Sample records for proximal pole nonunion

  1. Spontaneous Healing of a Pediatric Scaphoid Proximal Pole Fracture Nonunion. (United States)

    Rupani, Neal; Riley, Nicholas; McNab, Ian


    Background  Scaphoid fractures in the pediatric population are rare. The majority of nondisplaced fractures tend to unite; however, there is an increased risk of nonunion in proximal pole fractures. Limited evidence exists in their outcomes, owing to the scarcity of the fracture pattern. Case Description  A 13-year-old boy who presented late after developing a traumatic proximal pole scaphoid fracture developed nonunion. He was treated conservatively owing to it being asymptomatic and developed union at 18 months. Literature Review  No previous case of proximal pole pediatric scaphoid fractures with established nonunion that has developed union with conservative management has been described. Clinical Relevance  The authors highlight a unique case of an established proximal pole scaphoid nonunion in a child progressing to union with nonoperative intervention. Owing to its rarity and difficulty in obtaining research, we recommend consideration of nonoperative management of asymptomatic nondisplaced proximal pole fractures in children.

  2. Bone graft in the treatment of nonunion of the scaphoid with necrosis of the proximal pole: a literature review. (United States)

    Severo, Antônio Lourenço; Lemos, Marcelo Barreto; Lech, Osvandré Luiz Canfield; Barreto Filho, Danilo; Strack, Daniel Paulo; Candido, Larissa Knapp


    Scaphoid fractures are the most common fractures of the carpal bones, corresponding to 60%. Of these, 10% progress to nonunion; moreover, 3% can present necrosis of the proximal pole. There are various methods of treatment using vascularized and non-vascularized bone grafts. To evaluate and compare the rate of scaphoid consolidation with necrosis of the proximal pole using different surgical techniques. The authors conducted a review of the literature using the following databases: PubMed and BIREME/LILACS, where 13 case series were selected (ten with use of vascularized bone grafts and three of non-vascularized bone grafts), according to inclusion and exclusion criteria. In most cases VBGs were used, especially those based on the 1,2 intercompartmental supraretinacular artery, due to greater reproducibility in performing the surgical technique.

  3. Temporary antibiotic cement-covered gamma nail spacer for an infected nonunion of the proximal femur. (United States)

    Rodriguez, Hugo; Ziran, Bruce H


    We report the case of an infected nonunion of the proximal femoral in an elderly patient. There was extensive involvement of the entire proximal femur precluding salvage. An impromptu use of a cephalomedullary nail coated with antibiotic-laden bone cement is described, followed by reimplantation with a revision-type proximal femoral prosthesis. The patient had resection of the proximal femur, placement of a temporary functional spacer, and reimplantation after a course of antibiotics, with good success. The method we describe is a reasonable alternative when standard off-the-shelf systems or other methods of temporary spacer creation are not available.

  4. Avascular necrosis (AVN) of the proximal fragment in scaphoid nonunion: Is intravenous contrast agent necessary in MRI?

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    Schmitt, R., E-mail: [Department of Diagnostic and Interventional Radiology, Cardiovascular Center, Bad Neustadt an der Saale (Germany); Christopoulos, G.; Wagner, M. [Department of Diagnostic and Interventional Radiology, Cardiovascular Center, Bad Neustadt an der Saale (Germany); Krimmer, H. [Department of Hand Surgery, Cardiovascular Center, Bad Neustadt an der Saale (Germany); Fodor, S. [Department of Diagnostic and Interventional Radiology, Cardiovascular Center, Bad Neustadt an der Saale (Germany); Schoonhoven, J. van; Prommersberger, K.J. [Department of Hand Surgery, Cardiovascular Center, Bad Neustadt an der Saale (Germany)


    Purpose: The purpose of this prospective study is to assess the diagnostic value of intravenously applied contrast agent for diagnosing osteonecrosis of the proximal fragment in scaphoid nonunion, and to compare the imaging results with intraoperative findings. Materials and methods: In 88 patients (7 women, 81 men) suffering from symptomatic scaphoid nonunion, preoperative MRI was performed (coronal PD-w FSE fs, sagittal-oblique T1-w SE nonenhanced and T1-w SE fs contrast-enhanced, sagittal T2*-w GRE). MRI interpretation was based on the intensity of contrast enhancement: 0 = none, 1 = focal, 2 = diffuse. Intraoperatively, the osseous viability was scored by means of bleeding points on the osteotomy site of the proximal scaphoid fragment: 0 = absent, 1 = moderate, 2 = good. Results: Intraoperatively, 17 necrotic, 29 compromised, and 42 normal proximal fragments were found. In nonenhanced MRI, bone viability was judged necrotic in 1 patient, compromised in 20 patients, and unaffected in 67 patients. Contrast-enhanced MRI revealed 14 necrotic, 21 compromised, and 53 normal proximal fragments. Judging surgical findings as the standard of reference, statistical analysis for nonenhanced MRI was: sensitivity 6.3%, specificity 100%, positive PV 100%, negative PV 82.6%, and accuracy 82.9%; statistics for contrast-enhanced MRI was: sensitivity 76.5%, specificity 98.6%, positive PV 92.9%, negative PV 94.6%, and accuracy 94.3%. Sensitivity for detecting avascular proximal fragments was significantly better (p < 0.001) in contrast-enhanced MRI in comparison to nonenhanced MRI. Conclusion: Viability of the proximal fragment in scaphoid nonunion can be significantly better assessed with the use of contrast-enhanced MRI as compared to nonenhanced MRI. Bone marrow edema is an inferior indicator of osteonecrosis. Application of intravenous gadolinium is recommended for imaging scaphoid nonunion.

  5. [High bone consolidation rates after humeral head-preserving revision surgery in non-unions of the proximal humerus]. (United States)

    Aytac, S D; Schnetzke, M; Hudel, I; Studier-Fischer, S; Grützner, P A; Gühring, T


    Fractures of the subcapital and proximal humerus shaft region are common fractures of the human skeleton. Their treatment should provide an early functional after-care of the shoulder joint, that is prone to arthrofibrosis. Although the upper extremity is not weight-bearing the occurrence of proximal humerus non-unions leads to severe impairment with inability to work and restrictions of activity of daily life. The aim of this study was to investigate whether an operative revision of proximal humerus non-unions with reosteosynthesis and application of distant autologous bone grafts can lead to sufficient bone healing. The second aim was to find out whether patients achieved an acceptable functional outcome, as alternatively patients could be treated by reconstruction with a shoulder prosthesis. 27 patients (female = 15, male = 12) with reosteosynthesis of the proximal humerus and proximal humeral shaft due to non-union after initially operative fracture treatment were included between 2008 and 2014. Average age of patients was 56 years (23-87), 48% had no comorbidities, while 52% of the patients had at least 1 comorbidity such as diabetes, hypertension or nicotine abusus. The mean number of prior surgical intervention was 1.2 (1-3). The mean time between initial surgery and re-osteosynthesis was 12.3 months. Patients with signs of infection pseudarthrosis were excluded. The initial type of osteosynthesis was with plates (n = 16; thereof PHILOS Plate n = 14), and intramedullary nails (T2, Targon Nail, PHN, Seidel Nail; n = 11). Revision surgery was done with plate osteosynthesis (n = 26; thereof PHILOS Plate n = 4; LC Plate n = 10; angle plate n = 12). In 23 patients (89%) a distant bone transplantation was done from the iliac crest, and 1 patient received allogenous bone. Three patients (11%) received bone morphogenetic protein 7 (BMP 7) in combination with distant bone graft. Intraoperative swabs from the pseudarthrosis area

  6. Shock wave therapy compared with intramedullary screw fixation for nonunion of proximal fifth metatarsal metaphyseal-diaphyseal fractures. (United States)

    Furia, John P; Juliano, Paul J; Wade, Allison M; Schaden, Wolfgang; Mittermayr, Rainer


    The current "gold standard" for treatment of chronic fracture nonunion in the metaphyseal-diaphyseal region of the fifth metatarsal is intramedullary screw fixation. Complications with this procedure, however, are not uncommon. Shock wave therapy can be an effective treatment for fracture nonunions. The purpose of this study was to evaluate the safety and efficacy of shock wave therapy as a treatment of these nonunions. Twenty-three patients with a fracture nonunion in the metaphyseal-diaphyseal region of the fifth metatarsal received high-energy shock wave therapy (2000 to 4000 shocks; energy flux density per pulse, 0.35 mJ/mm(2)), and twenty other patients with the same type of fracture nonunion were treated with intramedullary screw fixation. The numbers of fractures that were healed at three and six months after treatment in each group were determined, and treatment complications were recorded. Twenty of the twenty-three nonunions in the shock wave group and eighteen of the twenty nonunions in the screw fixation group were healed at three months after treatment. One of the three nonunions that had not healed by three months in the shock wave group was healed by six months. There was one complication in the shock wave group (post-treatment petechiae) and eleven complications in the screw-fixation group (one refracture, one case of cellulitis, and nine cases of symptomatic hardware). Both intramedullary screw fixation and shock wave therapy are effective treatments for fracture nonunion in the metaphyseal-diaphyseal region of the fifth metatarsal. Screw fixation is more often associated with complications that frequently result in additional surgery.

  7. Accuracy of enhanced and unenhanced MRI in diagnosing scaphoid proximal pole avascular necrosis and predicting surgical outcome

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    Fox, M.G. [University of Virginia, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Wang, D.T. [University of Virginia, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Medical College of Wisconsin, Milwaukee, WI (United States); Chhabra, A.B. [University of Virginia Health System, Department of Orthopedics, Charlottesville, VA (United States)


    Determine the sensitivity, specificity and accuracy of unenhanced and enhanced MRI in diagnosing scaphoid proximal pole (PP) avascular necrosis (AVN) and correlate whether MRI can help guide the selection of a vascularized or nonvascularized bone graft. The study was approved by the IRB. Two MSK radiologists independently performed a retrospective review of unenhanced and enhanced MRIs from 18 patients (16 males, 2 females; median age, 17.5 years) with scaphoid nonunions and surgery performed within 65 days of the MRI. AVN was diagnosed on the unenhanced MRI when a diffusely decreased T1-W signal was present in the PP and on the enhanced MRI when PP enhancement was less than distal pole enhancement. Surgical absence of PP bleeding was diagnostic of PP AVN. Postoperative osseous union (OU) was assessed with computed tomography and/or radiographs. Sensitivity, specificity and accuracy for PP AVN were 71, 82 and 78 % for unenhanced and 43, 82 and 67 % for enhanced MRI. Patients with PP AVN on unenhanced MRI had 86 % (6/7) OU; 100 % (5/5) OU with vascularized bone grafts and 50 % (1/2) OU with nonvascularized grafts. Patients with PP AVN on enhanced MRI had 80 % (4/5) OU; 100 % (3/3) OU with vascularized bone grafts and 50 % (1/2) OU with nonvascularized grafts. Patients with viable PP on unenhanced and enhanced MRI had 91 % (10/11) and 92 % (12/13) OU, respectively, all but one with nonvascularized graft. When PP AVN is evident on MRI, OU is best achieved with vascularized grafts. If PP AVN is absent, OU is successful with nonvascularized grafts. (orig.)

  8. The surgical approach and source of bone graft for symptomatic nonunion of the scaphoid. (United States)

    Hull, W J; House, J H; Gustillo, R B; Kleven, L; Thompson, W


    In 2 groups of patients treated by bone grafting for scaphoid nonunions, one group had a dorsal or dorsolateral surgical approach with a bone graft from the radius while the other group had a volar approach with an iliac graft. The best results were obtained with an iliac graft. Through the volar approach it is relatively easy to avoid damage to the scaphoid arterial supply. A small proximal vascular pole led to a failure rate of 36%.

  9. Do fibula nonunions predict later tibia nonunions? (United States)

    Ko, Sang-Bong; Lee, Sang-Wook


    The purpose of this study was to evaluate the validity of fibula nonunion as a method for predicting tibia nonunion in the tibiofibula shaft fracture. Retrospective study. University hospital. From March 1998 to October 2008, 224 patients were enrolled. Among 224 patients, 153 patients were treated with intramedullary nail, 34 patients were treated with external fixator, 32 patients with plate and screws. The remaining 5 patients were treated nonsurgically with cast or brace. Patients followed up at 1, 2, 3, 6, 9, 12, and 18 months postoperatively. Multivariate analysis of the relationship between fibula and tibia union was conducted. Among the 224 patients, 169 patients were included in the fibula union group and 55 patients were in the fibula nonunion group. Mean age was 49 years (19-89 yrs); follow-up period was more than 18 months (18-109 mo). In the fibula union group, there were 21 patients (12.4%) with a tibia nonunion. In the fibula nonunion group, 21 patients (56.3%) had tibia nonunion. Fibula nonunion was significantly statistically associated with tibia nonunion (P = 0.002). Union time between the tibia and the fibula was statistically significant (P = 0.002). Fibula nonunion is a good predictor of tibia nonunion in patients with tibiofibula shaft fractures. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

  10. Infected nonunion of tibia

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    Milind Madhav Chaudhary


    Full Text Available Infected nonunions of tibia pose many challenges to the treating surgeon and the patient. Challenges include recalcitrant infection, complex deformities, sclerotic bone ends, large bone gaps, shortening, and joint stiffness. They are easy to diagnose and difficult to treat. The ASAMI classification helps decide treatment. The nonunion severity score proposed by Calori measures many parameters to give a prognosis. The infection severity score uses simple clinical signs to grade severity of infection. This determines number of surgeries and allows choice of hardware, either external or internal for definitive treatment. Co-morbid factors such as smoking, diabetes, nonsteroidal anti-inflammatory drug use, and hypovitaminosis D influence the choice and duration of treatment. Thorough debridement is the mainstay of treatment. Removal of all necrotic bone and soft tissue is needed. Care is exercised in shaping bone ends. Internal fixation can help achieve union if infection was mild. Severe infections need external fixation use in a second stage. Compression at nonunion site achieves union. It can be combined with a corticotomy lengthening at a distant site for equalization. Soft tissue deficit has to be covered by flaps, either local or microvascular. Bone gaps are best filled with the reliable technique of bone transport. Regenerate bone may be formed proximally, distally, or at both sites. Acute compression can fill bone gaps and may need a fibular resection. Gradual reduction of bone gap happens with bone transport, without need for fibulectomy. When bone ends dock, union may be achieved by vertical or horizontal compression. Biological stimulus from iliac crest bone grafts, bone marrow aspirate injections, and platelet concentrates hasten union. Bone graft substitutes add volume to graft and help fill defects. Addition of rh-BMP-7 may help in healing albeit at a much higher cost. Regeneration may need stimulation and augmentation. Induced

  11. Infected nonunion of tibia. (United States)

    Chaudhary, Milind Madhav


    Infected nonunions of tibia pose many challenges to the treating surgeon and the patient. Challenges include recalcitrant infection, complex deformities, sclerotic bone ends, large bone gaps, shortening, and joint stiffness. They are easy to diagnose and difficult to treat. The ASAMI classification helps decide treatment. The nonunion severity score proposed by Calori measures many parameters to give a prognosis. The infection severity score uses simple clinical signs to grade severity of infection. This determines number of surgeries and allows choice of hardware, either external or internal for definitive treatment. Co-morbid factors such as smoking, diabetes, nonsteroidal anti-inflammatory drug use, and hypovitaminosis D influence the choice and duration of treatment. Thorough debridement is the mainstay of treatment. Removal of all necrotic bone and soft tissue is needed. Care is exercised in shaping bone ends. Internal fixation can help achieve union if infection was mild. Severe infections need external fixation use in a second stage. Compression at nonunion site achieves union. It can be combined with a corticotomy lengthening at a distant site for equalization. Soft tissue deficit has to be covered by flaps, either local or microvascular. Bone gaps are best filled with the reliable technique of bone transport. Regenerate bone may be formed proximally, distally, or at both sites. Acute compression can fill bone gaps and may need a fibular resection. Gradual reduction of bone gap happens with bone transport, without need for fibulectomy. When bone ends dock, union may be achieved by vertical or horizontal compression. Biological stimulus from iliac crest bone grafts, bone marrow aspirate injections, and platelet concentrates hasten union. Bone graft substitutes add volume to graft and help fill defects. Addition of rh-BMP-7 may help in healing albeit at a much higher cost. Regeneration may need stimulation and augmentation. Induced membrane technique is an

  12. Comparison of proximal row carpectomy and midcarpal arthrodesis for the treatment of scaphoid nonunion advanced collapse (SNAC-wrist) and scapholunate advanced collapse (SLAC-wrist) in stage II. (United States)

    Dacho, Andreas K; Baumeister, Steffen; Germann, Guenter; Sauerbier, Michael


    Traumatic instability of the proximal carpal row is based either on a scaphoid fracture or a scapholunate dissociation. Long-standing scaphoid nonunion or scapholunate ligament insufficiency may lead to a carpal collapse and subsequent arthrosis. Controversy exists regarding the appropriate salvage procedure for patients with scapholunate advanced collapse (SLAC)- or scaphoid nonunion advanced collapse (SNAC)-wrist in stage II. Proximal row carpectomy (PRC) and midcarpal arthrodesis (MCA) are two commonly used options. The purpose of this retrospective study was to evaluate the functional outcome and pain relief in SNAC-SLAC-wrist stage II after MCA, compared to PRC in a long term follow up. In the MCA group 17 patients, nine SLAC- and eight SNAC-wrists, with an average age of 47 years at surgery and a mean follow up of 42 months were examined. The PRC group consisted of 30 patients, seven SLAC- and 23 SNAC-wrists, with an average age of 39 years at surgery and a mean follow up of 27 months. Active range of motion (AROM) was verified with a goniometer, grip strength was measured with a JAMAR-Dynamometer II. Pain was evaluated by a visual analogue scale from zero to 100 (VAS 0-100) under resting and stress conditions. Patients' upper extremity disability was measured with the DASH questionnaire. Radiographic evaluation was carried out by conventional X-ray to verify bony consolidation. Mean values of postoperative AROM in extension/flexion was 61 degrees in MCA, and 75 degrees in PRC patients; radial/ulnar deviation was 32 degrees and 33 degrees, respectively. Mean DASH-score was 21 in the MCA and 25 in the PRC group. Pain relief was 54% in MCA and 77% in PRC during resting conditions and 22% and 42% during stress conditions. Static grip strength was significantly higher following MCA than PRC (72% to 50%). Among both the MCA and PRC groups three patients required further treatment with total arthrodesis due to persisting pain or absence of bony consolidation. Our

  13. Plating, nailing, external fixation, and fibular strut grafting for non-union of humeral shaft fractures. (United States)

    Padhye, Kedar P; Kulkarni, Vidhisha S; Kulkarni, G S; Kulkarni, Milind G; Kulkarni, Sunil; Kulkarni, Ruta; Patil, Mayur D; Ravi, Priyanka Y


    To compare various treatment modalities (plating, Ilizarov external fixation, and non-vascular fibular cortical strut grafting) for non-union of humeral shaft fractures. Records of 9 women and 26 men aged 24 to 71 (mean, 42) years who presented with non-union of humeral shaft fractures were reviewed. The humeral shaft fractures were secondary to low-energy trauma (n=22) or vehicular accidents (n=13) and involved the proximal (n=9), middle (n=15), and distal (n=11) regions. 13 of the fractures were open. Infection was evident in 8 of the non-unions. For non-unions with infection (n=8), a 2-stage procedure entailing temporary Ilizarov fixation followed by plating was used. For non-unions without infection (n=23), one-stage plating and cancellous bone grafting was used. For non-unions of osteoporotic bone (n=4), one-stage non-vascularised fibular strut grafting was used. Outcome was measured using the Disabilities of the Arm, Shoulder and Hand (DASH) scoring system. The 35 patients were followed up for a mean of 16 (range, 6-60) months. All achieved bone union except for one (who had persistent infection). Respectively for non-unions with infection, nonunions without infection, and non-unions of osteoporotic bone, the mean times to bone union were 6.5 (range, 4-10), 5 (range, 4-8), and 10 (range, 6-14) months, the mean improvement in DASH score was 30, 43, and 18, and malalignment was noted in 5, 2, and one patient. Three patients had a preoperative radial nerve palsy for which standard tendon transfer was performed 6 weeks after treatment for non-union. Compression plating achieved the best results. An external fixator may be used temporarily for infected non-unions. Fibular strut grafting may be used when non-unions warrant additional stability.

  14. Hypertrophic Nonunion Humerus Mimicking an Enchondroma

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    N. K. Magu


    Full Text Available Introduction. Although fractures of humeral shaft show excellent results with conservative management, nonunion does occur. Case Report. We bring forth the case of a young male with a 1.5-year-old hypertrophic nonunion of the humerus mimicking an enchondroma. The initial X-ray images of the patient appeared to be an enchondroma, which only on further evaluation and histopathological analysis was diagnosed conclusively to be a hypertrophic nonunion. Discussion. Enchondromas are often incidentally diagnosed benign tumours. It is however not common to misdiagnose a hypertrophic nonunion to be an enchondroma. We present this case to highlight the unique diagnostic dilemma the treating team had to face.

  15. Tibia shaft fractures: costly burden of nonunions

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    Antonova Evgeniya


    Full Text Available Abstract Background Tibia shaft fractures (TSF are common for men and women and cause substantial morbidity, healthcare use, and costs. The impact of nonunions on healthcare use and costs is poorly described. Our goal was to investigate patient characteristics and healthcare use and costs associated with TSF in patients with and without nonunion. Methods We retrospectively analyzed medical claims in large U.S. managed care claims databases (Thomson Reuters MarketScan®, 16 million lives. We studied patients ≥ 18 years old with a TSF diagnosis (ICD-9 codes: 823.20, 823.22, 823.30, 823.32 in 2006 with continuous pharmaceutical and medical benefit enrollment 1 year prior and 2 years post-fracture. Nonunion was defined by ICD-9 code 733.82 (after the TSF date. Results Among the 853 patients with TSF, 99 (12% had nonunion. Patients with nonunion had more comorbidities (30 vs. 21, pre-fracture and were more likely to have their TSF open (87% vs. 70% than those without nonunion. Patients with nonunion were more likely to have additional fractures during the 2-year follow-up (of lower limb [88.9% vs. 69.5%, P  Conclusions Nonunions in TSF’s are associated with substantial healthcare resource use, common use of strong opioids, and high per-patient costs. Open fractures are associated with higher likelihood of nonunion than closed ones. Effective screening of nonunion risk may decrease this morbidity and subsequent healthcare resource use and costs.

  16. Non-union in forearm fractures

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    Jayakumar, P; Jupiter, J B


    Non-union in forearm fractures is an uncommon but complex problem. This is especially given the unique anatomical structure and function of the forearm, making treatment distinctly different to that of other long bone fractures...

  17. Treatment of nonunion in neglected long bone shaft fractures by osteoperiosteal decortication. (United States)

    Tall, M; Bonkoungou, D; Sawadogo, M; Da, S C; Toe, M F


    In emerging countries, nonunion in the shaft of fractured long bones is common. In a 3-year long prospective study, 50 patients (38 men, 12 women) with an average age of 40.9 years (range 17-60) were treated for neglected diaphyseal nonunion an average of 11 months (range 6-48) after the fracture event. The femur was involved 14 times, tibia 22 times, humerus eight times and forearm bones six times. All of these patients had consulted initially with a traditional bone setter at the time of fracture. The surgical procedure consisted of osteoperiosteal decortication followed by repermeabilization of the medullary canal and then internal fixation. Compression plating was used for the humerus, radius and ulna. Nonunion of the middle-third of the femur and tibia was treated by intramedullary nailing and nonunion of the proximal third of the femur with an inverted DCS screw-plate. Patients were reviewed clinically and with X-rays on postoperative days 21, 45, 90 and 120. Bone union was obtained in under 90 days in the upper limb and under 120 days in the lower limb. No additional grafting was needed. There were only two cases of leg length differences. Osteoperiosteal decortication is a reliable technique that leads to predictable, satisfactory results, given the limited materials required to treat long bone nonunion in emerging countries. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. Surgical Technique: Treatment of Distal Humerus Nonunions. (United States)

    Donders, Johanna C E; Lorich, Dean G; Helfet, David L; Kloen, Peter


    Open reduction and internal fixation of distal humerus fractures is standard of care with good to excellent outcome for most patients. However, nonunions of the distal humerus still occur. These are severely disabling problems for the patient and a challenge for the treating physician. Fortunately, a combination of standard nonunion techniques with new plate designs and fixation methods allow even the most challenging distal humeral nonunion to be treated successfully. The purpose of this manuscript is to describe our current technique in treating distal humeral nonunion as it has evolved over the last four decades. We have now follow-up on 62 treated patients. A few key steps are essential to obtain bone healing while regaining or preserving elbow motion. These include careful planning, extensile exposure, release of the ulnar nerve, capsular release and mobilization of the distal fragment, debridement, and finally stable fixation after alignment with application of bone graft. The vast majority of distal humeral nonunions can be treated successfully with open reduction and internal fixation. Important components of the treatment plan are careful preoperative planning, extensile approach, debridement, and solid fixation with-locking-plates and liberal use of bone graft.

  19. Non-Union Current Treatment Concept

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    Arash Moghaddam


    Full Text Available Context: This article wants to give a current concept for the challenging decision for conservative or operative treatment strategies of non-unions according to the principles of ‘diamond concept’ and aspects that have to be attended. Evidence Acquisition: Between February 2010 and March 2014, 424 patients with non-unions were treated at Heidelberg university hospital. This database has been analyzed at least one year after the treatment. The analysis and the experience in surgery and treatment of non-unions as well as present literature were prepared for this review as a current concept. Results: If an atrophic non-union is suggested, reosteosynthesis and biological stimulation is required. A revision surgery of autologous transplantation of cancellous bone from the iliac crest is often enough. Alternatively, reamer-irrigator-aspirator (RIA can be taken out of the femur with lower complications and pain in the extraction area and be combined with growth factors like bone morphogenetic proteins (BMPs, if consolidation after cancellous bone is still absent. In complex cases, consequential and radical removal of the infection often improved circulation through interventional angiography and use of the two-step procedure (the Masquelet technique as well as a tissue covering are required. Conclusions: By using the ‘diamond concept’ as a complex concept, non-unions can be treated in different stages in a targeted manner.

  20. Outcome of management of humerus diaphysis non-union | Sitati ...

    African Journals Online (AJOL)

    Background: The majority of diaphyseal humerus fractures heal uneventfully when treated nonoperatively, however, nonunion is not a rare event. Nonunion after conservative treatment can be successfully treated by open reduction and internal fixation. A nonunion of a diaphyseal fracture of the humerus can present a ...

  1. Labor law for the nonunion agency. (United States)

    Gilliland, J C


    Providers should not assume that because they are union free they need not worry about labor law. An agency can have obligations under labor laws even when no union is involved. Who are nonunion employees, legally speaking? What rights do they have, and how can agencies ensure that they are in compliance with those rights?

  2. Wage determination in the union and nonunion sectors. (United States)

    Bloch, F E; Kuskin, M S


    This study contains estimates of wage equations for white male union and nonunion employees. The authors find that nonunion wages are generally more responsive than union wages to individuals' education and experience and to regional price-level variation. Despite those differences, however, estimates of union-nonunion wage differentials based on these separate equations do not differ greatly from a differential obtained from a union dummy variable in an equation based on combined union and nonunion observations. Union-nonunion differentials vary widely across occupational groups and are generally larger in the lower skilled and more highly unionized occupations. The results for manufacturing, for which additional industry data are available, indicate a negative impact of high concentration ratios on the wages of all workers and a greater impact of establishment size on nonunion than on union wages. Data were drawn from the May 1973 Current Population Survey.

  3. Recalcitrant aseptic atrophic non-union of the shaft of the humerus after failure of surgical treatment: management by excision of non-union, bone grafting and stabilization by LCP in different modes. (United States)

    Babhulkar, Sudhir; Babhulkar, Sushrut; Vasudev, Aditya


    Non-union of the humeral shaft is infrequently noticed after surgical fixation. Sixty eight patients whose osteosynthesis of humeral shaft had failed leading to non-union were identified over a duration of 10 years from (January 2006 to December 2015). Clinical and radiographical follow-up was available for 64 patients (4 patients were lost for follow-up), with a mean age of 58 years (range 25-78 years). All patients had aseptic atrophic non-union of either: proximal shaft (n=12), mid shaft (n=38), and lower shaft (n=14). All these patients had failure of primary fixation, with a minimum duration from 36 to 110 weeks. Non-unions were operated by excision of non-union, autogenous bone grafting and osteosynthesis by locking compression plating. Adequate fixation of non-union with bone grafting was achieved in all patients. All non-unions healed well at an average of 16 weeks (range 6-36 weeks). The mean length of follow-up was 120 weeks (range 60-250 weeks). The mean range of movements following healing of non-union was forward flexion of 140°, external rotation and internal rotation of 30° at shoulder and average fixed flexion deformity of 10° and flexion of 130° at elbow. Two patients had postoperative radial nerve palsy because of neuropraxia, which recovered in eight weeks. Three patient developed superficial infections at the iliac crest, which settled with antibiotics, dressings in 3 weeks time and two patients had some discomfort over the fibular graft harvest site. In all patients complete clinical and radiological union was achieved with satisfactory outcome in terms of relief of symptoms and functional improvement in the range of movements. The main points in surgical treatment were complete excision of non-union, correction of deformity, use of plenty of corticocancellous graft, furthermore the use of intramedullary fibula and osteosynthesis by long locking compression plating in different modes of fixation provided good to excellent results and

  4. Outcome of Management of Humerus Diaphysis Non-union This ...

    African Journals Online (AJOL)


    Nonunion after conservative treatment can be successfully treated by open reduction and internal fixation. A nonunion of a diaphyseal fracture of the humerus can present a major functional problem. The main of our study was to document the outcome of management of non united diaphyseal humerus fractures with plate ...

  5. Extracorporeal Shock Wave Therapy for Nonunion of the Tibia (United States)


    well-perfused bone ends demonstrating abundant callus formation but inadequate mechanical stability. Atrophic nonunions were those with impaired...osseous biology evident as diminished callus formation or osteopenia on radiographs. Infected nonunions were defined by clinical presentation (fever...variables assessed included callus presence and size, bony trabecular bridging, and progressive opacification of the fracture line. Successful

  6. What is the Optimal Treatment of Atrophic Scaphoid Non-Union?

    Directory of Open Access Journals (Sweden)

    Alper Cirakli


    Full Text Available Aim: To evaluate the efficacy of the treatment method of autogenous iliac wing or radius bone graft and fixation with screw applied to cases of scaphoid non-union. Material and Method: A retrospective evaluation was made of 89 cases between 2000 and 2014. Postoperative measurements were taken of both wrists%u2019 movement with a goniometer and muscle strength was assessed with a dynamometer. Fractures were evaluated radiologically according to the Herbert-Fisher System and the functional results according to the Herbert-Fisher Classification System and the Mayo Clinic Modified Wrist Scoring System. The data were input to the SPSS system and evaluated with the Shapiro-Wilk test. Results: Non-union were on the right side in 47 and the left side in 42 cases. The fracture was seen to be in the waist in 60 cases (67.5%, in the proximal third in 27 cases (30.3% and in the distal third in two cases (2.2%. The mean follow-up period was 16.4 months (range, 5-72 months. Definitive findings of union were observed in 71 cases. The mean time to union was 14.9 weeks (range, 8-40 weeks. Discussion: The grafting procedure applied is an invasive technique but if it is considered that there are negative effects of open surgery on the feeding of the scaphoid bone, then in the treatment of scaphoid non-union which is atrophic non-union, ultimately autogenous bone grafting and screw fixation is a safe and successful method and because of the pain created by an iliac wing graft, radius distal bone graft can be considered more appropriate.

  7. Nonunion of forearm fracture: a rare instance in a toddler

    Directory of Open Access Journals (Sweden)

    Saini Pramod


    Full Text Available 【Abstract】 When compared to adults, pediatric frac-tures unite readily and nonunion is quite rare. Nonunion is often associated with open fractures, operative interventions, infection, pediatric osteogenesis imperfecta and neurofibromatosis. There are only a few studies and reports mentioning nonunion following conservative ma-nagement of closed pediatric fractures. We report here a case of an eighteen-month-old child who developed non-union following treatment of fracture of both forearm bones with cast and was successfully treated with plating. To the best of our knowledge, this is the youngest reported case of nonunion following conservative management of closed diaphyseal pediatric fracture. Key words: Forearm; Fractures, bone; Child

  8. Complications in proximal humeral fractures. (United States)

    Calori, Giorgio Maria; Colombo, Massimiliano; Bucci, Miguel Simon; Fadigati, Piero; Colombo, Alessandra Ines Maria; Mazzola, Simone; Cefalo, Vittorio; Mazza, Emilio


    Necrosis of the humeral head, infections and non-unions are among the most dangerous and difficult-to-treat complications of proximal humeral fractures. The aim of this work was to analyse in detail non-unions and post-traumatic bone defects and to suggest an algorithm of care. Treatment options are based not only on the radiological frame, but also according to a detailed analysis of the patient, who is classified using a risk factor analysis. This method enables the surgeon to choose the most suitable treatment for the patient, thereby facilitating return of function in the shortest possible time. The treatment of such serious complications requires the surgeon to be knowledgeable about the following possible solutions: increased mechanical stability; biological stimulation; and reconstructive techniques in two steps, with application of biotechnologies and prosthetic substitution. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Design and Clinical Application of Proximal Humerus Memory Connector (United States)

    Xu, Shuo-Gui; Zhang, Chun-Cai


    Treatment for comminuted proximal humerus fractures and nonunions are a substantial challenge for orthopedic surgeons. Plate and screw fixation does not provide enough stability to allow patients to begin functional exercises early after surgery. Using shape memory material nickel titanium alloy, we designed a new device for treating severe comminuted proximal humerus fractures that accommodates for the anatomical features of the proximal humerus. Twenty-two cases of comminuted fracture, malunion, and nonunion of the proximal humerus were treated with the proximal humeral memory connector (PHMC). No external fixation was needed after the operation and patients began active shoulder exercises an average of 8 days after the operation. Follow-up evaluation (mean 18.5 months) revealed that bone healing with lamellar bone formation occurred an average of 3.6 months after surgery for the fracture cases and 4.5 months after surgery for the nonunion cases. Average shoulder function was 88.5 according to the criteria of Michael Reese. PHMC is an effective new device to treat comminuted proximal humerus fractures and nonunions. The use of this device may reduce the need for shoulder joint arthroplasty.

  10. Early Revision Surgery for Tibial Plateau Non-union and Mal-union. (United States)

    Van Nielen, Dominic L; Smith, Christopher S; Helfet, David L; Kloen, Peter


    Although relatively rare, non-unions and mal-unions of tibial plateau fractures present significant challenges for the orthopedic surgeon. With careful pre-operative planning, tibial plateau mal-union or non-union revision surgery with intra-articular and varus opening osteotomies can provides good functional results when performed early (within 1 year) after primary surgical procedure. We present our treatment algorithm for approaching and treating non-union or mal-union of tibial plateau fractures. Our aim is to give surgeons treating these difficult injuries an overview of the pertinent literature as well as describe the challenges and pitfalls we have experienced when treating non-union or mal-union of tibial plateau fractures. Using two case examples from our institution, one for mal-union and one for mal-reduction, we describe our treatment algorithm and surgical technique for managing these difficult injuries. We also provide a brief literature review outlining relevant studies and summarizing outcomes for similar injuries. A systematic literature review was conducted with the aim of determining the methods and outcomes commonly reported in the literature regarding revision surgery following tibial plateau non-union or mal-union. Due to the nature of revision surgery, there are no long-term randomized trials dealing with outcomes, but rather several smaller case series exist from which larger conclusions have to be drawn. To date, we have successfully treated approximately 35 patients with this technique, and clinical follow-up continues to show good functional outcomes with reduced pain and little radiographic evidence of arthritic changes. Restoring long leg alignment, anatomic reduction of the articular surface, and achieving stable internal fixation are paramount in achieving the best long-term outcome. Due to the shallow soft tissue envelope around the proximal tibia, and the tendency for these fractures to fall into progressive valgus collapse, these

  11. Osteonecrosis of the femoral head, nonunion and potential risk factors in Pauwels grade-3 femoral neck fractures: A retrospective cohort study. (United States)

    Zhang, Yue-Lei; Chen, Song; Ai, Zi-Sheng; Gao, You-Shui; Mei, Jiong; Zhang, Chang-Qing


    The present study was to analyze clinical outcome of Pauwels grade-3 femoral neck fractures treated by different surgical techniques. Potential risk factors associated with nonunion and osteonecrosis of the femoral head (ONFH) were investigated as well. The retrospective study comprised of 67 sequential patients treated between January 2008 and December 2011. Patients with Pauwels grade-3 femoral neck fractures were treated by operative reduction and internal fixation. Cannulated screws (CS) were used in 46 patients, dynamic hip screw plus CS (DHS+CS) in 14, and locking compression plate (LCP) for proximal femur in 7. Reduction quality was assessed according to Haidukewych criteria. Postoperative radiographic examinations were conducted to observe fracture healing. Fracture displacement, comminution, fashion of internal fixation, and the sliding effect were analyzed, regarding the incidence of nonunion and ONFH. All patients had a follow-up of 21.6 ± 6.0 months on average. The phenomenon of sliding effect was observed in 16 cases (23.9%). In terms of reduction quality, 64 cases were graded as excellent, 2 were good, and 1 was poor. ONFH was presented in 15 cases (22.4%) and nonunion was found in 8 (11.9%), with 1 patient had ONFH and nonunion concomitantly. Profound hip contour was preserved in 45 cases (67.2%). The fashion of internal fixation yielded different results regarding ONFH and nonunion, whereas the effects of fracture displacement, comminution, and the sliding effect were not significant. ONFH and nonunion were common complications following Pauwels grade-3 femoral neck fractures. Higher incidence of ONFH in DHS+CS and of nonunion in the LCP group should be noted.

  12. Effectiveness of plate augmentation for femoral shaft nonunion after nailing

    Directory of Open Access Journals (Sweden)

    Chin-Jung Lin


    Conclusion: Plate augmentation with retention of the nail with autologous bone grafting may be an effective and reliable alternative in treating nonunion of the femoral shaft fracture after open reduction and internal fixation with intramedullary nail.

  13. Three-stage treatment protocol for recalcitrant distal femoral nonunion. (United States)

    Ma, Ching-Hou; Chiu, Yen-Chun; Tu, Yuan-Kun; Yen, Cheng-Yo; Wu, Chin-Hsien


    In this study, we proposed a three-stage treatment protocol for recalcitrant distal femoral nonunion and aimed to analyze the clinical results. We retrospective reviewed 12 consecutive patients with recalcitrant distal femoral nonunion undergoing our three-stage treatment protocol from January 2010 to December 2014 in our institute. The three-stage treatment protocol comprised debridement of the nonunion site, lengthening to eliminate leg length discrepancy, deformity correction, stabilization with a locked plate, filling of the defect with cement spacer for inducing membrane formation, and bone reconstruction using a cancellous bone autograft (Masquelet technique) or free vascularized fibular bone graft. The bone union time, wound complication, lower limbs alignment, amount of lengthening, knee range of motion, and functional outcomes were evaluated. Osseous union with angular deformity current study involved only a small number of patients and the intervention comprised three stages, we believe that such a protocol may be a valuable alternative for the treatment of recalcitrant distal femoral nonunion.

  14. Nonunion of acetabular fractures: evaluation with interactive multiplanar CT

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    Kuhlman, J.E.; Fishman, E.K.; Ney, D.R.; Brooker, A.F. Jr.; Magid, D.


    Nonunions involving fractures of the acetabulum are reportedly rare, with few citings and little discussion in the literature. It is possible that acetabular nonunions go undetected because imaging of the acetabulum is difficult by conventional radiography. We report two cases of fracture nonunion involving the weight-bearing surface of the acetabulum diagnosed with the aid of computed tomography (CT) and a newly developed interactive 2D/3D orthotool that uniquely processes and reformats routine CT data. The interactive 2D/3D orthotool is a sophisticated computer program that allows dynamic viewing of standard multiplanar reconstructions in the axial, coronal, and sagittal planes as well as multiple oblique projections. The 2D/3D orthotool provides on screen correlation of two-dimensional multiplanar images with three-dimensional reconstructions of the pelvis. The authors found this capability ideally suited for studying fractures with off-axis orientation such as those through the acetabular dome, greatly facilitating the diagnosis of nonunion.

  15. Risk factors for nonunion in patients with intracapsular femoral neck fractures treated with three cannulated screws placed in either a triangle or an inverted triangle configuration. (United States)

    Yang, Jui-Jung; Lin, Leou-Chyr; Chao, Kuo-Hua; Chuang, Shih-Youeng; Wu, Chia-Chun; Yeh, Tsu-Te; Lian, Yu-Tung


    Intracapsular femoral neck fractures are associated with high rates of nonunion. We aimed to identify risk factors for nonunion in patients with both displaced and nondisplaced intracapsular femoral neck fractures treated with three 7-mm parallel cannulated screws, placed in either a triangle or an inverted triangle configuration, using failure of fixation as the primary outcome. Clinical and radiographic data for patients with intracapsular femoral neck fractures treated with either triangle fixation (one proximal screw and two distal screws) or inverted triangle fixation (two proximal screws and one distal screw), between January 1, 2000, and July 30, 2009, were analyzed. A total of 202 patients, seventy-six men and 126 women with an average age (and standard deviation) of 64.53 ± 15.81 years (range, nineteen to ninety-three years), were included in the analysis. Union occurred in 158 patients, and nonunion occurred in forty-four. There were no differences between the union and nonunion groups with respect to age, sex, fracture side, fracture angle, fracture level, or estimated bone density. There were significant differences in fracture type, fixation configuration, reduction quality, and screw-tip subchondral purchase between patients with and without union. The estimated odds ratio for fracture nonunion was 2.93 (95% confidence interval [CI], 1.08, 7.96) in subjects with displaced fractures compared with those without displaced fractures (p = 0.035), 18.92 (95% CI, 1.91, 187.09) in subjects with borderline and unacceptable reduction compared with those with anatomic reduction (p = 0.012), and 2.92 (95% CI, 1.27, 6.69) for internal fixation with a triangle configuration compared with fixation with an inverted triangle configuration (p = 0.010). Screw fixation with a triangle configuration, a displaced fracture, and poor reduction are risk factors for nonunion in intracapsular femoral neck fractures treated with fixation with multiple screws.

  16. Repair of impact damaged utility poles with fiber reinforced polymers (FRP), phase II : [summary]. (United States)


    The aluminum and steel utility poles which support traffic signals, lighting, or mast-arm signs : are vulnerable to collisions from vehicles because of proximity to roadways. Removing these : poles for repair is costly and time-consuming, and removal...

  17. Surgical treatment of rib fracture nonunion: A single center experience. (United States)

    de Jong, M B; Houwert, R M; van Heerde, S; de Steenwinkel, M; Hietbrink, F; Leenen, L P H


    In contrast to the emerging evidence on the operative treatment of flail chest, there is a paucity of literature on the surgical treatment of rib fracture nonunion. The purpose of this study was to describe our standardized approach and report the outcome (e.g. patient satisfaction, pain and complications) after surgical treatment of a rib fracture nonunion. A single centre retrospective cohort study was performed at a level 1 trauma centre. Symptomatic rib nonunion was defined as a severe persistent localized pain associated with the nonunion of one or more rib fractures on a chest CT scan at least 3 months after the initial trauma. Patients after initial operative treatment of rib fractures were excluded. Nineteen patients (11 men, 8 women), with symptomatic nonunions were included. Fourteen patients were referred from other hospitals and 8 patients received treatment from a pain medicine specialist. The mean follow-up was 36 months. No in-hospital complications were observed. In 2 patients, new fractures adjacent to the implant, without new trauma were observed. Furthermore 3 patients requested implant removal with a persistent nonunion in one patient. There was a mean follow-up of 36 months, the majority of patients (n = 13) were satisfied with the results of their surgical treatment and all patients experienced a reduction in the number of complaints. Persisting pain was a common complaint. Three patients reporting severe pain used opioid analgesics on a daily or weekly basis. Only 1 patient needed ongoing treatment by a pain medicine specialist. Surgical fixation of symptomatic rib nonunion is a safe and feasible procedure, with a low perioperative complication rate, and might be beneficial in selected symptomatic patients in the future. In our study, although the majority of patients were satisfied and the pain level subjectively decreases, complaints of persistent pain were common. Copyright © 2018. Published by Elsevier Ltd.

  18. Epidemiology of Fracture Nonunion in 18 Human Bones. (United States)

    Zura, Robert; Xiong, Ze; Einhorn, Thomas; Watson, J Tracy; Ostrum, Robert F; Prayson, Michael J; Della Rocca, Gregory J; Mehta, Samir; McKinley, Todd; Wang, Zhe; Steen, R Grant


    Failure of bone fracture healing occurs in 5% to 10% of all patients. Nonunion risk is associated with the severity of injury and with the surgical treatment technique, yet progression to nonunion is not fully explained by these risk factors. To test a hypothesis that fracture characteristics and patient-related risk factors assessable by the clinician at patient presentation can indicate the probability of fracture nonunion. An inception cohort study in a large payer database of patients with fracture in the United States was conducted using patient-level health claims for medical and drug expenses compiled for approximately 90.1 million patients in calendar year 2011. The final database collated demographic descriptors, treatment procedures as per Current Procedural Terminology codes; comorbidities as per International Classification of Diseases, Ninth Revision codes; and drug prescriptions as per National Drug Code Directory codes. Logistic regression was used to calculate odds ratios (ORs) for variables associated with nonunion. Data analysis was performed from January 1, 2011, to December 31, 2012. Continuous enrollment in the database was required for 12 months after fracture to allow sufficient time to capture a nonunion diagnosis. The final analysis of 309 330 fractures in 18 bones included 178 952 women (57.9%); mean (SD) age was 44.48 (13.68) years. The nonunion rate was 4.9%. Elevated nonunion risk was associated with severe fracture (eg, open fracture, multiple fractures), high body mass index, smoking, and alcoholism. Women experienced more fractures, but men were more prone to nonunion. The nonunion rate also varied with fracture location: scaphoid, tibia plus fibula, and femur were most likely to be nonunion. The ORs for nonunion fractures were significantly increased for risk factors, including number of fractures (OR, 2.65; 95% CI, 2.34-2.99), use of nonsteroidal anti-inflammatory drugs plus opioids (OR, 1.84; 95% CI, 1.73-1.95), operative

  19. Bovine xenograft application for treatment of a metatarsal nonunion fracture in an alpaca (Vicugna pacos). (United States)

    Longo, F; Finotti, L; Bellini, L; Zavan, B; Busetto, R; Isola, M


    A 15-year-old female huacaya alpaca (Vicugna pacos) was referred because of a non-weight-bearing lameness (4/4) in the left pelvic limb caused by a grade three open metatarsal fracture. The referring veterinarian treated the fracture with conservative management using bandages, but it progressively evolved to a non-union. Clinical examination revealed external wounds on the medial and lateral surfaces of the metatarsus. Radiographs confirmed an open, nonarticular, displaced, diaphyseal fracture of the left metatarsus. Cancellous bone was sourced from bovine proximal and distal femur epiphyses, followed by a thermal shock procedure to achieve decellularisation, to produce a xenograft. Open reduction and internal fixation of the fracture using locking plates was performed. Alignment of the fracture fragments was corrected and the xenograft was placed at the debrided fracture site to stimulate and harness osteogenesis in situ. Clinical and radiographic follow-up was performed up to 40 weeks postoperatively. Clinical evaluations revealed that the alpaca gradually increased weight bearing following bandage removal 10 days after surgery. Serial radiographs showed correct alignment of the left metatarsus, progressive bone modelling and, complete bone union at 12 weeks. Ten months postoperatively the alpaca showed no signs of lameness and resumed normal activity. For management of a metatarsal non-union, a combination of bovine xenograft application and angular stable internal fixation progressed toward an excellent long-term recovery.

  20. Stress Fracture and Nonunion of Coronoid Process in a Gymnast

    Directory of Open Access Journals (Sweden)

    T. Hetling


    Full Text Available Background. Gymnasts have high mechanical loading forces of up to 14 times body weight. Overuse lesions are typical in wrists and stress fractures in the olecranon, while isolated fractures of the coronoid process are uncommon. We present a case of retraumatized nonunion stress fracture of the ulnar coronoid process. Case Description. A 19-year-old gymnast presented with elbow pain after training. Imaging confirmed an old fracture of the coronoid process. We describe a 6-month multiphase return to competition rehabilitation program, which allowed him to compete pain-freely. Literature Review. Acute and overuse injuries in gymnasts are known but no nonunion of the coronoid process has been described before. Only one case of stress fracture of coronoid process in a gymnast was reported. Purpose and Clinical Relevance. We could successfully and conservatively return to sport a reactivated nonunion of a stress fracture of the coronoid process.

  1. Risk profile of patients developing nonunion of the clavicle and outcome of treatment

    DEFF Research Database (Denmark)

    Ban, Ilija; Troelsen, Anders


    PURPOSE: The most common complication following treatment of a clavicle fracture is nonunion. Most nonunions are symptomatic and treatment is mostly operative. The aim of this study was to describe risk profiles of patients developing nonunion and what outcome is observed following operative...... treatment of clavicle nonunions. METHODS: In a consecutive series of 729 clavicle fractures we retrospectively identified 55 that developed nonunion (49 diaphysial and six lateral). All were treated operatively by reconstruction with (n = 28) or without (n = 27) autologous bone graft. Assessment...... of functionality and patient reported satisfaction and remission of symptoms was done a minimum of six months post-operatively by mail. Response rate was 60%. RESULTS: The overall nonunion rate was 7.5%. Nine nonunions were initially treated operatively. Risk factors associated with nonunion of our series...

  2. A unified theory of bone healing and nonunion: BHN theory. (United States)

    Elliott, D S; Newman, K J H; Forward, D P; Hahn, D M; Ollivere, B; Kojima, K; Handley, R; Rossiter, N D; Wixted, J J; Smith, R M; Moran, C G


    This article presents a unified clinical theory that links established facts about the physiology of bone and homeostasis, with those involved in the healing of fractures and the development of nonunion. The key to this theory is the concept that the tissue that forms in and around a fracture should be considered a specific functional entity. This 'bone-healing unit' produces a physiological response to its biological and mechanical environment, which leads to the normal healing of bone. This tissue responds to mechanical forces and functions according to Wolff's law, Perren's strain theory and Frost's concept of the "mechanostat". In response to the local mechanical environment, the bone-healing unit normally changes with time, producing different tissues that can tolerate various levels of strain. The normal result is the formation of bone that bridges the fracture - healing by callus. Nonunion occurs when the bone-healing unit fails either due to mechanical or biological problems or a combination of both. In clinical practice, the majority of nonunions are due to mechanical problems with instability, resulting in too much strain at the fracture site. In most nonunions, there is an intact bone-healing unit. We suggest that this maintains its biological potential to heal, but fails to function due to the mechanical conditions. The theory predicts the healing pattern of multifragmentary fractures and the observed morphological characteristics of different nonunions. It suggests that the majority of nonunions will heal if the correct mechanical environment is produced by surgery, without the need for biological adjuncts such as autologous bone graft. Cite this article: Bone Joint J 2016;98-B:884-91. ©2016 The British Editorial Society of Bone & Joint Surgery.

  3. [The acetabulum nonunion: reconstruction and reosteosynthesis : A long-term outcome]. (United States)

    Pluemer, J; Kruppa, C; Yilmaz, E; Schildhauer, T A; Dudda, M


    Acetabular nonunions are rare, especially after operative treatment of an acetabular fracture. There are only single reports of the reconstruction and therapy of acetabular nonunion. Furthermore, there are fewer reports for treatment of acetabular nonunion with a long follow-up. We report a successful revision of an acetabular nonunion after transversal fracture and previous operative intervention, as well as the long-term follow-up after revision surgery.

  4. Salvage of humeral nonunions with onlay bone plate allograft augmentation. (United States)

    Hornicek, F J; Zych, G A; Hutson, J J; Malinin, T I


    Eight women and one man were treated for 10 established diaphyseal humeral nonunions. Six patients sustained fractures in motor vehicle accidents and two patients sustained fractures in a fall. Two of the fractures were open. One patient with multiple myeloma originally was treated conservatively and received local radiation, followed by open reduction and internal plate fixation. The other patients previously were treated with fracture braces, intramedullary nails, dynamic compression plates, or a combination of these techniques. After removal of the surgical hardware and fibrous tissue at the nonunion site, stable fixation was accomplished using a cortical long bone plate allograft (femoral and tibial) or fibular shaft allograft and a dynamic compression plate. All humeral nonunions had united at an average of 2.9 months. Radiographic incorporation of the allograft cortical bone plate and fibular shaft into the host cortex occurred in all but one patient by 3 months. Graft to host junction healing was accomplished by incorporation of the cortical allograft plate into the host cortex, resulting in an increased diameter of the bone. Cortical allograft bone plates and fibular grafts provide structural and probably osteoinductive support to enhance healing of these nonunions.

  5. Calcaneal nonunion: Three cases and a review of the literature

    NARCIS (Netherlands)

    T. Schepers (Tim); P. Patka (Peter)


    textabstractThe long-term follow-up of intra-articular calcaneal fractures is often accompanied by complications. Frequently occurring are arthrosis, arthrofibrosis of the subtalar joint, and malunion. Uncommon is the calcaneal nonunion. A total of three cases is presented in this report, including

  6. Treatment of Atrophic Nonunion - A Report of Two Cases | Omeonu ...

    African Journals Online (AJOL)

    METHOD: We report a series of two cases of atrophic nonunions of long bones resulting from long periods of limb immobilization in traditional splints successfully treated by Ilizarov compression technique. RESULT: Long periods of limb immobilization in traditional fracture treatment often result to regional osteoporosis and ...

  7. Deficiency of inducible and endothelial nitric oxide synthase results in diminished bone formation and delayed union and nonunion development. (United States)

    Meesters, D M; Neubert, S; Wijnands, K A P; Heyer, F L; Zeiter, S; Ito, K; Brink, P R G; Poeze, M


    Between 5% and 10% of all fractures fail to heal adequately resulting in nonunion of the fracture fragments. This can significantly decrease a patient's quality of life and create associated psychosocial and socio-economic problems. Nitric oxide (NO) and nitric oxide synthases (NOS) have been found to be involved in fracture healing, but until now it is not known if disturbances in these mechanisms play a role in nonunion and delayed union development. In this study, we explored the role of endothelial and inducible NOS deficiency in a delayed union model in mice. A 0.45mm femur osteotomy with periosteal cauterization followed by plate-screw osteosynthesis was performed in the left leg of 20-24week old wild type, Nos2(-/-) and Nos3(-/-) mice. Contralateral unfractured legs were used as a control. Callus volume was measured using micro-computed tomography (μCT) after 28 and 42days of fracture healing. Immuno histochemical myeloperoxidase (MPO) staining was performed on paraffin embedded sections to assess neutrophil influx in callus tissue and surrounding proximal and distal marrow cavities of the femur. After 7 and 28days of fracture healing, femurs were collected for amino acid and RNA analysis to study arginine-NO metabolism. With μCT, delayed union was observed in wild type animals, whereas in both Nos2(-/-) and Nos3(-/-) mice nonunion development was evident. Both knock-out strains also showed a significantly increased influx of MPO when compared with wild type mice. Concentrations of amino acids and expression of enzymes related to the arginine-NO metabolism were aberrant in NOS deficient mice when compared to contralateral control femurs and wild type samples. In the present study we show for the first time that the absence of nitric oxide synthases results in a disturbed arginine-NO metabolism and inadequate fracture healing with the transition of delayed union into a nonunion in mice after a femur osteotomy. Based on these data we suggest that the

  8. Lower pole stones

    DEFF Research Database (Denmark)

    Sanguedolce, Francesco; Breda, Alberto; Millan, Felix


    PURPOSE: To assess efficacy and safety of prone- and supine percutaneous nephrolithotomy (PCNL) for the treatment of lower pole kidney stones. METHODS: Data from patients affected by lower pole kidney stones and treated with PCNL between December 2005 and August 2010 were collected retrospectively...

  9. Management of diabetic neuropathic foot and ankle malunions and nonunions

    Directory of Open Access Journals (Sweden)

    John J. Stapleton


    Full Text Available The management of diabetic neuropathic foot and ankle malunions and/or nonunions is often complicated by the presence of broken or loosened hardware, Charcot joints, infection, osteomyelitis, avascular bone necrosis, unstable deformities, bone loss, disuse and pathologic osteopenia, and ulcerations. The author discusses a rational approach to functional limb salvage with various surgical techniques that are aimed at achieving anatomic alignment, long-term osseous stability, and adequate soft tissue coverage. Emphasis is placed on techniques to overcome the inherent challenges that are encountered when surgically managing a diabetic nonunion and/or malunion. Particular attention is directed to the management of deep infection and Charcot neuroarthropathy in the majority of the cases presented.

  10. [Diagnosis of the scaphoid bone : Fractures, nonunion, circulation, perfusion]. (United States)

    Kahl, T; Razny, F K; Benter, J P; Mutig, K; Hegenscheid, K; Mutze, S; Eisenschenk, A


    The clinical relevance of scaphoid bone fractures is reflected by their high incidence, accounting for approximately 60 % among carpal fractures and for 2-3 % of all fractures. With adequate therapy most scaphoid bone fractures heal completely without complications. Insufficient immobilization or undiagnosed fractures increase the risk of nonunion and the development of pseudarthrosis.X-ray examination enables initial diagnosis of scaphoid fracture in 70-80 % of cases. Positive clinical symptoms by negative x‑ray results require further diagnostics by multi-slice spiral CT (MSCT) or MRI to exclude or confirm a fracture. In addition to the diagnosis and description of fractures MSCT is helpful for determining the stage of nonunion. Contrast enhanced MRI is the best method to assess the vitality of scaphoid fragments.

  11. Sacral Fracture Nonunion Treated by Bone Grafting through a Posterior Approach

    Directory of Open Access Journals (Sweden)

    Sang Yang Lee


    Full Text Available Nonunion of a sacral fracture is a rare but serious clinical condition which can cause severe chronic pain, discomfort while sitting, and significant restriction of the level of activities. Fracture nonunions reportedly occur most often after nonoperative initial treatment or inappropriate operative treatment. We report a case of fracture nonunion of the sacrum and pubic rami that resulted from non-operative initial treatment, which was treated successfully using bone grafting through a posterior approach and CT-guided percutaneous iliosacral screw fixation combined with anterior external fixation. Although autologous bone grafting has been the gold standard for the treatment of pelvic fracture nonunions, little has been written describing the approach. We utilized a posterior approach for bone grafting, which could allow direct visualization of the nonunion site and preclude nerve root injury. By this procedure, we were able to obtain the healing of fracture nonunion, leading to pain relief and functional recovery.

  12. Union rate after operative treatment of humeral shaft nonunion - A systematic review

    NARCIS (Netherlands)

    Peters, Rinne; Claessen, Femke MAP; Doornberg, Job N.; Kolovich, Gregory P.; Diercks, Ronald; van den Bekerom, Michel P. J.


    Introduction: Humeral shaft nonunions can lead to morbidity from subsequent operations, complications and impaired function. Currently there is no evidenced-based consensus for treatment of humeral shaft nonunions. Aim: We aimed to summarize and analyze union rates and complications after operative

  13. Olecranon osteotomy for exposure of fractures and nonunions of the distal humerus. (United States)

    Ring, David; Gulotta, Lawrence; Chin, Kingsley; Jupiter, Jesse B


    Although olecranon osteotomy provides excellent exposure of the distal humerus, enthusiasm for this approach has been limited by reports suggesting numerous complications. It has been suggested that specific techniques for creating and repairing an olecranon osteotomy may help limit complications. This paper describes a technique for olecranon osteotomy using an apex, distal, chevron-shaped osteotomy, Kirschner wires directed out the anterior ulnar cortex distal to the coronoid process and bent 180degrees and impacted into the olecranon proximally, and two 22- gauge, figure-of-eight, stainless steel tension wires. A single surgeon used this technique for exposure of a fracture (16 patients) or nonunion (29 patients) of the distal humerus in 45 consecutive patients. One patient returned to activity too soon, had loosening of the wire fixation, and required a second operation for plate fixation of the ulna. The remaining 44 osteotomies (98%) healed with good alignment within 6 months. There were no broken or migrated wires prior to healing. Twelve patients (27%) had removal of the wires used to repair the olecranon: in 6 patients, this was for symptoms related to the wires (13%); 1 for septic olecranon bursitis, and 5 at the time of another procedure (elbow capsular release in 4 patients and submuscular ulnar nerve transposition in 1). Olecranon osteotomy can be used for exposure of the distal humerus with a low rate of complications when specific techniques are used.

  14. Neptune's 'Hot' South Pole (United States)


    These thermal images show a 'hot' south pole on the planet Neptune. These warmer temperatures provide an avenue for methane to escape out of the deep atmosphere. The images were obtained with the Very Large Telescope in Chile, using an imager/spectrometer for mid-infrared wavelengths on Sept. 1 and 2, 2006. The telescope is operated by the European Organization for Astronomical Research in the Southern Hemisphere (known as ESO). Scientists say Neptune's south pole is 'hotter' than anywhere else on the planet by about 10 degrees Celsius (50 degrees Fahrenheit). The average temperature on Neptune is about minus 200 degrees Celsius (minus 392 degrees Fahrenheit). The upper left image samples temperatures near the top of Neptune's troposphere (near 100 millibar pressure, which is one-tenth the Earth atmospheric pressure at sea level). The hottest temperatures are indicated at the lower part of the image, at Neptune's south pole (see the graphic at the upper right). The lower two images, taken 6.3 hours apart, sample temperatures at higher altitudes in Neptune's stratosphere. They do show generally warmer temperatures near, but not at, the south pole. They also show a distinct warm area which can be seen in the lower left image and rotated completely around the back of the planet and returned to the earth-facing hemisphere in the lower right image.

  15. Proximal Hypospadias (United States)

    Kraft, Kate H.; Shukla, Aseem R.; Canning, Douglas A.


