mulhall, Kevin; Kelly, Daniel J

2017-10-01

Regenerating damaged tissue interfaces remains a significant clinical challenge, requiring recapitulation of the structure, composition, and function of the native enthesis. In the ligament-to-bone interface, this region transitions from ligament to fibrocartilage, to calcified cartilage and then to bone. This gradation in tissue types facilitates the transfer of load between soft and hard structures while minimizing stress concentrations at the interface. Previous attempts to engineer the ligament-bone interface have utilized various scaffold materials with an array of various cell types and/or biological cues. The primary goal of this study was to engineer a multiphased construct mimicking the ligament-bone interface by driving differentiation of a single population of mesenchymal stem cells (MSCs), seeded within blended fibrin-alginate hydrogels, down an endochondral, fibrocartilaginous, or ligamentous pathway through spatial presentation of growth factors along the length of the construct within a custom-developed, dual-chamber culture system. MSCs within these engineered constructs demonstrated spatially distinct regions of differentiation, adopting either a cartilaginous or ligamentous phenotype depending on their local environment. Furthermore, there was also evidence of spatially defined progression toward an endochondral phenotype when chondrogenically primed MSCs within this construct were additionally exposed to hypertrophic cues. The study demonstrates the feasibility of engineering spatially complex soft tissues within a single MSC laden hydrogel through the defined presentation of biochemical cues. This novel approach represents a new strategy for engineering the ligament-bone interface. Biotechnol. Bioeng. 2017;114: 2400-2411. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Alar ligaments: radiological aspects in the diagnosis of patients with whiplash injuries

International Nuclear Information System (INIS)

Muhle, C.; Brossmann, J.; Biederer, J.; Jahnke, Th.; Grimm, J.; Heller, M.

2002-01-01

Post-traumatic changes of the alar ligaments have been proposed to be the cause of chronic pain in patients after whiplash injury of the cervical spine. In addition to an asymmetric dens position, widening of the atlantodental distance to more than 12 mm can be an indirect sign of an alar ligament rupture. CT is recommended for detection of a avulsion fracture of the occipital condyle. Isolated ruptures of the alar ligaments are best visualized on MRI. In patients with chronic impairments after whiplash injuries changes of the alar ligaments on MRI must be differentiated from normal variants in healthy individuals. (orig.) [de

Quadriceps Tendon Autograft Medial Patellofemoral Ligament Reconstruction.

Science.gov (United States)

Fink, Christian; Steensen, Robert; Gföller, Peter; Lawton, Robert

2018-06-01

Critically evaluate the published literature related to quadriceps tendon (QT) medial patellofemoral ligament (MPFL) reconstruction. Hamstring tendon (HT) MPFL reconstruction techniques have been shown to successfully restore patella stability, but complications including patella fracture are reported. Quadriceps tendon (QT) reconstruction techniques with an intact graft pedicle on the patella side have the advantage that patella bone tunnel drilling and fixation are no longer needed, reducing risk of patella fracture. Several QT MPFL reconstruction techniques, including minimally invasive surgical (MIS) approaches, have been published with promising clinical results and fewer complications than with HT techniques. Parallel laboratory studies have shown macroscopic anatomy and biomechanical properties of QT are more similar to native MPFL than hamstring (HS) HT, suggesting QT may more accurately restore native joint kinematics. Quadriceps tendon MPFL reconstruction, via both open and MIS techniques, have promising clinical results and offer valuable alternatives to HS grafts for primary and revision MPFL reconstruction in both children and adults.

Detection of dementia in primary care: comparison of the original and a modified Mini-Cog Assessment with the Mini-Mental State Examination.

Science.gov (United States)

Kamenski, Gustav; Dorner, Thomas; Lawrence, Kitty; Psota, Georg; Rieder, Anita; Schwarz, Franz; Sepandj, Asita; Spiegel, Wolfgang; Strotzka, Stefan

2009-12-01

Background Dementia is considered widely under-detected in primary care, and general practitioners (GPs) frequently ask for easy to use tools to assist in its early detection.Aim To determine the degree of correlation between the Mini-Cog Assessment (Mini-Cog) as performed by GPs and the Mini-Mental State Examination (MMSE).Design of study This was a prospective study (2005, 2006) comparing two cognitive screening instruments.Setting Ten general practices in Austria, with patients with a hitherto undiagnosed suspicion of dementia seen consecutively.Method Sensitivity, specificity and positive and negative predictive values (PPVs and NPVs) of the Mini-Cog (applying both a colour-coded and the original rating method) were assessed for degree of correlation with the MMSE. In phase one GPs examined patients suspected of having dementia using the Mini-Cog; in phase two a neurologist retested them applying the MMSE, a clock-drawing test (CDT) and a routine clinical examination. A questionnaire on the practicability of the Mini-Cog was answered by GPs.Results Of the 107 patients who participated 86 completed the whole study protocol. The Mini-Cog, as performed by the ten GPs, displayed a sensitivity of 0.85 (95% CI: 0.71, 0.98), a specificity of 0.58 (95% CI: 0.46, 0.71), a PPV of 0.47 (95% CI: 0.33, 0.61) and an NPV of 0.90 (95% CI: 0.80, 0.99) as against the MMSE carried out by neurologists. The GPs judged the Mini-Cog useful and time saving.Conclusion The Mini-Cog has a high sensitivity and acceptable specificity in the general practice setting and has proved to be a practicable tool for the diagnosis of dementia in primary care.

Arthrographic differential diagnosis between ruptures of the anterior talofibular ligament, the joint capsule and the anterior tibiofibular ligament

International Nuclear Information System (INIS)

Moppes, F.I. van; Hoogenband, C.R. van den; Meijer, F.

1980-01-01

Aus einem Studium der Literatur, chirurgischen Befunden und Untersuchungen an Leichen kann es als unwahrscheinlich angesehen werden, dass bei einer Fussverstauchung vom Inversionstyp ein Riss des vorderen tibiofibularen Ligraments haeufig zusammen mit einem Gelenkkapselriss und einem seitlichen Baenderriss auftritt. Entgegen der Beobachtung anderer Verfasser fanden wir, dass ein Riss des vorderen tibiofularen Ligaments in keiner Weise aus dem Vorhandensein oder Nichtvorhandensein folgender arthrographischer Befunde geschlossen werden konnte: a) kontrastfreie Zone, b) tibiofibularer Rezessus, oder c) beide zusammen. Ein Gelenkkapselriss kann angenommen werden, wenn Kontrastmittel aus dem Gelenk in das weiche Gewebe austritt, ohne unterhalb oder seitlich in den Aussenknoechel zu dringen. Ein Austritt des Kontrastmittels unterhalb und seitlich des Aussenknoechels deutet auf einen Riss des vorderen tabofibularen Ligaments hin. Die anatomischen Zusammenhaenge zwischen Bandverbindung, Gelenkkapsel, tibiofibularem Rezessus und dem vorderen talofibularen Ligament wurden an Leichen und waehrend der chirurgischen Eingriffe studiert. Ausbreitung des Kontrastmittels im weichen Gewebe wird wahrscheinlich bestimmt durch die Anordnung und Beschaedigung der Weichteile und durch die Groesse des entstandenen Haematoms und folgt dem Weg des kleinsten Widerstandes. (orig.) [de

Prospects for Antineutrino Running at MiniBooNE

OpenAIRE

Wascko, M. O.

2006-01-01

MiniBooNE began running in antineutrino mode on 19 January, 2006. We describe the sensitivity of MiniBooNE to LSND-like nuebar oscillations and outline a program of antineutrino cross-section measurements necessary for the next generation of neutrino oscillation experiments. We describe three independent methods of constraining wrong-sign (neutrino) backgrounds in an antineutrino beam, and their application to the MiniBooNE antineutrino analyses.

Knee Ligament Injury and the Clinical Application of Tissue Engineering Techniques: A Systematic Review.

Science.gov (United States)

Riley, Thomas C; Mafi, Reza; Mafi, Pouya; Khan, Wasim S

2018-02-23

The incidence of knee ligament injury is increasing and represents a significant cost to healthcare providers. Current interventions include tissue grafts, suture repair and non-surgical management. These techniques have demonstrated good patient outcomes but have been associated graft rejection, infection, long term immobilization and reduced joint function. The limitations of traditional management strategies have prompted research into tissue engineering of knee ligaments. This paper aims to evaluate whether tissue engineering of knee ligaments offers a viable alternative in the clinical management of knee ligament injuries. A search of existing literature was performed using OVID Medline, Embase, AMED, PubMed and Google Scholar, and a manual review of citations identified within these papers. Silk, polymer and extracellular matrix based scaffolds can all improve graft healing and collagen production. Fibroblasts and stem cells demonstrate compatibility with scaffolds, and have been shown to increase organized collagen production. These effects can be augmented using growth factors and extracellular matrix derivatives. Animal studies have shown tissue engineered ligaments can provide the biomechanical characteristics required for effective treatment of knee ligament injuries. There is a growing clinical demand for a tissue engineered alternative to traditional management strategies. Currently, there is limited consensus regarding material selection for use in tissue engineered ligaments. Further research is required to optimize tissue engineered ligament production before clinical application. Controlled clinical trials comparing the use of tissue engineered ligaments and traditional management in patients with knee ligament injury could determine whether they can provide a cost-effective alternative. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Late rupture of the posterior cruciate ligament after total knee replacement.

OpenAIRE

Montgomery, R. L.; Goodman, S. B.; Csongradi, J.

1993-01-01

To our knowledge there have been no reports of late rupture of the posterior cruciate ligament (PCL) as a cause of instability in PCL-retaining total knee prostheses. In our experience of 150 total knee replacements using PCL-retaining prosthesis, three cases (2.0%) of late rupture of the posterior cruciate ligament have occurred, each leading to chronic instability, disabling pain, and revision arthroplasty. In each case rupture of the posterior cruciate ligament was confirmed at the time of...

The Influence of Interleukin-4 on Ligament Healing

Science.gov (United States)

Chamberlain, Connie S; Leiferman, Ellen M; Frisch, Kayt E; Wang, Sijian; Yang, Xipei; Brickson, Stacey L; Vanderby, Ray

2011-01-01

Despite a complex cascade of cellular events to reconstruct the damaged extracellular matrix, ligament healing results in a mechanically inferior scarred ligament. During normal healing, granulation tissue expands into any residual normal ligamentous tissue (creeping substitution), resulting in a larger region of healing, greater mechanical compromise, and an inefficient repair process. To control creeping substitution and possibly enhance the repair process, the anti-inflammatory cytokine, interleukin-4 (IL-4) was administered to rats prior to and after rupture of their medial collateral ligaments. In vitro experiments demonstrated a time-dependent effect on fibroblast proliferation after interleukin-4 treatment. In vivo treatments with interleukin-4 (100 ng/ml i.v.) for 5 days resulted in decreased wound size and type III collagen and increased type I procollagen, indicating a more regenerative early healing in response to the interleukin-4 treatment. However, continued treatment of interleukin-4 to day 11 antagonized this early benefit and slowed healing. Together, these results suggest that interleukin-4 influences the macrophages and T-lymphocytes but also stimulates fibroblasts associated with the proliferative phase of healing in a dose-, cell-, and time-dependent manner. Although treatment significantly influenced healing in the first week after injury, interleukin-4 alone was unable to maintain this early regenerative response. PMID:21518087

Effect of homeopathy on analgesic intake following knee ligament reconstruction: a phase III monocentre randomized placebo controlled study

Science.gov (United States)

Paris, A; Gonnet, N; Chaussard, C; Belon, P; Rocourt, F; Saragaglia, D; Cracowski, J L

2008-01-01

Aims The efficacy of homeopathy is still under debate. The objective of this study was to assess the efficacy of homeopathic treatment (Arnica montana 5 CH, Bryonia alba 5 CH, Hypericum perforatum 5 CH and Ruta graveolens 3 DH) on cumulated morphine intake delivered by PCA over 24 h after knee ligament reconstruction. Methods This was an add-on randomized controlled study with three parallel groups: a double-blind homeopathic or placebo arm and an open-label noninterventional control arm. Eligible patients were 18–60 years old candidates for surgery of the anterior cruciate ligament. Treatment was administered the evening before surgery and continued for 3 days. The primary end-point was cumulated morphine intake delivered by PCA during the first 24 h inferior or superior/equal to 10 mg day−1. Results One hundred and fifty-eight patients were randomized (66 in the placebo arm, 67 in the homeopathic arm and 25 in the noninterventional group). There was no difference between the treated and the placebo group for primary end-point (mean (95% CI) 48% (35.8, 56.3), and 56% (43.7, 68.3), required less than 10 mg day−1 of morphine in each group, respectively). The homeopathy treatment had no effect on morphine intake between 24 and 72 h or on the visual analogue pain scale, or on quality of life assessed by the SF-36 questionnaire. In addition, these parameters were not different in patients enrolled in the open-label noninterventional control arm. Conclusions The complex of homeopathy tested in this study was not superior to placebo in reducing 24 h morphine consumption after knee ligament reconstruction. What is already known about this subject The efficacy of homeopathy is still under debate and a recent meta-analysis recommended further randomized double-blind clinical trials to identify any clinical situation in which homeopathy might be effective. What this study adds The complex of homeopathy tested in this study (Arnica montana 5 CH, Bryonia alba 5 CH

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.

Use of palatally inserted mini-screw for upper molar distalization: A case series

Directory of Open Access Journals (Sweden)

Valliollah Arash

2015-09-01

Full Text Available  Abstract Reports have shown that molars can be distalized successfully with virtually no orthodontic anchorage loss with an intraosseous anchorage, even with fully erupted second molars. The purpose of this study was evaluating the effects of mini-screws as skeletal anchorage for upper molar distalization. In this case series, three patients needing maxillary first molar distalization, were selected. mini-screw was inserted in the anterior part of the palate. The screws were anchored to the first premolars by transpalatal arch and immediately loaded (150-160 g by 0.018-inch arch-wire and steel open-coil spring to distalize maxillary molars. The skeletal and dental changes were measured on cephalograms obtained before and after distalization. The amount of first molar distalization in the patients was 4 mm with 2°of tipping, 4 mm with 5°of tipping, and 3.5 mm with 2°of tipping respectively. Upper incisors and first premolars were stable during distalization.       

A mini-UAV VTOL Platform for Surveying Applications

Directory of Open Access Journals (Sweden)

Kuldeep Rawat

2014-05-01

Full Text Available In this paper we discuss implementation of a mini-Unmanned Aerial Vehicle (UAV vertical take-off and landing (VTOL platform for surveying activities related to highway construction. Recent advances in sensor and communication technologies have allowed scaling sizes of unmanned aerial platforms, and explore them for tasks that are economical and safe over populated or inhabited areas. In highway construction the capability of mini-UAVs to survey in hostile and/or hardly accessible areas can greatly reduce human risks. The project focused on developing a cost effective, remotely controlled, fuel powered mini-UAV VTOL (helicopter platform with certain payload capacity and configuration and demonstrated its use in surveying and monitoring activities required for highway planning and construction. With an on-board flight recorder global positioning system (GPS device, memory storage card, telemetry, inertial navigation sensors, and a video camera the mini-UAV can record flying coordinates and relay live video images to a remote ground receiver and surveyor. After all necessary integration and flight tests were done the mini-UAV helicopter was tested to operate and relay video from the areas where construction was underway. The mini-UAV can provide a platform for a range of sensors and instruments that directly support the operational requirements of transportation sector.

A Nano-indentation Identification Technique for Viscoelastic Constitutive Characteristics of Periodontal Ligaments

Directory of Open Access Journals (Sweden)

Ashrafi H.

2016-06-01

Full Text Available Introduction: Nano-indentation has recently been employed as a powerful tool for determining the mechanical properties of biological tissues on nano and micro scales. A majority of soft biological tissues such as ligaments and tendons exhibit viscoelastic or time-dependent behaviors. The constitutive characterization of soft tissues is among very important subjects in clinical medicine and especially, biomechanics fields. Periodontal ligament plays an important role in initiating tooth movement when loads are applied to teeth with orthodontic appliances. It is also the most accessible ligament in human body as it can be directly manipulated without any surgical intervention. From a mechanical point of view, this ligament can be considered as a thin interface made by a solid phase, consisting mainly of collagen fibers, which is immersed into a so-called ground substance. However, the viscoelastic constitutive effects of biological tissues are seldom considered rigorous during Nano-indentation tests. Methods: In the present paper, a mathematical contact approach is developed to enable determining creep compliance and relaxation modulus of distinct periodontal ligaments, using constant–rate indentation and loading time histories, respectively. An adequate curve-fitting method is presented to determine these characteristics based on the Nano-indentation of rigid Berkovich tips. Generalized Voigt-Kelvin and Wiechert models are used to model constitutive equations of periodontal ligaments, in which the relaxation and creep functions are represented by series of decaying exponential functions of time. Results: Time-dependent creep compliance and relaxation function have been obtained for tissue specimens of periodontal ligaments. Conclusion: To improve accuracy, relaxation and creep moduli are measured from two tests separately. Stress relaxation effects appear more rapidly than creep in the periodontal ligaments.

Biomechanical and histologic evaluation of tissue engineered ligaments using chitosan and hyaluronan hybrid polymer fibers: a rabbit medial collateral ligament reconstruction model.

Science.gov (United States)

Irie, Toru; Majima, Tokifumi; Sawaguchi, Naohiro; Funakoshi, Tadanao; Nishimura, Shin-Ichiro; Minami, Akio

2011-05-01

In this study, we used a rabbit medial collateral ligament reconstruction model to evaluate a novel chitosan-based hyaluronan hybrid polymer fiber scaffold for ligament tissue engineering and to examine whether mechanical forces exerted in an in vivo model increased extracellular matrix production by seeded fibroblasts. Scaffolds were used 2 weeks after incubation with fibroblasts obtained from the same rabbit in a cell-seeded scaffold (CSS) group and without cells in a noncell-seeded scaffold (NCSS) group. At 3, 6, and 12 weeks after surgery, the failure loads of the engineered ligaments in the CSS groups were significantly greater than those in the NCSS groups. At 6 weeks after surgery, the reconstructed tissue of the CSS group was positive for type I collagen, whereas that in the NCSS group was negative for type I collagen. At 12 weeks after surgery, the reconstructed tissue stained positive for type I collagen in the CSS group, but negative in the NCSS group. Our results indicate that the scaffold material enhanced the production of type I collagen and led to improved mechanical strength in the engineered ligament in vivo. Copyright © 2011 Wiley Periodicals, Inc.

Designing a mini subcritical nuclear reactor; Diseno de un mini reactor nuclear subcritico

Energy Technology Data Exchange (ETDEWEB)

Escobedo G, C. R.; Vega C, H. R.; Davila H, V. M., E-mail: rafelaescobedo@hotmail.com [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Jardin Juarez 147, Col. Centro, 98000 Zacatecas, Zac. (Mexico)

2015-10-15

In this work the design of a mini subcritical nuclear reactor formed by means of light water moderator, uranium as fuel, and isotopic neutron source of {sup 239}PuBe was carried out. The design was done by Monte Carlo methods with the code MCNP5 in which uranium was modeled in an array of concentric holes cylinders of 8.5, 14.5, 20.5, 26.5, 32.5 cm of internal radius and 3 cm of thickness, 36 cm of height. Different models were made from a single fuel cylinder (natural uranium) to five. The neutron source of {sup 239}PuBe was situated in the center of the mini reactor; in each arrangement was used water as moderator. Cross sections libraries Endf/Vi were used and the number of stories was large enough to ensure less uncertainty than 3%. For each case the effective multiplication factor k{sub e}-f{sub f}, the amplification factor and the power was calculated. Outside the mini reactor the ambient dose equivalent H (10) was calculated for different cases. The value of k{sub eff}, the amplification factor and power are directly related to the number of cylinders of uranium as fuel. Although the average energy of the neutrons {sup 239}PuBe is between 4.5 and 5 MeV in the case of the mini reactor for a cylinder, in the neutron spectrum the presence of thermal neutrons does not exist, so that produced fissions are generated with fast neutrons, and in designs of two and three rings the neutron spectra shows the presence of thermal neutrons, however the fissions are being generated with fast neutrons. Finally in the four and five cases the amount of moderator is enough to thermalized the neutrons and thereby produce the fission. The maximum value for k{sub eff} was 0.82; this value is very close to the assembly of Universidad Autonoma de Zacatecas generating a k{sub eff} of 0.86. According to the safety and radiation protection standards for the design of mini reactor of one, two and three cylinders they comply with the established safety, while designs of four and five

[The "Mini-ICF-Rating for Mental Disorders (Mini-ICF-P)". A short instrument for the assessment of disabilities in mental disorders].

