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Sample records for relative rib area

  1. Scaling of Haversian canal surface area to secondary osteon bone volume in ribs and limb bones.

    Science.gov (United States)

    Skedros, John G; Knight, Alex N; Clark, Gunnar C; Crowder, Christian M; Dominguez, Victoria M; Qiu, Shijing; Mulhern, Dawn M; Donahue, Seth W; Busse, Björn; Hulsey, Brannon I; Zedda, Marco; Sorenson, Scott M

    2013-06-01

    Studies of secondary osteons in ribs have provided a great deal of what is known about remodeling dynamics. Compared with limb bones, ribs are metabolically more active and sensitive to hormonal changes, and receive frequent low-strain loading. Optimization for calcium exchange in rib osteons might be achieved without incurring a significant reduction in safety factor by disproportionally increasing central canal size with increased osteon size (positive allometry). By contrast, greater mechanical loads on limb bones might favor reducing deleterious consequences of intracortical porosity by decreasing osteon canal size with increased osteon size (negative allometry). Evidence of this metabolic/mechanical dichotomy between ribs and limb bones was sought by examining relationships between Haversian canal surface area (BS, osteon Haversian canal perimeter, HC.Pm) and bone volume (BV, osteonal wall area, B.Ar) in a broad size range of mature (quiescent) osteons from adult human limb bones and ribs (modern and medieval) and various adult and subadult non-human limb bones and ribs. Reduced major axis (RMA) and least-squares (LS) regressions of HC.Pm/B.Ar data show that rib and limb osteons cannot be distinguished by dimensional allometry of these parameters. Although four of the five rib groups showed positive allometry in terms of the RMA slopes, nearly 50% of the adult limb bone groups also showed positive allometry when negative allometry was expected. Consequently, our results fail to provide clear evidence that BS/BV scaling reflects a rib versus limb bone dichotomy whereby calcium exchange might be preferentially enhanced in rib osteons. Copyright © 2013 Wiley Periodicals, Inc.

  2. Rib Fractures

    Science.gov (United States)

    ... Video) Achilles Tendon Tear Additional Content Medical News Rib Fractures By Thomas G. Weiser, MD, MPH, Associate Professor, ... Tamponade Hemothorax Injury to the Aorta Pulmonary Contusion Rib Fractures Tension Pneumothorax Traumatic Pneumothorax (See also Introduction to ...

  3. Computed tomography measurement of rib cage morphometry in emphysema.

    Directory of Open Access Journals (Sweden)

    Nicola Sverzellati

    Full Text Available BACKGROUND: Factors determining the shape of the human rib cage are not completely understood. We aimed to quantify the contribution of anthropometric and COPD-related changes to rib cage variability in adult cigarette smokers. METHODS: Rib cage diameters and areas (calculated from the inner surface of the rib cage in 816 smokers with or without COPD, were evaluated at three anatomical levels using computed tomography (CT. CTs were analyzed with software, which allows quantification of total emphysema (emphysema%. The relationship between rib cage measurements and anthropometric factors, lung function indices, and %emphysema were tested using linear regression models. RESULTS: A model that included gender, age, BMI, emphysema%, forced expiratory volume in one second (FEV1%, and forced vital capacity (FVC% fit best with the rib cage measurements (R(2 = 64% for the rib cage area variation at the lower anatomical level. Gender had the biggest impact on rib cage diameter and area (105.3 cm(2; 95% CI: 111.7 to 98.8 for male lower area. Emphysema% was responsible for an increase in size of upper and middle CT areas (up to 5.4 cm(2; 95% CI: 3.0 to 7.8 for an emphysema increase of 5%. Lower rib cage areas decreased as FVC% decreased (5.1 cm(2; 95% CI: 2.5 to 7.6 for 10 percentage points of FVC variation. CONCLUSIONS: This study demonstrates that simple CT measurements can predict rib cage morphometric variability and also highlight relationships between rib cage morphometry and emphysema.

  4. Ribbing disease

    International Nuclear Information System (INIS)

    Mukkada, Philson J; Franklin, Teenu; Rajeswaran, Rangasami; Joseph, Santhosh

    2010-01-01

    Ribbing disease is a rare sclerosing dysplasia that involves long tubular bones, especially the tibia and femur. It occurs after puberty and is reported to be more common in women. In this article we describe how Ribbing disease can be differentiated from diseases like Engelmann-Camurati disease, van Buchem disease, Erdheim-Chester disease, osteoid osteoma, chronic osteomyelitis, stress fracture, etc

  5. Model based rib-cage unfolding for trauma CT

    Science.gov (United States)

    von Berg, Jens; Klinder, Tobias; Lorenz, Cristian

    2018-03-01

    A CT rib-cage unfolding method is proposed that does not require to determine rib centerlines but determines the visceral cavity surface by model base segmentation. Image intensities are sampled across this surface that is flattened using a model based 3D thin-plate-spline registration. An average rib centerline model projected onto this surface serves as a reference system for registration. The flattening registration is designed so that ribs similar to the centerline model are mapped onto parallel lines preserving their relative length. Ribs deviating from this model appear deviating from straight parallel ribs in the unfolded view, accordingly. As the mapping is continuous also the details in intercostal space and those adjacent to the ribs are rendered well. The most beneficial application area is Trauma CT where a fast detection of rib fractures is a crucial task. Specifically in trauma, automatic rib centerline detection may not be guaranteed due to fractures and dislocations. The application by visual assessment on the large public LIDC data base of lung CT proved general feasibility of this early work.

  6. Influence of wall ribs on the thermal stratification and self-pressurization in a cryogenic liquid tank

    International Nuclear Information System (INIS)

    Fu, Juan; Sunden, Bengt; Chen, Xiaoqian

    2014-01-01

    Self-pressurization in a cylindrical ribbed tank which is partially filled with liquid hydrogen is investigated numerically under different rib spacing-to-height ratios. The Volume of Fluid (VOF) method is employed as well as a phase change model. Appropriate models are incorporated into the Ansys Fluent by the user-defined functions to carry out the computations. The ribbed surface is modeled as a finned surface and a conjugate transient heat transfer problem is formulated for predicting fluid flow currents and heat transfer. The effect of rib material and shapes is also studied. Numerical results indicate that the pressure rise can be reduced by ribs mounted on the tank wall. This phenomenon is more pronounced as the rib spacing-to-height ratio is reduced. A vortex is observed in the downstream region of each rib when the spacing-to-height has a relatively high value. Evaporation occurs as time elapses due to heat accumulation at the rib surfaces. Pressure starts to rise later with high thermal conductivity ribs and becomes higher with low thermal conductivity ribs when the ribs are of identical configuration in geometry. The final pressure rise seems to be monotonically versus increasing time. The semicircular ribs perform better than rectangular ones in control of the pressure rise and thermal stratification for identical cross sectional area and if the locations are kept the same

  7. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, Rick R. van [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam Zuid-Oost (Netherlands); Bilo, Rob A.C. [Netherlands Forensic Institute, Department of Forensic Pathology, Amsterdam (Netherlands); Robben, Simon G.F. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands)

    2009-01-15

    Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases reported in the literature. We present three neonates with both posterior rib fractures and ipsilateral clavicular fractures resulting from birth trauma. A review of the literature is also presented. The common denominator and a possible mechanical aetiology are discussed. In total, 13 cases of definitive birth-related posterior rib fractures were identified. Nearly all (9/10) posterior rib fractures were (as far as reported in the original publications) in the midline. In 12 of the 13 children, birth weight was high and in 7 children birth was complicated by shoulder dystocia. An interesting finding was that in cases where a clavicular fracture was present, this was on the ipsilateral side. Radiologists, when presented with a neonate with posterior rib fractures, should be aware of this rare differential diagnosis. (orig.)

  8. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature

    International Nuclear Information System (INIS)

    Rijn, Rick R. van; Bilo, Rob A.C.; Robben, Simon G.F.

    2009-01-01

    Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases reported in the literature. We present three neonates with both posterior rib fractures and ipsilateral clavicular fractures resulting from birth trauma. A review of the literature is also presented. The common denominator and a possible mechanical aetiology are discussed. In total, 13 cases of definitive birth-related posterior rib fractures were identified. Nearly all (9/10) posterior rib fractures were (as far as reported in the original publications) in the midline. In 12 of the 13 children, birth weight was high and in 7 children birth was complicated by shoulder dystocia. An interesting finding was that in cases where a clavicular fracture was present, this was on the ipsilateral side. Radiologists, when presented with a neonate with posterior rib fractures, should be aware of this rare differential diagnosis. (orig.)

  9. How different are the Kebara 2 ribs to modern humans?

    Science.gov (United States)

    Chapman, Tara; Beyer, Benoît; Sholukha, Victor; Semal, Patrick; Feipel, Veronique; Louryan, Stéphane; Van Sint Jan, Serge

    2017-12-30

    This study analyses rib geometric parameters of individual ribs of 14 modern human subjects (7 males and 7 females) in comparison to the reconstructed ribs of the Kebara 2 skeleton which was taken from the reconstruction of a Neandertal thorax by Sawyer & Maley (2005). Three-dimensional (3D) models were segmented from CT scans and each rib vertex cloud was placed into a local coordinate system defined from the rib principal axes. Rib clouds were then analysed using best fitting ellipses of the external contours of the cross-section areas. The centroid of each ellipse was then used to measure the centroidal pathway between each slice (rib midline). Curvature of the ribs was measured from the mid-line of the ribs as the sum of angles between successive centroids in adjacent cross sections. Distinct common patterns were noted in all rib geometric parameters for modern humans. The Kebara 2 reconstructed ribs also followed the same patterns. This study demonstrated that there are differences between the sexes in rib geometrical parameters, with females showing smaller rib width, chord length and arc length, but greater curvature (rib torsion, rib axial curvature, rib anterior-posterior bending) than males. The Kebara 2 reconstructed ribs were within the modern human range for the majority of geometrical parameters.

  10. Segmentation of ribs in digital chest radiographs

    Science.gov (United States)

    Cong, Lin; Guo, Wei; Li, Qiang

    2016-03-01

    Ribs and clavicles in posterior-anterior (PA) digital chest radiographs often overlap with lung abnormalities such as nodules, and cause missing of these abnormalities, it is therefore necessary to remove or reduce the ribs in chest radiographs. The purpose of this study was to develop a fully automated algorithm to segment ribs within lung area in digital radiography (DR) for removal of the ribs. The rib segmentation algorithm consists of three steps. Firstly, a radiograph was pre-processed for contrast adjustment and noise removal; second, generalized Hough transform was employed to localize the lower boundary of the ribs. In the third step, a novel bilateral dynamic programming algorithm was used to accurately segment the upper and lower boundaries of ribs simultaneously. The width of the ribs and the smoothness of the rib boundaries were incorporated in the cost function of the bilateral dynamic programming for obtaining consistent results for the upper and lower boundaries. Our database consisted of 93 DR images, including, respectively, 23 and 70 images acquired with a DR system from Shanghai United-Imaging Healthcare Co. and from GE Healthcare Co. The rib localization algorithm achieved a sensitivity of 98.2% with 0.1 false positives per image. The accuracy of the detected ribs was further evaluated subjectively in 3 levels: "1", good; "2", acceptable; "3", poor. The percentages of good, acceptable, and poor segmentation results were 91.1%, 7.2%, and 1.7%, respectively. Our algorithm can obtain good segmentation results for ribs in chest radiography and would be useful for rib reduction in our future study.

  11. Rib fracture - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000539.htm Rib fracture - aftercare To use the sharing features on this page, please enable JavaScript. A rib fracture is a crack or break in one or ...

  12. Atraumatic First Rib Fracture

    OpenAIRE

    Koray Aydogdu

    2014-01-01

    Rib fractures are usually seen after a trauma, while atraumatic spontaneous rib fractures are quite rare. A first rib fracture identified in our 17 years old female patient who had not a history of trauma except lifting a heavy weight was examined in details in terms of the potential complications and followed-up for a long time. We presented our experience on this case with atraumatic first rib fracture that has different views for the etiology in light of the literature.

  13. Surgical rib fixation

    OpenAIRE

    Marasco, Silvana

    2017-01-01

    Traumatic rib fracture injuries are being seen with increasing frequency in the hospital setting. They are often associated with other severe injuries and frequently require admission. The most severe form of rib fracture injury, flail chest, has a mortality of up to 33%. Rib fracture injuries have also been associated with chronic pain, malunion, deformity, disability and poor quality of life. Despite this, the standard of management for rib fracture injuries was, and in most ...

  14. Exercise-induced rib stress fractures: potential risk factors related to thoracic muscle co-contraction and movement pattern

    DEFF Research Database (Denmark)

    Vinther-Knudsen, Archibald; Kanstrup, I-L; Christiansen, E

    2006-01-01

    The etiology of exercise-induced rib stress fractures (RSFs) in elite rowers is unclear. The purpose of the study was to investigate thoracic muscle activity, movement patterns and muscle strength in elite rowers. Electromyographic (EMG) and 2-D video analysis were performed during ergometer rowing...

  15. Cardiopulmonary resuscitation (CPR)-related posterior rib fractures in neonates and infants following recommended changes in CPR techniques.

    Science.gov (United States)

    Franke, I; Pingen, A; Schiffmann, H; Vogel, M; Vlajnic, D; Ganschow, R; Born, M

    2014-07-01

    Posterior rib fractures are highly indicative of non-accidental trauma (NAT) in infants. Since 2000, the "two-thumbs" technique for cardiopulmonary resuscitation (CPR) of newborns and infants has been recommended by the American Heart Association (AHA). This technique is similar to the grip on an infant's thorax while shaking. Is it possible that posterior rib fractures in newborns and infants could be caused by the "two-thumbs" technique? Using computerized databases from three German children's hospitals, we identified all infants less than 12 months old who underwent professional CPR within a 10-year period. We included all infants with anterior-posterior chest radiographs taken after CPR. Exclusion criteria were sternotomy, osteopenia, various other bone diseases and NAT. The radiographs were independently reviewed by the Chief of Pediatric Radiology (MB) and a Senior Pediatrician, Head of the local Child Protection Team (IF). Eighty infants with 546 chest radiographs were identified, and 50 of those infants underwent CPR immediately after birth. Data concerning the length of CPR was available for 41 infants. The mean length of CPR was 11min (range: 1-180min, median: 3min). On average, there were seven radiographs per infant. A total of 39 infants had a follow-up radiograph after at least 10 days. No rib fracture was visible on any chest X-ray. The results of this study suggest rib fracture after the use of the "two-thumbs" CPR technique is uncommon. Thus, there should be careful consideration of abuse when these fractures are identified, regardless of whether CPR was performed and what technique used. The discovery of rib fractures in an infant who has undergone CPR without underlying bone disease or major trauma warrants a full child protection investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Nozzle airfoil having movable nozzle ribs

    Science.gov (United States)

    Yu, Yufeng Phillip; Itzel, Gary Michael

    2002-01-01

    A nozzle vane or airfoil structure is provided in which the nozzle ribs are connected to the side walls of the vane or airfoil in such a way that the ribs provide the requisite mechanical support between the concave side and convex side of the airfoil but are not locked in the radial direction of the assembly, longitudinally of the airfoil. The ribs may be bi-cast onto a preformed airfoil side wall structure or fastened to the airfoil by an interlocking slide connection and/or welding. By attaching the nozzle ribs to the nozzle airfoil metal in such a way that allows play longitudinally of the airfoil, the temperature difference induced radial thermal stresses at the nozzle airfoil/rib joint area are reduced while maintaining proper mechanical support of the nozzle side walls.

  17. Atraumatic First Rib Fracture

    Directory of Open Access Journals (Sweden)

    Koray Aydogdu

    2014-12-01

    Full Text Available Rib fractures are usually seen after a trauma, while atraumatic spontaneous rib fractures are quite rare. A first rib fracture identified in our 17 years old female patient who had not a history of trauma except lifting a heavy weight was examined in details in terms of the potential complications and followed-up for a long time. We presented our experience on this case with atraumatic first rib fracture that has different views for the etiology in light of the literature.

  18. Radiation Induced Rib Fractures on Bone Scan after Breast Cancer Surgery and Radiation Therapy

    International Nuclear Information System (INIS)

    Kim, Hae Won; Won, Kyoung Sook; Zeon, Seok Kil; Kim, Jin Hee

    2009-01-01

    This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest CT findings of rib fracture were analyzed. The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p=0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p=0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest CT, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p=0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p=0.001). Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis

  19. Radiation Induced Rib Fractures on Bone Scan after Breast Cancer Surgery and Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Won; Won, Kyoung Sook; Zeon, Seok Kil; Kim, Jin Hee [Keimyung University, School of Medicine, Daegu (Korea, Republic of)

    2009-08-15

    This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest CT findings of rib fracture were analyzed. The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p=0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p=0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest CT, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p=0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p=0.001). Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis.

  20. ACR Appropriateness Criteria® rib fractures.

    Science.gov (United States)

    Henry, Travis S; Kirsch, Jacobo; Kanne, Jeffrey P; Chung, Jonathan H; Donnelly, Edwin F; Ginsburg, Mark E; Heitkamp, Darel E; Kazerooni, Ella A; Ketai, Loren H; McComb, Barbara L; Parker, J Anthony; Ravenel, James G; Restrepo, Carlos Santiago; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D; Mohammed, Tan-Lucien H

    2014-11-01

    Rib fracture is the most common thoracic injury, present in 10% of all traumatic injuries and almost 40% of patients who sustain severe nonpenetrating trauma. Although rib fractures can produce significant morbidity, the diagnosis of associated complications (such as pneumothorax, hemothorax, pulmonary contusion, atelectasis, flail chest, cardiovascular injury, and injuries to solid and hollow abdominal organs) may have a more significant clinical impact. When isolated, rib fractures have a relatively low morbidity and mortality, and failure to detect isolated rib fractures does not necessarily alter patient management or outcome in uncomplicated cases. A standard posteroanterior chest radiograph should be the initial, and often the only, imaging test required in patients with suspected rib fracture after minor trauma. Detailed radiographs of the ribs rarely add additional information that would change treatment, and, although other imaging tests (eg, computed tomography, bone scan) have increased sensitivity for detection of rib fractures, there are little data to support their use. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review process include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  1. Factors affecting visualization of posterior rib fractures in abused infants

    International Nuclear Information System (INIS)

    Kleinman, P.K.; Adams, V.I.; Blackbourne, B.D.; Marks, S.C.

    1987-01-01

    Rib fractures in abused infants commonly occur in the posterior rib arcs. Fractures occurring near the costovertebral articulations are usually identified radiographically only once callus has formed. To assess the factors influencing the visibility of fractures near the costovertical articulations, the authors studied 103 posterior rib fractures occurring in 16 abused infants. Radiologic findings were correlated with CT findings and pathologic material from nine ribs in four patients. The limited visibility of fractures relates to (1) the frequent superimposition of the transverse process over the rib fracture site, (2) a fracture line that crosses at an obliquity to the x-ray beam, and (3) nondisplacement of rib fragments due to preservation of the posterior periosteum. Fresh rib fractures invisible on a frontal projection may be clearly defined on axial CT scans, or on postmortem radiographs. A knowledge of the factors influencing the visibility of these important injuries is useful in planning an appropriate diagnostic evaluation of suspected infant abuse

  2. Rib cage pain

    Science.gov (United States)

    ... any of the following: Bruised, cracked, or fractured rib Inflammation of cartilage near the ... the best cures for a ribcage fracture . Follow your health care provider's instructions for treating ...

  3. Rib fractures after reirradiation plus hyperthermia for recurrent breast cancer. Predictive factors

    International Nuclear Information System (INIS)

    Oldenborg, Sabine; Valk, Christel; Os, Rob van; Voerde Sive Voerding, Paul zum; Crezee, Hans; Tienhoven, Geertjan van; Rasch, Coen; Oei, Bing; Venselaar, Jack; Randen, Adrienne van

    2016-01-01

    Combining reirradiation (reRT) and hyperthermia (HT) has shown high therapeutic value for patients with locoregional recurrent breast cancer (LR). However, additional toxicity of reirradiation (e.g., rib fractures) may occur. The aim of this study is to determine the impact of potential risk factors on the occurrence of rib fractures. From 1982-2005, 234 patients were treated with adjuvant reRT + HT after surgery for LR. ReRT consisted typically of 8 fractions of 4 Gy twice a week, or 12 fractions of 3 Gy four times a week. A total of 118 patients were irradiated with abutted photon and electron fields. In all, 60 patients were irradiated using either one or alternating combinations of abutted AP electron fields. Hyperthermia was given once or twice a week. The 5-year infield local control (LC) rate was 70 %. Rib fractures were detected in 16 of 234 patients (actuarial risk: 7 % at 5 years). All rib fractures occurred in patients treated with a combination of photon and abutted electron fields (p = 0.000); in 15 of 16 patients fractures were located in the abutment regions. The other significant predictive factors for rib fractures were a higher fraction dose (p = 0.040), large RT fields, and treatment before the year 2000. ReRT + HT results in long-term LC. The majority of rib fractures were located in the photon/electron abutment area, emphasizing the disadvantage of field overlap. Large abutted photon/electron fields combined with 4 Gy fractions increase the number of rib fractures in this study group. However, as these factors were highly correlated no relative importance of the individual factors could be estimated. Increasing the number of HT sessions a week does not increase the risk of rib fractures. (orig.) [de

  4. Spontaneous rib fractures.

    Science.gov (United States)

    Katrancioglu, Ozgur; Akkas, Yucel; Arslan, Sulhattin; Sahin, Ekber

    2015-07-01

    Other than trauma, rib fracture can occur spontaneously due to a severe cough or sneeze. In this study, patients with spontaneous rib fractures were analyzed according to age, sex, underlying pathology, treatment, and complications. Twelve patients who presented between February 2009 and February 2011 with spontaneous rib fracture were reviewed retrospectively. The patients' data were evaluated according to anamnesis, physical examination, and chest radiographs. The ages of the patients ranged from 34 to 77 years (mean 55.91 ± 12.20 years), and 7 (58.4%) were male. All patients had severe cough and chest pain. The fractures were most frequently between 4th and 9th ribs; multiple rib fractures were detected in 5 (41.7%) patients. Eight (66.7%) patients had chronic obstructive pulmonary disease, 2 (16.7%) had bronchial asthma, and 2 (16.7%) had osteoporosis. Bone densitometry revealed a high risk of bone fracture in all patients. Patients with chronic obstructive pulmonary disease or bronchial asthma had been treated with high-dose steroids for over a year. Spontaneous rib fracture due to severe cough may occur in patients with osteoporosis, chronic obstructive pulmonary disease, or bronchial asthma, receiving long-term steroid therapy. If these patients have severe chest pain, chest radiography should be performed to check for bone lesions. © The Author(s) 2015.

  5. Cough-induced rib fractures.

    Science.gov (United States)

    Hanak, Viktor; Hartman, Thomas E; Ryu, Jay H

    2005-07-01

    To define the demographic, clinical, and radiological features of patients with cough-induced rib fractures and to assess potential risk factors. For this retrospective, single-center study, we identified all cases of cough-induced rib fractures diagnosed at the Mayo Clinic in Rochester, Minn, over a 9-year period between January 1, 1996, and January 31, 2005. Bone densitometry data from patients' medical records were analyzed, and T scores were used to classify patients into bone density categories. The mean +/- SD age of the 54 study patients at presentation was 55+/-17 years, and 42 patients (78%) were female. Patients presented with chest wall pain after onset of cough. Rib fracture was associated with chronic cough (> or =3 weeks' duration) in 85% of patients. Rib fractures were documented by chest radiography, rib radiography, computed tomography, or bone scan. Chest radiography had been performed in 52 patients and revealed rib fracture in 30 (58%). There were 112 fractured ribs in 54 patients. One half of patients had more than one fractured rib. Right-sided rib fractures alone were present in 17 patients (26 fractured ribs), left-sided in 23 patients (35 fractured ribs), and bilateral in 14 patients (51 fractured ribs). The most commonly fractured rib on both sides was rib 6. The fractures were most common at the lateral aspect of the rib cage. Bone densitometry was done in 26 patients and revealed osteopenia or osteoporosis in 17 (65%). Cough-induced rib fractures occur primarily in women with chronic cough. Middle ribs along the lateral aspect of the rib cage are affected most commonly. Although reduced bone density is likely a risk factor, cough-induced rib fractures can occur in the presence of normal bone density.

  6. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature

    NARCIS (Netherlands)

    van Rijn, Rick R.; Bilo, Rob A. C.; Robben, Simon G. F.

    2009-01-01

    BACKGROUND: Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases

  7. Rib fracture repair: indications, technical issues, and future directions.

    Science.gov (United States)

    Nirula, Raminder; Diaz, Jose J; Trunkey, Donald D; Mayberry, John C

    2009-01-01

    Rib fracture repair has been performed at selected centers around the world for more than 50 years; however, the operative indications have not been established and are considered controversial. The outcome of a strictly nonoperative approach may not be optimal. Potential indications for rib fracture repair include flail chest, painful, movable rib fractures refractory to conventional pain management, chest wall deformity/defect, rib fracture nonunion, and during thoracotomy for other traumatic indication. Rib fracture repair is technically challenging secondary to the human rib's relatively thin cortex and its tendency to fracture obliquely. Nonetheless, several effective repair systems have been developed. Future directions for progress on this important surgical problem include the development of minimally invasive techniques and the conduct of multicenter, randomized trials.

  8. Bifid rib: A rare anomaly

    Directory of Open Access Journals (Sweden)

    Mythili Krishnan Rathinasabapathi

    2015-01-01

    Full Text Available A case of the bifid rib was found during routine bone study. The distal part of the osseous rib bifurcated into two divisions with an angle of 60°. Both divisions had their own costal cartilage. Bifid rib is a congenital abnormality of the rib cage and usually asymptomatic, often discovered incidentally on chest X-ray. Effects of this neuroskeletal anomaly can include respiratory difficulties and neurological limitations.

  9. Rib fracture following stereotactic body radiotherapy: a potential pitfall.

    Science.gov (United States)

    Stanic, Sinisa; Boike, Thomas P; Rule, William G; Timmerman, Robert D

    2011-11-01

    Although the incidence of rib fractures after conventional radiotherapy is generally low (rib fractures are a relatively common complication of stereotactic body radiotherapy. For malignancy adjacent to the chest wall, the incidence of rib fractures after stereotactic body radiotherapy is as high as 10%. Unrecognized bone fractures can mimic bone metastases on bone scintigraphy, can lead to extensive workup, and can even lead to consideration of unnecessary systemic chemotherapy, as treatment decisions can be based on imaging findings alone. Nuclear medicine physicians and diagnostic radiologists should always consider rib fracture in the differential diagnosis.

  10. Cough-induced rib fractures.

    Science.gov (United States)

    Sano, Atsushi; Tashiro, Ken; Fukuda, Tsutomu

    2015-10-01

    Occasionally, patients who complain of chest pain after the onset of coughing are diagnosed with rib fractures. We investigated the characteristics of cough-induced rib fractures. Between April 2008 and December 2013, 17 patients were referred to our hospital with chest pain after the onset of coughing. Rib radiography was performed, focusing on the location of the chest pain. When the patient had other signs and symptoms such as fever or persistent cough, computed tomography of the chest was carried out. We analyzed the data retrospectively. Rib fractures were found in 14 of the 17 patients. The age of the patients ranged from 14 to 86 years (median 39.5 years). Ten patients were female and 4 were male. Three patients had chronic lung disease. There was a single rib fracture in 9 patients, and 5 had two or more fractures. The middle and lower ribs were the most commonly involved; the 10th rib was fractured most frequently. Cough-induced rib fractures occur in every age group regardless of the presence or absence of underlying disease. Since rib fractures often occur in the lower and middle ribs, rib radiography is useful for diagnosis. © The Author(s) 2015.

  11. Determinants of rib motion in flail chest.

    Science.gov (United States)

    Cappello, M; Legrand, A; De Troyer, A

    1999-03-01

    We have previously developed a canine model of isolated flail chest to assess the effects of this condition on the mechanics of breathing, and these studies have led to the conclusion that the respiratory displacement of the fractured ribs is primarily determined by the fall in pleural pressure (Delta Ppl) and the action of the parasternal intercostal muscles. The present studies were designed to test the validity of this conclusion. A flail was induced in six supine anesthetized animals by fracturing both dorsally and ventrally the second to fifth ribs on the right side of the chest, after which the phrenic nerve roots were bilaterally sectioned in the neck. Sectioning the phrenic nerves caused a 34% decrease in Delta Ppl, associated with a 39% increase in parasternal intercostal inspiratory EMG activity (p Delta Ppl during the subsequent inspiration, all animals again showed a clear-cut inward rib displacement. These observations therefore confirm that in dogs with flail chest, the inspiratory displacement of the fractured ribs is set by the balance between the force related to pleural pressure and that generated by the parasternal intercostals. These observations also point to the critical importance of the pattern of inspiratory muscle activation in determining the magnitude of rib cage paradox in such patients.

  12. Comparison of ultrasonography and radiography in diagnosis of rib fractures.

    Science.gov (United States)

    Pishbin, Elham; Ahmadi, Koorosh; Foogardi, Molood; Salehi, Maryam; Seilanian Toosi, Farrokh; Rahimi-Movaghar, Vafa

    2017-08-01

    Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography. The radiography was performed in a posteroanterior (PA) chest projection and oblique rib view centered over the area of trauma. The time duration spent in taking USG and radiography were recorded. The prevalence and location of fractures revealed by USG and radiography were compared. Sixty-one suspected patients were assessed. The male to female ratio was 2.4:1 (43 men and 18 women) with a mean ± SD age of (44.3 ± 19.7) years. There were totally 59 rib fractures in 38 (62.3%) patients based on radiography and USG, while 23 (37.7%) patients had no diagnostic evidence of rib lesions. USG revealed 58 rib fractures in 33 (54.1%) of 61 suspected patients and radiographs revealed 32 rib fractures in 20 (32.8%) of 61 patients. A total of 58 (98.3%) rib fractures were detected by USG, whereas oblique rib view and PA chest radiography showed 27 (45.8%) and 24 (40.7%) rib fractures, respectively. The average duration of USG was (12 ± 3) min (range 7-17 min), whereas the duration of radiography was (27 ± 6) min (range 15-37 min). The kappa coefficient showed a low level of agreement between both USG and PA chest radiography (kappa coefficient = 0.28), and between USG and oblique rib view (kappa coefficient = 0.32). USG discloses more fractures than radiography in

  13. Nineth Rib Syndrome after 10(th) Rib Resection.

    Science.gov (United States)

    Yu, Hyun Jeong; Jeong, Yu Sub; Lee, Dong Hoon; Yim, Kyoung Hoon

    2016-07-01

    The 12(th) rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the 10(th) rib was not felt, and an image of the rib-cage confirmed that the left 10(th) rib was severed. When applying pressure from the legs to the 9(th) rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with 9(th) rib syndrome, and ultrasound-guided 9(th) and 10(th) intercostal nerve blocks were performed around the tips of the severed 10(th) rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the 9(th) rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left 10(th) rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining 10(th) rib to impinge on the 9(th) intercostal nerves, causing pain.

  14. Rib fractures in blunt chest trauma - associated thoracic injuries

    Directory of Open Access Journals (Sweden)

    Iv. Dimitrov

    2017-09-01

    Full Text Available PURPOSE. The aim of our retrospective study was to analyze the patterns of associated thoracic injuries in patients underwent blunt chest trauma and rib fractures. METHODS. The study included 212 patients with rib fractures due to blunt thoracic trauma. The mechanism of trauma, the type of rib fracture and the type of associated injuries were analyzed. RESULTS. The patients were divided in two groups according to the number of fractured ribs-group I included the patients with up to two fractured ribs (72 patients-33,9%, and group II – with ≥3 fractured ribs (140 patients-66,1%. Associated chest injuries were present in 36 of the patients from group I (50%, and in 133 patients from group II (95%. Pulmonary contusion was the most common intrathoracicinjurie-65,6% of the cases. The mean hospital stay was 8, 7 days. The lethality rate was 16,9% -all of them due to the associated chest injuries. CONCLUSIONS. The mortality related to rib fractures is affected by the associated thoracic injuries, the advanced age, and the number of fractured ribs.

  15. Application of the rainfall infiltration breakthrough (RIB) model for ...

    African Journals Online (AJOL)

    2012-05-23

    May 23, 2012 ... In this paper, the physical meaning of parameters in the CRD and previous ... ity; the utility of the RIB model for application in different climatic areas under ...... TMG Aquifer feasibility study and pilot project ecological and.

  16. Coding Theory, Cryptography and Related Areas

    DEFF Research Database (Denmark)

    Buchmann, Johannes; Stichtenoth, Henning; Tapia-Recillas, Horacio

    Proceedings of anInternational Conference on Coding Theory, Cryptography and Related Areas, held in Guanajuato, Mexico. in april 1998......Proceedings of anInternational Conference on Coding Theory, Cryptography and Related Areas, held in Guanajuato, Mexico. in april 1998...

  17. Chondroblastoma of rib : case report

    International Nuclear Information System (INIS)

    Kim, Dong Hun; Kim, Kyung Rae; Ryu, Sang Wan

    2004-01-01

    Chondroblastoma is an uncommon, benign, cartilaginous neoplasm originating in an epiphysis or apophysis of a long tubular bone. The rib is an unusual site for chondroblastoma. The authors describe a case of chondroblastoma of the rib and present a brief review of the literature

  18. Chondroblastoma of rib : case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun; Kim, Kyung Rae; Ryu, Sang Wan [Kwangju Hospital, Kwangju (Korea, Republic of)

    2004-07-01

    Chondroblastoma is an uncommon, benign, cartilaginous neoplasm originating in an epiphysis or apophysis of a long tubular bone. The rib is an unusual site for chondroblastoma. The authors describe a case of chondroblastoma of the rib and present a brief review of the literature.

  19. Single crystalline silicon solar cells with rib structure

    Directory of Open Access Journals (Sweden)

    Shuhei Yoshiba

    2017-02-01

    Full Text Available To improve the conversion efficiency of Si solar cells, we have developed a thin Si wafer-based solar cell that uses a rib structure. The open-circuit voltage of a solar cell is known to increase with deceasing wafer thickness if the cell is adequately passivated. However, it is not easy to handle very thin wafers because they are brittle and are subject to warpage. We fabricated a lattice-shaped rib structure on the rear side of a thin Si wafer to improve the wafer’s strength. A silicon nitride film was deposited on the Si wafer surface and patterned to form a mask to fabricate the lattice-shaped rib, and the wafer was then etched using KOH to reduce the thickness of the active area, except for the rib region. Using this structure in a Si heterojunction cell, we demonstrated that a high open-circuit voltage (VOC could be obtained by thinning the wafer without sacrificing its strength. A wafer with thickness of 30 μm was prepared easily using this structure. We then fabricated Si heterojunction solar cells using these rib wafers, and measured their implied VOC as a function of wafer thickness. The measured values were compared with device simulation results, and we found that the measured VOC agrees well with the simulated results. To optimize the rib and cell design, we also performed device simulations using various wafer thicknesses and rib dimensions.

  20. Rib fracture in Prognathodon saturator (Mosasauridae, Late Cretaceous)

    NARCIS (Netherlands)

    Schulp, Anne S.; Walenkamp, G. H I M; Hofman, P.A.M.; Rothschild, B. M.; Jagt, J. W M

    2004-01-01

    Two unusual bumps occur on the internal surface of a rib of the marine reptile Prognathodon saturator from the Upper Cretaceous (Maastrichtian) of Maastricht, The Netherlands. These bumps are interpreted as stress fractures, possibly related to agonistic behaviour.

  1. Comparative Study of Convective Heat Transfer Performance of Steam and Air Flow in Rib Roughened Channels

    Science.gov (United States)

    Ma, Chao; Ji, Yongbin; Ge, Bing; Zang, Shusheng; Chen, Hua

    2018-04-01

    A comparative experimental study of heat transfer characteristics of steam and air flow in rectangular channels roughened with parallel ribs was conducted by using an infrared camera. Effects of Reynolds numbers and rib angles on the steam and air convective heat transfer have been obtained and compared with each other for the Reynolds number from about 4,000 to 15,000. For all the ribbed channels the rib pitch to height ratio (p/e) is 10, and the rib height to the channel hydraulic diameter ratio is 0.078, while the rib angles are varied from 90° to 45°. Based on experimental results, it can be found that, even though the heat transfer distributions of steam and air flow in the ribbed channels are similar to each other, the steam flow can obtain higher convective heat transfer enhancement capability, and the heat transfer enhancement of both the steam and air becomes greater with the rib angle deceasing from 90° to 45°. At Reynolds number of about 12,000, the area-averaged Nusselt numbers of the steam flow is about 13.9%, 14.2%, 19.9% and 23.9% higher than those of the air flow for the rib angles of 90°, 75°, 60° and 45° respectively. With the experimental results the correlations for Nusselt number in terms of Reynolds number and rib angle for the steam and air flow in the ribbed channels were developed respectively.

  2. What Accounts for Rib Fractures in Older Adults?

    Directory of Open Access Journals (Sweden)

    Lisa-Ann Wuermser

    2011-01-01

    Full Text Available To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21–93 years was followed in a long-term prospective study. Bone mineral density (BMD was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years, 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes.

  3. What Accounts for Rib Fractures in Older Adults?

    Science.gov (United States)

    Wuermser, Lisa-Ann; Achenbach, Sara J.; Amin, Shreyasee; Khosla, Sundeep; Melton, L. Joseph

    2011-01-01

    To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21–93 years was followed in a long-term prospective study. Bone mineral density (BMD) was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years), 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes. PMID:22028986

  4. What accounts for rib fractures in older adults?

    Science.gov (United States)

    Wuermser, Lisa-Ann; Achenbach, Sara J; Amin, Shreyasee; Khosla, Sundeep; Melton, L Joseph

    2011-01-01

    To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21-93 years was followed in a long-term prospective study. Bone mineral density (BMD) was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years), 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes.

  5. Various appearances of rib companion shadow mimicking a pathologic condition

    International Nuclear Information System (INIS)

    Choi, Yo Won; Yoo, Shi Joon; Im, Jung Gil

    1992-01-01

    We have observed that the companion shadow of the upper rib may be misinterpreted as a small pneumothorax or pleural plaque associated with asbestosis. To observe the radiographic characteristics of the normal companion shadow, we analyzed, on the posteroanterior(PA) chest radiographs, the companion shadow of 50 normal cases. Factors such as occurrence on each rib, the sharpness of the margin, the relative position to the rib, the shape and the thickness were observed. Also, we analyzed the displaced pleura of 4 pneumothorax cases to differentiate their findings from the findings of normal companion shadows. On 50 normal chest radiographs, 192 companion shadows were observed on the first to fourth ribs. In 173 of those shadows, the visceral margin of the companion shadow on the second rib simulated pneumothorax more closely than those on any other ribs due to its apical location and thinness. In six of 50 normal cases, the companion shadow in the first or second rib showed an inwardly convex lower margin, mimicking pleural plaque. The companion shadow was suggested on the plain chest radiograph by the following characteristics imultiplicity (47/50), thicker than normal pleura (3/4), persistent on serial films with the same shape and specific location(4/4)

  6. Accessory caudal axial and pelvic ribs

    International Nuclear Information System (INIS)

    Bohutova, J.; Kolar, J.; Vitovec, J.; Vyhnanek, L.

    1980-01-01

    Accessory caudal ribs are reported as an extremely curious anomaly in five patients. Once the fracture of this rib was a source of pains after injury. The different shapes of the ribs are documented in this clinical survey which is the most extensive in the present literature. Anomalous ribs arise due to inappropriate segmentation during the embryonal development of the axial skeleton. (orig.) [de

  7. Hybrid rib-slot-rib plasmonic waveguide with deep-subwavelength mode confinement and long propagation length

    Directory of Open Access Journals (Sweden)

    Kai Zheng

    2016-08-01

    Full Text Available We propose a hybrid plasmonic waveguide where a combined rib-slot-rib structure is added on the metal substrate within a low-index gap region. The optical properties of the quasi-TM fundamental mode are numerically calculated using the finite element method. Compared to the traditional hybrid plasmonic waveguide, our designed waveguiding structure can support modes with tighter confinement and longer propagation length, by properly adjusting the geometry of the rib-slot-rib structure and the gap height. In details, it can provide the hybrid mode with mode area λ2/12000 and reasonable propagation distance 23.78 μm, simultaneously. Its excellent optical performance can facilitate potential applications in ultra-compact nanophotonic devices and circuits.

  8. Fluid dynamics of Ribbed Annuli

    International Nuclear Information System (INIS)

    McCreery, G. E.; Pink, R. J.; Condie, K. G.; McEligot, D. M.

    2003-01-01

    Typical advanced gas-cooled reactor designs use periodic spacer ribs to center rods in circular cooling channels, e.g., as for control rods (General Atomics and others) and fuel rods (HTTR). In contrast to classical studies of axisymmetric annuli, the flow becomes three-dimensional but is typically periodic in the circumferential direction and - in some cases - in the streamwise direction. Fundamental measurements have been obtained for two idealizations of these complex geometries: an annulus with three ribs circumferentially and one with four. Laser Doppler Velocimetry (LDV) was employed with INEEL's unique Matched-Index-of-Refraction (MIR) flow facility to determine the velocity and turbulence fields. The initial experiment was aimed at obtaining benchmark data to test the capabilities of CFD (Computational Fluid Dynamics) codes to handle ribbed annular geometries without the complications of turbulent transport. The Reynolds number was about 1120. These conditions correspond to some stages during a pressurized cooldown (LOFA) event. Power spectral densities were obtained to determine the eddy shedding frequency downstream of the ribs. For the second experiment LDV measurements were obtained in another ribbed-annular model at a higher flow rate. For this nominally turbulent flow, evidence of laminarization appears in the flow converging to pass between ribs. The measurements indicated flow details which could be useful for assessment of CFD codes

  9. Delayed pneumothorax complicating minor rib fracture after chest trauma.

    Science.gov (United States)

    Lu, Ming-Shian; Huang, Yao-Kuang; Liu, Yun-Hen; Liu, Hui-Ping; Kao, Chiung-Lun

    2008-06-01

    Pneumothorax (PTX) after trauma is a preventable cause of death. Drainage procedures such as chest tube insertion have been traditionally advocated to prevent fatal tension PTX. We evaluated the safety of close observation in patients with delayed PTX complicating rib fracture after minor chest trauma. Adult patients (>18 years) with a diagnosis of chest trauma and 3 or fewer fractured ribs were reviewed. Case patients were divided according to age, location and number of fractured ribs, mechanism of trauma, and initial pulmonary complication after thoracic trauma for comparative analysis. There were 207 male (70.2%) and 88 female (29.8%) patients whose ages ranged from 18 to 93 years (median, 55 years). The mechanisms of trauma were a motor vehicle accident in 207 patients, falls in 66, pedestrian injury in 10, and assaults in 14. Ninety-five patients sustained 1 rib fracture, 95 had 2 rib fractures, and 105 suffered 3 rib fractures. Right-sided injury occurred in 164 cases, left-sided injury did in 127, and bilateral injury did in 4. The most frequent location of rib fractures was from the fourth rib to the ninth rib. The initial pulmonary complications after trauma were PTX in 16 patients, hemothorax in 43, pneumohemothorax in 14, lung contusion in 75, and isolated subcutaneous emphysema (SubcEmph) in 33. Thirty percent of the patients (n = 5/16) who presented with traumatic PTX were observed safely without drainage. Delayed PTX was recorded in 16 patients, occurring mostly during the first 2 days of their admission. Associated extrathoracic injury was recorded in 189 patients. The mean hospital stay of the patients was 7.66 days. Longer hospital stay was related to increasing number of fractured ribs, need for thoracic drainage, and the presence of associated extrathoracic injury. The mortality rate for the entire group was 2%. The presence of SubcEmph was the only risk factor associated with the development of delayed PTX. Patients sustaining blunt chest

  10. Rib fractures induced by coughing: an unusual cause of acute chest pain.

    Science.gov (United States)

    De Maeseneer, M; De Mey, J; Debaere, C; Meysman, M; Osteaux, M

    2000-03-01

    We report three patients with stress fractures of the ribs induced by coughing. Standard radiographs of the chest and ribs did not reveal evidence of rib fractures in any of the patients. Bone scintigraphy, performed 1 to 2 weeks after initial onset of symptoms, showed a focal area of increased uptake along the chest wall in all cases. Thin section angulated helical CT directly visualized the subtle rib fractures. Initial diagnosis of a cough-induced fracture of the rib may be difficult because of the associated underlying disorder, and unnecessary examinations are commonly performed. Identification of a cough-induced fracture of the rib using helical CT may be clinically important to avoid unnecessary concern and additional examinations.

  11. Nineth Rib Syndrome after 10th Rib Resection

    OpenAIRE

    Yu, Hyun Jeong; Jeong, Yu Sub; Lee, Dong Hoon; Yim, Kyoung Hoon

    2016-01-01

    The 12th rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractur...

  12. Epidural Analgesia after Rib Fractures.

    Science.gov (United States)

    Zaw, Andrea A; Murry, Jason; Hoang, David; Chen, Kevin; Louy, Charles; Bloom, Matthew B; Melo, Nicolas; Alban, Rodrigo F; Margulies, Daniel R; Ley, Eric J

    2015-10-01

    Pain associated with rib fractures impairs respiratory function and increases pulmonary morbidity. The purpose of this study was to determine how epidural catheters alter mortality and complications in trauma patients. We performed a retrospective study involving adult blunt trauma patients with moderate-to-severe injuries from January 1, 2004 to December 31, 2013. During the 10-year period, 526 patients met the inclusion criteria; 43/526 (8%) patients had a catheter placed. Mean age of patients with epidural catheter (CATH) was higher compared with patients without epidural catheter (NOCATH) (54 vs 48 years, P = 0.021), Injury Severity Score was similar (26 CATH vs 27 NOCATH, P = 0.84), and CATH had higher mean rib fractures (7.4 vs 4.1, P ribs fractured. The epidural cohort had longer hospital LOS and decreased mortality. In contrast to other studies, DVT rates were increased in patients who received epidural catheters.

  13. New Area Law in General Relativity.

    Science.gov (United States)

    Bousso, Raphael; Engelhardt, Netta

    2015-08-21

    We report a new area law in general relativity. A future holographic screen is a hypersurface foliated by marginally trapped surfaces. We show that their area increases monotonically along the foliation. Future holographic screens can easily be found in collapsing stars and near a big crunch. Past holographic screens exist in any expanding universe and obey a similar theorem, yielding the first rigorous area law in big bang cosmology. Unlike event horizons, these objects can be identified at finite time and without reference to an asymptotic boundary. The Bousso bound is not used, but it naturally suggests a thermodynamic interpretation of our result.

  14. Radiological, computertomographic, pathoanatomical and histological examination of the rib cartilage of the dog

    International Nuclear Information System (INIS)

    Lorber, B.

    2000-06-01

    This study was concerned with the representation and description of the rib cartilage of the dog and the abnormalities of such by means of radiological, computer tomographic, pathoanatomical and histological examinations and the comparison of the results of the various examination methods. The study material consisted of 100 ventral thorax walls of dogs of different ages and breeds. In 39 of the subjects, no abnormalities of rib cartilage other than unremarkable calcification were observed. Among the subjects, there were 11 puppies (0-3 months), whose rib cartilage appeared soft tissue dense due to the absence of calcification, 14 juvenile animals (4-18 months), the rib cartilage of which showed a typical finely granulated structure, and 14 adult dogs (over 18 months), whose rib cartilage exhibited a homogeneous to net-like calcified appearance. In the calcified rib cartilage, the histological section showed a centrally located spongiosa rod surrounded by a hyaline cartilage shell. The calcification tendency of the first pair of rib cartilage was remarkable: in 70 dogs, the first pair of rib cartilage remained uncalcified despite calcification of the other rib cartilage. Sixty-one dogs exhibited rib cartilage abnormalities. According to the radiological appearance of the abnormalities, they were divided into groups and their incidence was calculated. Abnormalities seen included interruption in the continuity of the calcified rib cartilage with and without callus formation, enlargement of rib cartilage, cuff formation, and abnormalities on the Articulationes sternocostales (projections in or around articulations, calcified and fractured joint surfaces). In addition, remarkable calcification patterns were observed. By means of CT examination the densities of the tissue forming the various abnormalities was determined. In the course of the pathoanatomical examination, it was shown that the interruptions in continuity with callus and the various enlarged areas of the

  15. X-ray diagnosis of rib chondrosarcoma

    International Nuclear Information System (INIS)

    Smakova, M.S.

    1982-01-01

    A study was made on X-ray images of 24 patients, suffering from rib chondrosarcoma with relapses. X-ray symptoms of rib chondrosarcoma, depending on process localization were improved. Chondrosarcoma of rib cartilage is characterized by soft-tissue component with calcareous inclusions or without them. Chondrosarcoma of rib bone is characterized by destruction and soft-tissue component. Chondrosarcoma relapses were localized in soft tissues

  16. Isolated rib fractures in geriatric patients

    OpenAIRE

    Elmistekawy, Elsayed M.; Hammad, Abd Almohsen M.

    2007-01-01

    Introduction: The goal of this study was to investigate the short-term outcomes in patients older than 60 years with isolated rib fractures and admitted to emergency hospital. Materials and Methods: This study included patients who were 60 years old or more and sustained blunt chest injury and had isolated rib fractures. The following data were obtained from the medical records: age, gender, number of fracture ribs, side of fracture ribs, mechanism and nature of injury, preexisting medical...

  17. The number of displaced rib fractures is more predictive for complications in chest trauma patients.

    Science.gov (United States)

    Chien, Chih-Ying; Chen, Yu-Hsien; Han, Shih-Tsung; Blaney, Gerald N; Huang, Ting-Shuo; Chen, Kuan-Fu

    2017-02-28

    Traumatic rib fractures can cause chest complications that need further treatment and hospitalization. We hypothesized that an increase in the number of displaced rib fractures will be accompanied by an increase in chest complications. We retrospectively reviewed the trauma registry between January 2013 and May 2015 in a teaching hospital in northeastern Taiwan. Patients admitted with chest trauma and rib fractures without concomitant severe brain, splenic, pelvic or liver injuries were included. The demographic data, such as gender, age, the index of coexistence disease, alcohol consumption, trauma mechanisms were analyzed as potential predictors of pulmonary complications. Pulmonary complications were defined as pneumothorax, hemothorax, flail chest, pulmonary contusion, and pneumonia. In the 29 months of the study period, a total of 3151 trauma patients were admitted to our hospital. Among them, 174 patients were enrolled for final analysis. The most common trauma mechanism was road traffic accidents (58.6%), mainly motorbike accidents (n = 70, 40.2%). Three or more displaced rib fractures had higher specificity for predicting complications, compared to three or more total rib fractures (95.5% vs 59.1%). Adjusting the severity of chest trauma using TTSS and Ribscore by multivariable logistic regression analysis, we found that three or more rib fractures or any displaced rib fracture was the most significant predictor for developing pulmonary complication (aOR: 5.49 95% CI: 1.82-16.55). Furthermore, there were 18/57 (31.6%) patients with fewer than three ribs fractures developed pulmonary complications. In these 18 patients, only five patients had delayed onset complications and four of them had at least one displaced rib fracture. In this retrospective cohort study, we found that the number of displaced or total rib fractures, bilateral rib fractures, and rib fractures in more than two areas were associated with the more chest complications. Furthermore

  18. XROMM analysis of rib kinematics during lung ventilation in the green iguana, Iguana iguana.

    Science.gov (United States)

    Brainerd, Elizabeth L; Moritz, Sabine; Ritter, Dale A

    2016-02-01

    The three-dimensional rotations of ribs during breathing are typically described as bucket-handle rotation about a dorsoventrally oriented axis, pump-handle rotation about a mediolateral axis, and caliper rotation about a rostrocaudal axis. In amniotes with double-headed ribs, rib motion is constrained primarily to one degree-of-freedom (DOF) rotation about an axis connecting the two rib articulations. However, in Squamata, the ribs are single headed and the hemispherical costovertebral joints permit rotations with three DOF. In this study, we used X-ray reconstruction of moving morphology (XROMM ) to quantify rib rotation during deep breathing in four green iguanas. We found that rib rotation was strongly dominated by bucket-handle rotation, thus exhibiting nearly hinge-like motion, despite the potential for more complex motions. The vertebral and sternal segments of each rib did not deform measurably during breathing, but they did move relative to each other at a thin, cartilaginous intracostal joint. While standing still and breathing deeply, four individual iguanas showed variability in their rib postures, with two breathing around a highly inflated posture, and two breathing around a posture with the ribs folded halfway back. Bucket-handle rotations showed clear rostrocaudal gradients, with rotation increasing from the third cervical to the first or second dorsal rib, and then decreasing again caudally, a pattern that is consistent with the intercostal muscles in the rostral intercostal spaces being the primary drivers of inspiration. The constrained, primarily bucket-handle rotations observed here during breathing do not help to explain the evolution of permissive, hemispherical costovertebral joints in squamates from the more constrained, double-headed rib articulations of other amniotes. © 2016. Published by The Company of Biologists Ltd.

  19. Thoracic epidural steroid injection for rib fracture pain.

    Science.gov (United States)

    Rauchwerger, Jacob J; Candido, Kenneth D; Deer, Timothy R; Frogel, Jonathan K; Iadevaio, Robert; Kirschen, Neil B

    2013-06-01

    Treatment for rib fracture pain can be broadly divided into pharmacologic approaches with oral and/or parenteral medication and interventional approaches utilizing neuraxial analgesia or peripheral nerve blocks to provide pain relief. Both approaches attempt to control nociceptive and neuropathic pain secondary to osseous injury and nerve insult, respectively. Success of treatment is ultimately measured by the ability of the selected modality to decrease pain, chest splinting, and to prevent sequelae of injury, such as pneumonia. Typically, opioids and NSAIDs are the drugs of first choice for acute pain because of ease of administration, immediate onset of action, and rapid titration to effect. In contrast, neuropathic pain medications have a slower onset of action and are more difficult to titrate to therapeutic effect. Interventional approaches include interpleural catheters, intercostal nerve blocks, paravertebral nerve blocks, and thoracic and lumbar epidural catheters. Each intervention has its own inherent advantages, disadvantages, and success rates. Rib fracture pain management practice is founded on the thoracic surgical and anesthesiology literature. Articles addressing rib fracture pain are relatively scarce in the pain medicine literature. As life expectancy increases, and as healthcare system modifications are implemented, pain medicine physicians may be consulted to treat increasing number of patients suffering rib fracture pain and may need to resort to novel therapeutic measures because of financial constraints imposed by those changes. Here we present the first published case series of thoracic epidural steroid injections used for management of rib fracture pain. © 2012 The Authors Pain Practice © 2012 World Institute of Pain.

  20. Rib Fracture Diagnosis in the Panscan Era.

    Science.gov (United States)

    Murphy, Charles E; Raja, Ali S; Baumann, Brigitte M; Medak, Anthony J; Langdorf, Mark I; Nishijima, Daniel K; Hendey, Gregory W; Mower, William R; Rodriguez, Robert M

    2017-12-01

    With increased use of chest computed tomography (CT) in trauma evaluation, traditional teachings in regard to rib fracture morbidity and mortality may no longer be accurate. We seek to determine rates of rib fracture observed on chest CT only; admission and mortality of patients with isolated rib fractures, rib fractures observed on CT only, and first or second rib fractures; and first or second rib fracture-associated great vessel injury. We conducted a planned secondary analysis of 2 prospectively enrolled cohorts of the National Emergency X-Radiography Utilization Study chest studies, which evaluated patients with blunt trauma who were older than 14 years and received chest imaging in the emergency department. We defined rib fractures and other thoracic injuries according to CT reports and followed patients through their hospital course to determine outcomes. Of 8,661 patients who had both chest radiograph and chest CT, 2,071 (23.9%) had rib fractures, and rib fractures were observed on chest CT only in 1,368 cases (66.1%). Rib fracture patients had higher admission rates (88.7% versus 45.8%; mean difference 42.9%; 95% confidence interval [CI] 41.4% to 44.4%) and mortality (5.6% versus 2.7%; mean difference 2.9%; 95% CI 1.8% to 4.0%) than patients without rib fracture. The mortality of patients with rib fracture observed on chest CT only was not statistically significantly different from that of patients with fractures also observed on chest radiograph (4.8% versus 5.7%; mean difference -0.9%; 95% CI -3.1% to 1.1%). Patients with first or second rib fractures had significantly higher mortality (7.4% versus 4.1%; mean difference 3.3%; 95% CI 0.2% to 7.1%) and prevalence of concomitant great vessel injury (2.8% versus 0.6%; mean difference 2.2%; 95% CI 0.6% to 4.9%) than patients with fractures of ribs 3 to 12, and the odds ratio of great vessel injury with first or second rib fracture was 4.4 (95% CI 1.8 to 10.4). Under trauma imaging protocols that commonly

  1. Epidural analgesia in patients with traumatic rib fractures

    DEFF Research Database (Denmark)

    Duch, P; Møller, M H

    2015-01-01

    BACKGROUND: Traumatic rib fractures are a common condition associated with considerable morbidity and mortality. Observational studies have suggested improved outcome in patients receiving continuous epidural analgesia (CEA). The aim of the present systematic review of randomised controlled trials...... (RCTs) was to assess the benefit and harm of CEA compared with other analgesic interventions in patients with traumatic rib fractures. METHODS: We performed a systematic review with meta-analysis and trial sequential analysis (TSA). Eligible trials were RCTs comparing CEA with other analgesic...... interventions in patients with traumatic rib fractures. Cumulative relative risks (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were estimated, and risk of systematic and random errors was assessed. The predefined primary outcome measures were mortality, pneumonia and duration...

  2. [Internal fixation treatment of multiple rib fractures with absorbable rib-connecting-pins under epidural anesthesia].

    Science.gov (United States)

    Liu, Jinliang; Li, Keyao; Ju, Zhenlong; Bai, Yan

    2011-03-01

    To study the indications, methods and experience of absorbable rib-connecting-pins fixation in the treatment of multiple rib fractures. 52 cases with multiple rib fractures were performed internal fixation with absorbable rib-connecting-pins under epidural anesthesia. All cases were followed up for 1 to 12 months, with an average of 5 months. All fractures were achieved healing in 3 to 6 months after the operation and were not found chest wall deformity. Absorbable rib-connecting-pins fixation is a simple and effective method and worthies recommending to perform operation for the appropriate cases with multiple rib fractures.

  3. Golfer's fracture of the ribs

    International Nuclear Information System (INIS)

    Lim, J. H.

    1980-01-01

    Golfer's fracture is stress fracture of the posterior portion of left 3, 4, 5, 6 or 7th ribs of golfer's, usually beginners,and it is considered due to exposure to unaccustomed severe exercise of this fascinating sport. Healing is usually uneventful, but possible complication may occur, because symptom is mild and golfers continue the exercise with physical therapy such as massage. Author report 4 cases of golfer's fracture, including 1 case complicated by platelike at electasis of lung.

  4. Golfer's fracture of the ribs

    Energy Technology Data Exchange (ETDEWEB)

    Lim, J H [Seoul District Armed Forces General Hospital, Seoul (Korea, Republic of)

    1980-06-15

    Golfer's fracture is stress fracture of the posterior portion of left 3, 4, 5, 6 or 7th ribs of golfer's, usually beginners,and it is considered due to exposure to unaccustomed severe exercise of this fascinating sport. Healing is usually uneventful, but possible complication may occur, because symptom is mild and golfers continue the exercise with physical therapy such as massage. Author report 4 cases of golfer's fracture, including 1 case complicated by platelike at electasis of lung.

  5. Rib forming tool for tubing

    Science.gov (United States)

    Rowley, James P.; Lewandowski, Edward F.; Groh, Edward F.

    1976-01-01

    Three cylindrical rollers are rotatably mounted equidistant from the center of a hollow tool head on radii spaced 120.degree. apart. Each roller has a thin flange; the three flanges lie in a single plane to form an internal circumferential rib in a rotating tubular workpiece. The tool head has two complementary parts with two rollers in one part of the head and one roller in the other part; the two parts are joined by a hinge. A second hinge, located so the rollers are between the two hinges, connects one of the parts to a tool bar mounted in a lathe tool holder. The axes of rotation of both hinges and all three rollers are parallel. A hole exposing equal portions of the three roller flanges is located in the center of the tool head. The two hinges permit the tool head to be opened and rotated slightly downward, taking the roller flanges out of the path of the workpiece which is supported on both ends and rotated by the lathe. The parts of the tool head are then closed on the workpiece so that the flanges are applied to the workpiece and form the rib. The tool is then relocated for forming of the next rib.

  6. Anatomical variation of human thoracic rib in dry bone.

    Directory of Open Access Journals (Sweden)

    Dr. Nalini Konkani

    2017-12-01

    Full Text Available Introduction: The Ribs are essential structure of osseous thorax and provide information that aids in the interpretation of radiologic images. The purpose of this study to investigate variations in thoracic rib and its morphological & clinical importance. So, In present study attempted to find out additional intercostal spaces due to bifurcation of ribs, less intercostal space due to fusion of ribs, variation of the normal ribs like, gap in the rib, fusion of one rib to another at a shaft of rib. Congenital abnormalities of the ribs are usually asymptomatic, often discovered incidentally on chest X-ray. Effects of this neuroskeletal anomaly can include respiratory difficulties and neurological limitations.Material & Method: The study was carried out in Bone Store of Department of Anatomy, B. J. Medical College, Ahmedabad, Gujarat. Study was carried out on 500 human dried ribs. And the variations in the ribs are studied. We got variation in the human ribs and studied. Result : Variations were seen like out of 500 ribs, Bifid rib having two ends 9(1.8%, rib having bifid space 2(0.4%, fusion rib at the level of shaft 1(0.2%, fusion of first rib and second rib 1(0.2%,first rib having two ends 1(0.2%. Conclusion: Bifid rib is an anatomical variant where the sternal end of the rib is cleaved into two. So we can rule out mesodermal abnormalities, parenchymal lung disease, chest wall tumor or costal fracture.

  7. Usefulness of Reformatted CT Rib Series in Patients with Thoracic Trauma

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Nam; Park, Seong Hoon; Kim, Na Hyung; Juhng, Seon Kwan; Yoon, Kwon Ha [Dept. of Radiology and Institute for Radiological Imaging Science, Wonkwang University School of Medicine, Iksan (Korea, Republic of); Bang, Dong Ho [Dept. of Radiology, Aerospace Medical Center, Cheongwon (Korea, Republic of)

    2013-01-15

    To assess the value of adding a reformatted computed tomography (CT) rib series to transversely reconstructed CT imaging in the evaluation of rib fractures in patients with suspected traumatic thoracic injuries. One hundred consecutive patients with suspected traumatic thoracic injuries underwent 128-section multi-detector row CT. Transverse CT images with 5-mm-thick sections were reconstructed and rib series were reformatted using isotropic vogel data. Three independent radiologists, who were blinded to the data, interpreted the CT scans at 2 sessions with a 4-week interval between the sessions. Only transverse CT images were reviewed at the first session. At the second session, the CT images were reviewed along with the reformatted CT rib series. The following parameters were analyzed: receiver operating characteristic (Roc) curve, pairwise comparisons of Roc curves, sensitivity, specificity, positive predictive value, and negative predictive value. There were 153 rib fractures in 29 patients. The level of the area under the Roc curve, Az improved for all observers. The diagnostic sensitivity and specificity of each observer tended to improve in the second session. The mean confidence scores for all observers of patients with rib fractures improved significantly in the second session. A reformatted CT rib series together with transverse CT scan is useful for the evaluation of rib fracture.

  8. Rib fractures after reirradiation plus hyperthermia for recurrent breast cancer. Predictive factors

    Energy Technology Data Exchange (ETDEWEB)

    Oldenborg, Sabine; Valk, Christel; Os, Rob van; Voerde Sive Voerding, Paul zum; Crezee, Hans; Tienhoven, Geertjan van; Rasch, Coen [University of Amsterdam, Department of Radiation Oncology, Z1-215, Academic Medical Center, Amsterdam (Netherlands); Oei, Bing; Venselaar, Jack [Institute Verbeeten (BVI), Tilburg (Netherlands); Randen, Adrienne van [University of Amsterdam (AMC), Department of Radiology Academic Medical Center, Amsterdam (Netherlands)

    2016-04-15

    Combining reirradiation (reRT) and hyperthermia (HT) has shown high therapeutic value for patients with locoregional recurrent breast cancer (LR). However, additional toxicity of reirradiation (e.g., rib fractures) may occur. The aim of this study is to determine the impact of potential risk factors on the occurrence of rib fractures. From 1982-2005, 234 patients were treated with adjuvant reRT + HT after surgery for LR. ReRT consisted typically of 8 fractions of 4 Gy twice a week, or 12 fractions of 3 Gy four times a week. A total of 118 patients were irradiated with abutted photon and electron fields. In all, 60 patients were irradiated using either one or alternating combinations of abutted AP electron fields. Hyperthermia was given once or twice a week. The 5-year infield local control (LC) rate was 70 %. Rib fractures were detected in 16 of 234 patients (actuarial risk: 7 % at 5 years). All rib fractures occurred in patients treated with a combination of photon and abutted electron fields (p = 0.000); in 15 of 16 patients fractures were located in the abutment regions. The other significant predictive factors for rib fractures were a higher fraction dose (p = 0.040), large RT fields, and treatment before the year 2000. ReRT + HT results in long-term LC. The majority of rib fractures were located in the photon/electron abutment area, emphasizing the disadvantage of field overlap. Large abutted photon/electron fields combined with 4 Gy fractions increase the number of rib fractures in this study group. However, as these factors were highly correlated no relative importance of the individual factors could be estimated. Increasing the number of HT sessions a week does not increase the risk of rib fractures. (orig.) [German] Der kombinierte Einsatz von Rebestrahlung (reRT) und Hyperthermie (HT) zeigt eine hohe Wirksamkeit bei Patienten mit lokoregional rezidiviertem Brustkrebs (LR). Jedoch koennen zusaetzliche toxische Effekte von reRT (z. B. Rippenfrakturen

  9. Microbiological Safety of Commercial Prime Rib Preparation Methods: Thermal Inactivation of Salmonella in Mechanically Tenderized Rib Eye.

    Science.gov (United States)

    Calle, Alexandra; Porto-Fett, Anna C S; Shoyer, Bradley A; Luchansky, John B; Thippareddi, Harshavardhan

    2015-12-01

    Boneless beef rib eye roasts were surface inoculated on the fat side with ca. 5.7 log CFU/g of a five-strain cocktail of Salmonella for subsequent searing, cooking, and warm holding using preparation methods practiced by restaurants surveyed in a medium-size Midwestern city. A portion of the inoculated roasts was then passed once through a mechanical blade tenderizer. For both intact and nonintact roasts, searing for 15 min at 260°C resulted in reductions in Salmonella populations of ca. 0.3 to 1.3 log CFU/g. For intact (nontenderized) rib eye roasts, cooking to internal temperatures of 37.8 or 48.9°C resulted in additional reductions of ca. 3.4 log CFU/g. For tenderized (nonintact) rib eye roasts, cooking to internal temperatures of 37.8 or 48.9°C resulted in additional reductions of ca. 3.1 or 3.4 log CFU/g, respectively. Pathogen populations remained relatively unchanged for intact roasts cooked to 37.8 or 48.9°C and for nonintact roasts cooked to 48.9°C when held at 60.0°C for up to 8 h. In contrast, pathogen populations increased ca. 2.0 log CFU/g in nonintact rib eye cooked to 37.8°C when held at 60.0°C for 8 h. Thus, cooking at low temperatures and extended holding at relatively low temperatures as evaluated herein may pose a food safety risk to consumers in terms of inadequate lethality and/or subsequent outgrowth of Salmonella, especially if nonintact rib eye is used in the preparation of prime rib, if on occasion appreciable populations of Salmonella are present in or on the meat, and/or if the meat is not cooked adequately throughout.

  10. Radiation-Induced Rib Fractures After Hypofractionated Stereotactic Body Radiation Therapy: Risk Factors and Dose-Volume Relationship

    Energy Technology Data Exchange (ETDEWEB)

    Asai, Kaori [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Shioyama, Yoshiyuki, E-mail: shioyama@radiol.med.kyushu-u.ac.jp [Department of Heavy Particle Therapy and Radiation Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Nakamura, Katsumasa; Sasaki, Tomonari; Ohga, Saiji; Nonoshita, Takeshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Yoshitake, Tadamasa [Department of Heavy Particle Therapy and Radiation Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Ohnishi, Kayoko [Department of Radiology, National Center for Global Health and Medicine, Tokyo (Japan); Terashima, Kotaro; Matsumoto, Keiji [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Hirata, Hideki [Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Honda, Hiroshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)

    2012-11-01

    Purpose: The purpose of this study was to clarify the incidence, the clinical risk factors, and the dose-volume relationship of radiation-induced rib fracture (RIRF) after hypofractionated stereotactic body radiation therapy (SBRT). Methods and Materials: One hundred sixteen patients treated with SBRT for primary or metastatic lung cancer at our institution, with at least 6 months of follow-up and no previous overlapping radiation exposure, were included in this study. To determine the clinical risk factors associated with RIRF, correlations between the incidence of RIRF and the variables, including age, sex, diagnosis, gross tumor volume diameter, rib-tumor distance, and use of steroid administration, were analyzed. Dose-volume histogram analysis was also conducted. Regarding the maximum dose, V10, V20, V30, and V40 of the rib, and the incidences of RIRF were compared between the two groups divided by the cutoff value determined by the receiver operating characteristic curves. Results: One hundred sixteen patients and 374 ribs met the inclusion criteria. Among the 116 patients, 28 patients (46 ribs) experienced RIRF. The estimated incidence of rib fracture was 37.7% at 3 years. Limited distance from the rib to the tumor (<2.0 cm) was the only significant risk factor for RIRF (p = 0.0001). Among the dosimetric parameters used for receiver operating characteristic analysis, the maximum dose showed the highest area under the curve. The 3-year estimated risk of RIRF and the determined cutoff value were 45.8% vs. 1.4% (maximum dose, {>=}42.4 Gy or less), 51.6% vs. 2.0% (V40, {>=}0.29 cm{sup 3} or less), 45.8% vs. 2.2% (V30, {>=}1.35 cm{sup 3} or less), 42.0% vs. 8.5% (V20, {>=}3.62 cm{sup 3} or less), or 25.9% vs. 10.5% (V10, {>=}5.03 cm{sup 3} or less). Conclusions: The incidence of RIRF after hypofractionated SBRT is relatively high. The maximum dose and high-dose volume are strongly correlated with RIRF.

  11. Plastic bowing of the ribs in children

    Energy Technology Data Exchange (ETDEWEB)

    Caro, P.A.; Borden, S. IV

    1988-06-01

    Four cases of plastic bowing of the ribs are presented. In three patients with Werdnig-Hoffman disease, plastic curvatures were associated with chronic pneumonia and atelectasis. We postulate that intrapulmonary retractive forces can deform ribs thinned by muscular atrophy. In turn, thoracic collapse can perpetuate lobar and segmental atelectasis. In one case of osteogenesis imperfecta without pneumonia, we believe normal muscle forces bent ribs weakened by deficiency of normal cortical architecture.