    Hypospadias results from abnormal development of the penis that leaves the urethral meatus proximal to its normal glanular position. Meatal position may be located anywhere along the penile shaft, but more severe forms of hypospadias may have a urethral meatus located at the scrotum or perineum. The spectrum of abnormalities may also include ventral curvature of the penis, a dorsally redundant prepuce, and atrophic corpus spongiosum. Due to the severity of these abnormalities, proximal hypospadias often requires more extensive reconstruction in order to achieve an anatomically and functionally successful result. We review the spectrum of proximal hypospadias etiology, presentation, correction, and possible associated complications. PMID:21516286

  16. Indications and outcomes of augmentation plating with decortication and autogenous bone grafting for femoral shaft nonunions. (United States)

    Park, Jin; Yang, Kyu Hyun


    Though augmentation plating (AP) with decortication and bone grafting (BG) reportedly has excellent outcomes for femoral shaft nonunions, there are no established indications of AP with decortication and BG. The purpose of this study was to evaluate the results of AP with decortication and autogenous BG for femoral shaft nonunions, focussing on the indications of AP with decortication and BG. Thirty-nine patients treated with AP combined with decortication and BG for femoral shaft nonunions after femoral nail failure between November 1996 and October 2010 were retrospectively reviewed. Indications of AP with decortication and BG at the time of surgery and outcomes (bony union) were evaluated. The mean follow-up duration was 24.8 months (range 12-81 months). Thirty-eight (97%) of 39 femoral shaft nonunions achieved bony union. One incompliant patient showed screw breakage, which was healed uneventfully with subsequent cast application. The mean time to union was 6.1 months (range 3-16 months). Primary indications at the time of surgery were nonisthmal femoral nonunions in 17 patients, isthmal nonunions in 10 patients (cortical bone defect in five and widened canal in five), failed exchange nail in seven patients, nonunions with malrotation in two patients and difficult removal in three patients. AP with decortication and autogenous BG is a good option for nonisthmal femoral shaft nonunions, such as supra-isthmal and infra-isthmal nonunions. In addition, this option is useful for selected cases of isthmal femoral shaft nonunions in which failure of exchange nailing is expected due to lack of a tight fit between the new larger nail and femoral cortices. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. [Angle-stable intramedullary nailing of proximal humerus fractures with the PHN (proximal humeral nail)]. (United States)

    Blum, Jochen; Hansen, Matthias; Rommens, Pol Maria


    Stable fixation of two- and three-part fractures of the proximal humerus through minimally invasive operative technique and rapid bone healing as well as restoration of original anatomy. Early functional training with the goal of restoration of former mobility and daily activities. Unstabile two- and three-part fractures of the proximal humerus (AO classification: 11-A2, 11-A3, 11-B1, 11-B2, 11-B3). Subcapital nonunion of the humerus. Pathologic fractures. Pediatric fractures of the proximal humerus. Fractures of the proximal humerus types 11-C2 und 11-C3 according to the AO classification. Active local infection, e.g., after former operation. Closed reduction. Anterior acromial incision, splitting of the deltoid muscle and the rotator cuff. Opening of the medullary canal with the awl. Nail introduction. Spiral blade introduction in cannulated technique through stab incision. Distal interlocking through aiming device, angle-stable blocking of nail and blade through end cap. Postoperative fixation in Gilchrist sling until 2nd postoperative day; then physiotherapy respecting fracture type and stability, local swelling, patient's age and compliance, and concomitant injuries. 151 proximal humeral fractures were treated with a proximal humeral nail (PHN). 108 patients could be followed up 1 year postoperatively. Significant complications were perforation of the articular surface through bolts or blades (n = 8), implant-related pain (n = 10), fragment dislocation (n = 2), nonunion (n = 2), humeral head necrosis (n = 3), and superficial infection (n = 1). 1 year after the operation, the Constant-Murley Score showed a median value of 75.3 in the injured shoulder and of 89.9 in the uninjured shoulder. The DASH (Disability of the Arm, Shoulder and Hand) Score was 5.9 preoperatively and 9.3 at 1 year postoperatively. The worst results regarding the Constant-Murley Score as well as the DASH Score were found in C-type fractures.

  18. Rad Pole Cam Development

    Energy Technology Data Exchange (ETDEWEB)

    Heckendorn, F. M.; Odell, D. M. C; Harpring, L. J.; Peterson, K. D.


    The RadPoleCam was developed to provide Department Of Energy (DOE) first responders the capability to assess the radiological and visual condition of remote or inaccessible locations. Real time gamma isotopic identification is provided to the first responder in the form of audio feedback (i.e. spoken through head phones) from a gamma detector mounted on a collapsible pole that can extend from 1 to 9 meters (6 to 29 feet). Simultaneously, selectable direct and side looking visual images are provided from the 5cm (2in) diameter, waterproof probe tip. The lightweight, self contained, ruggedized, system will provide a rapidly deployable field system for visual and radiological search and assessment of confined spaces and extended reach locations.

  19. A new variant of scaphoid reconstruction: Treatment of scaphoid non-union with avascular bone interponate and high compression screw (Synthes

    Directory of Open Access Journals (Sweden)

    Eder, Christian


    Full Text Available Scaphoid fractures as frequently overseen injuries often result in scaphoid non-unions, that need to be treated to prevent carpal collapse and secondary cartilage damage. Vital bone tissue and compression of fracture and bone graft ends seem to be crucial in for ossification and final bone healing. In the present study we compare our results using a high compression screw (HCS Synthes to results in the literature using different kinds of internal fixation including compression screws of various types. We present 22 patients with scaphoid non-unions treated with a bone graft and a HCS Synthes. We evaluated our post-operative results. The Manchester-Modified Disability of the Shoulder, Arm and Hand–Score (M-Dash imposed with an average of 29.8 points (MD=29 / SD=9.46 / MIN=18 / MAX=48. None of the re-evaluated patients sorrowed for pain in rest. Five patients stated pain (ranging from 4 to 8 on numeric analogue scale after heavy burden (e.g. boxing, weight lifting.In exploring the range of motion of the operated hand we deliver the following results: dorsal extension: average 72.73° (MD=80° / SD=17.23° / MIN=30° / MAX=85°, flexion: average 73.64° (MD=80° / SD=8.97° / MIN=60° / MAX=80°, ulnar deviation: average 39.09°, (MD=40° / SD=2.02° / MIN=35° / MAX=40°, radial deviation: average 29.09°, (MD=30° / SD=3.01° / MIN=20° / MAX=30°. Additionally a performance testing was conducted: fist clenching sign: complete without pain in 100%, pinch grip: complete in 100%, moderate pain in n=1 (8.33%, opposition digitus manus I–V complete in 100%, moderate pain n=2 (16.67%. Three patients with persisting fracture gap had a scaphoid bone fractured in the proximal third; one patient even with a very small proximal fragment. One persisting non-union was localized in the middle third (period between injury and operation = . In conclusion, our patients showed better healing rates compared to results presented in the literature. Non-unions

  20. Use of bone marrow derived stem cells in a fracture non-union

    Directory of Open Access Journals (Sweden)

    Binod C. Raulo


    Full Text Available This is an attempt of using in vitro cultured mesenchymal stem cells (MSCs from bone marrow in joining of a fracture non-union. Bone marrow cells were obtained and differentially centrifuged for MSCs that were grown in vitro in mesenchymal stem cell basal medium aseptically, for 10 d. The cell mass was injected around the fracture non-union. Healthy conditions of development of tissue regeneration at the trauma site and due bone joining were recorded. It is concluded that in vitro cultured MSCs had a blithesome effect on the fracture non-union.

  1. Valgus sliding subtrochanteric osteotomy for neglected fractures of the proximal femur; surgical technique and a retrospective case series. (United States)

    Gavaskar, Ashok S; Chowdary, Naveen T


    Conventional technique of valgus osteotomy of the proximal femur involves removal of a partial or full thickness lateral based wedge from the peritrochanteric region. The purpose of this article is to describe a novel technique of valgus subtrochanteric osteotomy for proximal femur nonunion. 11 patients with proximal femur nonunions {intracapsular fractures--7, extracapsular fractures--4} were treated using a new technique of sliding subtrochanteric osteotomy and DHS fixation. Outcomes analysed include radiological outcome in terms of improvement in Pauwel's angle, neck-shaft angle and evidence of radiological union at the nonunion site and osteotomy site. Other outcomes analysed include, measurement of limb length discrepancy and functional outcome assessment with Oxford hip score. Union at the nonunion site and the osteotomy site was achieved in all patients. There were significant improvements in the postoperative Pauwel's angle, neck shaft angle and Oxford hip score. Limb length discrepancy improved to less than 1 cm in all patients. There was no x ray evidence of avascular necrosis of the femoral head at one year follow-up. The sliding osteotomy technique is simple, does not need extensive pre operative planning or removal of bone from the proximal femur.

  2. Wood pole overhead lines

    CERN Document Server

    Wareing, Brian


    This new book concentrates on the mechanical aspects of distribution wood pole lines, including live line working, environmental influences, climate change and international standards. Other topics include statutory requirements, safety, profiling, traditional and probabilistic design, weather loads, bare and covered conductors, different types of overhead systems, conductor choice, construction and maintenance. A section has also been devoted to the topic of lightning, which is one of the major sources of faults on overhead lines. The book focuses on the effects of this problem and the strate

  3. Assessment of the Use of Tourniquet in the Plating of Non-Union of ...

    African Journals Online (AJOL)

    union of the tibia have not been studied. Objective: This study was aimed at evaluating the appropriateness of using tourniquet in plating non-union of the tibia. Design: An interventional study. Setting: National Orthopaedic Hospital, Dala, Kano, ...

  4. Peri-prosthetic humeral non-union: Where biology meets bio-mechanic. A case report

    Directory of Open Access Journals (Sweden)

    Ciurlia Emanuele


    Conclusion: We assume that an aggressive revision surgery done with bone autograft implant and a bone healing therapy administering teriparatide off-label can reduce the convalescence in non-unions and can improve prognosis.

  5. Hypertrophic non-union of a pathological forearm fracture secondary to multiple myeloma: a case report

    Directory of Open Access Journals (Sweden)

    Okoro Tosan


    Full Text Available Abstract Skeletal lesions in multiple myeloma are predominantly lytic and when non-union of pathological fractures occur it is typically atrophic. We report a lady of 61 years of age with myeloma who presented with a pathological fracture through an ulnar myeloma deposit. The fracture was immobilised initially then irradiated. Nine months later she re-presented with marked forearm pain particularly on rotation. Radiographs demonstrated a hypertrophic non-union of a pathological fracture with a typical elephant's hoof appearance. The fracture was immobilised using an ulnar nail. Whilst non-unions in metastatic malignancy are typically atrophic, just occasionally hypertrophic non-unions can occur. Management principles remain the same with stabilisation of the entire bone and early mobilisation being appropriate.

  6. The role of autologous bone graft in surgical treatment of hypertrophic nonunion of midshaft clavicle fractures

    Directory of Open Access Journals (Sweden)

    Hui-Kuang Huang


    Conclusion: LC-DCP fixation is an effective method for treating hypertrophic nonunion of mid-shaft clavicle fracture. Local bone graft is sufficient to achieve necessary union, and autologous bone graft from other sites of the body appears unnecessary.

  7. Plate fixation and bone grafting of distal clavicle nonunions: radiologic and functional outcomes

    NARCIS (Netherlands)

    Villa, Jordan C.; van der List, Jelle P.; Gausden, Elizabeth B.; Lorich, Dean G.; Helfet, David L.; Kloen, Peter; Wellman, David S.


    The optimal treatment for distal clavicle nonunions remains unknown. Small series have reported outcomes following distal fragment excision and various fixation techniques. We present the clinical, radiographic and functional outcomes after superior plating or double (superior and anteroinferior)

  8. Definite management of bilateral lower leg nonunion fractures by Ilizarov apparatus in polytraumatized patient: Case report


    Lalić Ivica; Obradović Mirko; Lukić-Šarkanović Mirka; Đan Vladimir


    Introduction. Nonunion of long bones may often be associated with significant function loss of affected extremity, joint stiffness, and even extremity amputation or systemic manifestations in the case of infection. The aim of this case report is to highlight the possibilities of Ilizarov apparatus in the treatment of fracture nonunions of both lower legs treated by different operative methods and to show that it is not necessary to remove osteosynthetic mat...

  9. Sandwich allografts for long-bone nonunions in patients with osteogenesis imperfecta: a retrospective study. (United States)

    Puvanesarajah, Varun; Shapiro, Jay R; Sponseller, Paul D


    Patients with osteogenesis imperfecta often develop nonunions, as internal fixation has limited applicability in this condition. We report the outcomes of a modified "sandwich technique" in the treatment of long-bone nonunions in patients with osteogenesis imperfecta; this technique brings circumferential stabilization and normal collagen to the nonunion site. From May 2003 through February 2012, twelve patients (eight females, four males; median age, 39.0 years; range, eleven to seventy-eight years) who had osteogenesis imperfecta (Sillence type I [three], type III [eight], and type IV [one]) and a combined total of thirteen nonunions (two humeral, two radial, three femoral, four tibial, and two ulnar; median duration, 15.0 months; range, six to 204 months) were treated at our institution with compressed sandwich allograft cortical struts. The struts were fashioned to be wide enough to allow for increased osteoconductive surface area and to approximate a hemicylindrical shape. Treatment history and demographics data were acquired through retrospective chart review. Follow-up radiographs were analyzed by two attending orthopaedic surgeons to determine radiographic findings. The median follow-up time was 4.6 years (range, 2.1 to 10.3 years). All thirteen nonunions, including one requiring a second graft procedure, healed with abundant, smooth allograft incorporation, resulting in an initial healing rate of 92% because of a refracture in one patient. This patient's nonunion ultimately healed with additional allograft struts and a new intramedullary rod. One patient required removal of prominent screws. The final follow-up examinations revealed no pain or refracture at the original nonunion site. All patients regained their prefracture level of function. Sandwich allograft struts constitute a durable, safe method for the stabilization and healing of persistent long-bone nonunions in patients with osteogenesis imperfecta. All patients showed incorporation of the

  10. Atrophic, aseptic, tibial nonunion: how effective is modified Judet's osteoperiosteal decortication technique and buttress plating? (United States)

    Binod, Bijukachhe; Nagmani, Singh; Bigyan, Bhandari; Rakesh, John; Prashant, Adhikari


    Tibial nonunion is the most common nonunion encountered by the orthopedic surgeon. Repeated surgeries, cost, increased duration of hospital stay, disability, pain all contribute to the increased morbidity. Many methods have been used to treat nonunion of tibia with variable results and none of them are 100 % successful. Our objective was to determine the effectiveness of modification of Judet's decortication technique and buttress plating, without bone graft, in the treatment of aseptic, atrophic tibial nonunion. Also, to find the correlation between time of achieving union and time since injury to decortication. Ours is a retrospective study conducted at a Level I trauma center. A total of 35 cases of atrophic tibial nonunion, irrespective of the cause, was treated by modifying Judet's osteoperiosteal decortication and plating during the time period January 2006 to July 2013. Demographic data, range of motion, time of achieving union and clinico-radiological evaluation for union of fracture were included as main outcome measurements. Union was achieved in all cases with a mean duration of 8.34 months. Pain and stiffness of joints were not reported in any case on long-term follow-up and the patients had satisfactory range of motion. Implant removal was done in three cases after fracture union. Treatment of atrophic tibial nonunion is challenging and management of each nonunion has to be customized based on the biological and mechanical characteristics of the nonunion. Plating with osteoperiosteal decortication is an effective and simple technique, which in our hands has shown to result in 100 % union rates without the need of additional bone healing augmentation procedures like bone grafting. Level II.

  11. Clavicle fracture nonunion in the paediatric population: a systematic review of the literature. (United States)

    Hughes, K; Kimpton, J; Wei, R; Williamson, M; Yeo, A; Arnander, M; Gelfer, Y


    Clavicle fracture nonunions are extremely rare in children. The aim of this systematic review was to assess what factors may predispose children to form clavicle fracture nonunions and evaluate the treatment methods and outcomes. We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aiming to find papers reporting clavicle fracture nonunion in children under the age of 18 years. Data was collected on patient demographics, fracture type, mechanism of injury (MOI), surgical intervention and reported outcome. Two independent reviewers evaluated all the data. A total of 13 articles reporting 21 cases of clavicle fracture nonunion were identified. The mean age at time of injury was 11.4 years (4 to 17). Falls were the most common MOI. The majority of nonunions occurred after displaced fractures on the right side. Six were refractures. Mean time of presentation following injury was 13.5 months (4 to 60). In all, 16 were treated surgically. Radiographic union was eventually achieved in 12 cases, with functional outcome satisfactory in all cases. Clavicle nonunion is an extremely rare but possible complication in children. The majority occur after displaced right-sided fractures or refractures and present around one year after injury. Surgical fixation provides good radiographic healing and functional outcomes. IV.

  12. Neptune's Wandering Hot Pole (United States)

    Orton, Glenn; Fletcher, Leigh; Yanamandra-Fisher, Padma; Geballe, Tom; Hammel, Heidi; Fujiyoshi, Takuya; Encrenaz, Therese; Hofstadter, Mark; Mousis, Olivier; Fuse, Tetsuharu


    Images of stratospheric emission from Neptune obtained in 2006 at ESO's Very Large Telescope (Orton et al., 2007, A&A 473, L5) revealed a near-polar hot spot near 70 deg. S latitude that was detectable in different filters sampling both methane (~7-micron) and ethane (~12-micron) emission from Neptune's stratosphere. Such a feature was not present in 2003 Keck and 2005 Gemini North observations: these showed only a general warming trend towards Neptune's pole that was longitudinally homogeneous. Because of the paucity of longitudinal sampling in the 2003, 2005 and 2006 images, it was not clear whether the failure to see this phenomenon in 2003 and 2005 was simply the result of insufficient longitudinal sampling or whether the phenomenon was truly variable in time. To unravel these two possibilities, we proposed for time on large telescopes that were capable of resolving Neptune at these wavelengths. We were granted time at Gemini South in 2007 using T-Recs, Subaru time in 2008 using the COMICS instrument and VLT time in 2008 and 2009 using VISIR. Two serendipitous T-Recs images of Neptune were also obtained in 2007 using a broad-band N (8-14 micron) filter, whose radiance is dominated by 12-micron ethane emission, and whose primary purpose was navigation of N-band spectroscopy. The feature was re-observed (i) in 2007 in the T-Recs N-band filter and (ii) in 2008 with COMICS in a 12.5-micron image. Unfortunately, none of the telescope time granted was sufficient to sample all longitudes over the 12-hour period of this latitude, and so no definitive separation of the two possibilities was obtained. However, considering the ensemble of images as a random sample of longitudes, it is likely that the phenomenon is ephemeral in time, as it was observed only twice among 9 independent observing epochs. We will continue to request observations to sample all longitudes systematically, but our current sample argues that the phenomenon is truly ephemera, because we most likely

  13. Ilizarov′s method for treatment of nonunion of diaphyseal fractures of the humerus

    Directory of Open Access Journals (Sweden)

    Kiran Manish


    Full Text Available Background: Nonunion in diaphyseal fractures of the humerus can be treated by various modalities like plating and bone grafting, exchange nailing, fibular strut grafting and Ilizarov′s method of ring fixation. To achieve union in infected nonunion in which multiple surgeries have already been done is further challenging. We conducted a prospective study wherein the outcome of the treatment of nonunion of diaphyseal fractures of the humerus by Ilizarov′s method was analyzed. Materials and Methods: Nineteen patients with diaphyseal nonunion of the humerus were treated by Ilizarov′s external fixator. These included nonunion after plating (n=11, intramedullary nailing (n=1 or conservative methods (n=7. In post-surgical infected nonunion (n=6, the implants were removed, debridement done, bone fragments were docked followed by application of ring fixator and compression. In aseptic nonunion (n=13, distraction for three weeks followed by compression was the protocol. Early shoulder and elbow physiotherapy was instituted. The apparatus was removed after clinical and radiological union and the results were assessed for bone healing and functional status. Results: Fracture union was achieved in all the 19 cases. Pin site infection was seen in 2 cases (10.52%. The bone healing results were excellent in eighteen cases (94.73% and good in one case (5.26%.The functional results were found to be excellent in fourteen cases (73.68%, good in four (21.05% and fair in one case (5.26%. Conclusion: Ilizarov′s method is an excellent option for treatment of septic and aseptic non union of diaphyseal fractures of the humerus as it addresses all the problems associated with non union of the humerus like infection, deformity and joint stiffness.

  14. Bone fracture nonunion rate decreases with increasing age: A prospective inception cohort study. (United States)

    Zura, Robert; Braid-Forbes, Mary Jo; Jeray, Kyle; Mehta, Samir; Einhorn, Thomas A; Watson, J Tracy; Della Rocca, Gregory J; Forbes, Kevin; Steen, R Grant


    Fracture nonunion risk is related to severity of injury and type of treatment, yet fracture healing is not fully explained by these factors alone. We hypothesize that patient demographic factors assessable by the clinician at fracture presentation can predict nonunion. A prospective cohort study design was used to examine ~2.5 million Medicare patients nationwide. Patients making fracture claims in the 5% Medicare Standard Analytic Files in 2011 were analyzed; continuous enrollment for 12months after fracture was required to capture the ICD-9-CM nonunion diagnosis code (733.82) or any procedure codes for nonunion repair. A stepwise regression analysis was used which dropped variables from analysis if they did not contribute sufficient explanatory power. In-sample predictive accuracy was assessed using a receiver operating characteristic (ROC) curve approach, and an out-of-sample comparison was drawn from the 2012 Medicare 5% SAF files. Overall, 47,437 Medicare patients had 56,492 fractures and 2.5% of fractures were nonunion. Patients with healed fracture (age 75.0±12.7SD) were older (pfracture patients had an age- and sex-adjusted death rate of 11.0% (pfracture in 14 of 18 bones were significantly more likely to die within one year of fracture (pFracture was associated with increased risk of death within 1year of fracture (pfracture is a major public health issue. Comorbidities associated with increased risk of nonunion include past or current smoking, alcoholism, obesity or morbid obesity, osteoarthritis, rheumatoid arthritis, type II diabetes, and/or open fracture (all, multivariate p<0.001). Nonunion prediction requires knowledge of 26 patient variables but predictive accuracy is currently comparable to the Framingham cardiovascular risk prediction. Copyright © 2016 Bioventus LLC. Published by Elsevier Inc. All rights reserved.

  15. Results after radioscapholunate arthrodesis with or without resection of the distal scaphoid pole. (United States)

    Mühldorfer-Fodor, Marion; Ha, Hue Phan; Hohendorff, Bernd; Löw, Steffen; Prommersberger, Karl Josef; van Schoonhoven, Jörg


    To evaluate the differences between radioscapholunate (RSL) arthrodesis alone versus RSL arthrodesis with additional distal scaphoidectomy. We retrospectively evaluated 61 patients who were treated with RSL arthrodesis for painful posttraumatic osteoarthritis. Thirty patients had an RSL arthrodesis with additional resection of the distal scaphoid pole (group A), and 31 had RSL arthrodesis alone (group B). Six patients in group A and 8 in group B had the RSL arthrodesis converted to a complete wrist arthrodesis during follow-up. Those patients were excluded from the survey. Of the remaining 47 patients, 35 (20 from group A, 15 from group B) returned for a clinical and radiological examination at an average of 28 (range, 10-47) months after the index surgery. The results were rated by the Disabilities of the Arm, Shoulder, and Hand score and the modified Mayo Wrist Score. The patients' outcomes after RSL arthrodesis with or without distal scaphoidectomy were compared for pain, wrist motion, grip strength, nonunion rate, osteoarthritis of the adjacent joints, the Disabilities of the Arm, Shoulder, and Hand score and the modified Mayo Wrist Score. Three patients with RSL arthrodesis alone showed a radioscaphoid nonunion. All arthrodeses in group A healed. In the clinical evaluation, there was no significant difference between groups A and B in the Disabilities of the Arm, Shoulder, and Hand score, the modified Mayo Wrist Score, grip strength, pain, or wrist motion. Assuming that wrist motion might be better in patients with a nonunion, the average wrist motion was recalculated after eliminating 3 patients with a radioscaphoid nonunion from group B. Radial deviation was then found to be significantly better in group A. Additional distal scaphoidectomy with RSL arthrodesis seems to improve postoperative radial deviation of the wrist. The radioscaphoid nonunion rate is high with RSL arthrodesis alone. Distal scaphoidectomy appeared to increase the successful fusion rate

  16. The South Pole Telescope

    Energy Technology Data Exchange (ETDEWEB)

    Ruhl, J.E.; Ade, P.A.R.; Carlstrom, J.E.; Cho, H.M.; Crawford,T.; Dobbs, M.; Greer, C.H.; Halverson, N.W.; Holzapfel, W.L.; Lanting,T.M.; Lee, A.T.; Leitch, E.M.; Leong, J.; Lu, W.; Lueker, M.; Mehl, J.; Meyer, S.S.; Mohr, J.J.; Padin, S.; Plagge, T.; Pryke, C.; Runyan, M.C.; Schwan, D.; Sharp, M.K.; Spieler, H.; Staniszewski, Z.; Stark, A.A.


    A new 10 meter diameter telescope is being constructed for deployment at the NSF South Pole research station. The telescope is designed for conducting large-area millimeter and sub-millimeter wave surveys of faint, low contrast emission, as required to map primary and secondary anisotropies in the cosmic microwave background. To achieve the required sensitivity and resolution, the telescope design employs an off-axis primary with a 10 m diameter clear aperture. The full aperture and the associated optics will have a combined surface accuracy of better than 20 microns rms to allow precision operation in the submillimeter atmospheric windows. The telescope will be surrounded with a large reflecting ground screen to reduce sensitivity to thermal emission from the ground and local interference. The optics of the telescope will support a square degree field of view at 2mm wavelength and will feed a new 1000-element micro-lithographed planar bolometric array with superconducting transition-edge sensors and frequency-multiplexed readouts. The first key project will be to conduct a survey over 4000 degrees for galaxy clusters using the Sunyaev-Zeldovich Effect. This survey should find many thousands of clusters with a mass selection criteria that is remarkably uniform with redshift. Armed with redshifts obtained from optical and infrared follow-up observations, it is expected that the survey will enable significant constraints to be placed on the equation of state of the dark energy.

  17. Nonunion of the femur treated with conventional osteosynthesis combined with autogenous and strut allogeneic bone grafts. (United States)

    Weng, Lin-Hsiu; Wang, Jun-Wen


    In this study, we reviewed the results of conventional osteosynthesis combined with strut onlay allografts and autogenous bone grafts as the treatment for nonunion of the femur. We conducted a retrospective study of 18 patients with nonunion of the femur treated with internal fixation (eight 95 degree fixed-angled blade plates, 7 intramedullary nails, 2 dynamic hip compression plates and screws, and 1 condylar buttress plate) and autogenous bone grafts and cortical strut allografts. There were 1.8 operations on average before surgery. The average time from the initial treatment of the fracture or osteotomy to surgery was 32.5 months. The average follow-up was 32.2 months. All 18 nonunions had healed by the time of follow-up. Positive intraoperative cultures (Staphylococcus epidermidis) in 2 patients were resolved by parenteral antibiotics with no additional treatment. Removal of implants was required in 5 patients because of screw irritation or bony union. One concomitant quadricepsplasty as well as 2 excisions of a protruding graft were required because of restricted knee motion or impingement. For difficult nonunions of the femur in the current study, strict adherence to the principles of the treatment of nonunion and the addition of strut allografts to enhance stability and repair potential proved to be a good alternative.

  18. Modified Nicoll's Graft for Treatment of Gap Non-union of Ulna: A Rare Case Report. (United States)

    Krishna, Chaitanya; Mondal, Jayanta; Sengupta, Anirudhha


    Despite the multitude of studies for the treatment of non-unions, no clear criterion has been established for treating a fracture of non-union. Non-union of radius and ulna produces a discrepancy in length which must be restored for adequate rotation and function. Nicoll described a technique of bridging gaps in long bones with solid blocks of cancellous bone and fixing the fragments with metal plates. We utilized modified Nicoll's graft using corticocancellous graft taken from iliac crest. In the present case, a 17-year-old male patient of eastern India presented with gap non-union of 3 cm in ulna of non-dominant hand, left side after 3 years and 6 months of trauma. There was linear surgical scar mark of 8 cm overlying ulna, but there was no sign of infection. He was functionally crippled with severe restriction of range of motion. The tricortical cancellous bone graft under optimal compression provides a good solution for the management of gap non-union of both bone forearm for deficit up to 3 cm with no evidence of infection.

  19. Association between the capitate-triquetrum distance and carpal collapse in scaphoid nonunion. (United States)

    Dimitriadis, Anastasios; Paraskevas, George; Kanavaros, Panagiotis; Barbouti, Alexandra; Vrettakos, Aristeidis; Kitsoulis, Panagiotis


    The effect of the lunate type on carpal collapse in cases of scaphoid nonunion has not been thoroughly investigated. The purpose of the present study was to determine whether any association exists or not between the capitate-triquetrum distance and occurrence of carpal collapse in cases of scaphoid nonunion. In a retrospective study, 76 patients with scaphoid nonunion formed two groups based on the capitate-triquetrum distance: forty-three patients with distance of less than 5 mm and 33 patients with distance of 5 mm or more. The two groups were comparable with respect to sex distribution, age, dominant hand involvement, manual labor, nonunion location and time from injury to final x-rays. Six patients (13.9%) in the capitate-triquetrum<5 mm group and 13 patients (39.4%) in the capitate-triquetrum≥5 mm group had no signs of collapse, with significant difference (p<0.05). Capitate-triquetrum distance could contribute in the decision making process for cases of scaphoid nonunion without straightforward indication for surgical intervention.

  20. The Gustilo-Anderson classification system as predictor of nonunion and infection in open tibia fractures. (United States)

    Thakore, R V; Francois, E L; Nwosu, S K; Attum, B; Whiting, P S; Siuta, M A; Benvenuti, M A; Smith, A K; Shen, M S; Mousavi, I; Obremskey, W T; Sethi, M K


    We sought to conduct the largest retrospective study to date of open tibia fractures and describe the incidence of complications and evaluate the potential predictive risk factors for complications. Patients with open tibia fractures treated with reamed intramedullary nail (IMN) across a 10-year period were evaluated. Patient charts were reviewed for demographics, type of open fracture (T), comorbidities, and postoperative complications. A multivariate model was conducted to determine the risk factors for each type of complication. Of the 486 patients with open tibia fractures, 13 % (n = 64) had infections, 12 % (n = 56) had nonunions, and 1 % (n = 7) had amputations. TIII fractures had much higher rates of each complication than TI and TII fractures. Fracture type was the only significant risk factor for both nonunion and infection. Our study found that the Gustilo grade of open tibia fracture is by far the greatest predictor of nonunion and infection.

  1. Treatment of subtrochanteric nonunion of the femur: whether to leave or to exchange the previous hardware. (United States)

    Kang, Soo Hwan; Han, Suk Ku; Kim, Yong Sik; Kim, Myung Jin


    Our aim was to compare the clinical results of two different methods for treatment of subtrochanteric nonunion: an additional fixation to the previous hardware, and exchange of previous hardware. We retrospectively analyzed 19 cases of subtrochanteric nonunion, and compared clinical results from 10 cases (Group 1) with exchange of the previous hardware, and 9 cases (Group 2) with retained previous hardware and an additional fixation. Autogenous bone grafting were performed for all cases. The mean age of the patients was 49.1 years in Group 1, and 48.2 years in Group 2. The mean follow-up period was 19.3 months. The union rate was 100% in Group 1, and 77.8% in Group 2 (phardware was better than in those with retained hardware in the treatment of subtrochanteric nonunion by complete removal of the interposed fibrous tissue and meticulous bone grafting leading to a biological environment to achieve bony union.

  2. Modified retrograde-locked nailing for aseptic femoral supracondylar nonunion with severe osteoporosis in elderly patients. (United States)

    Wu, Chi-Chuan


    Femoral supracondylar nonunions in elderly patients are uncommon. To date, there is no convincing technique for managing this condition. When the nonunion is associated with severe osteoporosis, treatment becomes even more complicated. We developed a modified retrograde-locked nailing technique to treat this complex lesion. Twenty-four aseptic femoral supracondylar nonunions with severe osteopenia in 24 elderly patients (aged ≥65 years) were treated. A retrograde femoral-locked nail was inserted in the dynamic mode. Next, the medial ½ to 2/3 marrow cavity in the nonunion site was filled with bone cement, and the lateral 1/3 to ½ marrow cavity received a cancellous bone graft with or without a bone graft substitute. A cylindrical brace was applied for 3 weeks postoperation. Early ambulation with a walker or wheelchair was encouraged. Twenty patients were followed up for an average period of 2.5 years (range, 1.1-4.5 years), and 18 nonunions healed. The union rate was 90.0% with an average union period of 4.9 months (range, 4-7 months). No deep infection or malunion was found. The two patients with persistent nonunions were advised to use a walker whenever necessary. The satisfactory rate for knee function improved from 0% preoperatively to 80.0% at the latest follow-up. The described technique may concomitantly provide sufficient stability and initiate osteogenic potential, thus facilitating bone union. This technique is simple with a low complication rate and thus should be considered as a useful alternative for treating this complex lesion.

  3. Surmanuhtlusele pole kohta / Marianne Mikko

    Index Scriptorium Estoniae

    Mikko, Marianne, 1961-


    Surmanuhtlusest kui inimõiguste rängimast rikkumisest. Lisatud: surmanuhtlus arvudes. Ilmunud ka Hiiu Leht 14. okt. 2008, lk. 2 ; Põhjarannik 16. okt. 2008, lk. 4 ; Pärnu Postimees 11. okt. 2008, lk. 19 ; Hiiu Leht : Nädalalõpp 14. nov. 2008, lk. 6, pealkiri kujul: surmanuhtlusele pole Euroopas kohta ; Meie Maa : Nädalalõpp 14. nov. 2008, lk. 6, pealkiri kujul: surmanuhtlusele pole Euroopas kohta

  4. Salvage of distal radius nonunion with a dorsal spanning distraction plate. (United States)

    Mithani, Suhail K; Srinivasan, Ramesh C; Kamal, Robin; Richard, Marc J; Leversedge, Fraser J; Ruch, David S


    Treatment of nonunion after previous instrumentation of distal radius fractures represents a reconstructive challenge. Resultant osteopenia provides a poor substrate for fixation, often necessitating wrist fusion for salvage. A spanning dorsal distraction plate (bridge plate) can be a useful adjunct to neutralize forces across the wrist, alone or in combination with nonspanning plates to achieve union, salvage wrist function, and avoid wrist arthrodesis in distal radius nonunion. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  5. Successful treatment of nonunion with teriparatide after failed ankle arthrodesis for Charcot arthropathy. (United States)

    Tamai, K; Takamatsu, K; Kazuki, K


    We describe a case of successful treatment to nonunion after multiple arthrodesis operations for Charcot arthropathy with teriparatide. We describe the case of a 25-year-old woman with severe Type I diabetes mellitus that resulted in nonunion after multiple arthrodesis operations for Charcot arthropathy. The woman sustained a femoral shaft fracture for which she underwent surgery with intramedullary nail fixation. Immediately after surgery, an empiric course of teriparatide was initiated. Femoral shaft fracture healing was observed after 2 weeks, and the woman was able to walk 12 weeks after the surgery, at which point plain film and computed tomography images revealed complete union of the ankle.

  6. Omentalisation as adjunctive treatment of an infected femoral nonunion fracture: a case report

    Directory of Open Access Journals (Sweden)

    McAlinden A


    Full Text Available Abstract A three-year-old male working border collie with an infected femoral nonunion fracture was managed in a two-stage procedure involving debridement and omentalisation, followed by stabilisation with a bone plate and an autogenous cancellous bone graft. Osseous union was documented radiographically 16 weeks after surgery. Telephone follow-up one year later revealed the dog had returned to full working function without evidence of lameness. To the authors' knowledge, this is the first clinical case described in the veterinary literature using omentalisation as an adjunct to the management of an infected, biologically inactive nonunion fracture.

  7. Successful use of autogenous bone graft for the treatment of a radius-ulna nonunion in an amputee dog

    Directory of Open Access Journals (Sweden)

    B.W. Minto


    Full Text Available Fracture nonunions represent important complications in orthopedic surgeries. Nonunion repairs or bone defects are surgically challenging. Our aim was to describe a nonunion case, which was repaired with rapid bone recovery. An 8-month-old male mixed breed dog that has been previously operated was presented to the Veterinary Medical Teaching Hospital of São Paulo State University, with a right radius-ulna nonunion and an amputated contralateral forelimb. A cancellous bone graft was collected from a partially amputated limb, in order to correct the nonunion, and used in association with a locking plate. After four weeks, the bone graft had been incorporated into the original bone. Clinical union with good weight bearing was achieved after eight weeks.

  8. Masquelet technique with external locking plate for recalcitrant distal tibial nonunion. (United States)

    Ma, Ching-Hou; Chiu, Yen-Chun; Tsai, Kun-Ling; Tu, Yuan-Kun; Yen, Cheng-Yo; Wu, Chin-Hsien


    In the present retrospective study, we aimed to analyze the results of treatment for recalcitrant distal tibial nonunion using Masquelet technique with locking plate as a definitive external fixator. We included 15 consecutive cases of distal tibial nonunion treated at our hospital between January 2012 and December 2015. The reconstructive procedure comprised debridement of the nonunion site, deformity correction, stabilization with an external locked plate, defect filling with cement spacer for inducing membrane formation, and bone reconstruction using a cancellous bone autograft (Masquelet technique). All patients were followed-up for at least one year. Fracture union occurred in all cases after a median of 6.5 months (range, 5-12 months). Mean ankle motion ranged from 12.3 (range, 5-20) degrees of dorsiflexion to 35 (range, 5-55) degrees of plantar flexion. At the final follow-up, the median Iowa ankle score was 83 (range, 68-91). Eight patients had excellent scores, six had good scores, and one had fail score. Although the current study involved only a small number of patients and the intervention comprised two stages, we consider that the used protocol is a simple and valuable alternative for the treatment of recalcitrant distal tibial nonunion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Nonunion of Fractures of the Ulna and Radius Diaphyses: Clinical and Radiological Results of Surgical Treatment

    Directory of Open Access Journals (Sweden)

    Boussakri H


    Full Text Available Aseptic nonunion of the radius and ulna is a major complication of forearm fractures, accounting for 2% to 10% of all forearm fractures. The aim of our study is to evaluate the functional and radiological results of surgical treatment of diaphyseal aseptic nonunion of the radius and ulna, with autologous bone grafting, decortication and internal plate fixation. A series of 21 patients (26 nonunions was retrospectively reviewed, the average age was 35 years with a mean of 31,58 years (range 12-44 years . The fractures included isolated radius (n=6 and ulna (n=10, and both radius and ulna (n=5. The Grace and Eversmann score was used to evaluate our results. Fifteen had very good results, five good and one average. Consolidation of the two bones was attained in 6.2 months. Therefore, the functional prognosis of the upper limb imposes the need for an adequate treatment. This management strategy has enabled us to have satisfactory results. However, the best treatment of nonunion remains the preventive treatment with an optimal management and care of the forearm fractures.

  10. Implant failure caused by non-union of bisphosphonate-associated subtrochanteric femur fracture.

    LENUS (Irish Health Repository)

    O'Neill, Barry James


    Bisphosphonate use has been identified as a contributory factor in atypical subtrochanteric fracture of the femur. These fractures are commonly treated with an intramedullary device. We present a case of implant failure of an intrameduallary device caused by non-union of an atypical subtrochanteric fracture.

  11. Proximal renal tubular acidosis (United States)

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate is not ...

  12. Outcome of plating, bone grafting and shortening of non-union humeral diaphyseal fracture. (United States)

    Khan, Mohammad Shoaib; Sahibzada, Ahmed Sohail; Khan, Mohammad Ayaz; Sultan, Shahid; Younas, Mohammed; Khan, Alam Zeb


    Humeral diaphyseal fracture usually heals with closed methods but when non union develops then it needs surgical intervention in the form of plating and bone grafting, intramedulary nailing (open or closed simple or interlocking nails) and external fixators (circular or one plane fixator). In our unit we treated non union humeral diaphyseal fracture with plating and bone grafting and shortening of fracture ends up to 4 to 5 cm when needed. This study was conducted at Orthopaedic Department of Ayub Teaching Hospital Abbottabad from January 2002 till December 2003. We included 15 cases with atrophic non-union in 9 (60%) and hypertrophic non-union in 6 (40%) patients. All atrophic non-union were treated with plating, bone shortening by transverse osteotomy and bone grafting, while hypertrophic non-union were treated with decortications of non-union ends and fixation with compression plates, with bone grafting in old age. Follow up measures were based on clinical (range of joints motion) and radiological (healing) findings. Follow up was done for up to 6 months. Out of 15 patients the age range was 20-80 years, 12 (80%) were male and 03 (20%) female. Right humerus involved in 5 (33.33%) while left humerus in 10 (66.66%) patients. In 9 (60%) patients with atrophic non union bone shortening by transverse cut osteotomy was done while in remaining patients with hypertrophic non-union plating was done in 2 (13.33%) cases and plating with bone grafting in 4 (26.66%) patients. Union was achieved in all patients after 16 to 20 weeks of surgery. In one patient (6.66%) of 75 years age with hypertrophic non-union implant was loosened after 03 months of surgery. At that time healing (Union) was evident on X-rays and humeral brace was applied for further 03 months. Two patients (13.33%) got neuropraxia of radial nerve which resolved with in 3 months time. 02 patients (13.33%) developed shoulder stiffness which resolved after exercise. In Non Union of Humerus shortening by

  13. Transverse Stress Fracture of the Proximal Patella (United States)

    Atsumi, Satoru; Arai, Yuji; Kato, Ko; Nishimura, Akinobu; Nakazora, Shigeto; Nakagawa, Shuji; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Sudo, Akihiro; Kubo, Toshikazu


    Abstract Among stress fractures associated with sports activities, patellar stress fracture is rare. Regarding patella stress fractures, so far only distal transverse or lateral longitudinal fractures have been reported, but there are no reports of transverse fractures occurring in the proximal patella. We describe an extremely rare case of transverse stress fracture of proximal patella in a 9-year-old athlete. A 9-year old boy, who participated in sports (sprints and Kendo) presented with left knee pain without any external injury. In plain radiographs, a fracture line was observed in the proximal 1/3 of the left patella, and a patella stress fracture was diagnosed. For treatment, because 7 months of conservative therapy showed no improvement, internal fixation was carried out using Acutrak screws, and bone union was thus achieved. Three months after the operation, he was able to return to his previous level of athletic sports activity. Regarding the mechanism of onset, it is believed that the causes are longitudinal traction force and patellofemoral contact pressure. On the other hand, the contact region of the patella with the femur changes with the flexion angle of the knee. In the current case, the fracture occurred at a site where the patella was in contact with the femur at a flexion angle of >90°, so it is believed that it occurred as a clinical condition from being subjected to repeated longitudinal traction force and patellofemoral contact pressure at a flexion angle of >90°, during the sports activities of sprints and Kendo. The nonunion of the transverse stress fracture of his proximal patella was successfully treated with internal fixation using Acutrak screws. PMID:26871789

  14. Limb-sparing surgery in a dog with osteosarcoma of the proximal femur. (United States)

    Liptak, Julius M; Pluhar, G Elizabeth; Dernell, William S; Withrow, Stephen J


    To report successful limb-sparing surgery in a dog with a proximal femoral osteosarcoma (OSA) using a composite allograft-prosthetic technique. Case report. Client-owned dog. A stage IIB OSA of the proximal aspect of the femur was resected in accordance with oncologic and limb-sparing principles. The osseous defect was reconstructed with a proximal femoral allograft and cemented, long-stemmed femoral prosthesis. Soft tissue reconstruction was achieved by suturing host tendons to their respective allogeneic tendons on the allograft. Coxofemoral joint function was preserved using standard total hip arthroplasty techniques. Limb-sparing surgery of the proximal aspect of the femur using a composite allograft-prosthetic technique resulted in excellent limb function. Postoperative complications included aseptic loosening of the femoral composite graft and allograft nonunion, which required revision, traumatic implant luxation, and local tumor recurrence. Limb function was excellent after surgical stabilization of the allograft nonunion but deteriorated after implant luxation 270 days postlimb-sparing surgery. Pulmonary and skeletal metastases were diagnosed and local tumor recurrence suspected 596 and 650 days postoperatively, respectively. The dog was euthanatized 688 days after limb-sparing surgery as a result of progressive local and metastatic disease. Limb-sparing surgery for dogs with primary bone tumors of the proximal aspect of the femur is feasible with good functional results.

  15. Orthogonal plating of Vancouver B1 and C-type periprosthetic femur fracture nonunions. (United States)

    Birch, Christopher E; Blankstein, Michael; Chlebeck, Jesse D; Bartlett Rd, Craig S


    Periprosthetic femoral shaft fractures are a significant complication after total hip arthroplasty (THA). Plate osteosynthesis has been the mainstay of treatment around well-fixed stems. Nonunions are a rare and challenging complication of this fixation method. We report the outcomes of a novel orthogonal plating surgical technique for Vancouver B1 and C-type periprosthetic fractures that previously failed open reduction internal fixation (ORIF). A retrospective review identified all patients with Vancouver B1/C THA periprosthetic femoral nonunions from 2010 to 2015. Exclusion criteria included open fractures and periprosthetic infections. The technique utilised a mechanobiologic strategy of atraumatic exposure, resection of necrotic tissue, bone grafting with adjuvant bone morphogenetic protein (BMP) and revision open reduction internal fixation with orthogonal plate osteosynthesis. 6 Vancouver B1/C periprosthetic femoral nonunions were treated. 5 patients were female with an average age of 80.3 years (range 72-91 years). The fractures occurred at a mean of 5.8 years (range 1-10 years) from their initial arthroplasty procedure. No patients underwent further revision surgery; there were no perioperative complications. All patients had a minimum of 11 months follow-up (mean 18.6, range 11-36 months). All fractures achieved osseous union, defined as solid bridging callus over at least 2 cortices and pain free, independent ambulation, at an average of 24.4 weeks (range 6.1-39.7 weeks). This is the 1st series describing orthogonal locked compression plating using modern implants for periprosthetic femoral nonunions. This technique should be considered in periprosthetic femur fracture nonunions around a well-fixed stem.

  16. Accordion technique combined with minimally invasive percutaneous decortication for the treatment of bone non-union. (United States)

    Zhang, Qun; Zhang, Wei; Zhang, Zhuo; Tang, Peifu; Zhang, Lihai; Chen, Hua


    A variety of approaches have been used to treat oligotrophic or atrophic non-union. Conventional methods are often associated with great operative trauma, increased blood loss, a risk of re-infection, higher medical costs, and complications at the donor site. This study aimed to assess the clinical efficacy of the accordion technique combined with Minimally Invasive Percutaneous Decortication (MIPD) for these types of bone non-union. From January 2010 to December 2015, 20 patients with long bone aseptic non-unions of the lower extremities without bone defects who were treated with the accordion technique combined with MIPD. The limb-length discrepancy (LLD) was less than 2cm in all patients. None of the patients received autogenous bone grafts during follow-up. All surgeries were performed by the same surgeon, and the modified Application of methods of Ilizarov (ASAMI) criteria were used to evaluate the operative effectiveness. A total of 20 patients were included in this study, and 1 patient was lost during follow-up. Fifteen of these patients presented with oligotrophic non-unions, and 5 patients presented with atrophic non-unions. The average follow-up period in these patients was 12.1 months (range: 8-42 months). The alternative compression and distraction procedure was repeated 1-3 times. Blood loss was 30 to 250ml during surgery. Ultimately, bone union was achieved in 19 patients and failed in 1 patient. The fractures healed within 4-8 months (average time: 5.9 months), and fracture healing was considered excellent in 19 patients and poor in 1 patient. Postoperative function was evaluated as excellent in 9 patients, good in 6 patients, fair in 4 patients, and poor in 1 patient. The accordion technique combined with MIPD, which is a simple, minimally invasive procedure that does not require autologous bone grafting, resulted in a high bone union rate and good postoperative function. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome

    Energy Technology Data Exchange (ETDEWEB)

    Schoierer, Oliver; Bender, Daniel; Schmidmaier, Gerhard [University Hospital Heidelberg, Heidelberg Trauma Research Group, Department of Orthopaedic and Trauma Surgery, Heidelberg (Germany); Bloess, Konstantin; Kauczor, Hans-Ulrich; Weber, Marc-Andre [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Burkholder, Iris [University of Applied Sciences of the Saarland, Department of Nursing and Health, Saarbruecken (Germany)


    To prospectively evaluate whether dynamic contrast-enhanced (DCE) MRI can assess vascularity within non-unions and predicts clinical outcome in combination with the clinical Non-Union Scoring System (NUSS). Fifty-eight patients with non-unions of extremities on CT underwent 3-T DCE MRI. Signal intensity curves obtained from a region-of-interest analysis were subdivided into those with more intense contrast agent uptake within the non-union than in adjacent muscle (vascularised non-union) and those with similar or less contrast uptake. The pharmacokinetic parameters of the Tofts model K{sub trans}, K{sub ep}, iAUC and V{sub e} were correlated with union at CT 1 year later (n = 49). Despite inserted osteosynthetic material, DCE parameters could be evaluated in 57 fractures. The sensitivity/specificity of vascularised non-unions as an indicator of good outcome was 83.9 %/50.0 % compared to 96.8 %/33.3 % using NUSS (n = 49). Logistic regression revealed a significant impact of NUSS on outcome (P = 0.04, odds ratio = 0.93). At first examination, median iAUC (initial area under the enhancement curve) for the ratio non-union/muscle was 10.28 in patients with good outcome compared with 3.77 in non-responders (P = 0.023). K{sub trans}, K{sub ep} and V{sub e} within the non-union were not significantly different initially (n = 57) or 1 year later (n = 19). DCE MRI can assess vascularity in fracture non-unions. A vascularised non-union correlates with good outcome. (orig.)

  18. Glass Waveguides for Periodic Poling

    DEFF Research Database (Denmark)

    Fage-Pedersen, Jacob; Jacobsen, Rune Shim; Kristensen, Martin


    Planar silica-based waveguide devices have been developed for second-harmonic generation by poling with periodic electrodes. We show that detrimental charge transport can occur along interfaces, but with proper choice of fabrication, high-quality devices are obtained....

  19. Pole climbing challenges and solutions

    Energy Technology Data Exchange (ETDEWEB)

    Murdoch, W.S.


    This article discussed methods of improving the safety of electricity linemen when climbing poles. A fall restrict system (FRS) program was recently implemented by the Indianapolis Power and Light (IPL) company. However, workers using the program were fatigued by the double belting requirements. Scenarios were then examined in order to solve the problems experienced by the linemen. A Brazilian method of climbing was then adapted for use with a rope positioning device (RPD) developed to accommodate IPL work practices and pole applications. The final pole climbing system was developed after consulting with a group of IPL linemen. The RPD system was tested alongside a conventional fall restrict system. The test demonstrated that the RPD system required significantly less time to complete than the conventional system. The climber was also able to use a 100 per cent fall protection system on a heavily obstructed pole with no greater effort than free climbing. It was concluded that the system can also be used in a Belay configuration to reduce rescue times and control fall distances. 5 figs.

  20. Kool pole vabrik / Peeter Kreitzberg

    Index Scriptorium Estoniae

    Kreitzberg, Peeter, 1948-2011


    Riigikogu liige Peeter Kreitzberg nimetab Res Publica kavandatavat koolireformi kirvereformiks, mis ei lähtu hariduse põhiprobleemidest. Autor pooldab haridusvõimaluste regionaalset võrdsust ning leiab, et hariduses pole vaja võistlust mõttetult õhutada

  1. Minimally invasive plate osteosynthesis for proximal humeral fractures. (United States)

    Koljonen, Paul Aarne; Fang, Christian; Lau, Tak Wing; Leung, Frankie; Cheung, Nigel W K


    To report the outcome after minimally invasive plate osteosynthesis (MIPO) through the deltoid-splitting approach for proximal humeral fractures. 10 men and 30 women aged 37 to 88 years underwent MIPO through the deltoid-splitting approach using the Proximal Humerus Internal Locking System or the Locking Proximal Humerus Plate for 2-part (n=18), 3-part (n=20), and 4-part (n=2) proximal humeral fractures. The rehabilitation protocol was standardised. All 40 patients were followed up at 3 months, 34 (85%) at 6 months, 30 (75%) at one year, and 13 (33%) at 2 years. Two patients had malunion. No patient had avascular necrosis, infection, nerve palsy, or nonunion. The mean Constant score at one year and 2 years was 75 and 87.5, respectively. The Constant score at 6 months correlated to that at one year (r=0.926, pfracture grade, or hand dominance. MIPO for fixation of proximal humeral fractures using a locking plate is safe and effective in enabling an early return of shoulder function.

  2. The Radiographic Union Score for Hip (RUSH) Identifies Radiographic Nonunion of Femoral Neck Fractures. (United States)

    Frank, Tym; Osterhoff, Georg; Sprague, Sheila; Garibaldi, Alisha; Bhandari, Mohit; Slobogean, Gerard P


    The Radiographic Union Score for Hip (RUSH) is a previously validated outcome instrument designed to improve intra- and interobserver reliability when describing the radiographic healing of femoral neck fractures. The ability to identify fractures that have not healed is important for defining nonunion in clinical trials and predicting patients who will likely require additional surgery to promote fracture healing. We sought to investigate the utility of the RUSH score to define femoral neck fracture nonunion. (1) What RUSH score threshold yields at least 98% specificity to diagnose nonunion at 6 months postinjury? (2) Using the threshold identified, are patients below this threshold at greater risk of reoperation for nonunion and for other indications? A representative sample of 250 out of a cohort of 725 patients with adequate 6-month hip radiographs was analyzed from a multinational elderly hip fracture trial (FAITH). All patients had a femoral neck fracture and were treated with either multiple cancellous screws or a sliding hip screw. Two reviewers independently determined the RUSH score based on the 6-month postinjury radiographs and interrater reliability was assessed with the interclass correlation coefficient (ICC). There was substantial reliability between the reviewers assigning the RUSH scores (ICC, 0.81; 95% confidence interval [CI], 0.76-0.85). The RUSH score is a checklist-based system that quantifies four measures of healing: cortical bridging, cortical fracture disappearance, trabecular consolidation, and trabecular fracture disappearance.. Fracture healing was determined by two independent methods: (1) concurrently by the treating surgeon using both clinical and radiographic assessments as per routine clinical care; and (2) retrospectively by a Central Adjudication Committee using complete obliteration of the fracture line on radiographs alone. Receiver operating characteristic tables were used to define a RUSH threshold score that was > 98

  3. Clinical effectiveness of Osigraft in long-bones non-unions. (United States)

    Calori, Giorgio Maria; Colombo, Massimiliano; Bucci, Miguel; Mazza, Emilio Luigi; Fadigati, Piero; Mazzola, Simone


    Current evidence, based primarily on case series, suggest that the eptotermin alfa (recombinant bone morphogenetic protein-7 (rhBM-7)), which is commercialized as Osigraft with an indication for tibial non-union, used in monotherapy or polytherapy, is a safe and effective therapy for long bones non-unions of lower and upper limbs. No previous study has compared the safety and the efficacy of Osigraft and the "gold standard" treatment for recalcitrant long-bones non-union, autologous bone graft (ABG). This study aims to compare the effectiveness of Osigraft and ABG in the treatment of post-traumatic, persistent long bone non-unions. In particular, the present study will focus exclusively on complex persistent non-unions, excluding simpler cases, in which it is likely that a simple revision of the osteosynthesis will be sufficient to promote union, and extremely severe cases in which there is an indication for amputation and prosthesis. The study addresses the following research question: 1. Is the effectiveness of eptotermin alfa comparable to that of ABG in the treatment of complex long bone non-unions? 2. Are there significant differences in the prevalence of adverse events between patients treated with eptotermin alfa and those treated with ABG? The study is an observational, retrospective study, located in one Experimental Recruiting Center (Ospedale Universitario G. PINI - Milano). The study was conducted with ethics approval and according with the existing Italian law. Demographic and clinical data were collected from patients Clinical Medical Records and other existing documentation, through a web based eCRF. The treatment (surgery with Osigraft or ABG) effectiveness was evaluated comparing the number of success cases (primary endpoint) and the length for clinical and radiological healing (secondary end-points). The treatment safety was evaluating comparing the prevalence of Adverse Events. Osigraft was demonstrated to be statistically equivalent to ABG with

  4. Patellar Shape-Memory Fixator for the Treatment of Comminuted Fractures of the Inferior Pole of the Patella (United States)

    Liu, Xin-Wei; Shang, Hui-Juan; Xu, Shuo-Gui; Wang, Zhi-Wei; Zhang, Chun-Cai; Fu, Qing-Ge


    Comminuted and displaced fractures of the inferior pole of the patella are not easy to reduce and it is difficult to fix the fragments soundly enough to allow early movement of the knee. The purpose of this study is to evaluate the clinical effectiveness of the internal fixation technique with Patellar Shape-Memory Fixator (PSMF) in acute comminuted fractures of the inferior pole of the patella. We retrospectively studied 25 patients with comminuted fractures of the inferior pole of the patella who were treated with PSMF and followed up for a mean period of 26 months (14 to 60). All the fractures healed at a mean of 6 weeks (5 to 7). The mean grading at the final follow-up was 29.5 points (27 to 30) using the Bostman score, with no observable restriction of movement. No breakage of the PSMF or infection occurred. No delayed union, nonunion, and infection were seen. This technique preserved the length of the patella, reduced the comminuted fragments of the inferior pole and avoided long-term immobilization of the knee.

  5. Ilizarov treatment of humeral shaft nonunion in an antiepileptic drug patient with uncontrolled generalized tonic-clonic seizure activity

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    Koulouvaris Panayiotis


    Full Text Available Abstract Nonunion of the humeral shaft in patients with antiepileptic drug associated metabolic bone disorder constitute a challenging surgical problem difficult to treat due to seizure activity, osteoporosis, and poor stabilization options. We report a case of nonunion of the humeral shaft in an antiepileptic drug patient with uncontrolled generalized tonic-clonic seizure activity successfully treated with Ilizarov external fixator and a follow-up of 4 years.

  6. Partial Pole Placement in LMI Region

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    Liuli Ou


    Full Text Available A new approach for pole placement of single-input system is proposed in this paper. Noncritical closed loop poles can be placed arbitrarily in a specified convex region when dominant poles are fixed in anticipant locations. The convex region is expressed in the form of linear matrix inequality (LMI, with which the partial pole placement problem can be solved via convex optimization tools. The validity and applicability of this approach are illustrated by two examples.

  7. Sectional Pole for Measuring Tree Heights (United States)

    R. H. Brendemuehl; James B. Baker


    A sectional aluminum pole designed by the Silviculture Laboratory at Marianna, Florida, has proved useful for measuring tree heights. It is more convenient than a sectional bamboo pole 1 or a telescoping fiberglass pole. A tree 5 to 30 feet in height can be measured to the nearest tenth of a foot in 30 seconds. The pole is constructed of low-cost, readily available...

  8. Surgery for the fractured clavicle: factors predicting nonunion. (United States)

    Jarvis, Neil E; Halliday, Lucy; Sinnott, Matthew; Mackenzie, Tanya; Funk, Lennard; Monga, Puneet


    This study identifies the reasons for failure after plate osteosynthesis of midshaft clavicle fractures, complication rates, and time to radiographic union. A retrospective review of 84 consecutive patients who had undergone surgical fixation for a midshaft clavicle fracture was performed. There were 82 patients who were included for analysis and operated on by 11 different surgeons using a mixture of locking (63%) and nonlocking (37%) plates. The rate of osteosynthesis failure was 12.2%. A logistical regression analysis found that failure of osteosynthesis had no relationship to type of plate used (P = .82), gender (P = .42), number of proximal (P = .96) or distal (P = .63) screws to the fracture, or length of plate (P = .42). Smoking was found to be the only risk factor (P = .02) that increased failure rates after midshaft clavicle osteosynthesis. Smoking was the only identifiable risk factor to increase failure rates in clavicle osteosynthesis. Preoperative counseling can identify those at increased risk of implant failure and can help improve clinical results by implementing a smoking cessation plan. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.


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    Ayhan Gormus


    Full Text Available International Labour Organization (ILO and United Nations Environment Programme (UNEP suggest that green sectors should offer decent jobs respecting to unions and international labor rights and fulfill requirements of labor laws and collective bargaining system. Also, non-unionized working in green sectors poses a significant challenge in terms of creation decent jobs. In this line, this article presents several evidences from British Labour Force Survey to find some socio-economic obstacles behind unionization in green sectors by using logistic regression modeling method. The results suggest that union membership decision in green sectors is affected by a range of demographic and work-related factors used in the study. For example, those who are 16-24 age band, women workers, those who are employed by small sized enterprises and takes charge in high-ranked occupations are higher likelihood of non-unionized working in green sectors, compared to rest of the sectors.

  10. Evaluation of nonunion fractures in dogs by use of B-mode ultrasonography, power Doppler ultrasonography, radiography, and histologic examination. (United States)

    Risselada, Marije; van Bree, Henri; Kramer, Martin; Chiers, Koen; Duchateau, Luc; Verleyen, Piet; Saunders, Jimmy H


    To investigate the use of ultrasonography to assess nonunion of fractures in dogs and to compare results of ultrasonography, radiography, and histologic examination. 8 nonunion fractures in 6 dogs (1 each in 5 dogs and 3 in 1 dog); dogs ranged from 7 to 94 months of age and weighed 6 to 30 kg. Diagnostic assessment consisted of complete clinical and orthopedic examinations, radiography, B-mode (brightness mode) ultrasonography, and power Doppler ultrasonography. Biopsy samples were obtained during surgery for histologic examination. They were stained with H&E and immunolabeled by use of anti-CD31 antibodies. Correlations of power Doppler score, power Doppler count, vessel area, and radiographic prediction with the mean number of vessels counted per hpf were derived. Radiographically, 7 of 8 nonunion fractures were diagnosed as atrophic and were therefore estimated to be nonviable. Vascularity of nonunion fractures during power Doppler ultrasonography ranged from nonvascularized to highly vascularized. Absolute vessel count during histologic examination ranged from 0 to 63 vessels/hpf; 5 nonunion sites had a mean count of > 10 vessels/hpf. Vascularity during power Doppler ultrasonography was highly correlated with the number of vessels per hpf, whereas the correlation between the radiographic assessment and histologic evaluation was low. Radiographic prediction of the viability of nonunion fractures underestimated the histologically assessed vascularity of the tissue. Power Doppler ultrasonography provided a more accurate estimation of the viability of the tissue and therefore the necessity for debridement and autografts during revision surgery.


