Concave distal end of ulna metaphysis alone is not a sign of rickets

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Oestreich, Alan E. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, 5031, Cincinnati, OH (United States)

2015-07-15

Statements have been made in the literature and in legal testimony that misrepresent the radiographic finding of concave distal end of the ulnar metaphysis. To demonstrate that a concave distal end of the ossified ulna in infancy can be normal. Eighty distal wrists of randomly selected infants in the first year of life with radiographic evidence that ruled out rickets were reviewed. In 16 of the cases (20%), mild or moderate concavity of the distal end of the ulna was seen. An intact metaphyseal collar of distal radius or ulna confirmed the absence of radiographic rickets. The finding of 20% of concave distal ulnas in the first year of life confirms the widely acknowledged statements that concave distal end of the ulna alone is not indicative of rickets. Statements to the contrary are not justified. (orig.)

Concave distal end of ulna metaphysis alone is not a sign of rickets

International Nuclear Information System (INIS)

Oestreich, Alan E.

2015-01-01

Statements have been made in the literature and in legal testimony that misrepresent the radiographic finding of concave distal end of the ulnar metaphysis. To demonstrate that a concave distal end of the ossified ulna in infancy can be normal. Eighty distal wrists of randomly selected infants in the first year of life with radiographic evidence that ruled out rickets were reviewed. In 16 of the cases (20%), mild or moderate concavity of the distal end of the ulna was seen. An intact metaphyseal collar of distal radius or ulna confirmed the absence of radiographic rickets. The finding of 20% of concave distal ulnas in the first year of life confirms the widely acknowledged statements that concave distal end of the ulna alone is not indicative of rickets. Statements to the contrary are not justified. (orig.)

Comparison of Direct Side-to-End and End-to-End Hypoglossal-Facial Anastomosis for Facial Nerve Repair.

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Samii, Madjid; Alimohamadi, Maysam; Khouzani, Reza Karimi; Rashid, Masoud Rafizadeh; Gerganov, Venelin

2015-08-01

The hypoglossal facial anastomosis (HFA) is the gold standard for facial reanimation in patients with severe facial nerve palsy. The major drawbacks of the classic HFA technique are lingual morbidities due to hypoglossal nerve transection. The side-to-end HFA is a modification of the classic technique with fewer tongue-related morbidities. In this study we compared the outcome of the classic end-to-end and the direct side-to-end HFA surgeries performed at our center in regards to the facial reanimation success rate and tongue-related morbidities. Twenty-six successive cases of HFA were enrolled. In 9 of them end-to-end anastomoses were performed, and 17 had direct side-to-end anastomoses. The House-Brackmann (HB) and Pitty and Tator (PT) scales were used to document surgical outcome. The hemiglossal atrophy, swallowing, and hypoglossal nerve function were assessed at follow-up. The original pathology was vestibular schwannoma in 15, meningioma in 4, brain stem glioma in 4, and other pathologies in 3. The mean interval between facial palsy and HFA was 18 months (range: 0-60). The median follow-up period was 20 months. The PT grade at follow-up was worse in patients with a longer interval from facial palsy and HFA (P value: 0.041). The lesion type was the only other factor that affected PT grade (the best results in vestibular schwannoma and the worst in the other pathologies group, P value: 0.038). The recovery period for facial tonicity was longer in patients with radiation therapy before HFA (13.5 vs. 8.5 months) and those with a longer than 2-year interval from facial palsy to HFA (13.5 vs. 8.5 months). Although no significant difference between the side-to-end and the end-to-end groups was seen in terms of facial nerve functional recovery, patients from the side-to-end group had a significantly lower rate of lingual morbidities (tongue hemiatrophy: 100% vs. 5.8%, swallowing difficulty: 55% vs. 11.7%, speech disorder 33% vs. 0%). With the side-to-end HFA

Flow and wall shear stress in end-to-side and side-to-side anastomosis of venous coronary artery bypass grafts

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Poulikakos Dimos

2007-09-01

Full Text Available Abstract Purpose Coronary artery bypass graft (CABG surgery represents the standard treatment of advanced coronary artery disease. Two major types of anastomosis exist to connect the graft to the coronary artery, i.e., by using an end-to-side or a side-to-side anastomosis. There is still controversy because of the differences in the patency rates of the two types of anastomosis. The purpose of this paper is to non-invasively quantify hemodynamic parameters, such as mass flow and wall shear stress (WSS, in end-to-side and side-to-side anastomoses of patients with CABG using computational fluid dynamics (CFD. Methods One patient with saphenous CABG and end-to-side anastomosis and one patient with saphenous CABG and side-to-side anastomosis underwent 16-detector row computed tomography (CT. Geometric models of coronary arteries and bypasses were reconstructed for CFD analysis. Blood flow was considered pulsatile, laminar, incompressible and Newtonian. Peri-anastomotic mass flow and WSS were quantified and flow patterns visualized. Results CFD analysis based on in-vivo CT coronary angiography data was feasible in both patients. For both types of CABG, flow patterns were characterized by a retrograde flow into the native coronary artery. WSS variations were found in both anastomoses types, with highest WSS values at the heel and lowest WSS values at the floor of the end-to-side anastomosis. In contrast, the highest WSS values of the side-to-side anastomosis configuration were found in stenotic vessel segments and not in the close vicinity of the anastomosis. Flow stagnation zones were found in end-to-side but not in side-to-side anastomosis, the latter also demonstrating a smoother stream division throughout the cardiac cycle. Conclusion CFD analysis of venous CABG based on in-vivo CT datasets in patients was feasible producing qualitative and quantitative information on mass flow and WSS. Differences were found between the two types of anastomosis

PIV-validated numerical modeling of pulsatile flows in distal coronary end-to-side anastomoses.

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Xiong, F L; Chong, C K

2007-01-01

This study employed particle image velocimetry (PIV) to validate a numerical model in a complementary approach to quantify hemodynamic factors in distal coronary anastomoses and to gain more insights on their relationship with anastomotic geometry. Instantaneous flow fields and wall shear stresses (WSS) were obtained from PIV measurement in a modified life-size silastic anastomosis model adapted from a conventional geometry by incorporating a smooth graft-artery transition. The results were compared with those predicted by a concurrent numerical model. The numerical method was then used to calculate cycle-averaged WSS (WSS(cyc)) and spatial wall shear stress gradient (SWSSG), two critical hemodynamic factors in the pathogenesis of intimal thickening (IT), to compare the conventional and modified geometries. Excellent qualitative agreement and satisfactory quantitative agreement with averaged normalized error in WSS between 0.8% and 8.9% were achieved between the PIV experiment and numerical model. Compared to the conventional geometry, the modified geometry produces a more uniform WSS(cyc) distribution eliminating both high and low WSS(cyc) around the toe, critical in avoiding IT. Peak SWSSG on the artery floor of the modified model is less than one-half that in the conventional case, and high SWSSG at the toe is eliminated. The validated numerical model is useful for modeling unsteady coronary anastomotic flows and elucidating the significance of geometry regulated hemodynamics. The results suggest the clinical relevance of constructing smooth graft-artery transition in distal coronary anastomoses to improve their hemodynamic performance.

Influence of suture technique and suture material selection on the mechanics of end-to-end and end-to-side anastomoses.

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Baumgartner, N; Dobrin, P B; Morasch, M; Dong, Q S; Mrkvicka, R

1996-05-01

Experiments were performed in dogs to evaluate the mechanics of 26 end-to-end and 42 end-to-side artery-vein graft anastomoses constructed with continuous polypropylene sutures (Surgilene; Davis & Geck, Division of American Cyanamid Co., Danbury, Conn.), continuous polybutester sutures (Novafil; Davis & Geck), and interrupted stitches with either suture material. After construction, the grafts and adjoining arteries were excised, mounted in vitro at in situ length, filled with a dilute barium sulfate suspension, and pressurized in 25 mm Hg steps up to 200 mm Hg. Radiographs were obtained at each pressure. The computed cross-sectional areas of the anastomoses were compared with those of the native arteries at corresponding pressures. Results showed that for the end-to-end anastomoses at 100 mm Hg the cross-sectional areas of the continuous Surgilene anastomoses were 70% of the native artery cross-sectional areas, the cross-sectional areas of the continuous Novafil anastomoses were 90% of the native artery cross-sectional areas, and the cross-sectional areas of the interrupted anastomoses were 107% of the native artery cross-sectional areas (p anastomoses demonstrated no differences in cross-sectional areas or compliance for the three suture techniques. This suggests that, unlike with end-to-end anastomoses, when constructing an end-to-side anastomosis in patients any of the three suture techniques may be acceptable.

A STUDY OF SURGICAL MANAGEMENT OF DISTAL FEMORAL FRACTURES BY DISTAL FEMORAL LOCKING COMPRESSION PLATE OSTEOSYNTHESIS

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Dema Rajaiah

2016-08-01

Full Text Available AIMS AND OBJECTIVES To study the fractures of distal end of femur and the mechanism of injury in distal end femur fractures, the advantages and disadvantages of open reduction and internal fixation of distal end femur fractures by distal femoral locking compression plate osteosynthesis and to analyse the outcome in terms of range of Knee motion, time to union, and limb shortening. RESULTS The mean age of patient is 44 years, 85% are males, road traffic accidents account for majority (80%, right side involved in 70%, Muller’s type C fracture is common, good range of movements is seen 90% of cases and union occurred in 95% in 5 months. The results were assessed using Neer’s score, seven (35% patients had excellent results, eight (40% patients had good results, four (20% patients had fair results and one (5% patient had poor result. CONCLUSION From our study, we conclude that DF-LCP is a safe and reliable implant and has shown excellent to satisfactory results in majority of intra-articular fractures (AO type C. Fixation with locking compression plate showed more effectiveness in severely osteoporotic bones, shorter operative stay, faster recovery, faster union rates and excellent functional outcome.

Correction of Hallux Valgus Interphalangeus With an Osteotomy of the Distal End of the Proximal Phalanx (Distal Akin Osteotomy).

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Vander Griend, Robert

2017-02-01

Operative correction of a symptomatic hallux valgus interphalangeus (HVI) deformity is often achieved with an osteotomy at the proximal end of the proximal phalanx (Akin osteotomy). However, the apex of the typical HVI deformity (center of rotation angle) is at the interphalangeal joint of the hallux. This study was done to evaluate the results of performing a medial closing wedge osteotomy at the distal end of the proximal phalanx. Thirty-three patients (33 feet) underwent an osteotomy at the distal end of the proximal phalanx for correction of HVI. All of the patients had other forefoot deformities which were corrected at the same time. Eight of these were revision procedures of prior forefoot operations. The length of follow-up was determined by the associated procedures with a minimum follow-up of 4 months. The preoperative hallux valgus interphalangeus angle averaged 16 degrees of valgus (range 7-32 degrees) and was corrected to an average of 2 degrees of valgus (range 5 degrees valgus to 5 degrees varus). All of the patients were satisfied with the postoperative appearance and function of the first toe. Because of simultaneous correction of numerous other forefoot problems, it was not possible to specifically isolate or evaluate the effects and benefits of this osteotomy using outcomes measures. There was one intraoperative complication resulting in a fracture extending into the adjacent IP joint. Correction of an HVI deformity can be achieved with an osteotomy at the distal end of the proximal phalanx. This was a safe technique with few complications and with good results in terms of both correction and patient satisfaction. Level IV, retrospective case series.

Yangian-type symmetries of non-planar leading singularities

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Frassek, Rouven [Department of Mathematical Sciences, Durham University,South Road, Durham DH1 3LE (United Kingdom); Meidinger, David [Institut für Mathematik und Institut für Physik, Humboldt-Universität zu Berlin,Zum Großen Windkanal 6, 12489 Berlin (Germany)

2016-05-18

We take up the study of integrable structures behind non-planar contributions to scattering amplitudes in N = 4 super Yang-Mills theory. Focusing on leading singularities, we derive the action of the Yangian generators on color-ordered subsets of the external states. Each subset corresponds to a single boundary of the non-planar on-shell diagram. While Yangian invariance is broken, we find that higher-level Yangian generators still annihilate the non-planar on-shell diagram. For a given diagram, the number of these generators is governed by the degree of non-planarity. Furthermore, we present additional identities involving integrable transfer matrices. In particular, for diagrams on a cylinder we obtain a conservation rule similar to the Yangian invariance condition of planar on-shell diagrams. To exemplify our results, we consider a five-point MHV on-shell function on a cylinder.

[Treatment of painful neuromas via end-to-side neurorraphy].

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Aszmann, O C; Moser, V; Frey, M

2010-08-01

Management of the painful neuroma has been subject to controversy since the earliest descriptions of this disabling problem. Today, treatment is limited to resection of the neuroma and implantation of the nerve in a muscle at a location where it is safe from irritation and trauma. This however is not attainable in many cases and it is our clinical experience, that nerves without a target remain a source of constant discomfort and pain. Recently we reported of the feasibility of neuroma prevention through end-to-side neurorraphy into adjacent sensory and/or motor nerves to provide a target for axons deprived of their endorgan. Here we report of our first clinical experience with this method in sixteen patients with longstanding upper and lower extremity neuromas. 16 patients were included in this study. All had neuromas of different sensory nerves of both the upper and lower extremity. 11 were of iatrogenic origin, 5 were caused by different traumas. 8 had previous attempts to surgically treat the neuroma. Finally, all were treated by end-to-side neurorraphy into adjacent nerves. Postoperatively quantitative sensorymotor testing was performed to evaluate possible changes of nerve function of the recipient nerves. Pain was evaluated by visual analogue score and changes in pain medication. In no patient a sensory or motor deficit or painful sensations were induced in the target area of the recipient nerve. Some had dysaesthesias for about 6 months, which finally subsided. All but 1 patient improved in their symptoms at a follow-up of more than 2 years. Previous experimental work and present clinical results suggest that axons of a severed peripheral nerve that are provided with a pathway and target through an end-to-side coaptation will either be pruned or establish some type of end-organ contact so that a neuroma can be prevented without inducing sensory or motor dysfunctions in the recipient nerve. Georg Thieme Verlag KG Stuttgart New York.

Mathematical modelling of ultrasonic testing of components with defects close to a non-planar surface

International Nuclear Information System (INIS)

Westlund, Jonathan; Bostroem, Anders

2011-05-01

Nondestructive testing with ultrasound is a standard procedure in the nuclear power industry. To develop and qualify the methods extensive experimental work with test blocks is usually required. This can be very time-consuming and costly and it also requires a good physical intuition of the situation. A reliable mathematical model of the testing situation can, therefore, be very valuable and cost-effective as it can reduce experimental work significantly. A good mathematical model enhances the physical intuition and is very useful for parametric studies, as a pedagogical tool, and for the qualification of procedures and personnel. The aim of the present report is to describe work that has been performed to model ultrasonic testing of components that contain a defect close to a nonplanar surface. For nuclear power applications this may be a crack or other defect on the inside of a pipe with a diameter change or connection. This is an extension of the computer program UTDefect, which previously only admits a planar back surface (which is often applicable also to pipes if the pipe diameter is large enough). The problems are investigated in both 2D and 3D, and in 2D both the simpler anti-plane (SH) and the in-plane (P-SV) problem are studied. The 2D investigations are primarily solved to get a 'feeling' for the solution procedure, the discretizations, etc. In all cases an integral equation approach with a Green's function in the kernel is taken. The nonplanar surface is treated by the boundary element method (BEM) where a division of the surface is made in small elements. The defects are mainly cracks, strip-like (in 2D) or rectangular (in 3D), and these are treated with more analytical methods. In 2D also more general defects are treated with the help of their transition (T) matrix. As in other parts of UTDefect the ultrasonic probes in transmission and reception are included in the model. In 3D normalization by a side drilled hole is possible. Some numerical results

49 CFR 231.4 - Fixed-end low-side gondola and low-side hopper cars.

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2010-10-01

... cars. 231.4 Section 231.4 Transportation Other Regulations Relating to Transportation (Continued... Fixed-end low-side gondola and low-side hopper cars. (Cars with sides 36 inches or less above the floor are low-side cars.) (a) Hand brakes—(1) Number. Same as specified for “Box and other house cars” (see...

True NOTES TME resection with splenic flexure release, high ligation of IMA, and side-to-end hand-sewn coloanal anastomosis.

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Marks, John H; Lopez-Acevedo, Nicolas; Krishnan, Barath; Johnson, Matthew N; Montenegro, Grace A; Marks, Gerald J

2016-10-01

Natural orifice transluminal endoscopic surgery (NOTES) represents the ultimate expression of minimally invasive surgery. We have developed and present here an initial feasibility and safety study of transanal total mesorectal excision (TME) with splenic flexure release, high ligation of the IMA and IMV, and side-to-end coloanal anastomosis with temporary diverting ileostomy for rectal cancer. A program of full NOTES TME resection with release of the splenic flexure, high ligation of the IMA/IMV, with side-to-end coloanal anastomosis was performed transanally from December 2013 to July 2014. Demographics, preoperative, perioperative, and postoperative data were prospectively obtained. Operative components were broken into TME, colonic mobilization, splenic flexure release, IMA/IMV transection, transanal extraction of specimen, and coloanal anastomosis for analysis of performance completion. There were 3 women and 1 man on whom we operated. Mean age was 56 (46-65). Mean BMI was 26 (23.8-30.2). The operation was completed entirely transanally in 2 patients. Transanal component completion of the operation was as follows: TME in 3/4; colonic mobilization in 4/4; splenic flexure release in 3/4; IMA/IMV transection in 3/4; transanal specimen extraction in 4/4; coloanal anastomosis in 4/4. Abdominal time for completion of component parts was: splenic flexure release 4:53 (min:s), IMA/IMV 19:43, completion of TME 13:41. Mean EBL was 194 cc (25-500). Aside from stoma site, there were no abdominal incisions. There were no mortalities. Mesorectum was intact in all 4 patients and with negative circumferential and distal margins. This experience supports the feasibility and safety of a true NOTES TME. The critical anatomic views demonstrated on video affirm the potential of this approach for distal rectal cancer. Colorectal surgery represents the most logical application for NOTES. While highly promising, a great deal of work remains to develop the technique and applicability

Bilateral en-masse distalization of maxillary posterior teeth with skeletal anchorage: a case report

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Saeed Noorollahian

Full Text Available ABSTRACT Objective: The aim of this study was to introduce a new method for bilateral distal movement of the entire maxillary posterior segment. Case report: A 17-year-old girl with Class I skeletal malocclusion (end-to-end molar relationships, deviated midline and space deficiency for left maxillary canine was referred for orthodontic treatment. She did not accept maxillary first premolars extraction. A modified Hyrax appliance (Dentaurum Ispringen, Germany was used for bilateral distalization of maxillary posterior teeth simultaneously. Expansion vector was set anteroposteriorly. Posterior legs of Hyrax were welded to first maxillary molar bands. All posterior teeth on each side consolidated with a segment of 0.017 × 0.025-in stainless steel wire from the buccal side. Anterior legs of Hyrax were bent into eyelet form and attached to the anterior palate with two mini-screws (2 × 10 mm (Jeil Medical Corporation Seoul, South Korea. Hyrax opening rate was 0.8 mm per month. Lateral cephalometric radiographs were used to evaluate the extent of distal movement. 3.5-mm distalization of posterior maxillary teeth was achieved in five months. Results: A nearly bodily distal movement without anchorage loss was obtained. Conclusion: The mini-screw-supported modified Hyrax appliance was found to be helpful for achieving en-masse distal movement of maxillary posterior teeth.

An innovative technique to distalize maxillary molar using microimplant supported rapid molar distalizer

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Meenu Goel

2013-01-01

Full Text Available Introduction: In recent years, enhancements in implants have made their use possible as a mode of absolute anchorage in orthodontic patients. In this paper, the authors have introduced an innovative technique to unilaterally distalize the upper left 1 st molar to obtain an ideal Class I molar relationship from a Class II existing molar relationship with an indigenous designed distalizer. Clinical Innovation: For effective unilateral diatalization of molar, a novel cantilever sliding jig assembly was utilized with coil spring supported by a buccally placed single micro implant. The results showed 3 mm of bodily distalization with 1 mm of intrusion and 2° of distal tipping of upper left 1 st molar in 1.5 months. Discussion: This appliance is relatively easy to insert, well-tolerated, and requires minimal patient cooperation compared to other present techniques of molar distalization. Moreover, it is particularly useful in cases that are Class II on one side and Class I on the other, with a minor midline discrepancy and nominal overjet. Patient acceptance level was reported to be within patients physiological and comfort limits.

Circular myotomy as an aid to resection and end-to-end anastomosis of the esophagus.

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Attum, A A; Hankins, J R; Ngangana, J; McLaughlin, J S

1979-08-01

Segments ranging from 40 to 70% of the thoracic esophagus were resected in 80 mongrel dogs. End-to-end anastomosis was effected after circular myotomy either proximal or distal, or both proximal and distal, to the anastomosis. Among dogs undergoing resection of 60% of the esophagus, distal myotomy enabled 6 of 8 animals to survive, and combined proximal and distal myotomy permitted 8 of 10 to survive. Cineesophagography was performed in a majority of the 50 surviving animals and showed no appreciable delay of peristalsis at the myotomy sites. When these sites were examined at postmortem examination up to 13 months after operation, 1 dog showed a small diverticulum but none showed dilatation or stricture. It is concluded that circular myotomy holds real promise as a means of extending the clinical application of esophageal resection with end-to-end anastomosis.

Giant cells tumor of radius distal end and bone reconstruction

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La O Duran, Eldis; Monzon Fernandez, Abel Nicolas; Sanz Delgado, Licett

2009-01-01

This is the case of a black women aged 40 presenting with a tumor of distal end of right radium with histological diagnosis of low-grade malignancy giant cells tumor and proposal of limb amputation. A conservative surgery was performed with a two-steps total exeresis of lesion sparing the oncologic margin. A fibular free-graft was used and wrist arthrodesis and internal fixation of graft using AO system. There was a good graft consolidation and an active incorporation of patient to social activities. The diagnosis, treatment, follow-up, rehabilitation and case prognosis are exposed

Small Angle Neutron Scattering (sans) Studies on "SIDE-END FIXED" and "SIDE-ON FIXED" Liquid Crystal Polymers

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Hardouin, F.; Noirez, L.; Keller, P.; Leroux, N.; Cotton, J. P.

The following sections are included: * Introduction * Experimental * Results and discussion * Determination of the backbone conformation in the nematic and smectic A phases of "side-end fixed" L.C. polymethacrylates (PMA) or polyacrylates (PA) * Determination of the global and backbone conformation in the nematic and smectic A phases of "side-end fixed" L.C. polysiloxanes (PMS) * Determination of the backbone conformation in the unique nematic phase (without smectic A phase) or in the reentrant nematic phase (below smectic A phase) of "side-end fixed" L.C. polyacrylates (PA) * Determination of the global conformation in the nematic phase of "side-on fixed" L.C. polysiloxanes (PMS) * Determination of the global conformation in the nematic phase of "diluted side-on fixed" L.C. copolysiloxanes * Determination of the backbone conformation in the nematic phase of "side-on fixed" L.C. polyacrylates * Conclusions * References

Ipsilateral simultaneous fracture of the trochlea involving the lateral end clavicle and distal end radius: a rare combination and a unique mechanism of injury

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Gupta RK

2014-07-01

Full Text Available 【Abstract】Isolated trochlea fracture in adults is a rare surgical entity as compared to its capitellar counterpart. It has been only mentioned sporadically in the literature as case reports. Fracture of the trochlea is accompanied by other elbow injuries like elbow dislocation, capitellum fracture, ulnar fracture and extraarticular condylar fracture. Here we report a unique case of isolated displaced trochlea fracture associated with fractures of the lateral end clavicle and the distal end radius. We propose a unique mechanism for this rare combination of injuries: typical triad of injury, i.e. fracture of the distal end radius with trochlea and fracture of the lateral end of the clavicle. Nonoperative treatment is recommended for undisplaced humeral trochlea fractures; but for displaced ones, anatomical reduction and internal fixation are essential to maintain the congruous trochleacoronoid articulation and hence to maintain the intrinsic stability of the elbow. Key words: Isolated trochlea fracture; Clavicle; Radius fractures

Geometric Three-Dimensional End-to-Side Microvascular Anastomosis: A Simple and Reproducible Technique.

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Ooi, Adrian S H; Butz, Daniel R; Fisher, Sean M; Collier, Zachary J; Gottlieb, Lawrence J

2018-05-01

 End-to-side (ETS) anastomoses are useful when preservation of distal vascularity is critical. The ideal ETS microanastomosis should maintain a wide aperture and have a smooth take-off point to minimize turbulence, vessel spasm, and thrombogenicity of the suture line. We have developed a unique, dependable, and reproducible geometric technique for ETS anastomoses, and analyze its efficacy in our series of patients.  The geometric ETS technique involves creating a three-dimensional (3D) diamond-shaped defect on the recipient vessel wall, followed by a slit incision of the donor vessel to create a "spatula" fitting this defect. This technique removes sutures from the point of most turbulent blood flow while holding the recipient vessel open with a patch vesselplasty effect. We perform a retrospective review of a single surgeon's experience using this technique.  The geometric 3D ETS technique was used in 87 free flaps with a total of 102 ETS anastomoses in a wide range of cases including head and neck, trunk and genitourinary, and extremity reconstruction. Overall, free flap success rates were 98%.  The geometric 3D ETS technique creates a wide anastomosis, minimizes turbulence-inducing thrombogenicity, and mechanically holds the recipient vessel open. It is reliable and reproducible, and when performed properly has been shown to have high rates of success in a large group of free tissue transfer patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A STUDY ON FRACTURE FIXATION OF DISTAL END OF RADIUS BY PERCUTANEOUS PINNING

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Kiran Kumar L

2016-07-01

within the normal functional range (minimum 30°, 24 (96.66% had pronation within the normal functional range (minimum 50°, 26 (86.66% had supination within the normal functional range (minimum 50°, 20 (66.66% had radial deviation within the normal functional range (minimum 15°, and all patients had ulnar deviation within the normal functional range (minimum 15°. 29 (96.66% patients had grip strength more than 60% compared to the opposite side. 1(3.33% had significant loss of grip strength (>60% compared to the opposite side. 7 patients had pain in the distal radioulnar joint. None patients had stiffness of the wrist. 1 patient (3.33% had a superficial wound infection and two (6.66% patients had pin tract infection. None of the patients had median nerve injury or arthritic changes as described by Knirk and Jupiter. There were no intraoperative complications. The study had 16.66% excellent, 80% good, 3.33% fair, and 0% poor result. CONCLUSIONS Kirschner wire fixation is a simple and reliable and effective method for maintenance of reduction in distal radius fractures especially in young adults. Unstable distal radius fractures, which may have a tendency to redisplace, plaster, pinning is a relatively effective method of fixation for reducible extra-articular fractures, simple intra-articular fractures that are nondisplaced, and in patients with good bone quality for restoration of preinjury anatomical alignment and there by the functional outcome in the management of distal radius fractures and allows early rehabilitation without jeopardising the fracture alignment. The functional end results have a direct relationship with the anatomical end results particularly in young adults though sometimes good functional results can be obtained even when anatomical results are poor due to innate mobility of wrist joint in elderly people. Pinning demonstrates good reproducible outcomes with minimal risk in appropriately selected fracture patterns. This technique can provide

The influence of distal-end heat treatment on deflection of nickel-titanium archwire.

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Silva, Marcelo Faria da; Pinzan-Vercelino, Célia Regina Maia; Gurgel, Júlio de Araújo

2016-01-01

The aim of this in vitro study was to evaluate the deflection-force behavior of nickel-titanium (NiTi) orthodontic wires adjacent to the portion submitted to heat treatment. A total of 106 segments of NiTi wires (0.019 x 0.025-in) and heat-activated NiTi wires (0.016 x 0.022-in) from four commercial brands were tested. The segments were obtained from 80 archwires. For the experimental group, the distal portion of each segmented archwire was subjected to heat treatment (n = 40), while the other distal portion of the same archwire was used as a heating-free control group (n = 40). Deflection tests were performed in a temperature-controlled universal testing machine. Unpaired Student's t-tests were applied to determine if there were differences between the experimental and control groups for each commercial brand and size of wire. Statistical significance was set at p wire. Heat treatment applied to the distal ends of rectangular NiTi archwires does not permanently change the elastic properties of the adjacent portions.

The anterior temporal artery: an underutilized but robust donor for revascularization of the distal middle cerebral artery.

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Tayebi Meybodi, Ali; Lawton, Michael T; Griswold, Dylan; Mokhtari, Pooneh; Payman, Andre; Benet, Arnau

2017-10-01

OBJECTIVE The anterior temporal artery (ATA) supplies an area of the brain that, if sacrificed, does not cause a noticeable loss of function. Therefore, the ATA may be used as a donor in intracranial-intracranial (IC-IC) bypass procedures. The capacities of the ATA as a donor have not been studied previously. In this study, the authors assessed the feasibility of using the ATA as a donor for revascularization of different segments of the distal middle cerebral artery (MCA). METHODS The ATA was studied in 15 cadaveric specimens (8 heads, excluding 1 side). First, the cisternal segment of the artery was untethered from arachnoid adhesions and small branches feeding the anterior temporal lobe and insular cortex, to evaluate its capacity for a side-to-side bypass to insular, opercular, and cortical segments of the MCA. Any branch entering the anterior perforated substance was preserved. Then, the ATA was cut at the opercular-cortical junction and the capacity for an end-to-side bypass was assessed. RESULTS From a total of 17 ATAs, 4 (23.5%) arose as an early MCA branch. The anterior insular zone and the frontal parasylvian cortical arteries were the best targets (in terms of mobility and caliber match) for a side-to-side bypass. Most of the insula was accessible for end-to-side bypass, but anterior zones of the insula were more accessible than posterior zones. End-to-side bypass was feasible for most recipient cortical arteries along the opercula, except for posterior temporal and parietal regions. Early ATAs reached significantly farther on the insular MCA recipients than non-early ATAs for both side-to-side and end-to-side bypasses. CONCLUSIONS The ATA is a robust arterial donor for IC-IC bypass procedures, including side-to-side and end-to-side techniques. The evidence provided in this work supports the use of the ATA as a donor for distal MCA revascularization in well-selected patients.

Stapled side-to-side anastomosis might be better than handsewn end-to-end anastomosis in ileocolic resection for Crohn's disease: a meta-analysis.

Science.gov (United States)

He, Xiaosheng; Chen, Zexian; Huang, Juanni; Lian, Lei; Rouniyar, Santosh; Wu, Xiaojian; Lan, Ping

2014-07-01

Ileocolic anastomosis is an essential step in the treatment to restore continuity of the gastrointestinal tract following ileocolic resection in patients with Crohn's disease (CD). However, the association between anastomotic type and surgical outcome is controversial. The aim of this meta-analysis is to compare surgical outcomes between stapled side-to-side anastomosis (SSSA) and handsewn end-to-end anastomosis (HEEA) after ileocolic resection in patients with CD. Studies comparing SSSA with HEEA after ileocolic resection in patients with CD were identified in PubMed and EMBASE. Outcomes such as complication, recurrence, and re-operation were evaluated. Eight studies (three randomized controlled trials, one prospective non-randomized trial, and four non-randomized retrospective trials) comparing SSSA (396 cases) and HEEA (425 cases) were included. As compared with HEEA, SSSA was superior in terms of overall postoperative complications [odds ratio (OR), 0.54; 95 % confidence interval (CI) 0.32-0.93], anastomotic leak (OR 0.45; 95 % CI 0.20-1.00), recurrence (OR 0.20; 95 % CI 0.07-0.55), and re-operation for recurrence (OR 0.18; 95 % CI 0.07-0.45). Postoperative hospital stay, mortality, and complications other than anastomotic leak were comparable. Based on the results of our meta-analysis, SSSA would appear to be the preferred procedure after ileocolic resection for CD, with reduced overall postoperative complications, especially anastomotic leak, and a decreased recurrence and re-operation rate.

A gastrocnemius heterotopical transplant model with end-to-side neurorraphy

OpenAIRE

Jaeger, Marcos Ricardo de Oliveira; Braga Silva, Jefferson [UNIFESP; Bain, James; Ely, Pedro Bins; Pires, Jefferson André; Ferreira, Lydia Masako [UNIFESP

2014-01-01

PURPOSE:To present an animal model to assess the effects of end-to-side innervation in the heterotopically transplanted model with reduced chances of neural contamination.METHODS: The medial portion of the gastrocnemius muscle in wistar male rats was isolated and its pedicle dissected and performed a flap in the abdominal portion. To prevent neural contamination in the abdominal region, the muscle was wrapped with a Goretex(r) sheet. The specimens were divided into 2 groups (G). In G1 was per...

Scattering Of Nonplanar Acoustic Waves

Science.gov (United States)

Gillman, Judith M.; Farassat, F.; Myers, M. K.

1995-01-01

Report presents theoretical study of scattering of nonplanar acoustic waves by rigid bodies. Study performed as part of effort to develop means of predicting scattering, from aircraft fuselages, of noise made by rotating blades. Basic approach was to model acoustic scattering by use of boundary integral equation to solve equation by the Galerkin method.

Nonplanar spiral states of the t-J model with classical spins

International Nuclear Information System (INIS)

Hamada, M.; Shimahara, H.; Mori, H.

1995-01-01

The spiral state in the two-dimensional t-J model is studied by numerical diagonalization of an effective Hamiltonian. We examine all possibilities of the spiral spin states including the nonplanar states. It is found that nonplanar spiral states occur, but the deviations from the planar spiral state in the nonplanar spiral states are small for small hole concentrations where our effective Hamiltonian is valid. The modulation of the spin configuration increases continuously from the antiferromagnetic order as the hole concentration increases, and discontinuously changes at a critical hole concentration. Then the state undergoes the first-order phase transition either to the (π,0) phase or to the ferromagnetic phase, depending on the value of J/t

49 CFR 231.2 - Hopper cars and high-side gondolas with fixed ends.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Hopper cars and high-side gondolas with fixed ends... cars and high-side gondolas with fixed ends. (Cars with sides more than 36 inches above the floor are high-side cars.) (a) Hand brakes—(1) Number. Same as specified for “Box and other house cars” (see...

The influence of distal-end heat treatment on deflection of nickel-titanium archwire

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Marcelo Faria da Silva

2016-02-01

Full Text Available Objective: The aim of this in vitro study was to evaluate the deflection-force behavior of nickel-titanium (NiTi orthodontic wires adjacent to the portion submitted to heat treatment. Material and Methods: A total of 106 segments of NiTi wires (0.019 x 0.025-in and heat-activated NiTi wires (0.016 x 0.022-in from four commercial brands were tested. The segments were obtained from 80 archwires. For the experimental group, the distal portion of each segmented archwire was subjected to heat treatment (n = 40, while the other distal portion of the same archwire was used as a heating-free control group (n = 40. Deflection tests were performed in a temperature-controlled universal testing machine. Unpaired Student's t-tests were applied to determine if there were differences between the experimental and control groups for each commercial brand and size of wire. Statistical significance was set at p < 0.05. Results: There were no statistically significant differences between the tested groups with the same size and brand of wire. Conclusions: Heat treatment applied to the distal ends of rectangular NiTi archwires does not permanently change the elastic properties of the adjacent portions.

Conformal, planarizing and bridging AZ5214-E layers deposited by a 'draping' technique on non-planar III V substrates

Science.gov (United States)

Eliás, P.; Strichovanec, P.; Kostic, I.; Novák, J.

2006-12-01

A draping technique was tested for the deposition of positive-tone AZ5214-E photo-resist layers on non-planar (1 0 0)-oriented III-V substrates, which had a variety of three-dimensional (3D) topographies micromachined in them that consisted, e.g., of mesa ridges confined to side facets with variable tilt, inverted pyramidal holes and stubs confined to perpendicular side facets. All objects were sharp-edged. In each draping experiment, an AZ5214-E sheet was (1) formed floating on the water surface, (2) lowered onto a non-planar substrate and (3) draped over it during drying to form either self-sustained, or conformal, or planarizing layers over the non-planar substrates. The draping process is based on the depression of the glass transition temperature Tg of AZ5214-E material induced by penetrant water molecules that interact with AZ5214-E. During the process, the molecules are initially trapped under an AZ5214-E sheet and then transported out through the sheet via permeation. The water-AZ5214-E interaction modifies the stiffness κ of the sheet. The magnitude of the effect depends on temperature T and on partial water vapour pressure difference p(T, P, κ): the net effect is that Tg = f(C(T, P), p(T, P, κ)) is lowered as the concentration C of water increases with T and p, where P is the permeability of the sheet. The interaction depressed the Tg of the sheets as low as or lower than 53 °C for 6 µm thick sheets. At room temperature T Tg, the sheet becomes rubbery and mouldable by adhesion and capillary forces. As a result, it can either contour or planarize the topography depending on its geometry and thickness of the sheet.

Side-to-end vs. straight stapled colorectal anastomosis after low anterior resection: results of randomized clinical trial.

Science.gov (United States)

Rybakov, E G; Pikunov, D Yu; Fomenko, O Yu; Chernyshov, S V; Shelygin, Yu A

2016-08-01

The aim of this study is to compare surgical, functional, physiologic outcomes and QOL after low anterior resection (LAR) with andside-to-end or straight colorectal anastomosis. Between 2012 and 2015, 86 patients with mid and low rectal tumors were enrolled into randomized trial. Wexner score, number of defecations, use of antidiarrheal medicine or laxatives, enemas, pads, episodes of nocturnal incontinence, and urgency were recorded. The Fecal Incontinence Quality of Life (FIQL) scale was used for assessment of QOL. Anal manometry and volumetric examination were performed. Six patients were excluded from the study. There was no mortality. The morbidity rate was 6 (14.6 %) for side-to-end vs. 8 (20.0 %) for straight anastomosis (p = 0.57). The median Wexner score was 5 vs. 6 (p = 0.033), 4 vs. 5 (p = 0.006), and 2 vs. 3 (p = 0.1) at 1, 3, and 6 months after stoma reversal, respectively. Side-to-end anastomosis resulted in a fewer mean numbers of bowel movements per day at the same check points of follow-up: 5.8 ± 0.14 vs. 6.4 ± 0.15 (p = 0.006), 3.7 ± 0.1 vs. 4.2 ± 0.1 (p = 0.003), and 2.5 ± 0.1 vs. 3.0 ± 0.10 (p = 0.0002), correspondingly. Maximal tolerated volume was higher for side-to-end anastomosis at 3 and 6 months of follow-up: 152.0 vs. 137.8 cm(3) (p = 0.002) and 180.5 vs. 167.0 cm(3) (p = 0.006), respectively. Better FIQL score was found at 1 and 3 months in the side-to-end group. Better functional outcomes and QOL were observed in a short period after stoma closure, but at 6 months of follow-up, the only benefit of side-to-end anastomosis was a lower number of bowel movements.

Short-term observations of the regenerative potential of injured proximal sensory nerves crossed with distal motor nerves

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Xiu-xiu Zhang

2017-01-01

Full Text Available Motor nerves and sensory nerves conduct signals in different directions and function in different ways. In the surgical treatment of peripheral nerve injuries, the best prognosis is obtained by keeping the motor and sensory nerves separated and repairing the nerves using the suture method. However, the clinical consequences of connections between sensory and motor nerves currently remain unknown. In this study, we analyzed the anatomical structure of the rat femoral nerve, and observed the motor and sensory branches of the femoral nerve in the quadriceps femoris. After ligation of the nerves, the proximal end of the sensory nerve was connected with the distal end of the motor nerve, followed by observation of the changes in the newly-formed regenerated nerve fibers. Acetylcholinesterase staining was used to distinguish between the myelinated and unmyelinated motor and sensory nerves. Denervated muscle and newly formed nerves were compared in terms of morphology, electrophysiology and histochemistry. At 8 weeks after connection, no motor nerve fibers were observed on either side of the nerve conduit and the number of nerve fibers increased at the proximal end. The proportion of newly-formed motor and sensory fibers was different on both sides of the conduit. The area occupied by autonomic nerves in the proximal regenerative nerve was limited, but no distinct myelin sheath was visible in the distal nerve. These results confirm that sensory and motor nerves cannot be effectively connected. Moreover, the change of target organ at the distal end affects the type of nerves at the proximal end.

Chaotic non-planar vibrations of the thin elastica. Part I: Experimental observation of planar instability

Science.gov (United States)

Cusumano, J. P.; Moon, F. C.

1995-01-01

In this two-part paper, the results of an investigation into the non-linear dynamics of a flexible cantilevered rod (the elastica) with a thin rectangular cross-section are presented. An experimental examination of the dynamics of the elastica over a broad parameter range forms the core of Part I. In Part II, the experimental work is related to a theoretical study of the mechanics of the elastica, and the study of a two-degree-of-freedom model obtained by modal projection. The experimental system used in this investigation is a rod with clamped-free boundary conditions, forced by sinusoidally displacing the clamped end. Planar periodic motions of the driven elastica are shown to lose stability at distinct resonant wedges, and the resulting motions are shown in general to be non-planar, chaotic, bending-torsion oscillations. Non-planar motions in all resonances exhibit energy cascading and dynamic two-well phenomena, and a family of asymmetric, bending-torsion non-linear modes is discovered. Correlation dimension calculations are used to estimate the number of active degrees of freedom in the system.

Studying psychosocial adaptation to end-stage renal disease: the proximal-distal model of health-related outcomes as a base model.

Science.gov (United States)

Chan, Ramony; Brooks, Robert; Erlich, Jonathan; Gallagher, Martin; Snelling, Paul; Chow, Josephine; Suranyi, Michael

2011-05-01

Studying psychosocial adaptation in end-stage renal disease (ESRD) is increasingly important, as it may explain the variability in health outcomes unaccounted for by clinical factors. The Brenner et al. proximal-distal model of health-related outcomes provides a theoretical foundation for understanding psychosocial adaptation and integrating health outcomes, clinical, and psychosocial factors (Brenner MH, Curbow B, Legro MW. The proximal-distal continuum of multiple health outcome measures: the case of cataract surgery. Med Care. 1995;33(4 Suppl):AS236-44). This study aims to empirically validate the proximal-distal model in the dialysis population and examine the impact of psychosocial factors on the model. A cross-sectional observational study was conducted with a sample of long-term dialysis patients (n=201). Eleven factors: quality of life (QoL), depression, positive affect, comorbidity, symptoms, physical functioning, disease accommodation, loss, self-efficacy, illness acceptance, and social support were measured by standardized psychometric scales. A three-month average of hemoglobin was used. Latent composite structural equation modeling was used to examine the models. The proximal-distal model with slight modification was supported by fit statistics [χ(2)=16.04, df=13, P=.25, root mean square error of approximation (RMSEA)=0.024], indicating that the impact of clinical factors on QoL is mediated through a range of functional and psychological factors, except for hemoglobin which impacts directly on QoL. The model with additional psychosocial factors was also supported by fit statistics (χ(2)=43.59, df=41, P=.36, RMSEA=0.018). These additional factors mainly impact on symptom status, psychological states, and QoL components of the model. The present study supported the proximal-distal model in the dialysis population and demonstrated the considerable impact of psychosocial factors on the model. The proximal-distal model plus psychosocial factors as a

Arthroplasty of the distal ulna distal in managing patients with post-traumatic disorders of the distal radioulnar joint: measurement of quality of life

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Marcio Aurélio Aita

2015-12-01

Full Text Available ABSTRACT OBJECTIVE: To measure the quality of life and clinical-functional results from patients diagnosed with osteoarthrosis of the distal radioulnar joint who underwent surgical treatment using the technique of total arthroplasty of the ulna, with a total or partial Ascension(r prosthesis of the distal ulna. METHODS: Ten patients were evaluated after 12 months of follow-up subsequent to total or partial arthroplasty of the distal ulna. All of them presented post-traumatic osteoarthrosis and/or chronic symptomatic instability of the distal radioulnar joint. The study was prospective. Seven patients had previously undergone wrist procedures (two cases with Darrach, three with Sauvé-Kapandji and two with ligament reconstruction of the fibrocartilage complex and three presented fractures of the distal ulna that evolved with pain, instability and osteoarthrosis of the distal radioulnar joint. The following were assessed: quality of life (DASH scale; percentage degree of palm grip strength (kgf and pronosupination range of motion in relation to the unaffected side; pain (VAS; return to work; subjective evaluation of radiography; and complications. RESULTS: The patients presented a mean range of motion of 174.5° (normal side: 180°. Quality of life was analyzed by applying the DASH questionnaire and the mean value found was 5.9. The mean pain score using the VAS was 2.3. The mean degree of palm grip strength (kgf was 50.7, which represented 90.7% of the strength on the unaffected side. The complication rate was 10%: this patient presented slight dorsal instability of the ulna and persistent pain, and did not return to work. This patient is still being followed up in the outpatient clinic and occupational therapy sector, with little improvement. He does not wish to undergo a new procedure. The mean length of follow-up was 16.8 months, with a minimum of 10 and maximum of 36 months. CONCLUSION: This concept is subject to the test of time

Multi-projector auto-calibration and placement optimization for non-planar surfaces

Science.gov (United States)

Li, Dong; Xie, Jinghui; Zhao, Lu; Zhou, Lijing; Weng, Dongdong

2015-10-01

Non-planar projection has been widely applied in virtual reality and digital entertainment and exhibitions because of its flexible layout and immersive display effects. Compared with planar projection, a non-planar projection is more difficult to achieve because projector calibration and image distortion correction are difficult processes. This paper uses a cylindrical screen as an example to present a new method for automatically calibrating a multi-projector system in a non-planar environment without using 3D reconstruction. This method corrects the geometric calibration error caused by the screen's manufactured imperfections, such as an undulating surface or a slant in the vertical plane. In addition, based on actual projection demand, this paper presents the overall performance evaluation criteria for the multi-projector system. According to these criteria, we determined the optimal placement for the projectors. This method also extends to surfaces that can be parameterized, such as spheres, ellipsoids, and paraboloids, and demonstrates a broad applicability.

A FUNCTIONAL EVALUATION STUDY OF DISTAL FEMORAL FRACTURES FIXED WITH DISTAL FEMORAL LOCKING PLATE

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Manikumar C. J

2017-04-01

Full Text Available BACKGROUND Fractures of the distal femur present considerable challenges in management. Older patients especially women sustain fractures due to osteoporosis. Supracondylar fractures of femur have a bimodal distribution. They account for 6% of all femur fractures and 31% if hip fractures were excluded. Nearly, 50% of distal femur intra-articular fractures are open fractures. Before 1970, most supracondylar fractures were treated nonoperatively; however, difficulties were often encountered including persistent angulatory deformity, knee joint incongruity, loss of knee motion and delayed mobilisation. The trend of open reduction and internal fixation has become evident in recent years with good results being obtained with AO blade plate, dynamic condylar screw, intramedullary supracondylar nail and locking compression plate. Elderly patients and osteoporosis pose difficulty in treating intra-articular fractures of the lower end of femur. Loss of stable fixation is of great concern in these cases. Hence, locking compression plate use has an advantage in these patients. MATERIALS AND METHODS In this study, 20 patients with closed fracture of distal femur were studied. All the cases were treated at the Department of Orthopaedics, Rangaraya Medical College/Government General Hospital, Kakinada, Andhra Pradesh, between November 2013 and November 2015. The method used for fracture fixation was open reduction and internal fixation with distal femoral locking plate. The duration of follow up ranged from 3 months to 24 months. All the fractures in this series were posttraumatic. The patients were functionally evaluated with Neer’s scoring system. 1 RESULTS Twenty distal femoral fractures were treated with distal femoral locking plates. 15 patients were males and 5 patients were females. The median age was 47 years ranging from 28-70 years. 16 of the fractures were caused by road traffic accidents and 2 were due to fall, 2 were due to assault. 12 patients

From large N nonplanar anomalous dimensions to open spring theory

Energy Technology Data Exchange (ETDEWEB)

Mello Koch, Robert de, E-mail: robert@neo.phys.wits.ac.za [National Institute for Theoretical Physics, Department of Physics and Centre for Theoretical Physics University of Witwatersrand, Wits, 2050 (South Africa); Kemp, Garreth, E-mail: Garreth.Kemp@students.wits.ac.za [National Institute for Theoretical Physics, Department of Physics and Centre for Theoretical Physics University of Witwatersrand, Wits, 2050 (South Africa); Smith, Stephanie, E-mail: Stephanie.Smith@students.wits.ac.za [National Institute for Theoretical Physics, Department of Physics and Centre for Theoretical Physics University of Witwatersrand, Wits, 2050 (South Africa)

2012-05-23

In this Letter we compute the nonplanar one-loop anomalous dimension of restricted Schur polynomials that have a bare dimension of O(N). This is achieved by mapping the restricted Schur polynomials into states of a specific U(p) irreducible representation. In this way the dilatation operator is mapped into a u(p) valued operator and, as a result, can easily be diagonalized. The resulting spectrum is reproduced by a model of springs between masses.

Similar Outcome After Colonic Pouch and Side-to-End Anastomosis in Low Anterior Resection for Rectal Cancer

Science.gov (United States)

Machado, Mikael; Nygren, Jonas; Goldman, Sven; Ljungqvist, Olle

2003-01-01

Objectives To compare a colonic J-pouch or a side-to-end anastomosis after low-anterior resection for rectal cancer with regard to functional and surgical outcome. Summary Background Data: A complication after restorative rectal surgery with a straight anastomosis is low- anterior resection syndrome with a postoperatively deteriorated anorectal function. The colonic J-reservoir is sometimes used with the purpose of reducing these symptoms. An alternative method is to use a simple side-to-end anastomosis. Methods: One-hundred patients with rectal cancer undergoing total mesorectal excision and colo-anal anastomosis were randomized to receive either a colonic pouch or a side-to-end anastomosis using the descending colon. Surgical results and complications were recorded. Patients were followed with a functional evaluation at 6 and 12 months postoperatively. Results: Fifty patients were randomized to each group. Patient characteristics in both groups were very similar regarding age, gender, tumor level, and Dukes’ stages. A large proportion of the patients received short-term preoperative radiotherapy (78%). There was no significant difference in surgical outcome between the 2 techniques with respect to anastomotic height (4 cm), perioperative blood loss (500 ml), hospital stay (11 days), postoperative complications, reoperations or pelvic sepsis rates. Comparing functional results in the 2 study groups, only the ability to evacuate the bowel in <15 minutes at 6 months reached a significant difference in favor of the pouch procedure. Conclusions: The data from this study show that either a colonic J-pouch or a side-to-end anastomosis performed on the descending colon in low-anterior resection with total mesorectal excision are methods that can be used with similar expected functional and surgical results. PMID:12894014

Non-planar corrections to the Pomeron and reggeons in the dual unitarity scheme

International Nuclear Information System (INIS)

Uschersohn, J.

1976-03-01

A special class of non-planar diagrams is studied, those in which the produced clusters are crossed. Insertion of these diagrams in the reggeon propagators accounts for exchange degeneracy breaking. The even signature reggeons get their intercept promoted to a larger value, while the odd signature ones are left unchanged. (author)

49 CFR 231.8 - Tank cars without side sills and tank cars with short side sills and end platforms.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Tank cars without side sills and tank cars with... APPLIANCE STANDARDS § 231.8 Tank cars without side sills and tank cars with short side sills and end platforms. (a) Hand brakes—(1) Number. Same as specified for “Box and other house cars” (see § 231.1(a)(1...

Ambient mass spectrometry: From the planar to the non-planar surface analysis

Czech Academy of Sciences Publication Activity Database

Rejšek, Jan; Vrkoslav, Vladimír; Cvačka, Josef

2017-01-01

Roč. 15, č. 1 (2017), s. 31 ISSN 2336-7202. [Mezioborové setkání mladých biologů, biochemiků a chemiků /17./. 30.05.2017-01.06.2017, Milovy] Institutional support: RVO:61388963 Keywords : ambient mass spectrometry * thin layer chromatography * non-planar surface analysis Subject RIV: CB - Analytical Chemistry, Separation

Nonplanar tertiary amides in rigid chiral tricyclic dilactams. Peptide group distortions and vibrational optical activity.

Science.gov (United States)

Pazderková, Markéta; Profant, Václav; Hodačová, Jana; Sebestík, Jaroslav; Pazderka, Tomáš; Novotná, Pavlína; Urbanová, Marie; Safařík, Martin; Buděšínský, Miloš; Tichý, Miloš; Bednárová, Lucie; Baumruk, Vladimír; Maloň, Petr

2013-08-22

We investigate amide nonplanarity in vibrational optical activity (VOA) spectra of tricyclic spirodilactams 5,8-diazatricyclo[6,3,0,0(1,5)]undecan-4,9-dione (I) and its 6,6',7,7'-tetradeuterio derivative (II). These rigid molecules constrain amide groups to nonplanar geometries with twisted pyramidal arrangements of bonds to amide nitrogen atoms. We have collected a full range vibrational circular dichroism (VCD) and Raman optical activity (ROA) spectra including signals of C-H and C-D stretching vibrations. We report normal-mode analysis and a comparison of calculated to experimental VCD and ROA. The data provide band-to-band assignment and offer a possibility to evaluate roles of constrained nonplanar tertiary amide groups and rigid chiral skeletons. Nonplanarity shows as single-signed VCD and ROA amide I signals, prevailing the couplets expected to arise from the amide-amide interaction. Amide-amide coupling dominates amide II (mainly C'-N stretching, modified in tertiary amides by the absence of a N-H bond) transitions (strong couplet in VCD, no significant ROA) probably due to the close proximity of amide nitrogen atoms. At lower wavenumbers, ROA spectra exhibit another likely manifestation of amide nonplanarity, showing signals of amide V (δ(oop)(N-C) at ~570 cm(-1)) and amide VI (δ(oop)(C'═O) at ~700 cm(-1) and ~650 cm(-1)) vibrations.

Percutaneous sclerotherapy of the internal spermatic vein for varicocele through an open ended guide wire

Energy Technology Data Exchange (ETDEWEB)

Wilms, G.; Oyen, R.; Casselman, J.; Baert, A.L.

1987-08-01

Percutaneous sclerotherapy of the internal spermatic vein through an open ended guide wire was performed in 50 patients with left sided variocele. The procedure was successful in 47 patients, without major complications. Percutaneous sclerotherapy through an open ended guide wire offers the advantage of very distal and superselective catheterization with complete embolization of the internal spermatic vein, its side branches and parallel collateral channels. Further follow-up hopefully will confirm the reduction of recurrence rate in our patients.

Silica-based microstructures on nonplanar substrates by femtosecond laser-induced nonlinear lithography

International Nuclear Information System (INIS)

Mizoshiri, M; Nishiyama, H; Hirata, Y; Nishii, J

2009-01-01

We developed a technique for the formation of nonplanar surfaces of inorganic optical materials by a combined process of nonlinear lithography and plasma etching. This technique can be used to fabricate structures even on non-flat substrates, which is difficult using current semiconductor technology. Three-dimensional patterns were written directly inside a positive-tone photoresist using femtosecond laser-induced nonlinear optical absorption. The patterns were then transferred to underlying nonplanar substrates by the ion beam etching technique. For the lithographic process, we obtained a minimum feature size of 900 nm, which is below the diffraction limit. We demonstrated the fabrication of silica-based hybrid diffractive-refractive lenses. Fresnel zone plates with smooth surfaces were obtained on convex microlenses. When a 633-nm-wavelength He-Ne laser was coupled normally to the hybrid lens, the primary focal length was measured as 630 μm. This hybridization shifted the focal length by 200 μm, which agreed with the theoretical value. Our process is useful for the precise fabrication of nonplanar structures based on inorganic materials.