  12. Plastic bowing of the ribs in children

    International Nuclear Information System (INIS)

    Caro, P.A.; Borden, S. IV

    1988-01-01

    Four cases of plastic bowing of the ribs are presented. In three patients with Werdnig-Hoffman disease, plastic curvatures were associated with chronic pneumonia and atelectasis. We postulate that intrapulmonary retractive forces can deform ribs thinned by muscular atrophy. In turn, thoracic collapse can perpetuate lobar and segmental atelectasis. In one case of osteogenesis imperfecta without pneumonia, we believe normal muscle forces bent ribs weakened by deficiency of normal cortical architecture. (orig.)

  13. Prevalence of Abuse Among Young Children with Rib Fractures: A Systematic Review

    Science.gov (United States)

    Paine, Christine Weirich; Fakeye, Oludolapo; Christian, Cindy W.; Wood, Joanne N.

    2016-01-01

    Objectives We aimed to estimate the prevalence of abuse in young children presenting with rib fractures and to identify demographic, injury, and presentation-related characteristics that affect the probability that rib fractures are secondary to abuse. Methods We searched PubMed/MEDLINE and CINAHL databases for articles published in English between January 1, 1990 and June 30, 2014 on rib fracture etiology in children ≤ 5 years old. Two reviewers independently extracted predefined data elements and assigned quality ratings to included studies. Study-specific abuse prevalences and the sensitivities, specificities, and positive and negative likelihood ratios of patients’ demographic and clinical characteristics for abuse were calculated with 95% confidence intervals. Results Data for 1,396 children ≤ 48 months old with rib fractures were abstracted from 10 articles. Among infants Rib fracture location was not associated with likelihood of abuse. The retrospective design of the included studies and variations in ascertainment of cases, inclusion/exclusion criteria, and child abuse assessments prevented further meta-analysis. Conclusions Abuse is the most common cause of rib fractures in infants rib fractures and characteristics associated with abusive rib fractures. PMID:27749806

  14. The effect of internal ribbing on forced convective heat transfer in circular-sectioned tubes

    International Nuclear Information System (INIS)

    Farhadi Rahmat-Abadi, K.; Morris, W. D.

    2003-01-01

    This paper presents the results of an experimental examination of the effect of internal circumferential ribs on forced convection in circular-sectioned tubes. The work is relevant to the internal cooling of gas turbine rotor blades. The influence of rib geometry is investigated for three different rib configurations and simple design-type, empirical equations are developed for estimating heat transfer at rib and mid-rib locations. It is demonstrated that heat transfer may be improved by up to three fold in relation to fully developed forced convection in smooth-walled tubes. The geometric parameters which have been used for the experiments are typical of those currently applied to gas turbine blade cooling designs

  15. Search for the maximum efficiency of a ribbed-surfaces device, providing a tight seal

    International Nuclear Information System (INIS)

    Boutin, Jeanne.

    1977-04-01

    The purpose of this experiment was to determine the geometrical characteristics of ribbed surfaces used to equip devices in translation or slow rotation motion and having to form an acceptable seal between slightly viscous fluids. It systematically studies the pressure loss coefficient lambda in function of the different parameters setting the form of ribs and their relative position on the opposite sides. It shows that the passages with two ribbed surfaces lead to highly better results than those with only one, the maximum value of lambda, equal to 0.5, being obtained with the ratios: pitch/clearance = 5, depth of groove/clearance = 1,2, and with their teeth face to face on the two opposite ribbed surfaces. With certain shapes, alternate position of ribs can lead to the maximum of lambda yet lower than 0.5 [fr

  16. Bilateral first rib fractures: A case report

    Directory of Open Access Journals (Sweden)

    Dilip Amonkar

    2014-01-01

    Full Text Available From the time first rib fractures were first described in 1869, they have been a source of anxiety to attendant trauma surgeons working in the accident and emergency department of major hospitals. First rib fractures are associated with major thoracic trauma and may involve injury to subclavian vessels, brachial plexus, and mediastinal structures. But these complications are more often seen following unilateral first rib fractures. In contrast, bilateral first rib fractures may follow insignificant trauma, suggesting a different mechanism involved. Serious vascular injuries and brachial plexus injuries are rare and angiograms for evaluation of these patients aren′t routinely warranted. The case that we report illustrates this very point.

  17. Increasing number of fractured ribs is not predictive of the severity of splenic injury following blunt trauma: an analysis of a National Trauma Registry database.

    Science.gov (United States)

    Boris, Kessel; Forat, Swaid; Itamar, Ashkenazi; Oded, Olsha; Kobi, Peleg; Adi, Givon; Igor, Jeroukhimov; Ricardo, Alfici

    2014-05-01

    Association between rib fractures and incidence of abdominal solid organs injury is well described. However, the correlation between the number of fractured ribs and severity of splenic injury is not clear. The purpose of this study was to assess whether an increasing number of rib fractures predicts the severity of splenic injury in blunt trauma patients. A retrospective cohort study involving blunt trauma patients with concomitant splenic injuries and rib fractures, between the years 1998 and 2012, registered in the Israeli National Trauma Registry. Of 321,618 patients with blunt mechanism of trauma, 57,130 had torso injuries, and of these 14,651 patients sustained rib fractures, and 3691 patients suffered from splenic injury. Concomitant splenic injury occurred in 1326 of the patients with rib fractures (9.1%), as compared to 2365 patients sustaining splenic injury without rib fractures (5.6%). The incidence of splenic injury among patients sustaining 5 or more rib fractures was significantly higher compared to patients suffering from 1 to 4 rib fractures. Among patients with splenic injury, the tendency to sustain associated rib fractures increased steadily with age. Patients with concomitant rib fractures had higher Injury Severity Score (ISS), but similar mortality rates, compared to patients with splenic injury without rib fractures. Among patients with concomitant rib fractures and splenic injury, there was no relation between the number of fractured ribs and the severity of splenic injury, neither as a whole group, nor after stratification according to the mechanism of injury. Although the presence of rib fractures increases the probability of splenic injury in blunt torso trauma, there is no relation between the number of fractured ribs and splenic injury severity. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Biomechanical investigation of different surgical strategies for the treatment of rib fractures using a three-dimensional human respiratory model.

    Science.gov (United States)

    Shih, Kao-Shang; Truong, Thanh An; Hsu, Ching-Chi; Hou, Sheng-Mou

    2017-11-02

    Rib fracture is a common injury and can result in pain during respiration. Conservative treatment of rib fracture is applied via mechanical ventilation. However, ventilator-associated complications frequently occur. Surgical fixation is another approach to treat rib fractures. Unfortunately, this surgical treatment is still not completely defined. Past studies have evaluated the biomechanics of the rib cage during respiration using a finite element method, but only intact conditions were modelled. Thus, the purpose of this study was to develop a realistic numerical model of the human rib cage and to analyse the biomechanical performance of intact, injured and treated rib cages. Three-dimensional finite element models of the human rib cage were developed. Respiratory movement of the human rib cage was simulated to evaluate the strengths and limitations of different scenarios. The results show that a realistic human respiratory movement can be simulated and the predicted results were closely related to previous study (correlation coefficient>0.92). Fixation of two fractured ribs significantly decreased the fixation index (191%) compared to the injured model. This fixation may provide adequate fixation stability as well as reveal lower bone stress and implant stress compared with the fixation of three or more fractured ribs.

  19. Rib fractures after percutaneous radiofrequency and microwave ablation of lung tumors: incidence and relevance.

    Science.gov (United States)

    Alexander, Erica S; Hankins, Carol A; Machan, Jason T; Healey, Terrance T; Dupuy, Damian E

    2013-03-01

    To retrospectively identify the incidence and probable risk factors for rib fractures after percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) of neoplasms in the lung and to identify complications related to these fractures. Institutional review board approval was obtained for this HIPAA-compliant retrospective study. Study population was 163 patients treated with MWA and/or RFA for 195 lung neoplasms between February 2004 and April 2010. Follow-up computed tomographic images of at least 3 months were retrospectively reviewed by board-certified radiologists to determine the presence of rib fractures. Generalized estimating equations were performed to assess the effect that patient demographics, tumor characteristics, treatment parameters, and ablation zone characteristics had on development of rib fractures. Kaplan-Meier curve was used to estimate patients' probability of rib fracture after ablation as a function of time. Clinical parameters (ie, pain in ribs or chest, organ damage caused by fractured rib) were evaluated for patients with confirmed fracture. Rib fractures in proximity to the ablation zone were found in 13.5% (22 of 163) of patients. Estimated probability of fracture was 9% at 1 year and 22% at 3 years. Women were more likely than were men to develop fracture after ablation (P = .041). Patients with tumors closer to the chest wall were more likely to develop fracture (P = .0009), as were patients with ablation zones that involved visceral pleura (P = .039). No patients with rib fractures that were apparently induced by RFA and MWA had organ injury or damage related to fracture, and 9.1% (2 of 22) of patients reported mild pain. Rib fractures were present in 13.5% of patients after percutaneous RFA and MWA of lung neoplasms. Patients who had ablations performed close to the chest wall should be monitored for rib fractures.

  20. Posterior-only spinal fusion without rib head resection for treating type I neurofibromatosis with intra-canal rib head dislocation

    Directory of Open Access Journals (Sweden)

    Dong Sun

    2013-12-01

    Full Text Available OBJECTIVES: Patients with Type I neurofibromatosis scoliosis with intra-canal rib head protrusion are extremely rare. Current knowledge regarding the diagnosis and treatment for this situation are insufficient. The purpose of this study is to share our experience in the diagnosis and surgical treatments for such unique deformities. METHODS: Six patients with Type I neurofibromatosis scoliosis with rib head dislocation into the spinal canal were diagnosed at our institution. Posterior instrumentation and spinal fusion without intra-canal rib head resection via a posterior-only approach was performed for deformity correction and rib head extraction. The efficacy and outcomes of the surgery were evaluated by measurements before, immediately and 24 months after the surgery using the following parameters: coronal spinal Cobb angle, apex rotation and kyphosis of the spine and the intra-canal rib head position. Post-operative complications, surgery time and blood loss were also evaluated. RESULTS: Patients were followed up for at least 24 months post-operatively. The three dimensional spinal deformity was significantly improved and the intra-canal rib head was significantly extracted from the canal immediately after the surgery. At follow-up 24 months after surgery, solid fusions were achieved along the fusion segments, and the deformity corrections and rib head positions were well maintained. There were no surgery-related complications any time after the surgery. CONCLUSIONS: Systematic examinations are needed to identify patients with Type I neurofibromatosis scoliosis with rib head dislocation into the canal who can be treated by posterior-only spinal fusion without rib head resection.

  1. Analysis and test of a 16-foot radial rib reflector developmental model

    Science.gov (United States)

    Birchenough, Shawn A.

    1989-01-01

    Analytical and experimental modal tests were performed to determine the vibrational characteristics of a 16-foot diameter radial rib reflector model. Single rib analyses and experimental tests provided preliminary information relating to the reflector. A finite element model predicted mode shapes and frequencies of the reflector. The analyses correlated well with the experimental tests, verifying the modeling method used. The results indicate that five related, characteristic mode shapes form a group. The frequencies of the modes are determined by the relative phase of the radial ribs.

  2. Rib Radiography versus Chest Computed Tomography in the Diagnosis of Rib Fractures.

    Science.gov (United States)

    Sano, Atsushi

    2018-05-01

     The accurate diagnosis of rib fractures is important in chest trauma. Diagnostic images following chest trauma are usually obtained via chest X-ray, chest computed tomography, or rib radiography. This study evaluated the diagnostic characteristics of rib radiography and chest computed tomography.  Seventy-five rib fracture patients who underwent both chest computed tomography and rib radiography between April 2008 and December 2013 were included. Rib radiographs, centered on the site of pain, were taken from two directions. Chest computed tomography was performed using a 16-row multidetector scanner with 5-mm slice-pitch without overlap, and axial images were visualized in a bone window.  In total, 217 rib fractures were diagnosed in 75 patients. Rib radiography missed 43 rib fractures in 24 patients. The causes were overlap with organs in 15 cases, trivial fractures in 21 cases, and injury outside the imaging range in 7 cases. Left lower rib fractures were often missed due to overlap with the heart, while middle and lower rib fractures were frequently not diagnosed due to overlap with abdominal organs. Computed tomography missed 21 rib fractures in 17 patients. The causes were horizontal fractures in 10 cases, trivial fractures in 9 cases, and insufficient breath holding in 1 case.  In rib radiography, overlap with organs and fractures outside the imaging range were characteristic reasons for missed diagnoses. In chest computed tomography, horizontal rib fractures and insufficient breath holding were often responsible. We should take these challenges into account when diagnosing rib fractures. Georg Thieme Verlag KG Stuttgart · New York.

  3. CFD Analysis on the Thermal Hydraulic Performance of an SAH Duct with Multi V-Shape Roughened Ribs

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2016-05-01

    Full Text Available This study presents the heat transfer and fluid flow characteristics in a rib-roughened SAH (solar air heater channel. The artificial roughness of the rectangular channel was in the form of a thin circular wire in discrete multi V-pattern rib geometries. The effect of this geometry on heat transfer, fluid flow, and performance augmentation was investigated using the CFD (computational fluid dynamics. The roughness parameters were a relative discrete distance of 0.69, a relative rib height of 0.043, a relative rib pitch of 10, a relative rib width of 6.0, and a flow-attack-angle of 60°. The discrete width ratios and Reynolds numbers ranged from 0.5 to 2.0 and from 2000 to 20,000, respectively. The CFD results using the renormalization k-epsilon model were in good agreement with the empirical relationship. This model was used to investigate the heat transfer and fluid flow characteristics in the multi V-pattern rib roughened SAH channel. The thermo-hydraulic performance was found to be the best for the discrete width ratio of 1.0. A discrete multi V-pattern rib combined with dimple staggered ribs also had better overall thermal performance compared to other rib shapes.

  4. PICTORIAL INTERLUDE Beware the bifid rib!

    African Journals Online (AJOL)

    be associated with Gorlin-Goltz basal cell nevus syndrome, a rare autosomal dominant condition characterised by multiple nevoid basal cell carcinomas, jaw cysts and bifid ribs. Further features include other rib anomalies, deficiency of the lateral clavicle, mandibular hypoplasia, macrocephaly and mental retardation.1.

  5. Scoliosis secondary to an unusual rib lesion.

    LENUS (Irish Health Repository)

    Burke, N G

    2012-04-01

    Tumours of the chest wall are uncommon and are usually malignant. A bone haemangioma is a rare benign vascular neoplasm, which more commonly occurs in middle-aged patients. We present the case of a scoliosis caused by a rib haemangioma in an adolescent male. Other causes of scoliosis secondary to rib lesions are discussed.

  6. A comparison between rib fracture patterns in peri- and post-mortem compressive injury in a piglet model.

    Science.gov (United States)

    Bradley, Amanda L; Swain, Michael V; Neil Waddell, J; Das, Raj; Athens, Josie; Kieser, Jules A

    2014-05-01

    Forensic biomechanics is increasingly being used to explain how observed injuries occur. We studied infant rib fractures from a biomechanical and morphological perspective using a porcine model. We used 24, 6th ribs of one day old domestic pigs Sus scrofa, divided into three groups, desiccated (representing post-mortem trauma), fresh ribs with intact periosteum (representing peri-mortem trauma) and those stored at -20°C. Two experiments were designed to study their biomechanical behaviour fracture morphology: ribs were axially compressed and subjected to four-point bending in an Instron 3339 fitted with custom jigs. Morphoscopic analysis of resultant fractures consisted of standard optical methods, micro-CT (μCT) and Scanning Electron Microscopy (SEM). During axial compression fresh ribs did not fracture because of energy absorption capabilities of their soft and fluidic components. In flexure tests, dry ribs showed typical elastic-brittle behaviour with long linear load-extension curves, followed by short non-linear elastic (hyperelastic) behaviour and brittle fracture. Fresh ribs showed initial linear-elastic behaviour, followed by strain softening and visco-plastic responses. During the course of loading, dry bone showed minimal observable damage prior to the onset of unstable fracture. Frozen then thawed bone showed similar patterns to fresh bone. Morphologically, fresh ribs showed extensive periosteal damage to the tensile surface with areas of collagen fibre pull-out along the tensile surface. While all dry ribs fractured precipitously, with associated fibre pull-out, the latter feature was absent in thawed ribs. Our study highlights the fact that under controlled loading, fresh piglet ribs (representing perimortem trauma) did not fracture through bone, but was associated with periosteal tearing. These results suggest firstly, that complete lateral rib fracture in infants may in fact not result from pure compression as has been previously assumed; and

  7. A study of the rib fall mechanism in soft coal and its control at a fully-mechanized top-coal caving face

    Energy Technology Data Exchange (ETDEWEB)

    Fang Xin-qiu; He Jie; Li Hai-chao [China University of Mining & Technology, Xuzhou (China). School of Mines

    2009-05-15

    The factors involved in rib-fall at a fully-mechanized top-coal caving face in the Wuyang mine were analyzed. The mechanical stress characteristics and the mechanism of rib-fall were modeled. Control principles and methods were proposed and a control project, and parameters for it, was identified. An underground industrial scale test was subsequently completed. The results show that arc shaped 'sliding surfaces' exist in the rib. The critical height of stable areas is 1.8 meters. The key to rib stability is the control of this arc shaped surface. Wooden bolts are used in the serious rib-fall zone to stabilize the rib. After implementation of the new project rib fall depth and scope were reduced significantly and tip-to-face caving was effectively controlled. 10 refs., 5 figs.

  8. Rib necrosis after postoperative irradiation with 6MeV x-ray to breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Asakawa, H; Watarai, J; Otawa, H [Miyagi Prefectural Adult Disease Center, Natori (Japan)

    1975-04-01

    In order to examine quality of rays in radiation injury in the rib by high energy x-ray, radiation injury in the rib was roentgenologically followed up in the subjects that received postoperative irradiation only with 6 MeV x-ray to breast cancer. The subjects consisted of 79 patients with the age of 30 to 78 and were irradiated with 200 rads of 6 MeV x-ray 5 times a week delivered in 5 to 6 weeks postoperatively. Two fields were irradiated in a day and the total dose reached more than 5,000 rads. Roentgenologic follow up for more than 12 months revealed that rib necrosis occurred in 9 (11%) of 79 patients and that there was no relation to the age of patient. The necrosis was most likely to develop in the right second rib 10 to 23 months after the irradiation and the mean was 16 months. To the rib region where necrosis occurred, 1,880 to 2,230 ret were irradiated and the mean was 2,014 ret. There found no relation between the irradiation dose and occurrence of rib necrosis in the extent of 4,000 to 6,000 rads for tumor doses. Radiation injury in the lung was complicated in 8 (89%) of 9 patients with rib necrosis, indicating high incidence.

  9. Cancer Related-Knowledge - Small Area Estimates

    Science.gov (United States)

    These model-based estimates are produced using statistical models that combine data from the Health Information National Trends Survey, and auxiliary variables obtained from relevant sources and borrow strength from other areas with similar characteristics.

  10. Compressive rib fracture: peri-mortem and post-mortem trauma patterns in a pig model.

    Science.gov (United States)

    Kieser, Jules A; Weller, Sarah; Swain, Michael V; Neil Waddell, J; Das, Raj

    2013-07-01

    Despite numerous studies on high impact fractures of ribs, little is known about compressive rib injuries. We studied rib fractures from a biomechanical and morphological perspective using 15, 5th ribs of domestic pigs Sus scrofa, divided into two groups, desiccated (representing post-mortem trauma) and fresh ribs with intact periosteum (representing peri-mortem trauma). Ribs were axially compressed and subjected to four-point bending in an Instron 3339 fitted with custom jigs. Morphoscopic analysis of resultant fractures consisted of standard optical methods, micro-CT (μCT) and scanning electron microscopy (SEM). During axial compression, fresh ribs had slightly higher strength because of energy absorption capabilities of their soft and fluidic components. In flexure tests, dry ribs showed typical elastic-brittle behaviour with long linear load-extension curves, followed by relatively short non-linear elastic (hyperelastic) behaviour and brittle fracture. Fresh ribs showed initial linear-elastic behaviour, followed by strain softening, visco-plastic responses. During the course of loading, dry bone showed minimal observable damage prior to the onset of unstable fracture. In contrast, fresh bone showed buckling-like damage features on the compressive surface and cracking parallel to the axis of the bone. Morphologically, all dry ribs fractured precipitously, whereas all but one of the fresh ribs showed incomplete fracture. The mode of fracture, however, was remarkably similar for both groups, with butterfly fractures predominating (7/15, 46.6% dry and wet). Our study highlights the fact that under controlled loading, despite seemingly similar butterfly fracture morphology, fresh ribs (representing perimortem trauma) show a non-catastrophic response. While extensive strain softening observed for the fresh bone does show some additional micro-cracking damage, it appears that the periosteum may play a key role in imparting the observed pseudo-ductility to the ribs

  11. Shanidar 3 Neandertal rib puncture wound and paleolithic weaponry.

    Science.gov (United States)

    Churchill, Steven E; Franciscus, Robert G; McKean-Peraza, Hilary A; Daniel, Julie A; Warren, Brittany R

    2009-08-01

    Since its discovery and initial description in the 1960s, the penetrating lesion to the left ninth rib of the Shanidar 3 Neandertal has been a focus for discussion about interpersonal violence and weapon technology in the Middle Paleolithic. Recent experimental studies using lithic points on animal targets suggest that aspects of weapon system dynamics can be inferred from the form of the bony lesions they produce. Thus, to better understand the circumstances surrounding the traumatic injury suffered by Shanidar 3, we conducted controlled stabbing experiments with replicas of Mousterian and Levallois points directed against the thoraces of pig carcasses. Stabs were conducted under both high and low kinetic energy conditions, in an effort to replicate the usual impact forces associated with thrusting spear vs. long-range projectile weapon systems, respectively. Analysis of the lesions produced in the pig ribs, along with examination of goat ribs subjected primarily to high kinetic energy stabs from an independent experiment, revealed consistent differences in damage patterns between the two conditions. In the case of Shanidar 3, the lack of major involvement of more than one rib, the lack of fracturing of the affected and adjacent ribs, and the lack of bony defects associated with the lesion (such as wastage, hinging, and radiating fracture lines) suggests that the weapon that wounded him was carrying relatively low kinetic energy. While accidental injury or attack with a thrusting spear or knife cannot absolutely be ruled out, the position, angulation, and morphology of the lesion is most consistent with injury by a low-mass, low-kinetic energy projectile weapon. Given the potential temporal overlap of Shanidar 3 with early modern humans in western Asia, and the possibility that the latter were armed with projectile weapon systems, this case carries more than simple paleoforensic interest.

  12. Rib Fracture Fixation: Indications and Outcomes.

    Science.gov (United States)

    Senekjian, Lara; Nirula, Raminder

    2017-01-01

    Rib fractures are a frequently identified injury in the trauma population. Not only are multiple rib fractures painful, but they are associated with an increased risk of adverse outcomes. Pneumonia in particular can be devastating, especially to an elderly patient, but other complications such as prolonged ventilation and increased intensive care and hospital durations of stay have a negative impact on the patient. Computed tomography scan is the best modality to diagnosis rib fractures but the treatment of fractures is still evolving. Currently patient care involves a multidisciplinary approach that includes pain control, aggressive pulmonary therapy, and possibly surgical fixation. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. When Should Abdominal Computed Tomography Be Considered in Patients with Lower Rib Fractures?

    Science.gov (United States)

    Jeroukhimov, Igor; Hershkovitz, Yehuda; Wiser, Itay; Kessel, Boris; Ayyad, Mohammed; Gatot, Inbar; Shapira, Zahar; Jeoravlev, Svetlana; Halevy, Ariel; Lavy, Ron

    2017-05-01

    Lower rib fractures are considered as a marker of intra-abdominal organ injury. Abdominal computed tomography (CT) is the "gold standard" examination for patients with lower rib fractures. However, the reported incidence of concomitant intra-abdominal injuries (IAI) is 20%-40%. The purpose of this study was to evaluate the incidence of intra-abdominal organ injuries in blunt trauma patients with lower rib fractures. Medical charts and radiology reports of patients with lower rib (from the 8th to 12th rib) fractures admitted to our center during a 6-year period were retrospectively reviewed. Patients were divided into two groups. Group I included patients with intra-abdominal injury (IAI) diagnosed either by CT or on urgent laparotomy, and Group II included those with normal abdominal CT scans. Data included demographics, mechanism of injury, laboratory tests, radiology results including number and location of fractured ribs, and incidence of IAI. Overall 318 patients were included in the study. Fifty-seven patients (17.9%) had 71 IAIs compared with 265 (82.1%) patients with no IAI. Logistic regression identified age younger than 55 years (relative risk [RR] = 7.2; 95% confidence interval [CI] 3.1-16.8; p = 0.001), bilateral rib fractures (RR = 3.9; 95% CI 1.1-13.5; p = 0.03) and decreased levels of hematocrit (RR = 2.4; 95% CI 1.2-4.8; p = 0.016) as independent risk factors for the presence of IAI. Abdominal CT should be considered in blunt trauma patients with lower rib fractures who are younger than 55 years of age and have bilateral rib fractures and decreased levels of hematocrit on admission. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Turbulent flow in a ribbed channel: Flow structures in the vicinity of a rib

    DEFF Research Database (Denmark)

    Wang, Lei; Salewski, Mirko; Sundén, Bengt

    2010-01-01

    PIV measurements are performed in a channel with periodic ribs on one wall. The emphasis of this study is to investigate the flow structures in the vicinity of a rib in terms of mean velocities, Reynolds stresses, probability density functions (PDF), and two-point correlations. The PDF distribution......-based visualization is applied to the separation bubble upstream of the rib. Salient critical points and limit cycles are extracted, which gives clues to the physical processes occurring in the flow....

  15. Novel classification system of rib fractures observed in infants.

    Science.gov (United States)

    Love, Jennifer C; Derrick, Sharon M; Wiersema, Jason M; Pinto, Deborrah C; Greeley, Christopher; Donaruma-Kwoh, Marcella; Bista, Bibek

    2013-03-01

    Rib fractures are considered highly suspicious for nonaccidental injury in the pediatric clinical literature; however, a rib fracture classification system has not been developed. As an aid and impetus for rib fracture research, we developed a concise schema for classifying rib fracture types and fracture location that is applicable to infants. The system defined four fracture types (sternal end, buckle, transverse, and oblique) and four regions of the rib (posterior, posterolateral, anterolateral, and anterior). It was applied to all rib fractures observed during 85 consecutive infant autopsies. Rib fractures were found in 24 (28%) of the cases. A total of 158 rib fractures were identified. The proposed schema was adequate to classify 153 (97%) of the observed fractures. The results indicate that the classification system is sufficiently robust to classify rib fractures typically observed in infants and should be used by researchers investigating infant rib fractures. © 2013 American Academy of Forensic Sciences.

  16. Optimizing rib width to height and rib spacing to deck plate thickness ratios in orthotropic decks

    Directory of Open Access Journals (Sweden)

    Abdullah Fettahoglu

    2016-12-01

    Full Text Available Orthotropic decks are composed of deck plate, ribs, and cross-beams and are frequently used in industry to span long distances, due to their light structures and load carrying capacities. Trapezoidal ribs are broadly preferred as longitudinal stiffeners in design of orthotropic decks. They supply the required stiffness to the orthotropic deck in traffic direction. Trapezoidal ribs are chosen in industrial applications because of their high torsional and buckling rigidity, less material and welding needs. Rib width, height, spacing, thickness of deck plate are important parameters for designing of orthotropic decks. In the scope of this study, rib width to height and rib spacing to deck plate thickness ratios are assessed by means of the stresses developed under different ratios of these parameters. For this purpose a FE-model of orthotropic bridge is generated, which encompasses the entire bridge geometry and conforms to recommendations given in Eurocode 3 Part 2. Afterwards necessary FE-analyses are performed to reveal the stresses developed under different rib width to height and rib spacing to deck plate thickness ratios. Based on the results obtained in this study, recommendations regarding these ratios are provided for orthotropic steel decks occupying trapezoidal ribs.

  17. Pulmonary embolism developing after rib fracture

    Directory of Open Access Journals (Sweden)

    Manabu Nemoto

    2014-04-01

    Full Text Available In this letter, we wanted to show that acute pulmonary embolism may be observed as a complication in patients with traumatic rib fracture and to emphasize on the importance the early diagnosis examinations in suspicious cases.

  18. RIBBED DOUBLE PIPE HEAT EXCHANGER: ANALYTICAL ANALYSIS

    Directory of Open Access Journals (Sweden)

    HUSSAIN H. AL-KAYIEM

    2011-02-01

    Full Text Available This paper presents the findings obtained by modeling a Double Pipe Heat Exchanger (DPHE equipped with repeated ribs from the inside for artificial roughing. An analytical procedure was developed to analyze the thermal and hydraulic performance of the DPHE with and without ribbing. The procedure was verified by comparing with experimental reported results and they are in good agreement. Several parameters were investigated in this study including the effect of ribs pitch to height ratios, P/e= 5, 10, 15, and 20, and ribs to hydraulic diameter ratios, e/Dh= 0.0595, 0.0765, and 0.107. These parameters were studied at various operating Reynolds number ranging from 2500 to 150000. Different installation configurations were investigated, too. An enhan-cement of 4 times in the heat transfer in terms of Stanton number was achieved at the expense of 38 times increase of pressure drop across the flow in terms of friction facto values.

  19. Corrosion of Spiral Rib Aluminized Pipe : [Summary

    Science.gov (United States)

    2012-01-01

    Large diameter, corrugated steel pipes are a common sight in the culverts that run alongside many Florida roads. Spiral-ribbed aluminized pipe (SRAP) has been widely specified by the Florida Department of Transportation (FDOT) for runoff drainage. Th...

  20. Corrosion of Spiral Rib Aluminized Pipe

    Science.gov (United States)

    2012-08-01

    Large diameter, corrugated steel pipes are a common sight in the culverts that run alongside many Florida roads. Spiral-ribbed aluminized pipe (SRAP) has been widely specified by the Florida Department of Transportation (FDOT) for runoff drainage. Th...

  1. Reports on various anomalies of the ribs

    Energy Technology Data Exchange (ETDEWEB)

    Brinkmann, G.; Brix, F.

    1988-02-01

    Three patients are presented who were suffering from different anomalies of the ribs: There was one each plus and minus variant and a female patient with Gorlin-Goltz syndrome (basal cell nevus syndrome) demonstrating several changes in the ribs as an expression of a genetically determined segmentation disturbance. These presentations are followed by a detailed discussion on the types and causes of such anomalies.

  2. Reports on various anomalies of the ribs

    International Nuclear Information System (INIS)

    Brinkmann, G.; Brix, F.

    1988-01-01

    Three patients are presented who were suffering from different anomalies of the ribs: There was one each plus and minus variant and a female patient with Gorlin-Goltz syndrome (basal cell nevus syndrome) demonstrating several changes in the ribs as an expression of a genetically determined segmentation disturbance. These presentations are followed by a detailed discussion on the types and causes of such anomalies. (orig.) [de

  3. Effect of Aspect Ratio, Channel Orientation, Rib Pitch-to-Height Ratio, and Number of Ribbed Walls on Pressure Drop Characteristics in a Rotating Channel with Detached Ribs

    Directory of Open Access Journals (Sweden)

    K. Arun

    2007-01-01

    Full Text Available The present work involves experimental investigation of the effects of aspect ratio, channel orientation angle, rib pitch-to-height ratio (P/e, and number of ribbed walls on friction factor in orthogonally rotating channel with detached ribs. The ribs are separated from the base wall to provide a small region of flow between the base wall and the ribs. Experiments have been conducted at Reynolds number ranging from 10000–17000 with rotation numbers varying from 0–0.38. Pitch-to-rib height ratios (P/e of 5 and 10 at constant rib height-to-hydraulic diameter ratio (e/D of 0.1 and a clearance ratio (C/e of 0.38 are considered. The rib angle of attack with respect to mainstream flow is 90∘. The channel orientation at which the ribbed wall becomes trailing surface (pressure side on which the Coriolis force acts is considered as the 0∘ orientation angle. For one-wall ribbed case, channel is oriented from 0∘ to 180∘ about its axis in steps of 30∘ to change the orientation angle. For two-wall ribbed case, the orientation angle is changed from 0∘ to 90∘ in steps of 30∘. Friction factors for the detached ribbed channels are compared with the corresponding attached ribbed channel. It is found that in one-wall detached ribbed channel, increase in the friction factor ratio with the orientation angle is lower for rectangular channel compared to that of square channel for both the pitch-to-rib height ratios of 5 and 10 at a given Reynolds number and rotation number. Friction factor ratios of two-wall detached ribbed rectangular channel are comparable with corresponding two-wall detached ribbed square channel both under stationary and rotating conditions.

  4. Successful emergency pain control for posterior rib fractures with ultrasound-guided erector spinae plane block.

    Science.gov (United States)

    Luftig, Josh; Mantuani, Daniel; Herring, Andrew A; Dixon, Brittany; Clattenburg, Eben; Nagdev, Arun

    2017-12-28

    The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed. The erector spinae plane block (ESPB) is conceptually similar to the SAPB, but targets the posterior thorax making it likely more effective for ED patients with posterior rib fractures. Our initial experience demonstrates consistent success with the ESPB for traumatic posterior rib fracture analgesia. Herein, we present the first description of the ESPB utilized in the ED. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Small female rib cage fracture in frontal sled tests.

    Science.gov (United States)

    Shaw, Greg; Lessley, David; Ash, Joseph; Poplin, Jerry; McMurry, Tim; Sochor, Mark; Crandall, Jeff

    2017-01-02

    The 2 objectives of this study are to (1) examine the rib and sternal fractures sustained by small stature elderly females in simulated frontal crashes and (2) determine how the findings are characterized by prior knowledge and field data. A test series was conducted to evaluate the response of 5 elderly (average age 76 years) female postmortem human subjects (PMHS), similar in mass and size to a 5th percentile female, in 30 km/h frontal sled tests. The subjects were restrained on a rigid planar seat by bilateral rigid knee bolsters, pelvic blocks, and a custom force-limited 3-point shoulder and lap belt. Posttest subject injury assessment included identifying rib cage fractures by means of a radiologist read of a posttest computed tomography (CT) and an autopsy. The data from a motion capture camera system were processed to provide chest deflection, defined as the movement of the sternum relative to the spine at the level of T8.  A complementary field data investigation involved querying the NASS-CDS database over the years 1997-2012. The targeted cases involved belted front seat small female passenger vehicle occupants over 40 years old who were injured in 25 to 35 km/h delta-V frontal crashes (11 to 1 o'clock). Peak upper shoulder belt tension averaged 1,970 N (SD = 140 N) in the sled tests. For all subjects, the peak x-axis deflection was recorded at the sternum with an average of -44.5 mm or 25% of chest depth. The thoracic injury severity based on the number and distribution of rib fractures yielded 4 subjects coded as Abbreviated Injury Scale (AIS) 3 (serious) and one as AIS 5 (critical). The NASS-CDS field data investigation of small females identified 205 occupants who met the search criteria. Rib fractures were reported for 2.7% of the female occupants. The small elderly test subjects sustained a higher number of rib cage fractures than expected in what was intended to be a minimally injurious frontal crash test condition. Neither field studies nor

  6. Rib fracture as a predictor of future fractures in young and older postmenopausal women: National Osteoporosis Risk Assessment (NORA)

    Science.gov (United States)

    Sajjan, S. G.; Barrett-Connor, E.; McHorney, C. A.; Miller, P. D.; Sen, S. S.; Siris, E.

    2013-01-01

    Summary A rib fracture history after age 45 was associated with a 5.4-fold increase in new rib fracture risk and a 2.4-fold increase in risk of any new clinical fracture in 155,031 postmenopausal women. A rib fracture history suggests osteoporosis and should be considered when evaluating patients for interventions to prevent fractures. Introduction Until recently, little attention was paid to rib fracture as an osteoporosis marker. Emerging evidence suggests rib fracture may be an osteoporotic fracture in men and women. We report the 5-year independent association between baseline rib fracture histories and self-reported future fractures by age (decade) in the NORA cohort (155,031 postmenopausal women, 50–99 years). Methods Participants reported fracture history and responded to follow-up surveys at years 1, 3, or 6. Women with a baseline rib fracture history without other fractures were compared with women with no fracture. Results At baseline, 4,758 (3.07%) women reported a rib fracture history without other fractures; 6,300 women reported 6,830 new clinical fractures, including wrist (2,271), rib (1,891), spine (1,136), hip (941), and forearm (591). Adjusted relative risk (ARR) values (95% confidence interval [CI]) for future fractures in women with rib fracture history versus women with no fracture history were 5.4 (4.8–6.1) at the rib, 2.1 (1.7–2.6) at the spine, and 1.4 (1.1–1.7) at the wrist, and not significant for forearm or hip fractures. Future fracture risk was at least doubled in women with a rib fracture history in all ages: ARR (95% CI) 3.4 (2.8–4.0) for ages 50–59, 2.5 (2.1–3.0) for ages 60–69, 2.0 (1.7–2.3) for ages 70–79, and 2.0 (1.6–2.6) for ages >80. Conclusions Rib fracture, the second most common clinical fracture in women (after wrist fracture), predicted future fractures of the rib, wrist, and spine at all ages. Women presenting with rib fractures should be evaluated for appropriate management to prevent future

  7. Variation in the human ribs geometrical properties and mechanical response based on X-ray computed tomography images resolution.

    Science.gov (United States)

    Perz, Rafał; Toczyski, Jacek; Subit, Damien

    2015-01-01

    Computational models of the human body are commonly used for injury prediction in automobile safety research. To create these models, the geometry of the human body is typically obtained from segmentation of medical images such as computed tomography (CT) images that have a resolution between 0.2 and 1mm/pixel. While the accuracy of the geometrical and structural information obtained from these images depend greatly on their resolution, the effect of image resolution on the estimation of the ribs geometrical properties has yet to be established. To do so, each of the thirty-four sections of ribs obtained from a Post Mortem Human Surrogate (PMHS) was imaged using three different CT modalities: standard clinical CT (clinCT), high resolution clinical CT (HRclinCT), and microCT. The images were processed to estimate the rib cross-section geometry and mechanical properties, and the results were compared to those obtained from the microCT images by computing the 'deviation factor', a metric that quantifies the relative difference between results obtained from clinCT and HRclinCT to those obtained from microCT. Overall, clinCT images gave a deviation greater than 100%, and were therefore deemed inadequate for the purpose of this study. HRclinCT overestimated the rib cross-sectional area by 7.6%, the moments of inertia by about 50%, and the cortical shell area by 40.2%, while underestimating the trabecular area by 14.7%. Next, a parametric analysis was performed to quantify how the variations in the estimate of the geometrical properties affected the rib predicted mechanical response under antero-posterior loading. A variation of up to 45% for the predicted peak force and up to 50% for the predicted stiffness was observed. These results provide a quantitative estimate of the sensitivity of the response of the FE model to the resolution of the images used to generate it. They also suggest that a correction factor could be derived from the comparison between microCT and

  8. Hydrodynamics and Heat Transfer in Flow over Rectangular Ribs on the Initially Smooth Surface

    Directory of Open Access Journals (Sweden)

    V. N. Afanasiev

    2017-01-01

    Full Text Available An efficiency of the heat exchange equipment and reducing their weight and size parameters can be considerably improved by using the optimal methods of heat transfer enhancement, which include a two-dimensional roughness, i.e. ribs, backward-facing steps, cavities, etc. deposited on the heat transfer surface. Their shape, sizes and positional relationship have a significant impact on the structure of the boundary layer and its exchange processes.As known, the most affordable and effective method of controlled influence on the structure of turbulent flow is to create a separation zone or other organized vortex structure in it. In order to successfully use the separation zone, it is necessary to know the mechanism of their interaction with the main turbulent flow and the mechanism of the process in separation zone itself. Heat transfer enhancement is provided mainly due to roughness impact on hydrodynamics of turbulent flow, if the rib height h does not exceed the thickness of the viscous sublayer, since heat transfer enhancement arises from breaking and destruction of viscous sublayer produced by the roughness ribs and emerging vortex zones – sources of turbulence. Usually, the height of ribs y+ ≈ 50, and the distance between them along the streamlined surface is 10-20 times greater. The coefficient of friction also increases, but if the height of ribs is sufficiently small and most of them are in the sublayer, the increase of the friction factor will not exceed the increase of the heat transfer coefficient.The paper presents results of experimental investigation of hydrodynamics and heat transfer in the separation zone before and after a rib and in the area of two rectangular ribs with the height of y+ £ 60. The ribs are placed on the flat plate and heated according to the law of qw = const. The structure of turbulent boundary layer from the standpoint of the universal logarithmic law of velocity distribution has been experimentally

  9. Trial of Injected Liposomal Bupivacaine vs Bupivacaine Infusion After Surgical Stabilization of Rib Fractures

    Science.gov (United States)

    2017-10-06

    Drug Effect; Rib Fractures; Rib Trauma; Surgical Procedure, Unspecified; Pain; Catheter (Other); Nerve Pain; Local Infiltration; Anesthesia, Local; Intercostal Rib; Opioid Dependence; Chest Injury Trauma; Pneumonia

  10. Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures

    OpenAIRE

    Chapman, Brandon C.; Overbey, Douglas M.; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T.; French, Andrew; Johnson, Jeffrey L.; Burlew, Clay C.; Barnett, Carlton; Moore, Ernest E.; Pieracci, Fredric M.

    2016-01-01

    Background Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. Objectives The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Methods Retrospective coho...

  11. Rib fixation for severe chest deformity due to multiple rib fractures.

    Science.gov (United States)

    Igai, Hitoshi; Kamiyoshihara, Mitsuhiro; Nagashima, Toshiteru; Ohtaki, Yoichi

    2012-01-01

    The operative indications for rib fracture repair have been a matter of debate. However, several reports have suggested that flail chest, pain on respiration, and chest deformity/defect are potential conditions for rib fracture repair. We describe our experience of rib fixation in a patient with severe chest deformity due to multiple rib fractures. A 70-year-old woman was admitted with right-sided multiple rib fractures (2nd to 7th) and marked chest wall deformity without flailing caused by an automobile accident. Collapse of the chest wall was observed along the middle anterior axillary line. At 11 days after the injury, surgery was performed to repair the chest deformity, as it was considered to pose a risk of restrictive impairment of pulmonary function or chronic intercostal pain in the future. Operative findings revealed marked displacement of the superior 4 ribs, from the 2nd to the 5th, and collapse of the osseous chest wall towards the thoracic cavity. After exposure of the fracture regions, ribs fixations were performed using rib staplers. The total operation time was 90 minutes, and the collapsed portion of the chest wall along the middle anterior axillary line was reconstructed successfully.

  12. Systemic administration of mesenchymal stem cells combined with parathyroid hormone therapy synergistically regenerates multiple rib fractures.

    Science.gov (United States)

    Cohn Yakubovich, Doron; Sheyn, Dmitriy; Bez, Maxim; Schary, Yeshai; Yalon, Eran; Sirhan, Afeef; Amira, May; Yaya, Alin; De Mel, Sandra; Da, Xiaoyu; Ben-David, Shiran; Tawackoli, Wafa; Ley, Eric J; Gazit, Dan; Gazit, Zulma; Pelled, Gadi

    2017-03-09

    A devastating condition that leads to trauma-related morbidity, multiple rib fractures, remain a serious unmet clinical need. Systemic administration of mesenchymal stem cells (MSCs) has been shown to regenerate various tissues. We hypothesized that parathyroid hormone (PTH) therapy would enhance MSC homing and differentiation, ultimately leading to bone formation that would bridge rib fractures. The combination of human MSCs (hMSCs) and a clinically relevant PTH dose was studied using immunosuppressed rats. Segmental defects were created in animals' fifth and sixth ribs. The rats were divided into four groups: a negative control group, in which animals received vehicle alone; the PTH-only group, in which animals received daily subcutaneous injections of 4 μg/kg teriparatide, a pharmaceutical derivative of PTH; the hMSC-only group, in which each animal received five injections of 2 × 10 6 hMSCs; and the hMSC + PTH group, in which animals received both treatments. Longitudinal in vivo monitoring of bone formation was performed biweekly using micro-computed tomography (μCT), followed by histological analysis. Fluorescently-dyed hMSCs were counted using confocal microscopy imaging of histological samples harvested 8 weeks after surgery. PTH significantly augmented the number of hMSCs that homed to the fracture site. Immunofluorescence of osteogenic markers, osteocalcin and bone sialoprotein, showed that PTH induced cell differentiation in both exogenously administered cells and resident cells. μCT scans revealed a significant increase in bone volume only in the hMSC + PTH group, beginning by the 4 th week after surgery. Eight weeks after surgery, 35% of ribs in the hMSC + PTH group had complete bone bridging, whereas there was complete bridging in only 6.25% of ribs (one rib) in the PTH-only group and in none of the ribs in the other groups. Based on the μCT scans, biomechanical analysis using the micro-finite element method demonstrated that

  13. Rib fracture after stereotactic radiotherapy for primary lung cancer: prevalence, degree of clinical symptoms, and risk factors.

    Science.gov (United States)

    Nambu, Atsushi; Onishi, Hiroshi; Aoki, Shinichi; Tominaga, Licht; Kuriyama, Kengo; Araya, Masayuki; Saito, Ryoh; Maehata, Yoshiyasu; Komiyama, Takafumi; Marino, Kan; Koshiishi, Tsuyota; Sawada, Eiichi; Araki, Tsutomu

    2013-02-07

    As stereotactic body radiotherapy (SBRT) is a highly dose-dense radiotherapy, adverse events of neighboring normal tissues are a major concern. This study thus aimed to clarify the frequency and degree of clinical symptoms in patients with rib fractures after SBRT for primary lung cancer and to reveal risk factors for rib fracture. Appropriate α/β ratios for discriminating between fracture and non-fracture groups were also investigated. Between November 2001 and April 2009, 177 patients who had undergone SBRT were evaluated for clinical symptoms and underwent follow-up thin-section computed tomography (CT). The time of rib fracture appearance was also assessed. Cox proportional hazard modeling was performed to identify risk factors for rib fracture, using independent variables of age, sex, maximum tumor diameter, radiotherapeutic method and tumor-chest wall distance. Dosimetric details were analyzed for 26 patients with and 22 randomly-sampled patients without rib fracture. Biologically effective dose (BED) was calculated with a range of α/β ratios (1-10 Gy). Receiver operating characteristics analysis was used to define the most appropriate α/β ratio. Rib fracture was found on follow-up thin-section CT in 41 patients. The frequency of chest wall pain in patients with rib fracture was 34.1% (14/41), and was classified as Grade 1 or 2. Significant risk factors for rib fracture were smaller tumor-chest wall distance and female sex. Area under the curve was maximal for BED at an α/β ratio of 8 Gy. Rib fracture is frequently seen on CT after SBRT for lung cancer. Small tumor-chest wall distance and female sex are risk factors for rib fracture. However, clinical symptoms are infrequent and generally mild. When using BED analysis, an α/β ratio of 8 Gy appears most effective for discriminating between fracture and non-fracture patients.

  14. Rib fracture after stereotactic radiotherapy for primary lung cancer: prevalence, degree of clinical symptoms, and risk factors

    International Nuclear Information System (INIS)

    Nambu, Atsushi; Marino, Kan; Koshiishi, Tsuyota; Sawada, Eiichi; Araki, Tsutomu; Onishi, Hiroshi; Aoki, Shinichi; Tominaga, Licht; Kuriyama, Kengo; Araya, Masayuki; Saito, Ryoh; Maehata, Yoshiyasu; Komiyama, Takafumi

    2013-01-01

    As stereotactic body radiotherapy (SBRT) is a highly dose-dense radiotherapy, adverse events of neighboring normal tissues are a major concern. This study thus aimed to clarify the frequency and degree of clinical symptoms in patients with rib fractures after SBRT for primary lung cancer and to reveal risk factors for rib fracture. Appropriate α/β ratios for discriminating between fracture and non-fracture groups were also investigated. Between November 2001 and April 2009, 177 patients who had undergone SBRT were evaluated for clinical symptoms and underwent follow-up thin-section computed tomography (CT). The time of rib fracture appearance was also assessed. Cox proportional hazard modeling was performed to identify risk factors for rib fracture, using independent variables of age, sex, maximum tumor diameter, radiotherapeutic method and tumor-chest wall distance. Dosimetric details were analyzed for 26 patients with and 22 randomly-sampled patients without rib fracture. Biologically effective dose (BED) was calculated with a range of α/β ratios (1–10 Gy). Receiver operating characteristics analysis was used to define the most appropriate α/β ratio. Rib fracture was found on follow-up thin-section CT in 41 patients. The frequency of chest wall pain in patients with rib fracture was 34.1% (14/41), and was classified as Grade 1 or 2. Significant risk factors for rib fracture were smaller tumor-chest wall distance and female sex. Area under the curve was maximal for BED at an α/β ratio of 8 Gy. Rib fracture is frequently seen on CT after SBRT for lung cancer. Small tumor-chest wall distance and female sex are risk factors for rib fracture. However, clinical symptoms are infrequent and generally mild. When using BED analysis, an α/β ratio of 8 Gy appears most effective for discriminating between fracture and non-fracture patients

  15. Rib fracture after stereotactic radiotherapy for primary lung cancer: prevalence, degree of clinical symptoms, and risk factors

    Directory of Open Access Journals (Sweden)

    Nambu Atsushi

    2013-02-01

    Full Text Available Abstract Background As stereotactic body radiotherapy (SBRT is a highly dose-dense radiotherapy, adverse events of neighboring normal tissues are a major concern. This study thus aimed to clarify the frequency and degree of clinical symptoms in patients with rib fractures after SBRT for primary lung cancer and to reveal risk factors for rib fracture. Appropriate α/β ratios for discriminating between fracture and non-fracture groups were also investigated. Methods Between November 2001 and April 2009, 177 patients who had undergone SBRT were evaluated for clinical symptoms and underwent follow-up thin-section computed tomography (CT. The time of rib fracture appearance was also assessed. Cox proportional hazard modeling was performed to identify risk factors for rib fracture, using independent variables of age, sex, maximum tumor diameter, radiotherapeutic method and tumor-chest wall distance. Dosimetric details were analyzed for 26 patients with and 22 randomly-sampled patients without rib fracture. Biologically effective dose (BED was calculated with a range of α/β ratios (1–10 Gy. Receiver operating characteristics analysis was used to define the most appropriate α/β ratio. Results Rib fracture was found on follow-up thin-section CT in 41 patients. The frequency of chest wall pain in patients with rib fracture was 34.1% (14/41, and was classified as Grade 1 or 2. Significant risk factors for rib fracture were smaller tumor-chest wall distance and female sex. Area under the curve was maximal for BED at an α/β ratio of 8 Gy. Conclusions Rib fracture is frequently seen on CT after SBRT for lung cancer. Small tumor-chest wall distance and female sex are risk factors for rib fracture. However, clinical symptoms are infrequent and generally mild. When using BED analysis, an α/β ratio of 8 Gy appears most effective for discriminating between fracture and non-fracture patients.

  16. Rib fracture after stereotactic radiotherapy for primary lung cancer: prevalence, degree of clinical symptoms, and risk factors

    Science.gov (United States)

    2013-01-01

    Background As stereotactic body radiotherapy (SBRT) is a highly dose-dense radiotherapy, adverse events of neighboring normal tissues are a major concern. This study thus aimed to clarify the frequency and degree of clinical symptoms in patients with rib fractures after SBRT for primary lung cancer and to reveal risk factors for rib fracture. Appropriate α/β ratios for discriminating between fracture and non-fracture groups were also investigated. Methods Between November 2001 and April 2009, 177 patients who had undergone SBRT were evaluated for clinical symptoms and underwent follow-up thin-section computed tomography (CT). The time of rib fracture appearance was also assessed. Cox proportional hazard modeling was performed to identify risk factors for rib fracture, using independent variables of age, sex, maximum tumor diameter, radiotherapeutic method and tumor-chest wall distance. Dosimetric details were analyzed for 26 patients with and 22 randomly-sampled patients without rib fracture. Biologically effective dose (BED) was calculated with a range of α/β ratios (1–10 Gy). Receiver operating characteristics analysis was used to define the most appropriate α/β ratio. Results Rib fracture was found on follow-up thin-section CT in 41 patients. The frequency of chest wall pain in patients with rib fracture was 34.1% (14/41), and was classified as Grade 1 or 2. Significant risk factors for rib fracture were smaller tumor-chest wall distance and female sex. Area under the curve was maximal for BED at an α/β ratio of 8 Gy. Conclusions Rib fracture is frequently seen on CT after SBRT for lung cancer. Small tumor-chest wall distance and female sex are risk factors for rib fracture. However, clinical symptoms are infrequent and generally mild. When using BED analysis, an α/β ratio of 8 Gy appears most effective for discriminating between fracture and non-fracture patients. PMID:23391264

  17. Isolated rib fractures in geriatric patients

    Directory of Open Access Journals (Sweden)

    Elmistekawy Elsayed

    2007-01-01

    Full Text Available Introduction: The goal of this study was to investigate the short-term outcomes in patients older than 60 years with isolated rib fractures and admitted to emergency hospital. Materials and Methods: This study included patients who were 60 years old or more and sustained blunt chest injury and had isolated rib fractures. The following data were obtained from the medical records: age, gender, number of fracture ribs, side of fracture ribs, mechanism and nature of injury, preexisting medical conditions, complications, admission to intensive care unit (ICU, need for mechanical ventilation, length of ICU and hospital stay and mortality. Results: For the study, 39 patients who were 60 years old or more and admitted to the hospital because of isolated rib fractures were enrolled. There were 28 males (71.7% and 11 females (28.3% with mean age of (66.84 ± 4.7 years. No correlation was found between comorbidities and hospital outcomes except in those who were diabetic (P-value = 0.005 and those with chronic lung disease (P-value = 0.006. Pulmonary complications were the most frequent complications encountered in those patients. Pulmonary complications were: lung contusion in 8 patients (20.5% and pulmonary infection in 6 patients (15.8%. Conclusion: Elderly patients sustaining blunt chest trauma had significant morbidity and potential for mortality.

  18. Rib Geometry Explains Variation in Dynamic Structural Response: Potential Implications for Frontal Impact Fracture Risk.

    Science.gov (United States)

    Murach, Michelle M; Kang, Yun-Seok; Goldman, Samuel D; Schafman, Michelle A; Schlecht, Stephen H; Moorhouse, Kevin; Bolte, John H; Agnew, Amanda M

    2017-09-01

    The human thorax is commonly injured in motor vehicle crashes, and despite advancements in occupant safety rib fractures are highly prevalent. The objective of this study was to quantify the ability of gross and cross-sectional geometry, separately and in combination, to explain variation of human rib structural properties. One hundred and twenty-two whole mid-level ribs from 76 fresh post-mortem human subjects were tested in a dynamic frontal impact scenario. Structural properties (peak force and stiffness) were successfully predicted (p rib cross-sectional geometry obtained via direct histological imaging (total area, cortical area, and section modulus) and were improved further when utilizing a combination of cross-sectional and gross geometry (robusticity, whole bone strength index). Additionally, preliminary application of a novel, adaptive thresholding technique, allowed for total area and robusticity to be measured on a subsample of standard clinical CT scans with varied success. These results can be used to understand variation in individual rib response to frontal loading as well as identify important geometric parameters, which could ultimately improve injury criteria as well as the biofidelity of anthropomorphic test devices (ATDs) and finite element (FE) models of the human thorax.

  19. Chondroblastoma of rib in situs inversus

    Directory of Open Access Journals (Sweden)

    Purwa R Patil

    2014-01-01

    Full Text Available Chondroblastoma is a rare benign cartilaginous tumour accounting for approximately 1% of all bone tumours. It commonly arises from epiphysis of a long bone, particularly the humerus, tibia and femur. Rib is an extremely rare site for this tumour with a few cases reported in the literature. It is commonly seen in children and adults between the ages of 10 - 20 years. Although roentgenographic findings are quite common characteristic of this tumour, it can sometimes be misdiagnosed as giant cell tumour, osteogenic sarcoma and myeloma on histopathology. We report a 26-year-old male patient with situs inversus and chondroblastoma of rib. To the best of our knowledge, this is the first case of chondroblastoma of the rib in a patient of situs inversus. Segmental resection is the treatment of choice. It usually behaves in a benign fashion, but few cases have shown local recurrences and distant metastasis; hence, follow-up of the patient is essential.

  20. Morbidity, mortality, associated injuries, and management of traumatic rib fractures

    Directory of Open Access Journals (Sweden)

    Frank Cheau-Feng Lin

    2016-06-01

    Conclusion: The severity of traumatic rib fractures was identified in this study. Therefore, a trauma team needs better preparation to provide effective treatment strategies when encountering thoracic trauma patients, especially patients who are older and have rib fractures.

  1. Post-accelerator LINAC design for the VECC RIB project

    Indian Academy of Sciences (India)

    acclerator type of RIB facility. The scheme utilises the existing = 130 room temperature variable energy cyclotron machine as the primary accelerator for the production of RIBs and radio frequency quadrupole (RFQ) and LINAC modules for ...

  2. Rib fractures and their association With solid organ injury: higher rib fractures have greater significance for solid organ injury screening.

    Science.gov (United States)

    Rostas, Jack W; Lively, Timothy B; Brevard, Sidney B; Simmons, Jon D; Frotan, Mohammad A; Gonzalez, Richard P

    2017-04-01

    The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures and solid organ injury. In all, 1,103 rib fracture patients were identified; 142 patients had liver injuries with 109 (77%) associated right rib fractures. Right-sided rib fractures with highest sensitivity for liver injury were middle rib segment (5 to 8) and lower segment (9 to 12) with liver injury sensitivities of 68% and 43%, respectively (P rib fractures. Left middle segment rib fractures and lower segment rib fractures had sensitivities of 80% and 63% for splenic injury, respectively (P Rib fractures higher in the thoracic cage have significant association with solid organ injury. Using rib fractures from middle plus lower segments as indication for abdominal screening will significantly improve rib fracture sensitivity for identification of solid organ injury. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Evaluating the Relationship between Rib Fractures and the Probability of Abdominal Trauma; a Brief Report

    Directory of Open Access Journals (Sweden)

    Vahid Monsef Kasmaei

    2015-02-01

    Full Text Available Introduction: Trauma is one of the most important causes of death in patients under 40 years of age and the third common cause of death regardless of age. Rib cage damages are one of the major reasons for death in the early minutes post-trauma. Therefore, the present study aimed to evaluate the frequency of intra-abdominal injury in the patients with rib fracture who were referred to emergency department. Methods: This cross-sectional study included 60 patients with rib fractures who were admitted to the emergency department of Poorsina Hospital, Rasht, Iran, from March 2011 to March2012. A checklist was filled out for all the patients including age, sex, trauma mechanism, side and site of fracture, the number of broken ribs, the results of abdominal ultrasonography, the need for laparotomy and mortality. The collected data were classified based on descriptive statistics and analyzed using SPSS 16. Results: 60 patients with the mean age of 47.26±13.71 years were admitted to the emergency department during this time (81.7% male. The most common mechanism of trauma was car accident [22(36.7%]. Among these 60 patients, 71 rib fractures in 3 levels of chest (upper, middle, lower were detected and 50 (83.3% in the same area. Mean number of fractured ribs was 2.85±2.2 (minimum: 1, maximum 10. In 3 (5% patients, fracture was on both sides. The results of abdominal ultrasonography in 7 (11.7% patients were positive. The number of fractured ribs (p=0.017 and the area of the fracture (p=0.048 showed a significant correlation with the presence of intra-abdominal free fluid. The fracture of more than 2 ribs directly correlated with the possibility of intra-abdominal hemorrhage (p<0.0001. Conclusion: Based on the results of this study, it seems that the number and area of the fractured ribs directly and significantly correlate with the probability of abdominal trauma based on the results of abdominal ultrasonography.

  4. Comparison of ultrasonography and radiography in diagnosis of rib fractures

    OpenAIRE

    Pishbin, Elham; Ahmadi, Koorosh; Foogardi, Molood; Salehi, Maryam; Seilanian Toosi, Farrokh; Rahimi-Movaghar, Vafa

    2017-01-01

    Purpose: Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. Methods: In this cross-s...

  5. Anatomically contoured plates for fixation of rib fractures.

    Science.gov (United States)

    Bottlang, Michael; Helzel, Inga; Long, William B; Madey, Steven

    2010-03-01

    : Intraoperative contouring of long bridging plates for stabilization of flail chest injuries is difficult and time consuming. This study implemented for the first time biometric parameters to derive anatomically contoured rib plates. These plates were tested on a range of cadaveric ribs to quantify plate fit and to extract a best-fit plating configuration. : Three left and three right rib plates were designed, which accounted for anatomic parameters required when conforming a plate to the rib surface. The length lP over which each plate could trace the rib surface was evaluated on 109 cadaveric ribs. For each rib level 3-9, the plate design with the highest lP value was extracted to determine a best-fit plating configuration. Furthermore, the characteristic twist of rib surfaces was measured on 49 ribs to determine the surface congruency of anatomic plates with a constant twist. : The tracing length lP of the best-fit plating configuration ranged from 12.5 cm to 14.7 cm for ribs 3-9. The corresponding range for standard plates was 7.1-13.7 cm. The average twist of ribs over 8-cm, 12-cm, and 16-cm segments was 8.3 degrees, 20.6 degrees, and 32.7 degrees, respectively. The constant twist of anatomic rib plates was not significantly different from the average rib twist. : A small set of anatomic rib plates can minimize the need for intraoperative plate contouring for fixation of ribs 3-9. Anatomic rib plates can therefore reduce the time and complexity of flail chest stabilization and facilitate spanning of flail segments with long plates.

  6. Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation

    Energy Technology Data Exchange (ETDEWEB)

    Watson, Tom Anthony; Arthurs, Owen John; Calder, Alistair Duncan [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); Muthialu, Nagarajan [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Cardiothoracic surgery, London (United Kingdom)

    2014-02-15

    Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects (''rib gaps''). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia. (orig.)

  7. Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation.

    Science.gov (United States)

    Watson, Tom Anthony; Arthurs, Owen John; Muthialu, Nagarajan; Calder, Alistair Duncan

    2014-02-01

    Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects ("rib gaps"). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia.

  8. Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation

    International Nuclear Information System (INIS)

    Watson, Tom Anthony; Arthurs, Owen John; Calder, Alistair Duncan; Muthialu, Nagarajan

    2014-01-01

    Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects (''rib gaps''). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia. (orig.)

  9. Rib fractures predict incident limb fractures: results from the European prospective osteoporosis study.

    Science.gov (United States)

    Ismail, A A; Silman, A J; Reeve, J; Kaptoge, S; O'Neill, T W

    2006-01-01

    Population studies suggest that rib fractures are associated with a reduction in bone mass. While much is known about the predictive risk of hip, spine and distal forearm fracture on the risk of future fracture, little is known about the impact of rib fracture. The aim of this study was to determine whether a recalled history of rib fracture was associated with an increased risk of future limb fracture. Men and women aged 50 years and over were recruited from population registers in 31 European centres for participation in a screening survey of osteoporosis (European Prospective Osteoporosis Study). Subjects were invited to complete an interviewer-administered questionnaire that included questions about previous fractures including rib fracture, the age of their first fracture and also the level of trauma. Lateral spine radiographs were performed and the presence of vertebral deformity was determined morphometrically. Following the baseline survey, subjects were followed prospectively by annual postal questionnaire to determine the occurrence of clinical fractures. The subjects included 6,344 men, with a mean age of 64.2 years, and 6,788 women, with a mean age of 63.6 years, who were followed for a median of 3 years (range 0.4-5.9 years), of whom 135 men (2.3%) and 101 women (1.6%) reported a previous low trauma rib fracture. In total, 138 men and 391 women sustained a limb fracture during follow-up. In women, after age adjustment, those with a recalled history of low trauma rib fracture had an increased risk of sustaining 'any' limb fracture [relative hazard (RH)=2.3; 95% CI 1.3, 4.0]. When stratified by fracture type the predictive risk was more marked for hip (RH=7.7; 95% CI 2.3, 25.9) and humerus fracture (RH=4.5; 95% CI 1.4, 14.6) than other sites (RH=1.6; 95% CI 0.6, 4.3). Additional adjustment for prevalent vertebral deformity and previous (non-rib) low trauma fractures at other sites slightly reduced the strength of the association between rib fracture and

  10. Analytical studies on the impact of using repeated-rib roughness in LMR [Liquid Metal Reactor] decay heat removal systems

    International Nuclear Information System (INIS)

    Obot, N.T.; Tessier, J.H.; Pedersen, D.R.

    1988-01-01

    A numerical study was carried out to determine the effects of roughness on the thermal performance of Liquid Metal Reactor (LMR) decay heat removal systems for a range of possible design configurations and operating conditions. The ranges covered for relative rib height (e/D/sub h/), relative pitch (p/e) and flow attack angle were 0.026--0.103, 5--20 and 0--90 degrees, successively. The heat flux was varied between 1.1 and 21.5 kW/m 2 (0.1 and 2.0 kW/ft 2 ). Calculations were made for three cases: smooth duct with no ribs, ribs on both the guard vessel and collector wall, and ribs on the collector wall only. The results indicate that significant benefits, amounting to nearly two-fold reductions in guard vessel and collector wall temperatures, can be realized by placing repeated ribs on both the guard vessel and the collector wall. The magnitudes of the reduction in the reactor vessel temperature are considerably smaller. In general, the level of improvement, be it with respect to temperature or heat flux, is only mildly affected by changes in rib height or pitch but exhibits greater sensitivity to the assumed value for the system form loss. When the ribs are placed only on the collector wall, the heat removal capability is substantially reduced

  11. First Rib Fracture Resulting in Horner's Syndrome.

    Science.gov (United States)

    Lin, You-Cheng; Chuang, Ming-Tsung; Hsu, Chin-Hao; Tailor, Al-Rahim Abbasali; Lee, Jung-Shun

    2015-12-01

    First rib fractures and traumatic Horner's syndrome are both quite rare, which can make it difficult to properly diagnose the combination of these 2 conditions in the emergency department. These conditions may be associated with severe medical emergencies, such as ongoing carotid dissection. We present the case of a 33-year-old man who sustained fractures to his right second, third, and fourth ribs and a delay in the diagnosis of left Horner's syndrome after he was involved in a traffic accident. Left Horner's syndrome was caused by a left transverse fracture of the first rib. This fracture was not detected on chest radiographs and required a 3-dimensional reconstructed neck computed tomography scan for detection. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: In the diagnosis of carotid artery dissection, conventional angiography is the criterion standard but is considered invasive. CTA is less invasive, time-saving, and can show more anatomic structures in the neck in addition to the carotid arteries. It is a good screening diagnostic modality in the traumatology department. Although the treatments for Horner's syndrome and first rib fracture are conservative, the early diagnosis of both conditions can resolve the anxiety and uncertainty experienced by both doctors and patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. [Internal fixation treatment of multiple rib fractures with absorbable rib-connecting-pins].

    Science.gov (United States)

    Liu, Jinliang; Li, Keyao; He, Jianning

    2011-01-01

    To study the indications, methods, and therapeutic effect of absorbable rib-connecting-pins fixation in the treatment of multiple rib fractures. Between March 2007 and September 2009, 40 patients with multiple rib fractures received internal fixation with absorbable rib-connecting-pins, including 8 one-side flail chest and 1 two-side flail chest. There were 32 males and 8 females with an average age of 39.8 years (range, 25-72 years). The injury was caused by traffic accident in 32 cases, falling from height in 6 cases, and blunt hitting in 2 cases. Preoperatively, imaging data of the chest X-ray or spiral CT three-dimensional (3D) examination showed that all patients had multiple ribs fractures and displacement. The number of fractured ribs was 4-10 (median, 6), and the fracture location ranged from the 2nd to the 10th ribs. Of them, 28 cases were accompanied by hemathorax, pneumothorax or hemopneumothorax; 5 cases by thoracic organ injury; and 10 cases by other part trauma. The time from injury to hospitalization was less than 1 day in 26 cases, 1-3 days in 12 cases, and 3-6 days in 2 cases, and the time from hospitalization to operation was 3 hours to 3 days (mean, 1.2 days). The median fixation rib number was 5 (range, 3-8). The mean operative time, the time in bed, and hospitalization days were 32 minutes (range, 15-50 minutes), 4.5 days (range, 2-7 days), and 11.2 days (range, 5-18 days), respectively. All incisions healed by first intention. No pulmonary infection, pulmonary atelectasis, intrathoracic infection or other complications occurred. All cases were followed up 6-12 months (mean, 8 months). PaO2 [(86.6 +/- 2.2) mmHg (1 mm Hg = 0.133 kPa)] and SpO2 (97.2% +/- 0.6%) at 2 hours after operation were obviously improved when compared with preoperative ones (PaO2 (53.6 + 4.7) mm Hg and SpO2 (86.2% + 1.8%)], showing significant differences (t = 2.971, P = 0.005; t = 2.426, P = 0.020). The chest X-ray films or spiral CT 3D indicated that fracture of rib

  13. Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures.

    Science.gov (United States)

    Chapman, Brandon C; Overbey, Douglas M; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T; French, Andrew; Johnson, Jeffrey L; Burlew, Clay C; Barnett, Carlton; Moore, Ernest E; Pieracci, Fredric M

    2016-12-01

    Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest. The CT finding of ≥ 3 additional fractures in patients with ≤ 3 rib fractures on CXR was considered clinically meaningful. Student's t-test and chi-square analysis were used for comparison. We identified 499 patients with rib fractures: 93 (18.6%) had CXR only, 7 (1.4%) had chest CT only, and 399 (79.9%) had both CXR and chest CT. Among these 399 patients, a total of 1,969 rib fractures were identified: 1,467 (74.5%) were missed by CXR. The median number of additional fractures identified by CT was 3 (range, 4 - 15). Of 212 (53.1%) patients with a clinically meaningful increase in the number of fractures, 68 patients underwent one or more clinical interventions: 36 SICU admissions, 20 pain catheter placements, 23 epidural placements, and 3 SSRF. Additionally, 70 patients had a chest tube placed for retained hemothorax or occult pneumothorax. Overall, 138 patients (34.5%) had a change in clinical management based upon CT chest. The chest X-ray missed ~75% of rib fractures seen on chest CT. Although patients with a clinical meaningful increase in the number of rib fractures were more likely to be admitted to the intensive care unit, there was no associated improvement in pulmonary outcomes.