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    Girish Kumar


    Full Text Available BACKGROUND: CONTEXT: Infected nonunion of long bones are a great challenge to treating surgeons. Various factors such as devitalisation of bone, soft tissue scarring, deformity, limb length discrepancy, joint stiffness and secondary osteoporosis need to be addressed along with financial constraints and compliance in management of such situations to choose appropriate treatment. Limb reconstruction system provides single stage, easy to construct and less cumbersome option to the patient. PURPOSE To evaluate safety and efficacy of limb reconstruction system in management of infected nonunion of long bones. STUDY DESIGN/SETTING Retrospective study. METHODS Thirteen patients with infected nonunion of long bones (tibia-8 cases and femur-5 cases were operated using limb reconstruction system. There were 11 males and 2 females. The average age was 35 years (range 21-50 years. All cases had established nonunion for at least 6 months with evidence of infection. The infection was active in 8 patients and non-draining in 5 patients. Ilizarov study group ASAMI score was used for bone results and functional results. Complications assessed as per Paley classification. RESULTS The mean time for union was 9.8 months (7-12 months. The mean follow up after LRS removal was 35.2 months (range 24- 44 months. Two cases had angulation of about 8 degrees (femur and remaining cases did not have any angulation. Infection was eradicated in all cases. Functional outcome was excellent in five patients and eight good in patients. Bone outcome was excellent eleven patients and good in two patients. CONCLUSIONS Limb reconstruction system is a safe and effective tool for simultaneous correction of limb length discrepancy; achieve union and infection control in a single stage. It is easy to perform with reliable results and less complications.


    Lalić, Ivica; Obradović, Mirko; Lukić Šarkonović, Mirka; Đana, Vladimir


    Nonunion of long bones may often be associated with significant function loss of affected extremity, joint stiffness, and even extremity amputation or systemic manifestations in the case of infection. The aim of this case report is to highlight the possibilities of Ilizarov apparatus in the treatment of fracture nonunions of both lower legs treated by different operative methods and to show that it is not necessary to remove osteosynthetic material (intramedullary nail) in every case when nonunion occurs to achieve its recovery. A 62 year-old man was injured in a traffic accident as a pedestrian in April2012, when he experienced polytrauma, including shaft fracture of the right femur, and segmental open fractures of the right (Gustillo-Anderson grade I) and left (Gustillo-Anderson grade II) lower leg. The fractures of right femur and right tibia were stabilized initially with intramedullary nails, while the left lower leg fracture was treated by unilateral external fixator. After 5 months, there were no clinical and radiographic signs of union on lower legs, therefore the patient underwent re-surgery. Ilizarov apparatus was applied on both lower legs. The patient was early verticalized and both apparatus were removed after 4 months. According to the modified protocol of the Association for the Study and Application of Methods of Ilizarov, the lower leg bony results were good and excellent, and the functional results were excellent on both sides. Nonunion fracture of the right lower leg initially treated by the method of intramedullary osteosynthesis and afterwards by placing Ilizarov apparatus shows that in some cases it is not indicated to remove fixative material in order to achieve full recovery of fracture, thus eliminating the danger of all negative effects resulting from the classical extensive surgical treatment.

  13. Nonsteroidal anti-inflammatory drugs' impact on nonunion and infection rates in long-bone fractures. (United States)

    Jeffcoach, David R; Sams, Valerie G; Lawson, Christy M; Enderson, Blaine L; Smith, Scott T; Kline, Heather; Barlow, Patrick B; Wylie, Douglas R; Krumenacker, Laura A; McMillen, James C; Pyda, Jordan; Daley, Brian J


    There is a dearth of clinical data regarding the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on long-bone fracture (LBF) healing in the acute trauma setting. The orthopedic community believes that the use of NSAIDs in the postoperative period will result in poor healing and increased infectious complications. We hypothesized that, first, NSAID use would not increase nonunion/malunion and infection rates after LBF. Second, we hypothesized that tobacco use would cause higher rates of these complications. A retrospective study of all patients with femur, tibia, and/or humerus fractures between October 2009 and September 2011 at a Level 1 academic trauma center was performed . In addition to nonunion/malunion and infection rates, patient records were reviewed for demographic data, mechanism of fracture, type of fracture, tobacco use, Injury Severity Score (ISS), comorbidities, and medications given. During the 24-month period, 1,901 patients experienced LBF; 231 (12.1%) received NSAIDs; and 351 (18.4%) were smokers. The overall complication rate including nonunion/malunion and infection was 3.2% (60 patients). Logistic regression analysis with adjusted odds ratios were calculated on the risk of complications given NSAID use and/or smoking, and we found that a patient is significantly more likely to have a complication if he or she received an NSAID (odds ratio, 2.17; 95% confidence interval, 1.15-4.10; p < 0.016) in the inpatient postoperative setting. Likewise, smokers are significantly more likely to have complications (odds ratio, 3.19; 95% confidence interval, 1.84-5.53; p < 0.001). LBF patients who received NSAIDs in the postoperative period were twice as likely and smokers more than three times likely to suffer complications such as nonunion/malunion or infection. We recommend avoiding NSAID in traumatic LBF. Epidemiologic & therapeutic study; level II.

  14. Peri-prosthetic humeral non-union: Where biology meets bio-mechanic. A case report


    Ciurlia Emanuele; Puddu Leonardo; Caggiari Gianfilippo; Andreozzi Matteo; Carlo Doria


    Introduction: The worldwide incidence of traumatic fractures has been growing over the last years due to the progressive aging of the population. Today, the increase of arthroplasty procedures in orthopaedic surgery is related to a high rate of peri-prosthetic fractures. Healing of the fracture is a multifactorial metabolic process; if these factors are impaired, healing process could be interrupted resulting in non-union. Presentation of case: We report our experience about a case of a hu...

  15. Role of Antibiotic Cement Coated Nailing in Infected Nonunion of Tibia

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    Bhatia C


    Full Text Available INTRODUCTION: Infected nonunion of long bones is a chronic and debilitating disorder. It is more difficult to deal with when the implant used for internal fixation itself becomes a potential media for infection because of bacterial adhesion and biofilm formation. Traditionally, it is managed by two- stage procedure for controlling the infection first and then treating the nonunion. This study has been undertaken to explore antibiotic cement coated nailing as single stage treatment modality for treating infection and achieving stability at the same time. MATERIALS AND METHODS: Twenty patients (above 18 years age with infected nonunion of tibia with bone gap less than 2 cm were managed using antibiotic cement coated K-nail. Antibiotic cement nail was prepared using endotracheal tube method. Antibiotics used were a combination of vancomycin and teicoplanin. RESULTS: Infection was controlled in 95% of the patients. Bony union was achieved in 12 of 20 (60% patients with antibiotic cement nailing as the only procedure with average time of union of 32 weeks. Remaining 8 patients required additional procedures like bone grafting or exchange nailing and these were done in six patients, with union of fracture. Two patients refused to undergo further procedures. Complications encountered were difficult nail removal in three cases, broken nail in two cases, and bent nail in one case. Recurrence of infection was observed in two patients. Average period of follow-up was 13 months. CONCLUSION: Antibiotic cement impregnated nailing is a simple, economical and effective single stage procedure for the management of infected nonunion of tibia. It is advantageous over external fixators, as it eliminates the complications of external fixators and has good patient compliance. The method utilizes existing easily available instrumentation and materials and is technically less demanding, and therefore can be performed at any general orthopaedic center.


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    Liliana Scutaru


    Full Text Available The paper analyzes the situation of clusters in Romania and their areas of activity and innovation in entrepreneurship Romanian state. It is made also a territorial distribution of clusters on the eight regions. The findings lead to the conclusion that there are some clusters that have the vocation to become poles of competitiveness in areas such as renewable energy, automotive, electronics, health, biotechnology, mechatronics or ICT (Information and Communication Technology which represent the resources for future of the Romanian economy. Regarding the degree of innovation of Romanian Small and Medium Enterprises (SMEs, the level is relatively modest, 30.8% of all enterprises being innovative. If we were to answer the question the title suggests, we would say "yes" to both since the innovative cluster as well as the competitiveness pole promotes par excellence, innovation through study, research and stimulation of creativity. And this is more than enough to support economic growth of Romania and maintain the competitiveness worldwide.

  17. Management of combined nonunion and limb-length discrepancy after vascularised fibular grafting. (United States)

    Abdel-Ghani, H; Ebeid, W; El-Barbary, H


    We describe the management of nonunion combined with limb-length discrepancy following vascularised fibular grafting for the reconstruction of long-bone defects in the lower limb after resection of a tumour in skeletally immature patients. We operated on nine patients with a mean age of 13.1 years (10.5 to 14.5) who presented with a mean limb-length discrepancy of 7 cm (4 to 9) and nonunion at one end of a vascularised fibular graft, which had been performed previously, to reconstruct a bone defect after resection of an osteosarcoma. Reconstruction was carried out using a ring fixator secured with correction by half pins of any malalignment, compression of the site of nonunion and lengthening through a metaphyseal parafocal osteotomy without bone grafting. The expected limb-length discrepancy at maturity was calculated using the arithmetic method. Solid union and the intended leg length were achieved in all the patients. Excessive scarring and the distorted anatomy from previous surgery in these patients required other procedures to be performed with minimal exposures and dissection in order to avoid further compromise to the vascularity of the graft or damage to neurovascular structures. The methods which we chose were simple and effective in addressing these complex problems.

  18. Coupled external fixator and skin flap transposition for treatment of exposed and nonunion bone

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    ZHAO Yong-gang


    Full Text Available 【Abstract】Objective: To discuss the effect of coupled external fixator and skin flap transposition on exposed and nonunion bones. Methods: The data of 12 cases of infected nonunion and exposed bone following open fracture treated in our hospital during the period of March 1998 to June 2008 were analysed. There were 10 male patients, 2 female patients, whose age were between 19-52 years and averaged 28 years. There were 10 tibial fractures and 2 femoral fractures. The course of diseases lasted for 12-39 months with the mean period of 19 months. All the cases were treated by the coupled external fixator and skin flap transposition. Results: Primary healing were achieved in 10 cases and delayed healing in 2 cases in whom the tibia was exposed due to soft tissue defect and hence local flap transposition was performed. All the 12 cases had bony union within 6-12 months after operation with the average time of 8 months. They were followed up for 1-3 years and all fractures healed up with good function and no infection recurrence. Conclusion: The coupled external fixator and skin flap transposition therapy have shown optimal effects on treating infected, exposed and nonunion bones. Key words: External fixators; Fracture fixation; Infection; Surgical flap

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

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    Sujit Kumar Tripathy


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

  20. Iatrogenic Radial Nerve Palsy After Humeral Shaft Nonunion Repair: More Common Than You Think. (United States)

    Kakazu, Rafael; Dailey, Steven K; Schroeder, Amanda J; Wyrick, John D; Archdeacon, Michael T


    To determine the rate of iatrogenic radial nerve palsy (RNP) after surgical repair of established humeral shaft nonunion (HSNU). Retrospective chart review. Level I trauma center. Fifty-four patients with HSNU, 10 (18.5%) of whom developed an iatrogenic RNP after nonunion repair. HSNU repair with compression plate stabilization with or without autogenous bone graft. Postoperative iatrogenic RNP. Ten (18.5%) patients developed iatrogenic radial nerve palsies: 8 experienced complete resolution (mean, 2.5 months) and 2 experienced partial resolution. There were no statistically significant differences between patients who developed nerve palsy and those who did not in regard to age, gender, tobacco use, diabetic status, previous RNP, initial management (operative vs. nonoperative), surgical approach, presence of infected nonunion, number of previous surgeries, or operative time (P > 0.05). The occurrence of iatrogenic RNP for patients undergoing surgical repair of an HSNU was 18.5%. According to historical data, this rate is nearly 3 times higher than for those undergoing open reduction and internal fixation of either acute humeral shaft fractures or HSNUs. Therapeutic Level IV. See Instructions for Authors for a complete description of Levels of Evidence.

  1. Influence of the moment exerted by the athlete on the pole in pole-vaulting performance. (United States)

    Morlier, Julien; Mesnard, Michel


    Current studies on pole-vaulting focus mostly on energy transfer data [Ekevad, M., Lundberg, B., 1995. Simulation of "smart" pole vaulting. Journal of Biomechanics 28, 1079-1090; Ekevad, M., Lundberg, B., 1997. Influence of pole length and stiffness on the energy conversion in pole-vaulting. Journal of Biomechanics, 30, 259-264; Linthorne, N.P., 2000. Energy loss in the pole vault take-off and the advantage of the flexible pole. Sports Engineering 3, 205-218; Schade, F., Arampatzis, A., Bruggemann, G.P., 2006. Reproducibility of energy parameters in the pole vault. Journal of Biomechanics 39, 146-147.] and often fail to take into account the actions exerted on the pole [Arampatzis, Schade, Bruggemann, 2004. Effect of the pole-human body interaction on pole-vaulting performance. Journal of Biomechanics 37, 1353-1360]. The present study integrates the 3D kinematics data of the athlete but also the actions measured at the end of the pole in the planting box and on the track during the last stride before take-off. It proposes a mechanical model allowing determination of the pole-vaulter's actions on the pole. The model is based on a global mechanical approach. The pole-vaulter's action on his upper and lower hand is concentrated on one middle point to solve the dynamics problem. The model was applied to seven experienced pole-vaulters. The force and the moment exerted on the pole by the pole-vaulter during the last stride before take off and during jump stage, were calculated. This analysis of the compressive force and bending moment for seven pole-vaulters helps to highlight the impact of the moment in the performance. The conclusion is confirmed by an additional comparative study carried out on two pole-vaulters, with comparable morphologies and performing with the same pole.

  2. Characteristic radiographic or magnetic resonance images of fresh osteoporotic vertebral fractures predicting potential risk for nonunion: a prospective multicenter study. (United States)

    Tsujio, Tadao; Nakamura, Hiroaki; Terai, Hidetomi; Hoshino, Masatoshi; Namikawa, Takashi; Matsumura, Akira; Kato, Minori; Suzuki, Akinobu; Takayama, Kazushi; Fukushima, Wakaba; Kondo, Kyoko; Hirota, Yoshio; Takaoka, Kunio


    Prospective multicenter study. To identify radiographic or magnetic resonance (MR) images of fresh vertebral fractures that can predict a high risk for delayed union or nonunion of osteoporotic vertebral fractures (OVFs). Vertebral body fractures are the most common fractures in osteoporosis patients. Conservative treatments are typically chosen for OVFs, and associated back pain generally subsides within several weeks with residual persistent deformity of the vertebral body. In some patients, OVF healing is impaired and correlated with prolonged back pain. However, assessments such as plain radiograph or MR images taken during the early phase to predict high risks for nonunions of OVFs and/or poor prognoses have not been identified. A total of 350 OVF patients from 25 institutes were enrolled in this clinical study. Plain radiograph and MR images of the OVFs were routinely taken at enrollment at the respective institutes. The findings on the plain radiograph and MR images were classified after enrollment in the study. All the patients were treated conservatively without any surgical intervention. After a 6-month follow-up, the patients were classified into two groups, a union group and a nonunion group, depending on the presence of an intravertebral cleft on plain radiograph or MR images. The associations of the images from the first visit with those of the corresponding nonunions at the 6-month follow-up were analyzed by multivariate logistic regression to elucidate specific image characteristics that may predict a high risk for nonunion of OVFs. Forty-eight patients (49 vertebrae) among the 350 patients (363 vertebrae) were classified as nonunions, indicating a nonunion incidence of 13.5% for conventional conservative treatments for OVFs. The statistical analyses revealed that a vertebral fracture in the thoracolumbar spine, presence of a middle-column injury, and a confined high intensity or a diffuse low intensity area in the fractured vertebrae on T2-weighted

  3. Modeling Staphylococcus epidermidis-Induced Non-Unions: Subclinical and Clinical Evidence in Rats.

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    Arianna Barbara Lovati

    Full Text Available S. epidermidis is one of the leading causes of orthopaedic infections associated with biofilm formation on implant devices. Open fractures are at risk of S. epidermidis transcutaneous contamination leading to higher non-union development compared to closed fractures. Although the role of infection in delaying fracture healing is well recognized, no in vivo models investigated the impact of subclinical low-grade infections on bone repair and non-union. We hypothesized that the non-union rate is directly related to the load of this commonly retrieved pathogen and that a low-grade contamination delays the fracture healing without clinically detectable infection. Rat femurs were osteotomized and stabilized with plates. Fractures were infected with a characterized clinical-derived methicillin-resistant S. epidermidis (10(3, 10(5, 10(8 colony forming units and compared to uninfected controls. After 56 days, bone healing and osteomyelitis were clinically assessed and further evaluated by micro-CT, microbiological and histological analyses. The biofilm formation was visualized by scanning electron microscopy. The control group showed no signs of infection and a complete bone healing. The 10(3 group displayed variable response to infection with a 67% of altered bone healing and positive bacterial cultures, despite no clinical signs of infection present. The 10(5 and 10(8 groups showed severe signs of osteomyelitis and a non-union rate of 83-100%, respectively. The cortical bone reaction related to the periosteal elevation in the control group and the metal scattering detected by micro-CT represented limitations of this study. Our model showed that an intra-operative low-grade S. epidermidis contamination might prevent the bone healing, even in the absence of infectious signs. Our findings also pointed out a dose-dependent effect between the S. epidermidis inoculum and non-union rate. This pilot study identifies a relevant preclinical model to assess the

  4. Automatic Pole and Q-Value Extraction for RF Structures

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    C. Potratz, H.-W. Glock, U. van Rienen, F. Marhauser


    The experimental characterization of RF structures like accelerating cavities often demands for measuring resonant frequencies of Eigenmodes and corresponding (loaded) Q-values over a wide spectral range. A common procedure to determine the Q-values is the -3dB method, which works well for isolated poles, but may not be applicable directly in case of multiple poles residing in close proximity (e.g. for adjacent transverse modes differing by polarization). Although alternative methods may be used in such cases, this often comes at the expense of inherent systematic errors. We have developed an automation algorithm, which not only speeds up the measurement time significantly, but is also able to extract Eigenfrequencies and Q-values both for well isolated and overlapping poles. At the same time the measurement accuracy may be improved as a major benefit. To utilize this procedure merely complex scattering parameters have to be recorded for the spectral range of interest. In this paper we present the proposed algorithm applied to experimental data recorded for superconducting higher-order-mode damped multi-cell cavities as an application of high importance.

  5. Mini-invasive treatment for delayed or non-union: the use of percutaneous autologous bone marrow injection

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    Trung Hau LE THUA


    Full Text Available Delayed union or nonunion of bone fracture is becoming less frequent, but still remains a challenging clinical problem. Autologous cancellous bone grafting that is the gold standard method, often involves donor site morbidities and complications. Once these fractures have been mechanically stabilized, other local factors should be investigated to promote delayed healing. The purpose of this study was to evaluate the initial outcome of the percutaneous injection of autologous bone marrow after concentration for the treatment of delayed or nonunion. Our subjects included 10 patients of delayed or nonunion fracture (3 female, 7 male with an average age of 28 years. All fractures were mechanically stabilized after accident. Delayed or nonunion affected the femur in 2 patients, the tibia in 5 patients, the humerus in 2 patients, and the ulna in 1 patient. Bone marrow aspirates were obtained from both the posterior superior iliac crest. Bone marrow aspiration concentrate was produced via density gradient centrifugation. Trocars were inserted in the delayed or nonunion gap under fluoroscopic guidance. The bone marrow aspiration concentrate was injected slowly. As results, all of 10 delayed or nonunion healed after treatment with percutaneous injection of autologous bone marrow. The mean time for new bone formation was 3.3 months, for clinical union was 5.2 months, and for radiological union was 11.8 months. The current study is encouraging in the initial outcome and percutaneous bone marrow implantation could be an effective and safe treatment for delayed or nonunion. [Biomed Res Ther 2015; 2(11.000: 389-395

  6. Delayed Expression of Circulating TGF-β1 and BMP-2 Levels in Human Nonunion Long Bone Fracture Healing. (United States)

    Hara, Yoshiaki; Ghazizadeh, Mohammad; Shimizu, Hajime; Matsumoto, Hisashi; Saito, Nobuyuki; Yagi, Takanori; Mashiko, Kazuki; Mashiko, Kunihiro; Kawai, Makoto; Yokota, Hiroyuki


    The healing process of bone fracture requires a well-controlled multistage and sequential order beginning immediately after the injury. However, complications leading to nonunion exist, creating serious problems and costs for patients. Transforming growth factor-beta 1 (TGF-β1) and bone morphogenic protein 2 (BMP-2) are two major growth factors involved in human bone fracture healing by promoting various stages of bone ossification. In this study, we aimed to determine the role of these factors during the fracture healing of human long bones and assess their impacts on nonunion condition. We performed a comprehensive analysis of plasma TGF-β1 and BMP-2 levels in blood samples from 10 patients with proved nonunion and 10 matched patients with normal union following a predetermined time schedule. The concentrations of TGF-β1 and BMP-2 were measured at each time point using a solid-phase ELISA. TGF-β1 and BMP-2 levels were detectable in all patients. For all patients, a maximal peak for TGF-β1 was found at 3-week. In normal union group, TGF-β1 showed a maximal peak at 2-week while nonunion group had a delayed maximal peak at 3-week. Plasma levels of BMP-2 for all patients and for normal union group reached a maximal peak at 1-week, but nonunion group showed a delayed maximal peak at 2-week. In general, plasma TGF-β1 or BMP-2 level was not significantly different between normal union and nonunion groups. The expression levels of TGF-β1 and BMP-2 appeared to be delayed in nonunion patients which could play an important role in developing an early marker of fracture union condition and facilitate improved patient's management.

  7. Multiset proximity spaces

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    A. Kandil


    Full Text Available A multiset is a collection of objects in which repetition of elements is essential. This paper is an attempt to explore the theoretical aspects of multiset by extending the notions of compact, proximity relation and proximal neighborhood to the multiset context. Examples of new multiset topologies, open multiset cover, compact multiset and many identities involving the concept of multiset have been introduced. Further, an integral examples of multiset proximity relations are obtained. A multiset topology induced by a multiset proximity relation on a multiset M has been presented. Also the concept of multiset δ- neighborhood in the multiset proximity space which furnishes an alternative approach to the study of multiset proximity spaces has been mentioned. Finally, some results on this new approach have been obtained and one of the most important results is: every T4- multiset space is semi-compatible with multiset proximity relation δ on M (Theorem 5.10.

  8. Closed fractures of the proximal tibia treated with a functional brace. (United States)

    Martinez, Alberto; Sarmiento, Augusto; Latta, Loren L


    It generally is agreed that fractures of the proximal tibia, when treated with intramedullary nails, are more likely to present technical difficulties and to be associated with an increased rate of complications. This study reports on 108 closed fractures located in the proximal third of the tibia that were treated with functional braces. Nonunion occurred in 2.7% of the patients; the final displacement and shortening averaged 20% and 3.5 mm, respectively. Eighty-eight percent of the fractures healed with less than 6 degrees of angular deformity. It seems that functional braces for closed fractures of the tibia, located in its proximal third, are a viable therapeutic approach that offers satisfactory clinical and radiographic results in a high percentage of instances.

  9. Proximal Femoral Fracture in Hip Arthrodesis Treated with Double Reconstruction Plates

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    Shunsuke Asakawa


    Full Text Available We present a rare clinical case of a 90-year-old female who sustained a proximal femoral neck fracture following long-standing hip arthrodesis. Since the fracture occurred relatively proximally and involved the pelvis, double-plate fixation was chosen to achieve rigid fixation. The reconstruction plate was placed at the posterior and anterior columns individually through single vertical incision. She was treated successfully, and she attained preinjury activity level. Proximal femoral fractures in arthrodesed hips need to be recognized as a fracture between the pelvis and femur. Rotational stress from the trunk and lower extremity requires rigid fixation to minimize the increase of displacement and the risk for nonunion.

  10. Predisposing factors and outcome of treatment of non-union of long-bone fractures in Ibadan, Nigeria. (United States)

    Ogunlade, S O; Omololu, A B; Alonge, T O; Diete, S T; Obawonyi, J E


    This study was done to find out factors that contribute to development of Non-union of long bone fractures in this environment and the outcome of operative intervention. This is a prospective hospital based study. All patients with Non-union of long bone fracture that presented in the hospital since January 1997 were recruited into the study. The data included causative factors, treatment given before presenting in the hospital, type of surgical procedure and result of treatment. The study was completed in December, 2005. 78 patients presented with 87 Non-union of long bones. A male, female ratio of 1.6:1 was encountered while 69.2 per cent of the patients were below the age 55years. Road Traffic Accident accounted for 68 fractures (78.2 per cent) while duration of injury before presentation varies from 6 months to 22 months. Atrophic non-union occurred in 60 cases (69.0 per cent) and hypertrophic non-union in 21 cases. Non-union of the femur occurred in 33 cases (37.9 per cent) humerus in 24 cases (27.6 per cent), tibia in 16 cases (18.4 per cent), radius and ulna in 14 cases (16.1 per cent). The initial treatments of the fresh fracture in the 78 patients with nonunion were by the traditional bonesetters in 51 patients (65.4 per cent) while the remaining fractures were treated by plaster of paris in hospital. Open reduction and internal fixation using plate and screws with bone grafting was the most common procedure for treating the non-union in most cases. Union was achieved in the entire patients following surgical intervention. Important factor that appears to contribute to non-union of long bone in this environment is soft tissue interposition between the fracture ends of the bone, which is found in all fractures with more than one diameter displacement. Another factor is interference with periosteal blood supply from disruption of soft tissue envelope as a result of high energy injuries which is also responsible for the displacements that were observed in

  11. Osteogenic potency of human bone marrow mesenchymal stem cells from femoral atrophic non-union fracture site

    Directory of Open Access Journals (Sweden)

    Ismail Hadisoebroto Dilogo


    Full Text Available Objective: Mesenchymal stem cells (MSCs exist in the site of atrophic non-union fracture. The aim of this study was to evaluate the osteogenic potency of MSCs in order to have a better understanding of the unclear pathophysiology of atrophic non-union fracture Methods: This is an in vitro experimental study. Sample was obtained from the non-union site of a patient with a 6-years-history of atrophic non-union fracture of right femur. The MSCs was isolated from the fracture site and was cultured in the growth medium. Confirmation of the MSCs was performed and then osteogenic differentiation was performed in mono-layered MSC grown in both home-made and commercial osteogenic media. To evaluate the osteogenic differentiation, we performed Alizarin red staining and colorimetric assay for alkaline phosphatase (ALP. Results: From Alizarin red staining, most cells in the osteoblast medium were stained red by the staining. The result of colorimetric assessment of ALP shows that peak concentration was reached after 4 minutes in osteogenic group and control group. Conclusion: The presence of ALP activity and positive Alizarin red staining in our study showed that MSCs stem cells obtained from site of atrophic non-union is capable to be differentiated into osteogenic cells. . J Clin Exp Invest 2014; 5 (2: 159-163

  12. Pole to Pole Videoconferences Connect Students and Scientists (United States)

    Sparrow, E. B.; Lemone, P.; Yule, S.; Boger, R.; Galloni, M.; Kopplin, M. R.


    Alaskan and Argentinean students as well as arctic and antarctic scientists participated in two International Polar Year (IPY) Pole to Pole Videoconferences in 2007 and 2008. The videoconferences involved elementary, middle and high school students as well as scientists from Alaska, Argentina, Colorado and Washington DC. Alaska students were located in Fairbanks, Healy, Shageluk and Wasilla while the Argentinean students were located in Ushuaia, Argentina, at the southern tip of South America. The purpose was to ask each other and the scientists about local environmental changes, seasonal indicators, and climate change, and how to study the seasonal indicators to determine whether they are being affected by climate change. The videoconferences were followed by web chats and web forums to allow more students in other countries including those in non-polar regions, to interact with scientists, and help students develop ideas for their research projects. These activities are part of the Seasons and Biomes Project that engages K-12 teachers and students in Earth system science investigations as a way of teaching and learning science. This project also provides professional development workshops to teachers and teacher trainers. Seasons and Biomes is one of the projects in the University of the Arctic IPY Higher Education Outreach Cluster Project that has been approved by the IPY Joint Committee. As well, it is part of the GLOBE program, an international hands-on, inquiry-based Earth and environmental science and education program for primary and secondary students in 110 countries. The videoconferences, web chats and forums generated much interest and enthusiasm among students and scientists, and have provided the impetus for student research project initiations and collaborations between schools.

  13. Designated fiber stress for wood poles (United States)

    Ronald W. Wolfe; Robert O. Kluge


    Wood poles have been used to support utility distribution lines for well over 100 years. Over that time, specifications for a “wood utility pole” have evolved from the closest available tree stem more than 15 ft in length to straight, durable timbers of lengths ranging up 125 ft and base diameters of as much as 27 in. The continued success of wood poles in this...

  14. Treatment of infected non-unions with segmental defects with a rail fixation system. (United States)

    Mudiganty, Srikanth; Daolagupu, Arup Kumar; Sipani, Arun Kumar; Das, Satyendra Kumar; Dhar, Arijit; Gogoi, Parag Jyoti


    We conducted this study to evaluate the use of rail fixation system in infected gap non-union of femur and tibia as an alternative to the established Ilizarov circular fixator technique. Prospective study. The study was done in the Department of Orthopaedic surgery in a medical school and level I trauma center to which the authors are/were affiliated. Between June 2010 and June 2015, 40 patients with infected gap non-union of femur and tibia were treated with the rail fixation system. Patients who were willing to undergo surgery and participate in the post-operative rehabilitation were included in the study. After radical debridement, the system was applied and corticotomy done. For closure of bone gap, acute docking and distraction was done in 18 cases and segmental bone transport in 22 cases. Early mobilization of patient was done along with aggressive physiotherapy. Bone and functional results were calculated according to ASAMI scoring system, and complications were classified according to Paley classification. The mean follow-up period was 22.56 months (range 8-44). Bone union with eradication of infection was achieved in all but 1 case (97.5%). Bone results were excellent in 57.5%, good 40%, fair 0% and poor in 2.5% cases, while functional result was excellent in 32.5%, good 65%, fair 0% and poor in 2.5% cases. The rail fixation system is an excellent alternative method to treat infected gap non-union of femur and tibia. It is simple, easy to use and patient-friendly.

  15. Are atrophic long-bone nonunions associated with low-grade infections?

    Directory of Open Access Journals (Sweden)

    Dapunt U


    Full Text Available Ulrike Dapunt,1 Ole Spranger,2 Simone Gantz,1 Irene Burckhardt,3 Stefan Zimmermann,3 Gerhard Schmidmaier,2 Arash Moghaddam2 1Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, 2HTRG–Heidelberg Trauma Research Group, Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, 3Department for Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg, Germany Abstract: Impaired fracture healing, especially when associated with bacterial infection, is a severe complication following long-bone fractures and requires special treatment. Because standard diagnostic techniques might provide falsely negative results, we evaluated the sonication method for detection of bacteria on implants of patients with fracture nonunions. A total of 49 patients with a nonunion (group NU and, for comparison, 45 patients who had undergone routine removal of osteosynthetic material (group OM, were included in the study. Five different diagnostic methods (culture of tissue samples, culture of intraoperative swabs, histopathology of tissue samples, culture of sonication fluid, and 16S ribosomal DNA polymerase chain reaction of sonication fluid were compared and related to clinical data. Among the diagnostic tests, culture of sonication fluid demonstrated by far the highest detection rate of bacteria (57% in group NU, and rather unexpectedly 40% in group OM. Culture of sonication samples also revealed a broad spectrum of bacteria, in particular Propionibacterium spp. In conclusion, our results indicate that more bacteria can be detected on implants of patients with atrophic nonunions of long-bone fractures by means of the sonication procedure, which provides a valuable additional diagnostic tool to decide on a surgical procedure (eg, two-step procedure and to further specify antimicrobial therapy. Keywords: sonication, osteosynthetic material, osteomyelitis 

  16. Analysis of ulnar variance as a risk factor for developing scaphoid nonunion. (United States)

    Lirola-Palmero, S; Salvà-Coll, G; Terrades-Cladera, F J


    Ulnar variance may be a risk factor of developing scaphoid non-union. A review was made of the posteroanterior wrist radiographs of 95 patients who were diagnosed of scaphoid fracture. All fractures with displacement less than 1mm treated conservatively were included. The ulnar variance was measured in all patients. Ulnar variance was measured in standard posteroanterior wrist radiographs of 95 patients. Eighteen patients (19%) developed scaphoid nonunion, with a mean value of ulnar variance of -1.34 (-/+ 0.85) mm (CI -2.25 - 0.41). Seventy seven patients (81%) healed correctly, and the mean value of ulnar variance was -0.04 (-/+ 1.85) mm (CI -0.46 - 0.38). A significant difference was observed in the distribution of ulnar variance (p<.05). These results remained significant after adjusting for age, with an OR of 0.69 (CI 0.49 to 0.95). The patients were categorized into two groups: ulnar variance less than -1mm, and ulnar variance greater than -1mm. It appears that patients with ulnar variance less than -1mm had an OR 4.58 (CI 1.51 to 13.89) with p<.007. Desai et al. concluded that radiological features of acute scaphoid fractures cannot be used to predict the likelihood of fracture union. For this reason, the existence of other risk factors was analysed. According to the results of the present study, it can be concluded that patients with scaphoid fracture and ulnar variance less than -1mm have a greater risk of developing scaphoid nonunion, OR 4.58 (CI 1.51 to 13.89) with p<.007. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  17. Mechanics of pole vaulting: a review. (United States)

    Frère, Julien; L'hermette, Maxime; Slawinski, Jean; Tourny-Chollet, Claire


    A good understanding of the mechanics of pole vaulting is fundamental to performance because this event is quite complex, with several factors occurring in sequence and/or in parallel. These factors mainly concern the velocities of the vaulter-pole system, the kinetic and potential energy of the vaulter and the strain energy stored in the pole, the force and torque applied by the athlete, and the pole design. Although the pole vault literature is vast, encompassing several fields such as medicine, sports sciences, mechanics, mathematics, and physics, the studies agree that pole vault performance is basically influenced by the energy exchange between the vaulter and pole. Ideally, as the athlete clears the crossbar, the vaulter mechanical energy must be composed of high potential energy and low kinetic energy, guaranteeing the high vertical component of the vault. Moreover, the force and torque applied by the vaulter influences this energy exchange and these factors thus must be taken into consideration in the analysis of performance. This review presents the variables that influence pole vault performance during the run-up, take-off, pole support, and free flight phases.

  18. Thoracic Outlet Syndrome in a Volleyball Player Due to Nonunion of the First Rib Fracture. (United States)

    Puttmann, Kathleen T; Satiani, Bhagwan; Vaccaro, Patrick


    Fracture of the first rib with ensuing callus formation is a rare cause of thoracic outlet syndrome. We report a case of a 17-year-old female volleyball player who presented with months of chronic arm pain. Radiographic imaging demonstrated nonunion fracture of the first rib. Physical therapy had been unsuccessful in relieving the pain, and surgical management was performed with resection of the first rib through a transaxillary approach with complete resolution of symptoms. Inflammation surrounding such fractures may destroy tissue planes, making dissection more technically difficult.

  19. [Tibial defects and infected non-unions : Treatment results after Masquelet technique]. (United States)

    Moghaddam, A; Ermisch, C; Fischer, C; Zietzschmann, S; Schmidmaier, G


    The treatment of non-unions with large bone defects or osteitis is a major challenge in orthopedic and trauma surgery. A new concept of therapy is a two-step procedure: Masquelet technique according to the diamond concept. Between February 2010 and June 2014, 55 patients with tibia non-unions or infections were treated in a two-step Masquelet technique in our center. The patients' average age was 48 (median 50; minimum 15-maximum 72) with an average BMI (body mass index) of 28 (27; 18-52). There were 10 (18 %) female and 45 (82 %) male patients in the group. All study patients went through a follow up. Bone healing and clinical functional data were collected, as well as data according to subjective patient statements about pain and everyday limitations. In 42 cases (76.4 %) the outcome was a sufficient bony consolidation. On average, the time to heal was 10.3 (8, 5; 3-40) months, defect gaps were 4 cm (3 cm; 0,6-26 cm), and on average the patients had had 6 (median 4; range 1-31) previous operations . In all cases patients received osteosynthesis as well as a defect filling with RIA (reamer-irrigator-aspirator), and growth factor BMP-7 (bone morphogenetic protein-7). In 13 cases (23.6 %) there was no therapeutic success. In the evaluation of the SF12 questionnaire the mental health score increased from 47.4 (49.1; 27.6-65.7) to 49.8 (53.0; 28.7-69.4) and the well-being score from 32.7 (32.7;16.9-55.7) to 36.6 (36.5; 24.6-55.9). The two-step bone grafting method in the Masquelet technique used for tibia non-unions according to the diamond concept is a promising treatment option. Its application for tibia shaft non-unions with large bone defects or infections means a high degree of safety for the patient.


    Directory of Open Access Journals (Sweden)

    B. A. Akhmedov


    Full Text Available Developed by the authors the method of treatment for nonunions and pseudoarthrosis of extremities long bones is described. It consist in mini-invasive preparation of interfragmentary space and bone grafting with cancellous graft from the wing of ilium. Successful use this method in 23 patients with gunshot wounds of humeral, forearm, femur and shin bones allows to recommend it for wide application. Suggested method of surgical treatment can be used not only after gunshot wounds, but after long bones fractures of another genesis.

  1. Judet osteoperiosteal decortication for treatment of non-union: the Cornwall experience. (United States)

    Guyver, Paul; Wakeling, Christopher; Naik, Kumar; Norton, Mark


    The treatment of non union can be challenging with a variety of surgical options available to achieve bone consolidation. Robert Judet first described a method of osteo-periosteal decortication in 1963. He stated that by elevating cortical chips that remain attached to the periosteum and overlying soft tissues surrounding the site of non-union, combined with mechanical support, the bone consolidated. Despite excellent results presented in 2008 of 99% union rates with a mean delay of 8 months, the technique has not yet become popularised. We aim to show that Judet's method of decortication can achieve good results in the management of failure of union in a hospital other than Judet's. Retrospective analysis was performed from December 2002 to December 2008 of 40 cases in 39 patients of osteoperiosteal decortication for fracture non-union. Concurrent stabilisation was with internal fixation only. All procedures were performed by one surgeon (MN) using the Judet technique after learning the technique in the originators hospital. A preoperative non union scoring system was also used to assess its use in predicting persistent non-union. Union was successfully achieved in 36 of the 39 surviving cases (92.3%) after a median delay of 8 months (range 3-47, SD 9.2) Twenty-six patients (65%) achieved union following the decortication procedure without subsequent operations. Factors such as open fracture and smoking did not have a statistically significant effect on union. The mean number of procedures following decortication was 0.68 (range 0-4). Metalwork failure occurred in 11 cases (28%), the majority in femoral decortications (n=9, 82%). The femur was the site of all persistent non unions in the series. Three patients had superficial infections and two had deep infections. The pre-operative non union scoring system (0-100) means were noticeably worse for the persistent non union group 42.0 (20-46) compared with the union group 31.0 (range 4-52). Osteoperiosteal

  2. Low-intensity pulsed ultrasound treatment for postoperative delayed union or nonunion of long bone fractures. (United States)

    Jingushi, Seiya; Mizuno, Kosaku; Matsushita, Takashi; Itoman, Moritoshi


    Postoperative delayed union and nonunion is the most common complication in fracture treatment. Recent studies have shown an accelerating effect of low-intensity pulsed ultrasound (LIPUS) on fracture repair. However, the indications for delayed union and nonunion are not clear. To clarify the factors which influence the effects of LIPUS, the data from a previous prospective multicenter study on LIPUS treatment for postoperative delayed union and nonunion of long bone fractures were reanalyzed. Seventy-two cases of long bone fracture, including those of the femur, tibia, humerus, radius, and ulna, were analyzed. The mean time from the most recent operation to the beginning of LIPUS treatment was 11.5 (3-68) months. The relationship between the background factors and the union rate was analyzed using a logistic regression method. In addition, long bone fractures in an upper extremity or in a lower extremity were analyzed separately. The union rate was 75% in all the cases of long bone fracture. There was a significant relationship between the union rate and the period from the most recent operation to the beginning of LIPUS treatment in all cases and in those that had long bone fracture of an upper extremity. There was also a significant relationship between the union rate and the time when a radiological improvement was first observed after the beginning of the treatment in all cases and in those with fractures in a lower extremity. When LIPUS treatment was started within 6 months of the most recent operation, 89.7% of all fractures healed. When an improvement in the radiological changes at the fracture site was observed after 4 months in those cases, then the sensitivity and specificity for union were more than 90%. LIPUS treatment should be started within 6 months of the most recent operation. Because LIPUS has been shown to be effective without causing either serious invasiveness or any undue risk to the patient, it may be considered the treatment of first choice

  3. Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing. (United States)

    Oh, Hyoung-Keun; Choo, Suk-Kyu; Kim, Ji-Wan; Lee, Mark


    We present the surgical technique of separate vertical wiring for displaced inferior pole fractures of the patella combined with Krachow suture and report the surgical outcomes. Between September 2007 to May 2012, 11 consecutive patients (mean age, 54.6 years) with inferior pole fractures of the patella (AO/OTA 34-A1) were retrospectively enrolled in this study. Through longitudinal incision, all patients underwent open reduction and internal fixation by separate vertical wiring combined with Krackow suture. The range of motion, loss of fixation, and Bostman score were primary outcome measures. The union time was 10 weeks after surgery on average (range: 8-12). No patient had nonunion, loss of reduction and wire breakage. There was no case of wound problem and irritation from the implant. At final follow-up, the average range of motion arc was 129.4° (range: 120-140). The mean Bostman score at last follow-up was 29.6 points (range: 28-30) and graded excellent in all cases. Separate vertical wiring combined with Krackow suture for inferior pole fractures of the patella is a useful technique that is easy to perform and can provide stable fixation with excellent results in knee function. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Proximal Probes Facility (United States)

    Federal Laboratory Consortium — The Proximal Probes Facility consists of laboratories for microscopy, spectroscopy, and probing of nanostructured materials and their functional properties. At the...

  5. Distraction lengthening of the proximal phalanx in distal thumb amputations. (United States)

    Cansü, Eren; Ünal, Mehmet Bekir; Parmaksızoğlu, Fatih; Gürcan, Serkan


    Thumb amputation is a major cause of hand dysfunction, and the treatment for distal thumb amputations remains controversial. Although finger reconstruction methods using distraction lengthening are known to restore finger length and function, we found no reports in the literature regarding phalangeal lengthening in thumb amputations. We aimed to evaluate proximal phalangeal lengthening in thumb amputations at or near the interphalangeal (IP) joint. We retrospectively evaluated patients who had undergone distraction lengthening of the proximal phalanx of the thumb. All patients underwent osteotomy, either during the initial procedure or as a second-stage procedure. Distraction began 10 days after osteotomy with the use of an external fixator that remained in place until ossification of the gap occurred without bone grafting. Patients were evaluated using the QuickDASH score. Fourteen patients with a mean age of 27 years and a mean follow-up period of 7 years were enrolled. The mean phalangeal lengthening achieved was 20 mm. Ossification occurred at all distraction sites, and the fixators were maintained for a mean of 85 days. The mean healing index was 42.5 days/cm. All 14 patients achieved the desired amount of phalangeal lengthening without major complications such as nonunion, premature union, or gross infection. For reconstruction in cases of distal thumb amputations, distraction lengthening of the proximal phalanx can be used to improve absolute length, web space, and grip distance. The technique is safe and effective, improves functionality/cosmesis, and offers a low complication risk.

  6. Role of autologous platelet-rich plasma in treatment of long-bone nonunions: a prospective study. (United States)

    Malhotra, R; Kumar, V; Garg, B; Singh, R; Jain, V; Coshic, P; Chatterjee, K


    Fracture union is a complex biological process, which depends upon several systemic and local factors. Disturbance of any of these factors may lead to nonunion of the fracture. These nonunions have a huge impact on quality of life as well as socioeconomical aspects. The platelets on activation release a number of growth factors and differentiation factors, which play important role in fracture healing. This study aimed to look for efficacy of platelet-rich plasma in the treatment of established fracture nonunions of long bones. A total of 94 patients with established nonunion of long bone (35 tibia, 30 femur, 11 humerus, 4 radius, 12 ulna, 2 with both radius and ulna) were included in this study. We injected 15-20 ml of autologous platelet-rich plasma (>2,000,000 platelets/μl) under image intensifier at each nonunion site. The fracture union was evaluated clinically and radiologically regularly at monthly interval till 4 months. Eighty-two patients had their fracture united at the end of 4 months. Thirty-four patients showed bridging trabeculae on X-rays at the end of 2 months, while 41 patients showed bridging trabeculae at the end of third month. Twelve patients did not show any attempt of union at 4 months and were labeled as failure of treatment. There were no complications. Platelet-rich plasma is a safe and effective treatment for the treatment of nonunions. More studies are needed to look into molecular mechanism of this fracture healing acceleration by platelet-rich plasma.

  7. Acute scaphoidectomy and four-corner fusion for the surgical treatment of trans-scaphoid perilunate fracture dislocation with pre-existing scaphoid non-union. (United States)

    Roberts, Darren; Power, Dominic Michael


    This paper presents a rare case of trans-scaphoid perilunate fracture dislocation with concurrent scaphoid non-union of the left wrist following a motorcycle accident. Emergent CT identified scaphoid non-union advanced collapse and an acute scaphoidectomy, four-corner fusion, denervation and radiocarpal ligament repair was performed. 2015 BMJ Publishing Group Ltd.

  8. Combined Bone Transportation and Lengthening Techniques for the Treatment of Septic Nonunion of the Forearm Followed by Tendon Transfer

    Directory of Open Access Journals (Sweden)

    Konstantinos Ditsios


    Full Text Available Infected nonunion of a forearm fracture complicated by a considerable skin-muscle defect poses a great challenge to orthopaedic surgeons. The treatment strategy comprises eradication of the infection, ensuring bony union and soft tissue coverage along with functional restoration. We report a case of a 23-year-old man with an open Gustilo-Anderson IIIb fracture complicated by infected nonunion after internal fixation. After thorough surgical debridement, a considerable soft tissue defect, extensor muscle loss, and posterior interosseous nerve laceration had to be addressed. He was finally treated with bone transportation and bone lengthening followed by tendon transfers.

  9. Miks pole Eestis edukat keskklassi? / Heimar Lenk

    Index Scriptorium Estoniae

    Lenk, Heimar, 1946-


    Riigikogu liikme sõnul pole Eesti häda mitte rikaste rikkuses, vaid selles, et meil pole välja kujunenud keskklassi. Eestis puudub keskklass seetõttu, et rahvas on majanduslikult liialt kihistunud, tugevalt paremale kaldu poliitika on soodustanud vaid kitsa kildkonna rikastumist

  10. New pole placement algorithm - Polynomial matrix approach (United States)

    Shafai, B.; Keel, L. H.


    A simple and direct pole-placement algorithm is introduced for dynamical systems having a block companion matrix A. The algorithm utilizes well-established properties of matrix polynomials. Pole placement is achieved by appropriately assigning coefficient matrices of the corresponding matrix polynomial. This involves only matrix additions and multiplications without requiring matrix inversion. A numerical example is given for the purpose of illustration.

  11. Management of a humeral shaft non-union after a Gustilo III C fracture. (United States)

    Conserva, Vito; Vicenti, Giovanni; Abate, Antonella; Pesce, Vito; Moretti, Biagio


    A 25-year-old man was admitted to our Department with an open humeral shaft fracture (Gustilo III C); two large wounds were noticed with ulnar artery and median nerve completely dissected. Initial primary treatment included irrigation, debridement and fracture stabilization with a monolateral external fixator followed by vascular and nerve repair and wound closure. At 6 months follow up the patient was able to use his arm without any painful stimuli and a CT scan showed the presence of postero-medial callus formation. Consequently, the external fixator was removed and the patient was discharged to physiotherapy. After 7 months, the patient presented with severe pain and functional impairment with no history of trauma. X rays showed recent re-fracture on a background of oligotrophic nonunion. Revision surgery included debridement of the non-union bone edges, reaming of the medullary canal and insertion of a humeral nail. Six months later osseous healing was noted with complete restoration of shoulder and elbow movement and partial recovery of the median nerve. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Triple attack technique for non-union of femoral neck fractures. (United States)

    Abdelazeem, Hazem; Abdelazeem, Ahmed; Al-Dars, Ahmed; Hegazy, Mohamed; Abdellatif, Nasef


    The purpose of this study was to describe the technique and clinical results following the utilization of biomechanical and biological means for adequate fracture healing in management of non-union of the neck of femur while preventing distortion of normal hip biomechanics. Twenty-two patients with non-united fractures of femoral neck in adults were treated with what was termed the 'triple attack' procedure. This constituted iliac autogenous bone grafting, valgus subtrochanteric osteotomy together with static fixation across the non-union fracture site of the neck to avoid delayed femoral neck shortening. All patients were classified as Pauwel's type III fractures. The mean time interval between the last operation and the current procedure was 4.6 months. Average operative time was 58.6 minutes. Patients were followed up for an average of 43.6 months. Complete union was achieved in all cases at an average of 4.3 months. Significant improvement of all radiological parameters was noticed together with the Harris hip score from an average of 21.2 pre-operatively to 89.6 at the last follow-up. The present study provides encouraging clinical and functional results to suggest that this newly described procedure ('triple attack') might be a valuable option in the management of non-united femoral neck fractures.

  13. Planar glass devices for efficient periodic poling

    DEFF Research Database (Denmark)

    Fage-Pedersen, Jacob; Jacobsen, Rune Shim; Kristensen, Martin


    We demonstrate that frequency-converting devices of high quality can be realised with glass poling. The devices, made with silica-on-silicon technology, are poled with periodic, embedded electrodes, and used for second-harmonic generation. We obtain precise control of the quasi phase-matching wav......We demonstrate that frequency-converting devices of high quality can be realised with glass poling. The devices, made with silica-on-silicon technology, are poled with periodic, embedded electrodes, and used for second-harmonic generation. We obtain precise control of the quasi phase......-matching wavelength and bandwidth, and a normalised conversion efficiency of 1.4×10-3 %/W/cm2 which, to our knowledge, is the highest obtained so far with periodic glass poling....

  14. Baryon transition form factors at the pole

    Energy Technology Data Exchange (ETDEWEB)

    Tiator, L.; Döring, M.; Workman, R. L.; Hadžimehmedović, M.; Osmanović, H.; Omerović, R.; Stahov, J.; Švarc, A.


    Electromagnetic resonance properties are uniquely defined at the pole and do not depend on the separation of the resonance from background or the decay channel. Photon-nucleon branching ratios are nowadays often quoted at the pole, and we generalize the considerations to the case of virtual photons. We derive and compare relations for nucleon to baryon transition form factors both for the Breit-Wigner and the pole positions. Using the MAID2007 and SAID SM08 partial wave analyses of pion electroproduction data, we compare the $G_M$, $G_E$, and $G_C$ form factors for the $\\Delta(1232)$ resonance excitation at the Breit-Wigner resonance and pole positions up to $Q^2=5$ GeV$^2$. We also explore the $E/M$ and $S/M$ ratios as functions of $Q^2$. For pole and residue extraction, we apply the Laurent + Pietarinen method.

  15. Poling of planar silica-based waveguides

    DEFF Research Database (Denmark)

    Arentoft, Jesper; Leistiko, Otto


    Planar silica-based waveguides were electrically poled at elevated temperatures and cooled with the field still applied. This procedure induced second-order nonlinear effects in the waveguides. Systematic studies of the dependence of the induced linear electro-optic effect on polilng temperature...... and the poling voltage were performed using a negative voltage on the top electrode. It was found that the optimum poling temperature is -430 C. A linear dependence of the induced linear electro-optic effect on the voltage was observed. The largest measured linear electro-optic coefficient was 0.07 pm/V. A model...... recorded with spatially resolved second-harmonic generation. Very large second-harmonic signals were obtained when poling with a positive voltage on a painted-on top electrode. Calibration of the signals to GaAs showed that the second-order nonlinear susceptibility of the poled glass corresponds to -48 pm...

  16. Surgical treatment of proximal humerus fractures using PHILOS plate

    Directory of Open Access Journals (Sweden)

    Vijay Sharma


    Full Text Available 【Abstract】Objective: To evaluate functional outcome and complications of open reduction and internal fixation with proximal humeral internal locking system (PHILOS plate for proximal humerus fractures. Methods: We reviewed 51 patients who underwent open reduction and internal fixation with PHILOS plate between the years 2007 to 2012. There were 35 men and 16 women with a mean age of 38 years (range 24-68. There were 41 patients in the age group of <60 years and 10 patients in the age group of >60 years. According to Neer classification system, 8, 15 and 23 patients had 2-part, 3-part, and 4-part fractures, respectively and 5 patients had 4-part fracture dislocation. All surgeries were carried out at our tertiary care trauma centre. Functional evaluation of the shoulder at final follow-up was done using Constant-Murley score. Results: The mean follow-up period was 30 months (range 12-44 months. Two patients were lost to followup. Of the remaining 49 patients, all fractures were united clinically and radiologically. The mean time for radiological union was 12 weeks (range 8-20 weeks. At the final follow-up the mean Constant-Murley score was 79 (range 50-100. The results were excellent in 25 patients, good in 13 patients, fair in 6 atients and poor in 5 patients. During the follow-up, four cases of varus malunion, one case of subacromial impingement, one case of deep infection, one case of intraarticular screw penetration and one case of failure of fi xation were noted. No cases of avascular necrosis, hardware failure, locking screw loosening or nonunion were noted. Conclusion: PHILOS provides stable fixation in proximal humerus fractures. To prevent potential complications like avascular necrosis, meticulous surgical dissection to preserve vascularity of humeral head is necessary. Key words: Proximal humerus fracture; Fracture fixation, internal; Proximal humeral internal locking system

  17. Holography with a Landau pole (United States)

    Faedo, Antón F.; Mateos, David; Pantelidou, Christiana; Tarrío, Javier


    Holography for UV-incomplete gauge theories is important but poorly understood. A paradigmatic example is d = 4, N=4 super Yang-Mills coupled to N f quark flavors, which possesses a Landau pole at a UV scale ΛLP. The dual gravity solution exhibits a UV singularity at a finite proper distance along the holographic direction. Despite this, holographic renormalization can be fully implemented via analytic continuation to an AdS solution. The presence of a UV cut-off manifests itself in several interesting ways. At energies E ≪ ΛLP no pathologies appear, as expected from effective field theory. In contrast, at scales E ≲ ΛLP the gravitational potential becomes repulsive, and at temperatures T ≲ ΛLP the specific heat becomes negative. Although we focus on N=4 super Yang-Mills with flavor, our qualitative results apply to a much more general class of theories, since they only depend on the fact that the metric near the UV singularity is a hyper-scaling violating metric with exponent θ > d - 1.

  18. Holography with a Landau pole

    Energy Technology Data Exchange (ETDEWEB)

    Faedo, Antón F. [Departament de Física Quántica i Astrofísica and Institut de Ciències del Cosmos (ICC), Universitat de Barcelona, Martí i Franquès 1, ES-08028, Barcelona (Spain); Mateos, David [Departament de Física Quántica i Astrofísica and Institut de Ciències del Cosmos (ICC), Universitat de Barcelona, Martí i Franquès 1, ES-08028, Barcelona (Spain); Institució Catalana de Recerca i Estudis Avançats (ICREA), Passeig Lluís Companys 23, ES-08010, Barcelona (Spain); Pantelidou, Christiana [Departament de Física Quántica i Astrofísica and Institut de Ciències del Cosmos (ICC), Universitat de Barcelona, Martí i Franquès 1, ES-08028, Barcelona (Spain); Tarrío, Javier [Physique Théorique et Mathématique, Université Libre de Bruxelles (ULB), and International Solvay Institutes, Campus de la Plaine CP 231, B-1050, Brussels (Belgium)


    Holography for UV-incomplete gauge theories is important but poorly understood. A paradigmatic example is d=4, N=4 super Yang-Mills coupled to N{sub f} quark flavors, which possesses a Landau pole at a UV scale Λ{sub LP}. The dual gravity solution exhibits a UV singularity at a finite proper distance along the holographic direction. Despite this, holographic renormalization can be fully implemented via analytic continuation to an AdS solution. The presence of a UV cut-off manifests itself in several interesting ways. At energies E≪Λ{sub LP} no pathologies appear, as expected from effective field theory. In contrast, at scales E≲Λ{sub LP} the gravitational potential becomes repulsive, and at temperatures T≲Λ{sub LP} the specific heat becomes negative. Although we focus on N=4 super Yang-Mills with flavor, our qualitative results apply to a much more general class of theories, since they only depend on the fact that the metric near the UV singularity is a hyper-scaling violating metric with exponent θ>d−1.

  19. Laparoscopic upper-pole nephroureterectomy in infants. (United States)

    Miranda, Marcio L; Oliveira-Filho, Antonio G; Carvalho, Patricia T; Ungersbock, Elaine; Olimpio, Hugo; Bustorff-Silva, Joaquim M


    Report the results of laparoscopic upper-pole nephroureterectomy in infants. Six consecutive infants underwent 7 laparoscopic upper-pole nephroureterectomy. Pre and postoperative evaluation included renal sonography, voiding cystourethrogram and renal scintigraphy. All infants showed upper-pole exclusion. Surgery was performed through a transperitoneal approach with full flank position in all infants. Three or 4 ports were used according to the necessity of retracting the liver. The distal ureter was ligated close to the bladder whenever reflux was present and the dysplastic upper-pole was divided with the help of an electrocautery. Data regarding operative time, postoperative use of analgesics, time to resume oral feeding, hospital stay and tubular function were collected and analyzed. All procedures were concluded as planned. Mean operative time was 135 min. One patient underwent staged bilateral upper-pole nephrectomy. There were no complications and the postoperative hospital stay was 48 hours in 5 procedures and 24 hours in 2 procedures. Pain medication was required only in the first day. Renal tubular function showed improvement in half of the cases. Laparoscopic partial nephrectomy is a safe and feasible procedure in infants. Due to the magnification provided by the lenses, a better vision of the structures is achieved, facilitating selective dissection of vascular upper-pole, renal parenchyma and distal ureter. This approach is less damaging to the lower pole, and is associated to low morbidity and a short hospital stay.

  20. Laparoscopic upper-pole nephroureterectomy in infants

    Directory of Open Access Journals (Sweden)

    Marcio L. Miranda


    Full Text Available OBJECTIVE: Report the results of laparoscopic upper-pole nephroureterectomy in infants. MATERIALS AND METHODS: Six consecutive infants underwent 7 laparoscopic upper-pole nephroureterectomy. Pre and postoperative evaluation included renal sonography, voiding cystourethrogram and renal scintigraphy. All infants showed upper-pole exclusion. Surgery was performed through a transperitoneal approach with full flank position in all infants. Three or 4 ports were used according to the necessity of retracting the liver. The distal ureter was ligated close to the bladder whenever reflux was present and the dysplastic upper-pole was divided with the help of an electrocautery. Data regarding operative time, postoperative use of analgesics, time to resume oral feeding, hospital stay and tubular function were collected and analyzed. RESULTS: All procedures were concluded as planned. Mean operative time was 135 min. One patient underwent staged bilateral upper-pole nephrectomy. There were no complications and the postoperative hospital stay was 48 hours in 5 procedures and 24 hours in 2 procedures. Pain medication was required only in the first day. Renal tubular function showed improvement in half of the cases. CONCLUSION: Laparoscopic partial nephrectomy is a safe and feasible procedure in infants. Due to the magnification provided by the lenses, a better vision of the structures is achieved, facilitating selective dissection of vascular upper-pole, renal parenchyma and distal ureter. This approach is less damaging to the lower pole, and is associated to low morbidity and a short hospital stay.

  1. Geometric Modelling of Octagonal Lamp Poles

    Directory of Open Access Journals (Sweden)

    T. O. Chan


    Full Text Available Lamp poles are one of the most abundant highway and community components in modern cities. Their supporting parts are primarily tapered octagonal cones specifically designed for wind resistance. The geometry and the positions of the lamp poles are important information for various applications. For example, they are important to monitoring deformation of aged lamp poles, maintaining an efficient highway GIS system, and also facilitating possible feature-based calibration of mobile LiDAR systems. In this paper, we present a novel geometric model for octagonal lamp poles. The model consists of seven parameters in which a rotation about the z-axis is included, and points are constrained by the trigonometric property of 2D octagons after applying the rotations. For the geometric fitting of the lamp pole point cloud captured by a terrestrial LiDAR, accurate initial parameter values are essential. They can be estimated by first fitting the points to a circular cone model and this is followed by some basic point cloud processing techniques. The model was verified by fitting both simulated and real data. The real data includes several lamp pole point clouds captured by: (1 Faro Focus 3D and (2 Velodyne HDL-32E. The fitting results using the proposed model are promising, and up to 2.9 mm improvement in fitting accuracy was realized for the real lamp pole point clouds compared to using the conventional circular cone model. The overall result suggests that the proposed model is appropriate and rigorous.

  2. Successful treatment of nonunion with an Ilizarov ring fixator after ankle fracture for Charcot arthropathy: a case report. (United States)

    Nozaka, Koji; Shimada, Yoichi; Kimura, Yoshiaki; Yamada, Shin; Kashiwagura, Takeshi; Sakuraba, Tsutomu; Wakabayashi, Ikuko


    Ankle fractures in patients with diabetes mellitus have long been recognized as a challenge to orthopedic surgeons. Nonunion and lengthy wound healing in high-risk patients with diabetes, particularly patients with peripheral arterial disease and renal failure, occur secondary to several clinical conditions and are often fraught with complications. Whether diabetic ankle fractures are best treated noninvasively or surgically is controversial. A 53-year-old Japanese man fractured his right ankle. The fractured ankle was treated nonsurgically with a plaster cast. Although he remained non-weight-bearing for 3 months, radiography at 3 months showed nonunion. The nonunion was treated by Ilizarov external fixation of the ankle. The external fixator was removed 99 days postoperatively, at which time the patient exhibited anatomical and functional recovery and was able to walk without severe complications. In patients with diabetes mellitus, severe nonunion of ankle fractures with Charcot arthropathy in which the fracture fragment diameter is very small and the use of internal fixation is difficult is a clinical challenge. Ilizarov external fixation allows suitable fixation to be achieved using multiple Ilizarov wires.

  3. A treatment for large defects of the tibia caused by infected nonunion: Ilizarov method with bone segment extension. (United States)

    Xu, K; Fu, X; Li, Y-M; Wang, C-G; Li, Z-J


    To investigate the efficacy of the Ilizarov technique with bone segment extension in tibial infected nonunion. From September 2003 to June 2011, we treated 30 patients (21 males, 9 females; age 19-49 years, mean 34.1 years) for tibial infected nonunion with bone defects. Eleven cases were compound fractures internally fixed with steel plates, nine were compound fractures internally fixed with IM Nails, eight were compound fractures externally fixed with external fixation devices, and two were closed fractures internally fixed with steel plates. All 30 patients underwent debridement followed by the Ilizarov technique using bone segment extension. After follow-up of 12 months-6 years (mean 29 months), stable union of fracture was achieved in all 30 patients. The time from bone fracture to union was 6-24 months, mean 8.8 months; external fixation was in place for 8-14 months, mean 10 months. External fixation index was 41 days/cm. Complications were three cases of pin site infection, one skin allergy, two fractures malunion, one early mineralization and one wire breakage. There were no cases of deep infection, nonunion or stiffness of the knee joint. According to the Paley fracture healing score criteria, 30 cases had excellent outcomes and two were good. The Ilizarov technique with bone segment extension is effective in treating tibial infected nonunion with large bone defects.