Double muscle innervation using end-to-side neurorrhaphy in rats Dupla inervação muscular com neurorrafia término-lateral em ratos

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Elisangela Jeronymo Stipp-Brambilla

2012-01-01

Full Text Available CONTEXT AND OBJECTIVE: One of the techniques used for treating facial paralysis is double muscle innervation using end-to-end neurorrhaphy with sectioning of healthy nerves. The aim of this study was to evaluate whether double muscle innervation by means of end-to-side neurorrhaphy could occur, with maintenance of muscle innervation. DESIGN AND SETTING: Experimental study developed at the Experimental Research Center, Faculdade de Medicina de Botucatu, Unesp. METHODS: One hundred rats were allocated to five groups as follows: G1, control group; G2, the peroneal nerve was sectioned; G3, the tibial nerve was transected and the proximal stump was end-to-side sutured to the intact peroneal nerve; G4, 120 days after the G3 surgery, the peroneal nerve was sectioned proximally to the neurorrhaphy; G5, 120 days after the G3 surgery, the peroneal and tibial nerves were sectioned proximally to the neurorrhaphy. RESULTS: One hundred and fifty days after the surgery, G3 did not show any change in tibial muscle weight or muscle fiber diameter, but the axonal fiber diameter in the peroneal nerve distal to the neurorrhaphy had decreased. Although G4 showed atrophy of the cranial tibial muscle 30 days after sectioning the peroneal nerve, the electrophysiological test results and axonal diameter measurement confirmed that muscle reinnervation had occurred. CONCLUSION: These findings suggest that double muscle innervation did not occur through end-to-side neurorrhaphy; the tibial nerve was not able to maintain muscle innervation after the peroneal nerve had been sectioned, although muscle reinnervation was found to have occurred, 30 days after the peroneal nerve had been sectioned.CONTEXTO E OBJETIVO: Uma das técnicas utilizadas para tratamento da paralisia facial é a dupla inervação muscular com neurorrafia término-terminal, seccionando-se nervos sadios. O objetivo deste trabalho foi avaliar a ocorrência de dupla inervação muscular através de

Nonplanar loops leave the Veneziano model photon massless

NARCIS (Netherlands)

Foda, O.

1987-01-01

The absence of a pole at p2=0 in the orientable nonplanar one-loop photon self-energy in the Veneziano model is verified. Thus the photon remains massless, and spontaneous symmetry breaking - at least as reported in this context in the literature - is not found.

Nonplanar loops leave the Veneziano model photon massless

International Nuclear Information System (INIS)

Foda, O.

1987-01-01

The absence of a pole at p 2 =0 in the orientable nonplanar one-loop photon self-energy in the Veneziano model is verified. Thus the photon remains massless, and spontaneous symmetry breaking - at least as reported in this context in the literature - is not found. (orig.)

Nonplanar loops leave the Veneziano model photon massless

Energy Technology Data Exchange (ETDEWEB)

Foda, O.

1987-04-16

The absence of a pole at p/sup 2/=0 in the orientable nonplanar one-loop photon self-energy in the Veneziano model is verified. Thus the photon remains massless, and spontaneous symmetry breaking - at least as reported in this context in the literature - is not found.

Constrained Quantum Mechanics: Chaos in Non-Planar Billiards

Science.gov (United States)

Salazar, R.; Tellez, G.

2012-01-01

We illustrate some of the techniques to identify chaos signatures at the quantum level using as guiding examples some systems where a particle is constrained to move on a radial symmetric, but non-planar, surface. In particular, two systems are studied: the case of a cone with an arbitrary contour or "dunce hat billiard" and the rectangular…

Defecation mechanisms after anterior resection with J-pouch-anal and side-to-end anastomosis in dogs.

Science.gov (United States)

Willis, S; Hölzl, F; Wein, B; Tittel, A; Schumpelick, V

2007-02-01

Colonic J-pouch-anal anastomosis or colonic side-to-end anastomosis is the reconstruction of choice after low anterior resection. However, the mechanisms of defecation after both reconstruction forms are still speculative. Low anterior rectal resections were performed in 12 dogs with six colonic J-pouch-anal (pouch) and six coloanal side-to-end (SE) reconstructions. Four months postoperative stool frequency, intestinal transit time, and neorectal compliance were determined by radiography and barostat. Defecation mechanisms were evaluated radiographically during expulsion of artificial stool. One dog with pouch reconstruction could not be evaluated due to an anastomotic leak, while the others had uncomplicated course. Spontaneous stool frequency was significantly increased with both reconstruction methods (control 2.0+/-0.9, pouch 2.7+/-1.2, SE 3.3+/-0.9 day; panastomosis. Our results show that pouch evacuation is passive and independent from pouch motility. The functional principle of the colonic J-pouch is not its reservoir function but a delay of colonic motility.

A Novel Non-Planar Transverse Stretching Process for Micro-Porous PTFE Membranes and Resulting Characteristics

KAUST Repository

Chang, Y.-H.

2018-02-26

Polytetrafluoroethylene (PTFE) micro-porous membranes were prepared from PTFE fine powder through extruding, rolling, and uniaxial longitudinally stretching. In contrast to conventional planar transverse stretching, a novel 3D mold design of non-planar transverse stretching process was employed in this study to produce micro-porous structure. The morphology, membrane thickness, mean pore size, and porosity of the PTFE membrane were investigated. The results show that the non-planar transverse stretched membranes exhibit more uniform average pore diameter with thinner membrane thickness. Morphological changes induced by planar and non-planar transverse stretching for pore characteristics were investigated. The stretching conditions, stretching temperature and rate, affect the stretched membrane. Increasing temperature facilitated the uniformity of pore size and uniformity of membrane thickness. Moreover, increase in stretching rate resulted in finer pore size and thinner membrane.

End-to-side neurotization with the phrenic nerve in restoring the function of toe extension: an experimental study in a rat model.

Science.gov (United States)

Jia, Xiaotian; Chen, Chao; Yang, Jianyun; Yu, Cong

2018-06-01

The phrenic nerve being transferred to the posterior division of the lower trunk with end-to-end neurorrhaphy is reported to be effective in restoring the function of digit extension in literature. However, the phrenic nerve is extremely important in respiration. We designed an animal experiment to discover whether the phrenic nerve being transferred to the posterior division of the lower trunk with end-to-side neurotization was feasible and provided the theoretical basis. A sum of 36 Sprague-Dawley rats was randomly assigned to one of two groups. In Group A, the phrenic nerve was transferred to the posterior division of the lower trunk with end-to-side neurotization. In Group B, the posterior division of the lower trunk was directly sutured. The results of behavioral assessment, electrophysiology, histology and nerve fiber count and muscle weight at 12 weeks postoperatively were recorded. In Group A, none of the rats experienced tachypnea. The motion of slight toe extension was observed. The results of electrophysiology, histology and nerve fiber count and muscle weight in Group A were not as well as those of Group B, but gradually improved with time. The phrenic nerve being transferred to the posterior division of lower trunk with end-to-side neurotization can partially restore the function of toe extension in a rat model. Whether the function of digit extension can be restored by the phrenic nerve with end-to-side neurotization in humans still needs more practice in clinic.

Printing line/space patterns on nonplanar substrates using a digital micromirror device-based point-array scanning technique

Science.gov (United States)

Kuo, Hung-Fei; Kao, Guan-Hsuan; Zhu, Liang-Xiu; Hung, Kuo-Shu; Lin, Yu-Hsin

2018-02-01

This study used a digital micromirror device (DMD) to produce point-array patterns and employed a self-developed optical system to define line-and-space patterns on nonplanar substrates. First, field tracing was employed to analyze the aerial images of the lithographic system, which comprised an optical system and the DMD. Multiobjective particle swarm optimization was then applied to determine the spot overlapping rate used. The objective functions were set to minimize linewidth and maximize image log slope, through which the dose of the exposure agent could be effectively controlled and the quality of the nonplanar lithography could be enhanced. Laser beams with 405-nm wavelength were employed as the light source. Silicon substrates coated with photoresist were placed on a nonplanar translation stage. The DMD was used to produce lithographic patterns, during which the parameters were analyzed and optimized. The optimal delay time-sequence combinations were used to scan images of the patterns. Finally, an exposure linewidth of less than 10 μm was successfully achieved using the nonplanar lithographic process.

Unilateral distalization of a maxillary molar with sliding mechanics: a case report.

Science.gov (United States)

Keles, Ahmet

2002-06-01

A unilateral Class II relationship could arise due to early loss of an upper second deciduous molar on one side during the mixed dentition period. This would allow the mesial drift of the molars, which may block the eruption of the second premolar. A 15-year 8-month-old male patient presented with a Class II molar relationship on the right, and Class I canine and molar relationship on the left side. His E was extracted when he was 5 years old. The 54 were impacted and the 3 was ectopically positioned due to the space loss from the mesial migration of the 76. In addition 21 1 were in cross-bite. Skeletally he had Class III tendency with low MMPA. He presented with a straight profile and retruded upper lip. For maxillary molar distalization, a newly developed 'Keles Slider' was used. The appliance was composed of one premolar and two molar bands, and the anchorage unit was composed of a wide Nance button. 46 were connected to the Nance button and, therefore, included into the anchorage unit. The point of distal force application was close to the centre of resistance of the 6 and parallel to the occlusal plane. Ni-Ti coil springs were used and 200 g of distal force was applied. Seven months later the space required for eruption of the permanent premolars and canine was regained, and the anterior cross-bite corrected. The appliance was removed and final alignment of the teeth was achieved with fixed appliances. At the end of the second phase treatment Class I molar and canine relationship was achieved on the both sides, the anterior cross-bite was corrected, inter-incisal angle was improved, and ideal overbite and overjet relationship was achieved. The active treatment time was 27 months.

Use of end-to-side arterial and venous anastomosis techniques for renal transplantation in two dogs.

Science.gov (United States)

Phillips, Heidi; Aronson, Lillian R

2012-02-01

A sexually intact male Old English Sheepdog and a sexually intact female Bull Terrier were evaluated for renal dysplasia and chronic renal failure, respectively. Both dogs were anemic and had high serum concentrations of urea nitrogen and creatinine. Electrolyte abnormalities (calcium and phosphorus) were also evident. The decision was made to pursue renal transplantation, and donor dogs were identified. End-to-side anastomosis of the renal artery and vein of each donor's left kidney to the recipient's ipsilateral external iliac artery and vein, respectively, was performed. The left caudal abdominal musculature was scarified by making an incision, and nephropexy to that musculature was performed with a simple interrupted pattern of polypropylene sutures. No intraoperative or postoperative complications associated with the vascular anastomoses were encountered. Azotemia, anemia, and electrolyte imbalances resolved after transplantation. The end-to-side anastomosis technique described here, which is a preferred method in human medicine, was successful, providing an alternative to other renal transplantation techniques in dogs. Additional studies are needed to determine whether any vascular anastomosis technique is preferable for use in dogs requiring renal transplantation.

Intra-articular osteotomy for distal humerus malunion

NARCIS (Netherlands)

Marti, René K.; Doornberg, Job

2009-01-01

Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular

Some remarks on non-planar Feynman diagrams

International Nuclear Information System (INIS)

Bielas, Krzysztof; Dubovyk, Ievgen; Gluza, Janusz

2013-12-01

Two criteria for planarity of a Feynman diagram upon its propagators (momentum ows) are presented. Instructive Mathematica programs that solve the problem and examples are provided. A simple geometric argument is used to show that while one can planarize non-planar graphs by embedding them on higher-genus surfaces (in the example it is a torus), there is still a problem with defining appropriate dual variables since the corresponding faces of the graph are absorbed by torus generators.

Some remarks on non-planar Feynman diagrams

Energy Technology Data Exchange (ETDEWEB)

Bielas, Krzysztof; Dubovyk, Ievgen; Gluza, Janusz [Silesia Univ., Katowice (Poland). Inst. of Physics; Riemann, Tord [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany)

2013-12-15

Two criteria for planarity of a Feynman diagram upon its propagators (momentum ows) are presented. Instructive Mathematica programs that solve the problem and examples are provided. A simple geometric argument is used to show that while one can planarize non-planar graphs by embedding them on higher-genus surfaces (in the example it is a torus), there is still a problem with defining appropriate dual variables since the corresponding faces of the graph are absorbed by torus generators.

Better functional outcome provided by short-armed sigmoid colon-rectal side-to-end anastomosis after laparoscopic low anterior resection: a match-paired retrospective study from China.

Science.gov (United States)

Zhang, Yuan-Chuan; Jin, Xiao-Dong; Zhang, Yu-Ting; Wang, Zi-Qiang

2012-04-01

Side-to-end anastomosis using the descending colon has been proved to be as effective as J pouch in alleviating low anterior resection syndrome. However, using the sigmoid colon, which is less compliant for reconstruction after rectal cancer surgery, is common in China due to less prevalence of diverticulosis. The effectiveness of using the sigmoid colon for a side-to-end colorectal anastomosis in improving bowel dysfunction after laparoscopic low anterior resection of rectal cancer has not been investigated. This study was designed to compare the functional and surgical outcomes between the two anastomoses. From October 2007 to December 2008, 16 rectal cancer patients underwent laparoscopic low anterior resection with short-armed (length of side limb 2-4 cm) side-to-end sigmoidorectal anastomosis at our department. The bowel functional results of these patients at 6 months and 1 year postoperatively were recorded and compared with that of another 1:2 matched 30 patients undergoing straight anastomosis. Bowel movement frequency in the side-to-end group was obviously less than that in the straight group 6 months postoperatively. Patients in the side-to-end group also had an improved incontinence score, a better ability to defer defecation, and less repeated evacuation. No differences were found between two groups 1 year after surgery. The study shows that the short-armed side-to-end colorectal anastomosis using the sigmoid colon can also improve the short-term bowel function in patients undergoing laparoscopic low anterior resection.

Simplified nonplanar wafer bonding for heterogeneous device integration

Science.gov (United States)

Geske, Jon; Bowers, John E.; Riley, Anton

2004-07-01

We demonstrate a simplified nonplanar wafer bonding technique for heterogeneous device integration. The improved technique can be used to laterally integrate dissimilar semiconductor device structures on a lattice-mismatched substrate. Using the technique, two different InP-based vertical-cavity surface-emitting laser active regions have been integrated onto GaAs without compromising the quality of the photoluminescence. Experimental and numerical simulation results are presented.

An Automatic Multi-Target Independent Analysis Framework for Non-Planar Infrared-Visible Registration.

Science.gov (United States)

Sun, Xinglong; Xu, Tingfa; Zhang, Jizhou; Zhao, Zishu; Li, Yuankun

2017-07-26

In this paper, we propose a novel automatic multi-target registration framework for non-planar infrared-visible videos. Previous approaches usually analyzed multiple targets together and then estimated a global homography for the whole scene, however, these cannot achieve precise multi-target registration when the scenes are non-planar. Our framework is devoted to solving the problem using feature matching and multi-target tracking. The key idea is to analyze and register each target independently. We present a fast and robust feature matching strategy, where only the features on the corresponding foreground pairs are matched. Besides, new reservoirs based on the Gaussian criterion are created for all targets, and a multi-target tracking method is adopted to determine the relationships between the reservoirs and foreground blobs. With the matches in the corresponding reservoir, the homography of each target is computed according to its moving state. We tested our framework on both public near-planar and non-planar datasets. The results demonstrate that the proposed framework outperforms the state-of-the-art global registration method and the manual global registration matrix in all tested datasets.

A nondestructive, reproducible method of measuring joint reaction force at the distal radioulnar joint.

Science.gov (United States)

Canham, Colin D; Schreck, Michael J; Maqsoodi, Noorullah; Doolittle, Madison; Olles, Mark; Elfar, John C

2015-06-01

To develop a nondestructive method of measuring distal radioulnar joint (DRUJ) joint reaction force (JRF) that preserves all periarticular soft tissues and more accurately reflects in vivo conditions. Eight fresh-frozen human cadaveric limbs were obtained. A threaded Steinmann pin was placed in the middle of the lateral side of the distal radius transverse to the DRUJ. A second pin was placed into the middle of the medial side of the distal ulna colinear to the distal radial pin. Specimens were mounted onto a tensile testing machine using a custom fixture. A uniaxial distracting force was applied across the DRUJ while force and displacement were simultaneously measured. Force-displacement curves were generated and a best-fit polynomial was solved to determine JRF. All force-displacement curves demonstrated an initial high slope where relatively large forces were required to distract the joint. This ended with an inflection point followed by a linear area with a low slope, where small increases in force generated larger amounts of distraction. Each sample was measured 3 times and there was high reproducibility between repeated measurements. The average baseline DRUJ JRF was 7.5 N (n = 8). This study describes a reproducible method of measuring DRUJ reaction forces that preserves all periarticular stabilizing structures. This technique of JRF measurement may also be suited for applications in the small joints of the wrist and hand. Changes in JRF can alter native joint mechanics and lead to pathology. Reliable methods of measuring these forces are important for determining how pathology and surgical interventions affect joint biomechanics. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

49 CFR 231.3 - Drop-end high-side gondola cars.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Drop-end high-side gondola cars. 231.3 Section 231... gondola cars. (a) Hand brakes—(1) Number. Same as specified for “Box and other house cars” (see § 231.1(a)(1)). (2) Dimensions. Same as specified for “Box and other house cars” (see § 231.1(a)(2)). (3...

49 CFR 231.5 - Drop-end low-side gondola cars.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Drop-end low-side gondola cars. 231.5 Section 231... gondola cars. (a) Hand brakes—(1) Number. Same as specified for “Box and other house cars” (see § 231.1(a)(1)). (2) Dimensions. Same as specified for “Box and other house cars” (see § 231.1(a)(2)). (3...

Intra-Articular Osteotomy for Distal Humerus Malunion

Directory of Open Access Journals (Sweden)

René K. Marti

2009-01-01

Full Text Available Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular necrosis of capitellum or trochlea is a major pitfall of the this technically challenging procedure. Two cases are presented which illustrate the potential problems of intra-articular osteotomy for malunion of the distal humerus.

[New anterolateral approach of distal femur for treatment of distal femoral fractures].

Science.gov (United States)

Zhang, Bin; Dai, Min; Zou, Fan; Luo, Song; Li, Binhua; Qiu, Ping; Nie, Tao

2013-11-01

To assess the effectiveness of the new anterolateral approach of the distal femur for the treatment of distal femoral fractures. Between July 2007 and December 2009, 58 patients with distal femoral fractures were treated by new anterolateral approach of the distal femur in 28 patients (new approach group) and by conventional approach in 30 patients (conventional approach group). There was no significant difference in gender, age, cause of injury, affected side, type of fracture, disease duration, complication, or preoperative intervention (P > 0.05). The operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, hospitalization days, and Hospital for Special Surgery (HSS) score of knee were recorded. Operation was successfully completed in all patients of 2 groups, and healing of incision by first intention was obtained; no vascular and nerves injuries occurred. The operation time and intraoperative fluoroscopy frequency of new approach group were significantly less than those of conventional approach group (P 0.05). All patients were followed up 12-36 months (mean, 19.8 months). Bone union was shown on X-ray films; the fracture healing time was (12.62 +/- 2.34) weeks in the new approach group and was (13.78 +/- 1.94) weeks in the conventional approach group, showing no significant difference (t=2.78, P=0.10). The knee HSS score at last follow-up was 94.4 +/- 4.2 in the new approach group, and was 89.2 +/- 6.0 in the conventional approach group, showing significant difference between 2 groups (t=3.85, P=0.00). New anterolateral approach of the distal femur for distal femoral fractures has the advantages of exposure plenitude, minimal tissue trauma, and early function rehabilitation training so as to enhance the function recovery of knee joint.

Reconstruction of lower end of radius using vascularized upper end of fibula

Directory of Open Access Journals (Sweden)

Koul Ashok

2007-01-01

Full Text Available Background: Giant cell tumor is a fairly common locally invasive tumor in young adults. The lower end of the radius is the second commonest site for this tumor. The most common treatment for this tumor is curettage with or without bone grafting but it carries a significant rate of recurrence. Excision is the treatment of choice, especially for cases in which the cortex has been breached. After excision of the distal end of the radius, different procedures have been described to reconstruct the defect of distal radius. These include partial arthrodesis and hemiarthroplasty using the upper end of the fibula. The upper end of the fibula has a morphological resemblance to the lower end of the radius and has been used to replace the latter. Traditionally it was used as a ′free′ (non-vascularized graft. More recently the upper end of the fibula has been transferred as a vascularized transfer for the same purpose. Though vascularized transfer should be expected to be more physiological, its superiority over the technically simpler non-vascularized transfer has not been conclusively proven. Materials and Methods: Two patients are presented who had giant cell tumor of distal radius. They underwent wide local excision and reconstruction with free vascularized upper end of the fibula. Result: Follow-up period was two and a half years and 12 months respectively. Both patients have returned to routine work. One patient has excellent functional result and the other has a good result. Conclusion: Vascularized upper end of fibula transfer is a reliable method of reconstruction for loss of the distal end of the radius that restores local anatomy and physiology.

[Distal clavicle fracture].

Science.gov (United States)

Seppel, G; Lenich, A; Imhoff, A B

2014-06-01

Reposition and fixation of unstable distal clavicle fractures with a low profile locking plate (Acumed, Hempshire, UK) in conjunction with a button/suture augmentation cerclage (DogBone/FibreTape, Arthrex, Naples, FL, USA). Unstable fractures of the distal clavicle (Jäger and Breitner IIA) in adults. Unstable fractures of the distal clavicle (Jäger and Breitner IV) in children. Distal clavicle fractures (Jäger and Breitner I, IIB or III) with marked dislocation, injury of nerves and vessels, or high functional demand. Patients in poor general condition. Fractures of the distal clavicle (Jäger and Breitner I, IIB or III) without marked dislocation or vertical instability. Local soft-tissue infection. Combination procedure: Initially the lateral part of the clavicle is exposed by a 4 cm skin incision. After reduction of the fracture, stabilization is performed with a low profile locking distal clavicle plate. Using a special guiding device, a transclavicular-transcoracoidal hole is drilled under arthroscopic view. Additional vertical stabilization is arthroscopically achieved by shuttling the DogBone/FibreTape cerclage from the lateral portal cranially through the clavicular plate. The two ends of the FibreTape cerclage are brought cranially via adjacent holes of the locking plate while the DogBone button is placed under the coracoid process. Thus, plate bridging is achieved. Finally reduction is performed and the cerclage is secured by surgical knotting. Use of an arm sling for 6 weeks. Due to the fact that the described technique is a relatively new procedure, long-term results are lacking. In the short term, patients postoperatively report high subjective satisfaction without persistent pain.

Probabilistic Prognosis of Non-Planar Fatigue Crack Growth

Science.gov (United States)

Leser, Patrick E.; Newman, John A.; Warner, James E.; Leser, William P.; Hochhalter, Jacob D.; Yuan, Fuh-Gwo

2016-01-01

Quantifying the uncertainty in model parameters for the purpose of damage prognosis can be accomplished utilizing Bayesian inference and damage diagnosis data from sources such as non-destructive evaluation or structural health monitoring. The number of samples required to solve the Bayesian inverse problem through common sampling techniques (e.g., Markov chain Monte Carlo) renders high-fidelity finite element-based damage growth models unusable due to prohibitive computation times. However, these types of models are often the only option when attempting to model complex damage growth in real-world structures. Here, a recently developed high-fidelity crack growth model is used which, when compared to finite element-based modeling, has demonstrated reductions in computation times of three orders of magnitude through the use of surrogate models and machine learning. The model is flexible in that only the expensive computation of the crack driving forces is replaced by the surrogate models, leaving the remaining parameters accessible for uncertainty quantification. A probabilistic prognosis framework incorporating this model is developed and demonstrated for non-planar crack growth in a modified, edge-notched, aluminum tensile specimen. Predictions of remaining useful life are made over time for five updates of the damage diagnosis data, and prognostic metrics are utilized to evaluate the performance of the prognostic framework. Challenges specific to the probabilistic prognosis of non-planar fatigue crack growth are highlighted and discussed in the context of the experimental results.

Number and location of drainage catheter side holes: in vitro evaluation.

Science.gov (United States)

Ballard, D H; Alexander, J S; Weisman, J A; Orchard, M A; Williams, J T; D'Agostino, H B

2015-09-01

To evaluate the influence of number and location of catheter shaft side holes regarding drainage efficiency in an in vitro model. Three different drainage catheter models were constructed: open-ended model with no side holes (one catheter), unilateral side hole model (six catheters with one to six unilateral side holes), and bilateral side hole model (six catheters with one to six bilateral side holes). Catheters were inserted into a drainage output-measuring device with a constant-pressure reservoir of water. The volume of water evacuated by each of the catheters at 10-second intervals was measured. A total of five trials were performed for each catheter. Data were analysed using one-way analysis of variance. The open-ended catheter had a mean drainage volume comparable to the unilateral model catheters with three, four, and five side holes. Unilateral model catheters had significant drainage volume increases up to three side holes; unilateral model catheters with more than three side holes had no significant improvement in drainage volume. All bilateral model catheters had significantly higher mean drainage volumes than their unilateral counterparts. There was no significant difference between the mean drainage volume with one, two, or three pairs of bilateral side holes. Further, there was no drainage improvement by adding additional bilateral side holes. The present in vitro study suggests that beyond a critical side hole number threshold, adding more distal side holes does not improve catheter drainage efficiency. These results may be used to enhance catheter design towards improving their drainage efficiency. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Complications of resection and reconstruction in giant cell tumour of distal end of radius - An analysis

Directory of Open Access Journals (Sweden)

Saraf S

2005-01-01

Full Text Available Background: The bulk of literature on the subject focuses on the resection of the tumor followed by reconstruction using autologous fibula, however, papers analyzing the failures of this procedure are scanty. The aim is to analyze the various factors responsible for the failures. Methods: Study included 42 patients of aggressive GCT of distal radius, resected and reconstructed using nonvascularised autologous fibula. Host graft junction was fixed using screws (6, intramedullary nail (21 and plate (15. The minimum follow-up was 2 years or till a complication occurred requiring second surgery. Result: The major complications were recurrence in 6 cases (spillage of tumor tissue in 3, poor biopsy site 2, recurrence along the nail tract one case; failure of host graft union in 8 cases due to inadequate contact at host graft junction, poor implant selection, inadequate immobilization and infection; significant instability at wrist in 6 cases due to poor stabilization at carpo fibular junction in addition to inherent instability due to poor congruity between fibulocarpal articulations. Conclusion: Reconstruction of distal end of radius using auto fibula has much higher complication rates than usually believed. A meticulous planning and its execution is must to minimize the problems. Use of dynamic plate for host graft junction and fixation of fibular head to adjacent ulna/carpal bones improves the results.

The effect of flexor tenotomy on healing and prevention of neuropathic diabetic foot ulcers on the distal end of the toe

Directory of Open Access Journals (Sweden)

van Netten Jaap J

2013-01-01

Full Text Available Abstract Background Flexor tenotomy is a minimally invasive surgical alternative for the treatment of neuropathic diabetic foot ulcers on the distal end of the toe. The influence of infection on healing and time to heal after flexor tenotomy is unknown. Flexor tenotomy can also be used as a prophylactic treatment. The effectiveness as a prophylactic treatment has not been described before. Methods A retrospective study was performed with the inclusion of all consecutive flexor tenotomies from one hospital between January 2005 and December 2011. Results From 38 ulcers, 35 healed (92%, with a mean time to heal of 22 ± 26 days. The longest duration for healing was found for infected ulcers that were penetrating to bone (35 days; p = .042. Cases of prophylactic flexor tenotomies (n=9 did not result in any ulcer or other complications during follow-up. Conclusions The results of this study suggest that flexor tenotomy may be beneficial for neuropathic diabetic foot ulcers on the distal end of the toe, with a high healing percentage and a short mean time to heal. Infected ulcers that penetrated to bone took a significantly longer time to heal. Prospective research, to confirm the results of this retrospective study, should be performed.

Novel nonplanar triphenylamine-centered oligofluorenes: Synthesis, thermal, photophysical and electrochemical properties

International Nuclear Information System (INIS)

Zhang Yujian; Ouyang Mi; Yu Chunhui; Hu Bin; Lou Qianping; Zhang Cheng

2011-01-01

A series of fluorene derivatives containing a triphenylamine (TPA) derivative core and two oligofluorene peripheries was effectively synthesized. These compounds are fluorescent and emission color ranges from blue to red. The spiro-skeleton molecular structure leads to excellent glass transition temperatures and weak intermolecular interactions. Simultaneously, novel nonplanar triphenylamine-centered oligofluorenes solve the spectral stability problem and hole-injection issue for fluorene-based materials. The photophysical properties of 6 and 7 are investigated in solvents with different polarities, which reveal the existence of the Charge Transfer (CT) excited-state in these molecules. - Highlights: → Novel nonplanar oligofluorenes consisting of triphenylamine (TPA) derivatives as the core and oligofluorenes as the peripheries were facilely prepared via CF 3 SO 3 H-promoted Friedel-Crafts and Suzuki cross-coupling reactions. → These as-prepared compounds effectively solve the spectral stability problem and hole-injection issue for fluorene-based materials. → The ability of hole-injection and emission color could be fine tuned by R substituent at the C4 position of TPA.

Massive planar and non-planar double box integrals for light N f contributions to

Science.gov (United States)

von Manteuffel, Andreas; Studerus, Cedric

2013-10-01

We present the master integrals needed for the light fermionic two-loop corrections to top quark pair production in the gluon fusion channel. Via the method of differential equations we compute the results in terms of multiple polylogarithms in a Laurent series about d = 4, where d is the space-time dimension. The most involved topology is a non-planar double box with one internal mass. We employ the coproduct-augmented symbol calculus and show that significant simplifications are possible for selected results using an optimised set of multiple polylogarithms.

Side-To-Side Nerve Bridges Support Donor Axon Regeneration Into Chronically Denervated Nerves and Are Associated With Characteristic Changes in Schwann Cell Phenotype.

Science.gov (United States)

Hendry, J Michael; Alvarez-Veronesi, M Cecilia; Snyder-Warwick, Alison; Gordon, Tessa; Borschel, Gregory H

2015-11-01

Chronic denervation resulting from long nerve regeneration times and distances contributes greatly to suboptimal outcomes following nerve injuries. Recent studies showed that multiple nerve grafts inserted between an intact donor nerve and a denervated distal recipient nerve stump (termed "side-to-side nerve bridges") enhanced regeneration after delayed nerve repair. To examine the cellular aspects of axon growth across these bridges to explore the "protective" mechanism of donor axons on chronically denervated Schwann cells. In Sprague Dawley rats, 3 side-to-side nerve bridges were placed over a 10-mm distance between an intact donor tibial (TIB) nerve and a recipient denervated common peroneal (CP) distal nerve stump. Green fluorescent protein-expressing TIB axons grew across the bridges and were counted in cross section after 4 weeks. Immunofluorescent axons and Schwann cells were imaged over a 4-month period. Denervated Schwann cells dedifferentiated to a proliferative, nonmyelinating phenotype within the bridges and the recipient denervated CP nerve stump. As donor TIB axons grew across the 3 side-to-side nerve bridges and into the denervated CP nerve, the Schwann cells redifferentiated to the myelinating phenotype. Bridge placement led to an increased mass of hind limb anterior compartment muscles after 4 months of denervation compared with muscles whose CP nerve was not "protected" by bridges. This study describes patterns of donor axon regeneration and myelination in the denervated recipient nerve stump and supports a mechanism where these donor axons sustain a proregenerative state to prevent deterioration in the face of chronic denervation.

Film formation of non-planar phthalocyanines on copper(i) iodide

OpenAIRE

Ramadan, A. J.; Fearn, S.; Jones, T. S. (Tim S.); Heutz, S.; Rochford, L. A. (Luke A.)

2016-01-01

Structural templating is frequently used in organic photovoltaic devices to control the properties of the functional layers and therefore improve efficiencies. Modification of the substrate temperatures has also been shown to impact the structure and morphology of phthalocyanine thin films. Here we combine templating by copper iodide and high substrate temperature growth and study its effect on the structure and morphology of two different non-planar phthalocyanines, chloroaluminium (ClAlPc) ...

Double 90 Degrees Counterrotated End-to-End-Anastomosis: An Experimental Study of an Intestinal Anastomosis Technique.

Science.gov (United States)

Holzner, Philipp; Kulemann, Birte; Seifert, Gabriel; Glatz, Torben; Chikhladze, Sophia; Höppner, Jens; Hopt, Ulrich; Timme, Sylvia; Bronsert, Peter; Sick, Olivia; Zhou, Cheng; Marjanovic, Goran

2015-06-01

The aim of the article is to investigate a new anastomotic technique compared with standardized intestinal anastomotic procedures. A total of 32 male Wistar rats were randomized to three groups. In the Experimental Group (n = 10), the new double 90 degrees inversely rotated anastomosis was used, in the End Group (n = 10) a single-layer end-to-end anastomosis, and in the Side Group (n = 12) a single-layer side-to-side anastomosis. All anastomoses were done using interrupted sutures. On postoperative day 4, rats were relaparotomized. Bursting pressure, hydroxyproline concentration, a semiquantitative adhesion score and two histological anastomotic healing scores (mucosal healing according to Chiu and overall anastomotic healing according to Verhofstad) were collected. Most data are presented as median (range). p < 0.05 was considered significant. Anastomotic insufficiency occurred only in one rat of the Side Group. Median bursting pressure in the Experimental Group was 105 mm Hg (range = 72-161 mm Hg), significantly higher in the End Group (164 mm Hg; range = 99-210 mm Hg; p = 0.021) and lower in the Side Group by trend (81 mm Hg; range = 59-122 mm Hg; p = 0.093). Hydroxyproline concentration did not differ significantly in between the groups. The adhesion score was 2.5 (range = 1-3) in the Experimental Group, 2 (range = 1-2) in the End Group, but there were significantly more adhesions in the Side Group (range = 3-4); p = 0.020 versus Experimental Group, p < 0.001 versus End Group. The Chiu Score showed the worst mucosal healing in the Experimental Group. The overall Verhofstad Score was significantly worse (mean = 2.032; standard deviation [SD] = 0.842) p = 0.031 and p = 0.002 in the Experimental Group, compared with the Side Group (mean = 1.729; SD = 0.682) and the End Group (mean = 1.571; SD = 0.612). The new anastomotic technique is feasible and did not show any relevant complication. Even though it was superior to the side-to-side anastomosis by trend with

Distal radioulnar joint injuries

Directory of Open Access Journals (Sweden)

Binu P Thomas

2012-01-01

Full Text Available Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint , forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments.The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis.

Sodium-cutting: a new top-down approach to cut open nanostructures on nonplanar surfaces on a large scale.

Science.gov (United States)

Chen, Wei; Deng, Da

2014-11-11

We report a new, low-cost and simple top-down approach, "sodium-cutting", to cut and open nanostructures deposited on a nonplanar surface on a large scale. The feasibility of sodium-cutting was demonstrated with the successfully cutting open of ∼100% carbon nanospheres into nanobowls on a large scale from Sn@C nanospheres for the first time.

Distal clavicular osteolysis: MR evidence for subchondral fracture

Energy Technology Data Exchange (ETDEWEB)

Kassarjian, Ara; Palmer, William E. [Massachusetts General Hospital, Department of Radiology, Division of Musculoskeletal Radiology, Yawkey Center, Boston, MA (United States); Llopis, Eva [Hospital de la Ribera, Department of Radiology, Valencia (Spain)

2007-01-15

To investigate the association between distal clavicular osteolysis and subchondral fractures of the distal clavicle at MRI. This study was approved by the hospital human research committee, which waived the need for informed consent. Three radiologists retrospectively analyzed 36 shoulder MR examinations in 36 patients with imaging findings of distal clavicular osteolysis. The presence of a subchondral fracture of the distal clavicle, abnormalities of the acromioclavicular joint, rotator cuff tears and labral tears were assessed by MRI. These cases were then compared with 36 age-matched controls. At MRI, 31 of 36 patients (86%) had a subchondral line within the distal clavicular edema, consistent with a subchondral fracture. Of the 36 patients, 32 (89%) had fluid in the acromioclavicular joint, while 27 of 36 patients (75%) had cysts or erosions in the distal clavicle. There were 13 patients (36%) with associated labral tears, while eight patients (22%) had partial-thickness rotator cuff tears. In the control group one of 36 (3%) had a subchondral line (P<0.05), while ten of 36 (28%) had rotator cuff tears and 13 of 36 (36%) had labral tears. These latter two were not statistically significant between the groups. A distal clavicular subchondral fracture is a common finding in patients with imaging evidence of distal clavicular osteolysis. These subchondral fractures may be responsible for the propensity of findings occurring on the clavicular side of the acromioclavicular joint. (orig.)

Distal clavicular osteolysis: MR evidence for subchondral fracture

International Nuclear Information System (INIS)

Kassarjian, Ara; Palmer, William E.; Llopis, Eva

2007-01-01

To investigate the association between distal clavicular osteolysis and subchondral fractures of the distal clavicle at MRI. This study was approved by the hospital human research committee, which waived the need for informed consent. Three radiologists retrospectively analyzed 36 shoulder MR examinations in 36 patients with imaging findings of distal clavicular osteolysis. The presence of a subchondral fracture of the distal clavicle, abnormalities of the acromioclavicular joint, rotator cuff tears and labral tears were assessed by MRI. These cases were then compared with 36 age-matched controls. At MRI, 31 of 36 patients (86%) had a subchondral line within the distal clavicular edema, consistent with a subchondral fracture. Of the 36 patients, 32 (89%) had fluid in the acromioclavicular joint, while 27 of 36 patients (75%) had cysts or erosions in the distal clavicle. There were 13 patients (36%) with associated labral tears, while eight patients (22%) had partial-thickness rotator cuff tears. In the control group one of 36 (3%) had a subchondral line (P<0.05), while ten of 36 (28%) had rotator cuff tears and 13 of 36 (36%) had labral tears. These latter two were not statistically significant between the groups. A distal clavicular subchondral fracture is a common finding in patients with imaging evidence of distal clavicular osteolysis. These subchondral fractures may be responsible for the propensity of findings occurring on the clavicular side of the acromioclavicular joint. (orig.)

A Wnt/beta-catenin pathway antagonist Chibby binds Cenexin at the distal end of mother centrioles and functions in primary cilia formation.

Directory of Open Access Journals (Sweden)

Nathan Steere

Full Text Available The mother centriole of the centrosome is distinguished from immature daughter centrioles by the presence of accessory structures (distal and subdistal appendages, which play an important role in the organization of the primary cilium in quiescent cells. Primary cilia serve as sensory organelles, thus have been implicated in mediating intracellular signal transduction pathways. Here we report that Chibby (Cby, a highly conserved antagonist of the Wnt/β-catenin pathway, is a centriolar component specifically located at the distal end of the mother centriole and essential for assembly of the primary cilium. Cby appeared as a discrete dot in the middle of a ring-like structure revealed by staining with a distal appendage component of Cep164. Cby interacted with one of the appendage components, Cenexin (Cnx, which thereby abrogated the inhibitory effect of Cby on β-catenin-mediated transcriptional activation in a dose-dependent manner. Cby and Cnx did not precisely align, as Cby was detected at a more distal position than Cnx. Cnx emerged earlier than Cby during the cell cycle and was required for recruitment of Cby to the mother centriole. However, Cby was dispensable for Cnx localization to the centriole. During massive centriogenesis in in vitro cultured mouse tracheal epithelial cells, Cby and Cnx were expressed in a similar pattern, which was coincident with the expression of Foxj1. Our results suggest that Cby plays an important role in organization of both primary and motile cilia in collaboration with Cnx.

A Wnt/beta-catenin pathway antagonist Chibby binds Cenexin at the distal end of mother centrioles and functions in primary cilia formation.

Science.gov (United States)

Steere, Nathan; Chae, Vanessa; Burke, Michael; Li, Feng-Qian; Takemaru, Ken-ichi; Kuriyama, Ryoko

2012-01-01

The mother centriole of the centrosome is distinguished from immature daughter centrioles by the presence of accessory structures (distal and subdistal appendages), which play an important role in the organization of the primary cilium in quiescent cells. Primary cilia serve as sensory organelles, thus have been implicated in mediating intracellular signal transduction pathways. Here we report that Chibby (Cby), a highly conserved antagonist of the Wnt/β-catenin pathway, is a centriolar component specifically located at the distal end of the mother centriole and essential for assembly of the primary cilium. Cby appeared as a discrete dot in the middle of a ring-like structure revealed by staining with a distal appendage component of Cep164. Cby interacted with one of the appendage components, Cenexin (Cnx), which thereby abrogated the inhibitory effect of Cby on β-catenin-mediated transcriptional activation in a dose-dependent manner. Cby and Cnx did not precisely align, as Cby was detected at a more distal position than Cnx. Cnx emerged earlier than Cby during the cell cycle and was required for recruitment of Cby to the mother centriole. However, Cby was dispensable for Cnx localization to the centriole. During massive centriogenesis in in vitro cultured mouse tracheal epithelial cells, Cby and Cnx were expressed in a similar pattern, which was coincident with the expression of Foxj1. Our results suggest that Cby plays an important role in organization of both primary and motile cilia in collaboration with Cnx.

Investigation of nonplanar modular coil systems for stellarator fusion reactors

International Nuclear Information System (INIS)

Harmeyer, E.

1988-12-01

Steady-state stellarators constitute an important option for a future fusion reactor. The helical magnetic field required for plasma confinement can be produced by means of a set of modular nonplanar coils. In order to achieve optimum power density of the plasma, the magnetic flux density inside the torus is made as high as possible. State-of-the-art estimates allow values of the magnetic flux density on axis of B 0 = 4-7 T. The present report is concerned with investigations on modular nonplanar stellarator coil systems. Coil systems with poloidal periodicity l=2 and a coil system of the W VII-AS type with superposed l=0, 1, 2, 3 terms are treated. Furthermore, the parameters are simultaneously varied while keeping constant the ratios of certain magnitudes. In the parameter space of the geometric values and coil number the following quantities are evaluated: maximum magnetic flux density in the coil domain, stored magnetic energy of the coil system, magnetic force density distribution or magnetic forces, and mechanical stress distribution in the coils. Numerical methods are applied in the programme systems used for these calculations. The aim of the study is to determine an optimum regime for the above parameters. The numerical results are compared with those of analytical approximation solutions. (orig.)

Comparison of blood loss between using non central part cutting knee prosthesis and distal central part cutting.

Science.gov (United States)

Malairungsakul, Anan

2014-12-01

Patients who undergo knee replacement surgery may need to receive a blood transfusion due to blood loss during the operation. Therefore it was important to improve the design of knee implant operative procedures in an attempt to reduce the rate of blood loss. The present study aimed to compare the blood loss between two types of knee replacement surgery. This is a retrospective study in which 78 patients received cemented knee replacements in Phayao Hospital between October 2010 and March 2012. There were two types of surgical procedure: 1) using an implant position covering the end of the femoral bone without cutting into the central part of the distal femoral, 2) using an implant position covering the end of the femoral bone cutting the central part of the distal femoral. Blood loss, blood transfusion, hemoglobin and hematocrit were recorded preoperatively, immediately postsurgery and 48 hours after surgery. Findings revealed that the knee replacement surgery using the implant position covering the end of the femoral bone without cutting the central part of the distal femoral significantly lowered the rate of blood loss when compared to using the implant position covering the end of the femoral bone with central cutting of the distal femor. The average blood loss during the operation without cutting at the central part of distal femoral was 49.50 ± 11.11 mL; whereas the operation cutting the central part of the distal femoral was 58.50 ± 11.69 mL. As regards blood loss, the knee replacement surgery using the implant position covering the end ofthefemoral bone without cutting the central part of distal femor was better than using the implant position covering the end of the femoral bone cutting at the central part of the distal femor.

Application of end-tidal carbon dioxide monitoring via distal gas samples in ventilated neonates.

Science.gov (United States)

Jin, Ziying; Yang, Maoying; Lin, Ru; Huang, Wenfang; Wang, Jiangmei; Hu, Zhiyong; Shu, Qiang

2017-08-01

Previous research has suggested correlations between the end-tidal partial pressure of carbon dioxide (P ET CO 2 ) and the partial pressure of arterial carbon dioxide (PaCO 2 ) in mechanically ventilated patients, but both the relationship between P ET CO 2 and PaCO 2 and whether P ET CO 2 accurately reflects PaCO 2 in neonates and infants are still controversial. This study evaluated remote sampling of P ET CO 2 via an epidural catheter within an endotracheal tube to determine the procedure's clinical safety and efficacy in the perioperative management of neonates. Abdominal surgery was performed under general anesthesia in 86 full-term newborns (age 1-30 days, weight 2.55-4.0 kg, American Society of Anesthesiologists class I or II). The infants were divided into 2 groups (n = 43 each), and carbon dioxide (CO 2 ) gas samples were collected either from the conventional position (the proximal end) or a modified position (the distal end) of the epidural catheter. The P ET CO 2 measured with the new method was significantly higher than that measured with the traditional method, and the difference between P ET CO 2 and PaCO 2 was also reduced. The accuracy of P ET CO 2 measured increased from 78.7% to 91.5% when the modified sampling method was used. The moderate correlation between P ET CO 2 and PaCO 2 by traditional measurement was 0.596, which significantly increased to 0.960 in the modified sampling group. Thus, the P ET CO 2 value was closer to that of PaCO 2 . P ET CO 2 detected via modified carbon dioxide monitoring had a better accuracy and correlation with PaCO 2 in neonates. Copyright © 2017. Published by Elsevier B.V.

Structural templating in a nonplanar phthalocyanine using single crystal copper iodide

OpenAIRE

Rochford, L. A. (Luke A.); Ramadan, Alexandra J.; Keeble, Dean S.; Ryan, Mary P.; Heutz, Sandrine; Jones, T. S. (Tim S.)

2015-01-01

Solution-grown copper iodide crystals are used as substrates for the templated growth of the nonplanar vanadyl phthalocyanine using organic molecular beam deposition. Structural characterization reveals a single molecular orientation produced by the (111) Miller plane of the copper iodide crystals. These fundamental measurements show the importance of morphology and structure in templating interactions for organic electronics applications.

Non-planar Feynman diagrams and Mellin-Barnes representations with AMBRE 3.0

International Nuclear Information System (INIS)

Dubovyk, Ievgen; Gluza, Janusz; Riemann, Tord

2016-04-01

We introduce the Mellin-Barnes representation of general Feynman integrals and discuss their evaluation. The Mathematica package AMBRE has been recently extended in order to cover consistently non-planar Feynman integrals with two loops. Prospects for the near future are outlined. This write-up is an introduction to new results which have also been presented elsewhere.

Complete mucosal healing of distal lesions induced by twice-daily budesonide 2-mg foam promoted clinical remission of mild-to-moderate ulcerative colitis with distal active inflammation: double-blind, randomized study.

Science.gov (United States)

Naganuma, Makoto; Aoyama, Nobuo; Tada, Tomohiro; Kobayashi, Kiyonori; Hirai, Fumihito; Watanabe, Kenji; Watanabe, Mamoru; Hibi, Toshifumi

2018-04-01

Budesonide foam is used for the topical treatment of distal ulcerative colitis. This phase III study was performed to confirm mucosal healing and other therapeutic effects of twice-daily budesonide 2-mg foam in patients with mild-to-moderate ulcerative colitis including left-sided colitis and pancolitis. This was a multicenter, randomized, placebo-controlled, double-blind trial. A total of 126 patients with mild-to-moderate ulcerative colitis with active inflammation in the distal colon were randomized to two groups receiving twice-daily budesonide 2 mg/25 ml foam or placebo foam. The primary endpoint was the percentage of complete mucosal healing of distal lesions (endoscopic subscore of 0) at week 6. Some patients continued the treatment through week 12. Drug efficacy and safety were evaluated. The percentages of both complete mucosal healing of distal lesions and clinical remission were significantly improved in the budesonide as compared with the placebo group (p = 0.0003 and p = 0.0035). Subgroup analysis showed similar efficacy of budesonide foam for complete mucosal healing of distal lesions and clinical remission regardless of disease type. The clinical remission percentage tended to be higher in patients achieving complete mucosal healing of distal lesions than in other patients. There were no safety concerns with budesonide foam. This study confirmed for the first time complete mucosal healing with twice-daily budesonide 2-mg foam in mild-to-moderate ulcerative colitis with distal active inflammation. The results also indicated that complete mucosal healing of distal lesions by budesonide foam promotes clinical remission of ulcerative colitis. Clinical trial registration no.: Japic CTI-142704.

Two-Loop Master Integrals for $\\gamma^{*} \\to 3$ Jets the Non-Planar Topologies

CERN Document Server

Gehrmann, T

2001-01-01

The calculation of the two-loop corrections to the three-jet production rate and to event shapes in electron--positron annihilation requires the computation of a number of two-loop four-point master integrals with one off-shell and three on-shell legs. Up to now, only those master integrals corresponding to planar topologies were known. In this paper, we compute the yet outstanding non-planar master integrals by solving differential equations in the external invariants which are fulfilled by these master integrals. We obtain the master integrals as expansions in $\\e=(4-d)/2$, where $d$ is the space-time dimension. The fully analytic results are expressed in terms of the two-dimensional harmonic polylogarithms already introduced in the evaluation of the planar topologies.

Muscle reinnervation in one or two stages?: experimental study in rats with end-to-side nerve graft Reinervação muscular em um ou dois estágios?: estudo experimental em ratos com enxerto de nervo término-lateral

Directory of Open Access Journals (Sweden)

Joseli Assem Bersaneti

2012-12-01

Full Text Available PURPOSE: To compare muscle reinnervation in one and two surgical stages using end-to-side neurorrhaphy (ESN without donor nerve injury. METHODS: The experiment was performed on four groups of 20 rats. Group 1 (G1, one stage, received the graft which was sutured to the tibial nerve, with ESN, and its free stump was sutured end-to-end to the distal stump of the sectioned peroneal nerve (PN, all in the same operation. In Group 2 (G2, two stages, the nerve graft was sutured to the tibial nerve, with ESN. Two months later the PN was sectioned and its distal stump connected to the distal stump of the graft as in G1. Normal control group (Gn received the graft only sutured to the tibial nerve, with ESN. Denervated control group (Gd, as well received the graft and had the PN sectioned and its two stumps buried in adjacent musculature, with the aim of denervating the cranial tibial muscle (CTM, the target of this study. The parameters used to evaluate CTM reinnervation were muscle mass, muscle fiber's minimum diameter and area. RESULTS: The mean CTM mass, the average of the muscular fibers areas and the average of the muscular fiber minimum diameters was higher (all pOBJETIVO: Comparar a reinervação muscular com enxerto de nervo em um e dois tempos operatórios, utilizando a neurorrafia término-lateral (NTL sem lesão do nervo doador. MÉTODOS: Vinte ratos foram distribuídos em quatro grupos. O grupo 1 (G1, um estágio, recebeu o enxerto que foi suturado ao nervo tibial (NT, por meio de NTL, e seu coto livre foi suturado por NTL ao coto distal do nervo peroneal (NP, seccionado a um centímetro do NT, na mesma cirurgia. O grupo 2 (G2, dois estágios, recebeu o enxerto de nervo na primeira cirurgia, como já descrito. Dois meses depois, na segunda cirurgia, o NP foi seccionado e seu coto distal ligado ao coto distal do enxerto como em G1. O grupo controle de normalidade (Gn recebeu o enxerto da mesma forma, apenas. E o grupo controle de denerva

Case report 353: Giant cell tumor of distal end of the femur, containing a fluid level as demonstrated by computed tomography

International Nuclear Information System (INIS)

Resnik, C.S.; Steffe, J.W.; Wang, S.E.

1986-01-01

In summary, a 22-year-old man presented after sustaining a minor injury to his left knee while playing football. Radiological studies showed the characteristic stigmata of a giant cell tumor in the distal end of the femur involving the medial femoral condyle. On computed tomography with the proper window settings a fluid level was demonstrated in the osteolytic lesion. At surgery, yellowish sanguinous fluid was aspirated from the lesion which was completely curetted. Pathological studies showed the typical stigmata of a giant cell tumor. (orig./SHA)

Robotic spleen-preserving distal pancreatectomy. A case report.

Science.gov (United States)

Vasilescu, C; Sgarbura, O; Tudor, S; Herlea, V; Popescu, I

2009-01-01

Distal pancreatectomy (DP) is the removal of the pancreatic tissue at the left side of the superior mesenteric vein and it is traditionally approached by an open or laparoscopic exposure. Preservation of the spleen is optional but appears to have a better immunological outcome. We present the case of a 53-year old patient with a 2.4/2.2 tumor located in the tail of the pancreas, with high tumour marker values for whom we decided to perform a robotic spleen-preserving distal pancreatectomy (RSPDP). The postoperative outcome was satisfactory. In conclusion, we recommend this type of approach for small pancreatic tail lesions.

DISTAL MYOPATHIES

Science.gov (United States)

Dimachkie, Mazen M.; Barohn, Richard J.

2014-01-01

Over a century ago, Gowers described two young patients in whom distal muscles weakness involved the hand, foot, sternocleidomastoid, and facial muscles in the other case the shoulder and distal leg musculature. Soon after, , similar distal myopathy cases were reported whereby the absence of sensory symptoms and of pathologic changes in the peripheral nerves and spinal cord at postmortem examination allowed differentiation from Charcot-Marie-Tooth disease. In 1951, Welander described autosomal dominant (AD) distal arm myopathy in a large Scandanavian cohort. Since then the number of well-characterized distal myopathies has continued to grow such that the distal myopathies have formed a clinically and genetically heterogeneous group of disorders. Affected kindred commonly manifest weakness that is limited to foot and toe muscles even in advanced stages of the disease, with variable mild proximal leg, distal arm, neck and laryngeal muscle involvement in selected individuals. An interesting consequence of the molecular characterization of the distal myopathies has been the recognition that mutation in a single gene can lead to more than one clinical disorder. For example, Myoshi myopathy (MM) and limb girdle muscular dystrophy (LGMD) type 2B are allelic disorders due to defects in the gene that encodes dysferlin. The six well described distal myopathy syndromes are shown in Table 1. Table 2 lists advances in our understanding of the myofibrillar myopathy group and Table 3 includes more recently delineated and less common distal myopathies. In the same manner, the first section of this review pertains to the more traditional six distal myopathies followed by discussion of the myofibrillar myopathies. In the third section, we review other clinically and genetically distinctive distal myopathy syndromes usually based upon single or smaller family cohorts. The fourth section considers other neuromuscular disorders that are important to recognize as they display prominent

Minimally invasive radical pancreatectomy for left-sided pancreatic cancer: Current status and future perspectives

Science.gov (United States)

Kang, Chang Moo; Lee, Sung Hwan; Lee, Woo Jung

2014-01-01

Minimally invasive distal pancreatectomy with splenectomy has been regarded as a safe and effective treatment for benign and borderline malignant pancreatic lesions. However, its application for left-sided pancreatic cancer is still being debated. The clinical evidence for radical antegrade modular pancreatosplenectomy (RAMPS)-based minimally invasive approaches for left-sided pancreatic cancer was reviewed. Potential indications and surgical concepts for minimally invasive RAMPS were suggested. Despite the limited clinical evidence for minimally invasive distal pancreatectomy in left-sided pancreatic cancer, the currently available clinical evidence supports the use of laparoscopic distal pancreatectomy under oncologic principles in well-selected left sided pancreatic cancers. A pancreas-confined tumor with an intact fascia layer between the pancreas and left adrenal gland/kidney positioned more than 1 or 2 cm away from the celiac axis is thought to constitute a good condition for the use of margin-negative minimally invasive RAMPS. The use of minimally invasive (laparoscopic or robotic) anterior RAMPS is feasible and safe for margin-negative resection in well-selected left-sided pancreatic cancer. The oncologic feasibility of the procedure remains to be determined; however, the currently available interim results indicate that even oncologic outcomes will not be inferior to those of open radical distal pancreatosplenectomy. PMID:24605031

Distal tibiofibular synostosis in a Nigerian: A case report | Owoeye ...

African Journals Online (AJOL)

X-ray of the bones showed an oblique fracture in the distal end of the shaft of fibula which is suggestive of post traumatic tibiofibular synostosis (TFS). Knowledge of distal TFS is important in resolving the puzzle of chronic shin pain of unknown origin and in accurate diagnosis of causes of ankle deformity and malformations.

The non-planar single-frequency ring laser with variable output coupling

Science.gov (United States)

Wu, Ke-ying; Yang, Su-hui; Wei, Guang-hui

2002-03-01

We put forward a novel non-planar single-frequency ring laser, which consists of a corner cube prism and a specially cut Porro prism made by Nd:YAG crystal. The relative angle between the corner cube and the Porro prism could be adjusted to control the output coupling of the laser resonator and the polarization-state of the output laser. A 1.06 μm single-frequency laser with 1 W output has been obtained.