  14. Modified technique to increase nostril cross-sectional area after using rib and septal cartilage graft over alar nasal cartilages Técnica modificada para aumentar a área seccional externa da narina após o uso de enxerto cartilaginoso de costela e septo sob as cartilagens alares nasais

    Directory of Open Access Journals (Sweden)

    Marcelo Wulkan

    2012-10-01

    Full Text Available PURPOSE: Describe a modified technique to increase nostril cross-sectional area using rib and septal cartilage graft over alar nasal cartilages. METHODS: A modified surgical technique was used to obtain, carve and insert cartilage grafts over alar nasal cartilages. This study used standardized pictures and measured 90 cadaveric nostril cross-sectional area using Autocad®; 30 were taken before any procedure and 60 were taken after grafts over lateral crura (30 using costal cartilage and 30 using septal cartilage. Statistical analysis were assessed using a model for repeated measures and ANOVA (Analysis of Variance for the variable "area". RESULTS: There's statistical evidence that rib cartilage graft is more effective than septal cartilage graft. The mean area after the insertion of septal cartilage graft is smaller than the mean area under rib graft treatment (no confidence interval for mean difference contains the zero value and all P-values are below the significance level of 5%. CONCLUSIONS: The technique presented is applicable to increase nostril cross section area in cadavers. This modified technique revealed to enhance more nostril cross section area with costal cartilage graft over lateral crura rather than by septal graft.OBJETIVO: Descrever uma técnica modificada para se aumentar a área seccional externa da narina com cartilagem septal e costal acima das cartilagens alares nasais. MÉTODOS: Utilizou-se uma técnica cirúrgica modificada para obter, esculpir e inserir enxertos de cartilagem sobre as cartilagens alares. Realizou-se fotos padronizadas e mensuração de 90 áreas seccionais externas de narina em cadáveres com Autocad®; 30 antes sem procedimento; 60 após a inclusão de enxertos sob a cruz lateral (30 usando cartilagem costal e 30 usando cartilagem septal. A análise estatística foi feita com um modelo de medidas repetidas e ANOVA para a variável "área" RESULTADOS: Existe evidência estatística de que o enxerto de

  15. Internal rib structure can be predicted using mathematical models: An anatomic study comparing the chest to a shell dome with application to understanding fractures.

    Science.gov (United States)

    Casha, Aaron R; Camilleri, Liberato; Manché, Alexander; Gatt, Ruben; Attard, Daphne; Gauci, Marilyn; Camilleri-Podesta, Marie-Therese; Mcdonald, Stuart; Grima, Joseph N

    2015-11-01

    The human rib cage resembles a masonry dome in shape. Masonry domes have a particular construction that mimics stress distribution. Rib cortical thickness and bone density were analyzed to determine whether the morphology of the rib cage is sufficiently similar to a shell dome for internal rib structure to be predicted mathematically. A finite element analysis (FEA) simulation was used to measure stresses on the internal and external surfaces of a chest-shaped dome. Inner and outer rib cortical thickness and bone density were measured in the mid-axillary lines of seven cadaveric rib cages using computerized tomography scanning. Paired t tests and Pearson correlation were used to relate cortical thickness and bone density to stress. FEA modeling showed that the stress was 82% higher on the internal than the external surface, with a gradual decrease in internal and external wall stresses from the base to the apex. The inner cortex was more radio-dense, P rib level. The internal anatomical features of ribs, including the inner and outer cortical thicknesses and bone densities, are similar to the stress distribution in dome-shaped structures modeled using FEA computer simulations of a thick-walled dome pressure vessel. Fixation of rib fractures should include the stronger internal cortex. © 2015 Wiley Periodicals, Inc.

  16. RIB FRACTURE AFTER BREAST RECONSTRUCTION WITH TISSUE EXPANDER

    Directory of Open Access Journals (Sweden)

    Uroš Ahčan

    2009-08-01

    Full Text Available Breast reconstruction with tissue expansion and later exchange with prosthesis is one of the most common methods for breast reconstruction. Women that are not appropriate for reconstruction with autologous tissue, women that have small breast or have a positive family history for breast cancer are most suitable for this type of reconstruction. Surgical technique of tissue expansion is relatively easy. Complications are rarely seen. With this case report we want to show the common, although occult existence of skeletal deformities in thorax after breast tissue expansion that may lead to rib fractures.

  17. Sand transport in a two pass internal cooling duct with rib turbulators

    International Nuclear Information System (INIS)

    Singh, Sukhjinder; Tafti, Danesh; Reagle, Colin; Delimont, Jacob; Ng, Wing; Ekkad, Srinath

    2014-01-01

    between two ribs. The rib face facing the flow is by far is the most susceptible to impingement and hence deposition and erosion. The results of this simulation are compared to experiments conducted on an identical two pass geometry with Arizona Road Dust particles. The numerical predictions showed good qualitative agreement with experimental measurements. These results identify the damage prone areas in the internal cooling passages of a turbine blade under the influence of sand ingestion. This information can help modify the geometry of the blade or location of film cooling holes to avoid hole blockage and degradation of heat transfer at the walls

  18. Traumatic Rib Injury: Patterns, Imaging Pitfalls, Complications, and Treatment.

    Science.gov (United States)

    Talbot, Brett S; Gange, Christopher P; Chaturvedi, Apeksha; Klionsky, Nina; Hobbs, Susan K; Chaturvedi, Abhishek

    2017-01-01

    The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures. Specific attention is also required for flail chest and for fractures due to pediatric nonaccidental trauma. Rib fractures are associated with significant morbidity and mortality, both of which increase as the number of fractured ribs increases. Key complications associated with rib fracture include pain, hemothorax, pneumothorax, extrapleural hematoma, pulmonary contusion, pulmonary laceration, acute vascular injury, and abdominal solid-organ injury. Congenital anomalies, including supernumerary or accessory ribs, vestigial anterior ribs, bifid ribs, and synostoses, are common and should not be confused with traumatic pathologic conditions. Nontraumatic mimics of traumatic rib injury, with or without fracture, include metastatic disease, primary osseous neoplasms (osteosarcoma, chondrosarcoma, Ewing sarcoma, Langerhans cell histiocytosis, and osteochondroma), fibrous dysplasia, and Paget disease. Principles of management include supportive and procedural methods of alleviating pain, treating complications, and stabilizing posttraumatic deformity. By recognizing and accurately reporting the imaging findings, the radiologist will add value to the care of patients with thoracic trauma. Online supplemental material is available for this article. © RSNA, 2017.

  19. The contribution of rib fractures to chronic pain and disability.

    Science.gov (United States)

    Gordy, Stephanie; Fabricant, Loic; Ham, Bruce; Mullins, Richard; Mayberry, John

    2014-05-01

    The contribution of rib fractures to chronic pain and disability is not well described. Two hundred three patients with rib fractures were followed for 6 months. Chronic pain was assessed using the McGill Pain Questionnaire Pain Rating Index and Present Pain Intensity (PPI) scales. Disability was defined as a decrease in work or functional status. The prevalence of chronic pain was 22% and disability was 53%. Acute PPI predicted chronic pain. Associated injuries, bilateral rib fractures, injury severity score, and number of rib fractures were not predictive of chronic pain. No acute injury characteristics were predictive of disability. Among 89 patients with isolated rib fractures, the prevalence of chronic pain was 28% and of disability was 40%. No injury characteristics predicted chronic pain. Bilateral rib fractures and acute PPI predicted disability. The contribution of rib fractures to chronic pain and disability is significant but unpredictable with conventional injury descriptors. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Tuberlent heat transfer and friction in four-wall convergent/divergent square channels with one ribbed wall

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Soo Whan; Lee, Myung Sung [Dept. of Mechanical System Engineering, Institute of Marine Industry, Gyeongsang National University, Jinju (Korea, Republic of)

    2015-10-15

    The local heat transfer and pressure drop of developed turbulent flows in convergent/divergent channels with square axial cross-sectional areas were experimentally investigated to improve the channel design, such as a gas turbine cooling system. Square convergent/divergent channels with one ribbed wall were manufactured with a fixed rib height e of 10 mm and a ratio of rib spacing p to height e of 10. The measurement was conducted for Reynolds numbers from 15,000 to 89,000. Convergent, divergent, and straight channels with ratios D{sub ho}/D{sub hi} of 0.75, 1.33, and 1.0, respectively, are considered. Of the three channel types, the ribbed divergent channel was found to produce the best thermal performance under identical flow rate, pumping power, and pressure loss conditions.

  1. Stress fractures of the ribs in elite competitive rowers: a report of nine cases

    Energy Technology Data Exchange (ETDEWEB)

    Dragoni, S. [Institute of Sport Medicine and Science of the Italian Olympic Committee, Department of Radiology, Rome (Italy); Giombini, A.; Ripani, M. [University of Motor Sciences, Department of Health, Rome (Italy); Di Cesare, A. [University of Rome ' ' La Sapienza' ' , Department of Physical Medicine and Rehabilitation, Rome (Italy); Magliani, G. [Medical Department of the Italian State Police, Rome (Italy)

    2007-10-15

    The objective was to report the clinical and imaging patterns of nine cases of stress fractures of the rib diagnosed in Italian Olympic rowers. Nine patients with stress fractures of the rib detected from 103 (8.7%) Italian team rowers competing between May 2000 and May 2006 were identified based on the database of a sports medicine institute. All athletes were male. They were aged between 17 and 31 years (mean: 24.4). Patient weight, fracture location, rowing side and imaging methods employed were noted. The diagnosis was made based on history, clinical examination and Tc-99m MDP bone scintigraphy. Eight of the 9 fractures were located anterolaterally between the fourth and ninth rib. In 1 of the 5 athletes with standard radiographs, a fracture line was visible and in 4 there was callus formation. In 2 athletes sonography was performed, which detected discontinuity of the rib surface and callus formation (1 case each). Stress fractures of the ribs are relatively common in competitive rowers. They are characterized by increasing lateral chest pain and typical scintigraphic, radiographic and sonographic findings. (orig.)

  2. Stress fractures of the ribs in elite competitive rowers: a report of nine cases

    International Nuclear Information System (INIS)

    Dragoni, S.; Giombini, A.; Ripani, M.; Di Cesare, A.; Magliani, G.

    2007-01-01

    The objective was to report the clinical and imaging patterns of nine cases of stress fractures of the rib diagnosed in Italian Olympic rowers. Nine patients with stress fractures of the rib detected from 103 (8.7%) Italian team rowers competing between May 2000 and May 2006 were identified based on the database of a sports medicine institute. All athletes were male. They were aged between 17 and 31 years (mean: 24.4). Patient weight, fracture location, rowing side and imaging methods employed were noted. The diagnosis was made based on history, clinical examination and Tc-99m MDP bone scintigraphy. Eight of the 9 fractures were located anterolaterally between the fourth and ninth rib. In 1 of the 5 athletes with standard radiographs, a fracture line was visible and in 4 there was callus formation. In 2 athletes sonography was performed, which detected discontinuity of the rib surface and callus formation (1 case each). Stress fractures of the ribs are relatively common in competitive rowers. They are characterized by increasing lateral chest pain and typical scintigraphic, radiographic and sonographic findings. (orig.)

  3. Heat Transfer Augmentation in Gas Turbine Blade Rectangular Passages Using Circular Ribs with Fins

    Directory of Open Access Journals (Sweden)

    Mohammed W. Al-Jibory

    2017-11-01

    Full Text Available In this paper, an experimental system  was designed and built to simulate conditions in the gas turbine blade cooling and run the experimental part. Boundary conditions are: inlet coolant air temperature is 300K with Reynolds numbers (Re=7901 .The surrounding constant hot air temperatures was (673 K.The numerical simulations were done by using software FLUENT version (14.5, in this part, it was presented the effect of using circular ribs having middle fin fitted in rectangular passage channel on fluid flow and heat transfer characteristics.  Ribs used with pitch-rib height of 10, rectangular channel of (30x60 mm cross section, 1.5 mm duct thickness and 0.5 m long. The temperature, velocity distribution contours, cooling air temperature distribution at the duct centerline, the inner wall surface temperature of the duct, and thermal performance factor are presented in this paper. it can be seen that the duct with all ribs with middle fins was the better case which leads to increase the coolant air temperature by (10.22 % and decrease the inner wall temperature by (6.15 % . The coolant air flow velocity seems to be accelerated and decelerated through the channel in the presence of ribs, so it was shown that the thermal performance factor along the duct is larger than 1, this is due to the fact that the ribs create turbulent conditions and increasing thermal surface area, and thus increasing heat transfer coefficient than the smooth channel.

  4. Osteoradionecrosis of the Ribs following Breast Radiotherapy

    Directory of Open Access Journals (Sweden)

    Luke Nicholls

    2015-08-01

    Full Text Available Introduction: Osteoradionecrosis (ORN of the chest wall is a rare complication after whole-breast radiotherapy (RT. Herein, we report a case of ORN involving the underlying ribs following adjuvant whole-breast RT using standard fractionation and conduct a review of the literature. Case Report: A previously well 43-year-old female with right-sided, early-stage, node-negative breast cancer was treated with breast-conserving surgery. She subsequently underwent adjuvant whole-breast RT receiving 50 Gy in 25 fractions over 5 weeks using standard tangential photon fields with 6 MV photons followed by an electron boost of 10 Gy in 5 fractions according to International Commission on Radiation Units (ICRU requirements. Eleven months after RT, the patient developed right lateral chest wall pain, with magnetic resonance imaging (MRI demonstrating two fractures involving the underlying right fifth and sixth ribs associated with fatty marrow changes in the second to sixth ribs, thus raising the possibility of ORN. Treatments including hyperbaric oxygen, pentoxifylline and vitamin E were used with symptomatic improvements. There was demonstrable resolution on follow-up MRI at 2.5 years. Conclusion: The incidence of ORN utilising modern RT techniques and standard fractionation is rare. Numerous treatments are available, with variable response rates. Emerging evidence of predictive gene profiling to estimate the risk of radiation sensitivity may assist in individualising preventative strategies to mitigate the risk of ORN.

  5. [Tuberculosis of the spine and ribs].

    Science.gov (United States)

    Wishnitzer, R; Landow, Z; Sagiv, S; Rozenhack, M; Eliraz, A

    1991-11-15

    Tuberculosis of the spine or ribs is uncommon, occurring in less than 1% of patients with tuberculosis (TB). 2 women are presented who recently immigrated from Ethiopia and India, respectively. One, aged 55, presented with chest pain, fatigue and several masses under the skin of the scalp. Chest X-ray and CT scan suggested Pancoast tumor, and the lateral parts of the first 2 right ribs were absent. The origin of the patient, clinical findings and positive PPD suggested TB of the ribs and anti-TB therapy resulted in cure. The diagnosis was later confirmed by a positive culture. The other woman, aged 68, presented with fatigue, mild abdominal pain and axillary lymphadenopathy. The PPD was positive and X-ray showed widening of the mediastinum. A caseating granuloma with Langhans epithelioid cells was found in a lymph node. Flaccid paraparesis developed before therapy was started. CT scan showed a typical picture of TB affecting the T3-T6 vertebrae. Drainage of a cold abscess of the spine via the anterior approach was followed by anti-TB therapy. Culture of a biopsied lymph node and of pus obtained at operation confirmed the diagnosis of TB. The patient died 2 months later from gastrointestinal bleeding. Awareness of the unusual presentations of various forms of TB is mandatory in countries with immigration from countries in which TB is still common.

  6. Cough induced rib fracture, rupture of the diaphragm and abdominal herniation

    Directory of Open Access Journals (Sweden)

    Wurl Peter

    2006-11-01

    Full Text Available Abstract Cough can be associated with many complications. In this article, we present a 59 year old male patient with a very rare combination of a cough related stress fracture of the ninth rib, a traumatic rupture of the diaphragm, and an abdominal wall herniation. The hernia was repaired through surgical treatment without bowel resection, the diaphragm and the internal and oblique abdominal muscle were adapted, and the abdomen was reinforced with a prolene net. Although each individual injury is well documented in the literature, the combination of rib fracture, abdominal herniation and diaphragm rupture has not been reported.

  7. Conventional radiography or ultra sound for rib fracture diagnosis: a literature review

    Directory of Open Access Journals (Sweden)

    Elham Pishbin

    2014-08-01

    Full Text Available Blunt chest trauma accounts for the majority of mortalities and morbidities in traumatized patients. Rib fractures are one of the most common chest wall injuries due to blunt chest trauma, which is estimated to occur in 10% of all traumatic injuries. Conventional radiography and ultra-sonography are two commonly methods used for rib fracture diagnosis with different accuracy. In this study, we described different methods used in diagnosis of injuries related to blunt chest trauma and we aimed to review several studies compared the diagnostic value of these methods.

  8. Thoracic Outlet Syndrome Caused by Hydatid Cyst of the First Rib-Rare But Important

    OpenAIRE

    Levy Faber, Dan; Best, Lael-Anson; Militianu, Daniela; Ben Nun, Alon

    2010-01-01

    Hydatid cysts are usually located in the liver and lungs. Skeletal echinococcosis is relatively rare and that of the rib is exceptional. Less than 50 cases of costal echinococcosis have been reported in the literature so far. To our knowledge, only one case report of thoracic outlet syndrome due to echinococcal cyst in the first rib was described in 1995. Accurate pre-operative diagnosis is important but may be challenging in some cases. Reported here is a case of echinococcosis of the first ...

  9. INAA application in the age dynamics assessment of major, minor, and trace elements in the human rib

    International Nuclear Information System (INIS)

    Zaichick, V.; Dyatlov, A.; Zaichick, S.

    2000-01-01

    The Ca, Cl, K, Mg, Na, P, and Sr concentration of rib-bone was studied of 78 relatively healthy 15-55 years old women and men using instrumental neutron activation analysis. A tendency for Ca, P, and Mg concentrations to decrease with age was found in subjects over 35 which was manifested more distinctively in women. It was shown that higher volumes of density, Ca and P concentrations as well as lower K, Cl, and H 2 O contents were typical of female ribs being compared to those in male ribs. The average annual losses of the rib Ca in the Russian women over 25 were estimated to be 0.7% of the concentration peak level. They agree well with data available for citizens of the USA and Germany. (author)

  10. PENGARUH KEPUASAN KONSUMEN TERHADAP KESETIAN MEREK (Studi Kasus Restoran The Prime Steak & Ribs Surabaya

    Directory of Open Access Journals (Sweden)

    Foedjiawati Foedjiawati

    2005-01-01

    Full Text Available This is a research which observes the relationship between customer satisfaction and their loyalty to The Prime Steak & Ribs Restaurant. The customer satisfaction is measured through some attributes such as, attributes related to the product, attributes related to the service, and attributes related to the purchase. Meanwhile, the loyalty of its brand is measured through habitual behaviour, switching cost, satisfaction, liking of the brand and commitment. The result of the research reveals that customer satisfaction levels to The Prime Steak & Ribs Restaurant tends to be good. Some attributes still have a variety of high grade, and there is a positive causal influence that is significant between the customer satisfaction and the loyalty of the brand. Thus, the result of the research is relevant and at the same time supports the theory of brand loyalty. Abstract in Bahasa Indonesia : Penelitian Pengaruh Kepuasan Konsumen terhadap Kesetiaan Merek pada Restoran the Prime Steak & Ribs, kepuasan konsumen diukur melalui Attributes related to the product, Attributes related to the service, Attributes related to the purchase, kesetiaan merek diukur melalui habitual behaviour, switching cost, satisfaction, liking of the brand, dan commitment. Hasil penelitian mengungkapakan bahwa kepuasan konsumen di The Prime Steak & Ribs mendapat penilaian yang cenderung baik, beberapa atribut masih mempunyai variasi penilaian yang tinggi, dan terdapat hubungan pengaruh positip yang signifikan antara kepuasan konsumen dengan kesetiaan merek, dengan demikian hasil penelitian mendukung konsep teori tentang kesetiaan merek. Kata kunci: kepuasan, kesetiaan merek.

  11. ribB and ribBA genes from Acidithiobacillus ferrooxidans: expression levels under different growth conditions and phylogenetic analysis.

    Science.gov (United States)

    Knegt, Fábio H P; Mello, Luciane V; Reis, Fernanda C; Santos, Marcos T; Vicentini, Renato; Ferraz, Lúcio F C; Ottoboni, Laura M M

    2008-01-01

    Acidithiobacillus ferrooxidans is a Gram-negative, chemolithoautotrophic bacterium involved in metal bioleaching. Using the RNA arbitrarily primed polymerase chain reaction (RAP-PCR), we have identified several cDNAs that were differentially expressed when A. ferrooxidans LR was submitted to potassium- and phosphate-limiting conditions. One of these cDNAs showed similarity with ribB. An analysis of the A. ferrooxidans ATCC 23270 genome, made available by The Institute for Genomic Research, showed that the ribB gene was not located in the rib operon, but a ribBA gene was present in this operon instead. The ribBA gene was isolated from A. ferrooxidans LR and expression of both ribB and ribBA was investigated. Transcript levels of both genes were enhanced in cells grown in the absence of K2HPO4, in the presence of zinc and copper sulfate and in different pHs. Transcript levels decreased upon exposure to a temperature higher than the ideal 30 degrees C and at pH 1.2. A comparative genomic analysis using the A. ferrooxidans ATCC 23270 genome revealed similar putative regulatory elements for both genes. Moreover, an RFN element was identified upstream from the ribB gene. Phylogenetic analysis of the distribution of RibB and RibBA in bacteria showed six different combinations. We suggest that the presence of duplicated riboflavin synthesis genes in bacteria must provide their host with some benefit in certain stressful situations.

  12. Rib fracture after stereotactic radiotherapy on follow-up thin-section computed tomography in 177 primary lung cancer patients

    Directory of Open Access Journals (Sweden)

    Saito Ryo

    2011-10-01

    Full Text Available Abstract Background Chest wall injury after stereotactic radiotherapy (SRT for primary lung cancer has recently been reported. However, its detailed imaging findings are not clarified. So this study aimed to fully characterize the findings on computed tomography (CT, appearance time and frequency of chest wall injury after stereotactic radiotherapy (SRT for primary lung cancer Materials and methods A total of 177 patients who had undergone SRT were prospectively evaluated for periodical follow-up thin-section CT with special attention to chest wall injury. The time at which CT findings of chest wall injury appeared was assessed. Related clinical symptoms were also evaluated. Results Rib fracture was identified on follow-up CT in 41 patients (23.2%. Rib fractures appeared at a mean of 21.2 months after the completion of SRT (range, 4 -58 months. Chest wall edema, thinning of the cortex and osteosclerosis were findings frequently associated with, and tending to precede rib fractures. No patients with rib fracture showed tumors > 16 mm from the adjacent chest wall. Chest wall pain was seen in 18 of 177 patients (10.2%, of whom 14 patients developed rib fracture. No patients complained of Grade 3 or more symptoms. Conclusion Rib fracture is frequently seen after SRT for lung cancer on CT, and is often associated with chest wall edema, thinning of the cortex and osteosclerosis. However, related chest wall pain is less frequent and is generally mild if present.

  13. Rib fracture after stereotactic radiotherapy on follow-up thin-section computed tomography in 177 primary lung cancer patients

    International Nuclear Information System (INIS)

    Nambu, Atsushi; Tominaga, Lichto; Maehata, Yoshiyasu; Sawada, Eiichi; Araki, Tsutomu; Onishi, Hiroshi; Aoki, Shinichi; Koshiishi, Tsuyota; Kuriyama, Kengo; Komiyama, Takafumi; Marino, Kan; Araya, Masayuki; Saito, Ryo

    2011-01-01

    Chest wall injury after stereotactic radiotherapy (SRT) for primary lung cancer has recently been reported. However, its detailed imaging findings are not clarified. So this study aimed to fully characterize the findings on computed tomography (CT), appearance time and frequency of chest wall injury after stereotactic radiotherapy (SRT) for primary lung cancer A total of 177 patients who had undergone SRT were prospectively evaluated for periodical follow-up thin-section CT with special attention to chest wall injury. The time at which CT findings of chest wall injury appeared was assessed. Related clinical symptoms were also evaluated. Rib fracture was identified on follow-up CT in 41 patients (23.2%). Rib fractures appeared at a mean of 21.2 months after the completion of SRT (range, 4 -58 months). Chest wall edema, thinning of the cortex and osteosclerosis were findings frequently associated with, and tending to precede rib fractures. No patients with rib fracture showed tumors > 16 mm from the adjacent chest wall. Chest wall pain was seen in 18 of 177 patients (10.2%), of whom 14 patients developed rib fracture. No patients complained of Grade 3 or more symptoms. Rib fracture is frequently seen after SRT for lung cancer on CT, and is often associated with chest wall edema, thinning of the cortex and osteosclerosis. However, related chest wall pain is less frequent and is generally mild if present

  14. Rib fracture after stereotactic radiotherapy on follow-up thin-section computed tomography in 177 primary lung cancer patients

    Science.gov (United States)

    2011-01-01

    Background Chest wall injury after stereotactic radiotherapy (SRT) for primary lung cancer has recently been reported. However, its detailed imaging findings are not clarified. So this study aimed to fully characterize the findings on computed tomography (CT), appearance time and frequency of chest wall injury after stereotactic radiotherapy (SRT) for primary lung cancer Materials and methods A total of 177 patients who had undergone SRT were prospectively evaluated for periodical follow-up thin-section CT with special attention to chest wall injury. The time at which CT findings of chest wall injury appeared was assessed. Related clinical symptoms were also evaluated. Results Rib fracture was identified on follow-up CT in 41 patients (23.2%). Rib fractures appeared at a mean of 21.2 months after the completion of SRT (range, 4 -58 months). Chest wall edema, thinning of the cortex and osteosclerosis were findings frequently associated with, and tending to precede rib fractures. No patients with rib fracture showed tumors > 16 mm from the adjacent chest wall. Chest wall pain was seen in 18 of 177 patients (10.2%), of whom 14 patients developed rib fracture. No patients complained of Grade 3 or more symptoms. Conclusion Rib fracture is frequently seen after SRT for lung cancer on CT, and is often associated with chest wall edema, thinning of the cortex and osteosclerosis. However, related chest wall pain is less frequent and is generally mild if present. PMID:21995807

  15. Current programmes on physical metallurgy and related areas in BARC

    International Nuclear Information System (INIS)

    1994-01-01

    Current research and development programmes on physical metallurgy and related areas from the following Divisions of Bhabha Atomic Research Centre are included in this report : Atomic Fuels Division, High Pressure Physics Division, Metallurgy Division, Radio Metallurgy Division, Solid State Physics Division. Important publications corresponding to each activity have also been listed. (author)

  16. Do Quiet Areas Afford Greater Health-Related Quality of Life than Noisy Areas?

    Directory of Open Access Journals (Sweden)

    Kim N. Dirks

    2013-03-01

    Full Text Available People typically choose to live in quiet areas in order to safeguard their health and wellbeing. However, the benefits of living in quiet areas are relatively understudied compared to the burdens associated with living in noisy areas. Additionally, research is increasingly focusing on the relationship between the human response to noise and measures of health and wellbeing, complementing traditional dose-response approaches, and further elucidating the impact of noise and health by incorporating human factors as mediators and moderators. To further explore the benefits of living in quiet areas, we compared the results of health-related quality of life (HRQOL questionnaire datasets collected from households in localities differentiated by their soundscapes and population density: noisy city, quiet city, quiet rural, and noisy rural. The dose-response relationships between noise annoyance and HRQOL measures indicated an inverse relationship between the two. Additionally, quiet areas were found to have higher mean HRQOL domain scores than noisy areas. This research further supports the protection of quiet locales and ongoing noise abatement in noisy areas.

  17. Computational Investigations in Rectangular Convergent and Divergent Ribbed Channels

    Science.gov (United States)

    Sivakumar, Karthikeyan; Kulasekharan, N.; Natarajan, E.

    2018-05-01

    Computational investigations on the rib turbulated flow inside a convergent and divergent rectangular channel with square ribs of different rib heights and different Reynolds numbers (Re=20,000, 40,000 and 60,000). The ribs were arranged in a staggered fashion between the upper and lower surfaces of the test section. Computational investigations are carried out using computational fluid dynamic software ANSYS Fluent 14.0. Suitable solver settings like turbulence models were identified from the literature and the boundary conditions for the simulations on a solution of independent grid. Computations were carried out for both convergent and divergent channels with 0 (smooth duct), 1.5, 3, 6, 9 and 12 mm rib heights, to identify the ribbed channel with optimal performance, assessed using a thermo hydraulic performance parameter. The convergent and divergent rectangular channels show higher Nu values than the standard correlation values.

  18. The Place of Ultrasonography in the Evaluation of Rib Fractures

    Directory of Open Access Journals (Sweden)

    Fulya Bakılan

    2015-12-01

    Full Text Available Objective: The aim of this study was to investigate whether ultrasonography is superior to chest x-ray in detecting rib fractures in patients with minor blunt chest trauma and chest pain. Materials and Methods: Ultrasonography findings of 32 patients with minor blunt chest trauma showing no evidence of a rib fracture on anteroposterior chest x-rays, were documented. Presence of cortical discontinuities, acoustic shadows, reverberation artifacts, and hematoma by ultrasonography was proposed as the diagnostic criteria for detecting the rib fracture. Results: Rib fracture was detected in 20 patients (62.5% according to ultrasonography results. A mildly displaced fracture was detected in 7 patients (35%, hematoma was detected in 3 patients (15% and multiple fractures (in 5th, 6th, 7th, and 8th ribs were detected in 1 patient (5%. Conclusion: The results of our study showed that ultrasonography is superior to chest x-ray, in detecting rib fractures.

  19. Evaluation of the Rib Lesions by Bone Scanning

    International Nuclear Information System (INIS)

    Park, Hyung Gun; Lee, Dong Soo; Lee, Myung Chul; Cho, Bo Youn; Koh, Chang Soon

    1983-01-01

    In order to establish criteria for distinguishing between occult fracture and metastases, we have reviewed 52 records of cancer patients and 24 of rib fracture patients referred for bone scanning. In 52 patients with biopsy-proven malignancy, multiple linear increased uptake of the ribs was found in 32 cases(61.5%), and was the most common finding. In 24 patients with rib fracture, all but 1 had fecal increased uptake of the ribs, and lesions almost always aligned in a row. By analyzing the appearance of rib lesions in total 76 patients, it was concluded that there is a high probability that rib lesions detected by bone scanning are bony metastases if 1) they are multiple linear as opposed to fecal, and 2) they are not aligned in the same location

  20. Bifid rib – usefulness of chest ultrasound. A case report

    Directory of Open Access Journals (Sweden)

    Magdalena Kryger

    2013-12-01

    Full Text Available The paper presents the possibility of using ultrasonography in the diagnosis of a congenital rib anomaly in the form of bifid rib. Bifid rib is a rare congenital abnormality of anterior chest wall. It manifests as a chest “lump.” Such lesions are detected during a routine physical examination or chest X-ray which is often performed for other reasons. The overall prevalence of bifid rib is estimated at 0.15% to 3.4% (mean 2% and it accounts for approximately 20% of all congenital rib anomalies. It is usually an unilateral lesion. The cases presented herein constitute the first pediatric cases in the available literature in which bifid rib anomaly was visualized by ultrasound examination.

  1. Onlay Rib Bone Graft in Elevation of Reconstructed Auricle: 17 Years of Experience

    Directory of Open Access Journals (Sweden)

    Taehoon Kim

    2013-05-01

    Full Text Available BackgroundA cartilage wedge block and covering flap are standard procedures for firm elevation of the ear in microtia correction. However, using costal cartilage for elevation of the reconstructed auricle can be insufficient, and the fixed cartilage wedge block may be absorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and uses up fascia, a potential source of reconstruction material. Therefore, we propose an innovative method using autologous onlay rib bone graft for auricular elevation of microtia.MethodsFrom February 1995 to August 2012, 77 patients received a first stage operation with a rib cartilage framework graft. In the second stage operation, a small full thickness of rib bone was harvested through the previous donor scar. The bihalved rib bone was inserted into the subperiosteal pocket beneath the cartilage framework.ResultsThe follow-up time ranged from 1 month to 17 years, with a mean of 3 years. All of the patients sustained the elevation of their ears very well during the follow-up period. Donor site problems, except for hypertrophic scars, were not observed. Surgery-related complications, specifically skin necrosis, infection, or hematoma, occurred in 4 cases.ConclusionsOnlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate material than cartilage, due to the bone-to-bone contact between the bone graft and the temporal bone. Postoperative minor correction of the elevation degree is straightforward and the skin graft survives better. Therefore, reconstructed auricle elevation using onlay rib bone graft is a useful and valuable method.

  2. Improvement of diagnostic confidence for detection of multiple myeloma involvement of the ribs by a new CT software generating rib unfolded images: Comparison with 5- and 1-mm axial images

    Energy Technology Data Exchange (ETDEWEB)

    Homann, Georg; Mustafa, Deedar Farhad; Nikolaou, Konstantin; Horger, Marius [Eberhard Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Weisel, Katja [Eberhard Karls University Tuebingen, Department of Internal Medicine II, Tuebingen (Germany); Ditt, Hendrik [Healthcare Sector Imaging and Therapy Division, Siemens AG, Forchheim (Germany)

    2015-04-02

    To investigate the performance of a new CT software generating rib unfolded images for improved detection of rib osteolyses in patients with multiple myeloma. One hundred sixteen patients who underwent whole-body reduced-dose multidetector computed tomography (WBRD-MDCT) for multiple myeloma diagnosis and during follow-up were retrospectively evaluated. Nonenhanced CT scans with 5- and 1-mm slice thickness were interpreted by two readers with focus on detection of rib involvement (location, number, fracture). Image analysis of ''unfolded,'' 1-mm-based CT rib images was subsequently undertaken. We classified the number of lytic bone lesions into 0, 1, 2, <5, <10 and ≥10. For all three data sets the reading time was registered. An approximated sum of 6,727 myeloma-related rib lesions was found. On a patient-based analysis, CT (5 mm), CT (1 mm) and CT (1 mm ''unfolded rib'') yielded a sensitivity, specificity and accuracy of 79.7/94.7/87.1, 88.1/93/90.5 and 98.3/96.5/97.4, respectively. In a lesion-based analysis, the sensitivity, specificity and accuracy of the three evaluations were 69.7/87.2/70.5, 79.8/55.9/78 and 96.5/89.7/96.1. Mean reading time for 5 mm/1 mm axial images and unfolded images was 178.7/215.1/90.8 s, respectively. The generation of ''unfolded rib'' images improves detection of rib involvement in patients with multiple myeloma and significantly reduces reading time. (orig.)

  3. Experimental investigation of cross-over jets in a rib-roughened trailing-edge cooling channel

    Science.gov (United States)

    Xue, Fei

    Increasing the rotor inlet temperature can dramatically increase the efficiency and power output of the gas turbine engine. However, the melting point of turbine blade material limits the realistic upper bound of the rotor inlet temperature. As a result, the development of high temperature turbine blade material and advanced turbine blade cooling technology determines the future of turbine blade engine. Adding impingement jet holes and rib turbulators in the inner cooling channel of the gas turbine blades are two effective ways to enhance the cooling effects. The purpose of this study is to figure out the influence of different combinations of jet holes and rib turbulators on the heat transfer efficiency. A tabletop scale test model is used in the study to simulate the cooling cavity of trailing edge and its feed channel in a real gas turbine blade. The Dimensional Analysis Theory is used in the study to eliminate the influence of scaling. Two different crossover slots are tested with 5 different rib arrangements, and each of the test geometries is tested for 6 jet Reynolds numbers ranging from 10,000 to 36,000. The two different crossover slots are the crossover slots with 0 and 5 degree tilt angles. The four different rib arrangements are ribs with 0 degree, 45 degree, 90 degree and 135 degree angles of attack with respect to the flow direction. Furthermore, a smooth test section (no ribs) was also tested. The steady state liquid crystal thermography is used to quantify the heat transfer performance of the target areas. The variation of Nusselt number versus Reynolds number is plotted for each of the 10 geometries. Also, the variation of Nusselt number versus Reynolds number are compared for different rib angles of attack with the same crossover slot tilt angle, and between different crossover slots tilt angles with the same rib angle. The results show that, the area-weighted average Nusselt number increases monotonically with the Reynolds number; the target

  4. Automatic three-dimensional rib centerline extraction from CT scans for enhanced visualization and anatomical context

    Science.gov (United States)

    Ramakrishnan, Sowmya; Alvino, Christopher; Grady, Leo; Kiraly, Atilla

    2011-03-01

    We present a complete automatic system to extract 3D centerlines of ribs from thoracic CT scans. Our rib centerline system determines the positional information for the rib cage consisting of extracted rib centerlines, spinal canal centerline, pairing and labeling of ribs. We show an application of this output to produce an enhanced visualization of the rib cage by the method of Kiraly et al., in which the ribs are digitally unfolded along their centerlines. The centerline extraction consists of three stages: (a) pre-trace processing for rib localization, (b) rib centerline tracing, and (c) post-trace processing to merge the rib traces. Then we classify ribs from non-ribs and determine anatomical rib labeling. Our novel centerline tracing technique uses the Random Walker algorithm to segment the structural boundary of the rib in successive 2D cross sections orthogonal to the longitudinal direction of the ribs. Then the rib centerline is progressively traced along the rib using a 3D Kalman filter. The rib centerline extraction framework was evaluated on 149 CT datasets with varying slice spacing, dose, and under a variety of reconstruction kernels. The results of the evaluation are presented. The extraction takes approximately 20 seconds on a modern radiology workstation and performs robustly even in the presence of partial volume effects or rib pathologies such as bone metastases or fractures, making the system suitable for assisting clinicians in expediting routine rib reading for oncology and trauma applications.

  5. PIV Measurements of Turbulent Flow in a Channel with Solid or Perforated Ribs

    DEFF Research Database (Denmark)

    Wang, Lei; Salewski, Mirko; Sundén, Bengt

    2011-01-01

    Particle image velocimetry measurements are performed in a channel with periodic ribs on one wall. We investigate the flow around two different rib configurations: solid and perforated ribs with a slit. The ribs obstruct the channel by 20% of its height and are arranged 10 rib heights apart. For ...

  6. An analysis of 214 cases of rib fractures

    OpenAIRE

    Karadayi, Sule; Nadir, Aydin; Sahin, Ekber; Celik, Burcin; Arslan, Sulhattin; Kaptanoglu, Melih

    2011-01-01

    INTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1) p...

  7. Radiographic abnormalities of ribs in β-thalassemic children

    International Nuclear Information System (INIS)

    Singcharoen, T.; Piyachon, C.; Kulapongs, P.

    1988-01-01

    Bone change is one of the most outstanding manifestations of marrow hyperplasia in thalassemia patients. In the thorax, marrow hyperplasia widens the ribs, thins the cortices, and erases most of their trabecular patterns. Thus, a variety of radiologic changes of the ribs have been described. The chest radiographs of 33 Thai children with β-thalassemia major were reviewed, and a spectrum of rib changes were observed

  8. Flow instability and critical heat flux in a ribbed annulus

    International Nuclear Information System (INIS)

    Yang, B.W.; Dougherty, T.; Fighetti, C.; Kokolis, S.; Reddy, G.D.; McAssey, E.V. Jr.; Coutts, A.

    1993-01-01

    An experimental program has been conducted to determine the onset of flow instability point in a heated annulus which is divided into four sub channels by non-conducting ribs. The onset of flow instability is identified by the minimum point in the pressure drop-velocity curve. Comparison with a ribless annulus show that the presence of ribs increases the minimum point velocity. In addition, data are presented which show that under certain conditions premature CHF can be induced by the ribs

  9. Stress injury of the rib in a swimmer

    Energy Technology Data Exchange (ETDEWEB)

    Heincelman, Carrie [University of Cincinnati Medical Center, Department of Orthopaedic Surgery, Cincinnati, OH (United States); Brown, Seth; England, Eric; Mehta, Kaushal; Wissman, Robert D. [University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2014-09-15

    Rib stress injuries are uncommonly reported but have been documented among athletes, most notably rowers. There have only been two prior case reports of rib stress injuries in swimmers, both of which were young females. Magnetic resonance (MR) imaging was either not obtained or the imaging characteristics were incompletely described. We present a case of an isolated third rib stress injury in a collegiate male swimmer diagnosed via MR imaging. We briefly discuss the possible etiologies for rib stress injuries, their MR appearance, as well as their treatment. (orig.)

  10. Case report 467: Cystic chondroblastoma left 4th rib

    Energy Technology Data Exchange (ETDEWEB)

    Sundaram, M.; McGuire, M.H.; Naunheim, K.; Schajowicz, F.

    1988-03-01

    A case of chondroblastoma in an 18-year-old female arising from a rib near the costotransverse articulation (presumably from the epiphysis of the articular process) has been described. The destructive pattern noted in the rib, associated with a large soft tissue mass, favored a malignant lesion rather than a benign one. Histologically, this tumor had large cystic and hemorrhagic components, consistent with the diagnosis of a cystic chondroblastoma of a rib. Curiously, this patient, like two others with chondroblastoma in a rib was asymptomatic, and attention to the abnormality was drawn from a routine chest radiography. The patient remains disease-free one and a half-years following surgery.

  11. Feasibility of emergency department point-of-care ultrasound for rib fracture diagnosis in minor thoracic injury.

    Science.gov (United States)

    Lalande, Élizabeth; Guimont, Chantal; Émond, Marcel; Parent, Marc Charles; Topping, Claude; Kuimi, Brice Lionel Batomen; Boucher, Valérie; Le Sage, Natalie

    2017-05-01

    The main objective of this study was to evaluate the feasibility of emergency department (ED) point-of-care ultrasound (PoCUS) for rib fracture diagnosis in patients with minor thoracic injury (mTI). Secondary objectives were to 1) evaluate patients' pain during the PoCUS procedure, 2) identify the limitations of the use of PoCUS technique, and 3) compare the diagnosis obtained with PoCUS to radiography results. Adult patients who presented with clinical suspicion of rib fractures after mTI were included. All patients underwent PoCUS performed by emergency physicians (EPs) prior to a rib view X-ray. A visual analogue scale (VAS) ranging from 0 to 100 was used to ascertain feasibility, patients' pain and clinicians' degree of certitude. Feasibility was defined as a score of more than 50 on the VAS. We documented the radiologists' interpretation of rib view X-ray. Radiologists were blinded to the PoCUS results. Ninety-six patients were included. A majority (65%) of EPs concluded that the PoCUS technique to diagnose rib fracture was feasible (VAS score > 50). Median score for feasibility was 63. Median score was 31 (Interquartile range [IQR] 5-57) for patients' pain related to the PoCUS. The main limiting factor of the PoCUS technique was pain during patient examination (15%). PoCUS examination appears to be a feasible technique for a rib fracture diagnosis in the ED.

  12. Analysis of the Shear Behavior of Stubby Y-Type Perfobond Rib Shear Connectors for a Composite Frame Structure.

    Science.gov (United States)

    Kim, Sang-Hyo; Kim, Kun-Soo; Lee, Do-Hoon; Park, Jun-Seung; Han, Oneil

    2017-11-22

    Shear connectors are used in steel beam-concrete slabs of composite frame and bridge structures to transfer shear force according to design loads. The existing Y-type perfobond rib shear connectors are designed for girder slabs of composite bridges. Therefore, the rib and transverse rebars of the conventional Y-type perfobond rib shear connectors are extremely large for the composite frames of building structures. Thus, this paper proposes stubby Y-type perfobond rib shear connectors, redefining the existing connectors, for composite frames of building structures; these were used to perform push-out tests. These shear connectors have relatively small ribs compared to the conventional Y-type perfobond rib shear connectors. To confirm the shear resistance of these stubby shear connectors, we performed an experiment by using transverse rebars D13 and D16. The results indicate that these shear connectors have suitable shear strength and ductility for application in composite frame structures. The shear strengths obtained using D13 and D16 were not significantly different. However, the ductility of the shear connectors with D16 was 45.1% higher than that of the shear connectors with D13.

  13. Experimental investigation of heat transfer and flow using V and broken V ribs within gas turbine blade cooling passage

    Science.gov (United States)

    Kumar, Sourabh; Amano, R. S.

    2015-05-01

    Gas turbines are extensively used for aircraft propulsion, land-based power generation, and various industrial applications. With an increase in turbine rotor inlet temperatures, developments in innovative gas turbine cooling technology enhance the efficiency and power output; these advancements of turbine cooling have allowed engine designs to exceed normal material temperature limits. For internal cooling design, techniques for heat extraction from the surfaces exposed to hot stream of gas are based on an increase in the heat transfer areas and on the promotion of turbulence of the cooling flow. In this study, an improvement in performance is obtained by casting repeated continuous V- and broken V-shaped ribs on one side of the two pass square channels into the core of the blade. A detailed experimental investigation is done for two pass square channels with a 180° turn. Detailed heat transfer distribution occurring in the ribbed passage is reported for a steady state experiment. Four different combinations of 60° V- and broken 60° V-ribs in a channel are considered. A series of thermocouples are used to obtain the temperature on the channel surface and local heat transfer coefficients are obtained for Reynolds numbers 16,000, 56,000 and 85,000 within the turbulent flow regime. Area averaged data are calculated in order to compare the overall performance of the tested ribbed surface and to evaluate the degree of heat transfer enhancement induced by the rib. Flow within the channels is characterized by heat transfer enhancing ribs, bends, rotation and buoyancy effects. A series of experimental measurements is performed to predict the overall performance of the channel. This paper presents an attempt to collect information about the Nusselt number, the pressure drop and the overall performance of the eight different ribbed ducts at the specified Reynolds number. The main contribution of this study is to evaluate the best combination of rib arrangements

  14. Multidrug Resistant Tuberculosis involving the Clavicle, Spine and Ribs

    Directory of Open Access Journals (Sweden)

    H Krishnan

    2011-03-01

    Full Text Available This report describes an unusual case of multidrug resistant tuberculosis (MDR-TB, involving the right clavicle and multicentric aytpical spine involvement without any neurological deficit. The female patient presented with acute onset of right clavicular pain associated with a one-month history of lower backache with constitutional symptoms. The clavicular lesion and MRI spine findings were highly suggestive of TB. Anti TB drugs (ATD were started empirically as Sabah, Malaysia the patient’s home, is an endemic area for TB. Despite, 2 months of ATD administration, the patient did not respond well clinically and developed left sided chest wall abscesses arising from the left 3rd and 6th ribs. She was then treated for MDR-TB infection and has responded well to this treatment.

  15. Food-Related Odors Activate Dopaminergic Brain Areas

    OpenAIRE

    Agnieszka Sorokowska; Agnieszka Sorokowska; Katherina Schoen; Cornelia Hummel; Pengfei Han; Jonathan Warr; Thomas Hummel

    2017-01-01

    Food-associated cues of different sensory categories have often been shown to be a potent elicitor of cerebral activity in brain reward circuits. Smells influence and modify the hedonic qualities of eating experience, and in contrast to smells not associated with food, perception of food-associated odors may activate dopaminergic brain areas. In this study, we aimed to verify previous findings related to the rewarding value of food-associated odors by means of an fMRI design involving careful...

  16. External relations on the classroom: Experiences area Andina University Foundation

    OpenAIRE

    Belén Leal Hurtado; Ruth Betty Aragón Aguilar

    2017-01-01

    This article is the result of a research project conducted in the academic context. Its aim was to analyze how the students of the Area Andina University Foundation conceive relations of friendship, relationships and management of conflicts outside the classroom. It was developed under a psychosocial approach of qualitative and exploratory, not comparative, type with application of the method of mixed focus groups with a population of 48 students, between 18 and 25 years, enrolled in the thir...

  17. Rib-pillar mining at Sigma Colliery

    Energy Technology Data Exchange (ETDEWEB)

    De Beer, J J.S.; Hunter, F; Neethling, A F [Sigma Colliery, Sasolburg (South Africa)

    1991-06-01

    The paper describes the rib-pillar extraction method now used at Sigma Colliery in the Orange Free State. In this method, access roadways (with a high safety factor) are developed into a block of coal suitable for total extraction; pillars that have a low safety factor are then formed and extracted immediately. The method, together with the current practices of labour management, has resulted in better utilization of the coal resources and capital, increased production and labour productivity, and improved safety. 11 figs.

  18. Primary clear cell sarcoma of rib

    International Nuclear Information System (INIS)

    Hersekli, Murat Ali; Ozkoc, Gurkan; Akpinar, Sercan; Ozalay, Metin; Tandogan, Reha N.; Bircan, Sema; Tuncer, Ilhan

    2005-01-01

    Clear cell sarcoma (malignant melanoma of soft tissues) is a very rare soft tissue neoplasm. It generally arises in tendons and aponeuroses. Although metastasis of malignant melanoma to bone is not uncommon, primary clear cell sarcoma of bone is an extremely rare neoplasm. To our knowledge five cases have been reported in the English literature. We present a case of primary clear cell sarcoma of bone in a 28-year-old woman arising in the left ninth rib. We treated the patient with total excision of the mass and postoperative radiotherapy. The patient is alive and well without local recurrence or distant metastasis at 33 months after surgery. (orig.)

  19. Detection of rib fractures in an abused infant using digital radiography: a laboratory study

    International Nuclear Information System (INIS)

    Kleinman, Paul K.; O'Connor, Brian; Nimkin, Katherine; Rayder, Shawn M.; Spevak, Melissa R.; Belanger, Patricia L.; Getty, David J.; Karellas, Andrew

    2002-01-01

    To assess the diagnostic performance of digital radiography using charge-coupled device (CCD) technology in the detection of rib fracture in infant abuse.Materials and methods. Four fractured posterior rib arcs and eight normal ribs removed at autopsy from a 10-month-old abused infant were radiographed using a CCD prototype, four clinical film-screen systems, and direct-exposure film. Each rib was viewed with these six systems in nine different projections. The resultant 648 images were assessed for probability of fracture (0-100%) by four pediatric radiologists. The calculated area under the resultant ROC curves (A z ) for the CCD was compared with those obtained with direct-exposure, high-detail, medium and fast film-screen radiographic systems. The mean A z for the CCD (0.937) fell within the range of the high-detail systems (0.934-0.940) and was significantly higher (p 20 line pairs per millimeter) the CCD performance was comparable (A z =0.944 vs. 0.937). The similar performance can be explained by the higher contrast resolution of the digital technology. This study indicates that in the ex vivo setting, digital radiology can perform comparably to high-detail film-screen imaging. The findings suggest that digital radiography has the potential to replace film-screen imaging in the evaluation of inflicted skeletal injury in infants. (orig.)

  20. Forced convection heat transfer of steam in a square ribbed channel

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Jiazeng; Gao, Jianmin; Gao, Tieyu [Xi' an Jiaotong University, Shaanxi (China)

    2012-04-15

    An experimental study of heat transfer characteristics of steam in a square channel (simulating a gas turbine blade cooling passage) with two opposite surfaces roughened by 60 deg parallel ribs was performed. The ranges of key governing parameters were: Reynolds numbers (Re) based on the channel hydraulic diameter (30000-140000), entry gauge pressure (0.2Mpa-0.5Mpa), heat flux of heat transfer surface area (5kWm{sup -2}-20kWm{sup -2}), and steam superheat (13 .deg. C-51 .deg. C). The test channel length was 1000mm, while the rib spacing (p/e) was 10, and the ratio of rib height (e) to hydraulic diameter (D) was 0.048. The test channel was heated by passing current through stainless steel walls instrumented with thermocouples. The local heat transfer coefficients on the ribbed wall from the channel entrance to the fully developed regions were measured. The semi-empirical correlation was fitted out by using the average Nusselt numbers in the fully developed region to cover the range of Reynolds number. The correlation can be used in the design of new generation of gas turbine blade cooled by steam.

  1. Case report: clinical and postmortem findings in four cows with rib fracture

    OpenAIRE

    Braun, Ueli; Warislohner, Sonja; Hetzel, Udo; Nuss, Karl

    2017-01-01

    BACKGROUND: Published reports of rib fractures in adult cattle are limited to the occurrence of chronic rib swellings caused by calluses, which are unremarkable from a clinical standpoint, whereas studies identifying clinical signs of rib fractures were not found in a literature search. This report describes the clinical and postmortem findings in four cows with rib fractures. CASE PRESENTATION: The 13th rib was fractured in three cows and the 11th rib in the remaining cow; three fractures...

  2. Is proportion burned severely related to daily area burned?

    International Nuclear Information System (INIS)

    Birch, Donovan S; Morgan, Penelope; Smith, Alistair M S; Kolden, Crystal A; Hudak, Andrew T

    2014-01-01

    The ecological effects of forest fires burning with high severity are long-lived and have the greatest impact on vegetation successional trajectories, as compared to low-to-moderate severity fires. The primary drivers of high severity fire are unclear, but it has been hypothesized that wind-driven, large fire-growth days play a significant role, particularly on large fires in forested ecosystems. Here, we examined the relative proportion of classified burn severity for individual daily areas burned that occurred during 42 large forest fires in central Idaho and western Montana from 2005 to 2007 and 2011. Using infrared perimeter data for wildfires with five or more consecutive days of mapped perimeters, we delineated 2697 individual daily areas burned from which we calculated the proportions of each of three burn severity classes (high, moderate, and low) using the differenced normalized burn ratio as mapped for large fires by the Monitoring Trends in Burn Severity project. We found that the proportion of high burn severity was weakly correlated (Kendall τ = 0.299) with size of daily area burned (DAB). Burn severity was highly variable, even for the largest (95th percentile) in DAB, suggesting that other variables than fire extent influence the ecological effects of fires. We suggest that these results do not support the prioritization of large runs during fire rehabilitation efforts, since the underlying assumption in this prioritization is a positive relationship between severity and area burned in a day. (letters)

  3. Comparison of Postoperative Pain Relief by Intercostal Block Between Pre-rib Harvest and Post-rib Harvest Groups

    International Nuclear Information System (INIS)

    Bashir, M. M.; Shahzad, M. A.; Yousaf, M. N.; Khan, B. A.; Khan, F. A.

    2014-01-01

    Objective: To compare intercostal nerve block before and after rib harvest in terms of mean postoperative pain score and mean postoperative tramadol usage. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Plastic Surgery, Mayo Hospital, KEMU, Lahore, from January 2011 to July 2012. Methodology: Patients (n = 120) of either gender with ASA class-I and II requiring autogenous costal cartilage graft were inducted. Patients having history of local anaesthetic hypersensitivity and age 60 years were excluded. Subjects were randomly assigned to pre-rib harvest (group-1) and post-rib harvest (group-2). Local anaesthetic mixture was prepared by adding 10 milliliters 2% lidocaine to 10 milliliters 0.5% bupivacaine to obtain a total 20 ml solution. Group-1 received local anaesthetic infiltration along the proposed incision lines and intercostals block before the rib harvest. Group-2 received the infiltration and block after rib harvest. Postoperative consumption of tramadol and pain scores were measured at 6 and 12 hours postoperatively using VAS. Results: Mean age was 31.43 A +- 10.78 years. The mean pain scores at 6 hours postoperatively were 1.033 A +- 0.609 and 2.4667 A +- 0.812 in pre-rib harvest and post-rib harvest groups respectively (p < 0.0001). The mean pain scores at 12 hours postoperatively were 1.45 A +- 0.565 and 3.65 A +- 0.633 in pre-rib harvest and post-rib harvest groups respectively (p < 0.0001). The mean tramadol used postoperatively in first 24 hours was 169 A +- 29.24 mg and 255 A +- 17.70 mg in prerib harvest and post-rib harvest groups respectively (p < 0.0001). Conclusion: Intercostal block administered before rib harvest as preemptive strategy result in decreased postoperative pain scores and narcotic use. (author)

  4. Surgical Management of Rib Fractures: Strategies and Literature Review.

    Science.gov (United States)

    de Jong, M B; Kokke, M C; Hietbrink, F; Leenen, L P H

    2014-06-01

    Rib fractures can cause significant problems in trauma patients, often resulting in pain and difficulty with respiration. To prevent pulmonary complications and decrease the morbidity and mortality rates of patients with rib fractures, currently there is a trend to provide surgical management of patients with flail chest. However, the indications for rib fracture fixation require further specification. Past and current strategies are described according to a review of the medical literature. A systematic review was performed including current indications for rib fracture fixation. MEDLINE (2000-2013) was searched, as well as Embase (2000-2013) and Cochrane Databases, using the keywords rib, fracture, fixation, plate, repair, and surgery. Three retrospective studies were found that described different techniques for rib fracture fixation. The results demonstrated a reduced number of ventilation days, decreased long-term morbidity and pain, and satisfactory rehabilitation after surgical treatment. In addition to flail chest, age, Injury Severity Score, and the number of rib fractures were important predictive factors for morbidity and mortality. Surgical rib fracture fixation might be indicated in a broader range of cases than is currently performed. Prospective randomized trials are needed for further confirmation. © The Finnish Surgical Society 2014.

  5. Quality of life after major trauma with multiple rib fractures.

    Science.gov (United States)

    Marasco, Silvana; Lee, Geraldine; Summerhayes, Robyn; Fitzgerald, Mark; Bailey, Michael

    2015-01-01

    Rib fractures are a common injury presenting to major trauma centres and community hospitals. Aside from the acute impact of rib fracture injury, longer-term morbidity of pain, disability and deformity have been described. Despite this, the mainstay of management for the vast majority of rib fracture injuries remains supportive only with analgesia and where required respiratory support. This study aimed to document the long-term quality of life in a cohort of major trauma patients with rib fracture injury over 24 months. Retrospective review (July 2006-July 2011) of 397 major trauma patients admitted to The Alfred Hospital with rib fractures and not treated with operative rib fixation. The main outcome measures were quality of life over 24 months post injury assessed using the Glasgow Outcome Scale Extended and SF12 health assessment forms and a pain questionnaire. Assessment over 24 months of major trauma patients with multiple rib fractures demonstrated significantly lower quality of life compared with published Australian norms at all time points measured. Return to work rates were poor with only 71% of those who were working prior to their accident, returning to any work. This study demonstrates a significant reduction in quality of life for rib fracture patients requiring admission to hospital, which does not return to the level of Australian norms for at least two years. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  6. Rib enlargement in premature infants with bronchopulmonary dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung; Han, Kim Bokyung; Chang, Yun Sil; Choo, In Wook [Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul (Korea, Republic of); Kim, Kyeong Ah [Anyang General Hospital, Anyang (Korea, Republic of)

    2000-04-01

    The purpose of this study is to describe the rib changes seen in patients with brochopulmonary dysplasia (BPD). Serial chest radiographs of nine premature infants with BPD who showed diffuse rib enlargement were reviewed for hyperinflation, which was compared with the observed degree of rib enlargement. Vibrator chest physiotherapy was performed in all cases, and five infants underwent conventional ventilation plus high frequency oscillatory ventilation therapy. Their calcium level was normal whereas alkaline phosphatase and phosphate levels were high. In all infants except one, liver enzyme levels were normal. For the treatment of patent ductus arteriosus, infection, and BPD, medications including indomethacin, antibiotics, and dexamethasone were administered. Vitamin D was given to all patients with total parenteral nutrition. Rib enlargement was found to be severe (n=3D4), moderate (n=3D3), or mild (n=3D2) with undulating margins or posterior tapering (n=3D2). Hyperinflation was noted in eight patients, in seven of whom it was moderate to severe. Among these seven, rib enlargement was severe (n=3D2), moderate (n=3D3), or mild (n=3D2). In one infant with mild hyperinflation, rib enlargement was severe. Bilateral irregular infiltrates and atelectases were noted in all patients. In BPD patients, rib enlargement may be seen. In order to differentiate this process from systemic bone disease or bony dysplasia, an awareness of the rib changes occurring in patients with BPD may be important. (author)

  7. The prevalence of cervical ribs in Enugu, Nigeria

    African Journals Online (AJOL)

    2015-11-18

    Nov 18, 2015 ... ... prevalence of cervical ribs and its variation with sex and age among patients ... The patients' identities were removed from the ... syndrome, only 8–10% actually has cervical rib as ... Anatomy, symptoms, diagnosis, and treatment. ... Illinois: American Association of Neurological Surgeons; 1998. p. 157-70.

  8. Rib enlargement in premature infants with bronchopulmonary dysplasia

    International Nuclear Information System (INIS)

    Yoon, Hye Kyung; Han, Kim Bokyung; Chang, Yun Sil; Choo, In Wook; Kim, Kyeong Ah

    2000-01-01

    The purpose of this study is to describe the rib changes seen in patients with brochopulmonary dysplasia (BPD). Serial chest radiographs of nine premature infants with BPD who showed diffuse rib enlargement were reviewed for hyperinflation, which was compared with the observed degree of rib enlargement. Vibrator chest physiotherapy was performed in all cases, and five infants underwent conventional ventilation plus high frequency oscillatory ventilation therapy. Their calcium level was normal whereas alkaline phosphatase and phosphate levels were high. In all infants except one, liver enzyme levels were normal. For the treatment of patent ductus arteriosus, infection, and BPD, medications including indomethacin, antibiotics, and dexamethasone were administered. Vitamin D was given to all patients with total parenteral nutrition. Rib enlargement was found to be severe (n=3D4), moderate (n=3D3), or mild (n=3D2) with undulating margins or posterior tapering (n=3D2). Hyperinflation was noted in eight patients, in seven of whom it was moderate to severe. Among these seven, rib enlargement was severe (n=3D2), moderate (n=3D3), or mild (n=3D2). In one infant with mild hyperinflation, rib enlargement was severe. Bilateral irregular infiltrates and atelectases were noted in all patients. In BPD patients, rib enlargement may be seen. In order to differentiate this process from systemic bone disease or bony dysplasia, an awareness of the rib changes occurring in patients with BPD may be important. (author)

  9. Flow regime mapping of vertical two-phase downflow in a ribbed annulus

    International Nuclear Information System (INIS)

    Kielpinski, A.L.

    1992-01-01

    Two-phase flow regimes have been mapped for vertical, cocurrent downflow in a narrow annulus which is partially segmented by the presence of longitudinal ribs. This geometry and flow condition has application to the analysis of a Large-Break Loss of Coolant Accident (LB-LOCA) in the production K-Reactor at the Savannah River Site (SRS). The ribbed annular geometry, particularly the presence of non-sealing ribs, gives rise to some unique phenomenological features. The flow behavior is influenced by the partial segmentation of the annulus into four quadrants or subchannels. A random element is induced by the natural bowing of the slender tubes; the width of the azimuthal flow path between two subchannels at a given axial location is indeterminate, and can take on any value between zero and the maximum clearance of 7.6 x l0 -4 m. When the rib gap is zero at a given location, it is at a maximum 180P away at the same axial location. The range of rib gaps is spanned in a single test section, as it would be also in a reactor assembly. As a result of these effects, flow regime maps obtained by other researchers for downflow in annuli are not accurate for defining flow regimes in a ribbed annulus. Flow regime transitions similar to those noted by, e.g., Bamea, were observed; the locations of these transitions were displaced with respect to the transition equations derived by Bamea. Experimental bubble rise velocity measurements were also obtained in the same test section. The bubble rise velocities were much higher than expected from the theory developed for slug bubbles in tubes, unribbed annuli, and rectangular channels. An elliptical-cap bubble rises faster than a slug bubble of the same area. Large, slug-shaped bubbles injected into the test section were observed to reduce in size as they rose, due to interaction with a longitudinal rib. They thereby adopted a shape more like an elliptical-cap bubble, hence rising faster than the original slug bubble

  10. Surgical stabilization of severe rib fractures decreases incidence of retained hemothorax and empyema.

    Science.gov (United States)

    Majercik, Sarah; Vijayakumar, Sathya; Olsen, Griffin; Wilson, Emily; Gardner, Scott; Granger, Steven R; Van Boerum, Don H; White, Thomas W

    2015-12-01

    Retained hemothorax (RH) is relatively common after chest trauma and can lead to empyema. We hypothesized that patients who have surgical fixation of rib fractures (SSRF) have less RH and empyema than those who have medical management of rib fractures (MMRF). Admitted rib fracture patients from January 2009 to June 2013 were identified. A 2:1 propensity score model identified MMRF patients who were similar to SSRF. RH, and empyema and readmissions, were recorded. Variables were compared using Fisher exact test and Wilcoxon rank-sum tests. One hundred thirty-seven SSRF and 274 MMRF were analyzed; 31 (7.5%) had RH requiring 35 interventions; 3 (2.2%) SSRF patients had RH compared with 28 (10.2%) MMRF (P = .003). Four (14.3%) MMRF subjects with RH developed empyema versus zero in the SSRF group (P = .008); 6 (19.3%) RH patients required readmission versus 14 (3.7%) in the non-RH group (P = .002). Patients with rib fractures who have SSRF have less RH compared with similar MMRF patients. Although not a singular reason to perform SSRF, this clinical benefit should not be overlooked. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. CASE REPORT:Chondrosarcoma of Rib on Fine Needle Aspiration Cytology – A Rare Site

    Directory of Open Access Journals (Sweden)

    Prakash M Patil

    2012-07-01

    Full Text Available Background: Fine needle aspiration cytology (FNAC is effective in the diagnosis of bone tumors when combined with careful radiologic and clinical evaluation. Chondrosarcomas often arise in the pelvis or bones of the trunk, but primary chest wall (rib chondrosarcomas are relatively rare. Case Reports: This is a case of a patient with a chondrosarcoma arising in the left lower rib who underwent resection. The patient was a 30-year-old man with a 10x8x6cm tumor in the anterior chest wall of the left side lower rib. On Fine Needle Aspiration Cytology (FNAC of the mass on the anterior chest wall, a diagnosis of a low grade chondrosarcoma was made. This was confirmed histopathologically as a dedifferentiated chondrosarcoma. Macroscopically on excision of gray to pink lobulated mass with adjacent soft tissue and bone with foci of hemorrhage and necrosis the mass measured (M 10x 8x 6 cm. Incidence of chondrosarcoma peaks in the 5th to 6th decade and most commonly involves the femur, humerus, pelvis, and scapula. It rarely involves rib.

  12. Area-wide traffic calming for preventing traffic related injuries.

    Science.gov (United States)

    Bunn, F; Collier, T; Frost, C; Ker, K; Roberts, I; Wentz, R

    2003-01-01

    It is estimated that by 2020 road traffic crashes will have moved from ninth to third in the world disease burden ranking, as measured in disability adjusted life years, and second in developing countries. The identification of effective strategies for the prevention of traffic related injuries is of global health importance. Area-wide traffic calming schemes that discourage through traffic on residential roads is one such strategy. To evaluate the effectiveness of area-wide traffic calming in preventing traffic related crashes, injuries, and deaths. We searched the following electronic databases: Cochrane Injuries Group's Specialised Register, Cochrane Controlled Trials Register, MEDLINE, EMBASE and TRANSPORT (NTIS, TRIS, TRANSDOC). We searched the web sites of road safety organisations, handsearched conference proceedings, checked reference lists of relevant papers and contacted experts in the area. The search was not restricted by language or publication status. Randomised controlled trials, and controlled before-after studies of area-wide traffic calming schemes. Two reviewers independently extracted data on type of study, characteristics of intervention and control areas, and length of data collection periods. Before and after data were collected on the total number of road traffic crashes, all road user deaths and injuries, pedestrian-motor vehicle collisions and road user deaths. The statistical package STATA was used to calculate rate ratios for each study, which were then pooled to give an overall estimate using a random effects model. We found no randomised controlled trials, but 16 controlled before-after trials met our inclusion criteria. Seven studies were done in Germany, six in the UK, two in Australia and one in the Netherlands. There were no studies in low or middle income countries. Eight trials reported the number of road traffic crashes resulting in deaths. The pooled rate ratio was 0.63 (0.14, 2.59 95% CI). Sixteen studies reported the number

  13. Investigation into the heat transfer performance of helically ribbed surfaces

    International Nuclear Information System (INIS)

    Firth, R.J.

    1981-12-01

    The first part of an investigation into flow and heat transfer in annular channels and seven pin clusters is described. One of the main aims of the project is to improve cluster heat transfer prediction codes for helically ribbed surfaces. A study is made of the heat transfer and flow characteristics of a helically ribbed pin in an annular channel. It is shown that the swirling flow, which is induced by the helical ribs, gives rise to substantially enhanced diffusivity levels. This phenomenon had not been taken into account by previous analysis techniques. The methods for analysing heat transfer and pressure drop data from annular channels which were originally developed for non-swirling flow are generalised to accommodate swirling flow. The new methods are shown to be consistent with empirical data. Roughness parameter data is presented for helically ribbed surfaces with an axial rib pitch into height ratio of about 7. (author)

  14. Rib fractures in chronic alcoholic men: Relationship with feeding habits, social problems, malnutrition, bone alterations, and liver dysfunction.

    Science.gov (United States)

    González-Reimers, Emilio; García-Valdecasas-Campelo, Elena; Santolaria-Fernández, Francisco; Milena-Abril, Antonio; Rodríguez-Rodríguez, Eva; Martínez-Riera, Antonio; Pérez-Ramírez, Alina; Alemán-Valls, María Remedios

    2005-10-01

    Rib fractures are common in alcoholics. This high prevalence might be due to ethanol-associated malnutrition, bone disease, liver dysfunction, or the peculiar lifestyle of the alcoholic with frequent trauma and altercations. In this study we try to discern the role of these factors on rib fracture (assessed on a plain thoracic X-ray film) in 81 consecutive alcoholic patients, 25 of them cirrhotics. Serum albumin, prothrombin aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), gamma-glutamyl transpeptidase, C-terminal cross-linking telopeptide of type 1 collagen, osteocalcin, insulin growth factor 1, 1,25-dihydroxyvitamin D, parathyroid hormone, estradiol, free testosterone, and corticosterone were measured, and the patients also underwent assessment of bone mineral density by a HOLOGIC QDR-2000 bone densitometer (Waltham, MA, USA). Body mass index, triceps skinfold, and brachial perimeter were also determined, and the patients and their families were asked about tobacco consumption, social and familial links, consumption of ethanol by other members of the family, kind of job, and feeding habits. Forty-two male nondrinker sanitary workers of similar age served as controls. Forty of the 81 patients showed rib fractures. There was a statistically significant association between rib fractures and disruption of social and familial links, irregular feeding habits (in bars or pubs, not at home), ethanol consumption by close relatives, and intensity of tobacco consumption, but not between rib fractures and liver function tests, nutritional parameters, or bone mineral density, besides a nearly significant trend (p = .053) with the presence of osteopenia at the femoral neck. Patients with major withdrawal symptoms at admission also presented more frequent rib fractures. We conclude that rib fractures in alcoholics are related to the peculiar lifestyle of these patients rather than to bone alterations, liver dysfunction, or nutritional status.