  4. [Reconstruction of condyle in treatment of refractory condylar nonunion and defect of humerus]. (United States)

    Niu, Yunfei; Zhang, Chuncai; Yu, Baoqing; Xu, Shuogui; Wang, Jialin; Su, Jiacan; Zhang, Peng; Guan, Huapeng; Liu, Xinwei; Li, Zhuodong


    To discuss the strategy of condylar reconstruction in the treatment of refractory condylar nonunion and defect of humerus. From September 1998 to September 2005, 18 patients with refractory condylar nonunion concomitant withdefect of humerus were treated. The series included 12 males and 6 females, aged 18 to 60 years. According to AO/ASIF system, primal fractures were classified, including 5 cases of type A3, 2 cases of type B1, 4 cases of type C2 and 7 cases of type C3 fractures. Condylar nonunion and defect of humerus were confirmed by preoperative X-ray. Defective bone mass was 1-4 cm2. The mean extension and flexion of elbow joint was 21.5 degrees (5-65 degrees) and 95.8 degrees (85.0-123.5 degrees) respectively. According to Cassebaum scoring system, the excellent and good rate was 27.8% (excellent in 1 case and good in 4 cases). Time from injury to operation averaged 22.8 months (7-52 months). All patients were operated with approach of olecranon osteotomy. Bone defect was reconstructed with iliac autograft. Shape memory compressive connector, Kirschner wire, cannulated nail, anatomic plates and reconstruction plates were used to fix. Eighteen patients were followed up 12-86 months (mean 27.6 months). All the incisions healed by first intention. No bone block displacement,loosening or breakage of internal fixation occurred. The time of bone union averaged 5.7 months (4-8 months). The mean extension and flexion of elbow joint were 11.4 degrees (0-44.5 degrees) and 128.6 degrees (105.5-144.5 degrees) 1 year after operation. Ectopicossification formed in 1 case at anterior part of elbow 4 months after operation. According to Cassebaum scoring system,the results were excellent in 8 cases, good in 6 cases, fair in 3 cases and poor in 1 case. The excellent and good rate was 77.8%. The shape of humeral condyle can be reconstructed with iliac autograft. Compressive internal fixation of bone block can promote bone union. Anatomical reconstruction, rigid internal

  5. Tree-loop duality relation beyond single poles

    Energy Technology Data Exchange (ETDEWEB)

    Bierenbaum, Isabella [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik; Buchta, Sebastian; Draggiotis, Petros; Malamos, Ioannis; Rodrigo, German [Valencia Univ. Paterna (Spain). Inst. de Fisica Corpuscular


    We develop the Tree-Loop Duality Relation for two- and three-loop integrals with multiple identical propagators (multiple poles). This is the extension of the Duality Relation for single poles and multi-loop integrals derived in previous publications. We prove a generalization of the formula for single poles to multiple poles and we develop a strategy for dealing with higher-order pole integrals by reducing them to single pole integrals using Integration By Parts.

  6. [{sup 18}F]FDG PET accurately differentiates infected and non-infected non-unions after fracture fixation

    Energy Technology Data Exchange (ETDEWEB)

    Wenter, Vera; Albert, Nathalie L.; Brendel, Matthias; Fendler, Wolfgang P.; Bartenstein, Peter [University of Munich, Department of Nuclear Medicine, Munich (Germany); Cyran, Clemens C. [University of Munich, Institute for Clinical Radiology, Munich (Germany); Friederichs, Jan; Mueller, Jan-Philipp; Militz, Matthias; Hungerer, Sven [BG Trauma Center Murnau, Department of Reconstructive Arthroplasty, Murnau (Germany); PMU Salzburg, Paracelsus Medical University, Salzburg (Austria); Hacker, Marcus [University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria)


    Complete fracture healing is crucial for good patient outcomes. A major complication in the treatment of fractures is non-union. The pathogenesis of non-unions is not always clear, although implant-associated infections play a significant role, especially after surgical treatment of open fractures. We aimed to evaluate the value of [{sup 18}F]FDG PET in suspected infections of non-union fractures. We retrospectively evaluated 35 consecutive patients seen between 2000 and 2015 with suspected infection of non-union fractures, treated at a level I trauma center. The patients underwent either [{sup 18}F]FDG PET/CT (N = 24), [{sup 18}F]FDG PET (N = 11) plus additional CT (N = 8), or conventional X-ray (N = 3). Imaging findings were correlated with final diagnosis based on intraoperative culture or follow-up. In 13 of 35 patients (37 %), infection was proven by either positive intraoperative tissue culture (N = 12) or positive follow-up (N = 1). [{sup 18}F]FDG PET revealed 11 true-positive, 19 true-negative, three false-positive, and two false-negative results, indicating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 85 %, 86 %, 79 %, 90 %, and 86 %, respectively. The SUV{sub max} was 6.4 ± 2.7 in the clinically infected group and 3.0 ± 1.7 in the clinically non-infected group (p <0.01). The SUV{sub ratio} was 5.3 ± 3.3 in the clinically infected group and 2.6 ± 1.5 in the clinically non-infected group (p <0.01). [{sup 18}F]FDG PET differentiates infected from non-infected non-unions with high accuracy in patients with suspected infections of non-union fractures, for whom other clinical findings were inconclusive for a local infection. [{sup 18}F]FDG PET should be considered for therapeutic management of non-unions. (orig.)

  7. Osteoinduction properties of different growth factors on cells from non-union patients: in vitro study for clinical application. (United States)

    Gigante, A; Cappella, M; Manzotti, S; Cecconi, S; Greco, F; Di Primio, R; Mattioli-Belmonte, M


    This report compares the effect of rhBMPs and PRG on cells derived from human non-union sites. Treatment of non-union continues to be a challenging task for the trauma surgeon often resulting in unsatisfactory results and long-term morbidity. Over the past two decades, the possibility to use growth factors in bone regeneration has been investigated. In this study we compared the in vitro capability of two recombinant human bone morphogenetic proteins (rhBMP-2 and rhBMP-7) and activated platelet-rich plasma (PRG) to stimulate proliferation and/or differentiation of cells derived from non-union patients. Cells derived from the lesion sites, osteoblasts and mesenchymal stem cells (MSCs) derived from other bone sites of the same patients were used. Treatment with rhBMP-7 or rhBMP-2 showed an improvement in the expression of osteoblastic markers (osteonectin and osteocalcin) in cells derived from human non-union sites. This enhancement was more marked in MSCs, while no significant changes were observed in osteoblast cultures. The PRG treatment produced in all analysed samples a considerable increase in cell proliferation without affecting cell differentiation. On the basis of our results, for an effective biological treatment of non-unions, small amounts of autologous bone marrow (MSCs) are necessary in the lesion site in order to provide both growth factors and a sufficient number of responsive cells. Finally, our results prove that sequential timing administration of PRG and rhBMPs may be used in new therapeutic strategy.

  8. One-stage reconstruction with open bone grafting and vacuum-assisted closure for infected tibial non-union. (United States)

    Deng, Zhouming; Cai, Lin; Jin, Wei; Ping, Ansong; Wei, Renxiong


    Non-union of the tibia complicated by osteomyelitis is one of the most challenging problems in orthopaedic surgery. There remains a significant amount of debate and controversy regarding the optimal medical management of infected tibial non-union. There are few articles which have reported the outcomes of treatment for infected non-union of tibia from single-stage reconstruction with open bone grafting plus vacuum-assisted closure (VAC). Our report covers experience between March 2007 and February 2010 of open bone grafting plus VAC in one stage for patients with infected tibial non-union. The time for bone union and wound healing to occur, the duration of hospitalisation, and the rate of resolution of infection were all analysed. The main outcome measures were based on a clinical scoring system that assessed functional ability, range of knee and ankle motion, shortening, infection and pain. Fifteen patients were involved in this study. All patients were followed up for an average of 22.6 months (range: 14-42 months). Bone union was achieved in 93.3% (14/15) of patients after a mean of 5.93 months (range: 3-10 months). All wounds healed within an average period of 5 weeks (range: 3-10 weeks), and the function and appearance of all limbs were satisfactory. Open bone grafting combined with VAC in a one-stage procedure can be a feasible alternative to the treatment of infected tibial non-union, especially for those wounds which are not good candidates for microsurgery; however, further studies are required to confirm the likely benefits.

  9. Functional outcomes of proximal row carpectomy: 2-year follow-up. (United States)

    Mandarano-Filho, Luiz Garcia; Campioto, Débora Schalge; Bezuti, Márcio Takey; Mazzer, Nilton; Barbieri, Cláudio Henrique


    : To evaluate functional outcomes of patients submit-ted to proximal row carpectomy for the treatment of wrist arthri-tis. : This is a retrospective study using wrist motion and grip strenght of patients diagnosed with Kienböck disease and scaphoid non-union surgically treated by this technique. : Eleven patients with 2-year follow-up were evaluated. Wrist motion (flexion, extension and ulnar deviation) and grip strength were significantly better from preoperative values. Ho-wever, no difference in radial deviation was observed in these patients. : Proximal row carpectomy provides an alternative option for treatment of wrist arthritis, resulting in better active range of motion and grip strength in the long run. Level of Evidence IV, Case Series.

  10. Application of Local Vibrations in Delayed and Non-Union Fractures: a Case Study (United States)

    Trombetta, Chiara; Abundo, Paolo; Foti, Calogero; Rosato, Nicola


    The aim of the study was to assess the efficacy of local vibration treatments (LV) in delayed-union and non-union fractures, through therapeutic exercise vibration (TEV) practice, analysing the radiological trend. The Medical Engineering Service of the Fondazione Policlinico Tor Vergata in collaboration with the Chair-Department of Rehabilitation Medicine of the University of Rome Tor Vergata and the Boscosystem company, is developing a device dedicated to LV application, to favour bone regeneration and muscle strengthening. This case report analyses the bone activity of a male patient presenting a right tibial fracture, treated with TEV. At the end of the TEV program, clinical results confirmed independent ambulation with disappearance of perimalleolar edema, while radiographic images revealed the presence of bone repair activity around the fracture line.

  11. Nonunion of the femoral neck: Possibilities and limitations of the various treatment modalities

    Directory of Open Access Journals (Sweden)

    Raaymakers Ernst


    Full Text Available Nowadays in cases of nonunions of the femoral neck, the surgeon is tempted to perform prosthetic replacement of the hip, more so if there is also evidence of avascular necrosis of the head of femur. This provides rapid pain relief and allows early mobilization. However, long-term results of hip arthroplasties, especially in younger people and in the presence of osteopenia, are not always as expected; and a less radical approach is worth considering. The intertrochanteric valgization osteotomy, described by Pauwels, is an excellent alternative for healthy patients up to 65 years of age with a nonunion of the femoral neck. A union rate of 80-90% of the nonunion is described by most authors. Leg length inequallity, rotational and angular deformities can be corrected at the same time. During the period 1973-1995, we performed valgization osteotomy according to Pauwels in 66 patients of, 18-72 years old (mean 49.5 years. 24 (37% of our patients died 4 months to 24 years (mean: 9.5 years after the operation. Union of the femoral neck was achieved in 58 (88% of the 66 patients; union of the osteotomy in 65 patients (99%. A good or excellent result was achieved in 62% (23 uneventful and 13 with healed, necrosis/arthrosis without need for further treatment of our patients. However, the method has its limits. We feel if there is too little bone stock inside the femoral head, a valgization osteotomy does not give good result. The radiographic signs of avascular necrosis in patients over 30 years of age is considered a contraindication for an osteotomy. However our results show that it is worthwhile trying to save the joint of young patients even in case of a segmental collapse. In the race between revascularization and collapse, often revascularization is the winner. We deliberately give nature its chance and don′t rely on the result of bleeding from drill holes in the head, nuclear scans and other methods to estimate vascularity. A secondary total hip

  12. VT Green Mountain Power Pole Data (United States)

    Vermont Center for Geographic Information — (Link to Metadata) Green Mountain Power (GMP) pole and OVERHEAD linear distribution/sub-transmission model data. THE LINEAR DISTRIBUTION LAYER ONLY INCLUDES OVERHEAD...

  13. The CRREL South Pole tunneling system

    National Research Council Canada - National Science Library

    Walsh, Michael R


    .... Army Cold Regions Research and Engineering Laboratory initiated a project to design, develop, fabricate, test, build, and deploy a system for the machining of unlined tunnels at the Amundsen-Scott South Pole Station...

  14. Failed Surgical Management of Acute Proximal Fifth Metatarsal (Jones) Fractures: A Retrospective Case Series and Literature Review. (United States)

    Granata, Jaymes D; Berlet, Gregory C; Philbin, Terrence M; Jones, Grant; Kaeding, Christopher C; Peterson, Kyle S


    Nonunion, delayed union, and refracture after operative treatment of acute proximal fifth metatarsal fractures in athletes is uncommon. This study was a failure analysis of operatively managed acute proximal fifth metatarsal fractures in healthy athletes. We identified 149 patients who underwent operative treatment for fifth metatarsal fractures. Inclusion criteria isolated skeletally mature, athletic patients under the age of 40 with a minimum of 1-year follow-up. Patients were excluded with tuberosity fractures, fractures distal to the proximal metaphyseal-diaphyseal region of the fifth metatarsal, multiple fractures or operative procedures, fractures initially treated conservatively, and medical comorbidities/risk factors for nonunion. Fifty-five patients met the inclusion/exclusion criteria. Four (7.3%) patients required a secondary operative procedure due to refracture. The average time to refracture was 8 months. All refractures were associated with bent screws and occurred in male patients who participated in professional basketball, professional volleyball, and college football. The average time for release to progressive weight-bearing was 6 weeks. Three patients were revised to a bigger size screw and went on to union. One patient was revised to the same-sized screw and required a second revision surgery for nonunion. All failures were refractures in competitive athletes who were initially treated with small diameter solid or cannulated stainless steel screws. The failures were not associated with early postoperative weight-bearing protocol. Maximizing initial fixation stiffness may decrease the late failure rate in competitive athletes. More clinical studies are needed to better understand risk factors for failure after screw fixation in the competitive, athletic population. Prognostic, Level IV: Case series. © 2015 The Author(s).

  15. Transverse Stress Fracture of the Proximal Patella: A Case Report. (United States)

    Atsumi, Satoru; Arai, Yuji; Kato, Ko; Nishimura, Akinobu; Nakazora, Shigeto; Nakagawa, Shuji; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Sudo, Akihiro; Kubo, Toshikazu


    Among stress fractures associated with sports activities, patellar stress fracture is rare. Regarding patella stress fractures, so far only distal transverse or lateral longitudinal fractures have been reported, but there are no reports of transverse fractures occurring in the proximal patella. We describe an extremely rare case of transverse stress fracture of proximal patella in a 9-year-old athlete.A 9-year old boy, who participated in sports (sprints and Kendo) presented with left knee pain without any external injury. In plain radiographs, a fracture line was observed in the proximal 1/3 of the left patella, and a patella stress fracture was diagnosed. For treatment, because 7 months of conservative therapy showed no improvement, internal fixation was carried out using Acutrak screws, and bone union was thus achieved. Three months after the operation, he was able to return to his previous level of athletic sports activity.Regarding the mechanism of onset, it is believed that the causes are longitudinal traction force and patellofemoral contact pressure. On the other hand, the contact region of the patella with the femur changes with the flexion angle of the knee. In the current case, the fracture occurred at a site where the patella was in contact with the femur at a flexion angle of >90°, so it is believed that it occurred as a clinical condition from being subjected to repeated longitudinal traction force and patellofemoral contact pressure at a flexion angle of >90°, during the sports activities of sprints and Kendo. The nonunion of the transverse stress fracture of his proximal patella was successfully treated with internal fixation using Acutrak screws.

  16. Total hip arthroplasty after failed treatment of proximal femur fracture. (United States)

    Tetsunaga, Tomonori; Fujiwara, Kazuo; Endo, Hirosuke; Noda, Tomoyuki; Tetsunaga, Tomoko; Sato, Toru; Shiota, Naofumi; Ozaki, Toshifumi


    Total hip arthroplasty (THA) is a good option as a salvage procedure after failed treatment of proximal femur fracture. The anatomy of the proximal femur, however, makes this surgery complicated and challenging. The purpose of this study was to evaluate the radiographic and clinical outcomes of THA after failed treatment of proximal femur fractures. We retrospectively analysed 50 consecutive THAs (42 women, 8 men; mean age 77 years) after failed treatment of a proximal femur fracture. Mean postoperative follow-up was 58.1 months. Preoperative diagnoses were femoral neck fracture in 18 hips and trochanteric fracture in 32 hips, including three that were infected. Failure resulted from cutout in 22 cases, osteonecrosis in 12, non-union with failed fixation in nine, postoperative osteoarthritis in four, and infection in three. Factors compared included radiographic assessment, complication rate, visual analogue scale (VAS), and Harris Hip Scores (HHS). Radiographic variables included femoral neck anteversion and cup and stem alignment. Absolute values of the differences in femoral neck anteversion between the affected and healthy sides were 6.0° in the femoral neck fracture group and 19.2° in the trochanteric fracture group (p = 0.01). There were no significant differences in cup anteversion (p = 0.20) or stem anteversion (p = 0.08). The complication rate was significantly higher in the trochanteric fracture group than in the femoral neck fracture group (25 vs 0%, p fracture group included three periprosthetic fractures (9.4%), two dislocations (6.3%), two surgical-site infections (6.3%), and one stem penetration (3.1%). Although no significant differences between groups were seen in the VAS or HHS at final follow-up (p = 0.32, 0.09, respectively), these measures were significantly improved at final follow-up in both groups (p fractures requires consideration of complication risk and incorrect femoral neck anteversion.

  17. On pole structure assignment in linear systems

    Czech Academy of Sciences Publication Activity Database

    Loiseau, J.-J.; Zagalak, Petr


    Roč. 82, č. 7 (2009), s. 1179-1192 ISSN 0020-7179 R&D Projects: GA ČR(CZ) GA102/07/1596 Institutional research plan: CEZ:AV0Z10750506 Keywords : linear systems * linear state feedback * pole structure assignment Subject RIV: BC - Control Systems Theory Impact factor: 1.124, year: 2009 pole structure assignment in linear systems.pdf

  18. Proximal femoral fractures: Principles of management and review of literature (United States)

    Mittal, Ravi; Banerjee, Sumit


    Purpose The purpose of this study was to review the principles involved in the management of proximal femoral fractures as reported in the literature. Methods: A medical literature search in the MEDLINE (PubMed) and Cochrane database was undertaken to review strategies and principles in proximal femoral fracture treatment. Randomized control trials and meta analysis were given preference while case reports/small series were rejected. Results and conclusions: Early anatomical reduction and surgical fixation remains the best option to reduce the risk of complications like non-union and avascular necrosis in treating fracture neck femurs. Cancellous screws continue to be the preferred treatment for fixation of neck femur fractures in younger population until the benefit of using sliding hip screws is validated by large multicentric studies. In the geriatric age group, early prosthetic replacement brings down the mortality and morbidity associated with neck femur fractures. Sliding hip screw (DHS) is the best available option for stable inter trochanteric fractures. The use of intramedullary nails e.g. PFN is beneficial in treating inter trochanteric fractures with comminution and loss of lateral buttress. Intramedullary implants have been proven to have increased success rates in subtrochanteric fractures and should be preferred over extramedullary plate fixation systems. PMID:25983451

  19. Predictors associated with nonunion and symptomatic malunion following non-operative treatment of displaced midshaft clavicle fractures-a systematic review of the literature

    DEFF Research Database (Denmark)

    Jørgensen, Ann Louise; Troelsen, Anders; Ban, Ilija


    was carried out in order to identify publications in English, reporting on predictors for nonunion and malunion in adults with displaced midshaft clavicle fractures. After applying inclusion and exclusion criteria, eight publications were included in this systematic review. RESULTS: A total of 2,117 midshaft...... factors associated with nonunion were identified, six of these (displacement, comminution, shortening, age, gender and smoking) were reported as predictors for nonunion. Outcome definitions varied among the studies. CONCLUSION: The included publications varied greatly in design, sample size, and quality...

  20. Minimally invasive percutaneous plating of proximal humeral shaft fractures with the Proximal Humerus Internal Locking System (PHILOS). (United States)

    Brunner, Alexander; Thormann, Sebastian; Babst, Reto


    This study evaluated our results after minimally invasive percutaneous plating of proximal humeral shaft fractures with the Proximal Humerus Internal Locking System (PHILOS, Synthes, Switzerland). Between 2005 and 2008, 15 patients with unilateral displaced proximal humeral shaft fractures were treated and followed up over a median period of 27 months (range, 12-38 months). The final follow-up included anteroposterior and lateral x-rays, range of shoulder motion, pain by visual analog scale (VAS), the Constant-Murley shoulder score, the Disabilities of Arm, Shoulder and Elbow (DASH) score, and the Short Form 36 (SF36) assessment. No intraoperative or postoperative complications occurred. No secondary fracture displacement or radial neuropathy was observed postoperatively. One patient had open reduction and internal fixation for pseudoarthrosis 16 months after the initial surgery. At the final follow-up, the median range of motion of the operated shoulder was flexion, 145°; extension, 45°; internal rotation, 40°; external rotation, 70°; and abduction, 135°. Median results on outcome assessments were VAS pain score, 0 points; Constant-Murley score, 74 points, representing 87.5% of the median Constant-Murley score of the unaffected shoulder; DASH score, 34 points, and the SF36, 83 points. Minimally invasive percutaneous plating with the PHILOS offers a valid option in the treatment of proximal humeral shaft fractures with comparable rates of nonunion and lower rates of radial neuropathy compared with open procedures. Furthermore, the results indicate that this method is associated with lower rates of wound infection and a shorter stay in the hospital for the patient. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Praveen Sivakumar K


    Full Text Available BACKGROUND Techniques for treating complex proximal humeral fractures vary and include fixations using tension bands, percutaneous pins, bone suture, T-plates, intramedullary nails, double tubular plates, hemiarthroplasty, plant tan humerus fixator plates, Polaris nails and blade plates. Complications of these techniques include cutout or back out of the screws and plates, avascular necrosis, nonunion, malunion, nail migration, rotator cuff impairment and impingement syndromes. Insufficient anchorage from conventional implants may lead to early loosening and failure, especially in osteoporotic bones. In general, nonoperative treatment of displaced three and four-part fractures of the proximal humerus leads to poor outcome due to intraarticular nature of injury and inherent instability of the fragments. Comminuted fractures of the proximal humerus are at risk of fixation failure, screw loosening and fracture displacement. Open reduction and internal fixation with conventional plate and screws has been associated with unacceptably high incidence of screw pull out. PHILOS (the proximal humeral internal locking system plate is an internal fixation system that enables angled stabilisation with multiple interlocking screws for fractures of the proximal humerus. MATERIALS AND METHODS 30 patients with proximal humerus fractures who were admitted in the Department of Orthopaedics, Government General Hospital, Kakinada, during the period November 2014 - November 2016 were taken up for study according to inclusion criteria. All patients were treated with PHILOS plate. These proximal humerus fractures were classified according to Neer’s classification. Patients were followed up at 6 weeks, 12 weeks and 6 months’ interval. Functional outcomes for pain, range of motion and muscle power and function were assessed using the Constant-Murley scoring system. Collected data analysed with independent t-test and ANNOVA test. RESULTS The outcome of the study was 1

  2. Capacitive proximity sensor (United States)

    Kronberg, James W.


    A proximity sensor based on a closed field circuit. The circuit comprises a ring oscillator using a symmetrical array of plates that creates an oscillating displacement current. The displacement current varies as a function of the proximity of objects to the plate array. Preferably the plates are in the form of a group of three pair of symmetric plates having a common center, arranged in a hexagonal pattern with opposing plates linked as a pair. The sensor produces logic level pulses suitable for interfacing with a computer or process controller. The proximity sensor can be incorporated into a load cell, a differential pressure gauge, or a device for measuring the consistency of a characteristic of a material where a variation in the consistency causes the dielectric constant of the material to change.

  3. Neighborhoods and manageable proximity

    Directory of Open Access Journals (Sweden)

    Stavros Stavrides


    Full Text Available The theatricality of urban encounters is above all a theatricality of distances which allow for the encounter. The absolute “strangeness” of the crowd (Simmel 1997: 74 expressed, in its purest form, in the absolute proximity of a crowded subway train, does not generally allow for any movements of approach, but only for nervous hostile reactions and submissive hypnotic gestures. Neither forced intersections in the course of pedestrians or vehicles, nor the instantaneous crossing of distances by the technology of live broadcasting and remote control give birth to places of encounter. In the forced proximity of the metropolitan crowd which haunted the city of the 19th and 20th century, as well as in the forced proximity of the tele-presence which haunts the dystopic prospect of the future “omnipolis” (Virilio 1997: 74, the necessary distance, which is the stage of an encounter between different instances of otherness, is dissipated.

  4. Treatment of atrophic tibia non-unions according to 'diamond concept': Results of one- and two-step treatment. (United States)

    Moghaddam, Arash; Zietzschmann, Severin; Bruckner, Thomas; Schmidmaier, Gerhard


    The successful treatment of atrophic tibia non-unions and tibia non-unions with large bone defects or infections is a major challenge in orthopedic and trauma surgery. This article evaluates the use of the 'diamond concept' using a one-step or two-step procedure according to 'Masquelet technique' in the treatment of atrophic tibia non-unions. Between February 2010 and March 2014, 102 patients with atrophic non-unions were treated according to the 'diamond concept' in our center. Ninety-nine were available for follow-up. Forty-nine received a one-step treatment (Group 1, G1) and 50 patients received a two-step treatment according to the 'Masquelet technique' (Group 2, G2). Clinical and radiological parameters were measured preoperatively as well as 4, 6, and 12 weeks and 6 and 12 months postoperatively. In order to evaluate the subjective health of patients, we used the SF-12 questionnaire. Data analysis was performed one year after treatment. The rate of consolidation in G1 was 84% and 80% in G2. The time to heal in G2 was 8.6 ± 2.9 months, which is significantly longer than in G1 being 6.9 ± 3.1 months. In comparison patients in G1/G2 had an average of 3.2/6.7 previous major surgeries. In G1, 4 of 8 patients who did not heal successfully showed positive intraoperative cultures. In G2, 26 patients (52%) initially presented with positive cultures. The results of the SF-12 questionnaire improved in both groups during the postoperative follow-up, but showed no significant differences between groups. In 29 patients a gentamycin-coated nail was used for reosteosynthesis. These patients showed by trend a lower rate of complications at a higher rate of consolidation. Our study showed that the 'diamond concept' is a suitable method for safely and effectively treating non-unions with large defects or infections. The use of an antibiotic-coated nail provides a therapeutic benefit. For large bone defects of infected non-unions the two-step procedure after Masquelet is an

  5. Atrofia muscular proximal familiar

    Directory of Open Access Journals (Sweden)

    José Antonio Levy


    Full Text Available Os autores relatam dois casos de atrofia muscular proximal familiar, moléstia caracterizada por déficit motor e atrofias musculares de distribuição proximal, secundárias a lesão de neurônios periféricos. Assim, como em outros casos descritos na literatura, foi feito inicialmente o diagnóstico de distrofia muscular progressiva. O diagnóstico correto foi conseguido com auxílio da eletromiografia e da biopsia muscular.

  6. 2D Stabilised analytic signal method in DC pole-pole potential data ...

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    Using analytic signal method, interpretation of pole-pole secondary electric potentials due to 2D conductive/resistive prisms is presented. The estimated parameters are the location, lateral extent or width and depth to top surface of the prism. Forward modelling is attempted by 2D-Finite. Difference method. The proposed ...

  7. 2D Stabilised analytic signal method in DC pole-pole potential data ...

    Indian Academy of Sciences (India)

    Using analytic signal method, interpretation of pole-pole secondary electric potentials due to 2D conductive/resistive prisms is presented. ... Scientist, National Environmental Engineering Research Institute (NEERI), Nehru Marg, Nagpur 440 020, India; Associate Professor, Department of Earth Sciences, IIT, Roorkee 247 ...

  8. Reorientation of the early lunar pole (United States)

    Takahashi, Futoshi; Tsunakawa, Hideo; Shimizu, Hisayoshi; Shibuya, Hidetoshi; Matsushima, Masaki


    Palaeomagnetic measurements suggest that an active core dynamo operated on the Moon from 4.2 to 3.56 billion years ago. Since the Apollo era, many magnetic anomalies have been observed on the Moon. The magnetization of the lunar crust in some of these regions could preserve the signature of an early dipolar magnetic field generated by a core dynamo. Thus, the magnetic anomalies may yield information about the position of the palaeomagnetic pole during the time that the dynamo operated. Here we present a comprehensive survey of magnetic anomalies on the lunar surface using magnetometer data obtained by the Lunar Prospector and Kaguya lunar orbiters. We extract magnetization vectors from 24 magnetic anomalies using an iterative inversion method and derive the palaeomagnetic poles. We find that the north poles, as well as the antipodal south poles, cluster in two distinct locations: one near the present rotation axis and the other at mid-latitude. The clustering is consistent with a dipole-dominated magnetic field generated in the lunar core by a dynamo that was reversing, much like that of Earth. Furthermore, the two pole clusters imply that the Moon experienced a polar wander event during its ancient history due to the reorientation of the Moon with respect to its spin axis by 45°-60°.

  9. [Experimental proximal carpectomy. Biodynamics]. (United States)

    Kuhlmann, J N


    Proximal carpectomy was performed in 10 fresh cadavre wrists. Dynamic x-rays were taken and the forces necessary to obtain different movements before and after the operation were measured. Comparison of these parameters clearly defines the advantages and limitations of carpectomy and indicates the reasons.

  10. Proximate Analysis of Coal (United States)

    Donahue, Craig J.; Rais, Elizabeth A.


    This lab experiment illustrates the use of thermogravimetric analysis (TGA) to perform proximate analysis on a series of coal samples of different rank. Peat and coke are also examined. A total of four exercises are described. These are dry exercises as students interpret previously recorded scans. The weight percent moisture, volatile matter,…

  11. Proximal Tibial Bone Graft (United States)

    ... the Big Toe Ailments of the Smaller Toes Diabetic Foot Treatments Currently selected Injections and other Procedures Treatments ... from which the bone was taken if the foot/ankle surgeries done at the same time allow for it. ... problems after a PTBG include infection, fracture of the proximal tibia and pain related ...

  12. Analysis of Tsallis' classical partition function's poles (United States)

    Plastino, A.; Rocca, M. C.


    When one integrates the q-exponential function of Tsallis' so as to get the partition function Z, a gamma function inevitably emerges. Consequently, poles arise. We investigate here the thermodynamic significance of these poles in the case of n classical harmonic oscillators (HO). Given that this is an exceedingly well known system, any new feature that may arise can safely be attributed to the poles' effect. We appeal to the mathematical tools used in Plastino et al. (2016) and Plastino and Rocca (2017), and obtain both bound and unbound states. In the first case, we are then faced with a classical Einstein crystal. We also detect what might be interpreted as pseudo gravitational effects.

  13. Shape change in the atlas with congenital midline non-union of its posterior arch: a morphometric geometric study. (United States)

    Ríos, Luis; Palancar, Carlos; Pastor, Francisco; Llidó, Susana; Sanchís-Gimeno, Juan Alberto; Bastir, Markus


    The congenital midline non-union of the posterior arch of the atlas is a developmental variant present at a frequency ranging from 0.7% to 3.9%. Most of the reported cases correspond to incidental findings during routine medical examination. In cases of posterior non-union, hypertrophy of the anterior arch and cortical bone thickening of the posterior arches have been observed and interpreted as adaptive responses of the atlas to increased mechanical stress. We sought to determine if the congenital non-union of the posterior arch results in a change in the shape of the atlas. This study is an analysis of the first cervical vertebrae from osteological collections through morphometric geometric techniques. A total of 21 vertebrae were scanned with a high-resolution three-dimensional scanner (Artec Space Spider, Artec Group, Luxembourg). To capture vertebral shape, 19 landmarks and 100 semilandmarks were placed on the vertebrae. Procrustes superimposition was applied to obtain size and shape data (MorphoJ 1.02; Klingenberg, 2011), which were analyzed through principal component analysis (PCA) and mean shape comparisons. The PCA resulted in two components explaining 22.32% and 18.8% of the total shape variance. The graphic plotting of both components indicates a clear shape difference between the control atlas and the atlas with posterior non-union. This observation was supported by statistically significant differences in mean shape comparisons between both types of vertebra (patlas is associated with significant changes in the shape of the vertebra. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Uncemented allograft-prosthetic composite reconstruction of the proximal femur

    Directory of Open Access Journals (Sweden)

    Li Min


    Full Text Available Background: Allograft-prosthetic composite can be divided into three groups names cemented, uncemented, and partially cemented. Previous studies have mainly reported outcomes in cemented and partially cemented allograft-prosthetic composites, but have rarely focused on the uncemented allograft-prosthetic composites. The objectives of our study were to describe a surgical technique for using proximal femoral uncemented allograft-prosthetic composite and to present the radiographic and clinical results. Materials and Methods: Twelve patients who underwent uncemented allograft-prosthetic composite reconstruction of the proximal femur after bone tumor resection were retrospectively evaluated at an average followup of 24.0 months. Clinical records and radiographs were evaluated. Results: In our series, union occurred in all the patients (100%; range 5-9 months. Until the most recent followup, there were no cases with infection, nonunion of the greater trochanter, junctional bone resorption, dislocation, allergic reaction, wear of acetabulum socket, recurrence, and metastasis. But there were three periprosthetic fractures which were fixed using cerclage wire during surgery. Five cases had bone resorption in and around the greater trochanter. The average Musculoskeletal Tumor Society (MSTS score and Harris hip score (HHS were 26.2 points (range 24-29 points and 80.6 points (range 66.2-92.7 points, respectively. Conclusions: These results showed that uncemented allograft-prosthetic composite could promote bone union through compression at the host-allograft junction and is a good choice for proximal femoral resection. Although this technology has its own merits, long term outcomes are yet not validated.

  15. Distraction osteogenesis for tibial nonunion with bone loss using combined Ilizarov and Taylor spatial frames versus a conventional circular frame

    Directory of Open Access Journals (Sweden)

    Ibrahim Elsayed Abdellatif Abuomira


    Full Text Available Abstract This retrospective review assesses 55 tibial nonunions with bone loss to compare union achieved with combined Ilizarov and Taylor spatial frames (I–TSF versus a conventional circular frame with the standard Ilizarov procedure. Seventeen (31 % of the 55 nonunions were infected. Thirty patients treated with I–TSF were compared with 25 patients treated with a conventional circular frame. In the I–TSF group, an average of 7.6 cm of bone was resected and the lengthening index (treatment time in months divided by lengthening amount in centimeters was 1.97. In the conventional circular frame group, a mean of 6.5 cm was resected and the lengthening index was 2.1. Consolidation at the docking site and at the regenerate bone occurred in 49 (89 % of 55 cases after the first procedure. No statistically significant difference was shown between the two groups. Superiority of one modality of treatment over the other cannot be concluded from our data. Application of combined Ilizarov and Taylor spatial frames for bone transport is useful for treatment of tibial nonunion with bone loss. Level of evidence Case series, Level III.

  16. Pole solutions for flame front propagation

    CERN Document Server

    Kupervasser, Oleg


    This book deals with solving mathematically the unsteady flame propagation equations. New original mathematical methods for solving complex non-linear equations and investigating their properties are presented. Pole solutions for flame front propagation are developed. Premixed flames and filtration combustion have remarkable properties: the complex nonlinear integro-differential equations for these problems have exact analytical solutions described by the motion of poles in a complex plane. Instead of complex equations, a finite set of ordinary differential equations is applied. These solutions help to investigate analytically and numerically properties of the flame front propagation equations.

  17. Fundamental pole parameters of the N(1470)

    CERN Document Server

    Lee, P S


    The position and residue of the S-matrix pole of the Delta (1236) have been shown to be unique and independent of the particular resonance formula used, thus resolving a discrepancy among phenomenological fits. Unlike the P/sub 33/ partial wave, the P/sub 11/ resonance is highly inelastic, very broad, and has a large background. This produces huge uncertainties in its mass and width, depending on the parametrization used. It is reported that the position of the N(1470) pole is uniquely determined, 1380-110i MeV, from fits to the CERN phase shifts. (10 refs).

  18. Anchor suture fixation of distal pole fractures of patella: twenty seven cases and comparison to partial patellectomy. (United States)

    Kadar, Assaf; Sherman, Haggai; Drexler, Michael; Katz, Eldad; Steinberg, Ely L


    Partial patellectomy (PP) and reattachment of the patellar ligament with transosseous suturing is the mainstay of surgical treatment for distal pole patellar fractures. An anchor suturing (AS) technique has recently been reported as an alternative to PP in such fractures and allows for bone-to-bone interface and possibly superior fracture healing than bone-to-tendon interface with PP. We present our experience with AS and compare it to PP. Between 2006 and 2011, 60 patients with distal pole patellar fracture underwent either AS (n = 27) or PP (n = 33). We retrospectively gathered their demographic data and information on fracture type, fixation technique, operation time, postoperative complications and knee range of motion. A telephone survey was performed to grade functional outcomes with standard questionnaires (the SF-12 for quality of life, the Kujala score for patellofemoral function and a visual analog scale [VAS] pain score). AS was equivalent to PP in terms of residual pain and functional outcomes (VAS: 2.45 vs. 2.26, p = 0.83 and Kujala score: 74.3 vs. 69, p = 0.351, respectively) as well as for knee range of motion. Complications included three cases of infection in each group, two cases of early hardware failure and one case of non-union in the AS group. Operation time was significantly shorter for AS compared to PP (68.5 vs. 79.1 min, p = 0.03). AS is non-inferior to PP for function and pain after distal pole patellar fractures and is superior to PP with regard to operative time. Common complications of this technique are hardware failure and infections. Therapeutic Level III.

  19. On the design of pole modules for inverse systems (United States)

    Wyman, B. F.; Sain, M. K.


    When a linear dynamical system admits more than one inverse, it is known that the pole module of any inverse must contain, either as a submodule or as a factor module, a module of fixed poles isomorphic to the zero module of the original system. Design of the pole module for such an inverse system is resolved by introducing a variable pole module for the inverse, by determining necessary and sufficient conditions for a desired module to be a variable pole module, and by studying the manner in which the fixed and variable modules assemble into the pole module of the inverse. If the fixed and variable pole spectra are disjoint, the pole module of the inverse system is a direct sum of the fixed- and variable-pole modules; if not, procedures for addressing the Jordan structure are presented.

  20. Scaphoid nonunion in break-dancers: a report of 3 cases. (United States)

    Cho, Chul-Hyun; Song, Kwang-Soon; Min, Byung-Woo; Bae, Ki-Cheor; Lee, Kyung-Jae; Kim, Sang-Hyon


    Most injuries resulting from break-dancing are minor, such as sprains and strains, but there is great potential for dance participants to sustain severe and life-threatening conditions, such as cervical cord injuries. Break-dancing carries many of the risks of conventional dance and gymnastics, but unlike those forms of activity, it is usually performed without trained supervision, as is supplied by coaches in other sports. It is necessary for clinicians to inquire more thoroughly into the nature of the activities that result in both unusual and common injuries in break-dancers and to educate break-dancers about the hazards of these activities. The pleasure of break-dancing carries with it the responsibility of proper and thorough preparation. It is essential that break-dancers wear protective devices and perform proper warm-up and cool-down exercises. Break-dancing has become a popular youth subculture. Its complex acrobatic moves, such as splits, handstands, spins, and tumbling, have important medical implications. We report 3 cases of scaphoid nonunion in a break-dancer, the first such report in the English literature to our knowledge. Accordingly, we believe that the clinician must inquire more thoroughly into the nature of patients' activities that result in both unusual and common injuries and educate those who are break-dancers about the hazards of this activity. Careful screening, instruction, and coaching of break-dancers will help prevent injuries.

  1. Cement Calcaneoplasty: An Innovative Method for Treating Nonunion in Calcaneal Insufficiency Fracture. (United States)

    Godavitarne, Charles; Fawzy, Ernest; Giancola, Giorgio; Louette, Luc


    Insufficiency type stress fractures are common in older patients with osteoporosis. Persistent pain after nonunion of these fractures can be disabling, with the management options often limited. We aimed to assess the suitability of fluoroscopic-guided injection of bone cement into a persistently symptomatic nonuniting calcaneal insufficiency fracture. To the best of our knowledge, this technique has not previously been described in the published data. After local subcutaneous anesthesia, the midpoint of the fracture site was accessed by trocar insertion under radiographic guidance, and bone cement was injected directly into the site. A preprocedure visual analog scale pain score of 90 of 100 was recorded. This had improved to 0 of 100 at the 12-month follow-up point after the procedure. The aim of the present case report was to raise awareness of percutaneous calcaneoplasty, which we believe to be a safe and well-tolerated technique for the management of osteoporotic insufficiency fracture of the calcaneus. We propose that this technique be considered when conservative methods aimed at promoting fracture healing have failed. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Perceived safety climate, job demands, and coworker support among union and nonunion injured construction workers. (United States)

    Gillen, Marion; Baltz, Davis; Gassel, Margy; Kirsch, Luz; Vaccaro, Diane


    This study evaluated injured construction workers' perceptions of workplace safety climate, psychological job demands, decision latitude, and coworker support, and the relationship of these variables to the injury severity sustained by the workers. Injury severity was assessed using the Health Assessment Questionnaire (HAQ), which evaluates functional limitations. Worker perceptions of workplace variables were determined by two instruments: (a) the Safety Climate Measure for Construction Sites and (b) the Job Content Questionnaire (JCQ). The overall model explained 23% of the variance in injury severity, with unique contributions provided by union status, the Safety Climate Score, and Psychological Job Demands. A positive significant correlation was found between injury severity and the Safety Climate Scores (r = .183, P = .003), and between the Safety Climate Scores and union status (r = .225, P Coworker Support, the responses between union and nonunion workers were very similar, indicating an overall high degree of job satisfaction. However, workers who experienced their workplace as more safe also perceived the level of management (r = -.55, P coworker (r = -.31, P < .001) support as being higher. The findings of this study underscore the critical need for construction managers to alert workers to dangerous work practices and conditions more frequently, and express concern and praise workers for safe work in a manner that is culturally acceptable in this industry. Workplace interventions that decrease the incidence and severity of injuries, but that are flexible enough to meet a variety of potentially competing imperatives, such as production deadlines and client demands, need to be identified.

  3. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi


    -displaced femoral neck fractures and prosthesis for displaced among the elderly; and sliding hip screw for stabile- and intramedullary nails for unstable- and sub-trochanteric fractures) but they are based on a variety of criteria and definitions - and often leave wide space for the individual surgeons' subjective...... guidelines for hip fracture surgery and discuss a method for future pathway/guideline implementation and evaluation. METHODS: By a PubMed search in March 2015 six studies of surgical treatment pathways covering all types of proximal femoral fractures with publication after 1995 were identified. Also we...... searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  4. Surgical Treatment of Undisplaced Femur Neck Fractures in Dementia Patients Using Proximal Femoral Nail Antirotation. (United States)

    Park, Bong-Ju; Cho, Hong-Man; Min, Woong-Bae


    People with dementia have poor mobility and discharge outcomes following hip fractures. The purpose of this study was to evaluate the clinical and radiological results of internal fixation of undisplaced femur neck fractures (Garden types 1 and 2) by proximal femoral nail antirotation (PFNA) in dementia patients. We studied retrospectively 19 patients with undisplaced femur neck fracture. All patients were over 70 years of age, walked independently with a cane or crutches and suffered moderate-to-severe dementia. Patients were treated with PFNA and followed-up for more than 2 years. Revision, loss of fixation, complications, and walking ability outcomes were measured. In walking-ability evaluation, patients showed an average decrease of just 0.2 points at the final follow-up. Walking ability was evaluated from before injury to 4 weeks after surgery and decreased by less than 0.5 points. Radiological bone union was achieved in 17 cases; the average time to bone union was 4.14 months (range, 2.5-7 months). Complications included non-union in two cases and femoral head avascular necrosis in one case of non-union. We found that for patients with osteoporotic bone tissues in their femoral heads or patients (e.g., those suffering dementia) for whom cooperating with medical workers for postoperative walking control or rehabilitation exercises is difficult, implanting a mechanically stable spiral blade for fixation of femoral neck fractures could facilitate walking after surgery.

  5. Volkmann's Ischemic Contracture with Atrophic Non-union of Ulna Managed by Bone Shortening and Transposition of Radial Autograft. (United States)

    L, Maheshwar; Kiran K, K; Kc, Vamshi; Prasad R, Siva


    Volkmann's ischemic contracture (VIC) is a complex and variable flexion deformity of wrist and fingers resulting from fibrosis and contracture of flexor muscles of forearm. It is caused by ischemic injury to the deep tissues enclosed in the tight unyielding osteo-facial compartments secondary to neglected acute compartment syndrome. VIC may be associated with malunion or non-union of forearm fractures. To the best of our knowledge, this article is the first case report of VIC associated with atrophic non-union of ulna managed by shortening of forearm bones combined with transposition of intercalary auto graft from the fellow bone. A seven year old boy presented with flexion deformity of wrist and hand with inability to use his left hand since three and half months subsequent to an injury to his left forearm due to fall from a tree of six feet height. The patient was diagnosed and treated by a native traditional bone setter for his Radius and Ulna fracture of left forearm with massaging and tight bandaging. On examination there was wasting of left forearm with positive Volkmann's sign, flexion contracture of wrist with loss of grip strength and tenderness over the upper and middle third junction of left ulna with a palpable gap. The radiograph of forearm revealed atrophic non-union of left ulna. In order to tackle both the issues, shortening osteotomy of radius with transposition of tubular radius intercalary graft onto ulna was done. Radius was fixed with a dynamic compression plate and Ulna was fixed with a rush nail effecting overall two and half centimetres shortening of both bones of forearm. This approach has addressed both atrophic non-union of ulna and VIC in a single stage and gave excellent functional outcome till the last follow-up of three years from the date of surgery. Bone shortening and transposition of auto-graft from the fellow bone may prove to be an excellent treatment modality for VIC with associated non-union of involved compartmental bones in

  6. Comparative study of the effect of PTH (1-84) and strontium ranelate in an experimental model of atrophic nonunion. (United States)

    Pérez Núñez, M I; Ferreño Blanco, D; Alfonso Fernández, A; Casado de Prado, J A; Sánchez Crespo, M; De la Red Gallego, M; Pascual Carra, A; Rodriguez López, T; Diego Cavia, S; Garcés Zarzalejo, C; Mayorga Fernández, M; Ruiz Martínez, E; Carrascal Vaquero, I; Riancho Moral, J A


    This study aimed to set up an experimental model of long bone atrophic nonunion and to explore the potential role of PTH-1-84 (PTH 1-84) and strontium ranelate (SrR). A model of atrophic nonunion was created in Sprague-Dawley rats at the femoral midshaft level. The animals were randomised into four groups. Group A1: control rodents, fracture without bone gap; Group A2: rodents with subtraction osteotomy (non-union model control) treated with saline; Group B: rodents with subtraction osteotomy treated with human-PTH (PTH 1-84); and Group C: rodents with subtraction osteotomy treated with strontium ranelate (SrR). The groups were followed for 12 weeks. X-rays were be obtained at weeks 1, 6 and 12. After sacrificing the animals, we proceeded to the biomechanical study and four point bending tests to evaluate the resistance of the callus and histological study. In second phase, the expression of genes related to osteoblast function was analysed by reverse transcription-quantitative PCR in rats subjected to substraction osteotomy and treated for 2 weeks. The animals were randomised into three groups: Group A2: rodents treated with saline; Group B: rodents treated with PTH 1-84 and Group C: rodents treated with SrR. No significant histological differences were found between animals subjected to subtraction osteotomy and treated with either saline or PTH (p=0.628), but significant difference existed between animals receiving saline or SrR (p=0.005). There were no significant differences in X-ray score between the saline and PTH groups at either 6 or 12 weeks (p=0.33 and 0.36, respectively). On the other hand, better X-ray scores were found in the SrR group (p=0.047 and 0.006 in comparison with saline, at 6 and 12 weeks, respectively). In line with this, biomechanical tests revealed improved results in the SrR group. Gene expression analysis revealed a slightly decreased levels of DKK1, a Wnt pathway inhibitor, in rats treated with SrR. SrR increases has a beneficial

  7. A Systematic Review and Meta-Analysis of Ilizarov Methods in the Treatment of Infected Nonunion of Tibia and Femur.

    Directory of Open Access Journals (Sweden)

    Peng Yin

    Full Text Available Infected nonunion of tibia and femur are common in clinical practice, however, the treatment of these diseases has still been a challenge for orthopaedic surgeons. Ilizarov methods can eradicate infection, compensate bone defects and promote the bone union through progressive bone histogenesis. The objective of this systematic review was to review current available studies reporting on Ilizarov methods in the treatment of infected nonunion of tibia and femur, and to perform meta-analysis of bone and functional results and complications to evaluate the efficacy of Ilizarov methods.A comprehensive literature search was performed from the SCI, PubMed, Cochrane Library; and Embase between January 1995 and August 2015. Some major data were statistically analyzed using weighted means based on the sample size in each study by SPSS 13.0, including number of patients, mean age, mean previous surgical procedures, mean bone defects, mean length of follow-up, bone union, complications per patient, external fixation time, and external fixation index(EFI. Bone results (excellent, good, fair and poor rate, functional results (excellent, good, fair and poor rate and complications were analyzed by Stata 9.0.A total of 590 patients from 24 studies were included in this systematic review. The average of bone union rate was 97.26% in all included studies. The poor rate in bone results and functional results was 8% (95%CI, 0.04-0.12; I2 = 44.1%, P = 0.065 and 10% (95%CI, 0.05-0.14; I2 = 34.7%, P = 0.121 in patients with infected nonunion of tibia and femur treated by Ilizarov methods. The rate of refracture, malunion, infectious recurrence, knee stiffness, amputation, limb edema and peroneal nerve palsy was respectively 4%, 7%, 5%, 12%, 4%, 13% and 13%.Our systematic review showed that the patients with infected nonunion of tibia and femur treated by Ilizarov methods had a low rate of poor bone and functional results. Therefore, Ilizarov methods may be a good choice

  8. Proximal humeral fractures


    Mauro, Craig S.


    Proximal humeral fractures may present with many different configurations in patients with varying co-morbities and expectations. As a result, the treating physician must understand the fracture pattern, the quality of the bone, other patient-related factors, and the expanding range of reconstructive options to achieve the best functional outcome and to minimize complications. Current treatment options range from non-operative treatment with physical therapy to fracture fixation using percuta...

  9. A Visit to the South Pole

    Indian Academy of Sciences (India)

    IAS Admin

    to fight not at the Indo-Pak border but at the South Polar Ice-Cap against the awful blizzards and the cryogenic environs of Antarctica where no Indian had ever wintered over earlier. My parents encouraged me to go ahead with the Antarctic Expedition and explore the South Pole. The Deputy High Commissioner of Australia ...

  10. Recent advances in poled optical fibres

    DEFF Research Database (Denmark)

    Pruneri, V.; Margulis, W.; Myrén, N.


    A second-order nonlinearity can be induced in optical fibres through poling. We describe accomplishments of the EU project GLAMOROUS in making low-cost high performance electrooptic and nonlinear optical fibre- and waveguide-based components. In particular a comparison with more traditional...

  11. Kosovo : kannatlikkusele lootmine pole plaan / Chris Patten

    Index Scriptorium Estoniae

    Patten, Chris


    Autor leiab, et arvestades Kosovo elanike ülekaalukat soovi olla vaba Serbiast, riigist, mis üritas nad kõrvaldada, ning alternatiivi täielikku puudumist Belgradi poolt, pole rahvusvahelisel kogukonnal muud võimalust kui anda Kosovole iseseisvus

  12. Stabilization, pole placement, and regular implementability

    NARCIS (Netherlands)

    Belur, MN; Trentelman, HL

    In this paper, we study control by interconnection of linear differential systems. We give necessary and sufficient conditions for regular implementability of a-given linear, differential system. We formulate the problems of stabilization and pole placement as problems of finding a suitable,

  13. Stabilization, Pole Placement, and Regular Implementability

    NARCIS (Netherlands)

    Belur, Madhu N.; Trentelman, H.L.


    In this paper, we study control by interconnection of linear differential systems. We give necessary and sufficient conditions for regular implementability of a given linear differential system. We formulate the problems of stabilization and pole placement as problems of finding a suitable,

  14. Numerical pole assignment by eigenvalue Jacobian inversion (United States)

    Sevaston, George E.


    A numerical procedure for solving the linear pole placement problem is developed which operates by the inversion of an analytically determined eigenvalue Jacobian matrix. Attention is given to convergence characteristics and pathological situations. It is not concluded that the algorithm developed is suitable for computer-aided control system design with particular reference to the scan platform pointing control system for the Galileo spacecraft.

  15. Lower pole renal cut injury due to the iliac wing fracture: A rare case report

    Directory of Open Access Journals (Sweden)

    Çaglar Yildirim


    Full Text Available The most frequent causes of blunt genitourinary injuries are falls from heights, motor vehicle accidents and sports injuries. Firearm injuries and penetrating stab wounds are also frequently encountered. Skeletal system traumas in the vicinity of the urogenital system can cause urological organ injuries. Though rarely, renal traumas can be dependent on the kinetic energy of the trauma and the retroperitoneal movement capacity of the kidneys and cannot be explained with the proximity of the kidney to the skeletal system. In cases with high-energy decelerations, renal pedicle and ureteropelvic junction traumas are more frequently observed. Herein, we presented a grade 3 left kidney lower pole injury developed secondary to A2 type pelvic fracture following a high energy deceleration trauma. It should not be forgotten that especially in this type of fractures, injuries of the lower renal pole can occur.

  16. Outcome of Inferior Patellar Pole Avulsion Fractures

    Directory of Open Access Journals (Sweden)

    Ruban Raj Joshi


    Full Text Available Introduction: The optimal treatment for inferior pole patella avulsion fractures has still been a topic of debate. The options include (a internal fixation of the pole fragment and (b resection of the avulsed fragment and repair of the patellar ligament to the patella. We present the comparative outcomes for patients with displaced inferior pole patella treated by resection and transosseous Ethibond® Krackow suture repair of patellar ligament with open reduction and internal fixation with modified tension band wiring and circumferential wiring. Methods: During a three year period between August 2013 and September 2016, twenty consecutive patients with distal pole fractures of the patella were prospectively enrolled in this study. These patients were divided into two groups. Group-T patients were treated with open reduction and internal fixation with modified tension band wire and  group-R patients by resection of the avulsed fragment and reattachment of the patellar ligament to the patella with #5 Ethibond®. Data entry and analysis was done by using SPSS version 20. Anatomical and functional outcome were compared. Results: Consecutive 20 patients were treated either with resection lower patellar pole (n=10 or with open reduction internal fixation with tension band wiring (n=10. Demographics were matched in two groups. Group-T required a longer hospital stay (U=13.5, p=0.005. Complications were seen more often in Goup-T compared to Group-R (p=0.005. Group-R had better scores (Bostman score U=6, p=0.001; SFMA U=7.5, p=0.001 and range of movement (p<0.05. Conclusion: Resection of the avulsed fragment and reattachment of the patellar ligament to the patella had better outcome according to the Bostman and SFMA dysfunction score, shorter hospital stay, and less complications as compared to open reduction and internal fixation with tension band wire and circumferential wiring.

  17. Reducing resource utilization during non-operative treatment of pediatric proximal humerus fractures. (United States)

    Gladstein, A Z; Schade, A T; Howard, A W; Camp, M W


    The majority of proximal humeral fractures in the skeletally immature are treated non-operatively. Operative indications vary but are largely based on degree of displacement. Non-union is rare. Non-operatively treated fractures are typically monitored radiographically to assess healing. We hypothesize that the decision to treat fractures operatively is made at the time of first imaging and that follow-up X-rays do not lead to a change in management. We retrospectively reviewed the records of 239 patients treated for proximal humerus fractures over a 5-year period. There were 225 who were treated non-operatively. Records were reviewed for the number of clinic visits and radiographs, as well as any change to operative management based on follow-up X-rays. The primary outcome of the study was the proportion of proximal humerus fractures, initially treated non-operatively, for which displacement or angulation on follow-up radiographs led to a change to operative treatment. Secondary outcomes were the number of follow-up radiographs obtained after the initial diagnosis and initiation of non-operative treatment. Of the 225 patients that were initially managed non-operatively, only 1 patient required subsequent surgical management. This patient underwent a proximal humerus epiphysiodesis 365 days from injury after development of a partial growth arrest. The mean number of fracture clinic visits for patients managed non-operatively was 2.67 (±1.24). The mean number of radiology department visits and radiographs obtained was 3.57 (±1.44) and 8.36 (±3.89) respectively. No clinical or radiographic non-unions were identified in these patients. No patients suffered a refracture during the review period. This study shows that of the 239 uncomplicated pediatric proximal humerus fractures treated at our hospital over a 5-year period, only 1 had a change in treatment plan, from non-operative to operative, based on follow-up radiographs. These data suggest that non

  18. Is non-union of tibial shaft fractures due to nonculturable bacterial pathogens? A clinical investigation using PCR and culture techniques

    Directory of Open Access Journals (Sweden)

    Gille Justus


    Full Text Available Abstract Background Non-union continues to be one of the orthopedist’s greatest challenges. Despite effective culture methods, the detection of low-grade infection in patients with non-union following tibial fracture still presents a challenge. We investigated whether “aseptic” tibial non-union can be the result of an unrecognized infection. Methods A total of 23 patients with non-union following tibial shaft fractures without clinical signs of infection were investigated. Intraoperative biopsy samples obtained from the non-union site were examined by means of routine culture methods and by polymerase chain reaction (PCR for the detection of 16 S ribosomal RNA (rRNA. Control subjects included 12 patients with tibial shaft fractures. Results 23 patients (8 women and 15 men; mean age: 47.4 years were included into this study. Preoperative C-reactive protein levels (mean: 20.8 mg/l and WBC counts (mean: 8,359/μl in the study group were not significantly higher than in the control group. None of the samples of non-union routine cultures yielded microorganism growth. Bacterial isolates were found by conventional culturing methods in only 1 case of an open fracture from the control group. In this case, PCR yielded negative results. 16 S rRNA was detected in tissue specimens from 2 patients (8.7% with non-union. The analysis of these variable species-specific sequences enabled the identification of specific microorganisms (1x Methylobacterium species, 1x Staphylococcus species. Both PCR-positive patients were culture-negative. Conclusions The combination of microbiological culture and broad-range PCR seems to substantially add to the number of microbiological diagnoses obtained and may improve the clinican’s ability to tailor therapy to the individual patient’s needs.

  19. The Influence of Pole Length on Performance, O2 Cost, and Kinematics in Double Poling. (United States)

    Losnegard, Thomas; Myklebust, Håvard; Skattebo, Øyvind; Stadheim, Hans Kristian; Sandbakk, Øyvind; Hallén, Jostein


    In the double-poling (DP) cross-country-skiing technique, propulsive forces are transferred solely through the poles. The aim of the current study was to investigate how pole length influences DP performance, O2 cost, and kinematics during treadmill roller skiing. Nine male competitive cross-country skiers (24 ± 3 y, 180 ± 5 cm, 72 ± 5 kg, VO2max running 76 ± 6 mL · kg(-1) · min(-1)) completed 2 identical test protocols using self-selected (84% ± 1% of body height) and long poles (self-selected + 7.5 cm; 88% ± 1% of body height) in a counterbalanced fashion. Each test protocol included a 5-min warm-up (2.5 m/s; 2.5°) and three 5-min submaximal sessions (3.0, 3.5, and 4.0 m/s; 2.5°) for assessment of O2 cost, followed by a selfpaced 1000-m time trial (~3 min, >5.0 m/s; 2.5°). Temporal patterns and kinematics were assessed using accelerometers and 2D video. Long poles reduced 1000-m time (mean ± 90% confidence interval; -1.0% ± 0.7%, P = .054) and submaximal O2 cost (-2.7% ± 1.0%, P = .002) compared with self-selected poles. The center-of-mass (CoM) vertical range of displacement tended to be smaller for long than for self-selected poles (23.3 ± 3.0 vs 24.3 ± 3.0 cm, P = .07). Cycle and reposition time did not differ between pole lengths at any speeds tested, whereas poling time tended to be shorter for self-selected than for long poles at the lower speeds (≤3.5 m/s, P ≤ .10) but not at the higher speeds (≥4.0 m/s, P ≥ .23). DP 1000-m time, submaximal O2 cost, and CoM vertical range of displacement were reduced in competitive cross-country skiers using poles 7.5 cm longer than self-selected ones.

  20. The location of infinite electrodes in pole-pole electrical surveys : consequences for 2D imaging


    Robain, Henri; Albouy, Yves; Dabas, M.; Descloitres, Marc; Camerlynck, C.; Mechler, P.; Tabbagh, A.


    In 2D-multielectrode electrical survey using the pole-pole array, the distance to "infinite electrodes" is actually finite. As a matter of fact, the available cable length generally impose a poor approximation of theoretical location of these electrodes at infinity. This study shows that in most of the cases, the resulting apparent resistivity pseudosection is strongly distorted. Numerical simulation validated by field test also shows that a particular finite array provides results that are a...

  1. Fatigue failure and cracking in high mast poles. (United States)


    This report presents the findings of a comprehensive research project to investigate the fatigue : cracking and failure of galvanized high mast illumination poles (HMIP). Ultrasonic inspection of : poles throughout the state has revealed the presence...

  2. Large second-harmonic generation in thermally poled silica waveguides

    DEFF Research Database (Denmark)

    Arentoft, Jesper; Kristensen, Martin; Pedersen, K.


    We report the observation of very large second-harmonic signals from thermally poled silica waveguide samples. Secondary ion mass spectrometry measurements show that significant amounts of silver ions are injected from the top electrode during poling.......We report the observation of very large second-harmonic signals from thermally poled silica waveguide samples. Secondary ion mass spectrometry measurements show that significant amounts of silver ions are injected from the top electrode during poling....

  3. External fixation for the treatment of open fractures of the proximal humerus caused by firearms

    Directory of Open Access Journals (Sweden)

    Mirić Dragan


    Full Text Available Nine patients with open fractures of the proximal humerus were treated using an external fixation device. All of them had grade III open fractures resulting from high-velocity missile and explosive injuries with massive foreign body contamination. Radial nerve injury was present in five and two multiply injuried patients with thoracic wall and abdominal viscera were present. There were no major arterial injuries. Chronic osteitis with fistula and sequestra developed in one. There were no nonunions and no refractures. Minor painless limitation of shoulder and elbow motion presented in all patient. Upper-third humeral open fractures due to firearms are a unique type of open fractures. They are usually highly comminuted therefore, stable fixation is difficult or impossible to achieve. On the other hand, the risk of infection is high following plate fixation. External fixation allows adequate management of the soft tissue wounds, provides stable bone fixation and allows early mobilization of the shoulder and elbow.