Science.gov (United States)

Linden, M; Baron, S

2005-06-01

Supplementary to the description of diseases at symptom level, the International Classification of Functioning, Disability and Health (ICF), edited by the WHO, for the first time enables a systematic description also at the level of disabilities and impairments. The Mini-ICF-Rating for Mental Disorders (Mini-ICF-P) is a short observer rating instrument for the assessment of disabilities, especially with regard to occupational functioning. The Mini-ICF-P was first evaluated empirically in 125 patients of a Department of Behavioural Medicine and Psychosomatics. Parallel-test reliability was r = 0.59. Correlates were found with cognitive and motivational variables and duration of sick leave from work. In summary, the Mini-ICF-P is a quick and practicable instrument.

Mini-Journals: Incorporating Inquiry, Quantitative Skills and Writing into Homework Assignments for Geochemistry and Planetary Science

Science.gov (United States)

Whittington, A. G.; Speck, A.; Witzig, S.

2011-12-01

As part of an NSF-funded project, "CUES: Connecting Undergraduates to the Enterprise of Science," new inquiry-based homework materials were developed for two upper-level classes at the University of Missouri: Geochemistry (required for Geology majors, fulfills the computing requirement by having 50% of the grade come from five spreadsheet-based homework assignments), and Solar System Science (open to seniors and graduate students, co-taught and cross-listed between Geology and Physics & Astronomy). Inquiry involves activities where the learner engages in scientifically oriented questions, gives priority to evidence in responding to questions, formulates explanations from evidence, connects explanations to scientific knowledge, and communicates and justifies explanations. We engage students in inquiry-based learning by presenting homework exercises as "mini-journal" articles that follow the format of a scientific journal article, including a title, authors, abstract, introduction, methods, results, discussion and citations to peer-reviewed literature. The mini-journal provides a scaffold and serves as a springboard for students to develop and carry out their own follow-up investigation. They then present their findings in the form of their own mini-journal. Mini-journals replace traditional homework problem sets with a format that more directly reflects and encourages scientific practice. Students are engaged in inquiry-based homework which encompass doing, thinking, and communicating, while the mini-journal allows the instructor to contain lines of inquiry within the limits posed by available resources. In the examples we present, research is conducted via spreadsheet modeling, where the students develop their own spreadsheets. Example assignments from Geochemistry include "Trace Element Partitioning During Mantle Melting and MORB Crystallization" and "Isotopic Investigations of Crustal Evolution in the Midcontinent US". The key differences between the old and new

Mini International Neuropsychiatric Interview (MINI: validação de entrevista breve para diagnóstico de transtornos mentais

Directory of Open Access Journals (Sweden)

Amorim Patrícia

2000-01-01

Full Text Available Objetivos: O MINI é uma entrevista diagnóstica padronizada breve (15-30 minutos, compatível com os critérios do DSM-III-R/IV e da CID-10, que é destinada à utilização na prática clínica e na pesquisa em atenção primária e em psiquiatria, e pode ser utilizada por clínicos após um treinamento rápido (de 1 a 3 horas. A versão Plus do MINI, mais detalhada, gera diagnósticos positivos dos principais transtornos psicóticos e do humor do DSM-IV. Este artigo apresenta os resultados de quatro estudos de validação do instrumento, realizados na Europa e nos EUA. Métodos: Os estudos 1 (França e 2 (EUA testaram a confiabilidade -entre avaliadores e teste-reteste -da versão DSM-III-R do MINI (n=84, sendo 42 pacientes psiquiátricos de cada centro e sua validade com relação ao CIDI (n=346, sendo 296 pacientes psiquiátricos e 50 controles e ao SCID-P (n=370, sendo 308 pacientes psiquiátricos e 62 controles, respectivamente. O estudo 3 testou a validade de diagnósticos gerados por clínicos gerais usando o MINI (DSM-IV com relação aos diagnósticos clínicos habituais de psiquiatras, em 409 pacientes de centros de atenção primária de quatro países (França, Espanha, Itália e Reino Unido. O estudo 4 testou a confiabilidade entre avaliadores (n=20 pacientes psiquiátricos e a validade dos módulos Transtornos Psicóticos, Depressão e Mania do MINI Plus - DSM IV (n=104 pacientes psiquiátricos com relação a dois critérios de referência: diagnósticos do CIDI e diagnósticos clínicos de psiquiatras. Análises quantitativas (índices de concordância e de validade e qualitativas (razões de discordância foram realizadas. Resultados: Os índices de confiabilidade do MINI (estudos 1 e 2 e do MINI Plus (estudo 4 foram globalmente satisfatórios. Comparados a vários critérios de referência (CIDI, SCID-P, opinião de peritos, em diferentes contextos (unidades psiquiátricas e centros de atenção primária, o MINI e o MINI

PV-hybrid and mini-grid

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-07-01

Within the 5th European PV-hybrid and mini-grid conference 29th and 30th April, 2010 in Tarragona (Spain) the following lectures were held: (1) Overview of IEA PVPS Task 11 PV-hybrid systems within mini grids; (2) Photovoltaic revolution for deployment in developing countries; (3) Legal and financial conditions for the sustainable operation of mini-grids; (4) EU instruments to promote renewable energies in developing countries; (5) PV hybridization of diesel electricity generators: Conditions of profitability and examples in differential power and storage size ranges; (6) Education suit of designing PV hybrid systems; (7) Sustainable renewable energy projects for intelligent rural electrification in Laos, Cambodia and Vietnam; (8) Techno-economic feasibility of energy supply of remote villages in Palestine by PV systems, diesel generators and electric grid (Case studies: Emnazeil and Atouf villages); (9) Technical, economical and sustainability considerations of a solar PV mini grid as a tool for rural electrification in Uganda; (10) Can we rate inverters for rural electrification on the basis of energy efficiency?; (11) Test procedures for MPPT charge controllers characterization; (12) Energy storage for mini-grid stabilization; (13) Redox flow batteries - Already an alternative storage solution for hybrid PV mini-grids?; (14) Control methods for PV hybrid mini-grids; (15) Partial AC-coupling in mini-grids; (15) Normative issues of small wind turbines in PV hybrid systems; (16) Communication solutions for PV hybrid systems; (17) Towards flexible control and communication of mini-grids; (18) PV/methanol fuel cell hybrid system for powering a highway security variable message board; (19) Polygeneration smartgrids: A solution for the supply of electricity, potable water and hydrogen as fuel for transportation in remote Areas; (20) Implementation of the Bronsbergen micro grid using FACDS; (21) A revisited approach for the design of PV wind hybrid systems; (22

[Internal fixation with one-hole microplate for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture].

Science.gov (United States)

Wang, Xi-Xun; Sun, De-Tao; Chen, Xu-Hui; Li, Jun; Cui, Yan; Hu, Ji-Chao; Shu, Zheng-Hua; He, Jian; Ding, Chao-Qi; Chen, Bo

2015-03-01

To study clinical effects of one-hole microplate internal fixation for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture. Twenty-two patients (16 males, 6 females) with collateral ligament injuries of the metacarpophalangeal joint of the thumb combined fracture were treated with one-hole microplate internal fixation. The age of the patients ranged from 18 to 53 years old with a mean age of 28.5 years old. The duration from injury to surgery ranged from 2 hours to 2 months, and the mean time was 6 days. All the patients had collateral ligament injuries combined with fracture of the metacarpophalangeal joint of the thumb. Thirteen patients had injuries in the right hand and 9 patients had injuries in the left hand. There were 18 cases of closed wound and 4 cases of open wound. Eighteen patients had fresh injuries ( 2 weeks). Sixteen patients had injuries in the ulnar collateral ligament of the thumb combined with fracture, 6 patients had radial collateral ligament injuries of the thumb combined with fracture, 4 cases of which were complicated with injuries of abductor pollicis brevis and the end of the flexor pollicis brevis tender. The size of the avulsed fragment was about 3.0 mm x 4.0 mm to 6.0 mm x 7.0 mm. The incisions of 22 patients healed by first intention. The follow-up periods ranged from 6 months to 5 years old,with an average of 2.5 years old. The thumb function was evaluated by Saetta and other evaluation criteria, and 20 patients got an excellent result and 2 good. The application of one-hole microplate internal fixation in treating collateral ligament injuries with fracture of the metacarpophalangeal joint of the thumb is an effective method.

Kinematics of the lateral ligamentous constraints of the elbow joint

DEFF Research Database (Denmark)

Olsen, Bo Sanderhoff; Søjbjerg, Jens Ole; Dalstra, Michel

1996-01-01

preventer of elbow joint laxity. The LCLC was observed to be a complex structure of ligamentous fibers rather than discreet bands. The LCLC forms a ligamentous constraint between the lateral humeral epicondyle and the ulna, stabilizing the elbow joint and forming a base for radial head stability...

The Mini-Cog, Clock Drawing Test, and the Mini-Mental State Examination in a German memory clinic: specificity of separation dementia from depression.

Science.gov (United States)

Milian, Monika; Leiherr, Anna-Maria; Straten, Guido; Müller, Stephan; Leyhe, Thomas; Eschweiler, Gerhard W

2013-01-01

The aim of this study was to assess the specificities of the Mini-Cog, the Clock Drawing Test (CDT), and the Mini-Mental State Examination (MMSE) against depression and healthy controls in a German Memory Clinic. Furthermore, we analyzed the specificities of all three screening instruments in dependence of actual depression severity. Data from 142 depressed elderly, 438 dementia patients, and 64 healthy controls were retrospectively analyzed. The CDT and an extraction of the three-item recall of the MMSE were used to constitute the Mini-Cog algorithm. Depression severity was rated by either the Beck Depression Inventory (BDI) or the Geriatric Depression Scale (GDS) depending on the age of the patients. The Mini-Cog achieved a specificity of 79.6% against depressed elderly and 100.0% against healthy subjects (p Mini-Cog and the CDT, but also showed the lowest sensitivity for the detection of dementia. Surprisingly, the depression severity had no effect on the specificity of the Mini-Cog and the CDT, only the MMSE was susceptible for the depression severity. Although the MMSE showed higher specificities, the weighting between the sensitivities and specificities in all tests prove again the Mini-Cog as a short, valid, and sensitive screening tool.

Magnetic resonance imaging evaluation of cruciate ligaments after arthroscopic reconstruction

Directory of Open Access Journals (Sweden)

Amit Kharat

2017-01-01

Full Text Available Background: Due to increase in road traffic and sports injuries, tears of anterior cruciate ligament (ACL and the posterior cruciate ligament (PCL of the knee are common. Magnetic resonance imaging (MRI is emerging as an important tool of diagnosis and evaluation of these injuries. Methods: We carried out a prospective study on role of MRI on ten patients who had undergone ACL or PCL repair over a period of six months. In this report we present three illustrative cases to capture the spectrum of findings in our series to underline the role of MRI in management of such injuries and discuss the modalities of the procedure. Results: In our series, as demonstrated by the cases, MRI had an important role in diagnosis and evaluation of injuries to the cruciate ligaments. Conclusion: MRI can play an important role, particularly in tertiary centres, in diagnosis and evaluation of reconstructed ACL and PCL ligaments of the knee joint.

The name cranial ovarian suspensory ligaments in mammalian anatomy should be used only to indicate the structures derived from the foetal cranial mesonephric and gonadal ligaments

NARCIS (Netherlands)

P. van der Schoot (P.)

1993-01-01

textabstractThe term ovarian suspensory ligament appears ambiguous when human adult anatomy textbooks are compared with human embryology or with general mammalian anatomy textbooks. The term ovarian suspensory ligament in laboratory rodents and domestic animals indicates homologous structures during

Visibility of Anterolateral Ligament Tears in Anterior Cruciate Ligament-Deficient Knees With Standard 1.5-Tesla Magnetic Resonance Imaging.

Science.gov (United States)

Hartigan, David E; Carroll, Kevin W; Kosarek, Frank J; Piasecki, Dana P; Fleischli, James F; D'Alessandro, Donald F

2016-10-01

To attempt to visualize the ligament with standard 1.5-tesla magnetic resonance imaging (MRI) in the acute anterior cruciate ligament (ACL)-torn knee, and if it is visible, attempt to characterize it as torn or intact at its femoral, meniscal, and tibial attachment sites. This was a retrospective MRI study based on arthroscopic findings of a known ACL tear in 72 patients between the years 2006 and 2010. Patients all had hamstring ACL reconstructions, no concomitant lateral collateral ligament, or posterolateral corner injury based on imaging and physical examination, and had a preoperative 1.5-tesla MRI scan with standard sequences performed within 3 weeks of the injury. Two fellowship-trained musculoskeletal radiologists retrospectively reviewed the preoperative MRI for visualization of the anterolateral ligament (ALL) for concomitant tears. Inter- and intraobserver reliability was calculated. Learning effect was analyzed to determine if radiologists' agreement improved as reads progressed. Both radiologists were able to visualize the ALL in 100% of the scans. Overall, ALL tears were noted in 26% by radiologist 1 and in 62% by radiologist 2. The agreement between the ligament being torn or not had a kappa of 0.54 between radiologists. The agreements in torn or not torn between radiologists in the femoral, meniscal, and tibial sites were 0.14, 0.15, and 0.31. The intraobserver reliability by radiologist 1 for femoral, meniscal, and tibial tears was 0.04, 0.57, and 0.54 respectively. For radiologist 2, they were 0.75, 0.61, and 0.55. There was no learning effect noted. ALL tears are currently unable to be reliably identified as torn or intact on standard 1.5-tesla MRI sequences. Proper imaging sequences are of crucial importance to reliably follow these tears to determine their clinical significance. Level IV, therapeutic case series study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Bilateral agenesis of the anterior cruciate ligament: MRI evaluation

Energy Technology Data Exchange (ETDEWEB)

Bedoya, Maria A.; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Radiology Department, Philadelphia, PA (United States); McGraw, Michael H. [Hospitalof theUniversityof Pennsylvania, Divisionof Orthopaedics, Philadelphia, PA (United States); Wells, Lawrence [The Children' s Hospital of Philadelphia, Division of Orthopaedics, Philadelphia, PA (United States)

2014-09-15

Bilateral agenesis of the anterior cruciate ligament (ACL) is extremely rare. We describe a 13-year-old girl who presented with bilateral knee pain without history of trauma; she has two family members with knee instability. Magnetic resonance imaging showed bilateral absence of the ACL, and medial posterior horn meniscal tears. Bilateral arthroscopic partial meniscectomy and anterior cruciate ligament reconstruction was performed. (orig.)

Anatomy and Histology of the Knee Anterolateral Ligament.

Science.gov (United States)

Helito, Camilo Partezani; Demange, Marco Kawamura; Bonadio, Marcelo Batista; Tírico, Luis Eduardo Passarelli; Gobbi, Riccardo Gomes; Pécora, José Ricardo; Camanho, Gilberto Luis

2013-12-01

Reconstruction of the anterior cruciate ligament (ACL) is one of the most common procedures in orthopaedic surgery. However, even with advances in surgical techniques and implants, some patients still have residual anterolateral rotatory laxity after reconstruction. A thorough study of the anatomy of the anterolateral region of the knee is needed. To study the anterolateral region and determine the measurements and points of attachments of the anterolateral ligament (ALL). Descriptive laboratory study. Dissections of the anterolateral structures of the knee were performed in 20 human cadavers. After isolating the ALL, its length, thickness, width, and points of attachments were determined. The femoral attachment of the ALL was based on the anterior-posterior and proximal-distal distances from the attachment of the lateral collateral ligament (LCL). The tibial attachment point was based on the distance from the Gerdy tubercle to the fibular head and the distance from the lateral tibial plateau. The ligaments from the first 10 dissections were sent for histological analysis. The ALL was found in all 20 knees. The femoral attachment of the ALL at the lateral epicondyle averaged 3.5 mm distal and 2.2 mm anterior to the attachment of the LCL. Two distal attachments were observed: one inserts into the lateral meniscus, the other between the Gerdy tubercle and the fibular head, approximately 4.4 mm distal to the tibial articular cartilage. The mean measurements for the ligament were 37.3 mm (length), 7.4 mm (width), and 2.7 mm (thickness). The histological analysis of the ligaments revealed dense connective tissue. The ALL is consistently present in the anterolateral region of the knee. Its attachment to the femur is anterior and distal to the attachment of the LCL. Moving distally, it bifurcates at close to half of its length. The ALL features 2 distal attachments, one at the lateral meniscus and the other between the Gerdy tubercle and the fibular head. The ALL may be

Outcome of hamstring ligament harvest for Anterior Cruciate Ligament reconstruction with allograft versus autograft: a clinical trial

Directory of Open Access Journals (Sweden)

Mehdi Moghtadaei

2013-11-01

Full Text Available Background: The goal of this study was to evaluate, functional capacity of the knee in flexion and internal rotation after hamstring ligament harvest for Anterior Cruciate Ligament (ACL reconstruction.Methods: Fifty patients (male and 18-45 years old with isolated ACL injury, randomly allocated in two equal groups (in one group, ACL reconstruction was performed with Tibialis Posterior allograft and in another group with quadruple hamstring ligament auto graft and before and 6 months after surgery in both groups isokinetic flexion strength and isometric internal rotation strength of knee evaluated with Biodex System 4 dynamometer and rotational torque recorder, in order. Isokinetic flexion strength evaluated in sitting and prone position; the later position was performed for deep flexion strength evaluation. Also subjective and objective assessment of all patients pre operatively and 6 months post operatively was documented with International Knee Documentation Committee (IKDC questionnaire. In this study for first time, rotational torque strength of knee was recorded with new design measure, from isometric aspect and not isokinetic.Results: Although significant improvements in IKDC scores, flexion and internal rotation capacity of the knee were observed in both groups, post operatively in respect to pre operatively; there was no significant difference between 2 groups. (P<0.05 or more than 95% confidence Interval of the differenceConclusion: This study demonstrates that ACL reconstruction surgery, improves knee performance in flexion and internal rotation, regardless of hamstring tendon harvesting. Considering potential complications of allograft (for example: transfer of harmful diseases from donor to recipient, it is logical to use hamstring auto graft ligament for ACL reconstruction surgery. Because result of this study is not longstanding follow up and limited to male sex, for more worthfull conclusion, we suggest future study in both sex

Roentgenologic diagnostics of capsular ligament lesions

Energy Technology Data Exchange (ETDEWEB)

Wirth, C.J.; Jaeger, M.

1981-10-01

The X-ray diagnostic is of obvious importance and relevance in the detection of acute or old capsular ligament lesions of the limb joint. On the one hand it serves as the plain radiograph (roentgenogram without contrast medium) for the assessment of osseous secondary lesions, for the documentation of luxationary positions of the joint partners, and in old capsular ligament lesions for the detection of an already existing arthrosis. On the other hand the X-ray images are of main importance, which are made from the hand-held limb in order to permit a comparison of the two sides, and which beyond the clinical detection of a joint instability indicate the extent and the direction of this instability and which also document it, and which allow in adolescents to recognize a separation of the epiphysis as an alternative to the capsular ligament rupture. Only in particular cases arthrography can provide some additional information, so for example in the case of an isolated syndesmosis rupture, ruptures of the rosette of the rotator muscle or of a damaged triangular disk in the hand. Angiography is only required in cases of traumatic luxations of the knee in order to exclude an intimal lesion of the popliteal artery.