  15. Painful rib hump: a new clinical sign for detecting intraspinal rib displacement in scoliosis due to neurofibromatosis

    Directory of Open Access Journals (Sweden)

    Katsalouli Marina

    2006-06-01

    Full Text Available Abstract Background Spinal cord compression and associate neurological impairment is rare in patients with scoliosis and neurofibromatosis. Common reasons are vertebral subluxation, dislocation, angulation and tumorous lesions around the spinal canal. Only twelve cases of intraspinal rib dislocation have been reported in the literature. The aim of this report is to present a case of rib penetration through neural foramen at the apex of a scoliotic curve in neurofibromatosis and to introduce a new clinical sign for its detection. Methods A 13-year-old girl was evaluated for progressive left thoracic kyphoscoliotic curve due to a type I neurofibromatosis. Clinical examination revealed multiple large thoracic and abdominal "cafe-au-lait" spots, neurological impairment of the lower limbs and the presence of a thoracic gibbous that was painful to pressure at the level of the left eighth rib (Painful Rib Hump. CT-scan showed detachment and translocation of the cephalic end of the left eighth rib into the adjacent enlarged neural foramen. The M.R.I. examination of the spine showed neither cord abnormality nor neurogenic tumor. Results The patient underwent resection of the intraspinal mobile eighth rib head and posterior spinal instrumentation and was neurologically fully recovered six months postoperatively. Conclusion Spine surgeons should be aware of intraspinal rib displacement in scoliotic curves in neurofibromatosis. Painful rib hump is a valuable diagnostic tool for this rare clinical entity.

  16. Food-Related Odors Activate Dopaminergic Brain Areas

    Directory of Open Access Journals (Sweden)

    Agnieszka Sorokowska

    2017-12-01

    Full Text Available Food-associated cues of different sensory categories have often been shown to be a potent elicitor of cerebral activity in brain reward circuits. Smells influence and modify the hedonic qualities of eating experience, and in contrast to smells not associated with food, perception of food-associated odors may activate dopaminergic brain areas. In this study, we aimed to verify previous findings related to the rewarding value of food-associated odors by means of an fMRI design involving carefully preselected odors of edible and non-edible substances. We compared activations generated by three food and three non-food odorants matching in terms of intensity, pleasantness and trigeminal qualities. We observed that for our mixed sample of 30 hungry and satiated participants, food odors generated significantly higher activation in the anterior cingulate cortex (right and left, insula (right, and putamen (right than non-food odors. Among hungry subjects, regardless of the odor type, we found significant activation in the ventral tegmental area in response to olfactory stimulation. As our stimuli were matched in terms of various perceptual qualities, this result suggests that edibility of an odor source indeed generates specific activation in dopaminergic brain areas.

  17. Rock geochemistry related to mineralization processes in geothermal areas

    Science.gov (United States)

    Kausar, A. Al; Indarto, S.; Setiawan, I.

    2018-02-01

    Abundant geothermal systems in Indonesia suggest high heat and mass transfer associated with recent or paleovolcanic arcs. In the active geothermal system, the upflow of mixed fluid between late stage hydrothermal and meteoric water might contain mass of minerals associated with epithermal mineralisation process as exemplified at Lihir gold mine in Papua New Guinea. In Indonesia, there is a lack of study related to the precious metals occurrence within active geothermal area. Therefore, in this paper, we investigate the possibility of mineralization process in active geothermal area of Guci, Central Java by using geochemical analysis. There are a lot of conducted geochemical analysis of water, soil and gas by mapping the temperature, pH, Hg and CO2 distribution, and estimating subsurface temperature based on geothermometry approach. Then we also apply rock geochemistry to find minerals that indicate the presence of mineralization. The result from selected geothermal area shows the presence of pyrite and chalcopyrite minerals on the laharic breccias at Kali Putih, Sudikampir. Mineralization is formed within host rock and the veins are associated with gold polymetallic mineralization.

  18. Relations and areas of interaction between landowners in a peri-urban area

    DEFF Research Database (Denmark)

    Richardt, Ann-Sofie

    2016-01-01

    While land management can be a subject of conflict in places where the composition of landowners is socially and culturally diverse, it also holds the potential of bringing landowners together across social groups. This chapter uses the case of a peri-urban area near Copenhagen, Denmark, to examine...... the relations landowners have through their use and management of land within and across social groups. To elaborate the analysis and discussion of social groups, social coherence and fragmentation, this chapter introduces the concepts of homophily and self-categorisation. Interviews with 40 landowners from two...... parishes addressed four types of land-based relations: (1) exchange of help and services; (2) debate of farming/management; (3) shared interests and (4) friendship. While the pattern of relations overall supported the idea that people interact more with their own social group, the analysis also showed...

  19. Surface Rupture Effects on Earthquake Moment-Area Scaling Relations

    Science.gov (United States)

    Luo, Yingdi; Ampuero, Jean-Paul; Miyakoshi, Ken; Irikura, Kojiro

    2017-09-01

    Empirical earthquake scaling relations play a central role in fundamental studies of earthquake physics and in current practice of earthquake hazard assessment, and are being refined by advances in earthquake source analysis. A scaling relation between seismic moment ( M 0) and rupture area ( A) currently in use for ground motion prediction in Japan features a transition regime of the form M 0- A 2, between the well-recognized small (self-similar) and very large (W-model) earthquake regimes, which has counter-intuitive attributes and uncertain theoretical underpinnings. Here, we investigate the mechanical origin of this transition regime via earthquake cycle simulations, analytical dislocation models and numerical crack models on strike-slip faults. We find that, even if stress drop is assumed constant, the properties of the transition regime are controlled by surface rupture effects, comprising an effective rupture elongation along-dip due to a mirror effect and systematic changes of the shape factor relating slip to stress drop. Based on this physical insight, we propose a simplified formula to account for these effects in M 0- A scaling relations for strike-slip earthquakes.

  20. Comparative study between rib imaging of DR dual energy subtraction technology and chest imaging

    International Nuclear Information System (INIS)

    Yu Jianming; Lei Ziqiao; Kong Xiangchuang

    2006-01-01

    Objective: To investigate the application value of DR dual energy subtraction technology in rib lesions. Methods: 200 patients were performed with chest DR dual energy subtraction, comparing the rib imaging between DR of thorax and chest imaging using ROC analysis. Results: Among the total of 200 patients, there are 50 cases of rib calcification, 7 cases of rib destruction, 22 cases of rib fracture. The calcification, destruction and fracture were displayed respectively by ribs below diaphragm and rib markings. The analytic parameter of rib imaging of DR dual energy subtraction Az is 0.9367, while that of rib imaging of chest Az is 0.6830. Conclusion: DR dual energy subtraction technology is superior to chest imaging in the displaying of rib lesion and ribs below diaphragm. (authors)

  1. [Analysis of 163 rib fractures by imaging examination].

    Science.gov (United States)

    Song, Tian-fu; Wang, Chao-chao

    2014-12-01

    To explore the applications of imaging examination on rib fracture sites in forensic identification. Features including the sites, numbers of the processed imaging examination and the first radiological technology at diagnosis in 56 cases of rib fractures from 163 injuries were retrospectively analyzed. The detection rate of the rib fractures within 14 days was 65.6%. The initial detection rate of anterior rib fracture proceeded by X-ray was 76.2%, then 90.5% detected at a second time X-ray, while the detection rate of CT was 66.7% and 80.0%, respectively. The initial detec- tion rate of rib fracture in axillary section proceeded by X-ray was 27.6%, then 58.6% detected at a second time X-ray, while the detection rate of CT was 54.3% and 80.4%, respectively. The initial detection rate of posterior rib fracture proceeded by X-ray was 63.6%, then 81.8% detected at a second time X-ray, while the detection rate of CT was 50.0% and 70.0%, respectively. It is important to pay attention to the use of combined imaging examinations and the follow-up results. In the cases of suspicious for rib fracture in axillary section, CT examination is suggested in such false X-ray negative cases.

  2. Measurement of local void fraction in a ribbed annulus

    International Nuclear Information System (INIS)

    Steimke, J.L.

    1992-01-01

    The computer code FLOWTRAN-TF is used to analyze hypothetical hydraulic accidents for the nuclear reactor at the Savannah River Site. During a hypothetical Large Break Loss-of-Coolant Accident (LOCA), reactor assemblies would contain a two-phase mixture of air and water which flows downward. Reactor assemblies consist of nested, ribbed annuli. Longitudinal ribs divide each annulus into four subchannels. For accident conditions, air and water can flow past ribs from one subchannel to another. For FLOWTRAN-TF to compute the size of those flows, it is necessary to know the local void fraction in the region of the rib. Measurements have previously been made of length-average void fraction in a ribbed annulus. However, no direct measurements were available of local void fraction. Due to the lack of data, a test was designed to measure local void fraction at the rib. One question addressed by the test was whether void fraction at the rib is solely a function of azimuthal-average void fraction or a function of additional variables such as pressure boundary conditions. This report provides a discussion of this test

  3. Numerical investigation of heat transfer enhancement in ribbed channel for the first wall of DFLL-TBM in ITER

    International Nuclear Information System (INIS)

    Jin Qiang; Liu Songlin; Li Min; Wang Weihua

    2012-01-01

    As an important component of Dual Functional Lithium Lead-Test Blanket Module (DFLL-TBM), the first wall (FW) must withstand and remove the heat flux from the plasma (q″ = 0.3 MW/m 2 ) and high nuclear power deposited in the structure at normal plasma operation scenario of ITER. In this paper the transverse ribs arranged along the plasma facing inner wall surface were used to enhance the heat transfer capability. After the validation compared with empirical correlations the Standard k–ω model was employed to do the numerical simulation using FLUENT code to investigate the heat transfer efficiency and flow performance of coolant in the ribbed channel preliminarily. The perforation on the bottom of rib was proposed near the lower heat transfer area (LHTA) to improve the heat transfer performance according to results of analyses.

  4. Modified rib pivot lateral thoracotomy: a case series.

    Science.gov (United States)

    Appelgrein, C; Hosgood, G

    2018-01-01

    To describe a modified rib pivot thoracotomy and its clinical application in client-owned dogs and cats. Case series of 24 dogs and 1 cat requiring a thoracotomy. A lateral thoracic incision over the required thoracic segment was made. The latissimus dorsi muscle was reflected dorsally. The predetermined rib was identified and the periosteum overlying the rib was elevated circumferentially, avoiding the intercostal neurovascular structures. Holes were pre-placed above and below the proposed osteotomy site. The rib was osteotomised and pivoted cranially. The pleura was incised and the required intrathoracic procedure was then performed. The thoracic cavity was closed by pre-placement of a suture through the pre-placed holes within the osteotomised rib. The pleura and intercostal musculature were closed, avoiding the intercostal neurovascular structures. The rib was re-apposed and the lateral approach was closed. The cases included were reviewed for both the rib pivoted as per the procedure required and postoperative complications. The study group comprised 8 Staffordshire Bull Terriers, 2 Poodles, 2 German Shepherd Dogs, 1 each of Basset Hound, Rhodesian Ridgeback, Golden Retriever, Australian Shepherd, Vizsla, Bull Mastiff, Schnauzer, Jack Russell Terrier, Bulldog, Deerhound, Labrador Retriever and Australian Terrier, and 1 cat. A modified rib pivot thoracotomy was performed for lung lobectomy (n = 11), oesophagectomy (7), subtotal pericardectomy (5), patent ductus arteriosus ligation (1) and thoracic duct ligation (1). Follow-up ranged from 2 to 40 weeks postoperatively. Postoperative complications included seroma formation in two dogs. A modified rib pivot thoracotomy should be considered as an alternative lateral thoracic approach with good exposure, minimal complications and low morbidity. © 2018 Australian Veterinary Association.

  5. Numerical simulation for rib and channel position effect on PEMFC performances

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Zhixiang; Wang, Cheng; Mao, Zongqiang [Institute of Nuclear and New Energy Technology, Tsinghua University, Beijing 100084 (China); Zhang, Haiyong [Lab of Sail, Cable and Paints, Navy Equipment Technology Institute, Beijing, 102442 (China)

    2010-04-15

    Simulation is an important method for engineers to probe the detailed transportation and reaction information inside fuel cells and guide their designs without large amount of experiments. Although many papers discussing fuel cell flow fields design could be found in documents, relative positions of the ribs and channels in the anode and cathode flow field plates haven't been paid attention to surprisingly. In this paper, simulation results were given to explain the influences of relative positions of the ribs and channels in the anode and cathode flow field plates on the proton exchange membrane fuel cell (PEMFC) performances. It is interesting that the influence differs with several factors and the information will be helpful for fuel cell design. (author)

  6. Operative Fixation of Rib Fractures Indications, Techniques, and Outcomes.

    Science.gov (United States)

    Galos, David; Taylor, Benjamin; McLaurin, Toni

    2017-01-01

    Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations. Operative fixation of select rib fractures has been increasing in popularity especially in patients with flail chest and respiratory compromise. Newer techniques use muscle sparing approaches and precontoured locking plate technology to obtain stable fixation and allow improved respiration. Current reports shows that rib fracture fixation offers the benefits of improved respiratory mechanics and improved pain control in the severe chest wall injury with resultant improvement in patient outcomes by decreasing time on the ventilator, time in the intensive care unit, and overall hospital length of stay.

  7. External relations on the classroom: Experiences area Andina University Foundation

    Directory of Open Access Journals (Sweden)

    Belén Leal Hurtado

    2017-09-01

    Full Text Available This article is the result of a research project conducted in the academic context. Its aim was to analyze how the students of the Area Andina University Foundation conceive relations of friendship, relationships and management of conflicts outside the classroom. It was developed under a psychosocial approach of qualitative and exploratory, not comparative, type with application of the method of mixed focus groups with a population of 48 students, between 18 and 25 years, enrolled in the third semester of the Faculty of Health Sciences: Nursing, Respiratory Therapy Optometry programs and the School of Design, Communication and Fine Arts, with programs: Graphic Design, Fashion Design, Culinary and Gastronomy in Bogotá. It was divided in three investigation phases. The first phase is about, conceptual approach to the subject. The second phase is about, analysis and interpretation of results decanted through the voices of young people, determining the categories of friendship, family and conflict management. In the last phase, discussion, conclusions and recommendations.

  8. Dose-volume histogram analysis for risk factors of radiation-induced rib fracture after hypofractionated proton beam therapy for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kanemoto, Ayae

    2013-01-01

    Background: Radiation-induced rib fracture has been reported as a late complication after external radiotherapy to the chest. The purpose of this study was to clarify the characteristics and risk factors of rib fracture after hypofractionated proton beam therapy (PBT). Material and methods: The retrospective study comprised 67 patients with hepatocellular carcinoma who were treated using PBT of 66 Cobalt-Gray-equivalents [Gy (RBE)] in 10 fractions. We analyzed the patients' characteristics and determined dose-volume histograms (DVHs) for the irradiated ribs, and then estimated relationships between risk of fracture and several dose-volume parameters. An irradiated rib was defined to be any rib included in the area irradiated by PBT as determined by treatment-planning computed tomography. Results. Among the 67 patients, a total of 310 ribs were identified as irradiated ribs. Twenty-seven (8.7%) of the irradiated ribs developed fractures in 11 patients (16.4%). No significant relationships were seen between incidence of fracture and characteristics of patients, including sex, age, tumor size, tumor site, and follow-up period (p ≥ 0.05). The results of receiver operating characteristic curve analysis using DVH parameters demonstrated that the largest area under the curve (AUC) was observed for the volume of rib receiving a biologically effective dose of more than 60 Gy 3 (RBE) (V60) [The equivalent dose in 2 Gy fractions (EQD2); 36 Gy 3 ] and the AUCs of V30 to V120 (EQD2; 18-72 Gy 3 ) and D max to D 1 0 cm 3 were similar to that of V60. No significant relationships were seen for DVH parameters and intervals from PBT to incidence of fracture. Conclusion. DVH parameters are useful in predicting late adverse events of rib irradiation. This study identified that V60 was a most statistically significant parameter, and V30 to V120 and D max to D 1 0 cm 3 were also significant and clinically useful for estimating the risk of rib fracture after hypofractionated PBT

  9. Dose-volume histogram analysis for risk factors of radiation-induced rib fracture after hypofractionated proton beam therapy for hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kanemoto, Ayae [Proton Medical Research Center and Dept. of Radiation Oncology, Univ. of Tsukuba, Ibaraki (Japan)], e-mail: ayaek@pmrc.tsukuba.ac.jp [and others

    2013-04-15

    Background: Radiation-induced rib fracture has been reported as a late complication after external radiotherapy to the chest. The purpose of this study was to clarify the characteristics and risk factors of rib fracture after hypofractionated proton beam therapy (PBT). Material and methods: The retrospective study comprised 67 patients with hepatocellular carcinoma who were treated using PBT of 66 Cobalt-Gray-equivalents [Gy (RBE)] in 10 fractions. We analyzed the patients' characteristics and determined dose-volume histograms (DVHs) for the irradiated ribs, and then estimated relationships between risk of fracture and several dose-volume parameters. An irradiated rib was defined to be any rib included in the area irradiated by PBT as determined by treatment-planning computed tomography. Results. Among the 67 patients, a total of 310 ribs were identified as irradiated ribs. Twenty-seven (8.7%) of the irradiated ribs developed fractures in 11 patients (16.4%). No significant relationships were seen between incidence of fracture and characteristics of patients, including sex, age, tumor size, tumor site, and follow-up period (p {>=} 0.05). The results of receiver operating characteristic curve analysis using DVH parameters demonstrated that the largest area under the curve (AUC) was observed for the volume of rib receiving a biologically effective dose of more than 60 Gy{sub 3} (RBE) (V60) [The equivalent dose in 2 Gy fractions (EQD2); 36 Gy{sub 3}] and the AUCs of V30 to V120 (EQD2; 18-72 Gy{sub 3}) and D{sub max} to D{sub 1}0{sub cm}{sup 3} were similar to that of V60. No significant relationships were seen for DVH parameters and intervals from PBT to incidence of fracture. Conclusion. DVH parameters are useful in predicting late adverse events of rib irradiation. This study identified that V60 was a most statistically significant parameter, and V30 to V120 and D{sub max} to D{sub 1}0{sub cm}{sup 3} were also significant and clinically useful for estimating

  10. Absence of uptake of the rib cage; diagnosis of a Poland's syndrome with the bone SPECT-CT

    International Nuclear Information System (INIS)

    Granier, P.; Mourad, M.

    2008-01-01

    We report the case of a 37-year-old man, investigated for pains of the right upper limb impairing the hand, the wrist and the shoulder after a surgery for fracture of the radius and the scaphoid. The 99m Tc-H.D.P. three-phase bone scintigraphy confirmed the diagnosis of acute phase of a reflex sympathetic dystrophy. The delayed images highlighted a focal absence of tracer uptake of the left anterior rib cage. The single photon emission computerized tomography guided by computerized tomography showed that it was related to the absence of the anterior part of the third and the fourth left ribs highlighting an aplasia of the left pectoralis major muscle. These anomalies led to the diagnosis of congenital malformation in connection with a Poland's syndrome. The differential diagnosis of this syndrome resulted in discussing the multiple etiologies of the photopenic lesions of the rib cage. (authors)

  11. Upper extremity and rib stress fractures in a child

    International Nuclear Information System (INIS)

    Moon, B.S.; Price, C.T.; Campbell, J.B.

    1998-01-01

    Stress fractures in children are rare compared with the incidence in [ults. This report describes an 11-year-old girl with stress fractures of the acromion, clavicle, and first rib on the left and contralateral fractures of the first and second ribs. It was eventually discovered that these fractures were caused by a nervous tic consisting of repetitive, vigorous shrugging and translation of the shoulders. (orig.)

  12. New technique for fixing rib fracture with bioabsorbable plate.

    Science.gov (United States)

    Oyamatsu, Hironori; Ohata, Norihisa; Narita, Kunio

    2016-09-01

    Fixation of a bone fracture with a bioabsorbable plate made of poly-L-lactide and hydroxyapatite has received attention. We adopted this technique for a rib fracture by bending the plate into a U-shape and fixing it with suture through the holes in the mesh of the plate and holes that are drilled in the edge of the fractured rib. The suture is also wound around the plate. © The Author(s) 2016.

  13. Lower thoracic rib stress fractures in baseball pitchers.

    Science.gov (United States)

    Gerrie, Brayden J; Harris, Joshua D; Lintner, David M; McCulloch, Patrick C

    2016-01-01

    Stress fractures of the first rib on the dominant throwing side are well-described in baseball pitchers; however, lower thoracic rib fractures are not commonly recognized. While common in other sports such as rowing, there is scant literature on these injuries in baseball. Intercostal muscle strains are commonly diagnosed in baseball pitchers and have a nearly identical presentation but also a highly variable healing time. The diagnosis of a rib stress fracture can predict a more protracted recovery. This case series presents two collegiate baseball pitchers on one team during the same season who were originally diagnosed with intercostal muscle strains, which following magnetic resonance imaging (MRI) were found to have actually sustained lower thoracic rib stress fractures. The first sustained a stress fracture of the posterior aspect of the right 8th rib on the dominant arm side, while the second presented with a left-sided 10th rib stress fracture on the nondominant arm side. In both cases, MRI was used to visualize the fractures as plain radiographs are insensitive and commonly negative early in patient presentation. Patients were treated with activity modification, and symptomatic management for 4-6 weeks with a graduated return to throwing and competition by 8-10 weeks. The repetitive high stresses incurred by pitching may cause either dominant or nondominant rib stress fractures and this should be included in the differential diagnosis of thoracic injuries in throwers. It is especially important that athletic trainers and team physicians consider this diagnosis, as rib fractures may have a protracted course and delayed return to play. Additionally, using the appropriate imaging techniques to establish an accurate diagnosis can help inform return-to-play decisions, which have important practical applications in baseball, such as roster management and eligibility.

  14. Rib fractures in coronary bypass patients: radionuclide detection

    International Nuclear Information System (INIS)

    Greenwald, L.V.; Baisden, C.E.; Symbas, P.N.

    1983-01-01

    Sternal retraction can cause the first rib to be fractured posteriorly, injuring the brachial plexus. The authors conducted bone scans of 24 consecutive open-heart surgery patients and found an unexpectedly high number of rib fractures which in all but one case had not been seen on the chest radiograph. Bone scans are recommended whenever there is unexplained non-incisional pain in a patient who has undergone sternal retraction

  15. The Place of Ultrasonography in the Evaluation of Rib Fractures

    OpenAIRE

    Fulya Bakılan; Gökhan Yüce; Ahmet Çağdaş Biçen; Tanju Keten

    2015-01-01

    Objective: The aim of this study was to investigate whether ultrasonography is superior to chest x-ray in detecting rib fractures in patients with minor blunt chest trauma and chest pain. Materials and Methods: Ultrasonography findings of 32 patients with minor blunt chest trauma showing no evidence of a rib fracture on anteroposterior chest x-rays, were documented. Presence of cortical discontinuities, acoustic shadows, reverberation artifacts, and hematoma by ultrasonography was...

  16. Outcomes after operative management of symptomatic rib nonunion.

    Science.gov (United States)

    Gauger, Erich M; Hill, Brian W; Lafferty, Paul M; Cole, Peter A

    2015-06-01

    To report the outcomes of rib reconstruction after painful nonunion. Retrospective case series. Level I trauma center. Between November 2007 and May 2013, 10 patients who presented with 16 rib nonunions and disabling pain were treated with reconstruction of their nonunited rib fractures. Rib nonunion reconstruction predominately with iliac crest bone graft and a tension band plate with a locked precontoured plating system for ribs. Demographic data, mechanism of injury, and number of rib nonunions were recorded. Operative procedure, length of follow-up, complications, Short Form Survey 36, and a patient questionnaire were also captured and documented. Eight of the 10 patients sustained their original fractures from a fall. Outcomes were available for the 10 patients at a mean follow-up of up of 18.6 months (range, 3-46 months). All 16 ribs went on to union with a mean time from reconstruction to union of 14.7 weeks (range, 12-24 weeks). At final follow-up, the mean mental and physical component Short Form Survey 36 scores were 54.4 and 43.5, respectively. Eight of the 10 patients were able to return to work and/or previous activities without limitations. Complications included 1 wound infection that resolved after irrigation and debridement with adjunctive antibiotics. One symptomatic implant was removed. Ten patients with 16 symptomatic rib nonunions were reconstructed using autologous bone graft and implant/mesh fixation manifesting in successful union with improved patient function and a low rate of complications. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  17. Ultrasonography as a better diagnostic efficiency in rib fracture

    OpenAIRE

    UZUN, Metin; BEKSAÇ, Burak; KARATAŞ, Adnan; KÜÇÜKDURMAZ, Fatih; KIRCALI, Bahar ANAYURDU; TETİK, Cihangir

    2013-01-01

    In this study, our aim was to demonstrate the need of use of ultrasonography in rib fractures in order not to face medicolegal problems. One hundred patients admitted to our emergency service with mild to moderate blunt thorax trauma were included in our study prospectively. The inclusion criteria were pain upon palpation of ribs, deep inspiration, coughing but no any other pathologies like a pneumothorax, hemothorax. All patients are evaluated with ultrasonography (USG) and direct X-rays. X-...

  18. An analysis of 214 cases of rib fractures

    Directory of Open Access Journals (Sweden)

    Sule Karadayi

    2011-01-01

    Full Text Available INTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1 patients with an isolated rib fracture (RF1 (n = 50, 23.4%, 2 patients with two rib fractures (RF2 (n = 53, 24.8%, and 3 patients with more than two rib fractures (RF3 (n = 111, 51.9%. The patients were evaluated and compared according to the number of rib fractures, mean age, associated chest injuries (hemothorax, pneumothorax, and/or pulmonary contusion, and co-existing injuries to other systems. FINDINGS: The mean age of the patients was 51.5 years. The distribution of associated chest injuries was 30% in group RF1, 24.6% in group RF2, and 75.6% in group RF3 (p<0.05. Co-existing injuries to other systems were 24% in group RF1, 23.2% in group RF2, and 52.6% in group RF3 (p<0.05. Two patients (4% in group RF1, 2 patients (3.8% in group RF2, and 5 patients (4.5% in group RF3 (total n = 9; 4.2% died. CONCLUSION: Patients with any number of rib fractures should be carefully screened for co-existing injuries in other body systems and hospitalized to receive proper treatment.

  19. A case of pathological rib fractures: focal osteolysis or osteoporosis?

    Science.gov (United States)

    Vrbanić, T S L; Novak, S; Sestan, B; Tudor, A; Gulan, G

    2008-03-01

    This paper reports on a unique, previously unreported, successful outcome in the case of a patient with focal osteolytic lesions of the ribs as a first sign of osteoporosis. The lesions were detected by chance after acute cough-induced rib fractures were seen on plain chest radiographs. The diagnosis had to be approached as a diagnosis of exclusion since known causes of the osteolytic process had to be eliminated. The authors describe multiple focal osteolytic lesions with rib fractures appearing in a pattern that could be confused with metastases. Laboratory results were normal. Final diagnosis was based on plain radiography, bone scan and bone densitometry. Pharmacomedical treatments for osteoporosis were applied. The patient was observed between the year 2000 and 2005. Five years later radiological and bone scintigraphy revealed resolution of the lesion. We conclude that osteoporosis should be included in the differential diagnosis of asymptomatic focal osteolysis of the ribs with rib fractures as a complication of acute cough. The case suggests that focal osteolytic lesions of the ribs may regress over time and become scintigraphically inactive.

  20. Rib fractures in trauma patients: does operative fixation improve outcome?

    Science.gov (United States)

    Majak, Peter; Næss, Pål A

    2016-12-01

    Renewed interest in surgical fixation of rib fractures has emerged. However, conservative treatment is still preferred at most surgical departments. We wanted to evaluate whether operative treatment of rib fractures may benefit severely injured patients. Several studies report a reduction in mechanical ventilation time, ICU length of stay (LOS), hospital LOS, pneumonia, need for tracheostomy, pain and costs in operatively treated patients with multiple rib fractures compared with patients treated nonoperatively. Although patient selection and timing of the operation seem crucial for successful outcome, no consensus exists. Mortality reduction has only been shown in a few studies. Most studies are retrospective cohort and case-control studies. Only four randomized control trials exist. Conservative treatment, consisting of respiratory assistance and pain control, is still the treatment of choice in the vast majority of patients with multiple rib fractures. In selected patients, operative fixation of fractured ribs within 72 h postinjury may lead to better outcome. More randomized control trials are needed to further determine who benefits from surgical fixation of rib fractures.

  1. RIB production with photofission of uranium

    Energy Technology Data Exchange (ETDEWEB)

    Oganessian, Yu.Ts. E-mail: oganessian@flnr.jinr.ru; Dmitriev, S.N.; Kliman, J.; Maslov, O.A.; Starodub, G.Ya.; Belov, A.G.; Tretiakova, S.P

    2002-04-22

    The process of uranium photofission with electron beams of 20-50 MeV is considered in terms of the production of fission fragments. It is shown that in the interaction between an electron beam (25 MeV in energy and 20 {mu}A in intensity), produced by a compact accelerator of the microtron type, and a uranium target of about 40 g/cm{sup 2} in thickness, an average of 1.5x10{sup 11} fission events per second is generated. According to the calculations and test experiments, this corresponds to the yield of {sup 132}Sn and {sup 142}Xe isotopes of approximately 2x10{sup 9}/s. The results of experiments on the optimal design of the U-target are presented. Problems are discussed connected with the separation of isotopes and isobars for their further acceleration up to energies of 5-18 MeV A. The photofission reactions of a heavy nucleus are compared with other methods of RIB production of medium mass nuclei.

  2. Comparison of changes in tidal volume associated with expiratory rib cage compression and expiratory abdominal compression in patients on prolonged mechanical ventilation.

    Science.gov (United States)

    Morino, Akira; Shida, Masahiro; Tanaka, Masashi; Sato, Kimihiro; Seko, Toshiaki; Ito, Shunsuke; Ogawa, Shunichi; Takahashi, Naoaki

    2015-07-01

    [Purpose] This study was designed to compare and clarify the relationship between expiratory rib cage compression and expiratory abdominal compression in patients on prolonged mechanical ventilation, with a focus on tidal volume. [Subjects and Methods] The subjects were 18 patients on prolonged mechanical ventilation, who had undergone tracheostomy. Each patient received expiratory rib cage compression and expiratory abdominal compression; the order of implementation was randomized. Subjects were positioned in a 30° lateral recumbent position, and a 2-kgf compression was applied. For expiratory rib cage compression, the rib cage was compressed unilaterally; for expiratory abdominal compression, the area directly above the navel was compressed. Tidal volume values were the actual measured values divided by body weight. [Results] Tidal volume values were as follows: at rest, 7.2 ± 1.7 mL/kg; during expiratory rib cage compression, 8.3 ± 2.1 mL/kg; during expiratory abdominal compression, 9.1 ± 2.2 mL/kg. There was a significant difference between the tidal volume during expiratory abdominal compression and that at rest. The tidal volume in expiratory rib cage compression was strongly correlated with that in expiratory abdominal compression. [Conclusion] These results indicate that expiratory abdominal compression may be an effective alternative to the manual breathing assist procedure.

  3. Heat Transfer and Friction Studies in a Tilted and Rib-Roughened Trailing-Edge Cooling Cavity with and without the Trailing-Edge Cooling Holes

    Directory of Open Access Journals (Sweden)

    M. E. Taslim

    2014-01-01

    Full Text Available Local and average heat transfer coefficients and friction factors were measured in a test section simulating the trailing-edge cooling cavity of a turbine airfoil. The test rig with a trapezoidal cross-sectional area was rib-roughened on two opposite sides of the trapezoid (airfoil pressure and suction sides with tapered ribs to conform to the cooling cavity shape and had a 22-degree tilt in the flow direction upstream of the ribs that affected the heat transfer coefficients on the two rib-roughened surfaces. The radial cooling flow traveled from the airfoil root to the tip while exiting through 22 cooling holes along the airfoil trailing-edge. Two rib geometries, with and without the presence of the trailing-edge cooling holes, were examined. The numerical model contained the entire trailing-edge channel, ribs, and trailing-edge cooling holes to simulate exactly the tested geometry. A pressure-correction based, multiblock, multigrid, unstructured/adaptive commercial software was used in this investigation. Realizable k-ε turbulence model in conjunction with enhanced wall treatment approach for the near wall regions was used for turbulence closure. The applied thermal boundary conditions to the CFD models matched the test boundary conditions. Comparisons are made between the experimental and numerical results.

  4. Anatomy, histology and elemental profile of long bones and ribs of the Asian elephant (Elephas maximus).

    Science.gov (United States)

    Nganvongpanit, Korakot; Siengdee, Puntita; Buddhachat, Kittisak; Brown, Janine L; Klinhom, Sarisa; Pitakarnnop, Tanita; Angkawanish, Taweepoke; Thitaram, Chatchote

    2017-09-01

    This study evaluated the morphology and elemental composition of Asian elephant (Elephas maximus) bones (humerus, radius, ulna, femur, tibia, fibula and rib). Computerized tomography was used to image the intraosseous structure, compact bones were processed using histological techniques, and elemental profiling of compact bone was conducted using X-ray fluorescence. There was no clear evidence of an open marrow cavity in any of the bones; rather, dense trabecular bone was found in the bone interior. Compact bone contained double osteons in the radius, tibia and fibula. The osteon structure was comparatively large and similar in all bones, although the lacuna area was greater (P < 0.05) in the femur and ulna. Another finding was that nutrient foramina were clearly present in the humerus, ulna, femur, tibia and rib. Twenty elements were identified in elephant compact bone. Of these, ten differed significantly across the seven bones: Ca, Ti, V, Mn, Fe, Zr, Ag, Cd, Sn and Sb. Of particular interest was the finding of a significantly larger proportion of Fe in the humerus, radius, fibula and ribs, all bones without an open medullary cavity, which is traditionally associated with bone marrow for blood cell production. In conclusion, elephant bones present special characteristics, some of which may be important to hematopoiesis and bone strength for supporting a heavy body weight.

  5. A 3' UTR-derived non-coding RNA RibS increases expression of cfa and promotes biofilm formation of Salmonella enterica serovar Typhi.

    Science.gov (United States)

    Zhao, Xin; Liu, Rui; Tang, Hao; Osei-Adjei, George; Xu, Shungao; Zhang, Ying; Huang, Xinxiang

    2018-05-08

    Bacterial non-coding RNAs (ncRNAs) are widely studied and found to play important roles in regulating various cellular processes. Recently, many ncRNAs have been discovered to be transcribed or processed from 3' untranslated regions (3' UTRs). Here we reported a novel 3' UTR-derived ncRNA, RibS, which could influence biofilm formation of Salmonella enterica serovar Typhi (S. Typhi). RibS was confirmed to be a ∼700 nt processed product produced by RNase III-catalyzed cleavage from the 3' UTR of riboflavin synthase subunit alpha mRNA, RibE. Overexpression of RibS increased the expression of the cyclopropane fatty acid synthase gene, cfa, which was located at the antisense strand. Biofilm formation of S. Typhi was enhanced by overexpressing RibS both in the wild type strain and cfa deletion mutant. Deletion of cfa attenuated biofilm formation of S. Typhi, while complementation of cfa partly restored the phenotype. Moreover, overexpressing cfa enhanced the biofilm formation of S. Typhi. In summary, RibS has been identified as a novel ncRNA derived from the 3' UTR of RibE that promotes biofilm formation of S. Typhi, and it appears to do so, at least in part, by increasing the expression of cfa. Copyright © 2018 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

  6. Detection of rib fractures in an abused infant using digital radiography: a laboratory study

    Energy Technology Data Exchange (ETDEWEB)

    Kleinman, Paul K. [Department of Radiology, UMASS Memorial Health Care, 55 Lake Avenue North, Worcester, MA 01655 (United States); O' Connor, Brian; Nimkin, Katherine [Department of Pediatric Radiology, New England Medical Center, 750 Washington Street, Boston, MA 02111 (United States); Rayder, Shawn M. [Department of Radiology, Cape Cod Hospital, 12 Park Street, Hyannis, MA 02601-5203 (United States); Spevak, Melissa R. [Department of Radiology, Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287 (United States); Belanger, Patricia L. [University of Massachusetts, Amherst, MA 01003 (United States); Getty, David J. [BBNT Solutions LLC, 10 Moulton Street, Cambridge, MA 02138 (United States); Karellas, Andrew [Department of Radiology, University of Mass. Medical School, Lake Avenue North, Worcester, MA 01655 (United States)

    2002-12-01

    To assess the diagnostic performance of digital radiography using charge-coupled device (CCD) technology in the detection of rib fracture in infant abuse.Materials and methods. Four fractured posterior rib arcs and eight normal ribs removed at autopsy from a 10-month-old abused infant were radiographed using a CCD prototype, four clinical film-screen systems, and direct-exposure film. Each rib was viewed with these six systems in nine different projections. The resultant 648 images were assessed for probability of fracture (0-100%) by four pediatric radiologists. The calculated area under the resultant ROC curves (A{sub z}) for the CCD was compared with those obtained with direct-exposure, high-detail, medium and fast film-screen radiographic systems. The mean A{sub z} for the CCD (0.937) fell within the range of the high-detail systems (0.934-0.940) and was significantly higher (p<0.05) than the medium and fast system (0.861 and 0.858, respectively). Despite a lower spatial resolution than direct-exposure film (7 line pairs per millimeter vs. >20 line pairs per millimeter) the CCD performance was comparable (A{sub z}=0.944 vs. 0.937). The similar performance can be explained by the higher contrast resolution of the digital technology. This study indicates that in the ex vivo setting, digital radiology can perform comparably to high-detail film-screen imaging. The findings suggest that digital radiography has the potential to replace film-screen imaging in the evaluation of inflicted skeletal injury in infants. (orig.)

  7. Use of the S-hook for Pelvic Fixation in Rib-Based Treatment of Early-Onset Scoliosis: A Multicenter Study.

    Science.gov (United States)

    Ramirez, Norman; Flynn, John M; Smith, John T; Vitale, Michael; Sturm, Peter F; DʼAmato, Charles; Samdani, Amer; Machiavelli, Raul; El-Hawary, Ron

    2015-06-01

    Retrospective review. The purpose of this study was to evaluate how several preoperative variables affect the outcome using the rib-to-pelvis S-hook constructs of a rib-based distraction implant (Vertical Expandable Prosthetic Titanium Rib). Rib-to-pelvis fixation with S-hooks is one of the options for distal anchoring of rib-based distraction growing rod construct to control early-onset spinal deformity. Since the initial report, the indications of pelvic fixation with S-hooks have been extended and modified. This is an institutional review board-approved retrospective study of patients who underwent rib-based growing rod system surgery-rib-to-pelvis construct with Dunn-McCarthy S-hook. Data evaluation included history, physical examination, preoperative and postoperative radiographs, surgical variables, and complications. Sixty-five patients were evaluated; 38 were male and 27 were female. Mean age at initial procedure was 71 months. The mean follow-up was 46 months. There was a statistically significant improvement of the immediate postoperative Cobb angle and the last follow-up Cobb angle (P < 0.0001). Fifty percent of the patients (32/65) had S-hook-related complications. The most common complication was sliding of the S-hook out of the iliac crest, followed by infection, neuropathic pain, distal migration of more than 2 cm, fracture of the hook, and bursitis. The complications were related to the preoperative ambulatory status, the use of end-to-end rod connectors, surgical time, and not positioning the hook over the central one-third of the iliac crest at the initial implantation. The use of the S-hook as a pelvic attachment of the rib-based system is indicated in nonambulatory patients with progressive, early-onset scoliosis curve with a lack of adequate anchor at the lumbar spine. Several technical factors should be considered to reduce the complication rate. 3.

  8. Potential Benefits of Rib Fracture Fixation in Patients with Flail Chest and Multiple Non-flail Rib Fractures.

    Science.gov (United States)

    Qiu, Meiguang; Shi, Zhanjun; Xiao, Jun; Zhang, Xuming; Ling, Shishui; Ling, Hao

    2016-12-01

    The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest ( n  = 38) and multiple non-flail rib fracture groups ( n  = 124). In the flail chest group, the mechanical ventilation time, ICU monitoring time, tracheostomies, thoracic deformity, and impaired pulmonary function and return to full-time employment were compared. In the multiple non-flail rib fracture group, fracture healing, visual analog scale (VAS) pain score, inpatient length of stay, atelectatic, pulmonary complications, and normal activity-returning time were compared. Patients in the flail chest operative fixation group had significantly shorter ICU stay, decreased ventilator requirements, fewer tracheostomies, less thoracic deformity and impaired pulmonary function, and more returned to full-time employment. Patients in the multiple non-flail rib fracture operative fixation had shorter hospital stay, less pain, earlier return to normal activity, more fracture healing, less atelectasis, and fewer pulmonary infections. This study demonstrates the potential benefits of surgical stabilization of flail chest and multiple non-flail rib fractures with plate fixation. When compared with conventional conservative management, operatively managed patients demonstrated improved clinical outcomes.

  9. Frequency of rib and sternum fractures associated with out-of-hospital cardiopulmonary resuscitation is underestimated by conventional chest X-ray.

    Science.gov (United States)

    Lederer, Wolfgang; Mair, Dieter; Rabl, Walter; Baubin, Michael

    2004-02-01

    Fractured ribs and sternum are frequent complications of thoracic compression during CPR in adults. This study was conducted to determine whether findings of plain chest radiography (CXR) correlate with post-mortem findings in patients who underwent cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest. CXR findings and autopsy results of CPR-related chest injuries comprising rib and sternum fractures were compared prospectively in 19 patients. Fractures were diagnosed in nine of 19 patients by means of radiology and in 18 of 19 patients by autopsy (rib fractures in 6/19 versus 17/19, P=0.002; sternum fractures in 5/19 versus in 9/19, P=0.227. The total number of isolated bone fractures detected by CXR was 18 (12 rib and six sternum fractures) and by autopsy 92 (83 rib and nine sternum fractures). The majority of rib fractures was located in the anterior part of the thoracic cage. Sternum fractures predominantly occurred in the lower third. Eight of 19 patients received either thrombolytic or antithrombotic treatment during CPR but no major bleeding complication associated with CPR was detected by autopsy. The findings of this study indicate that fractures associated with CPR are underreported in conventional radiographic investigations. No major bleeding complications related to CPR-associated fractures was detected.

  10. Comparison of analgesic interventions for traumatic rib fractures: a systematic review and meta-analysis.

    Science.gov (United States)

    Peek, Jesse; Smeeing, Diederik P J; Hietbrink, Falco; Houwert, Roderick M; Marsman, Marije; de Jong, Mirjam B

    2018-02-06

    Many studies report on outcomes of analgesic therapy for (suspected) traumatic rib fractures. However, the literature is inconclusive and diverse regarding the management of pain and its effect on pain relief and associated complications. This systematic review and meta-analysis summarizes and compares reduction of pain for the different treatment modalities and as secondary outcome mortality during hospitalization, length of mechanical ventilation, length of hospital stay, length of intensive care unit stay (ICU) and complications such as respiratory, cardiovascular, and/or analgesia-related complications, for four different types of analgesic therapy: epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks. PubMed, EMBASE and CENTRAL databases were searched to identify comparative studies investigating epidural, intravenous, paravertebral and intercostal interventions for traumatic rib fractures, without restriction for study type. The search strategy included keywords and MeSH or Emtree terms relating blunt chest trauma (including rib fractures), analgesic interventions, pain management and complications. A total of 19 papers met our inclusion criteria and were finally included in this systematic review. Significant differences were found in favor of epidural analgesia for the reduction of pain. No significant differences were observed between epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks, for the secondary outcomes. Results of this study show that epidural analgesia provides better pain relief than the other modalities. No differences were observed for secondary endpoints like length of ICU stay, length of mechanical ventilation or pulmonary complications. However, the quality of the available evidence is low, and therefore, preclude strong recommendations.

  11. Pulsed ultrasounds accelerate healing of rib fractures in an experimental animal model: an effective new thoracic therapy?

    Science.gov (United States)

    Santana-Rodríguez, Norberto; Clavo, Bernardino; Fernández-Pérez, Leandro; Rivero, José C; Travieso, María M; Fiuza, María D; Villar, Jesús; García-Castellano, José M; Hernández-Pérez, Octavio; Déniz, Antonio

    2011-05-01

    Rib fractures are a frequent traumatic injury associated with a relatively high morbidity. Currently, the treatment of rib fractures is symptomatic. Since it has been reported that pulsed ultrasounds accelerates repair of limb fractures, we hypothesized that the application of pulsed ultrasounds will modify the course of healing in an animal model of rib fracture. We studied 136 male Sprague-Dawley rats. Animals were randomly assigned to different groups of doses (none, 50, 100, and 250 mW/cm(2) of intensity for 3 minutes per day) and durations (2, 10, 20, and 28 days) of treatment with pulsed ultrasounds. In every subgroup, we analyzed radiologic and histologic changes in the bone callus. In addition, we examined changes in gene expression of relevant genes involved in wound repair in both control and treated animals. Histologic and radiologic consolidation was significantly increased by pulsed ultrasound treatment when applied for more than 10 days. The application of 50 mW/cm(2) was the most effective dose. Only the 100 and 250 mW/cm(2) doses were able to significantly increase messenger RNA expression of insulin-like growth factor 1, suppressor of cytokine signaling-2 and -3, and vascular endothelial growth factor and decrease monocyte chemoattractant protein-1 and collagen type II-alpha 1. Our findings indicate that pulsed ultrasound accelerates the consolidation of rib fractures. This study is the first to show that pulsed ultrasound promotes the healing of rib fractures. From a translational point of view, this easy, cheap technique could serve as an effective new therapeutic modality in patients with rib fractures. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  12. Prolonged pain and disability are common after rib fractures.

    Science.gov (United States)

    Fabricant, Loic; Ham, Bruce; Mullins, Richard; Mayberry, John

    2013-05-01

    The contribution of rib fractures to prolonged pain and disability may be underappreciated and undertreated. Clinicians are traditionally taught that the pain and disability of rib fractures resolves in 6 to 8 weeks. This study was a prospective observation of 203 patients with rib fractures at a level 1 trauma center. Chest wall pain was evaluated by the McGill Pain Questionnaire (MPQ) pain rating index (PRI) and present pain intensity (PPI). Prolonged pain was defined as a PRI of 8 or more at 2 months after injury. Prolonged disability was defined as a decrease in 1 or more levels of work or functional status at 2 months after injury. Predictors of prolonged pain and disability were determined by multivariate analysis. One hundred forty-five male patients and 58 female patients with a mean injury severity score (ISS) of 20 (range, 1 to 59) had a mean of 5.4 rib fractures (range, 1 to 29). Forty-four (22%) patients had bilateral fractures, 15 (7%) had flail chest, and 92 (45%) had associated injury. One hundred eighty-seven patients were followed 2 months or more. One hundred ten (59%) patients had prolonged chest wall pain and 142 (76%) had prolonged disability. Among 111 patients with isolated rib fractures, 67 (64%) had prolonged chest wall pain and 69 (66%) had prolonged disability. MPQ PPI was predictive of prolonged pain (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.4 to 2.5), and prolonged disability (OR, 2.2; 95% CI, 1.5 to 3.4). The presence of significant associated injuries was predictive of prolonged disability (OR, 5.9; 95% CI, 1.4 to 29). Prolonged chest wall pain is common, and the contribution of rib fractures to disability is greater than traditionally expected. Further investigation into more effective therapies that prevent prolonged pain and disability after rib fractures is needed. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Vital capacity helps predict pulmonary complications after rib fractures.

    Science.gov (United States)

    Carver, Thomas W; Milia, David J; Somberg, Chloe; Brasel, Karen; Paul, Jasmeet

    2015-09-01

    Traumatic rib fractures are associated with significant morbidity. Vital capacity (VC) assesses pulmonary function; however, limited data link VC to patient outcomes. Our objective was to determine if VC predicted complications and disposition in patients with rib fractures. This is a retrospective chart review of all patients with fractured ribs admitted to a Level 1 trauma center during a 4-year period. Patients were excluded if no VC was performed within 48 hours of admission. Data collected included demographics, hospital/intensive care unit length of stay, epidural, discharge to home versus extended care facility, mortality, chest Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), number of rib fractures, hemothorax/pneumothorax, presence of pulmonary contusion, presence of chest tube, chronic obstructive pulmonary disease, and average daily VC (percentage of predicted). Pulmonary complication was defined as pneumonia, need for intubation, new home O2 requirement, readmission for pulmonary issue, or intensive care unit transfer. Statistical analysis was performed using χ and multivariate logistic regression. Of 801 patients with rib fractures, 683 had VC performed within 48 hours. Average age was 53 years, median ISS was 13 (interquartile range, 9-18), and median length of stay was 5 days. Most (72%) were discharged home, and 26% went to extended care facility. Ten percent developed a pulmonary complication, and there were nine deaths. Every 10% increase in VC was associated with 36% decrease in likelihood of pulmonary complication. Patients with a VC greater than 50% had a significantly lower association of pulmonary complication (p = 0.017), and a VC of less than 30% was independently associated with pulmonary complication (odds ratio, 2.36). Patients with fractured ribs and VC of less than 30% have significant association for pulmonary complication. Higher VC is associated with lower likelihood of pulmonary complication. VC may help

  14. Relating normalization to neuronal populations across cortical areas.

    Science.gov (United States)

    Ruff, Douglas A; Alberts, Joshua J; Cohen, Marlene R

    2016-09-01

    Normalization, which divisively scales neuronal responses to multiple stimuli, is thought to underlie many sensory, motor, and cognitive processes. In every study where it has been investigated, neurons measured in the same brain area under identical conditions exhibit a range of normalization, ranging from suppression by nonpreferred stimuli (strong normalization) to additive responses to combinations of stimuli (no normalization). Normalization has been hypothesized to arise from interactions between neuronal populations, either in the same or different brain areas, but current models of normalization are not mechanistic and focus on trial-averaged responses. To gain insight into the mechanisms underlying normalization, we examined interactions between neurons that exhibit different degrees of normalization. We recorded from multiple neurons in three cortical areas while rhesus monkeys viewed superimposed drifting gratings. We found that neurons showing strong normalization shared less trial-to-trial variability with other neurons in the same cortical area and more variability with neurons in other cortical areas than did units with weak normalization. Furthermore, the cortical organization of normalization was not random: neurons recorded on nearby electrodes tended to exhibit similar amounts of normalization. Together, our results suggest that normalization reflects a neuron's role in its local network and that modulatory factors like normalization share the topographic organization typical of sensory tuning properties. Copyright © 2016 the American Physiological Society.

  15. Evaluation of Rib Fractures on a Single-in-plane Image Reformation of the Rib Cage in CT Examinations.

    Science.gov (United States)

    Dankerl, Peter; Seuss, Hannes; Ellmann, Stephan; Cavallaro, Alexander; Uder, Michael; Hammon, Matthias

    2017-02-01

    This study aimed to evaluate the diagnostic performance of using a reformatted single-in-plane image reformation of the rib cage for the detection of rib fractures in computed tomography (CT) examinations, employing different levels of radiological experience. We retrospectively evaluated 10 consecutive patients with and 10 patients without rib fractures, whose CT scans were reformatted to a single-in-plane image reformation of the rib cage. Eight readers (two radiologists, two residents in radiology, and four interns) independently evaluated the images for the presence of rib fractures using a reformatted single-in-plane image and a multi-planar image reformation. The time limit was 30 seconds for each read. A consensus of two radiologist readings was considered as the reference standard. Diagnostic performance (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) was assessed and evaluated per rib and per location (anterior, lateral, posterior). To determine the time limit, we prospectively analyzed the average time it took radiologists to assess the rib cage, in a bone window setting, in 50 routine CT examinations. McNemar test was used to compare the diagnostic performances. Single image reformation was successful in all 20 patients. The sensitivity, specificity, PPV, and NPV for the detection of rib fractures using the conventional multi-planar read were 77.5%, 99.2%, 89.9%, and 98.0% for radiologists; 46.3%, 99.7%, 92.5%, and 95.3% for residents; and 29.4%, 99.4%, 82.5%, and 93.9% for interns, respectively. Sensitivity, PPV, and NPV increased across all three groups of experience, using the reformatted single-in-plane image of the rib cage (radiologists: 85.0%, 98.6%, and 98.7%; residents: 80.0%, 92.8%, and 98.2%; interns: 66.9%, 89.9%, and 97.1%), whereas specificity did not change significantly (99.9%, 99.4%, and 99.3%). The diagnostic performance of the interns and residents was significantly better when

  16. Role of computed tomography in the diagnosis of rib and lung involvement in tuberculous retromammary abscesses

    International Nuclear Information System (INIS)

    Supe, A.N.; Prabhu, R.Y.; Priya, Hira

    2002-01-01

    Objective: To assess the role of computed tomography (CT) in the diagnosis of rib and lung involvement in tuberculous abscess in the retromammary region. Design and patients: Eight patients with tuberculous retromammary abscess were examined by CT and the findings were evaluated. A cold abscess (purulent collection with absence of acute inflammation) was aspirated in all cases. Diagnosis was confirmed by acid-fast bacillus culture, or histologic examination. Results: CT showed a relatively well marginated, inhomogeneous, hypodense lesions in all eight cases. Following administration of intravenous contrast medium, these lesions showed enhancing walls, suggestive of an infective collection. Lung involvement was seen in one patient. A direct communication from the retromammary lesion through the thoracic wall into the pleura was seen in five cases. In four cases destroyed rib fragments within the abscess were noted. Conclusion: A tuberculous abscess in the retromammary region is usually shown on CT as a focal, well-marginated, inhomogeneous, hypodense lesion with a surrounding enhancing rim. A direct communication with the pleura, a destroyed rib fragment in the abscess, and associated lung involvement may be revealed by CT. (orig.)

  17. Role of computed tomography in the diagnosis of rib and lung involvement in tuberculous retromammary abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Supe, A.N.; Prabhu, R.Y. [Department of Surgery, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai (India); Priya, Hira [Department of Radiology, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai (India)

    2002-02-01

    Objective: To assess the role of computed tomography (CT) in the diagnosis of rib and lung involvement in tuberculous abscess in the retromammary region. Design and patients: Eight patients with tuberculous retromammary abscess were examined by CT and the findings were evaluated. A cold abscess (purulent collection with absence of acute inflammation) was aspirated in all cases. Diagnosis was confirmed by acid-fast bacillus culture, or histologic examination. Results: CT showed a relatively well marginated, inhomogeneous, hypodense lesions in all eight cases. Following administration of intravenous contrast medium, these lesions showed enhancing walls, suggestive of an infective collection. Lung involvement was seen in one patient. A direct communication from the retromammary lesion through the thoracic wall into the pleura was seen in five cases. In four cases destroyed rib fragments within the abscess were noted. Conclusion: A tuberculous abscess in the retromammary region is usually shown on CT as a focal, well-marginated, inhomogeneous, hypodense lesion with a surrounding enhancing rim. A direct communication with the pleura, a destroyed rib fragment in the abscess, and associated lung involvement may be revealed by CT. (orig.)

  18. Analyses and Comparison of Solar Air Heater with Various Rib Roughness using Computational Fluid Dynamics (CFD)

    Science.gov (United States)

    Kumar, K. Ravi; Cheepu, Muralimohan; Srinivas, B.; Venkateswarlu, D.; Pramod Kumar, G.; Shiva, Apireddi

    2018-03-01

    In solar air heater, artificial roughness on absorber plate become prominent technique to improving heat transfer rate of air flowing passage as a result of laminar sublayer. The selection of rib geometries plays important role on friction characteristics and heat transfer rate. Many researchers studying the roughness shapes over the years to investigate the effect of geometries on the performance of friction factor and heat transfer of the solar air heater. The present study made an attempt to develop the different rib shapes utilised for creating artificial rib roughness and its comparison to investigate higher performance of the geometries. The use of computational fluid dynamics software resulted in correlation of friction factor and heat transfer rate. The simulations studies were performed on 2D computational fluid dynamics model and analysed to identify the most effective parameters of relative roughness of the height, width and pitch on major considerations of friction factor and heat transfer. The Reynolds number is varied in a range from 3000 to 20000, in the current study and modelling has conducted on heat transfer and turbulence phenomena by using Reynolds number. The modelling results showed the formation of strong vortex in the main stream flow due to the right angle triangle roughness over the square, rectangle, improved rectangle and equilateral triangle geometries enhanced the heat transfer extension in the solar air heater. The simulation of the turbulence kinetic energy of the geometry suggests the local turbulence kinetic energy has been influenced strongly by the alignments of the right angle triangle.

  19. Sapwood Area Related to Tree Size, Tree Age, and Leaf Area Index in Cedrus libani

    OpenAIRE

    Güney, Aylin

    2018-01-01

    Sapwoodincludes the water conducting part of the stem which transports water andminerals from roots to leaves. Studies using sap flow gauges have to determinethe area of the sapwood in order to scale measured sap flow densities to thetree or stand level. The aim of this study was to investigate the relationshipbetween sapwood area at breast height and other tree parameters which are easyto measure of the montane Mediterranean conifer Cedrus libani, including a total number of 92 study trees o...

  20. Differentiating the Causes of Spontaneous Rib Fracture After Breast Cancer.

    Science.gov (United States)

    Harris, Susan R

    2016-12-01

    Spontaneous rib fracture after treatment for primary breast cancer is not uncommon. Although metastatic disease accounts for about 30% of spontaneous rib fractures and should constitute the first line of diagnostic investigation, other possible contributors include primary osteoporosis or secondary osteoporosis resulting from cancer treatments. Chemotherapy-induced menopause, aromatase inhibitors, radiation therapy, and long-term bisphosphonate use can all contribute to bone fragility, including spontaneous rib fractures in the latter 3. Drawing on recent breast cancer practice guidelines as well as population-based studies of fracture risk for women with a history of breast cancer and systematic reviews, this Perspective will provide an update on recent developments in understanding how to differentiate the possible reasons for non-traumatic rib fracture in women treated for breast cancer. In addition to describing the various possible causes of spontaneous rib fracture, the recommended medical and imaging procedures for differentiating among the potential causes will be presented. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Flank pseudohernia following posterior rib fracture: a case report.

    Science.gov (United States)

    Butensky, Adam M; Gruss, Leah P; Gleit, Zachary L

    2016-10-01

    A pseudohernia is an abdominal wall bulge that may be mistaken for a hernia but that lacks the disruption of the abdominal wall that characterizes a hernia. Thus, the natural history and treatment of this condition differ from those of a hernia. This is the first report of a pseudohernia due to cough-associated rib fracture. A case of pseudohernia due to fractures of the 10 th and 11 th ribs in a 68-year-old white woman is presented. The patient suffered from a major coughing episode 1 year prior to her presentation, after which she noted a progressively enlarging bulge in her left flank. Computed tomography demonstrated a bulge in the abdominal wall containing bowel and spleen but with all muscle and fascial layers intact; in addition, lateral 10 th rib and posterior 11 th rib fractures were noted. As there was no defect in muscle or fascia, we diagnosed a pseudohernia, likely due to a denervation injury from the fractured ribs. Symptomatic treatment was recommended, including wearing a corset and referral to a pain management clinic. Symptomatic treatment is thought to be the mainstay of therapy for pseudohernias, as surgical intervention is unlikely to be of benefit.

  2. [Rib cage ostheosynthesis. Literature review and case reports].

    Science.gov (United States)

    Jiménez-Quijano, Andrés; Varón-Cotés, Juan Carlos; García-Herreros-Hellal, Luis Gerardo; Espinosa-Moya, Beatriz; Rivero-Rapalino, Oscar; Salazar-Marulanda, Michelle

    2015-01-01

    Fractures of the chest wall include sternum and rib fractures. Traditionally they are managed conservatively due to the anatomy of the rib cage that allows most of them to remain stable and to form a callus that unites the fractured segments. In spite of this management, some patients present with chronic pain or instability of the wall which makes them require some type of fixation. The present article performs a literature review based on 4 cases. The first case was a 61 year-old man with blunt chest trauma, with a great deformity of the chest wall associated with subcutaneous emphysema, and pneumothorax. The second case was a 51 year-old man with blunt chest trauma, initially managed at another institution, who despite treatment, had persistent pain and dyspnoea. The third case was a 30 year-old man that suffered a motor vehicle accident, with resulting pain and crepitation of the rib cage and with diagnostic images showing multiple rib fractures. The last case is a 62 year-old man that fell down the stairs, with blunt chest trauma with high intensity pain, dyspnoea and basal ipsilateral hypoventilation. Rib fracture fixation offers a good alternative in selected patients to decrease associated morbidity, leading to a patient's fast return to his or her working life. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  3. Emerging from the rib: resolving the turtle controversies.

    Science.gov (United States)

    Rice, Ritva; Riccio, Paul; Gilbert, Scott F; Cebra-Thomas, Judith

    2015-05-01

    Two of the major controversies in the present study of turtle shell development involve the mechanism by which the carapacial ridge initiates shell formation and the mechanism by which each rib forms the costal bones adjacent to it. This paper claims that both sides of each debate might be correct-but within the species examined. Mechanism is more properly "mechanisms," and there is more than one single way to initiate carapace formation and to form the costal bones. In the initiation of the shell, the rib precursors may be kept dorsal by either "axial displacement" (in the hard-shell turtles) or "axial arrest" (in the soft-shell turtle Pelodiscus), or by a combination of these. The former process would deflect the rib into the dorsal dermis and allow it to continue its growth there, while the latter process would truncate rib growth. In both instances, though, the result is to keep the ribs from extending into the ventral body wall. Our recent work has shown that the properties of the carapacial ridge, a key evolutionary innovation of turtles, differ greatly between these two groups. Similarly, the mechanism of costal bone formation may differ between soft-shell and hard-shell turtles, in that the hard-shell species may have both periosteal flattening as well as dermal bone induction, while the soft-shelled turtles may have only the first of these processes. © 2015 Wiley Periodicals, Inc.

  4. Design of 9 tesla superconducting solenoid for VECC RIB facility

    International Nuclear Information System (INIS)

    Das, Chiranjib; Ghosh, Siddhartha; Fatma, Tabassum; Dey, Malay Kanti; Bhunia, Uttam; Bandyopadhyay, Arup; Chakrabarti, Alok

    2013-01-01

    An ISOL post-accelerator type of RIB facility is being developed at our centre. The post acceleration scheme of a Radio Frequency Quadrupole (RFQ) followed by five IH LINAC cavities will provide energy of about 1.05 MeV/u. For further accelerating up to 2 MeV/u Superconducting Quarter Wave Resonators (SCQWR) will be used. The radial defocusing of the beam bunch during the acceleration using SCQWRs will be taken care of by a Superconducting Solenoid (SCS) within the same cryostat. In this report the electromagnetic design of an SCS will be discussed. A 9 T SCS having effective length of 340 mm has been designed with the special requirement that the fringing field should fall sharply to a value less than 100 mT at the surfaces of the adjacent superconducting cavities. The designed solenoid comprise of two co-axial split solenoid conductors surrounded by iron shields and a pair of bucking coils. Optimizations have been carried out for the total current sharing of the main coils and the bucking coils as well as for the relative orientation and dimension of each component of the solenoid. (author)

  5. Design of 9 tesla superconducting solenoid for VECC RIB facility

    Energy Technology Data Exchange (ETDEWEB)

    Das, Chiranjib; Ghosh, Siddhartha; Fatma, Tabassum; Dey, Malay Kanti; Bhunia, Uttam; Bandyopadhyay, Arup; Chakrabarti, Alok [Variable Energy Cyclotron Centre, Kolkata (India)

    2013-07-01

    An ISOL post-accelerator type of RIB facility is being developed at our centre. The post acceleration scheme of a Radio Frequency Quadrupole (RFQ) followed by five IH LINAC cavities will provide energy of about 1.05 MeV/u. For further accelerating up to 2 MeV/u Superconducting Quarter Wave Resonators (SCQWR) will be used. The radial defocusing of the beam bunch during the acceleration using SCQWRs will be taken care of by a Superconducting Solenoid (SCS) within the same cryostat. In this report the electromagnetic design of an SCS will be discussed. A 9 T SCS having effective length of 340 mm has been designed with the special requirement that the fringing field should fall sharply to a value less than 100 mT at the surfaces of the adjacent superconducting cavities. The designed solenoid comprise of two co-axial split solenoid conductors surrounded by iron shields and a pair of bucking coils. Optimizations have been carried out for the total current sharing of the main coils and the bucking coils as well as for the relative orientation and dimension of each component of the solenoid. (author)

  6. Quantifying the relative irreplaceability of important bird and biodiversity areas.

    Science.gov (United States)

    Di Marco, Moreno; Brooks, Thomas; Cuttelod, Annabelle; Fishpool, Lincoln D C; Rondinini, Carlo; Smith, Robert J; Bennun, Leon; Butchart, Stuart H M; Ferrier, Simon; Foppen, Ruud P B; Joppa, Lucas; Juffe-Bignoli, Diego; Knight, Andrew T; Lamoreux, John F; Langhammer, Penny F; May, Ian; Possingham, Hugh P; Visconti, Piero; Watson, James E M; Woodley, Stephen

    2016-04-01

    World governments have committed to increase the global protected areas coverage by 2020, but the effectiveness of this commitment for protecting biodiversity depends on where new protected areas are located. Threshold- and complementarity-based approaches have been independently used to identify important sites for biodiversity. We brought together these approaches by performing a complementarity-based analysis of irreplaceability in important bird and biodiversity areas (IBAs), which are sites identified using a threshold-based approach. We determined whether irreplaceability values are higher inside than outside IBAs and whether any observed difference depends on known characteristics of the IBAs. We focused on 3 regions with comprehensive IBA inventories and bird distribution atlases: Australia, southern Africa, and Europe. Irreplaceability values were significantly higher inside than outside IBAs, although differences were much smaller in Europe than elsewhere. Higher irreplaceability values in IBAs were associated with the presence and number of restricted-range species; number of criteria under which the site was identified; and mean geographic range size of the species for which the site was identified (trigger species). In addition, IBAs were characterized by higher irreplaceability values when using proportional species representation targets, rather than fixed targets. There were broadly comparable results when measuring irreplaceability for trigger species and when considering all bird species, which indicates a good surrogacy effect of the former. Recently, the International Union for Conservation of Nature has convened a consultation to consolidate global standards for the identification of key biodiversity areas (KBAs), building from existing approaches such as IBAs. Our results informed this consultation, and in particular a proposed irreplaceability criterion that will allow the new KBA standard to draw on the strengths of both threshold- and

  7. Characteristics of Rib Fractures in Child Abuse-The Role of Low-Dose Chest Computed Tomography.

    Science.gov (United States)

    Sanchez, Thomas R; Grasparil, Angelo D; Chaudhari, Ruchir; Coulter, Kevin P; Wootton-Gorges, Sandra L

    2018-02-01

    Our aim is to describe the radiologic characteristics of rib fractures in clinically diagnosed cases of child abuse and suggest a complementary imaging for radiographically occult injuries in highly suspicious cases of child abuse. Retrospective analysis of initial and follow-up skeletal surveys and computed tomography (CT) scans of 16 patients younger than 12 months were reviewed after obtaining approval from our institutional review board. The number, location, displacement, and age of the rib fractures were recorded. Out of a total 105 rib fractures, 84% (87/105) were detected on the initial skeletal survey. Seventeen percent (18/105) were seen only after follow-up imaging, more than half of which (11/18) were detected on a subsequent CT. Majority of the fractures were posterior (43%) and anterior (30%) in location. An overwhelming majority (96%) of the fractures are nondisplaced. Seventeen percent of rib fractures analyzed in the study were not documented on the initial skeletal survey. Majority of fractures are nondisplaced and located posteriorly or anteriorly, areas that are often difficult to assess especially in the acute stage. The CT scan is more sensitive in evaluating these types of fractures. Low-dose chest CT can be an important imaging modality for suspicious cases of child abuse when initial radiographic findings are inconclusive.

  8. Bolted Ribs Analysis for the ITER Vacuum Vessel using Finite Element Submodelling Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Zarzalejos, José María, E-mail: jose.zarzalejos@ext.f4e.europa.eu [External at F4E, c/Josep Pla, n.2, Torres Diagonal Litoral, Edificio B3, E-08019, Barcelona (Spain); Fernández, Elena; Caixas, Joan; Bayón, Angel [F4E, c/Josep Pla, n.2, Torres Diagonal Litoral, Edificio B3, E-08019, Barcelona (Spain); Polo, Joaquín [Iberdrola Ingeniería y Construcción, Avenida de Manoteras 20, 28050 Madrid (Spain); Guirao, Julio [Numerical Analysis Technologies, S L., Marqués de San Esteban 52, Entlo, 33209 Gijon (Spain); García Cid, Javier [Iberdrola Ingeniería y Construcción, Avenida de Manoteras 20, 28050 Madrid (Spain); Rodríguez, Eduardo [Mechanical Engineering Department EPSIG, University of Oviedo, Gijon (Spain)

    2014-10-15

    Highlights: • The ITER Vacuum Vessel Bolted Ribs assemblies are modelled using Finite Elements. • Finite Element submodelling techniques are used. • Stress results are obtained for all the assemblies and a post-processing is performed. • All the elements of the assemblies are compliant with the regulatory provisions. • Submodelling is a time-efficient solution to verify the structural integrity of this type of structures. - Abstract: The ITER Vacuum Vessel (VV) primary function is to enclose the plasmas produced by the ITER Tokamak. Since it acts as the first radiological barrier of the plasma, it is classified as a class 2 welded box structure, according to RCC-MR 2007. The VV is made of an inner and an outer D-shape, 60 mm-thick double shell connected through thick massive bars (housings) and toroidal and poloidal structural stiffening ribs. In order to provide neutronic shielding to the ex-vessel components, the space between shells is filled with borated steel plates, called In-Wall Shielding (IWS) blocks, and water. In general, these blocks are connected to the IWS ribs which are connected to adjacent housings. The development of a Finite Element model of the ITER VV including all its components in detail is unaffordable from the computational point of view due to the large number of degrees of freedom it would require. This limitation can be overcome by using submodelling techniques to simulate the behaviour of the bolted ribs assemblies. Submodelling is a Finite Element technique which allows getting more accurate results in a given region of a coarse model by generating an independent, finer model of the region under study. In this paper, the methodology and several simulations of the VV bolted ribs assemblies using submodelling techniques are presented. A stress assessment has been performed for the elements involved in the assembly considering possible types of failure and including stress classification and categorization techniques to analyse

  9. Numerical investigations of rib fracture failure models in different dynamic loading conditions.

    Science.gov (United States)

    Wang, Fang; Yang, Jikuang; Miller, Karol; Li, Guibing; Joldes, Grand R; Doyle, Barry; Wittek, Adam

    2016-01-01

    Rib fracture is one of the most common thoracic injuries in vehicle traffic accidents that can result in fatalities associated with seriously injured internal organs. A failure model is critical when modelling rib fracture to predict such injuries. Different rib failure models have been proposed in prediction of thorax injuries. However, the biofidelity of the fracture failure models when varying the loading conditions and the effects of a rib fracture failure model on prediction of thoracic injuries have been studied only to a limited extent. Therefore, this study aimed to investigate the effects of three rib failure models on prediction of thoracic injuries using a previously validated finite element model of the human thorax. The performance and biofidelity of each rib failure model were first evaluated by modelling rib responses to different loading conditions in two experimental configurations: (1) the three-point bending on the specimen taken from rib and (2) the anterior-posterior dynamic loading to an entire bony part of the rib. Furthermore, the simulation of the rib failure behaviour in the frontal impact to an entire thorax was conducted at varying velocities and the effects of the failure models were analysed with respect to the severity of rib cage damages. Simulation results demonstrated that the responses of the thorax model are similar to the general trends of the rib fracture responses reported in the experimental literature. However, they also indicated that the accuracy of the rib fracture prediction using a given failure model varies for different loading conditions.

  10. Neurofunctional areas related to food appetency in anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Juán José Cervantes-Navarrete

    2012-07-01

    Full Text Available In Anorexia Nervosa the observable phenomenon is the suppression of appetite. Little is known about the biological and psychological (top-down bases that maintain this pathological state. However, Anorexia Nervosa is a biological, psychological and social model where the main behavioral characteristic is the inhibition of eating behavior; not by bottom-up but top-down regulation. Objective: To explore the areas of the brain associated with food appetency through functional magnetic resonance in women with anorexia nervosa. Methods: The subjects include 5 female with Restrictive type of Anorexia Nervosa and five controls female with similar in age and low weigh. The subjects were within the MRI scanner and while took fMRI they saw food images that would generate appetite. The subjects were in fasting state and mentally prepare by instruction “imagine you are eating the food presented in the following images”. Results: Compared differences in the activation between subjects four regions were found significant: the anterior cingulate, left front medial region and the left and right midbrain. Conclusions: The patients with Anorexia Nervosa present different activated cerebral areas to those of the controls during the visual exposition to food in hungry state and with evoke cognitions associated with eat food; those regions may be implicated in reward and self-control.

  11. FRACTURES OF THE RIBS AND THE DIAPHRAGMATIC RUPTURE WITH A FORMATION OF THE TRANSDIAPHRAGMATIC INTERCOSTAL HERNIA AS A RESULT OF SEVERE COUGHING (CLINICAL OBSERVATION WITH A REVIEW OF THE LITERATURE

    Directory of Open Access Journals (Sweden)

    S. N. Danielyan

    2014-01-01

    Full Text Available ABSTRACT. Severe coughing might lead to development of a number of complications, including the diaphragmatic rupture and the ribs fractures. The report contains two similar rare clinical cases: male patients aged 48 and 74 years with transdiaphragmatic intercostal thoracic wall hernia after the rupture of the left half of the diaphragm and ribs fractures as a result of violent coughing. Both patients had a late diagnosis of injuries. Surgical therapy was performed via thoracotomy access using a mesh implant. histological study of the rib in the damaged area in one case detected fibrous osteodysplasia. The review of literature on this rare type of injury was analyzed. 

  12. Surgical treatment of rib fracture nonunion: A single center experience.

    Science.gov (United States)

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

    2018-03-01

    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 Elsevier Ltd. All rights reserved.

  13. Managing domino effect-related security of industrial areas

    NARCIS (Netherlands)

    Reniers, Genserik L L; Dullaert, W.; Audenaert, Amaryllis; Ale, B. J.M.; Soudan, K.

    In chemical enterprises, security managers are interested in easy-to-handle and user-friendly decision-support tools, providing them with straightforward information ready for implementation. Therefore, a theoretical conceptualization on how to manage-in a relatively simple way-the prevention and

  14. Burned-out seminoma revealed by solitary rib bone metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Nishisho, Toshihiko; Miyagi, Ryo; Sairyo, Koichi [Tokushima University Graduate School, Department of Orthopedics, Institute of Biomedical Sciences, Tokushima-city, Tokushima (Japan); Sakaki, Mika [Saitama Medical University International Medical Center, Department of Pathology, Hidaka-city, Saitama (Japan); Takao, Shoichiro [Tokushima University Graduate School, Department of Radiology, Institute of Biomedical Sciences, Tokushima-city, Tokushima (Japan)

    2017-10-15

    Burned-out tumor is a rare phenomenon in which a testicular tumor regresses in the primary lesion and progresses in a metastatic lesion. We report the case of a 30-year-old male with burned-out seminoma revealed by open biopsy of solitary 10th rib bone metastasis. He underwent inguinal orchiectomy, which revealed hyalinization, indicating a spontaneously regressed testicular tumor. Chemotherapy for seminoma was administered in three cycles of bleomycin + etoposide + cisplatin therapy. The chemotherapy was effective, and wide resection of the rib was subsequently performed. No postoperative chemotherapy was performed, and there has been no evidence of recurrence for 3 years postoperatively. (orig.)

  15. Sternoplasty and rib distraction in neonatal Jeune syndrome.

    LENUS (Irish Health Repository)

    Conroy, Eimear

    2010-09-01

    A 12-week-old boy with Jeune syndrome (asphyxiating thoracic dystrophy) was referred to the orthopaedic unit with progressive respiratory failure, recurrent respiratory tract infections, and recurrent admissions to the intensive care unit for ventilatory support. His chest x-ray revealed a small and narrow thoracic cage with short broad ribs and abnormal costal cartilages. His chest expansion was impaired by the short, horizontally positioned ribs resulting in alveolar hypoventilation. Without surgical intervention to expand his thoracic cage, he would die of respiratory failure.

  16. Individual Income, Area Deprivation, and Health: Do Income-Related Health Inequalities Vary by Small Area Deprivation?

    Science.gov (United States)

    Siegel, Martin; Mielck, Andreas; Maier, Werner

    2015-11-01

    This paper aims to explore potential associations between health inequalities related to socioeconomic deprivation at the individual and the small area level. We use German cross-sectional survey data for the years 2002 and 2006, and measure small area deprivation via the German Index of Multiple Deprivation. We test the differences between concentration indices of income-related and small area deprivation related inequalities in obesity, hypertension, and diabetes. Our results suggest that small area deprivation and individual income both yield inequalities in health favoring the better-off, where individual income-related inequalities are significantly more pronounced than those related to small area deprivation. We then apply a semiparametric extension of Wagstaff's corrected concentration index to explore how individual-level health inequalities vary with the degree of regional deprivation. We find that the concentration of obesity, hypertension, and diabetes among lower income groups also exists at the small area level. The degree of deprivation-specific income-related inequalities in the three health outcomes exhibits only little variations across different levels of multiple deprivation for both sexes. Copyright © 2014 John Wiley & Sons, Ltd.

  17. Acute rib fracture diagnosis in an infant by US: a matter of child protection

    International Nuclear Information System (INIS)

    Kelloff, Jennifer; Spivey, Maria; Hulett, Rebecca

    2009-01-01

    Rib fractures in infants and children are highly specific for inflicted injury in the absence of a major accidental injury or underlying bone disorder. We present a 9-week-old infant diagnosed with an acute rib fracture by US at the site where physicians palpated chest wall crepitus when no rib fractures had been visualized on the skeletal survey, including oblique views of the ribs. Based on the US diagnosis of the acute rib fracture the infant was taken into protective custody. Follow-up skeletal survey 2 weeks later revealed healing fractures of the left 6th and 7th posterolateral ribs and right 7th, 8th and 9th anterolateral ribs. We were unable to locate previous reports describing the diagnosis of rib fractures in infants by US. (orig.)

  18. Acute rib fracture diagnosis in an infant by US: a matter of child protection

    Energy Technology Data Exchange (ETDEWEB)

    Kelloff, Jennifer; Spivey, Maria [Washington University School of Medicine, Department of Pediatrics, Section on Child Abuse and Neglect, St. Louis Children' s Hospital, One Children' s Place, Box 8116, St. Louis, MO (United States); Hulett, Rebecca [Washington University School of Medicine, Department of Radiology, St. Louis Children' s Hospital, St. Louis, MO (United States)

    2009-01-15

    Rib fractures in infants and children are highly specific for inflicted injury in the absence of a major accidental injury or underlying bone disorder. We present a 9-week-old infant diagnosed with an acute rib fracture by US at the site where physicians palpated chest wall crepitus when no rib fractures had been visualized on the skeletal survey, including oblique views of the ribs. Based on the US diagnosis of the acute rib fracture the infant was taken into protective custody. Follow-up skeletal survey 2 weeks later revealed healing fractures of the left 6th and 7th posterolateral ribs and right 7th, 8th and 9th anterolateral ribs. We were unable to locate previous reports describing the diagnosis of rib fractures in infants by US. (orig.)

  19. Out with the old, in with the new: a novel approach to treating pain associated with rib fractures.

    Science.gov (United States)

    Truitt, Michael S; Mooty, R Clark; Amos, Joseph; Lorenzo, Manuel; Mangram, Alicia; Dunn, Ernest

    2010-10-01

    Rib fractures continue to be a challenging problem from both a pulmonary and analgesia standpoint. As a result, numerous modalities have been used to treat this condition, but none has proven universally available and efficacious. The objective of this pilot study was to assess the efficacy of a novel technique for placing an elastomeric infusion pump (EIP) catheter (On-Q; Lake Forest, CA, USA) in the extrathoracic paraspinous space to create a continuous intercostal nerve block. This was a prospective, nonrandomized study conducted in the surgical intensive care unit (SICU) of an urban level II trauma center. We developed a novel technique for placing EIP catheters in the extrathoracic paraspinous space to provide continuous intercostal nerve blockade. We subsequently evaluated 30 consecutive blunt trauma patients with three or more unilateral rib fractures. The catheters were infused with local anesthetic, and the dose was titrated to achieve adequate analgesia. For each patient, preplacement numeric pain scale scores (NPSs) and sustained maximum inspiration (SMI) lung volumes were determined. Sixty minutes following placement of the catheters, the NPS and SMI were repeated. The patients were monitored for any procedural or drug-related complications. The mean age of the patients was 65 years (22-92 years); the mean ISS was 14 (9-16); and the mean number of rib fractures was 4.4 (3-8). Overall, the mean NPS significantly improved (preplacement NPS 9.03, postplacement NPS 3.06; p pain secondary to rib fractures.

  20. Traffic-related particulate air pollution exposure in urban areas

    Science.gov (United States)

    Borrego, C.; Tchepel, O.; Costa, A. M.; Martins, H.; Ferreira, J.; Miranda, A. I.

    In the last years, there has been an increase of scientific studies confirming that long- and short-term exposure to particulate matter (PM) pollution leads to adverse health effects. The development of a methodology for the determination of accumulated human exposure in urban areas is the main objective of the current work, combining information on concentrations at different microenvironments and population time-activity pattern data. A link between a mesoscale meteorological and dispersion model and a local scale air quality model was developed to define the boundary conditions for the local scale application. The time-activity pattern of the population was derived from statistical information for different sub-population groups and linked to digital city maps. Finally, the hourly PM 10 concentrations for indoor and outdoor microenvironments were estimated for the Lisbon city centre, which was chosen as the case-study, based on the local scale air quality model application for a selected period. This methodology is a first approach to estimate population exposure, calculated as the total daily values above the thresholds recommended for long- and short-term health effects. Obtained results reveal that in Lisbon city centre a large number of persons are exposed to PM levels exceeding the legislated limit value.

  1. Experimental determination of average turbulent heat transfer and friction factor in stator internal rib-roughened cooling channels.

    Science.gov (United States)

    Battisti, L; Baggio, P

    2001-05-01

    In gas turbine cooling design, techniques for heat extraction from the surfaces exposed to the hot stream are based on the increase of the inner heat transfer areas and on the promotion of the turbulence of the cooling flow. This is currently obtained by casting periodic ribs on one or more sides of the serpentine passages into the core of the blade. Fluid dynamic and thermal behaviour of the cooling flow have been extensively investigated by means of experimental facilities and many papers dealing with this subject have appeared in the latest years. The evaluation of the average value of the heat transfer coefficient most of the time is inferred from local measurements obtained by various experimental techniques. Moreover the great majority of these studies are not concerned with the overall average heat transfer coefficient for the combined ribs and region between them, but do focus just on one of them. This paper presents an attempt to collect information about the average Nusselt number inside a straight ribbed duct. Series of measurements have been performed in steady state eliminating the error sources inherently connected with transient methods. A low speed wind tunnel, operating in steady state flow, has been built to simulate the actual flow condition occurring in a rectilinear blade cooling channel. A straight square channel with 20 transverse ribs on two sides has been tested for Re of about 3 x 10(4), 4.5 x 10(4) and 6 x 10(4). The ribbed wall test section is electrically heated and the heat removed by a stationary flow of known thermal and fluid dynamic characteristics.

  2. Biomechanical rationale and evaluation of an implant system for rib fracture fixation

    OpenAIRE

    Bottlang, M.; Walleser, S.; Noll, M.; Honold, S.; Madey, S. M.; Fitzpatrick, D.; Long, W. B.

    2010-01-01

    Background Biomechanical research directed at developing customized implant solutions for rib fracture fixation is essential to reduce the complexity and to increase the reliability of rib osteosynthesis. Without a simple and reliable implant solution, surgical stabilization of rib fractures will remain underutilized despite proven benefits for select indications. This article summarizes the research, development, and testing of a specialized and comprehensive implant solution for rib fractur...

  3. First rib fractures as an indicator of injury severity in major trauma

    OpenAIRE

    Sammy, I.A.; Chatha, H.; Lecky, F.; Bouamra, O.; Fragoso Iniguez, M.; Sattout, A.; Hickey, M.

    2016-01-01

    Introduction First rib fractures are traditionally considered indicators of increased morbidity and mortality in major trauma. However, this relationship has not been definitively proven. With an increase in computed tomography in major trauma, and the likely increase in detection of first rib fractures, this study re-evaluates whether first rib fractures are an indicator of injury severity. Discussion This study suggests that major trauma patients with first rib fractures have increased ISS ...

  4. Rib Fracture Patterns and Radiologic Detection – A Restraint-Based Comparison

    OpenAIRE

    Crandall, Jeff; Kent, Richard; Patrie, James; Fertile, Jay; Martin, Peter

    2000-01-01

    This paper presents a study of the rib fracture patterns generated in simulated frontal collisions and the visibility of the rib fractures on plain film radiographs. Using 29 cadaver subjects, rib fractures were identified on oblique, lateral, and anteroposterior chest films by five radiologists independently and were compared with fractures found during a detailed necropsy. Physical, geometric, and experimental factors demonstrated an influence on the ability of a radiologist to identify rib...

  5. Surgical Stabilization of Rib Fractures in a 6-Year-Old Child After Blunt Trauma.

    Science.gov (United States)

    Abdelsattar, Zaid M; Ishitani, Michael B; Kim, Brian D

    2017-12-01

    When identified, rib fractures in children are associated with high-energy trauma, nonaccidental trauma, or both. Traditionally, the optimal management of rib fractures in children is supportive care. In this case report, we present a 6-year-old boy who underwent surgical rib fixation for multiple displaced and comminuted rib fractures after being stepped on by a horse. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Area detectors technology and optics-Relations to nature

    International Nuclear Information System (INIS)

    PeIka, Jerzy B.

    2005-01-01

    Relations between natural vision and the artificial 2D imaging systems are discussed. A variety of animal vision as well as its main functional parts are briefly reviewed and compared with the artificial vision equivalents. An increasing advancement observed in human constructions of imaging devices due to recent rapid progress in science and technology is shown to resemble some sophisticated natural solutions formed by evolution in biological systems. The issues of the similarities and differences between the two kinds of vision are discussed. Main focus is put on optical systems forming the image, with special examples of the imaging systems designed to work in the region of the X-ray radiation. Examples of bio-inspired technological vision devices are presented

  7. Comparison of Computed Tomography and Chest Radiography in the Detection of Rib Fractures in Abused Infants

    Science.gov (United States)

    Wootton-Gorges, Sandra L.; Stein-Wexler, Rebecca; Walton, John W.; Rosas, Angela J.; Coulter, Kevin P.; Rogers, Kristen K.

    2008-01-01

    Purpose: Chest radiographs (CXR) are the standard method for evaluating rib fractures in abused infants. Computed tomography (CT) is a sensitive method to detect rib fractures. The purpose of this study was to compare CT and CXR in the evaluation of rib fractures in abused infants. Methods: This retrospective study included all 12 abused infants…

  8. Investigation of heat transfer and flow using ribs within gas turbine blade cooling passage: Experimental and hybrid LES/RANS modeling

    Science.gov (United States)

    Kumar, Sourabh

    Gas turbines are extensively used for aircraft propulsion, land based power generation and various industrial applications. Developments in innovative gas turbine cooling technology enhance the efficiency and power output, with an increase in turbine rotor inlet temperatures. These advancements of turbine cooling have allowed engine design to exceed normal material temperature limits. For internal cooling design, techniques for heat extraction from the surfaces exposed to hot stream are based on the increase of heat transfer areas and on promotion of turbulence of the cooling flow. In this study, it is obtained by casting repeated continuous V and broken V shaped ribs on one side of the two pass square channel into the core of blade. Despite extensive research on ribs, only few papers have validated the numerical data with experimental results in two pass channel. In the present study, detailed experimental investigation is carried out for two pass square channels with 180° turn. Detailed heat transfer distribution occurring in the ribbed passage is reported for steady state experiment. Four different combinations of 60° and Broken 60° V ribs in channel are considered. Thermocouples are used to obtain the temperature on the channel surface and local heat transfer coefficients are obtained for various Reynolds numbers, within the turbulent flow regime. Area averaged data are calculated in order to compare the overall performance of the tested ribbed surface and to evaluate the degree of heat transfer enhancement induced by the ribs with. Flow within the channels is characterized by heat transfer enhancing ribs, bends, rotation and buoyancy effects. Computational Fluid Dynamics (CFD) simulations were carried out for the same geometries using different turbulence models such as k-o Shear stress transport (SST) and Reynolds stress model (RSM). These CFD simulations were based on advanced computing in order to improve the accuracy of three dimensional metal

  9. Continuous intercostal nerve blockade for rib fractures: ready for primetime?

    Science.gov (United States)

    Truitt, Michael S; Murry, Jason; Amos, Joseph; Lorenzo, Manuel; Mangram, Alicia; Dunn, Ernest; Moore, Ernest E

    2011-12-01

    Providing analgesia for patients with rib fractures continues to be a management challenge. The objective of this study was to examine our experience with the use of a continuous intercostal nerve block (CINB). Although this technique is being used, little data have been published documenting its use and efficacy. We hypothesized that a CINB would provide excellent analgesia, improve pulmonary function, and decrease length of stay (LOS). Consecutive adult blunt trauma patients with three or more unilateral rib fractures were prospectively studied over 24 months. The catheters were placed at the bedside in the extrathoracic, paravertebral location, and 0.2% ropivacaine was infused. Respiratory rate, preplacement (PRE) numeric pain scale (NPS) scores, and sustained maximal inspiration (SMI) lung volumes were determined at rest and after coughing. Parameters were repeated 60 minutes after catheter placement (POST). Hospital LOS comparison was made with historical controls using epidural analgesia. Over the study period, 102 patients met inclusion criteria. Mean age was 69 (21-96) years, mean injury severity score was 14 (9-16), and the mean number of rib fractures was 5.8 (3-10). Mean NPS improved significantly (PRE NPS at rest = 7.5 vs. POST NPS at rest = 2.6, p pain control, and shortens LOS in patients with rib fractures.

  10. Snapping scapular syndrome secondary to rib intramedullary fixation device

    Directory of Open Access Journals (Sweden)

    Ezequiel E. Zaidenberg

    2015-01-01

    Conclusion: Surgeons should pay attention to any protrusion of intramedullary rib implants, especially in the evaluation of routine X-rays following surgical treatment. We should be aware of the possibility of this rare cause of snapping scapula syndrome to avoid delayed diagnosis and consider removing the implant will resolve the pain.

  11. Lidocaine patches reduce pain in trauma patients with rib fractures.

    Science.gov (United States)

    Zink, Karen A; Mayberry, John C; Peck, Ellen G; Schreiber, Martin A

    2011-04-01

    Rib fracture pain is notoriously difficult to manage. The lidocaine patch is effective in other pain scenarios with an excellent safety profile. This study assesses the efficacy of lidocaine patches for treating rib fracture pain. A prospectively gathered cohort of patients with rib fracture was retrospectively analyzed for use of lidocaine patches. Patients treated with lidocaine patches were matched to control subjects treated without patches. Subjective pain reports and narcotic use before and after patch placement, or equivalent time points for control subjects, were gathered from the chart. All patients underwent long-term follow-up, including a McGill Pain Questionnaire (MPQ). Twenty-nine patients with lidocaine patches (LP) and 29 matched control subjects (C) were analyzed. During the 24 hours before patch placement, pain scores and narcotic use were similar (LP 5.3, C 4.6, P = 0.19 and LP 51, C 32 mg morphine, P = 0.17). In the 24 hours after patch placement, LP patients had a greater decrease in pain scores (LP 1.2, C 0.0, P = 0.01) with no change in narcotic use (LP -8.4, C 0.5-mg change in morphine, P = 0.25). At 60 days, LP patients had a lower MPQ pain score (LP 7.7, C 12.2, P rib fracture pain. Lidocaine patches resulted in a sustained reduction in pain, outlasting the duration of therapy.

  12. Improving vertebra segmentation through joint vertebra-rib atlases

    Science.gov (United States)

    Wang, Yinong; Yao, Jianhua; Roth, Holger R.; Burns, Joseph E.; Summers, Ronald M.

    2016-03-01

    Accurate spine segmentation allows for improved identification and quantitative characterization of abnormalities of the vertebra, such as vertebral fractures. However, in existing automated vertebra segmentation methods on computed tomography (CT) images, leakage into nearby bones such as ribs occurs due to the close proximity of these visibly intense structures in a 3D CT volume. To reduce this error, we propose the use of joint vertebra-rib atlases to improve the segmentation of vertebrae via multi-atlas joint label fusion. Segmentation was performed and evaluated on CTs containing 106 thoracic and lumbar vertebrae from 10 pathological and traumatic spine patients on an individual vertebra level basis. Vertebra atlases produced errors where the segmentation leaked into the ribs. The use of joint vertebra-rib atlases produced a statistically significant increase in the Dice coefficient from 92.5 +/- 3.1% to 93.8 +/- 2.1% for the left and right transverse processes and a decrease in the mean and max surface distance from 0.75 +/- 0.60mm and 8.63 +/- 4.44mm to 0.30 +/- 0.27mm and 3.65 +/- 2.87mm, respectively.

  13. Application of the rainfall infiltration breakthrough (RIB) model for ...

    African Journals Online (AJOL)

    Application of the rainfall infiltration breakthrough (RIB) model for groundwater recharge estimation in west coastal South Africa. ... the data from Oudebosch with different rainfall and groundwater abstraction inputs are simulated to explore individual effects on water levels as well as recharge rate estimated on a daily basis.

  14. Rib fracture in a horse during an endurance race

    OpenAIRE

    Trigo, Pablo; Muñoz, Ana; Castejón, Francisco; Riber, Cristina; Hassel, Diana M.

    2011-01-01

    We describe a fatal case, in which a horse suffered a fall and as a consequence, rib fractures. Diagnosis was made postmortem and the horse died without showing clear signs of respiratory dysfunction. The retrospective reports of injuries can be important to reduce these traumatic events and to avoid fatalities.

  15. Single-transverse-mode Ti:sapphire rib waveguide laser

    NARCIS (Netherlands)

    Grivas, C.; Shepherd, D.P.; May-Smith, T.C.; Eason, R.W.; Pollnau, Markus

    2005-01-01

    Laser operation of Ti:sapphire rib waveguides fabricated using photolithography and ion beam etching in pulsed laser deposited layers is reported. Polarized laser emission was observed at 792.5 nm with an absorbed pump power threshold of 265 mW, which is more than a factor of 2 lower in comparison

  16. Rib fracture in a horse during an endurance race.

    Science.gov (United States)

    Trigo, Pablo; Muñoz, Ana; Castejón, Francisco; Riber, Cristina; Hassel, Diana M

    2011-11-01

    We describe a fatal case, in which a horse suffered a fall and as a consequence, rib fractures. Diagnosis was made postmortem and the horse died without showing clear signs of respiratory dysfunction. The retrospective reports of injuries can be important to reduce these traumatic events and to avoid fatalities.

  17. Flow field analysis inside a gas turbine trailing edge cooling channel under static and rotating conditions: Effect of ribs

    International Nuclear Information System (INIS)

    Mucignat, C.; Armellini, A.; Casarsa, L.

    2013-01-01

    Highlights: • Detailed PIV and Stereo PIV investigation on a rotating test section. • Static channel: absence of guiding effect for inclined ribs. • Static channel: the ribs influence significantly the flow also at the trailing edge. • Rotating channel: opposite flow features with respect to the static case. • The analyzed flow features justify the previously observed thermal performances. -- Abstract: The present work is part of a wider research program which concerns the aero-thermal characterization of cooling channels for the trailing edge of gas turbine blades. The selected passage model is characterized by a trapezoidal cross-section of high aspect-ratio and coolant discharge at the blade tip and along the wedge-shaped trailing edge, where seven elongated pedestals are also installed. In this contribution, a new channel configuration provided with inclined ribs installed inside the radial development region is analyzed, extending the previous results and completing the already available data base, thus providing an overall review of the aero-thermal performance of the considered passage. The velocity field inside the channel was measured by means of 2D and Stereo-PIV techniques in multiple flow planes under static and rotating conditions. The tests were performed under engine similar conditions with respect to both Reynolds (Re = 20,000) and Rotation (Ro = 0, 0.23) numbers. Time averaged flow fields and velocity fluctuation data inside the stationary and rotating channels are analyzed and also critically compared with the data acquired without ribs. In this way the effects on the flow field induced by both rotation and ribs are clearly described. In particular, the ribs modify substantially both the flow field on the channel walls where they are installed and the 3D separation structures that surround the pedestals. If also rotation is taken into account, the relative flow field is characterized by a considerable guiding effect of the ribs coupled

  18. The role of acoustic nonlinearity in tissue heating behind a rib cage using a high-intensity focused ultrasound phased array

    Science.gov (United States)

    Yuldashev, Petr V.; Shmeleva, Svetlana M.; Ilyin, Sergey A.; Sapozhnikov, Oleg A.; Gavrilov, Leonid R.; Khokhlova, Vera A.

    2013-04-01

    The goal of this study was to investigate theoretically the effects of nonlinear propagation in a high-intensity focused ultrasound (HIFU) field produced by a therapeutic phased array and the resultant heating of tissue behind a rib cage. Three configurations of focusing were simulated: in water, in water with ribs in the beam path and in water with ribs backed by a layer of soft tissue. The Westervelt equation was used to model the nonlinear HIFU field, and a 1 MHz phased array consisting of 254 circular elements was used as a boundary condition to the model. The temperature rise in tissue was modelled using the bioheat equation, and thermally necrosed volumes were calculated using the thermal dose formulation. The shapes of lesions predicted by the modelling were compared with those previously obtained in in vitro experiments at low-power sonications. Intensity levels at the face of the array elements that corresponded to the formation of high-amplitude shock fronts in the focal region were determined as 10 W cm-2 in the free field in water and 40 W cm-2 in the presence of ribs. It was shown that exposures with shocks provided a substantial increase in tissue heating, and its better spatial localization in the main focal region only. The relative effects of overheating ribs and splitting of the focus due to the periodic structure of the ribs were therefore reduced. These results suggest that utilizing nonlinear propagation and shock formation effects can be beneficial for inducing confined HIFU lesions when irradiating through obstructions such as ribs. Design of compact therapeutic arrays to provide maximum power outputs with lower intensity levels at the elements is necessary to achieve shock wave regimes for clinically relevant sonication depths in tissue.

  19. Rib cage deformities alter respiratory muscle action and chest wall function in patients with severe osteogenesis imperfecta.

    Directory of Open Access Journals (Sweden)

    Antonella LoMauro

    Full Text Available BACKGROUND: Osteogenesis imperfecta (OI is an inherited connective tissue disorder characterized by bone fragility, multiple fractures and significant chest wall deformities. Cardiopulmonary insufficiency is the leading cause of death in these patients. METHODS: Seven patients with severe OI type III, 15 with moderate OI type IV and 26 healthy subjects were studied. In addition to standard spirometry, rib cage geometry, breathing pattern and regional chest wall volume changes at rest in seated and supine position were assessed by opto-electronic plethysmography to investigate if structural modifications of the rib cage in OI have consequences on ventilatory pattern. One-way or two-way analysis of variance was performed to compare the results between the three groups and the two postures. RESULTS: Both OI type III and IV patients showed reduced FVC and FEV(1 compared to predicted values, on condition that updated reference equations are considered. In both positions, ventilation was lower in OI patients than control because of lower tidal volume (p<0.01. In contrast to OI type IV patients, whose chest wall geometry and function was normal, OI type III patients were characterized by reduced (p<0.01 angle at the sternum (pectus carinatum, paradoxical inspiratory inward motion of the pulmonary rib cage, significant thoraco-abdominal asynchronies and rib cage distortions in supine position (p<0.001. CONCLUSIONS: In conclusion, the restrictive respiratory pattern of Osteogenesis Imperfecta is closely related to the severity of the disease and to the sternal deformities. Pectus carinatum characterizes OI type III patients and alters respiratory muscles coordination, leading to chest wall and rib cage distortions and an inefficient ventilator pattern. OI type IV is characterized by lower alterations in the respiratory function. These findings suggest that functional assessment and treatment of OI should be differentiated in these two forms of the

  20. Prognosis of Primary and Recurrent Chondrosarcoma of the Rib.

    Science.gov (United States)

    Roos, Eva; van Coevorden, Frits; Verhoef, Cornelis; Wouters, Michel W; Kroon, Herman M; Hogendoorn, Pancras C W; van Houdt, Winan J

    2016-03-01

    Chondrosarcoma of the rib is a rare disease. Although surgery is the only curative treatment option, rib resection with an adequate margin can be challenging and local recurrence is a frequent problem. In this study, the prognosis of primary and recurrent chondrosarcoma of the rib is reported. Retrospective analysis was performed of patients treated for chondrosarcoma of the rib between 1984 and 2014 in three major tertiary referral centers in The Netherlands. Clinical and histopathological features were analyzed for their prognostic value using Kaplan-Meier and Cox proportional hazard analysis. Endpoints were set at local recurrent disease, metastasis rate, or death. Overall, 76 patients underwent a resection for a primary chondrosarcoma, and 26 patients underwent a resection for a recurrent chondrosarcoma. Five-year overall survival in the primary group was 90%, local recurrence rate was 17%, and metastasis rate was 12%. The 5-year outcome after recurrent chondrosarcoma was lower, with an overall survival of 65%, local recurrence rate of 27%, and metastasis rate of 27%. For primary chondrosarcoma, tumor size >5 cm and a positive resection margin were correlated with worse overall survival [hazard ratio (HR) 3.28, 95% confidence interval (CI) 1.03-10.44; HR 2.92, 95% CI 1.03-8.25). A higher histological grade was correlated with a higher local recurrence and metastasis rate (HR 5.92, 95% CI 1.11-31.65; HR 6.96, 95% CI 1.15-42.60). Surgical resection of both primary and recurrent chondrosarcoma of the rib is an effective treatment strategy. The oncological outcome after surgery is worse in tumors >5 cm, in tumors with positive resection margins and grade 3 chondrosarcoma.

  1. [Diagnosis and treatment of rib fracture during spontaneous vaginal delivery].

    Science.gov (United States)

    Jovanović, Nebojša; Ristovska, Nataša; Bogdanović, Zorica; Petronijević, Miloš; Opalić, Jasna; Plećaš, Darko

    2013-01-01

    Progress of labor in multiparous women usually is not accompanied with risk of any kind of birth trauma. We report a very rare case of rib fracture in a neonate during vaginal delivery in the 39/40 week of gestation. The expulsion started spontaneously without any manipulation from the obstetrician. Live male newborn was delivered 4650 g. in weight, 55 cm long, with head circumference of 39 cm, Apgar score 9. The child was immediately examined by the neonatologist. Crepitations were palpable over the left hemithorax, and auscultatory on the left side inspiratory cracks. Finding was suspicious for rib fracture on the left side posteriorly and brachial plexus palsy, while other findings were normal. X-ray finding was inconclusive, but suspicious for fracture of the 4th, 5th, and 6th left rib posteriorly, without dislocation of bone fragments. There were no signs of pneumothorax. Dorsal position of the newborn was considered sufficient, accompanied with analgetics. X-ray was scheduled in a week because formation of the calus would be the only objective sign of previous rib fracture. On the control X-ray fracture lines were clearly visible on the 3rd, 4th, 5th 6th and 7th rib posteriorly, without dislocation of bone fragments with initial calus formation. The child was discharged from hospital in good condition after two weeks, for further outpatient care. With timely diagnostics of this very rare intrapartal fracture, adequate treatment, dorsal position and close control of clinical condition of the newborn, serious and potentially life threatening complications can be avoided.

  2. Diagnosis and treatment of rib fracture during spontaneous vaginal delivery

    Directory of Open Access Journals (Sweden)

    Jovanović Nebojša

    2013-01-01

    Full Text Available Introduction. Progress of labor in multiparous women usually is not accompanied with risk of any kind of birth trauma. Case Outline. We report a very rare case of rib fracture in a neonate during vaginal delivery in the 39/40 week of gestation. The expulsion started spontaneously without any manipulation from the obstetrician. Live male newborn was delivered 4650 g. in weight, 55 cm long, with head circumference of 39 cm, Apgar score 9. The child was immediately examined by the neonatologist. Crepitations were palpable over the left hemithorax, and auscultatory on the left side inspiratory cracks. Finding was suspicious for rib fracture on the left side posteriorly and brachial plexus palsy, while other findings were normal. X­ray finding was inconclusive, but suspicious for fracture of the 4th, 5th, and 6th left rib posteriorly, without dislocation of bone fragments. There were no signs of pneumothorax. Dorsal position of the newborn was considered sufficient, accompanied with analgetics. X­ray was scheduled in a week because formation of the calus would be the only objective sign of previous rib fracture. On the control X­ray fracture lines were clearly visible on the 3rd, 4th, 5th, 6th and 7th rib posteriorly, without dislocation of bone fragments with initial calus formation. The child was discharged from hospital in good condition after two weeks, for further outpatient care. Conclusion. With timely diagnostics of this very rare intrapartal fracture, adequate treatment, dorsal position and close control of clinical condition of the newborn, serious and potentially life threatening complications can be avoided.

  3. Rib Fractures: To Fix or Not to Fix? An Evidence-Based Algorithm

    Directory of Open Access Journals (Sweden)

    Michael Bemelman

    2017-08-01

    Full Text Available Rib fractures are a common injury resulting from blunt chest trauma. The most important complications associated with rib fractures include death, pneumonia, and the need for mechanical ventilation. The development of new osteosynthesis materials has stimulated increased interest in the surgical treatment of rib fractures. Surgical stabilisation, however, is not needed for every patient with rib fractures or for every patient with flail chest. This paper presents an easy-to-use evidence-based algorithm, developed by the authors, for the treatment of patients with flail chest and isolated rib fractures.

  4. Fixation of a human rib by an intramedullary telescoping splint anchored by bone cement.

    Science.gov (United States)

    Liovic, Petar; Šutalo, Ilija D; Marasco, Silvana F

    2016-09-01

    A novel concept for rib fixation is presented that involves the use of a bioresorbable polymer intramedullary telescoping splint. Bone cement is used to anchor each end of the splint inside the medullary canal on each side of the fracture site. In this manner, rib fixation is achieved without fixation device protrusion from the rib, making the splint completely intramedullary. Finite element analysis is used to demonstrate that such a splint/cement composite can preserve rib fixation subjected to cough-intensity force loadings. Computational fluid dynamics and porcine rib experiments were used to study the anchor formation process required to complete the fixation.

  5. Case report 357: Chordoma of the fourth lumbar vertebra metastasizing to the thoracic spine and ribs

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, I.F.; Zwass, A.; O' Leary, P.F.; Steiner, G.C.

    1986-03-01

    In summary a fascinating case is presented in a 54-year-old man who developed a chordoma of the fourth lumbar vertebra which was treated by radiotherapy, with good results. The man remained asymptomatic relatively for several years and then presented with recurrence of back pain and neurological deficits. Plain films, CT and myelography showed considerable destruction of the body of L4 with a sclerotic pattern suggesting the effects of previous radiotherapy. A large paraspinal tissue mass extending into the spinal canal was present. Most interestingly the patient developed metastatic disease in the thoracic spine and ribs but no metastases other than in the skeleton. (orig./SHA).

  6. Neutron activation analysis of calcium/phosphorus ratio in rib bone of healthy humans

    International Nuclear Information System (INIS)

    Tzaphlidou, Margaret; Zaichick, Vladimir

    2002-01-01

    The Ca/P ratio was estimated in intact rib bone samples from healthy humans, 37 women and 45 men, aged from 15 to 55 years using instrumental neutron activation analysis. No statistically significant differences (p>0.05) age- or sex-related differences in the Ca/P ratio were observed. The mean value (M±SD) for the investigated parameter for the whole group studied, 2.33±0.34, was within a very wide range of published data and close to the median value

  7. The value of multislice helical CT in the diagnosis of the rib micro-fracture

    International Nuclear Information System (INIS)

    Wang Shuli; Wang Linsen; Sun Dingyuan; Deng Xin; Geng Xin; Li Jian; Liu Zhigang; Guo Lin; Jia Zhihong

    2005-01-01

    Objective: To evaluate the clinical value of MSCT with thin-section reconstruction and curved multiplanar reformation of rib micro-fracture. Methods: Thirty-eight patients suspected ribs fracture by clinical examination, which had negative appearance in X-ray film, were performed with MSCT scan with thin-section reconstructed and curved multiplanar reformation. The imaging of 5 mm, 1 mm thickness and curved reformatted imags were analysed by three groups of radiologists respectively. Results: Of the 38 patients, 26 patients were demonstrated ribs fracture with 1 mm thin-section reconstructed and curved multiplanar reformatted CT imaging, which were classified as complete fracture in 18 ribs and incomplete fracture in 41 ribs. The ends of the fractures displacement located within a distance of double-thickness of the cortex of the complete ribs fracture. With 5 mm thickness imaging, the accuracy of the diagnosis was 86.4%, 89.8% and 94.9% by three groups radiologists, respectively. Conclusion: The rib fracture is very common in clinic, the incomplete and non evident displacement complete ribs fracture are difficult to be diagnosed by plain radiography. The MSCT can produce a large range volume information scan. Thin-section reconstructed and curved multiplanar reformatted imaging should be the effective method in diagnosis of ribs fracture. The total rib pattern and location, extend of all the ribs fracture in this cases can be displayed in one scan by the curved multiplanar reformatted imaging. (authors)

  8. Short-Rib Polydactyly and Jeune Syndromes Are Caused by Mutations in WDR60

    Science.gov (United States)

    McInerney-Leo, Aideen M.; Schmidts, Miriam; Cortés, Claudio R.; Leo, Paul J.; Gener, Blanca; Courtney, Andrew D.; Gardiner, Brooke; Harris, Jessica A.; Lu, Yeping; Marshall, Mhairi; Scambler, Peter J.; Beales, Philip L.; Brown, Matthew A.; Zankl, Andreas; Mitchison, Hannah M.; Duncan, Emma L.; Wicking, Carol

    2013-01-01

    Short-rib polydactyly syndromes (SRPS I–V) are a group of lethal congenital disorders characterized by shortening of the ribs and long bones, polydactyly, and a range of extraskeletal phenotypes. A number of other disorders in this grouping, including Jeune and Ellis-van Creveld syndromes, have an overlapping but generally milder phenotype. Collectively, these short-rib dysplasias (with or without polydactyly) share a common underlying defect in primary cilium function and form a subset of the ciliopathy disease spectrum. By using whole-exome capture and massive parallel sequencing of DNA from an affected Australian individual with SRPS type III, we detected two novel heterozygous mutations in WDR60, a relatively uncharacterized gene. These mutations segregated appropriately in the unaffected parents and another affected family member, confirming compound heterozygosity, and both were predicted to have a damaging effect on the protein. Analysis of an additional 54 skeletal ciliopathy exomes identified compound heterozygous mutations in WDR60 in a Spanish individual with Jeune syndrome of relatively mild presentation. Of note, these two families share one novel WDR60 missense mutation, although haplotype analysis suggested no shared ancestry. We further show that WDR60 localizes at the base of the primary cilium in wild-type human chondrocytes, and analysis of fibroblasts from affected individuals revealed a defect in ciliogenesis and aberrant accumulation of the GLI2 transcription factor at the centrosome or basal body in the absence of an obvious axoneme. These findings show that WDR60 mutations can cause skeletal ciliopathies and suggest a role for WDR60 in ciliogenesis. PMID:23910462

  9. Short-rib polydactyly and Jeune syndromes are caused by mutations in WDR60.

    Science.gov (United States)

    McInerney-Leo, Aideen M; Schmidts, Miriam; Cortés, Claudio R; Leo, Paul J; Gener, Blanca; Courtney, Andrew D; Gardiner, Brooke; Harris, Jessica A; Lu, Yeping; Marshall, Mhairi; Scambler, Peter J; Beales, Philip L; Brown, Matthew A; Zankl, Andreas; Mitchison, Hannah M; Duncan, Emma L; Wicking, Carol

    2013-09-05

    Short-rib polydactyly syndromes (SRPS I-V) are a group of lethal congenital disorders characterized by shortening of the ribs and long bones, polydactyly, and a range of extraskeletal phenotypes. A number of other disorders in this grouping, including Jeune and Ellis-van Creveld syndromes, have an overlapping but generally milder phenotype. Collectively, these short-rib dysplasias (with or without polydactyly) share a common underlying defect in primary cilium function and form a subset of the ciliopathy disease spectrum. By using whole-exome capture and massive parallel sequencing of DNA from an affected Australian individual with SRPS type III, we detected two novel heterozygous mutations in WDR60, a relatively uncharacterized gene. These mutations segregated appropriately in the unaffected parents and another affected family member, confirming compound heterozygosity, and both were predicted to have a damaging effect on the protein. Analysis of an additional 54 skeletal ciliopathy exomes identified compound heterozygous mutations in WDR60 in a Spanish individual with Jeune syndrome of relatively mild presentation. Of note, these two families share one novel WDR60 missense mutation, although haplotype analysis suggested no shared ancestry. We further show that WDR60 localizes at the base of the primary cilium in wild-type human chondrocytes, and analysis of fibroblasts from affected individuals revealed a defect in ciliogenesis and aberrant accumulation of the GLI2 transcription factor at the centrosome or basal body in the absence of an obvious axoneme. These findings show that WDR60 mutations can cause skeletal ciliopathies and suggest a role for WDR60 in ciliogenesis. Copyright © 2013 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  10. Topological and sizing optimization of reinforced ribs for a machining centre

    Science.gov (United States)

    Chen, T. Y.; Wang, C. B.

    2008-01-01

    The topology optimization technique is applied to improve rib designs of a machining centre. The ribs of the original design are eliminated and new ribs are generated by topology optimization in the same 3D design space containing the original ribs. Two-dimensional plate elements are used to replace the optimum rib topologies formed by 3D rectangular elements. After topology optimization, sizing optimization is used to determine the optimum thicknesses of the ribs. When forming the optimum design problem, multiple configurations of the structure are considered simultaneously. The objective is to minimize rib weight. Static constraints confine displacements of the cutting tool and the workpiece due to cutting forces and the heat generated by spindle bearings. The dynamic constraint requires the fundamental natural frequency of the structure to be greater than a given value in order to reduce dynamic deflection. Compared with the original design, the improvement resulting from this approach is significant.

  11. Less-invasive stabilization of rib fractures by intramedullary fixation: a biomechanical evaluation.

    Science.gov (United States)

    Bottlang, Michael; Helzel, Inga; Long, William; Fitzpatrick, Daniel; Madey, Steven

    2010-05-01

    This study evaluated intramedullary fixation of rib fractures with Kirschner wires and novel ribs splints. We hypothesized that rib splints can provide equivalent fixation strength while avoiding complications associated with Kirschner wires, namely wire migration and cutout. The durability, strength, and failure modes of rib fracture fixation with Kirschner wires and rib splints were evaluated in 22 paired human ribs. First, intact ribs were loaded to failure to determine their strength. After fracture fixation with Kirschner wires and rib splints, fixation constructs were dynamically loaded to 360,000 cycles at five times the respiratory load to determine their durability. Finally, constructs were loaded to failure to determine residual strength and failure modes. All constructs sustained dynamic loading without failure. Dynamic loading caused three times more subsidence in Kirschner wire constructs (1.2 mm +/- 1.4 mm) than in rib splint constructs (0.4 mm +/- 0.2 mm, p = 0.09). After dynamic loading, rib splint constructs remained 48% stronger than Kirschner wire constructs (p = 0.001). Five of 11 Kirschner wire constructs failed catastrophically by cutting through the medial cortex, leading to complete loss of stability and wire migration through the lateral cortex. The remaining six constructs failed by wire bending. Rib splint constructs failed by development of fracture lines along the superior and interior cortices. No splint construct failed catastrophically, and all splint constructs retained functional reduction and fixation. Because of their superior strength and absence of catastrophic failure mode, rib splints can serve as an attractive alternative to Kirschner wires for intramedullary stabilization of rib fractures, especially in the case of posterior rib fractures where access for plating is limited.

  12. Clinical and Radiologic Predictive Factors of Rib Fractures in Outpatients With Chest Pain.

    Science.gov (United States)

    Zhang, Liang; McMahon, Colm J; Shah, Samir; Wu, Jim S; Eisenberg, Ronald L; Kung, Justin W

    To identify the clinical and radiologic predictive factors of rib fractures in stable adult outpatients presenting with chest pain and to determine the utility of dedicated rib radiographs in this population of patients. Following Institutional Review Board approval, we performed a retrospective review of 339 consecutive cases in which a frontal chest radiograph and dedicated rib series had been obtained for chest pain in the outpatient setting. The frontal chest radiograph and dedicated rib series were sequentially reviewed in consensus by two fellowship-trained musculoskeletal radiologists blinded to the initial report. The consensus interpretation of the dedicated rib series was used as the gold standard. Multiple variable logistic regression analysis assessed clinical and radiological factors associated with rib fractures. Fisher exact test was used to assess differences in medical treatment between the 2 groups. Of the 339 patients, 53 (15.6%) had at least 1 rib fracture. Only 20 of the 53 (37.7%) patients' fractures could be identified on the frontal chest radiograph. The frontal chest radiograph had a sensitivity of 38% and specificity of 100% when using the rib series as the reference standard. No pneumothorax, new mediastinal widening or pulmonary contusion was identified. Multiple variable logistic regression analysis of clinical factors associated with the presence of rib fractures revealed a significant association of trauma history (odds ratio 5.7 [p rib fractures in this population demonstrated a significant association of pleural effusion with rib fractures (odds ratio 18.9 [p rib fractures received narcotic analgesia in 47.2% of the cases, significantly more than those without rib fractures (21.3%, p rib fractures have a higher association with a history of minor trauma and age ≥40 in the adult population. Radiographic findings associated with rib fractures include pleural effusion. The frontal chest radiograph alone has low sensitivity in

  13. Current merchandising practices and characteristics of beef wholesale rib usage in three U.S. cities.

    Science.gov (United States)

    Wulf, D M; Romans, J R; Costello, W J

    1994-01-01

    Packers/processors, supermarket meat managers, and restaurant meat purchasers were surveyed to determine industry utilization of the beef wholesale rib. Nine packer/processors representing > 52% of the U.S. steer-heifer slaughter reported that more than two-thirds (68.5%) of the ribs were wholesaled as ribeye, lip-on (IMPS 112A) subprimals and that its predominance in the market makes it the standard for pricing. For merchandising variations of this cut (e.g., ribeye, lip-off), packer prices are adjusted to lip-on bases according to the relative yield. Excess fat was the most common complaint about ribeye steaks, reported by 78% of the packer/processors. In particular, 71% of them reported the "kernel" fat near the center of a ribeye steak between the longissimus and spinalis dorsi muscles is quite difficult to trim out and represents the greatest problem in merchandising. Forty-two percent of supermarket meat managers and 58% of restaurant meat purchasers thought the fat content of beef ribeyes discouraged consumers from purchasing all beef. Kernel fat was specifically cited by 36% of the restaurateurs. Alternative merchandising strategies should be employed to minimize the negative value effects of kernel fat. Even with excess fat being a concern to approximately half of the beef rib buyers, most still bought lip-on ribeyes and trimmed excess fat away. Apparently, they made this choice of lower price per weight, even though price per trimmed serving might be similar to lip-off ribeyes. Excess fat is being transported from packer/processor to buyers in the form of lip-on ribeyes because of the price relationships.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Perinatally lethal short rib-polydactyly syndromes. Pt. 1

    International Nuclear Information System (INIS)

    Sillence, D.; Kozlowski, K.; Bar-ziv, J.; Fuhrmann-Rieger, A.; Fuhrmann, W.; Pascu, F.

    1987-01-01

    Thirteen newborns with lethal short rib-polydactyly (SRP) have been reviewed, 11 with SRP type 3 (Verma-Naumoff) and 2 with SRP tye 2 (Majewski). In the former group there were three sets of siblings. The excess of males with SRP type III (Verma-Naumoff) is confirmed in this present study. A high frequency of phenotypic females including sex-reversed constitutional males with SRP type 1 (Saldino-Noonan) is in marked contrast to these findings in SRP type 3. Possible hypotheses include variable expressivity in non-Majewski short rib-polydactyly syndromes with sex-reversed and constitutional female cases tending to show more severe phenotypic expression both in terms of major anomalies and skeletal dysplastic effects. (orig.)

  15. Nonepiphyseal Giant Cell Tumor of the Rib: A Case Report

    Directory of Open Access Journals (Sweden)

    Hippocrates Moschouris

    2012-01-01

    Full Text Available A case of a 32-year-old female patient with a giant cell tumor originating in the middle part of the left 10th rib is presented. On X-rays and CT, the tumor caused a well-defined osteolysis with nonsclerotic borders. On MRI, it exhibited intermediate signal intensity on T1 sequences and central high signal and peripheral intermediate signal on T2 sequences. On contrast-enhanced MR images both central and peripheral-periosteal enhancement was noted. Thanks to its small size ( cm, the lesion was easily resected en bloc with a part of the affected rib. The patient is free of recurrence for 3 years after the operation.

  16. [Comparison of clinical effectiveness of thoracic epidural and intravenous patient-controlled analgesia for the treatment of rib fractures pain in intensive care unit].

    Science.gov (United States)

    Topçu, Ismet; Ekici, Zeynep; Sakarya, Melek

    2007-07-01

    The results of thoracic epidural and systemic patient controlled analgesia practice were evaluated retrospectively in patients with thoracic trauma. Patients who were admitted to the intensive care unit between 1997 and 2003, with a diagnosis of multiple rib fractures related to thoracic trauma were evaluated retrospectively. Data were recorded from 49 patients who met the following criteria; three or more rib fractures, initiation of PCA with I.V. phentanyl or thoracic epidural analgesia with phentanyl and bupivacaine. There were no significant differences between the groups concerning injury severity score. APACHE II score (8.1+/-1.6 and 9.2+/-1.7) and the number of rib fractures (4+/-1.1 and 6.8+/-2.7) were higher in thoracic epidural analgesia group (pPain scores of patients who received thoracic epidural analgesia were significantly lower as from 6th hour during whole therapy (prib fractures who require intensive care.

  17. Flow separation on transversal ribs in an open channel

    Czech Academy of Sciences Publication Activity Database

    Příhoda, Jaromír; Šulc, J.; Sedlář, M.; Zubík, P.

    2009-01-01

    Roč. 13, - (2009), s. 218-220 ISSN 1335-2938. [Stretnutie katedier mechaniky tekutín a termomechaniky. Jasná, Demanovská dolina, 24.06.2009-26.06.2009] R&D Projects: GA ČR GA103/09/0977 Institutional research plan: CEZ:AV0Z20760514 Keywords : free-surface flow * supercritical flow over ribs * numerical and experimental modelling Subject RIV: BK - Fluid Dynamics

  18. Morbidity, mortality, associated injuries, and management of traumatic rib fractures

    OpenAIRE

    Frank Cheau-Feng Lin; Ruei-Yun Li; Yung-Wei Tung; Kee-Ching Jeng; Stella Chin-Shaw Tsai

    2016-01-01

    Background: Thoracic trauma is responsible for approximately 25% of trauma deaths, and rib fractures are present in as many as 40–80% of patients, and intensive care and/or ventilator support are frequently required for these patients. To identify their risk factors would improve treatment strategies for these patients. Methods: Between March 2005 and December 2013, consecutive patients with blunt thoracic trauma, who were admitted to the Department of Thoracic Surgery at Tungs' Taichung M...

  19. Primary multifocal tuberculous osteomyelitis with involvement of the ribs

    Energy Technology Data Exchange (ETDEWEB)

    Chang, D.S. [New York University School of Medicine, New York, New York (United States); Rafii, M.; McGuinness, G. [Department of Radiology, NYU Medical Center, New York, NY (United States); Jagirdar, J.S. [Department of Pathology, NYU Medical Center, New York, New York (United States)

    1998-11-01

    Two cases of primary multifocal tuberculous osteomyelitis with involvement of the rib cage are presented. The lungs were normal and the appearance of the skeletal lesions did not suggest tuberculosis. These lesions were predominantly lytic, with minimal soft tissue involvement. Tuberculosis should be high in the differential diagnosis of multiple destructive bone lesions, especially in patients from regions where tuberculosis is endemic. (orig.) With 5 figs., 21 refs.

  20. Influência do grupo genético, condição sexual e tratamento antiparasitário nas medidas de área de olho do lombo e espessura de gordura in vivo e na carcaça de bovinos de corte Influence of breed, gender condition, and anti-parasitic treatment on the measurements of in vivo rib eye area and fat thickness and on the carcass of beef cattle

    Directory of Open Access Journals (Sweden)

    R.M.K. Pinheiro

    2009-06-01

    Full Text Available Foram estudados 48 bovinos machos oriundos de inseminação artificial, criados em pasto, sendo 24 (12 Nelore e 12 F1 ½ Red Angus-Nelore tratados com antiparasitários alopáticos e 24 (mesmo número de puros e cruzados tratados com o antiparasitário bioterápico Fator C&MC. Os animais foram desmamados aos oito meses, metade de cada subgrupo genético (6 foi castrado aos 13 meses e todos abatidos aos 32 meses, com o objetivo de verificar a influência do tratamento antiparasitário, do grupo genético e da condição sexual sobre as medidas de área de olho de lombo (AOL e espessura de gordura de lombo (EGL. Usaram-se medidas de ultrassonografia no animal vivo (AOLU e EGLU e na carcaça, plástico quadriculado e paquímetro (AOLC e EGLC. Os animais F1, os inteiros e os tratados com alopatia apresentaram peso vivo maior quando comparados aos Nelores, castrados e tratados com bioterápicos. Não houve diferença da AOLU e AOLC entre os grupos genéticos. EGLC foi mais alta nos cruzados. Os animais inteiros apresentaram AOLU e AOLC maiores que os castrados, e EGLU e EGLC menores. Foram altamente significativos os coeficientes de correlação entre as medidas por ultrassom e na carcaça para área de olho de lombo (0,87 e espessura de gordura do lombo (0,95.Forty-eight male bovines, products of artificial insemination and raised on pasture, were studied, being 24 (12 Nelore, 12 F1 ½ Nelore ½ Red Angus treated with allopathic antiparasitic drugs and 24 (same number of pure and crossbred treated with a biotherapic antiparasitic drug Factor C&MC. Animals were weaned at eight months of age and half of each genetic subgroup (six was castrated at 13 months of age. All animals were slaughtered at 32 months of age, in an attempt to evaluate the influence of antiparasitic treatment, genetic group, and gender condition in the measurements of rib eye area (AOL and fat thickness (EGL of loin. Measurements of ultrasonography were used for live animals (AOLU

  1. Reduction of rib fractures with a bioresorbable plating system: preliminary observations.

    Science.gov (United States)

    Vu, Kim-Chi; Skourtis, Mia E; Gong, Xi; Zhou, Minhao; Ozaki, Wayne; Winn, Shelley R

    2008-05-01

    Operative fixation of rib fractures can reduce morbidity and mortality. Currently, resorbable fixation devices are used in a variety of surgical procedures. A standard osteotomy was prepared in 30 New Zealand white rabbits at the 12th rib. Eighteen had surgical repair with bioresorbable plates and 12 underwent nonoperative management. Half the animals in each group were killed at 3-week postfracture and the remaining animals were killed at 6-week postfracture. Ribs were radiographed and processed histologically to assess fracture healing. Rib reduction was defined as the alignment of the rib ends in a structural condition similar to the prefractured state and quantitative radiomorphometry measured the radiopaque callus surrounding the rib injury sites. Statistical analysis was performed using Fisher's exact test and an unpaired Student's t test and significance was established at p rib fractures remained reduced in the operative group, whereas zero of six and three of six of the rib fractures remained reduced, respectively, in the nonoperative group. A statistically significant increase in radiopaque callus surrounding the rib injury sites was observed at 3 and 6 weeks in the fixed groups. Fixation of rib fractures with a bioresorbable miniplate system was superior to nonoperative treatment at the 3-week interval, with a statistically significant increase in radiopaque callus formation at both 3 and 6 weeks. Additional studies will evaluate the biomechanical outcomes and degradation tissue response after extended in vivo intervals.

  2. Case report: clinical and postmortem findings in four cows with rib fracture.

    Science.gov (United States)

    Braun, Ueli; Warislohner, Sonja; Hetzel, Udo; Nuss, Karl

    2017-02-06

    Published reports of rib fractures in adult cattle are limited to the occurrence of chronic rib swellings caused by calluses, which are unremarkable from a clinical standpoint, whereas studies identifying clinical signs of rib fractures were not found in a literature search. This report describes the clinical and postmortem findings in four cows with rib fractures. The 13th rib was fractured in three cows and the 11th rib in the remaining cow; three fractures were on the right and one on the left side. Clinical and postmortem findings varied considerably, and percussion of the rib cage elicited a pain response in only one cow. One cow had generalised peritonitis because of perforation of the rumen by the fractured rib. One cow was recumbent because of pain and became a downer cow, and two other cows had bronchopneumonia, which was a sequel to osteomyelitis of the fracture site in one. In the absence of a history of trauma, the diagnosis of rib fracture based on clinical signs alone is difficult. Although rib fractures undoubtedly are very painful, the four cases described in this report suggest that they are difficult to diagnose in cattle because associated clinical signs are nonspecific.

  3. Retrospective Analysis of 513 Cases Diagnosed with Rib Fracture Secondary to Blunt Thorax Trauma

    Directory of Open Access Journals (Sweden)

    Serdar Ozkan

    2017-05-01

    Full Text Available Aim: This study aimed to analyze blunt chest trauma cases who were diagnosed with rib fracture and to examine the regional differences likely to appear in trauma cases and treatment approaches. Material and Method: 513 cases who applied to the Emergency Service and Department of Thoracic Surgery between October 2013 and December 2014 due to blunt trauma and were diagnosed with rib fracture were retrospectively examined. The cases were evaluated in terms of etiological factors, thoracic, and other system injuries accompanying the rib fracture, prognosis, and the treatments applied. Results: Isolated rib fracture was present in 266 of the cases. Thoracic organ injuries such as pneumothorax, hemothorax, hemopneumothorax, lung contusion, or laceration and sternal fracture accompanying the rib fracture were present in 247 of the cases. While one or two rib fractures were detected in 298 cases, six or more rib fractures were present in 28 cases. 78.2% of hemothorax cases, 85.3% of pneumothorax cases, 95.4% of hemopneumothorax cases, 81.8% of bilateral pneumothorax cases, 26% of bilateral hemothorax cases, and 71.4% of bilateral hemopneumothorax cases were treated by applying tube thoracostomy. 129 cases diagnosed with thoracic organ injury in addition to rib fracture but not subjected to surgical intervention, and 266 cases diagnosed with isolated rib fracture were discharged with full recovery after appropriate medical treatment. Discussion: Most of the rib fractures occurring due to blunt trauma are treated successfully with medical treatments and conservative approaches and do not need advanced surgical treatments.

  4. Surgical plate fixation of multiple rib fractures: a case report.

    Science.gov (United States)

    Mitev, Konstantin; Neziri, Dashurie; Stoicovski, Emil; Mitrev, Zan

    2018-05-29

    The healthcare system in developing countries is limited; particularly, medical specialties such as emergency and trauma medicine are underdeveloped. Consequently, trauma injuries sustained in traffic accidents result in chronic morbidity more often than similar cases in developed countries. Multiple rib fractures induce significant patient morbidity. Current international guidelines recommend a multidisciplinary, surgery-based treatment approach to achieve optimal clinical benefit. We admitted a 41-year-old Albanian man to our emergency department following a pedestrian-vehicle accident 5 days earlier. He presented with severe upper thoracic pain, chest deformity, dyspnea, tachycardia, subcutaneous emphysema, and hematoma. Chest radiography pointed to hypoventilated lung fields and a minor pleural effusion. Computed tomographic scans indicated displaced fractures of right lateral ribs 5 -11, hyperdensity regions from bone fragments, and pulmonary contusion. The treatment consisted of surgical fixation of ribs 7-10 using titanium reconstruction plates and cortical locking screws. The patient's clinical condition rapidly improved postoperatively. Follow-up at 6 weeks confirmed a full return to preoperative daily activities and a high quality of life. In this case report, we present a novel and promising development in the field of trauma medicine in the Republic of Macedonia. Trauma injuries can be treated via advanced multidisciplinary medical care according to international standards, allowing optimal health recovery.

  5. Stabilization of multiple rib fractures in a canine model.

    Science.gov (United States)

    Huang, Ke-Nan; Xu, Zhi-Fei; Sun, Ju-Xian; Ding, Xin-Yu; Wu, Bin; Li, Wei; Qin, Xiong; Tang, Hua

    2014-12-01

    Operative stabilization is frequently used in the clinical treatment of multiple rib fractures (MRF); however, no ideal material exists for use in this fixation. This study investigates a newly developed biodegradable plate system for the stabilization of MRF. Silk fiber-reinforced polycaprolactone (SF/PCL) plates were developed for rib fracture stabilization and studied using a canine flail chest model. Adult mongrel dogs were divided into three groups: one group received the SF/PCL plates, one group received standard clinical steel plates, and the final group did not undergo operative fracture stabilization (n = 6 for each group). Radiographic, mechanical, and histologic examination was performed to evaluate the effectiveness of the biodegradable material for the stabilization of the rib fractures. No nonunion and no infections were found when using SF-PCL plates. The fracture sites collapsed in the untreated control group, leading to obvious chest wall deformity not encountered in the two groups that underwent operative stabilization. Our experimental study shows that the SF/PCL plate has the biocompatibility and mechanical strength suitable for fixation of MRF and is potentially ideal for the treatment of these injuries. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Erector spinae plane block may aid weaning from mechanical ventilation in patients with multiple rib fractures: Case report of two cases

    Directory of Open Access Journals (Sweden)

    Amar Nandhakumar

    2018-01-01

    Full Text Available Uncontrolled pain in patients with rib fracture leads to atelectasis and impaired cough which can progress to pneumonia and respiratory failure necessitating mechanical ventilation. Of the various pain modalities, regional anaesthesia (epidural and paravertebral is better than systemic and oral analgesics. The erector spinae plane block (ESPB is a new modality in the armamentarium for the management of pain in multiple rib fractures, which is simple to perform and without major complications. We report a case series where ESPB helped in weaning the patients from mechanical ventilation. Further randomised controlled studies are warranted in comparing their efficacy in relation to other regional anaesthetic techniques.

  7. SU-E-T-322: Dosimetric Evaluation of Rib Dose in Peripheral Lung Tumors Treated with X-Ray Voxel Monte Carlo (XVMC) Based Lung Stereotactic Body Radiotherapy (SBRT) Following RTOG 0915 Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Pokhrel, D; Sood, S; Badkul, R; Jiang, H; Kumar, P; Wang, F [University of Kansas Hospital, Kansas City, KS (United States)

    2015-06-15

    Purpose: To evaluate XVMC computed rib doses for peripherally located non-small-cell-lung tumors treated with SBRT following RTOG-0915 guidelines. Methods: Twenty patients with solitary peripherally located non-small-cell-lung tumors were treated using XVMC-based SBRT to 50–54Gy in 5−3 fractions, respectively, for PTV(V100%)=95%. Based on 4D-CT, ITV was delineated on MaximumIP images and organs-at-risk(OARs) including ribs were contoured on MeanIP images. Mean PTV(ITV+5mm uniform margin) was 46.1±38.7cc (range, 11.1–163.0cc). XVMC SBRT treatment plans were generated with a combination of non-coplanar 3D-conformal arcs/beams, and were delivered by Novalis-TX consisting of HD-MLCs and a 6MV-SRS(1000MU/min) beam, following RTOG-0915 criteria. XVMC rib maximum dose and dose to <1cc, <5cc, <10cc were evaluated as a function of PTV, prescription dose and 3D-distance from tumor isocenter to the most proximal rib contour. Plans were re-computed using heterogeneity-corrected pencil-beam (PB-hete) algorithm utilizing identical beam geometry/MLC positions and MUs and subsequently compared to XVMC. Results: XVMC average maximum rib dose was 50.9±6.4Gy (range, 35.1–59.3Gy). XVMC mean rib dose to <1cc was 41.6±5.6Gy (range, 27.9–47.9Gy), <5cc was 31.2±7.3Gy (range, 10.6–43.1Gy), and <10cc was 21.2±8.7Gy (range, 1.1–36Gy), respectively. For the given prescription, correlation between PTV and rib doses to <5cc (p=0.005) and <10cc (p=0.018) was observed. 3D-distance from the tumor isocenter to the proximal rib contour strongly correlated with maximum rib dose (p=0.0001). PB-hete algorithm overestimated maximum rib dose and dose to <1cc, <5cc, and <10cc of ribs by 5%, 3%, 3%, and 3%, respectively. Conclusion: PB-hete overestimates ribs dose relative to XVMC. Since all the clinical XVMC plans were generated without compromising the target coverage (per RTOG-0915), almost all patient’s ribs doses were higher than the protocol guidelines. As expected, larger tumor

  8. SU-E-T-322: Dosimetric Evaluation of Rib Dose in Peripheral Lung Tumors Treated with X-Ray Voxel Monte Carlo (XVMC) Based Lung Stereotactic Body Radiotherapy (SBRT) Following RTOG 0915 Guidelines

    International Nuclear Information System (INIS)

    Pokhrel, D; Sood, S; Badkul, R; Jiang, H; Kumar, P; Wang, F

    2015-01-01

    Purpose: To evaluate XVMC computed rib doses for peripherally located non-small-cell-lung tumors treated with SBRT following RTOG-0915 guidelines. Methods: Twenty patients with solitary peripherally located non-small-cell-lung tumors were treated using XVMC-based SBRT to 50–54Gy in 5−3 fractions, respectively, for PTV(V100%)=95%. Based on 4D-CT, ITV was delineated on MaximumIP images and organs-at-risk(OARs) including ribs were contoured on MeanIP images. Mean PTV(ITV+5mm uniform margin) was 46.1±38.7cc (range, 11.1–163.0cc). XVMC SBRT treatment plans were generated with a combination of non-coplanar 3D-conformal arcs/beams, and were delivered by Novalis-TX consisting of HD-MLCs and a 6MV-SRS(1000MU/min) beam, following RTOG-0915 criteria. XVMC rib maximum dose and dose to <1cc, <5cc, <10cc were evaluated as a function of PTV, prescription dose and 3D-distance from tumor isocenter to the most proximal rib contour. Plans were re-computed using heterogeneity-corrected pencil-beam (PB-hete) algorithm utilizing identical beam geometry/MLC positions and MUs and subsequently compared to XVMC. Results: XVMC average maximum rib dose was 50.9±6.4Gy (range, 35.1–59.3Gy). XVMC mean rib dose to <1cc was 41.6±5.6Gy (range, 27.9–47.9Gy), <5cc was 31.2±7.3Gy (range, 10.6–43.1Gy), and <10cc was 21.2±8.7Gy (range, 1.1–36Gy), respectively. For the given prescription, correlation between PTV and rib doses to <5cc (p=0.005) and <10cc (p=0.018) was observed. 3D-distance from the tumor isocenter to the proximal rib contour strongly correlated with maximum rib dose (p=0.0001). PB-hete algorithm overestimated maximum rib dose and dose to <1cc, <5cc, and <10cc of ribs by 5%, 3%, 3%, and 3%, respectively. Conclusion: PB-hete overestimates ribs dose relative to XVMC. Since all the clinical XVMC plans were generated without compromising the target coverage (per RTOG-0915), almost all patient’s ribs doses were higher than the protocol guidelines. As expected, larger tumor

  9. Comparison of Organ Location, Morphology, and Rib Coverage of a Midsized Male in the Supine and Seated Positions

    Directory of Open Access Journals (Sweden)

    Ashley R. Hayes

    2013-01-01

    Full Text Available The location and morphology of abdominal organs due to postural changes have implications in the prediction of trauma via computational models. The purpose of this study is to use data from a multimodality image set to devise a method for examining changes in organ location, morphology, and rib coverage from the supine to seated postures. Medical images of a male volunteer (78.6±0.77 kg, 175 cm in three modalities (Computed Tomography, Magnetic Resonance Imaging (MRI, and Upright MRI were used. Through image segmentation and registration, an analysis between organs in each posture was conducted. For the organs analyzed (liver, spleen, and kidneys, location was found to vary between postures. Increases in rib coverage from the supine to seated posture were observed for the liver, with a 9.6% increase in a lateral projection and a 4.6% increase in a frontal projection. Rib coverage area was found to increase 11.7% for the spleen. Morphological changes in the organs were also observed. The liver expanded 7.8% cranially and compressed 3.4% and 5.2% in the anterior-posterior and medial-lateral directions, respectively. Similar trends were observed in the spleen and kidneys. These findings indicate that the posture of the subject has implications in computational human body model development.

  10. Reconstruction of iliac crest with rib to prevent donor site complications: A prospective study of 26 cases

    Directory of Open Access Journals (Sweden)

    Dave B

    2007-01-01

    Full Text Available Background: The tricortical bone graft from the iliac crest are used to reconstruct the post corpectomy spinal defects. The donor iliac area defect is large and may give rise to pain at donor site, instability of pelvis, fracture of ilium, donor site muscle herniation or abdominal content herniation. Rib removed during thoracotomy was used by us to reconstruct the iliac crest defect. Materials and Methods: Twenty-six patients who underwent thoracotomy for dorsal spine corpectomy or curettage for various spinal pathologies from June 2002 to May 2004 were included in the study. After adequate decompression the spine was reconstructed by tricortical bone graft from iliac crest and reconstruction of the iliac crest was done with the rib removed for exposure during thoracotomy. Results: The mean follow up was 15 months. All patients had good graft incorporation which was evaluated on the basis of local tenderness and radiographs. One patient had graft displacement. Conclusion: The reconstruction of iliac crest by rib is a simple and effective procedure to prevent donor site complications.

  11. Rib stress fracture in a male adaptive rower from the arms and shoulders sport class: case report.

    Science.gov (United States)

    Smoljanovic, Tomislav; Bojanic, Ivan; Pollock, Courtney L; Radonic, Radovan

    2011-10-15

    Adaptive rowing is rowing or sculling for rowers with a physical disability. It debuted at the Paralympic Games in 2008. In order to ensure an equitable playing field, rowers with similar levels of physical function and disability are classified into different sport classes for competition. Rowers with an inability to use a sliding seat and impaired trunk function resulting in an inability to perform trunk forward and backward lean via hip flexion/extension are assigned to the Arms and Shoulders (AS) class. AS rowers have to use a chest strap set immediately below the chest in order to localize any trunk movement in AS class. Conditions created by adaptations of rowing equipment and technique within the AS class create unique stresses on the upper thoracic region. The following case report demonstrates how etiology and management of a rib stress fracture in an AS rower differs in comparison to able-body rowers. Of significant importance were the limitations imposed on the rower's ability to maintain rowing-specific fitness, due to the nature of the rib stress fracture and requirement to decrease force transmission through the ribs for several weeks. The rower's gradual return to full training was further impacted by obligatory use of the chest strap, which directly applied pressure over the injured area. Protective orthosis for the chest was designed and applied in order to dissipate pressure of the chest strap over the thorax during rowing (most importantly at the catch position) both on the ergometer and in the boat.

  12. High prevalence of simultaneous rib and vertebral fractures in patients with hip fracture.

    Science.gov (United States)

    Lee, Bong-Gun; Sung, Yoon-Kyoung; Kim, Dam; Choi, Yun Young; Kim, Hunchul; Kim, Yeesuk

    2017-02-01

    The purpose was to evaluate the prevalence and location of simultaneous fracture using bone scans in patients with hip fracture and to determine the risk factors associated with simultaneous fracture. One hundred eighty two patients with hip fracture were reviewed for this study. Clinical parameters and bone mineral density (BMD) of the lumbar vertebra and femoral neck were investigated. To identify acute simultaneous fracture, a bone scan was performed at 15.4±4.1days after hip fracture. The prevalence and location of simultaneous fracture were evaluated, and multivariate logistic regression analysis was performed to determine the risk factors. Simultaneous fracture was observed in 102 of 182 patients, a prevalence of 56.0%. Rib fracture was the most common type of simultaneous fracture followed by rib with vertebral fracture. The BMD of the lumbar vertebra was significantly lower in patients with simultaneous fracture (p=0.044) and was identified as an independent risk factor (odds ratio: OR 0.05, 95% confidence interval: CI 0.01-0.57). The prevalence of simultaneous fracture was relatively high among patients with hip fracture, and BMD was significantly lower in patients with simultaneous fracture than in patients without it. Surgeons should be aware of the possibility of simultaneous fracture in patients with hip fracture. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. The Vertebral Column, Ribs, and Sternum of the African Giant Rat (Cricetomys gambianus Waterhouse)

    Science.gov (United States)

    Olude, Matthew Ayokunle; Mustapha, Oluwaseun Ahmed; Ogunbunmi, Temitope Kehinde; Olopade, James Olukayode

    2013-01-01

    Examined bones were obtained from eight adult African giant rats, Cricetomys gambianus Waterhouse. Animals used had an average body mass of 730.00 ± 41.91 gm and body length of 67.20 ± 0.05 cm. The vertebral formula was found to be C7, T13, L6, S4, Ca31–36. The lowest and highest points of the cervicothoracic curvature were at C5 and T2, respectively. The spinous process of the axis was the largest in the cervical group while others were sharp and pointed. The greatest diameter of the vertebral canal was at the atlas (0.8 cm) and the lowest at the caudal sacral bones (2 mm). The diameter of the vertebral foramen was the largest at C1 and the smallest at the S4; the foramina were negligibly indistinct caudal to the sacral vertebrae. There were 13 pairs of ribs. The first seven pairs were sternal, and six pairs were asternal of which the last 2-3 pairs were floating ribs. The sternum was composed of deltoid-shaped manubrium sterni, four sternebrae, and a slender processus xiphoideus. No sex-related differences were observed. The vertebral column is adapted for strong muscular attachment and actions helping the rodent suited for speed, agility, dexterity, and strength which might enable it to overpower prey and escape predation. PMID:24288518

  14. The Vertebral Column, Ribs, and Sternum of the African Giant Rat (Cricetomys gambianus Waterhouse

    Directory of Open Access Journals (Sweden)

    Matthew Ayokunle Olude

    2013-01-01

    Full Text Available Examined bones were obtained from eight adult African giant rats, Cricetomys gambianus Waterhouse. Animals used had an average body mass of 730.00±41.91 gm and body length of 67.20±0.05 cm. The vertebral formula was found to be C7, T13, L6, S4, Ca31–36. The lowest and highest points of the cervicothoracic curvature were at C5 and T2, respectively. The spinous process of the axis was the largest in the cervical group while others were sharp and pointed. The greatest diameter of the vertebral canal was at the atlas (0.8 cm and the lowest at the caudal sacral bones (2 mm. The diameter of the vertebral foramen was the largest at C1 and the smallest at the S4; the foramina were negligibly indistinct caudal to the sacral vertebrae. There were 13 pairs of ribs. The first seven pairs were sternal, and six pairs were asternal of which the last 2-3 pairs were floating ribs. The sternum was composed of deltoid-shaped manubrium sterni, four sternebrae, and a slender processus xiphoideus. No sex-related differences were observed. The vertebral column is adapted for strong muscular attachment and actions helping the rodent suited for speed, agility, dexterity, and strength which might enable it to overpower prey and escape predation.

  15. DMSA scan nomograms for renal length and area: Related to patient age and to body weight, height or surface area

    International Nuclear Information System (INIS)

    Hassan, I.M.; Que, L.; Rutland, M.D.

    2002-01-01

    Aim: To create nomograms for renal size as measured from DMSA renal studies, and to test the nomograms for their ability to separate normal from abnormal kidneys. Method: Renal length was measured from posterior oblique views and renal area from posterior views. Results from 253 patients with bilateral normal kidneys were used to create nomograms for renal size relative to patient age, body height, weight or body surface area (BSA). The nomograms enclosed 95% of the normal kidneys, thus indicating the range for 95% confidence limits, and hence the specificity. Each nomogram was then tested against 46 hypertrophied kidneys and 46 damaged kidneys. Results: The results from nomograms of renal length and renal area, compared to age, body height, body weight and BSA are presented. For each nomogram, the range is presented as a fraction of the mean value, and the number of abnormal kidneys (hypertrophied or damaged) outside the normal range is presented as a percentage (indicating the sensitivity). Conclusion: Renal Area was no better than renal length for detecting abnormal kidneys. Patient age was the least useful method of normalisation. BSA normalisation produced the best results most frequently (narrower ranges and highest detection of abnormal kidneys)

  16. Effect of Channel Orientation and Rib Pitch-to-Height Ratio on Pressure Drop in a Rotating Square Channel with Ribs on Two Opposite Surfaces

    Directory of Open Access Journals (Sweden)

    Prabhu S. V.

    2005-01-01

    Full Text Available The effect of channel orientation and rib pitch-to-height ratio on the pressure drop distribution in a rib-roughened channel is an important issue in turbine blade cooling. The present investigation is a study of the overall pressure drop distribution in a square cross-sectioned channel, with rib turbulators, rotating about an axis normal to the free stream. The ribs are configured in a symmetric arrangement on two opposite surfaces with a rib angle of 90 ∘ to the mainstream flow. The study has been conducted for three Reynolds numbers, namely, 13 000, 17 000, and 22 000 with the rotation number varying from 0– 0.38 . Experiments have been carried out for various rib pitch-to-height ratios ( P/e with a constant rib height-to-hydraulic diameter ratio ( e/D of 0.1 . The test section in which the ribs are placed on the leading and trailing surfaces is considered as the base case ( orientation angle= 0 ∘ , Coriolis force vector normal to the ribbed surfaces. The channel is turned about its axis in steps of 15 ∘ to vary the orientation angle from 0 ∘ to 90 ∘ . The overall pressure drop does not change considerably under conditions of rotation for the base case. However, for the other cases tested, it is observed that the overall pressure drop increases with an increase in the rotation number for a given orientation angle and also increases with an increase in the orientation angle for a given rotation number. This change is attributed to the variation in the separation zone downstream of the ribs due to the presence of the Coriolis force—local pressure drop data is presented which supports this idea. At an orientation angle of 90 ∘ (ribs on the top and bottom surfaces, Coriolis force vector normal to the smooth surfaces, the overall pressure drop is observed to be maximum during rotation. The overall pressure drop for a case with a rib pitch-to-height ratio of 5 on both surfaces is found to be the highest

  17. Experimental and numerical analysis of interlocking rib formation at sheet metal blanking

    Science.gov (United States)

    Bolka, Špela; Bratuš, Vitoslav; Starman, Bojan; Mole, Nikolaj

    2018-05-01

    Cores for electrical motors are typically produced by blanking of laminations and then stacking them together, with, for instance, interlocking ribs or welding. Strict geometrical tolerances, both on the lamination and on the stack, combined with complex part geometry and harder steel strip material, call for use of predictive methods to optimize the process before actual blanking to reduce the costs and speed up the process. One of the major influences on the final stack geometry is the quality of the interlocking ribs. A rib is formed in one step and joined with the rib of the preceding lamination in the next. The quality of the joint determines the firmness of the stack and also influences its. The geometrical and positional accuracy is thus crucial in rib formation process. In this study, a complex experimental and numerical analysis of interlocking rib formation has been performed. The aim of the analysis is to numerically predict the shape of the rib in order to perform a numerical simulation of the stack formation in the next step of the process. A detailed experimental research has been performed in order to characterize influential parameters on the rib formation and the geometry of the ribs itself, using classical and 3D laser microscopy. The formation of the interlocking rib is then simulated using Abaqus Explicit. The Hilll 48 constitutive material model is based on extensive and novel material characterization process, combining data from in-plane and out-of-plane material tests to perform a 3D analysis of both, rib formation and rib joining. The study shows good correlation between the experimental and numerical results.

  18. A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

    Directory of Open Access Journals (Sweden)

    Gultekin Gulbahar

    2015-01-01

    Full Text Available First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

  19. A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

    OpenAIRE

    Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar

    2015-01-01

    First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare en...

  20. A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures.

    Science.gov (United States)

    Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar

    2015-01-01

    First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

  1. Association of Ipsilateral Rib Fractures With Displacement of Midshaft Clavicle Fractures.

    Science.gov (United States)

    Stahl, Daniel; Ellington, Matthew; Brennan, Kindyle; Brennan, Michael

    2017-04-01

    To determine whether the presence of ipsilateral rib fractures affects the rate of a clavicle fracture being unstable (>100% displacement). A retrospective review from 2002-2013 performed at a single level 1 trauma center evaluated 243 midshaft clavicle fractures. Single Level 1 trauma center. These fractures were subdivided into those with ipsilateral rib fractures (CIR; n = 149) and those without ipsilateral rib fractures (CnIR; n = 94). The amount of displacement was measured on the initial injury radiograph and subsequent follow-up radiographs. Fractures were classified into either 100% displacement, based on anteroposterior radiographs. Ipsilateral rib fractures were recorded based on which number rib was fractured and the total number of fractured ribs. One hundred sixteen (78%) of the CIR group and 51 (54%) of the CnIR group were found to have >100% displacement at follow-up (P = 0.0047). Seventy-two percent of the CIR group demonstrated progression from 100% displacement of the fracture compared with only 54% of the CnIR group (P fracture to >100% was 4.08 (P = 0.000194) when ribs 1-4 were fractured and not significant for rib fractures 5-8 or 9-12. The presence of concomitant ipsilateral rib fractures significantly increases the rate of midshaft clavicle fractures being >100% displaced. In addition, a fracture involving the upper one-third of the ribs significantly increases the rate of the clavicle fracture being >100% displaced on early follow-up. Clavicle fractures with associated ipsilateral rib fractures tend to demonstrate an increased amount of displacement on follow-up radiographs compared with those without ipsilateral rib fractures. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

  2. Safety-related site characteristics - a relative comparison of the Forsmark reference areas

    International Nuclear Information System (INIS)

    Winberg, Anders

    2010-12-01

    SKB has over the years from 2002 to 2008 conducted site investigations in Forsmark and Laxemar, with associated site modeling, design and safety analysis. In mid-2009 Forsmark was selected on the basis of analysis made as site for a future repository for spent nuclear fuel. Based on defined safety-related geoscientific location factors data from Forsmark are compared in relative terms with data from a number of locations in Sweden, previously studied by SKB. The factors compared include: the rock's composition and structures, future climate evolution, rock mechanical conditions, earthquakes, groundwater flow, groundwater composition, delay of solutes, and the ability to characterize and describe the location. Past comparisons of these properties for the selected sites show that none of these sites collectively show any significant benefit over Forsmark site for a repository. This does not preclude that there may be places on the basis of an overall assessment of geoscientific location factors could be equivalent to Forsmark

  3. Successful management of threatened aortic rupture late after rib fracture caused by blunt chest trauma.

    Science.gov (United States)

    Morimoto, Yoshihisa; Sugimoto, Takaki; Sakahira, Hideki; Matsuoka, Hidehito; Yoshioka, Yuki; Arase, Hiroki

    2014-05-01

    A 62-year-old man was crushed in a car accident and diagnosed with a fractured left ninth rib, pulmonary and heart contusion, hemopneumothorax, and descending aortic injury based on a computed tomography scan. He underwent chest tube drainage and was intubated for mechanical ventilation because a bone fragment of the ninth rib threatened to penetrate the descending aorta. On the second posttrauma day, computed tomography showed the bone fragment of the ninth rib approaching the descending aorta. He underwent graft replacement of the injured portion of the descending thoracic aorta, and we removed the fractured left ninth rib. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Rib fractures after chest physiotherapy for bronchiolitis or pneumonia in infants

    Energy Technology Data Exchange (ETDEWEB)

    Chalumeau, Martin [Service de Pneumologie et d' Allergologie Pediatriques, Hopital Necker-Enfants Malades, Paris (France); Service de Pediatrie, Hopital Saint-Vincent-de-Paul, Paris (France); Foix-l' Helias, Laurence; Scheinmann, Pierre; Zuani, Pierre [Service de Pneumologie et d' Allergologie Pediatriques, Hopital Necker-Enfants Malades, Paris (France); Gendrel, Dominique [Service de Pediatrie, Hopital Saint-Vincent-de-Paul, Paris (France); Ducou-le-Pointe, Hubert [Service de Radiologie, Hopital d' Enfants Armand-Trousseau, Avenue du Docteur Arnold Netter, 75571 Paris Cedex 12 (France)

    2002-09-01

    Heading AbstractBackground. The reported causes of rib fractures in infants are: child abuse, accidental injury, cardiopulmonary resuscitation, bone fragility, birth trauma and severe cough.Objective. To report chest physiotherapy (CPT) as a new cause of rib fractures in five infants.Materials and methods. We retrospectively identified all infants with rib fractures after CPT for bronchiolitis or pneumonia over a 4-year period in two paediatric and one paediatric radiology units in three university hospitals in Paris.Results. Five boys were identified. Their median age was 3 months. None had any other potential cause of rib fractures. The indication for CPT was bronchiolitis in four cases and pneumonia in one. The median number of rib fractures was four (range 1-5). Fractures were located between the 3rd and 8th ribs; they were lateral in four patients and posterior in one; they were unilateral in four patients and bilateral in one. Evolution was favourable in all cases. The prevalence of rib fractures after CPT during the study period was estimated at 1 in 1,000 infants hospitalised for bronchiolitis or pneumonia.Conclusions. CPT should be considered a potential, but very rare cause of rib fractures in infants. It can be of clinical relevance when rib fractures are the only feature suggestive of child abuse. (orig.)

  5. Rib fractures after chest physiotherapy for bronchiolitis or pneumonia in infants

    International Nuclear Information System (INIS)

    Chalumeau, Martin; Foix-l'Helias, Laurence; Scheinmann, Pierre; Zuani, Pierre; Gendrel, Dominique; Ducou-le-Pointe, Hubert

    2002-01-01

    Heading AbstractBackground. The reported causes of rib fractures in infants are: child abuse, accidental injury, cardiopulmonary resuscitation, bone fragility, birth trauma and severe cough.Objective. To report chest physiotherapy (CPT) as a new cause of rib fractures in five infants.Materials and methods. We retrospectively identified all infants with rib fractures after CPT for bronchiolitis or pneumonia over a 4-year period in two paediatric and one paediatric radiology units in three university hospitals in Paris.Results. Five boys were identified. Their median age was 3 months. None had any other potential cause of rib fractures. The indication for CPT was bronchiolitis in four cases and pneumonia in one. The median number of rib fractures was four (range 1-5). Fractures were located between the 3rd and 8th ribs; they were lateral in four patients and posterior in one; they were unilateral in four patients and bilateral in one. Evolution was favourable in all cases. The prevalence of rib fractures after CPT during the study period was estimated at 1 in 1,000 infants hospitalised for bronchiolitis or pneumonia.Conclusions. CPT should be considered a potential, but very rare cause of rib fractures in infants. It can be of clinical relevance when rib fractures are the only feature suggestive of child abuse. (orig.)

  6. Rib fractures: comparison of associated injuries between pediatric and adult population.

    Science.gov (United States)

    Kessel, Boris; Dagan, Jasmin; Swaid, Forat; Ashkenazi, Itamar; Olsha, Oded; Peleg, Kobi; Givon, Adi; Alfici, Ricardo

    2014-11-01

    Rib fractures are considered a marker of exposure to significant traumatic energy. In children, because of high elasticity of the chest wall, higher energy levels are necessary for ribs to fracture. The purpose of this study was to analyze patterns of associated injuries in children as compared with adults, all of whom presented with rib fractures. A retrospective cohort study involving blunt trauma patients with rib fractures registered in the National Trauma Registry was conducted. Of 6,995 trauma victims who were found to suffer from rib fractures, 328 were children and 6,627 were adults. Isolated rib fractures without associated injuries occurred in 19 children (5.8%) and 731 adults (11%). More adults had 4 or more fractured ribs compared with children (P pneumothorax (P = .006), spleen, and liver injury (P < .001). Mortality rate was 5% in both groups. The incidence of associated head, thoracic, and abdominal solid organ injuries in children was significantly higher than in adults suffering from rib fractures. In spite of a higher Injury Severity Score and incidence of associated injuries, mortality rate was similar. Mortality of rib fracture patients was mostly affected by the presence of extrathoracic injuries. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Cutoff-mesa isolated rib optical waveguide for III-V heterostructure photonic integrated circuits

    Science.gov (United States)

    Vawter, G.A.; Smith, R.E.

    1998-04-28

    A cutoff mesa rib waveguide provides single-mode performance regardless of any deep etches that might be used for electrical isolation between integrated electrooptic devices. Utilizing a principle of a cutoff slab waveguide with an asymmetrical refractive index profile, single mode operation is achievable with a wide range of rib widths and does not require demanding etch depth tolerances. This new waveguide design eliminates reflection effects, or self-interference, commonly seen when conventional rib waveguides are combined with deep isolation etches and thereby reduces high order mode propagation and crosstalk compared to the conventional rib waveguides. 7 figs.

  8. Surgical treatment of multiple rib fractures and flail chest in trauma: a one-year follow-up study.

    Science.gov (United States)

    Caragounis, Eva-Corina; Fagevik Olsén, Monika; Pazooki, David; Granhed, Hans

    2016-01-01

    Multiple rib fractures and unstable thoracic cage injuries are common in blunt trauma. Surgical management of rib fractures has received increasing attention in recent years and the aim of this 1-year, prospective study was to assess the long-term effects of surgery. Fifty-four trauma patients with median Injury Severity Score 20 (9-66) and median New Injury Severity Score 34 (16-66) who presented with multiple rib fractures and flail chest, and underwent surgical stabilization with plate fixation were recruited. Patients responded to a standardized questionnaire concerning pain, local discomfort, breathlessness and use of analgesics and health-related quality of life (EQ-5D-3 L) questionnaire at 6 weeks, 3 months, 6 months and 1 year. Lung function, breathing movements, range of motion and physical function were measured at 3 months, 6 months and 1 year. Symptoms associated with pain, breathlessness and use of analgesics significantly decreased from 6 weeks to 1 year following surgery. After 1 year, 13 % of patients complained of pain at rest, 47 % had local discomfort and 9 % used analgesics. The EQ-5D-3 L index increased from 0.78 to 0.93 and perceived overall health state increased from 60 to 90 % (p rib fractures and flail chest show a gradual improvement in symptoms associated with pain, quality of life, mobility, disability and lung function over 1 year post surgery. Therefore, the final outcome of surgery cannot be assessed before 1 year post-operatively.

  9. Visitation to Natural Areas on Campus and Its Relation to Place Identity and Environmentally Responsible Behaviors

    Science.gov (United States)

    Lawrence, Eva K.

    2012-01-01

    This study examined college students' visits to natural areas on campus and how these visits relate to place identity and environmentally responsible behaviors. The majority (76.5%) of the 115 participants visited the natural areas, and 55.7% of these students visited for a course requirement. Students who lived on campus, were younger, and…

  10. The applicability of Relative Floristic Resemblance to evaluate the conservation value of protected areas.

    NARCIS (Netherlands)

    Wieringa, J.J.; Sosef, M.S.M.

    2011-01-01

    s – It is important to know the contribution of a protected area to global conservation. A new method called ‘Relative Floristic Resemblance’ that uses databased and georeferenced herbarium specimens, is introduced. Its usefulness and applicability to assess the conservation value of protected areas

  11. Analytical relation between effective mode field area and waveguide dispersion in microstructure fibers.

    Science.gov (United States)

    Moenster, Mathias; Steinmeyer, Günter; Iliew, Rumen; Lederer, Falk; Petermann, Klaus

    2006-11-15

    For optical fibers exhibiting a radially symmetric refractive index profile, there exists an analytical relation that connects waveguide dispersion and the Petermann-II mode field radius. We extend the usefulness of this relation to the nonradially symmetric case of microstructure fibers in the anomalous dispersion regime, yielding a simple relation between dispersion and effective mode field area. Assuming a Gaussian mode distribution, we derive a fundamental upper limit for the effective mode field area that is required to obtain a certain amount of anomalous waveguide dispersion. This relation is demonstrated to show excellent agreement for fiber designs suited for supercontinuum generation and soliton lasers in the near infrared.

  12. Rib plating of acute and sub-acute non-union rib fractures in an adult with cystic fibrosis: a case report.

    Science.gov (United States)

    Dean, Nathan C; Van Boerum, Don H; Liou, Theodore G

    2014-10-01

    Rib fractures associated with osteoporosis have been reported to occur ten times more frequently in adults with cystic fibrosis. Fractures cause chest pain, and interfere with cough and sputum clearance leading to worsened lung function and acute exacerbations which are the two main contributors to early mortality in cystic fibrosis. Usual treatment involves analgesics and time for healing; however considerable pain and disability result due to constant re-injury from chronic repetitive cough. Recently, surgical plating of rib fractures has become commonplace in treating acute, traumatic chest injuries. We describe here successful surgical plating in a White cystic fibrosis patient with multiple, non-traumatic rib fractures. A-37-year old White male with cystic fibrosis was readmitted to Intermountain Medical Center for a pulmonary exacerbation. He had developed localized rib pain while coughing 2 months earlier, with worsening just prior to hospital admission in conjunction with a "pop" in the same location while bending over. A chest computerized tomography scan at admission demonstrated an acute 5th rib fracture and chronic non-united 6th and 7th right rib fractures. An epidural catheter was placed both for analgesia and to make secretion clearance possible in preparation for the surgery performed 2 days later. Under general anesthesia, he had open reduction and internal fixation of the right 5th, 6th and 7th rib fractures with a Synthes Matrix rib set. After several days of increased oxygen requirements, fever, fluid retention, and borderline vital signs, he stabilized. Numerical pain rating scores from his ribs were lower post-operatively and he was able to tolerate chest physical therapy and vigorous coughing. In our case report, rib plating with bone grafting improved rib pain and allowed healing of the fractures and recovery, although the immediate post-op period required close attention and care. We believe repair may be of benefit in selected cystic

  13. FEATURES OF WELDED TITANIUM STRUCTURE ELEMENT DESTRUCTION (RIBBED PANELS UNDER VIBRATION LOADS

    Directory of Open Access Journals (Sweden)

    Mr. Pavel V. Bakhmatov

    2016-12-01

    Full Text Available The article presents data on the experimental studies results of welded ribbed panel vibration load of the BT-20 titanium alloy. It was established that in the areas of attachment, there is elevated dynamic alternating stress, which in combination with the "hard" of the sample holder creates favorable conditions for the emergence and development of fatigue cracks, and stress concentrators greatly reduce the time before the formation of the hearth destruction. An exception in these zones of superficial defects do not affect the nature and kinetics of destruction. Construction of titanium alloys made in the application of gas-laser cutting blanks for optimal regimes in the technical environment of nitrogen and subsequent heat treatment on vibration reliability is not inferior to design, made by traditional technology.

  14. Bilateral First Rib Stress Fractures in a Basketball Player

    Directory of Open Access Journals (Sweden)

    Abidin (Radyoloji Kilincer

    2016-04-01

    Full Text Available I read the article published by Aydogdu et al with a great interest. I congratulate them for this successfully written case report. Additionally, I want to focus an important point about the case they presented is that the diagnosis in that case is likely stress fracture. It is understood from the text and title that they avoided to make a diagnosis of stress fracture in the case, despite of history of lifting heavy weights for three days. And also I decided to mention through this article to an example of our case with bilateral first rib old fractures.

  15. Nd:Ta2O5 rib waveguide lasers

    International Nuclear Information System (INIS)

    Unal, Bayram; Tai, C.-Y.; Shepherd, David P.; Wilkinson, James S.; Perney, Nicolas M.B.; Netti, M. Caterina; Parker, Gregory J.

    2005-01-01

    Ta 2 O 5 waveguides offer great potential for high-density active photonic crystal circuits and their combination with rare-earth dopants for active devices is of interest for increasing their potential functionality. To this end, neodymium-doped Ta 2 O 5 rib waveguide lasers have been fabricated on an oxidized silicon wafer by rf sputtering and argon ion-beam milling and laser action in this material has been demonstrated. Lasing was observed at wavelenghts between 1060 and 1080 nm and an absorbed pump power threshold of 87 mW was obtained

  16. Free spectral range adjustment of a silicon rib racetrack resonator

    International Nuclear Information System (INIS)

    Keča, T; Matavulj, P; Headley, W; Mashanovich, G

    2012-01-01

    One of the most important parameters that describe the quality of photonic components and devices is the free spectral range (FSR). In this paper, the measured outgoing power of a silicon rib racetrack resonator was compared with calculated transfer functions derived by coupled mode theory. The influence of geometric parameters on the FSR and resonant wavelength has been investigated. By altering the values of the coupling length and racetrack radius, derived transfer functions were adjusted to match experimental data. This procedure gives the possibility of estimating the FSR and resonant wavelength for different geometric parameters and predicting resonator functionality.

  17. Variability of in vivo linear microcrack accumulation in the cortex of elderly human ribs

    Directory of Open Access Journals (Sweden)

    Amanda M. Agnew

    2017-06-01

    Full Text Available Excessive accumulation of microdamage in the skeleton in vivo is believed to contribute to fragility and risk of fracture, particularly in the elderly. Current knowledge of how much in vivo damage accrual varies between individuals, if at all, is lacking. In this study, paired sixth ribs from five male and five female elderly individuals (76–92 years, mean age = 84.7 years were examined using en bloc staining and fluorescent microcopy to quantify linear microcracks present at the time of death (i.e. in vivo microdamage. Crack number, crack length, crack density, and crack surface density were measured for each complete cross-section, with densities calculated using the variable of bone area (which accounts for the influence of porosity on the cortex, unlike the more frequently used cortical area, and analyzed using a two-way mixed model analysis of variance. Results indicate that while microcracks between individuals differ significantly, differences between the left and right corresponding pairs within individuals and the pleural and cutaneous cortices within each rib did not. These results suggest that systemic influences, such as differential metabolic activity, affect the accumulation of linear microcracks. Furthermore, variation in remodeling rates between individuals may be a major factor contributing to differential fracture risk in the elderly. Future work should expand to include a wider age range to examine differences in in vivo microdamage accumulation across the lifespan, as well as considering the influence of bisphosphonates on microdamage accumulation in the context of compromised remodeling rates in the elderly.

  18. Relative risk of visceral leishmaniasis in Brazil: a spatial analysis in urban area.

    Directory of Open Access Journals (Sweden)

    Valdelaine Etelvina Miranda de Araújo

    2013-11-01

    Full Text Available BACKGROUND: Visceral leishmaniasis (VL is a vector-borne disease whose factors involved in transmission are poorly understood, especially in more urban and densely populated counties. In Brazil, the VL urbanization is a challenge for the control program. The goals were to identify the greater risk areas for human VL and the risk factors involved in transmission. METHODOLOGY: This is an ecological study on the relative risk of human VL. Spatial units of analysis were the coverage areas of the Basic Health Units (146 small-areas of Belo Horizonte, Minas Gerais State, Brazil. Human VL cases, from 2007 to 2009 (n = 412, were obtained in the Brazilian Reportable Disease Information System. Bayesian approach was used to model the relative risk of VL including potential risk factors involved in transmission (canine infection, socioeconomic and environmental features and to identify the small-areas of greater risk to human VL. PRINCIPAL FINDINGS: The relative risk of VL was shown to be correlated with income, education, and the number of infected dogs per inhabitants. The estimates of relative risk of VL were higher than 1.0 in 54% of the areas (79/146. The spatial modeling highlighted 14 areas with the highest relative risk of VL and 12 of them are concentrated in the northern region of the city. CONCLUSIONS: The spatial analysis used in this study is useful for the identification of small-areas according to risk of human VL and presents operational applicability in control and surveillance program in an urban environment with an unequal spatial distribution of the disease. Thus the frequent monitoring of relative risk of human VL in small-areas is important to direct and prioritize the actions of the control program in urban environment, especially in big cities.

  19. Restoration thinning and influence of tree size and leaf area to sapwood area ratio on water relations of Pinus ponderosa.

    Science.gov (United States)

    Simonin, K; Kolb, T E; Montes-Helu, M; Koch, G W

    2006-04-01

    Ponderosa pine (Pinus ponderosa Dougl. ex P. Laws) forest stand density has increased significantly over the last century (Covington et al. 1997). To understand the effect of increased intraspecific competition, tree size (height and diameter at breast height (DBH)) and leaf area to sapwood area ratio (A(L):A(S)) on water relations, we compared hydraulic conductance from soil to leaf (kl) and transpiration per unit leaf area (Q(L)) of ponderosa pine trees in an unthinned plot to trees in a thinned plot in the first and second years after thinning in a dense Arizona forest. We calculated kl and Q(L) based on whole- tree sap flux measured with heat dissipation sensors. Thinning increased tree predawn water potential within two weeks of treatment. Effects of thinning on kl and Q(L) depended on DBH, A(L):A(S) and drought severity. During severe drought in the first growing season after thinning, kl and Q(L) of trees with low A(L):A(S) (160-250 mm DBH; 9-11 m height) were lower in the thinned plot than the unthinned plot, suggesting a reduction in stomatal conductance (g(s)) or reduced sapwood specific conductivity (K(S)), or both, in response to thinning. In contrast kl and Q(L) were similar in the thinned plot and unthinned plot for trees with high A(L):A(S) (260-360 mm DBH; 13-16 m height). During non-drought periods, kl and Q(L) were greater in the thinned plot than in the unthinned plot for all but the largest trees. Contrary to previous studies of ponderosa pine, A(L):A(S) was positively correlated with tree height and DBH. Furthermore, kl and Q(L) showed a weak negative correlation with tree height and a strong negative correlation with A(S) and thus A(L):A(S) in both the thinned and unthinned plots, suggesting that trees with high A(L):A(S) had lower g(s). Our results highlight the important influence of stand competitive environment on tree-size-related variation in A(L):A(S) and the roles of A(L):A(S) and drought on whole-tree water relations in response to

  20. Management of mining-related damages in abandoned underground coal mine areas using GIS

    International Nuclear Information System (INIS)

    Lee, U.J.; Kim, J.A.; Kim, S.S.; Kim, W.K.; Yoon, S.H.; Choi, J.K.

    2005-01-01

    The mining-related damages such as ground subsidence, acid mine drainage (AMD), and deforestation in the abandoned underground coal mine areas become an object of public concern. Therefore, the system to manage the mining-related damages is needed for the effective drive of rehabilitation activities. The management system for Abandoned Underground Coal Mine using GIS includes the database about mining record and information associated with the mining-related damages and application programs to support mine damage prevention business. Also, this system would support decision-making policy for rehabilitation and provide basic geological data for regional construction works in abandoned underground coal mine areas. (authors)

  1. Entropy function and universality of entropy-area relation for small black holes

    International Nuclear Information System (INIS)

    Cai Ronggen; Chen, C.-M.; Maeda, Kei-ichi; Ohta, Nobuyoshi; Pang Dawei

    2008-01-01

    We discuss the entropy-area relation for the small black holes with higher curvature corrections by using the entropy function formalism and field redefinition method. We show that the entropy S BH of the small black hole is proportional to its horizon area A. In particular, we find a universal result that S BH =A/2G, the ratio is 2 times of Bekenstein-Hawking entropy-area formula in many cases of physical interest. In four dimensions, the universal relation is always true irrespective of the coefficients of the higher-order terms if the dilaton couplings are the same, which is the case for string effective theory, while in five dimensions, the relation again holds irrespective of the overall coefficient if the higher-order corrections are in the GB combination. We also discuss how this result generalizes to known physically interesting cases with Lovelock correction terms in various dimensions, and possible implications of the universal relation.

  2. An evolutionary attractor model for sapwood cross section in relation to leaf area.

    Science.gov (United States)

    Westoby, Mark; Cornwell, William K; Falster, Daniel S

    2012-06-21

    Sapwood cross-sectional area per unit leaf area (SA:LA) is an influential trait that plants coordinate with physical environment and with other traits. We develop theory for SA:LA and also for root surface area per leaf area (RA:LA) on the premise that plants maximizing the surplus of revenue over costs should have competitive advantage. SA:LA is predicted to increase in water-relations environments that reduce photosynthetic revenue, including low soil water potential, high water vapor pressure deficit (VPD), and low atmospheric CO(2). Because sapwood has costs, SA:LA adjustment does not completely offset difficult water relations. Where sapwood costs are large, as in tall plants, optimal SA:LA may actually decline with (say) high VPD. Large soil-to-root resistance caps the benefits that can be obtained from increasing SA:LA. Where a plant can adjust water-absorbing surface area of root per leaf area (RA:LA) as well as SA:LA, optimal RA:SA is not affected by VPD, CO(2) or plant height. If selection favours increased height more so than increased revenue-minus-cost, then height is predicted to rise substantially under improved water-relations environments such as high-CO(2) atmospheres. Evolutionary-attractor theory for SA:LA and RA:LA complements models that take whole-plant conductivity per leaf area as a parameter. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. The RIB production target for the SPES project

    Science.gov (United States)

    Monetti, Alberto; Andrighetto, Alberto; Petrovich, Carlo; Manzolaro, Mattia; Corradetti, Stefano; Scarpa, Daniele; Rossetto, Francesco; Martinez Dominguez, Fernando; Vasquez, Jesus; Rossignoli, Massimo; Calderolla, Michele; Silingardi, Roberto; Mozzi, Aldo; Borgna, Francesca; Vivian, Gianluca; Boratto, Enrico; Ballan, Michele; Prete, Gianfranco; Meneghetti, Giovanni

    2015-10-01

    Facilities making use of the Isotope Separator On-Line (ISOL) method for the production of Radioactive Ion Beams (RIB) attract interest because they can be used for nuclear structure and reaction studies, astrophysics research and interdisciplinary applications. The ISOL technique is based on the fast release of the nuclear reaction products from the chosen target material together with their ionization into short-lived nuclei beams. Within this context, the SPES (Selective Production of Exotic Species) facility is now under construction in Italy at INFN-LNL (Istituto Nazionale di Fisica Nucleare — Laboratori Nazionali di Legnaro). The SPES facility will produce RIBs mainly from n-rich isotopes obtained by a 40 MeV cyclotron proton beam (200 μA) directly impinging on a uranium carbide multi-foil fission target. The aim of this work is to describe and update, from a comprehensive point of view, the most important results obtained by the analysis of the on-line behavior of the SPES production target assembly. In particular an improved target configuration has been studied by comparing different codes and physics models: the thermal analyses and the isotope production are re-evaluated. Then some consequent radioprotection aspects, which are essential for the installation and operation of the facility, are presented.

  4. Ribbing disease: Uncommon cause of a common symptom

    International Nuclear Information System (INIS)

    Damle, Nishikant Avinash; Patnecha, Manish; Kumar, Praveen; Gadodia, Ankur; Subbarao, Kiran; Bal, Chandrasekhar

    2011-01-01

    Ribbing disease is a rare form of sclerosing dysplasia characterized by benign endosteal and periosteal bone growth confined to the diaphyses of the long bones, usually the tibiae and femora. It occurs after puberty and is more commonly seen in women. The most common presenting symptom is pain that is usually self-limited; however, progression is known. The etiology and optimal treatment for the disease are as yet undefined. We present here the case of a 31-year-old woman with clinical, radiological and bone scan manifestations of Ribbing disease corroborated by bone biopsy. Radiographs demonstrated cortical thickening of the diaphyses of both tibiae. 99mTc-methylene diphosphonate bone scan revealed intense irregular uptake in diaphyseal region of both tibiae. Magnetic resonance imaging showed cortical thickening with bone marrow edema in bilateral tibial diaphysis with minimal adjacent soft tissue edema. Bone biopsy revealed predominantly dense lamellar bone with irregular sized and spaced haversian systems. Serum and urine markers of bone metabolism were within normal limits. The patient was treated with analgesics, and had partial relief from pain. Medullary rimming is the next treatment option in case pain progresses. This report emphasizes the role of bone scan in the diagnosis of this rare condition

  5. Use of a 90° drill and screwdriver for rib fracture stabilization.

    Science.gov (United States)

    Nickerson, Terry P; Kim, Brian D; Zielinski, Martin D; Jenkins, Donald; Schiller, Henry J

    2015-03-01

    Rib fracture stabilization has become a more accepted practice although stabilization of the most cephalad ribs presents a unique challenge. We present our experience with use of a 90° drill and screwdriver to bridge these difficult rib fractures. This retrospective review included patients who underwent rib fracture stabilization from August 1, 2009, through September 30, 2012. Patients were divided into two groups: those whose procedure used the 90° device and those that did not. Data were compared using standard statistical analysis and reported as percentages and medians [interquartile ranges]. P values rib stabilized was different between the 2 groups (3 [2-5] vs. 5 [2-9]; P = 0.001), with more third rib stabilizations in the 90° group (38 vs. 20%; P = 0.04) as well as more total number of ribs fixed (5 vs. 4; P = 0.001). There was no difference in operative time between the 2 groups. The surgical reach for rib fracture stabilization has been extended with use of a 90° drill and screwdriver. High fractures under the scapula where access is technically challenging can be stabilized without prolonging operative times.

  6. Does Cardiopulmonary Resuscitation Cause Rib Fractures in Children? A Systematic Review

    Science.gov (United States)

    Maguire, Sabine; Mann, Mala; John, Nia; Ellaway, Bev; Sibert, Jo R.; Kemp, Alison M.

    2006-01-01

    Background: There is a diagnostic dilemma when a child presents with rib fractures after cardiopulmonary resuscitation (CPR) where child abuse is suspected as the cause of collapse. We have performed a systematic review to establish the evidence base for the following questions: (i) Does cardiopulmonary resuscitation cause rib fractures in…

  7. Rib Fractures : To Fix or Not to Fix? An Evidence-Based Algorithm

    NARCIS (Netherlands)

    Bemelman, Michael; de Kruijf, M W; van Baal, Mark; Leenen, Luke

    Rib fractures are a common injury resulting from blunt chest trauma. The most important complications associated with rib fractures include death, pneumonia, and the need for mechanical ventilation. The development of new osteosynthesis materials has stimulated increased interest in the surgical

  8. Frequency of intrathoracic injuries in children younger than 3 years with rib fractures.

    Science.gov (United States)

    Darling, Stephen E; Done, Stephen L; Friedman, Seth D; Feldman, Kenneth W

    2014-10-01

    Research documents that among children admitted to trauma intensive care units the number of rib fractures sustained indicates the child's likelihood of having and severity of intrathoracic injury. This has been misused in court to argue that children with multiple rib fractures who lack intrathoracic injury have abnormal bone fragility rather than inflicted injury. To determine frequency of intrathoracic injuries in children younger than 3 years with rib fractures in cases of child abuse and accidental trauma. We conducted a retrospective review of rib fractures caused by documented abuse or accidents from 2003 to 2010 in children treated at Seattle Children's Hospital and Harborview Medical Center. A senior pediatric radiologist and radiology fellow independently reviewed the imaging. Children with bone demineralization were excluded. Descriptive and simple comparative statistics were used. Seventy-two percent (47/65) of infants and toddlers with rib fractures were abused. Abused children had more rib fractures than accidentally injured children (5.55 vs. 3.11, P = 0.012). However intrathoracic injuries as a whole (55.6% vs. 12.8%, P fractures were equally frequent, but other extrathoracic fractures were more common with abuse (70.2% vs. 16.7%, P rib fractures than accidentally injured peers. This likely reflects different injury mechanics. Lack of intrathoracic injuries in abused children with rib fractures does not imply bone fragility.

  9. The use of nylon cable ties to repair rib fractures in neonatal foals

    OpenAIRE

    Downs, Chris; Rodgerson, Dwayne

    2011-01-01

    Commercially available nylon cable ties were used as a method of internal fixation for displaced rib fractures in 8 equine neonates. The procedure was effective, well-tolerated, rapid, and inexpensive. The use of nylon cable ties as internal fixation for displaced rib fractures in foals is an effective surgical procedure.

  10. Surgical Treatment of Snapping Scapula Syndrome Due to Malunion of Rib Fractures.

    Science.gov (United States)

    Ten Duis, Kaj; IJpma, Frank F A

    2017-02-01

    This report describes a case of snapping scapula syndrome (SSS) caused by malunited rib fractures. Abrasion of the deformed ribs was performed with good results. SSS as a cause of shoulder pain after thoracic trauma has to be considered and can be treated by a surgical abrasion technique. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Cryptococcal rib osteomyelitis as primary and only symptom of idiopathic CD4 penia

    DEFF Research Database (Denmark)

    Legarth, Rebecca A; Christensen, Merete; Calum, Henrik

    2014-01-01

    A 59-year old man with idiopathic CD4 lymphopenia presented with extensive disseminated Cryptococcus neoformans infection including a large rib cryptoccocoma, vertebral spondylitis and pleural empyema. Complete resection of the affected part of the rib was necessary after failure of initial antif...

  12. STRESS FRACTURE OF THE FIRST RIB IN A HIGH SCHOOL WEIGHT LIFTER

    Directory of Open Access Journals (Sweden)

    Hiroyuki Fujioka

    2009-06-01

    Full Text Available A 17-year-old boy, who played a weight lifting in high school, sustained stress fracture of the first rib without any causes. We successfully treated first rib stress fracture with limitation of using the upper extremity and with using low-intensity pulsed ultrasound

  13. Primary Osteoblastic Osteosarcoma of the Rib in an Adult: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Ah; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Ryoo, In Seon [Dept. of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Hyo Ah; Chung, Jin Haeng [Dept. of Patholgy, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Oh, Joo Han [Dept. of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2011-12-15

    We report the CT and magnetic resonance (MR) imaging appearances in an adult case of primary osteoblastic osteosarcoma of the rib. Osteosarcoma of the rib presents a diagnostic challenge because of the rarity of the lesion, especially with plain radiographs. The tumor should be suspected if CT and MR images demonstrate mineralization, suggestive of an osteoid matrix.

  14. Flow and heat transfer in parallel channel attached with equally-spaced ribs, 2

    International Nuclear Information System (INIS)

    Kunugi, Tomoaki; Takizuka, Takakazu

    1980-09-01

    Using a computer code for the analysis of the flow and heat transfer in a parallel channel attached with equally-spaced ribs, calculations are performed when a pitch to rib-width ratio is 7 : 1, a rib-width to rib-height ratio is 2 : 1 and a channel-height to rib-height is 3 : 1. Assuming that the fluid properties and the heat-flux at the wall of this channel are constant, characteristics of the flow and heat transfer are analyzed in the range of Reynolds number from 10 to 250. The following results are obtained: (1) The separation region behind a rib grows downstream with the increase of Reynolds number. (2) The pressure drop of ribbed channel is greater than that of the smooth channel, and increases as Reynolds number increases. (3) The mean Nusselt number of ribbed channel is about 10 - 11 at the upper wall and about 7.5 at the lower wall in the range of Reynolds number from 10 to 250. (author)

  15. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Directory of Open Access Journals (Sweden)

    Piseth Seng

    2015-01-01

    Full Text Available Sternum and rib osteomyelitis complicated from breast implant infection is rare. We report a case of early sternum and rib osteomyelitis occurred during breast implant infection managed in an inter-regional referral center for bone/joint infections in the south of France.

  16. Abdominal Organ Location, Morphology, and Rib Coverage for the 5(th), 50(th), and 95(th) Percentile Males and Females in the Supine and Seated Posture using Multi-Modality Imaging.

    Science.gov (United States)

    Hayes, Ashley R; Gayzik, F Scott; Moreno, Daniel P; Martin, R Shayn; Stitzel, Joel D

    The purpose of this study was to use data from a multi-modality image set of males and females representing the 5(th), 50(th), and 95(th) percentile (n=6) to examine abdominal organ location, morphology, and rib coverage variations between supine and seated postures. Medical images were acquired from volunteers in three image modalities including Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and upright MRI (uMRI). A manual and semi-automated segmentation method was used to acquire data and a registration technique was employed to conduct a comparative analysis between abdominal organs (liver, spleen, and kidneys) in both postures. Location of abdominal organs, defined by center of gravity movement, varied between postures and was found to be significant (p=0.002 to p=0.04) in multiple directions for each organ. In addition, morphology changes, including compression and expansion, were seen in each organ as a result of postural changes. Rib coverage, defined as the projected area of the ribs onto the abdominal organs, was measured in frontal, lateral, and posterior projections, and also varied between postures. A significant change in rib coverage between postures was measured for the spleen and right kidney (p=0.03 and p=0.02). The results indicate that posture affects the location, morphology and rib coverage area of abdominal organs and these implications should be noted in computational modeling efforts focused on a seated posture.

  17. Delayed chest wall hematoma caused by progressive displacement of rib fractures after blunt trauma

    Directory of Open Access Journals (Sweden)

    Nobuhiro Sato

    2016-06-01

    Full Text Available Rib fracture is a common injury resulting from blunt thoracic trauma. Although hemothorax and pneumothorax are known delayed complications of rib fracture, delayed chest wall hematoma has rarely been reported. We discuss the case of an 81-year-old woman who was not undergoing antiplatelet or anticoagulant therapy who presented to our emergency department after a traffic injury. This patient had a nondisplaced rib fracture that went undetected on the initial computed tomography scan; the development of progressive displacement led to hemorrhagic shock due to delayed chest wall hematoma. The chest wall hematoma was effectively diagnosed and treated via contrast-enhanced computed tomography and angiographic embolization. This case highlights the possibility of this potential delayed complication from a common injury such as a rib fracture. Keywords: Angiography, Chest wall, Delayed complication, Rib fracture, Thoracic injury

  18. Early intravenous ibuprofen decreases narcotic requirement and length of stay after traumatic rib fracture.

    Science.gov (United States)

    Bayouth, Lilly; Safcsak, Karen; Cheatham, Michael L; Smith, Chadwick P; Birrer, Kara L; Promes, John T

    2013-11-01

    Pain control after traumatic rib fracture is essential to avoid respiratory complications and prolonged hospitalization. Narcotics are commonly used, but adjunctive medications such as nonsteroidal anti-inflammatory drugs may be beneficial. Twenty-one patients with traumatic rib fractures treated with both narcotics and intravenous ibuprofen (IVIb) (Treatment) were retrospectively compared with 21 age- and rib fracture-matched patients who received narcotics alone (Control). Pain medication requirements over the first 7 hospital days were evaluated. Mean daily IVIb dose was 2070 ± 880 mg. Daily intravenous morphine-equivalent requirement was 19 ± 16 vs 32 ± 24 mg (P pain scores were lower in the Treatment group (P rib fractures significantly decreases narcotic requirement and results in clinically significant decreases in hospital length of stay. IVIb therapy should be initiated in patients with traumatic rib fractures to improve patient comfort and reduce narcotic requirement.

  19. [Relationship between PMI and ATR-FTIR Spectral Changes in Swine Costal Cartilages and Ribs].

    Science.gov (United States)

    Yao, Yao; Wang, Qi; Jing, Xiao-li; Li, Bing; Zhang, Yin-ming; Wang, Zhi-jun; Li, Cheng-zhi; Lin, Han-cheng; Zhang, Ji; Huang, Ping; Wang, Zhen-yuan

    2016-02-01

    To analyze postmortem chemical changes in Landrace costal cartilages and ribs using attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy, and to provide a novel technique for estimation of postmortem interval (PMI). The swines were sacrificed by hemorrhage and their costal cartilages and ribs were kept in 20 degrees C. The chemical analysis of the costal cartilages and ribs were performed using ATR-FTIR every 72 h. The correlation between the certain spectral parameters and PMI was also analyzed. The time-dependent changes of costal cartilages were more significant than ribs. There were no obvious changes for the main absorbance bands position, and some absorbance band ratios showed time-dependent changes and significant correlations with the PMI. ATR-FTIR has the ability to analyze postmortem chemical changes of the swine costal cartilages and ribs, and it can be a new method to estimate PMI based on spectroscopy.

  20. Interpretation of the peak areas in gamma-ray spectra that have a large relative uncertainty

    International Nuclear Information System (INIS)

    Korun, M.; Maver Modec, P.; Vodenik, B.

    2012-01-01

    Empirical evidence is provided that the areas of peaks having a relative uncertainty in excess of 30% are overestimated. This systematic influence is of a statistical nature and originates in way the peak-analyzing routine recognizes the small peaks. It is not easy to detect this influence since it is smaller than the peak-area uncertainty. However, the systematic influence can be revealed in repeated measurements under the same experimental conditions, e.g., in background measurements. To evaluate the systematic influence, background measurements were analyzed with the peak-analyzing procedure described by Korun et al. (2008). The magnitude of the influence depends on the relative uncertainty of the peak area and may amount, in the conditions used in the peak analysis, to a factor of 5 at relative uncertainties exceeding 60%. From the measurements, the probability for type-II errors, as a function of the relative uncertainty of the peak area, was extracted. This probability is near zero below an uncertainty of 30% and rises to 90% at uncertainties exceeding 50%. - Highlights: ► A systematic influence affecting small peak areas in gamma-ray spectra is described. ► The influence originates in the peak locating procedure, using a pre-determined sensitivity. ► The predetermined sensitivity makes peak areas with large uncertainties to be overestimated. ► The influence depends on the relative uncertainty of the number of counts in the peak. ► Corrections exceeding a factor of 3 are attained at peak area uncertainties exceeding 60%.

  1. From RIB production to the applications for accelerator driven hybrid systems

    International Nuclear Information System (INIS)

    Ridikas, D.; Mittig, W.

    1999-03-01

    The revival of interest for production of neutrons by light projectiles has been recently renewed because they are the basis in the development of powerful neutron sources for various applications like nuclear energy production and incineration of nuclear waste, material structure analysis, tritium production, etc. Another interest is related to the possibility of the production of radioactive ion beams (RIB) by neutron induced fission. One of the most important tasks in this context is to determine the most efficient way to convert the primary beam energy into neutrons produced afterwards. The problem is investigated by varying the incident energy of different projectiles for different target materials and assemblies. Consequently, a few direct applications of our investigations are presented and compared with experimental data or other theoretical estimations. (author)

  2. From RIB production to the applications for accelerator driven hybrid systems

    Energy Technology Data Exchange (ETDEWEB)

    Ridikas, D.; Mittig, W

    1999-03-01

    The revival of interest for production of neutrons by light projectiles has been recently renewed because they are the basis in the development of powerful neutron sources for various applications like nuclear energy production and incineration of nuclear waste, material structure analysis, tritium production, etc. Another interest is related to the possibility of the production of radioactive ion beams (RIB) by neutron induced fission. One of the most important tasks in this context is to determine the most efficient way to convert the primary beam energy into neutrons produced afterwards. The problem is investigated by varying the incident energy of different projectiles for different target materials and assemblies. Consequently, a few direct applications of our investigations are presented and compared with experimental data or other theoretical estimations.

  3. Low evaluation rate for osteoporosis among patients presenting with a rib fracture.

    Science.gov (United States)

    Kim, Whang; Gong, Hyun Sik; Lee, Seung Hoo; Park, Jin Woo; Kim, Kahyun; Baek, Goo Hyun

    2017-12-01

    This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. Increased emphasis or education for osteoporosis evaluation may be necessary in case of rib fractures. Rib fractures from a low-energy trauma are common in the elderly, and a history of rib fracture has been reported to increase the risk for a subsequent osteoporotic fracture. The purpose of this study was to evaluate how many of the patients presenting with an isolated rib fracture were being evaluated for osteoporosis and the risk for a subsequent fracture. We retrospectively reviewed all patients aged 50 years or older who were diagnosed with a rib fracture between January 2011 and April 2016 at a regional tertiary care university hospital near Seoul, South Korea. We excluded those who had been treated for osteoporosis or those with other concomitant fractures or fractures from a motor vehicle accident or cancer. We evaluated the frequency of dual energy X-ray absorptiometry (DXA) scan examinations in these patients. There were 231 patients with isolated rib fractures (132 men and 99 women). The mean age was 65 years. Rib fractures were most commonly diagnosed at the emergency department and most of the patients were referred to the department of thoracic surgery for follow-up evaluations. Of these 231 patients, 29 (12%) had DXA examinations after the injury, and only 9 (4%) of them did so within 6 months. Physicians specializing in orthopedic surgery, family medicine, internal medicine, rehabilitation medicine, and emergency medicine were ordering the examination. This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. This study suggests that increased emphasis or education for osteoporosis evaluation may be necessary for physicians who are often referred to for care of rib fractures.

  4. Traumatic Vertebral Fractures and Concomitant Fractures of the Rib in Southwest China, 2001 to 2010

    Science.gov (United States)

    Wang, Hongwei; Zhou, Yue; Ou, Lan; Li, Changqing; Liu, Jun; Xiang, Liangbi

    2015-01-01

    Abstract To our knowledge, the clinical characteristics of traumatic vertebral fractures and concomitant fractures of the rib (TVF-RF) have not been described in previous studies. To investigate the clinical characteristics of patients managed for TVF-RF. A retrospective study of 3142 patients who presented with traumatic vertebral fractures was performed. Two hundred twenty-six patients (7.2%) suffered from TVF-RF. Incidence rate ratios were then calculated with respect to the level of injury to the spine, the ASIA classification of neurological deficits and age. There were 171 male (75.7%) and 55 female (24.3%) patients with a mean age of 43.8 years. The most common mechanisms were falls from high heights in 81 cases and road traffic crashes in 67 cases. Right-sided rib injury occurred in 106 cases, left-sided injury occurred in 76 cases, and bilateral injury occurred in 44 cases. The most frequent location of the rib fractures was from the fourth rib to the ninth rib (70.3%, 510/725). Initial pulmonary complications (IPC) after trauma occurred in 116 cases (51.3%). The mortality rate for the entire group was 1.3% (3/226). The patients with thoracic vertebral fractures and neurological deficits had a higher frequency of multiple rib fractures and IPC than the other patients (P rib fractures, the frequency of IPC and mean intensive care unit (ICU) length of stay also increased. The rates of complications for patients with rib fractures were significantly different from those without rib fractures. We should pay much attention to the patients who presented with thoracic vertebral fractures and neurological deficits for minimizing further complications and mortality in such patients who had a higher frequency of multiple rib fractures and IPC than the other patients. PMID:26554809

  5. Focusing of high intensity ultrasound through the rib cage using a therapeutic random phased array

    Science.gov (United States)

    Bobkova, Svetlana; Gavrilov, Leonid; Khokhlova, Vera; Shaw, Adam; Hand, Jeffrey; #, ||

    2010-01-01

    A method for focusing high intensity ultrasound through a rib cage that aims to minimize heating of the ribs whilst maintaining high intensities at the focus (or foci) is proposed and tested theoretically and experimentally. Two approaches, one based on geometric acoustics and the other accounting for diffraction effects associated with propagation through the rib cage, are investigated theoretically for idealized source conditions. It is shown that for an idealized radiator the diffraction approach provides a 23% gain in peak intensity and results in significantly less power losses on the ribs (1% versus 7.5% of the irradiated power) compared with the geometric one. A 2D 1-MHz phased array with 254 randomly distributed elements, tissue mimicking phantoms, and samples of porcine rib cages are used in experiments; the geometric approach is used to configure how the array is driven. Intensity distributions are measured in the plane of the ribs and in the focal plane using an infra-red camera. Theoretical and experimental results show that it is possible to provide adequate focusing through the ribs without overheating them for a single focus and several foci, including steering at ± 10–15 mm off and ± 20 mm along the array axis. Focus splitting due to the periodic spatial structure of ribs is demonstrated both in simulations and experiments; the parameters of splitting are quantified. The ability to produce thermal lesions with a split focal pattern in ex vivo porcine tissue placed beyond the rib phantom is also demonstrated. The results suggest that the method is potentially useful for clinical applications of HIFU for which the rib cage lies between the transducer(s) and the targeted tissue. PMID:20510186

  6. Conditions of rib design for polycarbonate resin with high glossy surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Seong Won [Seoul National University of Science and Technology, Seoul (Korea, Republic of)

    2013-10-15

    Much attention has been being given to the importance of product surfaces in the field of plastic parts, as industrial design has become one of the key elements of product success. These plastic parts incorporate rib-like geometries on the non-appearance surfaces of plastic in order to increase the stiffness of rigidity of the section, but they often cause appearance problems of the product's surface overall by making a sink mark on that surface. The thickness, height and draft-angle of the rib are generally known as major parameters influencing the sink mark on the appearance surface. Therefore, designers of plastic parts must determine the variables of reinforcing ribs. The goal of this study is to find the optimum design variables in the mixing conditions of the thickness, the height and the draft angle of reinforcing ribs so that designers of plastic parts can easily determine the conditions of the reinforcing ribs as the part's section thickness varies within an objective limit in polycarbonate plastic resin and a high glossy surface that are widely applied in the creation of plastic products. We investigated the actual depths of sink marks on the surface of a specimen that was manufactured with an injection mold specifically for this study. Response surface methodology with the Box-Behnken design was used to analyze the regression curve of real depths with combinations of the thickness, height and draft angle of the ribs. The result shows that the most influential factor to increase the shrinkage is the thickness of ribs and that the optimum value of the rib thickness is a range from multiple of 0.25 to 0.34 of the section thickness. Also, the rib height and rib draft angle are not major factors that can change the sink amount.

  7. Conditions of rib design for polycarbonate resin with high glossy surfaces

    International Nuclear Information System (INIS)

    Jeong, Seong Won

    2013-01-01

    Much attention has been being given to the importance of product surfaces in the field of plastic parts, as industrial design has become one of the key elements of product success. These plastic parts incorporate rib-like geometries on the non-appearance surfaces of plastic in order to increase the stiffness of rigidity of the section, but they often cause appearance problems of the product's surface overall by making a sink mark on that surface. The thickness, height and draft-angle of the rib are generally known as major parameters influencing the sink mark on the appearance surface. Therefore, designers of plastic parts must determine the variables of reinforcing ribs. The goal of this study is to find the optimum design variables in the mixing conditions of the thickness, the height and the draft angle of reinforcing ribs so that designers of plastic parts can easily determine the conditions of the reinforcing ribs as the part's section thickness varies within an objective limit in polycarbonate plastic resin and a high glossy surface that are widely applied in the creation of plastic products. We investigated the actual depths of sink marks on the surface of a specimen that was manufactured with an injection mold specifically for this study. Response surface methodology with the Box-Behnken design was used to analyze the regression curve of real depths with combinations of the thickness, height and draft angle of the ribs. The result shows that the most influential factor to increase the shrinkage is the thickness of ribs and that the optimum value of the rib thickness is a range from multiple of 0.25 to 0.34 of the section thickness. Also, the rib height and rib draft angle are not major factors that can change the sink amount.

  8. Evaluation of solitary rib lesions in CA. breast patients for development of skeletal metastasis

    International Nuclear Information System (INIS)

    Fatima, A.; Fatima, S.; Khursheed, K.; Jafri, S.; Asghar, S.

    2004-01-01

    Determination of nature of single or double rib lesion on a bone scan is important but very difficult. In case of breast carcinoma rib lesion have particular importance, as they are one of the most common sites of metastasis. On the contrary surgical trauma and radiotherapy can induce metabolic changes, which can lead to rib lesions of benign etiology. As it is known that breast carcinoma patients having skeletal metastasis have worse prognosis so it is particularly important to differentiate between malignant and benign rib lesions. In this study etiology of rib lesions detected on bone scan was analyzed retrospectively patients. Study population consisted of breast cancer patients having solitary rib lesions on baseline or follow-up bone scan were included in the study. The etiology of solitary rib involvement was established using all the clinical, radiological and biochemical data available. The clinical and serial scintigraphic data were collected and analyzed for correlation in forty-two patients. Patients were followed up for at least two subsequent bone scans. Out of total study population nine patients (21.42%) developed skeletal metastasis on follow-up. Rest of the study population is disease free till last follow-up. All these patients developed metastasis within two years of appearance of the rib lesions. Correlation between sites of initial rib lesion, uptake pattern, size of tumor, mode of primary therapy, age of involvement, interval from initial therapy, biochemical and radiological findings was done. Correlation was seen between sites of uptake, uptake pattern, mode of primary therapy and biochemical findings with subsequent outcome of the patient. It is concluded from our study that solitary rib lesion have low incidence of malignancy if other risk factors are absent. (authors)

  9. Relative importance of habitat area and isolation for bird occurrence patterns in a naturally patchy landscape

    Science.gov (United States)

    Wilson, T.L.; Johnson, E.J.; Bissonette, J.A.

    2009-01-01

    There is debate among ecologists about whether total habitat area or patch arrangement contributes most to population and/or community responses to fragmented or patchy landscapes. We tested the relative effects of patch area and isolation for predicting bird occurrence in a naturally patchy landscape in the Bear River Mountains of Northern Utah, USA. We selected focal patches (mountain meadows) ranging in elevation from 1,920 to 2,860 m and in size from 0.6 to 182 ha. Breeding birds were sampled in each focal meadow during the summers of 2003 and 2004 using variable-distance point transects. Logistic regression and likelihood-based model selection were used to determine the relationship between likelihood of occurrence of three bird species (Brewer's sparrow, vesper sparrow, and white-crowned sparrow) and area, isolation, and proximity metrics. We used model weights and model-averaged confidence intervals to assess the importance of each predictor variable. Plots of area versus isolation were used to evaluate complex relationships between the variables. We found that meadow area was the most important variable for explaining occurrence for two species, and that isolation was the most important for the other. We also found that the absolute distance was more appropriate for evaluating isolation responses than was the species-specific proximity metric. Our findings add clarity to the debate between ecologists regarding the relative importance of area and isolation in species responses to patchy landscapes.

  10. Stormwater Management: Calculation of Traffic Area Runoff Loads and Traffic Related Emissions

    Directory of Open Access Journals (Sweden)

    Maximilian Huber

    2016-07-01

    Full Text Available Metals such as antimony, cadmium, chromium, copper, lead, nickel, and zinc can be highly relevant pollutants in stormwater runoff from traffic areas because of their occurrence, toxicity, and non-degradability. Long-term measurements of their concentrations, the corresponding water volumes, the catchment areas, and the traffic volumes can be used to calculate specific emission loads and annual runoff loads that are necessary for mass balances. In the literature, the annual runoff loads are often specified by a distinct catchment area (e.g., g/ha. These loads were summarized and discussed in this paper for all seven metals and three types of traffic areas (highways, parking lots, and roads; 45 sites. For example, the calculated median annual runoff loads of all sites are 355 g/ha for copper, 110 g/ha for lead (only data of the 21st century, and 1960 g/ha for zinc. In addition, historical trends, annual variations, and site-specific factors were evaluated for the runoff loads. For Germany, mass balances of traffic related emissions and annual heavy metal runoff loads from highways and total traffic areas were calculated. The influences on the mass fluxes of the heavy metal emissions and the runoff pollution were discussed. However, a statistical analysis of the annual traffic related metal fluxes, in particular for different traffic area categories and land uses, is currently not possible because of a lack of monitoring data.

  11. Estimating small area health-related characteristics of populations: a methodological review

    Directory of Open Access Journals (Sweden)

    Azizur Rahman

    2017-05-01

    Full Text Available Estimation of health-related characteristics at a fine local geographic level is vital for effective health promotion programmes, provision of better health services and population-specific health planning and management. Lack of a micro-dataset readily available for attributes of individuals at small areas negatively impacts the ability of local and national agencies to manage serious health issues and related risks in the community. A solution to this challenge would be to develop a method that simulates reliable small-area statistics. This paper provides a significant appraisal of the methodologies for estimating health-related characteristics of populations at geographical limited areas. Findings reveal that a range of methodologies are in use, which can be classified as three distinct set of approaches: i indirect standardisation and individual level modelling; ii multilevel statistical modelling; and iii micro-simulation modelling. Although each approach has its own strengths and weaknesses, it appears that microsimulation- based spatial models have significant robustness over the other methods and also represent a more precise means of estimating health-related population characteristics over small areas.

  12. Fore shock activity and its probabilistic relation to earthquake occurrence in Albania and the surrounding area

    Energy Technology Data Exchange (ETDEWEB)

    Peci, V. [Seismological Institute, Tirana (Albania); Maeda, K. [Meteorologial Research Institute, Tsukuba, Ibaraki (Japan). Dept. of Seismology and Volcanology Research; Matsmura, K.; Irikura, K. [Kyoto Univ., Kyoto (Japan). Inst. of Disaster Prevention Research

    1999-10-01

    The paper investigates some characteristics of fore shock activity of moderate and large earthquakes which occurred in the present century in Albania and the surrounding area. Using a prediction algorithm, based on possible fore shocks, the authors obtained a probabilistic relation between possible fore shocks and main shocks. Results recorded between 1901-1994 are analysed and discussed.

  13. Osteochondroma of the fifth rib resulting in recurrent hemothorax

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Mital [Cleveland Clinic Foundation, Department of Radiology - Musculoskeletal Imaging Fellowship, Cleveland, OH (United States); Bauer, Thomas W. [The Cleveland Clinic L-25, Departments of Pathology and Orthopaedic Surgery, Cleveland, OH (United States); Santoscoy, Thomas [Cleveland Clinic Foundation, Department of Thoracic and Cardiovascular Surgery, Mayfield Heights, OH (United States); Ilaslan, Hakan [Cleveland Clinic Foundation, Department of Radiology, Musculoskeletal Section, Cleveland, OH (United States)

    2015-12-15

    A 48-year-old man presented with recurrent spontaneous hemothoraces, which ultimately were found to be secondary to a pedunculated costal osteochondroma causing vascular injury. After initially undergoing endovascular coil embolization, he ultimately required segmental rib resection containing the offending lesion for definite treatment. Although a few cases of symptomatic costal osteochondromas have been reported in the literature, as far as we know, no previous reports have provided direct radiologic confirmation of active bleeding or the role of angiographic intervention. In this report, we highlight the importance of CT angiography in establishing a direct link between an osteochondroma and recurrent hemothorax. We also discuss the diagnostic imaging challenges associated with this condition and the use of a multidisciplinary treatment strategy involving both angiographic and operative management. (orig.)

  14. Are ranger patrols effective in reducing poaching-related threats within protected areas?

    Science.gov (United States)

    Moore, Jennnifer F.; Mulindahabi, Felix; Masozera, Michel K.; Nichols, James; Hines, James; Turikunkiko, Ezechiel; Oli, Madan K.

    2018-01-01

    Poaching is one of the greatest threats to wildlife conservation world-wide. However, the spatial and temporal patterns of poaching activities within protected areas, and the effectiveness of ranger patrols and ranger posts in mitigating these threats, are relatively unknown.We used 10 years (2006–2015) of ranger-based monitoring data and dynamic multi-season occupancy models to quantify poaching-related threats, to examine factors influencing the spatio-temporal dynamics of these threats and to test the efficiency of management actions to combat poaching in Nyungwe National Park (NNP), Rwanda.The probability of occurrence of poaching-related threats was highest at lower elevations (1,801–2,200 m), especially in areas that were close to roads and tourist trails; conversely, occurrence probability was lowest at high elevation sites (2,601–3,000 m), and near the park boundary and ranger posts. The number of ranger patrols substantially increased the probability that poaching-related threats disappear at a site if threats were originally present (i.e. probability of extinction of threats). Without ranger visits, the annual probability of extinction of poaching-related threats was an estimated 7%; this probability would increase to 20% and 57% with 20 and 50 ranger visits per year, respectively.Our results suggest that poaching-related threats can be effectively reduced in NNP by adding ranger posts in areas where they do not currently exist, and by increasing the number of patrols to sites where the probability of poaching activities is high.Synthesis and applications. Our application of dynamic occupancy models to predict the probability of presence of poaching-related threats is novel, and explicitly considers imperfect detection of illegal activities. Based on the modelled relationships, we identify areas that are most vulnerable to poaching, and offer insights regarding how ranger patrols can be optimally deployed to reduce poaching-related threats and

  15. Relative Food Prices and Obesity in U.S. Metropolitan Areas: 1976-2001

    Science.gov (United States)

    Xu, Xin; Variyam, Jayachandran N.; Zhao, Zhenxiang; Chaloupka, Frank J.