Planar and nonplanar ion acoustic shock waves in relativistic degenerate astrophysical electron-positron-ion plasmas

Energy Technology Data Exchange (ETDEWEB)

Ata-ur-Rahman,; Qamar, A. [Institute of Physics and Electronics, University of Peshawar, Peshawar 25000 (Pakistan); National Centre for Physics, QAU Campus, Shahdrah Valley Road, Islamabad 44000 (Pakistan); Ali, S. [National Centre for Physics, QAU Campus, Shahdrah Valley Road, Islamabad 44000 (Pakistan); Mirza, Arshad M. [Theoretical Plasma Physics Group, Physics Department, Quaid-i-Azam University, Islamabad 45320 (Pakistan)

2013-04-15

We have studied the propagation of ion acoustic shock waves involving planar and non-planar geometries in an unmagnetized plasma, whose constituents are non-degenerate ultra-cold ions, relativistically degenerate electrons, and positrons. By using the reductive perturbation technique, Korteweg-deVries Burger and modified Korteweg-deVries Burger equations are derived. It is shown that only compressive shock waves can propagate in such a plasma system. The effects of geometry, the ion kinematic viscosity, and the positron concentration are examined on the ion acoustic shock potential and electric field profiles. It is found that the properties of ion acoustic shock waves in a non-planar geometry significantly differ from those in planar geometry. The present study has relevance to the dense plasmas, produced in laboratory (e.g., super-intense laser-dense matter experiments) and in dense astrophysical objects.

Selection of peripheral intravenous catheters with 24-gauge side-holes versus those with 22-gauge end-hole for MDCT: A prospective randomized study

Energy Technology Data Exchange (ETDEWEB)

Tamura, Akio, E-mail: a.akahane@gmail.com [Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505 (Japan); Kato, Kenichi, E-mail: kkato@iwate-med.ac.jp [Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505 (Japan); Kamata, Masayoshi, E-mail: kamataaoi@yahoo.co.jp [Iwate Medical University Hospital, 19-1 Uchimaru, Morioka 020-8505 (Japan); Suzuki, Tomohiro, E-mail: suzukitomohiro123@gmail.com [Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505 (Japan); Suzuki, Michiko, E-mail: mamimichiko@me.com [Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505 (Japan); Nakayama, Manabu, E-mail: gakuymgt@yahoo.co.jp [Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505 (Japan); Tomabechi, Makiko, E-mail: mtomabechi@mac.com [Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505 (Japan); Nakasato, Tatsuhiko, E-mail: nakasato77@gmail.com [Department of Radiology, Southern Tohoku Research Institute for Neuroscience, 7-115 Yatsuyamada, Koriyama 963-8563 (Japan); Ehara, Shigeru, E-mail: ehara@iwate-med.ac.jp [Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505 (Japan)

2017-02-15

Highlights: • We compared 24-gauge side-hole and conventional 22-gauge end-hole catheters in MDCT. • The 24-gauge side-hole catheter is noninferior to the 22-gauge end-hole catheter. • The 24-gauge side-hole catheter is safe and facilitates optimal enhancement quality. • The 24-gauge side-hole catheter is suitable for patients with narrow or fragile veins. - Abstract: Purpose: To compare the 24-gauge side-holes catheter and conventional 22-gauge end-hole catheter in terms of safety, injection pressure, and contrast enhancement on multi-detector computed tomography (MDCT). Materials & methods: In a randomized single-center study, 180 patients were randomized to either the 24-gauge side-holes catheter or the 22-gauge end-hole catheter groups. The primary endpoint was safety during intravenous administration of contrast material for MDCT, using a non-inferiority analysis (lower limit 95% CI greater than −10% non-inferiority margin for the group difference). The secondary endpoints were injection pressure and contrast enhancement. Results: A total of 174 patients were analyzed for safety during intravenous contrast material administration for MDCT. The overall extravasation rate was 1.1% (2/174 patients); 1 (1.2%) minor episode occurred in the 24-gauge side-holes catheter group and 1 (1.1%) in the 22-gauge end-hole catheter group (difference: 0.1%, 95% CI: −3.17% to 3.28%, non-inferiority P = 1). The mean maximum pressure was higher with the 24-gauge side-holes catheter than with the 22-gauge end-hole catheter (8.16 ± 0.95 kg/cm{sup 2} vs. 4.79 ± 0.63 kg/cm{sup 2}, P < 0.001). The mean contrast enhancement of the abdominal aorta, celiac artery, superior mesenteric artery, and pancreatic parenchyma in the two groups were not significantly different. Conclusion: In conclusion, our study showed that the 24-gauge side-holes catheter is safe and suitable for delivering iodine with a concentration of 300 mg/mL at a flow-rate of 3 mL/s, and it may contribute to

Giant Cell Tumour of the Distal Ulna: A Rare Presentation

Directory of Open Access Journals (Sweden)

Ruben Jaya Kumar

2011-07-01

Full Text Available Giant-cell tumour (GCT of bone, a primary yet locally aggressive benign tumour, commonly affects patients between the ages of 20 and 40 years, with the peak incidence occurring in the third decade. Women are affected slightly more than men. The distal end of the ulna is an extremely uncommon site for primary bone tumours in general and giant cell tumours in particular. Wide resection of the distal ulna is the recommended treatment for GCT in such locations. Radio-ulna convergence and dorsal displacement of the ulna stump are known complications following ulna resection proximal to the insertion of the pronator quadratus. This leads to reduction in grip power and forearm rotatory motion. Stabilization of the ulna stump with extensor carpi ulnaris (ECU tendon after wide resection of the tumour has been described in the literature. We report a case of GCT of distal end of ulna treated with wide resection and stabilization with ECU tendon.

Suture anchor tenodesis in repair of distal Achilles tendon injuries.

Science.gov (United States)

Kiliçoğlu, Onder; Türker, Mehmet; Yildız, Fatih; Akalan, Ekin; Temelli, Yener

2014-01-01

Distal Achilles tendon avulsions are in the form of either bony and nonbony avulsion of Achilles tendon from its calcaneal insertion. Four patients with distal Achilles tendon avulsions or ruptures which were treated with tendon to bone repair using suture anchors are presented here. Operated leg was immobilized in above-knee cast for 4 weeks while the patient walked non-weight-bearing. Then, cast was changed to below knee, and full weight-bearing was allowed. Patients underwent gait analysis minimum at first postoperative year. Mean American Orthopedics Foot Ankle Society ankle/hindfoot score of patients at last visit was 88.75 (range 85-100), and Achilles tendon total rupture score was 77.75 (range 58-87). Mean passive dorsiflexion of injured ankles (14° ± 5°) was lower than uninjured ankles (23° ± 9°). All the kinematic parameters of gait analysis were comparable to the uninjured side. Maximum plantar flexion power of injured ankle was 1.40 W/kg, and this was significantly lower than the contralateral side value 2.38 W/kg; (P = 0.0143). There were no visually altered gait or problems in daily life. Suture anchor tenodesis technique of distal Achilles tendon avulsions was successful in achieving durable osteotendinous repairs.

Nerve supply to the internal anal sphincter differs from that to the distal rectum: an immunohistochemical study of cadavers.

Science.gov (United States)

Kinugasa, Yusuke; Arakawa, Takashi; Murakami, Gen; Fujimiya, Mineko; Sugihara, Kenichi

2014-04-01

Fecal incontinence is a common problem after anal sphincter-preserving operations. The intersphincteric autonomic nerves supplying the internal anal sphincter (IAS) are formed by the union of: (1) nerve fibers from Auerbach's nerve plexus of the most distal part of the rectum and (2) the inferior rectal branches of the pelvic plexus (IRB-PX) running along the conjoint longitudinal muscle coat. The aim of the present study is to identify the detailed morphology of nerves to the IAS. The study comprised histological and immunohistochemical evaluations of paraffin-embedded sections from a large block of anal canal from the preserved 10 cadavers. The IRB-PX came from the superior aspect of the levator ani and ran into the anal canal on the anterolateral side. These nerves contained both sympathetic and parasympathetic fibers, but the sympathetic content was much higher than in nerves from the distal rectum. All intramural ganglion cells in the distal rectum were neuronal nitric oxide synthase-positive and tyrosine hydroxylase-negative and were restricted to above the squamous-columnar epithelial junction. Parasympathetic nerves formed a lattice-like plexus in the circular smooth muscles of the distal rectum, whereas the IAS contained short, longitudinally running sympathetic and parasympathetic nerves, although sympathetic nerves were dominant. The major autonomic nerve input to the IAS seemed not to originate from the distal rectum but from the IRB-PX. Injury to the IRB-PX during surgery seemed to result in loss of innervation to the major part of the IAS.

End effect braking force reduction in high-speed single-sided linear induction machine

International Nuclear Information System (INIS)

Shiri, Abbas; Shoulaie, Abbas

2012-01-01

Highlights: ► A new analytical equation to model the end effect braking force of SLIM is derived. ► Equations for efficiency, power factor and output thrust are analytically derived. ► The effect of design variables on the performance of the motor is analyzed. ► An optimization method is employed to minimize the end effect braking force (EEBF). ► The results show that EEBF is minimized by appropriate selection of motor parameters. - Abstract: Linear induction motors have been widely employed in industry because of their simple structure and low construction cost. However, they suffer from low efficiency and power factor. In addition, existence of so called end effect influences their performance especially in high speeds. The end effect deteriorates the performance of the motor by producing braking force. So, in this paper, by using Duncan equivalent circuit model, a new analytical equation is proposed to model end effect braking force. Employing the proposed equation and considering all phenomena involved in the single-sided linear induction motor, a simple design procedure is presented and the effect of different design variables on the performance of the motor is analyzed. A multi-objective optimization method based on genetic algorithm is introduced to maximize efficiency and power factor, as well as to minimize the end effect braking force, simultaneously. Finally, to validate the optimization results, 2D finite element method is employed.

Stringent limitations on reductive perturbation studies of nonplanar acoustic solitons in plasmas

Energy Technology Data Exchange (ETDEWEB)

Verheest, Frank [Sterrenkundig Observatorium, Universiteit Gent, Krijgslaan 281, B–9000 Gent (Belgium); School of Chemistry and Physics, University of KwaZulu-Natal, Durban 4000 (South Africa); Hellberg, Manfred A. [School of Chemistry and Physics, University of KwaZulu-Natal, Durban 4000 (South Africa)

2016-06-15

More than fifty years ago, the Korteweg-de Vries equation was shown to describe not only solitary surface waves on shallow water, but also nonlinear ion-acoustic waves. Because of the algorithmic ease of using reductive perturbation theory, intensive research followed on a wide range of wave types. Soon, the formalism was extended to nonplanar modes by introducing a stretching designed to accommodate spherically and cylindrically symmetric ion-acoustic waves. Over the last two decades many authors followed this approach, but almost all have ignored the severe restrictions in parameter space imposed by the Ansatz. In addition, for other steps in the formalism, the justification is often not spelled out, leading to effects that are physically undesirable or ambiguous. Hence, there is a need to critically assess this approach to nonplanar modes and to use it with the utmost care, respecting the restrictions on its validity. Only inward propagation may be meaningfully studied and respect for weak nonlinearities of at most 1/10 implies that one cannot get closer to the axis or centre of symmetry than about 30 Debye lengths. Thus, one is in a regime where the modes are quasi-planar and not particularly interesting. Most papers disregard these constraints and hence reach questionable conclusions.

Agrin mutations lead to a congenital myasthenic syndrome with distal muscle weakness and atrophy.

Science.gov (United States)

Nicole, Sophie; Chaouch, Amina; Torbergsen, Torberg; Bauché, Stéphanie; de Bruyckere, Elodie; Fontenille, Marie-Joséphine; Horn, Morten A; van Ghelue, Marijke; Løseth, Sissel; Issop, Yasmin; Cox, Daniel; Müller, Juliane S; Evangelista, Teresinha; Stålberg, Erik; Ioos, Christine; Barois, Annie; Brochier, Guy; Sternberg, Damien; Fournier, Emmanuel; Hantaï, Daniel; Abicht, Angela; Dusl, Marina; Laval, Steven H; Griffin, Helen; Eymard, Bruno; Lochmüller, Hanns

2014-09-01

Congenital myasthenic syndromes are a clinically and genetically heterogeneous group of rare diseases resulting from impaired neuromuscular transmission. Their clinical hallmark is fatigable muscle weakness associated with a decremental muscle response to repetitive nerve stimulation and frequently related to postsynaptic defects. Distal myopathies form another clinically and genetically heterogeneous group of primary muscle disorders where weakness and atrophy are restricted to distal muscles, at least initially. In both congenital myasthenic syndromes and distal myopathies, a significant number of patients remain genetically undiagnosed. Here, we report five patients from three unrelated families with a strikingly homogenous clinical entity combining congenital myasthenia with distal muscle weakness and atrophy reminiscent of a distal myopathy. MRI and neurophysiological studies were compatible with mild myopathy restricted to distal limb muscles, but decrement (up to 72%) in response to 3 Hz repetitive nerve stimulation pointed towards a neuromuscular transmission defect. Post-exercise increment (up to 285%) was observed in the distal limb muscles in all cases suggesting presynaptic congenital myasthenic syndrome. Immunofluorescence and ultrastructural analyses of muscle end-plate regions showed synaptic remodelling with denervation-reinnervation events. We performed whole-exome sequencing in two kinships and Sanger sequencing in one isolated case and identified five new recessive mutations in the gene encoding agrin. This synaptic proteoglycan with critical function at the neuromuscular junction was previously found mutated in more typical forms of congenital myasthenic syndrome. In our patients, we found two missense mutations residing in the N-terminal agrin domain, which reduced acetylcholine receptors clustering activity of agrin in vitro. Our findings expand the spectrum of congenital myasthenic syndromes due to agrin mutations and show an unexpected

Toward endoscopes with no distal optics: video-rate scanning microscopy through a fiber bundle.

Science.gov (United States)

Andresen, Esben Ravn; Bouwmans, Géraud; Monneret, Serge; Rigneault, Hervé

2013-03-01

We report a step toward scanning endomicroscopy without distal optics. The focusing of the beam at the distal end of a fiber bundle is achieved by imposing a parabolic phase profile across the exit face with the aid of a spatial light modulator. We achieve video-rate images by galvanometric scanning of the phase tilt at the proximal end. The approach is made possible by the bundle, designed to have very low coupling between cores.

Nonplanar ion acoustic waves with kappa-distributed electrons

International Nuclear Information System (INIS)

Sahu, Biswajit

2011-01-01

Using the standard reductive perturbation technique, nonlinear cylindrical and spherical Kadomtsev-Petviashvili equations are derived for the propagation of ion acoustic solitary waves in an unmagnetized collisionless plasma with kappa distributed electrons and warm ions. The influence of kappa-distributed electrons and the effects caused by the transverse perturbation on cylindrical and spherical ion acoustic waves (IAWs) are investigated. It is observed that increase in the kappa distributed electrons (i.e., decreasing κ) decreases the amplitude of the solitary electrostatic potential structures. The numerical results are presented to understand the formation of ion acoustic solitary waves with kappa-distributed electrons in nonplanar geometry. The present investigation may have relevance in the study of propagation of IAWs in space and laboratory plasmas.

Planar and nonplanar electron-acoustic solitary waves in a plasma with a q-nonextensive electron velocity distribution

International Nuclear Information System (INIS)

Han, Jiu-Ning; Luo, Jun-Hua; Sun, Gui-Hua; Liu, Zhen-Lai; Ge, Su-Hong; Wang, Xin-Xing; Li, Jun-Xiu

2014-01-01

The nonlinear dynamics of nonplanar (cylindrical and spherical) electron-acoustic solitary wave structures in an unmagnetized, collisionless plasma composed of stationary ions, cold fluid electrons and hot q-nonextensive distributed electrons are theoretically studied. We discuss the effects of the nonplanar geometry, nonextensivity of hot electrons and ‘hot’ to ‘cold’ electron number density ratio on the time evolution characters of cylindrical and spherical solitary waves. Moreover, the effects of plasma parameters on the nonlinear structure induced by the interaction between two planar solitary waves are also investigated. It is found that these plasma parameters have significant influences on the properties of the above-mentioned nonlinear structures. Our theoretical study may be useful to understand the nonlinear features of electron-acoustic wave structures in astrophysical plasma systems. (paper)

Valgusdeformitet i anklen som følge af distal fibula-epifysefraktur

DEFF Research Database (Denmark)

Al-Aubaidi, Zaid

2011-01-01

Ankle fracture with involvement of the growth plate is the second most common paediatric fracture after the distal radius. The most common fracture type according to Salter Harris (SH) is type II of the distal tibia combined with green stick of the fibula. Isolated fracture of the distal fibular...... growth plate is not common and as a rule it does not give any growth arrest. We describe a case of isolated fibular fracture SH type II in a ten year-old girl which ended with symptomatic valgus deformity of the ankle. The patient was operated with good results....

Three-dimensional finite element analysis on canine teeth distalization by different accessories of bracket-free invisible orthodontics technology

Science.gov (United States)

Xu, Nuo; Lei, Xue; Yang, Xiaoli; Li, Xinhui; Ge, Zhenlin

2018-04-01

Objective: to compare canine tooth stress distribution condition during maxillary canine tooth distalization by different accessories of bracket-free invisible orthodontics technology after removal of maxillary first premolar, and provide basis for clinical design of invisible orthodontics technology. Method: CBCT scanning image of a patient with individual normal occlusion was adopted, Mimics, Geomagic and ProlE software were used for establishing three-dimensional models of maxilla, maxillary dentition, parodontium, invisible orthodontics appliance and accessories, ANSYS WORKBENCH was utilized as finite element analysis tools for analyzing stress distribution and movement pattern of canine tooth and parodontium when canine tooth was equipped with power arm and vertical rectangle accessory. Meanwhile, canine tooth none-accessory design group was regarded as a control. Result: teeth had even bistal surface stress distribution in the power arm group; stress was concentrated on distal tooth neck, and the stress was gradually deviated to mesial-labial side and distal lingual side in vertical rectangle group and none-accessory group. Conclusion: teeth tend to move as a whole in the Power arm group, vertical rectangle group has lower tooth gradient compared with the none-accessory group, teeth are inclined for movement in the none-accessory group, and canine teeth tend to rotate to the distal lingual side.

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.

Laparoscopic stomach-partitioning gastrojejunostomy with reduced-port techniques for unresectable distal gastric cancer.

Science.gov (United States)

Hirahara, Noriyuki; Matsubara, Takeshi; Hyakudomi, Ryoji; Hari, Yoko; Fujii, Yusuke; Tajima, Yoshitsugu

2014-03-01

The improvement of quality of life is of great importance in managing patients with far-advanced gastric cancer. We report a new cure and less invasive method of creating a stomach-partitioning gastrojejunostomy in reduced-port laparoscopic surgery for unresectable gastric cancers with gastric outlet obstruction. A 2.5-cm vertical intraumbilical incision was made, and EZ Access (Hakko Co., Ltd., Tokyo, Japan) was placed. After pneumoperitoneum was created, an additional 5-mm trocar was inserted in the right upper abdomen. A gastrojejunostomy was performed in the form of an antiperistaltic side-to-side anastomosis, in which the jejunal loop was elevated in the antecolic route and anastomosed to the greater curvature of the stomach using an endoscopic linear stapler. The jejunal loop together with the stomach was dissected with additional linear staplers just proximal to the common entry hole so that a functional end-to-end gastrojejunostomy was completed. At the same time, the stomach was partitioned using a linear stapler to leave a 2-cm-wide lumen in the lesser curvature. Subsequently, jejunojejunostomy was performed 30 cm distal to the gastrojejunostomy, and the stomach-partitioning gastrojejunostomy resembling Roux-en Y anastomosis was completed. All patients resumed oral intake on the day of operation. Neither anastomotic leakage nor anastomotic stricture was observed. Our less invasive palliative operation offers the utmost priority to improve quality of life for patients with unresectable gastric cancer.

Do the terms 'proximal' and 'distal' cause confusion amongst radiologists and other clinicians?

International Nuclear Information System (INIS)

Skillicorn, C.J.

2009-01-01

Aim: To investigate the use of the terms 'proximal' and 'distal', and what respondents think the terms mean, when applied to certain structures within the trunk, notably the veins and the biliary tract. Materials and Methods: Fifty-three respondents were interviewed using simplified anatomical diagrams. Respondents were asked what terms they would use to describe sites at opposite ends of the superior vena cava (SVC), internal jugular vein (IJV), common bile duct (CBD), and pancreatic duct. They were also asked which end of each of these structures they would think was being referred to if they read a radiological report that used these terms. Results: The terms 'proximal' and 'distal' were used by at least 50% of all respondents, and, specifically, at least 60% of radiologists at all four anatomical sites. Eighty-five percent (n = 45) of all respondents and 100% (n = 24) of radiologists agreed that the term 'proximal' CBD referred to its superior end. However, at the other sites there was marked disagreement, 67% (n = 16) of radiologists thought the superior SVC and superior IJV were 'proximal', 33% (n = 8) thought they were 'distal'. There was a 54% (n = 13) to 46% (n = 11) split amongst radiologists as to which end of the pancreatic duct was 'proximal'. Conclusion: The terms 'proximal' and 'distal' are the most frequently used terms to describe positions in veins and the biliary system, but there is widespread confusion about their meaning, which could lead to medical error and ultimately patient harm. The use of alternative terms is advised

Do the terms "proximal" and "distal" cause confusion amongst radiologists and other clinicians?

Science.gov (United States)

Skillicorn, C J

2009-04-01

To investigate the use of the terms "proximal" and "distal", and what respondents think the terms mean, when applied to certain structures within the trunk, notably the veins and the biliary tract. Fifty-three respondents were interviewed using simplified anatomical diagrams. Respondents were asked what terms they would use to describe sites at opposite ends of the superior vena cava (SVC), internal jugular vein (IJV), common bile duct (CBD), and pancreatic duct. They were also asked which end of each of these structures they would think was being referred to if they read a radiological report that used these terms. The terms "proximal" and "distal" were used by at least 50% of all respondents, and, specifically, at least 60% of radiologists at all four anatomical sites. Eighty-five percent (n=45) of all respondents and 100% (n=24) of radiologists agreed that the term "proximal" CBD referred to its superior end. However, at the other sites there was marked disagreement, 67% (n=16) of radiologists thought the superior SVC and superior IJV were "proximal", 33% (n=8) thought they were "distal". There was a 54% (n=13) to 46% (n=11) split amongst radiologists as to which end of the pancreatic duct was "proximal". The terms "proximal" and "distal" are the most frequently used terms to describe positions in veins and the biliary system, but there is widespread confusion about their meaning, which could lead to medical error and ultimately patient harm. The use of alternative terms is advised.

Study of nonlinear electron-acoustic solitary and shock waves in a dissipative, nonplanar space plasma with superthermal hot electrons

Energy Technology Data Exchange (ETDEWEB)

Han, Jiu-Ning, E-mail: hanjiuning@126.com; He, Yong-Lin; Luo, Jun-Hua; Nan, Ya-Gong; Han, Zhen-Hai; Dong, Guang-Xing [College of Physics and Electromechanical Engineering, Hexi University, Zhangye 734000 (China); Duan, Wen-Shan [College of Physics and Electronic Engineering, Northwest Normal University, Lanzhou 730070 (China); Li, Jun-Xiu [College of Civil Engineering, Hexi University, Zhangye 734000 (China)

2014-01-15

With the consideration of the superthermal electron distribution, we present a theoretical investigation about the nonlinear propagation of electron-acoustic solitary and shock waves in a dissipative, nonplanar non-Maxwellian plasma comprised of cold electrons, superthermal hot electrons, and stationary ions. The reductive perturbation technique is used to obtain a modified Korteweg-de Vries Burgers equation for nonlinear waves in this plasma. We discuss the effects of various plasma parameters on the time evolution of nonplanar solitary waves, the profile of shock waves, and the nonlinear structure induced by the collision between planar solitary waves. It is found that these parameters have significant effects on the properties of nonlinear waves and collision-induced nonlinear structure.

Pressure loss coefficient and flow rate of side hole in a lower end plug for dual-cooled annular nuclear fuel

Energy Technology Data Exchange (ETDEWEB)

Shin, Chang-Hwan, E-mail: shinch@kaeri.re.kr; Park, Ju-Yong, E-mail: juyong@kaeri.re.kr; In, Wang-Kee, E-mail: wkin@kaeri.re.kr

2013-12-15

Highlights: • A lower end plug with side flow holes is suggested to provide alternative flow paths of the inner channel. • The inlet loss coefficient of the lower end plug is estimated from the experiment. • The flow rate through the side holes is estimated in a complete entrance blockage of inner channel. • The consequence in the reactor core condition is evaluated with a subchannel analysis code. - Abstract: Dual-cooled annular nuclear fuel for a pressurized water reactor (PWR) has been introduced for a significant increase in reactor power. KAERI has been developing a dual-cooled annular fuel for a power uprate of 20% in an optimized PWR in Korea, the OPR1000. This annular fuel can help decrease the fuel temperature substantially relative to conventional cylindrical fuel at a power uprate. Annular fuel has dual flow channels around itself; however, the inner flow channel has a weakness in that it is isolated unlike the outer flow channel, which is open to other neighbouring outer channels for a coolant exchange in the reactor core. If the entrance of the inner channel is, as a hypothetical event, completely blocked by debris, the inner channel will then experience a rapid increase in coolant temperature such that a departure from nucleate boiling (DNB) may occur. Therefore, a remedy to avoid such a postulated accident is indispensable for the safety of annular fuel. A lower end plug with side flow holes was suggested to provide alternative flow paths in addition to the central entrance of the inner channel. In this paper, the inlet loss coefficient of the lower end plug and the flow rate through the side holes were estimated from the experimental results even in a complete entrance blockage of the inner channel. An optimization for the side hole was also performed, and the results are applied to a subchannel analysis to evaluate the consequence in the reactor core condition.

An end-to-end assessment of range uncertainty in proton therapy using animal tissues

Science.gov (United States)

Zheng, Yuanshui; Kang, Yixiu; Zeidan, Omar; Schreuder, Niek

2016-11-01

Accurate assessment of range uncertainty is critical in proton therapy. However, there is a lack of data and consensus on how to evaluate the appropriate amount of uncertainty. The purpose of this study is to quantify the range uncertainty in various treatment conditions in proton therapy, using transmission measurements through various animal tissues. Animal tissues, including a pig head, beef steak, and lamb leg, were used in this study. For each tissue, an end-to-end test closely imitating patient treatments was performed. This included CT scan simulation, treatment planning, image-guided alignment, and beam delivery. Radio-chromic films were placed at various depths in the distal dose falloff region to measure depth dose. Comparisons between measured and calculated doses were used to evaluate range differences. The dose difference at the distal falloff between measurement and calculation depends on tissue type and treatment conditions. The estimated range difference was up to 5, 6 and 4 mm for the pig head, beef steak, and lamb leg irradiation, respectively. Our study shows that the TPS was able to calculate proton range within about 1.5% plus 1.5 mm. Accurate assessment of range uncertainty in treatment planning would allow better optimization of proton beam treatment, thus fully achieving proton beams’ superior dose advantage over conventional photon-based radiation therapy.

Covalent functionalization of octagraphene with magnetic octahedral B6- and non-planar C6- clusters

Science.gov (United States)

Chigo-Anota, E.; Cárdenas-Jirón, G.; Salazar Villanueva, M.; Bautista Hernández, A.; Castro, M.

2017-10-01

The interaction between the magnetic boron octahedral (B6-) and non-planar (C6-) carbon clusters with semimetal nano-sheet of octa-graphene (C64H24) in the gas phase is studied by means of DFT calculations. These results reveal that non-planar-1 (anion) carbon cluster exhibits structural stability, low chemical reactivity, magnetic (1.0 magneton bohr) and semiconductor behavior. On the other hand, there is chemisorption phenomena when the stable B6- and C6- clusters are absorbed on octa-graphene nanosheets. Such absorption generates high polarity and the low-reactivity remains as on the individual pristine cases. Electronic charge transference occurs from the clusters toward the nanosheets, producing a reduction of the work function for the complexes and also induces a magnetic behavior on the functionalized sheets. The quantum descriptors obtained for these systems reveal that they are feasible candidates for the design of molecular circuits, magnetic devices, and nano-vehicles for drug delivery.

A new technique for determining orientation and motion of a 2-D, non-planar magnetopause

Directory of Open Access Journals (Sweden)

A. Blagau

2010-03-01

Full Text Available For a four-point mission like Cluster, the differences in position and time when the satellites detect the magnetopause or any other discontinuity, can be used to infer the discontinuity local orientation, thickness and motion. This timing technique, commonly assuming a planar geometry, offers an independent check for various single-spacecraft techniques. In the present paper we propose an extension of the timing method, capable of determining in a self-consistent way the macroscopic parameters of a two-dimensional, non-planar discontinuity. Such a configuration can be produced by a local bulge or indentation in the magnetopause, or by a large amplitude wave traveling on this surface, and is recognized in Cluster data when the single spacecraft techniques provide different individual normals contained roughly in the same plane. The model we adopted for the magnetopause assumes a layer of constant thickness of either cylindrical or parabolic shape, which has one or two degrees of freedom for the motion in the plane of the individual normals. The method was further improved by incorporating in a self-consistent way the requirement of minimum magnetic field variance along the magnetopause normal. An additional assumption, required in a previously proposed non-planar technique, i.e. that the non-planarity has negligible effects on the minimum variance analysis, is thus avoided. We applied the method to a magnetopause transition for which the various planar techniques provided inconsistent results. By contrast, the solutions obtained from the different implementations of the new 2-D method were consistent and stable, indicating a convex shape for the magnetopause. These solutions perform better than the planar solutions from the normal magnetic field variance perspective. The magnetopause dynamics and the presence of a non-zero normal magnetic field component in the analyzed event are discussed.

Application of Young-Michelson and Brown-Twiss interferometers for determining geometric parameters of nonplanar rough objects

NARCIS (Netherlands)

Mandrosov, V. I.

The possibility of using Young-Michelson and Brown-Twiss interferometers for measuring the angular dimensions and parameters of the surface shape of remote passively scattering and self-luminous nonplanar rough objects by optical radiation propagating from them is substantiated. The analysis is

Distal radius fractures result in alterations in scapular kinematics: a three-dimensional motion analysis.

Science.gov (United States)

Ayhan, Cigdem; Turgut, Elif; Baltaci, Gul

2015-03-01

Scapular motion is closely integrated with arm motion. Injury to a distal segment requires compensatory changes in the proximal segments leading to alterations in scapular motion. Since the effects of distal injuries on scapular kinematics remain unknown, in the present study we investigated the influences on scapular motion in patients with distal injuries. Sixteen subjects with a history of distal radius fracture and 20 asymptomatic healthy subjects (controls) participated in the study. Three-dimensional scapular and humeral kinematic data were collected on all 3 planes of shoulder elevation: frontal, sagittal, and scapular. All testing was performed in a single session; therefore, the sensors remained attached to the participants for all testing. The position and orientation data of the scapula at 30°, 60°, 90°, and 120° humerothoracic elevation and 120°, 90°, 60°, and 30° lowering were used for statistical comparisons. Independent samples t-test was used to compare the scapular internal/external rotation, upward/downward rotation, and anterior/posterior tilt between the affected side of subjects with a distal radius fracture and the dominant side of asymptomatic subjects at the same stage of humerothoracic elevation. Scapular internal rotation was significantly increased at 30° elevation (P=0.01), 90° elevation (P=0.03), and 30° lowering (P=0.03), and upward rotation was increased at 30° and 60° elevation (Pplane elevation. Scapular upward rotation and anterior tilt were significantly increased during 30° lowering on both the scapular (P=0.002 and 0.02, respectively) and sagittal planes (P=0.01 and 0.02. respectively). Patients with distal radius fractures exhibit altered scapular kinematics, which may further contribute to the development of secondary musculoskeletal pathologies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Hypoglossal-facial nerve "side"-to-side neurorrhaphy for facial paralysis resulting from closed temporal bone fractures.

Science.gov (United States)

Su, Diya; Li, Dezhi; Wang, Shiwei; Qiao, Hui; Li, Ping; Wang, Binbin; Wan, Hong; Schumacher, Michael; Liu, Song

2018-06-06

Closed temporal bone fractures due to cranial trauma often result in facial nerve injury, frequently inducing incomplete facial paralysis. Conventional hypoglossal-facial nerve end-to-end neurorrhaphy may not be suitable for these injuries because sacrifice of the lesioned facial nerve for neurorrhaphy destroys the remnant axons and/or potential spontaneous innervation. we modified the classical method by hypoglossal-facial nerve "side"-to-side neurorrhaphy using an interpositional predegenerated nerve graft to treat these injuries. Five patients who experienced facial paralysis resulting from closed temporal bone fractures due to cranial trauma were treated with the "side"-to-side neurorrhaphy. An additional 4 patients did not receive the neurorrhaphy and served as controls. Before treatment, all patients had suffered House-Brackmann (H-B) grade V or VI facial paralysis for a mean of 5 months. During the 12-30 months of follow-up period, no further detectable deficits were observed, but an improvement in facial nerve function was evidenced over time in the 5 neurorrhaphy-treated patients. At the end of follow-up, the improved facial function reached H-B grade II in 3, grade III in 1 and grade IV in 1 of the 5 patients, consistent with the electrophysiological examinations. In the control group, two patients showed slightly spontaneous innervation with facial function improved from H-B grade VI to V, and the other patients remained unchanged at H-B grade V or VI. We concluded that the hypoglossal-facial nerve "side"-to-side neurorrhaphy can preserve the injured facial nerve and is suitable for treating significant incomplete facial paralysis resulting from closed temporal bone fractures, providing an evident beneficial effect. Moreover, this treatment may be performed earlier after the onset of facial paralysis in order to reduce the unfavorable changes to the injured facial nerve and atrophy of its target muscles due to long-term denervation and allow axonal

Nonplanar Tertiary Amides in Rigid Chiral Tricyclic Dilactams. Peptide Group Distortions and Vibrational Optical Activity

Czech Academy of Sciences Publication Activity Database

Pazderková, Markéta; Profant, V.; Hodačová, J.; Šebestík, Jaroslav; Pazderka, T.; Novotná, P.; Urbanová, M.; Šafařík, Martin; Buděšínský, Miloš; Tichý, Miloš; Bednárová, Lucie; Baumruk, V.; Maloň, Petr

2013-01-01

Roč. 117, č. 33 (2013), s. 9626-9642 ISSN 1520-6106 R&D Projects: GA ČR GAP205/10/1276 Institutional support: RVO:61388963 Keywords : spirodilactams * amide bond * vibrational circular dichroism * non-planarity * Raman optical activity Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 3.377, year: 2013

Proximal and distal alignment of normal canine femurs: A morphometric analysis.

Science.gov (United States)

Kara, Mehmet Erkut; Sevil-Kilimci, Figen; Dilek, Ömer Gürkan; Onar, Vedat

2018-05-01

Many researchers are interested in femoral conformation because most orthopaedic problems of the long bones occur in the femur and its joints. The neck-shaft (NSA) and the anteversion (AVA) angles are good predictors for understanding the orientation of the proximal end of the femur. The varus (aLDFA) and procurvatum (CDFA) angles have also been used to understand the orientation of the distal end of the femur. The purposes of this study were to investigate the relationship between the proximal and distal angles of the femur and to compare the distal femoral angles in male and female dogs in order to investigate the sexual dimorphism. The measurements of normal CDFAs, which have not been previously reported, may also provide a database of canine distal femoral morphology. A total of 75 cleaned healthy femora from different breeds or mixed breed of dogs were used. The three-dimensional images were reconstructed from computed tomographic images. The AVA, NSA, aLDFA and CDFA were measured on the 3D images. The correlation coefficients were calculated among the measured angles. The distal femoral angles were also compared between male and female femora. The 95% confidence intervals of the AVA and the NSA were calculated to be 24.22°-29.50° and 144.97°-147.50°, respectively. The 95% confidence intervals of the aLDFA and the CDFA for all studied dogs were 92.62°-94.08° and 89.09°-91.94°, respectively. The NSA showed no correlation with either the aLDFA or CDFA. There was a weak inverse correlation between the AVA and CDFA and a weak positive correlation between the AVA and aLDFA. The differences in the aLDFA and CDFA measurements between male and female dog were not significant. In conclusion, femoral version, regardless of the plane, might have little influence on distal femoral morphology in normal dogs. Besides this, there is no evidence of a sexual dimorphism in the varus and procurvatum angles of the dog distal femur. The data from this study may be used in

Distal corporoplasty for distal cylinders extrusion after penile prosthesis implantation.

Science.gov (United States)

Carrino, Maurizio; Chiancone, Francesco; Battaglia, Gaetano; Pucci, Luigi; Fedelini, Paolo

2017-02-03

Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Several methods have been proposed for repairing a distal penile erosion. We present our preliminary experience in "Distal corporoplasty" technique. We enrolled 18 consecutive patients whose underwent a distal corporoplasty with simultaneous reimplantation of an "AMS 700 inflatable penile prosthesis (LGX)" from January 2013 to November 2015 at our hospital. All procedures were performed by a single surgical team. Intraoperative and postoperative complications have been classified and reported according to Satava6 and Clavien-Dindo (CD) system.7 Mean values with standard deviations (±SD) were computed and reported for all items. Mean age of the patients was 53.61 (±11.90) years. Mean body max index (BMI) was 24.22 (±2.51). Mean operative time was 85.2 (±13.1) minutes. Blood losses were minimal. No intraoperative complications are reported according to Satava classification. Four out of 18 patients (22.22%) experienced postoperative complications according to CD system. All patients had sexual intercourse for the first time postsurgery after a mean of 59.11 ± 2.08 days. Mean follow-up was 22.11 (±9.95). Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Distal corporoplasty was first described by Mulcahy. He reported a series of 14 patients with a follow-up of about 2 years with optimal functional outcomes. Moreover, distal corporoplasty resulted in shorter operative time, better function, less pain, and fewer recurrences than Gortex windsock repair.10 In our experience, distal corporoplasty is a simple and safe procedure in the treatment of distal cylinders extrusion when the prosthetic material is not exposed to the exterior.

Successful Self-Expandable Metallic Stent Placement for a Case of Distal Rectal Stenosis due to Gastric Cancer Metastasis

Directory of Open Access Journals (Sweden)

Takuya Okugawa

2013-05-01

Full Text Available A 47-year-old woman was diagnosed as having advanced gastric cancer with malignant ascites. Despite chemotherapy, recurrent peritoneal dissemination was seen 1.5 years after operation. A computed tomography scan revealed rectal stenosis due to Schnitzler's metastasis. When the distance from the distal end of the obstruction to the anal verge is less than 5 cm, stent replacement has been said to be contraindicated due to the development of anal pain and foreign body sensation. Although the distance from the distal end of the obstruction to the anal verge was 4 cm in this case, a WallFlex™ colonic stent could be placed. She stayed home, and luminal patency remained until she died 270 days after stent insertion. This report demonstrates that rectal obstruction located less than 5 cm from the anal verge due to Schnitzler's metastasis could be treated by stenting without any symptomatic or technical complications.

Management and treatment of distal ulcerative colitis

Directory of Open Access Journals (Sweden)

Andrea Calafiore

2013-12-01

Full Text Available Ulcerative colitis (UC is a chronic inflammatory condition that is confined to the colonic mucosa. Its main symptoms include diarrhea, rectal bleeding and abdominal pain. Approximately two-thirds of UC patients have disease confined distal to the splenic flexure, which can be treated effectively with topical therapy. This means the active drug can be delivered directly to the site of inflammation, limiting the systemic absorption and potential side effects. Topical treatment with aminosalicylates is the most effective approach in the treatment of these forms, provided that the formulation reaches the upper margin of the disease. Given this, the suppository formulation is the treatment of choice for proctitis and distal sigmoiditis. Thanks to their proximal spread, enemas, foams and gels represent the treatment of choice for proctosigmoiditis and for distal ulcerative colitis. Oral aminosalicylates are less effective than topical therapies in patients with active disease, while the combination of topical and oral treatment is more effective in patients refractory to topical or oral mono-therapy. Topically administered aminosalicylates play an important role in the maintenance of remission, but the long-term adhesion to therapy is poor. For this reason, the oral formulation is the first-line therapy in the maintenance of remission. Refractory patients can be treated with topical steroids or systemic steroids and TNF-alpha inhibitors in severe forms.

Combined open proximal and stent-graft distal repair for distal arch aneurysms: an alternative to total debranching.

Science.gov (United States)

Zierer, Andreas; Sanchez, Luis A; Moon, Marc R

2009-07-01

We present herein a novel, combined, simultaneous open proximal and stent-graft distal repair for complex distal aortic arch aneurysms involving the descending aorta. In the first surgical step, the transverse arch is opened during selective antegrade cerebral perfusion, and a Dacron graft (DuPont, Wilmington, DE) is positioned down the descending aorta in an elephant trunk-like fashion with its proximal free margin sutured circumferentially to the aorta just distal to the left subclavian or left common carotid artery. With the graft serving as the new proximal landing zone, subsequent endovascular repair is performed antegrade during rewarming through the ascending aorta.

Distal digital replantation.

Science.gov (United States)

Jazayeri, Leila; Klausner, Jill Q; Chang, James

2013-11-01

Hand surgeons have been hesitant to perform distal digital replantation because of the technical challenges and the perception of a high cost-to-benefit ratio. Recent studies, however, have shown high survival rates and excellent functional and aesthetic results, providing renewed enthusiasm for distal replantation. The authors reviewed the literature and summarize key points regarding the surgical treatment, perioperative care, and outcomes of distal digital replantation. They describe specific techniques and considerations for surgical repair in each of four distal zones as described by Sebastin and Chung. Zone 1A replantation involves an artery-only anastomosis of a longitudinal pulp artery. Venous anastomosis first becomes possible in zone 1B. Zone 1C involves periarticular amputations where arthrodesis of the distal interphalangeal joint is usually indicated. Repair of the artery, vein, and nerve is technically optimal in zone 1D, where venous anastomosis should be performed. Overall, survival rates for distal digital replantation are similar to those reported for more proximal replantation. The literature reports good outcomes regarding nail salvage, fingertip sensibility, and range of motion, with restoration of length and aesthetic appearance. Distal replantation performed at institutions that specialize in microsurgery and specifically tailored to the level of injury is associated with good survival, function, and patient satisfaction and superior aesthetic outcome. More prospective data are needed to evaluate the cost of treatment, psychological outcomes, and functional outcomes of distal replantation compared with revision amputation.

Winning end users active support to demand side response

Energy Technology Data Exchange (ETDEWEB)

Osorio, Jose [Rede Electrica Nacional, S.A., Lisbon (Portugal); Estanqueiro, Ana [Laboratorio Nacional de Energia e Geologia (LNEG), Lisbon (Portugal)

2012-07-01

While objectives proposed for Smart Grids and Smart metering may seem to be able to win easily end user's supports, a considerable amount of studies on social behavior concerning energy efficiency and sustainability show the gap between the values people would like to fulfill and their real life performance. As TSOs envision here a source of System Ancillary Services, measures to make the source really dependable, so that an adequate market design may really work are pointed out. (orig.)

Limb saving surgery for Ewing's sarcoma of the distal tibia: a case report.

Science.gov (United States)

Mizoshiri, Naoki; Shirai, Toshiharu; Terauchi, Ryu; Tsuchida, Shinji; Mori, Yuki; Katsuyama, Yusei; Hayashi, Daichi; Oka, Yoshinobu; Kubo, Toshikazu

2018-05-02

Ewing's sarcoma is a primary malignant tumor of bone occurring mostly in childhood. Few effective reconstruction techniques are available after wide resection of Ewing's sarcoma at the distal end of the tibia. Reconstruction after wide resection is especially difficult in children, as it is necessary to consider the growth and activity of the lower limbs. A 12-year-old Japanese boy had presented with right lower leg pain at age 8 years. Imaging examination showed a bone tumor accompanied by a large extra-skeletal mass in the distal part of his tibia. The tumor was histologically diagnosed as Ewing's sarcoma. The patient received chemotherapy, followed by wide resection. Reconstruction consisted of a bone transport method involving external fixation of Taylor Spatial Frame. To prevent infection after surgery, the external fixation pin was coated with iodine. One year after surgery, the patient showed poor consolidation of bone, so iliac bone transplantation was performed on the extended bones and docking site of the distal tibia. After 20 months, tibia formation was good. Three years after surgery, there was no evidence of tumor recurrence or metastases; bone fusion was good, and he was able to run. The bone transport method is an effective surgical method of reconstruction after wide resection of a bone tumor at the distal end of the tibia, if a pin can be inserted into the distal bone fragment. Coating external fixation pins with iodine may prevent postoperative infection.

Sphincter of Oddi botulinum toxin injection to prevent pancreatic fistula after distal pancreatectomy.

Science.gov (United States)

Hackert, Thilo; Klaiber, Ulla; Hinz, Ulf; Kehayova, Tzveta; Probst, Pascal; Knebel, Phillip; Diener, Markus K; Schneider, Lutz; Strobel, Oliver; Michalski, Christoph W; Ulrich, Alexis; Sauer, Peter; Büchler, Markus W

2017-05-01

Postoperative pancreatic fistula represents the most important complication after distal pancreatectomy. The aim of this study was to evaluate the use of a preoperative endoscopic injection of botulinum toxin into the sphincter of Oddi to prevent postoperative pancreatic fistula (German Clinical Trials Register number: DRKS00007885). This was an investigator-initiated, prospective clinical phase I/II trial with an exploratory study design. We included patients who underwent preoperative endoscopic sphincter botulinum toxin injection (100 units of Botox). End points were the feasibility, safety, and postoperative outcomes, including postoperative pancreatic fistula within 30 days after distal pancreatectomy. Botulinum toxin patients were compared with a control collective of patients undergoing distal pancreatectomy without botulinum toxin injection by case-control matching in a 1:1 ratio. Between February 2015 and February 2016, 29 patients were included. All patients underwent successful sphincter of Oddi botulinum toxin injection within a median of 6 (range 0-10) days before operation. One patient had an asymptomatic, self-limiting (48 hours) increase in serum amylase and lipase after injection. Distal pancreatectomy was performed in 24/29 patients; 5 patients were not resectable. Of the patients receiving botulinum toxin, 7 (29%) had increased amylase levels in drainage fluid on postoperative day 3 (the International Study Group of Pancreatic Surgery definition of postoperative pancreatic fistula grade A) without symptoms or need for reintervention. Importantly, no clinically relevant fistulas (International Study Group of Pancreatic Surgery grades B/C) were observed in botulinum toxin patients compared to 33% postoperative pancreatic fistula grade B/C in case-control patients (P botulinum toxin injection is a novel and safe approach to decrease the incidence of clinically relevant postoperative pancreatic fistula after distal pancreatectomy. The results of

Surgical Treatment of Carpal Tunnel Syndrome through a Minimal Incision on the Distal Wrist Crease: An Anatomical and Clinical Study

Directory of Open Access Journals (Sweden)

Hye Mi Yoo

2015-05-01

Full Text Available BackgroundAn anatomical analysis of the transverse carpal ligament (TCL and the surrounding structures might help in identifying effective measures to minimize complications. Here, we present a surgical technique based on an anatomical study that was successfully applied in clinical settings.MethodsUsing 13 hands from 8 formalin-fixed cadavers, we measured the TCL length and thickness, correlation between the distal wrist crease and the proximal end of the TCL, and distance between the distal end of the TCL and the palmar arch; the TCL cross sections and the thickest parts were also examined. Clinically, fasciotomy was performed on the relevant parts of 15 hands from 13 patients by making a minimally invasive incision on the distal wrist crease. Postoperatively, a two-point discrimination check was conducted in which the sensations of the first, second, and third fingertips and the palmar cutaneous branch injuries were monitored (average duration, 7 months.ResultsIn the 13 cadaveric hands, the distal wrist crease and the proximal end of the TCL were placed in the same location. The average length of the TCL and the distance from the distal TCL to the superficial palmar arch were 35.30±2.59 mm and 9.50±2.13 mm, respectively. The thickest part of the TCL was a region 25 mm distal to the distal wrist crease (average thickness, 4.00±0.57 mm. The 13 surgeries performed in the clinical settings yielded satisfactory results.ConclusionsThis peri-TCL anatomical study confirmed the safety of fasciotomy with a minimally invasive incision of the distal wrist crease. The clinical application of the technique indicated that the minimally invasive incision of the distal wrist crease was efficacious in the treatment of the carpal tunnel syndrome.

Turbine airfoil to shround attachment

Science.gov (United States)

Campbell, Christian X; Morrison, Jay A; James, Allister W; Snider, Raymond G; Eshak, Daniel M; Marra, John J; Wessell, Brian J

2014-05-06

A turbine airfoil (31) with an end portion (42) that tapers (44) toward the end (43) of the airfoil. A ridge (46) extends around the end portion. It has proximal (66) and distal (67) sides. A shroud platform (50) is bi-cast onto the end portion around the ridge without bonding. Cooling shrinks the platform into compression (62) on the end portion (42) of the airfoil. Gaps between the airfoil and platform are formed using a fugitive material (56) in the bi-casting stage. These gaps are designed in combination with the taper angle (44) to accommodate differential thermal expansion while maintaining a gas seal along the contact surfaces. The taper angle (44) may vary from lesser on the pressure side (36) to greater on the suction side (38) of the airfoil. A collar portion (52) of the platform provides sufficient contact area for connection stability.

Maxillary molar distalization with the dual-force distalizer supported by mini-implants: a clinical study.

Science.gov (United States)

Oberti, Giovanni; Villegas, Carlos; Ealo, Martha; Palacio, John Camilo; Baccetti, Tiziano

2009-03-01

The objective of this prospective study was to describe the clinical effects of a bone-supported molar distalizing appliance, the dual-force distalizer. The study group included 16 patients (mean age, 14.3 years) with Class II molar relationships. Study models and lateral cephalograms were taken before and after the distalizing movement to record significant dental and skeletal changes (Wilcoxon test). The average distalization time was 5 months, with a movement rate of 1.2 mm per month; the distalization amounts were 5.9 +/- 1.72 mm at the crown level and 4.4 +/- 1.41 mm at the furcation level. The average molar inclination was 5.6 degrees +/- 3.7 degrees ; this was less than the amount of inclination generated by bone-supported appliances that use single distalizing forces. The correlation between inclination and distalization was not significant, indicating predominantly bodily movement. The teeth anterior to the first molar moved distally also; the second premolars distalized an average of 4.26 mm, and the incisors retruded by 0.53 mm. The dual-force distalizer is a valid alternative distalizing appliance that generates controlled molar distalization with a good rate of movement and no loss of anchorage.

Laparoscopic Low Anterior Resection and Eversion Technique Combined With a Nondog Ear Anastomosis for Mid- and Distal Rectal Neoplasms

OpenAIRE

Zhuo, Changhua; Liang, Lei; Ying, Mingang; Li, Qingguo; Li, Dawei; Li, Yiwei; Peng, Junjie; Huang, Liyong; Cai, Sanjun; Li, Xinxiang

2015-01-01

Abstract The transanal eversion and prolapsing technique is a well-established procedure, and can ensure an adequate distal margin for patients with low rectal neoplasms. Potential leakage risks, however, are associated with bilateral dog ear formation, which results from traditional double-stapling anastomosis. The authors determined the feasibility of combining these techniques with a commercial stapling set to achieve a nondog ear (end-to-end) anastomosis for patients with mid- and distal ...

Treatment of a partially thrombosed giant aneurysm of the vertebral artery by aneurysm trapping and direct vertebral artery-posterior inferior cerebellar artery end-to-end anastomosis: technical case report.

Science.gov (United States)

Benes, Ludwig; Kappus, Christoph; Sure, Ulrich; Bertalanffy, Helmut

2006-07-01

The purpose of this article is to focus for the first time on the operative management of a direct vertebral artery (VA)-posterior inferior cerebellar artery (PICA) end-to-end anastomosis in a partially thrombosed giant VA-PICA-complex aneurysm and to underline its usefulness as an additional treatment option. The operative technique of a direct VA-PICA end-to-end anatomosis is described in detail. The VA was entering the large aneurysm sack. Distally, the PICA originated from the aneurysm sack-VA-complex. The donor and recipient vessel were cut close to the aneurysm. Whereas the VA was cut in a straight manner, the PICA was cut at an oblique 45-degree angle to enlarge the vascular end diameter. Vessel ends were flushed with heparinized saline and sutured. The thrombotic material inside the aneurysm sack was removed and the distal VA clipped, leaving the anterior spinal artery and brainstem perforators free. The patient regained consciousness without additional morbidity. Magnetic resonance imaging scans revealed a completely decompressed brainstem without infarction. The postoperative angiograms demonstrated a good filling of the anastomosed PICA. Despite the caliber mistmatch of these two vessels the direct VA-PICA end-to-end anastomosis provides an accurate alternative in addition to other anastomoses and bypass techniques, when donor and recipient vessels are suitable and medullary perforators do not have to be disrupted.

Medical expulsive treatment of distal ureteral stone using tamsulosin

International Nuclear Information System (INIS)

Ahmad, H.; Azim, W.; Akmal, M.; Murtaza, B.

2015-01-01

Many minimally invasive interventional techniques as well as expectant treatments exist for the management of lower ureteric calculi. This study was conducted to evaluate the efficacy of tamsulosin as an expulsive pharmacologic therapy for the treatment of distal ureteral stone. Methods: This randomized control trial included 100 patients over 18 years of age with stone Size = 8mm in distal 1/3 of ureter. Patients were randomly assigned into two groups (A and B). Group A Patients were given Capsule Tamsulosin 0.4 mg, 1 daily up to 4 weeks while group B patients were given placebo, 1 Capsule daily up to 4 weeks. The primary endpoint was expulsion rate. A written informed consent was taken from all the patients. Expulsion time, need for analgesics, need for hospitalization and drug side effects were secondary endpoints. Results: A total of 49 patients in group A and 48 patients in group B reported back, therefore 97 out of 100 patients were evaluated. Mean age of the patients was 36.34 years (range 18-57 years). Mean stone size was 5.78 mm (range 4-8 mm) in greatest dimension. A stone expulsion rate of 85.71% (42 patients) was noted in group A and 54.20% (26 patients) in group B. Group A revealed a statistically significant advantage in term of stone expulsion rate (p=0.032). Considering expulsion time in days group A showed statistically significant advantage (p=0.015). Regarding age, sex, stone size and stone lateralization (right/left), there was no significant difference between the group A and B. No drug side effects were noted in both the groups. Conclusion: By using tamsulosin a higher stone expulsion rates can be achieved in a shorter time. More randomized control trials are required to establish tamsulosin as a standard medical expulsive treatment for small distal ureteric calculus. (author)

Introduction of water into the heme distal side by Leu65 mutations of an oxygen sensor, YddV, generates verdoheme and carbon monoxide, exerting the heme oxygenase reaction.

Science.gov (United States)

Stranava, Martin; Martínková, Markéta; Stiborová, Marie; Man, Petr; Kitanishi, Kenichi; Muchová, Lucie; Vítek, Libor; Martínek, Václav; Shimizu, Toru

2014-11-01

The globin-coupled oxygen sensor, YddV, is a heme-based oxygen sensor diguanylate cyclase. Oxygen binding to the heme Fe(II) complex in the N-terminal sensor domain of this enzyme substantially enhances its diguanylate cyclase activity which is conducted in the C-terminal functional domain. Leu65 is located on the heme distal side and is important for keeping the stability of the heme Fe(II)-O2 complex by preventing the entry of the water molecule to the heme complex. In the present study, it was found that (i) Escherichia coli-overexpressed and purified L65N mutant of the isolated heme-bound domain of YddV (YddV-heme) contained the verdoheme iron complex and other modified heme complexes as determined by optical absorption spectroscopy and mass spectrometry; (ii) CO was generated in the reconstituted system composed of heme-bound L65N and NADPH:cytochrome P450 reductase as confirmed by gas chromatography; (iii) CO generation of heme-bound L65N in the reconstituted system was inhibited by superoxide dismutase and catalase. In a concordance with the result, the reactive oxygen species increased the CO generation; (iv) the E. coli cells overexpressing the L65N protein of YddV-heme also formed significant amounts of CO compared to the cells overexpressing the wild type protein; (v) generation of verdoheme and CO was also observed for other mutants at Leu65 as well, but to a lesser extent. Since Leu65 mutations are assumed to introduce the water molecule into the heme distal side of YddV-heme, it is suggested that the water molecule would significantly contribute to facilitating heme oxygenase reactions for the Leu65 mutants. Copyright © 2014 Elsevier Inc. All rights reserved.