Anterior cruciate ligament ganglion: case report

Directory of Open Access Journals (Sweden)

André Pedrinelli

Full Text Available CONTEXT: A ganglion is a cystic formation close to joints or tendinous sheaths, frequently found in the wrist, foot or knee. Intra-articular ganglia of the knee are rare, and most of them are located in the anterior cruciate ligament. The clinical picture for these ganglia comprises pain and movement restrictions in the knee, causing significant impairment to the patient. Symptoms are non-specific, and anterior cruciate ligament ganglia are usually diagnosed through magnetic resonance imaging or arthroscopy. Not all ganglia diagnosed through magnetic resonance imaging need to undergo surgical treatment: only those that cause clinical signs and symptoms do. Surgical results are considered good or excellent in the vast majority of cases. CASE REPORT: A 29-year-old male presented with pain in the left knee during a marathon race. Physical examination revealed limitation in the maximum range of knee extension and pain in the posterior aspect of the left knee. Radiographs of the left knee were normal, but magnetic resonance imaging revealed a multi-lobed cystic structure adjacent to the anterior cruciate ligament, which resembled a ganglion cyst. The mass was removed through arthroscopy, and pathological examination revealed a synovial cyst. Patient recovery was excellent, and he resumed his usual training routine five months later.

[Double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament at stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V].

Science.gov (United States)

Hu, Wen-yue; Yu, Chong; Huang, Zhong-ming; Han, Lei

2015-06-01

To explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V . From January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects. All patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up. Double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Lumbosacral interspinous ligament rupture associated with acute intrinsic spinal muscle degeneration

International Nuclear Information System (INIS)

Jinkins, Randy J.

2002-01-01

The objective of this study was to demonstrate lumbosacral interspinous ligament rupture, with or without related acute intrinsic spinal muscle degeneration. This study consisted of a prospective imaging analysis of consecutive 100 MRI studies in adult patients (mean age 56 years) presenting with low back pain. Alterations from the normal in the inter- and perispinal structures of the spine and perispinal soft tissues (e.g., spinal ligaments, perispinal muscles) were sought based upon studies on young volunteers without low back pain (n=10; mean age 23 years). Compared with the group without low back pain, many index cases (n=71, 71%) demonstrated hyperintensity (i.e., sprain or frank ligamentous rupture) of the interspinous ligament(s) on T2-weighted, fat-suppressed MRI studies at one (20 of 71, 28%) or multiple (51 of 71, 72%) levels. Associated intrinsic spinal muscle (e.g., interspinalis, multifidus muscles) degeneration was observed in a minority of cases overall (n=7, 7%), but was only seen in association with cases also demonstrating interspinous ligament degeneration/rupture (7 of 71, 10%). Lumbosacral interspinous ligament sprain or frank rupture, as well as related acute-subacute autotraumatic intrinsic spinal muscle rupture/degeneration, may be overlooked by many observers if fat-suppressed, T2-weighted MRI is not acquired. These musculoligamentous alterations are on occasion the only abnormalities recognized on MRI of the lumbosacral spine and may theoretically be sources of low back morbidity that potentially may respond to specific therapy. Because this study was an observational one, based solely upon medical imaging, future research must focus upon the correlation of the relevance of these findings with an age-matched asymptomatic control group and longitudinal clinicoradiologic therapeutic trials. (orig.)

Preventive lateral ligament tester (PLLT): a novel method to evaluate mechanical properties of lateral ankle joint ligaments in the intact ankle.

Science.gov (United States)

Best, Raymond; Böhle, Caroline; Mauch, Frieder; Brüggemann, Peter G

2016-04-01

To construct and evaluate an ankle arthrometer that registers inversion joint deflection at standardized inversion loads and that, moreover, allows conclusions about the mechanical strain of intact ankle joint ligaments at these loads. Twelve healthy ankles and 12 lower limb cadaver specimens were tested in a self-developed measuring device monitoring passive ankle inversion movement (Inv-ROM) at standardized application of inversion loads of 5, 10 and 15 N. To adjust in vivo and in vitro conditions, the muscular inactivity of the evertor muscles was assured by EMG in vivo. Preliminary, test-retest and trial-to-trial reliabilities were tested in vivo. To detect lateral ligament strain, the cadaveric calcaneofibular ligament was instrumented with a buckle transducer. After post-test harvesting of the ligament with its bony attachments, previously obtained resistance strain gauge results were then transferred to tensile loads, mounting the specimens with their buckle transducers into a hydraulic material testing machine. ICC reliability considering the Inv-ROM and torsional stiffness varied between 0.80 and 0.90. Inv-ROM ranged from 15.3° (±7.3°) at 5 N to 28.3° (±7.6) at 15 N. The different tests revealed a CFL tensile load of 31.9 (±14.0) N at 5 N, 51.0 (±15.8) at 10 N and 75.4 (±21.3) N at 15 N inversion load. A highly reliable arthrometer was constructed allowing not only the accurate detection of passive joint deflections at standardized inversion loads but also reveals some objective conclusions of the intact CFL properties in correlation with the individual inversion deflections. The detection of individual joint deflections at predefined loads in correlation with the knowledge of tensile ligament loads in the future could enable more individual preventive measures, e.g., in high-level athletes.

Does evaluation of the ligamentous compartment enhance diagnostic utility of sacroiliac joint MRI in axial spondyloarthritis?

DEFF Research Database (Denmark)

Weber, Ulrich; Maksymowych, Walter P; Chan, Stanley M

2015-01-01

in the ligamentous compartment and their potential diagnostic utility in axial SpA. We therefore aimed to evaluate the ligamentous compartment on sacroiliac joint MRI for lesion distribution and potential incremental value towards diagnosis of SpA over and above the traditional assessment of the cartilaginous...... and ligamentous compartment. The incremental value of evaluating the ligamentous additionally to the cartilaginous compartment alone for diagnosis of SpA was graded qualitatively. We determined the lesion distribution between the two compartments, and the impact of the ligamentous compartment evaluation...... on diagnostic utility. RESULTS: MRI bone marrow lesions solely in the ligamentous compartment in the absence of lesions in the cartilaginous compartment were reported in just 0-2.0/0-4.0 % (BME/fat metaplasia) of all subjects. Additional assessment of the ligamentous compartment was regarded as essential...

Validation and cultural adaptation of the Arabic versions of the Mini-Mental Status Examination - 2 and Mini-Cog test.

Science.gov (United States)

Albanna, Mohammad; Yehya, Arij; Khairi, Abdalla; Dafeeah, Elnour; Elhadi, Abdelsalam; Rezgui, Lamia; Al Kahlout, Shahada; Yousif, Adil; Uthman, Basim; Al-Amin, Hassen

2017-01-01

The elderly population is increasing around the world, and the prevalence of dementia increases with age. Hence, it is expected that the number of people with dementia will increase significantly in the coming years. The Mini-Mental Status Examination - 2 (MMSE-2) and Mini-Cog are widely used tests to screen for dementia. These scales have good reliability and validity and are easy to administer in clinical and research settings. The purpose of this study was to validate the Arabic versions of MMSE-2 and Mini-Cog. These scales were assessed against the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( DSM-IV-TR ) criteria for dementia, as the gold standard. The standard versions of the MMSE-2 and Mini-Cog were translated to Arabic following the back-translation method. Then, a trained rater administered these tests to 134 Arab elderly aged >60 years. A physician, blind to the results of these two tests, assessed the participants for vascular dementia or probable Alzheimer's disease, based on the DSM-IV-TR criteria. The sample included 67.2% Qataris. The mean age was 74.86 years (standard deviation =7.71), and 61.9% did not attend school. The mean of the adjusted scores of MMSE-2 based on age and education level was 19.60 (standard deviation =6.58). According to DSM-IV-TR , 17.2% of the participants had dementia. Sensitivity and specificity of the MMSE-2 and the Mini-Cog together were 71.4% and 61.6%, respectively, which were better than those of each test alone. Together, the Arabic versions of MMSE-2 and Mini-Cog are good screening tools for cognitive impairment in Arabs.

Trochleoplasty and medial patellofemoral ligament reconstruction for recurrent patellar dislocation

Directory of Open Access Journals (Sweden)

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.

Congenital hypogonadotropic hypogonadism: implications of absent mini-puberty.

Science.gov (United States)

Dwyer, Andrew A; Jayasena, Channa N; Quinton, Richard

2016-06-01

The phenomenon known as "mini-puberty" refers to activation of the neonatal hypothalamo-pituitary axis causing serum concentrations of gonadotrophins and testosterone (T) to approach adult male levels. This early neonatal period is a key proliferative window for testicular germ cells and immature Sertoli cells. Although failure to spontaneously initiate (adolescent) puberty is the most evident consequence of a defective gonadotropin-releasing hormone (GnRH) neurosecretory network, absent mini-puberty is also likely to have a major impact on the reproductive phenotype of men with congenital hypogonadotrophic hypogonadism (CHH). Furthermore, the phase of male mini-puberty represents a key window-of-opportunity to identify congenital GnRH deficiency (either isolated CHH, or as part of combined pituitary hormone deficiency) in childhood. Among male neonates exhibiting "red flag" indicators for CHH (i.e. maldescended testes with or without cryptorchidism) a single serum sample (between 4-8 weeks of life) can pinpoint congenital GnRH deficiency far more rapidly and with much greater accuracy than dynamic tests performed in later childhood or adolescence. Potential consequences for missing absent mini-puberty in a male neonate include the lack of monitoring of pubertal progression/lack of progression, and the missed opportunity for early therapeutic intervention. This article will review our current understanding of the mechanisms and clinical consequences of mini-puberty. Furthermore, evidence for the optimal clinical management of patients with absent mini-puberty will be discussed.

Mini AERCam Inspection Robot for Human Space Missions

Science.gov (United States)

Fredrickson, Steven E.; Duran, Steve; Mitchell, Jennifer D.

2004-01-01

The Engineering Directorate of NASA Johnson Space Center has developed a nanosatellite-class free-flyer intended for future external inspection and remote viewing of human spacecraft. The Miniature Autonomous Extravehicular Robotic Camera (Mini AERCam) technology demonstration unit has been integrated into the approximate form and function of a flight system. The spherical Mini AERCam free flyer is 7.5 inches in diameter and weighs approximately 10 pounds, yet it incorporates significant additional capabilities compared to the 35 pound, 14 inch AERCam Sprint that flew as a Shuttle flight experiment in 1997. Mini AERCam hosts a full suite of miniaturized avionics, instrumentation, communications, navigation, imaging, power, and propulsion subsystems, including digital video cameras and a high resolution still image camera. The vehicle is designed for either remotely piloted operations or supervised autonomous operations including automatic stationkeeping and point-to-point maneuvering. Mini AERCam is designed to fulfill the unique requirements and constraints associated with using a free flyer to perform external inspections and remote viewing of human spacecraft operations. This paper describes the application of Mini AERCam for stand-alone spacecraft inspection, as well as for roles on teams of humans and robots conducting future space exploration missions.

The iliolumbar ligament : its influence on stability of the sacroiliac joint

NARCIS (Netherlands)

Pool-Goudzwaard, A.L.; Hoek van Dijke, G; Mulder, P; Spoor, C.W.; Snijders, C.; Stoeckart, R.

2003-01-01

STUDY DESIGN: In human specimens the influence of the iliolumbar ligament on sacroiliac joint stability was tested during incremental moments applied to the sacroiliac joints. OBJECTIVES: To assess whether the iliolumbar ligament is able to restrict sacroiliac joint mobility in embalmed cadavers.

Clinical diagnosis of an anterior cruciate ligament rupture : A meta-analysis

NARCIS (Netherlands)

Benjammse, A; Gokeler, A; van der Schans, CP

Study Design: Meta-analysis. Objectives: To define the accuracy of clinical tests for assessing anterior cruciate ligament (ACL) ruptures. Background: The cruciate ligaments, and especially the ACL, are among the most commonly injured structures of the knee. Given the increasing injury prevalence,

Distribution of lymphatic tissues and autonomic nerves in supporting ligaments around the cervix uteri.

Science.gov (United States)

Zhang, Jianping; Feng, Lanlan; Lu, Yi; Guo, Dongxia; Xi, Tengteng; Wang, Xiaochun

2013-05-01

To investigate the distribution of lymphatic tissues and nerves in the supporting ligaments around the cervix uteri for their tomographical relationship, 9 adult female cadavers were used in this study. Following the incision of all supporting ligaments around the cervix, hematoxylin and esosin (H&E) and immunohistochemical staining of various sections of these ligaments was performed to enable the distribution of lymph tissues and autonomic nerves to be observed. Four lymph nodes were identified in three cadaver specimens. Three lymph nodes were present at a distance of 2.0 cm from the cervix in the cranial side of the cardinal ligaments (CLs), and one lymph node was located at a distance of 4.0 cm from the cervix in the cranial side of the uterosacral ligament (USL). The lymphatic vessels were dispersed in the CLs, scattered in the cervical side of the USLs, and occasionally distributed in the vesicouterine ligaments (VULs). In the CLs, parasympathetic nerves were located at the pelvic lateral wall and went downwards and medially into the cervix, while sympathetic fibers were located in the middle and lower parts of the ligaments. In the USLs, the autonomic nerves, which consisted primarily of sympathetic fibers, went downwards and laterally from the pelvic wall to the cervix. In the VULs, parasympathetic and sympathetic nerves were located in the inner sides of the vesical veins in the deep layers of the ligaments. It is concluded that there are few lymphatic tissues in the supporting ligaments around the cervix uteri, and that nerve‑sparing radical hysterectomy (NSRH) may be a safe method for the treatment of early‑stage cervical cancer.

A Nano-indentation Identification Technique for Viscoelastic Constitutive Characteristics of Periodontal Ligaments.

Science.gov (United States)

Ashrafi, H; Shariyat, M

2016-06-01

Nano-indentation has recently been employed as a powerful tool for determining the mechanical properties of biological tissues on nano and micro scales. A majority of soft biological tissues such as ligaments and tendons exhibit viscoelastic or time-dependent behaviors. The constitutive characterization of soft tissues is among very important subjects in clinical medicine and especially, biomechanics fields. Periodontal ligament plays an important role in initiating tooth movement when loads are applied to teeth with orthodontic appliances. It is also the most accessible ligament in human body as it can be directly manipulated without any surgical intervention. From a mechanical point of view, this ligament can be considered as a thin interface made by a solid phase, consisting mainly of collagen fibers, which is immersed into a so-called ground substance. However, the viscoelastic constitutive effects of biological tissues are seldom considered rigorous during Nano-indentation tests. In the present paper, a mathematical contact approach is developed to enable determining creep compliance and relaxation modulus of distinct periodontal ligaments, using constant-rate indentation and loading time histories, respectively. An adequate curve-fitting method is presented to determine these characteristics based on the Nano-indentation of rigid Berkovich tips. Generalized Voigt-Kelvin and Wiechert models are used to model constitutive equations of periodontal ligaments, in which the relaxation and creep functions are represented by series of decaying exponential functions of time. Time-dependent creep compliance and relaxation function have been obtained for tissue specimens of periodontal ligaments. To improve accuracy, relaxation and creep moduli are measured from two tests separately. Stress relaxation effects appear more rapidly than creep in the periodontal ligaments.

A Nano-indentation Identification Technique for Viscoelastic Constitutive Characteristics of Periodontal Ligaments

Science.gov (United States)

Ashrafi, H.; Shariyat, M.

2016-01-01

Introduction Nano-indentation has recently been employed as a powerful tool for determining the mechanical properties of biological tissues on nano and micro scales. A majority of soft biological tissues such as ligaments and tendons exhibit viscoelastic or time-dependent behaviors. The constitutive characterization of soft tissues is among very important subjects in clinical medicine and especially, biomechanics fields. Periodontal ligament plays an important role in initiating tooth movement when loads are applied to teeth with orthodontic appliances. It is also the most accessible ligament in human body as it can be directly manipulated without any surgical intervention. From a mechanical point of view, this ligament can be considered as a thin interface made by a solid phase, consisting mainly of collagen fibers, which is immersed into a so-called ground substance. However, the viscoelastic constitutive effects of biological tissues are seldom considered rigorous during Nano-indentation tests. Methods In the present paper, a mathematical contact approach is developed to enable determining creep compliance and relaxation modulus of distinct periodontal ligaments, using constant–rate indentation and loading time histories, respectively. An adequate curve-fitting method is presented to determine these characteristics based on the Nano-indentation of rigid Berkovich tips. Generalized Voigt-Kelvin and Wiechert models are used to model constitutive equations of periodontal ligaments, in which the relaxation and creep functions are represented by series of decaying exponential functions of time. Results Time-dependent creep compliance and relaxation function have been obtained for tissue specimens of periodontal ligaments. Conclusion To improve accuracy, relaxation and creep moduli are measured from two tests separately. Stress relaxation effects appear more rapidly than creep in the periodontal ligaments. PMID:27672630

Mini-chamber, an advanced protection concept for NIF

International Nuclear Information System (INIS)

Peterson, P.F.; Scott, J.M.

1996-01-01

Inertial confinement fusion (ICF) target debris and ablated near-target materials pose the primary threat to the National Ignition Facility (NIF) final optics debris shields, as well as a major challenge in future inertial fusion energy (IFE) power plants. This work discusses a NIF 'mini-chamber,' designed to mitigate the debris threat. Although the NIF base-line design protects against debris using a frost-protected target positioner and refractory first-wall coatings, the mini-chamber provides important flexibility in three areas: debris-shield protection from beyond-design basis shots (i.e. heavy hohlraums, special diagnostics, shields); fielding of large experiments with significant surface ablation; and studying key ablation and gas-dynamics issues for liquid-wall IFE power plants. Key mini-chamber modeling results are presented, followed by discussion of equipment requirements for fielding a NIF mini-chamber. 7 refs., 3 figs

In vivo metacarpophalanageal joint collateral ligament length changes during flexion.

Science.gov (United States)

Sun, Y C; Sheng, X M; Chen, J; Qian, Z W

2017-07-01

We investigated the in vivo length changes of the collateral ligaments of metacarpophalangeal joint during flexion. We obtained computed tomography scans of index, middle, ring and little fingers at 0°, 30°, 60° and 90° of joint flexion from six hands of six healthy adult volunteers. Three of them had their dominant right hand studied, and the other three had their non-dominant left hand studied. We measured and analysed the radial and ulnar collateral ligaments of each metacarpophalangeal joint from the reconstructed images. We found that the dorsal and middle portions of the both radial and ulnar collateral ligament lengthened progressively during digital flexion and reached the maximum at 90° flexion. The length of the volar portion increased from 0° to 30° flexion and then decreased from 30° to 60° flexion, reaching the minimum at 90°. In conclusion, three portions of collateral ligaments on both sides of the metacarpophalangeal joint have variable length changes during flexion, which act to stabilize the joint through its flexion arc.

A Soft Gripper with Rigidity Tunable Elastomer Strips as Ligaments.

Science.gov (United States)

Nasab, Amir Mohammadi; Sabzehzar, Amin; Tatari, Milad; Majidi, Carmel; Shan, Wanliang

2017-12-01

Like their natural counterparts, soft bioinspired robots capable of actively tuning their mechanical rigidity can rapidly transition between a broad range of motor tasks-from lifting heavy loads to dexterous manipulation of delicate objects. Reversible rigidity tuning also enables soft robot actuators to reroute their internal loading and alter their mode of deformation in response to intrinsic activation. In this study, we demonstrate this principle with a three-fingered pneumatic gripper that contains "programmable" ligaments that change stiffness when activated with electrical current. The ligaments are composed of a conductive, thermoplastic elastomer composite that reversibly softens under resistive heating. Depending on which ligaments are activated, the gripper will bend inward to pick up an object, bend laterally to twist it, and bend outward to release it. All of the gripper motions are generated with a single pneumatic source of pressure. An activation-deactivation cycle can be completed within 15 s. The ability to incorporate electrically programmable ligaments in a pneumatic or hydraulic actuator has the potential to enhance versatility and reduce dependency on tubing and valves.