    2014-01-01

    This study investigates the impact of food price on obesity, by exploring the co-occurrence of obesity growth with relative food price reduction between 1976 and 2001. Analyses control for female labor participation and metropolitan outlet densities that might affect body weight. Both the first-difference and fixed effects approaches provide consistent evidence suggesting that relative food prices have substantial impacts on obesity and such impacts were more pronounced among the low-educated. These findings imply that relative food price reductions during the time period could plausibly explain about 18% of the increase in obesity among the U.S. adults in metropolitan areas. PMID:25502888

  16. Spotted hyaena space use in relation to human infrastructure inside a protected area.

    Science.gov (United States)

    Belton, Lydia E; Cameron, Elissa Z; Dalerum, Fredrik

    2016-01-01

    Increasing human population growth has led to elevated levels of human-carnivore conflict. However, some carnivore populations have adapted to urban environments and the resources they supply. Such associations may influence carnivore ecology, behaviour and life-history. Pockets of urbanisation sometimes occur within protected areas, so that anthropogenic influences on carnivore biology are not necessarily confined to unprotected areas. In this study we evaluated associations between human infrastructure and related activity and space use of spotted hyaenas within one of the largest protected areas in South Africa, the Kruger National Park. Home range size was smaller for the dominant female of a clan living in close proximity to humans than that of the dominant female of a clan without direct access to human infrastructure. The home range including human infrastructure was also used less evenly during the night, presumably when the animals were active. Within this home range, a village area was preferred during the night, when the least modified areas within the village were preferred and administration and highly modified areas were avoided. During the day, however, there were no preference or avoidance of the village area, but all habitats except unmodified habitats within the village area were avoided. We suggest that human infrastructure and associated activity influenced hyaena space use, primarily through alterations in the spatial distribution of food. However, these effects may have been indirectly caused by habitat modification that generated favourable hunting habitat rather than a direct effect caused by access to human food such as garbage. Because of the often pivotal effects of apex predators in terrestrial ecosystems, we encourage further work aimed to quantify how human presence influences large carnivores and associated ecosystem processes within protected areas.

  17. Identifying areas of need relative to liver disease: geographic clustering within a health service district.

    Science.gov (United States)

    El-Atem, Nathan; Irvine, Katharine M; Valery, Patricia C; Wojcik, Kyle; Horsfall, Leigh; Johnson, Tracey; Janda, Monika; McPhail, Steven M; Powell, Elizabeth E

    2017-08-01

    accessing tertiary hospital liver services are clustered within specific geographic areas. The most striking geographic clustering was seen for people living with chronic hepatitis B, in regions with a relatively high proportion of people born in Vietnam and China. In addition to ethnicity, the data show an apparent ecological association between liver disease and both socioeconomic and educational and/or occupational disadvantage. What are the implications for practitioners? Identifying where demand for clinical services arises is an important step for service planning and preparing for potential outreach programs to optimise community-based care. It is likely that outreach programs to engage and enhance primary care services in geographic areas from which the greatest demand for tertiary liver disease speciality care arises would yield greater relative return on investment than non-targeted outreach programs.

  18. Number of rib fractures thresholds independently predict worse outcomes in older patients with blunt trauma.

    Science.gov (United States)

    Shulzhenko, Nikita O; Zens, Tiffany J; Beems, Megan V; Jung, Hee Soo; O'Rourke, Ann P; Liepert, Amy E; Scarborough, John E; Agarwal, Suresh K

    2017-04-01

    There have been conflicting reports regarding whether the number of rib fractures sustained in blunt trauma is associated independently with worse patient outcomes. We sought to investigate this risk-adjusted relationship among the lesser-studied population of older adults. A retrospective review of the National Trauma Data Bank was performed for patients with blunt trauma who were ≥65 years old and had rib fractures between 2009 and 2012 (N = 67,695). Control data were collected for age, sex, injury severity score, injury mechanism, 24 comorbidities, and number of rib fractures. Outcome data included hospital mortality, hospital and intensive care unit durations of stay, duration of mechanical ventilation, and the occurrence of pneumonia. Multiple logistic and linear regression analyses were performed. Sustaining ≥5 rib fractures was associated with increased intensive care unit admission (odds ratio: 1.14, P rib fractures was associated with an increased incidence of pneumonia (odds ratio: 1.32, P rib fractures was associated with increased mortality (odds ratio: 1.51, P rib fractures is a significant predictor of worse outcomes independent of patient characteristics, comorbidities, and trauma burden. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Concurrent rib and pelvic fractures as an indicator of solid abdominal organ injury.

    Science.gov (United States)

    Al-Hassani, Ammar; Afifi, Ibrahim; Abdelrahman, Husham; El-Menyar, Ayman; Almadani, Ammar; Recicar, Jan; Al-Thani, Hassan; Maull, Kimball; Latifi, Rifat

    2013-01-01

    To study the association of solid organ injuries (SOIs) in patients with concurrent rib and pelvic fractures. Retrospective analysis of prospectively collected data from November 2007 to May 2010. Patients' demographics, mechanism of injury, Injury severity scoring, pelvic fracture, and SOIs were analyzed. Patients with SOIs were compared in rib fractures with and without pelvic fracture. The study included 829 patients (460 with rib fractures ± pelvic fracture and 369 with pelvic fracture alone) with mean age of 35 ± 12.7 years. Motor vehicle crashes (45%) and falls from height (30%) were the most common mechanism of injury. The overall incidence of SOIs in this study was 22% (185/829). Further, 15% of patient with rib fractures had associated pelvic fracture. SOI was predominant in patients with concurrent rib fracture and pelvic fracture compared to ribs or pelvic fractures alone (42% vs. 26% vs. 15%, respectively, p = 0.02). Concurrent multiple rib fractures and pelvic fracture increases the risk of SOI compared to either group alone. Lower RFs and pelvic fracture had higher association for SOI and could be used as an early indicator of the presence of SOIs. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  20. [Surgical fixation of rib fractures with clips and titanium bars (STRATOS System). Preliminary experience].

    Science.gov (United States)

    Moreno De La Santa Barajas, Pablo; Polo Otero, María Dolores; Delgado Sánchez-Gracián, Carlos; Lozano Gómez, Manuel; Toscano Novella, Alberto; Calatayud Moscoso Del Prado, Julia; Leal Ruiloba, Sonsoles; Choren Durán, Maria L

    2010-09-01

    Rib fractures are very common in closed chest injuries. The majority of these patients suffer significant pain with movement and cough. The purpose of this study is to assess the usefulness of titanium rib bars and clips in stabilising rib fractures. Twenty-two patients with rib fractures were treated with open reduction and internal fixation between 2008 and 2009. Indications for treatment were defined as; 1) Patients with unstable chest (13 patients), 2) Patients with pain or instability due to rib fractures (6 patients), and 3) Significant traumatic deformities of the chest wall (3 patients). Age, traumatic mechanism, chest and associated injuries, surgical data, complications and follow-up were prospectively analysed. The surgical technique is described. The majority of patients were extubated immediately after surgery. All patients with pain or instability showed a subjective improvement or disappearance of pain after the surgery. Four patients had a wound infection which had to be drained. After 3 months, 55% of the patients had returned to work or normal life. The results in each group are described. Open reduction with internal fixation of rib fractures is a good alternative. The use of titanium rib bars and clips give good clinical results, are easy to apply and have few complications. Copyright © 2010 AEC. Published by Elsevier Espana. All rights reserved.

  1. Chest wall reconstruction with autologas rib grafts in dogs and report of a clinic case.

    Science.gov (United States)

    Tunçözgür, B; Elbeyli, L; Güngör, A; Işik, F; Akay, H

    1999-09-01

    Nowadays, in chest wall reconstruction prosthetic materials are generally used. However, the rejections of prosthetic materials and infections frequently occur in chest wall reconstruction, especially after radiotherapy or resection that is performed due to infections. We used 10 mongrel dogs and performed resections of 8 cm diameter on their chest walls. In the reconstruction of these defects, in five of the subjects, we used two free rib grafts with periosteum to be resected from the contralateral side and in other five subjects, we used free rib grafts without periosteum. After this experimental study, sternal resection was performed in a 24-year-old man because of sternal osteomyelitis. First to obtain rib grafts with periosteum, partial resection was performed to 5th, 7th, and 9th ribs of the lateral left side. After, total sternal resection, end to end anastomosis was performed to the 2nd, 3rd, 4th and 5th anterior ends of the ribs. Autogeneous rib grafts were found to be enough to provide chest wall stabilization. The contralateral autogeneous free rib grafts can successfully be used in reconstruction of wide chest wall defects. This method is found to be effective and sufficient to prevent infection, rejection and to provide stabilization.

  2. Radiologic-anatomic correlation of thoracic vertebrae and rib shadows in chest digital radiograph

    International Nuclear Information System (INIS)

    Yamaguchi, Isao; Itoh, Harumi

    2007-01-01

    The purpose of this study was to provide an introduction to parsing the radiologic appearance of thoracic vertebrae and ribs. In the study, the radiologic-anatomic correlation technique was applied to promote further understanding of normal chest radiographs. The thoracic vertebrae and ribs of chest radiographs were compared with each macroscopic radiologic and computed tomography (CT) image. The rib parsed the linear shadow of the body of the rib. The macroscopic and radiologic images of thoracic vertebrae and ribs were evaluated to explain their normal radiologic findings. The results of such correlation were summarized as follows: The lamina of the vertebral arch was visualized due to anterior rotation of the upper thoracic vertebrae. The density ratio of the thoracic-vertebrae shadow was almost the same in the vertebral body and vertebral arch. The linear shadow superimposed on the rib corresponded to the inferior margin of the rib. The radiologic-anatomic correlation technique was useful to evaluate normal radiologic findings, and the study was useful to radiological technologists. (author)

  3. Current Knowledge of Leishmania Vectors in Mexico: How Geographic Distributions of Species Relate to Transmission Areas

    Science.gov (United States)

    González, Camila; Rebollar-Téllez, Eduardo A.; Ibáñez-Bernal, Sergio; Becker-Fauser, Ingeborg; Martínez-Meyer, Enrique; Peterson, A. Townsend; Sánchez-Cordero, Víctor

    2011-01-01

    Leishmaniases are a group of vector-borne diseases with different clinical manifestations caused by parasites transmitted by sand fly vectors. In Mexico, the sand fly Lutzomyia olmeca olmeca is the only vector proven to transmit the parasite Leishmania mexicana to humans, which causes leishmaniasis. Other vector species with potential medical importance have been obtained, but their geographic distributions and relation to transmission areas have never been assessed. We modeled the ecological niches of nine sand fly species and projected niches to estimate potential distributions by using known occurrences, environmental coverages, and the algorithms GARP and Maxent. All vector species were distributed in areas with known recurrent transmission, except for Lu. diabolica, which appeared to be related only to areas of occasional transmission in northern Mexico. The distribution of Lu. o. olmeca does not overlap with all reported cutaneous leishmaniasis cases, suggesting that Lu. cruciata and Lu. shannoni are likely also involved as primary vectors in those areas. Our study provides useful information of potential risk areas of leishmaniasis transmission in Mexico. PMID:22049037

  4. Keeping an Open Mind: Cognitive Bias in the Evaluation of an Infant with Posterior-Lateral Rib Fractures

    Directory of Open Access Journals (Sweden)

    Katie Johnson

    2017-01-01

    Full Text Available A four-month-old former premature male is incidentally found to have posterior-lateral rib fractures during evaluation of a febrile illness. This finding led to the initiation of a workup for nonaccidental trauma. A thorough history and physical exam ultimately led to the diagnosis, which was not related to abuse. This case highlights a rare sequela of patent ductus arteriosus repair, cautions medical teams to remain aware of how cognitive bias can affect diagnostic decision-making, and emphasizes the importance of a thorough history, physical exam, and medical record review in cases of suspected nonaccidental trauma.

  5. Rib fractures under anterior-posterior dynamic loads: experimental and finite-element study.

    Science.gov (United States)

    Li, Zuoping; Kindig, Matthew W; Kerrigan, Jason R; Untaroiu, Costin D; Subit, Damien; Crandall, Jeff R; Kent, Richard W

    2010-01-19

    The purpose of this study was to investigate whether using a finite-element (FE) mesh composed entirely of hexahedral elements to model cortical and trabecular bone (all-hex model) would provide more accurate simulations than those with variable thickness shell elements for cortical bone and hexahedral elements for trabecular bone (hex-shell model) in the modeling human ribs. First, quasi-static non-injurious and dynamic injurious experiments were performed using the second, fourth, and tenth human thoracic ribs to record the structural behavior and fracture tolerance of individual ribs under anterior-posterior bending loads. Then, all-hex and hex-shell FE models for the three ribs were developed using an octree-based and multi-block hex meshing approach, respectively. Material properties of cortical bone were optimized using dynamic experimental data and the hex-shell model of the fourth rib and trabecular bone properties were taken from the literature. Overall, the reaction force-displacement relationship predicted by both all-hex and hex-shell models with nodes in the offset middle-cortical surfaces compared well with those measured experimentally for all the three ribs. With the exception of fracture locations, the predictions from all-hex and offset hex-shell models of the second and fourth ribs agreed better with experimental data than those from the tenth rib models in terms of reaction force at fracture (difference rib responses and bone fractures for the loading conditions considered, but coarse hex-shell models with constant or variable shell thickness were more computationally efficient and therefore preferred. Copyright 2009 Elsevier Ltd. All rights reserved.

  6. Action of the isolated canine diaphragm on the lower ribs at high lung volumes.

    Science.gov (United States)

    De Troyer, André; Wilson, Theodore A

    2014-10-15

    The normal diaphragm has an inspiratory action on the lower ribs, but subjects with chronic obstructive pulmonary disease commonly have an inward displacement of the lateral portions of the lower rib cage during inspiration. This paradoxical displacement, conventionally called 'Hoover's sign', has traditionally been attributed to the direct action of radially oriented diaphragmatic muscle fibres. In the present study, the inspiratory intercostal muscles in all interspaces in anaesthetized dogs were severed so that the diaphragm was the only muscle active during inspiration. The displacements of the lower ribs along the craniocaudal and laterolateral axes and the changes in pleural pressure (∆Ppl) and transdiaphragmatic pressure were measured during occluded breaths and mechanical ventilation at different lung volumes between functional residual capacity (FRC) and total lung capacity. From these data, the separate effects on rib displacement of ∆Ppl and of the force exerted by the diaphragm on the ribs were determined. Isolated spontaneous diaphragm contraction at FRC displaced the lower ribs cranially and outward, but this motion was progressively reversed into a caudal and inward motion as lung volume increased. However, although the force exerted by the diaphragm on the ribs decreased with increasing volume, it continued to displace the ribs cranially and outward. These observations suggest that Hoover's sign is usually caused by the decrease in the zone of apposition and, thus, by the dominant effect of ∆Ppl on the lower ribs, rather than an inward pull from the diaphragm. © 2014 The Authors. The Journal of Physiology © 2014 The Physiological Society.

  7. Sex determination based on a thoracic vertebra and ribs evaluation using clinical chest radiography.

    Science.gov (United States)

    Tsubaki, Shun; Morishita, Junji; Usumoto, Yosuke; Sakaguchi, Kyoko; Matsunobu, Yusuke; Kawazoe, Yusuke; Okumura, Miki; Ikeda, Noriaki

    2017-07-01

    Our aim was to investigate whether sex can be determined from a combination of geometric features obtained from the 10th thoracic vertebra, 6th rib, and 7th rib. Six hundred chest radiographs (300 males and 300 females) were randomly selected to include patients of six age groups (20s, 30s, 40s, 50s, 60s, and 70s). Each group included 100 images (50 males and 50 females). A total of 14 features, including 7 lengths, 5 indices for the vertebra, and 2 types of widths for ribs, were utilized and analyzed for sex determination. Dominant features contributing to sex determination were selected by stepwise discriminant analysis after checking the variance inflation factors for multicollinearity. The accuracy of sex determination using a combination of the vertebra and ribs was evaluated from the selected features by the stepwise discriminant analysis. The accuracies in each age group were also evaluated in this study. The accuracy of sex determination based on a combination of features of the vertebra and ribs was 88.8% (533/600). This performance was superior to that of the vertebra or ribs only. Moreover, sex determination of subjects in their 20s demonstrated the highest accuracy (96.0%, 96/100). The features selected in the stepwise discriminant analysis included some features in both the vertebra and ribs. These results indicate the usefulness of combined information obtained from the vertebra and ribs for sex determination. We conclude that a combination of geometric characteristics obtained from the vertebra and ribs could be useful for determining sex. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Experimental investigations on frictional resistance and velocity distribution of rough wall with regularly distributed triangular ribs

    International Nuclear Information System (INIS)

    Motozawa, Masaaki; Ito, Takahiro; Iwamoto, Kaoru; Kawashima, Hideki; Ando, Hirotomo; Senda, Tetsuya; Tsuji, Yoshiyuki; Kawaguchi, Yasuo

    2013-01-01

    Highlights: • Flow over the regularly distributed triangular ribs was investigated. • Simultaneous measurement of flow resistance and velocity profile was performed. • Flow resistance was measured directly and velocity profile was measured by LDV. • Flow resistance was estimated by the information of the velocity field. • Estimated flow resistance has good agreement with the measured flow resistance. -- Abstract: The relationship between the flow resistance of a turbulent flow over triangular ribs regularly distributed on a wall surface and the velocity distribution around the ribs was investigated experimentally. A concentric cylinder device composed of an inner test cylinder and an outer cylinder was employed to measure the flow resistance using the torque of the shaft of the inner cylinder and the velocity distribution of the flow around a rib by laser Doppler velocimetry (LDV) simultaneously. We prepared four inner test cylinders having 4, 8, 12 and 16 triangular ribs on the surface with the same interval between them. Each rib had an isosceles right triangle V-shape and a height of 2 mm. To investigate the relationship between flow resistance and velocity distribution, we estimated the frictional drag and pressure drag acting on the surface of the ribs separately using the velocity distribution. Therefore, we could also estimate the total flow resistance using the velocity distribution. As a result of the experiment, the flow resistance and the attachment point downstream of the rib were shown to depend on the distance between ribs. Moreover, the flow resistance estimated using the velocity distribution had good agreement with the flow resistance measured using the torque of the inner cylinder

  9. Flow Structure and Heat Transfer of Jet Impingement on a Rib-Roughened Flat Plate

    Directory of Open Access Journals (Sweden)

    Abdulrahman H. Alenezi

    2018-06-01

    Full Text Available The jet impingement technique is an effective method to achieve a high heat transfer rate and is widely used in industry. Enhancing the heat transfer rate even minimally will improve the performance of many engineering systems and applications. In this numerical study, the convective heat transfer process between orthogonal air jet impingement on a smooth, horizontal surface and a roughened uniformly heated flat plate is studied. The roughness element takes the form of a circular rib of square cross-section positioned at different radii around the stagnation point. At each location, the effect of the roughness element on heat transfer rate was simulated for six different heights and the optimum rib location and rib dimension determined. The average Nusselt number has been evaluated within and beyond the stagnation region to better quantify the heat transfer advantages of ribbed surfaces over smooth surfaces. The results showed both flow and heat transfer features vary significantly with rib dimension and location on the heated surface. This variation in the streamwise direction included both augmentation and decrease in heat transfer rate when compared to the baseline no-rib case. The enhancement in normalized averaged Nusselt number obtained by placing the rib at the most optimum radial location R/D = 2 was 15.6% compared to the baseline case. It was also found that the maximum average Nusselt number for each location was achieved when the rib height was close to the corresponding boundary layer thickness of the smooth surface at the same rib position.

  10. Isolated Cervical Rib Fracture: A Rare Etiology of Thoracic Outlet Syndrome

    Directory of Open Access Journals (Sweden)

    Rayees Ahmad Dar

    2011-01-01

    Full Text Available Isolated fracture of a cervical rib is a very rare entity and usually presents as a painless swelling or as thoracic outlet syndrome. We describe a case of a 45-year-old woman with history of fall two months back. She presented with symptoms of neurogenic thoracic outlet syndrome for one month. Isolated left cervical rib fracture was documented on X-ray cervical spine. Her fractured cervical rib was resected through a supraclavicular approach, and symptoms resolved completely in the postoperative period.

  11. Preoperative three-dimensional printing for surgical stabilization of rib fractures

    Directory of Open Access Journals (Sweden)

    Wei-Chun Lin

    2018-01-01

    Full Text Available Pulmonary trauma is a significant cause of morbidity and mortality in patients with major trauma. Chest wall contusion with rib fracture is very common. Surgical stabilization of rib fracture (SSRF has traditionally required an exploratory thoracotomy for adequate exposure. Minimally invasive approaches for SSRF are now being developed. However, preoperative localization of rib fractures and intraoperative designing of titanium plates require additional time. We present a novel technique involving three-dimensional printing for promoting SSRF with a minimally invasive approach that is efficient and provides good patient outcomes.

  12. Thoracic Outlet Syndrome in a Volleyball Player Due to Nonunion of the First Rib Fracture.

    Science.gov (United States)

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

    2016-11-01

    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.

  13. Reoperative surgical stabilization of a painful nonunited rib fracture using bone grafting and a metal plate.

    Science.gov (United States)

    Cho, Yang Hyun; Kim, Hyun Koo; Kang, Du-Young; Choi, Young Ho

    2009-09-01

    We report a case of a nonunited sixth rib in a patient with multiple rib fractures who underwent internal fixation using a wire and Judet strut 3 times. During the following 3 years, the patient continued to complain of pain and instability. At surgery, a pseudarthrosis between the ends of the sixth rib was excised. A longitudinal gutter crossing the fracture site was fashioned and splinted with an inlay block of cancellous bone grafted from the iliac crest; stabilization was accomplished with a reconstruction plate and screws. The following 2 years of follow-up demonstrated no instability or pain.

  14. Naumoff short-rib polydactyly syndrome compounded with Mohr oral-facial-digital syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Young, L.W.; Wilhelm, L.L. [Loma Linda Univ., CA (United States). Medical Center; Zuppan, C.W. [Div. of Pediatric Pathology, Loma Linda University Medical Center, CA (United States); Clark, R. [Div. of Medical Genetics, Loma Linda University Medical Center, CA (United States)

    2001-01-01

    A stillborn baby boy had findings of severe constitutional dwarfism with short limbs, short ribs, and polydactyly that were consistent with Naumoff (type III) short-rib polydactyly syndrome. He also had additional congenital anomalies, including cleft palate, notching of the upper lip, small tongue with accessory sublingual tissue. These oral and pharyngeal anomalies were consistent with Mohr (type II) oral-facial-digital syndrome. We suggest the stillborn infant represented a compound of Naumoff short-rib polydactyly syndrome (SRPS-III) and Mohr oral-facial-digital syndrome (OFDS-II). (orig.)

  15. Effects of age-related increases in sapwood area, leaf area, and xylem conductivity on height-related hydraulic costs in two contrasting coniferous species

    Science.gov (United States)

    Jean-Christophe Domec; Barbara Lachenbruch; Michele L. Pruyn; Rachel Spicer

    2012-01-01

    Introduction: Knowledge of vertical variation in hydraulic parameters would improve our understanding of individual trunk functioning and likely have important implications for modeling water movement to the leaves. Specifically, understanding how foliage area (Al), sapwood area (As), and hydraulic specific...

  16. The ribs unfolded - a CT visualization algorithm for fast detection of rib fractures: effect on sensitivity and specificity in trauma patients

    International Nuclear Information System (INIS)

    Ringl, Helmut; Lazar, Mathias; Toepker, Michael; Woitek, Ramona; Prosch, Helmut; Asenbaum, Ulrika; Balassy, Csilla; Toth, Daniel; Weber, Michael; Mang, Thomas; Hajdu, Stefan; Soza, Grzegorz; Wimmer, Andreas

    2015-01-01

    To assess a radiologist's detection rate of rib fractures in trauma CT when reading curved planar reformats (CPRs) of the ribs compared to reading standard MPRs. Two hundred and twenty trauma CTs (146 males, 74 females) were retrospectively subjected to a software algorithm to generate CPRs of the ribs. Patients were split into two equal groups. Sixteen patients were excluded due to insufficient segmentation, leaving 107 patients in group A and 97 patients in group B. Two radiologists independently evaluated group A using CPRs and group B using standard MPRs. Two different radiologists reviewed both groups with the inverse methods setting. Results were compared to a standard of reference created by two senior radiologists. The reference standard identified 361 rib fractures in 61 patients. Reading CPRs showed a significantly higher overall sensitivity (P < 0.001) for fracture detection than reading standard MPRs, with 80.9 % (584/722) and 71.5 % (516/722), respectively. Mean reading time was significantly shorter for CPRs (31.3 s) compared to standard MPRs (60.7 s; P < 0.001). Using CPRs for the detection of rib fractures accelerates the reading of trauma patient chest CTs, while offering an increased overall sensitivity compared to conventional standard MPRs. (orig.)

  17. The ribs unfolded - a CT visualization algorithm for fast detection of rib fractures: effect on sensitivity and specificity in trauma patients

    Energy Technology Data Exchange (ETDEWEB)

    Ringl, Helmut; Lazar, Mathias; Toepker, Michael; Woitek, Ramona; Prosch, Helmut; Asenbaum, Ulrika; Balassy, Csilla; Toth, Daniel; Weber, Michael; Mang, Thomas [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Hajdu, Stefan [Medical University of Vienna, Department of Trauma Surgery, Vienna (Austria); Soza, Grzegorz; Wimmer, Andreas [Siemens AG, Healthcare Sector, Computed Tomography, Forchheim (Germany)

    2015-07-15

    To assess a radiologist's detection rate of rib fractures in trauma CT when reading curved planar reformats (CPRs) of the ribs compared to reading standard MPRs. Two hundred and twenty trauma CTs (146 males, 74 females) were retrospectively subjected to a software algorithm to generate CPRs of the ribs. Patients were split into two equal groups. Sixteen patients were excluded due to insufficient segmentation, leaving 107 patients in group A and 97 patients in group B. Two radiologists independently evaluated group A using CPRs and group B using standard MPRs. Two different radiologists reviewed both groups with the inverse methods setting. Results were compared to a standard of reference created by two senior radiologists. The reference standard identified 361 rib fractures in 61 patients. Reading CPRs showed a significantly higher overall sensitivity (P < 0.001) for fracture detection than reading standard MPRs, with 80.9 % (584/722) and 71.5 % (516/722), respectively. Mean reading time was significantly shorter for CPRs (31.3 s) compared to standard MPRs (60.7 s; P < 0.001). Using CPRs for the detection of rib fractures accelerates the reading of trauma patient chest CTs, while offering an increased overall sensitivity compared to conventional standard MPRs. (orig.)

  18. Dorsiflexor muscle-group thickness in children with cerebral palsy: Relation to cross-sectional area

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Magnusson, Peter; Jensen, Bente Rona

    2009-01-01

    If the thickness and cross-sectional area of the dorsiflexor muscle group are related in children with cerebral palsy, measurements of muscle thickness may be used to monitor changes in muscle size due to training or immobilisation in these patients. We assessed the validity and reliability.......001), and the reliability of the muscle-thickness measurements was high in the healthy subjects (ICC_{2.1} = 0.94, standard error of measurement = 0.04 cm). The dorsiflexor muscle-thickness was 22% less in the affected compared to the non-affected leg in children with hemiplegic cerebral palsy (P ..., the dorsiflexor cross-sectional area was 32% less in the affected compared to the non-affected leg (P = 0.002). Measurements of dorsiflexor muscle-thickness can be reliably obtained, and they reflect dorsiflexor cross-sectional area in children with cerebral palsy....

  19. Increased genetic divergence between two closely related fir species in areas of range overlap

    Science.gov (United States)

    Wang, Jing; Abbott, Richard J; Ingvarsson, Pär K; Liu, Jianquan

    2014-01-01

    Because of introgressive hybridization, closely related species can be more similar to each other in areas of range overlap (parapatry or sympatry) than in areas where they are geographically isolated from each other (allopatry). Here, we report the reverse situation based on nuclear genetic divergence between two fir species, Abies chensiensis and Abies fargesii, in China, at sites where they are parapatric relative to where they are allopatric. We examined genetic divergence across 126 amplified fragment length polymorphism (AFLP) markers in a set of 172 individuals sampled from both allopatric and parapatric populations of the two species. Our analyses demonstrated that AFLP divergence was much greater between the species when comparisons were made between parapatric populations than between allopatric populations. We suggest that selection in parapatry may have largely contributed to this increased divergence. PMID:24772279

  20. Baseline geophysical data for hazard management in coastal areas in relation to earthquakes and tsunamis

    Digital Repository Service at National Institute of Oceanography (India)

    Murthy, K.S.R.

    is another factor for some of the intraplate earthquakes in the South Indian Shield, which includes the Eastern and Western Continental Margins of India. Baseline geophysical data for hazard management in coastal areas in relation to earthquakes... surge. Keywords Hazard management, marine geophysical data, geomorphology and tsunami surge, coastal seismicity Date received: 7 August 2015; accepted: 15 October 2015 CSIR – National Institute of Oceanography, Visakhapatnam, India Corresponding author...

  1. Idiopathic and normal lateral lumbar curves: muscle effects interpreted by 12th rib length asymmetry with pathomechanic implications for lumbar idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Theodoros B. Grivas

    2016-10-01

    congenitally lengthened, induced mechanically, or both. Several small muscles are attached to the 12th ribs. We focus attention here on the largest of these muscles namely, QL. It has attachments to the pelvis, 12th ribs and transverse processes of lumbar vertebrae as origins and as insertions. Given increased muscle activity on the lumbar curve convexity and similar to the interpretations of earlier workers outlined above, we suggest two hypotheses, relatively increased activity of the right QL muscle causes the LLCs (first hypothesis; or counteracts the lumbar curvature as part of the body’s attempt to compensate for the curvature (second hypothesis. These hypotheses may be tested by electrical stimulation studies of QL muscles in subjects with lumbar IS by revealing respectively curve worsening or correction. We suggest that one mechanism leading to relatively increased length of the right 12 ribs is mechanotransduction in accordance with Wolff’s and Pauwels Laws.

  2. The effect of cooling conditions on convective heat transfer and flow in a steam-cooled ribbed duct

    International Nuclear Information System (INIS)

    Shui, Linqi; Gao, Jianmin; Shi, Xiaojun; Liu, Jiazeng; Xu, Liang

    2014-01-01

    This work presents a numerical and experimental investigation on the heat transfer and turbulent flow of cooling steam in a rectangular duct with 90 .deg. ribs and studies the effect of cooling conditions on the heat transfer augmentation of steam. In the calculation, the variation range of Reynolds is from 10,000 to 190,000, the inlet temperature varies from 300 .deg. C to 500 .deg. C and the outlet pressure is from 0.5MPa to 6MPa. The aforementioned wide ranges of flow parameters cover the actual operating condition of coolant used in the gas turbine blades. The computations are carried with four turbulence models (the standard k-ε, the renormalized group (RNG) k-ε, the Launder-Reece-Rodi (LRR) and the Speziale-Sarkar-Gatski (SSG) turbulence models). The comparison of numerical and experimental results reveals that the SSG turbulence model is suitable for steam flow in the ribbed duct. Therefore, adopting the conjugate calculation technique, further study on the steam heat transfer and flow characteristics is performed with SSG turbulence model. The results show that the variation of cooling condition strongly impacts the forced convection heat transfer of steam in the ribbed duct. The cooling supply condition of a relative low temperature and medium pressure could bring a considerable advantage on steam thermal enhancement. In addition, comparing the heat transfer level between steam flow and air flow, the performance advantage of using steam is also influenced by the cooling supply condition. Changing Reynolds number has little effect on the performance superiority of steam cooling. Increasing pressure would strengthen the advantage, but increasing temperature gives an opposite result.

  3. Chondromyxoid fibroma of rib with a novel chromosomal translocation: a report of four additional cases at unusual sites

    Directory of Open Access Journals (Sweden)

    Parwani Anil V

    2007-11-01

    Full Text Available Abstract Background Chondromyxoid fibromas (CMFs are rare benign chondroid/myxoid matrix-producing tumors that occur in metaphyses of long tubular bones, and very rarely in small bones of hands and feet. Flat bone involvement is even more uncommon. Prior cytogenetic analyses have identified complex abnormalities involving chromosome 6 in the majority of cases. Methods A search for CMF over an 8-year period (1999–2006 from the surgical pathology files of our institution yielded 16 cases. Four cases occurred in relatively unusual regions, three from the small bones of distal extremities and one from the rib. The rib lesion wassubmitted forroutinecytogenetic analysis. Results Radiographic studies revealed that all four lesions were well-defined expansile radiolucent lesions which expanded the bony cortices with lobulated margins, sclerotic rim, septation, and no calcification. Morphologically, all four lesions showed typical features of CMF and had low proliferative index with Ki-67. Cytogenetic analysis on the rib lesion revealed a novel chromosomal translocation, t(1;5(p13;p13. None of the four patients had a recurrence after a mean duration of follow-up of 24 months. Conclusion CMF originating in unusual locations should be distinguished from chondrosarcomas, especially on small biopsies, and should be included in the differential diagnosis. As previously noted in the literature, the cells can be positive for actin but unlike conventional chondroid neoplasms can be negative for S-100. To our knowledge, this is the first report describing a novel chromosomal translocation, t(1;5(p13;p13 in CMF.

  4. The effect of cooling conditions on convective heat transfer and flow in a steam-cooled ribbed duct

    Energy Technology Data Exchange (ETDEWEB)

    Shui, Linqi; Gao, Jianmin; Shi, Xiaojun; Liu, Jiazeng; Xu, Liang [Xi' an Jiaotong University, Xi' an (China)

    2014-01-15

    This work presents a numerical and experimental investigation on the heat transfer and turbulent flow of cooling steam in a rectangular duct with 90 .deg. ribs and studies the effect of cooling conditions on the heat transfer augmentation of steam. In the calculation, the variation range of Reynolds is from 10,000 to 190,000, the inlet temperature varies from 300 .deg. C to 500 .deg. C and the outlet pressure is from 0.5MPa to 6MPa. The aforementioned wide ranges of flow parameters cover the actual operating condition of coolant used in the gas turbine blades. The computations are carried with four turbulence models (the standard k-ε, the renormalized group (RNG) k-ε, the Launder-Reece-Rodi (LRR) and the Speziale-Sarkar-Gatski (SSG) turbulence models). The comparison of numerical and experimental results reveals that the SSG turbulence model is suitable for steam flow in the ribbed duct. Therefore, adopting the conjugate calculation technique, further study on the steam heat transfer and flow characteristics is performed with SSG turbulence model. The results show that the variation of cooling condition strongly impacts the forced convection heat transfer of steam in the ribbed duct. The cooling supply condition of a relative low temperature and medium pressure could bring a considerable advantage on steam thermal enhancement. In addition, comparing the heat transfer level between steam flow and air flow, the performance advantage of using steam is also influenced by the cooling supply condition. Changing Reynolds number has little effect on the performance superiority of steam cooling. Increasing pressure would strengthen the advantage, but increasing temperature gives an opposite result.

  5. Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol.

    Science.gov (United States)

    Witt, Cordelie E; Bulger, Eileen M

    2017-01-01

    Rib fractures are common among patients sustaining blunt trauma, and are markers of severe bodily and solid organ injury. They are associated with high morbidity and mortality, including multiple pulmonary complications, and can lead to chronic pain and disability. Clinical and radiographic scoring systems have been developed at several institutions to predict risk of complications. Clinical strategies to reduce morbidity have been studied, including multimodal pain management, catheter-based analgesia, pulmonary hygiene, and operative stabilization. In this article, we review risk factors for morbidity and complications, intervention strategies, and discuss experience with bundled clinical pathways for rib fractures. In addition, we introduce the multidisciplinary rib fracture management protocol used at our level I trauma center.

  6. Giant cell tumor of the rib: Two cases of F-18 FDG PET/CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Lim; Yoo, Le Ryung; Lee, Yeong Joo; Jung, Chan Kwon [Seoul St. Mary' s Hospital, College of MedicineThe Catholic University of Korea, Seoul (Korea, Republic of); Park, Sonya Young Ju [Molecular Imaging Program, Dept. of Radiology, Stanford Hospital and Clinics, Stanford (Korea, Republic of)

    2017-06-15

    We report two cases of giant cell tumor arising from the rib and their F-18 FDG PET/CT findings. The two patients complained of chest wall pain, and large lobulated soft tissue masses with intense FDG uptake were seen on F-18 FDG PET/CT. A malignant tumor such as osteosarcoma or chondrosarcoma was suspected due to the large size of the mass, bony destruction, and intense FDG uptake. En bloc resection was performed and final pathologic results revealed giant cell tumor of the rib. Giant cell tumor of the rib is very rare, and larger lesions with high FDG uptake can be misdiagnosed as an intrathoracic malignancy arising from the rib, pleura, or chest wall.

  7. Phrenic Arterial Injury Presenting as Delayed Hemothorax Complicating Simple Rib Fracture.

    Science.gov (United States)

    Ahn, Hong Joon; Lee, Jun Wan; Kim, Kun Dong; You, In Sool

    2016-04-01

    Delayed hemothorax after blunt torso injury is rare, but might be associated with significant morbidity and mortality. We present a case of delayed hemothorax bleeding from phrenic artery injury in a 24-year-old woman. The patient suffered from multiple rib fractures on the right side, a right hemopneumothorax, thoracic vertebral injury and a pelvic bone fracture after a fall from a fourth floor window. Delayed hemothorax associated with phrenic artery bleeding, caused by a stab injury from a fractured rib segment, was treated successfully by a minimally invasive thoracoscopic surgery. Here, we have shown that fracture of a lower rib or ribs might be accompanied by delayed massive hemothorax that can be rapidly identified and promptly managed by thoracoscopic means.

  8. Plating versus wiring for fixation of traumatic rib and sternal fractures

    Directory of Open Access Journals (Sweden)

    Mostafa Kamel Abd-Elnaim

    2017-12-01

    Conclusions: Plating of rib and sternal fractures had better outcome than wiring, regarding better chest wall stability and restoration of chest contour; also it had shorter intensive care unit, hospital and ventilator days.

  9. Sonography of occult rib and costal cartilage fractures: a case series.

    Science.gov (United States)

    Mattox, Ross; Reckelhoff, Kenneth E; Welk, Aaron B; Kettner, Norman W

    2014-06-01

    The purpose of this case series is to describe the use of diagnostic ultrasound (US) in the detection of occult rib and costal cartilage fractures presenting as chest wall pain to a chiropractic clinic. Three patients presented with chest wall pain and tenderness. Two of the patients presented with acute chest wall injury and 1 carried a previous diagnosis of rib fracture after trivial trauma 2 months earlier. Diagnostic US was selected as a non-ionizing imaging tool for these patients after negative digital radiography studies. All fractures were considered isolated as there was no associated injury, such as pneumothorax. Both of the acute cases were followed up to complete healing (evidence of osseous union) using US. All patients eventually achieved pain-free status. In these cases, US was more sensitive than radiography for diagnosing these cases of acute rib and costal cartilage fractures. Early recognition of rib injury could avoid potential complications from local manipulative therapy.

  10. Assessment and management of rib fracture pain in geriatric population: an ode to old age.

    Science.gov (United States)

    Wardhan, Richa

    2013-10-01

    Pain management for traumatic rib fractures has been described in literature, but there is paucity of data when it comes to acute pain management in the elderly, let alone pain resulting from traumatic rib fractures. This article focuses on challenges of assessment of pain in elderly patients and the various options available for pain management including utilization of nerve blocks. Nerve blocks are instrumental in treating rib fracture pain along with utilization of opioids and nonopioids thus formulating a multimodal approach to pain management. The goal is to devise a proper pain management regimen for geriatric patients with rib fractures to decrease the morbidity and mortality associated with it. Developing institutional protocols is one step forward towards quality care for such patients.

  11. Exercise-induced rib stress fractures: influence of reduced bone mineral density

    DEFF Research Database (Denmark)

    Vinther, Anders; Kanstrup, Inge-Lis; Christiansen, Erik

    2005-01-01

    study investigated BMD in seven Danish national team rowers with previous rib stress fracture (RSF) and 7 controls (C) matched for gender, age, height, weight and training experience. Total body scan and specific scans of the lumbar spine (L2-L4), femoral neck and distal radius were performed using......Exercise-induced rib stress fractures have been reported frequently in elite rowers during the past decade. The etiology of rib stress fractures is unclear, but low bone mineral density (BMD) has been suggested to be a potential risk factor for stress fractures in weight-bearing bones. The present...... density may be a potential risk factor for the development of exercise-induced rib stress fractures in elite rowers....

  12. Flexural strength and behaviour of SFRSCC ribbed slab under four point bending

    Science.gov (United States)

    Ahmad, Hazrina; Hashim, Mohd Hisbany Mohd; Bakar, Afidah Abu; Hamzah, Siti Hawa; Rahman, Fadhillah Abdul

    2017-11-01

    An experimental investigation was carried out to study the ultimate strength and behaviour of SFRSCC ribbed slab under four point bending. Comparison was been made between ribbed slab that was fully reinforced with steel fibres (SFWS) with conventionally reinforced concrete ribbed slab (CS and CRC). The volume fraction of the 35 mm hooked end steel fibres used in the mix was 1% (80 kg/m3) with the aspect ratio of 65. Three full scale slab samples with the dimension of 2.8 x 1.2 m with 0.2 m thickness was constructed for the purpose of this study. The slab samples was loaded until failure in a four point bending test. As a whole, based on the results, it can be concluded that the performance of the steel fiber reinforced samples (SFWS) was found to be almost equivalent to the conventionally reinforced concrete ribbed slab sample (CRC).

  13. Posterior rib fractures in a young infant who received chiropractic care.

    Science.gov (United States)

    Wilson, Paria Majd; Greiner, Mary V; Duma, Elena M

    2012-11-01

    We report on a 21-day-old infant with healing posterior rib fractures that were noted after a chiropractic visit for colic. Chiropractors are the third largest group of health care professionals in the United States, and colic is the leading complaint for pediatric chiropractic care. Rib fractures, specifically when posterior, are traditionally considered to be secondary to nonaccidental trauma. Thorough investigation is necessary to rule out bone fragility and genetic disorders, but patient history is key when evaluating unexplained fractures.

  14. Risk Factors for Pneumonia in Ventilated Trauma Patients with Multiple Rib Fractures

    OpenAIRE

    Park, Hyun Oh; Kang, Dong Hoon; Moon, Seong Ho; Yang, Jun Ho; Kim, Sung Hwan; Byun, Joung Hun

    2017-01-01

    Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and De...

  15. The chemical heritage of Aspergillus flavus in A. oryzae RIB 40

    OpenAIRE

    Rank, Christian; Klejnstrup, Marie Louise; Petersen, Lene Maj; Frisvad, Jens Christian; Larsen, Thomas Ostenfeld

    2011-01-01

    Aspergillus oryzae is a very important species in biotechnology and has been used for centuries in traditional Asian fermentation. The RIB40 strain is particularly interesting as it was one of the first genome sequenced Aspergilli together with A. flavus, a prominent food and feed contaminant capable of producing aflatoxin. These species can be perceived as ecotypes. We have analyzed A. oryzae RIB40 and found that the chemical potential could be enhanced significantly under certain conditions...

  16. Frequency of intrathoracic injuries in children younger than 3 years with rib fractures

    International Nuclear Information System (INIS)

    Darling, Stephen E.; Done, Stephen L.; Friedman, Seth D.; Feldman, Kenneth W.

    2014-01-01

    Research documents that among children admitted to trauma intensive care units the number of rib fractures sustained indicates the child's likelihood of having and severity of intrathoracic injury. This has been misused in court to argue that children with multiple rib fractures who lack intrathoracic injury have abnormal bone fragility rather than inflicted injury. To determine frequency of intrathoracic injuries in children younger than 3 years with rib fractures in cases of child abuse and accidental trauma. We conducted a retrospective review of rib fractures caused by documented abuse or accidents from 2003 to 2010 in children treated at Seattle Children's Hospital and Harborview Medical Center. A senior pediatric radiologist and radiology fellow independently reviewed the imaging. Children with bone demineralization were excluded. Descriptive and simple comparative statistics were used. Seventy-two percent (47/65) of infants and toddlers with rib fractures were abused. Abused children had more rib fractures than accidentally injured children (5.55 vs. 3.11, P = 0.012). However intrathoracic injuries as a whole (55.6% vs. 12.8%, P < 0.001) and individual types of intrathoracic injuries were more common with accidents. Rates of other thoracic cage injuries did not differ substantially (27.8% accidents vs. 12.8% abuse, P = 0.064). Intracranial and intra-abdominal injuries and skull fractures were equally frequent, but other extrathoracic fractures were more common with abuse (70.2% vs. 16.7%, P < 0.001). Abused infants and toddlers have fewer intrathoracic injuries but more rib fractures than accidentally injured peers. This likely reflects different injury mechanics. Lack of intrathoracic injuries in abused children with rib fractures does not imply bone fragility. (orig.)

  17. Frequency of intrathoracic injuries in children younger than 3 years with rib fractures

    Energy Technology Data Exchange (ETDEWEB)

    Darling, Stephen E. [Kapiolani Children' s Hospital, The Department of Radiology, Honolulu, HI (United States); Done, Stephen L.; Friedman, Seth D. [Seattle Children' s Hospital, The Department' s of Radiology, Seattle, WA (United States); University of Washington School of Medicine, Seattle, WA (United States); Feldman, Kenneth W. [Seattle Children' s Hospital, Pediatrics, General Pediatrics Division, Seattle, WA (United States); Seattle Children' s Protection Program, Children' s Protection Program, M/S M2-10, Seattle, WA (United States); University of Washington School of Medicine, Seattle, WA (United States)

    2014-10-15

    Research documents that among children admitted to trauma intensive care units the number of rib fractures sustained indicates the child's likelihood of having and severity of intrathoracic injury. This has been misused in court to argue that children with multiple rib fractures who lack intrathoracic injury have abnormal bone fragility rather than inflicted injury. To determine frequency of intrathoracic injuries in children younger than 3 years with rib fractures in cases of child abuse and accidental trauma. We conducted a retrospective review of rib fractures caused by documented abuse or accidents from 2003 to 2010 in children treated at Seattle Children's Hospital and Harborview Medical Center. A senior pediatric radiologist and radiology fellow independently reviewed the imaging. Children with bone demineralization were excluded. Descriptive and simple comparative statistics were used. Seventy-two percent (47/65) of infants and toddlers with rib fractures were abused. Abused children had more rib fractures than accidentally injured children (5.55 vs. 3.11, P = 0.012). However intrathoracic injuries as a whole (55.6% vs. 12.8%, P < 0.001) and individual types of intrathoracic injuries were more common with accidents. Rates of other thoracic cage injuries did not differ substantially (27.8% accidents vs. 12.8% abuse, P = 0.064). Intracranial and intra-abdominal injuries and skull fractures were equally frequent, but other extrathoracic fractures were more common with abuse (70.2% vs. 16.7%, P < 0.001). Abused infants and toddlers have fewer intrathoracic injuries but more rib fractures than accidentally injured peers. This likely reflects different injury mechanics. Lack of intrathoracic injuries in abused children with rib fractures does not imply bone fragility. (orig.)

  18. Passive microwave observations of inundation area and the area/stage relation in the Amazon River floodplain

    International Nuclear Information System (INIS)

    Sippel, S.J.; Hamilton, S.K.; Melack, J.M.; Novo, E.M.M.

    1998-01-01

    Inundation patterns in Amazon River floodplains are revealed by analysis of the 37GHz polarization difference observed by the Scanning Multichannel Microwave Radiometer on the Nimbus-7 satellite. Flooded area is estimated at monthly intervals for January 1979 through August 1987 using mixing models that account for the major landscape units with distinctive microwave emission characteristics. Results are presented separately for 12 longitudinal reaches along the Amazon River main stem in Brazil as well as for three major tributaries (the Jurua, Purus and Madeira rivers). The total area along the Amazon River main stem that was flooded (including both floodplain and open water) varied between 19 000 and 91 000 km 2 . The correlation between flooded area and river stage is used to develop a predictive relationship and reconstruct regional inundation patterns in the floodplain of the Amazon River main stem over the past 94 years of stage records (1903± 1996). The mean flooded area along the Amazon River during this 94-year period was 46 800 km 2 , of which the openwater surfaces of river channels and floodplain lakes comprised about 20 700 km 2 . (author)

  19. Dorsal and ventral working memory-related brain areas support distinct processes in contextual cueing.

    Science.gov (United States)

    Manginelli, Angela A; Baumgartner, Florian; Pollmann, Stefan

    2013-02-15

    Behavioral evidence suggests that the use of implicitly learned spatial contexts for improved visual search may depend on visual working memory resources. Working memory may be involved in contextual cueing in different ways: (1) for keeping implicitly learned working memory contents available during search or (2) for the capture of attention by contexts retrieved from memory. We mapped brain areas that were modulated by working memory capacity. Within these areas, activation was modulated by contextual cueing along the descending segment of the intraparietal sulcus, an area that has previously been related to maintenance of explicit memories. Increased activation for learned displays, but not modulated by the size of contextual cueing, was observed in the temporo-parietal junction area, previously associated with the capture of attention by explicitly retrieved memory items, and in the ventral visual cortex. This pattern of activation extends previous research on dorsal versus ventral stream functions in memory guidance of attention to the realm of attentional guidance by implicit memory. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Rib Bone Graft Adjusted to Fit the Facial Asymmetry: A Frame Structure Graft.

    Science.gov (United States)

    Lee, Yoon Ho; Choi, Jong Hwan; Hwang, Kun; Choi, Jun Ho

    2015-10-01

    The authors introduce the concept of a "frame structure graft" in which a harvested rib bone was adjusted to fit facial asymmetry. On the costochondral junction of the sixth or seventh rib, a 5 cm incision was made. Through a subperiosteal dissection, the rib bone was harvested. Using a reciprocating saw, the harvested rib was scored on its anterior surface as well as its posterior surface with a partial depth at different intervals. The harvested rib bone was placed on the skin surface of the unaffected side of the face and a curvature was created exactly matching that of the unaffected side by bending the bone using a greenstick fracture. Thereafter, the graft was adjusted to conceal the asymmetry of the deficient side. The adjusted "frame structure" was transferred to the defect through the incisions on the affected side, and the "frame structure" graft was placed on the mandible or zygoma. The graft fixation was done externally with at least 2 Kirschner wires (K-wires). From January 2005 to August 2013, a total of 30 patients (13 men, 17 women, mean age 25.6 years) received a frame structure graft. All 30 patients achieved good healing at the operation site without complications. Donor-site morbidity as pneumothorax from the rib bone harvest was not found. Merits of this frame structure graft, the authors think, are that this method could allow a similar curvature to the normal side. In addition, the procedure itself is easy.

  1. Multiple Rib Nonunion: Open Reduction and Internal Fixation and Iliac Crest Bone Graft Aspirate.

    Science.gov (United States)

    Kaplan, Daniel J; Begly, John; Tejwani, Nirmal

    2017-08-01

    Rib fractures are a common chest injury that can typically be treated nonoperatively. However, a percentage of these will go on to nonunion, either because of unique characteristics of the fracture itself or because of a variety of poor healing factors of the host. If a patient has continued symptomology beyond 3 months, surgeons may consider operative management. Although isolated resection of fibrous scar tissue from the nonunion site may be sufficient in some cases, it may also be necessary to provide additional structural integrity to the rib depending on the extent of the fracture pattern and resection. This goal can be achieved operatively with rib plating and bone grafting to promote healing. This video demonstrates the use of plating in the treatment of rib nonunion. It begins with relevant background information on rib fractures and nonunions, then details the approach, open reduction and internal fixation of 3 ribs using plates and bone graft aspirate. Pearls and pitfalls are included during the surgical technique aspect of the video to both help guide surgeons new to the procedure and provide potentially advantageous technical details to more experienced surgeons.

  2. First rib fractures: not always a hallmark of severe trauma-a report of three cases

    Directory of Open Access Journals (Sweden)

    Jaiswal Atin

    2013-08-01

    Full Text Available 【Abstract】According to medical literature, fracture of the first rib is quite rare and the bilateral condition is especially rare. This type of fracture is usually associated with severe intrathoracic trauma and other bony or neurovascular injuries, thus can be considered as a harbinger of major trauma. However here we present three cases of low velocity first rib fractures without any major trauma or multisystem injuries. All the three patients were treated conservatively and did well on simple analgesics and rest and had no early or late complications. It can be seen that not all the first rib fractures are associated with major trauma or multisystem injuries. There is a variant of first rib fracture with low velocity injuries which is not associated with any major complications in contrast to majority of first rib fractures associated with high velocity injuries. Causative factor of such injuries may be violent muscular contraction of scalenus anterior or serratus anterior, but not direct trauma. Key words: Rib fractures; Wounds and injuries; Multiple trauma

  3. The Efficacy of Platelet-Rich Plasma in the Treatment of Rib Fractures.

    Science.gov (United States)

    Gunay, Samil; Candan, Huseyin; Yılmaz, Rahsan; Eser, Irfan; Aydoğmus, Umit

    2017-10-01

    Background  Rib fracture is the most common result of thoracic traumas. Intrapulmonary shunt, alveolar capillary membrane damage, intra-alveolar hemorrhage, and hypoxia may develop following rib fractures. Therefore, prompt treatment is important. The aim of this experimental study was to analyze the effects of platelet-rich plasma (PRP) on rib fractures to secure a speedier and more efficient treatment method. Materials and Methods  The study involved 18 New Zealand white rabbits, randomly divided into three groups as Group 1, the sham group with no surgical intervention; Group 2, the control group in which simple rib fractures were applied and no treatment; and Group 3, in which rib fractures were applied and then PRP treatment was administered. Results  The mean recovery plate thickness measurements were found to be statistically significantly higher in the PRP group compared with the other groups ( p  rib fractures and used easily in pseudoarthrosis, surgical fracture, or flail chest. Georg Thieme Verlag KG Stuttgart · New York.

  4. Prevalence and characteristics of rib fractures in ex-preterm infants.

    Science.gov (United States)

    Lucas-Herald, Angela; Butler, Sandra; Mactier, Helen; McDevitt, Helen; Young, David; Ahmed, Syed Faisal

    2012-12-01

    This study aimed to identify the prevalence and characteristics of rib fractures in ex-preterm infants. Infants born at rib fractures, and the case notes of all affected individuals were scrutinized. Of the 3318 eligible preterm infants, 1446 had a total of 9386 chest radiographs. Of these infants, 26 (1.8%) were identified as having a total of 62 rib fractures. Their median (range) gestation at birth was 26 weeks (23-34). The median chronological age of these infants at the time of the radiograph was 14 weeks (5 weeks to 8 months). The median corrected gestational age at the time of the radiograph was 39 weeks (34 weeks to 4 months). Of the 62 fractures, 27 (36%) were sited posteriorly, and 15 (53%) of the infants with posterior rib fractures were diagnosed with osteopathy of prematurity. Classic risk including conjugated hyperbilirubinemia and diuretics, were present in 23 of 26 (88%) infants. A full skeletal survey was performed in 8 of 26 (31%). Investigations for nonaccidental injury occurred in 4 of 26 (15%) cases. Evidence of rib fractures is present in ~2% of ex-preterm infants. The evaluation of these fractures in infancy requires a detailed neonatal history irrespective of the site of rib fracture.

  5. Retrospective evaluation and dating of non-accidental rib fractures in infants

    International Nuclear Information System (INIS)

    Sanchez, T.R.; Nguyen, H.; Palacios, W.; Doherty, M.; Coulter, K.

    2013-01-01

    Aim: To describe the sequential appearance of healing rib fractures on initial and follow-up radiographs using published guidelines in approximating the age of rib fractures in infants with the aim of establishing a more objective method of dating rib fractures by measuring the thickness of the callous formation. Materials and methods: This was a retrospective analysis of initial and follow-up digital skeletal surveys of infants less than 12 months of age performed between January 2008 and January 2012 at the University of California Davis Children's Hospital. Six radiological features of rib fractures evaluating the appearance of the callous formation (C stage) and fracture line (F stage) were assessed. Patients with osteogenesis imperfecta, known vitamin D deficiency, and skeletal or metabolic dysplasia were not included in the study. Thereafter, callous thickness was measured and recorded for each stage. Results: Sixteen infants (age range 1–11 months, seven males and nine females) with 23 rib fractures were analysed. The thickness of the callous formation follows a predictable pattern advancing one stage after a 2-week follow-up with progressive callous thickening starting from stage 2, peaks at around stage 4, and then tapers and remodels until it almost disappears when the fracture is healed at stage 6. Conclusion: It appears that rib fractures in infants follow a predictable pattern of healing. Measuring the thickness of the callous formation is a more objective way of guiding the radiologist in estimating the age of the fracture

  6. A prospective, controlled clinical evaluation of surgical stabilization of severe rib fractures.

    Science.gov (United States)

    Pieracci, Fredric M; Lin, Yihan; Rodil, Maria; Synder, Madelyne; Herbert, Benoit; Tran, Dong Kha; Stoval, Robert T; Johnson, Jeffrey L; Biffl, Walter L; Barnett, Carlton C; Cothren-Burlew, Clay; Fox, Charles; Jurkovich, Gregory J; Moore, Ernest E

    2016-02-01

    Previous studies of surgical stabilization of rib fractures (SSRF) have been limited by small sample sizes, retrospective methodology, and inclusion of only patients with flail chest. We performed a prospective, controlled evaluation of SSRF as compared with optimal medical management for severe rib fracture patterns among critically ill trauma patients. We hypothesized that SSRF improves acute outcomes. We conducted a 2-year clinical evaluation of patients with any of the following rib fracture patterns: flail chest, three or more fractures with bicortical displacement, 30% or greater hemithorax volume loss, and either severe pain or respiratory failure despite optimal medical management. In the year 2013, all patients were managed nonoperatively. In the year 2014, all patients were managed operatively. Outcomes included respiratory failure, tracheostomy, pneumonia, ventilator days, tracheostomy, length of stay, daily maximum incentive spirometer volume, narcotic requirements, and mortality. Univariate and multivariable analyses were performed. Seventy patients were included, 35 in each group. For the operative group, time from injury to surgery was 2.4 day, operative time was 1.5 hours, and the ratio of ribs fixed to ribs fractured was 0.6. The operative group had a significantly higher RibScore (4 vs. 3, respectively, p fracture patterns. Therapeutic study, level II.

  7. Regional effects of ovariectomy and cadmium on bone mineral in ribs from aged female beagles

    International Nuclear Information System (INIS)

    Hurst, D.R.

    1991-01-01

    The purpose of this study was to evaluate effects of estrogen depletion and cadmium (Cd) on bone calcium and to determine if these effects were localized in specific regions of ribs. Fourteen female beagles with 45 Ca labeled skeletons were divided into four groups: sham controls (SO-); ovariectomized (OV-); shams exposed to Cd (SO+); ovariecomized exposed to Cd (OV+). Total Cd exposure period was 7 months, including 1 month by capsules and 6 months by drinking H 2 O. Ribs were taken at necropsy from 12 of the 14 dogs, and each rib was quartered. Wet, dry, and ash weights, as well as total Ca and 45 Ca content, were determined for each quarter. Analysis of ribs from control animals demonstrated that a given rib is heterogeneous in composition. One end appears to be less mineralized and more metabolically active than other regions. The OV- and OV+ mid-rib regions had significantly lower dry and ash weights than SO-. Total Ca contents of these same regions were also decreased in the OV- and OV+. The only significant change in Ca/dry and Ca/ash was observed when comparing OV+ to SO-. Analysis of treatment suggests that there are regional effects following ovariectomy increased the loss of bone mineral occurring as a result of ovariectomy. 30 refs., 1 fig

  8. A Study on the Performance of the Split Reaction Water Turbine with Guide Ribs

    Science.gov (United States)

    Allen, Deuel H.; Villanueva, Eliseo P.

    2015-09-01

    The development of technologies that make use of renewable energy is of great significance presently. A new kind of turbine called Split Reaction Water Turbine (SRWT) using PVC pipes as material is a major contribution towards harnessing the energy potentials of small stream low head water resources. SRWTs of diameter to height ratio (D/H = 110 cm/160 cm) were tested at the MSU-IIT College of Engineering Fluid Engineering Laboratory. Data on volumetric flow and pressure head at the turbine inlet of the SRWT were recorded using National Instrument Data Processing System using LabView software. In later experiments, guide ribs were installed at the vane of the exit nozzles in order to determine the difference in the performance of the ribbed and the non-ribbed SRWT. Simulations of the running SRWT were conducted using SOLIDWORKS software. Results of the simulations aided in the thorough analyses of the data from the experimental runs. A comparison of data from the ribbed and non-ribbed SRWT shows that guide ribs were effective in directing the momentum of the exiting water to improve the speed of rotation. In this study, the increase in the speed of the Split Reaction Water Turbine was as much as 46%.

  9. Rib head protrusion into the central canal in type 1 neurofibromatosis

    International Nuclear Information System (INIS)

    Ton, Jimmy; Yen, Philip; Stein-Wexler, Rebecca; Gupta, Munish

    2010-01-01

    Intraspinal rib head dislocation is an important but under-recognized consequence of dystrophic scoliosis in patients with neurofibromatosis 1 (NF1). To present clinical and imaging findings of intraspinal rib head dislocation in NF1. We retrospectively reviewed clinical presentation, imaging, operative reports and post-operative courses in four NF1 patients with intraspinal rib head dislocation and dystrophic scoliosis. We also reviewed 17 cases from the English literature. In each of our four cases of intraspinal rib head dislocation, a single rib head was dislocated on the convex apex of the curve, most often in the mid- to lower thoracic region. Cord compression occurred in half of these patients. Analysis of the literature yielded similar findings. Only three cases in the literature demonstrates the MRI appearance of this entity; most employ CT. All of our cases include both MRI and CT; we review the subtle findings on MRI. Although intraspinal rib head dislocation is readily apparent on CT, sometimes MRI is the only cross-sectional imaging performed. It is essential that radiologists become familiar with this entity, as subtle findings have significant implications for surgical management. (orig.)

  10. Flexural performance of steel fiber reinforced concrete (SFRC) ribbed slab with various topping thicknesses

    Science.gov (United States)

    Rahman, Fadhillah Abdul; Bakar, Afidah Abu; Hashim, Mohd Hisbany Mohd; Ahmad, Hazrina

    2017-11-01

    Ribbed slab provides lighter slab than an equivalent solid slab which helps in reducing the weight with its voids. However, in order to overcome the drawbacks in the construction process, the application of steel fibre reinforcement concrete (SFRC) is seen as an alternative material to be used in the slab. This study is performed to investigate the behaviour of SFRC as the main material in ribbed slab, omitting the conventional reinforcements, under four-point bending test. Three equivalent samples of ribbed slabs were prepared for this study with variations in the topping thickness of 100, 75 and 50 mm. The flexural strength of ribbed slab with 100 mm topping shows similar loading carrying capacity with the 75mm topping while 50 mm gave the lowest ultimate loading. First cracks for all slabs occurred at the topping. The cracks began from the external ribs and propagates toward the internal rib. Incorporation of steel fibres help in giving a longer deflection softening than a sudden brittle failure, thus proves its ability to increase energy absorption capacity and improving cracking behaviour.

  11. Heat transfer and friction characteristics in steam cooled rectangular channels with rib turbulators

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Jianying; Gao, Tieyu; Li, Guojun [Xi' an Jiaotong University, Xi' an (China)

    2014-01-15

    We studied the heat transfer and friction characteristics in steam-cooled rectangular channels with rib turbulators on W side or H side walls in the Reynolds number (Re) range of 10000-80000. Each of the test channels was welded by four stainless steel plates to simulate the actual geometry and heat transfer structure of blade/vane internal cooling passage. The length of the channel L was 1000 mm, the cross section of the channel was 40 mm X 80 mm, and the pitch-to-rib height ratio p/e was kept at 10. The channel blockage ratio (W/H) was 0.047. Results showed that the Nusselt number (Nu) distributions displayed different trends at the entrance region with the increase of Re for the rib turbulators on the W side walls. The heat transfer performance of the rib turbulators on the H side walls was about 24- 27% higher than that on the W side walls at the same pumping power. In addition, semi-empirical correlations for the two cases, rib turbulators on W side walls and rib turbulators on H side walls, were developed based on the heat transfer results, which could be used in the design of the internal cooling passage of new generation steam-cooled gas turbine blade/vane.

  12. Rib fractures and death from deletion of osteoblast βcatenin in adult mice is rescued by corticosteroids.

    Science.gov (United States)

    Duan, JinZhu; Lee, Yueh; Jania, Corey; Gong, Jucheng; Rojas, Mauricio; Burk, Laurel; Willis, Monte; Homeister, Jonathon; Tilley, Stephen; Rubin, Janet; Deb, Arjun

    2013-01-01

    Ribs are primarily made of cortical bone and are necessary for chest expansion and ventilation. Rib fractures represent the most common type of non-traumatic fractures in the elderly yet few studies have focused on the biology of rib fragility. Here, we show that deletion of βcatenin in Col1a2 expressing osteoblasts of adult mice leads to aggressive osteoclastogenesis with increased serum levels of the osteoclastogenic cytokine RANKL, extensive rib resorption, multiple spontaneous rib fractures and chest wall deformities. Within days of osteoblast specific βcatenin deletion, animals die from respiratory failure with a vanishing rib cage that is unable to sustain ventilation. Increased bone resorption is also observed in the vertebrae and femur. Treatment with the bisphosphonate pamidronate delayed but did not prevent death or associated rib fractures. In contrast, administration of the glucocorticoid dexamethasone decreased serum RANKL and slowed osteoclastogenesis. Dexamethasone preserved rib structure, prevented respiratory compromise and strikingly increased survival. Our findings provide a novel model of accelerated osteoclastogenesis, where deletion of osteoblast βcatenin in adults leads to rapid development of destructive rib fractures. We demonstrate the role of βcatenin dependent mechanisms in rib fractures and suggest that glucocorticoids, by suppressing RANKL, may have a role in treating bone loss due to aggressive osteoclastogenesis.

  13. A Novel Biodegradable Polycaprolactone Fixator for Osteosynthesis Surgery of Rib Fracture: In Vitro and in Vivo Study

    Directory of Open Access Journals (Sweden)

    Yi-Hsun Yu

    2015-11-01

    Full Text Available Osteosynthesis surgery for rib fractures is controversial and challenging. This study developed a noval poly(ε-caprolactone (PCL-based biodegradable “cable-tie” fixator for osteosynthesis surgery for rib fractures. A biodegradable fixator specifically for fractured ribs was designed and fabricated by a micro-injection molding machine in our laboratory. The fixator has three belts that could be passed through matching holes individually. The locking mechanism allows the belt movement to move in only one direction. To examine the in vitro biomechanical performance, ribs 3–7 from four fresh New Zealand rabbits were employed. The load to failure and stress-strain curve was compared in the three-point bending test among native ribs, titanium plate-fixed ribs, and PCL fixator-fixed ribs. In the in vivo animal study, the sixth ribs of New Zealand rabbits were osteotomized and osteosynthesis surgery was performed using the PCL fixator. Outcomes were assessed by monthly X-ray examinations, a final micro-computed tomography (CT scan, and histological analysis. The experimental results suggested that the ribs fixed with the PCL fixator were significantly less stiff than those fixed with titanium plates (p < 0.05. All ribs fixed with the PCL fixators exhibited union. The bridging callus was confirmed by gross, radiographic micro-three-dimensional (3D CT, and histological examinations. In addition, there was no significant inflammatory response of the osteotomized ribs or the PCL-rib interface during application. The novel PCL fixator developed in this work achieves satisfactory results in osteosynthesis surgery for rib fractures, and may provide potential applications in other orthopedic surgeries.

  14. Trauma patient adverse outcomes are independently associated with rib cage fracture burden and severity of lung, head, and abdominal injuries.

    Science.gov (United States)

    Dunham, C Michael; Hileman, Barbara M; Ransom, Kenneth J; Malik, Rema J

    2015-01-01

    We hypothesized that lung injury and rib cage fracture quantification would be associated with adverse outcomes. Consecutive admissions to a trauma center with Injury Severity Score ≥ 9, age 18-75, and blunt trauma. CT scans were reviewed to score rib and sternal fractures and lung infiltrates. Sternum and each anterior, lateral, and posterior rib fracture was scored 1 = non-displaced and 2 = displaced. Rib cage fracture score (RCFS) = total rib fracture score + sternal fracture score + thoracic spine Abbreviated Injury Score (AIS). Four lung regions (right upper/middle, right lower, left upper, and left lower lobes) were each scored for % of infiltrate: 0% = 0; ≤ 20% = 1, ≤ 50% = 2, > 50% = 3; total of 4 scores = lung infiltrate score (LIS). Of 599 patients, 193 (32%) had 854 rib fractures. Rib fracture patients had more abdominal injuries (p fractures (p = 0.0028) and death or need for mechanical ventilation ≥ 3 days (Death/Vdays ≥ 3) (p rib fracture patients, Glasgow Coma Score 3-12 or head AIS ≥ 2 occurred in 43%. A lung infiltrate or hemo/pneumothorax occurred in 55%. Thoracic spine injury occurred in 23%. RCFS was 6.3 ± 4.4 and Death/Vdays ≥ 3 occurred in 31%. Death/Vdays ≥ 3 rates correlated with RCFS values: 19% for 1-3; 24% for 4-6; 42% for 7-12 and 65% for ≥ 13 (p rib fracture score (p = 0.08) or number of fractured ribs (p = 0.80). Rib fracture patients have increased risk for truncal injuries and adverse outcomes. Adverse outcomes are independently associated with rib cage fracture burden. Severity of head, abdominal, and lung injuries also influence rib fracture outcomes.

  15. Reading a suspenseful literary text activates brain areas related to social cognition and predictive inference.

    Directory of Open Access Journals (Sweden)

    Moritz Lehne

    Full Text Available Stories can elicit powerful emotions. A key emotional response to narrative plots (e.g., novels, movies, etc. is suspense. Suspense appears to build on basic aspects of human cognition such as processes of expectation, anticipation, and prediction. However, the neural processes underlying emotional experiences of suspense have not been previously investigated. We acquired functional magnetic resonance imaging (fMRI data while participants read a suspenseful literary text (E.T.A. Hoffmann's "The Sandman" subdivided into short text passages. Individual ratings of experienced suspense obtained after each text passage were found to be related to activation in the medial frontal cortex, bilateral frontal regions (along the inferior frontal sulcus, lateral premotor cortex, as well as posterior temporal and temporo-parietal areas. The results indicate that the emotional experience of suspense depends on brain areas associated with social cognition and predictive inference.

  16. Relations, interactions and networks of cultural tourism stakeholders in rural areas of Vojvodina

    Directory of Open Access Journals (Sweden)

    Pavlović Nataša

    2015-01-01

    Full Text Available Contemporary trends, which are characterized by a very strong level of competition and the maturity of the market, become more than ever essential for success of tourist destinations. Rural areas in Vojvodina, because of its authentic atmosphere and multiculturalism, have significant advantages for cultural tourism. Each participant who creates a tourism product in toda y's competitive environment aims to have a strong focus on customer satisfaction, which indicates the necessity of adopting the concept of total relationship marketing. The aim of this paper is to show how cultural institutions, souvenir craftsmen, tourism organizations, travel agencies and other stakeholders achieve cooperation and apply modern concept of total relationship marketing for the purposes of satisfying the needs of tourists. The paper will explore the fundamental postulates of relationship marketing applied by key stakeholders of cultural tourism in rural areas, and will get reference results on relations, interactions and networks.

  17. CLASSIFICATION OF TRAFFIC RELATED SHORT TEXTS TO ANALYSE ROAD PROBLEMS IN URBAN AREAS

    Directory of Open Access Journals (Sweden)

    A. M. M. Saldana-Perez

    2017-09-01

    Full Text Available The Volunteer Geographic Information (VGI can be used to understand the urban dynamics. In the classification of traffic related short texts to analyze road problems in urban areas, a VGI data analysis is done over a social media’s publications, in order to classify traffic events at big cities that modify the movement of vehicles and people through the roads, such as car accidents, traffic and closures. The classification of traffic events described in short texts is done by applying a supervised machine learning algorithm. In the approach users are considered as sensors which describe their surroundings and provide their geographic position at the social network. The posts are treated by a text mining process and classified into five groups. Finally, the classified events are grouped in a data corpus and geo-visualized in the study area, to detect the places with more vehicular problems.

  18. Classification of Traffic Related Short Texts to Analyse Road Problems in Urban Areas

    Science.gov (United States)

    Saldana-Perez, A. M. M.; Moreno-Ibarra, M.; Tores-Ruiz, M.

    2017-09-01

    The Volunteer Geographic Information (VGI) can be used to understand the urban dynamics. In the classification of traffic related short texts to analyze road problems in urban areas, a VGI data analysis is done over a social media's publications, in order to classify traffic events at big cities that modify the movement of vehicles and people through the roads, such as car accidents, traffic and closures. The classification of traffic events described in short texts is done by applying a supervised machine learning algorithm. In the approach users are considered as sensors which describe their surroundings and provide their geographic position at the social network. The posts are treated by a text mining process and classified into five groups. Finally, the classified events are grouped in a data corpus and geo-visualized in the study area, to detect the places with more vehicular problems.

  19. Loopholes of laws and regulations related to redevelopment of former sites of radioactive material control area

    International Nuclear Information System (INIS)

    Akatsuka, Hiroshi

    2003-01-01

    We found loopholes of laws and regulations for supervising radioactive materials. It is not obliged to measure the soil radioactivity of the sites that were formerly used as scientific or engineering institutes, or hospitals with a radioactive material control area. If the former institutes or hospitals made studies with radioactive materials before the enforcement of the law concerning prevention from radiation hazards due to isotopes and its detailed regulations, it is concluded that there was the period when the radioactive materials were not under management. If it is found that the radioactive materials were applied at the former site before the enforcement of the related laws and regulations, the radioactivity in the soil of the redeveloped area should be examined, which should be obliged by some laws or regulations. (author)

  20. Modeling and Simulation of Turbulent Flows through a Solar Air Heater Having Square-Sectioned Transverse Rib Roughness on the Absorber Plate

    Directory of Open Access Journals (Sweden)

    Anil Singh Yadav

    2013-01-01

    Full Text Available Solar air heater is a type of heat exchanger which transforms solar radiation into heat energy. The thermal performance of conventional solar air heater has been found to be poor because of the low convective heat transfer coefficient from the absorber plate to the air. Use of artificial roughness on a surface is an effective technique to enhance the rate of heat transfer. A CFD-based investigation of turbulent flow through a solar air heater roughened with square-sectioned transverse rib roughness has been performed. Three different values of rib-pitch (P and rib-height (e have been taken such that the relative roughness pitch (P/e=14.29 remains constant. The relative roughness height, e/D, varies from 0.021 to 0.06, and the Reynolds number, Re, varies from 3800 to 18,000. The results predicted by CFD show that the average heat transfer, average flow friction, and thermohydraulic performance parameter are strongly dependent on the relative roughness height. A maximum value of thermohydraulic performance parameter has been found to be 1.8 for the range of parameters investigated. Comparisons with previously published work have been performed and found to be in excellent agreement.

  1. Modeling and simulation of turbulent flows through a solar air heater having square-sectioned transverse rib roughness on the absorber plate.

    Science.gov (United States)

    Yadav, Anil Singh; Bhagoria, J L

    2013-01-01

    Solar air heater is a type of heat exchanger which transforms solar radiation into heat energy. The thermal performance of conventional solar air heater has been found to be poor because of the low convective heat transfer coefficient from the absorber plate to the air. Use of artificial roughness on a surface is an effective technique to enhance the rate of heat transfer. A CFD-based investigation of turbulent flow through a solar air heater roughened with square-sectioned transverse rib roughness has been performed. Three different values of rib-pitch (P) and rib-height (e) have been taken such that the relative roughness pitch (P/e = 14.29) remains constant. The relative roughness height, e/D, varies from 0.021 to 0.06, and the Reynolds number, Re, varies from 3800 to 18,000. The results predicted by CFD show that the average heat transfer, average flow friction, and thermohydraulic performance parameter are strongly dependent on the relative roughness height. A maximum value of thermohydraulic performance parameter has been found to be 1.8 for the range of parameters investigated. Comparisons with previously published work have been performed and found to be in excellent agreement.

  2. Sediment yield during typhoon events in relation to landslides, rainfall, and catchment areas in Taiwan

    Science.gov (United States)

    Chen, Chi-Wen; Oguchi, Takashi; Hayakawa, Yuichi S.; Saito, Hitoshi; Chen, Hongey; Lin, Guan-Wei; Wei, Lun-Wei; Chao, Yi-Chiung

    2018-02-01

    Debris sourced from landslides will result in environmental problems such as increased sediment discharge in rivers. This study analyzed the sediment discharge of 17 main rivers in Taiwan during 14 typhoon events, selected from the catchment area and river length, that caused landslides according to government reports. The measured suspended sediment and water discharge, collected from hydrometric stations of the Water Resources Agency of Taiwan, were used to establish rating-curve relationships, a power-law relation between them. Then sediment discharge during typhoon events was estimated using the rating-curve method and the measured data of daily water discharge. Positive correlations between sediment discharge and rainfall conditions for each river indicate that sediment discharge increases when a greater amount of rainfall or a higher intensity of rainfall falls during a typhoon event. In addition, the amount of sediment discharge during a typhoon event is mainly controlled by the total amount of rainfall, not by peak rainfall. Differences in correlation equations among the rivers suggest that catchments with larger areas produce more sediment. Catchments with relatively low sediment discharge show more distinct increases in sediment discharge in response to increases in rainfall, owing to the little opportunity for deposition in small catchments with high connectivity to rivers and the transportation of the majority of landslide debris to rivers during typhoon events. Also, differences in geomorphic and geologic conditions among catchments around Taiwan lead to a variety of suspended sediment dynamics and the sediment budget. Positive correlation between average sediment discharge and average area of landslides during typhoon events indicates that when larger landslides are caused by heavier rainfall during a typhoon event, more loose materials from the most recent landslide debris are flushed into rivers, resulting in higher sediment discharge. The high

  3. Mutiple Spontaneous Rib Fractures in Patient with Cushing's Syndrome.

    Science.gov (United States)

    Lee, Hyun Jung; Je, Ji Hye; Seo, Ji Hye; Na, Young Ju; Yoo, Hye Jin

    2014-11-01

    Glucocorticoid (GC) excess, including Cushing's syndrome, is a common cause of secondary osteoporosis. Thirty to fifty percent of Cushing's syndrome patients experience non-traumatic fractures, which is often the presenting manifestation of Cushing's syndrome. However, there have been rare cases of Cushing's syndrome diagnosed only based upon bone manifestations. We describe a case of Cushing's syndrome that was diagnosed in a 44-year-old woman who initially visited our hospital due to multiple non-traumatic rib fractures. She did not exhibit any other manifestations of Cushing's syndrome such as moon face, buffalo hump or abdominal striae. Initially, we evaluated her for bone metastases from a cancer of unknown origin, but there was no evidence of metastatic cancer. Instead, we found a left adrenal incidentaloma. As a result of the hormone study, she was diagnosed as having Cushing's syndrome. Interestingly, her bony manifestation of Cushing's syndrome, which was evident in the bone scan and bone mineral densitometry, completely recovered after a left adrenalectomy. Therefore, the possibility of Cushing's syndrome as a cause of secondary osteoporosis should be considered in young patients with non-traumatic multiple fractures, with or without any other typical features of Cushing's syndrome.

  4. Production of light radioactive ion beams (RIB) using inverse kinematics

    International Nuclear Information System (INIS)

    Das, J.J.; Sugathan, P.; Madhavan, N.; Madhusudhana Rao, P.V.; Jhingan, A.; Varughese, T.; Barua, S.; Nath, S.; Sinha, A.K.; Kumar, B.; Zacharias, J.

    2005-01-01

    At Nuclear Science Centre (NSC), New Delhi, we have implemented a facility to produce low energy light radioactive ion beams (RIBs) using (p,n) type of reactions in inverse kinematics. For this purpose primary beams from the 15-UD Pelletron accelerator impinged on a thin polypropylene foil mounted on a rotating/linearly moving target assembly. For efficiently separating the secondary beam from primary beam, the existing recoil mass spectrometer (RMS) HIRA was operated with new ion optics. Suitable hardware modifications were also made. Using this facility, we have extracted a 7 Be beam of purity better than 99% and spot-size ∼4 mm in diameter. This 7 Be beam has been utilized in a variety of experiments in the energy range of 15-22 MeV. Typical beam parameters are: intensity 10 4 pps, angular spread ±30 mrad and energy spread ±0.5 MeV. Development of appropriate detector setup/target arrangement were also made to perform these experiments. In this paper, we describe the implementation of this project

  5. A positive (negative) surface ionization source concept for RIB generation

    International Nuclear Information System (INIS)

    Alton, G.D.; Mills, G.D.

    1995-01-01

    A novel, versatile, new concept, spherical-geometry, positive (negative) surface-ionization source has been designed and fabricated which will have the capability of generating both positive- and negative-ion beams without mechanical changes to the source. The source utilizes a highly permeable, high-work-function Ir ionizer (φ∼ = 5.29 eV) for ionizing highly electropositive atoms/molecules; while for negative-surface ionization, the work function is lowered to φ ∼ = 1.43 eV by continually feeding cesium vapor through the ionizer matrix. The use of Cs to effect low work function surfaces for negative ion beam generation has the potential of overcoming the chronic poisoning effects experienced with LaB 6 while enhancing the probability for negative ion formation of atomic and molecular species with low to intermediate electron affinities. The flexibility of operation in either mode makes it especially attractive for RIB applications and, therefore, the source will be used as a complementary replacement for the high-temperature electron impact ionization sources presently in use at the HRIBF The design features and operational principles of the source will be described in this report

  6. Image Classification of Ribbed Smoked Sheet using Learning Vector Quantization

    Science.gov (United States)

    Rahmat, R. F.; Pulungan, A. F.; Faza, S.; Budiarto, R.

    2017-01-01

    Natural rubber is an important export commodity in Indonesia, which can be a major contributor to national economic development. One type of rubber used as rubber material exports is Ribbed Smoked Sheet (RSS). The quantity of RSS exports depends on the quality of RSS. RSS rubber quality has been assigned in SNI 06-001-1987 and the International Standards of Quality and Packing for Natural Rubber Grades (The Green Book). The determination of RSS quality is also known as the sorting process. In the rubber factones, the sorting process is still done manually by looking and detecting at the levels of air bubbles on the surface of the rubber sheet by naked eyes so that the result is subjective and not so good. Therefore, a method is required to classify RSS rubber automatically and precisely. We propose some image processing techniques for the pre-processing, zoning method for feature extraction and Learning Vector Quantization (LVQ) method for classifying RSS rubber into two grades, namely RSS1 and RSS3. We used 120 RSS images as training dataset and 60 RSS images as testing dataset. The result shows that our proposed method can give 89% of accuracy and the best perform epoch is in the fifteenth epoch.

  7. Physics with Heavy Neutron Rich Ribs at the Hribf

    Science.gov (United States)

    Radford, David

    2002-10-01

    The Holifield Radioactive Ion Beam Facility at the Oak Ridge National Laboratory has recently produced the world's first post-accelerated beams of heavy neutron-rich nuclei. B(E2;0^+ arrow 2^+) values for neutron-rich ^126,128Sn and ^132,134,136Te isotopes have been measured by Coulomb excitation of radioactive ion beams in inverse kinematics. The results for ^132Te and ^134Te (N=80,82) show excellent agreement with systematics of lighter Te isotopes, but the B(E2) value for ^136Te (N=84) is unexpectedly small. Single-neutron transfer reactions leading to ^135Te were identified using a ^134Te beam on ^natBe and ^13C targets at energies just above the Coulomb barrier. The use of the Be target provided an unambiguous signature for neutron transfer through the detection of two correlated α particles, arising from the breakup of unstable ^8Be. The results of these experiments will be discussed, togther with plans for future experiments with these heavy n-rich RIBs.

  8. High-efficiency target-ion sources for RIB generation

    International Nuclear Information System (INIS)

    Alton, G.D.

    1993-01-01

    A brief review is given of high-efficiency ion sources which have been developed or are under development at ISOL facilities which show particular promise for use at existing, future, or radioactive ion beam (RIB) facilities now under construction. Emphasis will be placed on those sources which have demonstrated high ionization efficiency, species versatility, and operational reliability and which have been carefully designed for safe handling in the high level radioactivity radiation fields incumbent at such facilities. Brief discussions will also be made of the fundamental processes which affect the realizable beam intensities in target-ion sources. Among the sources which will be reviewed will be selected examples of state-of-the-art electron-beam plasma-type ion sources, thermal-ionization, surface-ionization, ECR, and selectively chosen ion source concepts which show promise for radioactive ion beam generation. A few advanced, chemically selective target-ion sources will be described, such as sources based on the use of laser-resonance ionization, which, in principle, offer a more satisfactory solution to isobaric contamination problems than conventional electromagnetic techniques. Particular attention will be given to the sources which have been selected for initial or future use at the Holifield Radioactive Ion Beam Facility now under construction at the Oak Ridge National Laboratory

  9. Shared "core" areas between the pain and other task-related networks.

    Directory of Open Access Journals (Sweden)

    Franco Cauda

    Full Text Available The idea of a 'pain matrix' specifically devoted to the processing of nociceptive inputs has been challenged. Alternative views now propose that the activity of the primary and secondary somatosensory cortices (SI, SII, the insula and cingulate cortex may be related to a basic defensive system through which significant potentially dangerous events for the body's integrity are detected. By reviewing the role of the SI, SII, the cingulate and the insular cortices in the perception of nociceptive and tactile stimuli, in attentional, emotional and reward tasks, and in interoception and memory, we found that all these task-related networks overlap in the dorsal anterior cingulate cortex, the anterior insula and the dorsal medial thalamus. A thorough analysis revealed that the 'pain-related' network shares important functional similarities with both somatomotor-somatosensory networks and emotional-interoceptive ones. We suggest that these shared areas constitute the central part of an adaptive control system involved in the processing and integration of salient information coming both from external and internal sources. These areas are activated in almost all fMRI tasks and have been indicated to play a pivotal role in switching between externally directed and internally directed brain networks.

  10. Traditional male circumcision-related fatalities in the Mthatha area of South Africa.

    Science.gov (United States)

    Meel, B L

    2010-10-01

    Traditional male circumcision is still widely practised by the Xhosa population throughout South Africa. Male circumcision is carried out mainly during summer and winter seasons. This is a retrospective record review of the male circumcision-related fatalities at Mthatha General Hospital during 2005 and 2006. The purpose of this study is to highlight the problem of circumcision-related deaths in the Mthatha area of South Africa. Twenty-five deaths related to traditional circumcisions were recorded over the period. The common causes of deaths were septicaemia (9 patients; 36%), pneumonia (5; 20%), dehydration (3; 12%), assault (3; 12%), thromboembolism (2; 8%), gangrene (2; 8%) and congestive heart failure (1; 4%). All fatalities were among black Africans with a median age of 17.56 (SD = 2.56) years. In seven deaths (28%) the young men came from the Libode District. The youngest victim was 12 years old. Most of the deaths (13; 52%) occurred in July 2006. The mortality associated with traditional male circumcision in the Mthatha area of South Africa is alarming.

  11. Synopsis of some preliminary computational studies related to unsaturated zone transport at Area G

    International Nuclear Information System (INIS)

    Vold, E.

    1998-03-01

    Computational transport models are described with applications in three problem areas related to unsaturated zone moisture movement beneath Area G. These studies may be used to support the ongoing maintenance of the site Performance Assessment. The three areas include: a 1-D transient analysis with average tuff hydraulic properties in the near surface region with computed results compared to field data; the influence on near surface transient moisture percolation due to realistic distributions in hydraulic properties derived statistically from the observed variance in the field data; and the west to east moisture flow in a 2-D steady geometry approximation of the Pajarito Plateau. Results indicate that a simple transient model for transport of moisture volume fraction fits field data well compared to a moisture pulse observed in the active disposal unit, pit 37. Using realistic infiltration boundary conditions for summer showers and for spring snow melt conditions, the computed moisture pulses show significant propagation to less than 10-ft depth. Next, the hydraulic properties were varied on a 2-D grid using statistical distributions based on the field data means and variances for the hydraulic parameters. Near surface transient percolation in these conditions shows a qualitatively realistic percolation with a spatially variable wave front moving into the tuff; however, the flow does not channel into preferred paths and suggests there is no formation of fast paths which could enhance transportation of contaminants. Finally, moisture transport is modeled through an unsaturated 2-D slice representing the upper stratigraphic layers beneath Area G and a west-to-east cut of several miles to examine possible lateral movement from the west where percolation is assumed to be greater than at Area G. Results show some west-to-east moisture flux consistent with the assumed profile for the percolation boundary conditions

  12. Fate of Escherichia coli O157:H7 in mechanically tenderized beef prime rib following searing, cooking, and holding under commercial conditions.

    Science.gov (United States)

    Porto-Fett, Anna C S; Shoyer, Bradley A; Thippareddi, Harshavardhan; Luchansky, John B

    2013-03-01

    We evaluated the effect of commercial times and temperatures for searing, cooking, and holding on the destruction of Escherichia coli O157:H7 (ECOH) within mechanically tenderized prime rib. Boneless beef ribeye was inoculated on the fat side with ca. 5.7 log CFU/g of a five-strain cocktail of ECOH and then passed once through a mechanical tenderizer with the fat side facing upward. The inoculated and tenderized prime rib was seared by broiling at 260°C for 15 min in a conventional oven and then cooked in a commercial convection oven at 121.1°C to internal temperatures of 37.8, 48.9, 60.0, and 71.1°C before being placed in a commercial holding oven maintained at 60.0°C for up to 8 h. After searing, ECOH levels decreased by ca. 1.0 log CFU/g. Following cooking to internal temperatures of 37.8 to 71.1°C, pathogen levels decreased by an additional ca. 2.7 to 4.0 log CFU/g. After cooking to 37.8, 48.9, or 60.0°C and then warm holding at 60.0°C for 2 h, pathogen levels increased by ca. 0.2 to 0.7 log CFU/g. However, for prime rib cooked to 37.8°C, pathogen levels remained relatively unchanged over the next 6 h of warm holding, whereas for those cooked to 48.9 or 60.0°C pathogen levels decreased by ca. 0.3 to 0.7 log CFU/g over the next 6 h of warm holding. In contrast, after cooking prime rib to 71.1°C and holding for up to 8 h at 60.0°C, ECOH levels decreased by an additional ca. 0.5 log CFU/g. Our results demonstrated that to achieve a 5.0-log reduction of ECOH in blade tenderized prime rib, it would be necessary to sear at 260°C for 15 min, cook prime rib to internal temperatures of 48.9, 60.0, or 71.1°C, and then hold at 60.0°C for at least 8 h.

  13. Objective method to report planner-independent skin/rib maximal dose in balloon-based high dose rate (HDR) brachytherapy for breast cancer

    International Nuclear Information System (INIS)

    Kim, Yongbok; Trombetta, Mark G.

    2011-01-01

    Purpose: An objective method was proposed and compared with a manual selection method to determine planner-independent skin and rib maximal dose in balloon-based high dose rate (HDR) brachytherapy planning. Methods: The maximal dose to skin and rib was objectively extracted from a dose volume histogram (DVH) of skin and rib volumes. A virtual skin volume was produced by expanding the skin surface in three dimensions (3D) external to the breast with a certain thickness in the planning computed tomography (CT) images. Therefore, the maximal dose to this volume occurs on the skin surface the same with a conventional manual selection method. The rib was also delineated in the planning CT images and its maximal dose was extracted from its DVH. The absolute (Abdiff=|D max Man -D max DVH |) and relative (Rediff[%]=100x(|D max Man -D max DVH |)/D max DVH ) maximal skin and rib dose differences between the manual selection method (D max Man ) and the objective method (D max DVH ) were measured for 50 balloon-based HDR (25 MammoSite and 25 Contura) patients. Results: The average±standard deviation of maximal dose difference was 1.67%±1.69% of the prescribed dose (PD). No statistical difference was observed between MammoSite and Contura patients for both Abdiff and Rediff[%] values. However, a statistically significant difference (p value max >90%) compared with lower dose range (D max <90%): 2.16%±1.93% vs 1.19%±1.25% with p value of 0.0049. However, the Rediff[%] analysis eliminated the inverse square factor and there was no statistically significant difference (p value=0.8931) between high and low dose ranges. Conclusions: The objective method using volumetric information of skin and rib can determine the planner-independent maximal dose compared with the manual selection method. However, the difference was <2% of PD, on average, if appropriate attention is paid to selecting a manual dose point in 3D planning CT images.

  14. Methodology for the Model-based Small Area Estimates of Cancer-Related Knowledge - Small Area Estimates

    Science.gov (United States)

    The HINTS is designed to produce reliable estimates at the national and regional levels. GIS maps using HINTS data have been used to provide a visual representation of possible geographic relationships in HINTS cancer-related variables.

  15. Development of unbonded and bonded areas in relation to Populus species wood characteristics in grinding

    Science.gov (United States)

    L.K. Lehtonen; J.H. Lehto; A.W. Rudie

    2004-01-01

    In terms of fibre development in mechanical pulping, most of the energy is spent on the creation of specific surface area. The total surface area created can be divided into two categories: surface area that adds to the unbonded area (optical properties) and surface area that adds to the bonded area (strength properties) of mechanical papers. This paper considers these...

  16. Association between religiousness and blood donation among Brazilian postgraduate students from health-related areas.

    Science.gov (United States)

    Zangiacomi Martinez, Edson; Dos Santos Almeida, Rodrigo Guimarães; Garcia Braz, Ana Carolina; Duarte de Carvalho, Antonio Carlos

    2014-01-01

    The aim of this study was to examine the association between religiousness and blood donation among postgraduate students. The Portuguese-language version of the Duke University Religion Index was administered to a sample of 226 Brazilian students with ages ranging from 22 to 55 years. All study participants had completed undergraduate courses in health-related areas. In the present study, 23.5% of the students were regular donors. Organizational religiousness was found to be associated with attitudes related to blood donation. This study also shows evidence that regular blood donors have a higher intrinsic religiousness than subjects who donate only once and do not return. This study shows that the attitudes concerning blood donation may have some association with religiosity. Copyright © 2014 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

  17. Association between religiousness and blood donation among Brazilian postgraduate students from health-related areas

    Directory of Open Access Journals (Sweden)

    Edson Zangiacomi Martinez

    2014-06-01

    Full Text Available OBJECTIVE: The aim of this study was to examine the association between religiousness and blood donation among postgraduate students.METHODS: The Portuguese-language version of the Duke University Religion Index was administered to a sample of 226 Brazilian students with ages ranging from 22 to 55 years. All study participants had completed undergraduate courses in health-related areas.RESULTS: In the present study, 23.5% of the students were regular donors. Organizational religiousness was found to be associated with attitudes related to blood donation. This study also shows evidence that regular blood donors have a higher intrinsic religiousness than subjects who donate only once and do not return.CONCLUSION: This study shows that the attitudes concerning blood donation may have some association with religiosity.

  18. Study of climate change related to deforestation in the Xishuangbanna area, Yunnan, China

    International Nuclear Information System (INIS)

    Chungcheng Li; Cong Lai

    1991-01-01

    The analysis of the results of deforestation and the meteorological data of the Xinshuangbanna region of China shows that there are possible relations between the deforestation and climate change. With the forest area decreased by 33% during the past 30 years, the climate of this region has also been changed. The annual mean temperature has been increased by 0.7C, of which the increase is 0.97C in the dry season and 0.53C in the wet season. Together with the annual temperature increase the temperature variations have also been increased, which has resulted in more frequent low temperature damage to the local plantation agriculture. The relative humidity decreased by 3% annually; and the annual precipitation also decreased, with a decrease in the wet season of 6.8% and an increase in the dry season of 20.8%

  19. Pulmonary nodule registration in serial CT scans based on rib anatomy and nodule template matching

    International Nuclear Information System (INIS)

    Shi Jiazheng; Sahiner, Berkman; Chan, H.-P.; Hadjiiski, Lubomir; Zhou, C.; Cascade, Philip N.; Bogot, Naama; Kazerooni, Ella A.; Wu, Y.-T.; Wei, J.

    2007-01-01

    An automated method is being developed in order to identify corresponding nodules in serial thoracic CT scans for interval change analysis. The method uses the rib centerlines as the reference for initial nodule registration. A spatially adaptive rib segmentation method first locates the regions where the ribs join the spine, which define the starting locations for rib tracking. Each rib is tracked and locally segmented by expectation-maximization. The ribs are automatically labeled, and the centerlines are estimated using skeletonization. For a given nodule in the source scan, the closest three ribs are identified. A three-dimensional (3D) rigid affine transformation guided by simplex optimization aligns the centerlines of each of the three rib pairs in the source and target CT volumes. Automatically defined control points along the centerlines of the three ribs in the source scan and the registered ribs in the target scan are used to guide an initial registration using a second 3D rigid affine transformation. A search volume of interest (VOI) is then located in the target scan. Nodule candidate locations within the search VOI are identified as regions with high Hessian responses. The initial registration is refined by searching for the maximum cross-correlation between the nodule template from the source scan and the candidate locations. The method was evaluated on 48 CT scans from 20 patients. Experienced radiologists identified 101 pairs of corresponding nodules. Three metrics were used for performance evaluation. The first metric was the Euclidean distance between the nodule centers identified by the radiologist and the computer registration, the second metric was a volume overlap measure between the nodule VOIs identified by the radiologist and the computer registration, and the third metric was the hit rate, which measures the fraction of nodules whose centroid computed by the computer registration in the target scan falls within the VOI identified by the

  20. Relative humidity impact on aerosol parameters in a Paris suburban area

    Directory of Open Access Journals (Sweden)

    H. Randriamiarisoa

    2006-01-01

    Full Text Available Measurements of relative humidity (RH and aerosol parameters (scattering cross section, size distributions and chemical composition, performed in ambient atmospheric conditions, have been used to study the influence of relative humidity on aerosol properties. The data were acquired in a suburban area south of Paris, between 18 and 24 July 2000, in the framework of the 'Etude et Simulation de la Qualité de l'air en Ile-de-France' (ESQUIF program. According to the origin of the air masses arriving over the Paris area, the aerosol hygroscopicity is more or less pronounced. The aerosol chemical composition data were used as input of a thermodynamic model to simulate the variation of the aerosol water mass content with ambient RH and to determine the main inorganic salt compounds. The coupling of observations and modelling reveals the presence of deliquescence processes with hysteresis phenomenon in the hygroscopic growth cycle. Based on the Hänel model, parameterisations of the scattering cross section, the modal radius of the accumulation mode of the size distribution and the aerosol water mass content, as a function of increasing RH, have been assessed. For the first time, a crosscheck of these parameterisations has been performed and shows that the hygroscopic behaviour of the accumulation mode can be coherently characterized by combined optical, size distribution and chemical measurements.

  1. Application of perturbed angular correlations to chemistry and related areas of solid state physics

    Energy Technology Data Exchange (ETDEWEB)

    Rinneberg, H H [Freie Univ. Berlin (Germany, F.R.)

    1979-06-01

    The paper reviews the more recent applications of ..gamma..-..gamma.. time-differential perturbed angular correlation (TDPAC) to chemistry and related areas of solid state physics. Topics which are discussed in some detail include: Supertransferred hyperfine fields at diamagnetic impurities in antiferromagnetic transition metal compounds and their relation to the covalency of the transition metal-ligand bond; effects of charge transfer on the quadrupole interactions in various partially covalent insulators measured by PAC; fluctuating electric field gradients in heptafluorohafnates; the influence of charge density waves in TaS/sub 2/ and the effect of intercalating on the field gradients at /sup 181/Ta; recent advances in the understanding of electric field gradients in metals; information obtained by PAC on the microscopic structure of alloys as well as defects in pure metals after quenching, implantation or irradiation. Magnetic and electric phase transitions observed in PAC spectra are briefly mentioned. In addition, recent measurements in liquids and gases are reviewed. Three introductory sections are devoted to a brief discussion of the time-differential PAC technique, to a concise explanation of the theoretical expressions needed to analyse PAC spectra and to a short description of the experimental set-up. An outlook suggests some areas of possible future applications.

  2. Role of medial premotor areas in action language processing in relation to motor skills.

    Science.gov (United States)

    Courson, Melody; Macoir, Joël; Tremblay, Pascale

    2017-10-01

    The literature reports that the supplementary motor area (SMA) and pre-supplementary motor area (pre-SMA) are involved in motor planning and execution, and in motor-related cognitive functions such as motor imagery. However, their specific role in action language processing remains unclear. In the present study, we investigated the impact of repetitive transcranial magnetic stimulation (rTMS) over SMA and pre-SMA during an action semantic analogy task (SAT) in relation with fine motor skills (i.e., manual dexterity) and motor imagery abilities in healthy non-expert adults. The impact of rTMS over SMA (but not pre-SMA) on reaction times (RT) during SAT was correlated with manual dexterity. Specifically, results show that rTMS over SMA modulated RT for those with lower dexterity skills. Our results therefore demonstrate a causal involvement of SMA in action language processing, as well as the existence of inter-individual differences in this involvement. We discuss these findings in light of neurolinguistic theories of language processing. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Numerical Study of the Rib Arrangements for Enhancing Heat Transfer in a Two-pass Channel of Large Aspect Ratio

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sol; Choi, Seok Min; Sohn, Ho-Seong; Cho, Hyung Hee [Yonsei Univ., Seoul (Korea, Republic of)

    2017-03-15

    The present study investigated the effect of the rib arrangement and a guide vane for enhancing internal cooling of the blade. Two types of rib arrangements were used in the first and second passage in parallel. Aspect ratio of the channel was 5 and a fixed Reynolds number based on hydraulic diameter was 10,000. The attack angle of rib was 60°, rib pitch-to-height ratio (p/e) was 10, and the rib height-to-hydraulic-diameter ratio (e/D{sub n}) was 0.075. The effect of an interaction between Dean vortices and the secondary vortices from the first passage was observed. Overall, the attack angle of rib in the first passage was dominant factor to heat transfer and flow patterns in turning region. Also, the channel with a guide vane showed enhanced heat transfer at the tip surface with reducing flow separation and recirculation.

  4. Study of the temperature rise induced by a focusing transducer with a wide aperture angle on biological tissue containing ribs

    International Nuclear Information System (INIS)

    Wang Xin; Lin Jiexing; Liu Xiaozhou; Liu Jiehui; Gong Xiufen

    2016-01-01

    We used the spheroidal beam equation to calculate the sound field created by focusing a transducer with a wide aperture angle to obtain the heat deposition, and then we used the Pennes bioheat equation to calculate the temperature field in biological tissue with ribs and to ascertain the effects of rib parameters on the temperature field. The results show that the location and the gap width between the ribs have a great influence on the axial and radial temperature rise of multilayer biological tissue. With a decreasing gap width, the location of the maximum temperature rise moves forward; as the ribs are closer to the transducer surface, the sound energy that passes through the gap between the ribs at the focus decreases, the maximum temperature rise decreases, and the location of the maximum temperature rise moves forward with the ribs. (paper)

  5. Replacing conventional or brown-mid rib corn silage with brown-mid rib sudangrass silage in the diets of lactating dairy cows

    Science.gov (United States)

    Forages that use less water, but are high in digestibility, are sought as alternatives to traditional forages such as corn silage. Brown mid-rib (BMR) sudangrass is a possible alternative that can provide high-quality forage as a replacement for corn silage. The objective of this study was to evalua...

  6. Numerical prediction on turbulent heat transfer of a spacer ribbed fuel rod for high temperature gas-cooled reactors

    International Nuclear Information System (INIS)

    Takase, Kazuyuki

    1994-11-01

    The turbulent heat transfer of a fuel rod with three-dimensional trapezoidal spacer ribs for high temperature gas-cooled reactors was analyzed numerically using the k-ε turbulence model, and investigated experimentally using a simulated fuel rod under the helium gas condition of a maximum outlet temperature of 1000degC and pressure of 4MPa. From the experimental results, it found that the turbulent heat transfer coefficients of the fuel rod were 18 to 80% higher than those of a concentric smooth annulus at a region of Reynolds number exceeding 2000. On the other hand, the predicted average Nusselt number of the fuel rod agreed well with the heat transfer correlation obtained from the experimental data within a relative error of 10% with Reynolds number of more than 5000. It was verified that the numerical analysis results had sufficient accuracy. Furthermore, the numerical prediction could clarify quantitatively the effects of the heat transfer augmentation by the spacer rib and the axial velocity increase due to a reduction in the annular channel cross-section. (author)

  7. Numerical analysis of developing turbulent flow in a U-bend of strong curvature with rib-roughened walls

    International Nuclear Information System (INIS)

    Sugiyama, Hitoshi; Watanabe, Chiriki

    2003-01-01

    Numerical analysis has been performed for three-dimensional developing turbulent flow in the U-bend of strong curvature with rib-roughened walls by using an algebraic Reynolds stress model. In this calculation, the algebraic Reynolds stress model is adopted in order to predict preciously Reynolds stresses and boundary fitted-coordinate system is introduced as the method for coordinate transformation to set exactly boundary conditions along complicated shape in rib-roughed walls. Calculated results of mean velocity and Reynolds stresses are compared with the experimental data in order to examine the validity of the presented numerical method and the algebraic Reynolds stress model. It has been pointed out as a characteristic feature from the experimental result that the maximum velocity appears near the inner wall of curved duct, which phenomenon is not recognized in mild curved duct. The present method could predict such velocity profiles correctly and reproduce the separated flow generated near the outlet cross section of curved duct. Adding to this, calculated results show clearly that the generation of maximum velocity near a inner wall is caused by pressure driven secondary flow which moves to inner wall from outer wall along symmetrical axis. As for the comparison of Reynolds stresses, the present turbulent model relatively predicts the experimental data well except for the flow separated region which is located near the outlet cross section of curved duct. (author)

  8. Clinical Analysis for the Correlation of Intra-abdominal Organ Injury in the Patients with Rib Fracture

    OpenAIRE

    Park, Seongsik

    2012-01-01

    Background Although it is rare for the fracture itself to become a life threatening injury in patients suffering from rib fracture, the lives of these patients are occasionally threatened by other associated injuries. Especially, early discovery of patients with rib fracture and intra-abdominal organ injury is extremely important to the prognosis. This study analyzed the link between rib fracture and intra-abdominal injury to achieve improved treatment. Materials and Methods Among trauma pati...

  9. Analysis of bone healing in flail chest injury: do we need to fix both fractures per rib?

    Science.gov (United States)

    Marasco, Silvana; Liew, Susan; Edwards, Elton; Varma, Dinesh; Summerhayes, Robyn

    2014-09-01

    Surgical rib fixation (SRF) for severe rib fracture injuries is generating increasing interest in the medical literature. It is well documented that poorly healed fractured ribs can lead to chronic pain, disability, and deformity. An unanswered question in SRF for flail chest injury is whether it is sufficient to fix one fracture per rib, on successive ribs, thus converting a flail chest injury into simple fractured ribs, or whether both ends of the floating segment of the chest wall should be fixed. This study aimed to analyze SRF in flail chest injury, assessing 3-month outcomes for nonfixed fractured rib ends in the flail segment. This is a retrospective review (2005-2013) of 60 consecutive patients who underwent SRF for flail chest injury admitted to the Alfred Hospital, Melbourne, Australia. Imaging by three-dimensional computed tomography (3D CT) of the chest at admission was compared with follow-up 3D CT at 3 months after injury. The 3-month CT scans were assessed for degree of healing and presence of residual deformity at the fracture fixation site. Follow-up CT was performed in 52 of the 60 patients. At 3 months after surgery, 86.5% of the patients had at least partial healing with good alignment and adequate fracture stabilization. Hardware failure was noted in five patients (9.6%) and occurred with the absorbable prostheses only. Six patients who had preoperative overlapping or displacement showed no improvement in deformity despite fixing the lateral fractures. Callus formation and bony bridging between adjacent ribs was often noted in the rib fractures not fixed (28 of 52 patients, 54%) This retrospective review of 3D CT chest at 3 months after rib fixation indicates that a philosophy of fixing only one fracture per rib in a flail segment does not avoid deformity and displacement, particularly in posterior rib fractures. Therapeutic study, level V; epidemiologic study, level V.

  10. The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

    Science.gov (United States)

    Bemelman, Michael; van Baal, Mark; Yuan, Jian Zhang; Leenen, Luke

    2016-01-01

    More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950’s, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has become available suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation. PMID:26889439

  11. The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

    Directory of Open Access Journals (Sweden)

    Michael Bemelman

    2016-02-01

    Full Text Available More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950’s, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has becomeavailable suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

  12. Cronkhite-Canada syndrome associated with rib fractures: a case report.

    Science.gov (United States)

    Yuan, Bosi; Jin, Xinxin; Zhu, Renmin; Zhang, Xiaohua; Liu, Jiong; Wan, Haijun; Lu, Heng; Shen, Yunzhu; Wang, Fangyu

    2010-10-18

    Cronkhite-Canada syndrome (CCS) is a rare multiple gastrointestinal polyposis. Up till now, many complications of CCS have been reported in the literature, but rib fracture is not included. We report a case of a 58-year-old man who was admitted to our hospital with a 6-month history of frequent diarrhea, intermittent hematochezia and a weight loss of 13 kg. On admission, physical examination revealed alopecia of the scalp, hyperpigmentation of the hands and soles, and dystrophy of the fingernails. Laboratory data revealed hypocalcaemia and hypoproteinemia. Esophagogastroduodenoscopy, video capsule endoscopy and colonoscopy revealed various sizes of generalized gastrointestinal polyps. Histological examination of the biopsy specimens obtained from the stomach and the colon showed adenomatous polyp and inflammatory polyp respectively. Thus, a diagnosis of CCS was made. After treatment with corticosteroids for 24 days and nutritional support for two months, his clinical condition improved. Two months later, he was admitted to our hospital for the second time with frequent diarrhea and weight loss. The chest radiography revealed fractures of the left sixth and seventh ribs. Examinations, including emission computed tomography, bone densitometry test, and other serum parameters, were performed, but could not identify the definite etiology of the rib fractures. One month later, the patient suffered from aggravating multiple rib fractures due to the ineffective treatment, persistent hypocalcaemia and malnutrition. This is the first case of a CCS patient with multiple rib fractures. Although the association between CCS and multiple rib fractures in this case remains uncertain, we presume that persistent hypocalcaemia and malnutrition contribute to this situation, or at least aggravate this rare complication. Besides, since prolonged corticosteroid therapy will result in an increased risk of osteoporotic fracture, CCS patients who accept corticosteroid therapy could be

  13. Cronkhite-Canada syndrome associated with rib fractures: a case report

    Directory of Open Access Journals (Sweden)

    Wan Haijun

    2010-10-01

    Full Text Available Abstract Background Cronkhite-Canada syndrome (CCS is a rare multiple gastrointestinal polyposis. Up till now, many complications of CCS have been reported in the literature, but rib fracture is not included. Case Presentation We report a case of a 58-year-old man who was admitted to our hospital with a 6-month history of frequent diarrhea, intermittent hematochezia and a weight loss of 13 kg. On admission, physical examination revealed alopecia of the scalp, hyperpigmentation of the hands and soles, and dystrophy of the fingernails. Laboratory data revealed hypocalcaemia and hypoproteinemia. Esophagogastroduodenoscopy, video capsule endoscopy and colonoscopy revealed various sizes of generalized gastrointestinal polyps. Histological examination of the biopsy specimens obtained from the stomach and the colon showed adenomatous polyp and inflammatory polyp respectively. Thus, a diagnosis of CCS was made. After treatment with corticosteroids for 24 days and nutritional support for two months, his clinical condition improved. Two months later, he was admitted to our hospital for the second time with frequent diarrhea and weight loss. The chest radiography revealed fractures of the left sixth and seventh ribs. Examinations, including emission computed tomography, bone densitometry test, and other serum parameters, were performed, but could not identify the definite etiology of the rib fractures. One month later, the patient suffered from aggravating multiple rib fractures due to the ineffective treatment, persistent hypocalcaemia and malnutrition. Conclusions This is the first case of a CCS patient with multiple rib fractures. Although the association between CCS and multiple rib fractures in this case remains uncertain, we presume that persistent hypocalcaemia and malnutrition contribute to this situation, or at least aggravate this rare complication. Besides, since prolonged corticosteroid therapy will result in an increased risk of osteoporotic

  14. Estimation of carcass composition using rib dissection of calf-fed Holstein steers supplemented zilpaterol hydrochloride.

    Science.gov (United States)

    McEvers, T J; May, N D; Reed, J A; Walter, L J; Hutcheson, J P; Lawrence, T E

    2018-04-14

    A serial harvest was conducted every 28 d from 254 to 534 d on feed (DOF) to quantify changes in growth and composition of calf-fed Holstein steers (n = 115, initial body weight (BW) = 449.2 ± 19.9 kg). One-half were supplemented with the β-2 adrenergic agonist zilpaterol hydrochloride (ZH; 8.33 mg/kg 100% dry matter (DM) basis) during the final 20 d followed by a 3-d withdrawal prior to harvest; the remainder was fed a non-ZH control (CON) ration. Five steers were randomly selected and harvested after 226 DOF which served as a reference point for modeling purposes. Fabricated carcass soft tissue was ground, mixed, and subsampled for proximate analysis. Moreover, following the traditional method of rib dissection which includes the 9th, 10th, and 11th rib contained within the IMPS 103 primal, the relationship of carcass chemical composition to 9-10-11 rib composition was evaluated. Carcasses in this investigation had more (P carcasses and rib dissections. Using regression procedures, models were constructed to describe the relationship of rib dissection (RD) composition including separable lean (RDSL), separable fat (RDSF), separable bone (RDSB), ether extract (RDEE), protein (RDP), moisture (RDM), and ash (RDA) with carcass composition. Carcass lean (CL), carcass fat (CF), and carcass bone (CB) were correlated (P carcass, carcass ether extract (CEE), carcass protein (CP), carcass moisture (CM), and carcass ash (CA) were correlated (P ≤ 0.01) with simple r values of 0.75, 0.31, 0.66, and 0.37, respectively. Equations to predict carcass fatness from rib dissection variables and ZH supplementation status were only able to account for 50 and 56%, of the variability of CF and CEE, respectively. Overall, the relationships quantified and equations developed in this investigation do not support use of 9/10/11 rib dissection for estimation of carcass composition of calf-fed Holstein steers.

  15. Effects of rotation on flow in an asymmetric rib-roughened duct: LES study

    International Nuclear Information System (INIS)

    Borello, D.; Salvagni, A.; Hanjalić, K.

    2015-01-01

    Highlights: • Ribbed duct reproduces most of the phenomena occurring in internal cooling channels of blade turbines (rotor and stator). • LES analysis of the flow in a ribbed duct was carried out aiming at detecting the influence of rotation on the turbulence. • In destabilizing conditions, rotation enhances turbulence close to the ribbed duct thus enhancing removal of fluid from the wall and improving mixing. • In stabilizing conditions, turbulence is suppressed by rotation close to the ribbed wall. - Abstract: We report on large-eddy simulations (LES) of fully-developed asymmetric flow in a duct of a rectangular cross-section in which square-sectioned, equally-spaced ribs oriented perpendicular to the flow direction, were mounted on one of the walls. The configuration mimics a passage of internal cooling of a gas-turbine blade. The duct flow at a Reynolds number Re = 15,000 (based on hydraulic diameter D_h and bulk flow velocity U_0) was subjected to clock-wise (stabilising) and anti-clock-wise (destabilising) orthogonal rotation at a moderate rotational number Ro = ΩD_h/U_0 = 0.3, where Ω is the angular velocity. The LES results reproduced well the available experimental results of Coletti et al. (2011) (in the mid-plane adjacent to the ribbed wall) and provided insight into the whole duct complementing the reference PIV measurement. We analyzed the effects of stabilising and destabilising rotation on the flow, vortical structures and turbulence statistics by comparison with the non-rotating case. The analysis includes the identification of depth of penetration of the rib-effects into the bulk flow, influence of flow three-dimensionality and the role of secondary motions, all shown to be strongly affected by the rotation and its direction.

  16. Development of a socket-type rib coaptation device made of poly-L-lactide fibers: feasibility study in a canine model

    Science.gov (United States)

    Komatsu, Teruya; Sakaguchi, Yasuto; Muranishi, Yusuke; Yutaka, Yojiro; Date, Hiroshi; Nakamura, Tatsuo

    2018-01-01

    Background Costal coaptation pins made of poly-L-lactide (PLA) are clinically available for fixing surgically divided ribs. However, the clinical results of such rib fixation have not been completely satisfactory. We aimed to develop a new rib coaptation socket system and explore its clinical applicability. Methods We surgically divided three consecutive ribs of each beagle dog, and rib coaptation sockets were implanted to stabilize each rib. Fifteen 3-dimensional (3D)-printed and 30 PLA fiber knitted sockets were implanted in five and ten dogs, respectively, to stabilize the artificially divided ribs. Mechanical analysis of the sockets and radiographical examination of costal fixation were performed to evaluate the effectiveness of the newly developed socket system for rib stabilization. Results All 15 ribs with 3D-printed sockets had displaced 1 month after the operation. Three ribs in one dog with implanted PLA fiber knitted sockets were displaced radiographically after 1 month, and the grade of displacement remained unchanged after 6 months. The remaining 27 ribs fixed with PLA fiber knitted sockets did not show any displacement. Conclusions The PLA fiber knitted rib coaptation socket system was sufficiently durable for the stabilization of divided ribs with biocompatibility. This promising finding can be applied for clinical stabilization of divided ribs. PMID:29850125

  17. Combining Functional Neuroimaging with Off-Line Brain Stimulation: Modulation of Task-Related Activity in Language Areas

    Science.gov (United States)

    Andoh, Jamila; Paus, Tomas

    2011-01-01

    Repetitive TMS (rTMS) provides a noninvasive tool for modulating neural activity in the human brain. In healthy participants, rTMS applied over the language-related areas in the left hemisphere, including the left posterior temporal area of Wernicke (LTMP) and inferior frontal area of Broca, have been shown to affect performance on word…

  18. Heat transfer in a two-pass internally ribbed turbine blade coolant channel with cylindrical vortex generators

    Energy Technology Data Exchange (ETDEWEB)

    Hibbs, R.; Chen, Y.; Nikitopoulos, D. [Louisiana State Univ., Baton Rouge, LA (United States)] [and others

    1995-10-01

    The effect of vortex generators on the mass (heat) transfer from the ribbed passage of a two pass turbine blade coolant channel is investigated with the intent of optimizing the vortex generator geometry so that significant enhancements in mass/heat transfer can be achieved. In the experimental configuration considered, ribs are mounted on two opposite walls; all four walls along each pass are active and have mass transfer from their surfaces but the ribs are non-participating. Mass transfer measurements, in the form of Sherwood number ratios, are made along the centerline and in selected inter-rib modules. Results are presented for Reynolds number in the range of 5,000 to 40,000, pitch to rib height ratios of 10.5 and 21, and vortex generator-rib spacing to rib height ratios of 0.55, and 1.5. Centerline and spanwise averaged Sherwood number ratios are presented along with contours of the Sherwood number ratios. Results indicate that the vortex generators induce substantial increases in the local mass transfer rates, particularly along the side walls, and modest increases in the average mass transfer rates. The vortex generators have the effect of making the inter-rib profiles along the ribbed walls more uniform. Along the side walls, horse-shoe vortices that characterize the vortex generator wake are associated with significant mass transfer enhancements. The wake effects and the levels of enhancement decrease somewhat with increasing Reynolds number and decreasing pitch.

  19. Chest Wall Volume Receiving >30 Gy Predicts Risk of Severe Pain and/or Rib Fracture After Lung Stereotactic Body Radiotherapy

    International Nuclear Information System (INIS)

    Dunlap, Neal E.; Cai, Jing; Biedermann, Gregory B.; Yang, Wensha; Benedict, Stanley H.; Sheng Ke; Schefter, Tracey E.; Kavanagh, Brian D.; Larner, James M.

    2010-01-01

    Purpose: To identify the dose-volume parameters that predict the risk of chest wall (CW) pain and/or rib fracture after lung stereotactic body radiotherapy. Methods and Materials: From a combined, larger multi-institution experience, 60 consecutive patients treated with three to five fractions of stereotactic body radiotherapy for primary or metastatic peripheral lung lesions were reviewed. CW pain was assessed using the Common Toxicity Criteria for pain. Peripheral lung lesions were defined as those located within 2.5 cm of the CW. A minimal point dose of 20 Gy to the CW was required. The CW volume receiving ≥20, ≥30, ≥40, ≥50, and ≥60 Gy was determined and related to the risk of CW toxicity. Results: Of the 60 patients, 17 experienced Grade 3 CW pain and five rib fractures. The median interval to the onset of severe pain and/or fracture was 7.1 months. The risk of CW toxicity was fitted to the median effective concentration dose-response model. The CW volume receiving 30 Gy best predicted the risk of severe CW pain and/or rib fracture (R 2 = 0.9552). A volume threshold of 30 cm 3 was observed before severe pain and/or rib fracture was reported. A 30% risk of developing severe CW toxicity correlated with a CW volume of 35 cm 3 receiving 30 Gy. Conclusion: The development of CW toxicity is clinically relevant, and the CW should be considered an organ at risk in treatment planning. The CW volume receiving 30 Gy in three to five fractions should be limited to 3 , if possible, to reduce the risk of toxicity without compromising tumor coverage.

  20. Beliefs about chlamydia testing amongst young people living in relatively deprived areas.

    Science.gov (United States)

    Booth, A R; Harris, P R; Goyder, E; Norman, P

    2013-06-01

    This study uses the theory of planned behaviour (TPB) as a framework to investigate salient beliefs about chlamydia testing, amongst young people living in relatively deprived areas. These beliefs may form targets for intervention to increase testing in this high-risk population. Participants recruited from colleges in deprived areas of a UK city, completed open-ended questions designed to elicit salient beliefs. Responses were content analysed and categorized as describing behavioural, normative or control beliefs. Beliefs were elicited from 128 respondents (51% male; median age = 17). The commonest behavioural belief, which could have a positive or negative impact on screening intentions, was that testing provides information about health status. Partners were referred to most commonly amongst the normative beliefs. Practical aspects and concerns about social implications of testing were common control beliefs. References to several negative emotions emerged throughout. This study indicates that raising awareness of chlamydia as a serious sexual health problem may not be the best way to increase the uptake of testing in a high-risk population. Promoting chlamydia testing as potentially providing reassurance may be an alternative. It may also be important to reduce perceptions of social disapproval as well as negative emotion regarding chlamydia testing.

  1. The relation between geochemical characteristics and landslide in Hungtsaiping area, Nantou, Taiwan

    Science.gov (United States)

    Lin, P.; Tsai, L.

    2009-12-01

    Hungtsaiping is located at the south bank of the Yonglu stream, Chungliao Village of Nantou County, central Taiwan. Hungtsaiping landslide was triggered by the Chi-Chi earthquake (Mw=7.6) occurring on September 20, 1999 UTC near the town of Chi-Chi in Nantou County, central Taiwan. Coping with the geological and geomorphologic investigations, this study makes an attempt to find the relation between geochemical characteristics and landslide in Hungtsaiping area. Water samples were collected from spring waters, creeks, ponds, groundwater and the Yonglu stream once every month from May 2008 to May 2009. Oxygen and hydrogen stable isotopic, ionic concentrations, as well as electrical conductivity and pH value were analyzed. The results indicate that calcium and magnesium bicarbonate-rich water was found on the top and the middle part of the slope. On the other hand, sodium bicarbonate-rich water as well as exceptionally high sulfate concentration was found on the foot of the slope, the sulfate content decreased with increasing elevations until the middle part of slope. A conceptual model of flow process and water origin in Hungtsaiping landslide was established by summarizing the features of hydrogeochemical analyses and the profiles in this study. Keywords: landslide, geochemical characteristics, isotope, hydrochemistry. Fig. 1 The sampling locations of Hungtsaiping landslide. Fig. 2 Isogram: the concentration of sulfate in May 2008 in Hungtsaiping area.

  2. Chemical approaches toward graphene-based nanomaterials and their applications in energy-related areas.

    Science.gov (United States)

    Luo, Bin; Liu, Shaomin; Zhi, Linjie

    2012-03-12

    A 'gold rush' has been triggered all over the world for exploiting the possible applications of graphene-based nanomaterials. For this purpose, two important problems have to be solved; one is the preparation of graphene-based nanomaterials with well-defined structures, and the other is the controllable fabrication of these materials into functional devices. This review gives a brief overview of the recent research concerning chemical and thermal approaches toward the production of well-defined graphene-based nanomaterials and their applications in energy-related areas, including solar cells, lithium ion secondary batteries, supercapacitors, and catalysis. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. The relational of Mesozoic volcanism to uranium mineralization in Guyuan-Hongshanzi area

    International Nuclear Information System (INIS)

    Wu Rengui; Xu Zhe; Yu Zhenqing; Jiang Shan; Shen Kefeng

    2011-01-01

    Based on the time of Mesozoic volcanism,the characteristic of major and trace element, and REE pattern of the volcanic rocks in Guyuan-Hongshanzi area, The Mesozoic volcanism can be divided into the early cycle and later cycle during the Early Cretaceous, and it's magma series is classified in two sub-series, one is alkaline series of trachyte dominated and another is subalkaline series of rhyolite dominated. The relations between Mesozoic volcanism and uranium mineralization is mainly shown in four aspects: (1) Uranium mineralization controlled by the coexist of two magma series; (2) Uranium mineralization controlled by superhypabyssal porphyry body in later cycle volcanism during the Early Cretaceous; (3) The porphyry body close to uranium mineralization,bearing the genesis characteristics of crust-mantle action; and (4) High Si and K content in the chemical composition of the mineralization volcanic rocks. (authors)

  4. METHODOLOGICAL PECULIARITIES OF TEACHING FUTURE ECONOMISTS TO READ ENGLISH TEXTS RELATED TO PROFESSIONAL AREA

    Directory of Open Access Journals (Sweden)

    Ліліана Білогорка

    2015-09-01

    Full Text Available The role of reading competence in the structure of English professionally oriented communicative competence has been analysed; types of economics texts which should be used in teaching future economists – scientific economics texts, texts of professional economics activity, educational economics texts, texts of non-professional economics activity have been defined; the necessity of using not only authentic, but also semi-authentic and adapted texts in teaching future economists to read English texts related to professional area has been grounded; bachelor’s level requirements for students’ knowledge and skills in skimming, scanning reading and reading for detail have been defined; direct (cognitive and compensatory and indirect (metacognitive, affective and social learning strategies to enhance the quality of text reading have been specified in the article.

  5. The economic-geographical and environmental polarization as a factor of new functional relations between areas

    Directory of Open Access Journals (Sweden)

    Milinčić Miroljub A.

    2004-01-01

    Full Text Available Geographical clustering, in the way of economic-geographical polarization represents regular and positive process of development of human society. These processes are characterized by stressed intensity, together with relatively short time dimension at the territory of Serbia. Extreme recent ecological polarization is the main consequence of this type of recomposition of economic-geographical elements in the territory of Serbia. At the one hand, anthropogenic or socio-economic areas (locations, axis and crossroads of development are formed, together with the numerous ecological problems as developing barriers, while at the other hand are territories of economic-geographical stagnation also with satisfying quality of basic natural resources and environmental condition. These differences generates and permanently increases their spatial, resource and ecological interdependence.

  6. Stress fractures of the rib arising from the manufactory assembly line

    International Nuclear Information System (INIS)

    Arima, Toru; Iwasaki, Masayuki

    2007-01-01

    We investigated stress injuries of the rib arising from the assembly line. The patients, all males, were 20 in number and divided into two groups; those with stress fracture (n=13) and those with ''pre-fracture'' (n=7). The former group with the average age of 37 years was involved by a single fracture in 10 patients and multiple fractures in 3, ranging from 5th to 8th ribs, with the affected side on the right in 9 and the left in 4. All 13 fractures occurred in the posterior half of the rib, in which 5 were located in its lateral portion, 5 in the middle, and 3 in the posterior. The latter group with the average age of 32 years were involved on the right side in 4 and the left in 3. The working pattern causing rib injuries was either repeated raising of the upper extremity or forward pushing of the shoulder girdle. The symptom was back pain, and aggravated especially in elevation of the arm, deep breathing and sneezing. Local tenderness over the fracture site was noted in all cases. X-ray findings at initial examination revealed fractures in most cases and 3D-CT was employed in 9 questionable cases to assess fracture conditions. In the ''pre-fracture'' group, although the fracture was not recognized on X-ray, the diagnosis was made as an impending fracture based on the localized tenderness on the rib. As to treatment, bust band fixation and work load reduction were performed. Stress fractures of the rib have been occasionally reported in sports medicine, but not so much in industrial medicine. This specific injury has been treated in literature as muscle strain because of the absence of apparent trauma. It is important to recognize the underlying pathology to make the correct diagnosis. In the early stage of rib fractures, 3D-CT was more useful than X-ray in making diagnosis and assessing the bony union. As to the pathomechanism of this condition, it was postulated that repeated raising or forward pushing of the arm applying excessive traction to the origin of the

  7. Area/latency optimized early output asynchronous full adders and relative-timed ripple carry adders.

    Science.gov (United States)

    Balasubramanian, P; Yamashita, S

    2016-01-01

    This article presents two area/latency optimized gate level asynchronous full adder designs which correspond to early output logic. The proposed full adders are constructed using the delay-insensitive dual-rail code and adhere to the four-phase return-to-zero handshaking. For an asynchronous ripple carry adder (RCA) constructed using the proposed early output full adders, the relative-timing assumption becomes necessary and the inherent advantages of the relative-timed RCA are: (1) computation with valid inputs, i.e., forward latency is data-dependent, and (2) computation with spacer inputs involves a bare minimum constant reverse latency of just one full adder delay, thus resulting in the optimal cycle time. With respect to different 32-bit RCA implementations, and in comparison with the optimized strong-indication, weak-indication, and early output full adder designs, one of the proposed early output full adders achieves respective reductions in latency by 67.8, 12.3 and 6.1 %, while the other proposed early output full adder achieves corresponding reductions in area by 32.6, 24.6 and 6.9 %, with practically no power penalty. Further, the proposed early output full adders based asynchronous RCAs enable minimum reductions in cycle time by 83.4, 15, and 8.8 % when considering carry-propagation over the entire RCA width of 32-bits, and maximum reductions in cycle time by 97.5, 27.4, and 22.4 % for the consideration of a typical carry chain length of 4 full adder stages, when compared to the least of the cycle time estimates of various strong-indication, weak-indication, and early output asynchronous RCAs of similar size. All the asynchronous full adders and RCAs were realized using standard cells in a semi-custom design fashion based on a 32/28 nm CMOS process technology.

  8. Postglacial relative sea-level history of the Prince Rupert area, British Columbia, Canada

    Science.gov (United States)

    Letham, Bryn; Martindale, Andrew; Macdonald, Rebecca; Guiry, Eric; Jones, Jacob; Ames, Kenneth M.

    2016-12-01

    This paper presents a history of relative sea level (RSL) change for the last 15,000 years in the Prince Rupert region on the northern coast of British Columbia, Canada. One hundred twenty-three radiocarbon ages of organic material from isolation basin cores, sediment sequence exposures, and archaeological sites having a recognized relation to past sea levels constrain postglacial RSL. The large number of new measurements relating to past sea-level provides a well constrained RSL curve that differs in significant ways from previously published results. After deglaciation following the Last Glacial Maximum, the region experienced an isostatically-induced rapid RSL drop from as much 50 m asl to as low as -6.3 m asl in as little as a few centuries between 14,500 BP and 13,500 BP. After a lowstand below current sea level for about 2000 years during the terminal Pleistocene, RSL rose again to a highstand at least 6 m asl after the end of the Younger Dryas. RSL slowly dropped through the Holocene to close to its current position by 2000-1500 BP, with some potential fluctuations between 3500 and 1500 BP. This study highlights variation in RSL histories across relatively short distances, which must be accounted for by local RSL reconstructions such as this one. This RSL curve aided in the identification of an 8000-9000 year old archaeological site on a 10-12 m asl terrace, which is currently the earliest dated archaeological site in the area, and it provides guidance for searching for even older archaeological remains. We highlight the utility and potential of this refined RSL history for developing surveys for other archaeological sites associated with paleoshorelines.

  9. Flexural behaviour and punching shear of selfcompacting concrete ribbed slab reinforced with steel fibres

    Directory of Open Access Journals (Sweden)

    Ahmad Hazrina

    2017-01-01

    Full Text Available This paper investigates the effects of steel fibres as a replacement to the conventional reinforcement under flexural behaviour and punching shear in self-compacting (SCC ribbed slab reinforced with steel fibres. Four ribbed slabs with similar dimensions of 2.8 m length × 1.2 m width and 0.2m thickness were constructed. Two of the samples were considered as control samples (conventionally reinforced with reinforcement bars and welded mesh while another two samples were fully reinforced with 1% (80 kg/m3 volume of steel fibres incorporated to the SCC mix. For the flexural behaviour study, the ribbed slab samples were subjected to two line loads under four point bending. Meanwhile, for the punching shear analysis, the ribbed slab samples were subjected to a point load to simulate loading from the column. The analysis of the experimental results displayed that steel fibres incorporation had been found to effectively delay the first crack occurrence under both flexural and punching shear. The steel fibre replacement has been proven to be able to sustain up to 80% and 73% of the ultimate load resistance for flexural and punching shear, respectively, in comparison to conventionally reinforced ribbed slab structure. The visual observation carried out during the experiment exhibited similar failure mode for both steel fibre reinforced and control samples. This was observed for both flexural and punching shear samples. Overall, it can be concluded that the steel fibres had displayed a promising potential to effectively replace the conventional reinforcements.

  10. In Vivo Assessment of Elasticity of Child Rib Cortical Bone Using Quantitative Computed Tomography

    Directory of Open Access Journals (Sweden)

    Y. Zhu

    2017-01-01

    Full Text Available Elasticity of the child rib cortical bone is poorly known due to the difficulties in obtaining specimens to perform conventional tests. It was shown on the femoral cortical bone that elasticity is strongly correlated with density for both children and adults through a unique relationship. Thus, it is assumed that the relationships between the elasticity and density of adult rib cortical bones could be expanded to include that of children. This study estimated in vivo the elasticity of the child rib cortical bone using quantitative computed tomography (QCT. Twenty-eight children (from 1 to 18 y.o. were considered. Calibrated QCT images were prescribed for various thoracic pathologies. The Hounsfield units were converted to bone mineral density (BMD. A relationship between the BMD and the elasticity of the rib cortical bone was applied to estimate the elasticity of children’s ribs in vivo. The estimated elasticity increases with growth (7.1 ± 2.5 GPa at 1 y.o. up to 11.6 ± 1.9 GPa at 18 y.o.. This data is in agreement with the few previous values obtained using direct measurements. This methodology paves the way for in vivo assessment of the elasticity of the child cortical bone based on calibrated QCT images.

  11. Methods of counting ribs on chest CT: the modified sternomanubrial approach

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Kyung Sik; Kim, Sung Jin; Jeon, Min Hee; Lee, Seung Young; Bae, Il Hun [Chungbuk National University, Cheongju (Korea, Republic of)

    2007-08-15

    The purpose of this study was to evaluate the accuracy of each method of counting ribs on chest CT and to propose a new method: the anterior approach with using the sternocostal joints. CT scans of 38 rib lesions of 27 patients were analyzed (fracture: 25, metastasis: 11, benign bone disease: 2). Each lesion was independently counted by three radiologists with using three different methods for counting ribs: the sternoclavicular approach, the xiphisternal approach and the modified sternomanubrial approach. The rib lesions were divided into three parts of evaluation of each method according to the location of the lesion as follows: the upper part (between the first and fourth thoracic vertebra), the middle part (between the fifth and eighth) and the lower part (between the ninth and twelfth). The most accurate method was a modified sternomanubrial approach (99.1%). The accuracies of a xiphisternal approach and a sternoclavicular approach were 95.6% and 88.6%, respectively. A modified sternomanubrial approach showed the highest accuracies in all three parts (100%, 100% and 97.9%, respectively). We propose a new method for counting ribs, the modified sternomanubrial approach, which was more accurate than the known methods in any parts of the bony thorax, and it may be an easier and quicker method than the others in clinical practice.

  12. Ketamine as an Analgesic Adjuvant in Adult Trauma Intensive Care Unit Patients With Rib Fracture.

    Science.gov (United States)

    Walters, Mary K; Farhat, Joseph; Bischoff, James; Foss, Mary; Evans, Cory

    2018-03-01

    Rib fracture associated pain is difficult to control. There are no published studies that use ketamine as a therapeutic modality to reduce the amount of opioid to control rib fracture pain. To examine the analgesic effects of adjuvant ketamine on pain scale scores in trauma intensive care unit (ICU) rib fracture. This retrospective, case-control cohort chart review evaluated ICU adult patients with a diagnosis of ≥1 rib fracture and an Injury Severity Score >15 during 2016. Patients received standard-of-care pain management with the physician's choice analgesics with or without ketamine as a continuous, fixed, intravenous infusion at 0.1 mg/kg/h. A total of 15 ketamine treatment patients were matched with 15 control standard-of-care patients. Efficacy was measured via Numeric Pain Scale (NPS)/Behavioral Pain Scale (BPS) scores, opioid use, and ICU and hospital length of stay. Safety of ketamine was measured by changes in vital signs, adverse effects, and mortality. Average NPS/BPS, severest NPS/BPS, and opioid use were lower in the ketamine group than in controls (NPS: 4.1 vs 5.8, P rib fracture.

  13. Rib and sternum fractures in the elderly and extreme elderly following motor vehicle crashes.

    Science.gov (United States)

    Bansal, Vishal; Conroy, Carol; Chang, David; Tominaga, Gail T; Coimbra, Raul

    2011-05-01

    As the population ages, the need to protect the elderly during motor vehicle crashes becomes increasingly critical. This study focuses on causation of elderly rib and sternum fractures in seriously injured elderly occupants involved in motor vehicle crashes. We used data from the Crash Injury Research and Engineering Network (CIREN) database (1997-2009). Study case criteria included occupant (≥ 65 years old) drivers (sitting in the left outboard position of the first row) or passengers (sitting in the first row right outboard position) who were in frontal or side impacts. To avoid selection bias, only occupants with a Maximum Abbreviated Injury Scale (MAIS) 3 (serious) or greater severity injury were included in this study. Odds ratios were used as a descriptive measure of the strength of association between variables and Chi square tests were used to determine if there was a statistically significant relationship between categorical variables. Of the 211 elderly (65-79 years old) occupants with thoracic injury, 92.0% had rib fractures and 19.6% had sternum fractures. For the 76 extreme elderly (80 years or older) with thoracic injury, 90.4% had rib fractures and 27.7% had sternum fractures. Except for greater mortality and more rib fractures caused by safety belts, there were no differences between the extreme elderly and the elderly occupants. Current safety systems may need to be redesigned to prevent rib and sternum fractures in occupants 80 years and older. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. First-rib stress fracture in two adolescent swimmers: a case report.

    Science.gov (United States)

    Low, Sara; Kern, Michael; Atanda, Alfred

    2016-01-01

    First-rib stress fractures have been described in adolescent athletes in various sports, with only one prior case report of first-rib stress fractures in an adolescent female swimmer. There is a need for research on the cause, management, and prevention of these injuries as they lead to significant morbidity and critical time away from sport for these aspiring athletes. We aimed to describe first-rib stress fractures as a potential cause for non-specific atraumatic chronic shoulder pain in adolescent swimmers and to discuss the different presentations, unique risk factors, treatment, and potential injury prevention strategies of such fractures. We discussed two such cases which were successfully treated with activity modification with restriction of all overhead activity, gradually progressive physical therapy and a return to swimming protocol. First-rib stress fractures can vary in presentation and should be in the differential diagnosis in adolescent swimmers with chronic shoulder pain. These injuries can be successfully managed with rest from overhead activities and physical therapy. Gradual return to competitive swimming can be achieved even with non-union of a first-rib stress fracture. Emphasis on balanced strength training in different muscle groups and proper swimming technique is essential to prevent these injuries.

  15. In Situ Splitting of a Rib Bone Graft for Reconstruction of Orbital Floor and Medial Wall.

    Science.gov (United States)

    Uemura, Tetsuji; Yanai, Tetsu; Yasuta, Masato; Harada, Yoshimi; Morikawa, Aya; Watanabe, Hidetaka; Kurokawa, Masato

    2017-06-01

    In situ splitting of rib bone graft was conducted in 22 patients for the repair of orbital fracture with no other complicating fractures. A bone graft was harvested from the sixth or seventh rib in the right side. The repair of the orbital floor and medial wall was successful in all the cases. Ten patients had bone grafting to the orbital floor, eight had it done onto medial wall, and 4 onto both floor and wall after reduction. The mean length of in situ rib bone graft was 40.9 mm (range, 20-70 mm), the mean width of these was 14.9 mm (range, 8-20 mm). The bone grafting was done by one leaf for 15 cases and two leafs for 7 cases in size of defects. The technique of in situ splitting of a rib bone graft for the repair of the orbital floor and medial wall is a simple and safe procedure, easily taking out the in situ splitting of a rib, and less pain in donor site. It has proved to be an optimal choice in craniofacial reconstruction, especially the defects of orbital floor and medial wall.

  16. Pitfalls associated with open reduction and internal fixation of fractured ribs.

    Science.gov (United States)

    Sarani, Babak; Schulte, Leah; Diaz, Jose J

    2015-12-01

    Rib fracture is exceedingly common and remains a leading cause of death in patients with chest injury. Probability of death increases by 19% with each broken rib, and the probability of death increases further with age. Treatment is centered on pain control and early mobilization to provide adequate pulmonary hygiene. Multimodality interventions, such as incentive spirometry, postural changes, and coughing, are pivotal in minimizing the risk of pneumonia and death. Recently, many studies have found mortality benefit to operation fixation (ORIF) of ribs in select patients. However, this procedure remains underutilized partly due to lack of familiarity with its technique and pitfalls by trauma surgeons, in particular. Whereas there are publications on operative technique, there are no studies describing pitfalls associated with this procedure. The purpose of this paper is to describe pitfalls on the technical aspects of ORIF of the ribs based on the medical literature where possible and based on our experience in instances where peer reviewed evidence is lacking. The paper is not meant to serve as a protocol for managing rib fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.