  4. 46 CFR 111.79-3 - Grounding pole. (United States)


    ... 46 Shipping 4 2010-10-01 2010-10-01 false Grounding pole. 111.79-3 Section 111.79-3 Shipping COAST... REQUIREMENTS Receptacles § 111.79-3 Grounding pole. Each receptacle outlet that operates at 100 volts or more must have a grounding pole. ...

  5. 30 CFR 56.12048 - Communication conductors on power poles. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Communication conductors on power poles. 56... Electricity § 56.12048 Communication conductors on power poles. Telegraph, telephone, or signal wires shall not be installed on the same crossarm with power conductors. When carried on poles supporting...

  6. Determination of pole orientations and shapes of asteroids (United States)

    Magnusson, Per; Barucci, M. Antonietta; Drummond, Jack D.; Lumme, Kari; Ostro, Steven J.


    The principles of asteroid light-curve inversion are discussed together with basic principles involved in approaches for deriving asteroid pole and shape parameters from photometry data. The merits of various pole determination techniques are described and compared. Results obtained so far on the pole orientations and shapes of asteroids are presented.



    Cherednychenko N. A.; Lutsenko Y. V.; Trunev A. P.


    Based on local semantic information models, we have examined the dependence of the dynamics of the displacement of the pole positions of celestial objects. We have also developed and differentiated an analysis of ASK-pole modeling of dynamics within sixty-year cycles of reference points and substantiated reasons for the population inversion and singular states in the dynamics of the pole

  8. Theoretical modeling and experimental analyses of laminated wood composite poles (United States)

    Cheng Piao; Todd F. Shupe; Vijaya Gopu; Chung Y. Hse


    Wood laminated composite poles consist of trapezoid-shaped wood strips bonded with synthetic resin. The thick-walled hollow poles had adequate strength and stiffness properties and were a promising substitute for solid wood poles. It was necessary to develop theoretical models to facilitate the manufacture and future installation and maintenance of this novel...

  9. Surgical Treatment of an Infected Nonunion of the Middle Third of the Femur Associated with Femoral Shortening in a Hemophilia Patient

    Directory of Open Access Journals (Sweden)

    Ahmet Salduz


    Full Text Available The management of nonunion and limb length discrepancy has remained a constant challenge in hemophilic patients. In this study, we aimed to present the treatment of femur infected nonunion and limb length discrepancy in a twenty-seven-year-old patient with hemophilia type A. A 27-year-old male patient with hemophilia type A referred to our institution for the treatment of right femur infected nonunion and 10 cm shortness of the femur. Resection of the nonunion site and bone-to-bone fixation with autologous bone grafting were performed. Compression to the pseudoarthrosis site and distraction from new osteotomy site were applied with the unilateral external fixator. Union was achieved, and 6 cm lengthening was obtained according to the initial length. Patient was followed up for 7 years. After this treatment, the patient is able to walk with full weight bearing on the affected extremity with 4 cm shortening which is compensated by the heel lift. The results of this case indicate that limb lengthening and treatment of nonunion with the external fixation could be reliable and effective method for hemophilic patients.

  10. Cassini/CIRS Observations of Saturn’s Polar Vortices from Proximal Orbit Observations (United States)

    Achterberg, Richard; Bjoraker, Gordon L.; Hesman, Brigette E.; Flasar, F. Michael


    The proximal orbit phase of the Cassini mission, with periapses inside the inner edge of the rings, has allowed observations of Saturn’s atmosphere with unprecedented spatial resolution. During the periapse periods on 26 April and 29 June 2017, the Composite Infrared Spectrometer (CIRS) performed scans over both the north and south poles with a spatial resolution better than 0.2° of latitude, over a factor of 4 better resolution than previous observations. A further observation of the south pole is planned on 20 Aug 2017.Previous thermal infrared observations of Saturn’s poles [1,2] showed a compact hot spot in the upper troposphere at each pole, roughly coincident with the hurricane-like polar vortex seen in visible imaging [3]. Preliminary results from the proximal orbit scans of the north pole, near summer solstice, show that in the upper troposphere, the meridional temperature gradient increases sharply at about 89°N, with the temperature increasing by ~5K between 89°N and the pole, with the temperature gradient persisting all the way to the pole within the spatial resolution of the observation. In the northern stratosphere, the polar hot spot is broader than in the troposphere, extending to ~86°N at 4 mbar, and disappearing into the general meridional gradient at 1 mbar.[1] G. S. Orton and P. A. Yanamadra-Fisher, Science 307, 696[2] L. N. Fletcher et al., Science, 319, 79[3] U. A. Dyudina et al., Icarus, 202, 240.

  11. Pole Inflation - Shift Symmetry and Universal Corrections


    Broy, Benedict J.; Galante, Mario; Roest, Diederik; Westphal, Alexander


    An appealing explanation for the Planck data is provided by inflationary mod els with a singular non-canonical kinetic term: a Laurent expansion of the kinetic function translates into a potential with a nearly shift-symmetric plateau in canonical fields. The shift symmetry can be broken at large field values by including higher-order poles, which need to be hierarchically suppressed in order not to spoil the inflationary plateau. The herefrom resulting corrections to the inflationary dynamic...

  12. Pole Positions of the Delta(1232) Resonance


    Kelabi, Mohamed E.


    The phase shift of pion nucleon elastic scattering D33, corresponding to isospin I=3/2 and angular momentum J=3/2, has been parameterized over the range 1100 < W < 1375 MeV, using the single channel p Pi+ data from CNS-DAC. By employing our four parameters formula, the pole positions of corresponding to the Delta(1232) resonance are then identified.

  13. Self Assembly and Pyroelectric Poling for Organics (United States)


    using NEXAFS, contact angle goniometry and atomic force microscopy. It is concluded that if a SAM promotes a homogenous liquid-like surface with...graphene transistors (Fig. 5). It is found that by knowing the z-component of the SAM dipole one can reliably predict the shift in graphene charge...using pyroelectric elements as reliable conformal and detachable electric field source to achieve efficient poling of EO polymers and overcoming some

  14. The Gattini South Pole UV experiment (United States)

    Moore, Anna M.; Ahmed, Sara; Ashley, Michael C. B.; Croner, Ernest; Delacroix, Alex; Ebihara, Yusuke; Fucik, Jason; Martin, D. Christopher; Velur, Viswa; Weatherwax, Allan


    The Gattini South Pole UV experiment (Gattini SPUV) was deployed to the South Pole dark sector in February 2010 and has recently completed a highly successful first season of winter time observations. The experiment has, for the first time ever, measured and categorized the optical night sky brightness at the very blue wavelengths. The experiment consists of a remotely operated 6” aperture custom designed telescope. The telescope feeds a blue sensitive imager with 4 degree field of view that contains a bank of 3 filters: SDSS g’, Bessel U and a custom “super U” filter specifically designed to probe the sky emission at wavelengths approaching the atmospheric cut-off. The filters are continually cycled with exposure times ranging from 30 to 300 seconds throughout the winter period. The telescope, in addition, feeds a 2 degree long slit VPH grating spectrograph with R~1000. The bandwidth is 350-450nm. The spectra are recorded simultaneously with the imager exposures. The experiment is designed for low temperature Antarctic operation and resides on the roof of the MAPO building in the South Pole Antarctic sector. The primary science goals are to categorize the Antarctic winter-time sky background at the very bluest of wavelengths as a pathfinder for the Antarctic Cosmic Web Imager. We present a technical overview of the experiment and results from the first winter season.

  15. Use of antibiotic cement-impregnated intramedullary nail in treatment of infected non-union of long bone

    Directory of Open Access Journals (Sweden)

    Shyam Ashok


    Full Text Available Background: In cases with infected non-union, the primary step is eradication of the infection before attempting to achieve union. Release of antibiotics from the bone cement at a high concentration and its penetration to the surrounding tissues, including cortical and cancellous bone, prompted the use of antibiotic cement in the control of bone infection. The aim of this study is to summarize our experience with the use of antibiotic cement-impregnated intramedullary nail (ACIIN for control of infection in cases of infected non-union with bone defect. Materials and Methods: We prospectively studied 25 cases of infected non-union (23 femora and two tibiae. There were 24 males and one female, with the mean age being 33 years (range, 21-58 years. All patients had high-velocity road traffic accidents except one patient who had farmland injury. There were seven closed fractures, one grade I compound, two grade II compound fractures, five grade IIIA compound fractures, and 10 grade IIIB compound fractures. ACIIN was used in all cases after adequate debridement. Patients were classified according to the amount of bone defect present after debridement: group 1 with bone defect < 4 cm (n=13, group 2 with bone defect ≥4-< 6 cm (n=7, and group 3 with bone defect ≥6 cm (n=5. Infection control was judged on the basis of discharge through the wound and laboratory parameters. All patients were followed-up, with an average follow-up time of 29 months (range, 18-40 months. The mean duration of retention of the intramedullary rod was 8 weeks (range, 6-12 weeks. Results: In group 1, all cases achieved infection control, with three patients achieving bone union without any need of secondary procedure. In group 2, all cases achieved infection control but the time taken was significantly longer than for group 1 (p-value 0.0002. All the cases required a secondary procedure in the form of either interlocking intramedullary nailing with iliac crest bone graft or

  16. The science of the lunar poles (United States)

    Lucey, P. G.


    It was the great geochemist Harold Urey who first called attention to peculiar conditions at the poles of the Moon where the very small inclination of the lunar spin axis with respect to the sun causes craters and other depressions to be permanently shaded from sunlight allowing very low temperatures. Urey suggested that the expected low temperature surfaces could cold trap and collect any vapors that might transiently pass through the lunar environment. Urey's notion has led to studies of the poles as a new research area in lunar science. The conditions and science of the poles are utterly unlike those of the familiar Moon of Neil Armstrong, and the study of the poles is similar to our understanding of the Moon itself at the dawn of the space age, with possibilities outweighing current understanding. Broadly, we can treat the poles as a dynamic system of input, transport, trapping, and loss. Volatile sources range from continuous, including solar wind, the Earth's polar fountain and micrometeorites, to episodic, including comets and wet asteroids, to nearly unique events including late lunar outgassing and passage through giant molecular clouds. The lunar exosphere transports volatiles to the poles, complicated by major perturbances to the atmosphere by volatile-rich sources. Trapping includes cold trapping, but also in situ creation of more refractory species such as organics, clathrates and water-bearing minerals, as well as sequester by regolith overturn or burial by larger impacts. Finally, volatiles are lost to space by ionization and sweeping. Spacecraft results have greatly added to the understanding of the polar system. Temperatures have been precisely measured by LRO, and thermal models now allow determination of temperature over the long evolution of the lunar orbit, and show very significant changes in temperature and temperature distribution with time and depth. Polar topography is revealed in detail by Selene and LRO laser altimeters while direct

  17. Some Properties of Fuzzy Soft Proximity Spaces (United States)

    Demir, İzzettin; Özbakır, Oya Bedre


    We study the fuzzy soft proximity spaces in Katsaras's sense. First, we show how a fuzzy soft topology is derived from a fuzzy soft proximity. Also, we define the notion of fuzzy soft δ-neighborhood in the fuzzy soft proximity space which offers an alternative approach to the study of fuzzy soft proximity spaces. Later, we obtain the initial fuzzy soft proximity determined by a family of fuzzy soft proximities. Finally, we investigate relationship between fuzzy soft proximities and proximities. PMID:25793224

  18. Augmentation of bone healing in delayed and atrophic nonunion of fractures of long bones by partially decalcified bone allograft (decal bone). (United States)

    Jain, Anuj; Kumar, Sudhir; Aggarwal, Aditya N; Jajodia, Nitesh


    Autograft from iliac crest is considered as gold standard for augmentation of bone healing in delayed and nonunion of fractures. Bone demineralized with 0.6N hydrochloric acid has shown to retain its osteoinductive capacity. We report the outcome of partially decalcified bone allograft (decal bone) in the treatment of delayed union and atrophic nonunions of bones. Twenty patients with clinicoradiological diagnosis of delayed union or atrophic nonunion of long bone fractures were included in this retrospective study. Patients at extreme of ages (60 years), pathological fractures, metabolic bone diseases, infected nonunion, hypertrophic nonunion and those having systemic illness like diabetes mellitus and on drugs that impair fracture healing were excluded from the study. Decal bone was prepared in the bone bank and maintained in department of orthopedics. Allografting was done in 20 patients of delayed union (9/20) and atrophic nonunion (11/20) of long bone fractures with mean age of 34 years (range 18-55 years). The bones involved were humerus (8/20), tibia (7/20) and femur (5/20). Fourteen patients underwent treatment in the form of internal fixation and allografting and six patients were operated with osteoperiosteal allografting. Nineteen patients achieved union in mean time of 14.9 weeks range (range 8-20 weeks). Eight patients had serous discharge from the operative site that subsided in 11 days (range 4-21 days). One patient had pus discharge that required repeat debridement and antibiotics for 6 weeks. The fracture healed in 16 weeks. The partially decalcified bone allograft is an effective modality for augmentation of bone healing without complication associated with autograft like donor site morbidity, increased blood loss and increase in the surgical time.


    Directory of Open Access Journals (Sweden)

    Ion Dorin BUMBENECI


    Full Text Available The purpose of this study is to evaluate the level of assimilation for the terms "Proximity Management" and "Proximity Manager", both in the specialized literature and in practice. The study has two parts: the theoretical research of the two terms, and an evaluation of the use of Proximity management in 32 companies in Gorj, Romania. The object of the evaluation resides in 27 companies with less than 50 employees and 5 companies with more than 50 employees.

  20. Magnetic resonance aspects in ulnar styloid nonunion; Aspectos da ressonancia magnetica no diagnostico da nao uniao do processo estiloide da ulna

    Energy Technology Data Exchange (ETDEWEB)

    Vianna, Jaine Moradillo Mello; Freire, Maxime Figueiredo de Oliveira [Hospital Alvorada de Moema, Sao Paulo, SP (Brazil)]. E-mail:


    Ulnar syloid process nonunion fractures are common, although isolated fractures may not be recognized and become a persistent wrist pain. Most time the fractures are asymptomatic. It is important , in symptomatic patients, the characterization of the lesion and the commitment of other structures that compose distal radio-ulnar joint for proper treatment. The classification is based on radio-ulnar joint stability. We report wrist magnetic resonance images from two patients, each one with one type of nonunion classification, which is based in anatomic findings and treatment options. (author)

  1. [Validation of the Osteomyelitis Diagnosis Score on the Basis of a Retrospective Analysis of 100 Patients with Non-Union of the Tibia]. (United States)

    Steinhausen, E; Lundin, S; Dahmen, J; Zulueta La Rosa, G; Al Malat, T; Glombitza, M; Rixen, D


    Background: The accurate diagnosis of "osteomyelitis" is difficult and is often delayed. However, early and radical therapy of osteomyelitis is essential. The osteomyelitis diagnosis score (ODS) was developed to predict the probability of osteomyelitis. The aim of our study was to validate the ODS and to investigate its practicability in daily routine. Material and Methods: The ODS is based on five diagnostic procedures: 1. clinical history/risk factors, 2. clinical examination/laboratory results, 3. diagnostic imaging, 4. microbiology and 5. histopathology. Each diagnostic procedure includes numerous individual findings, which are rated with 1-6 points, depending on their relevance. If the sum of the five diagnostic criteria is ≥ 17 points, the diagnosis "osteomyelitis" can be viewed as safe, between 8-17 points as probable and between 2-7 points as possible. This retrospective study included 100 patients with non-union of the tibia (2002-2010). The patients were classified into two groups: septic non-union of the tibia (experimental intervention; gold standard: positive detection of bacteria and/or positive histology) and aseptic non-union of the tibia (control intervention; no detection of bacteria and/or histology). Epidemiological data, the score's total number of points and the number of points of the score's five diagnostic procedures were analysed. Results: 71 patients exhibited aseptic non-union of the tibia, 29 patients septic non-union. Patients with septic non-union obtained a mean of 20.8 points, and 24 at least 18 points; the diagnosis "osteomyelitis" is then presumed to be certain. Patients with aseptic non-union obtained a mean of 11.3 points, and only 3/71 patients received > 17 points. Both groups obtained the majority of points in the diagnostic procedure "clinical history". The difference between the two groups is highly significant (p < 0.001). The score's sensitivity is 82.8 %, with a specificity of 95.8 %. Conclusion: The ODS

  2. Use of stem-cell sheets expressing bone morphogenetic protein-7 in the management of a nonunion radial fracture in a Toy Poodle. (United States)

    Song, Jaeyong; Kim, Yongsun; Kweon, Oh-Kyeong; Kang, Byung-Jae


    A 12-year-old castrated Toy Poodle was referred to the Kangwon National University Animal Hospital with an oligotrophic nonunion fracture in the distal 1/3 of the left radius and an intact ulna. After fixation by a locking plate and screws, adipose-derived mesenchymal stem-cell sheets expressing bone morphogenetic protein 7 (BMP-7) were transplanted to the fracture site to enhance the healing activity. The fracture was healed at 9 weeks after surgery. In the present case, the mesenchymal stem-cell sheets expressing BMP-7 promoted bone regeneration and healing in a nonunion fracture.

  3. Jupiter's interior and deep atmosphere: The initial pole-to-pole passes with the Juno spacecraft

    DEFF Research Database (Denmark)

    Bolton, S. J.; Adriani, Alberto; Adumitroaie, V.


    On 27 August 2016, the Juno spacecraft acquired science observations of Jupiter, passing less than 5000 kilometers above the equatorial cloud tops. Images of Jupiter's poles show a chaotic scene, unlike Saturn's poles. Microwave sounding reveals weather features at pressures deeper than 100 bars...... of magnitude more precise. This has implications for the distribution of heavy elements in the interior, including the existence and mass of Jupiter's core. The observed magnetic field exhibits smaller spatial variations than expected, indicative of a rich harmonic content....

  4. Use of intramedullary fibular strut graft: a novel adjunct to plating in the treatment of osteoporotic humeral shaft nonunion. (United States)

    Vidyadhara, S; Vamsi, K; Rao, Sharath K; Gnanadoss, James J; Pandian, S


    Humeral shaft fractures respond well to conservative treatment and unite without much problem. Since it is uncommon, there is not much discussion regarding the management of nonunion in the literature, and hence this is a challenge to the treating orthopaedic surgeon. Osteoporosis of the fractured bone and stiffness of the surrounding joints compounds the situation further. The Ilizarov fixator, locking compression plate, and vascularised fibular graft are viable options in this scenario but are technically demanding. We used a fibular strut graft for bridging the fracture site in order to enhance the pull-out strength of the screws of the dynamic compression plate. Six patients in the study had successful uneventful union of the fracture at the last follow-up. The fibula is easy to harvest and produces less graft site morbidity. None of the study patients needed additional iliac crest bone grafting. This is the largest reported series of patients with osteoporotic atrophic nonunion of humerus successfully treated solely using the combination of an intramedullary fibular strut graft and dynamic compression plate.

  5. Surgical interventions for treating acute fractures or non-union of the middle third of the clavicle. (United States)

    Lenza, Mário; Faloppa, Flávio


    This review covers two conditions: acute clavicle fractures and non-union resulting from failed fracture healing. Clavicle (collarbone) fractures account for around 4% of all fractures. While treatment for these fractures is usually non-surgical, some types of clavicular fractures, as well as non-union of the middle third of the clavicle, are often treated surgically. This is an update of a Cochrane review first published in 2009. To evaluate the effects (benefits and harms) of different methods of surgical treatment for acute fracture or non-union of the middle third of the clavicle. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (27 June 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 5), MEDLINE (1966 to June week 3 2014), EMBASE (1988 to 2014 week 25), LILACS (1982 to 27 June 2014), trial registries and reference lists of articles. We applied no language or publication restrictions. We considered randomised and quasi-randomised controlled trials evaluating any surgical intervention for treating people with fractures or non-union of the middle third of the clavicle. The primary outcomes were shoulder function or disability, pain and treatment failure (measured by the number of participants who had undergone or were being considered for a non-routine secondary surgical intervention for symptomatic non-union, malunion or other complications). Two review authors selected eligible trials, independently assessed risk of bias and cross-checked data. Where appropriate, we pooled results of comparable trials. We included seven trials in this review with 398 participants. Four trials were new in this update.The four new trials (160 participants) compared intramedullary fixation with open reduction and internal fixation with plate for treating acute middle third clavicle fractures in adults. Low quality evidence from the four trials indicated that intramedullary fixation did not

  6. Computed tomographic evaluation of the proximal femur: A predictive classification in displaced femoral neck fracture management

    Directory of Open Access Journals (Sweden)

    Narender Kumar Magu


    Full Text Available Background: Femoral neck fracture is truly an enigma due to the high incidence of avascular necrosis and nonunion. Different methods have been described to determine the size of the femoral head fragment, as a small head has been said to be associated with poor outcome and nonunion due to inadequate implant purchase in the proximal fragment. These methods were two dimensional and were affected by radiography techniques, therefore did not determine true head size. Computed tomography (CT is an important option to measure true head size as images can be obtained in three dimensions. Henceforth, we subjected patients to CT scan of hip in cases with displaced fracture neck of femur. The study aims to define the term "small head or inadequate size femoral head" objectively for its prognostic significance. Materials and Methods: 70 cases of displaced femoral neck fractures underwent CT scan preoperatively for proximal femoral geometric measurements of both hips. Dual energy X-ray absorptiometry scan was done in all cases. Patients were treated with either intertrochanteric osteotomy or lag screw osteosynthesis based on the size of the head fragment on plain radiographs. Results: The average femoral head fragment volume was 57 cu cm (range 28.3-84.91 cu cm; standard deviation 14 cu cm. Proximal fragment volume of >43 cu cm was termed adequate size (type I and of ≤43 cu cm as small femoral head (type II. Fractures which united (n = 54 had a relatively large average head size (59 cu cm when compared to fractures that did not (n = 16, which had a small average head size (49 cu cm and this difference was statistically significant. In type I fractures union rate was comparable in both osteotomy and lag screw groups (P > 0.05. Lag screw fixation failed invariably, while osteotomy showed good results in type II fractures (P < 0.05. Conclusion: Computed tomography scan of the proximal femur is advisable for measuring true size of head fragment. An objective

  7. The Pole Orientation, Pole Precession, and Moment of Inertia Factor of Saturn (United States)

    Jacobson, R. A.; French, R. G.; Nicholson, P. D.; Hedman, M.; Colwell, J. E.; Marouf, E.; Rappaport, N.; McGhee, C.; Sepersky, T.; Lonergan, K.


    This paper discusses our determination of the Saturn's pole orientation and precession using a combination of Earthbased and spacecraft based observational data. From our model of the polar motion and the observed precession rate we obtain a value for Saturn's polar moment of inertia

  8. Secondary electron emission yield on poled silica based thick films

    DEFF Research Database (Denmark)

    Braga, D.; Poumellec, B.; Cannas, V.


    injection, we pointed out an electric field 0.5 µm below the surface for our poling conditions and directed in the same direction as the external field applied during the poling process. Then, the dependence of on the injected dose of electrons allows us to deduce that the poling process disturbs the glass......Studies on the distribution of the electric field produced by a thermal poling process in a layer of Ge-doped silica on silicon substrate, by using secondary electron emission yield (SEEY) measurements () are presented. Comparing 0 between poled and unpoled areas, the SEEY at the origin of electron...... structure strongly enough for leading to a weak conductivity. It is then easy to display the poled areas. We have also pointed out an effect of the electric properties of the glass on the measurements obtained with the Electron Probe for MicroAnalysis....

  9. Minimally Invasive Treatment of Displaced Proximal Humeral Fractures in Patients Older Than 70 Years Using the Humerusblock

    Directory of Open Access Journals (Sweden)

    Robert Bogner


    Full Text Available Background. Surgical treatment of proximal humeral fractures (PHF in osteoporotic bone of elderly patients is challenging. The aim of this retrospective study was to evaluate the clinical and radiological outcome after percutaneous reduction and internal fixation of osteoporotic PHF in geriatric patients using the semirigid Humerusblock device. Methods. In the study period from 2005 to 2010, 129 patients older than 70 years were enrolled in the study. After a mean follow-up of 23 months, a physical examination, using the Constant-Murley score and the VAS pain scale, was performed. Furthermore radiographs were taken to detect signs of malunion, nonunion, and avascular necrosis. Results. The recorded Constant-Murley score was 67.7 points (87.7% of the noninjured arm for two-part fractures, 67.9 points (90.8% for three-part fractures, and 43.0 points (56.7% for four-part fractures. In ten shoulders (7.8% loss of reduction and in four shoulders (3.1% nonunion were the reason for revision surgery. Avascular humeral head necrosis developed in eight patients (6.2%. Conclusions. In two- and three-part fractures postoperative results are promising. Sufficient ability for the activities of daily living was achieved. In four-part fractures the functional results were less satisfying regarding function and pain with a high postoperative complication rate. In those patients other treatment strategies should be considered. Study design. Therapeutic retrospective case series (evidence-based medicine (EBM level IV.

  10. Minimally Invasive Treatment of Displaced Proximal Humeral Fractures in Patients Older Than 70 Years Using the Humerusblock. (United States)

    Bogner, Robert; Ortmaier, Reinhold; Moroder, Philipp; Karpik, Stefanie; Wutte, Christof; Lederer, Stefan; Auffarth, Alexander; Resch, Herbert


    Background. Surgical treatment of proximal humeral fractures (PHF) in osteoporotic bone of elderly patients is challenging. The aim of this retrospective study was to evaluate the clinical and radiological outcome after percutaneous reduction and internal fixation of osteoporotic PHF in geriatric patients using the semirigid Humerusblock device. Methods. In the study period from 2005 to 2010, 129 patients older than 70 years were enrolled in the study. After a mean follow-up of 23 months, a physical examination, using the Constant-Murley score and the VAS pain scale, was performed. Furthermore radiographs were taken to detect signs of malunion, nonunion, and avascular necrosis. Results. The recorded Constant-Murley score was 67.7 points (87.7% of the noninjured arm) for two-part fractures, 67.9 points (90.8%) for three-part fractures, and 43.0 points (56.7%) for four-part fractures. In ten shoulders (7.8%) loss of reduction and in four shoulders (3.1%) nonunion were the reason for revision surgery. Avascular humeral head necrosis developed in eight patients (6.2%). Conclusions. In two- and three-part fractures postoperative results are promising. Sufficient ability for the activities of daily living was achieved. In four-part fractures the functional results were less satisfying regarding function and pain with a high postoperative complication rate. In those patients other treatment strategies should be considered. Study design. Therapeutic retrospective case series (evidence-based medicine (EBM) level IV).

  11. Genetic predisposition to fracture non-union: a case control study of a preliminary single nucleotide polymorphisms analysis of the BMP pathway

    Directory of Open Access Journals (Sweden)

    Giannoudis Peter V


    Full Text Available Abstract Background Despite the known multi-factorial nature of atrophic fracture non-unions, a possible genetic predisposition for the development of this complication after long bone fractures remains unknown. This pilot study aimed to address this issue by performing a preliminary SNP analysis of specific genes known to regulate fracture healing. Methods A total of fifteen SNPs within four genes of the Bone Morphogenetic Protein (BMP pathway (BMP-2, BMP-7, NOGGIN and SMAD6 were examined, in 109 randomly selected patients with long bone fractures as a result of motor vehicle accident, fall or direct blow. There were sixty-two patients with atrophic non-union and forty-seven patients (54 fractures with uneventful fracture union. Overall SNPs frequencies were computed with respect to patient's age, gender, smoking habits, fracture-associated parameters and the use of nonsteroidal anti-inflammatory drugs (NSAIDs, and tested for their association to the impaired bone healing process, using binary logistic regression (STATA 11.1; StataCorp, Texas USA. Results Statistical analysis revealed age to be an important covariate in the development of atrophic non-union (p = 0.01, OR 1.05 [per year], and two specific genotypes (G/G genotype of the rs1372857 SNP, located on NOGGIN and T/T genotype of the rs2053423 SNP, located on SMAD6 to be associated with a greater risk of fracture non-union (p = 0.02, OR 4.56 and p = 0.04, OR 10.27, respectively, after adjustment for age. Conclusions This is the first clinical study to investigate the potential existence of genetic susceptibility to fracture non-union. Even though no concrete conclusions can be obtained from this pilot study, our results indicate the existence of a potential genetically predetermined impairment within the BMP signalling cascade, initiated after a fracture and when combined with other risk factors could synergistically increase the susceptibility of a patient to develop non-union. Further

  12. Electromechanical properties of a disc-type salient-pole brushless DC motor with different pole numbers

    Energy Technology Data Exchange (ETDEWEB)

    Lukaniszyn, M.; Jagiela, M.; Wrobel, R.


    A brushless, permanent magnet, three-phase disc-type salient-pole DC motor with co-axial flux in the stator is considered. Electromechanical properties of a basic eight-pole motor are compared with those for a 16-pole one of the same volume, in order to contrast the two potential candidates for variable-speed, low-cost drives. As a basis of the comparative analysis, 3D FEM magnetic field modelling and circuit analysis considering an electronic commutator are employed. Increasing the number of poles results in unfavourable raising in the switching frequency. The eight-pole motor construction has been shown in simulations to have higher efficiency and lower power losses than its 16-pole counterpart. (Author)

  13. Intramedullary Pinning with Tension-Band Wiring for Surgical Neck Fractures Of the Proximal Humerus in Elderly Patients

    Directory of Open Access Journals (Sweden)

    Cheng-Chang Lu


    Full Text Available Most proximal humeral fractures in the elderly population are related to osteoporosis. Several methods have been proposed to treat surgical neck fractures of the proximal humerus in elderly people. This study investigates a new method of intramedullary pinning with tension-band wiring. From June 1998 to March 2001, 10 female patients with a mean age of 73.0 years and displaced two- or three-part surgical neck fractures of the proximal humerus were studied. Two intramedullary pins were used with tension-band wiring via a deltopectoral approach with minimum dissection. The mean follow-up was 20.6 months. Final outcome was evaluated using the constant score, visual analog scale (VAS score, questionnaire, and an outcome assessment form. The outcome was excellent in four patients, good in five, and fair in one. The mean Constant score was 80.8 and the VAS score was 83.0. There was no nonunion, avascular necrosis, deep infection, or pin migration. No patient needed further revision open reduction with internal fixation or prosthesis replacement. We therefore concluded that intramedullary pinning with tension-band wiring is a safe, reliable method, with few complications, for treating surgical neck fractures of the proximal humerus in elderly patients.

  14. What is the Effect of 90-Degree Double-Plate Fixation with Grafting on Healing of Humeral Shaft Non-unions

    Directory of Open Access Journals (Sweden)

    Mutlu Çobanoğlu


    Full Text Available Objective: Our aim was to investigate the clinical and radiological outcomes of double-plate fixation with grafting in the treatment of non-union of humeral shaft fractures. Materials and Methods: We performed a retrospective chart review of patients operated between 2006 and 2012 due to humeral shaft non-union. Patients undergoing surgery with double-plate fixation were included and those treated with external fixator, single plate, intramedullary nails and patients with pathological fractures and infected non-unions were excluded. Surgical intervention via anterolateral or posterior approach included radial nerve identification, decortication and reestablishment of medullary canal followed by compression plating with double-plate fixation and frequent application of autogenous grafts or allografts. Main outcome measures were success rate of non-union repair, rate of re-intervention and complications, range of motion, assessment of pain Visual analogue scale (VAS and function Disabilities of the arm, shoulder and hand (DASH and overall outcome Stewart-Hundley classification. Results: Ten patients were treated with double-plate fixation. The study group included six females and four males aged 36 to 70 years. Union was achieved within 4.5 and 8 months in all cases. The mean preoperative VAS score of 6.1 decreased to 2, postoperatively, with an associated decrease in the mean DASH score from 74.1 to 23.4. Excellent or good results were obtained in nine cases. There was no incidence of radial nerve palsy or infection. Conclusion: Our study provides level 4 evidence of the effectiveness of treating non-union fractures of the humeral shaft with double-plate fixation and grafting in providing good-to-excellent functional results and high union rate without any significant complication.

  15. Fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Brorson, Stig


    . The bandages were further supported by splints made of wood or coarse grass. Healing was expected in forty days. Different fracture patterns have been discussed and classified since Ancient Greece. Current classification of proximal humeral fractures mainly relies on the classifications proposed by Charles......, classification of proximal humeral fractures remains a challenge for the conduct, reporting, and interpretation of clinical trials. The evidence for the benefits of surgery in complex fractures of the proximal humerus is weak. In three systematic reviews I studied the outcome after locking plate osteosynthesis......Fractures of the proximal humerus have been diagnosed and managed since the earliest known surgical texts. For more than four millennia the preferred treatment was forceful traction, closed reduction, and immobilization with linen soaked in combinations of oil, honey, alum, wine, or cerate...

  16. The infrastructure of psychological proximity

    DEFF Research Database (Denmark)

    Nickelsen, Niels Christian Mossfeldt


    ). The experience of psychological proximity between patient and nurse is provided through confidence, continuity and the practical set-up. This constitutes an important enactment of skillfulness, which may render telemedicine a convincing health service in the future. Methodology: The study draws on a pilot...... (Langstrup & Winthereik 2008). This study contributes by showing the infrastructure of psychological proximity, which is provided by way of device, confidence, continuity and accountability....

  17. Computed tomographic evaluation of the proximal femur: A predictive classification in displaced femoral neck fracture management. (United States)

    Magu, Narender Kumar; Magu, Sarita; Rohilla, Rajesh Kumar; Batra, Amit; Jaipuria, Abhishek; Singh, Amanpreet


    Femoral neck fracture is truly an enigma due to the high incidence of avascular necrosis and nonunion. Different methods have been described to determine the size of the femoral head fragment, as a small head has been said to be associated with poor outcome and nonunion due to inadequate implant purchase in the proximal fragment. These methods were two dimensional and were affected by radiography techniques, therefore did not determine true head size. Computed tomography (CT) is an important option to measure true head size as images can be obtained in three dimensions. Henceforth, we subjected patients to CT scan of hip in cases with displaced fracture neck of femur. The study aims to define the term small head or inadequate size femoral head" objectively for its prognostic significance. 70 cases of displaced femoral neck fractures underwent CT scan preoperatively for proximal femoral geometric measurements of both hips. Dual energy X-ray absorptiometry scan was done in all cases. Patients were treated with either intertrochanteric osteotomy or lag screw osteosynthesis based on the size of the head fragment on plain radiographs. The average femoral head fragment volume was 57 cu cm (range 28.3-84.91 cu cm; standard deviation 14 cu cm). Proximal fragment volume of >43 cu cm was termed adequate size (type I) and of ≤43 cu cm as small femoral head (type II). Fractures which united (n = 54) had a relatively large average head size (59 cu cm) when compared to fractures that did not (n = 16), which had a small average head size (49 cu cm) and this difference was statistically significant. In type I fractures union rate was comparable in both osteotomy and lag screw groups (P > 0.05). Lag screw fixation failed invariably, while osteotomy showed good results in type II fractures (P femoral head size (type I and type II) is proposed. Osteosynthesis should be the preferred method of treatment in type I and osteotomy or prosthetic replacement is the method of choice for

  18. Solar Open Flux Migration from Pole to Pole: Magnetic Field Reversal. (United States)

    Huang, G-H; Lin, C-H; Lee, L C


    Coronal holes are solar regions with low soft X-ray or low extreme ultraviolet intensities. The magnetic fields from coronal holes extend far away from the Sun, and thus they are identified as regions with open magnetic field lines. Coronal holes are concentrated in the polar regions during the sunspot minimum phase, and spread to lower latitude during the rising phase of solar activity. In this work, we identify coronal holes with outward and inward open magnetic fluxes being in the opposite poles during solar quiet period. We find that during the sunspot rising phase, the outward and inward open fluxes perform pole-to-pole trans-equatorial migrations in opposite directions. The migration of the open fluxes consists of three parts: open flux areas migrating across the equator, new open flux areas generated in the low latitude and migrating poleward, and new open flux areas locally generated in the polar region. All three components contribute to the reversal of magnetic polarity. The percentage of contribution from each component is different for different solar cycle. Our results also show that the sunspot number is positively correlated with the lower-latitude open magnetic flux area, but negatively correlated with the total open flux area.

  19. Regge Poles in Neutron Scattering by a Cylinder

    Directory of Open Access Journals (Sweden)

    K. V. Protasov


    Full Text Available We establish asymptotic expressions for the positions of Regge poles for cold neutron scattering on mesoscopic cylinder mirror as well as for the S-matrix residuals. We outline the correspondence between Regge poles and near-surface quasi-stationary neutron states. Such states are of practical importance for studying subtle effects of neutron-surface interaction.

  20. Measurement of acoustic attenuation in South Pole ice

    NARCIS (Netherlands)

    Abbasi, R.; Abdou, Y.; Abu-Zayyad, T.; Adams, J.; Aguilar, J.A.; Ahlers, M.; Andeen, K.; Auffenberg, J.; Bai, X.; Baker, M.; Barwick, S.W.; Bay, R.; Alba, J.L.B.; Beattie, K.; Beatty, J.J.; Bechet, S.; Becker, J.K.; Becker, K.H.; Benabderrahmane, M.L.; Berdermann, J.; Berghaus, P.; Berley, D.; Bernardini, E.; Bertrand, D.; Besson, D.Z.; Bissok, M.; Blaufuss, E.; Boersma, D.J.; Bohm, C.; Boser, S.; Botner, O.; Bradley, L.; Braun, J.; Buitink, S.; Carson, M.; Chirkin, D.; Christy, B.; Clem, J.; Clevermann, F.; Cohen, S.; Colnard, C.; Cowen, D.F.; D'Agostino, M.V.; Danninger, M.; Clercq, C. De; Demirors, L.; Depaepe, O.; Descamps, F.; Desiati, P.; Vries-Uiterweerd, G. de; DeYoung, T.; Diaz-Velez, J.C.; Dreyer, J.; Dumm, J.P.; Duvoort, M.R.; Ehrlich, R.; Eisch, J.; Ellsworth, R.W.; Engdegard, O.; Euler, S.; Evenson, P.A.; Fadiran, O.; Fazely, A.R.; Feusels, T.; Filimonov, K.; Finley, C.; Foerster, M.M.; Fox, B.D.; Franckowiak, A.; Franke, R.; Gaisser, T.K.; Gallagher, J.; Ganugapati, R.; Geisler, M.; Gerhardt, L.; Gladstone, L.; Glusenkamp, T.; Goldschmidt, A.; Goodman, J.A.; Grant, D.; Griesel, T.; Gross, A.; Grullon, S.; Gunasingha, R.M.; Gurtner, M.; Gustafsson, L.; Ha, C.; Hallgren, A.; Halzen, F.; Han, K.; Hanson, K.; Helbing, K.; Herquet, P.; Hickford, S.; Hill, G.C.; Hoffman, K.D.; Homeier, A.; Hoshina, K.; Hubert, D.; Huelsnitz, W.; Lafebre, S.J.


    Using the South Pole Acoustic Test Setup (SPATS) and a retrievable transmitter deployed in holes drilled for the IceCube experiment, we have measured the attenuation of acoustic signals by South Pole ice at depths between 190 m and 500 m. Three data sets, using different acoustic sources, have been

  1. Fabrication of periodically poled lithium niobate chips for optical ...

    Indian Academy of Sciences (India)


    Nov 27, 2015 ... An electric-field poling process was established that yielded uniform periodically poled lithium niobate (PPLN) in 0.5 mm thick lithium niobate substrate. We have fabricated 50 mm long fanned as well as multigrating PPLNs having period variations from 25 m to 32 m. These PPLNs are required for ...

  2. pbx is required for pole and eye regeneration in planarians (United States)

    Chen, Chun-Chieh G.; Wang, Irving E.; Reddien, Peter W.


    Planarian regeneration involves regionalized gene expression that specifies the body plan. After amputation, planarians are capable of regenerating new anterior and posterior poles, as well as tissues polarized along the anterior-posterior, dorsal-ventral and medial-lateral axes. Wnt and several Hox genes are expressed at the posterior pole, whereas Wnt inhibitory genes, Fgf inhibitory genes, and prep, which encodes a TALE-family homeodomain protein, are expressed at the anterior pole. We found that Smed-pbx (pbx for short), which encodes a second planarian TALE-family homeodomain transcription factor, is required for restored expression of these genes at anterior and posterior poles during regeneration. Moreover, pbx(RNAi) animals gradually lose pole gene expression during homeostasis. By contrast, pbx was not required for initial anterior-posterior polarized responses to wounds, indicating that pbx is required after wound responses for development and maintenance of poles during regeneration and homeostatic tissue turnover. Independently of the requirement for pbx in pole regeneration, pbx is required for eye precursor formation and, consequently, eye regeneration and eye replacement in homeostasis. Together, these data indicate that pbx promotes pole formation of body axes and formation of regenerative progenitors for eyes. PMID:23318641

  3. Fabrication of periodically poled lithium niobate chips for optical ...

    Indian Academy of Sciences (India)

    the electric field poling technique is the lateral domain spreading occurring in LN during the poling process. By applying an external electric field exceeding the co- ercive field of the material, domains first nucleate along the edges of the electrodes, because of the increased field strength caused by the fringing field, and ...

  4. 30 CFR 57.12048 - Communication conductors on power poles. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Communication conductors on power poles. 57... MINES Electricity Surface and Underground § 57.12048 Communication conductors on power poles. Telegraph, telephone, or signal wires shall not be installed on the same crossarm with power conductors. When carried...

  5. Finite element analyses of wood laminated composite poles (United States)

    Cheng Piao; Todd F. Shupe; R.C. Tang; Chung Y. Hse


    Finite element analyses using ANSYS were conducted on orthotropic, polygonal, wood laminated composite poles subjected to a body force and a concentrated load at the free end. Deflections and stress distributions of small-scale and full-size composite poles were analyzed and compared to the results obtained in an experimental study. The predicted deflection for both...

  6. Kolm aastat hiljem : ühisrinnet pole / Erkki Bahovski

    Index Scriptorium Estoniae

    Bahovski, Erkki, 1970-


    Autori hinnangul pole kolm aastat tagasi suurriikide juhtide poolt avaldatud soov koostööks rahvusvahelise terrorismi vastu võitlemisel tänaseks teostunud. Samuti pole suudetud kõrvale tõrjuda riikide omavahelisi huvisid ning ajaloolisi tüliküsimusi

  7. Kremli insaider : Putinil pole peaministri kohta vaja / Jaanus Piirsalu

    Index Scriptorium Estoniae

    Piirsalu, Jaanus, 1973-


    Moskvas arvatakse, et kui president Vladimir Putin on otsustanud saada peaministriks, pole enam eriti oluline järgmise riigipea isik. Kõige suuremaks peetakse Viktor Zubkovi shansse riigipea kohale. Politoloog Gleb Pavlovski hinnangul pole peaministriks saamine Putinile praegu üldse ahvatlev. Lisa: Kas Zhirinovski pääseb uude riigiduumasse?

  8. Second harmonic generation from corona-poled polymer thin films ...

    Indian Academy of Sciences (India)


    Feb 9, 2014 ... Abstract. We characterize thermal stability of second harmonic generation (SHG) properties of four different Y-type polymers poled using corona poling method. These polymers are based on donor–acceptor–donor-type repeating unit with different aromatic moieties acting as donors and dicyanomethylene ...

  9. Second generation locked plating for complex proximal humerus fractures in very elderly patients. (United States)

    Gavaskar, Ashok S; Karthik B, Bhupesh; Tummala, Naveen C; Srinivasan, Parthasarathy; Gopalan, Hitesh


    Humeral head sacrificing procedures are more favored in elderly patients with complex proximal humerus fractures because of high incidence of failures and complications with osteosynthesis. The purpose of this study is to assess the outcome of second generation locked plating techniques in 3 and 4 part fractures in active elderly patients >70years with an emphasis on function and complications. 29 patients with displaced 3 and 4 part proximal humerus fractures were treated using the principles of second-generation proximal humerus locked plating. Fixed angle locked plating (PHILOS) using the anterolateral deltoid spilt approach augmented with traction cuff sutures was performed. Minimum of 7 locking head screws including 2 calcar screws were used. In cases with a comminuted medial calcar, an endosteal fibular strut was used. Subchondral metaphyseal bone voids were filled with injectable calcium phosphate cement. Radiological outcome (union, head - shaft angle, tuberosity reduction), functional outcome assessment (Constant and ASES scores) and complications (loss of reduction, nonunion and osteonecrosis) were assessed. The fracture united in 24 of the 26 patients available for follow up at a mean of 27 months (12-40 months). 3 patients developed complications that required arthroplasty (fixation failure in 2 patients and osteonecrosis in 1 patient). Follow up age adjusted Constant (63.1±11.9) and ASES scores (62.58±7.5) showed the extent of functional improvement post surgery. Patients with fractures having a non-comminuted medial calcar and valgus displacement of the humeral head had better functional scores and fewer complications. Osteosynthesis with second generation locked plating techniques provide satisfactory outcome in very elderly patients with complex proximal humerus fractures with minimal complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Thrust plate prosthesis for proximal femoral deformity: a series of 15 patients. (United States)

    Karatosun, Vasfi; Unver, Bayram; Gültekin, Alper; Günal, Izge


    Patients with coxarthrosis and proximal femoral deformity experience problems with total hip arthroplasty. A custom-made prosthesis or a proximal osteotomy is required for such cases, and these also increase the rate of complications. The purpose of this study was to evaluate the results of the thrust plate prosthesis (TPP) in patients with deformity of the proximal femur. Fifteen patients (7 females, 8 males) with a mean age of 56.4 years (range 19-75 years) at the time of the surgery were included in the study. The etiology was traumatic coxarthrosis in 12, and nonunion of a femoral neck fracture with osteonecrosis of the femoral head in the remaining three. While the femoral component was a third-generation TPP in all patients, the acetabular component was a Protek expansion cup in 12, and a cementless standard cup in three patients. All operations were performed through a Hardinge approach. Patients were followed up for at least 3 years (range 36-116 months) and evaluated clinically with the Harris Hip Score. The mean preoperative Harris Hip Score increased from 51.2 (range 15-79) to 92.7 (range 60-100) at the latest assessment. In two cases, loosening of the femoral component was observed in zone 3, both 12 months postoperatively. One was replaced by an intramedullary prosthesis, and the other was asymptomatic. TPP is a good alternative for patients with malformations of the proximal femur. The use of TPP avoids technical difficulties and a custom-made prosthesis.

  11. POLE mutations in families predisposed to cutaneous melanoma

    DEFF Research Database (Denmark)

    Aoude, Lauren G; Heitzer, Ellen; Johansson, Peter


    whole-genome and exome data from probands of 34 melanoma families lacking pathogenic mutations in known high penetrance melanoma susceptibility genes: CDKN2A, CDK4, BAP1, TERT, POT1, ACD and TERF2IP. We found a novel germline mutation, POLE p.(Trp347Cys), in a 7-case cutaneous melanoma family......Germline mutations in the exonuclease domain of POLE have been shown to predispose to colorectal cancers and adenomas. POLE is an enzyme involved in DNA repair and chromosomal DNA replication. In order to assess whether such mutations might also predispose to cutaneous melanoma, we interrogated...... variants in the exonuclease domain of POLE. Although this frequency is not significantly higher than that in unselected Caucasian controls, we observed multiple cancer types in the melanoma families, suggesting that some germline POLE mutations may predispose to a broad spectrum of cancers, including...

  12. Centrosomes and mitotic spindle poles: a recent liaison? (United States)

    Chavali, Pavithra L; Peset, Isabel; Gergely, Fanni


    Centrosomes comprise two cylindrical centrioles embedded in the pericentriolar material (PCM). The PCM is an ordered assembly of large scaffolding molecules, providing an interaction platform for proteins involved in signalling, trafficking and most importantly microtubule nucleation and organization. In mitotic cells, centrosomes are located at the spindle poles, sites where spindle microtubules converge. However, certain cell types and organisms lack centrosomes, yet contain focused spindle poles, highlighting that despite their juxtaposition in cells, centrosomes and mitotic spindle poles are distinct physical entities. In the present paper, we discuss the origin of centrosomes and summarize their contribution to mitotic spindle assembly and cell division. We then describe the key molecular players that mediate centrosome attachment to mitotic spindle poles and explore why co-segregation of centrosomes and spindle poles into daughter cells is of potential benefit to organisms.

  13. X-ray pole figure analysis. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Jarboe, D.M.; Lacey, D.E.


    Crystal orientation in a polycrystalline material determines the characteristics of the material. When a material is deformed, a specific crystallographic orientation of the grains with respect to the deformation direction becomes predominant. A technique used to determine crystal orientation or texture is the construction of a pole figure. A pole figure is a contour map, in stereographic projection, of the concentration of poles of selected crystallographic planes as a function of spatial orientation. The data used to produce pole figures are obtained by X-ray diffraction techniques. The techniques are complicated and can be simplified using computerized data acquisition, reduction, and CRT display techniques. Pole figures of cold-rolled cartridge brass (70Cu--30Zn) taken from published literature were found to closely compare with results achieved at Bendix Kansas City.

  14. Pole Dancing Auto-ethnography – Practice, Pedagogy, Performance

    Directory of Open Access Journals (Sweden)

    Amy Patricia Cadwallader


    Full Text Available In this research paper, the author addresses the following four questions: 1 What are the implications of bringing pole dancing into concert dance, not as a caricature or theatrical version of what is performed in strip clubs, but as its own, free-standing art form? 2 In what ways will years of ballet and modern dance training influence the type of dancing that emerges from dancers when poles and other apparatuses are introduced? 3 How can the author create an original pole dancing style and pedagogical methods for teaching it? 4 Who participates in pole fitness classes and how does the demographic change based on location? What about when pole fitness classes are offered in an academic setting? The author shares first-hand experiences of investigating pole dancing in fitness classes, attending performances, engaging in a rehearsal process with highly trained dancers, and teaching pole dancing to movers with a wide range of abilities. The author addresses how research plans changed as she encountered limitations of budget and time constraints. The author also elaborates on the creative process that she engaged in with her thesis cast, collaborators, and supporting designers in the making of Super-beneath, a theatrical dance work that uses five, free-standing poles. She outline the vignettes, overall structure, and narrative of the work. The author then discusses where this research fits into the larger field of pole dancing, and the even larger field of dance. In the final sections of this paper, the author describes her pedagogical practices relating to pole classes, what “practice as research” means to her, and how she would like to continue on this research trajectory in the future.

  15. Territorial Balancing of Poles of Development

    Directory of Open Access Journals (Sweden)



    Full Text Available The paper is part of the study "Specific problems of the development of the settlement network in south-eastern Romania. Regions of development 3 (South, 4 (South-West and 8 (Bucharest-Ilfov" elaborated during 2004 – 2006, within the AMTRANS programme funded by the Ministry of Education and Research, coordinated by INCD – URBANPROIECT in partnership with the Institute of Geography of the Romanian Academy and the Qualification in Statistics National Centre. The general objective of the project was sustainable and balanced spatial development of the settlement network and promotion of new relationships between urban and rural. Concretely, the study has produced a model of a polycentric and balanced settlement network according to the European principles. The case study testing and validating this model took place in southern Romania, territory exhibiting acutely the entire range of problems related to the state of the settlement network: profoundly large rural areas, accentuated dynamics of declaring new cities without sufficient evidence, excessive polarization exercised by Bucharest, etc. The paper presents the intervention directions needed to balance in the territory urban poles within the studied area, focusing on the establishment of orientation policies to consolidate the role of each settlement based on the hierarchical level of importance: European, national, regional, and local. The paper also identifies possible functional urban areas: the metropolitan area of Bucharest, areas of potential strategic integration, areas of cooperation between the small and medium-sized cities and the rural regions. Within each of these areas, the paper proposes to establish new relationships between urban and rural based on partnership, involving cooperation and coordination in achieving common goals.The study considers that the poles of development are the key element of proposed model, and their identification, formation, and balanced distribution

  16. Lessons learned from treating patients with unstable multifragmentary fractures of the proximal humerus by minimal invasive plate osteosynthesis. (United States)

    Oh, Hyoung Keun; Cho, Dae Yeon; Choo, Suk Kyu; Park, Jong Woong; Park, Ki Chul; Lee, Jung Il


    The authors present clinical and radiographic results of minimal invasive plate osteosynthesis (MIPO) for three- or four-part fractures of the proximal humerus. Twenty-six patients with three- or four-part proximal humeral fractures treated with the MIPO technique through the deltoid splitting approach were clinically and radiographically evaluated at a minimum of 12 months with an average of 20.1 months. The valgus-impacted type of three-part fracture was excluded to verify the results of the MIPO with unstable multifragmentary fractures of the proximal humerus. Twenty female patients and six male patients were included (mean age 67 years; range 18-90 years). No cases of nonunion were seen. The mean forward flexion, abduction, and external rotation were 145°, 119°, and 48°, respectively. The mean visual analog scale (VAS) for pain was 1.47 points. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score was 14.5 points, and the mean UCLA score was 29.6 points. The mean neck-shaft angle was 134°. Twenty-three patients had adequate medial support, and three patients did not have adequate medial support on initial postoperative radiographs. Five shoulders (19 %) developed complicated results. Two cases of proximal malposition of the plate (7.7 %) and two intra-articular screw penetrations (7.7 %) were observed. One case of osteonecrosis of the humeral head was identified at the final follow-up (3.8 %). The MIPO technique provides reliable radiologic and functional outcomes for three- and four-part proximal humeral fractures. Our results might support the use of MIPO for treating unstable multi fragmentary fractures of proximal humerus such as three- or four-part fractures to decrease osteonecrosis of humeral head.

  17. Management of the proximal tibia fractures by mini external fixation: A case series of 30 cases

    Directory of Open Access Journals (Sweden)

    Samar K Biswas


    Full Text Available Background: Management of high velocity trauma is a challenging problem because of morbidity of trauma and sometime residual problems of failure of proper healing of fractures with the restriction of movements of knee, shortening, and added risk of compartment syndrome in the proximal tibia fracture. There is always risk of post-operative infection and infected non-union in extensive open surgical procedure and internal fixation. Hence, there is always look out for the middle path procedure for a solution to the above said problems with the added advantage of less hospital stay and early return to work by minimal invasive procedure and stabilization of fracture reduction by multiple K-wire fixation with a frame applied externally. Stabilization of fracture with reduced pain allows early movements of neighbouring joint knee and ankle; hence, reduces the chances of fracture diseases. With this we have been stimulated to take-up the study of managing the proximal tibia fracture by mini external fixator. Aim: The aim of this study was to manage proximal tibia fractures by mini external fixator and evaluate the results and efficacy of this method. Material and Method: A total of 30 patients having proximal tibial fractures admitted at our center between 2008 and 2010 were taken and the procedure carried out was closed manipulative reduction and stabilization with mini external fixator. All acute proximal tibia fractures including tibial plateau fractures above 17 years of age of either sex were included in the study. Fracture more than 3 weeks old were excluded from the study. Result: Out of 30 cases 13 were excellent, 14 cases good, and 3 showed fair. It was found that type 5 and 6 of Schatzker′s classification have lesser outcome type of fractures Conclusion: We have found that management of the proximal tibia fractures by mini external fixation method has a better outcome. Early mobilization of knee in the proximal tibia fractures after

  18. Pole-factorization theorem in quantum electrodynamics

    Energy Technology Data Exchange (ETDEWEB)

    Stapp, H.P.


    In quantum electrodynamics a classical part of the S-matrix is normally factored out in order to obtain a quantum remainder that can be treated perturbatively without the occurrence of infrared divergences. However, this separation, as usually performed, introduces spurious large-distance effects that produce an apparent breakdown of the important correspondence between stable particles and poles of the S-matrix, and, consequently, lead to apparent violations of the correspondence principle and to incorrect results for computations in the mesoscopic domain lying between the atomic and classical regimes. An improved computational technique is described that allows valid results to be obtained in this domain, and that leads, for the quantum remainder, in the cases studied, to a physical-region singularity structure that, as regards the most singular parts, is the same as the normal physical-region analytic structure in theories in which all particles have non-zero mass. The key innovations here are to define the classical part in coordinate space, rather than in momentum space, and to define there a separation of the photon-electron coupling into its classical and quantum parts that has the following properties: (1) The contributions from the terms containing only classical couplings can be summed to all orders to give a unitary operator that generates the coherent state that corresponds to the appropriate classical process, and (2) The quantum remainder can be rigorously shown to exhibit, as regards its most singular parts, the normal analytic structure. 22 refs.

  19. Mitogenomic diversity in Russians and Poles. (United States)

    Malyarchuk, Boris; Litvinov, Andrey; Derenko, Miroslava; Skonieczna, Katarzyna; Grzybowski, Tomasz; Grosheva, Aleksandra; Shneider, Yuri; Rychkov, Sergei; Zhukova, Olga


    Complete mtDNA genome sequencing improves molecular resolution for distinguishing variation between individuals and populations, but there is still deficiency of mitogenomic population data. To overcome this limitation, we used Sanger-based protocol to generate complete mtDNA sequences of 376 Russian individuals from six populations of European part of Russia and 100 Polish individuals from northern Poland. Nearly complete resolution of mtDNA haplotypes was achieved - about 97% of haplotypes were unique both in Russians and Poles, and no haplotypes overlapped between them when indels were considered. While European populations showed a low, but statistically significant level of between-population differentiation (Fst=0.66%, p=0), Russians demonstrate lack of between-population differences (Fst=0.22%, p=0.15). Results of the Bayesian skyline analysis of Russian mitogenomes demonstrate not only post-Last Glacial Maximum expansion, but also rapid population growth starting from about 4.3kya (95% CI: 2.9-5.8kya), i.e. in the Bronze Age. This expansion strongly correlates with the Kurgan model established by archaeologists and confirmed by paleogeneticists. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. The North Celestial Pole Monitoring Project (United States)

    Blake, R. M.; Castelaz, M.; Phillips, J.


    In the past ten years a renaissance has occurred in the study of transient phenomena using small, dedicated optical telescopes. This has largely been driven by the successful detection of planetary transits with small telescopes (Henry et al. 2000) and the successful recovery of optical afterglows of gamma ray bursts (e.g. Halpern et al. 1997). The telescopes involved are designed to slew at rapid rates accurately across the sky when a burst alert occurs, or to study a single patch of sky to detect transits. We have constructed a dedicated robotic instrument to monitor the region within 4 degrees of the north celestial pole continuously every clear night. Using a sequence of short and long exposures the telescope collects data to conduct searches for transient and variable objects and monitor the Cepheid variable Polaris. Previous authors (Kamper et al. 1984; Evans et al. 1998) have observed Polaris to nearly cease its pulsation, a unique behavior for a Cepheid variable. Monitoring Polaris with high secular coverage should help explain this behavior. We describe here the design of the observatory, its operation and control systems and give preliminary examples of the data products from this unique project.

  1. Cubesat Proximity Operations Demonstration (CPOD) (United States)

    Villa, Marco; Martinez, Andres; Petro, Andrew


    The CubeSat Proximity Operations Demonstration (CPOD) project will demonstrate rendezvous, proximity operations and docking (RPOD) using two 3-unit (3U) CubeSats. Each CubeSat is a satellite with the dimensions 4 inches x 4 inches x 13 inches (10 centimeters x 10 centimeters x 33 centimeters) and weighing approximately 11 pounds (5 kilograms). This flight demonstration will validate and characterize many new miniature low-power proximity operations technologies applicable to future missions. This mission will advance the state of the art in nanosatellite attitude determination,navigation and control systems, in addition to demonstrating relative navigation capabilities.The two CPOD satellites are scheduled to be launched together to low-Earth orbit no earlier than Dec. 1, 2015.

  2. South Pole Fault Zone, 900 km long and almost through the pole (United States)

    Wise, D. U.; Cianfarra, P.; Salvini, F.


    The most prominent feature of snow and ice topography of the East Antarctic Plateau is the 850 x 1100 km Pensacola Basin, named for the mountain range at its mouth. The basin's headwall is a remarkably linear 900 km-long, 100 -200 km-wide zone wherein snow surface slopes of 3 m/km contrast with values of 1 m/km on either side, a total relief of 200 to 400 meters. About 700 km of this slope lies along the 35th meridian, the remainder continuing through the pole for another 200 km. Satellite images show an easily mapped zebra-striped snow unit occurs throughout the basin and beyond. The stripes are well-known from other areas as megadunes, enigmatic, upwind climbing dunes of alternating snow and ice bands with 2 km wavelength and only 1-4 m amplitude. Superposition relationships show this unit is the bottom member of a four-unit snow stratigraphy, the basis for the first geologic map of the youngest snow units of the South Pole region. The megadune stripes are draped obliquely down over the headwall slope to disappear beneath younger snow fill of the Recovery Basin at its foot before cropping out again on the floor of the main basin. Nearer the pole, the slope forms the edge of a 15,000 km2 triangular plateau, the pole located half-way down the slope. Megadune stripes from higher elevations disappear beneath younger snows of the small basin and the pole to reappear on the floor of the main basin as ghosts of megadune stripes. Farther out on the floor they emerge from beneath this thin cover as fully exposed megadune stripes. An overlay of the snow- geologic map across the relatively low resolution maps of bedrock topography shows the surface slope separates two domains of contrasting bedrock topography, the lower elevation domain corresponding to the basin floor. The most likely explanation for this remarkably linear snow slope is flow of ice over a previously unrecognized 200-400 m-high, 900 km-long bedrock fault-line scarp. Along its distal end, the surface slope

  3. Evidence of Space-Charge Effects in Thermal Poling

    DEFF Research Database (Denmark)

    Wu, X.; Arentoft, Jesper; Wong, D.


    The in situ thermal poling processes in germanosilicate fibers for positive and negative poling voltages are significantly different. Thermal poling of silica fibers consists of two processes: the faster linear process of charge migration and the subsequent single exponential process of charge...... ionization. Both the shielding electrical field due to charge migration and the ionization electrical field due to charge ionization are able to be frozen-in at room temperature acid lead to the residual linear electrooptic effects, The observations support that the mechanism of the induced electrooptic...... effects is based on space charge electrical fields instead of dipole/bond orientation....

  4. Domain wall width of lithium niobate poled during growth

    CERN Document Server

    Brooks, R; Hole, D E; Callejo, D; Bermudez, V; Diéguez, E


    Good quality crystals of periodically poled lithium niobate can be generated directly during growth. However, the temperature gradients at the zone boundaries define the width of the regions where the polarity is reversed. Hence, the region influenced the domain transition may be a significant fraction of the overall poling period for material poled during growth. Evidence for the scale of this feature is reported both by chemical etching and by the less common method of ion beam luminescence and the 'domain wall' width approximately 1 mu m for these analyses. The influence of the reversal region may differ for alternative techniques but the relevance to device design for second harmonic generation is noted.