The structure of the coracoacromial ligament: fibrocartilage differentiation does not necessarily mean pathology.

Science.gov (United States)

Milz, S; Jakob, J; Büttner, A; Tischer, T; Putz, R; Benjamin, M

2008-02-01

The coracoacromial ligament forms part of the coracoacromial arch and is implicated in impingement syndrome and acromial spur formation. Here, we describe its structure and the composition of its extracellular matrix. Ligaments were obtained from 15 cadavers, nine from older people (average age 74.7 years) and six from younger individuals (average age 24.2 years). Cryosections of methanol-fixed tissue were cut and sections were immunolabelled with monoclonal antibodies against collagens, glycosaminoglycans, proteoglycans, matrix proteins and neurofilament proteins. Both ligament entheses were highly fibrocartilaginous and immunolabelled strongly for type II collagen, aggrecan and link protein. The area of labelling was more extensive in older people. However, fibrocartilage also characterized the ligament midsubstance, particularly with increased age. Signs of fibrocartilage degeneration were more common in older people. Ligament fat (containing blood vessels and nerve fibers) was conspicuous in both age groups, especially between fiber bundles at the entheses. We conclude that fibrocartilage is a normal feature but becomes more pronounced with age. It is not necessarily pathological, for it simply indicates that the ligament is subject to compression and/or shear. Nevertheless, the prominence of fibrocartilage at the acromial enthesis may relate to the frequency with which enthesophytes develop.

Mini-Implants: New Possibilities in Interdisciplinary Treatment Approaches

Directory of Open Access Journals (Sweden)

Biju Sebastian

2014-01-01

Full Text Available The introduction of mini-implants has broadened the range of tooth movements possible by fixed appliance therapy alone. The limits of fixed orthodontic treatment have become more a matter of facial appearance than anchorage. Many complex cases which would previously have required surgery or functional appliances can now be treated with fixed appliance therapy using mini-implants. A mutilated dentition case where mini-implants were used to provide anchorage for intrusion of molars and retraction of anterior teeth is reported here to illustrate this point.

Role of integrins in the periodontal ligament: organizers and facilitators.

Science.gov (United States)

Barczyk, Malgorzata; Bolstad, Anne Isine; Gullberg, Donald

2013-10-01

The periodontal ligament is the tissue that connects teeth to bone. The periodontal ligament is a fascinating tissue from a cell biologist's point of view, and because of its special properties and stem-cell content it has also come into the limelight in emerging fields of regenerative medicine. An increased range of genetically modified mouse models offer new tools for studying molecular mechanisms of tooth development. However, owing to species-specific organization of the tooth apparatus, the use of genetic animal models to study the role of the periodontal ligament in normal human tooth physiology and tooth pathology is challenging. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Acute and chronic tears of anterior cruciate ligament : role of gadolinium-enhanced MR imaging

International Nuclear Information System (INIS)

Lee, Eun Jung; Jee, Won Hee; Im, Soo A; Chun, Ho Jong; Jung, Hyun Seouk; Kim, Soo Young; Kwon, Tae An; Song, Sun Wha; Choi, Kyu Ho

1998-01-01

To evaluate the efficacy of fat-suppressed gadolinium-enhanced MR imaging in differentiating acute from chronic ligament tears of anterior cruciate ligament. Materials and Methods : MR images of 22 patients with arthroscopically proven complete tear of the anterior cruciate ligament were retrospectively reviewed. The interval between injury and MR examination was one day to seven years. When ligament tear was detected on MR image with three months of injury, the case was considered acute;if detected after three months had elapsed, it was judged to be chronic. The extent of contrast enhancement was graded as 1, 2 or 3; grade 1, enhancement was confined to the expected ligament region; grade 2, enhancement extended to the joint capsule; grade 3, enhancement extended beyond the joint capsule. The grades of contrast enhancement correlated with the acute and chronic stages of ligament tears. Associated bone bruise and/or adjacent soft tissue edema were also evaluated. Results : Among 15 patients with acute ligament tear, nine (60%) showed grade 3 enhancement; among seven in whom tearing was chronic, four (57%) showed grade 1 enhancement. Bone bruising was present in 100% of acute tears (15/15) and 29 % of chronic tears (2/7). Soft tissue edema was associated in 87% of acute tears (13/15) and 29% of chronic tears(2/7). Conclusion : Fat-suppressed gadolinium-enhanced MR imaging could help differentiate acute from chronic tears of anterior cruciate ligament, as well as bone bruising and tissue edema

Clinical efficacy of open reduction and semirigid internal fixation in management of displaced pediatric mandibular fractures: A series of 10 cases and surgical guidelines

OpenAIRE

Samir Joshi; Rajesh Kshirsagar; Akshay Mishra; Rahul Shah

2015-01-01

Aim: To evaluate the efficacy of open reduction and semirigid internal fixation in the management of displaced pediatric mandibular fractures. Method: Ten patients with displaced mandibular fractures treated with 1.5 mm four holed titanium mini-plate and 4 mm screws which were removed within four month after surgery. Results: All cases showed satisfactory bone healing without any growth disturbance. Conclusion: Open reduction and rigid internal fixation (ORIF) with 1.5 mm titanium mini- plate...

Energy efficient mini bars in hotel rooms; Energieffektive minibarer til hotelvaerelser

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-12-15

The project 'Energy-efficient mini bars for hotel rooms' is carried out from February December 2005. The project is financed by Elfor's PSO funds and also by the participants in the project, HORESTA and Teknologisk Institut. Mini bars consume up to 10% of the total electricity costs of a hotel. Therefore, the energy consumption of mini bars has been brought into focus in this project. The existing mini bar market has been analysed and measurements have been carried out on the type of mini bars that are used most often. In that way, energy consumption, net volume, energy efficiency, energy labelling, noise level and cooling capacity have been determined. In the course of the project, mini bars from IndelB, Domestic and Vibocold have been tested. With regard to energy consumption, the test results showed large deviations from the consumption stated by the manufacturer. Only 1 of the 6 tested mini bars received an energy label B - the others were labelled with F or G. Therefore, there is a great potential for developing more energy efficient mini bars. A list covering the energy consumption, energy labelling, noise level etc. of the tested mini bars and a guide to new purchases can be found on HORESTA's homepage www.horesta.dk. (au)

Tendon and ligament as novel cell sources for engineering the knee meniscus.

Science.gov (United States)

Hadidi, P; Paschos, N K; Huang, B J; Aryaei, A; Hu, J C; Athanasiou, K A

2016-12-01

The application of cell-based therapies in regenerative medicine is hindered by the difficulty of acquiring adequate numbers of competent cells. For the knee meniscus in particular, this may be solved by harvesting tissue from neighboring tendons and ligaments. In this study, we have investigated the potential of cells from tendon and ligament, as compared to meniscus cells, to engineer scaffold-free self-assembling fibrocartilage. Self-assembling meniscus-shaped constructs engineered from a co-culture of articular chondrocytes and either meniscus, tendon, or ligament cells were cultured for 4 weeks with TGF-β1 in serum-free media. After culture, constructs were assessed for their mechanical properties, histological staining, gross appearance, and biochemical composition including cross-link content. Correlations were performed to evaluate relationships between biochemical content and mechanical properties. In terms of mechanical properties as well as biochemical content, constructs engineered using tenocytes and ligament fibrocytes were found to be equivalent or superior to constructs engineered using meniscus cells. Furthermore, cross-link content was found to be correlated with engineered tissue tensile properties. Tenocytes and ligament fibrocytes represent viable cell sources for engineering meniscus fibrocartilage using the self-assembling process. Due to greater cross-link content, fibrocartilage engineered with tenocytes and ligament fibrocytes may maintain greater tensile properties than fibrocartilage engineered with meniscus cells. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Effect of the Periodontal Ligament of the Bilateral Support Teeth on the Stress Analysis of Dental Implant

Directory of Open Access Journals (Sweden)

Xie Yanhua

2017-01-01

Full Text Available The aim of this work is to analyze the function of natural teeth’s periodontal ligament and the effects of periodontal ligament on implants by the finite element method (FEM, when static functional loads occur. The finite element analysis models are established, which consist of fragment of mandible, natural teeth, periodontal ligament, and implant. Finite element software Abaqus is used to analyze the stress transfer in models with or without periodontal ligament, and mandibular first molar is implant. The implant obtained the maximum stress value of 87.71MPa when periodontal ligament of natural tooth is absent, but the maximum value reduces to 38.43 MPa with the action of periodontal ligament. It illustrates that periodontal ligament has significant effects on stress transfer. When the finite element model of single natural tooth or dentition with implant is generated, periodontal ligament should be taken into account.

Novel strategies in tendon and ligament tissue engineering: Advanced biomaterials and regeneration motifs

OpenAIRE

Kuo Catherine K; Marturano Joseph E; Tuan Rocky S

2010-01-01

Abstract Tendon and ligaments have poor healing capacity and when injured often require surgical intervention. Tissue replacement via autografts and allografts are non-ideal strategies that can lead to future problems. As an alternative, scaffold-based tissue engineering strategies are being pursued. In this review, we describe design considerations and major recent advancements of scaffolds for tendon/ligament engineering. Specifically, we outline native tendon/ligament characteristics criti...

Engineering the bone-ligament interface using polyethylene glycol diacrylate incorporated with hydroxyapatite.

Science.gov (United States)

Paxton, Jennifer Z; Donnelly, Kenneth; Keatch, Robert P; Baar, Keith

2009-06-01

Ligaments and tendons have previously been tissue engineered. However, without the bone attachment, implantation of a tissue-engineered ligament would require it to be sutured to the remnant of the injured native tissue. Due to slow repair and remodeling, this would result in a chronically weak tissue that may never return to preinjury function. In contrast, orthopaedic autograft reconstruction of the ligament often uses a bone-to-bone technique for optimal repair. Since bone-to-bone repairs heal better than other methods, implantation of an artificial ligament should also occur from bone-to-bone. The aim of this study was to investigate the use of a poly(ethylene glycol) diacrylate (PEGDA) hydrogel incorporated with hydroxyapatite (HA) and the cell-adhesion peptide RGD (Arg-Gly-Asp) as a material for creating an in vitro tissue interface to engineer intact ligaments (i.e., bone-ligament-bone). Incorporation of HA into PEG hydrogels reduced the swelling ratio but increased mechanical strength and stiffness of the hydrogels. Further, HA addition increased the capacity for cell growth and interface formation. RGD incorporation increased the swelling ratio but decreased mechanical strength and stiffness of the material. Optimum levels of cell attachment were met using a combination of both HA and RGD, but this material had no better mechanical properties than PEG alone. Although adherence of the hydrogels containing HA was achieved, failure occurs at about 4 days with 5% HA. Increasing the proportion of HA improved interface formation; however, with high levels of HA, the PEG HA composite became brittle. This data suggests that HA, by itself or with other materials, might be well suited for engineering the ligament-bone interface.

The effect of constitutive representations and structural constituents of ligaments on knee joint mechanics.

Science.gov (United States)

Orozco, Gustavo A; Tanska, Petri; Mononen, Mika E; Halonen, Kimmo S; Korhonen, Rami K

2018-02-02

Ligaments provide stability to the human knee joint and play an essential role in restraining motion during daily activities. Compression-tension nonlinearity is a well-known characteristic of ligaments. Moreover, simpler material representations without this feature might give reasonable results because ligaments are primarily in tension during loading. However, the biomechanical role of different constitutive representations and their fibril-reinforced poroelastic properties is unknown. A numerical knee model which considers geometric and material nonlinearities of meniscus and cartilages was applied. Five different constitutive models for the ligaments (spring, elastic, hyperelastic, porohyperelastic, and fibril-reinforced porohyperelastic (FRPHE)) were implemented. Knee joint forces for the models with elastic, hyperelastic and porohyperelastic properties showed similar behavior throughout the stance, while the model with FRPHE properties exhibited lower joint forces during the last 50% of the stance phase. The model with ligaments as springs produced the lowest joint forces at this same stance phase. The results also showed that the fibril network contributed substantially to the knee joint forces, while the nonfibrillar matrix and fluid had small effects. Our results indicate that simpler material models of ligaments with similar properties in compression and tension can be used when the loading is directed primarily along the ligament axis in tension.

Development on mini X-ray diode

International Nuclear Information System (INIS)

Jiang Shaoen; Sun Kexu; Peng Nengling; Huang Tianxuan; Cui Yanli; Yi Rongqing; Chen Jiusen

2004-01-01

The mini X-ray diode (M-XRD) was developed, and was used in mini soft X-ray spectrometer. Compared with traditional XRD, M-XRD's volume reduces to 1/30. M-XRD's property was experimentally examined on Shenguang II laser facility. The experimental results indicated that the temporal response and sensitivity of M-XRD are basically consistent with traditional XRD. The equivalent circuit of XRD was analyzed, and its response time and linear saturated current were calculated. (authors)

Injured lateral ankle ligaments: technique and assessment of MRI

International Nuclear Information System (INIS)

Breitenseher, M.J.; Trattnig, S.; Kukla, C.; Gaebler, C.; Kaider, A.; Haller, J.; Heinz-Peer, G.; Imhof, H.

1996-01-01

56 patients with the clinical diagnosis of sprained ankles were investigated. Evaluation of the anterior (AFTL) and posterior fibulotalar ligament (PFTL) was performed with the foot in dorsiflexion (20 ) and of the fibulo calcanear ligament (FCL) in plantarflexion (45 ). Axial T 1 w-SE and T 2 w-TSE images were obtained. Full-length visualisation of ligmaments in one slice and the extent of injury were evaluated. 12 ankle injuries were confirmed by operation. With MRI full-length visualisation of lateral ankle ligaments was possible in 86%. A partial/complete rupture of the AFTL was noticed in 33/64% and of the FCI in 29/39%, and of the PFTL in 27/5%. Sensitivity/specificity of MRI when compared to surgery was 100/100% for injuries of the AFTL, 64/100% for the FCL, and 33/78% for the PFTL. (orig./MG) [de

Functional anatomy of the lateral collateral ligament of the elbow.

Science.gov (United States)

Hackl, M; Bercher, M; Wegmann, K; Müller, L P; Dargel, J

2016-07-01

The aim of this study was to analyze the functional anatomy of the lateral collateral ligament complex (LCLC) and the surrounding forearm extensors. Using 81 human cadaveric upper extremities, the anatomy of the forearm extensors-especially the anconeus, supinator and extensor carpi ulnaris (ECU)-was analyzed. After removal of aforementioned extensors the functional anatomy of the LCLC was analyzed. The origin of the LCLC was evaluated for isometry. The insertion types of the lateral ulnar collateral ligament (LUCL) were analyzed and classified. The ECU runs parallel to the RCL to dynamically preserve varus stability. The supinator and anconeus muscle fibers coalesce with the LCLC and lengthen during pronation. The anconeus fibers run parallel to the LUCL in full flexion. The LCLC consists of the annular ligament (AL) and the isometric radial collateral ligament (RCL). During elbow flexion, its posterior branches (LUCL) tighten while the anterior branches loosen. When performing a pivot shift test, the loosened LUCL fibers do not fully tighten in full extension. The LUCL inserts along with the AL at the supinator crest. Three different insertion types could be observed. The LUCL represents the posterior branch of the RCL rather than a distinct ligament. It is non-isometric and lengthens during elbow flexion. The RCL was found to be of vital importance for neutralization of posterolateral rotatory forces. Pronation of the forearm actively stabilizes the elbow joint as the supinator, anconeus and biceps muscle work in unison to increase posterolateral rotatory stability.

Mini Tracheostomy for Obstructive Sleep Apnea: An Evidence Based Proposal

Science.gov (United States)

Camacho, Macario; Zaghi, Soroush; Chang, Edward T.; Song, Sungjin A.; Szelestey, Blake; Certal, Victor

2016-01-01

Objective. To search for articles evaluating the use of tracheostomies (either permanent stomas or tracheostomy tubes) in adult obstructive sleep apnea (OSA) patients and to evaluate the potential for the use of mini tracheostomies as treatment for OSA. Study Design. Systematic review. Methods. Nine databases were searched from inception through July 21, 2015. Results. The overall tracheostomy search yielded 516 articles, of which eighteen studies provided polysomnographic data. No study was identified (empty review) for the use of mini tracheostomies for treating OSA. The mini tracheostomy search yielded ninety-five articles which describe findings for either mini tracheostomy kits (inner cannula diameter of 4 mm) or the performance of mini tracheotomies. Six articles described the use of mini tracheostomies as a temporary procedure to relieve acute upper airway obstruction and none described the use for OSA. For tracheostomy stomal sites, suturing the skin directly to the tracheal rings with defatting can minimize stomal site collapse. The smallest tracheostomy stomal size that can successfully treat OSA has not been described. Conclusion. Mini tracheostomies as small as 4 mm have been successfully used in the short term to relieve upper airway obstruction. Given that polysomnography data are lacking, additional research is needed. PMID:26925105

Mini Tracheostomy for Obstructive Sleep Apnea: An Evidence Based Proposal

Directory of Open Access Journals (Sweden)

Macario Camacho

2016-01-01

Full Text Available Objective. To search for articles evaluating the use of tracheostomies (either permanent stomas or tracheostomy tubes in adult obstructive sleep apnea (OSA patients and to evaluate the potential for the use of mini tracheostomies as treatment for OSA. Study Design. Systematic review. Methods. Nine databases were searched from inception through July 21, 2015. Results. The overall tracheostomy search yielded 516 articles, of which eighteen studies provided polysomnographic data. No study was identified (empty review for the use of mini tracheostomies for treating OSA. The mini tracheostomy search yielded ninety-five articles which describe findings for either mini tracheostomy kits (inner cannula diameter of 4 mm or the performance of mini tracheotomies. Six articles described the use of mini tracheostomies as a temporary procedure to relieve acute upper airway obstruction and none described the use for OSA. For tracheostomy stomal sites, suturing the skin directly to the tracheal rings with defatting can minimize stomal site collapse. The smallest tracheostomy stomal size that can successfully treat OSA has not been described. Conclusion. Mini tracheostomies as small as 4 mm have been successfully used in the short term to relieve upper airway obstruction. Given that polysomnography data are lacking, additional research is needed.

Mini-flank supra-12th rib incision for open partial nephrectomy for renal tumor with RENAL nephrometry score ≥10: an innovation of traditional open surgery.