Strain and the optoelectronic properties of nonplanar phosphorene monolayers

Science.gov (United States)

Mehboudi, Mehrshad; Utt, Kainen; Terrones, Humberto; Harriss, Edmund O.; Pacheco SanJuan, Alejandro A.; Barraza-Lopez, Salvador

2015-01-01

Lattice kirigami, ultralight metamaterials, polydisperse aggregates, ceramic nanolattices, and 2D atomic materials share an inherent structural discreteness, and their material properties evolve with their shape. To exemplify the intimate relation among material properties and the local geometry, we explore the properties of phosphorene––a new 2D atomic material––in a conical structure, and document a decrease of the semiconducting gap that is directly linked to its nonplanar shape. This geometrical effect occurs regardless of phosphorene allotrope considered, and it provides a unique optical vehicle to single out local structural defects on this 2D material. We also classify other 2D atomic materials in terms of their crystalline unit cells, and propose means to obtain the local geometry directly from their diverse 2D structures while bypassing common descriptions of shape that are based from a parametric continuum. PMID:25918413

Neurotization of the biceps muscle by end-to-side neurorraphy between ulnar and musculocutaneous nerves. A series of five cases.

Science.gov (United States)

Franciosi, L F; Modestti, C; Mueller, S F

1998-01-01

Three patients with avulsed C5, C6, and C7 roots and two patients with avulsed C5 and C6 roots after trauma of the brachial plexus, were treated by neurotization of the biceps using nerve fibers derived from the ulnar nerve and obtained by end-to-side neurorraphy between the ulnar and musculocutaneous nerves. The age of patients ranged from 19 to 45. The interval between the accident and surgery was 2 to 13 months. Return of biceps contraction was observed 4 to 6 months after surgery. Four patients recovered grade 4 elbow flexion. One 45-year-old patient did not obtain any biceps contraction after 9 months.

Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

Directory of Open Access Journals (Sweden)

Vittorio Imperatore

2014-06-01

Full Text Available Objectives: To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET of distal ureteric stones. Patients and methods: Observational data were collected retrospectively from patients who received silodosin (N = 50 or tamsulosin (N = 50 as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared. Results: Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant. Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant. Mean number of pain episodes were 1.6 and 1.7 in the silodosin and tamsulosin group, respectively (p not significant. The mean number of analgesic requirement was 0.84 and 0.9 for the silodosin and tamsulosin group, respectively (p not significant. Overall, incidence of side effects was similar in both groups. Patients taking silodosin experienced an higher incidence of retrograde ejaculation but a lower incidence of side effects related to peripheral vasodilation when compared to patients taking tamsulosin. Subgroup analysis demonstrated significantly lower mean expulsion times and pain episodes in patients with stones ≤ 5 mm in both groups. Conclusions: Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.

Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin.

Science.gov (United States)

Imperatore, Vittorio; Fusco, Ferdinando; Creta, Massimiliano; Di Meo, Sergio; Buonopane, Roberto; Longo, Nicola; Imbimbo, Ciro; Mirone, Vincenzo

2014-06-30

To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET) of distal ureteric stones. Observational data were collected retrospectively from patients who received silodosin (N = 50) or tamsulosin (N = 50) as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared. Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant). Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant). Mean number of pain episodes were 1.6 and 1.7 in the silodosin and tamsulosin group, respectively (p not significant). The mean number of analgesic requirement was 0.84 and 0.9 for the silodosin and tamsulosin group, respectively (p not significant). Overall, incidence of side effects was similar in both groups. Patients taking silodosin experienced an higher incidence of retrograde ejaculation but a lower incidence of side effects related to peripheral vasodilation when compared to patients taking tamsulosin. Subgroup analysis demonstrated significantly lower mean expulsion times and pain episodes in patients with stones ≤ 5 mm in both groups. Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.

Change of manufacturing technique for the W7-X nonplanar coil cases

International Nuclear Information System (INIS)

Gehring, M.; Schaefer, P.; Herrmann, K.D.; Scheller, H.

2001-01-01

The geometry of the coil cases of the nonplanar coil system for the Wendelstein 7-X (W7-X) experiment (Sapper, The superconducting magnet system for the W7-X stellarator. Proceedings 12th Topical Meeting on the Fusion Technology) was changed to a more complex shape compared to the DEMO Coil case (Kronhardt et al., 1998. Proceedings of the 20th SOFT (1998) 731-734). Therefore the manufacturing technique developed for the DEMO Coil case cannot be used for the series production of 50 coils. For the final design of the coil cases, investigations were performed to find a technique suitable for manufacturing the cases within the required geometrical tolerances and mechanical characteristics. In order to qualify the manufacturing technique a complete half case was cast and machined afterwards. The casting procedure was optimised with respect to the geometrical accuracy and the mechanical characteristics at 4.2 K. Measurements of the yield strength, the tensile strength, the elongation, and the Young's modulus were performed at room- and cryo-temperature (4 and 7 K). The influence of the heat treatment, the annealing temperature and the size of the casting on the mechanical values is shown. The requirements on the stainless steel are a yield strength of 800 MPa at 4 K and an elongation at fracture of >25%. The magnetic permeability has to be <1.01. Furthermore the welding properties of the case material were investigated. The development program showed that casting of complete case half shells is a feasible manufacturing technique for the series production of the Wendelstein 7-X nonplanar coil cases

Giant-Cell Tumor of the Distal Ulna Treated by Wide Resection and Ulnar Support Reconstruction: A Case Report

Directory of Open Access Journals (Sweden)

Akio Minami

2010-01-01

Full Text Available Giant-cell tumor of bone occurred in the distal end of the ulna is extremely uncommon. A 23-year-old male had a giant-cell tumor occurred in the distal end of the ulna. After wide resection of the distal segment of the ulna including giant-cell tumor, ulnar components of the wrist joint were reconstructed with modified Sauvé-Kapandji procedure using the iliac bone graft, preserving the triangular fibrocartilage complex and ulnar collateral ligament in order to maintain ulnar support of the wrist, and the proximal stump of the resected ulna was stabilized by tenodesis using the extensor carpi ulnaris tendon. One year after operation, the patient's wrist was pain-free and had a full range of motion. Postoperative X-rays showed no abnormal findings including recurrence of the giant-cell tumor and ulnar translation of the entire carpus. The stability of the proximal stump of the distal ulna was also maintained.

Demand Side Management: An approach to peak load smoothing

Science.gov (United States)

Gupta, Prachi

A preliminary national-level analysis was conducted to determine whether Demand Side Management (DSM) programs introduced by electric utilities since 1992 have made any progress towards their stated goal of reducing peak load demand. Estimates implied that DSM has a very small effect on peak load reduction and there is substantial regional and end-user variability. A limited scholarly literature on DSM also provides evidence in support of a positive effect of demand response programs. Yet, none of these studies examine the question of how DSM affects peak load at the micro-level by influencing end-users' response to prices. After nearly three decades of experience with DSM, controversy remains over how effective these programs have been. This dissertation considers regional analyses that explore both demand-side solutions and supply-side interventions. On the demand side, models are estimated to provide in-depth evidence of end-user consumption patterns for each North American Electric Reliability Corporation (NERC) region, helping to identify sectors in regions that have made a substantial contribution to peak load reduction. The empirical evidence supports the initial hypothesis that there is substantial regional and end-user variability of reductions in peak demand. These results are quite robust in rapidly-urbanizing regions, where air conditioning and lighting load is substantially higher, and regions where the summer peak is more pronounced than the winter peak. It is also evident from the regional experiences that active government involvement, as shaped by state regulations in the last few years, has been successful in promoting DSM programs, and perhaps for the same reason we witness an uptick in peak load reductions in the years 2008 and 2009. On the supply side, we estimate the effectiveness of DSM programs by analyzing the growth of capacity margin with the introduction of DSM programs. The results indicate that DSM has been successful in offsetting the

Maxillary molar distalization with aligners in adult patients: a multicenter retrospective study

Directory of Open Access Journals (Sweden)

Serena Ravera

2016-04-01

Full Text Available Abstract Background The aim of the present study was to test the hypothesis that bodily maxillary molar distalization was not achievable in aligner orthodontics. Methods Forty lateral cephalograms obtained from 20 non-growing subjects (9 male, 11 female; average age 29.73 years (group S, who underwent bilateral distalization of their maxillary dentition with Invisalign aligners (Align Technology, Inc., San José, CA, USA, were considered for the study. Skeletal class I or class II malocclusion and a bilateral end-to-end class II molar relationship were the main inclusion criteria. Cephalograms were taken at two time points: (T0 pretreatment and (T2 post-treatment. Treatment changes were evaluated between the time points using 39 variables by means of paired t test. The level of significance was set at P < 0.05. Reproducibility of measurements was assessed by the intraclass correlation coefficient (ICC. Results The mean treatment time was 24.3 ± 4.2 months. At the post-treatment point, the first molar moved distally 2.25 mm without significant tipping (P = 0.27 and vertical movements (P = 0.43. The second molar distalization was 2.52 mm without significant tipping (P = 0.056 and vertical movements (P = 0.25. No significant movements were detected on the lower arch. SN^GoGn and SPP^GoGn angles showed no significant differences between pre- and post-treatment cephalograms (P = 0.22 and P = 0.85, respectively. Conclusions Aligner therapy in association with composite attachments and class II elastics can distalize maxillary first molars by 2.25 mm without significant tipping and vertical movements of the crown. No changes to the facial height were revealed.

Nanopatterning of tools for replication of non-planar polymer surfaces

DEFF Research Database (Denmark)

Cech, Jiri

in the order of expected lifetime in descending order: aluminum, titanium, and nickel. The second problem addressed is the forming of a nanostructured surface on a non-planar substrate. We used the hydrostatic nanoimprinting technique, with the HSQ films deposited by spin-coating and spray-coating methods...... with nanostructured surfaces, we need to fabricate molds facing the same problem. In this work, we address this problem. At first, we need to verify if the previously reported monolayer adhesion-reducing coating (FDTS) can be used under different conditions during actual injection molding. Such coatings are critical...... to facilitate de-molding of the nanopatterned parts. We analyzed the coated surfaces of aluminum, titanium, and nickel molds before and after 500 molding cycles, using X-ray photoelectron spectroscopy, AFM and contact angle measurements. We show that the contact angle and that the fluorine concentration...

Assignment of the Nance-Horan syndrome to the distal short arm of the X chromosome.

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Zhu, D; Alcorn, D M; Antonarakis, S E; Levin, L S; Huang, P C; Mitchell, T N; Warren, A C; Maumenee, I H

1990-11-01

There are three types of X-linked cataracts recorded in Mendelian Inheritance in Man (McKusick 1988): congenital total, with posterior sutural opacities in heterozygotes; congenital, with microcornea or slight microphthalmia; and the cataract-dental syndrome or Nance-Horan (NH) syndrome. To identify a DNA marker close to the gene responsible for the NH syndrome, linkage analysis on 36 members in a three-generation pedigree including seven affected males and nine carrier females was performed using 31 DNA markers. A LOD score of 1.662 at theta = 0.16 was obtained with probe 782 from locus DXS85 on Xp22.2-p22.3. Negative LOD scores were found at six loci on the short arm, one distal to DXS85, five proximal, and six probes spanning the long arm were highly negative. These results make the assignment of the locus for NH to the distal end of the short arm of the X chromosome likely.

Midterm Follow-up of Treating Volar Marginal Rim Fractures with Variable Angle Lcp Volar Rim Distal Radius Plates.

Science.gov (United States)

Goorens, Chul Ki; Geeurickx, Stijn; Wernaers, Pascal; Staelens, Barbara; Scheerlinck, Thierry; Goubau, Jean

2017-06-01

Specific treatment of the volar marginal rim fragment of distal radius fractures avoids occurance of volar radiocarpal dislocation. Although several fixation systems are available to capture this fragment, adequately maintaining internal fixation is difficult. We present our experience of the first 10 cases using the 2.4 mm variable angle LCP volar rim distal radius plate (Depuy Synthes®, West Chester, US), a low-profile volar rim-contouring plate designed for distal plate positioning and stable buttressing of the volar marginal fragment. Follow-up patient satisfaction, range of motion, grips strength, functional scoring with the QuickDASH and residual pain with a numeric rating scale were assessed. Radiological evaluation consisted in evaluating fracture consolidation, ulnar variance, volar angulation and maintenance of the volar rim fixation. The female to male ratio was 5:5 and the mean age was 52.2 (range, 17-80) years. The mean follow-up period was 11 (range, 5-19) months postoperatively. Patient satisfaction was high. The mean total flexion/extension range was 144° (range, 100-180°) compared to the contralateral uninjured side 160° (range, 95-180°). The mean total pronation/supination range was 153° (range, 140-180°) compared to the contralateral uninjured side 170° (range, 155-180°). Mean grip strength was 14 kg (range, 9-22), compared to the contralateral uninjured side 20 kg (range, 12-25 kg). Mean pre-injury level activity QuickDASH was 23 (range, 0-34.1), while post-recovery QuickDASH was 25 (range 0-43.2). Residual pain was 1.5 on the visual numerical pain rating scale. Radiological evaluation revealed in all cases fracture consolidation, satisfactory reconstruction of ulnar variance, volar angulation and volar rim. We encountered no flexor tendon complications, although plate removal was systematically performed after fracture consolidation. The 2.4 mm variable angle LCP volar rim distal radius plates is a valid treatment option for treating

Side-emitting fiber optic position sensor

Science.gov (United States)

Weiss, Jonathan D [Albuquerque, NM

2008-02-12

A side-emitting fiber optic position sensor and method of determining an unknown position of an object by using the sensor. In one embodiment, a concentrated beam of light source illuminates the side of a side-emitting fiber optic at an unknown axial position along the fiber's length. Some of this side-illuminated light is in-scattered into the fiber and captured. As the captured light is guided down the fiber, its intensity decreases due to loss from side-emission away from the fiber and from bulk absorption within the fiber. By measuring the intensity of light emitted from one (or both) ends of the fiber with a photodetector(s), the axial position of the light source is determined by comparing the photodetector's signal to a calibrated response curve, look-up table, or by using a mathematical model. Alternatively, the side-emitting fiber is illuminated at one end, while a photodetector measures the intensity of light emitted from the side of the fiber, at an unknown position. As the photodetector moves further away from the illuminated end, the detector's signal strength decreases due to loss from side-emission and/or bulk absorption. As before, the detector's signal is correlated to a unique position along the fiber.

Reverse Distal Transverse Palmar Arch in Distal Digital Replantation.

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Wei, Ching-Yueh; Orozco, Oscar; Vinagre, Gustavo; Shafarenko, Mark

2017-11-01

Refinements in microsurgery have made distal finger replantation an established technique with high success rates and good functional and aesthetic outcomes. However, it still represents a technically demanding procedure due to the small vessel caliber and frequent lack of vessel length, requiring the use of interpositional venous grafts in some instances. We describe a new technique for anastomosis in fingertip replantation, whereby the need for venous grafts is eliminated. Applying the reverse distal transverse palmar arch technique, 11 cases of distal digital replantation were performed between January 2011 and July 2016. The described procedure was used for arterial anastomosis in 10 cases and arteriovenous shunting for venous drainage in 1 case. A retrospective case review was conducted. The technical description and clinical outcome evaluations are presented. Ten of the 11 replanted digits survived, corresponding to an overall success rate of 91%. One replant failed due to venous insufficiency. Blood transfusions were not required for any of the patients. Follow-up (range, 1.5-5 months) revealed near-normal range of motion and good aesthetic results. All of the replanted digits developed protective sensation. The average length of hospital admission was 5 days. All patients were satisfied with the results and were able to return to their previous work. The use of the reverse distal transverse palmar arch is a novel and reliable technique in distal digital replantation when an increase in vessel length is required, allowing for a tension-free arterial repair without the need for vein grafts.

Closed retrograde retrieval of the distal broken segment of femoral cannulated intramedullary nail using a ball-tipped guide wire.

Science.gov (United States)

Metikala, Sreenivasulu; Mohammed, Riazuddin

2011-07-01

Extracting broken segments of intramedullay nails from long bones can be an operative challenge, particularly from the distal end. We report a case series where a simple and reproducible technique of extracting broken femoral cannulated nails using a ball-tipped guide wire is described. This closed technique involves no additional equipment or instruments. Eight patients who underwent the described method were included in the study. The technique involves using a standard plain guide wire passed through the cannulated distal broken nail segment after extraction of the proximal nail fragment. The plain guide wire is then advanced distally into the knee joint carefully under fluoroscopy imaging. Over this wire, a 5-millimeter (mm) cannulated large drill bit is used to create a track up to the distal broken nail segment. Through the small knee wound, a ball-tipped guide wire is passed, smooth end first, till the ball engages the end of the nail. The guide wire is then extracted along with the broken nail through the proximal wound. The method was successfully used in all eight patients for removal of broken cannulated intramedullary nail from the femoral canal without any complications. All patients underwent exchange nailing with successful bone union in six months. None of the patients had any problems at the knee joint at the final follow-up. We report a technique for successful extraction of the distal fragment of broken femoral intramedullary nails without additional surgical approaches.

Oxidative stress and apoptosis of Carassius auratus lymphocytes induced by nonplanar (PCB153) and coplanar (PCB169) polychlorinated biphenyl congeners in vitro

Institute of Scientific and Technical Information of China (English)

ZHANG Jian-ying; ZHANG Hang-jun; NI Wan-min

2009-01-01

and the coplanar congener was more cytotoxic than nonplanar congener. This study suggests that cytotoxicity mechanisms of the PCB congeners on fish lymphocytes depend on their planarity and chemical structures.

Use of Relative vs Fixed Offset Distance to Define Region of Interest at the Distal Radius and Tibia in High-Resolution Peripheral Quantitative Computed Tomography

DEFF Research Database (Denmark)

Shanbhogue, Vikram V; Hansen, Stinus; Halekoh, Ulrich

2015-01-01

adjacent to the measurement site. This study aimed at compare the morphologic variation in measurements using the standard fixed offset distance to define the distal starting slice against those obtained by using a relative measurement position scaled to the individual bone length at the distal radius...... defined by, first, the standard measurement protocol, where the most distal CT slice was 9.5 mm and 22.5 mm from the end plate of the radius and tibia, respectively, and second, the relative measurement method, where the most distal CT slice was at 4% and 7% of the radial and tibial lengths, respectively....... Volumetric densities and microarchitectural parameters were compared between the 2 methods. Measurements of the total and cortical volumetric density and cortical thickness at the radius and tibia and cortical porosity, trabecular volumetric density, and trabecular number at the tibia were significantly...

Non-planar dislocations: 3D models and thermally-activated glide processes

International Nuclear Information System (INIS)

Ngan, A.H.W.

2005-01-01

In recent years, there has been a renewed interest in studying the cross-slip of screw dislocations in the simple face-centred cubic (FCC) structure. This paper serves to address parallel developments in modelling the cross-slip of screw dislocations in the body-centred cubic (BCC) structure and the ordered L1 2 structure. In the latter two cases, the dislocation cores have non-planar spreading offering high intrinsic Peierls stresses. The flow behaviours of these materials, such as the non-Schmid behaviour and temperature-dependence of flow stress, are largely due to the behaviours of single dislocations. 3D atomistic modelling of the minimum-energy path for the glide processes in these cases is performed with an aim to reconcile with experimentally determined activation energies for slip

Nonplanar nanoselective area growth of InGaAs/InP

DEFF Research Database (Denmark)

Kuznetsova, Nadezda; Colman, Pierre; Semenova, Elizaveta

2014-01-01

In this study, we have investigated metal-organic vapor phase epitaxial nano-patterned selective area growth of InGaAs/InP on non-planar (001) InP surfaces. Due to high etching resistance and the small molecular size of negative tone electron beam HSQ resist, the protection mask formed in HSQ has...... small feature sizes in ten nanometers scale and allow realization of in-situ etching. As was observed in the SAG regime, in-situ etching of InP by carbon tetrabromide leads to formation of self-limited structures. By altering etching time, the groove shape can be changed from a triangular trench...... to anistropic or isotropic character of etching. The investigated technique of nano-patterned selective area growth allows obtaining different profiles of structures and different quantum structures such as quantum well or wires in the same growth run. To investigate the shape and crystalline quality...

End-user challenges to security digitalisation and integration: a retail perspective

OpenAIRE

Lahtinen, Markus

2008-01-01

With the assumed digitalisation happening on the end-user side, progressive systems integrators stress the importance of changing the business concept from being installers to being service and solution providers. However, less is known about the details of this process on the end-user side. Based on an online survey of loss prevention managers it can be stated that security digitalisation and further business integration of security is a top agreement among the respondents. Integ...

Median nerve fascicular anatomy as a basis for distal neural prostheses.

Science.gov (United States)

Planitzer, Uwe; Steinke, Hanno; Meixensberger, Jürgen; Bechmann, Ingo; Hammer, Niels; Winkler, Dirk

2014-05-01

Functional electrical stimulation (FES) serves as a possible therapy to restore missing motor functions of peripheral nerves by means of cuff electrodes. FES is established for improving lower limb function. Transferring this method to the upper extremity is complex, due to a lack of anatomical data on the physiological configuration of nerve fascicles. Our study's aim was to provide an anatomical basis for FES of the median nerve in the distal forearm and hand. We investigated 21 distal median nerves from 12 body donors. The peripheral fascicles were traced back by removing the external and interfascicular epineurium and then assigned to 4 quadrants. A distinct motor and sensory distribution was observed. The fascicles innervating the thenar eminence and the first lumbrical muscle originated from the nerves' radial parts in 82%. The fascicle supplying the second lumbrical muscle originated from the ulnar side in 78%. No macroscopically visible plexus formation was observed for the distal median nerve in the forearm. The findings on the distribution of the motor branches of the median nerve and the missing plexus formation may likely serve as an anatomical basis for FES of the distal forearm. However, due to the considerable variability of the motor branches, cuff electrodes will need to be adapted individually in FES. Taking into account the sensory distribution of the median nerve, FES may also possibly be applied in the treatment of regional pain syndromes. Copyright © 2013 Elsevier GmbH. All rights reserved.

Quantum switching of π-electron rotations in a nonplanar chiral molecule by using linearly polarized UV laser pulses.

Science.gov (United States)

Mineo, Hirobumi; Yamaki, Masahiro; Teranishi, Yoshiaki; Hayashi, Michitoshi; Lin, Sheng Hsien; Fujimura, Yuichi

2012-09-05

Nonplanar chiral aromatic molecules are candidates for use as building blocks of multidimensional switching devices because the π electrons can generate ring currents with a variety of directions. We employed (P)-2,2'-biphenol because four patterns of π-electron rotations along the two phenol rings are possible and theoretically determine how quantum switching of the π-electron rotations can be realized. We found that each rotational pattern can be driven by a coherent excitation of two electronic states under two conditions: one is the symmetry of the electronic states and the other is their relative phase. On the basis of the results of quantum dynamics simulations, we propose a quantum control method for sequential switching among the four rotational patterns that can be performed by using ultrashort overlapped pump and dump pulses with properly selected relative phases and photon polarization directions. The results serve as a theoretical basis for the design of confined ultrafast switching of ring currents of nonplanar molecules and further current-induced magnetic fluxes of more sophisticated systems.

Spleen-preserving distal pancreatectomy in trauma.

Science.gov (United States)

Schellenberg, Morgan; Inaba, Kenji; Cheng, Vincent; Bardes, James M; Lam, Lydia; Benjamin, Elizabeth; Matsushima, Kazuhide; Demetriades, Demetrios

2018-01-01

Traumatic injuries to the distal pancreas are infrequent. Universally accepted recommendations about the need for routine splenectomy with distal pancreatectomy do not exist. The aims of this study were to compare outcomes after distal pancreatectomy and splenectomy versus spleen-preserving distal pancreatectomy, and to define the appropriate patient population for splenic preservation. All patients who underwent distal pancreatectomy (January 1, 2007, to December 31, 2014) were identified from the National Trauma Data Bank. Patients with concomitant splenic injury and those who underwent partial splenectomy were excluded. Demographics, clinical data, procedures, and outcomes were collected. Study groups were defined by surgical procedure: distal pancreatectomy and splenectomy versus spleen-preserving distal pancreatectomy. Baseline characteristics between groups were compared with univariate analysis. Multivariate analysis was performed with logistic and linear regression to examine differences in outcomes. Over the 8-year study period, 2,223 patients underwent distal pancreatectomy. After excluding 1,381 patients with concomitant splenic injury (62%) and 8 (pancreatectomy and splenectomy, those who underwent spleen-preserving distal pancreatectomy were younger (p pancreatectomy (p = 0.017). Complications, mortality, and intensive care unit LOS were not significantly different. In young patients after blunt trauma who are not severely injured, a spleen-preserving distal pancreatectomy should be considered to allow for conservation of splenic function and a shorter hospital LOS. In all other patients, the surgeon should not hesitate to remove the spleen with the distal pancreas. Therapy, level IV.

Distal Oblique Bundle Reinforcement for Treatment of DRUJ Instability.

Science.gov (United States)

Brink, Peter R G; Hannemann, Pascal F W

2015-08-01

Background Chronic, dynamic bidirectional instability in the distal radioulnar joint (DRUJ) is diagnosed clinically, based on the patient's complaints and the finding of abnormal laxity in the vicinity of the distal ulna. In cases where malunion is ruled out or treated and there are no signs of osteoarthritis, stabilization of the DRUJ may offer relief. To this end, several different techniques have been investigated over the past 90 years. Materials and Methods In this article we outline the procedure for a new technique using a tendon graft to reinforce the distal edge of the interosseous membrane. Description of Technique A percutaneous technique is used to harvest the palmaris longus tendon and to create a tunnel, just proximal to the sigmoid notch, through the ulna and radius in an oblique direction. By overdrilling the radial cortex, the knotted tendon can be pulled through the radius and ulna and the knot blocked at the second radial cortex, creating a strong connection between the radius and ulna at the site of the distal oblique bundle (DOB). The tendon is fixed in the ulna with a small interference screw in full supination, preventing subluxation of the ulna out of the sigmoid notch during rotation. Results Fourteen patients were treated with this novel technique between 2011 and October 2013. The QuickDASH score at 25 months postoperatively (range 16-38 months) showed an improvement of 32 points. Similarly, an improvement of 33 points (67-34 months) was found on the PRWHE. Only one recurrence of chronic, dynamic bidirectional instability in the DRUJ was observed. Conclusion This simple percutaneous tenodesis technique between radius and ulna at the position of the distal edge of the interosseous membrane shows promise in terms of both restoring stability and relieving complaints related to chronic subluxation in the DRUJ.

Treatment of lithic tumors of the distal ending of the radius: Results of two surgical techniques in a series of cases

International Nuclear Information System (INIS)

Escandon, Santiago; Soto, Camilo; Pulido, Edgar

2003-01-01

The distal ending of the radius can bear several tumors with different degrees of aggressiveness that depend on the extension of the tumor. Their treatment varies according to the aggressiveness it and can include curettage only or may require more extensive surgical procedures including, in some cases reconstructive surgery. The present study describes two surgical reconstructive techniques and their results in a series of cases. Five patients underwent radio-carpal, and three Ulnar-carpal arthrodesis with non-vascularized autologous bone graft from the iliac crest. Pathology diagnosis included: six giant cell tumors, one Ewing's sarcoma, and one chondroblastoma. There were five males and three females, with an average age of 34.6 years (rank: 17-52). All the patients underwent wide surgical resection of the tumor, and only the patient with the Ewing's sarcoma received additionally adjuvant chemotherapy and radiotherapy. Five patients had compromise of the surrounding soft tissues. Two had limitation of movement of the fingers, and one hypoesthesia. One patient with ulnar arthrodesis had a fracture of the cubitus, at the proximal ending of the plate, secondary to trauma. AII patients have been followed for an average time of 12.8 months (rank: 0.5-72). There have been no episodes of infection. Neither non-union of the osteotomies, nor failures of fixation or recurrences were observed

Asymmetrical distalization of maxillary molars with zygomatic anchorage, improved superelastic nickel-titanium alloy wires, and open-coil springs.

Science.gov (United States)

Ishida, Takayoshi; Yoon, Hyung Sik; Ono, Takashi

2013-10-01

In nongrowing patients with skeletal Class II malocclusion, premolar extraction or maxillary distalization can be used as camouflage treatment. Zygomatic anchorage enables distalization in uncooperative or noncompliant patients. We describe 1 such procedure in a 24-year-old woman. We used novel improved superelastic nickel-titanium archwires combined with nickel-titanium open-coil springs to provide a constant and continuous low force to the dentition. We were able to successfully eliminate the protrusive profile and correct the Class II molar relationship using this system of zygomatic anchorage. The posterior occlusal relationships were improved to achieve Class I canine and molar relationships on both sides, and ideal overbite and overjet relationships were established. Facial esthetics was improved with decreased protrusion of the upper and lower lips. The method used here is a promising alternative to traditional distalization techniques and might offer an effective and simple means of distalizing maxillary molars in uncooperative patients. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Social Support Contributes to Outcomes following Distal Radius Fractures

Directory of Open Access Journals (Sweden)

Caitlin J. Symonette

2013-01-01

Full Text Available Background. Distal radius fractures are the most common fracture of the upper extremity and cause variable disability. This study examined the role of social support in patient-reported pain and disability at one year following distal radius fracture. Methods. The Medical Outcomes Study Social Support Survey was administered to a prospective cohort of 291 subjects with distal radius fractures at their baseline visit. Pearson correlations and stepwise linear regression models (F-to-remove 0.10 were used to identify whether social support contributes to wrist fracture outcomes. The primary outcome of pain and disability at one year was measured using the Patient Rated Wrist Evaluation. Results. Most injuries were low energy (67.5% and were treated nonoperatively (71.9%. Pearson correlation analysis revealed that higher reported social support correlated with improved Patient Rated Wrist Evaluation scores at 1 year, r(n=181=-0.22, P<0.05. Of the subscales within the Social Support Survey, emotional/informational support explained a significant proportion of the variance in 1-year Patient Rated Wrist Evaluation scores, R2=4.7%, F (1, 181 = 9.98, P<0.05. Conclusion. Lower emotional/informational social support at the time of distal radius fracture contributes a small but significant percentage to patient-reported pain and disability outcomes.

Palliative end ileostomy and gastrojejunostomy for a metastatic distal transverse colonic malignancy complicated by a proximal duodenocolic fistula: a case report.

Science.gov (United States)

Pamathy, Gnanaselvam; Jayarajah, Umesh; Gunathilaka, Yapa Hamillage Hemantha; Sivaganesh, Sivasuriya

2017-08-14

Fistulae between the colon and upper gastrointestinal tract are distressing and uncommon complications of malignancies involving this region. We report a case of a middle-aged man with a locally advanced and metastatic distal transverse colon malignancy who presented with a duodenocolic fistula proximal to the primary tumor and underwent palliative surgery. A 50-year-old Sri Lankan man presented to our hospital with a history of feculent vomiting of 1 week's duration preceded by worsening constipation and abdominal fullness of 2 months' duration. He also complained of anorexia and significant weight loss over the previous month. His physical examination was unremarkable except for his wasted appearance. Flexible sigmoidoscopy done at his local hospital had not revealed any abnormality in the left colon. Gastroduodenoscopy did not reveal fecal matter or any mucosal abnormalities in the stomach or duodenum. An abdominal contrast-enhanced computed tomographic scan showed a mid-to-distal transverse colonic tumor with a duodenocolic fistula proximal to the primary lesion. At laparotomy, he was found to have an unresectable, locally advanced mid transverse colon tumor with diffuse peritoneal and mesenteric deposits and mild ascites. Palliative end ileostomy and gastrojejunostomy were performed before closure. Histology from the malignant deposits revealed a well-differentiated adenocarcinoma. He made an uneventful recovery with good symptomatic relief. Malignant gastric or duodenocolic fistulae are uncommon complications of locally advanced colonic malignancies with direct invasion to the stomach or duodenum. Although the characteristic clinical presentation of feculent vomiting suggests the diagnosis, cross-sectional imaging is confirmative in addition to staging the disease. Management is guided by disease stage, nutritional status, and the general condition of the patient and ranges from extensive bowel resection including the fistula to palliative options.

Autosomal dominant distal myopathy: Linkage to chromosome 14

Energy Technology Data Exchange (ETDEWEB)

Laing, N.G.; Laing, B.A.; Wilton, S.D.; Dorosz, S.; Mastaglia, F.L.; Kakulas, B.A. [Australian Neuromuscular Research Institute, Perth (Australia); Robbins, P.; Meredith, C.; Honeyman, K.; Kozman, H.

1995-02-01

We have studied a family segregating a form of autosomal dominant distal myopathy (MIM 160500) and containing nine living affected individuals. The myopathy in this family is closest in clinical phenotype to that first described by Gowers in 1902. A search for linkage was conducted using microsatellite, VNTR, and RFLP markers. In total, 92 markers on all 22 autosomes were run. Positive linkage was obtained with 14 of 15 markers tested on chromosome 14, with little indication of linkage elsewhere in the genome. Maximum two-point LOD scores of 2.60 at recombination fraction .00 were obtained for the markers MYH7 and D14S64 - the family structure precludes a two-point LOD score {ge} 3. Recombinations with D14S72 and D14S49 indicate that this distal myopathy locus, MPD1, should lie between these markers. A multipoint analysis assuming 100% penetrance and using the markers D14S72, D14S50, MYH7, D14S64, D14S54, and D14S49 gave a LOD score of exactly 3 at MYH7. Analysis at a penetrance of 80% gave a LOD score of 2.8 at this marker. This probable localization of a gene for distal myopathy, MPD1, on chromosome 14 should allow other investigators studying distal myopathy families to test this region for linkage in other types of the disease, to confirm linkage or to demonstrate the likely genetic heterogeneity. 24 refs., 3 figs., 1 tab.

Comparison of standard laparoscopic distal pancreatectomy with minimally invasive distal pancreatectomy using the da Vinci S system.

Science.gov (United States)

Ito, Masahiro; Asano, Yukio; Shimizu, Tomohiro; Uyama, Ichiro; Horiguchi, Akihiko

2014-01-01

Minimally invasive procedures for pancreatic pathologies are increasingly being used, including distal pancreatectomy. This study aimed to assess the indications for and outcomes of the da Vinci distal pancreatectomy procedure. We reviewed the medical records of patients who underwent pancreatic head resection from April 2009 to September 2013. Four patients (mean age, 52.7 years) underwent da Vinci distal pancreatectomy and 10 (mean age, 68.0 +/- 12.1 years) underwent laparoscopic distal pancreatectomy. The mean surgical duration was 292 +/- 153 min and 306 +/- 29 min, the mean blood loss was 153 +/- 71 mL and 61.7 +/- 72 mL, and the mean postoperative length of stay was 24 +/- 11 days and 14 +/- 3 days in the da Vinci distal pancreatectomy and laparoscopic distal pancreatectomy groups, respectively. One patient who underwent da Vinci distal pancreatectomy developed a pancreatic fistula, while 2 patients in the laparoscopic distal pancreatectomy group developed splenic ischemia and gastric torsion, respectively. Laparoscopic and robotic pancreatic resection were both safe and feasible in selected patients with distal pancreatic pathologies. Further studies are necessary to clarify the role of robotic surgery in the advanced laparoscopic era.

A PROSPECTIVE STUDY OF DISTAL TIBIAL FRACTURES BY MIPO (LCP)

OpenAIRE

Chandra Sekharam Naidu; Ch.Murali Krishna; Sankara Rao; Dharma Rao; Ashok Kumar

2015-01-01

INTRODUCTION: D istal tibial fractures represent a significant challenge to most of the surgeons even today. They constitute 1 - 10% of all lower extremity fractures . 1 The difficulty in treating the fractures of distal tibial end is exemplif ied by orthopedists, who in the first half of twentieth century, believed these injuries were so severe and fraught with so many complications, that these fractures wer...

Treatment of tailgut cysts by extended distal rectal segmental resection with rectoanal anastomosis.

Science.gov (United States)

Volk, Andreas; Plodeck, Verena; Toma, Marieta; Saeger, Hans-Detlev; Pistorius, Steffen

2017-04-01

Complete surgical resection is the treatment of choice for tailgut cysts, because of their malignant potential and tendency to regrow if incompletely resected. We report our experience of treating patients with tailgut cysts, and discuss diagnostics, surgical approaches, and follow-up. We performed extended distal rectal segmental resection of the tailgut cyst, with rectoanal anastomosis. We report the clinical, radiological, pathological, and surgical findings, describe the procedures performed, and summarize follow-up data. Two patients underwent en-bloc resection of a tailgut cyst, the adjacent part of the levator muscle, and the distal rectal segment, followed by an end-to-end rectoanal anastomosis. There was no evidence of anastomotic leakage postoperatively. At the time of writing, our patients were relapse-free with no, or non-limiting, symptoms of anal incontinence, respectively. This surgical approach appears to have a low complication rate and good recovery outcomes. Moreover, as the sphincter is preserved, so is the postoperative anorectal function. This approach could result in a low recurrence rate.

Load transfer characteristics of unilateral distal extension removable partial dentures with polyacetal resin supporting components.

Science.gov (United States)

Jiao, T; Chang, T; Caputo, A A

2009-03-01

To photoelastically examine load transfer by unilateral distal extension removable partial dentures with supporting and retentive components made of the lower stiffness polyacetal resins. A mandibular photoelastic model, with edentulous space distal to the right second premolar and missing the left first molar, was constructed to determine the load transmission characteristics of a unilateral distal extension base removable partial denture. Individual simulants were used for tooth structure, periodontal ligament, and alveolar bone. Three designs were fabricated: a major connector and clasps made from polyacetal resin, a metal framework as the major connector with polyacetal resin clasp and denture base, and a traditional metal framework I-bar removable partial denture. Simulated posterior bilateral and unilateral occlusal loads were applied to the removable partial dentures. Under bilateral and left side unilateral loading, the highest stress was observed adjacent to the left side posterior teeth with the polyacetal removable partial denture. The lowest stress was seen with the traditional metal framework. Unilateral loads on the right edentulous region produced similar distributed stress under the denture base with all three designs but a somewhat higher intensity with the polyacetal framework. The polyacetal resin removable partial denture concentrated the highest stresses to the abutment and the bone. The traditional metal framework I-bar removable partial denture most equitably distributed force. The hybrid design that combined a metal framework and polyacetal clasp and denture base may be a viable alternative when aesthetics are of primary concern.

Is Bone Grafting Necessary in the Treatment of Malunited Distal Radius Fractures?

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Disseldorp, Dominique J. G.; Poeze, Martijn; Hannemann, Pascal F. W.; Brink, Peter R. G.

2015-01-01

Background Open wedge osteotomy with bone grafting and plate fixation is the standard procedure for the correction of malunited distal radius fractures. Bone grafts are used to increase structural stability and to enhance new bone formation. However, bone grafts are also associated with donor site morbidity, delayed union at bone–graft interfaces, size mismatch between graft and osteotomy defect, and additional operation time. Purpose The goal of this study was to assess bone healing and secondary fracture displacement in the treatment of malunited distal radius fractures without the use of bone grafting. Methods Between January 1993 and December 2013, 132 corrective osteotomies and plate fixations without bone grafting were performed for malunited distal radius fractures. The minimum follow-up time was 12 months. Primary study outcomes were time to complete bone healing and secondary fracture displacement. Preoperative and postoperative radiographs during follow-up were compared with each other, as well as with radiographs of the uninjured side. Results All 132 osteotomies healed. In two cases (1.5%), healing took more than 4 months, but reinterventions were not necessary. No cases of secondary fracture displacement or hardware failure were observed. Significant improvements in all radiographic parameters were shown after corrective osteotomy and plate fixation. Conclusion This study shows that bone grafts are not required for bone healing and prevention of secondary fracture displacement after corrective osteotomy and plate fixation of malunited distal radius fractures. Level of evidence Therapeutic, level IV, case series with no comparison group PMID:26261748

Surgical induction, histological evaluation, and MRI identification of cartilage necrosis in the distal femur in goats to model early lesions of osteochondrosis.

Science.gov (United States)

Tóth, F; Nissi, M J; Wang, L; Ellermann, J M; Carlson, C S

2015-02-01

Identify and interrupt the vascular supply to portions of the distal femoral articular-epiphyseal cartilage complex (AECC) in goat kids to induce cartilage necrosis, characteristic of early lesions of osteochondrosis (OC); then utilize magnetic resonance imaging (MRI) to identify necrotic areas of cartilage. Distal femora were perfused and cleared in goat kids of various ages to visualize the vascular supply to the distal femoral AECC. Vessels located on the axial aspect of the medial femoral condyle (MFC) and on the abaxial side of the lateral trochlear ridge were transected in eight 4- to 5-day-old goats to induce cartilage necrosis. Goats were euthanized 1, 2, 3, 4, 5, 6, 9, and 10 weeks post operatively and operated stifles were harvested. Adiabatic T1ρ relaxation time maps of the harvested distal femora were generated using a 9.4 T MR scanner, after which samples were evaluated histologically. Interruption of the vascular supply to the MFC caused lesions of cartilage necrosis in 6/8 goat kids that were demonstrated histologically. Adiabatic T1ρ relaxation time mapping identified these areas of cartilage necrosis in 5/6 cases. No significant findings were detected after transection of perichondrial vessels supplying the lateral trochlear ridge. Cartilage necrosis, characteristic of early OC, can be induced by interrupting the vascular supply to the distal femoral AECC in goat kids. The ability of high field MRI to identify these areas of cartilage necrosis in the AECC using the adiabatic T1ρ sequence suggests that this technique may be useful in the future for the early diagnosis of OC. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Laparoscopic distal pancreatectomy: results of a prospective non-randomized study from a tertiary center.

Science.gov (United States)

Palanivelu, C; Shetty, R; Jani, K; Sendhilkumar, K; Rajan, P S; Maheshkumar, G S

2007-03-01

Though laparoscopic distal pancreatectomy for benign conditions was first described in the early 1990s, it has not become as popular as other laparoscopic surgeries. Published literature on this topic consists of several case reports and a handful of small series. We present our experience, which, to the best of our knowledge, is the largest series reported to date. Since 1998, 22 patients have undergone distal pancreatectomy at our institute. The technique of distal pancreatosplenectomy, as well as spleen-preserving distal pancreatectomy, is described. Four males and 18 females in the age range of 12-69 years underwent operation. Splenic preservation was possible in 7 patients. The tumor diameter ranged from 2.1 cm to 7.4 cm. The mean operating time was 215 min. The mean length of incision required for specimen retrieval was 3.4 cm. All patients were started on a liquid diet on the first postoperative day. The median hospital stay was 4 days. One patient developed a pancreatic fistula that was managed conservatively. At the end of an average follow-up of 4.6 years, no recurrence has been reported. Laparoscopic distal pancreatectomy is a safe procedure, with minimal morbidity, rapid recovery, and short hospital stay. In appropriate cases, splenic preservation is feasible.

Ex-vivo release of Pipeline Embolization Device polytetrafluoroethylene (PTFE) sleeves for improved distal landing zone accuracy in-vivo: A technical note.

Science.gov (United States)

Griessenauer, Christoph J; Gupta, Raghav; Moore, Justin; Thomas, Ajith J; Ogilvy, Christopher S

2016-12-01

Distal landing zone accuracy is critical in some intracranial aneurysms treated with the Pipeline Embolization Device (PED), and delayed opening of the distal end of the device can complicate the procedure. Here, we report a technical nuance that facilitates accurate placement of the distal end of the PED by ex-vivo, pre-implantation release of the PED Flex polytetrafluoroethylene (PTFE) sleeves. The PED Flex is partially pushed out of the introducer sheath ex-vivo, pre-implantation until the distal PED opens entirely and the PTFE sleeves are located distal to the device. Without inverting the PTFE sleeves, the PED is carefully pulled back into the introducer sheath placing the PTFE sleeves inside the device. The PED is loaded into the microcatheter and advanced toward the site of implantation. When the PED is initially deployed and pushed out of the microcatheter, it opens immediately and provides an anchor for the remainder of the deployment process. We present a video (supplementary material) that illustrates the technique along with an illustrative case. Ex-vivo, pre-implantation release of the PTFE sleeves is an option in aneurysm treatment where distal landing accuracy is critical. Even without the protection of the PTFE sleeves, our clinical observation shows that the PED can be advanced safely through the microcatheter in selected cases. © The Author(s) 2016.

Arthroscopic Resection of The Distal Clavicle With Concomitant Subacromial Decompression: A Case Series

Directory of Open Access Journals (Sweden)

HZ Chan

2014-07-01

Full Text Available Shoulder impingement syndrome and acromioclavicular joint osteoarthritis often occur simultaneously and easily missed. Kay et al. reported excellent results with combined arthroscopic subacromial decompression and resection of the distal end of the clavicle in patients with both disorders. Arthroscopic treatment of these disorders produces more favourable results than open procedures. We report two patients who were not responding to conservative management and were treated with direct arthroscopic distal clavicle excision and subacromial decompression in single setting. Both patients gained good postoperative outcome in terms of pain score, function and strength improvement assessed objectively with visual analogue score (VAS and University of California Los Angeles Score (UCLA.

Dose ratio proton radiography using the proximal side of the Bragg peak

Energy Technology Data Exchange (ETDEWEB)

Doolan, P. J., E-mail: paul.doolan.09@ucl.ac.uk; Royle, G.; Gibson, A. [Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT (United Kingdom); Lu, H.-M. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Prieels, D.; Bentefour, E. H. [Ion Beam Applications (IBA), 3 Chemin du Cyclotron, Louvain la Neuve B-1348 (Belgium)

2015-04-15

Purpose: In recent years, there has been a movement toward single-detector proton radiography, due to its potential ease of implementation within the clinical environment. One such single-detector technique is the dose ratio method in which the dose maps from two pristine Bragg peaks are recorded beyond the patient. To date, this has only been investigated on the distal side of the lower energy Bragg peak, due to the sharp falloff. The authors investigate the limits and applicability of the dose ratio method on the proximal side of the lower energy Bragg peak, which has the potential to allow a much wider range of water-equivalent thicknesses (WET) to be imaged. Comparisons are made with the use of the distal side of the Bragg peak. Methods: Using the analytical approximation for the Bragg peak, the authors generated theoretical dose ratio curves for a range of energy pairs, and then determined how an uncertainty in the dose ratio would translate to a spread in the WET estimate. By defining this spread as the accuracy one could achieve in the WET estimate, the authors were able to generate lookup graphs of the range on the proximal side of the Bragg peak that one could reliably use. These were dependent on the energy pair, noise level in the dose ratio image and the required accuracy in the WET. Using these lookup graphs, the authors investigated the applicability of the technique for a range of patient treatment sites. The authors validated the theoretical approach with experimental measurements using a complementary metal oxide semiconductor active pixel sensor (CMOS APS), by imaging a small sapphire sphere in a high energy proton beam. Results: Provided the noise level in the dose ratio image was 1% or less, a larger spread of WETs could be imaged using the proximal side of the Bragg peak (max 5.31 cm) compared to the distal side (max 2.42 cm). In simulation, it was found that, for a pediatric brain, it is possible to use the technique to image a region with a

Delayed primary end-to-end anastomosis for traumatic long segment urethral stricture and its short-term outcomes

Directory of Open Access Journals (Sweden)

Rajarshi Kumar

2017-01-01

Full Text Available Background: The purpose of this study is to evaluate the aetiology of posterior urethral stricture in children and analysis of results after delayed primary repair with extensive distal urethral mobilisation. Materials and Methods: This was a retrospective study carried out in a tertiary care centre from January 2009 to December 2013. Results: Eight children with median age 7.5 years (range 4–11 years, underwent delayed anastomotic urethroplasty: Six through perineal and two through combined perineal and transpubic approach. All the eight children had long-segment >2 cm stricture: Three posterior and five anterior urethral stricture. On a mean follow-up period of 33 months (range 24–48 m, all were passing urine with good flow and stream. Conclusion: End-to-end anastomosis in post-traumatic long segment posterior urethral stricture between prostatic and penile urethra in children is possible by perineal or combined perineal and transpubic approach with good results without any urethral replacement.

Protein diversity in discrete structures at the distal tip of the trypanosome flagellum

Czech Academy of Sciences Publication Activity Database

Varga, Vladimír; Moreira-Leite, F.; Portman, N.; Gull, K.

2017-01-01

Roč. 114, č. 32 (2017), E6546-E6555 ISSN 0027-8424 Institutional support: RVO:68378050 Keywords : flagellar distal end * trypanosome * flagella connector * axonemal capping structure * structure immunoprecipitation Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Cell biology Impact factor: 9.661, year: 2016

Impact of Right-Sided Aneurysm, Rupture Status, and Size of Aneurysm on Perforator Infarction Following Microsurgical Clipping of Posterior Communicating Artery Aneurysms with a Distal Transsylvian Approach.

Science.gov (United States)

Tanabe, Jun; Ishikawa, Tatsuya; Moroi, Junta; Sakata, Yoshinori; Hadeishi, Hiromu

2018-03-01

Posterior communicating artery (PCoA) aneurysms are among the most common aneurysms. Because blockage of the PCoA and perforators can cause adverse outcomes, occlusion of these arteries by surgical clipping should be avoided. The impact of factors on PCoA perforator infarction when using a distal transsylvian approach for PCoA aneurysms was examined. A total of 183 patients underwent PCoA aneurysm clipping, excluding application of fenestrated clips. Patients were divided into 2 groups: patients with PCoA perforator infarction (infarction group) and patients without infarction (noninfarction group). Multiple factors were analyzed in the 2 groups. Twenty-two of the 183 patients (12.0%) showed perforator infarction, mainly on magnetic resonance imaging evaluation, resulting in permanent deficits in 2 patients (1.1%). The proportion of right-sided operations (86.4% vs. 53.4%; P = 0.005) and surgery for rupture (90.9% vs. 55.9%; P = 0.002) were significantly higher in the infarction group than in the noninfarction group. Aneurysms were significantly larger in the infarction group (8.4 ± 3.8 mm) than in the noninfarction group (6.3 ± 3.0 mm; P = 0.02). Ruptured status (odds ratio [OR], 7.35; P = 0.01), right side (OR, 5.19; P = 0.01), and aneurysm size (OR, 1.18; P = 0.02) remained independent predictors of perforator infarction on multivariate logistic regression analysis. Ruptured status, right side, and large PCoA aneurysm were independent predictors of PCoA perforator infarction. Symptoms due to PCoA perforating infarction were mostly transient and rarely affected outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

Total elbow arthroplasty for the treatment of distal humeral fractures.

Science.gov (United States)

Gallucci, G L; Larrondo Calderón, W; Boretto, J G; Castellaro Lantermo, J A; Terán, J; de Carli, P

2016-01-01

To report the clinical-functional outcomes of the treatment of humeral distal fractures with a total elbow prosthesis. This retrospective study was performed in two surgical centres. A total of 23patients were included, with a mean age of 79years, and of which 21 were women. The inclusion criteria were: patients with humeral distal fractures, operated on using a Coonrad-Morrey prosthesis, and with a follow-up of more than one year. According to AO classification, 15fractures were type C3, 7 C2 and 1 A2. All patients were operated on without de-insertion of the extensor mechanism. The mean follow-up was 40 months. Flexor-extension was 123-17°, with a total mobility arc of 106° (80% of the contralateral side). Pain, according to a visual analogue scale was 1. The Mayo Elbow Performance Index (MEPI) was 83 points. Excellent results were obtained in 8 patients, good in 13, medium in 1, and poor in 1. The mean DASH (disability) score was 24 points. Treatment of humeral distal fractures with total elbow arthroplasty could be a good treatment option, but indications must be limited to patients with complex fractures, poor bone quality, with osteoporosis and low functional demands. In younger patients, the use is limited to serious cases where there is no other treatment option. Level of Evidence IV. Copyright © 2016 SECOT. Published by Elsevier Espana. All rights reserved.

Minimally invasive locked plating of distal tibia fractures is safe and effective.

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Ronga, Mario; Longo, Umile Giuseppe; Maffulli, Nicola

2010-04-01

Distal tibial fractures are difficult to manage. Limited soft tissue and poor vascularity impose limitations for traditional plating techniques that require large exposures. The nature of the limitations for traditional plating techniques is intrinsic to the large exposure required to approach distal tibia, a bone characterized by limited soft tissue coverage and poor vascularity. The locking plate (LP) is a new device for treatment of fractures. We assessed the bone union rate, deformity, leg-length discrepancy, ankle range of motion, return to preinjury activities, infection, and complication rate in 21 selected patients who underwent minimally invasive osteosynthesis of closed distal tibia fractures with an LP. According to the AO classification, there were 12 Type A, 5 Type B, and 4 Type C fractures. The minimum followup was 2 years (average, 2.8 years; range, 2-4 years). Two patients were lost to followup. Union was achieved in all but one patient by the 24th postoperative week. Four patients had angular deformity less than 7 degrees . No patient had a leg-length discrepancy more than 1.1 cm. Five patients had ankle range of motion less than 20 degrees compared with the contralateral side. Sixteen patients had not returned to their preinjury sporting or leisure activities. Three patients developed a delayed infection. We judge the LP a reasonable device for treating distal tibia fractures. The level of physical activities appears permanently reduced in most patients. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Top-forms of leading singularities in nonplanar multi-loop amplitudes

Energy Technology Data Exchange (ETDEWEB)

Chen, Baoyi; Cheung, Yeuk-Kwan E.; Xie, Ruofei; Xin, Yuan [Nanjing University, Department of Physics, Nanjing (China); Chen, Gang [Zhejiang Normal University, Department of Physics, Jinhua (China); Nanjing University, Department of Physics, Nanjing (China)

2018-02-15

The on-shell diagram is a very important tool in studying scattering amplitudes. In this paper we discuss the on-shell diagrams without external BCFW bridges. We introduce an extra step of adding an auxiliary external momentum line. Then we can decompose the on-shell diagrams by removing external BCFW bridges to a planar diagram whose top-form is well known now. The top-form of the on-shell diagram with the auxiliary line can be obtained by adding the BCFW bridges in an inverse order as discussed in our former paper (Chen et al. in Eur Phys J C 77(2):80 2017). To get the top-form of the original diagram, the soft limit of the auxiliary line is needed. We obtain the evolution rule for the Grassmannian integral and the geometry constraint in the soft limit. This completes the top-form description of leading singularities in nonplanar scattering amplitudes of N = 4 Super Yang-Mills (SYM), which is valid for arbitrary higher-loops and beyond the Maximally-Helicity-Violation (MHV) amplitudes. (orig.)

Distal renal tubular acidosis

Science.gov (United States)

... this disorder. Alternative Names Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA Images Kidney anatomy Kidney - blood and urine flow References Bose A, Monk RD, Bushinsky DA. Kidney ...

Application of Young-Michelson and Brown-Twiss interferometers for determining geometric parameters of nonplanar rough objects

International Nuclear Information System (INIS)

Mandrosov, V I

2008-01-01

The possibility of using Young-Michelson and Brown-Twiss interferometers for measuring the angular dimensions and parameters of the surface shape of remote passively scattering and self-luminous nonplanar rough objects by optical radiation propagating from them is substantiated. The analysis is based on the properties of approximate transverse functions of field coherence B t and B t ' and intensity coherence B ti and B ti ' formed by the time averaging of the products of fields and intensities taken at two points of a receiving aperture (the prime denotes self-luminous objects). The averaging time is set to be much longer than the coherence time of radiation propagating from an object. It is shown that for the radiation coherence length much smaller than the depth of the visible region of the object, the functions B t and B t ' are proportional to the Fourier transform of the intensity distribution in the image of a remote object, which is the generalisation of the Van Cittert-Zernicke theorem to the case of a nonplanar object, while functions B ti and B ti ' are proportional to the squares of the modulus of the Fourier transform of this distribution. It is also shown that the recording of functions B t and B t ' with a Young-Michelson interferometer gives only the angular dimensions of the visible region of objects, whereas the recording of functions B ti and B ti ' with a Brown-Twiss interferometer allows one to find these dimensions and the radius of curvature of the object surface. (laser radiation scattering)

The feasibility and advantages of billroth-I reconstruction in distal gastric cancers following resection.

Science.gov (United States)

Ganesh, M S; Reddy, K G; Venkata Subbareddy, D S

2012-01-01

Gastric carcinomas are common malignancies in southern India and distal stomach remains the commonest site in low socio economic groups. Surgery still remains an important modality of treatment to achieve local control and also relieve obstructive symptoms. In this study we investigated the feasibility of performing a gastrectomy and billroth-1 type of anastomosis in a rural cancer center setting, with parameters like adequacy of margins, ease of anastomosis and its functional results were analysed. Eight patients presenting to a rurally based cancer center underwent a distal gastrectomy and billroth-1 type of anastomosis for continuity restoration. All the patients had adequate proximal and distal marg. The surgical time varied between-hrs. The anastomosis was constructed without any tension on bowel ends in all patients. The average time to start oral feeds varied between- None of the patients showed symptoms of bile reflux nor dumping. The average hospital stay varied between. Billroth-1 anastomosis is a physiologically more natural way of restoring continuity following a gastrectomy and it is a procedure which would be technically more simpler and decrease per and post operative complications and allow speedier post operative recovery following surgery on distal gastric cancers.

Efficacy and Safety of Tamsulosin in Medical Expulsive Therapy for Distal Ureteral Stones with Renal Colic: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial.

Science.gov (United States)

Ye, Zhangqun; Zeng, Guohua; Yang, Huan; Tang, Kun; Zhang, Xiaochun; Li, Hong; Li, Weibing; Wu, Zhong; Chen, Lingwu; Chen, Xingfa; Liu, Xiankui; Deng, Yaoliang; Pan, Tiejun; Xing, Jinchun; Wang, Shusheng; Cheng, Yue; Gu, Xiaojian; Gao, Wenxi; Yang, Jianggen; Zhang, Yonghai; Mi, Qiwu; Qi, Lin; Li, Jiongming; Hu, Weilie; Liang, Peiyu; Sun, Zhaolin; Xu, Changbao; Long, Yongfu; Liao, Yongbin; Liu, Siping; Liu, Guoqing; Xu, Xun; He, Wei; Chen, Zhiqiang; Xu, Hua

2017-11-12

Recent large high-quality trials have questioned the clinical effectiveness of medical expulsive therapy using tamsulosin for ureteral stones. To evaluate the efficacy and safety of tamsulosin for distal ureteral stones compared with placebo. We conducted a double-blind, placebo-controlled study of 3296 patients with distal ureteral stones, across 30 centers, to evaluate the efficacy and safety of tamsulosin. Participants were randomly assigned (1:1) into tamsulosin (0.4mg) or placebo groups for 4 wk. The primary end point of analysis was the overall stone expulsion rate, defined as stone expulsion, confirmed by negative findings on computed tomography, over a 28-d surveillance period. Secondary end points included time to stone expulsion, use of analgesics, and incidence of adverse events. Among 3450 patients randomized between September 1, 2011, and August 31, 2013, 3296 (96%) were included in the primary analysis. Tamsulosin benefits from a higher stone expulsion rate than the placebo (86% vs 79%; ptamsulosin for the treatment of large distal ureteral stones (>5mm). Considering the secondary end points, tamsulosin-treated patients reported a shorter time to expulsion (ptamsulosin use benefits distal ureteral stones in facilitating stone passage and relieving renal colic. Subgroup analyses find that tamsulosin provides a superior expulsion rate for stones >5mm, but no effect for stones ≤5mm. In this report, we looked at the efficacy and safety of tamsulosin for the treatment of distal ureteral stones. We find that tamsulosin significantly facilitates the passage of distal ureteral stones and relieves renal colic. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

A new method for evaluating the conformations and normal modes of macromolecule vibrations with a reduced force field. 2. Application to nonplanar distorted metal porphyrins

Energy Technology Data Exchange (ETDEWEB)

Unger, E.; Beck, M.; Lipski, R.J.; Dreybrodt, W.; Medforth, C.J.; Smith, K.M.; Schweitzer-Stenner, R.

1999-11-11

The authors have developed a novel method for molecular mechanics calculations and normal-mode analysis. It is based on symmetry of local units that constitutes the given molecule. Compared with general valence force field calculations, the number of free parameters is reduced by 40--80% in the procedure. It was found to reproduce very well the vibrational frequencies and mode compositions of aromatic compounds and porphyrins, as shown by comparison with DFT calculations. A slightly altered force field obtained from Ni(II) porphin was then used to calculate the structure and the normal modes of several meso-substituted Ni(II) porphyrins which are known to be subject to significant ruffling and/or saddling distortions. This method satisfactorily reproduces their nonplanar structure and Raman band frequencies in the natural abundance and isotopic derivative spectra. The polarization properties of bands from out-of-plane modes are in accordance with the predicted nonplanar distortions. Moreover, some of the modes below 800 cm{sup {minus}1} which appear intense in the Raman spectra contain considerable contributions from both in-plane and out-of-plane vibrations, so that the conventional mode assignments become questionable. The authors also demonstrate that the intensity and polarization of some low-frequency Raman bands can be used as a (quantitative) marker to elucidate type and magnitude of out-of-plane distortions. These were recently shown to affect heme groups of hemoglobin, myoglobin, and, in particular, of cytochrome c.

The boomerang flap in managing injuries of the dorsum of the distal phalanx.

Science.gov (United States)

Chen, S L; Chou, T D; Chen, S G; Cheng, T Y; Chen, T M; Wang, H J

2000-09-01

Finding an appropriate soft-tissue grafting material to close a wound located over the dorsum of a finger, especially the distal phalanx, can be a difficult task. The boomerang flap mobilized from the dorsum of the proximal phalanx of an adjacent digit can be useful when applied as an island pedicle skin flap. The vascular supply to the skin flap is derived from the retrograde perfusion of the dorsal digital artery. Mobilization and lengthening of the vascular pedicle are achieved by dividing the distal end of the dorsal metacarpal artery at the bifurcation and incorporating two adjacent dorsal digital arteries into one. The boomerang flap was used in seven individuals with injuries involving the dorsal aspect of the distal phalanx over the past year. Skin defects in all patients were combined with bone,joint, or tendon exposure. The authors found that the flap was reliable and technically simple to design and execute. This one-step procedure preserves the proper palmar digital artery to the fingertip and has proven valuable for the coverage of wide and distal defects because it has the advantages of an extended skin paddle and a lengthened vascular pedicle. When conventional local flaps are inadequate, the boomerang flap should be considered for its reliability and low associated morbidity.

Long-term follow-up of treatment of erectile dysfunction after radical prostatectomy using nerve grafts and end-to-side somatic-autonomic neurorraphy: a new technique.

Science.gov (United States)

Souza Trindade, José Carlos; Viterbo, Fausto; Petean Trindade, André; Fávaro, Wagner José; Trindade-Filho, José Carlos Souza

2017-06-01

To study a novel penile reinnervation technique using four sural nerve grafts and end-to-side neurorraphies connecting bilaterally the femoral nerve and the cavernous corpus and the femoral nerve and the dorsal penile nerves. Ten patients (mean [± sd; range] age 60.3 [± 4.8; 54-68] years), who had undergone radical prostatectomy (RP) at least 2 years previously, underwent penile reinnervation in the present study. Four patients had undergone radiotherapy after RP. All patients reported satisfactory sexual activity prior to RP. The surgery involved bridging of the femoral nerve to the dorsal nerve of the penis and the inner part of the corpus cavernosum with sural nerve grafts and end-to-side neurorraphies. Patients were evaluated using the International Index of Erectile Function (IIEF) questionnaire and pharmaco-penile Doppler ultrasonography (PPDU) preoperatively and at 6, 12 and 18 months postoperatively, and using a Clinical Evolution of Erectile Function (CEEF) questionnaire, administered after 36 months. The IIEF scores showed improvements with regard to erectile dysfunction (ED), satisfaction with intercourse and general satisfaction. Evaluation of PPDU velocities did not reveal any difference between the right and left sides or among the different time points. The introduction of nerve grafts neither caused fibrosis of the corpus cavernosum, nor reduced penile vascular flow. CEEF results showed that sexual intercourse began after a mean of 13.7 months with frequency of sexual intercourse varying from once daily to once monthly. Acute complications were minimal. The study was limited by the small number of cases. A total of 60% of patients were able to achieve full penetration, on average, 13 months after reinnervation surgery. Patients previously submitted to radiotherapy had slower return of erectile function. We conclude that penile reinnervation surgery is a viable technique, with effective results, and could offer a new treatment method for ED after

Color-suppression of non-planar diagrams in bosonic bound states

Science.gov (United States)

Alvarenga Nogueira, J. H.; Ji, Chueng-Ryong; Ydrefors, E.; Frederico, T.

2018-02-01

We study the suppression of non-planar diagrams in a scalar QCD model of a meson system in 3 + 1 space-time dimensions due to the inclusion of the color degrees of freedom. As a prototype of the color-singlet meson, we consider a flavor-nonsinglet system consisting of a scalar-quark and a scalar-antiquark with equal masses exchanging a scalar-gluon of a different mass, which is investigated within the framework of the homogeneous Bethe-Salpeter equation. The equation is solved by using the Nakanishi representation for the manifestly covariant bound-state amplitude and its light-front projection. The resulting non-singular integral equation is solved numerically. The damping of the impact of the cross-ladder kernel on the binding energies are studied in detail. The color-suppression of the cross-ladder effects on the light-front wave function and the elastic electromagnetic form factor are also discussed. As our results show, the suppression appears significantly large for Nc = 3, which supports the use of rainbow-ladder truncations in practical non-perturbative calculations within QCD.

The effects of FK1706 on nerve regeneration and bladder function recovery following an end-to-side neurorrhaphy in rats.

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Gao, Wansheng; He, Xiangfei; Li, Yunlong; Wen, Jianguo

2017-11-07

Immunophilin ligands are neuroregenerative agents binding to FK506 binding proteins, by which stimulate recovery of neurons in a variety of injury nerves. FK1706 is a novel immunophilin ligand which has neuroprotective and neuroregenerative effects but without immunosuppressive activity. At present, most reports about FK1706 in ameliorating nerve injury and functional recovery are limited to cavernous nerve injury and erectile function recovery. This study aimed to demonstrate the effects of FK1706 on nerve regeneration and bladder function recovery following an end-to-side neurorrhaphy in rat models. The numbers of regenerated myelinated axons of the pelvic parasympathetic nerve (PPN) in the three groups' rats (FK1706 + ETS, ETS and control groups) were evaluated. Their intravesical pressure (IVP), S100β and growth associated protein 43 (GAP43) expressions were also compared. In FK1706 + ETS group, 90% the rats showed that the frequency of FG labeled neurons was larger than the 3.5 cutoff value, 100% the rats showed that the frequency of FG-FB double-labeled neurons was larger than the 5.5 cutoff value. The average maximum of IVP in FK1706 + ETS group reached 76.3% of the value in control group. Their average number of myelinated axons of regenerated PPN reached 80% of the amount in control group. The nerve regeneration-associated markers data indicated that the expression level of S100β and GAP43 in FK1706 + ETS group was approximately 2-fold higher than that of ETS group (P side neurorrhaphy, FK1706 effectively enhanced the nerve regeneration and bladder function recovery.

Distal protection in cardiovascular medicine: current status.

Science.gov (United States)

Ali, Onn Akbar; Bhindi, Ravinay; McMahon, Aisling C; Brieger, David; Kritharides, Leonard; Lowe, Harry C

2006-08-01

Iatrogenic and spontaneous downstream microembolization of atheromatous material is increasingly recognized as a source of cardiovascular morbidity and mortality. Devising ways of reducing this distal embolization using a variety of mechanical means--distal protection--is currently under intense and diverse investigation. This review therefore summarizes the present status of distal protection. It examines the problem of distal embolization, describes the available distal protection devices, reviews those areas of cardiovascular medicine where distal protection devices are being investigated, and discusses potential future developments.

Method for brazing together planar and nonplanar metal members

International Nuclear Information System (INIS)

Hammersand, F.G.; Witkowski, A.J.

1985-01-01

The invention relates to a method and apparatus for brazing two metal members together, at least one of which is nonplanar, in a brazing furnace using a substantially pure brazing material. The method comprises the steps of utilizing a brazing fixture to hold the two metal members in tangential relation to one another along a portion of each member so that a cavity is formed adjacent to the contacting portions. A braze material is then positioned within the cavity. The braze fixture, the metal members, and the braze material are then placed in a brazing furnace. A heat shield is then placed over the braze fixture, the metal members, and the braze material to shield the braze material from direct furnace radiation. The furnace temperature is linearly increased at a rate of about 180 0 C. per hour until a temperature of 350 0 C. is achieved. Heat is transferred by conduction from the metal members to the braze material to cause the braze material to melt. Some material from the metal members slowly diffuses into the braze material forming a braze joint. The furnace is rapidly cooled to room temperature using nitrogen gas. The brazed assemblies made according to this method are superior to assemblies formed by heliarc welding

J-pouch vs. side-to-end anastomosis after hand-assisted laparoscopic low anterior resection for rectal cancer: A prospective randomized trial on short and long term outcomes including life quality and functional results.

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Okkabaz, Nuri; Haksal, Mustafa; Atici, Ali Emre; Altuntas, Yunus Emre; Gundogan, Ersin; Gezen, Fazli Cem; Oncel, Mustafa

2017-11-01

To analyze the outcomes of j-pouch and side-to-end anastomosis in rectal cancer patients treated with laparoscopic hand-assisted low anterior resection. Prospective trial on cases randomized to have a colonic j-pouch or a side-to-end anastomosis after low anterior resection. Demographics, characteristics of disease and treatment, perioperative results, and functional outcomes and life quality were compared between the groups. Seventy four patients were randomized. Reservoir creation was withdrawn in 17 (23%) patients, mostly related to reach problem (n = 11, 64.7%). Anastomotic leakage rate was significantly higher in j-pouch group (8 [27.6%] vs. 0, p = 0.004). Stoma closure could not be achieved in 16 (28.1%) patients. Life quality and functional outcomes, measured 4, 8 and 12 months after the stoma reversal, were similar. Colonic j-pouch and side-to-end anastomosis are similar regarding perioperative measures including operation time, rates of postoperative complications, reoperation and 30-day mortality, and hospitalization period except anastomotic leak rate, which is higher in j-pouch group. Postoperative aspects are not different in patients receiving either technique including functional outcomes and life quality for the first year after stoma closure. In our opinion, both techniques may be preferred during the daily practice while performing laparoscopic surgery; but surgeons may be aware of a possibly higher anastomotic leak rate in case of a j-pouch. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Stem cells from glomerulus to distal tubule: a never-ending story?

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Melania Puddu

2016-08-01

Full Text Available The growing interest of research in the field of renal stem cells and kidney regeneration aims to get results that allow its clinical application, favoring the birth and development of regenerative medicine.Nephrogenesis requires differentiation into epithelial cells of a population of progenitor mesenchymal cells. Since this process ends at 36-38 weeks of gestational age, it is quite likely to imagine that such a population disappears in the human kidney after birth. However, several studies have identified in different parts of the adult kidney cells having the characteristics of stem cells that would be involved in renal regenerative processes. They may be classified as resident mesenchymal/epithelial progenitors and often share the same genetic and epigenetic profile as progenitor stem cells active during embryonic life, thus suggesting a common origin.Current literature includes two lines of thought: one attributes to stem cells a fundamental role in renal regeneration processes while the other sustains the intervention of other mechanisms.The aim of this review is to report on progress made in research in the field of kidney regeneration starting from the past century and arriving at the present, with an analysis of scientific works that have produced the most important results in this field. Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015 · Cagliari (Italy · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordano

Locking plate fixation in distal metaphyseal tibial fractures: series of 79 patients.

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Gupta, Rakesh K; Rohilla, Rajesh Kumar; Sangwan, Kapil; Singh, Vijendra; Walia, Saurav

2010-12-01

Open reduction and internal fixation in distal tibial fractures jeopardises fracture fragment vascularity and often results in soft tissue complications. Minimally invasive osteosynthesis, if possible, offers the best possible option as it permits adequate fixation in a biological manner. Seventy-nine consecutive adult patients with distal tibial fractures, including one patient with a bilateral fracture of the distal tibia, treated with locking plates, were retrospectively reviewed. The 4.5-mm limited-contact locking compression plate (LC-LCP) was used in 33 fractures, the metaphyseal LCP in 27 fractures and the distal medial tibial LCP in the remaining 20 fractures. Fibula fixation was performed in the majority of comminuted fractures (n = 41) to maintain the second column of the ankle so as to achieve indirect reduction and to prevent collapse of the fracture. There were two cases of delayed wound breakdown in fractures fixed with the 4.5-mm LC-LCP. Five patients required primary bone grafting and three patients required secondary bone grafting. All cases of delayed union (n = 7) and nonunion (n = 3) were observed in cases where plates were used in bridge mode. Minimally invasive plate osteosynthesis (MIPO) with LCP was observed to be a reliable method of stabilisation for these fractures. Peri-operative docking of fracture ends may be a good option in severely impacted fractures with gap. The precontoured distal medial tibial LCP was observed to be a better tolerated implant in comparison to the 4.5-mm LC-LCP or metaphyseal LCP with respect to complications of soft tissues, bone healing and functional outcome, though its contour needs to be modified.

Numerical investigations of the unsteady blood flow in the end-to-side arteriovenous fistula for hemodialysis.

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Jodko, Daniel; Obidowski, Damian; Reorowicz, Piotr; Jóźwik, Krzysztof

2016-01-01

The aim of this study was to investigate the blood flow in the end-to-side arteriovenous (a-v) fistula, taking into account its pulsating nature and the patient-specific geometry of blood vessels. Computational Fluid Dynamics (CFD) methods were used for this analysis. DICOM images of the fistula, obtained from the angio-computed tomography, were a source of the data applied to develop a 3D geometrical model of the fistula. The model was meshed, then the ANSYS CFX v. 15.0 code was used to perform simulations of the flow in the vessels under analysis. Mesh independence tests were conducted. The non-Newtonian rheological model of blood and the Shear Stress Transport model of turbulence were employed. Blood vessel walls were assumed to be rigid. Flow patterns, velocity fields, the volume flow rate, the wall shear stress (WSS) propagation on particular blood vessel walls were shown versus time. The maximal value of the blood velocity was identified in the anastomosis - the place where the artery is connected to the vein. The flow rate was calculated for all veins receiving blood. The blood flow in the geometrically complicated a-v fistula was simulated. The values and oscillations of the WSS are the largest in the anastomosis, much lower in the artery and the lowest in the cephalic vein. A strong influence of the mesh on the results concerning the maximal and area-averaged WSS was shown. The relation between simulations of the pulsating and stationary flow under time-averaged flow conditions was presented.

Total elbow arthroplasty in distal humerus fracture in patients older than 65 years.

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Gerardo Gallucci

2016-05-01

Full Text Available Objective To report the clinical-functional results of the treatment of humeral distal fractures with a total elbow prosthesis in patients older than 65 years old. Material and methods This retrospective paper was performed in two surgical centers. Criteria inclusion were: patients with humeral distal fractures, > 65 years, operated on with Coonrad-Morrey prostheses, and with a follow-up of  >1 year. Twenty-one patients were included. Twenty were women with an average age of 79 years old. According to AO classification, 13 fractures were type C3, 7 C2 and 1 A2. All patientes were operated on without desinsertion of the extensor mechanism. Average follow-up was 40 months. Results Flexo-extension was 123-17°, with a total arc of mobility of 106° (80 % of the contralateral side. Pain according to AVE was 1. The MEPI was 83 points: 8 patients had excellent results, 11 good, 1 regular and 1 bad. Average DASH score was 24 points. Conclusion Treatment of humeral distal fractures with total elbow arthoplasty in patients older than 65 years old, may lead to a good option of treatment, but indications must be limited to patients with complex fractures, bad bone quality, with osteoporosis and low functional demands.

Nonplanar Nanoscale Fin Field Effect Transistors on Textile, Paper, Wood, Stone, and Vinyl via Soft Material-Enabled Double-Transfer Printing.

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Rojas, Jhonathan P; Torres Sevilla, Galo A; Alfaraj, Nasir; Ghoneim, Mohamed T; Kutbee, Arwa T; Sridharan, Ashvitha; Hussain, Muhammad Mustafa

2015-05-26

The ability to incorporate rigid but high-performance nanoscale nonplanar complementary metal-oxide semiconductor (CMOS) electronics with curvilinear, irregular, or asymmetric shapes and surfaces is an arduous but timely challenge in enabling the production of wearable electronics with an in situ information-processing ability in the digital world. Therefore, we are demonstrating a soft-material enabled double-transfer-based process to integrate flexible, silicon-based, nanoscale, nonplanar, fin-shaped field effect transistors (FinFETs) and planar metal-oxide-semiconductor field effect transistors (MOSFETs) on various asymmetric surfaces to study their compatibility and enhanced applicability in various emerging fields. FinFET devices feature sub-20 nm dimensions and state-of-the-art, high-κ/metal gate stacks, showing no performance alteration after the transfer process. A further analysis of the transferred MOSFET devices, featuring 1 μm gate length, exhibits an ION value of nearly 70 μA/μm (VDS = 2 V, VGS = 2 V) and a low subthreshold swing of around 90 mV/dec, proving that a soft interfacial material can act both as a strong adhesion/interposing layer between devices and final substrate as well as a means to reduce strain, which ultimately helps maintain the device's performance with insignificant deterioration even at a high bending state.

Tamsulosin versus tadalafil as a medical expulsive therapy for distal ureteral stones: A prospective randomized study.

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Kc, Hari Bahadur; Shrestha, Anil; Acharya, Ganesh Bhakta; Basnet, Robin Bahadur; Shah, Arvind Kumar; Shrestha, Parash Mani

2016-09-01

This study aimed to compare the safety and efficacy of tamsulosin and tadalafil as medical expulsive therapy for distal ureteral stones. This prospective randomized study was conducted at the Department of Urology of Bir Hospital over a period of 12 months in patients with distal ureteral stones sized 5 to 10 mm. Patients were randomly divided into 2 groups: group A received tamsulosin 0.4 mg and group B received tadalafil 10 mg at bedtime for 2 weeks. Stone expulsion rate, number of ureteric colic episodes and pain score, analgesic requirements, and adverse drug effects were noted in both groups. Statistical analyses were performed by using Student t-test and chi-square test. Altogether 85 patients, 41 in group A and 44 in group B, were enrolled in the study. The patients' average age was 31.72±12.63 years, and the male-to-female ratio was 1.5:1. Demographic profiles, stone size, and baseline investigations were comparable between the 2 groups. The stone expulsion rate was significantly higher in the tadalafil group than in the tamsulosin group (84.1% vs. 61.0%, p=0.017). Although the occurrence of side effects was higher with tadalafil, this difference was not significant (p=0.099). There were no serious adverse effects. Tadalafil has a significantly higher stone expulsion rate than tamsulosin when used as a medical expulsive therapy for distal ureteral stones sized 5-10 mm. Both drugs are safe, effective, and well tolerated with minor side effects.

Using Sankey diagrams to map energy flow from primary fuel to end use

International Nuclear Information System (INIS)

Subramanyam, Veena; Paramshivan, Deepak; Kumar, Amit; Mondal, Md. Alam Hossain

2015-01-01

Highlights: • Energy flows from both supply and demand sides shown through Sankey diagrams. • Energy flows from reserves to energy end uses for primary and secondary fuels shown. • Five main energy demand sectors in Alberta are analyzed. • In residential/commercial sectors, highest energy consumption is in space heating. • In the industrial sector, highest energy use is in the mining subsector. - Abstract: The energy sector is the largest contributor to gross domestic product (GDP), income, employment, and government revenue in both developing and developed nations. But the energy sector has a significant environmental footprint due to greenhouse gas (GHG) emissions. Efficient production, conversion, and use of energy resources are key factors for reducing the environmental footprint. Hence it is necessary to understand energy flows from both the supply and the demand sides. Most energy analyses focus on improving energy efficiency broadly without considering the aggregate energy flow. We developed Sankey diagrams that map energy flow for both the demand and supply sides for the province of Alberta, Canada. The diagrams will help policy/decision makers, researchers, and others to understand energy flow from reserves through to final energy end uses for primary and secondary fuels in the five main energy demand sectors in Alberta: residential, commercial, industrial, agricultural, and transportation. The Sankey diagrams created for this study show total energy consumption, useful energy, and energy intensities of various end-use devices. The Long-range Energy Alternatives Planning System (LEAP) model is used in this study. The model showed that Alberta’s total input energy in the five demand sectors was 189 PJ, 186 PJ, 828.5PJ, 398 PJ, and 50.83 PJ, respectively. On the supply side, the total energy input and output were found to be 644.84 PJ and 239 PJ, respectively. These results, along with the associated energy flows were depicted pictorially using

Mapping of the left-sided phrenic nerve course in patients undergoing left atrial catheter ablations.

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Huemer, Martin; Wutzler, Alexander; Parwani, Abdul S; Attanasio, Philipp; Haverkamp, Wilhelm; Boldt, Leif-Hendrik

2014-09-01

Catheter ablation of atrial fibrillation has been associated with left-sided phrenic nerve palsy. Knowledge of the individual left phrenic nerve course therefore is essential to prevent nerve injury. The aim of this study was to test the feasibility of an intraprocedural pace mapping and reconstruction of the left phrenic nerve course and to characterize which anatomical areas are affected. In patients undergoing left atrial catheter ablation, a three-dimensional map of the left atrial anatomical structures was created. The left-sided phrenic nerve course was determined by high-output pace mapping and reconstructed in the map. In this study, 40 patients with atrial fibrillation or atrial tachycardias were included. Left phrenic nerve capture was observed in 23 (57.5%) patients. Phrenic nerve was captured in 22 (55%) patients inside the left atrial appendage, in 22 (55%) in distal parts, in 21 (53%) in medial parts, and in two (5%) in ostial parts of the appendage. In three (7.5%) patients, capture was found in the distal coronary sinus and in one (2.5%) patient in the left atrium near the left atrial appendage ostium. Ablation target was changed due to direct spatial relationship to the phrenic nerve in three (7.5%) patients. No phrenic nerve palsy was observed. Left-sided phrenic nerve capture was found inside and around the left atrial appendage in the majority of patients and additionally in the distal coronary sinus. Phrenic nerve mapping and reconstruction can easily be performed and should be considered prior catheter ablations in potential affected areas. ©2014 Wiley Periodicals, Inc.

Minimally Invasive Surgical Approach to Distal Fibula Fractures: A Technique Tip

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Tyler A. Gonzalez

2017-01-01

Full Text Available Wound complications following ankle fracture surgery are a major concern. Through the use of minimally invasive surgical techniques some of these complications can be mitigated. Recent investigations have reported on percutaneous fixation of distal fibula fractures demonstrating similar radiographic and functional outcomes to traditional open approaches. The purpose of this manuscript is to describe in detail the minimally invasive surgical approach for distal fibula fractures.

Imaging of the Distal Tibiofibular Syndesmosis: Anatomy in Relation to Radiological Diagnosis

NARCIS (Netherlands)

J.J. Hermans (John)

2011-01-01

textabstractInjury to the distal tibiofibular syndesmosis can occur after an ankle sprain or after an acute ankle fracture. In an estimated 1-11% of all ankle sprains, injury of the distal tibiofibular syndesmosis occurs which is known as a high ankle sprain. However, depending on the type and

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

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Gupta Vinay

2013-06-01

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

Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

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Tae-Soo Park

2016-01-01

Full Text Available Background: Symptomatic acromioclavicular joint (ACJ lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42-70 years. The mean duration of followup was 6 years and 2 months (range 4-8 years 10 months. The results were evaluated using the University of California Los Angeles (UCLA shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly ( P < 0.001. There were no specific complications at the latest followup. Conclusion: It is critical in this procedure to resect the distal clavicle evenly from superior to inferior in an en bloc fashion without any small bony remnants and to preserve the capsule and acromioclavicular ligament superoposteriorly. This arthroscopic procedure is a reliable and reproducible technique for painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor.

Robotic distal pancreatectomy versus conventional laparoscopic distal pancreatectomy: a comparative study for short-term outcomes.

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Lai, Eric C H; Tang, Chung Ngai

2015-09-01

Robotic system has been increasingly used in pancreatectomy. However, the effectiveness of this method remains uncertain. This study compared the surgical outcomes between robot-assisted laparoscopic distal pancreatectomy and conventional laparoscopic distal pancreatectomy. During a 15-year period, 35 patients underwent minimally invasive approach of distal pancreatectomy in our center. Seventeen of these patients had robot-assisted laparoscopic approach, and the remaining 18 had conventional laparoscopic approach. Their operative parameters and perioperative outcomes were analyzed retrospectively in a prospective database. The mean operating time in the robotic group (221.4 min) was significantly longer than that in the laparoscopic group (173.6 min) (P = 0.026). Both robotic and conventional laparoscopic groups presented no significant difference in spleen-preservation rate (52.9% vs. 38.9%) (P = 0.505), operative blood loss (100.3 ml vs. 268.3 ml) (P = 0.29), overall morbidity rate (47.1% vs. 38.9%) (P = 0.73), and post-operative hospital stay (11.4 days vs. 14.2 days) (P = 0.46). Both groups also showed no perioperative mortality. Similar outcomes were observed in robotic distal pancreatectomy and conventional laparoscopic approach. However, robotic approach tended to have the advantages of less blood loss and shorter hospital stay. Further studies are necessary to determine the clinical position of robotic distal pancreatectomy.

End Effects on the Linear Induction MHD Generator Calculated by Two-Sided Laplace Transform

Energy Technology Data Exchange (ETDEWEB)

Engeln, F.; Peschka, W. [Deutsche Versuchsanstalt fuer Luft- und Raumfahrt e.V., Institut fuer Energiewandlung und Elektrische Antriebe, Stuttgart, Federal Republic of Germany (Germany)

1966-11-15

In induction MHD systems special problems occur where the flow enters or leaves the magnetic field. These problems are generally described as end effects. Large gradients of the magnetic field are present at the inlet and also at the outlet of an MHD induction engine, these generating electric current systems in the fluid which may spoil the performance characteristics of the generator due to the interaction with the primary field of the engine. The two-dimensional induction MHD generator of finite length, using a polyphase winding system to obtain a travelling magnetic field, is treated as a boundary value problem by two-sided Laplace transform. For simplicity incompressibility is assumed. The two- dimensional boundary value problem of the induction engine is solved for - {infinity} Less-Than-Over-Equal-To x Less-Than-Over-Equal-To {infinity}. x is parallel to the flow direction of the linear MHD generator. In the region 0 Less-Than-Over-Equal-To x Less-Than-Over-Equal-To L the magnetic travelling wave is sinusoidal with a cyclical frequency {omega} and a phase-velocity v{sub s}. At x = 0 the conducting incompressible working fluid enters the field region and leaves it at the point-x = L. Two mathematical methods can be used to solve the boundary value problem, the Fourier transform or the two-sided Laplace transform. The latter offers the advantage of representing a complex analytical function in the image space. Moreover, it is possible to obtain the characteristics of the generator in the image space (e. g. field configuration, power flow function, etc.). That implies a large simplification of mathematical treatment. The solution in the original space then is given by asymptotic expansion of the known image function. (author)

Communicatively Constructing the Bright and Dark Sides of Hope: Family Caregivers’ Experiences during End of Life Cancer Care

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Jody Koenig Kellas

2017-05-01

Full Text Available (1 Background: The communication of hope is complicated, particularly for family caregivers in the context of cancer who struggle to maintain hope for themselves and their loved ones in the face of terminality. In order to understand these complexities, the current study examines the bright and dark sides of how hope is communicated across the cancer journey from the vantage point of bereaved family caregivers; (2 Methods: We analyzed interviews with bereaved family caregivers using qualitative thematic and case oriented strategies to identify patterns in the positive and negative lived experiences when communicating about hope at the end of life; (3 Results: Two overarching patterns of hope emerged. Those who experienced hope as particularized (focused on cure cited communication about false hope, performing (faking it, and avoidance. Those who transitioned from particularized to generalized hope (hope for a good death reported acceptance, the communication of hope as social support, prioritizing family, and balancing hope and honesty; (4 Conclusion: Family caregivers face myriad complexities in managing the bright and dark sides of hope. Interventions should encourage concurrent oncological and palliative care, increased perspective-taking among family members, and encourage the transition from particularized to generalized hope.

Communicatively Constructing the Bright and Dark Sides of Hope: Family Caregivers’ Experiences during End of Life Cancer Care

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Koenig Kellas, Jody; Castle, Katherine M.; Johnson, Alexis; Cohen, Marlene Z.

2017-01-01

(1) Background: The communication of hope is complicated, particularly for family caregivers in the context of cancer who struggle to maintain hope for themselves and their loved ones in the face of terminality. In order to understand these complexities, the current study examines the bright and dark sides of how hope is communicated across the cancer journey from the vantage point of bereaved family caregivers; (2) Methods: We analyzed interviews with bereaved family caregivers using qualitative thematic and case oriented strategies to identify patterns in the positive and negative lived experiences when communicating about hope at the end of life; (3) Results: Two overarching patterns of hope emerged. Those who experienced hope as particularized (focused on cure) cited communication about false hope, performing (faking it), and avoidance. Those who transitioned from particularized to generalized hope (hope for a good death) reported acceptance, the communication of hope as social support, prioritizing family, and balancing hope and honesty; (4) Conclusion: Family caregivers face myriad complexities in managing the bright and dark sides of hope. Interventions should encourage concurrent oncological and palliative care, increased perspective-taking among family members, and encourage the transition from particularized to generalized hope. PMID:28505118

A Case of Distal Vaginal Agenesis Presenting with Recurrent Urinary Tract Infection and Pyuria in a Prepubertal Girl.

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Dural, Ozlem; Ugurlucan, Funda Gungor; Yasa, Cenk; Bastu, Ercan; Eren, Hulya; Yuksel, Bahar; Celik, Serdal; Akhan, Suleyman Engin

2017-02-01

Isolated distal vaginal agenesis is a rare anomaly and mostly becomes symptomatic after menarche. We describe an unusual presentation of this anomaly in a prepubertal girl. An 11-year-old prepubertal girl presented with recurrent urinary tract infection, pyuria, and right-sided renal agenesis. The findings of perineal inspection, ultrasonography, and magnetic resonance imaging were consistent with a distal vaginal agenesis with pyometrocolpos. Discharging pyometrocolpos with dissection of the atretic portion and a pull-through vaginoplasty were performed. A cystoscopy showed no sign of a vesicovaginal or uterine fistula. This rare presentation of distal vaginal agenesis reminds us that congenital malformations of the female genital tract should be considered in patients with congenital anomalies of the urinary system and/or recurrent urinary tract infection, even during the prepubertal period. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Effects of low-energy laser irradiation on the distalization velocity during experimental canine tooth movement in humans: 'comparative clinical study'

International Nuclear Information System (INIS)

Cruz, Delma Rebelo

2003-01-01

This research investigated the effects of low level laser therapy (LLLT) upon the velocity of canine tooth movement and consequently bone remodeling. A total of eleven patients were treated with a 780 nm diode laser. One side of the upper arcade was considered control group and was not irradiated but received mechanical activation every thirty days. The opposite side received the same mechanical activation but was also irradiated at days 0, 3, 7 and 14 of each month. Data of the biometrical progress were taken on both sides on days 3,7,14,21 and 30 of each month. The results indicate that all patients showed significant acceleration of the distalization velocity on the side treated with LLLT when compared to the control. (author)

Iterative reconstruction with attenuation compensation from cone-beam projections acquired via nonplanar orbits

International Nuclear Information System (INIS)

Zeng, G.L.; Weng, Y.; Gullberg, G.T.

1997-01-01

Single photon emission computed tomography (SPECT) imaging with cone-beam collimators provides improved sensitivity and spatial resolution for imaging small objects with large field-of-view detectors. It is known that Tuy's cone-beam data sufficiency condition must be met to obtain artifact-free reconstructions. Even though Tuy's condition was derived for an attenuation-free situation, the authors hypothesize that an artifact-free reconstruction can be obtained even if the cone-beam data are attenuated, provided the imaging orbit satisfies Tuy's condition and the exact attenuation map is known. In the authors' studies, emission data are acquired using nonplanar circle-and-line orbits to acquire cone-beam data for tomographic reconstructions. An extended iterative ML-EM (maximum likelihood-expectation maximization) reconstruction algorithm is derived and used to reconstruct projection data with either a pre-acquired or assumed attenuation map. Quantitative accuracy of the attenuation corrected emission reconstruction is significantly improved

Immunohistochemical Mapping of Sensory Nerve Endings in the Human Triangular Fibrocartilage Complex.

Science.gov (United States)

Rein, Susanne; Semisch, Manuel; Garcia-Elias, Marc; Lluch, Alex; Zwipp, Hans; Hagert, Elisabet

2015-10-01

The triangular fibrocartilage complex is the main stabilizer of the distal radioulnar joint. While static joint stability is constituted by osseous and ligamentous integrity, the dynamic aspects of joint stability chiefly concern proprioceptive control of the compressive and directional muscular forces acting on the joint. Therefore, an investigation of the pattern and types of sensory nerve endings gives more insight in dynamic distal radioulnar joint stability. We aimed to (1) analyze the general distribution of sensory nerve endings and blood vessels; (2) examine interstructural distribution of sensory nerve endings and blood vessels; (3) compare the number and types of mechanoreceptors in each part; and (4) analyze intrastructural distribution of nerve endings at different tissue depth. The subsheath of the extensor carpi ulnaris tendon sheath, the ulnocarpal meniscoid, the articular disc, the dorsal and volar radioulnar ligaments, and the ulnolunate and ulnotriquetral ligaments were dissected from 11 human cadaver wrists. Sensory nerve endings were counted in five levels per specimen as total cell amount/cm(2) after staining with low-affinity neurotrophin receptor p75, protein gene product 9.5, and S-100 protein and thereafter classified according to Freeman and Wyke. All types of sensory corpuscles were found in the various structures of the triangular fibrocartilage complex with the exception of the ulnolunate ligament, which contained only Golgi-like endings, free nerve endings, and unclassifiable corpuscles. The articular disc had only free nerve endings. Furthermore, free nerve endings were the predominant sensory nerve ending (median, 72.6/cm(2); range, 0-469.4/cm(2)) and more prevalent than all other types of mechanoreceptors: Ruffini (median, 0; range, 0-5.6/cm(2); difference of medians, 72.6; p fibrocartilage complex (p ≤ 0.001, respectively) except the ulnolunate ligament. More blood vessels were seen in the volar radioulnar ligament (median, 363

Distal Insertional Footprint of the Brachialis Muscle: 3D Morphometric Study

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Srinath Kamineni

2015-01-01

Full Text Available Objective. The purpose of this study is to describe the three-dimensional morphometry of the brachialis muscle at its distal attachment to the ulna. Methods. Fifty cadaveric elbows were dissected and the brachialis distal insertion was isolated on the ulna bone and probed with a three-dimensional digitizer, to create a three-dimensional model of the footprint. Measurements and analysis of each footprint shape were recorded and compared based on gender and size. Results. There was significant gender difference in the surface length (P= 0.002 and projected length (P= 0.001 of the brachialis footprint. The shapes of the footprint also differed among the specimens. Conclusion. The shape of the brachialis muscle insertion differed among all the specimens without significant variation in gender or sides. There was also a significant difference in muscle length between males and females with little difference in the width and surface area. Significance. The information obtained from this study is important for kinematic understanding and surgical procedures around the elbow joint as well as the understanding of the natural age related anatomy of the brachialis footprint morphology.

Large-scale lateral nanowire arrays nanogenerators

Science.gov (United States)

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

2014-01-07

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

Miniscrew-assisted mandibular molar distalization in a patient with skeletal class-III malocclusion: A clinical case report

Directory of Open Access Journals (Sweden)

Seyed Mohammadreza Safavi

2013-01-01

Full Text Available In nongrowing patients with mild skeletal Class-III malocclusion, premolar extraction or molar distalization in the lower arch can be done as a part of camouflage treatment. Temporary anchorage devices are widely used for this purpose because they do not produce undesirable reciprocal effects and do not depend on the patient′s cooperation. However, most reported cases in this regard have used interradicular miniscrews in the mandibular arch and these have a risk of failure as they can loosen due to collision with adjacent roots. This article showcases mandibular molar distalization utilizing miniscrews, inserted at the retromolar area to correct a Class-III problem. A 24-year-old girl with a mild skeletal Class-III malocclusion and dental Class-III molar and canine relationship bilaterally was referred for orthodontic treatment. The treatment plan included distalization of the lower molars bilaterally followed by full fixed appliance therapy, after third molar extractions. For the lower molar distalization, the miniscrews were inserted at the retromolar pad. At the end of 21 months, a Class-I molar and canine relationship, normal overjet and overbite were obtained. The average amount of distalization of mandibular first molar was 3.2 mm at the crown level. In conclusion, placing miniscrews at the retromolar pad area for lower molar distalization was found to be a simple and effective method for correcting anterior cross bite and mandibular anterior crowding or protrusion, without the need for patient compliance.

Better long-term outcomes with hilar ductoplasty and a side-to-side Roux-en-Y hepaticojejunostomy.

Science.gov (United States)

Xia, Hong-Tian; Liu, Yang; Yang, Tao; Liang, Bin; Wang, Jing; Dong, Jia-Hong

2017-07-01

Whether a wide hilar hepaticojejunostomy after bile duct cyst (BDC) excision can prevent the development of postoperative complications remains an unanswered question. We compared our outcomes after a minimum of 2-y follow-up in patients with Todani type Ia choledochal cyst treated with hilar ductoplasty followed by a side-to-side Roux-en-Y hepaticojejunostomy (ductoplasty group) or radical cyst resection with an end-to-side Roux-en-Y hepaticojejunostomy (conventional group). We retrospectively reviewed the records of patients with Todani type Ia choledochal cyst who received radical cyst excision from January 1997 to December 2012, and we compared the groups' postoperative complications and surgical outcomes. The groups' baseline demographics were similar, except for age. The gender distribution and preoperative presenting symptoms were comparable in the ductoplasty (n = 72) and conventional (n = 53) groups (all P > 0.05). Average age was 37.0 y for the ductoplasty group and 41.8 y for the conventional group (P = 0.024). The short-term complication rate of the groups was not significantly different (conventional group, 13.2% [7/53]; ductoplasty group, 8.3% [6/72]; all P > 0.05). A significant between-group difference was found in the long-term complication rate of biliary-enteric anastomotic strictures (9.4% in the conventional group and 0% in the ductoplasty group, P = 0.012). The rates of satisfactory surgical outcomes were 91.1% and 77.1% in the ductoplasty and conventional groups, respectively (P = 0.036). The application of hilar ductoplasty with a side-to-side Roux-en-Y hepaticojejunostomy as the primary surgery for bile duct cyst excision significantly reduced the postoperative complication of biliary-enteric anastomotic stricture and greatly improved our patients' prognosis with regard to biliary function. Copyright © 2017 Elsevier Inc. All rights reserved.

Laparoscopic Low Anterior Resection and Eversion Technique Combined With a Nondog Ear Anastomosis for Mid- and Distal Rectal Neoplasms

Science.gov (United States)

Zhuo, Changhua; Liang, Lei; Ying, Mingang; Li, Qingguo; Li, Dawei; Li, Yiwei; Peng, Junjie; Huang, Liyong; Cai, Sanjun; Li, Xinxiang

2015-01-01

Abstract The transanal eversion and prolapsing technique is a well-established procedure, and can ensure an adequate distal margin for patients with low rectal neoplasms. Potential leakage risks, however, are associated with bilateral dog ear formation, which results from traditional double-stapling anastomosis. The authors determined the feasibility of combining these techniques with a commercial stapling set to achieve a nondog ear (end-to-end) anastomosis for patients with mid- and distal rectal neoplasms. Patients with early-stage (c/ycT1–2N0), mid- to distal rectal neoplasms and good anal sphincter function were included in this study. Laparoscopic low anterior resection was performed with a standard total mesorectal excision technique downward to the pelvic floor as low as possible. The bowel was resected proximal to the lesion with an endoscopic linear stapler. An anvil was inserted extracorporeally into the proximal colon via an extended working pore. The distal rectum coupled with the lesion was prolapsed and everted out of the anus. The neoplasm was resected with a sufficient margin above the dentate line under direct sight. A transrectal anastomosis without dog ears was performed intracorporeally to reconstitute the continuity of the bowel. Eleven cases, 6 male and 5 female patients, were included in this study. The mean operative time was 191 (129–292) minutes. The mean blood loss was 110 (30–300) mL. The median distal margin distance from the lower edge of the lesion to the dentate line was 1.5 (0.5–2.5) cm. All the resection margins were negative. Most patients experienced uneventful postoperative recoveries. No patient had anastomotic leak. Most patients had an acceptable stool frequency after loop ileostomy closure. Our preliminary data demonstrated the safety and feasibility of achieving a sound anastomosis without risking potential anastomotic leakage because of dog ear formation. PMID:26683958

THE DEAD-END ELIMINATION THEOREM AND ITS USE IN PROTEIN SIDE-CHAIN POSITIONING

NARCIS (Netherlands)

DESMET, J; DEMAEYER, M; HAZES, B; LASTERS, [No Value

1992-01-01

THE prediction of a protein's tertiary structure is still a considerable problem because the huge amount of possible conformational space' makes it computationally difficult. With regard to side-chain modelling, a solution has been attempted by the grouping of side-chain conformations into

An anatomical study of the proximal aspect of the medial femoral condyle to define the proximal-distal condylar length

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Chia-Ming Chang

2017-01-01

Full Text Available Objective: Despite its possible role in knee arthroplasty, the proximal-distal condylar length (PDCL of the femur has never been reported in the literature. We conducted an anatomic study of the proximal aspect of the medial femoral condyle to propose a method for measuring the PDCL. Materials and Methods: Inspection of dried bone specimens was carried out to assure the most proximal condylar margin (MPCM as the eligible starting point to measure the PDCL. Simulation surgery was performed on seven pairs of cadaveric knees to verify the clinical application of measuring the PDCL after locating the MPCM. Interobserver reliability of this procedure was also analyzed. Results: Observation of the bone specimens showed that the MPCM is a concavity formed by the junction of the distal end of the supracondylar ridge and the proximal margin of the medial condyle. This anatomically distinctive structure made the MPCM an unambiguous landmark. The cadaveric simulation surgical dissection demonstrated that the MPCM is easily accessed in a surgical setting, making the measurement of the PDCL plausible. The intraclass correlation coefficient was 0.78, indicating good interobserver reliability for this technique. Conclusion: This study has suggested that the PDCL can be measured based on the MPCM in a surgical setting. PDCL measurement might be useful in joint line position management, selection of femoral component sizes, and other applications related to the proximal-distal dimension of the knee. Further investigation is required.

Study on Oneself Developed to Apparatus Position of Measurement of BMD in the Distal Radius

International Nuclear Information System (INIS)

Han, Man Seok; Song, Jae Yong; Lee, Hyun Kuk; Yu, Se Jong; Kim, Yong Kyun

2009-01-01

The aim of this study was to evaluate the difference of bone mineral density according to distal radius rotation and to develop the supporting tool to measure rotation angles. CT scanning and the measurement of BMD by DXA of the appropriate position of the forearm were performed on 20 males. Twenty healthy volunteers without any history of operations, anomalies, or trauma were enrolled. The CT scan was used to evaluate the cross sectional structure and the rotation angle on the horizontal plane of the distal radius. The rotational angle was measured by the m-view program on the PACS monitor. The DXA was used in 20 dried radii of cadaveric specimens in pronation and supination with five and ten degrees, respectively, including a neutral position (zero degrees) to evaluate the changes of BMD according to the rotation. The mean rotation angle of the distal radius on CT was 7.4 degrees of supination in 16 cases (80%), 3.3 degrees of pronation in three cases (15%), and zero degree of neutral in one case (9%), respectively. The total average rotation angle in 20 people was 5.4 degrees of supination. In the cadaveric study, the BMD of the distal radius was different according to the rotational angles. The lowest BMD was obtained at 3.3 degrees of supination. In the case of the measurement of BMD in the distal radius with a neutral position, the rotational angle of the distal radius is close to supination. Pronation is needed for the constant measurement of BMD in the distal radius with the rotation angle measuring at the lowest BMD and about five degrees of pronation of the distal radius is recommended.

Non-Planar Nano-Scale Fin Field Effect Transistors on Textile, Paper, Wood, Stone, and Vinyl via Soft Material-Enabled Double-Transfer Printing

KAUST Repository

Rojas, Jhonathan Prieto; Sevilla, Galo T.; Alfaraj, Nasir; Ghoneim, Mohamed T.; Kutbee, Arwa T.; Sridharan, Ashvitha; Hussain, Muhammad Mustafa

2015-01-01

The ability to incorporate rigid but high-performance nano-scale non-planar complementary metal-oxide semiconductor (CMOS) electronics with curvilinear, irregular, or asymmetric shapes and surfaces is an arduous but timely challenge in enabling the production of wearable electronics with an in-situ information-processing ability in the digital world. Therefore, we are demonstrating a soft-material enabled double-transfer-based process to integrate flexible, silicon-based, nano-scale, non-planar, fin-shaped field effect transistors (FinFETs) and planar metal-oxide-semiconductor field effect transistors (MOSFETs) on various asymmetric surfaces to study their compatibility and enhanced applicability in various emerging fields. FinFET devices feature sub-20 nm dimensions and state-of-the-art, high-κ/metal gate stack, showing no performance alteration after the transfer process. A further analysis of the transferred MOSFET devices, featuring 1 μm gate length exhibits ION ~70 μA/μm (VDS = 2 V, VGS = 2 V) and a low sub-threshold swing of around 90 mV/dec, proving that a soft interfacial material can act both as a strong adhesion/interposing layer between devices and final substrate as well as a means to reduce strain, which ultimately helps maintain the device’s performance with insignificant deterioration even at a high bending state.

Non-Planar Nano-Scale Fin Field Effect Transistors on Textile, Paper, Wood, Stone, and Vinyl via Soft Material-Enabled Double-Transfer Printing

KAUST Repository

Rojas, Jhonathan Prieto

2015-05-01

The ability to incorporate rigid but high-performance nano-scale non-planar complementary metal-oxide semiconductor (CMOS) electronics with curvilinear, irregular, or asymmetric shapes and surfaces is an arduous but timely challenge in enabling the production of wearable electronics with an in-situ information-processing ability in the digital world. Therefore, we are demonstrating a soft-material enabled double-transfer-based process to integrate flexible, silicon-based, nano-scale, non-planar, fin-shaped field effect transistors (FinFETs) and planar metal-oxide-semiconductor field effect transistors (MOSFETs) on various asymmetric surfaces to study their compatibility and enhanced applicability in various emerging fields. FinFET devices feature sub-20 nm dimensions and state-of-the-art, high-κ/metal gate stack, showing no performance alteration after the transfer process. A further analysis of the transferred MOSFET devices, featuring 1 μm gate length exhibits ION ~70 μA/μm (VDS = 2 V, VGS = 2 V) and a low sub-threshold swing of around 90 mV/dec, proving that a soft interfacial material can act both as a strong adhesion/interposing layer between devices and final substrate as well as a means to reduce strain, which ultimately helps maintain the device’s performance with insignificant deterioration even at a high bending state.

Mini replants: fingertip replant distal to the IP or DIP joint.

Science.gov (United States)

Dautel, G; Barbary, S

2007-01-01

Amputations through the distal interphalangeal joint or distal to this joint are frequent and they represent probably one of the best indications for replantation. Details on the vascular anatomy of the fingertip have to be perfectly known by the surgeon who will have to deal with these replantations. Factors such as age, mechanism of amputation and type of anastomosis will influence the overall success rate of the procedure. Return of a true static two points discrimination can be observed in children even in the absence of any neural repair.

Manufactoring the non-planar coils for the Wendelstein 7-X experiment

International Nuclear Information System (INIS)

Scheller, H.; Theisen, E.; Heyn, K.

2005-01-01

Because of the conditions associated with is use, nuclear fusion is a highly promising future energy supply option. The current objective of research worldwide is to demonstrate the feasibility of fusion power plants. The Wendelstein 7-X experiment at present under construction in Greifswald by the Max Planck Institute for Plasma Physics (IPP) is to demonstrate this feasibility for the stellarator concept. Babcock Noell Nuclear (BNN) in a consortium with Ansaldo Superconduttori, Genoa (ASG) has been commissioned by IPP to build the fifty superconducting non-planar coils constituting the magnet cage of the Wendelstein 7-X experiment. The coils will be assembled at the Zeitz manufacturing plant of BNM, a subsidiary of BNN. Manufacturing such a complex system is possible with the proper europeanwide network of subcontractors contributing special components. Thus, the superconductors were made by the German-Italian consortium, EAS, Hanau, and OCSI, Fornaci di Barga, Italy; the stainless steel housings are cast be Oesterby Gjutery AB in Sweden, the winding packs for BNN are produced by ABB, Neusaess, and mechanical finishing and final 3D measurement is performed by C-CON in Germany. (orig.)

[Distal radius fractures--retrospective quality control after conservative and operative therapy].

Science.gov (United States)

Sommer, C; Brendebach, L; Meier, R; Leutenegger, A

2001-01-01

The distal radius fracture is the most frequent fracture in the adult patient. The wide spectrum of different types of fracture and the coexisting factors make the choice for the optimal treatment difficult. As an interne quality control we retrospectively evaluated all patients with distal radius fractures treated in 1995 at our institution. The study included 69 adult patients with 71 distal radius fractures. After on average 26 months 58 patients with 59 fractures were clinically and radiologically evaluated. The patients were asked to give supplementary information about their follow-up treatment as well as any remaining physical difficulties and limitations in the daily life. All x-rays of the broken radius were carefully analysed and compared with the opposite side. The final results were evaluated according to the "Demerit Point System". Patients were treated with five different therapeutical methods. 76.3% of the patients showed a very good/good final result. In 56.7% of the cases secondary fracture dislocation occurred; the dislocation-rate of fractures treated with percutaneous k-wires was 93.3%! A clear correlation between secondary displacement and final results was found. A main factor for an optimal outcome is the anatomic restoration of length and axis of the distal radius as well as of joint congruency, also moderate angular deformities are well tolerated. Our collective showed an unexpected high rate of secondary displacement, especially in the k-wire group. The reasons for this unsatisfactory event are manifold: too optimistic indication, insufficient follow-up examination in the first four to six weeks, inconsequent change to a more stable fixation method in case of a secondary dislocation. The results of this retrospective evaluation had a major impact on our concept of treatment. The dorso-radial double-plate technique combined with bone graft will be more used in the future especially in younger patients. The new standardised concept is the

Exact solution of planar and nonplanar weak shock wave problem in gasdynamics

International Nuclear Information System (INIS)

Singh, L.P.; Ram, S.D.; Singh, D.B.

2011-01-01

Highlights: → An exact solution is derived for a problem of weak shock wave in adiabatic gas dynamics. → The density ahead of the shock is taken as a power of the position from the origin of the shock wave. → For a planar and non-planar motion, the total energy carried by the wave varies with respect to time. → The solution obtained for the planer, and cylindrically symmetric flow is new one. → The results obtained are also presented graphically for different Mach numbers. - Abstract: In the present paper, an analytical approach is used to determine a new exact solution of the problem of one dimensional unsteady adiabatic flow of planer and non-planer weak shock waves in an inviscid ideal fluid. Here it is assumed that the density ahead of the shock front varies according to the power law of the distance from the source of disturbance. The solution of the problem is presented in the form of a power in the distance and the time.

A PROSPECTIVE STUDY OF DISTAL TIBIAL FRACTURES BY MIPO (LCP

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Chandra Sekharam Naidu

2015-05-01

Full Text Available INTRODUCTION: D istal tibial fractures represent a significant challenge to most of the surgeons even today. They constitute 1 - 10% of all lower extremity fractures . 1 The difficulty in treating the fractures of distal tibial end is exemplif ied by orthopedists, who in the first half of twentieth century, believed these injuries were so severe and fraught with so many complications, that these fractures were deemed not amenable for surgical reconstruction . 2 Conservative treatment by POP cast l ead to prolonged immobilization, leading to ankle and knee stiffness affecting quality of life of the patient . 3 Operative treatment is indicated for most tibial fractures caused by high energy trauma. Operative treatment allows early motion, and avoids sho rtening and other complications associated with prolonged immobilization . 4 The fundamental goal of treatment of distal tibial fractures is restoration of normal or near normal alignment and articular congruity and finally to obtain a well healed fracture; pain free weight bearing ; and functional ROM of ankle joint. For the past decade, plating has been successful in treating complex fractures of the lower extremity especially distal tibia . 5 Conventional ORIF have been associated with complications like infe ction and delayed or non - union due to devitalisation of bony fragments and additional damage to the soft tissues . 6 To improve fracture healing, more “biological” methods have been developed in the last decade to lessen the surgical dissection, preserving b lood supply to bony fragments and containing at least partially the fracture haematoma . 7 Recently, the trend is towards use of a Locking compression plate for treatment of fractures of the distal part of the tibia 8 . Compared with a conventional plate, a Lo cking compression plate imparts a higher degree of stability and provides better protection against primary and secondary losses of reduction and minimization of bone

Accurate, safe, and rapid method of intraoperative tumor identification for totally laparoscopic distal gastrectomy: injection of mixed fluid of sodium hyaluronate and patent blue.

Science.gov (United States)

Nakagawa, Masatoshi; Ehara, Kazuhisa; Ueno, Masaki; Tanaka, Tsuyoshi; Kaida, Sachiko; Udagawa, Harushi

2014-04-01

In totally laparoscopic distal gastrectomy, determining the resection line with safe proximal margins is often difficult, particularly for tumors located in a relatively upper area. This is because, in contrast to open surgery, identifying lesions by palpating or opening the stomach is essentially impossible. This study introduces a useful method of tumor identification that is accurate, safe, and rapid. On the operation day, after inducing general anesthesia, a mixture of sodium hyaluronate and patent blue is injected into the submucosal layer of the proximal margin. When resecting stomach, all marker spots should be on the resected side. In all cases, the proximal margin is examined histologically by using frozen sections during the operation. From October 2009 to September 2011, a prospective study that evaluated this method was performed. A total of 34 patients who underwent totally laparoscopic distal gastrectomy were enrolled in this study. Approximately 5 min was required to complete the procedure. Proximal margins were negative in all cases, and the mean ± standard deviation length of the proximal margin was 23.5 ± 12.8 mm. No side effects, such as allergy, were encountered. As a method of tumor identification for totally laparoscopic distal gastrectomy, this procedure appears accurate, safe, and rapid.

Changes in the structural properties of peripheral nerves after transection.

Science.gov (United States)

Toby, E B; Meyer, B M; Schwappach, J; Alvine, G

1996-11-01

Changes in peripheral nerve structural properties after transection were measured weekly for 5 weeks in the distal stump of the sciatic nerve in 50 Sprague-Dawley rats. Each week after transection, the distal stump of the transected nerve showed increased stiffness when compared to intact nerves. Linear elastic stiffness reached a maximum at weeks 1 and 2 after transection, when the transected nerves were 15% stiffer than the contralateral control sides. Toughness was also increased and reached a maximum at week 4 with a 50% difference between values for experimental and control sides. Overall failure load was between 21% and 27% greater, peaking at week 3. An increase in stiffness of the distal stump would result in increased tension at the suture line, as the nerve gap is overcome when performing a delayed neurorraphy. These data suggest, with respect to structural properties, that an end-to-end repair should be carried out at the time of injury; after only 1 week, significant stiffness in the distal segment of the nerve developed, which should result in an increase in tension at the repair site.

Influence of Implant Position on Stress Distribution in Implant-Assisted Distal Extension Removable Partial Dentures: A 3D Finite Element Analysis.

Science.gov (United States)

Memari, Yeganeh; Geramy, Allahyar; Fayaz, Amir; Rezvani Habib Abadi, Shirin; Mansouri, Yasaman

2014-09-01

Distal extension removable partial denture is a prosthesis with lack of distal dental support with a 13-fold difference in resiliency between the mucosa and the periodontal ligament, resulting in leverage during compression forces. It may be potentially destructive to the abutments and the surrounding tissues. The aim of this study was to assess the effect of implant location on stress distribution, in distal extension implant assisted removable partial dentures. Three-dimensional models of a bilateral distal extension partially edentulous mandible containing anterior teeth and first premolar in both sides of the arch, a partial removable denture and an implant (4×10mm) were designed. With the aid of the finite element program ANSYS 8.0, the models were meshed and strictly vertical forces of 10 N were applied to each cusp tip. Displacement and von Mises Maps were plotted for visualization of results. When an implant was placed in the second premolar region, the highest stress on implant, abutment tooth and cancellous bone was shown. The lowest stress was shown on implant and bone in the 1(st) molar area. Implants located in the first molar area showed the least distribution of stresses in the analyzed models.

Patterns of triangular fibrocartilage complex (TFCC) injury associated with severely dorsally displaced extra-articular distal radius fractures.

Science.gov (United States)

Scheer, Johan H; Adolfsson, Lars E

2012-06-01

The aim of the study was to examine triangular fibrocartilage (TFCC) injury patterns associated with unstable, extra-articular dorsally displaced distal radius fractures. Twenty adult patients with an Arbeitsgemeinschaft für Osteosynthesefragen (AO), type A2 or A3, distal radius fracture with an initial dorsal angulation greater than 20° were included. Nine had a tip fracture (distal to the base) of the ulnar styloid and 11 had no such fracture. They were all openly explored from an ulnopalmar approach and TFCC injuries were documented. Eleven patients also underwent arthroscopy and intra-articular pathology was recorded. All patients had TFCC lesions of varying severity, having an extensor carpi ulnaris subsheath avulsion in common. Eighteen out of 20 also displayed deep foveal radioulnar ligament lesions, with decreasingly dorsal fibres remaining. The extent of this foveal injury could not be appreciated by radiocarpal arthroscopy. Severe displacement of an extra-articular radius fracture suggests an ulnar-sided ligament injury to the TFCC. The observed lesions concur with findings in a previous cadaver study. The lesions follow a distinct pattern affecting both radioulnar as well as ulnocarpal stabilisers. Copyright © 2012 Elsevier Ltd. All rights reserved.

In vivo laser assisted end-to-end anastomosis with ICG-infused chitosan patches

Science.gov (United States)

Rossi, Francesca; Matteini, Paolo; Esposito, Giuseppe; Scerrati, Alba; Albanese, Alessio; Puca, Alfredo; Maira, Giulio; Rossi, Giacomo; Pini, Roberto

2011-07-01

Laser assisted vascular repair is a new optimized technique based on the use of ICG-infused chitosan patch to close a vessel wound, with or even without few supporting single stitches. We present an in vivo experimental study on an innovative end-to-end laser assisted vascular anastomotic (LAVA) technique, performed with the application of ICGinfused chitosan patches. The photostability and the mechanical properties of ICG-infused chitosan films were preliminary measured. The in vivo study was performed in 10 New Zealand rabbits. After anesthesia, a 3-cm segment of the right common carotid artery was exposed, thus clamped proximally and distally. The artery was then interrupted by means of a full thickness cut. Three single microsutures were used to approximate the two vessel edges. The ICG-infused chitosan patch was rolled all over the anastomotic site and welded by the use of a diode laser emitting at 810 nm and equipped with a 300 μm diameter optical fiber. Welding was obtained by delivering single laser spots to induce local patch/tissue adhesion. The result was an immediate closure of the anastomosis, with no bleeding at clamps release. Thus animals underwent different follow-up periods, in order to evaluate the welded vessels over time. At follow-up examinations, all the anastomoses were patent and no bleeding signs were documented. Samples of welded vessels underwent histological examinations. Results showed that this technique offer several advantages over conventional suturing methods: simplification of the surgical procedure, shortening of the operative time, better re-endothelization and optimal vascular healing process.

Symptom scoring systems to diagnose distal polyneuropathy in diabetes : the Diabetic Neuropathy Symptom score

NARCIS (Netherlands)

Meijer, J.W.G.; Smit, A.J.; van Sonderen, E.; Groothoff, J.W.; Eisma, W.H.; Links, T.P.

2002-01-01

AIMS: To provide one of the diagnostic categories for distal diabetic polyneuro-pathy,several symptom scoring systems are available, which are often extensive andlack in validation. We validated a new four-item Diabetic Neuropathy Symptom (DNS) scorefor diagnosing distal diabetic polyneuropathy.

Laparoscopic side-to-side pancreaticojejunostomy for chronic pancreatitis in children

Directory of Open Access Journals (Sweden)

Kyoichi Deie

2016-01-01

Full Text Available Surgical pancreatic duct (PD drainage for chronic pancreatitis in children is relatively rare. It is indicated in cases of recurrent pancreatitis and PD dilatation that have not responded to medical therapy and therapeutic endoscopy. We performed laparoscopic side-to-side pancreaticojejunostomy for two paediatric patients with chronic pancreatitis. The main PD was opened easily by electrocautery after locating the dilated PD by intraoperative ultrasonography. The dilated PD was split longitudinally from the pancreatic tail to the pancreatic head by laparoscopic coagulation shears or electrocautery after pancreatography. A laparoscopic side-to-side pancreaticojejunostomy was performed by a one-layered technique using continuous 4-0 polydioxanone (PDS sutures from the pancreatic tail to the pancreatic head. There were no intraoperative or postoperative complications or recurrences. This procedure has cosmetic advantages compared with open surgery for chronic pancreatitis. Laparoscopic side-to-side pancreaticojejunostomy in children is feasible and effective for the treatment of chronic pancreatitis.

Autosomal dominant distal myopathy due to a novel ACTA1 mutation.

Science.gov (United States)

Liewluck, Teerin; Sorenson, Eric J; Walkiewicz, Magdalena A; Rumilla, Kandelaria M; Milone, Margherita

2017-08-01

Mutations in skeletal muscle α-actin 1-encoding gene (ACTA1) cause autosomal dominant or recessive myopathies with marked clinical and pathological heterogeneity. Patients typically develop generalized or limb-girdle pattern of weakness, but recently a family with scapuloperoneal myopathy was reported. We describe a father and 2 children with childhood-to-juvenile onset distal myopathy, carrying a novel dominant ACTA1 variant, c.757G>C (p.Gly253Arg). Father had delayed motor development and developed significant proximal weakness later in life; he was initially misdiagnosed as having spinal muscular atrophy based on electromyographic findings. His children had predominant anterior distal leg and finger extensor involvement. Nemaline rods were abundant on the daughter's biopsy, absent on the father's initial biopsy, and extremely rare on the father's subsequent biopsy a decade later. The father's second biopsy also showed myofibrillar pathology and rare fibers with actin filament aggregates. The present family expands the spectrum of actinopathy to include a distal myopathy. Copyright © 2017 Elsevier B.V. All rights reserved.

Volar plating for distal radius fractures--do not trust the image intensifier when judging distal subchondral screw length.

Science.gov (United States)

Park, Derek H; Goldie, Boyd S

2012-09-01

The use of the volar plate to treat distal radius fractures is increasing but despite the theoretical advantages of a volar approach there have been reports of extensor tendon ruptures due to prominent screw tips protruding past the dorsal cortex. The valley in the intermediate column between Lister tubercle and the sigmoid notch of the distal radius makes it difficult to rely on fluoroscopy to judge screw length. Our aim was to quantify the dimensions of this valley and to demonstrate the danger of relying on intraoperative image intensification fluoroscopy to determine lengths of distal screws. We measured the depth of this valley in the intermediate column of the distal radius in 33 patients with computed tomographic (9 patients) or magnetic resonance image (24 patients) scans of the wrist. There was a consistent valley in all images examined [average 1.8 mm (95% confidence interval, 1.6-2.0 mm)]. Thirty-nine percent of wrists had a valley depth of at least 2 mm. Standard lateral views or rotation of the forearm to obtain oblique views does not identify prominent screw tips; and whatever the rotation of the forearm, screw tips protruding beyond dorsal cortex may look as if it is within the bone when in fact it is out. When drilling we suggest noting the depth at which the drill bit just penetrates dorsal cortex and routinely downsize the distal screw length by 2 mm. We caution against relying on flourosocopy when judging the length of the distal subchondral screws.

Quantum coherent π-electron rotations in a non-planar chiral molecule induced by using a linearly polarized UV laser pulse

Science.gov (United States)

Mineo, Hirobumi; Fujimura, Yuichi

2015-06-01

We propose an ultrafast quantum switching method of π-electron rotations, which are switched among four rotational patterns in a nonplanar chiral aromatic molecule (P)-2,2’- biphenol and perform the sequential switching among four rotational patterns which are performed by the overlapped pump-dump laser pulses. Coherent π-electron dynamics are generated by applying the linearly polarized UV pulse laser to create a pair of coherent quasidegenerated excited states. We also plot the time-dependent π-electron ring current, and discussed ring current transfer between two aromatic rings.

Conceptualizing distal drivers in land use competition

DEFF Research Database (Denmark)

Niewhöner, Jörg; Nielsen, Jonas Ø; Gasparri, Gasparri

2016-01-01

This introductory chapter explores the notion of ‘distal drivers’ in land use competition. Research has moved beyond proximate causes of land cover and land use change to focus on the underlying drivers of these dynamics. We discuss the framework of telecoupling within human–environment systems...... as a first step to come to terms with the increasingly distal nature of driving forces behind land use practices. We then expand the notion of distal as mainly a measure of Euclidian space to include temporal, social, and institutional dimensions. This understanding of distal widens our analytical scope...... for the analysis of land use competition as a distributed process to consider the role of knowledge and power, technology, and different temporalities within a relational or systemic analysis of practices of land use competition. We conclude by pointing toward the historical and social contingency of land use...

Potassium secretion in mammalian distal colon

DEFF Research Database (Denmark)

Sørensen, Mads Vaarby

2009-01-01

Epithelial organs adjust the „inner milieu“ of the body and are crucial for all homeostatic processes. Epithelial transport of different solutes and water is regulated phenomena. The regulation processes include both long term hormonal regulation and short term local agonist mediated regulation....... This research project is the summary of 3 original papers addressing the functional role of different regulating factors on ion transport in mouse distal colon. The first paper addresses the effect of luminal nucleotides on electrogenic Na+ absorption. The distal colon, like the distal nephron is an aldosterone......-sensitive tissue and participates in the regulation of Na+ excretion. In the distal nephron it was found that luminal nucleotides inhibit ENaC-mediated Na+ absorption. Here it was addressed whether luminal nucleotides regulate Na+ absorption and if so, which of the known luminal P2 receptors are involved. Using...

Bone morphometry and mineral contents of the distal part of the fractured third metacarpal bone in thoroughbred racehorses

International Nuclear Information System (INIS)

Yoshihara, T.; Oikawa, M.; Wada, R.; Hasegawa, M.; Kaneko, M.

1990-01-01

Most of the bone fractures in racehorses occur in the fore limb, especially in the metacarpal joint during the racing and training. The longitudinal fracture of the third metacarpal bone (Mc III) often occurs in the osteosclerotic and/or necrotic lesions in the distal part of the bone. To elucidate the endogenous factors of its fracture, soft radiograms of 4 fractured and 4 non-fractured control cases have been investigated morphometrically by a image analyzer. In addition, to analyze the quality of these bones, 20 elements of mineral contents in the crashed bones have been measured using a fluorescent X-ray analyzer. As the results, the osteosclerotic change was observed in both groups in the plantar side of the distal part of Mc III, however, no significant differences were found in the bone morphometry. No significant differences in the 19 elements of bone mineral were found except Fe. From these findings, the mechanism of the occurrence of the longitudinal fracture in the Mc III remains to be elucidated. In future, further work needs to be done with regard to the mechanical intensity and collagen disposition of the distal part of the Mc III

Unilateral maxillary molar distalization with zygoma-gear appliance.

Science.gov (United States)

Kilkis, Dogan; Bayram, Mehmet; Celikoglu, Mevlut; Nur, Metin

2012-08-01

The aim of this study was to present the orthodontic treatment of a 15-year-old boy with a unilateral maxillary molar distalization system, called the zygoma-gear appliance. It consisted of a zygomatic anchorage miniplate, an inner bow, and a Sentalloy closed coil spring (GAC International, Bohemia, NY). A distalizing force of 350 g was used during the distalization period. The unilateral Class II malocclusion was corrected in 5 months with the zygoma-gear appliance. The maxillary left first molar showed distalization of 4 mm with an inclination of 3°. The maxillary premolars moved distally with the help of the transseptal fibers. In addition, there were slight decreases in overjet (-0.5 mm) and maxillary incisor inclination (-1°), indicating no anchorage loss from the zygoma-gear appliance. Preadjusted fixed appliances (0.022 × 0.028-in, MBT system; 3M Unitek, Monrovia, Calif) were placed in both arches to achieve leveling and alignment. After 14 months of unilateral distalization with the zygoma-gear appliance and fixed appliances, Class I molar and canine relationships were established with satisfactory interdigitation of the posterior teeth. Acceptable overjet and overbite were also achieved. This article shows that this new system, the zygoma-gear appliance, can be used for unilateral maxillary molar distalization without anchorage loss. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Flexible and transparent silicon-on-polymer based sub-20 nm non-planar 3D FinFET for brain-architecture inspired computation

KAUST Repository

Sevilla, Galo T.; Rojas, Jhonathan Prieto; Fahad, Hossain M.; Hussain, Aftab M.; Ghanem, Rawan; Smith, Casey; Hussain, Muhammad Mustafa

2014-01-01

An industry standard 8′′ silicon-on-insulator wafer based ultra-thin (1 μm), ultra-light-weight, fully flexible and remarkably transparent state-of-the-art non-planar three dimensional (3D) FinFET is shown. Introduced by Intel Corporation in 2011 as the most advanced transistor architecture, it reveals sub-20 nm features and the highest performance ever reported for a flexible transistor. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Flexible and transparent silicon-on-polymer based sub-20 nm non-planar 3D FinFET for brain-architecture inspired computation

KAUST Repository

Sevilla, Galo T.

2014-02-22

An industry standard 8′′ silicon-on-insulator wafer based ultra-thin (1 μm), ultra-light-weight, fully flexible and remarkably transparent state-of-the-art non-planar three dimensional (3D) FinFET is shown. Introduced by Intel Corporation in 2011 as the most advanced transistor architecture, it reveals sub-20 nm features and the highest performance ever reported for a flexible transistor. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Absorção de anticorpos do colostro em bezerros: II. Estudo no intestino delgado distal Colostral antibodies absorption in calves: II. Distal small intestine

Directory of Open Access Journals (Sweden)

Rosana Bessi

2002-11-01

Full Text Available Com o objetivo de estudar a morfologia e determinar a localização da enzima fosfatase ácida na região distal do intestino delgado de bezerros, do nascimento ao fechamento intestinal, foram coletadas amostras de 15 animais machos em três idades: ao nascer sem que houvesse a ingestão de colostro; três horas após a ingestão da primeira refeição de colostro e aos três dias de idade. Observou-se, ao nascimento, a presença de um grande vacúolo, que dominava todo o citoplasma das células epiteliais do jejuno distal e íleo. Após a ingestão de colostro, verificou-se o acúmulo de material absorvido nesses vacúolos. Foi detectada a reação de fosfatase ácida nas células absortivas de bezerros recém-nascidos, antes e após a ingestão de colostro. Aos três dias de idade, uma nova população de células geralmente não vacuoladas, com sistema endocítico apical reduzido, foi observada recobrindo as vilosidades intestinais. Portanto, em bezerros a maturação do epitélio absortivo do intestino delgado distal pode iniciar-se com o aumento da atividade enzimática nos vacúolos absortivos, culminando com a rápida substituição das células fetais por células diferenciadas não pinocíticas, o que determinaria o término da transferência de anticorpos maternos.The localization of acid phosphatase at distal small intestine and its morphology were studied f0rom birth to intestinal closure from fifteen male dairy calves aged: unsuckled neonatal, three hours after colostrum ingestion and three days old. At birth, the presence of a large vacuole was found and it expanded all over the epithelial cells cytoplasm at distal jejunum and ileum. For colostrum fed calves, ingested material could be observed in the vacuole. The phosphatase acid reaction was detected in the absorptive cells of suckled and unsuckled newborn calves. Calves aged three days old, a new population of non-vacuolated cells and reduced apical endocytic system were found

Linear intra-bone geometry dependencies of the radius: Radius length determination by maximum distal width

International Nuclear Information System (INIS)

Baumbach, S.F.; Krusche-Mandl, I.; Huf, W.; Mall, G.; Fialka, C.

2012-01-01

Purpose: The aim of the study was to investigate possible linear intra-bone geometry dependencies by determining the relation between the maximum radius length and maximum distal width in two independent populations and test for possible gender or age effects. A strong correlation can help develop more representative fracture models and osteosynthetic devices as well as aid gender and height estimation in anthropologic/forensic cases. Methods: First, maximum radius length and distal width of 100 consecutive patients, aged 20–70 years, were digitally measured on standard lower arm radiographs by two independent investigators. Second, the same measurements were performed ex vivo on a second cohort, 135 isolated, formalin fixed radii. Standard descriptive statistics as well as correlations were calculated and possible gender age influences tested for both populations separately. Results: The radiographic dataset resulted in a correlation of radius length and width of r = 0.753 (adj. R 2 = 0.563, p 2 = 0.592) and side no influence on the correlation. Radius length–width correlation for the isolated radii was r = 0.621 (adj. R 2 = 0.381, p 2 = 0.598). Conclusion: A relatively strong radius length–distal width correlation was found in two different populations, indicating that linear body proportions might not only apply to body height and axial length measurements of long bones but also to proportional dependency of bone shapes in general.

A PROSPECTIVE STUDY OF CLINICAL OUTCOME AFTER USING LIGAMENTOTAXIS IN MANAGEMENT OF DISTAL RADIUS FRACTURES

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Chandrashekhar V. Mudgal

2017-04-01

Full Text Available BACKGROUND A study was done to evaluate the effect of the ligamentotaxis in the management of intraarticular fractures of the distal radius. MATERIALS AND METHODS 34 patients were studied prospectively between March 2014 and February 2016. All patients had intraarticular fracture of distal end of radius and all were treated with ligamentotaxis after closed reduction with fluoroscopic guidance. The follow-up period was 12 months. At the time of surgery, the mean age was 45.29 years. RESULTS In all fracture cases, the mean of fracture union was 5.8 weeks. During the final follow-up, the mean range of motion was 55.30 in flexion, 56.60 in extension, 21.0 in ulnar deviation, 9.00 in radial deviation, 70.30 in pronation and 67.10 in supination. According to the scoring system of Gartland and Werley, the clinical and functional outcomes showed that 15 patients (44.1% had excellent results, 14 (41.1% had good results, 3 (8.8% had fair results and 2 (5.8% had poor results. CONCLUSION Closed reduction under fluoroscopic image guidance and the ligamentotaxis is useful and effective in the treatment of intraarticular fractures of the distal radius.

Fractures of the distal phalanx in the horse

International Nuclear Information System (INIS)

Yovich, J.V.

1989-01-01

Fractures of the distal phalanx are an important cause of lameness referable to the foot. Depending on the fracture configuration and articular involvement, conservative or surgical treatment may be required. Fractures of the distal phalanx have been divided into six categories based on fracture configuration. Discussion of clinical features, management, and prognosis for horses with distal phalangeal fractures is presented for each fracture type

Expectations in Culturally Unfamiliar Music: Influences of Proximal and Distal Cues and Timbral Characteristics

Directory of Open Access Journals (Sweden)

Catherine J Stevens

2013-11-01

Full Text Available Listeners’ musical perception is influenced by cues that can be stored in short-term memory (e.g. within the same musical piece or long-term memory (e.g. based on one’s own musical culture. The present study tested how these cues (referred to as respectively proximal and distal cues influence the perception of music from an unfamiliar culture. Western listeners who were naïve to Gamelan music judged completeness and coherence for newly constructed melodies in the Balinese gamelan tradition. In these melodies, we manipulated the final tone with three possibilities: the original gong tone, an in-scale tone replacement or an out-of-scale tone replacement. We also manipulated the musical timbre employed in Gamelan pieces. We hypothesized that novice listeners are sensitive to out-of-scale changes, but not in-scale changes, and that this might be influenced by the more unfamiliar timbre created by Gamelan sister instruments whose harmonics beat with the harmonics of the other instrument, creating a timbrally shimmering sound. The results showed: 1 out-of-scale endings were judged less complete than original gong and in-scale endings; 2 for melodies played with sister instruments, in-scale endings were judged as less complete than original endings. Furthermore, melodies using the original scale tones were judged more coherent than melodies containing few or multiple tone replacements; melodies played on single instruments were judged more coherent than the same melodies played on sister instruments. Additionally, there is some indication of within-session statistical learning, with expectations for the initially-novel materials developing during the course of the experiment. The data suggest the influence of both distal cues (e.g. previously unfamiliar timbres and proximal cues (within the same sequence and over the experimental session on the perception of melodies from other cultural systems based on unfamiliar tunings and scale systems.

Expectations in culturally unfamiliar music: influences of proximal and distal cues and timbral characteristics.

Science.gov (United States)

Stevens, Catherine J; Tardieu, Julien; Dunbar-Hall, Peter; Best, Catherine T; Tillmann, Barbara

2013-01-01

Listeners' musical perception is influenced by cues that can be stored in short-term memory (e.g., within the same musical piece) or long-term memory (e.g., based on one's own musical culture). The present study tested how these cues (referred to as, respectively, proximal and distal cues) influence the perception of music from an unfamiliar culture. Western listeners who were naïve to Gamelan music judged completeness and coherence for newly constructed melodies in the Balinese gamelan tradition. In these melodies, we manipulated the final tone with three possibilities: the original gong tone, an in-scale tone replacement or an out-of-scale tone replacement. We also manipulated the musical timbre employed in Gamelan pieces. We hypothesized that novice listeners are sensitive to out-of-scale changes, but not in-scale changes, and that this might be influenced by the more unfamiliar timbre created by Gamelan "sister" instruments whose harmonics beat with the harmonics of the other instrument, creating a timbrally "shimmering" sound. The results showed: (1) out-of-scale endings were judged less complete than original gong and in-scale endings; (2) for melodies played with "sister" instruments, in-scale endings were judged as less complete than original endings. Furthermore, melodies using the original scale tones were judged more coherent than melodies containing few or multiple tone replacements; melodies played on single instruments were judged more coherent than the same melodies played on sister instruments. Additionally, there is some indication of within-session statistical learning, with expectations for the initially-novel materials developing during the course of the experiment. The data suggest the influence of both distal cues (e.g., previously unfamiliar timbres) and proximal cues (within the same sequence and over the experimental session) on the perception of melodies from other cultural systems based on unfamiliar tunings and scale systems.

Rounded leaf end effect of multileaf collimator on penumbra width and radiation field offset: an analytical and numerical study

International Nuclear Information System (INIS)

Zhou, Dong; Zhang, Hui; Ye, Peiqing

2015-01-01

Penumbra characteristics play a significant role in dose delivery accuracy for radiation therapy. For treatment planning, penumbra width and radiation field offset strongly influence target dose conformity and organ at risk sparing. In this study, we present an analytical and numerical approach for evaluation of the rounded leaf end effect on penumbra characteristics. Based on the rule of half-value layer, algorithms for leaf position calculation and radiation field offset correction were developed, which were advantageous particularly in dealing with large radius leaf end. Computer simulation was performed based on the Monte Carlo codes of EGSnrc/BEAMnrc, with groups of leaf end radii and source sizes. Data processing technique of curve fitting was employed for deriving penumbra width and radiation field offset. Results showed that penumbra width increased with source size. Penumbra width curves for large radius leaf end were U-shaped. This observation was probably related to the fact that radiation beams penetrated through the proximal and distal leaf sides. In contrast, source size had negligible impact on radiation field offset. Radiation field offsets were found to be constant both for analytical method and numerical simulation. However, the overall resulting values of radiation field offset obtained by analytical method were slightly smaller compared with Monte Carlo simulation. The method we proposed could provide insight into the investigation of rounded leaf end effects on penumbra characteristics. Penumbra width and radiation field offset calibration should be carefully performed to commission multileaf collimator for intensity modulated radiotherapy

Distal technologies and type 1 diabetes management.

Science.gov (United States)

Duke, Danny C; Barry, Samantha; Wagner, David V; Speight, Jane; Choudhary, Pratik; Harris, Michael A

2018-02-01

Type 1 diabetes requires intensive self-management to avoid acute and long-term health complications. In the past two decades, substantial advances in technology have enabled more effective and convenient self-management of type 1 diabetes. Although proximal technologies (eg, insulin pumps, continuous glucose monitors, closed-loop and artificial pancreas systems) have been the subject of frequent systematic and narrative reviews, distal technologies have received scant attention. Distal technologies refer to electronic systems designed to provide a service remotely and include heterogeneous systems such as telehealth, mobile health applications, game-based support, social platforms, and patient portals. In this Review, we summarise the empirical literature to provide current information about the effectiveness of available distal technologies to improve type 1 diabetes management. We also discuss privacy, ethics, and regulatory considerations, issues of global adoption, knowledge gaps in distal technology, and recommendations for future directions. Copyright © 2018 Elsevier Ltd. All rights reserved.

End to End Travel

Data.gov (United States)

US Agency for International Development — E2 Solutions is a web based end-to-end travel management tool that includes paperless travel authorization and voucher document submissions, document approval...

Influence of Implant Position on Stress Distribution in Implant-Assisted Distal Extension Removable Partial Dentures: A 3D Finite Element Analysis.

Directory of Open Access Journals (Sweden)

Yeganeh Memari

2014-10-01

Full Text Available Distal extension removable partial denture is a prosthesis with lack of distal dental support with a 13-fold difference in resiliency between the mucosa and the periodontal ligament, resulting in leverage during compression forces. It may be potentially destructive to the abutments and the surrounding tissues. The aim of this study was to assess the effect of implant location on stress distribution, in distal extension implant assisted removable partial dentures.Three-dimensional models of a bilateral distal extension partially edentulous mandible containing anterior teeth and first premolar in both sides of the arch, a partial removable denture and an implant (4×10mm were designed. With the aid of the finite element program ANSYS 8.0, the models were meshed and strictly vertical forces of 10 N were applied to each cusp tip. Displacement and von Mises Maps were plotted for visualization of results.When an implant was placed in the second premolar region, the highest stress on implant, abutment tooth and cancellous bone was shown. The lowest stress was shown on implant and bone in the 1(st molar area.Implants located in the first molar area showed the least distribution of stresses in the analyzed models.

Effect of the Length of Side Group Substitution on Optical and Electroluminescene Properties

Energy Technology Data Exchange (ETDEWEB)

Shin, Hwan Gyu; Kang, Hyeon Mi; Kim, Beom Jin; Park, Young Il [The Catholic University, Bucheon (Korea, Republic of); Yu, Young Jun [Korea Research Institute of Chemical Technology, Ulsan (Korea, Republic of); Park, Jong Wook [LG display Co., Gyeonggi (Korea, Republic of)

2014-09-15

Blue emitting materials, 9,10-bis-biphenyl-4-yl-anthracene (AC-P), 9,10-bis-[1,1';4',1'']terphenyl-4-yl-anthracene (AC-DP), and 9,10-bis[3'',5''-deiphenyltriphenyl-4'-yl]anthracene (AC-TP) were synthesized through boration and Suzuki aryl-aryl coupling reaction. EL performance of blue light-emitters was optimized and improved by varying the chemical structures of the side groups. In the thin film state, the three materials exhibit PLmax values in the range of 442-456 nm. EL device with the synthesized compounds in the following configuration was fabricated: ITO/4,4',4''-tris(N-(2-naphthyl)-N-phenylamino)triphenylamine (2-TNATA) 60nm/N,N'-bis (naphthalene-1-yl)-N,N'-bis(phenyl)benzidine (NPB) 15nm/synthesized blue emitting materials (30nm)/1,3,5- tri(1-phenyl-1H-benzo[d]imidazol-2-yl)phenyl (TPBi) 20nm/LiF 1nm/Al 200nm. The current efficiency and C.I.E. value of AC-TP were 3.87 cd/A and (0.15, 0.12). A bulky and non-planar side group helps to prevent π-π* stacking interaction, which should lead to the formation of more reliable amorphous film. This is expected to have a positive effect on the high efficiency of the operating OLED device.

Distal Communication by Chimpanzees (Pan troglodytes): Evidence for Common Ground?

Science.gov (United States)

Leavens, David A; Reamer, Lisa A; Mareno, Mary Catherine; Russell, Jamie L; Wilson, Daniel; Schapiro, Steven J; Hopkins, William D

2015-01-01

van der Goot et al. (2014) proposed that distal, deictic communication indexed the appreciation of the psychological state of a common ground between a signaler and a receiver. In their study, great apes did not signal distally, which they construed as evidence for the human uniqueness of a sense of common ground. This study exposed 166 chimpanzees to food and an experimenter, at an angular displacement, to ask, "Do chimpanzees display distal communication?" Apes were categorized as (a) proximal or (b) distal signalers on each of four trials. The number of chimpanzees who communicated proximally did not statistically differ from the number who signaled distally. Therefore, contrary to the claim by van der Goot et al., apes do communicate distally. © 2015 The Authors. Child Development © 2015 Society for Research in Child Development, Inc.

Characteristics of Differently Located Colorectal Cancers Support Proximal and Distal Classification: A Population-Based Study of 57,847 Patients.

Directory of Open Access Journals (Sweden)

Jiao Yang

Full Text Available It has been suggested that colorectal cancer be regarded as several subgroups defined according to tumor location rather than as a single entity. The current study aimed to identify the most useful method for grouping colorectal cancer by tumor location according to both baseline and survival characteristics.Cases of pathologically confirmed colorectal adenocarcinoma diagnosed from 2000 to 2012 were identified from the Surveillance, Epidemiology, and End Results database and categorized into three groups: right colon cancer (RCC, left colon cancer (LCC, and rectal cancer (ReC. Adjusted hazard ratios for known predictors of disease-specific survival (DSS in colorectal cancer were obtained using a Cox proportional hazards regression model.The study included 57847 patients: 43.5% with RCC, 37.7% with LCC, and 18.8% with ReC. Compared with LCC and ReC, RCC was more likely to affect old patients and women, and to be at advanced stage, poorly differentiated or un-differentiated, and mucinous. Patients with LCC or ReC had better DSS than those with RCC in subgroups including stage III or IV disease, age ≤70 years and non-mucinous adenocarcinoma. Conversely, patients with LCC or ReC had worse DSS than those with RCC in subgroups including age ˃70 years and mucinous adenocarcinoma.RCC differed from both LCC and ReC in several clinicopathologic characteristics and in DSS. It seems reasonable to group colorectal cancer into right-sided (i.e., proximal and left-sided (i.e., distal ones.

Comparison of Internal Fixations for Distal Clavicular Fractures Based on Loading Tests and Finite Element Analyses

Directory of Open Access Journals (Sweden)

Rina Sakai

2014-01-01

Full Text Available It is difficult to apply strong and stable internal fixation to a fracture of the distal end of the clavicle because it is unstable, the distal clavicle fragment is small, and the fractured region is near the acromioclavicular joint. In this study, to identify a superior internal fixation method for unstable distal clavicular fracture, we compared three types of internal fixation (tension band wiring, scorpion, and LCP clavicle hook plate. Firstly, loading tests were performed, in which fixations were evaluated using bending stiffness and torsional stiffness as indices, followed by finite element analysis to evaluate fixability using the stress and strain as indices. The bending and torsional stiffness were significantly higher in the artificial clavicles fixed with the two types of plate than in that fixed by tension band wiring (P<0.05. No marked stress concentration on the clavicle was noted in the scorpion because the arm plate did not interfere with the acromioclavicular joint, suggesting that favorable shoulder joint function can be achieved. The stability of fixation with the LCP clavicle hook plate and the scorpion was similar, and plate fixations were stronger than fixation by tension band wiring.

Distal displacement of the maxilla and the upper first molar.

Science.gov (United States)

Baumrind, S; Molthen, R; West, E E; Miller, D M

1979-06-01

Data from a sample of 198 Class II cases treated with various appliances which deliver distally directed forces to the maxilla were examined to determine the frequency of absolute distal displacement of the upper first molar and of the maxilla. Analysis revealed that such distal displacement is possible and that it is, in fact, a frequent finding following treatment. Long-range stability of distal displacement was not assessed.

SIDE TO SIDE DIFFERENCES BETWEEN DOMINANT AND NON-DOMINANT ARM'S BONE DENSITY AND ISOMETRIC HANDGRIP STRENGTH IN MALES AND FEMALES AGED 40-65 YEARS OLD.

Science.gov (United States)

Krasniqi, Ermira; Koni, Mynyr; Kabashi, Antigona; Bahtiri, Abedin; Gjeli, Selda; Boshnjaku, Arben

2016-10-01

This observational, cross-sectional study, investigates and compares the differences of BMD, T-score, Z-score and isometric strength between dominant (D) versus non-dominant (ND) arms of 162 subjects aged 40-65 in a developing, low income country (Kosova). Bone Mineral Density (BMD), T-score and Z-score at distal forearm regions of both arms (measured by DXA scan), together with the Handgrip Isometric Strength (HIS) (by handgrip) were evaluated in a total subjects (53 Males and 109 Females). Additionally, General Healthcare Status Questionnaire together with self-administrated International Physical Activity Questionnaire (IPAQ) were filled. Significant differences (p0.05) were observed in Males BMD comparing to significantly higher results (p0.05) in males. When comparing the total subject's BMD, T-score, Z-score and Handgrip based on the PA levels (1 to 3 according to IPAQ scoring) no significant differences (p>0.05) were found between PA1, as well as PA3 whereas significantly differences (p<0.05) were found in D arms of PA2 level. The study analyses side-to-side differences in bone density and muscular force between D and ND arms amongst a population which is frequently exposed to diagnostic screenings for age related osteomuscular conditions (aged 40-60), and demonstrates that these differences should be in consideration amongst clinicians, but not in the way it is done right now.

Electrical network capacity support from demand side response: Techno-economic assessment of potential business cases for small commercial and residential end-users

International Nuclear Information System (INIS)

Martínez Ceseña, Eduardo A.; Good, Nicholas; Mancarella, Pierluigi

2015-01-01

Demand Side Response (DSR) is recognised for its potential to bring economic benefits to various electricity sector actors, such as energy retailers, Transmission System Operators (TSOs) and Distribution Network Operators (DNOs). However, most DSR is provided by large industrial and commercial consumers, and little research has been directed to the quantification of the value that small (below 100 kW) commercial and residential end-users could accrue by providing DSR services. In particular, suitable models and studies are needed to quantify potential business cases for DSR from small commercial and residential end-users. Such models and studies should consider the technical and physical characteristics of the power system and demand resources, together with the economic conditions of the power market. In addition, the majority of research focuses on provision of energy arbitrage or ancillary services, with very little attention to DSR services for network capacity support. Accordingly, this paper presents comprehensive techno-economic methodologies for the quantification of three capacity-based business cases for DSR from small commercial and residential end-users. Case study results applied to a UK context indicate that, if the appropriate regulatory framework is put in place, services for capacity support to both DNOs and TSOs can result into potentially attractive business cases for DSR from small end-users with minimum impact on their comfort level. -- Highlights: •We present three business cases for DSR from domestic and commercial end-users. •A comprehensive techno-economic methodology is proposed for the quantification of each DSR business cases. •The regulatory implications associated with each business case are discussed

[TREATMENT OF PRONATION EXTERNAL ROTATION ANKLE FRACTURE COMBINED WITH SEPARATION OF DISTAL TIBIOFIBULAR SYNDESMOSIS].

Science.gov (United States)

Wu, Benwen; Ding, Zhenqi; Huang, Guofeng; Liu, Guojun; Cai, Zhemin; Ding, Luobin; Li, Xiang

2016-09-08

To evaluate the difference between using and not using syndesmotic screw to treat pronation external rotation (PER) ankle fracture combined with separation of distal tibiofibular syndesmosis. Between April 2011 and October 2014, 46 cases of PER ankle fracture combined with separation of distal tibiofibular syndesmosis were treated, and syndesmotic screw was used in 24 cases (fixation group) and syndesmotic screw was not used in 22 cases (non-fixation group). There was no significant difference in gender, age, weight, cause of injury, side, injury to operation time, and fracture type between 2 groups ( P >0.05). The time for full weight-bearing, fracture healing time, and complications were recorded after operation. Anteroposterior and lateral X-ray films were taken to measure the tibiofibular overlap (TBOL) and tibiofibular clear space (TBCS). Baird-Jackson score was used to evaluate functional recovery of the ankle. All incision healed by first intention without complications. The cases were followed up 13-18 months (mean, 15.2 months) in 2 groups. The time for full weight-bearing was 8-12 weeks (median, 11 weeks) in fixation group, which was significantly later than that in non-fixation group (range, 6-10 weeks; median, 8 weeks) ( Z =-5.049, P =0.000). X-ray examination showed reduction of separation of distal tibiofibular syndesmosis. All fractures healed. The fracture healing time was (13.83±1.37) weeks in fixation group, and was (13.91±1.31) weeks in non-fixation group, showing no significant difference ( t =-0.191, P =0.945). No separation of distal tibiofibular syndesmosis, delayed union, nonunion, loosening, or breakage of fixation devices was observed in 2 groups. There was no significant difference in TBOL, TBCS, Baird-Jackson score and the excellent and good rate between 2 groups ( P >0.05). If the medial, lateral, and posterior structures of the ankle could be repaired according to injury, no significant influence on functional outcome of ankle or

Rearrangement of the distal pocket accompanying E7 His → Gln substitution in elephant carbonmonoxy- and oxymyoglobin: 1H NMR identification of a new aromatic residue in the heme pocket

International Nuclear Information System (INIS)

Yu, L.P.; La Mar, G.N.; Mizukami, H.

1990-01-01

Two-dimensional 1 H NMR methods have been used to assign side-chain resonances for the residues in the distal heme pocket of elephant carbonmonoxymyoglobin (MbCO) and oxymyoglobin (MbO 2 ). It is shown that, while the other residues in the heme pocket are minimally perturbed, the Phe CD4 residue in elephant MbCO and MbO 2 resonates considerably upfield compared to the corresponding residue in sperm whale MbCO. The new NOE connectivities to Val E11 and heme-induced ring current calculations indicate that Phe CD4 has been inserted into the distal heme pocket by reorienting the aromatic side chain and moving the CD corner closer to the heme. The CζH proton of the Phe CD4 was found to move toward the iron of the heme by ∼4 angstrom relative to the position in sperm whale MbCO, requiring minimally a 3-angstrom movement of the CD helical backbone. The significantly altered distal conformation in elephant myoglobin, rather than the single distal E7 substitution, forms a plausible basis for its altered functional properties of lower autoxidation rate, higher redox potential, and increased affinity for CO ligand. These results demonstrate that one-to-one interpretation of amino acid residue substitution (E7 His → Gln) is oversimplified and that conformational changes of substituted proteins which are not readily predicted have to be considered for interpretation of their functional properties

Distal splenorenal shunt with partial spleen resection

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Gajin Predrag

2007-01-01

Full Text Available Introduction: Hypersplenism is a common complication of portal hypertension. Cytopenia in hypersplenism is predominantly caused by splenomegaly. Distal splenorenal shunt (Warren with partial spleen resection is an original surgical technique that regulates cytopenia by reduction of the enlarged spleen. Objective. The aim of our study was to present the advantages of distal splenorenal shunt (Warren with partial spleen resection comparing morbidity and mortality in a group of patients treated by distal splenorenal shunt with partial spleen resection with a group of patients treated only by a distal splenorenal shunt. Method. From 1995 to 2003, 41 patients with portal hypertension were surgically treated due to hypersplenism and oesophageal varices. The first group consisted of 20 patients (11 male, mean age 42.3 years who were treated by distal splenorenal shunt with partial spleen resection. The second group consisted of 21 patients (13 male, mean age 49.4 years that were treated by distal splenorenal shunt only. All patients underwent endoscopy and assessment of oesophageal varices. The size of the spleen was evaluated by ultrasound, CT or by scintigraphy. Angiography was performed in all patients. The platelet and white blood cell count and haemoglobin level were registered. Postoperatively, we noted blood transfusion, complications and total hospital stay. Follow-up period was 12 months, with first checkup after one month. Results In the first group, only one patient had splenomegaly postoperatively (5%, while in the second group there were 13 patients with splenomegaly (68%. Before surgery, the mean platelet count in the first group was 51.6±18.3x109/l, to 118.6±25.4x109/l postoperatively. The mean platelet count in the second group was 67.6±22.8x109/l, to 87.8±32.1x109/l postoperatively. Concerning postoperative splenomegaly, statistically significant difference was noted between the first and the second group (p<0.05. Comparing the

Laparoscopic versus open distal pancreatectomy for pancreatic cancer.

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Riviere, Deniece; Gurusamy, Kurinchi Selvan; Kooby, David A; Vollmer, Charles M; Besselink, Marc G H; Davidson, Brian R; van Laarhoven, Cornelis J H M

2016-04-04

Surgical resection is currently the only treatment with the potential for long-term survival and cure of pancreatic cancer. Surgical resection is provided as distal pancreatectomy for cancers of the body and tail of the pancreas. It can be performed by laparoscopic or open surgery. In operations on other organs, laparoscopic surgery has been shown to reduce complications and length of hospital stay as compared with open surgery. However, concerns remain about the safety of laparoscopic distal pancreatectomy compared with open distal pancreatectomy in terms of postoperative complications and oncological clearance. To assess the benefits and harms of laparoscopic distal pancreatectomy versus open distal pancreatectomy for people undergoing distal pancreatectomy for pancreatic ductal adenocarcinoma of the body or tail of the pancreas, or both. We used search strategies to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Science Citation Index Expanded and trials registers until June 2015 to identify randomised controlled trials (RCTs) and non-randomised studies. We also searched the reference lists of included trials to identify additional studies. We considered for inclusion in the review RCTs and non-randomised studies comparing laparoscopic versus open distal pancreatectomy in patients with resectable pancreatic cancer, irrespective of language, blinding or publication status.. Two review authors independently identified trials and independently extracted data. We calculated odds ratios (ORs), mean differences (MDs) or hazard ratios (HRs) along with 95% confidence intervals (CIs) using both fixed-effect and random-effects models with RevMan 5 on the basis of intention-to-treat analysis when possible. We found no RCTs on this topic. We included in this review 12 non-randomised studies that compared laparoscopic versus open distal pancreatectomy (1576 participants: 394 underwent laparoscopic distal pancreatectomy and 1182

Comparison between open and arthroscopic-assisted foveal triangular fibrocartilage complex repair for post-traumatic distal radio-ulnar joint instability.

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Luchetti, R; Atzei, A; Cozzolino, R; Fairplay, T; Badur, N

2014-10-01

The aim of this study was to assess the objective and subjective functional outcomes after foveal reattachment of proximal or complete ulnar-sided triangular fibrocartilage complex lesions by two surgical procedures: an open technique or an arthroscopically assisted repair. The study was done prospectively on 49 wrists affected by post-traumatic distal radio-ulnar joint instability. Twenty-four patients were treated with the open technique (Group 1) and 25 by the arthroscopically assisted technique (Group 2). Magnetic resonance imaging demonstrated a clear foveal detachment of the triangular fibrocartilage complex in 67% of the cases. Arthroscopy showed a positive ulnar-sided detachment of the triangular fibrocartilage complex (positive hook test) in all cases. Distal radio-ulnar joint stability was obtained in all but five patients at a mean follow-up of 6 months. Both groups had improvement of all parameters with significant differences in wrist pain scores, Mayo wrist score, Disability of the Arm, Shoulder and Hand questionnaire and Patient-Rated Wrist/Hand Evaluation questionnaire scores. There were no significant post-operative differences between the two groups in the outcome parameters except for the Disability of the Arm Shoulder and Hand questionnaire score, which was significantly better in Group 2 (p < 0.001). © The Author(s) 2013.

Clinico-radiographic Studies on The Prevalent Distal Limb Affections in Working Equine at Luxor City

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A. A.A. Abdel-Hady

2017-01-01

Full Text Available To illustrate the clinical and radiographic findings of some distal limbs affections in Ninety two animals (24 horses and 68 donkeys which were admitted to Animal Care Hospital in Luxor. Each animal was subjected to thorough clinical and radiographic examination; the grade of lameness was recorded and the best radiographic views were taken.  Fifteen types of distal limb affections were evident. The most prevalent affections in donkeys were high and low ring bone (29.35% and hoof abscess ( 9.78% followed by traumatic arthritis of the fetlock (6.52%, suspensory ligament desmitis (5.43%, fracture of first phalanx (5.43%, fracture of PII (4.35%, side bone (3.26%  whereas, fracture of metacarpal bone (1.09%, sesamoditis (1.09% and flexural deformities (1.09%  represented the lowest prevalent affections.On the other hand, side bone (4.35%, fracture of the metacarpal bone (4.35% represented the most prevalent affections in horses followed by high and low ring bone (3.26%, fractures of PI (2.17%, PII (2.17%, subluxation of coronopedal joint (2.17% and punctured wounds in of the hoof (2.17%, traumatic arthritis of the fetlock joint (2.17%. Whereas, navicular disease (1.09%, suspensory ligament desmitis (1.09% and hoof abscess (1.09% were the lowest prevalent affections in horses. Treatment was not recommended in certain cases. In conclusion, although the wide stride progress have made in diagnostic imaging in recent decades, the x ray still offers a satisfactory tool for diagnostic imaging in equine limb practice that is useful for equine practitioners.

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

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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 comparison between robotic-assisted laparoscopic distal pancreatectomy versus laparoscopic distal pancreatectomy.

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Goh, Brian K P; Chan, Chung Yip; Soh, Hui-Ling; Lee, Ser Yee; Cheow, Peng-Chung; Chow, Pierce K H; Ooi, London L P J; Chung, Alexander Y F

2017-03-01

This study aims to compare the early perioperative outcomes of robotic-assisted laparoscopic distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP). The clinicopathologic features of 45 consecutive patients who underwent minimally-invasive distal pancreatectomy from 2006 to 2015 were retrospectively reviewed. Thirty-nine patients who met our study criteria were included. Eight patients underwent RDP and 31 had LDP. There were 10 (25.6%) open conversions. Six (15.4%) patients had major (> grade 2) morbidities and there was no in-hospital mortality. There were 14 (35.9%) grade A and 9 (23.1%) grade B pancreatic fistulas. Comparison between RDP and LDP demonstrated no significant difference between the patients' baseline characteristics except there was increased frequency of spleen-preserving pancreatectomies (3 (37.5%) vs 25 (80.6%), P=0.016) and splenic-vessel preservation (5 (62.5%) vs 4 (12.9%), P=0.003) in RDP. Comparison between outcomes demonstrated that RDP was associated with a longer median operation time (452.5 (range, 300-685) vs 245 min (range, 85-430), P=0.001) and increased frequency of the procedure completed purely laparoscopically (8 (100%) vs 18 (58.1%), P=0.025). RDP can be safely adopted and is equivalent to LDP in most perioperative outcomes. It is also associated with a decreased frequency of the need for hand-assistance laparoscopic surgery or open conversion but needed a longer operation time. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Growth of strained InGaAs/GaAs quantum wells and index guided injection lasers over nonplanar substrates by molecular beam epitaxy

International Nuclear Information System (INIS)

Arent, D.J.; Galeuchet, Y.D.; Nilsson, S.; Meier, H.P.

1990-01-01

Strained InGaAs/GaAs quantum wells were grown on nonplanar substrates by molecular beam epitaxy and studied by scanning electron microscopy and low temperature spatially and spectrally resolved cathodoluminescence spectroscopy. For (100) ridges and grooves formed with (311)A sidewalls, almost complete removal of In from the strained quantum wells on the (311)A facet is observed. Corresponding increases of In content in the quantum wells grown on the (100) facets indicate that most if not all of the In is displaced from the (311)A facet via interplanar adatom migration. Ga adatom migration is also observed under our growth conditions such that quantum wells grown nominally near the critical layer thickness on structures less than ≅2.5 μm wide are no longer pseudomorphically strained, as detected by luminescence linewidth analysis. We present the first results of strained InGaAs/GaAs index guided injection lasers grown by single-step molecular beam epitaxy over nonplanar substrates and show that differences greater than 50 meV in the effective band gap of a 70 A quantum well can be achieved between the gain region and the nonabsorbing waveguide without relaxing the strain. Room temperature threshold currents as low as 6 mA for 4 μmx750 μm uncoated devices lasing continuously at a wavelength of 1.01 μm have been achieved

Structural equation modeling of the proximal–distal continuum of adherence drivers

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McHorney CA

2012-11-01

Full Text Available Colleen A McHorney,1 Ning Jackie Zhang,2 Timothy Stump,3 Xiaoquan Zhao41US Outcomes Research, Merck, North Wales, PA, 2University of Central Florida, Orlando, 3Indiana University School of Medicine, Indianapolis, 4George Mason University, Fairfax, USAObjectives: Nonadherence to prescription medications has been shown to be significantly influenced by three key medication-specific beliefs: patients' perceived need for the prescribed medication, their concerns about the prescribed medication, and perceived medication affordability. Structural equation modeling was used to test the predictors of these three proximal determinants of medication adherence using the proximal–distal continuum of adherence drivers as the organizing conceptual framework.Methods: In Spring 2008, survey participants were selected from the Harris Interactive Chronic Illness Panel, an internet-based panel of hundreds of thousands of adults with chronic disease. Respondents were eligible for the survey if they were aged 40 years and older, resided in the US, and reported having at least one of six chronic diseases: asthma, diabetes, hyperlipidemia, hypertension, osteoporosis, or other cardiovascular disease. A final sample size of 1072 was achieved. The proximal medication beliefs were measured by three multi-item scales: perceived need for medications, perceived medication concerns, and perceived medication affordability. The intermediate sociomedical beliefs and skills included four multi-item scales: perceived disease severity, knowledge about the prescribed medication, perceived immunity to side effects, and perceived value of nutraceuticals. Generic health beliefs and skills consisted of patient engagement in their care, health information-seeking tendencies, internal health locus of control, a single-item measure of self-rated health, and general mental health. Structural equation modeling was used to model proximal–distal continuum of adherence drivers.Results: The

Side-by-side comparisons of evacuated compound parabolic concentrator and flat plate solar collector systems at temperatures of 90 to 100C

Science.gov (United States)

Allen, J. W.; Schertz, W. W.; Wantroba, A. S.

1987-03-01

This collector system study is an extension of a previous system study in which Argonne National Laboratory (ANL) compared the performance of three solar energy systems operated side by side for over a year. In the present system study, four solar energy systems were operated side by side for part of a year. Two of the collector systems used commercially available compound parabolic concentrator (CPC) collectors, one used a commercially available flat plate collector, and one used an experimental CPC collector built by The University of Chicago. The collectors were mounted in fixed positions; they did not track the Sun, and their tilt angles were not seasonally adjusted. All of the collector arrays faced south and were tilted at 42 deg with respect to the horizon (to match the 42 deg N latitude at ANL). All four collector systems started each day with their storage temperatures at 90 C. During the day, each system was operated by its own solar controller. At the end of the day, the tanks were mixed and the temperature changes in the tanks were measured. The change in storage energy was calculated from the temperature change, the heat capacity of the storage system, and the pump energy.

Cost-effectiveness of laparoscopic versus open distal pancreatectomy for pancreatic cancer.

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Gurusamy, Kurinchi Selvan; Riviere, Deniece; van Laarhoven, C J H; Besselink, Marc; Abu-Hilal, Mohammed; Davidson, Brian R; Morris, Steve

2017-01-01

A recent Cochrane review compared laparoscopic versus open distal pancreatectomy for people with for cancers of the body and tail of the pancreas and found that laparoscopic distal pancreatectomy may reduce the length of hospital stay. We compared the cost-effectiveness of laparoscopic distal pancreatectomy versus open distal pancreatectomy for pancreatic cancer. Model based cost-utility analysis estimating mean costs and quality-adjusted life years (QALYs) per patient from the perspective of the UK National Health Service. A decision tree model was constructed using probabilities, outcomes and cost data from published sources. A time horizon of 5 years was used. One-way and probabilistic sensitivity analyses were undertaken. The probabilistic sensitivity analysis showed that the incremental net monetary benefit was positive (£3,708.58 (95% confidence intervals (CI) -£9,473.62 to £16,115.69) but the 95% CI includes zero, indicating that there is significant uncertainty about the cost-effectiveness of laparoscopic distal pancreatectomy versus open distal pancreatectomy. The probability laparoscopic distal pancreatectomy was cost-effective compared to open distal pancreatectomy for pancreatic cancer was between 70% and 80% at the willingness-to-pay thresholds generally used in England (£20,000 to £30,000 per QALY gained). Results were sensitive to the survival proportions and the operating time. There is considerable uncertainty about whether laparoscopic distal pancreatectomy is cost-effective compared to open distal pancreatectomy for pancreatic cancer in the NHS setting.

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

Directory of Open Access Journals (Sweden)

Nurhat Ozkalayci

2016-01-01

Full Text Available 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.

Derivation and implementation of a cone-beam reconstruction algorithm for nonplanar orbits

International Nuclear Information System (INIS)

Kudo, Hiroyuki; Saito, Tsuneo

1994-01-01

Smith and Grangeat derived a cone-beam inversion formula that can be applied when a nonplanar orbit satisfying the completeness condition is used. Although Grangeat's inversion formula is mathematically different from Smith's, they have similar overall structures to each other. The contribution of this paper is two-fold. First, based on the derivation of Smith, the authors point out that Grangeat's inversion formula and Smith's can be conveniently described using a single formula (the Smith-Grangeat inversion formula) that is in the form of space-variant filtering followed by cone-beam backprojection. Furthermore, the resulting formula is reformulated for data acquisition systems with a planar detector to obtain a new reconstruction algorithm. Second, the authors make two significant modifications to the new algorithm to reduce artifacts and numerical errors encountered in direct implementation of the new algorithm. As for exactness of the new algorithm, the following fact can be stated. The algorithm based on Grangeat's intermediate function is exact for any complete orbit, whereas that based on Smith's intermediate function should be considered as an approximate inverse excepting the special case where almost every plane in 3-D space meets the orbit. The validity of the new algorithm is demonstrated by simulation studies

Fracture heuristics: surgical decision for approaches to distal radius fractures. A surgeon's perspective.

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Wichlas, Florian; Tsitsilonis, Serafim; Kopf, Sebastian; Krapohl, Björn Dirk; Manegold, Sebastian

2017-01-01

Introduction: The aim of the present study is to develop a heuristic that could replace the surgeon's analysis for the decision on the operative approach of distal radius fractures based on simple fracture characteristics. Patients and methods: Five hundred distal radius fractures operated between 2011 and 2014 were analyzed for the surgeon's decision on the approach used. The 500 distal radius fractures were treated with open reduction and internal fixation through palmar, dorsal, and dorsopalmar approaches with 2.4 mm locking plates or underwent percutaneous fixation. The parameters that should replace the surgeon's analysis were the fractured palmar cortex, and the frontal and the sagittal split of the articular surface of the distal radius. Results: The palmar approach was used for 422 (84.4%) fractures, the dorsal approach for 39 (7.8%), and the combined dorsopalmar approach for 30 (6.0%). Nine (1.8%) fractures were treated percutaneously. The correlation between the fractured palmar cortex and the used palmar approach was moderate (r=0.464; p<0.0001). The correlation between the frontal split and the dorsal approach, including the dorsopalmar approach, was strong (r=0.715; p<0.0001). The sagittal split had only a weak correlation for the dorsal and dorsopalmar approach (r=0.300; p<0.0001). Discussion: The study shows that the surgical decision on the preferred approach is dictated through two simple factors, even in the case of complex fractures. Conclusion: When the palmar cortex is displaced in distal radius fractures, a palmar approach should be used. When there is a displaced frontal split of the articular surface, a dorsal approach should be used. When both are present, a dorsopalmar approach should be used. These two simple parameters could replace the surgeon's analysis for the surgical approach.

Strains Around Abutment Teeth with Different Attachments Used for Implant-Assisted Distal Extension Partial Overdentures: An In Vitro Study.

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ELsyad, Moustafa Abdou; Omran, Abdelbaset Omar; Fouad, Mohammed Mohammed

2017-01-01

The aim of this study was to evaluate and compare strain around abutment teeth with different attachments used for implant-assisted distal extension partial overdentures (IADEPODs). A mandibular Kennedy class I acrylic model (remaining teeth from first premolar to first premolar) was constructed. A conventional partial denture was constructed over the model (control, group 1). Two laboratory implants were then placed bilaterally in the first molar areas parallel to each other and perpendicular to the residual ridge. Three additional experimental partial overdentures (PODs) were constructed and connected to the implants using ball (group 2), magnetic (group 3), and Locator (group 4) attachments. Three linear strain gauges were bonded buccal, lingual, and distal to the first premolar abutment tooth at the right (loading) and the left (nonloading) sides. For each group, a universal testing device was used to apply a unilateral vertical static load (50 N) on the first molar area, and the strain was recorded using a multichannel digital strainometer. Significant differences between groups and between sites of strain gauges were detected. Strains recorded for all groups were compressive (negative) in nature. Group 1 demonstrated the highest strain, followed by group 3 and group 4; group 2 recorded the lowest strain. For group 2, the highest strain was recoded at the lingual nonloading side. For group 1, group 3, and group 4, the highest strain was recorded at the buccal loading side. Within the limitation of the present study, ball attachments used to retain IADEPODs to the implants were associated with lower strains around abutment teeth than Locator and magnetic attachments. The highest strain was recorded with conventional partial dentures. © 2015 by the American College of Prosthodontists.

Nuclear fuel element end fitting

International Nuclear Information System (INIS)

Jabsen, F.S.

1980-01-01

An invention is described whereby end fittings are formed from lattices of mutually perpendicular plates. At the plate intersections, sockets are secured to the end fittings in a manner that permits the longitudinal axes of each of the sockets to align with the respective lines of intersection of the plates. The sockets all protrude above one of the surfaces of the end fitting. Further, a detent is formed in the proturding sides of each of the sockets. Annular grooves are formed in each of the ends of the fuel rods that are to be mounted between the end fittings. The socket detents protrude into the respective annular grooves, thus engaging the grooves and retaining the fuel rods and end fittings in one integral structure. (auth)

Nonunions of the distal tibia treated by reamed intramedullary nailing

NARCIS (Netherlands)

Richmond, Jeffrey; Colleran, Kevin; Borens, Olivier; Kloen, Peter; Helfet, David L.

2004-01-01

The purpose of this study is to determine the efficacy of reamed intramedullary nailing in the treatment of nonunions of the distal one-fourth of the tibia. Nonunions of the distal tibia are particularly difficult to treat given the short distal segment, the proximity to the ankle joint, and the

Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction

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Ibrahim F. Ghalayini

2006-12-01

Full Text Available OBJECTIVE: We compared the efficacy of extracorporeal shock wave lithotripsy (ESWL and ureteroscopy (URS for the treatment of distal ureteral calculi with respect to patient satisfaction. MATERIALS AND MHETODS: This is a prospective study where a total of 212 patients with solitary, radiopaque distal ureteral calculi were treated with ESWL (n = 92 using Dornier lithotriptor S (MedTech Europe GmbH or URS (n = 120. Patient and stone characteristics, treatment parameters, clinical outcomes, and patient satisfaction were assessed for each group. RESULTS: The 2 groups were comparable in regard to patient age, sex, stone size, and side of treatment. The stone-free status for ESWL and URS at 3 months was 81.5% and 97.5%, respectively (p < 0.0001. In addition, 88% of patients who underwent ESWL versus 20% who underwent URS were discharged home the day of procedure. Minor complications occurred in 3.3% and 8.3% of the ESWL and URS groups, respectively (p = 0.127. No ureteral perforation or stricture occurred in the URS group. Postoperative flank pain and dysuria were more severe in the URS than ESWL group, although the differences were not statistically significant (p = 0.16. Patient satisfaction was high for both groups, including 94% for URS and 80% for ESWL (p = 0.002. CONCLUSIONS: URS is more effective than ESWL for the treatment of distal ureteral calculi. ESWL was more often performed on an outpatient basis, and showed a trend towards less flank pain and dysuria, fewer complications and quicker convalescence. Patient satisfaction was significantly higher for URS according to the questionnaire used in this study.

Patients with triangular fibrocartilage complex injuries and distal radioulnar joint instability have reduced rotational torque in the forearm.

Science.gov (United States)

Andersson, J K; Axelsson, P; Strömberg, J; Karlsson, J; Fridén, J

2016-09-01

A total of 20 patients scheduled for wrist arthroscopy, all with clinical signs of rupture to the triangular fibrocartilage complex and distal radioulnar joint instability, were tested pre-operatively by an independent observer for strength of forearm rotation. During surgery, the intra-articular pathology was documented by photography and also subsequently individually analysed by another independent hand surgeon. Arthroscopy revealed a type 1-B injury to the triangular fibrocartilage complex in 18 of 20 patients. Inter-rater reliability between the operating surgeon and the independent reviewer showed absolute agreement in all but one patient (95%) in terms of the injury to the triangular fibrocartilage complex and its classification. The average pre-operative torque strength was 71% of the strength of the non-injured contralateral side in pronation and supination. Distal radioulnar joint instability with an arthroscopically verified injury to the triangular fibrocartilage complex is associated with a significant loss of both pronation and supination torque. Case series, Level IV. © The Author(s) 2015.

Laparoscopic Low Anterior Resection and Eversion Technique Combined With a Nondog Ear Anastomosis for Mid- and Distal Rectal Neoplasms: A Preliminary and Feasibility Study.

Science.gov (United States)

Zhuo, Changhua; Liang, Lei; Ying, Mingang; Li, Qingguo; Li, Dawei; Li, Yiwei; Peng, Junjie; Huang, Liyong; Cai, Sanjun; Li, Xinxiang

2015-12-01

The transanal eversion and prolapsing technique is a well-established procedure, and can ensure an adequate distal margin for patients with low rectal neoplasms. Potential leakage risks, however, are associated with bilateral dog ear formation, which results from traditional double-stapling anastomosis. The authors determined the feasibility of combining these techniques with a commercial stapling set to achieve a nondog ear (end-to-end) anastomosis for patients with mid- and distal rectal neoplasms. Patients with early-stage (c/ycT1-2N0), mid- to distal rectal neoplasms and good anal sphincter function were included in this study. Laparoscopic low anterior resection was performed with a standard total mesorectal excision technique downward to the pelvic floor as low as possible. The bowel was resected proximal to the lesion with an endoscopic linear stapler. An anvil was inserted extracorporeally into the proximal colon via an extended working pore. The distal rectum coupled with the lesion was prolapsed and everted out of the anus. The neoplasm was resected with a sufficient margin above the dentate line under direct sight. A transrectal anastomosis without dog ears was performed intracorporeally to reconstitute the continuity of the bowel. Eleven cases, 6 male and 5 female patients, were included in this study. The mean operative time was 191 (129-292) minutes. The mean blood loss was 110 (30-300) mL. The median distal margin distance from the lower edge of the lesion to the dentate line was 1.5 (0.5-2.5) cm. All the resection margins were negative. Most patients experienced uneventful postoperative recoveries. No patient had anastomotic leak. Most patients had an acceptable stool frequency after loop ileostomy closure. Our preliminary data demonstrated the safety and feasibility of achieving a sound anastomosis without risking potential anastomotic leakage because of dog ear formation.

[Instability of the distal radioulnar joint: Treatment options for ulnar lesions of the triangular fibrocartilage complex].

Science.gov (United States)

Spies, C K; Prommersberger, K J; Langer, M; Müller, L P; Hahn, P; Unglaub, F

2015-08-01

Injuries of the triangular fibrocartilage complex (TFCC) may be fatal to the distal radioulnar joint (DRUJ). This structure is one of the crucial stabilizers and guarantees unrestricted pronosupination of the forearm. A systematic examination is mandatory to diagnose DRUJ instability reliably. A clinical examination in comparison to the contralateral side is obligatory. Plain radiographs are required to exclude osseous lesions or deformities. Computed tomography of both wrists in neutral, pronation and supination is necessary to verify DRUJ instability in ambiguous situations. Based on a systematic examination wrist and DRUJ arthroscopy identify lesions clearly. Injuries of the radioulnar ligaments which entail DRUJ instability, should be reconstructed preferably anatomically. Ulnar-sided TFCC lesions may often cause DRUJ instability. Osseous ligament avulsions are mostly treated osteosynthetically. Ligament tears may be refixated using anchor or transosseous sutures. Tendon transplants are necessary for an anatomical reconstruction in cases of irreparable ruptures.

Distinct subclassification of DRG neurons innervating the distal colon and glans penis/distal urethra based on the electrophysiological current signature.

Science.gov (United States)

Rau, Kristofer K; Petruska, Jeffrey C; Cooper, Brian Y; Johnson, Richard D

2014-09-15

Spinal sensory neurons innervating visceral and mucocutaneous tissues have unique microanatomic distribution, peripheral modality, and physiological, pharmacological, and biophysical characteristics compared with those neurons that innervate muscle and cutaneous tissues. In previous patch-clamp electrophysiological studies, we have demonstrated that small- and medium-diameter dorsal root ganglion (DRG) neurons can be subclassified on the basis of their patterns of voltage-activated currents (VAC). These VAC-based subclasses were highly consistent in their action potential characteristics, responses to algesic compounds, immunocytochemical expression patterns, and responses to thermal stimuli. For this study, we examined the VAC of neurons retrogradely traced from the distal colon and the glans penis/distal urethra in the adult male rat. The afferent population from the distal colon contained at least two previously characterized cell types observed in somatic tissues (types 5 and 8), as well as four novel cell types (types 15, 16, 17, and 18). In the glans penis/distal urethra, two previously described cell types (types 6 and 8) and three novel cell types (types 7, 14, and 15) were identified. Other characteristics, including action potential profiles, responses to algesic compounds (acetylcholine, capsaicin, ATP, and pH 5.0 solution), and neurochemistry (expression of substance P, CGRP, neurofilament, TRPV1, TRPV2, and isolectin B4 binding) were consistent for each VAC-defined subgroup. With identification of distinct DRG cell types that innervate the distal colon and glans penis/distal urethra, future in vitro studies related to the gastrointestinal and urogenital sensory function in normal as well as abnormal/pathological conditions may be benefitted. Copyright © 2014 the American Physiological Society.

End-user GHG emissions from energy. Reallocation of emissions from energy industries to end users 2005-2009

Energy Technology Data Exchange (ETDEWEB)

Fernandez, R. (European Environment Agency (EEA), Copenhagen (Denmark)); Watterson, J. (AEA Technology plc - EEA' s European Topic Centre on Air Pollution and Climate Change Mitigation (ETC/ACM) (United Kingdom))

2011-12-15

The objective of this report is to help improve the understanding of past greenhouse gas (GHG) emission trends in the energy sector from the demand or end-user side. To do this, the report develops a methodology to redistributes emissions from energy industries to the final users (by sector) of that energy. This reallocation is done on the basis of Eurostat's energy balances and GHG inventories for the energy sector as reported to the United Nations Framework Convention on Climate Change (UNFCCC), for the period 2005-2009. (Author)

End-user GHG emissions from energy. Reallocation of emissions from energy industries to end users 2005-2010

Energy Technology Data Exchange (ETDEWEB)

Fernandez, R. [European Environment Agency (EEA), Copenhagen (Denmark); Watterson, J. [AEA Technology plc - EEA' s European Topic Centre on Air Pollution and Climate Change Mitigation (ETC/ACM) (United Kingdom)

2012-12-15

The objective of this report is to help improve the understanding of past GHG emission trends in the energy sector from the demand or end-user side. To do this, the report develops a methodology to redistributes emissions from energy industries to the final users (by sector) of that energy. This reallocation is done on the basis of Eurostat's energy balances and GHG inventories for the energy sector as reported to the United Nations Framework Convention on Climate Change (UNFCCC), for the period 2005-2010. (Author)

Planar and non-planar nucleus-acoustic shock structures in self-gravitating degenerate quantum plasma systems

Science.gov (United States)

Zaman, D. M. S.; Amina, M.; Dip, P. R.; Mamun, A. A.

2017-11-01

The basic properties of planar and non-planar (spherical and cylindrical) nucleus-acoustic (NA) shock structures (SSs) in a strongly coupled self-gravitating degenerate quantum plasma system (containing strongly coupled non-relativistically degenerate heavy nuclear species, weakly coupled non-relativistically degenerate light nuclear species, and inertialess non-/ultra-relativistically degenerate electrons) have been investigated. The generalized quantum hydrodynamic model and the reductive perturbation method have been used to derive the modified Burgers equation. It is shown that the strong correlation among heavy nuclear species acts as the source of dissipation and is responsible for the formation of the NA SSs with positive (negative) electrostatic (self-gravitational) potential. It is also observed that the effects of non-/ultra-relativistically degenerate electron pressure, dynamics of non-relativistically degenerate light nuclear species, spherical geometry, etc., significantly modify the basic features of the NA SSs. The applications of our results in astrophysical compact objects like white dwarfs and neutron stars are briefly discussed.

Near infrared spectroscopy for controlling the quality of distal leg perfusion in remote access cardiopulmonary bypass.

Science.gov (United States)

Schachner, Thomas; Bonaros, Nikolaos; Bonatti, Johannes; Kolbitsch, Christian

2008-12-01

The prevention of leg ischemia is necessary in all patients undergoing femoral artery cannulation for extracorporeal circulation. Near infrared spectroscopy (NIRS) is an established non-invasive method for measuring tissue oxygen saturation. Ten patients underwent robotically assisted endoscopic coronary surgery or ASD repair on the arrested heart using aortic endo-occlusion catheters. They were monitored by transcutaneous NIRS (placed on both lower legs) for quality control of distal leg perfusion during femoral access cardiopulmonary bypass. The baseline NIRS values were 61 (52-80) on the cannulated side versus 70 (53-80) on the contralateral leg (p=n.s.). During clamping of the femoral artery for installation of the remote access perfusion system the tissue oxygen saturation dropped to 38 (18-58) (p=0.001 vs baseline) while it remained stable on the contralateral leg. After successful implantation of the distal leg perfusion the NIRS values normalized to similar amounts on both legs. We conclude that transcutaneous NIRS of the lower legs might be a useful non-invasive tool for monitoring leg perfusion in patients undergoing extracorporeal circulation via the femoral vessels.

Endoscopically observable white nodule caused by distal intramural lymphatic spread of rectal cancer: a case report

Directory of Open Access Journals (Sweden)

Tsumura Ayako

2012-10-01

Full Text Available Abstract This report describes a case of rectal cancer with endoscopically observable white nodules caused by distal intramural lymphatic spread. A 57-year-old female presented to our hospital with frequent diarrhea and hemorrhoids. Computed tomography showed bilateral ovarian masses and three hepatic tumors diagnosed as rectal cancer metastases, and also showed multiple lymph node involvement. The patient was preoperatively diagnosed with stage IV rectal cancer. Colonoscopy demonstrated that primary rectal cancer existed 15 cm from the anal verge and that there were multiple white small nodules on the anal side of the primary tumor extending to the dentate line. Biopsies of the white spots were performed, and they were identified as adenocarcinoma. The patient underwent Hartmann’s procedure because of the locally advanced primary tumor. The white nodules were ultimately diagnosed as being caused by intramural lymphatic spreading because lymphatic permeation was strongly positive at the surrounding area. Small white nodules near a primary rectal cancer should be suspected of being intramural spreading. Endoscopic detection of white nodules may be useful for the diagnosis of distal intramural spread.

Contemporary Management of Primary Distal Urethral Cancer

NARCIS (Netherlands)

Traboulsi, S.L.; Witjes, J.A.; Kassouf, W.

2016-01-01

Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation

Class II correction prior to orthodontics with the carriere distalizer.

Science.gov (United States)

McFarlane, Bruce

2013-01-01

Class II correction is a challenge in orthodontics with many existing devices being complex, too compliance-driven, or too prone to breakage. The Carriere Distalizer allows for straightforward Class II correction prior to orthodontics (fixed or clear aligners) at a time when no other mechanics interfere, and compliance is at its best.

Comparison of distal soft-tissue procedures combined with a distal chevron osteotomy for moderate to severe hallux valgus: first web-space versus transarticular approach.

Science.gov (United States)

Park, Yu-Bok; Lee, Keun-Bae; Kim, Sung-Kyu; Seon, Jong-Keun; Lee, Jun-Young

2013-11-06

There are two surgical approaches for distal soft-tissue procedures for the correction of hallux valgus-the dorsal first web-space approach, and the medial transarticular approach. The purpose of this study was to compare the outcomes achieved after use of either of these approaches combined with a distal chevron osteotomy in patients with moderate to severe hallux valgus. One hundred and twenty-two female patients (122 feet) who underwent a distal chevron osteotomy as part of a distal soft-tissue procedure for the treatment of symptomatic unilateral moderate to severe hallux valgus constituted the study cohort. The 122 feet were randomly divided into two groups: namely, a dorsal first web-space approach (group D; sixty feet) and a medial transarticular approach (group M; sixty-two feet). The clinical and radiographic results of the two groups were compared at a mean follow-up time of thirty-eight months. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scale hallux metatarsophalangeal-interphalangeal scores improved from a mean and standard deviation of 55.5 ± 12.8 points preoperatively to 93.5 ± 6.3 points at the final follow-up in group D and from 54.9 ± 12.6 points preoperatively to 93.6 ± 6.2 points at the final follow-up in group M. The mean hallux valgus angle in groups D and M was reduced from 32.2° ± 6.3° and 33.1° ± 8.4° preoperatively to 10.5° ± 5.5° and 9.9° ± 5.5°, respectively, at the time of final follow-up. The mean first intermetatarsal angle in groups D and M was reduced from 15.0° ± 2.8° and 15.3° ± 2.7° preoperatively to 6.5° ± 2.2° and 6.3° ± 2.4°, respectively, at the final follow-up. The clinical and radiographic outcomes were not significantly different between the two groups. The final clinical and radiographic outcomes between the two approaches for distal soft-tissue procedures were comparable and equally successful. Accordingly, the results of this study suggest that the medial transarticular

Furosemide/Fludrocortisone Test and Clinical Parameters to Diagnose Incomplete Distal Renal Tubular Acidosis in Kidney Stone Formers.

Science.gov (United States)

Dhayat, Nasser A; Gradwell, Michael W; Pathare, Ganesh; Anderegg, Manuel; Schneider, Lisa; Luethi, David; Mattmann, Cedric; Moe, Orson W; Vogt, Bruno; Fuster, Daniel G

2017-09-07

Incomplete distal renal tubular acidosis is a well known cause of calcareous nephrolithiasis but the prevalence is unknown, mostly due to lack of accepted diagnostic tests and criteria. The ammonium chloride test is considered as gold standard for the diagnosis of incomplete distal renal tubular acidosis, but the furosemide/fludrocortisone test was recently proposed as an alternative. Because of the lack of rigorous comparative studies, the validity of the furosemide/fludrocortisone test in stone formers remains unknown. In addition, the performance of conventional, nonprovocative parameters in predicting incomplete distal renal tubular acidosis has not been studied. We conducted a prospective study in an unselected cohort of 170 stone formers that underwent sequential ammonium chloride and furosemide/fludrocortisone testing. Using the ammonium chloride test as gold standard, the prevalence of incomplete distal renal tubular acidosis was 8%. Sensitivity and specificity of the furosemide/fludrocortisone test were 77% and 85%, respectively, yielding a positive predictive value of 30% and a negative predictive value of 98%. Testing of several nonprovocative clinical parameters in the prediction of incomplete distal renal tubular acidosis revealed fasting morning urinary pH and plasma potassium as the most discriminative parameters. The combination of a fasting morning urinary threshold pH 3.8 mEq/L yielded a negative predictive value of 98% with a sensitivity of 85% and a specificity of 77% for the diagnosis of incomplete distal renal tubular acidosis. The furosemide/fludrocortisone test can be used for incomplete distal renal tubular acidosis screening in stone formers, but an abnormal furosemide/fludrocortisone test result needs confirmation by ammonium chloride testing. Our data furthermore indicate that incomplete distal renal tubular acidosis can reliably be excluded in stone formers by use of nonprovocative clinical parameters. Copyright © 2017 by the American

Traumatic Distal Ulnar Artery Thrombosis

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Ahmet A. Karaarslan

2014-01-01

Full Text Available This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases.

A missing link between RON expression and oncological outcomes in resected left-sided pancreatic cancer.

Science.gov (United States)

Han, Dai Hoon; Kang, Chang Moo; Lee, Sung Whan; Hwang, Ho Kyoung; Lee, Woo Jung

2017-10-01

Alteration and activation of recepteur d'origine nantais (RON) expression is known to be associated with cancer progression and decreased survival in various types of human cancer, including pancreatic cancer. Therefore, in the present study, RON expression levels were determined in resected left-sided pancreatic cancer to evaluate the potential oncological role of RON in the clinical setting of distal pancreatic cancer. From January 2005 to December 2011, a total of 57 patients underwent radical distal pancreatectomy for left-sided pancreatic cancer. Ductal adenocarcinoma was confirmed in all patients. Among these patients, 17 patients who received preoperative neoadjuvant treatment and 7 patients without available paraffin-embedded tissue blocks were excluded from the present study. RON expression in a the pancreatic cancer cell lines ASPC-1, BxPC-3, MiaPaCa-3 and Panc-1, as well as in resected left-sided pancreatic cancer specimens was determined by Western blot analysis. RON and vascular endothelial growth factor (VEGF) overexpression in resected left-sided pancreatic cancer was also evaluated by immunohistochemistry using pre-diluted anti-RON and anti-VEGF antibodies. An association was identified between the oncological outcome and RON overexpression. Increased levels of RON expression were observed in two pancreatic cancer cell lines, AsPC-1 and BxPC-3. RON overexpression was detected in specimens from 15/33 patients (45.5%) using immunohistochemistry. No significant association was identified between RON overexpression and VEGF overexpression (25.5 vs. 87.9%; P=0.667). No significant differences in disease-free survival or disease-specific survival associated with RON overexpression were identified. Although the results of previous studies have suggested that RON is a potential target for the treatment of pancreatic cancer, in the present study no association between RON overexpression and any adverse oncological effect was identified.

Defective distal regulatory element at the 5' upstream of rat prolactin gene of steroid-nonresponsive GH-subclone.

Science.gov (United States)

Kumar, V; Wong, D T; Pasion, S G; Biswas, D K

1987-12-08

The prolactin-nonproducing (PRL-) GH cell strains (rat pituitary tumor cells in culture). GH12C1 and F1BGH12C1, do not respond to steroid hormones estradiol or hydrocortisone (HC). However, the stimulatory effect of estradiol and the inhibitory effect of hydrocortisone on prolactin synthesis can be demonstrated in the prolactin-producing GH cell strain, GH4C1. In this investigation we have examined the 5' end flanking region of rat prolactin (rat PRL) gene of steroid-responsive, GH4C1 cells to identify the positive and negative regulatory elements and to verify the status of these elements in steroid-nonresponsive F1BGH12C1 cells. Results presented in this report demonstrate that the basel level expression of the co-transferred Neo gene (neomycin phosphoribosyl transferase) is modulated by the distal upstream regulatory elements of rat PRL gene in response to steroid hormones. The expression of adjacent Neo gene is inhibited by dexamethasone and is stimulated by estradiol in transfectants carrying distal regulatory elements (SRE) of steroid-responsive cells. These responses are not observed in transfectants with the rat PRL upstream sequences derived from steroid-nonresponsive cells. The basal level expression of the host cell alpha-2 tubulin gene is not affected by dexamethasone. We report here the identification of the distal steroid regulatory element (SRE) located between 3.8 and 7.8 kb upstream of the transcription initiation site of rat PRL gene. Both the positive and the negative effects of steroid hormones can be identified within this upstream sequence. This distal SRE appears to be nonfunctional in steroid-nonresponsive cells. Though the proximal SRE is functional, the defect in the distal SRE makes the GH substrain nonresponsive to steroid hormones. These results suggest that both the proximal and the distal SREs are essential for the mediation of action of steroid hormones in GH cells.

[Roof folding and rotary pushing for the treatment of back to back fractures of distal radius and ulna in children].

Science.gov (United States)

Xu, Ping; Dong, Xiao-jun; Lu, Zhou-tong; Wang, Gongjun; Zhang, Han-qing; Chen, Xuan-ning; Li, Dong

2015-09-01

To evaluate the technique and the clinical effect of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back". From January 2012 to February 2014,38 children with distal radius and ulna fracture of "back to back" were treated by using the technique of folding roof and rotary pushing to reset and splint fixation including 23 males and 15 females with an average age of 9.5 years old ranging from 6 to 14 years old. Injury time was from 45 min to 3 days (averaged 1.3 days). All cases was unilateral closed fracture without symptoms of nerve injury occurred. The wrist joint anteroposterior and lateral radiographs showed double fracture of radius and ulna, and the broken end of radius was typical "back to back" displacement. The quality of reduction was assessed according to Dienst recommendation on the combination of Aro measurement, and the therapeutic effect was evaluated using standard of Anderson function. All patients were followed up from 3 to 13 months with an average of 6 months. There were no iatrogenic nerve injury. Thirty cases were treated successfully for the first time, 8 cases were again reset successfully; 28 cases were anatomical reduction, 7 cases were near anatomic reduction, 3 cases were functional reduction. At the second day 7 cases with hand and finger swelling appeared in multiple reset patients. Quality results of reduction were excellent in 33 cases, good in 5 cases. According to the standard of Anderson function evaluation, 35 cases were excellent, 3 cases were good. All fractures were healed with of deformity of wrist. Using the technique of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back" is very successful, the patient's limb function recovered well, the whole operation process is simple.

Standardizing an End-to-end Accounting Service

Science.gov (United States)

Greenberg, Edward; Kazz, Greg

2006-01-01

Currently there are no space system standards available for space agencies to accomplish end-to-end accounting. Such a standard does not exist for spacecraft operations nor for tracing the relationship between the mission planning activities, the command sequences designed to perform those activities, the commands formulated to initiate those activities and the mission data and specifically the mission data products created by those activities. In order for space agencies to cross-support one another for data accountability/data tracing and for inter agency spacecraft to interoperate with each other, an international CCSDS standard for end-to-end data accountability/tracing needs to be developed. We will first describe the end-to-end accounting service model and functionality that supports the service. This model will describe how science plans that are ultimately transformed into commands can be associated with the telemetry products generated as a result of their execution. Moreover, the interaction between end-to-end accounting and service management will be explored. Finally, we will show how the standard end-to-end accounting service can be applied to a real life flight project i.e., the Mars Reconnaissance Orbiter project.

Minimally invasive percutaneous plate fixation of distal tibia fractures.

LENUS (Irish Health Repository)

Bahari, Syah

2007-10-01

We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.

The role of imaging in diagnosing diseases of the distal radioulnar joint, triangular fibrocartilage complex, and distal ulna.

Science.gov (United States)

Squires, Judy H; England, Eric; Mehta, Kaushal; Wissman, Robert D

2014-07-01

The purpose of this article is to review the anatomy, biomechanics, and multimodality imaging findings of common and uncommon distal radioulnar joint (DRUJ), triangular fibrocartilage complex, and distal ulna abnormalities. The DRUJ is a common site for acute and chronic injuries and is frequently imaged to evaluate chronic wrist pain, forearm dysfunction, and traumatic forearm injury. Given the complex anatomy of the wrist, the radiologist plays a vital role in the diagnosis of wrist pain and dysfunction.

Laparoscopic distal pancreatectomy for adenocarcinoma: safe and reasonable?

Science.gov (United States)

Postlewait, Lauren M.

2015-01-01

As a result of technological advances during the past two decades, surgeons now use minimally invasive surgery (MIS) approaches to pancreatic resection more frequently, yet the role of these approaches for pancreatic ductal adenocarcinoma resections remains uncertain, given the aggressive nature of this malignancy. Although there are no controlled trials comparing MIS technique to open surgical technique, laparoscopic distal pancreatectomy for pancreatic adenocarcinoma is performed with increasing frequency. Data from retrospective studies suggest that perioperative complication profiles between open and laparoscopic distal pancreatectomy are similar, with perhaps lower blood loss and fewer wound infections in the MIS group. Concerning oncologic outcomes, there appear to be no differences in the rate of achieving negative margins or in the number of lymph nodes (LNs) resected when compared to open surgery. There are limited recurrence and survival data on laparoscopic compared to open distal pancreatectomy for pancreatic adenocarcinoma, but in the few studies that assess long term outcomes, recurrence rates and survival outcomes appear similar. Recent studies show that though laparoscopic distal pancreatectomy entails a greater operative cost, the associated shorter length of hospital stay leads to decreased overall cost compared to open procedures. Multiple new technologies are emerging to improve resection of pancreatic cancer. Robotic pancreatectomy is feasible, but there are limited data on robotic resection of pancreatic adenocarcinoma, and outcomes appear similar to laparoscopic approaches. Additionally fluorescence-guided surgery represents a new technology on the horizon that could improve oncologic outcomes after resection of pancreatic adenocarcinoma, though published data thus far are limited to animal models. Overall, MIS distal pancreatectomy appears to be a safe and reasonable approach to treating selected patients with pancreatic ductal

[Comparison of laparoscopic distal pancreatectomy and open distal pancreatectomy in pancreatic ductal adenocarcinoma].

Science.gov (United States)

Xu, K; Su, J J; Su, M; Yan, L; Feng, J; Xin, X L; Chen, Y L

2017-10-23

Objective: To compare and evaluate the curative effect of laparoscopic distal pancreatectomy(LDP) and traditional open distal pancreatectomy(ODP) in pancreatic ductal adenocarcinoma. Methods: The clinical data of 15 patients treated by LDP and 87 contemporaneous cases treated by ODP from January 2010 to November 2015 was collected, and the curative effect and prognosis of these patients were retrospectively analyzed. Results: The operation time of LDP group was (286.5±48.1) min, significantly longer than that of OPD group(226.6±56.8) min ( P 0.05). In both LDP group and ODP group, none occurred percutaneous drainage, re-admissions, second operation or perioperative death. Conclusions: Compared to ODP, LDP is much safer and more steady in perioperative periodand operation. Patients of pancreatic ductal adenocarcinoma received LDP can acquire more benefit and recovery sooner, and LDP is a safe and effective operative method.

The dynamic behavior of bacterial macrofibers growing with one end prevented from rotating: variation in shaft rotation along the fiber's length, and supercoil movement on a solid surface toward the constrained end

Directory of Open Access Journals (Sweden)

Chen Liling

2003-08-01

Full Text Available Abstract Background Bacterial macrofibers twist as they grow, writhe, supercoil and wind up into plectonemic structures (helical forms the individual filaments of which cannot be taken apart without unwinding that eventually carry loops at both of their ends. Terminal loops rotate about the axis of a fiber's shaft in contrary directions at increasing rate as the shaft elongates. Theory suggests that rotation rates should vary linearly along the length of a fiber ranging from maxima at the loop ends to zero at an intermediate point. Blocking rotation at one end of a fiber should lead to a single gradient: zero at the blocked end to maximum at the free end. We tested this conclusion by measuring directly the rotation at various distances along fiber length from the blocked end. The movement of supercoils over a solid surface was also measured in tethered macrofibers. Results Macrofibers that hung down from a floating wire inserted through a terminal loop grew vertically and produced small plectonemic structures by supercoiling along their length. Using these as markers for shaft rotation we observed a uniform gradient of initial rotation rates with slopes of 25.6°/min. mm. and 36.2°/min. mm. in two different fibers. Measurements of the distal tip rotation in a third fiber as a function of length showed increases proportional to increases in length with constant of proportionality 79.2 rad/mm. Another fiber tethered to the floor grew horizontally with a length-doubling time of 74 min, made contact periodically with the floor and supercoiled repeatedly. The supercoils moved over the floor toward the tether at approximately 0.06 mm/min, 4 times faster than the fiber growth rate. Over a period of 800 minutes the fiber grew to 23 mm in length and was entirely retracted back to the tether by a process involving 29 supercoils. Conclusions The rate at which growing bacterial macrofibers rotated about the axis of the fiber shaft measured at various

Ulnar-sided wrist pain. II. Clinical imaging and treatment

Energy Technology Data Exchange (ETDEWEB)

Watanabe, Atsuya; Souza, Felipe [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Vezeridis, Peter S.; Blazar, Philip [Brigham and Women' s Hospital, Department of Orthopaedic Surgery, Boston, MA (United States); Yoshioka, Hiroshi [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); University of California-Irvine, Department of Radiological Sciences, Irvine, CA (United States); UC Irvine Medical Center, Department of Radiological Sciences, Orange, CA (United States)

2010-09-15

Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed. (orig.)

Minimally Invasive Distal Metatarsal Osteotomy for Mild-to-Moderate Hallux Valgus Deformity

Directory of Open Access Journals (Sweden)

Yu-Chuan Lin

2009-08-01

Full Text Available Minimally invasive surgery has recently been introduced for foot and ankle surgery, and hallux valgus surgery is no exception. The purpose of our study was to analyze the early results and to present our experience of minimally invasive distal metatarsal osteotomy in correcting mild-to-moderate hallux valgus deformities. Between September 2005 and December 2006, 31 consecutive patients (47 feet with mild-to-moderate hallux valgus deformities underwent minimally invasive distal metatarsal osteotomies. The clinical and radiographic outcomes were assessed. The satisfaction rate was 90.32%. The mean total American Orthopedic Foot and Ankle Society halluxmetatarsophalangeal-interphalangeal scale was 92.7 points. Complications included two (4.26% episodes of stiffness, six (12.77% episodes of pin tract infection, and one (2.13% deep infection. There were no cases with nonunion, malunion, overcorrection, transfer metatarsalgia or osteonecrosis. On weight-bearing anteroposterior foot radiographs, the mean hallux valgus angle and first intermetatarsal angle corrections were 11.8° and 6.3°, respectively, which is a statistically significant difference (p < 0.001 between the preoperative and postoperative status. Here, minimally invasive distal metatarsal osteotomy was associated with good satisfaction, functional improvement and low complication rates. This technique offers an effective, safe and simple way to treat hallux valgus with a first intermetatarsal angle less than 15°.

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

Directory of Open Access Journals (Sweden)

Alex Guedes

2009-01-01

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

SIDE TO SIDE DIFFERENCES BETWEEN DOMINANT AND NON-DOMINANT ARM’S BONE DENSITY AND ISOMETRIC HANDGRIP STRENGTH IN MALES AND FEMALES AGED 40-65 YEARS OLD

Science.gov (United States)

Krasniqi, Ermira; Koni, Mynyr; Kabashi, Antigona; Bahtiri, Abedin; Gjeli, Selda; Boshnjaku, Arben

2016-01-01

Objective: This observational, cross-sectional study, investigates and compares the differences of BMD, T-score, Z-score and isometric strength between dominant (D) versus non-dominant (ND) arms of 162 subjects aged 40-65 in a developing, low income country (Kosova). Material and Methods: Bone Mineral Density (BMD), T-score and Z-score at distal forearm regions of both arms (measured by DXA scan), together with the Handgrip Isometric Strength (HIS) (by handgrip) were evaluated in a total subjects (53 Males and 109 Females). Additionally, General Healthcare Status Questionnaire together with self-administrated International Physical Activity Questionnaire (IPAQ) were filled. Results: Significant differences (p0.05) were observed in Males BMD comparing to significantly higher results (p0.05) in males. When comparing the total subject’s BMD, T-score, Z-score and Handgrip based on the PA levels (1 to 3 according to IPAQ scoring) no significant differences (p>0.05) were found between PA1, as well as PA3 whereas significantly differences (p<0.05) were found in D arms of PA2 level. Conclusion: The study analyses side-to-side differences in bone density and muscular force between D and ND arms amongst a population which is frequently exposed to diagnostic screenings for age related osteomuscular conditions (aged 40-60), and demonstrates that these differences should be in consideration amongst clinicians, but not in the way it is done right now. PMID:27999479

Distal radius: anatomical morphometric gender characteristics. Do anatomical pre-shaped plates pay attention on it?

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Oppermann, Johannes; Bredow, Jan; Beyer, Frank; Neiss, Wolfram Friedrich; Spies, Christian K; Eysel, Peer; Dargel, Jens; Wacker, Max

2015-01-01

The purpose of the study was to investigate differences in the osseous structure anatomy of male and female distal radii. Morphometric data were obtained of 49 distal human cadaveric radii. An imprint of the distal edge was attained using silicone mass and the palmar cortical angle (PCA) of the lateral and intermediate column, here declared as medial, according to the concept of Rikli and Rigazzoni. The lateral and medial length and five widths were digitally measured by three observers. In order to compare the measurements an unpaired t test was used. To prove the reliability of the measurements an intraclass correlation analyses was done. Overall mean medial PCA was 148.25° (SD ± 6.83) and mean lateral PCA 156.07° (SD ± 7.00). In male specimens, the mean medial PCA was 147.38° (SD ± 6.01) and mean lateral PCA was 153.6° (SD ± 6.20) whereas in female specimens, the mean medial PCA was 149.41° (SD ± 7.79) and the mean lateral PCA 159.37° (SD ± 6.78), with statistical significance for the female lateral PCA. No gender significant difference for the medial PCA and no significant side difference for the PCA's could be found. The ICC of the observers was r = 0.936 and 0.976 for the medial and for lateral PCA 0.957-0.984. The palmar cortical length of the distal radius was significantly longer in male specimens. For all widths, larger values for male radii were measured, being statistically significant in all cases. Male dimensions concerning the wide were significantly larger when compared with females. Regarding the PCA at the medial and lateral column, we found significant difference for lateral PCA concerning the gender. Overall, study results demonstrated an angle of 148.25° ± 6.83 for the medial PCA and 156.07° ± 7.00 for the lateral PCA.

OISI dynamic end-to-end modeling tool

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Kersten, Michael; Weidler, Alexander; Wilhelm, Rainer; Johann, Ulrich A.; Szerdahelyi, Laszlo

2000-07-01

The OISI Dynamic end-to-end modeling tool is tailored to end-to-end modeling and dynamic simulation of Earth- and space-based actively controlled optical instruments such as e.g. optical stellar interferometers. `End-to-end modeling' is meant to denote the feature that the overall model comprises besides optical sub-models also structural, sensor, actuator, controller and disturbance sub-models influencing the optical transmission, so that the system- level instrument performance due to disturbances and active optics can be simulated. This tool has been developed to support performance analysis and prediction as well as control loop design and fine-tuning for OISI, Germany's preparatory program for optical/infrared spaceborne interferometry initiated in 1994 by Dornier Satellitensysteme GmbH in Friedrichshafen.

Distal finger replantation.

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Scheker, Luis R; Becker, Giles W

2011-03-01

Reconstruction of the fingertip distal to the flexor tendon insertion by replantation remains controversial and technically challenging, but the anatomy of the fingertip has been well described and provides help in surgical planning. The open-book surgical technique is described with potential complications and is illustrated with clinical cases. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Robotic versus laparoscopic distal pancreatectomy: an up-to-date meta-analysis.

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Guerrini, Gian Piero; Lauretta, Andrea; Belluco, Claudio; Olivieri, Matteo; Forlin, Marco; Basso, Stefania; Breda, Bruno; Bertola, Giulio; Di Benedetto, Fabrizio

2017-11-09

Laparoscopic distal pancreatectomy (LDP) reduces postoperative morbidity, hospital stay and recovery as compared with open distal pancreatectomy. Many authors believe that robotic surgery can overcome the difficulties and technical limits of LDP thanks to improved surgical manipulation and better visualization. Few studies in the literature have compared the two methods in terms of surgical and oncological outcome. The aim of this study was to compare the results of robotic (RDP) and laparoscopic distal pancreatectomy. A systematic review and meta-analysis was conducted of control studies published up to December 2016 comparing LDP and RDP. Two Reviewers independently assessed the eligibility and quality of the studies. The meta-analysis was conducted using either the fixed-effect or the random-effect model. Ten studies describing 813 patients met the inclusion criteria. This meta-analysis shows that the RDP group had a significantly higher rate of spleen preservation [OR 2.89 (95% confidence interval 1.78-4.71, p < 0.0001], a lower rate of conversion to open OR 0.33 (95% CI 0.12-0.92), p = 0.003] and a shorter hospital stay [MD -0.74; (95% CI -1.34 -0.15), p = 0.01] but a higher cost than the LDP group, while other surgical outcomes did not differ between the two groups. This meta-analysis suggests that the RDP procedure is safe and comparable in terms of surgical results to LDP. However, even if the RDP has a higher cost compared to LDP, it increases the rate of spleen preservation, reduces the risk of conversion to open surgery and is associated to shorter length of hospital stay.

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

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

2007-01-01

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

Effect of electron temperature on small-amplitude electron acoustic solitary waves in non-planar geometry

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Bansal, Sona; Aggarwal, Munish; Gill, Tarsem Singh

2018-04-01

Effects of electron temperature on the propagation of electron acoustic solitary waves in plasma with stationary ions, cold and superthermal hot electrons is investigated in non-planar geometry employing reductive perturbation method. Modified Korteweg-de Vries equation is derived in the small amplitude approximation limit. The analytical and numerical calculations of the KdV equation reveal that the phase velocity of the electron acoustic waves increases as one goes from planar to non planar geometry. It is shown that the electron temperature ratio changes the width and amplitude of the solitary waves and when electron temperature is not taken into account,our results completely agree with the results of Javidan & Pakzad (2012). It is found that at small values of τ , solitary wave structures behave differently in cylindrical ( {m} = 1), spherical ( {m} = 2) and planar geometry ( {m} = 0) but looks similar at large values of τ . These results may be useful to understand the solitary wave characteristics in laboratory and space environments where the plasma have multiple temperature electrons.

Multicenter comparative study of laparoscopic and open distal pancreatectomy using propensity score-matching.

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Nakamura, Masafumi; Wakabayashi, Go; Miyasaka, Yoshihiro; Tanaka, Masao; Morikawa, Takanori; Unno, Michiaki; Tajima, Hiroshi; Kumamoto, Yusuke; Satoi, Sohei; Kwon, Masanori; Toyama, Hirochika; Ku, Yonson; Yoshitomi, Hideyuki; Nara, Satoshi; Shimada, Kazuaki; Yokoyama, Takahide; Miyagawa, Shinichi; Toyama, Yoichi; Yanaga, Katsuhiko; Fujii, Tsutomu; Kodera, Yasuhiro; Tomiyama, Yasuyuki; Miyata, Hiroaki; Takahara, Takeshi; Beppu, Toru; Yamaue, Hiroki; Miyazaki, Masaru; Takada, Tadahiro

2015-10-01

Laparoscopic distal pancreatectomy has been shown to be associated with favorable postoperative outcomes using meta-analysis. However, there have been no randomized controlled studies yet. This study aimed to compare laparoscopic and open distal pancreatectomy using propensity score-matching. We retrospectively collected perioperative data of 2,266 patients who underwent distal pancreatectomy in 69 institutes from 2006-2013 in Japan. Among them, 2,010 patients were enrolled in this study and divided into two groups, laparoscopic distal pancreatectomy and open distal pancreatectomy. Perioperative outcomes were compared between the groups using unmatched and propensity matched analysis. After propensity score-matching, laparoscopic distal pancreatectomy was associated with favorable perioperative outcomes compared with open distal pancreatectomy, including higher rate of preservation of spleen and splenic vessels (P pancreatectomy was associated with more favorable perioperative outcomes than open distal pancreatectomy. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

[Sciatic nerve block "out-of-plane" distal to the bifurcation: effective and safe].

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Geiser, T; Apel, J; Vicent, O; Büttner, J

2017-03-01

Ultrasound guided distal sciatic nerve block (DSB) at bifurcation level shows fast onset and provides excellent success rates. However, its safe performance might be difficult for the unexperienced physician. Just slightly distal to the bifurcation, the tibial nerve (TN) and common fibular nerve (CFN) can be shown clearly separated from each other. Therefore, we investigated if a block done here would provide similar quality results compared to the DSB proximally to the division, with a potentially lower risk of nerve damage. In this randomized, prospective trial, 56 patients per group received either a DSB distal to the bifurcation "out-of-plane" (dist.) or proximally "in-plane" (prox.) with 30 ml of Mepivacaine 1% each. Success was tested by a blinded examiner after 15 and 30 min respectively (sensory and motor block of TN and CFN: 0 = none, 2 = complete, change of skin temperature). Videos of the blocks were inspected by an independent expert retrospectively with regard to the spread of the local anesthetic (LA) and accidental intraneural injection. Cumulative single nerve measurements and temperature changes revealed significant shorter onset and better efficacy (dist/prox: 15 min: 3.13 ± 1.86/1.82 ± 1.62; 30 min: 5.73 ± 1.92/3.21 ± 1.88; T 15 min : 30.3 ± 3.48/28.0 ± 3.67, T 30 min . 33.0 ± 2.46/30.6 ± 3.86; MV/SD; ANOVA; p safe application of the LA, so an effective block can be done with just one injection. DSB slightly distal to the bifurcation, in an out-of-plane technique between the TN and CFN, can be done fast, effectively and safe.

HAEMATOMA BLOCK- AN EFFECTIVE ALTERNATIVE TO GENERAL ANAESTHESIA FOR REDUCTION OF DISTAL RADIUS FRACTURES

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Prabhati Rani Mishra

2016-12-01

Full Text Available BACKGROUND Most common fracture in elderly patients is distal radius fracture. The most common method of management is closed reduction and immobilisation. The aim of the study is to compare the analgesic effects of haematoma block and general anaesthesia for closed reduction of distal fracture of radius. MATERIALS AND METHODS A prospective randomised controlled study was carried out among 100 patients of age group between 15-70 years of either sex who had fracture distal radius between 2015-2016. The patients having multiple fractures, pathological fractures or suffering from any organic diseases were excluded from the study. After taking informed written consent, the patients were randomised into two equal groups. In group A, reduction of fracture was done following administration of IV propofol and in group B after infiltration with 2% lignocaine into fracture haematoma site. Pain score was compared by VAS before, during and after manipulation in both the groups. Time taken from presentation at emergency department to reduction and discharge from hospital was also compared. Statistical analysis was done by applying SPSS software. RESULTS 100 patients of mean age 42.5 years, male: female 43:57 with fracture distal radius were studied. Mean time from admission to fracture reduction in group A was 2.64±0.93 hours and in group B 0.90±0.45 hours (P=0.0001. Discharge time from hospital after reduction of fracture in group A was 4.24±0.94 hours and in group B 0.75±0.2 hours (P=0.0001. VAS during reduction in group A was 0 and in group B 0.98±0.8 (P=0.0001. 10 minutes after reduction VAS in group A was 2.28±0.24 and group B 0.72±0.45 (P=0.0001. CONCLUSION For closed reduction of distal radius fracture, haematoma block with lignocaine is safe and effective alternative to intravenous general anaesthesia with propofol.

Distal renal tubular acidosis and hepatic lipidosis in a cat.

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Brown, S A; Spyridakis, L K; Crowell, W A

1986-11-15

Clinical and laboratory evidence of hepatic failure was found in a chronically anorectic cat. Simultaneous blood and urine pH determinations established a diagnosis of distal renal tubular acidosis. The cat did not respond to treatment. Necropsy revealed distal tubular nephrosis and hepatic lipidosis. The finding of distal renal tubular acidosis in a cat with hepatic lipidosis emphasizes the importance of complete evaluation of acid-base disorders in patients.

Minimally Invasive and Open Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

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Brogan, Kit; Lindisfarne, Edward; Akehurst, Harold; Farook, Usama; Shrier, Will; Palmer, Simon

2016-11-01

Minimally invasive surgical (MIS) techniques are increasingly being used in foot and ankle surgery but it is important that they are adopted only once they have been shown to be equivalent or superior to open techniques. We believe that the main advantages of MIS are found in the early postoperative period, but in order to adopt it as a technique longer-term studies are required. The aim of this study was to compare the 2-year outcomes of a third-generation MIS distal chevron osteotomy with a comparable traditional open distal chevron osteotomy for mild-moderate hallux valgus. Our null hypothesis was that the 2 techniques would yield equivalent clinical and radiographic results at 2 years. This was a retrospective cohort study. Eighty-one consecutive feet (49 MIS and 32 open distal chevron osteotomies) were followed up for a minimum 24 months (range 24-58). All patients were clinically assessed using the Manchester-Oxford Foot Questionnaire. Radiographic measures included hallux valgus angle, the intermetatarsal angle, hallux interphalangeal angle, metatarsal phalangeal joint angle, distal metatarsal articular angle, tibial sesamoid position, shape of the first metatarsal head, and plantar offset. Statistical analysis was done using Student t test or Wilcoxon rank-sum test for continuous data and Pearson chi-square test for categorical data. Clinical and radiologic postoperative scores in all domains were substantially improved in both groups (P .05). There were no significant differences in complications between the 2 groups ( > .5). The midterm results of this third-generation technique show that it was a safe procedure with good clinical outcomes and comparable to traditional open techniques for symptomatic mild-moderate hallux valgus. Level III, retrospective comparative study. © The Author(s) 2016.

Computational fluid dynamic evaluation of the side-to-side anastomosis for arteriovenous fistula.

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Hull, Jeffrey E; Balakin, Boris V; Kellerman, Brad M; Wrolstad, David K

2013-07-01

The goal of this research was to compare side-to-side (STS) and end-to-side (ETS) anastomoses in a computer model of the arteriovenous fistula with computational fluid dynamic analysis. A matrix of 17 computer arteriovenous fistula models (SolidWorks, Dassault Systèmes, France) of artery-vein pairs (3-mm-diameter artery + 3-mm-diameter vein and 4-mm-diameter artery +6-mm-diameter vein elliptical anastomoses) in STS, 45° ETS, and 90° ETS configurations with cross-sectional areas (CSAs) of 3.5 to 18.8 mm(2) were evaluated with computational fluid dynamic software (STAR-CCM+; CD-adapco, Melville, NY) in simulations at defined flow rates from 600 to 1200 mL/min and mean arterial pressures of 50 to 140 mm Hg. Models and configurations were evaluated for pressure drop across the anastomosis, arterial inflow, venous outflow, arterial outflow, velocity vector, and wall shear stress (WSS) profile. Pressure drop across the anastomosis was inversely proportional to anastomotic CSA and to venous outflow and was proportional to arterial inflow. Pressure drop was greater in 3 + 3 models than in 4 + 6 STS models; 90° ETS configurations had the lowest pressure drops and were nearly identical, whereas 45° ETS configurations had the highest pressure drops. Venous outflow in the 4 + 6 model in STS configurations, evaluated at 100 mm Hg arterial inflow pressure, was 390, 592, 610, and 886 mL/min in anastomotic CSAs of 3.5, 5.3, 7.1, and 18.8 mm(2), respectively, and was similar in 90° ETS (609 and 908 mL/min) and lower in 45° ETS (534 and 562 mL/min) configurations at CSAs of 5.3 and 18.8 mm(2). The mean increase in venous outflow was 69 mL/min (range, -59 to 134) between 3 + 3 and 4 + 6 models at 100 mm Hg arterial inflow. The most uniform WSS profile occurs in STS anastomoses followed by 45° ETS and then 90° ETS anastomoses. The STS and 90° ETS anastomoses have high venous outflow and a tendency toward reversed arterial outflow. The 45° ETS anastomosis has reduced venous

Young Children's Sibling Relationship Quality: Distal and Proximal Correlates

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Kretschmer, Tina; Pike, Alison

2009-01-01

Background: Relationships within families are interdependent and related to distal environmental factors. Low socioeconomic status (SES) and high household chaos (distal factors) have been linked to less positive marital and parent-child relationships, but have not yet been examined with regard to young children's sibling relationships. The…

[Treatment of pediatric distal femur fractures by external fixator combined with limited internal fixation].

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Wei, Sheng-wang; Shi, Zhan-ying; Hu, Ju-zheng; Wu, Hao

2016-03-01

To discuss the clinical effects of external fixator combined with limited internal fixation in the treatment of pediatric distal femur fractures. From January 2008 to June 2014, 17 children of distal femur fractures were treated by external fixator combined with limited internal fixation. There were 12 males and 5 females, aged from 6 to 13 years old with an average of 10.2 years, ranged in the course of disease from 1 h to 2 d. Preoperative diagnoses were confirmed by X-ray films in all children. There were 11 patients with supracondylar fracture , and 6 patients with intercondylar comminuted fracture. According to AO/ASIF classification, 9 fractures were type A1, 5 cases were type A2,and 3 cases were type C1. The intraoperative and postoperative complications, postoperative radiological examination, lower limbs length and motion of knee joints were observed. Knee joint function was assessed by KSS score. All the patients were followed up from 6 to 38 months with an average of 24.4 months. No nerve or blood vessel injury was found. One case complicated with the external fixation loosening, 2 cases with the infection of pin hole and 3 cases with the leg length discrepancy. Knee joint mobility and length measurement (compared with the contralateral), the average limited inflexion was 10 degrees (0 degrees to 20 degrees), the average limited straight was 4 degrees (0 degrees to 10), the average varus or valgus angle was 3 degrees (0 degrees to 5 degrees). KSS of the injured side was (96.4 +/- 5.0) points at final follow-up, 16 cases got excellent results and 1 good. All fractures obtained healing and no epiphyseal closed early was found. External fixator combined with limited internal fixation has advantages of simple operation, reliable fixation, early functional exercise in treating pediatric distal femurs fractures.

Stress analysis on the free-end distal extension of an implant-supported mandibular complete denture

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Gustavo Diniz Greco

2009-06-01

Full Text Available A comparative and qualitative analysis of the tensions generated in the cantilever region of an implant-supported mandibular complete denture was conducted using the three-dimensional finite element method. The mechanical properties of the components were input in the model and a load of 15 N was applied in pre-determined points. In the first simulation, the load was applied on the occlusal surface of the first premolar. In the second simulation, it was applied on the first and second premolars. In the third simulation, it was applied on the first and second premolars and on the first molar. The different occlusion patterns produced similar tension distributions in the cantilever region, which followed a similar pattern in the three simulations. In all of the cases, the highest levels of tension were located in the region of the first implant. However, as the loads were dislocated distally, the tensions increased considerably. The more extensive the cantilever, the more compromised will be the infrastructure, the prosthetic components and the implants. Regardless of the length of the cantilever, the highest tensions will always be located in the region of the implant next to the load application point.

[Clinical observation on the effect of joint mobilization in treating elderly patients after distal radius fractures operation].

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Jia, Xue-Feng; Cai, Hong-Xin; Lin, Ge-Sheng; Fang, Ji-Shi; Wang, Yong; Wu, Zhi-Yong; Tu, Xu-Hui

2017-07-25

To investigate the effect of joint mobilization on postoperative wrist joint function, pain and grip strength for elderly patients with distal radius fracture. From January 2015 to June 2016, a total of 67 elderly patients with distal radius fracture were randomly divided into routine exercise group and joint mobilization group. Among them, 37 patients in the routine exercise group underwent conventional distal radius fracture postoperative joint function exercise regimen, including 16 males and 21 females with a mean age of (67.8±3.2) years old ranging from 60 to 72 years old;the injured side was dominant in 23 cases and non-dominant in 14 cases;injury mechanism was fall in 26 cases, traffic accident in 11 cases; for AO type, 6 cases were type B3, 18 cases were type C1, 7 cases were type C2, 6 cases was type C3. Other 30 patients in the joint mobilization group underwent joint mobilization on the basis of the routine exercise group including 14 males and 16 females with a mean age of (67.1±4.0) years old ranging from 61 to 74 years old; the injured side was dominant in 21 cases and non-dominant in 9 cases;injury mechanism was fall in 25 cases, traffic accident in 5 cases;for AO type, 8 cases were type B3, 13 cases were type C1, 6 cases were type C2, 9 cases were type C3. The wrist joint activity, Gartland-Werley wrist joint function score, VAS pain score and grip strength were observed at 3 months afrer treatment. After 3 months' treatment, the VAS in the routine exercise group was higher than that of the joint mobilization group ( P joint mobilization group was higher than that in routine exercise group( P joint mobilization group( P joint mobilization group had no significant difference ( P >0.05). In the comparison of each item of Gartland-Werley, there was no significant difference between two groups in residual deformity and complication( P >0.05); the average score of subjective score, objective score and total score in routine exercise group were

Fractures of the bilateral distal radius and scaphoid: a case report

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Ozkan Korhan

2008-03-01

Full Text Available Abstract Introduction Bilateral fractures of the distal radius and scaphoid are extremely rare injuries. Case presentation A patient with bilateral comminuted, displaced distal fractures of the radius and bilateral fractures of the scaphoid was treated via internal fixation of the scaphoid fractures with Herbert screws and internal fixation of the distal radius fractures with locked volar plating. Conclusion Rigid internal fixation of distal radius and scaphoid fractures is mandatory to start early active rehabilitation of the wrist without the need for wrist immobilization with a plaster or external skeletal fixation.

MRI of fractures of the distal radius: comparison with conventional radiographs

International Nuclear Information System (INIS)

Spence, L.D.; Eustace, S.

1998-01-01

Objective. To compare the evaluation of fractures of the distal radius with MRI and conventional radiographs. To demonstrate the ability of MRI to detect unsuspected soft tissue derangement accompanying this common injury. Design and patients. Twenty-one consecutive inpatients admitted following fracture of the distal radius underwent preoperative evaluation with both conventional radiographs and MRI. In each case, analysis was made of both the osseous and soft tissue injury. MRI findings were compared with those identified on conventional radiographs and at subsequent surgical fixation. Results. Of 21 patients with fractures of the distal radius, 20 had extension to the radiocarpal articulation, 14 had distal radio-ulnar joint extension and 5 had avulsion of the ulnar styloid.Occult carpal bone fractures accompanying fracture of the distal radius were identified in two patients: one of the capitate and the other of the second metacarpal base. Ten patients (48%) had associated soft tissue injury: six patients had scapholunate ligament rupture, two patients had disruption of the triangular fibrocartilage, one patient had extensor carpi ulnaris tenosynovitis and one patient had a tear of a dorsal radiocarpal ligament. Of five patients with ulnar styloid avulsions, none had evidence of triangular fibrocartilage tears. Conclusion. MRI affords better evaluation of osseous injury accompanying distal radial fractures than conventional radiographs. Intra-articular soft tissue injury accompanies distal radial fractures in almost 50% of cases. Scapholunate ligament disruption commonly accompanies intra-articular fracture through the lunate facet of the distal radius. Fracture of the ulnar styloid is infrequently associated with tear of the triangular fibrocartilage. (orig.)

MRI of fractures of the distal radius: comparison with conventional radiographs

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Spence, L.D.; Eustace, S. [Medical Center, Boston, MA (United States). Dept. of Radiol.; Savenor, A.; Nwachuku, I.; Tilsley, J. [Department of Orthopedics, Boston Medical Center, Boston, MA 02118 (United States)

1998-05-01

Objective. To compare the evaluation of fractures of the distal radius with MRI and conventional radiographs. To demonstrate the ability of MRI to detect unsuspected soft tissue derangement accompanying this common injury. Design and patients. Twenty-one consecutive inpatients admitted following fracture of the distal radius underwent preoperative evaluation with both conventional radiographs and MRI. In each case, analysis was made of both the osseous and soft tissue injury. MRI findings were compared with those identified on conventional radiographs and at subsequent surgical fixation. Results. Of 21 patients with fractures of the distal radius, 20 had extension to the radiocarpal articulation, 14 had distal radio-ulnar joint extension and 5 had avulsion of the ulnar styloid.Occult carpal bone fractures accompanying fracture of the distal radius were identified in two patients: one of the capitate and the other of the second metacarpal base. Ten patients (48%) had associated soft tissue injury: six patients had scapholunate ligament rupture, two patients had disruption of the triangular fibrocartilage, one patient had extensor carpi ulnaris tenosynovitis and one patient had a tear of a dorsal radiocarpal ligament. Of five patients with ulnar styloid avulsions, none had evidence of triangular fibrocartilage tears. Conclusion. MRI affords better evaluation of osseous injury accompanying distal radial fractures than conventional radiographs. Intra-articular soft tissue injury accompanies distal radial fractures in almost 50% of cases. Scapholunate ligament disruption commonly accompanies intra-articular fracture through the lunate facet of the distal radius. Fracture of the ulnar styloid is infrequently associated with tear of the triangular fibrocartilage. (orig.) With 5 figs., 16 refs.

ANATOMIC AND PHYSIOLOGICAL FEATURES OF DISTAL LOWER LEG AND THEIR INFLUENCE ON THE PROCESS OF OSTEOGENESIS

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Desimir Mladenović

2010-06-01

Full Text Available Osteogenesis is the process of bone tissue forming, i.e. bone or callus regeneration. This process is influenced by many factors, and the degree of bone fragments’ stability and vascularization in the fracture area are the basic local factors which determine the nature of reparative process. Regenerative process of all bone structures increases with increasing of blood supply.The distal lower leg has its specific biomechanical features, and plays an important role in the transfer of body weight to foot. The distal part of tibia has a small diameter, which as a consequence has reduced diameter in medullar cave. Through this anatomic feature, the medullar network in the lower tibia part is also reduced.As for anatomic aspect, vascularization in the lower end of tibia is poor. It primarily depends on periosteal vascularization, because medullar vascularization is reduced. Fasciae, tendons and skin cover the lower part of the leg, and there is no muscle mass. These tissues have poor vascular network and that is why the extraosseous blood circulation in tibia is poor, and does not participate in the osteogenesis process. For these reasons, distal lower leg represents a predelection site for delayed osteogenesis and pseudoarthrosys development.Osteosynthesis causes secondary damage to bone and soft tissue circulation. The screw plate damages the periosteal circulation – in the lower part of tibia it is the main source of vascularization, and for this reason, this method of osteosynthesis should not be applied. The external fixator has a sparing role regarding vascularization, and that is the reason why this method is recommended for fracture stabilization at the level of distal lower leg.

Debris mitigation measures by satellite design and operational methods - Findings from the DLR space debris End-to-End Service

Science.gov (United States)

Sdunnus, H.; Beltrami, P.; Janovsky, R.; Koppenwallner, G.; Krag, H.; Reimerdes, H.; Schäfer, F.

Debris Mitigation has been recognised as an issue to be addressed by the space faring nations around the world. Currently, there are various activities going on, aiming at the establishment of debris mitigation guidelines on various levels, reaching from the UN down to national space agencies. Though guidelines established on the national level already provide concrete information how things should be done (rather that specifying what should be done or providing fundamental principles) potential users of the guidelines will still have the need to explore the technical, management, and financial implications of the guidelines for their projects. Those questions are addressed by the so called "Space Debris End-to-End Service" project, which has been initiated as a national initiative of the German Aerospace Centre (DLR). Based on a review of already existing mitigation guidelines or guidelines under development and following an identification of needs from a circle of industrial users the "End-to-End Service Gu idelines" have been established for designer and operators of spacecraft. The End-to-End Service Guidelines are based on requirements addressed by the mitigation guidelines and provide recommendations how and when the technical consideration of the mitigation guidelines should take place. By referencing requirements from the mitigation guidelines, the End-to-End Service Guidelines address the consideration of debris mitigation measures by spacecraft design and operational measures. This paper will give an introduction to the End-to-End Service Guidelines. It will focus on the proposals made for mitigation measures by the S/C system design, i.e. on protective design measures inside the spacecraft and on design measures, e.g. innovative protective (shielding) systems. Furthermore, approaches on the analytical optimisation of protective systems will be presented, aiming at the minimisation of shield mass under conservation of the protective effects. On the

The impact of splenectomy on outcomes after distal and total pancreatectomy

Directory of Open Access Journals (Sweden)

Bramhall Simon

2007-06-01

Full Text Available Abstract Background Several authors advocate spleen preserving distal pancreatectomy, because of the increased complication rate after splenectomy. Methods Postoperative complications and survival after distal and total pancreatectomy, were recorded and retrospectively analyzed according to spleen preservation. Patients, who underwent distal and total pancreatectomy without histologically proven adenocarcinoma, or extrapancreatic disease, were included in the cohort which was divided into splenectomy and no splenectomy groups. Statistical analysis was performed using Fisher's test. Results The study group consisted of 62 patients who underwent distal and total pancreatectomy between 26/11/1987 to 6/1/2006. Splenectomy was performed in 35 out of 62 patients (56.5%, distal pancreatectomy was performed in 49 out of 62 patients (79%. Morbidity rate was 28.6% in splenectomy group and 14.8% in the no splenectomy group (p = 0.235, while 30 days mortality rate was 2.9%; one patient died in the splenectomy group (p = 1. Conclusion Spleen-preservation did not influence the outcomes after distal and total pancreatectomy in our series.

A double sided silicon strip detector as a DRAGON end detector

CERN Document Server

Wrede, C; Rogers, J G; D'Auria, J M

2003-01-01

The new DRAGON facility (detector of recoils and gammas of nuclear reactions), located at the TRlUMF-ISAC Radioactive Beams facility in Vancouver, Canada is now operational. This facility is used to study radiative proton capture reactions in inverse kinematics (heavy ion beam onto a light gaseous target) with both stable beams and radioactive beams of mass A=13-26 in the energy range 0.15-1.5 MeV/u. A double sided silicon strip detector (DSSSD) has been used to detect recoil ions. Tests have been performed to determine the performance of this DSSSD.

Minimally Invasive Distal Pancreatectomy: Review of the English Literature.

Science.gov (United States)

Wang, Kai; Fan, Ying

2017-02-01

Recently, the superiority of the minimally invasive approach, which results in a better cosmetic result, faster recovery, and shorter length of hospital stay, is a technique that has been progressively recognized as it has developed. And the minimally invasive approach has been applied to distal pancreatectomy (DP), which is a standard method for the treatment of benign, borderline, and part of malignant lesions of the pancreatic body and tail. This article aims to analyze the types, postoperative recovery, and outcomes of laparoscopic distal pancreatectomy (LDP). A systematic search of the scientific literature was performed using PubMed, EMBASE, online journals, and the Internet for all publications on LDP. Articles were selected if the abstract contained patients who underwent LDP for pancreatic diseases. All selected articles were reviewed and analyzed. If there were no contraindications for LDP, this operation is suitable for benign, borderline, or malignant tumors of the pancreatic body and tail, which should try to be performed with preservation of the spleen. LDP is safe and feasible under some conditions to experienced surgeon. Single-incision laparoscopic distal pancreatectomy (S-LDP) and robotic laparoscopic distal pancreatectomy (R-LDP) perioperative outcomes are similar with conventional multi-incision laparoscopic distal pancreatectomy (C-LDP). And the advantages of S-LDP and R-LDP require further exploration. With the application of enhanced recovery program (ERP), length of hospital stay and costs are reduced. LDP is safe and feasible under some conditions. Compared with open distal pancreatectomy, LDP has a lot of advantages; a trend was observed for LDP to replace traditional open surgery. LDP combined with ERP is expected to become standard in the treatment of pancreatic body and tail lesions.

Clinical relevance of distal biceps insertional and footprint anatomy

NARCIS (Netherlands)

van den Bekerom, Michel P J; Kodde, Izaäk F.; Aster, Asir; Bleys, Ronald L A W; Eygendaal, Denise

2016-01-01

Purpose: The aim of this review was to present an overview, based on a literature search, of surgical anatomy for distal biceps tendon repairs, based on the current literature. Methods: A narrative review was performed using Pubmed/Medline using key words: Search terms were distal biceps,

[Intramedullary nailing of the distal tibia illustrated with the Expert(TM) tibia nail].

Science.gov (United States)

El Attal, R; Hansen, M; Rosenberger, R; Smekal, V; Rommens, P M; Blauth, M

2011-12-01

Restoration of axis, length, and rotation of the lower leg. Sufficient primary stability of the osteosynthesis for functional aftercare and to maintain joint mobility. Good bony healing in closed and open fractures. Closed and open fractures of the tibia and complete lower leg fractures distal to the isthmus (AO 42), extraarticular fractures of the distal tibia (AO 43 A1/A2/A3), segmental fractures of the tibia with a fracture in the distal tibia, and certain intraarticular fractures of the distal tibia without impression of the joint line with the use of additional implants (AO 43 C1) Patient in reduced general condition (e.g., bed ridden), flexion of the knee of less than 90°, patients with knee arthroplasty of the affected leg, infection in the area of the nail's insertion, infection of the tibial cavity, complex articular fractures of the proximal or distal tibia with joint depression. Closed reduction of the fracture preferably on a fracture table or using a distractor or an external fixation frame. If necessary, use pointed reduction clamps or sterile drapery. In some cases, additional implants like percutaneous small fragment screws, poller screws or k-wires are helpful. Open reduction is rarely necessary and must be avoided. Opening of the proximal tibia in line with the medullary canal. Canulated insertion of the Expert(TM) tibia nail (ETN; Synthes GmbH, Oberdorf, Switzerland) with reaming of the medullary canal. Control of axis, length, and rotation. Distal interlocking with the radiolucent drill and proximal interlocking with the targeting device. Immediate mobilization of ankle and knee joint. Mobilization with 20 kg weight-bearing with crutches. X-ray control 6 weeks postoperatively and increased weight-bearing depending on the fracture status. In cases with simple fractures, good bony contact, or transverse fracture pattern, full weight-bearing at the end of week 6 is targeted. Between July 2004 and May 2005, 180 patients were included in a

Potential functional and pathological side effects related to off-target pharmacological activity.

Science.gov (United States)

Lynch, James J; Van Vleet, Terry R; Mittelstadt, Scott W; Blomme, Eric A G

2017-09-01

Most pharmaceutical companies test their discovery-stage proprietary molecules in a battery of in vitro pharmacology assays to try to determine off-target interactions. During all phases of drug discovery and development, various questions arise regarding potential side effects associated with such off-target pharmacological activity. Here we present a scientific literature curation effort undertaken to determine and summarize the most likely functional and pathological outcomes associated with interactions at 70 receptors, enzymes, ion channels and transporters with established links to adverse effects. To that end, the scientific literature was reviewed using an on-line database, and the most commonly reported effects were summarized in tabular format. The resultant table should serve as a practical guide for research scientists and clinical investigators for the prediction and interpretation of adverse side effects associated with molecules interacting with components of this screening battery. Copyright © 2017 Elsevier Inc. All rights reserved.

Impact of a Nationwide Training Program in Minimally Invasive Distal Pancreatectomy (LAELAPS)

NARCIS (Netherlands)

de Rooij, Thijs; van Hilst, Jony; Boerma, Djamila; Bonsing, Bert A.; Daams, Freek; van Dam, Ronald M.; Dijkgraaf, Marcel G.; van Eijck, Casper H.; Festen, Sebastiaan; Gerhards, Michael F.; Koerkamp, Bas Groot; van der Harst, Erwin; de Hingh, Ignace H.; Kazemier, Geert; Klaase, Joost; de Kleine, Ruben H.; van Laarhoven, Cornelis J.; Lips, Daan J.; Luyer, Misha D.; Molenaar, I. Quintus; Patijn, Gijs A.; Roos, Daphne; Scheepers, Joris J.; van der Schelling, George P.; Steenvoorde, Pascal; Vriens, Menno R.; Wijsman, Jan H.; Gouma, Dirk J.; Busch, Olivier R.; Hilal, Mohammed Abu; Besselink, Marc G.; de Boer, Marieke T.

2016-01-01

Objective:To study the feasibility and impact of a nationwide training program in minimally invasive distal pancreatectomy (MIDP).Summary of Background Data:Superior outcomes of MIDP compared with open distal pancreatectomy have been reported. In the Netherlands (2005 to 2013) only 10% of distal

Two-wave propagation in in vitro swine distal ulna

Science.gov (United States)

Mano, Isao; Horii, Kaoru; Matsukawa, Mami; Otani, Takahiko

2015-07-01

Ultrasonic transmitted waves were obtained in an in vitro swine distal ulna specimen, which mimics a human distal radius, that consists of interconnected cortical bone and cancellous bone. The transmitted waveforms appeared similar to the fast waves, slow waves, and overlapping fast and slow waves measured in the specimen after removing the surface cortical bone (only cancellous bone). In addition, the circumferential waves in the cortical bone and water did not affect the fast and slow waves. This suggests that the fast-and-slow-wave phenomenon can be observed in an in vivo human distal radius.

Energy, cost, and emission end-use profiles of homes: An Ontario (Canada) case study

International Nuclear Information System (INIS)

Aydinalp Koksal, Merih; Rowlands, Ian H.; Parker, Paul

2015-01-01

Highlights: • Hourly electricity consumption data of seven end-uses from 25 homes are analyzed. • Hourly load, cost, and emission profiles of end-uses are developed and categorized. • Side-by-side analysis of energy, cost, and environmental effects is conducted. • Behaviour and outdoor temperature based end-uses are determined. • Share of each end-use in the total daily load, cost, and emission is determined. - Abstract: Providing information on the temporal distributions of residential electricity end-uses plays a major role in determining the potential savings in residential electricity demand, cost, and associated emissions. While the majority of the studies on disaggregated residential electricity end-use data provided hourly usage profiles of major appliances, only a few of them presented analysis on the effect of hourly electricity consumption of some specific end-uses on household costs and emissions. This study presents side-by-side analysis of energy, cost, and environment effects of hourly electricity consumption of the main electricity end-uses in a sample of homes in the Canadian province of Ontario. The data used in this study are drawn from a larger multi-stakeholder project in which electricity consumption of major end-uses at 25 homes in Milton, Ontario, was monitored in five-minute intervals for six-month to two-year periods. In addition to determining the hourly price of electricity during the monitoring period, the hourly carbon intensity is determined using fuel type hourly generation and the life cycle greenhouse gas intensities specifically determined for Ontario’s electricity fuel mix. The hourly load, cost, and emissions profiles are developed for the central air conditioner, furnace, clothes dryer, clothes washer, dishwasher, refrigerator, and stove and then grouped into eight day type categories. The side-by-side analysis of categorized load, cost, and emission profiles of the seven electricity end-uses provided information on

Comparison of Lower Limb Segments Kinematics in a Taekwondo Kick. An Approach to the Proximal to Distal Motion

Directory of Open Access Journals (Sweden)

Estevan Isaac

2015-09-01

Full Text Available In taekwondo, there is a lack of consensus about how the kick sequence occurs. The aim of this study was to analyse the peak velocity (resultant and value in each plane of lower limb segments (thigh, shank and foot, and the time to reach this peak velocity in the kicking lower limb during the execution of the roundhouse kick technique. Ten experienced taekwondo athletes (five males and five females; mean age of 25.3 ±5.1 years; mean experience of 12.9 ±5.3 years participated voluntarily in this study performing consecutive kicking trials to a target located at their sternum height. Measurements for the kinematic analysis were performed using two 3D force plates and an eight camera motion capture system. The results showed that the proximal segment reached a lower peak velocity (resultant and in each plane than distal segments (except the peak velocity in the frontal plane where the thigh and shank presented similar values, with the distal segment taking the longest to reach this peak velocity (p < 0.01. Also, at the instant every segment reached the peak velocity, the velocity of the distal segment was higher than the proximal one (p < 0.01. It provides evidence about the sequential movement of the kicking lower limb segments. In conclusion, during the roundhouse kick in taekwondo inter-segment motion seems to be based on a proximo-distal pattern.

Communication technologies for demand side management

Energy Technology Data Exchange (ETDEWEB)

Uuspaeae, P [VTT Energy, Espoo (Finland)

1998-08-01

The scope of this research is data communications for electric utilities, specifically for the purposes of Demand Side Management (DSM). Demand Side Management has the objective to change the customer`s end use of energy in a manner that benefits both the customer and the utility. For example, peak demand may be reduced, and the peak demand may be relocated to off peak periods. Thus additional investments in generation and network may be avoided. A number of Demand Side Management functions can be implemented if a communication system is available between the Electric Utility and the Customer. The total communication capacity that is needed, will depend on several factors, such as the functions that are chosen for DSM, and on the number and type of customers. Some functions may be handled with one-way communications, while some other functions need to have two-way communication

A randomized side-by-side study comparing alexandrite laser at different pulse durations for port wine stains

DEFF Research Database (Denmark)

Carlsen, Berit C; Wenande, Emily; Erlendsson, Andres M

2017-01-01

hypertrophic (n = 7) PWS were included. Four side-by-side test areas were marked within each lesion. Three test areas were randomized to Alex laser at pulse durations of 3, 5, or 10 ms (8 mm spot, DCD 60/40), while the fourth was untreated. The lowest effective fluence to create purpura within the entire test...... spot was titrated and applied to intervention areas. Standardized clinical photographs were taken prior to, immediately after laser exposure and at 6-8 weeks follow up. Clinical PWS clearance and laser-related side effects were assessed using clinical photos. RESULTS: Alex laser at 3, 5, and 10 ms......BACKGROUND AND OBJECTIVES: Pulsed dye laser (PDL) represents the gold-standard treatment for port wine stains (PWS). However, approximately 20% of patients are poor responders and yield unsatisfactory end-results. The Alexandrite (Alex) laser may be a therapeutic alternative for selected PWS...

Fishtail deformity - a delayed complication of distal humeral fractures in children

Energy Technology Data Exchange (ETDEWEB)

Narayanan, Srikala [Massachusetts General Hospital, Department of Radiology, Division of Pediatric Imaging, Boston, MA (United States); University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Shailam, Randheer; Nimkin, Katherine [Massachusetts General Hospital, Department of Radiology, Division of Pediatric Imaging, Boston, MA (United States); Grottkau, Brian E. [Massachusetts General Hospital, Department of Orthopaedics, Pediatric Orthopaedics, Boston, MA (United States)

2015-06-15

Concavity in the central portion of the distal humerus is referred to as fishtail deformity. This entity is a rare complication of distal humeral fractures in children. The purpose of this study is to describe imaging features of post-traumatic fishtail deformity and discuss the pathophysiology. We conducted a retrospective analysis of seven cases of fishtail deformity after distal humeral fractures. Seven children ages 7-14 years (five boys, two girls) presented with elbow pain and history of distal humeral fracture. Four of the seven children had limited range of motion. Five children had prior grade 3 supracondylar fracture treated with closed reduction and percutaneous pinning. One child had a medial condylar fracture and another had a lateral condylar fracture; both had been treated with conservative casting. All children had radiographs, five had CT and three had MRI. All children had a concave central defect in the distal humerus. Other imaging features included joint space narrowing with osteophytes and subchondral cystic changes in four children, synovitis in one, hypertrophy or subluxation of the radial head in three and proximal migration of the ulna in two. Fishtail deformity of the distal humerus is a rare complication of distal humeral fractures in children. This entity is infrequently reported in the radiology literature. Awareness of the classic imaging features can result in earlier diagnosis and appropriate treatment. (orig.)

Fishtail deformity - a delayed complication of distal humeral fractures in children

International Nuclear Information System (INIS)

Narayanan, Srikala; Shailam, Randheer; Nimkin, Katherine; Grottkau, Brian E.

2015-01-01

Concavity in the central portion of the distal humerus is referred to as fishtail deformity. This entity is a rare complication of distal humeral fractures in children. The purpose of this study is to describe imaging features of post-traumatic fishtail deformity and discuss the pathophysiology. We conducted a retrospective analysis of seven cases of fishtail deformity after distal humeral fractures. Seven children ages 7-14 years (five boys, two girls) presented with elbow pain and history of distal humeral fracture. Four of the seven children had limited range of motion. Five children had prior grade 3 supracondylar fracture treated with closed reduction and percutaneous pinning. One child had a medial condylar fracture and another had a lateral condylar fracture; both had been treated with conservative casting. All children had radiographs, five had CT and three had MRI. All children had a concave central defect in the distal humerus. Other imaging features included joint space narrowing with osteophytes and subchondral cystic changes in four children, synovitis in one, hypertrophy or subluxation of the radial head in three and proximal migration of the ulna in two. Fishtail deformity of the distal humerus is a rare complication of distal humeral fractures in children. This entity is infrequently reported in the radiology literature. Awareness of the classic imaging features can result in earlier diagnosis and appropriate treatment. (orig.)

Tamsulosin hydrochloride vs placebo for management of distal ureteral stones: a multicentric, randomized, double-blind trial.

Science.gov (United States)

Vincendeau, Sébastien; Bellissant, Eric; Houlgatte, Alain; Doré, Bertrand; Bruyère, Franck; Renault, Alain; Mouchel, Catherine; Bensalah, Karim; Guillé, François

2010-12-13

α-Blockers induce selective relaxation of ureteral smooth muscle with subsequent inhibition of ureteral spasms and dilatation of the ureteral lumen. The aim of the study was to evaluate the efficacy and safety of the α-blocker tamsulosin hydrochloride in patients with ureteral colic owing to a distal ureteral stone. This was a multicenter, placebo-controlled, randomized, double-blind study. Patients with emergency admission for ureteral colic with a 2- to 7-mm-diameter radio-opaque distal ureteral stone were included in the study. They received tamsulosin (0.4 mg/d) or matching placebo until stone expulsion or day 42, whichever came first. The main end point was time to stone expulsion between inclusion and day 42. Sequential statistical analysis was performed using the triangular test. A total of 129 patients with acute renal colic were recruited from emergency wards between February 1, 2002, and December 8, 2006, in 6 French hospitals. Of these 129 randomized patients (placebo, 63; tamsulosin, 66), 7 were excluded from analyses: 5 for major deviations from inclusion criteria, 1 for stone expulsion before the first treatment administration, and 1 for consent withdrawal. At inclusion, mean (SD) stone diameters were 3.2 (1.2) and 2.9 (1.0) mm in the placebo and tamsulosin groups, respectively (P = .23). Expulsion delay distributions during 42 days did not show any difference (P = .30). The numbers of patients who spontaneously expelled their stone within 42 days were 43 of 61 (70.5%) and 47 of 61 (77.0%) in the placebo and tamsulosin groups, respectively (P = .41). Corresponding delays were 10.1 (10.0) and 9.6 (9.8) days (P = .82). Other secondary end points and tolerance were not different between groups. Although well tolerated, a daily administration of 0.4 mg of tamsulosin did not accelerate the expulsion of distal ureteral stones in patients with ureteral colic. clinicaltrials.gov Identifier: NCT00151567.

Spontaneous distal rupture of the plantar fascia.

Science.gov (United States)

Gitto, Salvatore; Draghi, Ferdinando

2018-07-01

Spontaneous ruptures of the plantar fascia are uncommon injuries. They typically occur at its calcaneal insertion and usually represent a complication of plantar fasciitis and local treatment with steroid injections. In contrast, distal ruptures commonly result from traumatic injuries. We describe the case of a spontaneous distal rupture of the plantar fascia in a 48-year-old woman with a low level of physical activity and no history of direct injury to the foot, plantar fasciitis, or steroid injections. © 2017 Wiley Periodicals, Inc.

Torsion of wandering spleen and distal pancreas

International Nuclear Information System (INIS)

Sheflin, J.R.; Lee, C.M.; Kretchmar, K.A.

1984-01-01

Wandering spleen is the term applied to the condition in which a long pedicle allows the spleen to lie in an abnormal location. Torsion of a wandering spleen is an unusual cause of an acute abdomen and is rarely diagnosed preoperatively. Associated torsion of the distal pancreas is even more uncommon. The authors describe a patient with torsion of a wandering spleen and distal pancreas, who was correctly diagnosed, and define the merits of the imaging methods used. The initial examination should be 99 /sup m/Tc-sulfur colloid liner-spleen scanning

A novel model of distal colon cancer in athymic mice Novo modelo de câncer de cólon distal em camundongos atímicos

Directory of Open Access Journals (Sweden)

Denise Gonçalves Priolli

2012-06-01

Full Text Available PURPOSE: The present a novel adenocarcinoma model in athymic mice. METHODS: Seven athymic mice were used. Colon diversion and distal fistula were made. Adenocarcinoma cells were inoculated in the submucosa of fistula. Tumor growth was monitored daily. Scintigraphy with 99mTc-MIBI was performed to identify the tumor. RESULTS: The model of distal colon cancer is feasible. Tumor detection was possible by both, macroscopically and molecular imaging. All resections demonstrated poorly differentiated tumors. Colon obstruction occurred in one case, similarly to evolution in human tumors of distal colon. CONCLUSION: The proposed model of distal colon cancer is feasible, allows for easy monitoring of tumoral growth by both, macroscopically and molecular imaging, and is suitable for studying the evolution of tumor with implementation of cytotoxic therapy in vivo.OBJETIVO: Apresentar novo modelo de adenocarcinoma distal em camundongos atímicos. MÉTODOS: Foram utilizados sete camundongos atímicos. Desvio do cólon distal e fístula foram feitas. Células de adenocarcinoma foram inoculadas na submucosa da fístula. O crescimento do tumor foi monitorado diariamente. Cintilografia com 99mTc-MIBI foi realizada para identificar o tumor. RESULTADOS: O modelo de câncer de cólon distal é viável. Detecção do tumor foi possível macroscopicamente e por imagem molecular. Todas as ressecções demonstraram tumores pouco diferenciados. Obstrução do cólon ocorreu em um caso, de forma semelhante à evolução em tumores humanos do cólon distal. CONCLUSÃO: O modelo de câncer do cólon distal proposto é viável, permite a monitorização fácil do crescimento tumoral macroscopicamente e por imagem molecular, sendo adequado para o estudo da evolução de tumor com aplicação de terapia citotóxica in vivo.

O esôfago curto e o refluxo distal são fatores de risco para o refluxo proximal? Short length of the esophagus and distal reflux are risk factors for proximal esophageal reflux?

Directory of Open Access Journals (Sweden)

Humberto Oliveira Serra

2010-12-01

esophageal distal reflux are risk factors for proximal reflux among patients presenting respiratory symptoms. METHODS: A hundred and seven patients were evaluated prospectively by interview, esophagoscopy, manometry and 24-hour esophageal pH monitoring. Student's t test (two-sided, Spearman's rank correlation, Chi-square and odds ratio were used in the statistical analysis. Significance level was set at 0.05. RESULTS: Respiratory symptoms that motivated the search for gastroesophageal reflux disease were cough 43 (40.2%; throat irritation 25 (23.4%, pharyngeal globe 23 (21.5% and hoarseness 16 (14.9 %. By esophagoscopy, 22 (27.2% presented some degree of esophagitis. A hiatal hernia was observed in 14 (17.5% patients. According to manometry, 11 (10.8% had lower esophageal sphincter hypotonia. The average esophageal body length was 24.3 (± 1.9 cm, ranging from 20 to 30 cm. The esophageal length was not associated with the presence of proximal esophageal reflux. As indicated by pH monitoring, 23 (21.5% presented pathologic distal reflux and 12 (11.2% had proximal reflux. CONCLUSION: The esophageal length was not associated with the presence of proximal esophageal reflux. Patients who had pathological distal esophageal reflux, independent of the esophageal length, were 4.6 times more likely to have proximal esophageal reflux.

Simultaneous bilateral distal biceps tendon repair: case report

Directory of Open Access Journals (Sweden)

Thiago Medeiros Storti

Full Text Available ABSTRACT Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

Simultaneous bilateral distal biceps tendon repair: case report.

Science.gov (United States)

Storti, Thiago Medeiros; Paniago, Alexandre Firmino; Faria, Rafael Salomon Silva

2017-01-01

Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

Does a distal forearm fracture lead to evaluation for osteoporosis? A retrospective cohort study in 147 Danish women

DEFF Research Database (Denmark)

Rud, Bo; Greibe, Rasmus; Hyldstrup, Lars

2005-01-01

In postmenopausal women, a low-trauma distal forearm fracture is a risk factor for osteoporosis and future fracture, which indicates osteoporosis follow-up according to prevailing guidelines. We decided to determine how often women over 45 yr presenting with a low-trauma distal forearm fracture t......, and it emphasizes the need to decide on a local level how to provide osteoporosis follow-up for women with fragility fractures. Udgivelsesdato: 2005 Spring......In postmenopausal women, a low-trauma distal forearm fracture is a risk factor for osteoporosis and future fracture, which indicates osteoporosis follow-up according to prevailing guidelines. We decided to determine how often women over 45 yr presenting with a low-trauma distal forearm fracture...... to a Danish emergency department during a 1-yr period were followed up for osteoporosis. We performed a retrospective review of hospital records and we sent the women and their general practitioners (GPs) questionnaires regarding the follow-up undertaken in primary care. Finally, we invited the women...

A Bayes Theory-Based Modeling Algorithm to End-to-end Network Traffic

OpenAIRE

Zhao Hong-hao; Meng Fan-bo; Zhao Si-wen; Zhao Si-hang; Lu Yi

2016-01-01

Recently, network traffic has exponentially increasing due to all kind of applications, such as mobile Internet, smart cities, smart transportations, Internet of things, and so on. the end-to-end network traffic becomes more important for traffic engineering. Usually end-to-end traffic estimation is highly difficult. This paper proposes a Bayes theory-based method to model the end-to-end network traffic. Firstly, the end-to-end network traffic is described as a independent identically distrib...

Spleen and splenic vessel preserving distal pancreatectomy for bifocal PNET in a young patient with MEN1.

Science.gov (United States)

Conrad, Claudius; Schwarz, Lilian; Perrier, Nancy; Fleming, Jason B; Katz, Matthew H G; Aloia, Thomas A; Vauthey, Jean-Nicolas; Lee, Jeffrey E

2016-10-01

MEN1 patients requiring resection of neuroendocrine tumors (pNET) are frequently young, active patients in whom a minimal access approach minimizes perioperative morbidity and splenic preservation decreases the risk of post-splenectomy sepsis. Laparoscopic spleen preserving distal pancreatectomy can be performed with removal (Warshaw's technique) or preservation of the splenic vessels, the later having a higher rate of successful splenic preservation. This is an active, 16-year-old Jehovah's Witness with trifocal nonfunctioning neuroendocrine tumor in the proximal body and tail of the pancreas as part of MEN1 syndrome. A spleen preserving distal pancreatectomy was performed with the final pathology showing three pNET with low mitotic count and three lymph nodes free of cancer (final stage pT2pN0). This video demonstrates patient and trocar positioning as well as operative tactics for a laparoscopic distal pancreatectomy with preservation of splenic vessels. Intraoperative ultrasound is crucial in assessing pNETs' relation to critical vessels, pancreatic duct, and to exclude synchronous lesions. The video focuses on safe laparoscopic creation of the retropancreatic tunnel and dissecting the pancreas off the splenic vessels using novel energy devises to control direct splenic venous branches into the pancreas. Improvements in laparoscopic techniques and technology have enabled surgeons to preserve the major splenic vessels to avoid splenic infarcts, abscesses and re-operations, and minimize the risk of left-sided portal hypertension. Splenic preservation is particularly important in young MEN1 patients undergoing laparoscopic pancreatectomy for pNET due to the increased risk of overwhelming post-splenectomy sepsis.

A Bayes Theory-Based Modeling Algorithm to End-to-end Network Traffic

Directory of Open Access Journals (Sweden)

Zhao Hong-hao

2016-01-01

Full Text Available Recently, network traffic has exponentially increasing due to all kind of applications, such as mobile Internet, smart cities, smart transportations, Internet of things, and so on. the end-to-end network traffic becomes more important for traffic engineering. Usually end-to-end traffic estimation is highly difficult. This paper proposes a Bayes theory-based method to model the end-to-end network traffic. Firstly, the end-to-end network traffic is described as a independent identically distributed normal process. Then the Bases theory is used to characterize the end-to-end network traffic. By calculating the parameters, the model is determined correctly. Simulation results show that our approach is feasible and effective.

Fernandez osteotomy of radio distal with mal united fracture

International Nuclear Information System (INIS)

Garcia Herrera, Alvaro; Bocanegra, Sergio; Suarez, Fabio

2003-01-01

We review prospectively our experience in the military hospital in Bogota, Colombia, with the opening-wedge osteotomy for the treatment of a mal united fracture of the distal end of the radius in fifty-six consecutive patients from 1990 to 2002. The indications for operation were pain predominantly in the radio-ulnar joint and functional limitation with grip strength loss. Preoperative radiographs revealed an average ulnar inclination of 14 degrees, an average ulnar variance of four millimeters, and increased dorsal tilt (colles deformity) that averaged 28 degrees. All patients had limited function. The average grip strength was a force of fifteen kilograms compared with a force of thirty-one kilograms in the contralateral hand. Postoperatively, all of the patients had substantial improvement in function, relief of pain and grip strength increased. The functional results were rated as very good in eleven patients, good in thirty-six, fair in nine

A patient specific finite element simulation of intramedullary nailing to predict the displacement of the distal locking hole.

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Mortazavi, Javad; Farahmand, Farzam; Behzadipour, Saeed; Yeganeh, Ali; Aghighi, Mohammad

2018-05-01

Distal locking is a challenging subtask of intramedullary nailing fracture fixation due to the nail deformation that makes the proximally mounted targeting systems ineffective. A patient specific finite element model was developed, based on the QCT data of a cadaveric femur, to predict the position of the distal hole of the nail postoperatively. The mechanical interactions of femur and nail (of two sizes) during nail insertion was simulated using ABAQUS in two steps of dynamic pushing and static equilibrium, for the intact and distally fractured bone. Experiments were also performed on the same specimen to validate the simulation results. A good agreement was found between the model predictions and the experimental observations. There was a three-point contact pattern between the nail and medullary canal, only on the proximal fragment of the fractured bone. The nail deflection was much larger in the sagittal plane and increased for the larger diameter nail, as well as for more distally fractured or intact femur. The altered position of the distal hole was predicted by the model with an acceptable error (mean: 0.95; max: 1.5 mm, in different tests) to be used as the compensatory information for fine tuning of proximally mounted targeting systems. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

Cost-effectiveness of laparoscopic versus open distal pancreatectomy for pancreatic cancer

NARCIS (Netherlands)

Gurusamy, Kurinchi Selvan; Riviere, Deniece; van Laarhoven, C. J. H.; Besselink, Marc; Abu-Hilal, Mohammed; Davidson, Brian R.; Morris, Steve

2017-01-01

A recent Cochrane review compared laparoscopic versus open distal pancreatectomy for people with for cancers of the body and tail of the pancreas and found that laparoscopic distal pancreatectomy may reduce the length of hospital stay. We compared the cost-effectiveness of laparoscopic distal

Distal anastomotic vein adjunct usage in infrainguinal prosthetic bypasses.

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McPhee, James T; Goodney, Philip P; Schanzer, Andres; Shaykevich, Shimon; Belkin, Michael; Menard, Matthew T

2013-04-01

Single-segment saphenous vein remains the optimal conduit for infrainguinal revascularization. In its absence, prosthetic conduit may be used. Existing data regarding the significance of anastomotic distal vein adjunct (DVA) usage with prosthetic grafts are based on small series. This is a retrospective cohort analysis derived from the regional Vascular Study Group of New England as well as the Brigham and Women's hospital database. A total of 1018 infrainguinal prosthetic bypass grafts were captured in the dataset from 73 surgeons at 15 participating institutions. Propensity scoring and 3:1 matching was performed to create similar exposure groups for analysis. Outcome measures of interest included: primary patency, freedom from major adverse limb events (MALEs), and amputation free survival at 1 year as a function of vein patch utilization. Time to event data were compared with the log-rank test; multivariable Cox proportional hazard models were used to evaluate the adjusted association between vein cuff usage and the primary end points. DVA was defined as a vein patch, cuff, or boot in any configuration. Of the 1018 bypass operations, 94 (9.2%) had a DVA whereas 924 (90.8%) did not (no DVA). After propensity score matching, 88 DVAs (25%) and 264 no DVAs (75%) were analyzed. On univariate analysis of the matched cohort, the DVA and no DVA groups were similar in terms of mean age (70.0 vs 69.0; P = .55), male sex (58.0% vs 58.3%; P > .99), and preoperative characteristics such as living at home (93.2% vs 94.3%; P = .79) and independent ambulatory status (72.7% vs 75.7%; P = .64). The DVA and no DVA groups had similar rates of major comorbidities such as hypertension chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, and dialysis dependence (P > .05 for all). Likewise, they had similar rates of distal origin grafts (13.6% vs 12.5%; P = .85), critical limb ischemia indications (P = .53), and prior arterial bypass (58% vs 47%; P = .08

Soft Roof Failure Mechanism and Supporting Method for Gob-Side Entry Retaining

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Hongyun Yang

2015-10-01

Full Text Available To study the soft roof failure mechanism and the supporting method for a gateway in a gently inclined coal seam with a dip angle of 16° kept for gob-side entry retaining, and through the methodology of field investigation and numerical and analytical modeling, this paper analyzed the stress evolution law of roof strata at the working face end and determined that the sharp horizontal stress unloading phenomenon along the coal wall side did not appear after the working face advanced. Conversely, the horizontal stress along the gob side instantly decreased and the tensile stress produced, and the vertical stress in the central part of the roof had a higher reduction magnitude as well. An in-depth study indicates that the soft roof of the working face end subsided and seriously separated due to the effect of the front abutment pressure and the roof hanging length above the gob line, as well as certain other factors, including the rapid unloading of the lateral stress, tension and shear on the lower roof rock layer and dynamic disturbance. Those influencing factors also led to rapid crack propagation on a large scale and serious fracturing in the soft roof of the working face end. However, in the gob stress stabilized zone, the soft roof in the gob-side entry retaining has a shearing failure along the filling wall inside affected by the overburden pressure, rock bulking pressure, and roof gravity. To maintain the roof integrity, decrease the roof deformation, and enable the control of the working face end soft roof and the stabilization of the gob-side entry retaining roof, this study suggests that the preferred bolt installation angle for the soft roof situation is 70° based on the rock bolt extrusion strengthening theory.

[PERSONALIZED DISTAL FEMORAL VALGUS RESECTION ANGLE IN PRIMARY TOTAL KNEE ARTHROPLASTY].

Science.gov (United States)

Wang, Xilong; Shang, Xifu; Ll, Guoyuan; He, Rui; Zheng, Jie

2015-01-01

To investigate the feasibility and effectiveness of a personalized distal femoral valgus resection angle for improving postoperative coronal alignment of lower limb in total knee arthroplasty (TKA). A retrospective analysis was made on the clinical data of 50 patients who received primary TKA between January 2013 and February 2013. There were 11 male and 39 female patients with degenerative knee osteoarthritis. The patients were divided into 2 groups. In test group (n=25), the resection angle was adjusted to the femoral mechanical anatomical angle (FMA); in control group (n=25), a fixed distal valgus resection angle of 5° was used. There was no significant difference in gender, age, body mass index, disease duration, sides, grade, preoperative FMA, mechanical femorotibial angle (MFT), and preoperative Knee Society Score (KSS) between 2 groups (P > 0.05). Whole long X-ray film was taken to measure FMA and MFT at 3 days after operation, postoperative KSS was used to evaluate the knee function after 6 and 15 months. MFT was (-0.20 ± 1.87)° in test group and was (1.71 ± 3.67)° in control group, showing significant difference between 2 groups (t = 2.32, P = 0.02). The ideal MFT angle (0 ± 3)° was achieved in 22 patients (88%) of test group and in 16 patients (64%) of control group, showing significant difference between 2 groups (χ2 = 2.32, P = 0.02). Primary healing of incision was obtained in all patients of 2 groups. No deep venous thrombosis occurred. The patients of 2 groups were followed up 15 months after operation. There was significant difference in KSS between test and control groups at 6 months (88.23 ± 2.57 vs. 82.92 ± 2.59) (t = 7.26, P = 0.00) and at 15 months (90.76 ± 2.77 vs. 88.65 ± 1.77) (t = 3.20, P = 0.02). No sign of prosthesis loosening was observed by X-ray examination. Compared with using of a fixed distal femoral resection angle, an individual FMA can significantly improve the postoperative MFT and promote early recovery of the knee

Fractures of the distal radius in children: A retrospective evaluation

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Selma Yazıcı

2012-06-01

Full Text Available Objectives: This study designed to evaluate the resultsof treatment, closed reduction and percutaneous wires, ofthe distal radius fractures in children.Materials and methods: A retrospective analysis wascarried out in children aged between 5-15 years who presentedwith a displaced fracture of the distal radius to ourhospital. They were initially treated with closed reductionand cast immobilization. If the fractures redisplaced treatedby percutaneous Kirschner (K- wire with scope undera general anaesthesia.Results: Totally 104 patients, who have distal radius fractureswere treated by closed reduction and immobilizationin a plaster cast. 13 patient who have distal radiusfractures were treated by closed reduction under generalanaesthesia and fixed by percutaneous Kirschner (K-wire. Patients with impaired the alignment of the fracturein late period were usually completely displaced fractures.(n=5, 4,3%, in early period, completely displaced fractures(n=5, 4,3% are superior to partial displaced fractures(n=2, 1,7%.Conclusion: In our study, when children with distal radiusfracture first come, they were treated by closed reductionand immobilization in a plaster cast. We thought that inredisplaced fractures patients were suitable for the closedreduction with percutaneous wire treatment.

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

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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.       

Laparoscopic radical nephroureterectomy: dilemma of the distal ureter.

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Steinberg, Jordan R; Matin, Surena F

2004-03-01

Laparoscopic nephroureterectomy has recently emerged as a safe, minimally invasive approach to upper tract urothelial cancers. The most controversial and challenging feature of laparoscopic nephroureterectomy is the management of the distal ureter. We review the most common methods of managing the distal ureter, with emphasis on contemporary oncologic outcomes, indications, advantages, and disadvantages. There are currently in excess of five different approaches to the lower ureter. These techniques often combine features of endoscopic, laparoscopic, or open management. They include open excision, a transvesical laparoscopic detachment and ligation technique, laparoscopic stapling of the distal ureter and bladder cuff, the "pluck" technique, and ureteral intussusception. Each technique has distinct advantages and disadvantages, differing not only in technical approach, but oncological principles as well. While the existing published data do not overwhelmingly support one approach over the others, the open approach remains one of the most reliable and oncologically sound procedures. The principles of surgical oncology dictate that a complete, en-bloc resection, with avoidance of tumor seeding, remains the preferred treatment of all urothelial cancers. The classical open technique of securing the distal ureter and bladder cuff achieves this principle and has withstood the test of time. Transvesical laparoscopic detachment and ligation is an oncologically valid approach in patients without bladder tumors, but is limited by technical considerations. The laparoscopic stapling technique maintains a closed system but risks leaving behind ureteral and bladder cuff segments. Both transurethral resection of the ureteral orifice (pluck) and intussusception techniques should be approached with caution, as the potential for tumor seeding exists. Additional long-term comparative outcomes are needed to solve the dilemma of the distal ureter.

Osteoblastoma-like osteosarcoma of the distal tibia

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Abramovici, Luigia; Steiner, German C. [Department of Pathology and Laboratory Medicine, Hospital for Joint Diseases, New York, NY (United States); Kenan, Samuel [Department of Orthopaedic Oncology Surgery, Hospital for Joint Diseases, New York, NY (United States); Hytiroglou, Prodromos [Aristotle University, Thessaloniki (Greece); Rafii, Mahvash [Department of Radiology, Hospital for Joint Diseases, New York, NY (United States)

2002-03-01

We report a case of a 14-year-old boy with an intracompartmental lytic lesion with poorly defined margins in the right distal tibia that was originally treated with curettage and bone grafting. Histologic examination showed an osteoblastic tumor with unusual features, which was found on consultation to be an osteoblastoma-like osteosarcoma, a rare, low-grade variant of osteosarcoma. Subsequently, the patient underwent en bloc resection of the distal tibia, which was replaced with vascularized bone graft and followed by chemotherapy. Two years later, he is alive with lung metastases. (orig.)

Osteoblastoma-like osteosarcoma of the distal tibia

International Nuclear Information System (INIS)

Abramovici, Luigia; Steiner, German C.; Kenan, Samuel; Hytiroglou, Prodromos; Rafii, Mahvash

2002-01-01

We report a case of a 14-year-old boy with an intracompartmental lytic lesion with poorly defined margins in the right distal tibia that was originally treated with curettage and bone grafting. Histologic examination showed an osteoblastic tumor with unusual features, which was found on consultation to be an osteoblastoma-like osteosarcoma, a rare, low-grade variant of osteosarcoma. Subsequently, the patient underwent en bloc resection of the distal tibia, which was replaced with vascularized bone graft and followed by chemotherapy. Two years later, he is alive with lung metastases. (orig.)

[Distal fixation prosthesis for unstable intertrochanteric fractures in elderly patients: a mid-term follow-up study].

Science.gov (United States)

Zhang, Zhan-feng; Min, Ji-kang; Zhong, Jian-ming; Wang, Dan

2016-06-01

To explore mid-term follow up results of distal fixation prosthesis in treating unstable intertrochanteric fractures in elderly patients. From May 2008 to March 2014,58 elderly patients with unstable intertrochanteric were treated with distal fixation prosthesis, among them, there were 15 males and 43 females aged from 75 to 87 years old with an average of 83.2 years old. Fracture were classified according to Evans classification, 39 cases were type I c and 19 cases were type I d. Surgical risk was evaluated before operation, 9 patients were performed total hip arthroplasty and 49 patients were performed prosthetic replacement hip joint function of patients with different age period, Evans classificaton, prothesis type, fixation method were evaluated respectively by using Harris score. Fifty-six patients were followed up from 13 to 36 months with an average of 21.6 months. Harris score was 83.51 ± 6.40, 5 cases got excellent results, 38 cases good and 13 cases moderate. Harris score of patients aged from 75 to 80 years old was 88.64 ± 2.35, 81.64 ± 6.40 in patients aged more than 80 years old, and had significant differences between two groups; Harris score in patients with type Evans I c was 83.64 ± 6.53, and 83.11 ± 6.08 in type Evans I d, while there was no significant differences between two groups. There was no obvious meaning in Harris score between patients with tension band (83.63 ± 6.15) and without tension band (82.41 ± 6.57). There was no significant meaning in Harris score between patients with normal distal fixation prosthesis (83.34 ± 6.43) and femoral moment reconstruction distal fixation prosthesis (83.92 ± 6.51). There was 1 patient occurred hip joint dislocation on the operative side and re-dislocation after manual reduction, then received open reduction. Two patients occurred femoral osteolysis without clinical symptoms, and treated conservative treatment. Artificial joint replacement for unstable intertrochanteric fractures in elderly

Limited distal organelles and synaptic function in extensive monoaminergic innervation.

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Tao, Juan; Bulgari, Dinara; Deitcher, David L; Levitan, Edwin S

2017-08-01

Organelles such as neuropeptide-containing dense-core vesicles (DCVs) and mitochondria travel down axons to supply synaptic boutons. DCV distribution among en passant boutons in small axonal arbors is mediated by circulation with bidirectional capture. However, it is not known how organelles are distributed in extensive arbors associated with mammalian dopamine neuron vulnerability, and with volume transmission and neuromodulation by monoamines and neuropeptides. Therefore, we studied presynaptic organelle distribution in Drosophila octopamine neurons that innervate ∼20 muscles with ∼1500 boutons. Unlike in smaller arbors, distal boutons in these arbors contain fewer DCVs and mitochondria, although active zones are present. Absence of vesicle circulation is evident by proximal nascent DCV delivery, limited impact of retrograde transport and older distal DCVs. Traffic studies show that DCV axonal transport and synaptic capture are not scaled for extensive innervation, thus limiting distal delivery. Activity-induced synaptic endocytosis and synaptic neuropeptide release are also reduced distally. We propose that limits in organelle transport and synaptic capture compromise distal synapse maintenance and function in extensive axonal arbors, thereby affecting development, plasticity and vulnerability to neurodegenerative disease. © 2017. Published by The Company of Biologists Ltd.

Surgical treatment of distal biceps tendon rupture: a case report

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Cristina N. Cozma

2017-11-01

Full Text Available Objectives. Distal biceps tendon rupture affects the functional upperextremity movement, impairing supination and flexion strength. According to age, profession and additional risks treatment might be nonoperative or surgical. Methods. We describe the case of a 43 years old male patient who sustained an injury to his right distal biceps and was diagnosed with acute right distal biceps rupture. Surgical treatment was decided and biceps tendon was reinserted to the radius tuberosity using a combination of a cortical button fixation associated with an interference screw. Results. Postoperative functional result was favorable with no complications and with no movement limitation after one month. Conclusions. When possible, distal biceps tendon repair should be realized surgically because this permits restoring of the muscle strength to near normal levels with no loss of motion. Nerve complications are common; therefore the surgery should be realized by experienced upper extremity surgeons.