  5. A discussion on leading renormalon in the pole mass (United States)

    Komijani, J.


    Perturbative series of some quantities in quantum field theories, such as the pole mass of a quark, suffer from a kind of divergence called renormalon divergence. In this paper, the leading renormalon in the pole mass is investigated, and a map is introduced to suppress this renormalon. The inverse of the map is then used to generate the leading renormalon and obtain an expression to calculate its overall normalization. Finally, the overall normalization of the leading renormalon of the pole mass is calculated for several values of quark flavors.

  6. N-terminal telopeptides of type I collagen and bone mineral density for early diagnosis of nonunion: An experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    Jian-Ping Lin


    Full Text Available Background: The diagnosis and treatment of bone nonunion have been studied extensively. Diagnosis and treatment of nonunion are mainly performed based on the interpretation of clinico-radiographic findings, which depend on the clinician′s experience and the degree of bone callus formation during the fracture-healing process. However, resolution may be compromised when the bone mineral content is <25%. A feasible method of monitoring bone-healing is therefore needed. We monitored a rabbit model of bone nonunion by regular radiographic examinations, QCT detection, and biomarker concentrations. Materials and Methods: Twenty purebred New Zealand rabbits (10 male and 10 female, 5-6 months of age, 2.5-3.0 kg were divided into bone defect Group (I that 10 left radius bones underwent resection of 1.5 cm of mid-radius bone and bone fracture Group (II that another 10 left radius bones underwent only mid-radius fracture. Quantitative computed tomography detection of bone mineral density (BMD and serum markers of bone formation (osteocalcin [OC], bone-specific alkaline phosphatase and bone resorption (C- and N-terminal telopeptides of type I collagen (NTX and tartrate-resistant acid phosphatase 5b were assayed. There are twenty rabbits (10 male and 10 females. The age was 5-6 months weighing 2.5-3.0 kg. The defect was created in middle 1/3 radius in 10 rabbits and fracture was created in middle 1/3 radius of 10 rabbits. Results: BMD and NTX concentrations were significantly lower at 5 weeks postoperatively compared to the preoperative values and were significantly different between the two groups. OC showed no significant difference before and after surgery. Conclusions: BMD and NTX concentrations may be useful for early detection of bone nonunion in rabbits.

  7. Volkmann?s Ischemic Contracture with Atrophic Non-union of Ulna Managed by Bone Shortening and Transposition of Radial Autograft


    L, Maheshwar; Kiran K, K; KC, Vamshi; Prasad R, Siva


    Introduction: Volkmann?s ischemic contracture (VIC) is a complex and variable flexion deformity of wrist and fingers resulting from fibrosis and contracture of flexor muscles of forearm. It is caused by ischemic injury to the deep tissues enclosed in the tight unyielding osteo-facial compartments secondary to neglected acute compartment syndrome. VIC may be associated with malunion or non-union of forearm fractures. To the best of our knowledge, this article is the first case report of VIC as...


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION Clavicle fracture is one of the most common fracture presenting to the fracture clinic, accounting for about 5-10% of all the adult trauma reported but still the controversy exists with regards to the definitive management. AIM To evaluate the surgical outcome of nonunion clavicle in patients treated previously with surgical management or conservative management, using plate and slivers of autologous iliac crest corticocancellous bone. DESIGN Retrospective analysis of patients operated between May 2005 and February 2013 for nonunion of the clavicle. METHODS AND MATERIALS Twenty patients who were operated between May 2005 and February 2013 for nonunion of the clavicle at our hospital were recruited for our study and followup data was collected from our hospital records till their last outpatient visit. Inclusion criteria included patients with no evidence of radiological union, persistence of pain, cosmetic deformity, dysfunction or gross movement at the fracture site even after 16 weeks of conservative treatment or in cases of primary fixation failure. STATISTICAL ANALYSIS All Statistical analyses were made using Statistical Package Software for Social Sciences (SPSS version 17.0 software (Chicago, IL, USA for descriptive data. Chi2 test was used to compare the categorical data. RESULTS At the end of an average followup of 19 months, the average Visual Analogue Score for pain was 1.9±2.2 (range 0-6, the mean ASES score was 81±18.5 (51-100, and the mean Constant–Murley score was 80±17 (51-100. All the patients had a stable radiological union at the end of the followup period. There were no complications pertaining to the hardware or infection. CONCLUSION Treatment of nonunion of clavicle by using corticocancellous bone is well documented; however, use of iliac corticocancellous bone graft shaped in long slivers will give mechanical stability to the plate reconstruct in addition to providing a scaffold for new bone formation than

  9. Technique of laparoscopic transperitoneal lower pole heminephroureterectomy. (United States)

    Mahomed, Anies


    Laparoscopic transperitoneal nephrectomy is technically feasible in most cases of benign renal disease. To date, there have been isolated reports of laparoscopic transperitoneal heminephroureterectomy of principally the upper moiety of a duplex system. Rarely reported are lower moiety nephroureterectomies. The aim of this IPEG submission is to present a 3-minute video demonstrating the technical details of a transperitoneal laparoscopic, right, lower moiety, heminephroureterectomy in a 3-year-old. METHODS/TECHNIQUES: A child with marginally functioning (ultrasonic scalpel and hook diathermy. A critical step at this stage was definition of the superior limit of the pelvis, which corresponded to the level of vascular demarcation. The renal parenchyma was transected at this point by using the ultrasonic scalpel, which ensured reasonable hemostasis. Complete hemostasis was assured by approximating the divided kidney with a series of three interrupted intracorporeal sutures. The subtending ureter was dissected close to the bladder base, where it was ligated and divided. A drain was placed percutaneously in the renal bed and the specimen retrieved via an extended umbilical incision. The patient was started on fluids on recovery with oral feeds introduced the next morning. The drain was removed prior to discharge on day 2. At 6 months post-resection, the patient remains well. Laparoscopic transperitoneal lower pole heminephroureterectomy is technically feasible for benign renal disease in children. The combination of ultrasonic scalpel and intracorporeal suturing is adequate to control bleeding of the transected kidney. Dissection of the ureter distally to bladder neck is easily achieved without change in port position. Recovery is robust with minimal requirement for analgesia. The wider space, better view, and ability to access all of the urinary tract make this a tenable alternative to other laparoscopic approaches.

  10. PopZ identifies the new pole, and PodJ identifies the old pole during polar growth in Agrobacterium tumefaciens. (United States)

    Grangeon, Romain; Zupan, John R; Anderson-Furgeson, James; Zambryski, Patricia C


    Agrobacterium tumefaciens elongates by addition of peptidoglycan (PG) only at the pole created by cell division, the growth pole, whereas the opposite pole, the old pole, is inactive for PG synthesis. How Agrobacterium assigns and maintains pole asymmetry is not understood. Here, we investigated whether polar growth is correlated with novel pole-specific localization of proteins implicated in a variety of growth and cell division pathways. The cell cycle of A. tumefaciens was monitored by time-lapse and superresolution microscopy to image the localization of A. tumefaciens homologs of proteins involved in cell division, PG synthesis and pole identity. FtsZ and FtsA accumulate at the growth pole during elongation, and improved imaging reveals FtsZ disappears from the growth pole and accumulates at the midcell before FtsA. The L,D-transpeptidase Atu0845 was detected mainly at the growth pole. A. tumefaciens specific pole-organizing protein (Pop) PopZAt and polar organelle development (Pod) protein PodJAt exhibited dynamic yet distinct behavior. PopZAt was found exclusively at the growing pole and quickly switches to the new growth poles of both siblings immediately after septation. PodJAt is initially at the old pole but then also accumulates at the growth pole as the cell cycle progresses suggesting that PodJAt may mediate the transition of the growth pole to an old pole. Thus, PopZAt is a marker for growth pole identity, whereas PodJAt identifies the old pole.


    African Journals Online (AJOL)

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    SHORT COMMUNICATION. PROXIMATE COMPOSITION, MINERAL CONTENT AND ANTINUTRITIONAL. FACTORS OF SOME CAPSICUM (Capsicum annum) VARIETIES GROWN IN. ETHIOPIA. Esayas K.1, Shimelis A.2, Ashebir F.3, Negussie R.3, Tilahun B.4 and Gulelat D.4*. 1Hawassa University, Department of Food ...

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

    Directory of Open Access Journals (Sweden)

    CK Chan


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

  13. Pole-to-pole biogeography of surface and deep marine bacterial communities. (United States)

    Ghiglione, Jean-François; Galand, Pierre E; Pommier, Thomas; Pedrós-Alió, Carlos; Maas, Elizabeth W; Bakker, Kevin; Bertilson, Stefan; Kirchmanj, David L; Lovejoy, Connie; Yager, Patricia L; Murray, Alison E


    The Antarctic and Arctic regions offer a unique opportunity to test factors shaping biogeography of marine microbial communities because these regions are geographically far apart, yet share similar selection pressures. Here, we report a comprehensive comparison of bacterioplankton diversity between polar oceans, using standardized methods for pyrosequencing the V6 region of the small subunit ribosomal (SSU) rRNA gene. Bacterial communities from lower latitude oceans were included, providing a global perspective. A clear difference between Southern and Arctic Ocean surface communities was evident, with 78% of operational taxonomic units (OTUs) unique to the Southern Ocean and 70% unique to the Arctic Ocean. Although polar ocean bacterial communities were more similar to each other than to lower latitude pelagic communities, analyses of depths, seasons, and coastal vs. open waters, the Southern and Arctic Ocean bacterioplankton communities consistently clustered separately from each other. Coastal surface Southern and Arctic Ocean communities were more dissimilar from their respective open ocean communities. In contrast, deep ocean communities differed less between poles and lower latitude deep waters and displayed different diversity patterns compared with the surface. In addition, estimated diversity (Chao1) for surface and deep communities did not correlate significantly with latitude or temperature. Our results suggest differences in environmental conditions at the poles and different selection mechanisms controlling surface and deep ocean community structure and diversity. Surface bacterioplankton may be subjected to more short-term, variable conditions, whereas deep communities appear to be structured by longer water-mass residence time and connectivity through ocean circulation.

  14. Characterization of Periodically Poled Nonlinear Materials Using Digital Image Processing

    National Research Council Canada - National Science Library

    Alverson, James R


    .... A new approach based on image processing across an entire z+ or z- surface of a poled crystal allows for better quantification of the underlying domain structure and directly relates to device performance...

  15. Fatigue performance of brass breakaway light pole couplings. (United States)


    Breakaway couplings connect light pole bases to foundation anchor bolts and are intended to fracture on impact after vehicle collision to : protect drivers and passengers from severe injury. The coupling consists of an internally threaded hollow hexa...

  16. Current superimposition variable flux reluctance motor with 8 salient poles

    National Research Council Canada - National Science Library

    Kazuaki Takahara; Katsuhiro Hirata; Noboru Niguchi; Akira Kohara


    We propose a current superimposition variable flux reluctance motor for a traction motor of electric vehicles and hybrid electric vehicles, which consists of 10 salient poles in the rotor and 12 slots in the stator...

  17. Methane Isotopes in South Pole Firn Air, 2008, Version 1 (United States)

    National Aeronautics and Space Administration — This data set contains depth profiles for delta carbon-13 (δ13C) and delta deuterium (δD) of methane (CH4) in South Pole firn air. The investigators obtained air...

  18. The Achievements of the GLAMOROUS Project on Poling

    DEFF Research Database (Denmark)

    Margulis, Walter; Myrén, N.; Fage-Pedersen, Jacob


    The GLAMOROUS project had as objective to demonstrate the feasibility of fibre and waveguide components with a second order nonlinearity induced by poling. The accomplishments of this nine-partners European Research Project are described.......The GLAMOROUS project had as objective to demonstrate the feasibility of fibre and waveguide components with a second order nonlinearity induced by poling. The accomplishments of this nine-partners European Research Project are described....

  19. Improved damper cage design for salient-pole synchronous generators


    Nuzzo, Stefano; Degano, Michele; Galea, Michael; Gerada, C.; Gerada, David; Brown, N.L.


    The benefits of implementing a damper winding in salient-pole, synchronous generators are widely known and well consolidated. It is also well known that such a winding incurs extra losses in the machine due to a number of reasons. In order to improve the overall efficiency and performance of classical salient-pole, wound field, synchronous generators that employ the traditional damper cage, an improved amortisseur winding topology that reduces the inherent loss is proposed and investigated in...

  20. Correction of mandibular nonunion and malocclusion by plate fixation and autogenous cortical bone grafts in two dogs. (United States)

    Boudrieau, R J; Tidwell, A S; Ullman, S L; Gores, B R


    Two dogs were treated for severe malocclusion secondary to segmental defects in the mandibular bodies as a result of nonhealing mandibular fractures. The problems of fibrous nonunions with large fracture gaps, the potential for infection, and the severe malocclusion were addressed in considering definitive surgical correction. The segmental defects in both dogs were spanned by use of autogenous cortical grafts (full-thickness rib segments or full cortical diaphyseal ulnar segments), supplemented with autogenous cancellous graft, and were stabilized with screw-and-plate fixation. Radiographic evaluation of bone healing and graft incorporation was difficult because of the implants, which obscured full observation of the bone graft sites. Successful graft revascularization, determined by 99mradiophosphate localization, was shown in both dogs; fairly uniform isotope uptake was observed throughout the graft sites and was continuous with the recipient bone. Mildly increased uptake was observed at 6 months and at 1 year after surgery and was considered consistent with remodeling associated with fracture healing. Observation of complete graft revascularization within 1 year provided ample evidence that the autografts were incorporated, with sufficient remodeling to characterize bone union.

  1. POLE mutations in families predisposed to cutaneous melanoma. (United States)

    Aoude, Lauren G; Heitzer, Ellen; Johansson, Peter; Gartside, Michael; Wadt, Karin; Pritchard, Antonia L; Palmer, Jane M; Symmons, Judith; Gerdes, Anne-Marie; Montgomery, Grant W; Martin, Nicholas G; Tomlinson, Ian; Kearsey, Stephen; Hayward, Nicholas K


    Germline mutations in the exonuclease domain of POLE have been shown to predispose to colorectal cancers and adenomas. POLE is an enzyme involved in DNA repair and chromosomal DNA replication. In order to assess whether such mutations might also predispose to cutaneous melanoma, we interrogated whole-genome and exome data from probands of 34 melanoma families lacking pathogenic mutations in known high penetrance melanoma susceptibility genes: CDKN2A, CDK4, BAP1, TERT, POT1, ACD and TERF2IP. We found a novel germline mutation, POLE p.(Trp347Cys), in a 7-case cutaneous melanoma family. Functional assays in S. pombe showed that this mutation led to an increased DNA mutation rate comparable to that seen with a Pol ε mutant with no exonuclease activity. We then performed targeted sequencing of POLE in 1243 cutaneous melanoma cases and found that a further ten probands had novel or rare variants in the exonuclease domain of POLE. Although this frequency is not significantly higher than that in unselected Caucasian controls, we observed multiple cancer types in the melanoma families, suggesting that some germline POLE mutations may predispose to a broad spectrum of cancers, including melanoma. In addition, we found the first mutation outside the exonuclease domain, p.(Gln520Arg), in a family with an extensive history of colorectal cancer.

  2. Lower-pole intracapsular tonsillectomy in obstructive sleep apnea patients. (United States)

    Kim, Su Jin; Kwon, Chul; Koh, Tae Kyung; Lee, Kun Hee; Kim, Sung Wan


    Lower-pole intracapsular tonsillectomy (LPIT) is a valuable surgical technique capable of decreasing post-operative bleeding in obstructive sleep apnea (OSA) patients. This study performed LPIT to simultaneously reduce post-operative bleeding of lower pole and prevent recurrent tonsillitis of upper pole and compared its effects to extracapsular tonsillectomy (ET). ET was performed in the extracapsular plane, with complete monopolar dissection. In LPIT, the upper pole of palatine tonsil was removed by electrocautery with the extracapsular plane, followed by removal of the lower-pole by plasma ablation with the intracapsular plane. Post-operative bleeding incidence, bleeding site, and degree of pain were compared between the two groups. Three hundred and forty-seven patients diagnosed of OSA with polysomnography were enrolled. ET was performed in 152 patients and LPIT in 195 patients. There were no significant differences in post-operative pain between the two groups. The LPIT group showed significantly lower total bleeding incidence than the ET group (4.1% vs 9.2%; p = .05). In particular, lower-pole bleeding incidence was lower in the LPIT group than the ET group (1.0% vs 5.3%; p = .02).

  3. International Youth Conference on the Poles (United States)

    Church, A. K.; Kuhn, T. S.; Baeseman, J.; Garmulewicz, A.; Raymond, M.; Salmon, R.


    The International Polar Year (IPY) is an international effort, involving more than 50 countries, to focus research in both the sciences and social sciences on the world's Polar Regions. In order to secure youth involvement in the IPY, the Youth Steering Committee (YSC) has been formed, aiming specifically to network young polar researchers from all backgrounds enabling collaboration and to involve this group in outreach focused towards other young people. A conference targeted directly at an audience of early career researchers and international youth will be central to fulfilling these aims. The YSC has therefore developed the concept of the International Youth Conference on the Poles (IYCP). Proposed for 2008, this conference will bring together youth from a diverse set of backgrounds and nationalities to discuss the issues affecting the Polar Regions, their effects on a global scale and ways of addressing these issues. The conference will also serve to highlight ongoing IPY research, especially research being undertaken by young researchers, and provide a perennial framework for youth involvement in polar research and policies. The IYCP will run for three days in May 2008, attracting an international youth audience, as well as representatives from polar organizations, teachers, politicians, policy makers, the general public and media. The IYCP will be divided into three sections. Youth Roundtable Discussions will bring youth together to discuss issues affecting the Polar Regions and potential solutions to these. A Young Researchers Conference will provide the opportunity for young researchers working in the Polar Regions to present their work to an interdisciplinary audience. The Polar Fair will provide an interactive environment for youth to learn about the Polar Regions. The IYCP will be of great importance to the IPY because it will serve as the principle venue during the Polar Year where youth from many different disciplines, backgrounds and countries will

  4. [Separate vertical wiring combined with tension band and Kirschner-wire plus cerclage wire in the treatment of displaced inferior pole fractures of the patella]. (United States)

    Zhang, J; Jiang, X Y; Huang, X W


    To investigate the clinical efficacy and outcomes of two separate vertical wiring combined with tension band and Kirschner-wire plus cerclage wire in the treatment of displaced inferior pole fractures of the patella. From January 2013 to January 2015, 15 consecutive patients (mean age 54.5 years) with inferior pole fractures of the patella were retrospectively included in this study. All the patients underwent open reduction and internal fixation by separate vertical wiring combined with tension band and Kirschner-wire plus cerclage wire through longitudinal incision, 4.5 d (range: 3.1-5.9 d) after initial injury. A safety check for early knee range of motion was performed before wound closure. The complications including infection, nonunion, loss of fixation and any wire breakage or irritation from implant were recorded. Anteroposterior and lateral views of the knee joint obtained during the follow-up were used to assess bony union based on the time when the fracture line disappeared. At the time of the final outpatient follow up, functional evaluation of the knee joint was conducted by Bostman system. The follow-up time was 13.1 months (range: 12-19 months) after surgery on average, immediate motion without immobilization in all the cases was allowed and there was no case of reduction loss of the fracture and wire breakage. There was no case of irritation from the implant. At the final follow-up, the average range of motion (ROM) arc was 126.7° (range: 115°-140°), the average ROM lag versus contralateral healthy leg was 10.3° (range: 0°-35°). The mean Bostman score at the last follow-up was 28.9 (range: 27-30), and graded excellent in most cases. Two separate vertical wiring is an easy and effective method to reduce the displaced inferior pole fracture of patella. Augmentation of separate vertical wiring with tension band and Kirschner-wire plus cerclage wire in these patients provides enough strength to protected the early exercise of the knee joint and

  5. Bone grafting via reamer-irrigator-aspirator for nonunion of open Gustilo-Anderson type III tibial fractures treated with multiplanar external fixator. (United States)

    Kusnezov, Nicholas; Prabhakar, Gautham; Dallo, Matthew; Thabet, Ahmed M; Abdelgawad, Amr A


    The purpose of this investigation was to evaluate the outcomes following reamer-irrigator-aspirator (RIA) autogenous bone grafting (ABG) of high-grade open tibia fracture nonunions stabilized via multiplanar external fixation. We retrospectively reviewed all patients with Gustilo-Anderson type III open tibia fractures treated with multiplanar external fixation and who underwent RIA ABG for nonunion at our institutional Level 1 Trauma Center between 2008 and 2015. All patients between 15 and 65 years of age with a minimum of six-month follow-up were included. The primary outcomes of interest were achievement of union, time to union, and incidence of revision surgery. Complications and all-cause reoperation were recorded as secondary endpoints. Fifteen patients met the inclusion criteria with a mean age of 41.1 ± 14.0 years. RIA ABG was harvested from the femur in all cases, with a mean volume of 34 ± 15 mL. At an average follow-up of 13.3 ± 6.8 months, all patients achieved union, including two who required repeat RIA ABG. One patient experienced a femoral shaft fracture four months following RIA that required intramedullary fixation. The average time to union was 6.0 ± 6.3 months. Twelve patients (80%) went on to union within six months and 13 (86.7%) within one year. Five patients experienced a total of six post-operative complications including three deep infections, one refracture through the nonunion site, and one gradual varus deformity. Two patients in this series required a subsequent RIA autografting procedure secondary to persistent nonunion despite initial RIA. We found that RIA ABG offered a reliable solution to nonunion of Gustilo-Anderson type III open tibial fractures treated with multiplanar external fixation, circumventing the need to change the method of fixation. © The Authors, published by EDP Sciences, 2017.

  6. Bone grafting via reamer-irrigator-aspirator for nonunion of open Gustilo-Anderson type III tibial fractures treated with multiplanar external fixator

    Directory of Open Access Journals (Sweden)

    Kusnezov Nicholas


    Full Text Available Introduction: The purpose of this investigation was to evaluate the outcomes following reamer-irrigator-aspirator (RIA autogenous bone grafting (ABG of high-grade open tibia fracture nonunions stabilized via multiplanar external fixation. Methods: We retrospectively reviewed all patients with Gustilo-Anderson type III open tibia fractures treated with multiplanar external fixation and who underwent RIA ABG for nonunion at our institutional Level 1 Trauma Center between 2008 and 2015. All patients between 15 and 65 years of age with a minimum of six-month follow-up were included. The primary outcomes of interest were achievement of union, time to union, and incidence of revision surgery. Complications and all-cause reoperation were recorded as secondary endpoints. Results: Fifteen patients met the inclusion criteria with a mean age of 41.1 ± 14.0 years. RIA ABG was harvested from the femur in all cases, with a mean volume of 34 ± 15 mL. At an average follow-up of 13.3 ± 6.8 months, all patients achieved union, including two who required repeat RIA ABG. One patient experienced a femoral shaft fracture four months following RIA that required intramedullary fixation. The average time to union was 6.0 ± 6.3 months. Twelve patients (80% went on to union within six months and 13 (86.7% within one year. Five patients experienced a total of six post-operative complications including three deep infections, one refracture through the nonunion site, and one gradual varus deformity. Two patients in this series required a subsequent RIA autografting procedure secondary to persistent nonunion despite initial RIA. Conclusion: We found that RIA ABG offered a reliable solution to nonunion of Gustilo-Anderson type III open tibial fractures treated with multiplanar external fixation, circumventing the need to change the method of fixation.

  7. Volkmann’s Ischemic Contracture with Atrophic Non-union of Ulna Managed by Bone Shortening and Transposition of Radial Autograft (United States)

    L, Maheshwar; Kiran K, K; KC, Vamshi; Prasad R, Siva


    Introduction: Volkmann’s ischemic contracture (VIC) is a complex and variable flexion deformity of wrist and fingers resulting from fibrosis and contracture of flexor muscles of forearm. It is caused by ischemic injury to the deep tissues enclosed in the tight unyielding osteo-facial compartments secondary to neglected acute compartment syndrome. VIC may be associated with malunion or non-union of forearm fractures. To the best of our knowledge, this article is the first case report of VIC associated with atrophic non-union of ulna managed by shortening of forearm bones combined with transposition of intercalary auto graft from the fellow bone. Case Report: A seven year old boy presented with flexion deformity of wrist and hand with inability to use his left hand since three and half months subsequent to an injury to his left forearm due to fall from a tree of six feet height. The patient was diagnosed and treated by a native traditional bone setter for his Radius and Ulna fracture of left forearm with massaging and tight bandaging. On examination there was wasting of left forearm with positive Volkmann’s sign, flexion contracture of wrist with loss of grip strength and tenderness over the upper and middle third junction of left ulna with a palpable gap. The radiograph of forearm revealed atrophic non-union of left ulna. In order to tackle both the issues, shortening osteotomy of radius with transposition of tubular radius intercalary graft onto ulna was done. Radius was fixed with a dynamic compression plate and Ulna was fixed with a rush nail effecting overall two and half centimetres shortening of both bones of forearm. This approach has addressed both atrophic non-union of ulna and VIC in a single stage and gave excellent functional outcome till the last follow-up of three years from the date of surgery. Conclusion: Bone shortening and transposition of auto-graft from the fellow bone may prove to be an excellent treatment modality for VIC with associated

  8. Cost effectiveness of tibial nonunion treatment: A comparison between rhBMP-7 and autologous bone graft in two Italian centres. (United States)

    Giorgio Calori, Maria; Capanna, Rodolfo; Colombo, Massimiliano; De Biase, Pietro; O'Sullivan, Carol; Cartareggia, Valentina; Conti, Costanza


    Current evidences show that recombinant human bone morphogenetic protein 7 (rhBMP-7, eptotermin alfa) can be considered an effective alternative to autologous bone graft (ABG) in the treatment of tibial nonunions. Few studies, so far, have analysed the costs of treating tibial nonunions with either rhBMP-7 or ABG and none of them has specifically considered the Italian situation. The aim of the present study was to capture, through observational retrospective methods, the direct medical costs associated with the treatment of tibial nonunions with rhBMP-7 or ABG in Italy and to compare the cost effectiveness of the two interventions. The secondary objective was to perform a cost-reimbursement analysis for hospitalisations associated with the two treatments. Data of 54 patients with indication for tibial nonunion were collected from existing data sources. Of these patients, 26 were treated with ABG and 28 with rhBMP-7. The study captured the direct medical costs for treating each tibial nonunion, considering both inpatient and outpatient care. The hospital reimbursement was calculated from discharge registries, based on diagnosis-related group (DRG) values. A subgroup of patients (n=30) was also interviewed to capture perceived health during the follow-up, and the quality-adjusted life years (QALYs) were subsequently computed. The two groups were similar for what concerns baseline characteristics. While the medical costs incurred during the hospitalisation associated with treatment were on average €3091.21 higher (P<0.001) in patients treated with rhBMP-7 (reflecting the product procurement costs), the costs incurred during the follow-up were on average €2344.45 higher (P=0.02) in patients treated with ABG. Considering all costs incurred from the treatment, there was a borderline statistical evidence (P=0.04) for a mean increase of €795.42, in the rhBMP-7 group. Furthermore, the study demonstrated that, without appropriate reimbursement, the hospital undergoes

  9. Photoactivated In Vivo Proximity Labeling. (United States)

    Beck, David B; Bonasio, Roberto


    Identification of molecular interactions is paramount to understanding how cells function. Most available technologies rely on co-purification of a protein of interest and its binding partners. Therefore, they are limited in their ability to detect low-affinity interactions and cannot be applied to proteins that localize to difficult-to-solubilize cellular compartments. In vivo proximity labeling (IPL) overcomes these obstacles by covalently tagging proteins and RNAs based on their proximity in vivo to a protein of interest. In IPL, a heterobifunctional probe comprising a photoactivatable moiety and biotin is recruited by a monomeric streptavidin tag fused to a protein of interest. Following UV irradiation, candidate interacting proteins and RNAs are covalently biotinylated with tight spatial and temporal control and subsequently recovered using biotin as an affinity handle. Here, we describe experimental protocols to discover novel protein-protein and protein-RNA interactions using IPL. © 2017 by John Wiley & Sons, Inc. Copyright © 2017 John Wiley & Sons, Inc.

  10. Prox-1 Automated Proximity Operations (United States)


    on demonstrating the functionality required to meet minimum mission success criteria. The minimum mission includes on- orbit spacecraft checkout of...also includes deployment of LightSail-B from the P-POD, and imaging of LightSail-B for 20 minutes as it recedes from Prox-1. small satellite ; proximity...criteria. The minimum mission includes on- orbit spacecraft checkout of all spacecraft subsystems, including flight qualification of the following new

  11. The practice of pole dance as a leisure activity in Denmark

    DEFF Research Database (Denmark)

    Jensen, Andorra Lynn


    to October 2014. Furthermore, I have conducted five interviews with pole studio owners and 14 shorter interviews with pole dancers. The study showed that the pole dance culture is complex; there is more than one way to practice pole dance both in terms of movements, attire, and attitude. This article...

  12. Corona poling of nonlinear polymer thin films for electro-optic modulators (United States)

    Hill, R. A.; Knoesen, A.; Mortazavi, M. A.


    We have developed an experimental technique for corona poling a nonlinear polymer thin film for use in electro-optic modulators. This method eliminates the pinhole and surface roughness damage that has been observed when corona poling a nonlinear polymer deposited on a conducting substrate. Electro-optic modulators have been constructed to compare this corona poling technique to the contact poling technique commonly used with electro-optic devices. Experimental results are presented that demonstrate that the corona poled electro-optic devices were poled with electric fields near the dielectric breakdown of the thin polymer films—fields that are often difficult to achieve with contact poling.

  13. Thermal poling of femtosecond laser-written waveguides in fused silica. (United States)

    Ng, Jason C; Qian, Li; Herman, Peter R


    Thermal poling of femtosecond laser written waveguides was investigated using second-harmonic microscopy under three approaches: (1) pre-poling and (2) post-poling in which fused silica substrates were poled before or after waveguide formation, respectively, and (3) double poling in which poling was applied both before and after laser writing. Effective nonlinear waveguide interaction strength was assessed relative to the mode profile and the assessments demonstrated an erasure effect of 81% in pre-poling and an ion migration blocking effect of 26% in post-poling. Double poling was found to recover the nonlinearity over the modal zone, overcoming prior difficulties with combining laser processing and thermal poling, opening up a future avenue for creating active devices through femtosecond laser writing of nonlinear optical circuits in fused silica.

  14. Toward pole inflation and attractors in supergravity: Chiral matter field inflation (United States)

    Kobayashi, T.; Seto, O.; Tatsuishi, T. H.


    In string-inspired supergravity theory, the Kähler metric of chiral matter fields often has a pole. Such a Kähler metric is interesting from the viewpoint of the framework of the pole inflation, where the scalar potential can be stretched out to be flat around the pole for a canonically normalized field and inflation can be realized. However, when the Kähler metric has a pole, the scalar potential can also have a pole at the same point in supergravity theory. We study such supergravity models with a pole, and provide numerical analysis of inflationary dynamics and resultant density perturbation. In contrast with the usual pole inflation models, inflation in this supergravity-based model occurs not on the pole but in a region apart from the pole. We show that the existence of the pole in the scalar potential is crucial nevertheless. We also examine attractor behavior of our model.


    African Journals Online (AJOL)


    PROXIMATE AND ELEMENTAL COMPOSITION OF WHITE GRUBS. 1 Alhassan, A. J. 1M .S. Sule, 1J. ... ABSTRACT. This study determined the proximate and mineral element composition of whole white grubs using standard methods of analysis. Proximate ... days, before pulverized to powder and kept in plastic container.

  16. Poles in the Dutch Cape Colony 1652-1814

    Directory of Open Access Journals (Sweden)

    Kowalski Mariusz


    Full Text Available The contribution of Poles to the colonisation and development of the Dutch Cape Colony is not commonly known. Yet, Poles have been appearing in this colony since its very inception (1652. During the entire period considered here the presence of Poles was the result of the strong economic ties between Poland and the Netherlands. At the end of this period there was an increase in their share, in connection with the presence of numerous alien military units on the territory of the Colony, because of Poles having served in these units. Numerous newcomers from Poland settled in South Africa for good, established families, and their progeny made up part of the local society. The evidence of this phenomenon is provided by the present-day Afrikaner families of, for instance, Drotsky, Kitshoff, Kolesky, Latsky, Masuriek, Troskie, Zowitsky, and others. A quite superficial estimation implies that the settlers coming from Poland could make up a bit over 1% of the ancestors of the present-day Afrikaners. Poles would also participate in the pioneering undertakings within the far-off fringes of the Colony, including the robbery-and-trade expedition of 1702.

  17. Analysis of car’s frontal collision against pole (United States)

    Ispas, N.; Nastasoiu, M.


    Reducing the effects of traffic accidents over the occupants is a major objective of collision attempts. Impacts between the car and the pole are very dangerous for the physical integrity of the car’s occupants. To minimalize the effects of such events on the passengers of a vehicle, a whole series of efforts by both designers and experienced engineers led to increasingly the vehicles safety. The main aim of these paper is to quantify the influences over the car passengers of loads involved by car against pole collisions using the same car model at different speeds. Also, this kind on occupant influences were study using a small car model. Other goal of the paper was the study of the cars stiffness in frontal collision against the pole. The paper’s experimental results were obtained by support of DSD, Dr. Steffan Datentechnik GmbH - Linz, Austria. The described tests were performed in full test facility of DSD Linz, in “Easter 2016 PC-Crash Seminar”. Cars accelerations, velocities, rotations angles after pole impact were registered and discussed. The novelty of the paper consists in studies referred for the same car model involved in car against pole collisions at different impact speeds. Paper’s conclusions can be future used for car safety improvement.

  18. Anaphase A: Disassembling Microtubules Move Chromosomes toward Spindle Poles

    Directory of Open Access Journals (Sweden)

    Charles L. Asbury


    Full Text Available The separation of sister chromatids during anaphase is the culmination of mitosis and one of the most strikingly beautiful examples of cellular movement. It consists of two distinct processes: Anaphase A, the movement of chromosomes toward spindle poles via shortening of the connecting fibers, and anaphase B, separation of the two poles from one another via spindle elongation. I focus here on anaphase A chromosome-to-pole movement. The chapter begins by summarizing classical observations of chromosome movements, which support the current understanding of anaphase mechanisms. Live cell fluorescence microscopy studies showed that poleward chromosome movement is associated with disassembly of the kinetochore-attached microtubule fibers that link chromosomes to poles. Microtubule-marking techniques established that kinetochore-fiber disassembly often occurs through loss of tubulin subunits from the kinetochore-attached plus ends. In addition, kinetochore-fiber disassembly in many cells occurs partly through ‘flux’, where the microtubules flow continuously toward the poles and tubulin subunits are lost from minus ends. Molecular mechanistic models for how load-bearing attachments are maintained to disassembling microtubule ends, and how the forces are generated to drive these disassembly-coupled movements, are discussed.

  19. Assessment of Pole Erosion in a Magnetically Shielded Hall Thruster (United States)

    Mikellides, Ioannis G.; Ortega, Alejandro L.


    Numerical simulations of a 6-kW laboratory Hall thruster called H6 have been performed to quantify the erosion rate at the inner pole. The assessments have been made in two versions of the thruster, namely the unshielded (H6US) and magnetically shielded (H6MS) configurations. The simulations have been performed with the 2-D axisymmetric code Hall2De which employs a new multi-fluid ion algorithm to capture the presence of low-energy ions in the vicinity of the poles. It is found that the maximum computed erosion rate at the inner pole of the H6MS exceeds the measured rate of back-sputtered deposits by 4.5 times. This explains only part of the surface roughening that was observed after a 150-h wear test, which covered most of the pole area exposed to the plasma. For the majority of the pole surface the computed erosion rates are found to be below the back-sputter rate and comparable to those in the H6US which exhibited little to no sputtering in previous tests. Possible explanations for the discrepancy are discussed.

  20. Longitudinal analysis of osteogenic and angiogenic signaling factors in healing models mimicking atrophic and hypertrophic non-unions in rats.

    Directory of Open Access Journals (Sweden)

    Susann Minkwitz

    Full Text Available Impaired bone healing can have devastating consequences for the patient. Clinically relevant animal models are necessary to understand the pathology of impaired bone healing. In this study, two impaired healing models, a hypertrophic and an atrophic non-union, were compared to physiological bone healing in rats. The aim was to provide detailed information about differences in gene expression, vascularization and histology during the healing process. The change from a closed fracture (healing control group to an open osteotomy (hypertrophy group led to prolonged healing with reduced mineralized bridging after 42 days. RT-PCR data revealed higher gene expression of most tested osteogenic and angiogenic factors in the hypertrophy group at day 14. After 42 days a significant reduction of gene expression was seen for Bmp4 and Bambi in this group. The inhibition of angiogenesis by Fumagillin (atrophy group decreased the formation of new blood vessels and led to a non-healing situation with diminished chondrogenesis. RT-PCR results showed an attempt towards overcoming the early perturbance by significant up regulation of the angiogenic regulators Vegfa, Angiopoietin 2 and Fgf1 at day 7 and a further continuous increase of Fgf1, -2 and Angiopoietin 2 over time. However µCT angiograms showed incomplete recovery after 42 days. Furthermore, lower expression values were detected for the Bmps at day 14 and 21. The Bmp antagonists Dan and Twsg1 tended to be higher expressed in the atrophy group at day 42. In conclusion, the investigated animal models are suitable models to mimic human fracture healing complications and can be used for longitudinal studies. Analyzing osteogenic and angiogenic signaling patterns, clear changes in expression were identified between these three healing models, revealing the importance of a coordinated interplay of different factors to allow successful bone healing.

  1. Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures

    Directory of Open Access Journals (Sweden)

    A. Panagopoulos


    Full Text Available Background. The purpose of this study was to report our experience with shoulder hemiarthroplasty in the context of old trauma. Methods. 33 patients with failed treatment for a complex proximal humeral fracture underwent prosthetic hemiarthroplasty. There were 15 men and 18 women with a mean age of 58.1 years. The average period from initial treatment was 14.9 months. Sequelae included 11 malunions, 4 nonunions, 15 cases with avascular necrosis (AVN and 3 neglected posterior locked dislocations. Follow up investigation included radiological assessment and clinical evaluation using the Constant score and a visual analogue pain scale. Results. After a mean follow up of 82.5 months the median Constant score was 75.7 points, improved by 60% in comparison to preoperative values. Greater tuberosity displacement, large cuff tears and severe malunion were the factors most affected outcome. No cases of stem loosening or severe migration were noted. 60% of the patients were able to do activities up to shoulder level compared with 24% before reconstruction. Conclusions. Late shoulder hemiarthroplasty is technically difficult and the results are inferior to those reported for acute humeral head replacement, nonetheless remains a satisfactory reconstructive option when primary treatment fails.

  2. Finger Proximal Interphalangeal Joint Dislocation. (United States)

    Ramponi, Denise; Cerepani, Mary Jo


    Finger dislocations are common injuries that are often managed by emergency nurse practitioners. A systematic physical examination following these injuries is imperative to avoid complications. Radiographic views, including the anteroposterior, lateral, and oblique views, are imperative to evaluate these finger dislocations. A dorsal dislocation of the proximal interphalangeal (PIP) joint is the most common finger dislocation type often easily reduced. A volar PIP dislocation can often be difficult to reduce and may result in finger deformity. Finger dislocations should be reduced promptly. Referral to an orthopedic hand specialist is required if the dislocation is unable to be reduced or if the finger joint is unstable following reduction attempts.

  3. Equilibrium properties of proximity effect

    Energy Technology Data Exchange (ETDEWEB)

    Esteve, D.; Pothier, H.; Gueron, S.; Birge, N.O.; Devoret, M.


    The proximity effect in diffusive normal-superconducting (NS) nano-structures is described by the Usadel equations for the electron pair correlations. We show that these equations obey a variational principle with a potential which generalizes the Ginzburg-Landau energy functional. We discuss simple examples of NS circuits using this formalism. In order to test the theoretical predictions of the Usadel equations, we have measured the density of states as a function of energy on a long N wire in contact with a S wire at one end, at different distances from the NS interface. (authors). 12 refs.

  4. Global plate tectonics and the secular motion of the pole (United States)

    Soler, T.


    Astronomical data compiled during the last 70 years by the international organizations providing the coordinates of the instantaneous pole clearly shows a persistent drift of the mean pole. The differential contributions to the earth's second-order tensor of inertia were obtained and applied, resulting in no significant displacement of the earth's principal axis. In view of the above, the effect that theoretical geophysical models for absolute plate velocities may have on an apparent displacement of the mean pole as a consequence of station drifting was analyzed. The investigation also reports new values for the crustal tensor of inertia (assuming an ellipsoidal earth) and the orientation of its axis of figure, reopening the old speculation of a possible sliding of the whole crustover the upper mantle, including the supporting geophysical and astronomic evidence.


    Directory of Open Access Journals (Sweden)

    Bahadır KARASULU


    Full Text Available High performance computing techniques can be used effectively for solution of the complex scientific problems. Pole balancing problem is a basic benchmark tool of robotic field, which is an important field of Artificial Intelligence research areas. In this study, a solution is developed for pole balancing problem using Artificial Neural Network (ANN and high performance computation technique. Algorithm, that basis of the Reinforcement Learning method which is used to find the force of pole's balance, is transfered to parallel environment. In Implementation, C is preferred as programming language and Message Passing Interface (MPI is used for parallel computation technique. Self–Organizing Map (SOM ANN model's neurons (artificial neural nodes and their weights are distributed to six processors of a server computer which equipped with each quad core processor (total 24 processors. In this way, performance values are obtained for different number of artificial neural nodes. Success of method based on results is discussed.

  6. Russians, Jews, and Poles: Russification and Antisemitism 1881-1914

    Directory of Open Access Journals (Sweden)

    Theodor R. Weeks


    Full Text Available Relations between Poles and Jews deteriorated significantly in the three decades leading up to World War I. Many reasons for this phenomenon can be given, for example: economic competition, a general atmosphere of acute nationalism, increased migration, perceived threats to traditional forms of life and religion. Exacerbating all of these factors, however, was the fact of Polish statelessness and the extreme sensitivity of Poles to perceived threats to their culture and nation. In particular within the Russian Empire, Poles perceived the very future of their nation at risk. In such circumstances the continued existence of Jewish cultural difference combined with the development of specifically Jewish forms of national awakening (e.g., the Bund and Zionism were understood by many in Polish society as ingratitude and collaboration with the Russian occupier

  7. A myxobacterial S-motility protein dances with poles. (United States)

    Huitema, Edgar; Viollier, Patrick H


    Coordinated movement of packs of S-motile Myxococcus xanthus cells relies on extrusion and retraction of pili that are located at one cell pole. At regular intervals the pili switch their polar location and cells reverse direction. Recently, the FrzS S-motility protein was observed to localize predominantly to the piliated pole. In time, FrzS was redeployed to the opposite pole and its sequestration at the new site coincided with cell reversal. The C-terminal region of FrzS, a response regulator homolog, is rich in coiled-coil motifs and is required for dynamic localization and proper motility. These results raise the possibility that proper spatial control of FrzS has an important role in the regulation of cell reversal and S-motility.

  8. Electromagnetic Radial Forces in a Hybrid Eight-Stator-Pole, Six-Rotor-Pole Bearingless Switched-Reluctance Motor (United States)

    Morrison, Carlos R.; Siebert, Mark W.; Ho, Eric J.


    Analysis and experimental measurement of the electromagnet force loads on the hybrid rotor in a novel bearingless switched-reluctance motor (BSRM) have been performed. A BSRM has the combined characteristics of a switched-reluctance motor and a magnetic bearing. The BSRM has an eight-pole stator and a six-pole hybrid rotor, which is composed of circular and scalloped lamination segments. The hybrid rotor is levitated using only one set of stator poles. A second set of stator poles imparts torque to the scalloped portion of the rotor, which is driven in a traditional switched reluctance manner by a processor. Analysis was done for nonrotating rotor poles that were oriented to achieve maximum and minimum radial force loads on the rotor. The objective is to assess whether simple one-dimensional magnetic circuit analysis is sufficient for preliminary evaluation of this machine, which may exhibit strong three-dimensional electromagnetic field behavior. Two magnetic circuit geometries, approximating the complex topology of the magnetic fields in and around the hybrid rotor, were employed in formulating the electromagnetic radial force equations. Reasonable agreement between the experimental results and the theoretical predictions was obtained with typical magnetic bearing derating factors applied to the predictions.

  9. Plate fixation of extra-articular fractures of the proximal phalanx: do new implants cause less problems? (United States)

    Brei-Thoma, Pascale; Vögelin, Esther; Franz, Torsten


    Limited range of finger motion is a frequent complication after plate fixation of phalangeal fractures. The purpose of this study was to evaluate the results of plate fixation of extra-articular fractures of the proximal phalanx using current low-profile mini-fragment-systems. From 2006 to 2012, 32 patients with 36 extra-articular fractures of the proximal phalanx of the triphalangeal fingers were treated with open reduction and plate fixation (ORPF) using 1.2 and 1.5 mm mini-fragment systems. Patients presenting with open fractures grade 2 and 3 or relevant laceration of adjacent structures were excluded from the study. We retrospectively evaluated the rate of mal-union or non-union after ORPF, the need for revision surgery, for plate removal, and for tenolysis. Data were analyzed for further complications with regard to infections or complex regional pain syndrome (CRPS). No infections were noted. Five patients developed transient symptoms of CRPS. Six weeks postoperatively, total active finger motion (TAM) averaged 183°, and all 32 patients underwent formal hand therapy. At the latest follow-up or at the time of plate removal, respectively, the mean TAM improved to 213°. Extension lag of proximal interphalangeal joints was found in 67 % of all fractured fingers. Secondary surgery was necessary in 14 of 32 patients (2 corrective osteotomies, 12 plate removals including 7 procedures explicitly because of reduced mobility). Despite of new implant designs significant problems persist. Adhesions of extensor tendons leading to limited range of finger motion are still the most frequent complications after ORPF of proximal phalangeal fractures, even in absence of significant soft-tissue damage. Therapeutic, Retrospective, Level IV.

  10. Pulsed electromagnetic fields for the treatment of tibial delayed unions and nonunions. A prospective clinical study and review of the literature

    Directory of Open Access Journals (Sweden)

    Assiotis Aggelos


    Full Text Available Abstract Background Pulsed electromagnetic fields (PEMF stimulation for the treatment of bone nonunion or delayed union have been in use for several years, but on a limited basis. The aim of this study was to assess the overall efficacy of the method in tibial delayed unions and nonunions and identify factors that could affect the final outcome. Methods We prospectively reviewed 44 patients (27 men with a mean age of 49.6 ± 18.4 years that received PEMF therapy due to tibial shaft delayed union or nonunion. In all cases, fracture gap was less than 1 cm and infection or soft tissue defects were absent. Results Fracture union was confirmed in 34 cases (77.3%. No relationship was found between union rate and age (p = 0.819, fracture side (left or right (p = 0.734, fracture type (simple or comminuted, open or closed (p = 0.111, smoking (p = 0.245, diabetes (p = 0.68 and initial treatment method applied (plates, nail, plaster of paris (p = 0.395. The time of treatment onset didn’t affect the incidence of fracture healing (p = 0.841. Although statistical significance was not demonstrated, longer treatment duration showed a trend of increased probability of union (p = 0.081. Conclusion PEMF stimulation is an effective non-invasive method for addressing non-infected tibial union abnormalities. Its success is not associated with specific fracture or patient related variables and it couldn’t be clearly considered a time-dependent phenomenon.

  11. Poles Living in Ireland and their Quality of Life

    Directory of Open Access Journals (Sweden)

    Agnieszka NOLKA


    Full Text Available The economic growth of Ireland resulted in a significant number of Poles migrating to Ireland following the EU enlargement in 2004. The article explores the quality of life of Poles living in Ireland. Using data from a preliminary survey conducted in 2006, several dimensions of living conditions are analysed, including interpersonal relations, material security, health and healthcare. The study shows that evaluations of almost all aspects of quality of life improved, apart from components such as healthcare and the ability to acquire help from social organisations. Also interpersonal relations, contrary to the initial assumption, were enhanced by migration to Ireland.

  12. Synchronized Lunar Pole Impact Plume Sample Return Trajectory Design (United States)

    Genova, Anthony L.; Foster, Cyrus; Colaprete, Tony


    The presented trajectory design enables two maneuverable spacecraft launched onto the same trans-lunar injection trajectory to coordinate a steep impact of a lunar pole and subsequent sample return of the ejecta plume to Earth. To demonstrate this concept, the impactor is assumed to use the LCROSS missions trajectory and spacecraft architecture, thus the permanently-shadowed Cabeus crater on the lunar south pole is assumed as the impact site. The sample-return spacecraft is assumed to be a CubeSat that requires a complimentary trajectory design that avoids lunar impact after passing through the ejecta plume to enable sample-return to Earth via atmospheric entry.

  13. Finite Element Analysis of Boron Diffusion in Wooden Poles

    DEFF Research Database (Denmark)

    Krabbenhøft, Kristian; Hoffmeyer, P.; Bechgaard, C.


    The problem of describing the migration of dissolved boron in wood is treated with special reference to the commonly used remedial treatment of wooden poles. The governing equations are derived and discussed together with some of the material parameters required. The equations are solved by the f......The problem of describing the migration of dissolved boron in wood is treated with special reference to the commonly used remedial treatment of wooden poles. The governing equations are derived and discussed together with some of the material parameters required. The equations are solved...... by the finite element method and, finally, results showing the effect of different treatment strategies are presented....

  14. Traumatic amputation of the left lower renal pole in children

    Energy Technology Data Exchange (ETDEWEB)

    Waxman, J.; Belman, A.B.; Kass, E.J.


    Four children between 5 and 10 years old suffered traumatic amputation of the left lower renal pole following flank trauma. All patients were evaluated with excretory urography and isotope renography. The renal scan clearly demonstrated failure of perfusion of the lower renal pole and urinary extravasation, and was believed to be more valuable than the standard excretory urogram as a diagnostic tool. All children were managed similarly: delayed (72 to 96 hours) exploration, simple removal of the amputated segment and insertion of a Penrose drain. They all have done well. The patients were normotensive at followup and had excellent function of the remaining portion of the kidney.

  15. Nontraumatic osteonecrosis of the distal pole of the scaphoid

    Directory of Open Access Journals (Sweden)

    Bhavuk Garg


    Full Text Available Post traumatic osteonecrosis of distal pole of scaphoid is very rare. We present a case of 34 years old male, drill operator by occupation with nontraumatic osteonecrosis of distal pole of the scaphoid. The patient was managed conservatively and was kept under regular follow-up every three months. The patient was also asked to change his profession. Two years later, the patient had no pain and had mild restriction of wrist movements (less than 15 degrees in either direction. The radiographs revealed normal density of the scaphoid suggesting revascularization.

  16. Induction Motor with Switchable Number of Poles and Toroidal Winding

    Directory of Open Access Journals (Sweden)



    Full Text Available This paper presents a study of an induction motor provided with toroidal stator winding. The ring-type coils offer a higher versatility in obtaining a different number of pole pairs by means of delta/star and series/parallel connections respectively. As consequence, the developed torque can vary within large limits and the motor can be utilized for applications that require, for example, high load torque values for a short time. The study involves experimental tests and FEM simulation for an induction machine with three configurations of pole pairs. The conclusions attest the superiority of the toroidal winding for certain applications such as electric vehicles or lifting machines.

  17. Definitive studies on pole-top resuscitation. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, A.S.; Ridolpho, P.F.; Cole, J.E.


    This report summarizes the history of the application of cardiopulmonary resuscitation to the electric shock victim located at the top of a utility pole. This dramatic and urgent situation requires that rescue be attempted with procedures which are thoroughly understood and effective. Questions related to the use of resuscitation and precordial thump at the pole top were subjected to experimental testing, both in animals and in humans. Results of this study clearly demonstrate the advantages of postponing resuscitation until the victim has been lowered to the ground. The author concludes with seven recommendations for emergency treatment at the scene.

  18. Pedagogický odkaz Ivana Poledňáka


    Čižinská, Klára


    The bachelor thesis covers the personality of Ivan Poledňák and his music-teaching heritage. In the first part his life, his activities in musical educational organizations and teaching at universities in the Czech Republic are described. In the second part his musical pedagogical publications are analysed. The aim of this thesis is to punctuate to his big contribution in music education. KEYWORDS Ivan Poledňák, Musically pedagogical inventiveness, Music-school-tomorrow, 40 radio lectures of ...

  19. Plate motion and the secular shift of the mean pole (United States)

    Liu, H.; Carpenter, L.; Agreen, R. W.


    The global plate motion indicates that changes in the products of inertia of the earth due to tectonic plate movement may provide a secular shift of the mean pole. A mathematical procedure for calculating this shift based on the plate theory is presented. Explicit expressions were obtained for the dependence of the secular polar shift on the dimensions and locations of the plate boundaries. Numerical results show that the secular motion of the mean pole is 0.0002 sec/year in the direction of 67 W. Hence, it is deduced that the influence of the plate motion on the secular polar shift may account for 10% of the observed value.

  20. Revised paleomagnetic pole for the Sonoma Volcanics, California (United States)

    Mankinen, E.A.


    Paleomagnetic sampling of the Miocene and Pliocene Sonoma Volcanics, northern California, was undertaken to supplement an earlier collection. Data from 25 cooling units yield positive fold and reversal tests, and a paleomagnetic pole located at 80.2??N., 069.2??E., with ??95 = 6.8??. This paleopole is significantly displaced (9.6?? ?? 5.3?? of latitude) to the farside of the geographic pole. A highly elliptical distribution of the data in both direction and VGP space indicates that incomplete averaging of geomagnetic secular variation is a more likely explanation for this anomaly than is northward translation of the volcanic field. -Author

  1. Repetitive posterior iliac crest autograft harvest resulting in an unstable pelvic fracture and infected non-union: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ziran Navid M


    Full Text Available Abstract Fractures of the pelvic ring have been well studied, and the biomechanical relationship between the anterior and posterior elements is an important concept to understand these complex injuries. The vast majority of these injuries are due to trauma. However, in rare circumstances, autogenous bone graft harvesting may lead to an unstable pelvic ring. In this case report, we describe a rare complication in a 70-year old female patient who developed an unstable pelvis and an infected non-union secondary to repeated posterior iliac graft harvest. The orthopaedic surgeon should be aware of this detrimental complication associated with extensive or repeated posterior iliac crest graft harvest.

  2. ENPA endine juht seisukohti muutnud pole / Hendrik Vosman

    Index Scriptorium Estoniae

    Vosman, Hendrik


    Eelmisel aastal Eestit vähemuste diskrimineerimises süüdistanud Euroopa Nõukogu Parlamentaarse Assamblee endine esimees Rene van der Linden pole oma seisukohta muutnud ning usub endiselt, et tema jutt inimõiguste rikkumiste kohta Eestis peab paika. Vt. samas: Van der Linden

  3. Families of Poles in the Netherlands (FPN) survey. Wave 1

    NARCIS (Netherlands)

    Karpinska, K.; Dykstra, P.A.; Fokkema, T.


    The release of formal restrictions on the free movement of Central and Eastern Europeans that started with the end of the Cold War and the eastward enlargement of the European Union in the 2000s have led to new migration flows in Europe. In the Netherlands, in absolute terms, Poles are the largest

  4. Probability models of the x, y pole coordinates data (United States)

    Sen, A.; Niedzielski, T.; Kosek, W.


    The aim of this study is to find the most appropriate probabilistic model for the x, y pole coordinates time series. We have analyzed the IERS eopc04_05 data set covering the period 1962 - 2008. We have also considered the residual x, y pole coordinate time series, which is computed as the difference between the original data and the corresponding least-squares model of the Chandler circle and annual ellipse. Using the measures of skewness and kurtosis of the empirical distribution of the data, we find that the x, y pole coordinates and the corresponding residuals time series cannot be modeled by a normal (Gaussian) distribution. A normal distribution has zero skewness and a kurtosis value of 3. We have fitted several non- Gaussian distributions to the datasets. They include the Generalized Extreme Value distribution, 4-parameter Beta distribution, Johnson SB and SU distributions, Generalized Pareto distribution and Wakeby distribution. Suitability of these distributions as probabilistic models for the x, y pole coordinates and the corresponding residuals time series are discussed.

  5. Liz Taylor : minu van Gogh pole natsidele kuulunud

    Index Scriptorium Estoniae


    Elizabeth Taylor palus kohtult otsust, et talle kuuluvat 15 miljonit dollarit maksvat Vincent van Goghi maali "Vaade Saint-Remy varjupaigale" pole natsid Margarete Mauthneri juudiperekonna käest vägivaldselt ära võtnud. E. Taylori isa ostis maali 1963. a. Londonis oksjonilt

  6. BMP regulates vegetal pole induction centres in early xenopus development. (United States)

    Nachaliel, N; Re'Em-Kalma, Y; Eshed, O; Elias, S; Frank, D


    Bone morphogenetic protein (BMP) plays an important role in mesoderm patterning in Xenopus. The ectopic expression of BMP-4 protein hyperventralizes embryos, whereas embryos expressing a BMP-2/4 dominant-negative receptor (DNR) are hyperdorsalized. Mesoderm is initially induced in the marginal zone by cells in the underlying vegetal pole. While much is known about BMP's expression and role in patterning the marginal zone, little is known about its early role in regulating vegetal mesoderm induction centre formation. The role of BMP in regulating formation of vegetal mesoderm inducing centres during early Xenopus development was examined. Ectopic BMP-4 expression in vegetal pole cells inhibited dorsal mesoderm induction but increased ventral mesoderm induction when recombined with animal cap ectoderm in Nieuwkoop explants. 32-cell embryos injected with BMP-4 RNA in the most vegetal blastomere tier were not hyperdorsalized by LiCl treatment. The ectopic expression of Smad or Mix.1 proteins in the vegetal pole also inhibited dorsal mesoderm induction in explants and embryos. Expression of the BMP 2/4 DNR in the vegetal pole increased dorsal mesoderm induction and inhibited ventral mesoderm induction in explants and embryos. These results support a role for BMP signalling in regulating ventral vegetal and dorsal vegetal mesoderm induction centre formation during early Xenopus development.

  7. Diplodia natalensis , Pole Evans: a causal agent of citrus gummosis ...

    African Journals Online (AJOL)

    Isolations were made from the barks of gummosis-infected citrus trees from orchards of the University of Ghana Agricultural Research Station at Kade. The isolation media used were 1.5% water agar, 1.5% water agar + nystatin and 1.5% water agar + benomyl. Four isolates including Diplodia natalensis Pole Evans, ...

  8. Finite element analysis of boron diffusion in wooden Poles

    DEFF Research Database (Denmark)

    Krabbenhøft, Kristian; Hoffmeyer, Preben; Bechgaard, Carl


    The problem of describing the migration of dissolved boron in wood is treated with special reference to the commonly used remedial treatment of wooden poles. The governing equations are derived and discussed together with some of the material parameters required. The equations are solved by the f...... by the finite element method and, finally, results showing the effect of different treatment strategies are presented....

  9. Finite Element Analysis of Boron Diffusion in Wooden Poles

    DEFF Research Database (Denmark)

    Krabbenhøft, Kristian; Hoffmeyer, Preben; Bechgaard, Carl


    The problem of describing the migration of dissolved boron in wood is treated with special reference to the commonly used remedial treatment of wooden poles. The governing equations are derived and discussed together with some of the material parameters required. The equations are solved by the f...... by the finite element method and, finally, results showing the effect of different treatment strategies are presented....

  10. "Mulle vaja pole kanti sooja ..." : [luuletused] / Fjodor Istomin

    Index Scriptorium Estoniae

    Istomin, Fjodor


    Sisu: "Mulle vaja pole kanti sooja ..." ; Majajäetud paik ; Linn ; "Su päike õhtuks laskub tasapisi ..." ; "Üksteist elama ärge õpetage ..." ; "Võta vastu kõik, mis on ..." ; Mida sa, mida sa, linnuke, laulad ...". Eluloolisi andmeid autori kohta lk. 261. Luuletused paralleelselt eesti ja komi keeles

  11. Omavalitsused pole KOIT kava komisjoni otsusega rahul / Hannes Sarv

    Index Scriptorium Estoniae

    Sarv, Hannes


    KOIT kava maakondlik komisjon valis kaheksa projekti hulgast esimeseks Käina koolimaja miljoniinvesteeringu, millega pole rahul mitte ükski omavalitsus peale Käina. Lisa: Koit kavast rahastamiseks esitasid kaheksa projekti omavalitsused ja üks mittetulundusühing

  12. Kick, Glide, Pole! Cross-Country Skiing Fun (Part II) (United States)

    Duoos, Bridget A.


    Part I of Kick, Glide, Pole! Cross-Country Skiing Fun, which was published in last issue, discussed how to select cross-country ski equipment, dress for the activity and the biomechanics of the diagonal stride. Part II focuses on teaching the diagonal stride technique and begins with a progression of indoor activities. Incorporating this fun,…

  13. Bacterial diversity in snow on North Pole ice floes

    DEFF Research Database (Denmark)

    Hauptmann, Aviaja Zenia Edna Lyberth; Stibal, Marek; Bælum, Jacob


    The microbial abundance and diversity in snow on ice floes at three sites near the North Pole was assessed using quantitative PCR and 454 pyrosequencing. Abundance of 16S rRNA genes in the samples ranged between 43 and 248 gene copies per millilitre of melted snow. A total of 291,331 sequences we...

  14. Diplodia natalensis Pole Evans, the causal agent of citrus gummosis ...

    African Journals Online (AJOL)

    Four isolates including Diplodia natalensis Pole Evans, Fusarium solani Appel + Wr., and two other identified fungi were obtained. The two fungi were unidentified on Potato Dextrose Agar (PDA). When the isolates were tested for pathogenicity, only D. natalensis induced the disease symptoms in the inoculated ...

  15. Poled-glass devices: Influence of surfaces and interfaces

    DEFF Research Database (Denmark)

    Fage-Pedersen, Jacob; Jacobsen, Rune Shim; Kristensen, Martin


    Devices in periodically poled glass must have a large periodic variation of the built-in field. We show that the periodic variation can be severely degraded by charge dynamics taking place at the external (glass–air) interface or at internal (glass–glass) interfaces if the interfaces have imperfe...