Science.gov (United States)

Wang, Hang; Sun, Li-an; Wang, Yiwei; Xiang, Zhuoyi; Zhou, Lin; Guo, Jianming; Wang, Guomin

2015-04-01

The skill of supra-12th rib mini-flank approach for open partial nephrectomy (MI-OPN) provides an advanced operative method for renal tumor. Compared with laparoscopic and robotic surgery, it may be a feasible selection for the complex renal tumors. We describe our techniques and results of MI-OPN in complex renal tumors with high RENAL nephrometry score (RENAL nephrometry score ≥10). Fifty-five patients diagnosed with renal tumors between January 2009 and July 2013 were included in this study. Eligibility criteria comprised of patients with complex renal tumor (RENAL score ≥10) being candidates for partial nephrectomy (PN). All patients received MI-OPN and all surgeries were performed by a single urologist. The preoperative workup comprised of medical history, physical examination, and routine laboratory tests. Serum creatinine was recorded preoperatively and 2 to 3 months after operation. Operative time, ischemia time, blood loss, operative and postoperative complications, renal function, and pathology parameters were recorded. MI-OPN was successfully performed in all cases. Mean tumor size was 4.7 cm (range: 2.5-8.1). Mean warm ischemia time was 28.1 minutes (range: 21-39), mean operative time was 105 minutes (range: 70-150) and mean estimated blood loss was 68 mL (range: 10-400). Mean postoperative hospital stay was 6.5 days (range: 5-12). Postoperative complications were found in 3 patients (5.5%). The mean pre- and postoperative serum creatinine levels were 76.2 μmol/L (range: 47-132) and 87.1 μmol/L (range: 61-189) with significant difference (P = 0.004). The mean pre- and postoperative estimated glomerular filtration rate (eGFR) were 91.5 (range: 34-133) and 82.5 (range: 22-126.5), respectively with significant difference (P = 0.024). In an average follow-up of 19.9 months (range: 8-50), no local recurrence or systemic progression occurred. In conclusion, MI-OPN can combine the benefits of both minimal invasive and traditional open

Revisiting the stability of mini-implants used for orthodontic anchorage

Directory of Open Access Journals (Sweden)

Chung-Chen Jane Yao

2015-11-01

Conclusion: This study revealed that once the dental surgeon becomes familiar with the procedure, the stability of orthodontic mini-implants depends on the type of mini-implant, age of the patient, implantation site, and the healing time of the mini-implant. Miniplates are a more feasible anchorage system when miniscrews fail repeatedly.

Comparison of potentials between stem cells isolated from human anterior cruciate ligament and bone marrow for ligament tissue engineering.

Science.gov (United States)

Cheng, Ming-Te; Liu, Chien-Lin; Chen, Tain-Hsiung; Lee, Oscar K

2010-07-01

We have previously isolated and identified stem cells from human anterior cruciate ligament (ACL). The purpose of this study was to evaluate the differences in proliferation, differentiation, and extracellular matrix (ECM) formation abilities between bone marrow stem cells (BMSCs) and ACL-derived stem cells (LSCs) from the same donors when cultured with different growth factors, including basic fibroblast growth factor (bFGF), epidermal growth factor, and transforming growth factor-beta 1 (TGF-beta1). Ligament tissues and bone marrow aspirate were obtained from patients undergoing total knee arthroplasty and ACL reconstruction surgeries. Proliferation, colony formation, and population doubling capacity as well as multilineage differentiation potentials of LSCs and BMSCs were compared. Gene expression and ECM production for ligament engineering were also evaluated. It was found that BMSCs possessed better osteogenic differentiation potential than LSCs, while similar adipogenic and chondrogenic differentiation abilities were observed. Proliferation rates of both LSCs and BMSCs were enhanced by bFGF and TGF-beta1. TGF-beta1 treatment significantly increased the expression of type I collagen, type III collagen, fibronectin, and alpha-smooth muscle actin in LSCs, but TGF-beta1 only upregulated type I collagen and tenascin-c in BMSCs. Protein quantification further confirmed the results of differential gene expression and suggested that LSCs and BMSCs increase ECM production upon TGF-beta1 treatment. In summary, in comparison with BMSCs, LSCs proliferate faster and maintain an undifferentiated state with bFGF treatment, whereas under TGF-beta1 treatment, LSCs upregulate major tendinous gene expression and produce a robust amount of ligament ECM protein, making LSCs a potential cell source in future applications of ACL tissue engineering.

Exercise Rehabilitation after Anterior Cruciate Ligament Reconstruction

Directory of Open Access Journals (Sweden)

Keun Ok An

2017-06-01

Full Text Available OBJECTIVES Exercise rehabilitation after anterior cruciate ligament (ACL reconstruction has changed dramatically in recent years. In this review, we discuss recent changes in exercise programs related to ACL rehabilitation. METHODS We conducted a literature review of recently published articles related exercise programs after ACL reconstruction. RESULTS The accelerated rehabilitation program, which allows patients to achieve full extension ofthe knee early in the postoperative period, is now a widely practiced rehabilitation program. A prospective study of rehabilitation programs after ACL reconstruction showed that early joint exercises do not interfere with the healing of grafts. Instead, they alleviate pain, thereby reducing the negative impact. Moreover, according to several biomechanical studies, open kinetic chain exercises are potentially disadvantageous to knee stability. There is no evidence that early weight bearing results in weakening of graft distraction or internal fixation compared with delayed weight bearing. CONCLUSIONS In conclusion, prevention of ACL injuries and rehabilitative exercise training can help to achieve optimal exercise performance while avoiding the risk of sports-related injury.

Berkeley mini-collider

International Nuclear Information System (INIS)

Schroeder, L.S.

1984-06-01

The Berkeley Mini-Collider, a heavy-ion collider being planned to provide uranium-uranium collisions at T/sub cm/ less than or equal to 4 GeV/nucleon, is described. The central physics to be studied at these energies and our early ideas for a collider detector are presented

Effects of glucosamine on proteoglycan loss by tendon, ligament and joint capsule explant cultures.

Science.gov (United States)

Ilic, M Z; Martinac, B; Samiric, T; Handley, C J

2008-12-01

To investigate the effect of glucosamine on the loss of newly synthesized radiolabeled large and small proteoglycans by bovine tendon, ligament and joint capsule. The kinetics of loss of (35)S-labeled large and small proteoglycans from explant cultures of tendon, ligament and joint capsule treated with 10mM glucosamine was investigated over a 10-day culture period. The kinetics of loss of (35)S-labeled small proteoglycans and the formation of free [(35)S]sulfate were determined for the last 10 days of a 15-day culture period. The proteoglycan core proteins were analyzed by gel electrophoresis followed by fluorography. The metabolism of tendon, ligament and joint capsule explants exposed to 10mM glucosamine was evaluated by incorporation of [(3)H]serine and [(35)S]sulfate into protein and glycosaminoglycans, respectively. Glucosamine at 10mM stimulated the loss of small proteoglycans from ligament explant cultures. This was due to the increased loss of both macromolecular and free [(35)S]sulfate to the medium indicating that glucosamine affected the release of small proteoglycans as well as their intracellular degradation. The degradation pattern of small proteoglycans in ligament was not affected by glucosamine. In contrast, glucosamine did not have an effect on the loss of large or small proteoglycans from tendon and joint capsule or large proteoglycans from ligament explant cultures. The metabolism of cells in tendon, ligament and joint capsule was not impaired by the presence of 10mM glucosamine. Glucosamine stimulated the loss of small proteoglycans from ligament but did not have an effect on small proteoglycan catabolism in joint capsule and tendon or large proteoglycan catabolism in ligament, tendon or synovial capsule. The consequences of glucosamine therapy at clinically relevant concentrations on proteoglycan catabolism in joint fibrous connective tissues need to be further assessed in an animal model.

Miscellaneous conditions of tendons, tendon sheaths, and ligaments.

Science.gov (United States)

Dyson, S J; Dik, K J

1995-08-01

The use of diagnostic ultrasonography has greatly enhances our ability to diagnose injuries of tendons and tendon sheaths that were previously either unrecognized or poorly understood. For may of these injuries, there is currently only a small amount of follow-up data. This article considers injuries of the deep digital flexor tendon and its accessory ligament, the carpal tunnel syndrome soft tissue swellings on the dorsal aspect of the carpus, intertubercular (bicipital) bursitis and bicipital tendinitis, injuries of the gastrocnemius tendon, common calcaneal tendinitis, rupture of peroneus (fibularis tertius) and ligaments injuries of the back.

MRI appearance of the distal insertion of the anterior cruciate ligament of the knee: an additional criterion for ligament ruptures

Energy Technology Data Exchange (ETDEWEB)

Oldrini, G.; Teixeira, P.G.; Chanson, A.; Osemont, B.; Louis, M.; Blum, A. [CHU Nancy, Service d' imagerie Guilloz, Nancy (France); Erpelding, M.L. [CHU Nancy, Hopitaux de Brabois Allee du Morvan, Service Epidemiologie et Evaluation Cliniques, Vandoeuvre-les-Nancy (France)

2012-09-15

Anterior cruciate ligament tears are frequent and if not diagnosed may lead to relevant patient disability. Magnetic resonance imaging is the method of choice for the non-invasive diagnosis of these tears. Despite the high performance of this method some cases are challenging and the criteria described in the literature are not sufficient to reach a diagnosis. We propose a systematic method for the evaluation of anterior cruciate ligament tears based on the aspect of its distal portion. Magnetic resonance studies of 132 knees were evaluated in correlation with arthroscopy. The performance of the proposed method was compared with that of classic imaging signs of anterior cruciate ligament tear. The impact of image quality and reader expertise on the proposed method and the classic signs of tear were taken into account. This method had a sensitivity and specificity of 91.1% and 82.9% for the detection of abnormal ACLs. The interobserver agreement (kappa) of the proposed method was significantly higher than that of the classic signs at all levels of expertise (0.89 vs 0.76). This method was not influenced by image quality. Distal ACL analysis identified more partial tears and synovialization (granulation scar tissue) than the conventional method (71% vs 58.5% for partial tears and 83.5% vs 58.5% for synovialization). The proposed classification has a high performance and reproducibility for the identification of abnormal anterior cruciate ligament. The results were influenced neither by the level of expertise of the readers nor by the image quality. (orig.)

Acromioclavicular dislocation: postoperative evaluation of the coracoclavicular ligaments using magnetic resonance

Directory of Open Access Journals (Sweden)

Rafael Salomon Silva Faria

2015-04-01

Full Text Available OBJECTIVE: To radiologically evaluate the healing of the coracoclavicular ligaments after surgical treatment for acromioclavicular dislocation.METHODS: Ten patients who had undergone surgical treatment for acromioclavicular dislocation via a posterosuperior route at least one year earlier were invited to return for radiological assessment using magnetic resonance. This evaluation was done by means of analogy with the scale described in the literature for studying the healing of the anterior cruciate ligament of the knee and for measuring the healed coracoclavicular ligaments.RESULTS: A scar structure of fibrous appearance had formed in 100% of the cases. In 50% of the cases, the images of this structure had a good appearance, while the other 50% were deficient.CONCLUSION: Late postoperative evaluation using magnetic resonance, on patients who had been treated for acute acromioclavicular dislocation using a posterosuperior route in the shoulder, showed that the coracoclavicular ligaments had healed in 100% of the cases, but that this healing was deficient in 50%.

Perlindungan Hukum Hak Kekayaan Intelektual (Hki) Dalam Waralaba Retail Mini Market Di Yogyakarta Mini Market Di Yogyakarta

OpenAIRE

Hariyanto Hariyanto, S.H., M.KN

2009-01-01

The Law Protection Intellectual Property Right in Mini Market Retail Franchise in YogyakartaFranchise business is more happening in Indonesia. This fast development indicates an interesting investment which on the same time helps the business subjects in starting their own business with a low risk. The franchise business which commonly stable is retail business. One of retail business which serves the main needs and daily needs is mini market Alfamart and Indomaret.This research aims to ident...

Unstable metacarpal and phalangeal fractures: treatment by internal fixation using AO mini-fragment plates and screws.

Science.gov (United States)

Mumtaz, Mohammad Umar; Farooq, Muneer Ahmad; Rasool, Altaf Ahmad; Kawoosa, Altaf Ahmad; Badoo, Abdul Rashid; Dhar, Shabir Ahmad

2010-07-01

Accurate open reduction and internal fixation for metacarpal and phalangeal fractures of the hand is required in less than 5% of the patients; otherwise, closed treatment techniques offer satisfactory results in most of these cases as these fractures are stable either before or after closed reduction. AO mini-fragment screws and plates, when used in properly selected cases, can provide rigid fixation, allowing early mobilization of joints and hence good functional results while avoiding problems associated with protruding K-wires and immobilization. The advantages of such internal fixation urged us to undertake such a study in our state where such hand injuries are commonly seen. Forty patients with 42 unstable metacarpal and phalangeal fractures were treated with open reduction and internal fixation using AO mini-fragment screws and plates over a period of three years in a prospective manner. The overall results were good in 78.5% of cases, fair in 19% of cases and poor in 2.5% of cases, as judged according to the criteria of the American Society for Surgery of the Hand. This technique is a reasonable option for treating unstable metacarpal and phalangeal fractures as it provides a highly rigid fixation, which is sufficient to allow early mobilization of the adjacent joints, thus helping to achieve good functional results.

Orthodontic mechanics using mini-implant measured by FBG

Science.gov (United States)

Trannin, Pamela G.; Milczewski, Maura S.; de Oliveira, Walmir; Guariza Filho, Odilon; Lopes, Stephani C. P. S.; Kalinowski, Hypolito J.

2015-07-01

The magnitude of the force generated during orthodontic mechanics anchored in mini-implant in a maxilla model was analyzed. Data was collected during the insertion of the mini-implant and at the moment of applying forces to the structure of the maxilla and dentition. To obtain quantitative results, the Fibre Bragg Gratings (FBG) were inserted in an elastomeric material reproducing a maxilla model. It was observed levels of forces of approximately 3,78N next to the root of first premolar by the insertion of the mini-implant and different levels of the force to different orthodontic mechanics applied on the dental system.

Initial validation of the Mini-Mental Adjustment to Cancer (Mini-MAC) scale: study of Portuguese end-of-life cancer patients.

Science.gov (United States)

Pereira, Filomena Moreira Pinto; Santos, Célia Samarina Vilaça de Brito

2014-10-01

The Mini-Mental Adjustment to Cancer Scale (Mini-MAC) is a 29-item instrument designed to evaluate the responses developed by cancer patients during their mental adjustment to diagnosis and treatment. This study aims to validate the Mini-Mental Adjustment to Cancer Scale (Mini-MAC) translated and adapted to the Portuguese language and culture, in end-of-life cancer patients receiving palliative care. The instrument was administered to 346 Portuguese end-of-life cancer patients, receiving care through outpatient visits or admitted into palliative care units, without cognitive symptoms and with symptoms under control. A cross-sectional validation study using orthogonal rotation through the varimax method followed by convergent and discriminant validity. The analysis of the main components confirms the existence of five factors, demonstrating the validity of the construct, with good internal consistency in the subscales and Cronbach's alpha values between 0.78 and 0.93. Good test-retest reliability was also found, and r values for subscales ranged from 0.62 to 0.99. The instrument proved to be a reliable, valid and sensitive measure in the study of mental adjustment of Portuguese end-of-life patients with cancer receiving palliative care. Nurses can use the Mini-MAC Scale in research and clinical practice in order to evaluate the mental adjustment of Portuguese end-of-life cancer patients receiving palliative care. Copyright © 2014 Elsevier Ltd. All rights reserved.

A proof that Witten's open string theory gives a single cover of moduli space

International Nuclear Information System (INIS)

Zwiebach, B.; Massachusetts Inst. of Tech., Cambridge

1991-01-01

We show that Witten's open string diagrams are surfaces with metrics of minimal area under the condition that all nontrivial open Jordan curves be longer or equal to π. The minimal area property is used together with a mini-max problem to establish a new existence and uniqueness theorem for quadratic differentials in open Riemann surfaces with or without punctures on the boundaries. This theorem implies that the Feynman rules of open string theory give a single cover of the moduli of open Riemann surfaces. (orig.)

Subject-Specific Carpal Ligament Elongation in Extreme Positions, Grip, and the Dart Thrower's Motion

Science.gov (United States)

Rainbow, Michael J.; Kamal, Robin N.; Moore, Douglas C.; Akelman, Edward; Wolfe, Scott W.; Crisco, Joseph J.

2015-01-01

This study examined whether the radiocarpal and dorsal capsular ligaments limit end-range wrist motion or remain strained during midrange wrist motion. Fibers of these ligaments were modeled in the wrists of 12 subjects over multiple wrist positions that reflect high demand tasks and the dart thrower's motion. We found that many of the volar and dorsal ligaments were within 5% of their maximum length throughout the range of wrist motion. Our finding of wrist ligament recruitment during midrange and end-range wrist motion helps to explain the complex but remarkably similar intersubject patterns of carpal motion. PMID:26367853

A New Orthodontic Appliance with a Mini Screw for Upper Molar Distalization.

Science.gov (United States)

Ozkalayci, Nurhat; Yetmez, Mehmet

2016-01-01

The aim of this study is to present a new upper molar distalization appliance called Cise distalizer designed as intraoral device supported with orthodontic mini screw for upper permanent molar distalization. The new appliance consists of eight main components. In order to understand the optimum force level, the appliance under static loading is tested by using strain gage measurement techniques. Results show that one of the open coils produces approximately 300 gr distalization force. Cise distalizer can provide totally 600 gr distalization force. This range of force level is enough for distalization of upper first and second molar teeth.

A control system of a mini survey facility for photometric monitoring

Science.gov (United States)

Tsutsui, Hironori; Yanagisawa, Kenshi; Izumiura, Hideyuki; Shimizu, Yasuhiro; Hanaue, Takumi; Ita, Yoshifusa; Ichikawa, Takashi; Komiyama, Takahiro

2016-08-01

We have built a control system for a mini survey facility dedicated to photometric monitoring of nearby bright (Kdome and a small (30-mm aperture) wide-field (5 × 5 sq. deg. field of view) infrared (1.0-2.5 microns) camera on an equatorial fork mount, as well as power sources and other associated equipment. All the components other than the camera are controlled by microcomputerbased I/O boards that were developed in-house and are in many of the open-use instruments in our observatory. We present the specifications and configuration of the facility hardware, as well as the structure of its control software.

MR imaging diagnosis of posterior cruciate ligament injury: importance of ancillary findings

International Nuclear Information System (INIS)

Hwang, Kang Ik; Lee, Jong Hwa; Kim, Young Sun; Lee, Jung Hwoi; Ki, Tae Sung; Park, Jong Oag

1997-01-01

To evaluate the importance of two ancillary findings of anterior tibial plateau bruise/fracture and popliteus muscle strain on MR diagnosis of posterior cruicate ligament injury. We retrospectively evaluated 48 patients with confirmed posterior cruciate ligament tear. We studied the incidence of anterior tibial plateau injury and popliteus muscle strain, and the specificity of popliteus muscle strain with or without bony injury. A complete tear of the posterior cruciate ligament was noted in 37 cases, a partial tear in 11. Anterior tibial plateau lesion was found in 21 of 48 cases (44%); This total was made up of 17/37 PCL complete tears (46%) and 4/11 partial tears (36%). The difference in the incidence of complete and partial tears is not statistically significant. Popliteus muscle injury was found in 20 of 48 cases (42%), the total consisted of 19/37 PCL complete tears (51%) and 1/11 partial tears (10%). The incidence of 42% is relatively high, approximating that of bony injury. The difference in the incidence of complete and partial tears is statistically significant (p < 0.006). Specificity for posterior cruciate ligament tear is 69%(20/29), and when concomitant with anterior tibial plateau injury is 94%(16/17). As in the case of anterior cruciate ligament injury, these documented ancillary findings of anterior tibial plateau and popliteus muscle injuries are very helpful when MR diagnosis of posterior cruciate ligament injury itself and differentiation of partial and complete rupture are doubtful

Novel Treatment of a Scapholunate Ligament Injury with Proximal Pole Scaphoid Nonunion

Science.gov (United States)

Gaspar, Michael P.; Kane, Patrick M.; Jacoby, Sidney M.; Culp, Randall W.