  16. Automated Pole Placement Algorithm for Multivariable Optimal Control Synthesis. (United States)


    is required to be ’stabilizeable’ meaning that in its contrilability canonical form given by equation 2.9 below, the matrix A. is asymptotically...available in MIMO system. It was also shown in the above design examples that the Linear Quadratic Pole Placement procedures possess such quality . Some

  17. In-situ poling and structurization of piezoelectric particulate composites. (United States)

    Khanbareh, H; van der Zwaag, S; Groen, W A


    Composites of lead zirconate titanate particles in an epoxy matrix are prepared in the form of 0-3 and quasi 1-3 with different ceramic volume contents from 10% to 50%. Two different processing routes are tested. Firstly a conventional dielectrophoretic structuring is used to induce a chain-like particle configuration, followed by curing the matrix and poling at a high temperature and under a high voltage. Secondly a simultaneous combination of dielectrophoresis and poling is applied at room temperature while the polymer is in the liquid state followed by subsequent curing. This new processing route is practiced in an uncured thermoset system while the polymer matrix still possess a relatively high electrical conductivity. Composites with different degrees of alignment are produced by altering the magnitude of the applied electric field. A significant improvement in piezoelectric properties of quasi 1-3 composites can be achieved by a combination of dielectrophoretic alignment of the ceramic particles and poling process. It has been observed that the degree of structuring as well as the functional properties of the in-situ structured and poled composites enhance significantly compared to those of the conventionally manufactured structured composites. Improving the alignment quality enhances the piezoelectric properties of the particulate composites.

  18. Design and performance of the South Pole Acoustic Test Setup

    Energy Technology Data Exchange (ETDEWEB)

    Abdou, Y. [Department of Subatomic and Radiation Physics, University of Gent, B-9000 Gent (Belgium); Becker, K.-H. [Department of Physics, University of Wuppertal, D-42119 Wuppertal (Germany); Berdermann, J. [DESY, D-15735 Zeuthen (Germany); Bissok, M. [III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen (Germany); Bohm, C. [Oskar Klein Centre and Department of Physics, Stockholm University, SE-10691 Stockholm (Sweden); Boeser, S.; Bothe, M. [DESY, D-15735 Zeuthen (Germany); Carson, M. [Department of Subatomic and Radiation Physics, University of Gent, B-9000 Gent (Belgium); Descamps, F., E-mail: [Department of Subatomic and Radiation Physics, University of Gent, B-9000 Gent (Belgium); Fischer-Wolfarth, J.-H. [DESY, D-15735 Zeuthen (Germany); Gustafsson, L.; Hallgren, A. [Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala (Sweden); Heinen, D. [III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen (Germany); Helbing, K. [Department of Physics, University of Wuppertal, D-42119 Wuppertal (Germany); Heller, R. [DESY, D-15735 Zeuthen (Germany); Hundertmark, S. [Oskar Klein Centre and Department of Physics, Stockholm University, SE-10691 Stockholm (Sweden); Karg, T. [Department of Physics, University of Wuppertal, D-42119 Wuppertal (Germany); Krieger, K. [DESY, D-15735 Zeuthen (Germany); Laihem, K.; Meures, T. [III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen (Germany); and others


    The South Pole Acoustic Test Setup (SPATS) was built to evaluate the acoustic characteristics of the South Pole ice in the 10-100 kHz frequency range, for the purpose of assessing the feasibility of an acoustic neutrino detection array at the South Pole. The SPATS hardware consists of four vertical strings deployed in the upper 500 m of the South Pole ice cap. The strings form a trapezoidal array with a maximum baseline of 543 m. Each string has seven stages equipped with one transmitter and one sensor module (glaciophone). Sound is detected or generated by piezoelectric ceramic elements inside the modules. Analogue signals are sent to the surface on electric cables where they are digitized by a PC-based data acquisition system. The data from all strings are collected on a central computer in the IceCube Laboratory from where they are sent to a central data storage facility via a satellite link or stored locally on tape. A technical overview of SPATS and its performance is presented.

  19. USACE Participation in the Pole Mountain Advanced Classification Demonstration (United States)


    mm millimeter Nfa number of false alarms PMTMA Pole Mountain Target and Maneuver Area Sky Sky Research, Inc SLO San Luis Obispo...correctly identified as TOI and numbers of false alarms, Nfa , at the threshold are the metrics for this objective. 3.3.2 Data Requirements A list

  20. Poles Apart? Gender Differences in Proposals for Sexuality Education Content (United States)

    Allen, Louisa


    Are young women and men's preferences for sexuality education content poles apart? This article explores gender differences in senior school students' suggestions for issues sexuality education should cover. Findings are analysed in relation to debate about mixed and single sex classrooms and boys' perceived disinterest in lessons. It is argued…

  1. Delivery of Fuel and Construction Materials to South Pole Station (United States)


    South hicles have not developed over the recent past (Re- Pole sufficient to allow operation of wheeled fer to the section on Feasibility for a...route around this field is probable. The remainder of the route appears to have a surface of primarily firm snow with mod- est-sized sastrugi

  2. Minimally invasive plate osteosynthesis for open fractures of the proximal tibia. (United States)

    Kim, Joon-Woo; Oh, Chang-Wug; Jung, Won-Ju; Kim, Ji-Soo


    Relatively few studies have addressed plate osteosynthesis for open proximal tibial fractures by now. The purpose of this study was to assess the results of minimally invasive plate osteosynthesis (MIPO) for open fractures of the proximal tibia. Thirty-four patients with an open proximal tibial fracture were treated by MIPO. Thirty of these, who followed for over 1 year, constituted the subject of this retrospective study. According to the AO Foundation and Orthopaedic Trauma Association (AO-OTA) classification, there were 3 patients of type 41-C, 6 of type 42-A, 8 of type 42-B, and 13 of type 42-C. In terms of the Gustilo and Anderson's open fracture grading system, 11 patients were of grade I, 6 were of grade II, and 13 were of grade III (III-A, 6; III-B, 6; III-C, 1). After thorough debridement and wound cleansing, when necessary, a soft tissue flap was placed. Primary MIPO (simultaneous plate fixation with soft tissue procedures) was performed in 18 patients, and staged MIPO (temporary external fixation followed by soft tissue procedures and subsequent conversion to plate fixation after soft tissue healing) was performed in 12 patients. Results were assessed according to the achievement and time to union, complications (including infections), and function of the knee joint using Knee Society scores. Statistical analysis was performed to identify factors influencing results. Primary union was achieved by 24 of the 30 study subjects. Early bone grafting was performed in 6 cases with a massive initial bone defect expected to result in non-union. No patient had malalignment greater than 10°. The mean Knee Society score was 88.7 at final follow-up visits, 23 patients achieved an excellent result, and 7 a good result. There were 3 superficial and 5 deep infections, but none required early implant removal. Functional results were similar for primary and staged MIPO (p = 0.113). Fracture pattern (p = 0.089) and open fracture grade (p = 0.079) were not found to

  3. Staged minimally invasive plate osteosynthesis of proximal tibial fractures with acute compartment syndrome. (United States)

    Kim, Joon-Woo; Oh, Chang-Wug; Oh, Jong-Keon; Kyung, Hee-Soo; Park, Kyeong-Hyeon; Kim, Hee-June; Jung, Jae-Wook; Jung, Young-Soo


    High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome. Twenty-eight patients with proximal tibial fractures accompanied by acute compartment syndrome who underwent staged MIPO and had a minimum of 12 months follow-up were enrolled. According to the AO/OTA classification, 6 were 41-A, 15 were 41-C, 2 were 42-A and 5 were 42-C fractures; this included 6 cases of open fractures. Immediate fasciotomy was performed once compartment syndrome was diagnosed and stabilization of the fracture followed using external fixation. After the soft tissue condition normalized, internal conversion with MIPO was done on an average of 37 days (range, 9-158) after index trauma. At the time of internal conversion, the external fixator pin site grades were 0 in 3 cases, 1 in 12 cases, 2 in 10 cases and 3 in 3 cases, as described by Dahl. Radiographic assessment of bony union and alignment and a functional assessment using the Knee Society Score and American Orthopedic Foot and Ankle Society (AOFAS) score were carried out. Twenty-six cases achieved primary bony union at an average of 18.5 weeks. Two cases of nonunion healed after autogenous bone grafting. The mean Knee Society Score and the AOFAS score were 95 and 95.3 respectively, at last follow-up. Complications included 1 case of osteomyelitis in a patient with a grade IIIC open fracture and 1 case of malunion caused by delayed MIPO due to poor wound conditions. Duration of external fixation and the external fixator pin site grade were not related to the

  4. Inferior patellar pole fragmentation in children: just a normal variant?

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H.; Vogelius, Esben S.; Orth, Robert C.; Guillerman, R.P.; Jadhav, Siddharth P. [Texas Children' s Hospital, E.B. Singleton Pediatric Radiology, Houston, TX (United States)


    Fragmentary ossification of the inferior patella is often dismissed as a normal variant in children younger than 10 years of age. The purpose of this study was to determine whether fragmentary inferior patellar pole ossification is a normal variant or is associated with symptoms or signs of pathology using MRI and clinical exam findings as reference. A retrospective review was performed on 150 patients ages 5-10 years who underwent 164 knee radiography and MRI exams (45.1% male, mean age: 7.8 years). The presence or absence of inferior patellar pole fragmentation on radiography was correlated with the presence or absence of edema-like signal on MR images. Clinical notes were reviewed for the presence of symptoms or signs referable to the inferior patellar pole. These data were compared with a 1:1 age- and sex-matched control group without inferior pole fragmentation. Statistical analysis was performed using two-tailed t-tests. Forty of 164 (24.4%) knee radiographs showed fragmentary ossification of the inferior patella. Of these 40 knees, 62.5% (25/40) had edema-like signal of the inferior patellar bone marrow compared with 7.5% (3/40) of controls (P = 0.035). Patients with fragmentary ossification at the inferior patella had a significantly higher incidence of documented focal inferior patellar pain compared with controls (20% vs. 2.5%, P = 0.015). Inferior patellar pole fragmentation in children 5 to 10 years of age may be associated with localized symptoms and bone marrow edema-like signal and should not be routinely dismissed as a normal variant of ossification. (orig.)

  5. Two-pole structure of the D0⁎(2400

    Directory of Open Access Journals (Sweden)

    Miguel Albaladejo


    Full Text Available The so far only known charmed non-strange scalar meson is dubbed as D0⁎(2400 in the Review of Particle Physics. We show, within the framework of unitarized chiral perturbation theory, that there are in fact two (I=1/2,JP=0+ poles in the region of the D0⁎(2400 in the coupled-channel Dπ, Dη and DsK¯ scattering amplitudes. With all the parameters previously fixed, we predict the energy levels for the coupled-channel system in a finite volume, and find that they agree remarkably well with recent lattice QCD calculations. This successful description of the lattice data is regarded as a strong evidence for the two-pole structure of the D0⁎(2400. With the physical quark masses, the poles are located at (2105−8+6−i102−12+10 MeV and (2451−26+36−i134−8+7 MeV, with the largest couplings to the Dπ and DsK¯ channels, respectively. Since the higher pole is close to the DsK¯ threshold, we expect it to show up as a threshold enhancement in the DsK¯ invariant mass distribution. This could be checked by high-statistic data in future experiments. We also show that the lower pole belongs to the same SU(3 multiplet as the Ds0⁎(2317 state. Predictions for partners in the bottom sector are also given.

  6. Proximity sensor technology for manipulator end effectors (United States)

    Johnston, A. R.


    Optical proximity sensing techniques which could be used to help control the critical grasping phase of a remote manipulation are described. The proximity sensors described use a triangulation geometry to detect a surface located in a pre-determined region. The design of the proximity sensors themselves is discussed, as well as their application to manipulator control with a local control loop, and possibilities for future development are discussed.


    Directory of Open Access Journals (Sweden)

    Satish Koti


    =15 are treated by conventional distraction osteosynthesis while the patients in the group M (n=10 are treated by Masquelet’s technique. Patient demographics, radiological bone union rates, time taken to achieve bone union, and infection rates and their statistical significances are compared to come to a scientific conclusion. RESULTS The study was done over a period of 2 years (November 2012 to September 2014. During this period, we observed 25 cases of tibial bone defects, which were managed by either distraction osteogenesis (Group D:15 cases or Masquelet technique (Group M:10 cases. In our study, the mean age of group D and group M were 40.9 years (SD±9.89 and 37.8 years (9.13 respectively. In the present study, most of the patients belong to male gender in either groups (8 in group M and 13 in group D. Female gender has 2 patients in either group. In the present study, we observed trauma with infection (46.66% and trauma (40% were common aetiological causes for tibial bone defects. There was no significant difference in defect size between the two groups (p=0.889. There was no significant difference between the union rates between the two groups (p=0.358. There was a statistically significant lower duration of union time in group D (p=0.045.There was no statistically significant difference in postoperative infections between the two groups (p=0.175. In group D, two different techniques were done (Compression distraction technique and bone transport technique. On comparing the union rates in both subgroups in group D, there was no statistically significant difference (p=1.0. There was a statistically significant strongly positive correlation between tibial bone defect size and time taken for union in group D, which was not so in group M. CONCLUSION Masquelet two-stage technique for management of defect nonunions is a relatively newer technique with its own share of technical difficulty and disadvantages. This technique requires a lot of improvisation to improve

  8. Proximate composition and antinutrient content of pumpkin ...

    African Journals Online (AJOL)

    Proximate composition and antinutrient content of pumpkin ( Cucurbita pepo ) and sorghum ( Sorghum bicolor ) flour blends fermented with Lactobacillus plantarum , Aspergillus niger and Bacillus subtilis.

  9. Inspection of Wooden Poles in Electrical Power Distribution Networks in Artvin, Turkey

    Directory of Open Access Journals (Sweden)

    Engin Derya Gezer


    Full Text Available According to Trabzon Electricity Distribution Local Directorship’s statistical data, there are 208.000 utility poles in Trabzon, 180.000 utility poles in Rize, and 121.000 utility poles in Artvin. Every year, 17.000 new utility poles are placed in these three cities. The average lifetime of a treated-wood utility pole is typically 40 to 50 years. However, the average lifetime of a treated-wood utility pole in the Eastern Black Sea Region is only about 10–15 years. In this study, the suggestions for enhancing the service life of treated-wood utility poles in Artvin vicinity were listed by determining the deteriorations and degradations using both visual inspection and nondestructive test methods. The results showed that the most important factors affecting the service life of utility poles were the decay due to fungi, insects, inadequate impregnation, and the deep cracks and splits.

  10. Is it possible to reduce the knee joint compression force during level walking with hiking poles?

    DEFF Research Database (Denmark)

    Jensen, S B; Henriksen, M; Aaboe, J


    estimated by using a biomechanical knee joint model. The results showed that the subjects were able to increase the pole force by 2.4 times the normal pole force. However, this did not lead to a reduction in the knee joint compressive force and we rejected our hypothesis. In conclusion, the use of poles......Walking with hiking poles has become a popular way of exercising. Walking with poles is advocated as a physical activity that significantly reduces the loading of the hip, knee and ankle joints. We have previously observed that pole walking does not lead to a reduction of the load on the knee joint....... However, it is unclear whether an increased force transmitted through the poles can reduce the load on the knee joint. Thus, the purpose of the present study was to investigate if an increased load transmitted through the arms to the poles could reduce the knee joint compression force during level walking...

  11. Vanemad pole rahul laste kooli suunamisega / Marko Suurmägi

    Index Scriptorium Estoniae

    Suurmägi, Marko


    Viljandi kooliminevate laste vanemad pole rahul sellega, et neil pole võimalik oma last soovitud kooli panna. Kuna Viljandi Maagümnaasiumis ei jätku kohti, peavad osa lapsi minema Valuoja Põhikooli

  12. Personaliotsinguteenust tasub kasutada siis, kui rahaline kokkuhoid pole esmane / Merike Lees

    Index Scriptorium Estoniae

    Lees, Merike, 1976-


    Ilmunud ka: Delovõje Vedomosti 1. veebr. lk. 13. Personaliotsinguteenuse kasutamine on õigustatud siis, kui ettevõttes pole personalispetsialisti ning rahaline kokkuhoid pole esmatähtis. Kommenteerivad: Eero Erastus, Madis Sander ja Marti Rehemaa

  13. [The splenic inferior pole of rats and hyperbaric oxygen]. (United States)

    Paulo, Isabel Cristina Andreatta Lemos; Paulo, Danilo Nagib Salomão; Ferrari, Thiago Antunes; Azeredo, Thiago Caetano Valadão de; Silva, Alcino Lázaro da


    To study the functional and morphological features of the lower pole of the spleen in rats submitted, or not, to postoperative hyperbaric oxygen therapy. Seventy-nine Wistar rats, weighing 248.7 +/- 27 g, divided into two groups [group A - simulation (n=40), group B - lower pole (n=39)] underwent surgery and were subdivided into two groups: 11 and 70 postoperative days. Each subgroup was subdivided into animals not treated (nt) (A11nt, n=10; B11nt, n=13; A70nt, n=10; B70nt, n=9) and treated with hyperbaric oxygen (t) (A11t, n=10; B11t, n=9; A70t, n=10; B70t, n=8). Blood was collected for measurement of lipids and immunoglobulins, platelet and Howell-Jolly body count before and after surgery. The spleen and lower pole were removed for histology. There was an increase of total cholesterol (p=0.002), VLDL-cholesterol and triglycerides (p=0.003) and of LDL-cholesterol (p=0.013) in subgroup B11nt, and no alterations were observed in the other subgroups. IgM decreased in subgroups B11t (p=0.007), B11nt (p=0.0000), B70nt (p=0.0005), B70t (p=0.02), and no change was observed in the simulation group. The number of platelets increased in subgroups B11nt (p=0.002) and B11t (p=0.01) and remained unchanged in the other subgroups. Howell-Jolly bodies were less numerous in subgroup B70nt than in subgroup B11nt (p=0.019). Lower pole viability was better in subgroup B11t than in B11nt and in subgroup B70 than in B11, and did not differ between subgroups B70t and B70nt. Function and viability of the remaining lower pole improved during the late postoperative period. Viability and function of the lower pole were better during the early but not during the late postoperative period, in animals submitted to hyperbaric oxygen therapy.

  14. Practical Implications of Pole Series Convergence and the Early-time in Transient Backscatter (United States)


    response the poles can be extracted by fitting the signal as a sum of complex exponentials [6,7]. For an accurate pole estimation in practical...attempt to fit the early-time signal to the late-time representation. Some of these poles may be the result of the MPM’s attempt to estimate the poles...Davis, " Prony , Matrix Pencil & Antennas," Virginia Tech Electromagnetics Seminar, 2008.

  15. Functional outcome following proximal humeral interlocking system plating for displaced proximal humeral fractures


    Thyagarajan David; Haridas Samarth; Jones Denise; Dent Colin; Evans Richard; Williams Rhys


    Aim: To assess the functional outcome following internal fixation with the PHILOS (proximal humeral interlocking system) for displaced proximal humeral fractures. Patients and Methods: We reviewed 30 consecutive patients treated surgically with the proximal humeral locking plate for a displaced proximal humeral fracture. Functional outcome was determined using the American Shoulder and Elbow Society (ASES) score and Constant Murley score. Results: Average age of the patients was 58 years...

  16. Best Proximity Points for a New Class of Generalized Proximal Mappings

    Directory of Open Access Journals (Sweden)

    Tayyab Kamran


    Full Text Available The best proximity points are usually used to find the optimal approximate solution of the operator equation Tx = x, when T has no fixed point. In this paper, we prove some best proximity point theorems for nonself multivalued operators, following the foot steps of Basha and Shahzad [Best proximity point theorems for generalized proximal contractions, Fixed Point Theory Appl., 2012, 2012:42].

  17. Consequences of Avulsion Fracture of the Proximal Phalanx Caused by a Technical Failure of Hallux Valgus Surgery. (United States)

    Park, Young Uk; Lee, Kyung Tai; Jegal, Hyuk; Kim, Ki Chun; Choo, Ho Sik; Kweon, Heon Ju


    Several cases of avulsion fracture of the proximal phalanx of the big toe during the lateral capsular release procedure were observed. However, these fractures have not been reported as a complication of hallux valgus surgery. The purpose of the present study was to report the proximal phalanx base fracture as an unrecognized complication and to evaluate the clinical and radiographic consequences of this complication. We retrospectively reviewed 225 feet that had undergone hallux valgus surgery involving proximal chevron osteotomy and distal soft tissue release from May 2009 to December 2012. Of these 225 feet (198 patients), 12 (5.3%) developed proximal phalanx base fracture postoperatively. These patients were assigned to the fracture group. The remaining patients were assigned to the nonfracture group. Patients were followed to observe whether the fractures united and whether degenerative changes developed at the first metatarsophalangeal joint because of this fracture. The mean follow-up period was 36 (range 12 to 72) months. All the subjects in the fracture and nonfracture groups underwent weightbearing anteroposterior and lateral radiographs of the foot at the initial presentation and final follow-up point. The 2 groups were compared with respect to the hallux valgus angle, intermetatarsal angle, range of motion, American Orthopaedic Foot and Ankle Society score, satisfaction, and degenerative changes. No significant differences were found in age, follow-up period, hallux valgus angle, intermetatarsal angle, range of motion of the first metatarsophalangeal joint, American Orthopaedic Foot and Ankle Society score, satisfaction, and degenerative changes between the 2 groups. Ten (83.3%) of the 12 fractures healed, 2 (16.7% of the fractures, 0.89% of the operated feet) progressed to asymptomatic nonunion, and 3 (1.33%) developed first metatarsophalangeal joint degeneration. Avulsion fracture of the proximal phalanx of the big toe is an uncommon complication of

  18. The Neville-Aitken formula for rational interpolants with prescribed poles (United States)

    Carstensen, C.; Mühlbach, G.


    Using a polynomial description of rational interpolation with prescribed poles a simple purely algebraic proof of a Neville-Aitken recurrence formula for rational interpolants with prescribed poles is presented. It is used to compute the general Cauchy-Vandermonde determinant explicitly in terms of the nodes and poles involved.

  19. Effect of Materials and Manufacturing on the Bending Stiffness of Vaulting Poles (United States)

    Davis, C. L.; Kukureka, S. N.


    The increase in the world record height achieved in pole vaulting can be related to the improved ability of the athletes, in terms of their fitness and technique, and to the change in materials used to construct the pole. For example in 1960 there was a change in vaulting pole construction from bamboo to glass fibre reinforced polymer (GFRP)…

  20. Finite element modeling of small-scale tapered wood-laminated composite poles with biomimicry features (United States)

    Cheng Piao; Todd F. Shupe; R.C. Tang; Chung Y. Hse


    Tapered composite poles with biomimicry features as in bamboo are a new generation of wood laminated composite poles that may some day be considered as an alternative to solid wood poles that are widely used in the transmission and telecommunication fields. Five finite element models were developed with ANSYS to predict and assess the performance of five types of...

  1. Double Trouble: A Rare Case of Bilateral Upper Pole Ureteropelvic Junction Obstruction

    Directory of Open Access Journals (Sweden)

    Craig A. Peters


    Full Text Available A 16-year-old girl presented with bilateral back pain caused by bilateral upper pole ureteropelvic junction obstructions; an extremely rare phenomenon. Bilateral robotically assisted upper pole pyeloplasties were preformed at the same setting with an excellent clinical response. Although rare, upper pole ureteropelvic junction obstruction is a defined entity that urologists should be aware of.

  2. Mechanical properties of small-scale laminated wood composite poles: effects of taper and webs (United States)

    Cheng Piao; Todd F. Shupe; R.C. Tang; Chung Y. Hse


    Laminated hollow wood composite poles represent an efficient utilization of the timber resource and a promising alternative for solid poles that are commonly used in the power transmission and telecommunication lines. The objective of this study was to improve the performance of composite poles by introducing the bio-mimicry concept into the design of hollow wood...

  3. Preliminary phytochemical screening, proximate and elemental ...

    African Journals Online (AJOL)

    The seed powder of Moringa oleifera was analysed for its phytochemical, proximate and elemental composition using Folin-Denis spectrophotometric method, gravimetric method and energy dispersing X-ray fluorescence (EDXRF) transmission emission technique respectively. The seed powder had the following proximate ...

  4. Bimalleolar ankle fracture with proximal fibular fracture

    NARCIS (Netherlands)

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


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

  5. Grouping by Proximity in Haptic Contour Detection (United States)

    Overvliet, Krista E.; Krampe, Ralf Th.; Wagemans, Johan


    We investigated the applicability of the Gestalt principle of perceptual grouping by proximity in the haptic modality. To do so, we investigated the influence of element proximity on haptic contour detection. In the course of four sessions ten participants performed a haptic contour detection task in which they freely explored a haptic random dot display that contained a contour in 50% of the trials. A contour was defined by a higher density of elements (raised dots), relative to the background surface. Proximity of the contour elements as well as the average proximity of background elements was systematically varied. We hypothesized that if proximity of contour elements influences haptic contour detection, detection will be more likely when contour elements are in closer proximity. This should be irrespective of the ratio with the proximity of the background elements. Results showed indeed that the closer the contour elements were, the higher the detection rates. Moreover, this was the case independent of the contour/background ratio. We conclude that the Gestalt law of proximity applies to haptic contour detection. PMID:23762364

  6. Proximate analysis on four edible mushrooms ADEDAYO ...

    African Journals Online (AJOL)

    Michael Horsfall

    Vol. 15 (1) 9 - 11. Full-text Available Online at Proximate analysis on four edible mushrooms. ADEDAYO, MAJEKODUNMI RACHEL. Nigerian Stored Product Research Institute, P.M.B.3032, Kano. ABSTRACT: Proximate study was conducted on four edible mushrooms commonly found in farmlands in.

  7. Proximate Sources of Collective Teacher Efficacy (United States)

    Adams, Curt M.; Forsyth, Patrick B.


    Purpose: Recent scholarship has augmented Bandura's theory underlying efficacy formation by pointing to more proximate sources of efficacy information involved in forming collective teacher efficacy. These proximate sources of efficacy information theoretically shape a teacher's perception of the teaching context, operationalizing the difficulty…

  8. Phytochemical screening, proximate analysis and anticonvulsant ...

    African Journals Online (AJOL)

    Spigelia anthelmia is used traditionally in Southern Nigeria for the treatment of infant convulsion and epilepsy. This study investigated the phytochemical constituents, proximate analysis and anticonvulsant effect of the methanolic extract of Spigelia anthelmia. Phytochemical evaluation and proximate analysis was carried ...

  9. Lunar Meteorites Sayh Al Uhaymir 449 and Dhofar 925, 960, and 961: Windows into South Pole (United States)

    Ziegler, Ryan A.; Jolliff, B. L.; Korotev, R. L.


    In 2003, three lunar meteorites were collected in close proximity to each other in the Dhofar region of Oman: Dhofar 925 (49 g), Dhofar 960 (35 g), and Dhofar 961 (22 g). In 2006, lunar meteorite Sayh al Uhaymir (SaU) 449 (16.5 g) was found about 100 km to the NE. Despite significant differences in the bulk composition of Dhofar 961 relative to Dhofar 925/960 and SaU 449 (which are identical to each other), these four meteorites are postulated to be paired based on their find locations, bulk composition, and detailed petrographic analysis. Hereafter, they will collectively be referred to as the Dhofar 961 clan. Comparison of meteorite and component bulk compositions to Lunar Prospector 5-degree gamma-ray data suggest the most likely provenance of this meteorite group is within the South Pole-Aitken Basin. As the oldest, largest, and deepest recognizable basin on the Moon, the composition of the material within the SPA basin is of particular importance to lunar science. Here we review and expand upon the geochemistry and petrography of the Dhofar 961 clan and assess the likelihood that these meteorites come from within the SPA basin based on their bulk compositions and the compositions and characteristics of the major lithologic components found within the breccia.

  10. Claw-pole Synchronous Generator for Compressed Air Energy Storage

    Directory of Open Access Journals (Sweden)

    PAVEL Valentina


    Full Text Available This paper presents a claw-poles generator for compressed air energy storage systems. It is presented the structure of such a system used for compensating of the intermittency of a small wind energy system. For equipping of this system it is chosen the permanent magnet claw pole synchronous generator obtained by using ring NdFeB permanentmagnets instead of excitation coil. In such a way the complexity of the scheme is reduced and the generator become maintenance free. The new magnetic flux density in the air-gap is calculated by magneticreluctance method and by FEM method and the results are compared with measured values in the old and new generator.

  11. The South Pole Imaging Fabry Perot Interferometer (SPIFI) (United States)

    Stacey, G. J.; Bradford, C. M.; Swain, M. R.; Jackson, J. M.; Bolato, A. D.; Davidson, J. A.; Savage, M.


    The design and construction of the South Pole imaging Fabry-Perot interferometer (SPIFI) is reported. The SPIFI is a direct detection imaging spectrometer for use in the far infrared and submillimeter bands accessible to the 1.7 m telescope at the South Pole, and in the submillimeter bands accessible to the 15 m James Clerk Maxwell Telescope (JCMT), HI. It employs a 5 x 5 silicon bolometer array and three cryogenic Fabry Perot interferometers in series in order to achieve velocity resolutions of between 300 km/s and 30 km/s over the entire field of view with a resolution of up to 1 km/s at the center pixel. The scientific justification for the instrument is discussed, considering the spectral lines available to SPIFI. The optical path, the cryogenic Fabry-Perot, the adiabatic demagnetization refrigerator and the detector array are described. The instrument's sensitivity is presented and compared with coherent systems.

  12. H-infinity synthesis using a bilinear pole shifting transform (United States)

    Chiang, R. Y.; Safonov, M. G.


    An H-inifinity control law design is presented for a benchmark problem consisting of an undamped pair of spring-coupled masses with a sensor and actuator that are not collocated. This simple mechanical system captures many of the salient features of more complex aircraft and space structure vibration control problems. The H-infinity problem formulation enables the issue of stability robustness in the face of large mass and spring constant variation to be directly addressed. Constraints on closed-loop dominant pole locations and settling time are accommodated via a simple s-plane bilinear transform. The transform parameter can give direct control of closed-loop disturbance settling time and controller open-loop pole-zero locations. A four-state H-infinity minimum phase controller was found to meet the given specifications of each design. Detailed analysis on the tradeoffs of sensor noise vs control energy are also presented.

  13. On the ultimate uncertainty of the top quark pole mass (United States)

    Beneke, M.; Marquard, P.; Nason, P.; Steinhauser, M.


    We combine the known asymptotic behaviour of the QCD perturbation series expansion, which relates the pole mass of a heavy quark to the MS ‾ mass, with the exact series coefficients up to the four-loop order to determine the ultimate uncertainty of the top-quark pole mass due to the renormalon divergence. We perform extensive tests of our procedure by varying the number of colours and flavours, as well as the scale of the strong coupling and the MS ‾ mass. Including an estimate of the internal bottom and charm quark mass effect, we conclude that this uncertainty is around 110 MeV. We further estimate the additional contribution to the mass relation from the five-loop correction and beyond to be around 300 MeV.

  14. Successful treatment of groin pain syndrome in a pole-vault athlete with core stability exercise: a case report. (United States)

    Dello Iacono, Antonio; Maffulli, Nicola; Laver, Lior; Padulo, Johnny


    The purpose of this case report is to present a case of groin pain in a pole vault athlete describing the biomechanical features of the injury`s mechanism, acute medical management, and its successful rehabilitation. A 22 years old professional pole-vaulter sustained an injury during a regular training session. The athlete reported significant left lower abdominal and left proximal adductor discomfort in all activities, including basic trunk motion when moving in bed, sit to stand, and walking, and was unable to return to the regular training. Clinical evaluation and imaging studies addressed the injury to a case of adductor-related groin pain associated with pubic symphysis degeneration. Treatment consisted of an exercise-based therapeutic protocol based on trunk and core muscle strengthening and stability program, with progressive motor and functional demands. Significant improvements in the overall clinical findings and functional outcomes were reported after 52 days of intervention when the athletes returned to his full athletic activity. These results suggest that an appropriate rehabilitation program, focused on trunk and core musculature stability exercise addressing to sport-related specific demands, should be considered as an optimal conservative method in the multidisciplinary approach for treatment of groin pain and prior to any surgical intervention.

  15. Intramedullary compression device for proximal ulna fracture. (United States)

    Hong, Choon Chiet; Han, Fucai; Decruz, Joshua; Pannirselvam, Vinodhkumar; Murphy, Diarmuid


    Proximal ulna fractures account for 20% of all proximal forearm fractures. Many treatment options are available for such fractures, such as cast immobilisation, plate and screw fixation, tension band wiring and intramedullary screw fixation, depending on the fracture pattern. Due to the subcutaneous nature of the proximal forearm, it is vulnerable to open injuries over the dorsal aspect of the proximal ulna. This may in turn prove challenging, as it is critical to obtain adequate soft tissue coverage to reduce the risk of implant exposure and bony infections. We herein describe a patient with a Gustillo III-B open fracture of the proximal ulna, treated with minimally invasive intramedullary screw fixation using a 6.0-mm cannulated headless titanium compression screw (FusiFIX, Péronnas, France).

  16. Characterization of Periodically Poled Nonlinear Materials Using Digital Image Processing (United States)


    20 Figure 25. Calculated and measured threshold of PPLN crystal. ....................... 21 Figure 26. Representative diagram (using a motorized stage or manually) of an etched material, in this case periodically poled lithium niobate ( PPLN ), using a reasonably high...validate the accuracy of the image processing routines. The setup is shown in Figure 24. Where the 1.064µm wavelength laser beam reaches the PPLN crystal

  17. Tööpuudus 29%, palavikku pole / Rachel Donadio

    Index Scriptorium Estoniae

    Donadio, Rachel


    Lõuna-Hispaanias asuvas Cádizis on töötus 29%, ometi pole eurotsooni kõrgeim tööpuuduse määr tekitanud linnas sügavat sotsiaalset rahutust ega massilisi proteste, sest üsna kõrge elukvaliteedi tagavad töötutele kompleksne turvavõrk, mis koosneb varimajandusest, perekonna toetusest ja valitsuse toetusest

  18. SPATS - an Acoustic Array at the South Pole

    Energy Technology Data Exchange (ETDEWEB)

    Boeser, S [DESY, Zeuthen (Germany); Bohm, C [Stockholm University, Stockholm (Sweden); Descamps, F [DESY, Zeuthen (Germany); Fischer, J [DESY, Zeuthen (Germany); Hallgren, A [Uppsala University, Uppsala (Sweden); Heller, R [DESY, Zeuthen (Germany); Hulth, P O [Stockholm University, Stockholm (Sweden); Hundertmark, S [Stockholm University, Stockholm (Sweden); Krieger, K [DESY, Zeuthen (Germany); Nahnhauer, R [DESY, Zeuthen (Germany); Pohl, M [DESY, Zeuthen (Germany); Price, B [University of California, Berkeley (United States); Sulanke, K [DESY, Zeuthen (Germany); Vandenbroucke, J [University of California, Berkeley (United States)


    The detection of extraterrestrial EHE neutrinos requires detection volumes at least one order of magnitude larger than currently constructed km3 optical neutrino detectors. In ice, it is anticipated that the absorption length for acoustic waves reaches up to to several kilometers. This makes ice an attractive host environment for a next generation acoustic neutrino detector. To measure the acoustic properties of ice at South Pole, a test setup has been developed, ready to be deployed in the 2006/07 summer season.

  19. Edgar Savisaar : BRS pole piisavalt investeerinud / Raigo Neudorf

    Index Scriptorium Estoniae

    Neudorf, Raigo


    Majandus- ja kommunikatsiooniminister on rahul, et riigi ja BRS-iga saavutati kokkulepe ettevõtte aktsiate tagasiostuks, kuid leiab, et BRS pole täitnud võetud investeerimiskohustusi ning seega peab järgnevatel aastatel suunama ettevõtte kaasajastamisse miljardeid kroone. Vt. samas: Jüri Käo: investeeringute kogumaht ületas nõutu; Savisaar: Jüri Käo ajab pada; Pingelised läbirääkimised BRS-iga

  20. Poling of PVDF matrix composites for integrated structural load sensing (United States)

    Haghiashtiani, Ghazaleh; Greminger, Michael A.; Zhao, Ping


    The purpose of this study is to create and evaluate a smart composite structure that can be used for integrated load sensing and structural health monitoring. In this structure, PVDF films are used as the matrix material instead of epoxy resin or other thermoplastics. The reinforcements are two layers of carbon fiber with one layer of Kevlar separating them. Due to the electrical conductivity properties of carbon fiber and the dielectric effect of Kevlar, the structure acts as a capacitor. Furthermore, the piezoelectric properties of the PVDF matrix can be used to monitor the response of the structure under applied loads. In order to exploit the piezoelectric properties of PVDF, the PVDF material must be polarized to align the dipole moments of its crystalline structure. The optimal condition for poling the structure was found by performing a 23 factorial design of experiment (DoE). The factors that were studied in DoE were temperature, voltage, and duration of poling. Finally, the response of the poled structure was monitored by exposing the samples to an applied load.

  1. Background Studies for Acoustic Neutrino Detection at the South Pole (United States)

    Abbasi, R.; Abdou, Y.; Abu-Zayyad, T.; Adams, J.; Aguilar, J. A.; Ahlers, M.; Andeen, K.; Auffenberg, J.; Bai, X.; Baker, M.; hide


    The detection of acoustic signals from ultra-high energy neutrino interactions is a promising method. to measure the flux of cosmogenic neutrinos expected on Earth. The energy threshold for this process depends strongly on the absolute noise level in the target material. The South Pole Acoustic Test Setup (SPATS). deployed in the upper part of four boreholes of the IceCube Neutrino Observatory, has monitored the noise in Antarctic ice at the geographic South Pole for more than two years down to 500 m depth. The noise is very stable and Gaussian distributed, Lacking an in situ calibration up to now, laboratory measurements have been used to estimate the absolute noise level in the 10-50 kHz frequency range to be smaller than 20 mPa. Using a threshold trigger. sensors of the South Pole Acoustic Test Setup registered acoustic events in the IceCube detector volume and its vicinity. Acoustic signals from refreezing IceCube holes and from anthropogenic sources have been used to test the localization of acoustic events. An upper limit on the neutrino flux at energies E(sub v) > 10(exp 11) GeV is derived from acoustic data taken over eight months.

  2. Factorization and resummation for collinear poles in QCD amplitudes

    Energy Technology Data Exchange (ETDEWEB)

    Dixon, Lance J.; Magnea, Lorenzo; Sterman, George


    We study the origin of subleading soft and collinear poles of form factors and amplitudes in dimensionally-regulated massless gauge theories. In the case of form factors of fundamental fields, these poles originate from a single function of the coupling, denoted G({alpha}{sub s}), depending on both the spin and gauge quantum numbers of the field. We relate G({alpha}{sub s}) to gauge-theory matrix elements involving the gluon field strength. We then show that G({alpha}{sub s}) is the sum of three terms: a universal eikonal anomalous dimension, a universal non-eikonal contribution, given by the coefficient B{sub {delta}}({alpha}{sub s}) of {delta}(1-z) in the collinear evolution kernel, and a process-dependent short-distance coefficient function, which does not contribute to infrared poles. Using general results on the factorization of soft and collinear singularities in fixed-angle massless gauge theory amplitudes, we conclude that all such singularities are captured by the eikonal approximation, supplemented only by the knowledge of B{sub {delta}}({alpha}{sub s}). We explore the consequences of our results for conformal gauge theories, where in particular we find a simple exact relation between the form factor and the cusp anomalous dimension.


    Directory of Open Access Journals (Sweden)

    Aida CATANA


    Full Text Available The demographic dynamics analysed in the context of the relationship between economic development and social inclusion presents an image of the sustainable development of a community as well as the manner how the financial resources have been used. With an allocation of 74.3 million euro in the programming period 2007-2013, the Brasov Growth Pole has pursued the contribution to the achievement of sustainable development since 2005 by the participation in the Agenda 21. The implementation of projects with European financing in areas such as transport, social and educational infrastructure or tourism have generated changes/demographic movements, which this paper proposes to present. The evolution of the stable population, its dynamics at the level of each locality that is part of the Brasov growth pole as well as the dynamics of the number of employees or the development of the unemployment rate are presented by the cluster analysis. The effects of the European financing obtained from Regional Operational Programme 2007-2013 are thus reflected in the sustainable development of the Brasov growth pole from the point of view of the dynamics of the population

  4. Different pole structures in line shapes of the X(3872)

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Xian-Wei; Oller, J.A. [Universidad de Murcia, Departamento de Fisica, Murcia (Spain)


    We introduce a near-threshold parameterization that is more general than the effective-range expansion up to and including the effective range because it can also handle a near-threshold zero in the D{sup 0} anti D{sup *0} S-wave. In terms of it we analyze the CDF data on inclusive p anti p scattering to J/ψπ{sup +}π{sup -}, and the Belle and BaBar data on B decays to K J/ψπ{sup +}π{sup -} and KD anti D{sup *0} around the D{sup 0} anti D{sup *0} threshold. It is shown that data can be reproduced with similar quality for X(3872) being a bound and/or a virtual state. We also find that X(3872) might be a higher-order virtual-state pole (double or triplet pole), in the limit in which the small D{sup *0} width vanishes. Once the latter is restored the corrections to the pole position are non-analytic and much bigger than the D{sup *0} width itself. The X(3872) compositeness coefficient in D{sup 0} anti D{sup *0} ranges from nearly 0 up to 1 in the different scenarios. (orig.)

  5. Comparative Investigation on the Performance of Modified System Poles and Traditional System Poles Obtained from PDC Data for Diagnosing the Ageing Condition of Transformer Polymer Insulation Materials

    Directory of Open Access Journals (Sweden)

    Jiefeng Liu


    Full Text Available The life expectancy of a transformer is largely depended on the service life of transformer polymer insulation materials. Nowadays, several papers have reported that the traditional system poles obtained from polarization and depolarization current (PDC data can be used to assess the condition of transformer insulation systems. However, the traditional system poles technique only provides limited ageing information for transformer polymer insulation. In this paper, the modified system poles obtained from PDC data are proposed to assess the ageing condition of transformer polymer insulation. The aim of the work is to focus on reporting a comparative investigation on the performance of modified system poles and traditional system poles for assessing the ageing condition of a transformer polymer insulation system. In the present work, a series of experiments have been performed under controlled laboratory conditions. The PDC measurement data, degree of polymerization (DP and moisture content of the oil-immersed polymer pressboard specimens were carefully monitored. It is observed that, compared to the relationships between traditional system poles and DP values, there are better correlations between the modified system poles and DP values, because the modified system poles can obtain much more ageing information on transformer polymer insulation. Therefore, the modified system poles proposed in the paper are more suitable for the diagnosis of the ageing condition of transformer polymer insulation.


    Directory of Open Access Journals (Sweden)

    H. Zheng


    Full Text Available Object detection and recognition from LiDAR (Light Detection And Ranging data has been a research topic in the fields of photogrammetry and computer vision. Unlike point clouds collected in well-controlled indoor environments, point clouds in urban environments are more complex due to complexity of the real world. For example, trees sometimes close to signs or buildings, which will cause occlusions in the point clouds. Current object detection or reconstruction algorithms will have problems when recognizing objects with severe occlusions caused by trees etc. In this paper, a robust vegetation removal method and a DBSCAN based pole-like object detection method are proposed. Based on observation that major difference between vegetation and other rigid objects is their penetrability with respect to LiDAR, we introduce a local roughness measure to differentiate rigid objects from non-rigid ones (vegetation in this paper. First, a local sphere with a small radius is generated for each input point. Three principal components of the local sphere are then calculated, and a plane is determined. The roughness is obtained through calculating the standard deviation of distances from all inside points to the plane by a weighted summation of the normalized distances. The further the point to the plane, the smaller the weight is. Finally, a graph cuts based method is introduced to classify the input point sets into two groups. The data term is defined by the normalized roughness of the current point, and the smoothness term is defined by the normalized distance between the point and its nearest neighbour point. In terms of pole-like object detection, first, a uniformed 2D grid is generated through projecting all the points to the XY-plane. The seed points of the pole-like objects are obtained by determining the x and y coordinates by the centres of the highest density cells of the grid and the z coordinate by the mean height of the point sets of each object

  7. Poling of lead zirconate titanate ceramics and flexible piezoelectric composites by the corona discharge technique

    Energy Technology Data Exchange (ETDEWEB)

    Waller, D.; Safari, A.; Igbal, T.


    Poling of composites having a polymer matrix with 0-3 connectivity is difficult because the electric field within the high-dielectric-constant grains is far smaller than in the low-dielectric-constant polymer matrix. Therefore, very large electric fields are required to pole these types of composites. However, large electric fields often cause dielectric breakdown of the samples. In this study for improved poling, the corona discharge technique was used to pole piezoelectric ceramics, fired PXT composites, and 0.5PbTiO/sub 3/ . 0.5BiFeO/sub 3/ 0-3 polymer composites. An experimental setup for corona poling is described.

  8. Least 1-Norm Pole-Zero Modeling with Sparse Deconvolution for Speech Analysis

    DEFF Research Database (Denmark)

    Shi, Liming; Jensen, Jesper Rindom; Christensen, Mads Græsbøll


    In this paper, we present a speech analysis method based on sparse pole-zero modeling of speech. Instead of using the all-pole model to approximate the speech production filter, a pole-zero model is used for the combined effect of the vocal tract; radiation at the lips and the glottal pulse shape....... Moreover, to consider the spiky excitation form of the pulse train during voiced speech, the modeling parame- ters and sparse residuals are estimated in an iterative fashion using a least 1-norm pole-zero with sparse deconvolution algorithm. Com- pared with the conventional two-stage least squares pole...

  9. Proximal Alternating Direction Method with Relaxed Proximal Parameters for the Least Squares Covariance Adjustment Problem

    Directory of Open Access Journals (Sweden)

    Minghua Xu


    Full Text Available We consider the problem of seeking a symmetric positive semidefinite matrix in a closed convex set to approximate a given matrix. This problem may arise in several areas of numerical linear algebra or come from finance industry or statistics and thus has many applications. For solving this class of matrix optimization problems, many methods have been proposed in the literature. The proximal alternating direction method is one of those methods which can be easily applied to solve these matrix optimization problems. Generally, the proximal parameters of the proximal alternating direction method are greater than zero. In this paper, we conclude that the restriction on the proximal parameters can be relaxed for solving this kind of matrix optimization problems. Numerical experiments also show that the proximal alternating direction method with the relaxed proximal parameters is convergent and generally has a better performance than the classical proximal alternating direction method.

  10. Transoral vertebral augmentation with polymethylmethacrylate in the treatment of a patient with a dens fracture nonunion and subarticular vertebral body fracture of C2

    Energy Technology Data Exchange (ETDEWEB)

    Beall, Douglas P. [University of Oklahoma, Clinical Radiology of Oklahoma, Oklahoma City, OK (United States); Martin, Hal D. [Oklahoma Sports Science and Orthopaedics, Oklahoma City (United States); Stapp, Annette M. [Physicians Group, Clinical Radiology of Oklahoma, Oklahoma City, OK (United States); Stanfield, Matthew


    The injection of polymethylmethacrylate (PMMA) is a minimally invasive, image-guided procedure used to treat vertebral fractures due to osteoporosis, metastatic lesions, multiple myeloma, and benign but destabilizing bone tumors. The injection of PMMA into the C2 vertebral body using the transoral technique has been reported in three separate patients for treatment of benign tumors (a vertebral hemangioma and an aneurysmal bone cyst) and for multiple myeloma in the third patient. Although the injection of PMMA into the vertebral body is most commonly performed to treat benign vertebral compression fractures, a transoral C2 approach has not been reported in the English literature as a treatment for a benign fracture of C2. We report the treatment of a fracture and nonunion of the base of the dens and a subarticular fracture of the vertebral body of C2 using a bilateral transoral approach. (orig.)

  11. The Life Saving Effects of Hospital Proximity

    DEFF Research Database (Denmark)

    Bertoli, Paola; Grembi, Veronica

    We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from......) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters...

  12. Long-term results of midcarpal arthrodesis in the treatment of scaphoid nonunion advanced collapse (SNAC-Wrist) and scapholunate advanced collapse (SLAC-Wrist). (United States)

    Dacho, Andreas; Grundel, Johanna; Holle, Gisbert; Germann, Günter; Sauerbier, Michael


    Outcome evaluation of midcarpal arthrodesis in the treatment of scaphoid nonunion advanced collapse (SNAC-wrist) and scapholunate advanced collapse (SLAC-wrist). Scaphoid nonunion or scapholunate ligament instability results in carpal collapse and subsequent arthrosis. These conditions, termed SLAC-wrist and SNAC-wrist, are the most common patterns of arthrosis in the wrist. The purpose of this retrospective study was the evaluation of functional outcomes following midcarpal arthrodesis and of patients' satisfaction with these outcomes. Forty-nine patients were reexamined at a mean follow-up time of 47 months. Active range of motion (AROM) was verified with a goniometer; grip strength was measured with a JAMAR-Dynamometer II. Pain was evaluated by a visual analogue scale from zero to 100 (VAS 0-100) for stress and under resting conditions. Patients' upper-extremity functioning was captured with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Radiographic evaluation of bony consolidation was verified by conventional x-ray. Postoperative AROM was 56% and grip strength was 76% compared with the contralateral side. The DASH score was 29 points. Pain relief was 34% at rest and 31% after stress. Forty-five patients demonstrated bony consolidation in x-ray control. Six patients (12%) further required a total arthrodesis of the wrist because of pain or absence of bony consolidation. Our data demonstrate that midcarpal arthrodesis is a reliable procedure for treating SLAC- and SNAC-wrists in stages II and III and, furthermore, one which preserves some range of motion. Total wrist fusion should only be used in exceptional circumstances.

  13. Use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.

    Directory of Open Access Journals (Sweden)

    Stefano Giannotti

    Full Text Available BACKGROUND: Tissue engineering appears to be an attractive alternative to the traditional approach in the treatment of fracture non-unions. Mesenchymal stromal cells (MSCs are considered an appealing cell source for clinical intervention. However, ex vivo cell expansion and differentiation towards the osteogenic lineage, together with the design of a suitable scaffold have yet to be optimized. Major concerns exist about the safety of MSC-based therapies, including possible abnormal overgrowth and potential cancer evolution. AIMS: We examined the long-term efficacy and safety of ex vivo expanded bone marrow MSCs, embedded in autologous fibrin clots, for the healing of atrophic pseudarthrosis of the upper limb. Our research work relied on three main issues: use of an entirely autologous context (cells, serum for ex vivo cell culture, scaffold components, reduced ex vivo cell expansion, and short-term MSC osteoinduction before implantation. METHODS AND FINDINGS: Bone marrow MSCs isolated from 8 patients were expanded ex vivo until passage 1 and short-term osteo-differentiated in autologous-based culture conditions. Tissue-engineered constructs designed to embed MSCs in autologous fibrin clots were locally implanted with bone grafts, calibrating their number on the extension of bone damage. Radiographic healing was evaluated with short- and long-term follow-ups (range averages: 6.7 and 76.0 months, respectively. All patients recovered limb function, with no evidence of tissue overgrowth or tumor formation. CONCLUSIONS: Our study indicates that highly autologous treatment can be effective and safe in the long-term healing of bone non-unions. This tissue engineering approach resulted in successful clinical and functional outcomes for all patients.

  14. Fibreglass as an alternative to wood poles : Transmission and distribution poles and crossarms : use of fiber reinforced composite materials for overhead electric utility lines

    Energy Technology Data Exchange (ETDEWEB)

    Wiles, J.R. [Shakespeare Composites and Electronics, Newberry, SC (United States)


    For over thirty years, Shakespeare Composites and Electronics has manufactured fiberglass composite lighting and utility poles, as well as being the number one maker of composite crossarms. Composite poles have a few advantages, such as being lightweight, they do no rust, are woodpecker and termite resistant, use no harmful chemicals, and have long life. A chart displaying the comparative pole weights is presented. The key design factors of fiberglass composite utility poles are: pole diameter, fiberglass type and wind angle, layers (thickness) of fiberglass, resin type and formulation, resin mix consistency, cure cycle and maximum curing temperature, and others. Two charts were also displayed presenting 40 feet class 4 pole bending strengths and 40 feet class 2 pole bending strengths. The author indicated that composite poles have a better strength consistency than wood, while being as consistent as steel and prestressed concrete. The design is based on an overload factor of safety of 2.5 for numerous installations. Some of the analytical methods used include mechanical testing, finite element modeling, and thermal analysis. The author describes in detail the concerns associated with attachments. Coating consists of a system of ultra violet blockers in the resin followed by an added resin rich polyester veil outer surface. In addition, there is a proprietary coating process with additional ultra violet blockers. Quality control is effected at the plant. The weathering system lasts 80 years. figs.

  15. Proximity and Collaboration in European Nanotechnology

    NARCIS (Netherlands)

    Cunningham, S.W.; Werker, C.


    Collaborations are particularly important for the development and deployment of technology. We analyze the influence of organizational, technological and geographical proximity on European nanotechnology collaborations with the help of a publication dataset and additional geographical information.

  16. Promoting proximal formative assessment with relational discourse (United States)

    Scherr, Rachel E.; Close, Hunter G.; McKagan, Sarah B.


    The practice of proximal formative assessment - the continual, responsive attention to students' developing understanding as it is expressed in real time - depends on students' sharing their ideas with instructors and on teachers' attending to them. Rogerian psychology presents an account of the conditions under which proximal formative assessment may be promoted or inhibited: (1) Normal classroom conditions, characterized by evaluation and attention to learning targets, may present threats to students' sense of their own competence and value, causing them to conceal their ideas and reducing the potential for proximal formative assessment. (2) In contrast, discourse patterns characterized by positive anticipation and attention to learner ideas increase the potential for proximal formative assessment and promote self-directed learning. We present an analysis methodology based on these principles and demonstrate its utility for understanding episodes of university physics instruction.

  17. Ammonia transport in the proximal tubule. (United States)

    Hamm, L L; Simon, E E


    The transport of ammonia in the proximal tubule is a complex interaction of a number of processes. Ammonia transport in the proximal tubule is clearly bidirectional; ammonia is secreted into the early proximal tubule lumen, but later in the proximal tubule, efflux out of the lumen may result in net ammonia reabsorption. Two mechanisms of ammonia transport have clearly been established: NH3 diffusion and NH4+ transport on the Na(+)-H+ exchanger. The relative contribution of these pathways to ammonia transport is still unsettled. Other pathways for ammonia transport, particularly NH4+ efflux out of the lumen, may be important as well. A variety of factors may modulate ammonia transport: plasma, cell and luminal pH, luminal flow rate, luminal potassium, and angiotensin II. Each of these factors also alters ammonia production rates and in most circumstances, ammonia transport appears to follow ammonia production rates.

  18. Proximate composition and cholesterol concentrations of ...

    African Journals Online (AJOL)



    DWB) for raw and fried samples, respectively, but decreased to 295.20 ... Key words: Rhynchophorus phoenicis, Oryctes monoceros, proximate composition, cholesterol, heat treatment. INTRODUCTION. Insects have played ...


    African Journals Online (AJOL)

    Babatunde Emmanuel


    Oct 6, 2011 ... Fish allows for protein improved nutrition in that it has a high biological value in terms of high ... marine algae upon which the fish feed [11]. ... Proximate composition of catfish Clarias gariepinus and Tarpon atlanticus were.

  20. Proximal migration of hardware in patients undergoing midcarpal fusion with headless compression screws. (United States)

    Shifflett, Grant D; Athanasian, Edward A; Lee, Steve K; Weiland, Andrew J; Wolfe, Scott W


    Background Scaphoid excision and limited intercarpal fusion is a common surgical procedure performed for degenerative disorders of the wrist including scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist deformities. Postoperative screw migration is a rare but devastating complication that can result in severe degenerative changes in the radiocarpal joint. Questions/Purposes The purpose of this study is to report on a series of patients who developed proximal migration of their hardware following limited intercarpal fusions with headless compression screws. Patients and Methods Four patients were identified between 2001 and 2012 who were indicated for and underwent scaphoid excision and midcarpal fusions with headless compression screw fixation and subsequently developed hardware migration with screw protrusion into the radiocarpal joint. Detailed chart review was performed. Results Mean age at surgery was 64 years (57-69 years). All patients had the diagnosis of SLAC wrist. Mean time to detection of failure was 6 months (4-8 months). All patients demonstrated radiographic union prior to failure based on plain films. Radiographs revealed screw backout with erosion of the radial lunate facet in all patients. Calculated carpal height ratios demonstrated a drop from an average 44.2% to 39.5% at the time of hardware migration. All four patients underwent hardware removal. One patient was not indicated for any further surgery, and two patients underwent further revision surgery. All three patients reported complete pain relief. One patient refused a salvage procedure and had subsequent persistent pain. Conclusions This study reports a serious complication of scaphoid excision and midcarpal fusion performed with headless compression screws. We advise surgeons to be aware of this potential complication and consider employing methods to reduce the risk of hardware migration. Additionally, we recommend at least 8 months of

  1. Phytochemical screening, proximate analysis and acute toxicity ...

    African Journals Online (AJOL)

    Phytochemical screening, proximate analysis and acute toxicity studies were carried out on the leaf extract of Cola lepidota, in accordance with established standard procedures. The proximate analysis reveals a moisture content of 27.43 ± 3.11 % w/w, total ash value 9.32 ± 0.27 % w/w, acid insoluble ash 3.12 ± 1.05 % w/w ...

  2. Proximate, Mineral and Phytochemical Composition of Dioscorea ...

    African Journals Online (AJOL)


    ABSTRACT: Proximate, mineral and phytochemical composition of Dioscorea dumetorum tubers was investigated using standard procedures. Proximate analysis included in g% dry weight: crude protein (6.44 ± 0.32), crude fat (0.75 ± 0.04), crude fibre (15.00 ± 0.56), total ash. (3.45 ± 0.20) and a moisture content of 70.04 ...

  3. Painful Spastic Hip Dislocation: Proximal Femoral Resection


    Albiñana, Javier; Gonzalez-Moran, Gaspar


    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despit...

  4. Energy harvesting using AC machines with high effective pole count (United States)

    Geiger, Richard Theodore

    In this thesis, ways to improve the power conversion of rotating generators at low rotor speeds in energy harvesting applications were investigated. One method is to increase the pole count, which increases the generator back-emf without also increasing the I2R losses, thereby increasing both torque density and conversion efficiency. One machine topology that has a high effective pole count is a hybrid "stepper" machine. However, the large self inductance of these machines decreases their power factor and hence the maximum power that can be delivered to a load. This effect can be cancelled by the addition of capacitors in series with the stepper windings. A circuit was designed and implemented to automatically vary the series capacitance over the entire speed range investigated. The addition of the series capacitors improved the power output of the stepper machine by up to 700%. At low rotor speeds, with the addition of series capacitance, the power output of the hybrid "stepper" was more than 200% that of a similarly sized PMDC brushed motor. Finally, in this thesis a hybrid lumped parameter / finite element model was used to investigate the impact of number, shape and size of the rotor and stator teeth on machine performance. A typical off-the-shelf hybrid stepper machine has significant cogging torque by design. This cogging torque is a major problem in most small energy harvesting applications. In this thesis it was shown that the cogging and ripple torque can be dramatically reduced. These findings confirm that high-pole-count topologies, and specifically the hybrid stepper configuration, are an attractive choice for energy harvesting applications.

  5. Laparoscopic upper pole heminephroureterectomy in children: Seven-year experience

    Directory of Open Access Journals (Sweden)

    Antonio Marte


    Full Text Available Background: Minimally invasive surgery is the current approach to perform heminephroureterectomy (HN in children. This can be obtained through a transperitoneal (TP or a retroperitoneal approach. Here, we report our experience using a TP approach. Materials and Methods: From 2005 to 2014, 22 TP laparoscopic upper poles HN were performed at our institution. There were nine girls and 13 boys aged between 20 months and 6 years (mean age 3.9. Eight patients were diagnosed prenatally, 17 patients presented with urinary tract infection (UTI and three with vomiting and failure to thrive. The indication for HN was reflux nephropathy and UTI in non-functioning upper pole in 19 patients and cystic dysplasia in 1 patient. The surgical technique involved the following steps: Cystoscopic recognition; positioning of 3-4 trocar (right HN; identification of the kidney (detachment of the colon; isolation and low ligation of the dilated ureter; decrossing from renal vessels; section of the parenchyma by LigaSure; haemostasis with clips and LigaSure; drain. Results: The mean operative time was 154 min (range: 81-220 min. All patients were discharged from the 2 nd to 4 th day. Neither major complication nor conversion was recorded. 1 patient presented leakage of urine for 7 days from the drainage which resolved spontaneously. At ultrasound follow-up, 5 patients showed a secondary perirenal cyst, 2-5 cm diameter that resolved spontaneously. Conclusion: The results indicate that laparoscopic upper pole heminephrectomy is the treatment of choice in cases of non-functioning dilated lower segments of duplicated kidneys. The use of laparoscopic approach offers a good working space, a good visual control of the vessels and allows a very low isolation of the ureteral stump which counterbalance the peritoneal violation.

  6. Proximity sensor system development. CRADA final report

    Energy Technology Data Exchange (ETDEWEB)

    Haley, D.C. [Oak Ridge National Lab., TN (United States); Pigoski, T.M. [Merrit Systems, Inc. (United States)


    Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors.

  7. Transformations through Proximity Flying: A Phenomenological Investigation (United States)

    Holmbom, Maria; Brymer, Eric; Schweitzer, Robert D.


    Participation in extreme sports has been linked to personal transformations in everyday life. Descriptions of lived experience resulting from transformative experiences are limited. Proximity flying, a relatively new discipline involving BASE jumping with a wingsuit where participants fly close to solid structures, is arguably one of the most extreme of extreme sports. The aim of this paper, part of a larger phenomenological study on the lived experience of proximity flying, is to explicate the ways in which participating in proximity flying influences the everyday lives of participants. Interpretative phenomenological analysis was used to explicate the lived experience of six proximity pilots. An analysis of interview transcripts revealed three significant themes describing the lived experience of participants. First, experiences of change were described as positive and skills developed through proximity flying were transferable into everyday life. Second, transformative experiences were considered fundamental to participants’ perspectives on life. Third, experience of transformation influenced their sense of personal identity and facilitated flourishing in other aspects of everyday life. Participants were clear that their experiences in proximity flying facilitated a profound process of transformation which manifest as changes in everyday capabilities and behaviors, values and sense of identity. PMID:29104552

  8. Bacterial diversity in snow on North Pole ice floes

    DEFF Research Database (Denmark)

    Hauptmann, Aviaja Zenia Edna Lyberth; Stibal, Marek; Bælum, Jacob


    The microbial abundance and diversity in snow on ice floes at three sites near the North Pole was assessed using quantitative PCR and 454 pyrosequencing. Abundance of 16S rRNA genes in the samples ranged between 43 and 248 gene copies per millilitre of melted snow. A total of 291,331 sequences were...... sites clustered together when compared to the underlying environments of sea ice and ocean water. The Shannon indices ranged from 2.226 to 3.758, and the Chao1 indices showed species richness between 293 and 353 for the three samples. The relatively low abundances and diversity found in the samples...