2016-01-01

Background  Nonunion of scaphoid proximal pole fractures presents a challenging management dilemma to hand surgeons. This problem is further complicated in the uncommon concurrence of scapholunate (SL) ligament disruption. Case Description  A 39-year-old male patient presented with new-onset wrist pain following a remote history of a proximal pole scaphoid fracture sustained as a teenager, which was treated nonoperatively. Six months before presentation, the patient sustained a fall while snowboarding. The patient was found to have a chronic nonunion of his scaphoid proximal pole with an associated SL ligament disruption. As the proximal fragment was too small to be amenable to fixation, the patient was treated with an arthroscopic partial scaphoid excision and SL ligament reconstruction using a scapholunateintercarpal screw placed percutaneously. At 26 months, the patient exhibited no pain, near-normal strength, and wrist motion, and expressed a high-level of satisfaction from his surgery. Literature Review  Although cases of SL ligament disruption with concomitant proximal scaphoid fractures have been reported, to our knowledge, this is the first report of SL ligament rupture occurring in the setting of a preexisting proximal pole scaphoid nonunion. Clinical Relevance  We report the use of SL ligament reconstruction augmented with intercarpal screw fixation, and excision of the proximal pole scaphoid nonunion. This minimallyinvasive approach may be a particularly useful option in young, active patients such as our own, where a motion-sacrificing salvage procedure would be less than ideal. PMID:27616829

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

Maximum atmosphere at the Mini Atomiades

CERN Multimedia

Rachel Bray, Atomiades organizer team

2016-01-01

CERN Clubs Coordination Committee and CERN Staff Association host the ASCERI Mini Atomiades June 2016.   The CERN team won the tennis tournament for the Mini Atomiades 2016. (Photo: Erwin Van Hove) Over 180 participants from 10 different European Scientific Research Institutes came together on the first weekend of June in Divonne-les-Bains to take part in the ASCERI Sport & Science Mini Atomiades. Sports men and women from Belgium, Germany, France, Hungary, Russia and Switzerland battled it out in four different tournaments for medals, cups and, above all, lots of fun. The four disciplines included football, golf, tennis and a 10km race. CERN was victorious in tennis, golf and the men's and women's 10km, and despite the CERN football team putting up an excellent fight against some very strong teams they came almost last (we cannot win everything, can we?). But CERN were the clear winners for team spirit, community and camaraderie, as confirmed by all the comp...

Influence of different implant materials on the primary stability of orthodontic mini-implants

OpenAIRE

Chin-Yun Pan; Szu-Ting Chou; Yu-Chuan Tseng; Yi-Hsin Yang; Chao-Yi Wu; Ting-Hsun Lan; Pao-Hsin Liu; Hong-Po Chang

2012-01-01

This study evaluates the influence of different implant materials on the primary stability of orthodontic mini-implants by measuring the resonance frequency. Twenty-five orthodontic mini-implants with a diameter of 2 mm were used. The first group contained stainless steel mini-implants with two different lengths (10 and 12 mm). The second group included titanium alloy mini-implants with two different lengths (10 and 12 mm) and stainless steel mini-implants 10 mm in length. The mini-implants w...

Ultrastructure of periprosthetic Dacron knee ligament tissue. Two cases of ruptured anterior cruciate ligament reconstruction.

Science.gov (United States)

Salvi, M; Velluti, C; Misasi, M; Bartolozzi, P; Quacci, D; Dell'Orbo, C

1991-04-01

Light- and electron-microscopic investigations were performed on two failed Dacron ligaments that had been removed from 2 patients shortly after failure of the implant 2-3 years after reconstruction of the anterior cruciate ligament. Two different cell populations and matrices were correlated with closeness to the Dacron threads. Fibroblasts surrounded by connective tissue with collagen fibrils were located far from the Dacron threads. Roundish cells, appearing to be myofibroblasts surrounded by a more lax connective tissue and elastic fibers, were found close to the Dacron threads. The presence of myofibroblasts and the matrix differentiation could be attributed to the different mechanical forces acting on the Dacron and on the connective tissue because of their different coefficients of elasticity. The sparse occurrence of inflammatory cells in the synovial membrane and in the connective tissue surrounding the Dacron supports the biologic inertness of this artificial material. However, the repair tissue was not structured to resist tension stresses.

Tissue-engineering strategies for the tendon/ligament-to-bone insertion.

Science.gov (United States)

Smith, Lester; Xia, Younan; Galatz, Leesa M; Genin, Guy M; Thomopoulos, Stavros

2012-01-01

Injuries to connective tissues are painful and disabling and result in costly medical expenses. These injuries often require reattachment of an unmineralized connective tissue to bone. The uninjured tendon/ligament-to-bone insertion (enthesis) is a functionally graded material that exhibits a gradual transition from soft tissue (i.e., tendon or ligament) to hard tissue (i.e., mineralized bone) through a fibrocartilaginous transition region. This transition is believed to facilitate force transmission between the two dissimilar tissues by ameliorating potentially damaging interfacial stress concentrations. The transition region is impaired or lost upon tendon/ligament injury and is not regenerated following surgical repair or natural healing, exposing the tissue to risk of reinjury. The need to regenerate a robust tendon-to-bone insertion has led a number of tissue engineering repair strategies. This review treats the tendon-to-bone insertion site as a tissue structure whose primary role is mechanical and discusses current and emerging strategies for engineering the tendon/ligament-to-bone insertion in this context. The focus lies on strategies for producing mechanical structures that can guide and subsequently sustain a graded tissue structure and the associated cell populations.

Treatment of chronic deltoid ligament injury using suture anchors.

Science.gov (United States)

Wang, Xu; Ma, Xin; Zhang, Chao; Wang, Chen; Huang, Jia-zhang

2014-08-01

To explore the efficacy of overlapping suture-anchor fixation for treatment of chronic deltoid ligament injury. Seventeen patients (11 men, 6 women of mean age 32.1 years [range, 18-58 years]) who had undergone surgery for chronic deltoid ligament injury from January 2007 to December 2011 were retrospectively analyzed. Preoperatively, they had undergone bilateral weight-bearing posterior-anterior radiographs, (MRI) and ultrasound examinations of the ankle. Ankle arthroscopy was performed to confirm the diagnosis, followed by surgery to clear intra-articular proliferating synovial tissues and remove cartilage debris and scar tissue. The deep layer of the deltoid ligament was sutured onto the tip of the medial malleolus and its superficial layer sutured onto its periosteum and fixed with suture anchors. American Orthopedic Foot and Ankle Society (AOFAS) scoring system for the ankle-hindfoot was used to evaluate the ankles pre- and post-operatively. The 17 patients were followed up for 12-34 months (mean 20.1 months). The angle between the long axes of the talus and first metatarsal and the hindfoot angle measured in a hindfoot alignment view (as described by Saltzman) were reduced from 5.4° ± 1.8° and 8.2° ± 2.6° preoperatively to 4.0° ± 0.9° and 5.3° ± 1.3° postoperatively, respectively. The mean AOFAS ankle-hindfoot score was 76.8 ± 7.0 preoperatively and 94.1 ± 3.3 at the last follow-up visit. Ten patients were scored as excellent, six as good, and one as fair. Pain was relieved in all patients and no patients had recurrent deltoid ligament injury. Using suture anchors to treat chronic deltoid ligament injury has relatively satisfactory outcomes. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

Sports Injury-Related Fingers and Thumb Deformity Due to Tendon or Ligament Rupture.

Science.gov (United States)

Bai, Rong-Jie; Zhang, Hui-Bo; Zhan, Hui-Li; Qian, Zhan-Hua; Wang, Nai-Li; Liu, Yue; Li, Wen-Ting; Yin, Yu-Ming

2018-05-05

Hand injuries are very common in sports, such as skiing and ball sports. One of the major reasons causing hand and finger deformity is due to ligament and tendon injury. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) can demonstrate the complex anatomy of the fingers and thumb, especially the tendons and ligaments, and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities. Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers. A total of 20 healthy volunteers' hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study. All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression (PD FS) in axial, coronal, and sagittal plane, respectively. Subsequently, all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw (six in coronal plane, six in sagittal plane, and four in axial plane). The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament (UCL) at the metacarpal phalangeal joint (MCPJ) of thumb between 20 healthy volunteers and 44 patients (confirmed by surgery) were analyzed. The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers' hands showed uniform low-signal intensity on all the sequences of the MRI. Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb, 12 cases with UCL injury at MCPJ of the thumb (Stener lesion = 8 and non-Stener lesion = 4), 6 cases with the central slip injury, 12 cases with terminal tendon injury, and 14 cases with flexor digitorum profundus injury. The ligaments and tendons disruption manifested as increased signal intensity and poor definition, discontinuity, and heterogeneous signal intensity of the involved ligaments and tendons. Sports

RESULTS OF DIAGNOSTICAL BLOCK OF LONG DORSAL SACROILIAC LIGAMENT UNDER SONOGRAPHIC CONTROL IN PATIENTS WITH LOW BACK PAIN

Directory of Open Access Journals (Sweden)

Yurkovskiy A. M.

2018-02-01

Full Text Available Purpose: to improve effectiveness of diagnostic block of long dorsal sacroiliac ligament performed under sonographic control in patients with low back pain caused by pathology of this ligament. Material and methods: the research included 35 patients (average age 46,2±12,5 years with symptoms of low back pain caused by pathology of long dorsal sacroiliac ligament. Diagnostical block of the given ligament was made under ultrasound control. Results: significant pain syndrome reduction was observed in all patients with ligamentopathy of long dorsal sacroiliac ligament. Conclusion: compared to "blind" technique, long dorsal sacroiliac ligament block performed under sonographic control is a more efficient method of verification and treatment for low back pain syndrome in case of long dorsal sacroiliac ligament injury.

The use of synthetic ligaments in the design of an enhanced stability total knee joint replacement.

Science.gov (United States)

Stokes, Michael D; Greene, Brendan C; Pietrykowski, Luke W; Gambon, Taylor M; Bales, Caroline E; DesJardins, John D

2018-03-01

Current total knee replacement designs work to address clinically desired knee stability and range of motion through a balance of retained anatomy and added implant geometry. However, simplified implant geometries such as bearing surfaces, posts, and cams are often used to replace complex ligamentous constraints that are sacrificed during most total knee replacement procedures. This article evaluates a novel total knee replacement design that incorporates synthetic ligaments to enhance the stability of the total knee replacement system. It was hypothesized that by incorporating artificial cruciate ligaments into a total knee replacement design at specific locations and lengths, the stability of the total knee replacement could be significantly altered while maintaining active ranges of motion. The ligament attachment mechanisms used in the design were evaluated using a tensile test, and determined to have a safety factor of three with respect to expected ligamentous loading in vivo. Following initial computational modeling of possible ligament orientations, a physical prototype was constructed to verify the function of the design by performing anterior/posterior drawer tests under physiologic load. Synthetic ligament configurations were found to increase total knee replacement stability up to 94% compared to the no-ligament case, while maintaining total knee replacement flexion range of motion between 0° and 120°, indicating that a total knee replacement that incorporates synthetic ligaments with calibrated location and lengths should be able to significantly enhance and control the kinematic performance of a total knee replacement system.

Arthroscopic procedures and therapeutic results of anatomical reconstruction of the coracoclavicular ligaments for acromioclavicular Joint dislocation.

Science.gov (United States)

Takase, K; Yamamoto, K

2016-09-01

Surgical treatment is recommended for type 5 acromioclavicular joint dislocation on Rockwood's classification. We believe that anatomic repair of the coracoclavicular ligaments best restores the function of the acromioclavicular joint. We attempted to correctly reconstruct the anatomy of the coracoclavicular ligaments under arthroscopy, and describe the minimally invasive arthroscopic procedure. There were 22 patients; mean age at surgery, 38.1 years. Mean time to surgery was 13.2 days. Mean follow-up was 3 years 2 months. The palmaris longus tendon was excised from the ipsilateral side to replace the conoid ligament, while artificial ligament was used for reconstructing the trapezoid ligament. Both ligament reconstructions were performed arthroscopically. No temporary fixation of the acromioclavicular joint was performed. On postoperative radiographic evaluation, 4 patients showed subluxation and 2 showed dislocation of the acromioclavicular joint; the other 16 patients had maintained reduction at the final consultation. MR images 1year after surgery clearly revealed the reconstructed ligaments in 19 patients. Only 1 patient showed osteoarthritis of the acromioclavicular joint. Although it requires resection of the ipsilateral palmaris longus for grafting, we believe that anatomic reconstruction of both coracoclavicular ligaments best restores the function of the acromioclavicular joint. 4. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Impact of implant design on primary stability of orthodontic mini-implants.

Science.gov (United States)

Wilmes, Benedict; Ottenstreuer, Stephanie; Su, Yu-Yu; Drescher, Dieter

2008-01-01

Skeletal anchorage with mini-implants has greatly broadened the treatment possibilities in orthodontics over the last few years. To reduce implant failure rates, it is advisable to obtain adequate primary stability. The aim of this study was to quantitatively analyze the impact of implant design and dimension on primary stability. Forty-two porcine iliac bone segments were prepared and embedded in resin. To evaluate the primary stability, we documented insertion torques of the following mini-implants: Aarhus Screw, AbsoAnchor, LOMAS, Micro-Anchorage-System, ORLUS and Spider Screw. In each bone, five Dual Top Screws were inserted for reference purposes to achieve comparability among the specimens. We observed wide variation in insertion torques and hence primary stability, depending on mini-implant design and dimension; the great impact that mini-implant diameter has on insertion torques was particularly conspicuous. Conical mini-implants achieved higher primary stabilities than cylindrical designs. The diameter and design of the mini-implant thread have a distinctive impact on primary stability. Depending on the region of insertion and local bone quality, the choice of the mini-implant design and size is crucial to establish sufficient primary stability.

Pelvic belt effects on sacroiliac joint ligaments: a computational approach to understand therapeutic effects of pelvic belts.

Science.gov (United States)

Sichting, Freddy; Rossol, Jerome; Soisson, Odette; Klima, Stefan; Milani, Thomas; Hammer, Niels

2014-01-01

The sacroiliac joint is a widely described source of low back pain. Therapeutic approaches to relieve pain include the application of pelvic belts. However, the effects of pelvic belts on sacroiliac joint ligaments as potential pain generators are mostly unknown. The aim of our study was to analyze the influence of pelvic belts on ligament load by means of a computer model. Experimental computer study using a finite element method. A computer model of the human pelvis was created, comprising bones, ligaments, and cartilage. Detailed geometries, material properties of ligaments, and in-vivo pressure distribution patterns of a pelvic belt were implemented. The effects of pelvic belts on ligament strain were computed in the double-leg stance. Pelvic belts increase sacroiliac joint motion around the sagittal axis but decrease motion around the transverse axis. With pelvic belt application, most of the strained sacroiliac joint ligaments were relieved, especially the sacrospinous, sacrotuberous, and the interosseous sacroiliac ligaments. Sacroiliac joint motion and ligament strains were minute. These results agree with validation data from other studies. Assigning homogenous and linear material properties and excluding muscle forces are clear simplifications of the complex reality. Pelvic belts alter sacroiliac joint motion and provide partial relief of ligament strain that is subjectively marked, although minimal in absolute terms. These findings confirm theories that besides being mechanical stabilizers, the sacroiliac joint ligaments are likely involved in neuromuscular feedback mechanisms. The results from our computer model help with unraveling the therapeutic mechanisms of pelvic belts.

In vitro characterization of self-assembled anterior cruciate ligament cell spheroids for ligament tissue engineering.

Science.gov (United States)

Hoyer, M; Meier, C; Breier, A; Hahner, J; Heinrich, G; Drechsel, N; Meyer, M; Rentsch, C; Garbe, L-A; Ertel, W; Lohan, A; Schulze-Tanzil, G

2015-03-01

Tissue engineering of an anterior cruciate ligament (ACL) implant with functional enthesis requires site-directed seeding of different cell types on the same scaffold. Therefore, we studied the suitability of self-assembled three-dimensional spheroids generated by lapine ACL ligament fibroblasts for directed scaffold colonization. The spheroids were characterized in vitro during 14 days in static and 7 days in dynamic culture. Size maintenance of self-assembled spheroids, the vitality, the morphology and the expression pattern of the cells were monitored. Additionally, we analyzed the total sulfated glycosaminoglycan, collagen contents and the expression of the ligament components type I collagen, decorin and tenascin C on protein and for COL1A1, DCN and TNMD on gene level in the spheroids. Subsequently, the cell colonization of polylactide-co-caprolactone [P(LA-CL)] and polydioxanone (PDS) polymer scaffolds was assessed in response to a directed, spheroid-based seeding technique. ACL cells were able to self-assemble spheroids and survive over 14 days. The spheroids decreased in size but not in cellularity depending on the culture time and maintained or even increased their differentiation state. The area of P[LA-CL] scaffolds, colonized after 14 days by the cells of one spheroid, was in average 4.57 ± 2.3 mm(2). Scaffolds consisting of the polymer P[LA-CL] were more suitable for colonization by spheroids than PDS embroideries. We conclude that ACL cell spheroids are suitable as site-directed seeding strategy for scaffolds in ACL tissue engineering approaches and recommend the use of freshly assembled spheroids for scaffold colonization, due to their balanced proliferation and differentiation.

Arcuate ligament of the wrist: normal MR appearance and its relationship to palmar midcarpal instability: a cadaveric study

International Nuclear Information System (INIS)

Chang, Weiling; Peduto, Anthony J.; Aguiar, Rodrigo O.C.; Trudell, Debra J.; Resnick, Donald L.

2007-01-01

To describe the magnetic resonance (MR) imaging and gross anatomic appearance of the scaphocapitate (SC) ligament and triquetrohamocapitate (THC) ligament, which are the radial and ulnar limbs of the composite arcuate ligament, a critical volar midcarpal stabilizing ligament. T1 spin-echo and 3D gradient-echo MR imaging in the standard, coronal oblique, and axial oblique planes were performed both before and following midcarpal arthrography in seven cadaveric wrists. The seven specimens were then sectioned in selected planes to optimally visualize the SC and THC ligaments. These specimens were analyzed and correlated with their corresponding MR images. The SC and THC ligaments can be visualized in MR images as structures of low signal intensity that form an inverted ''V'' joining the proximal and distal carpal rows. The entire ligamentous complex is best visualized with coronal and axial oblique MR imaging but can also be seen in standard imaging planes. SC and THC ligaments together form the arcuate ligament of the wrist. Their function is crucial to the normal functioning of the wrist. Palmar midcarpal instability (PMCI) is a resulting condition when abnormalities of these ligaments occur. Dedicated MR imaging in the coronal and axial imaging planes can be performed in patients suspected of having PCMI. (orig.)

Arcuate ligament of the wrist: normal MR appearance and its relationship to palmar midcarpal instability: a cadaveric study

Energy Technology Data Exchange (ETDEWEB)

Chang, Weiling [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Sharp-Grossmont Hospital, Department of Radiology, La Mesa, CA (United States); Peduto, Anthony J. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Westmead Hospital and Western Clinical School of Sydney University, Department of Radiology, Sydney (Australia); Aguiar, Rodrigo O.C. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Universidade Federal do Rio de Janeiro, Rio de Janerio (Brazil); Trudell, Debra J.; Resnick, Donald L. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States)

2007-07-15

To describe the magnetic resonance (MR) imaging and gross anatomic appearance of the scaphocapitate (SC) ligament and triquetrohamocapitate (THC) ligament, which are the radial and ulnar limbs of the composite arcuate ligament, a critical volar midcarpal stabilizing ligament. T1 spin-echo and 3D gradient-echo MR imaging in the standard, coronal oblique, and axial oblique planes were performed both before and following midcarpal arthrography in seven cadaveric wrists. The seven specimens were then sectioned in selected planes to optimally visualize the SC and THC ligaments. These specimens were analyzed and correlated with their corresponding MR images. The SC and THC ligaments can be visualized in MR images as structures of low signal intensity that form an inverted ''V'' joining the proximal and distal carpal rows. The entire ligamentous complex is best visualized with coronal and axial oblique MR imaging but can also be seen in standard imaging planes. SC and THC ligaments together form the arcuate ligament of the wrist. Their function is crucial to the normal functioning of the wrist. Palmar midcarpal instability (PMCI) is a resulting condition when abnormalities of these ligaments occur. Dedicated MR imaging in the coronal and axial imaging planes can be performed in patients suspected of having PCMI. (orig.)

Anterior Cruciate Ligament Reconstruction in Ehlers-Danlos Syndrome

Directory of Open Access Journals (Sweden)

John Williams

2015-01-01

Full Text Available This report details the reconstruction of the anterior cruciate ligament in an 18-year-old man with Ehlers-Danlos syndrome (EDS. The reduced mechanical properties of the tissue in EDS can pose a challenge to the orthopaedic surgeon. In this case, we describe the use of a hamstring autograft combined with a Ligament Advanced Reinforcement System (LARS. There was a good radiographical, clinical, and functional outcome after two years. This technique gave a successful outcome in the reconstruction of the ACL in a patient with EDS and therefore may help surgeons faced with the same clinical scenario.

Spiral ligament and stria vascularis changes in cochlear otosclerosis: effect on hearing level.

Science.gov (United States)

Doherty, Joni K; Linthicum, Fred H

2004-07-01

To investigate the effect of changes within the spiral ligament and stria vascularis on hearing in cochlear otosclerosis, we examined spiral ligament hyalinization, stria vascularis atrophy, and sensory hearing loss in cochlear otosclerosis and described changes in ion transport molecule expression. Retrospective. Tertiary referral center. Thirty-two cochleae from 24 temporal bone donors with histologic evidence of cochlear otosclerosis, including spiral ligament hyalinization. Audiography. Measurements of spiral ligament width, stria vascularis, and bone-conduction thresholds were compared by the amount of hyalinization. Expression of the ion transport molecules Na,K-ATPase, connexin 26, and carbonic anhydrase II were assessed by immunohistochemical techniques. Hyalinization most often involved the posterior basal turn (88%) and the posterior middle turn (27%). Spiral ligament hyalinization correlated significantly with stria vascularis atrophy in the posterior middle turn of the cochlea (rho = -0.63, p Bone-conduction thresholds at 2,000 and 4,000 Hz were significantly associated with the amount of stria vascularis atrophy (rho = -0.44, -0.40, p recycling, resulting in loss of endocochlear potential and sensory hearing loss.

Sonography of the anterior oblique ligament of the trapeziometacarpal joint: a study of cadavers and asymptomatic volunteers.

Science.gov (United States)

Chiavaras, Mary M; Harish, Srinivasan; Oomen, Glen; Popowich, Terry; Wainman, Bruce; Bain, James R

2010-12-01

The purpose of this study was to evaluate the ability of ultrasound to identify and characterize the anterior oblique ligament of the thumb in cadavers and asymptomatic volunteers. The anterior oblique ligaments of four cadaveric hands were imaged with a high-resolution transducer. The ligaments were then injected with 0.1% methylene blue using ultrasound guidance. To confirm identification of the ligament, the base of the thumb was immediately dissected, revealing the exact location of the dye. The bilateral ligaments in 40 asymptomatic adult volunteers were imaged. Surgical dissection confirmed injection of methylene blue into all cadaveric ligaments. The proximal attachment of the anterior oblique ligament was well defined in all the hands, and the distal attachment was well defined in 94% of the hands. The mean thickness of the anterior oblique ligament at the metacarpal attachment (0.7 mm), midportion (0.98 mm), and trapezial attachment (0.65 mm) did not differ significantly with respect to sex, right and left side, or hand dominance and was weakly correlated with weight, height, body mass index, and age. The length of the ligament was statistically significantly different between the dominant (10.6 mm) and nondominant (9.6 mm) hands. The volar metacarpal translation with palmar abduction stress did not differ significantly between the dominant (0.7 mm) and nondominant (0.8 mm) hands. There was no association between the degree of translation and the biologic characteristics (weight, height, body mass index, and age). High-resolution ultrasound can be used to identify and measure the thickness of the anterior oblique ligament. Dynamic ultrasound imaging can depict volar translation of the metacarpal, which may facilitate diagnosis of ligamentous injury.

Understanding acute ankle ligamentous sprain injury in sports

Directory of Open Access Journals (Sweden)

Fong Daniel TP

2009-07-01

Full Text Available Abstract This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms. Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms. The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative

Incorporating ligament laxity in a finite element model for the upper cervical spine.

Science.gov (United States)

Lasswell, Timothy L; Cronin, Duane S; Medley, John B; Rasoulinejad, Parham

2017-11-01

Predicting physiological range of motion (ROM) using a finite element (FE) model of the upper cervical spine requires the incorporation of ligament laxity. The effect of ligament laxity can be observed only on a macro level of joint motion and is lost once ligaments have been dissected and preconditioned for experimental testing. As a result, although ligament laxity values are recognized to exist, specific values are not directly available in the literature for use in FE models. The purpose of the current study is to propose an optimization process that can be used to determine a set of ligament laxity values for upper cervical spine FE models. Furthermore, an FE model that includes ligament laxity is applied, and the resulting ROM values are compared with experimental data for physiological ROM, as well as experimental data for the increase in ROM when a Type II odontoid fracture is introduced. The upper cervical spine FE model was adapted from a 50th percentile male full-body model developed with the Global Human Body Models Consortium (GHBMC). FE modeling was performed in LS-DYNA and LS-OPT (Livermore Software Technology Group) was used for ligament laxity optimization. Ordinate-based curve matching was used to minimize the mean squared error (MSE) between computed load-rotation curves and experimental load-rotation curves under flexion, extension, and axial rotation with pure moment loads from 0 to 3.5 Nm. Lateral bending was excluded from the optimization because the upper cervical spine was considered to be primarily responsible for flexion, extension, and axial rotation. Based on recommendations from the literature, four varying inputs representing laxity in select ligaments were optimized to minimize the MSE. Funding was provided by the Natural Sciences and Engineering Research Council of Canada as well as GHMBC. The present study was funded by the Natural Sciences and Engineering Research Council of Canada to support the work of one graduate student

A low-level diode laser therapy reduces the lipopolysaccharide (LPS)-induced periodontal ligament cell inflammation

International Nuclear Information System (INIS)

Huang, T H; Chen, C C; Liu, S L; Lu, Y C; Kao, C T

2014-01-01

The purpose of this study was to investigate the cytologic effects of inflammatory periodontal ligament cells in vitro after low-level laser therapy. Human periodontal ligament cells were cultured, exposed to lipopolysaccharide and subjected to low-level laser treatment of 5 J cm −2 or 10 J cm −2 using a 920 nm diode laser. A periodontal ligament cell attachment was observed under a microscope, and the cell viability was quantified by a mitochondrial colorimetric assay. Lipopolysaccharide-treated periodontal ligament cells were irradiated with the low-level laser, and the expression levels of several inflammatory markers, iNOS, TNF-α and IL-1, and pErk kinase, were analyzed by reverse transcription polymerase chain reaction and western blot. The data were collected and analyzed by one-way analysis of variance; p < 0.05 indicated a statistically significant difference. The low-level laser treatment of periodontal ligament cells increased their ability to attach and survive. After irradiation, the expression levels of iNOS, TNF-α and IL-1 in lipopolysaccharide-exposed periodontal ligament cells decreased over time (p < 0.05). In periodontal ligament cells, low-level diode laser treatment increased the cells’ proliferative ability and decreased the expression of the examined inflammatory mediators. (letters)

Acute neck pain caused by pseudogout attack of calcified cervical yellow ligament: a case report.

Science.gov (United States)

Kobayashi, Takashi; Miyakoshi, Naohisa; Abe, Toshiki; Abe, Eiji; Kikuchi, Kazuma; Noguchi, Hideaki; Konno, Norikazu; Shimada, Yoichi

2016-05-30

Calcification of the yellow ligament sometimes compresses the spinal cord and can induce myelopathy. Usually, the calcification does not induce acute neck pain. We report a case of a patient with acute neck pain caused by calcium pyrophosphate dihydrate in a calcified cervical yellow ligament. A 70-year-old Japanese woman presented with acute neck pain. She had a moderately high fever (37.5 °C), and her neck pain was so severe that she could not move her neck in any direction. Computed tomography showed a high-density area between the C5 and C6 laminae suspicious for calcification of the yellow ligament. Magnetic resonance imaging showed intermediate-signal intensity on T1-weighted imaging and high-signal intensity on T2-weighted imaging surrounding a low-signal region on both T1- and T2-weighted imaging with cord compression. There was a turbid, yellow fluid collection in the yellow ligament at the time of operation. Histologically, calcium pyrophosphate dihydrate crystals were found in the fluid, and she was diagnosed as having a pseudogout attack of the yellow ligament. Pseudogout attack of the cervical yellow ligament is rare, but this clinical entity should be added to the differential diagnosis of acute neck pain, especially when calcification of the yellow ligament exists.

Engineering tendon and ligament tissues: present developments towards successful clinical products.

Science.gov (United States)

Rodrigues, Márcia T; Reis, Rui L; Gomes, Manuela E

2013-09-01

Musculoskeletal diseases are one of the leading causes of disability worldwide. Among them, tendon and ligament injuries represent an important aspect to consider in both athletes and active working people. Tendon and ligament damage is an important cause of joint instability, and progresses into early onset of osteoarthritis, pain, disability and eventually the need for joint replacement surgery. The social and economical burden associated with these medical conditions presents a compelling argument for greater understanding and expanding research on this issue. The particular physiology of tendons and ligaments (avascular, hypocellular and overall structural mechanical features) makes it difficult for currently available treatments to reach a complete and long-term functional repair of the damaged tissue, especially when complete tear occurs. Despite the effort, the treatment modalities for tendon and ligament are suboptimal, which have led to the development of alternative therapies, such as the delivery of growth factors, development of engineered scaffolds or the application of stem cells, which have been approached in this review. Copyright © 2012 John Wiley & Sons, Ltd.

Collateral ligament strains during knee joint laxity evaluation before and after TKA.

Science.gov (United States)

Delport, Hendrik; Labey, Luc; De Corte, Ronny; Innocenti, Bernardo; Vander Sloten, Jos; Bellemans, Johan

2013-08-01

Passive knee stability is provided by the soft tissue envelope. There is consensus among orthopedic surgeons that good outcome in Total Knee Arthroplasty requires equal tension in the medial/lateral compartment of the knee joint, as well as equal tension in the flexion/extension gap. The purpose of this study was to quantify the ligament laxity in the normal non-arthritic knee before and after Posterior-Stabilized Total Knee Arthroplasty. We hypothesized that the Medial/Lateral Collateral Ligament shows minimal changes in length when measured directly by extensometers in the native human knee during varus/valgus laxity testing. We also hypothesized that due to differences in material properties and surface geometry, native laxity is difficult to reconstruct using a Posterior-Stabilized Total Knee. Six specimens were used to perform this in vitro cadaver test using extensometers to provide numerical values for laxity and varus-valgus tilting in the frontal plane. This study enabled a precise measurement of varus-valgus laxity as compared with the clinical assessment. The strains in both ligaments in the replaced knee were different from those in the native knee. Both ligaments were stretched in extension, in flexion the Medial Collateral Ligament tends to relax and the Lateral Collateral Ligament remains tight. As material properties and surface geometry of the replaced knee add stiffness to the joint, we recommend to avoid overstuffing the joint, when using this type of Posterior-Stabilized Total Knee Arthroplasty, in order to obtain varus/valgus laxity close to the native joint. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sheet, ligament and droplet formation in swirling primary atomization

Directory of Open Access Journals (Sweden)

Changxiao Shao

2018-04-01

Full Text Available We report direct numerical simulations of swirling liquid atomization to understand the physical mechanism underlying the sheet breakup of a non-turbulent liquid swirling jet which lacks in-depth investigation. The volume-of-fluid (VOF method coupled with adapted mesh refinement (AMR technique in GERRIS code is employed in the present simulation. The mechanisms of sheet, ligament and droplet formation are investigated. It is observed that the olive-shape sheet structure is similar to the experimental result qualitatively. The numerical results show that surface tension, pressure difference and swirling effect contribute to the contraction and extension of liquid sheet. The ligament formation is partially at the sheet rim or attributed to the extension of liquid hole. Especially, the movement of hairpin vortex exerts by an anti-radial direction force to the sheet surface and leads to the sheet thinness. In addition, droplet formation is attributed to breakup of ligament and central sheet.

Sheet, ligament and droplet formation in swirling primary atomization

Science.gov (United States)

Shao, Changxiao; Luo, Kun; Chai, Min; Fan, Jianren

2018-04-01

We report direct numerical simulations of swirling liquid atomization to understand the physical mechanism underlying the sheet breakup of a non-turbulent liquid swirling jet which lacks in-depth investigation. The volume-of-fluid (VOF) method coupled with adapted mesh refinement (AMR) technique in GERRIS code is employed in the present simulation. The mechanisms of sheet, ligament and droplet formation are investigated. It is observed that the olive-shape sheet structure is similar to the experimental result qualitatively. The numerical results show that surface tension, pressure difference and swirling effect contribute to the contraction and extension of liquid sheet. The ligament formation is partially at the sheet rim or attributed to the extension of liquid hole. Especially, the movement of hairpin vortex exerts by an anti-radial direction force to the sheet surface and leads to the sheet thinness. In addition, droplet formation is attributed to breakup of ligament and central sheet.

Review of common conditions associated with periodontal ligament widening

Energy Technology Data Exchange (ETDEWEB)

Mortazavi, Hamed; Baharvand, Maryam [Dept. of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of)

2016-12-15

The aim of this article is to review a group of lesions associated with periodontal ligament (PDL) widening. An electronic search was performed using specialized databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus to find relevant studies by using keywords such as “periodontium”, “periodontal ligament”, “periodontal ligament space”, “widened periodontal ligament”, and “periodontal ligament widening”. Out of nearly 200 articles, about 60 were broadly relevant to the topic. Ultimately, 47 articles closely related to the topic of interest were reviewed. When the relevant data were compiled, the following 10 entities were identified: occlusal/orthodontic trauma, periodontal disease/periodontitis, pulpo-periapical lesions, osteosarcoma, chondrosarcoma, non-Hodgkin lymphoma, progressive systemic sclerosis, radiation-induced bone defect, bisphosphonate-related osteonecrosis, and osteomyelitis. Although PDL widening may be encountered by many dentists during their routine daily procedures, the clinician should consider some serious related conditions as well.

Review of common conditions associated with periodontal ligament widening

International Nuclear Information System (INIS)

Mortazavi, Hamed; Baharvand, Maryam

2016-01-01

The aim of this article is to review a group of lesions associated with periodontal ligament (PDL) widening. An electronic search was performed using specialized databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus to find relevant studies by using keywords such as “periodontium”, “periodontal ligament”, “periodontal ligament space”, “widened periodontal ligament”, and “periodontal ligament widening”. Out of nearly 200 articles, about 60 were broadly relevant to the topic. Ultimately, 47 articles closely related to the topic of interest were reviewed. When the relevant data were compiled, the following 10 entities were identified: occlusal/orthodontic trauma, periodontal disease/periodontitis, pulpo-periapical lesions, osteosarcoma, chondrosarcoma, non-Hodgkin lymphoma, progressive systemic sclerosis, radiation-induced bone defect, bisphosphonate-related osteonecrosis, and osteomyelitis. Although PDL widening may be encountered by many dentists during their routine daily procedures, the clinician should consider some serious related conditions as well

Effect of Recycling Protocol on Mechanical Strength of Used Mini-Implants

OpenAIRE

Estelita, Sérgio; Janson, Guilherme; Chiqueto, Kelly; Ferreira, Eduardo Silveira

2014-01-01

Purpose. This study evaluated the influence of recycling process on the torsional strength of mini-implants. Materials and Methods. Two hundred mini-implants were divided into 4 groups with 50 screws equally distributed in five diameters (1.3 to 1.7 mm): control group (CG): unused mini-implants, G1: mini-implants inserted in pig iliac bone and removed, G2: same protocol of group 1 followed by sonication for cleaning and autoclave sterilization, and G3: same insertion protocol of group 1 follo...

Anatomy and histology of apical support: a literature review concerning cardinal and uterosacral ligaments.

Science.gov (United States)

Ramanah, Rajeev; Berger, Mitchell B; Parratte, Bernard M; DeLancey, John O L

2012-11-01

The objective of this work was to collect and summarize relevant literature on the anatomy, histology, and imaging of apical support of the upper vagina and the uterus provided by the cardinal (CL) and uterosacral (USL) ligaments. A literature search in English, French, and German languages was carried out with the keywords apical support, cardinal ligament, transverse cervical ligament, Mackenrodt ligament, parametrium, paracervix, retinaculum uteri, web, uterosacral ligament, and sacrouterine ligament in the PubMed database. Other relevant journal and textbook articles were sought by retrieving references cited in previous PubMed articles. Fifty references were examined in peer-reviewed journals and textbooks. The USL extends from the S2 to the S4 vertebra region to the dorsal margin of the uterine cervix and/or to the upper third of the posterior vaginal wall. It has a superficial and deep component. Autonomous nerve fibers are a major constituent of the deep USL. CL is defined as a perivascular sheath with a proximal insertion around the origin of the internal iliac artery and a distal insertion on the cervix and/or vagina. It is divided into a cranial (vascular) and a caudal (neural) portions. Histologically, it contains mainly vessels, with no distinct band of connective tissue. Both the deep USL and the caudal CL are closely related to the inferior hypogastric plexus. USL and CL are visceral ligaments, with mesentery-like structures containing vessels, nerves, connective tissue, and adipose tissue.

Ligamentous and capsular restraints to experimental posterior elbow joint dislocation

DEFF Research Database (Denmark)

Deutch, S.R.; Olsen, B.S.; Jensen, S.L.

2003-01-01

the anterior capsule and the lateral collateral ligament complex (LCLC), whereas in the flexed elbow the anterior capsule did not have a stabilizing effect. In flexed joint positions, the LCLC seems to be the only immediate stabilizer against PEFR, and thereby against posterolateral instability and possibly...... against posterior dislocation. The medial collateral ligament did not have any immediate stabilizing effect, but it prevented the final step of the posterior dislocation....

MR imaging of the lateral collateral ligaments after ankle sprain

International Nuclear Information System (INIS)

Grebe, P.; Kreitner, K.F.; Roeder, W.; Kersjes, W.; Hennes, R.; Runkel, M.

1995-01-01

35 patients with ankle sprain were examined by MRI and stress radiographs. 13 were operated afterwards, 22 patients underwent a functional conservative therapy and were examined by MRI and stress radiographs and second time after three months. MRI reports were correct in 12 of 13 operated cases. After conservative therapy we did not find any disrupted ankle ligament. MRI showed intact ligaments thickened by scar. (orig./MG) [de

Achondroplasia manifesting as enchondromatosis and ossification of the spinal ligaments: a case report

Directory of Open Access Journals (Sweden)

Al Kaissi Ali

2008-08-01

Full Text Available Abstract Introduction A girl presented with achondroplasia manifested as mild knee pain associated with stiffness of her back. A skeletal survey showed enchondroma-like metaphyseal dysplasia and ossification of the spinal ligaments. Magnetic resonance imaging of the spine further clarified the pathological composites. Case presentation A 7-year-old girl presented with the classical phenotypic features of achondroplasia. Radiographic documentation showed the co-existence of metaphyseal enchondromatosis and development of spinal bony ankylosis. Magnetic resonance imaging showed extensive ossification of the anterior and posterior spinal ligaments. Additional features revealed by magnetic resonance imaging included calcification of the peripheral vertebral bodies associated with anterior end-plate irregularities. Conclusion Enchondromas are metabolically active and may continue to grow and evolve throughout the patient's lifetime; thus, progressive calcification over a period of years is not unusual. Ossification of the spinal ligaments has a specific site of predilection and often occurs in combination with senile ankylosing vertebral hyperostosis. Nevertheless, ossification of the spinal ligaments has been encountered in children with syndromic malformation complex. It is a multifactorial disease in which complex genetic and environmental factors interact, potentially leading to chronic pressure on the spinal cord and nerve roots with subsequent development of myeloradiculopathy. Our patient presented with a combination of achondroplasia, enchondroma-like metaphyseal dysplasia and calcification of the spinal ligaments. We suggest that the development of heterotopic bone formation along the spinal ligaments had occurred through an abnormal ossified enchondral mechanism. We postulate that ossification of the spinal ligaments and metaphyseal enchondromatous changes are related to each other and represent impaired terminal differentiation of

Dynamic high-resolution ultrasound of intrinsic and extrinsic ligaments of the wrist: How to make it simple.

Science.gov (United States)

Gitto, Salvatore; Messina, Carmelo; Mauri, Giovanni; Aliprandi, Alberto; Sardanelli, Francesco; Sconfienza, Luca Maria

2017-02-01

Wrist ligaments are crucial structures for the maintenance of carpal stability. They are classified into extrinsic ligaments, connecting the carpus with the forearm bones or distal radioulnar ligaments, and intrinsic ligaments, entirely situated within the carpus. Lesions of intrinsic and extrinsic ligaments of the wrist have been demonstrated to occur largely, mostly in patients with history of trauma and carpal instability, or rheumatoid arthritis. Ultrasound allows for rapid, cost-effective, non-invasive and dynamic evaluation of the wrist, and may represent a valuable diagnostic tool. Although promising results have been published, ultrasound of wrist ligaments is not performed in routine clinical practice, maybe due to its technical feasibility regarded as quite complex. This review article aims to enlighten readers about the normal sonographic appearance of intrinsic and extrinsic carpal ligaments, and describe a systematic approach for their sonographic assessment with detailed anatomic landmarks, dynamic manoeuvres and scanning technique. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Mini-mental Parkinson (MMP) as a dementia screening test: comparison with the Mini-Mental State Examination (MMSE).

Science.gov (United States)

Larner, Andrew J

2012-07-01

As populations age, screening instruments for cognitive impairment and dementia will become of increasing importance in clinical practice. Mini-Mental Parkinson (MMP), a derivative of the Mini-Mental State Examination (MMSE), was originally described as a cognitive screening instrument for use in Parkinson's disease. Its item content addresses some of the acknowledged shortcomings of the MMSE. Pragmatic use of MMP in general cognitive clinics has not previously been examined. To compare the performance of two scales, Mini-Mental Parkinson (MMP) and the Mini-Mental State Examination (MMSE), as cognitive screening instruments for dementia in a memory clinic population. MMP was administered prospectively to 201 consecutive new patient referrals independent of other tests used to establish dementia diagnosis according to standard diagnostic criteria (DSM-IV). Diagnostic utility of MMP for dementia was measured and compared with MMSE. MMP proved easy to use and acceptable to patients. Optimal test accuracy (0.86) was at MMP cutoff of ≤ 17/32, with sensitivity 0.51, specificity 0.97, positive predictive value 0.83, negative predictive value 0.87, and area under Receiver Operating Characteristic curve 0.89. Using a higher cutoff (≤ 29/32), MMP sensitivity was 1.00 with specificity 0.70. MMP scores correlated with MMSE (r = 0.93) and diagnostic agreement was high (κ = 0.85). MMP is a useful screening instrument in the memory clinic setting, with patients who fall below the designated cutoff requiring further investigation to ascertain a cause for their cognitive impairment.

Mini-clinical evaluation exercise til evaluering af kommunikation og samarbejde i ambulatoriet

DEFF Research Database (Denmark)

Eriksen, Jesper Grau; Simonsen, Dorit; Bastholt, Lars

2009-01-01

INTRODUCTION: In the revised Danish medical specialist training increased focus has been placed on competences which are hard to evaluate such as communication skills. Mini-CEX seems promising as an evaluation tool. Our aim was to test: 1) whether mini-CEX was useable in the evaluation...... of communicative and cooperative skills and 2) whether mini-CEX would provide reproducible data. MATERIAL AND METHODS: Twenty-one residents were evaluated by mini-CEX by trained observers. Seventeen residents had at least two observations within a short period of time and these data were used to estimate the mini...

Effects of Different Angles of the Traction Table on Lumbar Spine Ligaments: A Finite Element Study.

Science.gov (United States)

Farajpour, Hekmat; Jamshidi, Nima

2017-12-01

The traction bed is a noninvasive device for treating lower back pain caused by herniated intervertebral discs. In this study, we investigated the impact of the traction bed on the lower back as a means of increasing the disc height and creating a gap between facet joints. Computed tomography (CT) images were obtained from a female volunteer and a three-dimensional (3D) model was created using software package MIMICs 17.0. Afterwards, the 3D model was analyzed in an analytical software (Abaqus 6.14). The study was conducted under the following traction loads: 25%, 45%, 55%, and 85% of the whole body weight in different angles. Results indicated that the loading angle in the L3-4 area had 36.8%, 57.4%, 55.32%, 49.8%, and 52.15% effect on the anterior longitudinal ligament, posterior longitudinal ligament, intertransverse ligament, interspinous ligament, and supraspinous ligament, respectively. The respective values for the L4-5 area were 32.3%, 10.6%, 53.4%, 56.58%, and 57.35%. Also, the body weight had 63.2%, 42.6%, 44.68%, 50.2%, and 47.85% effect on the anterior longitudinal ligament, posterior longitudinal ligament, intertransverse ligament, interspinous ligament, and supraspinous ligament, respectively. The respective values for the L4-5 area were 67.7%, 89.4%, 46.6%, 43.42% and 42.65%. The authenticity of results was checked by comparing with the experimental data. The results show that traction beds are highly effective for disc movement and lower back pain relief. Also, an optimal angle for traction can be obtained in a 3D model analysis using CT or magnetic resonance imaging images. The optimal angle would be different for different patients and thus should be determined based on the decreased height of the intervertebral disc, weight and height of patients.

Dynamic high-resolution ultrasound of intrinsic and extrinsic ligaments of the wrist: How to make it simple

International Nuclear Information System (INIS)

Gitto, Salvatore; Messina, Carmelo; Mauri, Giovanni; Aliprandi, Alberto; Sardanelli, Francesco; Sconfienza, Luca Maria

2017-01-01

Highlights: • US allows for rapid, cost-effective, and non-invasive assessment of wrist ligaments. • Knowledge of landmarks and dynamic manoeuvres is basic for a systematic examination. • A sequential approach is effective, timesaving and feasible in clinical practice. - Abstract: Wrist ligaments are crucial structures for the maintenance of carpal stability. They are classified into extrinsic ligaments, connecting the carpus with the forearm bones or distal radioulnar ligaments, and intrinsic ligaments, entirely situated within the carpus. Lesions of intrinsic and extrinsic ligaments of the wrist have been demonstrated to occur largely, mostly in patients with history of trauma and carpal instability, or rheumatoid arthritis. Ultrasound allows for rapid, cost-effective, non-invasive and dynamic evaluation of the wrist, and may represent a valuable diagnostic tool. Although promising results have been published, ultrasound of wrist ligaments is not performed in routine clinical practice, maybe due to its technical feasibility regarded as quite complex. This review article aims to enlighten readers about the normal sonographic appearance of intrinsic and extrinsic carpal ligaments, and describe a systematic approach for their sonographic assessment with detailed anatomic landmarks, dynamic manoeuvres and scanning technique.

Dynamic high-resolution ultrasound of intrinsic and extrinsic ligaments of the wrist: How to make it simple

Energy Technology Data Exchange (ETDEWEB)

Gitto, Salvatore, E-mail: sal.gitto@gmail.com [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano (Italy); Messina, Carmelo [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano (Italy); Mauri, Giovanni [Servizio di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese (Italy); Dipartimento di Radiologia Interventistica, Istituto Europeo di Oncologia, Via Ripamonti 435, 20141 Milano (Italy); Aliprandi, Alberto [Servizio di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese (Italy); Sardanelli, Francesco [Servizio di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133 Milano (Italy); Sconfienza, Luca Maria [Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133 Milano (Italy); Unità Operativa di Radiologia/Diagnostica per Immagini con Servizio di Radiologia Interventistica, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milano (Italy)

2017-02-15

Highlights: • US allows for rapid, cost-effective, and non-invasive assessment of wrist ligaments. • Knowledge of landmarks and dynamic manoeuvres is basic for a systematic examination. • A sequential approach is effective, timesaving and feasible in clinical practice. - Abstract: Wrist ligaments are crucial structures for the maintenance of carpal stability. They are classified into extrinsic ligaments, connecting the carpus with the forearm bones or distal radioulnar ligaments, and intrinsic ligaments, entirely situated within the carpus. Lesions of intrinsic and extrinsic ligaments of the wrist have been demonstrated to occur largely, mostly in patients with history of trauma and carpal instability, or rheumatoid arthritis. Ultrasound allows for rapid, cost-effective, non-invasive and dynamic evaluation of the wrist, and may represent a valuable diagnostic tool. Although promising results have been published, ultrasound of wrist ligaments is not performed in routine clinical practice, maybe due to its technical feasibility regarded as quite complex. This review article aims to enlighten readers about the normal sonographic appearance of intrinsic and extrinsic carpal ligaments, and describe a systematic approach for their sonographic assessment with detailed anatomic landmarks, dynamic manoeuvres and scanning technique.

Mini-conference and Related Sessions on Laboratory Plasma Astrophysics

International Nuclear Information System (INIS)

Hantao Ji

2004-01-01

This paper provides a summary of some major physics issues and future perspectives discussed in the Mini-Conference on Laboratory Plasma Astrophysics. This Mini-conference, sponsored by the Topical Group on Plasma Astrophysics, was held as part of the American Physical Society's Division of Plasma Physics 2003 Annual Meeting (October 27-31, 2003). Also included are brief summaries of selected talks on the same topic presented at two invited paper sessions (including a tutorial) and two contributed focus oral sessions, which were organized in coordination with the Mini-Conference by the same organizers

Mini-conference and Related Sessions on Laboratory Plasma Astrophysics

Energy Technology Data Exchange (ETDEWEB)

Hantao Ji

2004-02-27

This paper provides a summary of some major physics issues and future perspectives discussed in the Mini-Conference on Laboratory Plasma Astrophysics. This Mini-conference, sponsored by the Topical Group on Plasma Astrophysics, was held as part of the American Physical Society's Division of Plasma Physics 2003 Annual Meeting (October 27-31, 2003). Also included are brief summaries of selected talks on the same topic presented at two invited paper sessions (including a tutorial) and two contributed focus oral sessions, which were organized in coordination with the Mini-Conference by the same organizers.

Allograft tendon reconstruction of the anterior talofibular ligament and calcaneofibular Ligament in the treatment of chronic ankle instability.

Science.gov (United States)

Wang, Weikai; Xu, Guo Hong

2017-04-08

The purpose was retrospectively to investigate functional and clinical outcomes after anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) reconstruction using a single allograft. Patients with severe chronic lateral instability of the ankle underwent surgery after conservative treatment failed. Ultrasounds of the ankle were performed, and if the AFTL and CFL were completely torn without enough soft tissue for repair, the ligaments were reconstructed using allograft tendon. Outcomes were assessed by clinical examination, stress radiography, ultrasound, the American Orthopaedic Foot and Ankle Society score (AOFAS), and Karlsson Ankle Functional score (KAFS) before surgery and at final follow-up. Nineteen patients, ten men and nine women with mean age of 27.9 years (range, 19-41 years), underwent reconstruction. Mean follow-up was 30 months (range, 24-40 months). At final follow-up, all patients had returned to activity without instability, pain, or limited range of motion. On stress radiography, mean talar tilt angle decreased from 17.32° ± 3.58° before surgery to 4.16° ± 1.12° at follow-up (p surgery to 3.97 ± 0.99 mm at follow-up (p < 0.05). Mean AOFAS improved from 64.00 ± 18.43 to 90.32 ± 5.17 points (p < 0.001), and mean KAFS improved from 50.84 ± 16.73 to 90.89 ± 5.08 points (p < 0.001). Ultrasound showed the reconstructed ligaments maintained good continuity and excellent tension. No case of infection and immunological rejection was reported. This novel reconstruction technique takes into account the anatomical specialty of AFTL and CFL. This case series showed increased stability of the ankle in clinical and functional outcomes. The trial registration number (TRN) and date of registration: ChiCTR-ORC-17010796 , Mar 6th 2017. Retrospectively registered.

Alterations of the transverse ligament: an MRI study comparing patients with acute whiplash and matched control subjects.

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Ulbrich, Erika Jasmin; Eigenheer, Sandra; Boesch, Chris; Hodler, Juerg; Busato, André; Schraner, Christian; Anderson, Suzanne E; Bonel, Harald; Zimmermann, Heinz; Sturzenegger, Matthias

2011-10-01

The objective of our study was to evaluate whether there is injury to the transverse ligament of the atlas in patients with acute whiplash. Ninety patients with an acute (transverse ligament was measured on midsagittal T1 volumetric interpolated breath-hold examination (VIBE) images and transverse reformatted VIBE images. The signal intensity of the transverse ligament was measured on transverse STIR images and on transverse reformatted T1 VIBE images before and after IV administration of gadoterate. Contrast between the transverse ligament and CSF and alterations of contrast after gadoterate injection were calculated. Patients had a minimally thicker transverse ligament (posttraumatic swelling) than control subjects, and the difference in thickness was significant in men only (p = 0.03). In patients, a significant signal alteration of the transverse ligament (p = 0.03) was seen on STIR (posttraumatic edema) and native VIBE sequences. The contrast between the transverse ligament and the CSF on VIBE images was significantly (p = 0.005) lower in patients than in control subjects. With the application of a contrast agent, the contrast difference between the transverse ligament and CSF in patients and control subjects was less pronounced (p = 0.038). There was no abnormal uptake of contrast agent by the transverse ligament or CSF. The results of our study indicate possible involvement of the transverse ligament in whiplash injury. Although MRI may be helpful to study injury-related changes of anatomic structures in cohorts, it is not suited for individual diagnosis because the alterations are too small.

Screening for Dementia in Older Adults: Comparison of Mini-Mental State Examination, Mini-Cog, Clock Drawing Test and AD8.

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Yang, Li; Yan, Jing; Jin, Xiaoqing; Jin, Yu; Yu, Wei; Xu, Shanhu; Wu, Haibin

2016-01-01

This study was conducted to estimate screening performance of dementia screening tools including Mini-Mental State Examination (MMSE), Mini-Cog, Clock Drawing Test (CDT) and Ascertain Dementia 8 questionnaire (AD8) for older adults. 2015 participants aged 65 years or more in eastern China were enrolled. 4 screening tests were administered and scored by specifically trained psychiatrists. We used data from two-by-two tables to calculate the sensitivity, specificity, and positive and negative predictive values (PPV/NPV). Our study showed that dementia was highly prevalent among elderly in Zhejiang province. The Mini-Cog, with excellent screening characteristics and spending less time, could be considered to be used as a screening tool among communities to help to diagnose dementia early.

Arthrographic diagnosis of ruptured calcaneofibular ligament. I

International Nuclear Information System (INIS)

Vuust, M.

1980-01-01

A new projection, oblique axial, is recommended for the arthrography of the acute sprained ankle for the correct diagnosis of a ruptured calcaneofibular ligament. Its value is experimentally confirmed. (Auth.)

The Use of Canine Stifle Orthotics for Cranial Cruciate Ligament Insufficiency

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Brittany Jean Carr

2016-01-01

Full Text Available Objective: To assess weight bearing of dogs treated for unilateral cranial cruciate ligament insufficiency with a custom stifle orthotic.Background: Cranial cruciate ligament (CCL insufficiency is the most common cause of hind limb lameness in dogs. While there are numerous options for surgical management, surgery is not always an option. Recently, the use of canine stifle orthotics has also emerged as a means to non-surgically manage patients with cranial cruciate ligament insufficiency.  Evidentiary value:  This is a retrospective study of ten dogs treated for unilateral cranial cruciate ligament rupture with a stifle orthotic.Methods: Medical records (January 2005- December 2012 of ten dogs treated for unilateral cranial cruciate ligament rupture with a stifle orthotic were reviewed.  Temporospatial gait analysis was performed using a pressure sensing walkway at baseline and 90 days or greater post orthotic placement to identify weight bearing with total pressure index % (TPI%.Results: TPI% improved significantly by 5.1% in the affected limb when compared to baseline (p = 0.0020. At final gait analysis, TPI% significantly improved by 3% in the affected limb with the orthotic off when compared to the unaffected limb (p = 0.0020.Conclusion: Custom canine stifle orthotics allow for improved weight bearing in the affected limb.Application: Custom canine stifle orthotics should be considered for cases with concurrent medical conditions or financial constraints that do not allow for surgical intervention.

Proteomic differences between native and tissue‐engineered tendon and ligament

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Tew, Simon R.; Peffers, Mandy; Canty‐Laird, Elizabeth G.; Comerford, Eithne

2016-01-01

Tendons and ligaments (T/Ls) play key roles in the musculoskeletal system, but they are susceptible to traumatic or age‐related rupture, leading to severe morbidity as well as increased susceptibility to degenerative joint diseases such as osteoarthritis. Tissue engineering represents an attractive therapeutic approach to treating T/L injury but it is hampered by our poor understanding of the defining characteristics of the two tissues. The present study aimed to determine differences in the proteomic profile between native T/Ls and tissue engineered (TE) T/L constructs. The canine long digital extensor tendon and anterior cruciate ligament were analyzed along with 3D TE fibrin‐based constructs created from their cells. Native tendon and ligament differed in their content of key structural proteins, with the ligament being more abundant in fibrocartilaginous proteins. 3D T/L TE constructs contained less extracellular matrix (ECM) proteins and had a greater proportion of cellular‐associated proteins than native tissue, corresponding to their low collagen and high DNA content. Constructs were able to recapitulate native T/L tissue characteristics particularly with regard to ECM proteins. However, 3D T/L TE constructs had similar ECM and cellular protein compositions indicating that cell source may not be an important factor for T/L tissue engineering. PMID:27080496

A postmenopausal woman with sciatica from broad ligament leiomyoma: a case report.

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Tsai, Ya-Chu May

2016-10-31

Unilateral lower abdominal pain and/or sciatic nerve pain is a common presentation in the elderly population. The prevalence of broad ligament leiomyoma is leiomyomas to be clinically significant. Thus, we highlight a case of symptomatic broad ligament leiomyoma in a postmenopausal woman whose symptoms improved after definitive treatment. A 62-year-old postmenopausal Macedonian woman was referred to our gynecological department with unexplained pain in her left leg and left iliac fossa region on walking. There was minimal relief with increasing analgesia use prescribed by the family physician. Investigations revealed an ipsilateral adnexal mass and subsequent treatment with laparoscopic broad ligament myomectomy helped to alleviate her symptoms. Our case highlights the importance of staying mindful of alternate diagnoses when presented with a common presentation of iliac fossa pain and pain in the leg. Although broad ligament leiomyomas are benign tumors, the uncommon symptomatic presentation led us to report and focus some attention on this type of tumor.

Sources of adult mesenchymal stem cells for ligament and tendon tissue engineering.

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Dhinsa, Baljinder S; Mahapatra, Anant N; Khan, Wasim S

2015-01-01

Tendon and ligament injuries are common, and repair slowly with reduced biomechanical properties. With increasing financial demands on the health service and patients to recover from tendon and ligament injuries faster, and with less morbidity, health professionals are exploring new treatment options. Tissue engineering may provide the answer, with its unlimited source of natural cells that in the correct environment may improve repair and regeneration of tendon and ligament tissue. Mesenchymal stem cells have demonstrated the ability to self renew and have multilineage differentiation potential. The use of bone marrow-derived mesenchymal stem cells has been reported, however significant in vitro culture expansion is required due to the low yield of cells, which has financial implications. Harvesting of bone marrow cells also has associated morbidity. Several studies have looked at alternative sources for mesenchymal stem cells. Reports in literature from animal studies have been encouraging, however further work is required. This review assesses the potential sources of mesenchymal stem cells for tissue engineering in tendons and ligaments.