  9. Ülikoolid pole mängukannid / Sirje Tohver

    Index Scriptorium Estoniae

    Tohver, Sirje


    TPÜ korraldas 16. märtsil̀ 2001 ümarlaua "Ülikoolid pole mängukannid", kus oli arutusel riikliku koolitustellimuse vähenemine avalik-õiguslikele ülikoolidele. Osalesid TPÜ filoloogiateaduskonna dekaan dots. H. Mattisen, kultuuriteaduskonna dekaan prof. A. Avarand, akadeemiline prorektor dots. L. Jõgi, teadus- ja arendusprorektor prof. P. Normak, haridusminister T. Lukas, TPÜ rektor prof. M. Arvisto ja EKA rektor prof. A. Keskküla, TTÜ rektor prof. A. Keevallik, EMA õppeprorektor A. Pung

  10. São Paulo metrópole comunicacional


    Canevacci, Massimo; Targioni, trad. Paolo


    Este ensaio inicia analizando etnograficamente a mudança da metrópole comunicacional. Os modernos conceitos de produção, identitade, dialéctica e sociedade dessolvem-se entre a comunicação digital e o consumo performático. São Paulo é um contexto comunicacional fluido onde se aplicam relações entre bodyscape e location, desse modo produzindo multisensorialidades. My essay is an ethnographical focus about communicational metropolis. So modern concepts as production, ...

  11. A new air-Cherenkov array at the South Pole

    CERN Document Server

    Dickinson, J E; Hart, S P; Hill, G C; Hinton, J A; Lloyd-Evans, J; Potter, D; Pryke, C L; Rochester, K; Schwarz, R; Watson, A A


    VULCAN comprises a 9 element array of air-Cherenkov radiation detectors established at the South Pole. VULCAN operates in coincidence with the air-shower array SPASE-2 and the two Antarctic Muon And Neutrino Detector Arrays, AMANDA A and B, supplementing the data gathered by these instruments with a measurement of the lateral distribution of air-Cherenkov light from extensive air-showers. An overview of the aims and methods of the whole coincidence experiment (SPASE-2, VULCAN and AMANDA) can be found in an accompanying paper (Dickinson et al., Nucl. Instr. and Meth. A (1999), to be published).

  12. Full Range ZVS Phase Shifted Power Converter with "Poles"

    CERN Document Server

    Bordry, Frederick


    The study and development of a quasi-resonant power converter, with Full Bridge - PhaseShifted - Pulse Width Modulation (FB-PS-PWM) topology is presented. The originality of thepaper is the adding of resonant networks (poles) on each leg to get soft commutation (ZeroVoltage Switching ZVS) over the full range of the output current. The design of the polestructure and the component ratings are described. Simulations and a [1000A-15V] converterprototype, using dual-thyristor, validate the theoretical studies.



    OZOGLU, Yusuf


    One solution to the high torque ripple problem of the switched reluctance motor is to modify its pole geometry. To show how much this solution is effective, static field analyses are usually contended with. However, dynamic analyses of SRM are to be made to get a real model of SRM. In this study, dynamic analysis of conventional SRM and the modified SRM are made and their performance parameters are compared with each other. The comparison shows an improvement of 23.6 % in torque ripple and 18...

  14. Detection and Classification of Pole-Like Objects from Mobile Mapping Data (United States)

    Fukano, K.; Masuda, H.


    Laser scanners on a vehicle-based mobile mapping system can capture 3D point-clouds of roads and roadside objects. Since roadside objects have to be maintained periodically, their 3D models are useful for planning maintenance tasks. In our previous work, we proposed a method for detecting cylindrical poles and planar plates in a point-cloud. However, it is often required to further classify pole-like objects into utility poles, streetlights, traffic signals and signs, which are managed by different organizations. In addition, our previous method may fail to extract low pole-like objects, which are often observed in urban residential areas. In this paper, we propose new methods for extracting and classifying pole-like objects. In our method, we robustly extract a wide variety of poles by converting point-clouds into wireframe models and calculating cross-sections between wireframe models and horizontal cutting planes. For classifying pole-like objects, we subdivide a pole-like object into five subsets by extracting poles and planes, and calculate feature values of each subset. Then we apply a supervised machine learning method using feature variables of subsets. In our experiments, our method could achieve excellent results for detection and classification of pole-like objects.

  15. Investigation Effects of Narrowing Rotor Pole Embrace to Efficiency and Cogging Torque at PM BLDC Motor

    Directory of Open Access Journals (Sweden)

    Cemil Ocak


    Full Text Available Engineers think that pole embrace size of a PM BLDC motor affects directly the efficiency and the torque. Dealing with theexperimental research, in the studywe have investigated the effects of narrowing rotor pole embrace step by step by changing sizes parametrically. By doing so, high efficiency and low cogging torque would have been obtained for a 20 W PM BLDC motor. In order to do this,pole arc to pole pitch ratio of magnets at the rotor poles has been changed parametrically (0.5 to 1 by genetic algorithm methodfirst. Then the electromagnetic field dispersions, output parameters of the motor, new rotor constructions have been obtained; and new pole embrace has been derived from the variation of pole arc to pole pitch ratio. We have also calculatedthe magnetic flux distribution, output power, torque, cogging torque and efficiency values analytically and the effects of new pole embrace to motor efficiency and torque have been simulated. The developed 18 slots, 6 poles, surface mounted inner runner configuration rotor machine is proposed as to be used insmall dentistry apparatus.


    Directory of Open Access Journals (Sweden)

    K. Fukano


    Full Text Available Laser scanners on a vehicle-based mobile mapping system can capture 3D point-clouds of roads and roadside objects. Since roadside objects have to be maintained periodically, their 3D models are useful for planning maintenance tasks. In our previous work, we proposed a method for detecting cylindrical poles and planar plates in a point-cloud. However, it is often required to further classify pole-like objects into utility poles, streetlights, traffic signals and signs, which are managed by different organizations. In addition, our previous method may fail to extract low pole-like objects, which are often observed in urban residential areas. In this paper, we propose new methods for extracting and classifying pole-like objects. In our method, we robustly extract a wide variety of poles by converting point-clouds into wireframe models and calculating cross-sections between wireframe models and horizontal cutting planes. For classifying pole-like objects, we subdivide a pole-like object into five subsets by extracting poles and planes, and calculate feature values of each subset. Then we apply a supervised machine learning method using feature variables of subsets. In our experiments, our method could achieve excellent results for detection and classification of pole-like objects.

  17. Blinded histopathological characterisation of POLE exonuclease domain-mutant endometrial cancers: sheep in wolf's clothing. (United States)

    Van Gool, Inge C; Ubachs, Jef E H; Stelloo, Ellen; de Kroon, Cor D; Goeman, Jelle J; Smit, Vincent T H B M; Creutzberg, Carien L; Bosse, Tjalling


    POLE exonuclease domain mutations identify a subset of endometrial cancer (EC) patients with an excellent prognosis. The use of this biomarker has been suggested to refine adjuvant treatment decisions, but the necessary sequencing is not widely performed and is relatively expensive. Therefore, we aimed to identify histopathological and immunohistochemical characteristics to aid in the detection of POLE-mutant ECs. Fifty-one POLE-mutant endometrioid, 67 POLE-wild-type endometrioid and 15 POLE-wild-type serous ECs were included (total N = 133). An expert gynaecopathologist, blinded to molecular features, evaluated each case (two or more slides) for 16 morphological characteristics. Immunohistochemistry was performed for p53, p16, MLH1, MSH2, MSH6, and PMS2. POLE-mutant ECs were characterised by a prominent immune infiltrate: 80% showed peritumoral lymphocytes and 59% showed tumour-infiltrating lymphocytes, as compared with 43% and 28% of POLE-wild-type endometrioid ECs, and 27% and 13% of their serous counterparts (P < 0.01, all comparisons). Of POLE-mutant ECs, 33% contained tumour giant cells; this proportion was significantly higher than that in POLE-wild-type endometrioid ECs (10%; P = 0.003), but not significantly different from that in serous ECs (53%). Serous-like features were as often (focally) present in POLE-mutant as in POLE-wild-type endometrioid ECs (6-24%, depending on the feature). The majority of POLE-mutant ECs showed wild-type p53 (86%), negative/focal p16 (82%) and normal mismatch repair protein expression (90%). A simple combination of morphological and immunohistochemical characteristics (tumour type, grade, peritumoral lymphocytes, MLH1, and p53 expression) can assist in prescreening for POLE exonuclease domain mutations in EC, increasing the probability of a mutation being detected from 7% to 33%. This facilitates the use of this important prognostic biomarker in routine pathology. © 2017 John Wiley & Sons Ltd.

  18. Treatment of three- and four-part proximal humeral fractures with locking proximal humerus plate. (United States)

    Sun, Jing-Cheng; Li, Yu-Lin; Ning, Guang-Zhi; Wu, Qiang; Feng, Shi-Qing


    The purpose of this study was to evaluate the effectiveness and complications of the locking proximal humerus plate to treat proximal humerus fractures. A retrospective clinical trial. Department of Orthopaedics, Tianjin Medical University General Hospital. Sixty-eight consecutive patients with three- or four-part fractures of the proximal humerus were treated with locking proximal humerus plates. The deltopectoral anterolateral acromial approach was used to the proximal humerus; open reduction and locking proximal humerus plate were applied. Constant Score was used to measure the shoulder functional recovery, and Visual Analog Scale (VAS) was used to measure subjective evaluation of pain. The radiology was observed. After average 26.7 months, the average Constant Score was 72.6 ± 13.2 points and the average VAS was 1.2 ± 0.8 points. All the complications such as screw perforation into the glenohumeral joint, screws loosening, soft tissue infections, avascular necrosis and delayed union occurred in eight cases (11.8 %). The effectiveness of the locking proximal humerus plate was similar to other published literatures on treating fractures of the proximal humerus; however, a lower complications rate in short follow-up time was observed in this study. It may potentially provide a favorable option for treating three- or four-part fractures of the proximal humerus. Dealing with each particular fracture pattern, surgeons should have a decision of appropriate way to internal fixation.

  19. Interventions for treating proximal humeral fractures in adults. (United States)

    Handoll, Helen H G; Brorson, Stig


    fracture displacement and non-union (2/52 versus 1/54; 2 trials).One quasi-randomised trial (28 participants) found the Gilchrist-type sling was generally more comfortable than the Desault-type sling (body bandage). One trial (48 participants) testing pulsed electromagnetic high-frequency energy provided no evidence. Two trials (62 participants) provided evidence indicating little difference in outcome between instruction for home exercises versus supervised physiotherapy. One trial (48 participants) reported, without presentable data, that home exercise alone gave better early and comparable long-term results than supervised exercise in a swimming pool plus home exercise.Eight trials, involving 567 older participants, evaluated surgical intervention for displaced fractures. There was high quality evidence of no clinically important difference in patient-reported shoulder and upper-limb function at one- or two-year follow-up between surgical (primarily locking plate fixation or hemiarthroplasty) and non-surgical treatment (sling immobilisation) for the majority of displaced proximal humeral fractures; and moderate quality evidence of no clinically important difference between the two groups in quality of life at two years (and at interim follow-ups at six and 12 months). There was moderate quality evidence of little difference between groups in mortality in the surgery group (17/248 versus 12/248; risk ratio (RR) 1.40 favouring non-surgical treatment, 95% confidence interval (CI) 0.69 to 2.83; P = 0.35; 6 trials); only one death was explicitly linked with the treatment. There was moderate quality evidence of a higher risk of additional surgery in the surgery group (34/262 versus 16/261; RR 2.06, 95% CI 1.18 to 3.60; P = 0.01; 7 trials). Although there was moderate evidence of a higher risk of adverse events after surgery, the 95% confidence intervals for adverse events also included the potential for a greater risk of adverse events after non-surgical treatment

  20. Uncertainty maps for asteroid shape and pole solutions (United States)

    Bartczak, Przemyslaw; Dudzinski, Grzegorz


    SAGE (Shaping Asteroids with Genetic Evolution) inversion method is based on genetic algorithm to obtain pole solutions, rotation periods and non-convex shapes of asteroids (Bartczak, 2014). During the process computer graphics methods are used to compare model's synthetic lightcurves to photometric observations. The method is suitable for modelling both single and binary objects. A modelling run starts with a sphere, with no assumptions about the shape, and subsequently it converges to a stable spin and shape solution. Center of mas and moment of inertia are calculated for each model.Modelling of an asteroid consists of multiple runs of the process, each of them following different path towards a stable solution. As a result we obtain a family of solutions. If enough data is provided, solutions are consistent with each other and can be used for error estimation.We choose only the best models from a family of solutions, meaning every model that fits 5% threshold above best χ2 found. By comparing them we are able to construct a map of uncertainties for the shape, showing areas in good and poor agreement with chosen models. Such map can then be represented with a 3D visualisation. Moreover, we create a map of errors for pole solutions and periods.

  1. FBG strain sensibilized monitor on railway switch pole (United States)

    Li, Weilai; Liu, Jie; Pan, Jianjun; Pang, Jin; Lu, Xiaoshan; Zhou, Ciming


    Fiber Bragg Grating (FBG) sensing technology was used to dynamically monitor multiple parameters of railway switch machine poles, including time of movement, direction and quantity of loading and locking force, and states of loading resistance. Ring shape FBG strain gauge and strain sensibilized methods significantly increased the monitoring sensitivity. Installing approaches adapted the harsh environment in railway application. The monitoring results showed that for a Siemens S700K switch machine, its pole pressured stroke took 5s. Maximum load: -5.9kN, average load: -3.3kN. Vibration caused by resistance exists, its period: 0.1s, range: 0.5kN~1.6kN. After the stroke, the locking force was kept at -0.6kN. In tensile stroke, it also took 5s. Maximum load: 6.8kN, average load: 5.5kN. Vibration period: 0.1s, range: 0.7kN~2kN. Locking force: 0.2 kN. This long-term and on-line detecting method could meet railway switch condition monitoring demands of more than 100,000 switch machines in this country.

  2. Elemental Mercury Diffusion Processes and Concentration at the Lunar Poles (United States)

    Moxley, Frederick; Killen, Rosemary M.; Hurley, Dana M.


    In 2009, the Lyman Alpha Mapping Project (LAMP) spectrograph onboard the Lunar Reconnaissance Orbiter (LRO) spacecraft made the first detection of element mercury (Hg) vapor in the lunar exosphere after the Lunar Crater Observing and Sensing Satellite (LCROSS) Centaur rocket impacted into the Cabeus crater in the southern polar region of the Moon. The lunar regolith core samples from the Apollo missions determined that Hg had a devolatilized pattern with a concentration gradient increasing with depth, in addition to a layered pattern suggesting multiple episodes of burial and volatile loss. Hg migration on the lunar surface resulted in cold trapping at the poles. We have modeled the rate at which indigenous Hg is lost from the regolith through diffusion out of lunar grains. We secondly modeled the migration of Hg vapor in the exosphere and estimated the rate of cold-trapping at the poles using a Monte Carlo technique. The Hg vapor may be lost from the exosphere via ionization, Jeans escape, or re-impact into the surface causing reabsorption.

  3. [Analysis of activity pole restructuring at Oran University Hospital, Algeria]. (United States)

    Chougrani, Saada; Ouhadj, Salah


    The EHUO project of reorganization of medical units into the new activity poles is a complex exercise and a challenge in relation to structural, organizational, and especially cultural barriers. The relationships between the EHUO and the Ministry of Health leave no room for autonomy. Funding continues to be provided through grants. Furthermore, no regulatory and technical support is available to the EHUO actors for development of the local project and even less for restructuring. The authors describe and analyze the planned new organization from limited material available produced by the administration (notes and instructions) and the services projects analysis document prepared by our team. The proposed poles are based on draft projects integrating the various units, with no reformulation in the context of a shared vision or a coherent point of view including the interactions between all parts of the project. Theoretically expected effects, such as autonomy, and management contracts for instance, are not on the agenda. The internal contract does not appear to be at the heart of the debate. Economies of scale and sharing of resources are only vaguely discussed. Important prerequisites are necessary for this ambitious and highly structuring project. The EHUO actors must strive to reach an agreement on a common vision and values to be protected together as part of a collectively designed project to ensure good governance.

  4. Present status of the South Pole acoustic test setup (SPATS)

    Energy Technology Data Exchange (ETDEWEB)

    Tosi, D.; Boeser, S.; Fischer, J.H.; Heller, R.; Krieger, K.; Nahnhauer, R.; Pohl, M.; Sulanke, K.H. [DESY, Zeuthen (Germany); Bohm, C.; Hundertmark, S. [Stockholm Univ. (Sweden); Descamps, F. [DESY, Zeuthen (Germany); Ghent Univ. (Belgium); Hallgren, A. [Uppsala Univ. (Sweden); Price, B.; Vandenbroucke, J. [Univ. of California, Berkeley, CA (United States)


    Acoustic detection in ice is a promising method to investigate the low flux of ultra high energy neutrinos (E>10{sup 18} eV). Due to the long predicted attenuation length of acoustic waves generated by neutrino-induced cascades, a volume of several km{sup 3}, as available in the polar ice cap, may be equipped with sparse sensors. In order to study in-situ the absorption, the refraction of sound and the background noise, the South Pole Acoustic Test Setup (SPATS), consisting of 21 pairs of sensors and transmitters organized in 3 strings, has been developed. Low temperature tests simulating the harsh South Pole environment and long range tests in an ice-covered lake have been undertaken. The results obtained demonstrate the robustness of the setup and allow a first estimate of the expected performance. A simulation showing the capability of the system concerning refraction and absorptivity of the ice is presented, together with the first results of the installed setup, which is planned to be deployed in the austral summer season 2006-2007. (orig.)

  5. Albedo of Permanently Shadowed Regions of the Lunar Poles (United States)

    Riner, M. A.; Lucey, P. G.; Bussey, B.; Cahill, J. T.; McGovern, A.


    Due to the slight tilt in the Moon's spin axis, some topographic depressions near the lunar poles experience permanent shadow and may serve as cold traps, harboring water ice and/or other volatile compounds [1]. Permanently shadowed regions (PSRs) provide an opportunity toward understanding the amount, nature and transport of volatiles on the Moon and may also be a potential resource for human exploration. While many different data sets have suggested the presence of water ice in PSRs near the lunar poles many questions remain. For example, ice does not appear to be uniformly distributed across identified PSRs. More work is needed to understand the distribution of ice in PSRs and how delivery and retention mechanisms influence the distribution. The active illumination of the Lunar Orbiter Laser Altimeter (LOLA) provides a unique contribution toward exploration PSR exploration. While LOLA is principally a laser altimeter used for quantitative topography and related cartographic and geodetic applications [2], LOLA also measures the intensity and width of the return laser pulse (1064 nm) from the surface. Here we use a global mosaic (4 pixels per degree) of LOLA albedo data corrected for instrumental drift, irregular variations, and calibrated to normal albedo using local equatorial measurements of normal albedo obtained by the Kaguya Multiband Imager [3]. Recent work using LOLA albedo shows the floor of Shackleton crater, near the lunar south pole, is brighter than the surrounding terrain (and the interior of nearby craters) at 1064 nm [4]. This albedo difference may be due to decreased space weathering due to shadowing from the Sun or to a 1 μm thick layer with 20% water ice a the surface of the crater floor [4]. Here we use LOLA dayside reflectance measurements to examine the albedo of PSRs catalogued by [5] derived from illumination modeling of a hybrid 100 m/pixel LOLA-LROC digital terrain model (DTM) up to 83° north and south latitudes. The upper latitude

  6. The effect of poling conditions on the performance of piezoelectric energy harvesters fabricated by wet chemistry

    KAUST Repository

    Fuentes-Fernandez, Erika Maria-Anai


    The effect of poling conditions on the power output of piezoelectric energy harvesters using sol-gel based Pb(Zr0.53,Ti0.47)O3-Pb(Zn1/3,Nb2/3)O3 piezoelectric thin-films has been investigated. A strong correlation was established between the poling efficiency and harvester output. A method based on simple capacitance-voltage measurements is shown to be an effective approach to estimate the power output of harvesters poled under different conditions. The poling process was found to be thermally activated with an activation energy of 0.12 eV, and the optimum poling conditions were identified (200 kV cm-1, 250 °C for 50 min). The voltage output and power density obtained under optimum poling conditions were measured to be 558 V cm-2 and 325 μW cm-2, respectively. © The Royal Society of Chemistry.2015.

  7. Iron Pole Shape Optimization of IPM Motors Using an Integrated Method

    Directory of Open Access Journals (Sweden)



    Full Text Available An iron pole shape optimization method to reduce cogging torque in Interior Permanent Magnet (IPM motors is developed by using the reduced basis technique coupled by finite element and design of experiments methods. Objective function is defined as the minimum cogging torque. The experimental design of Taguchi method is used to build the approximation model and to perform optimization. This method is demonstrated on the rotor pole shape optimization of a 4-poles/24-slots IPM motor.

  8. Development and validation of system for measuring poling forces during Nordic walking

    Directory of Open Access Journals (Sweden)

    Jakub Krejčí


    Full Text Available BACKGROUND: Recently, the popularity of Nordic walking (NW has been rising steadily. Many scientific studies researched the promising and beneficial effects of this form of physical activity. However, only a few studies provided data about the forces acting on the poles. We did not find a commercially available system that enables the measurement of the poling forces. OBJECTIVE: The objective of this paper was to develop and validate a system for measuring the poling forces during NW. METHODS: Strain gauge force tranducers were mounted below the grips of standard NW poles. The transducer signals were amplified and converted to digital form for transmitting to a personal computer. Special software was developed for processing the measured data and the calculation method of output variables was described. Validation of the system was performed using a Kistler force plate. Poling cycles with peak force of about 150 N were imitated by pressing the pole over a force plate. RESULTS: A function sample of the measurement system was constructed. Validation yielded the mean absolute error of 1.1 N in case of poling cycles without pole impacts or 3.0 N in case of poling cycles with impacts. CONCLUSIONS: The validation result of our system is comparable to the results of similar systems used for measurements during cross-country skiing. The system enables independent measurement of the poling forces on both poles and the duration of measurement can be up to one hour. The system provides a tool that can be used to answer a number of questions that researches raise about NW. Understanding of the biomechanical and physiological aspects of poling action can constitute a scientific basis for promoting, teaching and training of NW.

  9. Next-to-leading order contributions to the pole mass of gluino in minimal gauge mediation


    Lee, Jae Yong; Yoon, Yeo Woong


    We compute the pole mass of the gluino in the minimal gauge mediation to two-loop order. The pole mass of the gluino begins to arise at one-loop order and the two-loop order correction shifts the leading order pole mass by 20% or even more. This shift is much larger than the expected accuracy of the mass determination at the LHC, and should be reckoned with for precision studies on the SUSY breaking parameters.

  10. Lower Pole Calyceal Stone and Lithotripsy are Issues with Clearance Fact or Reality?

    Directory of Open Access Journals (Sweden)

    M. Hammad Ather


    Full Text Available The lower pole calyceal (LPC stone continues to be an enigma. The complex anatomy of the lower pole collecting system, along with other factors like acute pelvi calyceal angle and narrow and long infundibulum, are some of the complicating factors affecting stone clearance. There have been many studies assessing the impact of collecting system anatomy and most conclude that the complex anatomy of the lower pole collecting system does impact the overall stone-free rate.

  11. Locking plate fixation for proximal humerus fractures.

    LENUS (Irish Health Repository)

    Burke, Neil G


    Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.

  12. Experimental study of flow around a pole standing in a scour

    Directory of Open Access Journals (Sweden)

    Tsutsui Takayuki


    Full Text Available The characteristics of fluid flow and fluid force of the pole standing in scour were investigated with several different scour depths conditions by using a wind tunnel. The scour was modeled into a mortar, with an inverted circular cone. The diameter of the pole was 40 mm and the scour depth was changed from H / D (= depth / diameter of the pole 0.25 to 1.75. The free stream velocity was 16 m / s, making the Reynolds number 4.2 × 104. Flow visualization was carried out using a surface oil-film method and smoke-wire method. The surface pressure distributions on the pole and the scour were measured and the drag coefficient acting on the pole was determined by integrating the surface pressure distribution on the pole. The characteristics of the flow around the pole and the drag acting on the pole standing on the scour were clarified. The results show that as the scour depth become deep, the flow around the pole is extremely characteristic and the drag coefficient has a maximum value at Z / D = 0.25 and a minimum value at about the midpoint between the ground level and the bottom of the scour.

  13. Desigualdades urbanas e desigualdades sociais nas metrópoles brasileiras


    Marcelo Gomes Ribeiro


    Resumo Este trabalho objetiva analisar as desigualdades urbanas das principais metrópoles do país por meio do Índice de Bem-Estar Urbano (IBEU), elaborado pelo Observatório das Metrópoles. Como a análise do IBEU revela desigualdades de bem-estar urbano no interior das metrópoles, procura-se relacionar essas desigualdades urbanas com o perfil socioeconômico das pessoas que compõem as diferentes áreas das metrópoles. É observado nítida correspondência entre as desigualdades urbanas e as desigua...

  14. Time domain oscillating poles: Stability redefined in Memristor based Wien-oscillators

    KAUST Repository

    Talukdar, Abdul Hafiz Ibne


    Traditionally, the necessary and sufficient condition for any system to be oscillating is that its poles are located on the imaginary (jω) axis. In this paper, for the first time, we have shown that systems can oscillate with time-domain oscillating poles. The idea is verified using a Memristor based Wien oscillator. Sustained oscillations are observed without having the poles of the system fixed on the imaginary axis and the oscillating behavior of the system poles is reported. The oscillating resistance and triangular shape of FFT are also demonstrated with mathematical reasoning and simulation results to support the unusual and surprising characteristics. © 2009 IEEE.

  15. Industrial Computed Tomography using Proximal Algorithm

    KAUST Repository

    Zang, Guangming


    In this thesis, we present ProxiSART, a flexible proximal framework for robust 3D cone beam tomographic reconstruction based on the Simultaneous Algebraic Reconstruction Technique (SART). We derive the proximal operator for the SART algorithm and use it for minimizing the data term in a proximal algorithm. We show the flexibility of the framework by plugging in different powerful regularizers, and show its robustness in achieving better reconstruction results in the presence of noise and using fewer projections. We compare our framework to state-of-the-art methods and existing popular software tomography reconstruction packages, on both synthetic and real datasets, and show superior reconstruction quality, especially from noisy data and a small number of projections.

  16. Correlation between social proximity and mobility similarity. (United States)

    Fan, Chao; Liu, Yiding; Huang, Junming; Rong, Zhihai; Zhou, Tao


    Human behaviors exhibit ubiquitous correlations in many aspects, such as individual and collective levels, temporal and spatial dimensions, content, social and geographical layers. With rich Internet data of online behaviors becoming available, it attracts academic interests to explore human mobility similarity from the perspective of social network proximity. Existent analysis shows a strong correlation between online social proximity and offline mobility similarity, namely, mobile records between friends are significantly more similar than between strangers, and those between friends with common neighbors are even more similar. We argue the importance of the number and diversity of common friends, with a counter intuitive finding that the number of common friends has no positive impact on mobility similarity while the diversity plays a key role, disagreeing with previous studies. Our analysis provides a novel view for better understanding the coupling between human online and offline behaviors, and will help model and predict human behaviors based on social proximity.

  17. [Disorders of sex development and proximal hypospadias]. (United States)

    Oswald, J


    Children with ambiguous genitalia due to different chromosome or gonadal sex are a particular challenge concerning the diagnostic and therapeutic implications. Proximal hypospadias patients with normal gonadal development should be distinguished from children with DSD (disorders of sex development) to guarantee normal gender identity and the best possible surgical therapy. This paper focuses on the terminology, embryology, and pathophysiology of the different manifestations of DSD. The state of knowledge about this disease pattern with particular emphasis on proximal hypospadias based on national and international scientific discussions is presented. The different clinical pictures as well as therapeutic options of DSD with a special focus on recent literature and giving particular attention to patients with proximal hypospadias are presented. Because of the complexity of patients suffering from disorders of sex development an interdisciplinary DSD healthcare team including a paediatric endocrinologist as well as paediatric urologist should be provided. These specialists enable an accurate diagnosis in severe hypospadias patients without reference to DSD diseases patterns.

  18. Infiltrating/sealing proximal caries lesions

    DEFF Research Database (Denmark)

    Martignon, S; Ekstrand, K R; Gomez, J


    This randomized split-mouth controlled clinical trial aimed at assessing the therapeutic effects of infiltration vs. sealing for controlling caries progression on proximal surfaces. Out of 90 adult students/patients assessed at university clinics and agreeing to participate, 39, each with 3...... differences in lesion progression between infiltration and placebo (P = 0.0012) and between sealing and placebo (P = 0.0269). The study showed that infiltration and sealing are significantly better than placebo treatment for controlling caries progression on proximal lesions. No significant difference...... proximal lesions identified radiographically around the enamel-dentin junction to the outer third of the dentin, were included. Lesions were randomly allocated for treatment to test-A (Infiltration: ICON-pre-product; DMG), test-B (Sealing: Prime-Bond-NT; Dentsply), or control-C (Placebo). Primary outcome...

  19. A systematic review of the clinical applications and complications of bone marrow aspirate concentrate in management of bone defects and nonunions. (United States)

    Imam, Mohamed A; Holton, James; Ernstbrunner, Lukas; Pepke, Wojciech; Grubhofer, Florian; Narvani, Ali; Snow, Martyn


    Fracture healing encompasses a succession of dynamic multifactorial metabolic events, which ultimately re-establishes the integrity of the biomechanical properties of the bone. Up to 10% of the fractures occurring annually will need additional surgical procedures because of impaired healing. The aim of this article is to review the current literature regarding the use of bone marrow aspirate concentrate (BMAC) and its effectiveness in the management of bone defects. We have included all published clinical literature investigating the development, techniques and applications of BMAC. Language, design and risk of bias did not deter the initial inclusion of any study. Our search was exclusively limited to studies involving human subjects. A PRISMA compliant search was carried out as published in 2009. This included the online databases: PubMed, EMBASE, clinical and the Cochrane library from 1960 to the end of May 2015. MeSH terms used included: "Bone" AND "Marrow" AND "Aspirate" AND "Concentrate" AND "Bone Defects" AND "NONUNION". Eligible studies were independently appraised by two authors using the Critical Appraisal Skills Program checklist. For the purpose of narrative review, relevant studies were included irrespective of methodology or level of evidence. Thirty-four of the 103 (48 PubMed and 55 EMBASE) results yielded by the preliminary search were included. Exclusions included three duplicate records, six letters, 17 non-orthopaedics related studies and four records irrelevant to our search topic. The CASP appraisal confirmed a satisfactory standard of 31 studies. They all had clearly defined objectives, were well designed and conducted appropriately to meet them. The published studies reported the use of BMAC in non-union and fracture healing (15 studies), bone defects (nine studies), spine fusion (two studies), distraction osteogensis (two studies) and complications related to the use of BMAC (seven studies). Stem cells found in BMAC have the

  20. Knowledge networks in the Dutch aviation industry: The proximity paradox

    NARCIS (Netherlands)

    Broekel, T.; Boschma, R.A.


    The importance of geographical proximity for interaction and knowledge sharing has been discussed extensively in recent years. There is increasing consensus that geographical proximity is just one out of many types of proximities that might be relevant. We argue that proximity may be a crucial

  1. The developmental spectrum of proximal radioulnar synostosis

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, Alison M. [University of Manitoba, Winnipeg Regional Health Association Program of Genetics and Metabolism, Winnipeg, MB (Canada); University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, WRHA Program of Genetics and Metabolism, Departments of Paediatrics and Child Health, Biochemistry and Medical Genetics, Winnipeg, MB (Canada); Kibria, Lisa [University of Manitoba, Department of School of Medical Rehabilitation, Winnipeg, MB (Canada); Reed, Martin H. [University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, Department of Diagnostic Imaging, Winnipeg, MB (Canada)


    Proximal radioulnar synostosis is a rare upper limb malformation. The elbow is first identifiable at 35 days (after conception), at which stage the cartilaginous anlagen of the humerus, radius and ulna are continuous. Subsequently, longitudinal segmentation produces separation of the distal radius and ulna. However, temporarily, the proximal ends are united and continue to share a common perichondrium. We investigated the hypothesis that posterior congenital dislocation of the radial head and proximal radioulnar fusion are different clinical manifestations of the same primary developmental abnormality. Records were searched for ''proximal radioulnar fusion/posterior radial head dislocation'' in patients followed at the local Children's Hospital and Rehabilitation Centre for Children. Relevant radiographic, demographic and clinical data were recorded. Ethics approval was obtained through the University Research Ethics Board. In total, 28 patients met the inclusion criteria. The majority of patients (16) had bilateral involvement; eight with posterior dislocation of the radial head only; five had posterior radial head dislocation with radioulnar fusion and two had radioulnar fusion without dislocation. One patient had bilateral proximal radioulnar fusion and posterior dislocation of the left radial head. Nine patients had only left-sided involvement, and three had only right-sided involvement.The degree of proximal fusion varied, with some patients showing 'complete' proximal fusion and others showing fusion that occurred slightly distal to the radial head: 'partially separated.' Associated disorders in our cohort included Poland syndrome (two patients), Cornelia de Lange syndrome, chromosome anomalies (including tetrasomy X) and Cenani Lenz syndactyly. The suggestion of a developmental relationship between posterior dislocation of the radial head and proximal radioulnar fusion is supported by the fact that both anomalies

  2. Microtubules search for chromosomes by pivoting around the spindle pole (United States)

    Tolic-Norrelykke, Iva


    During cell division, proper segregation of genetic material between the two daughter cells requires that the spindle microtubules attach to the chromosomes via kinetochores, protein complexes on the chromosome. The central question, how microtubules find kinetochores, is still under debate. We observed in fission yeast that kinetochores are captured by microtubules pivoting around the spindle pole body, instead of growing towards the kinetochores. By introducing a theoretical model, we show that the observed angular movement of microtubules is sufficient to explain the process of kinetochore capture. Our theory predicts that the speed of the capture process depends mainly on how fast microtubules pivot. We confirmed this prediction experimentally by speeding up and slowing down microtubule pivoting. Thus, microtubules explore space by pivoting, as they search for intracellular targets such as kinetochores.

  3. Roadside tree/pole crash barrier field test (United States)

    Wilson, A. H.


    A series of tests was carried out to evaluate the performance of a crash barrier designed to protect the occupants of an automobile from serious injury. The JPL barrier design is a configuration of empty aluminum beverage cans contained in a tear-resistant bag which, in turn, is encased in a collapsible container made of plywood and steel. Tests were conducted with a driven vehicle impacting the barrier. The basic requirements of NCHRP Report 153 were followed except that speeds of 30 mph rather than 60 mph were used. Accelerometer readings on the driver's helmet showed that the driver was never subjected to dangerous decelerations, and never experienced more than temporary discomfort. Also, all of the requirements of the cited report were met. An extrapolation of data indicated that the JPL barrier installed in front of a tree or telephone pole along a roadside would also have met the requirements at a speed of 40 mph.

  4. Lunar South Pole space water extraction and trucking system

    Energy Technology Data Exchange (ETDEWEB)

    Zuppero, A. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States). Idaho National Engineering and Environmental Lab.]|[Univ. of Idaho, Moscow, ID (United States); Zupp, G. [National Aeronautics and Space Administration, Houston, TX (United States). Johnson Space Center; Schnitzler, B.; Larson, T.K.; Rice, J.W. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States). Idaho National Engineering and Environmental Lab.


    This concept proposes to use thermal processes alone to extract water from the lunar South Pole and launch payloads to low lunar orbit. Thermal steam rockets would use water propellant for space transportation. The estimated mass of a space water tanker powered by a nuclear heated steam rocket suggests it can be designed for launch in the Space Shuttle bay. The performance depends on the feasibility of a nuclear reactor rocket engine producing steam at 1,100 degrees Kelvin, with a power density of 150 Megawatts per ton of rocket, and operating for thousands of 20 minute cycles. An example uses reject heat from a small nuclear electric power supply to melt 17,800 tons per year of lunar ice. A nuclear heated steam rocket would use the propellant water to launch and deliver 3,800 tons of water per year to a 100 km low lunar orbit.

  5. Cassini observes the active south pole of Enceladus. (United States)

    Porco, C C; Helfenstein, P; Thomas, P C; Ingersoll, A P; Wisdom, J; West, R; Neukum, G; Denk, T; Wagner, R; Roatsch, T; Kieffer, S; Turtle, E; McEwen, A; Johnson, T V; Rathbun, J; Veverka, J; Wilson, D; Perry, J; Spitale, J; Brahic, A; Burns, J A; Delgenio, A D; Dones, L; Murray, C D; Squyres, S


    Cassini has identified a geologically active province at the south pole of Saturn's moon Enceladus. In images acquired by the Imaging Science Subsystem (ISS), this region is circumscribed by a chain of folded ridges and troughs at approximately 55 degrees S latitude. The terrain southward of this boundary is distinguished by its albedo and color contrasts, elevated temperatures, extreme geologic youth, and narrow tectonic rifts that exhibit coarse-grained ice and coincide with the hottest temperatures measured in the region. Jets of fine icy particles that supply Saturn's E ring emanate from this province, carried aloft by water vapor probably venting from subsurface reservoirs of liquid water. The shape of Enceladus suggests a possible intense heating epoch in the past by capture into a 1:4 secondary spin/orbit resonance.

  6. Neoproterozoic paleomagnetic poles in the Taoudeni basin (West Africa) (United States)

    Boudzoumou, Florent; Vandamme, Didier; Affaton, Pascal; Gattacceca, Jérôme


    A palaeomagnetic study was carried out on Neoproterozoic samples from seven sites of the sub-basins of Gourma and Bobo Dioulasso, which include a Marinoan glaciogenic deposit. Magnetic mineralogy is represented essentially by magnetite and hematite. The mean directions of the sites are calculated on the high temperature component (500-670 °C). Two locations provide data constrained by statistical reversal and fold tests and determining Neoproterozoic virtual geomagnetic poles. The palaeolatitudes display very low values which place the West-African craton in the sub-equatorial position during the Marinoan glaciation. This result enhances the Snowball Earth hypothesis, which places most of the continental landmasses, and notably Africa, at low latitudes during the Neoproterozoic.

  7. The South Pole Acoustic Test Setup: calibrations and lake test

    Energy Technology Data Exchange (ETDEWEB)

    Boeser, S [DESY, Platanenallee 6, D-15738 Zeuthen (Germany); Bohm, C [University Stockholm, Fysikum, SE-106 91 Stockholm (Sweden); Descamps, F [DESY, Platanenallee 6, D-15738 Zeuthen (Germany); Fischer, J [DESY, Platanenallee 6, D-15738 Zeuthen (Germany); Hallgren, A [University Uppsala, Department of Radiation Sciences, Box 535, SE-751 21 Uppsala (Sweden); Heller, R [DESY, Platanenallee 6, D-15738 Zeuthen (Germany); Hundertmark, S [University Stockholm, Fysikum, SE-106 91 Stockholm (Sweden); Krieger, K [DESY, Platanenallee 6, D-15738 Zeuthen (Germany); Nahnhauer, R [DESY, Platanenallee 6, D-15738 Zeuthen (Germany); Pohl, M [DESY, Platanenallee 6, D-15738 Zeuthen (Germany); Price, P B [Department of Physics, University of California, Berkeley, CA 94720 (United States); Sulanke, K [DESY, Platanenallee 6, D-15738 Zeuthen (Germany); Vandenbroucke, J [Department of Physics, University of California, Berkeley, CA 94720 (United States)


    In order to detect the small neutrino fluxes expected at ultra-high energies, large volumes of materials have to be instrumented with inexpensive but sensitive acoustic sensors. The South Pole Acoustic Test Setup (SPATS) will be installed in the Antarctic ice during the polar season 2006/2007 after which the collected data will be used to reveal the acoustic properties of the South Polar ice cap. The developed piezoceramic based ultrasound sensors and transmitters that are part of this system have been extensively studied during calibration measurements in water, using a commercial hydrophone as reference. Also, a SPATS system test was accomplished in Lake Tornetraesk, Abisko (Sweden). This allowed verification of the DAQ system, transmitter range and sensor performance. Here the results of the calibrations and the Abisko lake measurements are reported.

  8. The South Pole Acoustic Test Setup: calibrations and lake test (United States)

    Böser, S.; Bohm, C.; Descamps, F.; Fischer, J.; Hallgren, A.; Heller, R.; Hundertmark, S.; Krieger, K.; Nahnhauer, R.; Pohl, M.; Price, P. B.; Sulanke, K.; Vandenbroucke, J.


    In order to detect the small neutrino fluxes expected at ultra-high energies, large volumes of materials have to be instrumented with inexpensive but sensitive acoustic sensors. The South Pole Acoustic Test Setup (SPATS) will be installed in the Antarctic ice during the polar season 2006/2007 after which the collected data will be used to reveal the acoustic properties of the South Polar ice cap. The developed piezoceramic based ultrasound sensors and transmitters that are part of this system have been extensively studied during calibration measurements in water, using a commercial hydrophone as reference. Also, a SPATS system test was accomplished in Lake Torneträsk, Abisko (Sweden). This allowed verification of the DAQ system, transmitter range and sensor performance. Here the results of the calibrations and the Abisko lake measurements are reported.

  9. Dynamical origin and the pole structure of X(3872). (United States)

    Danilkin, I V; Simonov, Yu A


    The dynamical mechanism of channel coupling with the decay channels is applied to the case of coupled charmonium--DD* states with JPC=1++. A pole analysis is done and the DD* production cross section is calculated in qualitative agreement with experiment. The sharp peak at the D0D0* threshold and flat background are shown to be due to Breit-Wigner resonance, shifted by channel coupling from the original position of 3954 MeV for the 23P1, QQ state. A similar analysis, applied to the n=2, 3P2, 1P1, 3P0, allows us to associate the first one with the observed Z(3930) J=2 and explains the destiny of 3P0.

  10. Determination of regional Euler pole parameters for Eastern Austria (United States)

    Umnig, Elke; Weber, Robert; Schartner, Matthias; Brueckl, Ewald


    The horizontal motion of lithospheric plates can be described as rotations around a rotation axes through the Earth's center. The two possible points where this axes intersects the surface of the Earth are called Euler poles. The rotation is expressed by the Euler parameters in terms of angular velocities together with the latitude and longitude of the Euler pole. Euler parameters were calculated from GPS data for a study area in Eastern Austria. The observation network is located along the Mur-Mürz Valley and the Vienna Basin. This zone is part of the Vienna Transfer Fault, which is the major fault system between the Eastern Alps and the Carpathians. The project ALPAACT (seismological and geodetic monitoring of ALpine-PAnnonian ACtive Tectonics) investigated intra plate tectonic movements within the Austrian part in order to estimate the seismic hazard. Precise site coordinate time series established from processing 5 years of GPS observations are available for the regional network spanning the years from 2010.0 to 2015.0. Station velocities with respect to the global reference frame ITRF2008 have been computed for 23 sites. The common Euler vector was estimated on base of a subset of reliable site velocities, for stations directly located within the area of interest. In a further step a geokinematic interpretation shall be carried out. Therefore site motions with respect to the Eurasian Plate are requested. To obtain this motion field different variants are conceivable. In a simple approach the mean ITRF2008 velocity of IGS site GRAZ can be adopted as Eurasian rotational velocity. An improved alternative is to calculate site-specific velocity differences between the Euler rotation and the individual site velocities. In this poster presentation the Euler parameters, the residual motion field as well as first geokinematic interpretation results are presented.

  11. Estimation of the Gravimetric Pole Tide Using GGP Superconducting Gravimeters (United States)

    Ziegler, Y.; Hinderer, J.; Rogister, Y. J.; Rosat, S.


    The movement of the Earth rotation axis induces a perturbation of the surface gravity field through (1) the variation of the centrifugal force along with (2) surface deformation and mass redistribution. This effect of the polar motion can be recovered from the gravimetric data and we usually estimate the amplitude Aobserved and the phase φobserved of the perturbation. Those values are compared to theoretical estimates Atheoretical and φtheoretical based on astronomically-determined time series of the pole position. In this work, we use superconducting gravimeter (SG) data from the Global Geodynamics Project (GGP) and Earth orientation parameters provided by the International Earth Rotation and Reference Systems Service (IERS). First, we compute the gravimetric factor δ = Aobserved/Atheoretical and phase lag κ = φobserved - φtheoretical at the Chandler period, which is approximately 14 months, using Strasbourg gravimetric data that span more than 15 years. We discuss the influence of the processing (filtering, drift and offsets removal), the importance of the corrections (atmospheric and hydrological loading, ocean pole tide) and the convergence with time of the computed values. Second, we extend the method to process jointly the gravity data from a set of SG stations and estimate a global gravimetric factor. We apply a spatial data weighting taking into account the latitude and longitude dependency, which is a degree-2, order-1, surface spherical harmonics, of the gravity perturbation related to polar motion. Third, we stack the resulting signal to improve the signal-to-noise ratio. The stacking method enables us to get rid of local effects that considerably affect the individual estimates of the gravimetric factor at the Chandler period. This method will provide a set of optimal amplitude factor and phase lag that we will compare to the results obtained for each station.

  12. The Potential Characteristics Of Adsorbed Water At The Lunar Poles (United States)

    Hibbitts, Charles A.; Dyar, D.; Orlando, T.


    Hydrogen can be trapped in the surface of the moon through a variety of processes and from many different origins. Solar wind particles may explain a portion of the elevated hydrogen abundance at the lunar poles, and could react with the regolith to form water ions (OH-) (Starukhina and Shkuratov, 2000). A few layers of molecular water, such as from cometary impacts, could be thermodynamically stable at the poles (e.g. Cocks et al., 2002) although Eschelman and Parks (1999) predict that initially molecular water would be sufficiently mobile in the sunlit regions to eventually chemically bond to the regolith grains. Previous laboratory experiments support this premise, demonstrating that monolayer water forms OH- with Temperature-Programmed Desorption (TPD) analyses showing a monolayer (of OH-) on TiO2 is stable below 295K, two layers are stable below 195K, and more layers form water ice (Lane et al., 2009). Water ice can exist on the Moon, but only in the cold portions of permanently-shadowed craters (Watson et al.,1961, Vasavada et al., 1999). Even here, though, the water may exist as individually adsorbed molecules unable to migrate to form ice grains because the molecules are immobilized by the cold temperatures and electrostatic bonding to the regolith grains (Hibbitts et al., 2009). The spectral characteristics and observable strengths of the 3-micron fundamental (strongest) absorption feature are specific to these forms of `water’ and one or two layers on lunar regolith grains should have a detectable 3-micron feature given the regolith's effective surface area of 1m2/g (Cadenhead, 1972). The absorption band in water-ice is narrow positioned 3.1 microns, water is broad 2.9 microns, and the band associated with adsorbed water varies with physical state and temperature from 2.8 microns to 3 microns. This work is funded by the NASA LASER progam.

  13. Ecliptic-poles Stellar Survey (EclipSS) (United States)

    Ayres, Thomas


    BACKGROUND: Now and in coming years, a number of orbiting observatories will be scanning the skies for astrometry (Gaia), transiting exoplanets (TESS), and high-energy sources (eROSITA). A key characteristic of these surveys is their high degree of exposure in the ecliptic polar regions, north and south; a natural consequence of their preferred scanning orientation. Further, JWST, although not a scanning instrument, also holds the ecliptic poles in special regard because they are accessible at all times (continuous viewing zones), a key advantage for exo-planet studies.THIS PROPOSAL: Record FUV spectra, with COS G130M, of a well-defined sample of sunlike dwarfs (F2V-K2V) at the ecliptic poles to take advantage of the enhanced, wholistic information concerning rotation periods, sizes, masses, metallicities, ages, activity levels, and coronal properties that will be available for bright e-polar stars over the next few years. There is a sweet spot at about 8th magnitude where sunlike stars are not too bright for TESS, bright enough for eROSITA, and just right for COS. The G130M channel captures a wide range of ionization states, especially of Si, N, O, and C; the hydrogen Lyman-alpha emission; and also coronal forbidden transitions of Fe XII (124 nm) and Fe XXI (135 nm); altogether reflecting gas temperatures from 10,000 K to 10 MK in the magnetically disturbed stellar outer atmospheres. The combined photometric (starspots), asteroseismic, FUV, and X-ray measurements will inform community-wide efforts to explore stellar activity and its underlying magnetic machine, the Dynamo. This is a unique opportunity, and one - like a solar eclipse - too good to pass up.

  14. Effect of materials and manufacturing on the bending stiffness of vaulting poles (United States)

    Davis, C. L.; Kukureka, S. N.


    The increase in the world record height achieved in pole vaulting can be related to the improved ability of the athletes, in terms of their fitness and technique, and to the change in materials used to construct the pole. For example in 1960 there was a change in vaulting pole construction from bamboo to glass fibre reinforced polymer (GFRP) composites. The lighter GFRP pole enabled the athletes to have a faster run-up, resulting in a greater take-off speed, giving them more kinetic energy to convert into potential energy and hence height. GFRP poles also have a much higher failure stress than bamboo, so the poles were engineered to bend under the load of the athlete, thereby storing elastic strain energy that can be released as the pole straightens, resulting in greater energy efficiency. The bending also allowed athletes to change their vaulting technique from a style that involved the body remaining almost upright during the vault to one where the athlete goes over the bar with their feet upwards. Modern vaulting poles can be made from GFRP and/or carbon fibre reinforced polymer (CFRP) composites. The addition of carbon fibres maintains the mechanical properties of the pole, but allows a reduction in the weight. The number and arrangement of the fibres determines the mechanical properties, in particular the bending stiffness. Vaulting poles are also designed for an individual athlete to take into account each athlete’s ability and physical characteristics. The poles are rated by ‘weight’ to allow athletes to select an appropriate pole for their ability. This paper will review the development of vaulting poles and the requirements to maximize performance. The properties (bending stiffness and pre-bend) and microstructure (fibre volume fraction and lay-up) of typical vaulting poles will be discussed. Originally published as Davis C L and Kukureka S N (2004) Effect of materials and manufacturing on the bending stiffness of vaulting poles The Engineering of

  15. Inspection of Pole-Like Structures Using a Visual-Inertial Aided VTOL Platform with Shared Autonomy

    Directory of Open Access Journals (Sweden)

    Inkyu Sa


    Full Text Available This paper presents an algorithm and a system for vertical infrastructure inspection using a vertical take-off and landing (VTOL unmanned aerial vehicle and shared autonomy. Inspecting vertical structures such as light and power distribution poles is a difficult task that is time-consuming, dangerous and expensive. Recently, micro VTOL platforms (i.e., quad-, hexa- and octa-rotors have been rapidly gaining interest in research, military and even public domains. The unmanned, low-cost and VTOL properties of these platforms make them ideal for situations where inspection would otherwise be time-consuming and/or hazardous to humans. There are, however, challenges involved with developing such an inspection system, for example flying in close proximity to a target while maintaining a fixed stand-off distance from it, being immune to wind gusts and exchanging useful information with the remote user. To overcome these challenges, we require accurate and high-update rate state estimation and high performance controllers to be implemented onboard the vehicle. Ease of control and a live video feed are required for the human operator. We demonstrate a VTOL platform that can operate at close-quarters, whilst maintaining a safe stand-off distance and rejecting environmental disturbances. Two approaches are presented: Position-Based Visual Servoing (PBVS using an Extended Kalman Filter (EKF and estimator-free Image-Based Visual Servoing (IBVS. Both use monocular visual, inertia, and sonar data, allowing the approaches to be applied for indoor or GPS-impaired environments. We extensively compare the performances of PBVS and IBVS in terms of accuracy, robustness and computational costs. Results from simulations Sensors 2015, 15 22004 and indoor/outdoor (day and night flight experiments demonstrate the system is able to successfully inspect and circumnavigate a vertical pole.

  16. preliminary phytochemical screening, proximate and elemental

    African Journals Online (AJOL)


    ABSTRACT. The seed powder of Moringa oleifera was analysed for its phytochemical, proximate and elemental composition using Folin-Denis spectrophotometric method, gravimetric method and energy dispersing X-ray fluorescence (EDXRF) transmission emission technique respectively. The seed powder had the ...

  17. Proximate, mineral composition, antioxidant activity, and total ...

    African Journals Online (AJOL)

    Four varieties of the red pepper fruits (Capsicum species) were evaluated for chemical composition, antioxidant activity and total phenolic contents using standard analytical technique, ferric-ion reducing antioxidant potential (FRAP) assay and Folin-Colcalteau method respectively. The proximate composition values ...

  18. 9__43 - 50__Tijjani_Proximate

    African Journals Online (AJOL)


    Sena et al., 1998). In Nigeria, the plant is commonly consumed by the Hausa speaking communities as a spice and a sauce (Ibrahim et al., 2012). However, during preparation the leaves and stem are not carefully separated before processing of food. Thus, the present study was aimed at evaluating the proximate, minerals ...

  19. Phytochemistry and proximate composition of ginger ( Zingiber ...

    African Journals Online (AJOL)

    ... a little crude fibre content of 0.92 %. The results indicated that ginger rhizome is an excellent natural remedy for a wide range of ailments. Keywords: Zingiber officinale, spice, rhizome, phytochemistry, proximate analysis, Zingiberaceae, zingerone, methanolic extraction. Journal of Pharmaceutical and Allied Sciences, Vol.


    African Journals Online (AJOL)



    Oct 24, 2012 ... opinions are analyzed and it revealed that the site has major impacts on the residents perceived quality of life, security and ... Key words: Landfill, Property value, Health and safety, Residential property, Solous. Introduction. The location ... Proximity to landfills and hazardous waste sites can severely affect ...

  1. Renal fibrosis: Primacy of the proximal tubule. (United States)

    Gewin, Leslie S


    Tubulointerstitial fibrosis (TIF) is the hallmark of chronic kidney disease and best predictor of renal survival. Many different cell types contribute to TIF progression including tubular epithelial cells, myofibroblasts, endothelia, and inflammatory cells. Previously, most of the attention has centered on myofibroblasts given their central importance in extracellular matrix production. However, emerging data focuses on how the response of the proximal tubule, a specialized epithelial segment vulnerable to injury, plays a central role in TIF progression. Several proximal tubular responses such as de-differentiation, cell cycle changes, autophagy, and metabolic changes may be adaptive initially, but can lead to maladaptive responses that promote TIF both through autocrine and paracrine effects. This review discusses the current paradigm of TIF progression and the increasingly important role of the proximal tubule in promoting TIF both in tubulointerstitial and glomerular injuries. A better understanding and appreciation of the role of the proximal tubule in TIF has important implications for therapeutic strategies to halt chronic kidney disease progression. Copyright © 2017 International Society of Matrix Biology. Published by Elsevier B.V. All rights reserved.

  2. 182 179 Comparative Study on the Proximate

    African Journals Online (AJOL)


    Dec 2, 2008 ... Key words: Annona squamosa, Fruits, Proximate, Minerals, nutrient density. INTRODUCTION. Sugar apple (Annona squamosa) also called. “Gwanda masar” in Hausa belong to the family. Annonacae. The most widely grown of all the species are A. muricata, A. cherimola, A reticulata, A. senegalensis and ...

  3. Phytochemical Screening, Proximate and Mineral Composition of ...

    African Journals Online (AJOL)

    Leaves of sweet potato (Ipomoea batatas) grown in Tepi area was studied for their class of phytochemicals, mineral and proximate composition using standard analytical methods. The phytochemical screening revealed the presence of alkaloids, flavonoid, terpenoids, saponins, quinones, phenol, tannins, amino acid and ...

  4. Phytochemical screening, proximate and elemental analysis of ...

    African Journals Online (AJOL)

    Citrus sinensis was screened for its phytochemical composition and was evaluated for the proximate and elemental analysis. The phytochemical analysis indicated the presence of reducing sugar, saponins, cardiac glycosides, tannins and flavonoids. The elemental analysis indicated the presence of the following mineral ...

  5. Phytochemical Screening and Proximate Analysis of Newbouldia ...

    African Journals Online (AJOL)

    The study was conducted to assess the phytochemical and proximate composition of Newboudia laevis leaves and Allium sativum bulb extracts. The leaves and bulbs extracts were analyzed for their chemical composition and antinutritional factors (ANFs) which include moisture, crude protein, crude fat, crude fiber, total ash ...

  6. Disability occurrence and proximity to death

    NARCIS (Netherlands)

    Klijs, Bart; Mackenbach, Johan P.; Kunst, Anton E.


    Purpose. This paper aims to assess whether disability occurrence is related more strongly to proximity to death than to age. Method. Self reported disability and vital status were available from six annual waves and a subsequent 12-year mortality follow-up of the Dutch GLOBE longitudinal study.

  7. [Four family members with proximal myotonic myopathy

    NARCIS (Netherlands)

    Tieleman, A.A.; Velden, M.P. van der; Visser, M.C.; Wokke, J.H.J.; Scheffer, H.; Engelen, B.G.M. van


    A 41-year-old woman had a 15-year history of pain in her thighs and arms, which also became weaker, and a decrease in visual acuity. Her 35-year-old brother, their 38-year-old sister and their 64-year-old mother also had myalgia, myotonia and proximal muscle weakness, and the women also had

  8. Phytochemical screening, proximate and elemental analysis of ...

    African Journals Online (AJOL)

    ... was about 0.01 in concentration. Proximate analysis also shows that it has a high nutritional value such as carbohydrate, fibre, Ash, fat and protein. These results recommended the consumption of these peels of desired physiochemical properties as sources of food fibres or low-calorie bulk ingredients in food applications ...

  9. Proximate composition and consumer acceptability of African ...

    African Journals Online (AJOL)

    The aim of the study was to assess the organoleptic differences of Clarias gariepinus smoked with two different energy sources, Anogeissus leiocarpus and Tamarindus indica with the help of a hedonic scale and to determine possible proximate composition difference between the smoked products. Smoking of the fishes ...

  10. Controllable proximity effect in superconducting hybrid devices

    NARCIS (Netherlands)

    Bakurskiy, S.V.


    This thesis is devoted to the study of controllable proximity effects in superconductors, both in terms of fundamental aspects and applications. As a part of this thesis theoretical description was suggested for a number of structures with superconducting electrodes and multiple interlayers. These

  11. Proximate, chemical compositions and sulphur concentrations on ...

    African Journals Online (AJOL)

    0, 10, 20, 50, 100, 150, 200, 250 and 300 ppm) on the nutritional value and the proximate composition of six selected mango cultivars (Tommy Atkins, Peach, Saber, Sunshine, Keitt and Vhavenda) grown in South Africa. The study shows that ...

  12. Proximate composition, bread characteristics and sensory ...

    African Journals Online (AJOL)

    This study was carried out to investigate proximate composition, bread characteristics and sensory evaluation of cocoyam-wheat composite breads at different levels of cocoyam flour substitution for human consumption.A whole wheat bread (WWB) and cocoyam-composite breads (CCB1,CCB 2 and CCB 3) were prepared ...

  13. Evaluation of the Proximate, Chemical and Phytochemical ...

    African Journals Online (AJOL)

    The increased interest in the utilization of the leaves of Moringa oleifera necessitated this study which evaluated the proximate, chemical and phytochemical composition, especially the presence of anti- physiological and toxic factors in the leaves. The results of the phytochemical analyses were: alkaloid 1.24 ± 0.141%; ...

  14. comparative proximate composition and antioxidant vitamins

    African Journals Online (AJOL)


    ABSTRACT. The proximate composition and antioxidant vitamins analysis of two varieties of honey (dark amber and light amber) were carried out using standard methods. The values for moisture, ash, crude lipid, crude protein and crude carbohydrate contents of the two honeys, (light amber and dark amber) are 9.39 ...

  15. Proximate composition and cholesterol concentrations of ...

    African Journals Online (AJOL)

    Proximate composition and cholesterol concentrations of Rhynchophorus phoenicis and Oryctes monoceros larvae subjected to different heat treatments. ... 514.63 mg/100g dry weight basis (DWB) for raw and fried samples, respectively, but decreased to 295.20 mg/100 g DWB in the smoke-dried samples. Similarly, the ...

  16. Preliminary Phytochemical Screening, Elemental and Proximate ...

    African Journals Online (AJOL)

    The study aimed at phytochemical screening, elemental and proximate composition of two varieties of Cyperus esculentus (tiger nut) big yellow and small brown nuts using standard methods. The phytochemicals tested for were alkaloid, saponin, tannin, glycoside, flavonoid, steroid and resin. All the aforementioned ...

  17. Protein biomarker validation via proximity ligation assays. (United States)

    Blokzijl, A; Nong, R; Darmanis, S; Hertz, E; Landegren, U; Kamali-Moghaddam, M


    The ability to detect minute amounts of specific proteins or protein modifications in blood as biomarkers for a plethora of human pathological conditions holds great promise for future medicine. Despite a large number of plausible candidate protein biomarkers published annually, the translation to clinical use is impeded by factors such as the required size of the initial studies, and limitations of the technologies used. The proximity ligation assay (PLA) is a versatile molecular tool that has the potential to address some obstacles, both in validation of biomarkers previously discovered using other techniques, and for future routine clinical diagnostic needs. The enhanced specificity of PLA extends the opportunities for large-scale, high-performance analyses of proteins. Besides advantages in the form of minimal sample consumption and an extended dynamic range, the PLA technique allows flexible assay reconfiguration. The technology can be adapted for detecting protein complexes, proximity between proteins in extracellular vesicles or in circulating tumor cells, and to address multiple post-translational modifications in the same protein molecule. We discuss herein requirements for biomarker validation, and how PLA may play an increasing role in this regard. We describe some recent developments of the technology, including proximity extension assays, the use of recombinant affinity reagents suitable for use in proximity assays, and the potential for single cell proteomics. This article is part of a Special Issue entitled: Biomarkers: A Proteomic Challenge. © 2013.

  18. Phytochemical screening, proximate and elemental analysis of ...

    African Journals Online (AJOL)

    Michael Horsfall

    2009). The aim of this study was to analyses the extract of. Citrus sinensis peels for the phytochemical, proximate and elemental composition. MATERIALS AND METHODS. Plant materials Fresh peels of Citrus sinensis were collected from Uselu market in Benin City, Edo. State, Nigeria. It was identified and authenticated by.

  19. Keldysh proximity action for disordered superconductors

    Indian Academy of Sciences (India)

    Abstract. We review a novel approach to the superconductive proximity effect in dis- ordered normal–superconducting (N–S) structures. The method is based on the multi- charge Keldysh action and is suitable for the treatment of interaction and fluctuation effects. As an application of the formalism, we study the subgap ...

  20. Goal-Proximity Decision-Making (United States)

    Veksler, Vladislav D.; Gray, Wayne D.; Schoelles, Michael J.


    Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed…