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Sample records for ribbed channel analysed

  1. 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.

  2. 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...... of u′ is bimodal in the separated shear layer downstream of the rib. The maximum Reynolds shear stresses occur at the leading edge of the rib. Based on quadrant analysis, it is found that ejection motions make a dominant contribution to the Reynolds shear stress in this region. Moreover, topology......-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....

  3. 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 the perforated ribs, the slit height is 20% of the rib height, and the open-area ratio is 16%. We discuss the flow in terms of mean velocity, streamlines, vorticity, turbulence intensity, and Reynolds shear stress. We find that the recirculation bubbles after the perforated ribs are significantly smaller than...... those after the solid ribs. The reattachment length after perforated ribs is smaller by about 45% compared with the solid ribs. In addition, the Reynolds shear stresses around the perforated ribs are significantly smaller than in the solid rib case, leading to a reduction of the pressure loss...

  4. Computational study on effects of rib height and thickness on heat transfer enhancement in a rib roughened square channel

    Indian Academy of Sciences (India)

    ANUJ K SHUKLA; ANUPAM DEWAN

    2016-06-01

    A computational study was carried out for the heat transfer augmentation in a three-dimensional square channel fitted with different types of ribs. The standard k–e model and its two variants (RNG and realizable) were used for turbulence modeling. The predictions were compared with available experimental andcomputational results. Three rib configurations were used in the present study: 90° continuous attached ribs, 60° V-shaped broken attached thick and thin ribs. It was observed that the maximum heat transfer occurs at the normalized rib spacing (p/e) = 10 in the case of 90° attached ribs. The effects of the blockage ratio and rib thickness were investigated for 60° V-shaped broken ribs with Re = 10,000–30,000 and p/e = 10. It was observed that the average Nusselt number decreases with an increase in the Reynolds number for almost all configurations studied in the present study. For the 60° V-shaped broken ribs, increasing the blockage ratio had an adverse effect on the heat transfer. It was also observed that thin ribs perform better than thick ribs.

  5. Cold plate with combined inclined impingement and ribbed channels

    Energy Technology Data Exchange (ETDEWEB)

    Parida, Pritish R.

    2015-12-22

    Heat transfer devices and methods for making the same that include a first enclosure having at least one inlet port; a second enclosure having a bottom plate and one or more dividing walls to establish channels, at least one internal surface of each channel having rib structures to create turbulence in a fluid flow; and a jet plate connecting the first enclosure and the second enclosure having impinging jets that convey fluid from the first enclosure to the channels, said impinging jets being set at an angular deviation from normal to cause local acceleration of fluid and to increase a local heat transfer rate.

  6. Effect of rib angle on local heat/mass transfer distribution in a two-pass rib-roughened channel

    Science.gov (United States)

    Chandra, P. R.; Han, J. C.; Lau, S. C.

    1987-01-01

    The naphthalene sublimation technique is used to investigate the heat transfer characteristics of turbulent air flow in a two-pass channel. A test section that resembles the internal cooling passages of gas turbine airfoils is employed. The local Sherwood numbers on the ribbed walls were found to be 1.5-6.5 times those for a fully developed flow in a smooth square duct. Depending on the rib angle-of-attack and the Reynolds number, the average ribbed-wall Sherwood numbers were 2.5-3.5 times higher than the fully developed values.

  7. Heat transfer and friction factors in the ribbed square convergent and divergent channels

    Science.gov (United States)

    Lee, M. S.; Ahn, S. W.

    2016-06-01

    Heat transfer and friction factors are reported for the measurements of turbulent flows in the convergent and divergent square channels with one-sided ribbed wall as well as two opposite in-line ribbed walls. The study covers three different hydraulic diameter ratios between inlet and exit at the test section such as Dho/Dhi = 0.75, 1.0, and 1.33 and Reynolds numbers in the range of 25,000-79,000. The channels, composing of ten isolated copper sections in the length of test section of 1 m, have the hydraulic diameter of 87.5 mm for the straight channel (Dho/Dhi = 1.0); the rib height-to-hydraulic diameter is 0.114; the rib pitch-to-height ratio equals 10. On the contrary to public opinion that the friction factor depends on the portion of the ribbed area, the total friction factor in the two opposite ribbed walls are lower than in the one-sided ribbed wall in the divergent channel of Dho/Dhi = 1.33 because the total pressure, summing positive dynamic and negative static pressures, is acted. The results show that the two opposite ribbed divergent channel of Dho/Dhi = 1.33 provides the best heat transfer enhancement and the two opposite ribbed convergent channel of Dho/Dhi = 0.75 provides the worst friction factor enhancement, and the ribbed divergent channels are generally recommended.

  8. 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

  9. Experimental and Numerical Study on Heat Transfer Enhancement of a Rectangular Channel with Discontinuous Crossed Ribs and Grooves

    Institute of Scientific and Technical Information of China (English)

    唐新宜; 朱冬生

    2012-01-01

    Experimental and numerical investigations have been conducted to study turbulent flow of water and heat transfer characteristics in a rectangular channel with discontinuous crossed ribs and grooves.The tests investigated the overall heat transfer performance and friction factor in ribbed and ribbed-grooved channels with rib angle of 30°.The experimental results show that the overall thermo-hydraulic performance for ribbed-grooved channel is increased by 10%-13.6% when compared to ribbed channel.The investigation on the effects of different rib angles and rib pitches on heat transfer characteristics and friction factor in ribbed-grooved channel was carried out using Fluent with SST(shear-stress transport) k-ω turbulence model.The numerical results indicate that the case for rib angle of 45° shows the best overall thermo-hydraulic performance,about 18%-36% higher than the case for rib angle of 0°.In addition,the flow patterns and local heat transfer characteristics for ribbed and ribbed-grooved channels based on the numerical simulation were also analyzed to reveal the mechanism of heat transfer enhancement.

  10. Turbulence and Scale Measurements in a Square Channel with Transverse Square Ribs

    Directory of Open Access Journals (Sweden)

    Richard B. Rivir

    1996-01-01

    and staggered multiple ribs. Test conditions for multiple ribs use p/H = 10, H/D 0.17, and Re⁡D 23,000. Measured results highlight the spatial distribution and evolution of turbulence intensity and integral scale from the flow entrance of the first period to the developed regime near the exit of the third period. The highly turbulent, shear layer initiated near the trailing upper-edge of a rib elevates the turbulence level in the mainstream of the channel. The magnitude of turbulence intensity in the channel core rises from 0.7% in the approaching flow to about 20–25% near the exit of the third period. The integral scale dominating the mainstream flow increases from approximately one-half the rib-height, 0.5H, in the approaching flow to 1.5-2.5H behind the first rib and further downstream.

  11. Effect of adiabatic square ribs on natural convection in an asymmetrically heated channel

    Science.gov (United States)

    Abidi-Saad, Aissa; Kadja, Mahfoud; Popa, Catalin; Polidori, Guillaume

    2017-02-01

    A 2-D numerical simulation is carried out to investigate the effect of two adiabatic square ribs on laminar flow and heat transfer in an asymmetrically heated channel. The two ribs are symmetrically located on each wall, exactly above the heating zone. The computational procedure is made by solving the unsteady bi-dimensional continuity, momentum and energy equations with the finite volume method. The investigations focused more specifically on the influence of ribs sizes on the flow structure and heat transfer enhancement. The results showed that the variation of ribs sizes significantly alters the heat transfer and fluid flow distribution along the channel, especially in the vicinity of protrusions. Also, the results show that streamlines, isotherms, and the number, sizes and formation of vortex structures inside the channel strongly depend on the size of protrusions. The changes in heat transfer parameters have also been presented.

  12. Schlieren visualization of water natural convection in a vertical ribbed channel

    Science.gov (United States)

    Fossa, M.; Misale, M.; Tanda, G.

    2015-11-01

    Schlieren techniques are valuable tools for the qualitative and quantitative visualizations of flows in a wide range of scientific and engineering disciplines. A large number of schlieren systems have been developed and documented in the literature; majority of applications involve flows of gases, typically air. In this work, a schlieren technique is applied to visualize the buoyancy-induced flow inside vertical ribbed channels using water as convective fluid. The test section consists of a vertical plate made of two thin sheets of chrome-plated copper with a foil heater sandwiched between them; the external sides of the plate are roughened with transverse, square-cross-sectioned ribs. Two parallel vertical walls, smooth and unheated, form with the heated ribbed plate two adjacent, identical and asymmetrically heated, vertical channels. Results include flow schlieren visualizations with colour-band filters, reconstructions of the local heat transfer coefficient distributions along the ribbed surfaces and comparisons with past experiments performed using air as working fluid.

  13. Pressure drop and mass transfer in two-pass ribbed channels

    Science.gov (United States)

    Chandra, P. R.; Han, J. C.

    1989-01-01

    The combined effects of the sharp 180-deg turn and of the rib configuration on the pressure drop and mass transfer characteristics in a two-pass square channel with a pair of opposite rib-roughened walls (to simulate turbine airfoil cooling passages) were determined for a Reynolds number range of 10,000-60,000. Heat transfer enhancements were compared for the first pass and for the two-pass channel with the sharp 180-deg turn. Correlations for the fully-developed friction factors and loss coefficients were obtained.

  14. Ti:sapphire rib channel waveguide fabricated by reactive ion etching of a planar waveguide

    NARCIS (Netherlands)

    Crunteanu, A.; Jänchen, G.; Salathé, R.P.; Hoffmann, P.; Pollnau, M.; Eason, R.W.; Shepherd, D.P.

    2002-01-01

    We were successful in creating 1.4-µm high ribs in a Ti:sapphire planar waveguide by reactive ion etching. Optical investigations of the obtained structure showed channel-waveguide fluorescence emission of the Ti:sapphire layer after Ar-ion excitation.

  15. 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.

  16. Numerical investigation of turbulent flow and heat transfer in channel with ribs

    DEFF Research Database (Denmark)

    Myllerup, Lisbeth; Larsen, Poul Scheel

    1999-01-01

    The performance of three different low-Reynolds number turbulence models has been explored for the benchmark test of fully developed (periodic) flow in a ribbed plane channel. Results are presented for two values of the Reynolds number (based on mean velocity and hydraulic diameter), Re = 37......,200 and Re = 12,600, for which experimental data are available for the flow field and heat transfer, respectively. Comparison with experimental data includes the Nusselt number distribution along ribbed surface and profiles of mean velocity....

  17. Numerical simulation of effective efficiency of a discrete multi V-pattern rib solar air channel

    Science.gov (United States)

    Kumar, Anil; Saini, R. P.; Saini, J. S.

    2016-10-01

    The use of artificial roughness in the form of repeated ribs has been found to be an efficient method of improving the heat transfer to fluid flowing in the channel. In this study, performance of solar air channel as a function of discrete multi V-pattern rib shapes has been investigated. The e/D was varied from 0.022 to 0.043, Gd/Lv was varied from 0.24 to 0.80, g/e was varied from 0.5 to 1.5, α was varied from 30° to 75°, P/e was varied from 6.0 to 12.0 and W/w was varied from 1.0 to 10.0. A methodology has been developed for the prediction of effective efficiency. Based on the values of effective efficiency, an optimization has been carried out to determine the set of data of roughness shapes parameters that correspond to better effective efficiency for given values of operating parameters of the air channel. Design plots have been represent to depict the data of individual roughness shapes parameters that characterize the optimum condition as a function of performance parameter and intensity of radiation. It was observed that the maximum values of effective efficiency for e/D of 0.043, Gd/Lv of 0.69, g/e of 1.0, α of 60°, P/e of 8.0 and W/w of 6.0. Discrete multi v-rib shape has been found to be better thermohydraulic performance (effective efficiency) as comparison to other rib shapes solar air channels.

  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. Pressure Loss Through Sharp 180 deg Turn in a Relatively Short Two-Pass Smooth and RibRoughened Channel

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    The local pressure distributions and resistance coefficients(f1 and f2) through the sharp 180 deg turn in a relatively short (L/De=4) two-pass smooth and rib-roughened channel were investigated for a Reynolds number range of 1.0×103,9.0×103.The rib pitch-to-herght ratios(p/e) were 5,10,and 20,The rib height-to-hydraulic diamter ratios(e/De) were 0.025,0.050 and 0.10,and the rib angles of attack(a) were 90,45,60,-45,and -60 deg.Rids were installed not only in before and after turn regions but also in turn region.The results show that resistance coefficients remain approximately constant when Reynolds number is more than 3.0×104,The effects of the rib configuration(rib spacing,rib height,and rib orientation)on the inlet straight duct resistance coefficient(f2) were significant, however,their effects on the overall resistance coefficient(f1) were diluted by the sharp-180 turn.For this relatively short channel(L/De=4),the overall resistance coefficient(f1) was greatly affected by the sharp turn.Correlations for the overall resistance(f1) and inlet straight duct resistance coefficient (f2) are presented.

  20. Study on critical heat flux in narrow rectangular channel with repeated-rib roughness. 1. Experimental facility and preliminary experiments

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, Hidetaka; Terada, Atsuhiko; Kaminaga, Masanori; Hino, Ryutaro [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    2001-10-01

    In the design of a spallation target system, the water cooling system, for example a proton beam window and a safety hull, is used with narrow channels, in order to remove high heat flux and prevent lowering of system performance by absorption of neutron. And in narrow channel, heat transfer enhancement using 2-D rib is considered for reduction the cost of cooling component and decrease inventory of water in the cooling system, that is, decrease of the amount of irradiated water. But few studies on CHF with rib have been carried out. Experimental and analytical studies with rib-roughened test section, in 10:1 ratio of pitch to height, are being carried out in order to clarify the CHF in rib-roughened channel. This paper presents the review of previous researches on heat transfer in channel with rib roughness, overview of the test facility and the preliminary experimental and analytical results. As a result, wall friction factors were about 3 times as large as that of smooth channel, and heat transfer coefficients are about 2 times as large as that of smooth channel. The obtained CHF was as same as previous mechanistic model by Sudo. (author)

  1. Hybrid RANS/LES of turbulent flow in a rotating rib-roughened channel

    Science.gov (United States)

    Xun, Qian-Qiu; Wang, Bing-Chen

    2016-07-01

    In this paper, we investigate the effect of the Coriolis force on the flow field in a rib-roughened channel subjected to either clockwise or counter-clockwise system rotation using hybrid RANS/LES based on wall modelling. A simplified dynamic forcing scheme incorporating backscatter is proposed for the hybrid simulation approach. The flow is characterized by a Reynolds number of Re = 1.5 × 104 and a rotation number Ro ranging from -0.6 to 0.6. The mean flow speed and turbulence level near the roughened wall are enhanced under counter-clockwise rotation and suppressed under clockwise rotation. The Coriolis force significantly influences the stability of the wall shear layer and the free shear layers generated by the ribs. Consequently, it is interesting to observe that the classification of the roughness type relies not only on the pitch ratio, but also on the rotation number in the context of rotating rib-roughened flows. In order to validate the present hybrid approach, the first- and second-order statistical moments of the velocity field obtained from the simulations are thoroughly compared with the available laboratory measurement data.

  2. New experimental results on local heat transfer inside a rectangular channel with rib-roughened surfaces

    Science.gov (United States)

    Fustinoni, D.; Gramazio, P.; Vitali, L.; Niro, A.

    2017-01-01

    In this paper we present new experimental results on local heat transfer characteristics of a forced air-flow through a 12-mm-height, rectangular channel of 1:10 aspect ratio, with square-cross-section ribs mounted onto the lower surface. Data are collected on a completely redesigned test section. Specifically, the electric heater is made of very thin copper tracks, in direct contact with the air flow and covering at 97.5% the channel lower surface to guarantee a very uniform heat flux. The copper tracks are laminated onto a 2-mm thick board of FR-4 glass epoxy to provide negligible heat conduction inside the plate and heat losses from its sides. Finally, the channel walls are in XPS and, into the upper one, a double glazing consisting of two 120 mm x 120 mm Germanium windows is mounted to allow optical access to the IR camera and to reduce local heat dispersions. Data here presented refer to convection over 4 mm x 2 mm ribs in transverse configuration for Reynolds numbers, based on the duct hydraulic diameter, ranging between 700 and 8000. Preliminary tests show how the new apparatus has significantly improved the quality, the ease and the quickness of the measurements.

  3. Heat transfer performance comparison of steam and air in gas turbine cooling channels with different rib angles

    Science.gov (United States)

    Shi, Xiaojun; Gao, Jianmin; Xu, Liang; Li, Fajin

    2013-11-01

    Using steam as working fluid to replace compressed air is a promising cooling technology for internal cooling passages of blades and vanes. The local heat transfer characteristics and the thermal performance of steam flow in wide aspect ratio channels ( W/ H = 2) with different angled ribs on two opposite walls have been experimentally investigated in this paper. The averaged Nusselt number ratios and the friction factor ratios of steam and air in four ribbed channels were also measured under the same test conditions for comparison. The Reynolds number range is 6,000-70,000. The rib angles are 90°, 60°, 45°, and 30°, respectively. The rib height to hydraulic diameter ratio is 0.047. The pitch-to-rib height ratio is 10. The results show that the Nusselt number ratios of steam are 1.19-1.32 times greater than those of air over the range of Reynolds numbers studied. For wide aspect ratio channels using steam as the coolant, the 60° angled ribs has the best heat transfer performance and is recommended for cooling design.

  4. Sexual Dimorphism of the First Rib: A Comparative Approach Using Metric and Geometric Morphometric Analyses.

    Science.gov (United States)

    Lynch, Jeffrey James; Cross, Peter; Heaton, Vivienne

    2017-09-01

    This research investigated the sexual dimorphism of the first human rib using geometric morphometric and metric approaches on a sample of 285 specimens containing European Americans and African Americans from the Hamann-Todd collection. Metric measurements were investigated for sexual dimorphism and ancestral differences using univariate statistics. Four type II landmarks and 40 sliding semi-landmarks were placed outlining the dorsal and ventral curvatures of the ribs. Landmark data were processed using Generalized Procrustes Analyses with Procrustes distance sliding, and the subsequent coordinates were investigated for sexual dimorphism and ancestral differences using Procrustes ANOVAs. Both geometric morphometric and metric data were analyzed using cross-validated discriminant function analyses to test the hypothesis that variables from both approaches can be combined to increase sex classification rate. European Americans had sex correctly classified as high as 88.05% and African Americans as high as 70.86% using a combination of metric and geometric morphometric variables. © 2017 American Academy of Forensic Sciences.

  5. Flow field investigation in rotating rib-roughened channel by means of particle image velocimetry

    Energy Technology Data Exchange (ETDEWEB)

    Coletti, Filippo [Karman Institute for Fluid Dynamics, Turbomachinery and Propulsion Department, Rhode-Saint-Genese (Belgium); Stanford University, Mechanical Engineering Department, Stanford, CA (United States); Maurer, Thomas [Karman Institute for Fluid Dynamics, Turbomachinery and Propulsion Department, Rhode-Saint-Genese (Belgium); Stuttgart University, Institute of Aerospace Thermodynamics, Stuttgart (Germany); Arts, Tony [Karman Institute for Fluid Dynamics, Turbomachinery and Propulsion Department, Rhode-Saint-Genese (Belgium); Di Sante, Alberto [Karman Institute for Fluid Dynamics, Turbomachinery and Propulsion Department, Rhode-Saint-Genese (Belgium); General Electric, Florence (Italy)

    2012-04-15

    The turbulent velocity field over the rib-roughened wall of an orthogonally rotating channel is investigated by means of two-dimensional particle image velocimetry (PIV). The flow direction is outward, with a bulk Reynolds number of 1.5 x 10{sup 4} and a rotation number ranging from 0.3 to 0.38. The measurements are obtained along the wall-normal/streamwise plane at mid-span. The PIV system rotates with the channel, allowing to measure directly the relative flow velocity with high spatial resolution. Coriolis forces affect the stability of the boundary layer and free shear layer. Due to the different levels of shear layer entrainment, the reattachment point is moved downstream (upstream) under stabilizing (destabilizing) rotation, with respect to the stationary case. Further increase in rotation number pushes further the reattachment point in stabilizing rotation, but does not change the recirculation length in destabilizing rotation. Turbulent activity is inhibited along the leading wall, both in the boundary layer and in the separated shear layer; the opposite is true along the trailing wall. Coriolis forces affect indirectly the production of turbulent kinetic energy via the Reynolds shear stresses and the mean shear. Two-point correlation is used to characterize the coherent motion of the separated shear layer. Destabilizing rotation is found to promote large-scale coherent motions and accordingly leads to larger integral length scales; on the other hand, the spanwise vortices created in the separating shear layer downstream of the rib are less organized and tend to be disrupted by the three-dimensional turbulence promoted by the rotation. The latter observation is consistent with the distributions of span-wise vortices detected in instantaneous flow realizations. (orig.)

  6. Experimental study on heat transfer augmentation for high heat flux removal in rib-roughened narrow channels

    Energy Technology Data Exchange (ETDEWEB)

    Islam, M.S.; Monde, Masanori [Saga Univ. (Japan); Hino, Ryutaro; Haga, Katsuhiro; Sudo, Yukio

    1997-07-01

    Frictional pressure drop and heat transfer performance in a very narrow rectangular channel having one-sided constant heat flux and repeated-ribs for turbulent flow have been investigated experimentally, and their experimental correlations were obtained using the least square method. The rib pitch-to-height ratios(p/k) were 10 and 20 while holding the rib height constant at 0.2mm, the Reynolds number(Re) from 2,414 to 98,458 under different channel heights of 1.2mm, 2.97mm, and 3.24mm, the rib height-to-channel equivalent diameter(k/De) of 0.03, 0.04, and 0.09 respectively. The results show that the rib-roughened surface augments heat transfer 2-3 times higher than that of the smooth surface with the expense of 2.8-4 times higher frictional pressure drop under Re=5000-10{sup 5}, p/k=10, and H=1.2mm. Experimental results obtained by channel height, H=1.2mm shows a little bit higher heat transfer and friction factor performance than the higher channel height, H=3.24mm. The effect of fin and consequently higher turbulence intensity are responsible for producing higher heat transfer rates. The obtained correlations could be used to design the cooling passages between the target plates to remove high heat flux up to 12MW/m{sup 2} generated at target plates in a high-intensity proton accelerator system. (author). 54 refs.

  7. Numerical investigation of turbulent flow within a channel with chamfered edge ribs in stream-wise direction

    Science.gov (United States)

    Bianco, Vincenzo; Borreani, Walter; Lomonaco, Guglielmo

    2017-06-01

    The present paper reports a numerical investigation of a forced convection water flow within a two-dimensional ribbed channel. A uniform heat flux is applied on the external walls. The flow regime is turbulent and Reynolds numbers are in the range 10·103÷100·103. Square and chamfered rib shapes with different arrangements are analyzed in terms of various dimensionless heights and pitches of elements. The investigation is accomplished by using a CFD code and its aim consists in finding of arrangements to obtain a high Performance Evaluation Criterion (PEC). Results are presented in terms of temperature and velocity fields, profiles of average Nusselt number, average heat transfer coefficients and required pumping power. Heat transfer enhancement increases with the ribs presence, but it is accompanied by an increasing pumping power. In particular, the best performances in terms of Nusselt are shown for p/e = 4 and 12 for both the square and chamfered cases. The heat transfer improves as Reynolds number raises, but a substantial increase of pumping power is also observed. The utilization of chamfered ribs allows to increase the PEC, especially at low Re. The maximum PEC is equal to 1.3 and it is obtained for Re = 104 and p/e = 4.

  8. Local heat/mass transfer distributions around sharp 180 deg turns in two-pass smooth and rib-roughened channels

    Science.gov (United States)

    Han, J. C.; Chandra, P. R.; Lau, S. C.

    1988-01-01

    The napthalene sublimation technique was employed to study the detailed mass transfer distributions around the sharp 180 deg turns in a two-pass, square, smooth channel and in an identical channel with two rib-roughened opposite walls. Experiments conducted for Reynolds numbers of 15,000, 30,000, and 60,000 indicate that the Sherwood numbers on the top, outer, and inner walls around the turn in the rib-roughened channel are higher than the corresponding Sherwood numbers around the turn in the smooth channel. Sherwood numbers after the sharp turn are found to be higher than those before the turn for both the smooth and the ribbed channels.

  9. Local heat/mass transfer and pressure drop in a two-pass rib-roughened channel for turbine airfoil cooling

    Science.gov (United States)

    Han, J. C.; Chandra, P. R.

    1987-01-01

    The heat transfer characteristics of turbulent air flow in a multipass channel were studied via the naphthalene sublimation technique. The naphthalene-coated test section, consisting of two straight, square channels joined by a 180 deg turn, resembled the internal cooling passages of gas turbine airfoils. The top and bottom surfaces of the test channel were roughened by rib turbulators. The rib height-to-hydraulic diameter ratio (e/D) were 0.063 and 0.094, and the rib pitch-to-height ratio (P/e) were 10 and 20. The local heat/mass transfer coefficients on the roughened top wall and on the smooth divider and side walls of the test channel were determined for three Reynolds numbers of 15, 30, and 60, thousand, and for three angles of attack (alpha) of 90, 60, and 45 deg. Results showed that the local Sherwood numbers on the ribbed walls were 1.5 to 6.5 times those for a fully developed flow in a smooth square duct. The average ribbed-wall Sherwood numbers were 2.5 to 3.5 times higher than the fully developed values, depending on the rib angle of attack and the Reynolds number. The results also indicated that, before the turn, the heat/mass transfer coefficients in the cases of alpha = 60 and 45 deg were higher than those in the case of alpha=90 deg. However, after the turn, the heat/mass transfer coefficients in the oblique-rib cases were lower than those in the transverse rib case. Correlations for the average Sherwood number ratios for individual channel surfaces and for the overall Sherwood number ratios are reported. Correlations for the fully developed friction factors and for the loss coefficients are also provided.

  10. Ribbing disease

    Directory of Open Access Journals (Sweden)

    Mukkada Philson

    2010-01-01

    Full Text Available 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.

  11. Rib Fractures

    Science.gov (United States)

    ... Commentary Recent News Scientists Working on Solar-Powered Prosthetic Limbs Exercise a Great Prescription to Help Older Hearts Bavencio Approved for Rare Skin Cancer Older Mothers May Raise Better-Behaved Kids, Study ... or a collapsed lung (pneumothorax—see Traumatic Pneumothorax ). An injury that fractures the lower ribs sometimes also damages the liver (see Liver ...

  12. Rib cage pain

    Science.gov (United States)

    ... pain or discomfort in the area of the ribs. Considerations With a broken rib, the pain is worse when bending and twisting ... any of the following: Bruised, cracked, or fractured rib Inflammation of cartilage near the breastbone ( costochondritis ) Osteoporosis ...

  13. 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.

  14. 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.

  15. No breakpoint for mortality in pediatric rib fractures.

    Science.gov (United States)

    Rosenberg, Graeme; Bryant, Alex K; Davis, Kimberly A; Schuster, Kevin M

    2016-03-01

    Rib fracture number correlates with mortality in adult trauma patients, sharply rising above six fractured ribs. Because of the pliability of younger ribs, pediatric ribs are believed to require more energy to fracture. We hypothesized this will result in a different rib fracture-associated pediatric mortality rate. We queried the National Trauma Data Bank (American College of Surgeons, Chicago, Illinois) for patients younger than 21 years with and without rib fractures (2002-2009), abstracting the number of rib fractures, diagnoses, procedures, and outcomes. Univariable and multivariable analyses were performed with logistic regression to adjust for age and concomitant injury. We identified 729,240 pediatric patients, 19,442 with rib fractures. Mortality doubled from 1.79% without rib fracture to 5.81% for one rib fracture and then nearly linearly increased to 8.23% for seven fractures unlike the pattern in adults. This pattern persisted irrespective of the age group evaluated. Ventilator days also increased with increasing number of rib fractures. Adjusted odds of mortality increased up to six rib fractures for all age groups. Penetrating injury, concomitant injury, and hemothorax all predicted mortality on multivariable analysis. More than two rib fractures also predicted chest tube placement (odds ratio [OR], thoracostomy 11.89 (11.37-12.44), thoracotomy 5.89 (5.17-6.84), thoracoscopy (6.28-12.03), laparotomy 2.68 (2.49-2.89). Mortality increased nearly linearly for increasing numbers of pediatric rib fractures without an inflection. Odds of mortality increases with each additional rib fractured in all pediatric age groups. Prognostic and epidemiologic study, level III.

  16. [Surgical treatment of cervical rib syndrome].

    Science.gov (United States)

    Sultanov, D D; Usmanov, N U; Kurbanov, N R; Abdulloev, N K

    2011-01-01

    The authors report herein the results of examination and surgical management of fifty-one patients presenting with cervical ribs. Of these, there were 33 women. Compression of the neurovascular bundle (NVB) was found to be caused by a supplementary cervical rib in twenty-three patients while in the remaining 28 patients by a rudimentary cervical rib. Twenty-two patients were found to have clinical manifestations of Raynaud's syndrome. The presence of abnormal cervical ribs was determined roentgenologically. All the patients with rudimentary cervical ribs and twelve of the 23 patients with supplementary cervical ribs were diagnosed as having bilateral abnormalities. Haemodynamics was studied by Doppler ultrasonography revealing blood flow impairments in upper-limb arteries in Edson's test in patients with supplementary cervical ribs and Raynaud's syndrome. In rudimentary cervical rib - only in the development of Raynaud's syndrome. The nervous function was studied by means of electroneuromyography (ENMG). All the patients were diagnosed as having a significant decrease in both motor and sensitive nervous conductivity of the radial and median nerves. All patients were operated on under endotracheal anaesthesia. Decompression operations were carried out in fifty-one patients, with selective thoracocervical sympathectomy performed in twelve. For treating rudimentary cervical rib, we worked out a combined method of an operative intervention. Analysing the obtained surgical outcomes showed the following: forty-four patients (86.3%) endured the operation with no complications. Intraoperative complications were noted to occur in 5.9% of patients and complications in the immediate postoperative period were observed to develop in 7.8% of patients. All the encountered complications turned out transient, easily amendable to treatment, and did not influence the final outcome of the operation. In the remote period up to 5 years positive results remained in 90.2% of the patients.

  17. Development of NUPREP PC Version and Input Structures for NUCIRC Single Channel Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Churl; Jun, Ji Su; Park, Joo Hwan

    2007-12-15

    The input file for a steady-state thermal-hydraulic code NUCIRC consists of common channel input data and specific channel input data in a case of single channel analysis. Even when all the data is ready for the 380 channels' single channel analyses, it takes long time and requires enormous effort to compose an input file by hand-editing. The automatic pre-processor for this tedious job is a NUPREP code. In this study, a NUPREP PC version has been developed from the source list in the program manual of NUCIRC-MOD2.000 that is imported in a form of an execution file. In this procedure, some errors found in PC executions and lost statements are fixed accordingly. It is confirmed that the developed NUPREP code produces input file correctly for the CANDU-6 single channel analysis. Additionally, the NUCIRC input structure and data format are summarized for a single channel analysis and the input CARDs required for the creep information of aged channels are listed.

  18. 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.

  19. Analysing Gas-Liquid Flow in PEM Electrolyser Micro-Channels

    DEFF Research Database (Denmark)

    Lafmejani, Saeed Sadeghi; Olesen, Anders Christian; Kær, Søren Knudsen

    2016-01-01

    understanding of the gas-liquid flow in both the porous media and the channel is necessary for insuring proper oxygen, water and heat management of the electrolysis cell. In this work, the patterns of vertical upward gas-liquid flow in a 5×1×94 mm micro-channel are experimentally analysed. A sheet of titanium...... felt is used as a permeable wall for permeation of air through a column of water similar to the phenomenon encountered at the anode. The transparent setup is operated ex-situ and the gas-liquid flow regimes are identified using a camera....

  20. Thermal-hydraulics of helium cooled First Wall channels and scoping investigations on performance improvement by application of ribs and mixing devices

    Energy Technology Data Exchange (ETDEWEB)

    Arbeiter, Frederik, E-mail: frederik.arbeiter@kit.edu [Karlsruhe Institute of Technology, Institute of Neutron Physics and Reactor Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany); Bachmann, Christian [EUROfusion – Programme Management Unit, Garching (Germany); Chen, Yuming; Ilić, Milica; Schwab, Florian [Karlsruhe Institute of Technology, Institute of Neutron Physics and Reactor Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany); Sieglin, Bernhard [Max-Planck-Institut für Plasmaphysik, Garching (Germany); Wenninger, Ronald [EUROfusion – Programme Management Unit, Garching (Germany)

    2016-11-01

    Highlights: • Existing first wall designs and expected plasma heat loads are reviewed. • Heat transfer enhancement methods are investigated by CFD. • The results for heat transfer and friction are given, compared and explained. • Relations for needed pumping power and gained thermal heat are shown. • A range for the maximum permissible heat loads from the plasma is estimated. - Abstract: The first wall (FW) of DEMO is a component with high thermal loads. The cooling of the FW has to comply with the material's upper and lower temperature limits and requirements from stress assessment, like low temperature gradients. Also, the cooling has to be integrated into the balance-of-plant, in a sense to deliver exergy to the power cycle and require a limited pumping power for coolant circulation. This paper deals with the basics of FW cooling and proposes optimization approaches. The effectiveness of several heat transfer enhancement techniques is investigated for the use in helium cooled FW designs for DEMO. Among these are wall-mounted ribs, large scale mixing devices and modified hydraulic diameter. Their performance is assessed by computational fluid dynamics (CFD), and heat transfer coefficients and pressure drop are compared. Based on the results, an extrapolation to high heat fluxes is tried to estimate the higher limits of cooling capabilities.

  1. 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.

  2. Analysing Gas-Liquid Flow in PEM Electrolyser Micro-Channels

    DEFF Research Database (Denmark)

    Lafmejani, Saeed Sadeghi; Olesen, Anders Christian; Kær, Søren Knudsen

    2016-01-01

    understanding of the gas-liquid flow in both the porous media and the channel is necessary for insuring proper oxygen, water and heat management of the electrolysis cell. In this work, the patterns of vertical upward gas-liquid flow in a 5×1×94 mm micro-channel are experimentally analysed. A sheet of titanium...... and are fairly expensive. One means of increasing the hydrogen yield to cost ratio of such systems, is to increase the operating current density. However, at high current densities, management of heat and mass transfer in the anode current collector and channel becomes crucial. This entails that further...... felt is used as a permeable wall for permeation of air through a column of water similar to the phenomenon encountered at the anode. The transparent setup is operated ex-situ and the gas-liquid flow regimes are identified using a camera....

  3. 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.

  4. SHORT RIB POLYDACTYLY SYNDROME

    Directory of Open Access Journals (Sweden)

    Z Moinfar

    2007-09-01

    Full Text Available Short rib polydactyly syndrome (SRPS is a very rare congenital anomaly that is classified into four subtypes. It is an autosomal recessive inherited disease. We report a case of this syndrome without a previous family history of congenital defects.

  5. Left Rib Pain - Football

    National Research Council Canada - National Science Library

    Ireland, M; Zimmerman, E

    2001-01-01

    .... His ribs healed uneventfully, on requestioning him, family history is significant in that patient's father had polycystic kidney disease and died of cancer. He has two brothers who were checked for polycystic kidney disease. All immediate family members tested negative for polycystic kidney disease.

  6. Analysing Gas-Liquid Flow in PEM Electrolyser Micro-Channels (Abstract)

    DEFF Research Database (Denmark)

    Lafmejani, Saeed Sadeghi; Olesen, Anders Christian; Kær, Søren Knudsen

    2016-01-01

    and are fairly expensive. One means of increasing the hydrogen yield to cost ratio of such systems, is to increase the operating current density. However, at high current densities, management of heat transfer and fluid flow in the anode GDL and channel becomes crucial. This entails that further understanding...... of the gas-liquid flow in both the porous media and the channel is necessary for insuring proper oxygen, water and heat management of the electrolysis cell. In this work, the vertical upward gas-liquid flow pattern in a 0.5×1×94 mm micro-channel is both numerically and experimentally analysed. A sheet...... the transparent cell is made which consists of a channel for the inlet air and a channel for the water-bubble flow. The transparent material is Plexiglas that is sealed with a sheet of silicon. The conventional co-current gas-liquid two-phase flow patterns, such as bubbly flow, slug flow and annular flow...

  7. 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.

  8. 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.

  9. Transient analyses on the cooling channels of the DEMO HCPB blanket concept under accidental conditions

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yuming, E-mail: Yuming.chen@kit.edu; Ghidersa, Bradut-Eugen; Jin, Xue Zhou

    2016-11-01

    Highlights: • This paper presents transient CFD analyses on the cooling channels of the DEMO HCPB FW for accidental scenarios LOCA and LOFA. • In both LOCA & LOFA, the wall temperature increases quickly to an unacceptable level within seconds. • If the coolant flow rate is maintained at a half of nominal value in case of LOFA (partial LOFA), the wall temperature rises much slower, but will still leads to a damage of structure within minutes. • The simulated heat transfer coefficients were compared with empirical correlations. - Abstract: Helium Cooled Pebble Bed (HCPB) blanket concept is one of the DEMO (Demonstration Power Plant) blanket concepts running for the final DEMO design selection. In this paper, transient analyses on the cooling channels of the FW are carried out by means of CFD simulations for the selected accidental scenarios loss-of-coolant-accident (LOCA) and loss-of-flow-accident (LOFA). ANSYS-CFX is used for the simulations. The simulation results help to understand how fast the temperature of the FW can increase and what is the time window that is available until the temperature of the structural material reaches the design limit in order to be able to define a suitable protection strategy for the system. In view of later developments of the models, the heat transfer coefficients calculated with CFD are compared with the values predicted by two widely used correlations for turbulent pipe flows.

  10. Shape Optimization of Inclined Ribs as Heat Transfer Augmentation Device

    Institute of Scientific and Technical Information of China (English)

    Kwang-Yong Kim; Hong-Min Kim

    2006-01-01

    This work presents numerical optimization techniques for the design of a rectangular channel with inclined ribs to enhance turbulent heat transfer.The response surface method with Reynolds-averaged Navier-Stokes analysis is used for optimization.Shear stress transport turbulence model is used as a turbulence closure.Computational results for local heat transfer rate show a reasonable agreement with the experimental data.Width-to-rib height ratio and attack angle of the rib are chosen as design variables.The objective function is defined as a linear combination of heat-transfer and friction-loss related terms with the weighting factor.Full-factorial experimental design method is used to determine the data points.Optimum shapes of the channel have been obtained in a range of the weighting factor.

  11. 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.

  12. The effect of spacer ribs on Ledinegg type flow instabilities

    Energy Technology Data Exchange (ETDEWEB)

    Coutts, D.A.

    1993-09-09

    An experimental program has been completed which evaluated the effect of a flow obstruction in a heated channel on the onset of flow instability (OBI). The test channel was rectangular (80 {times} 3 mm), heated on one surface, and equipped with view ports. Tests were conducted in a flow controlled mode at heat fluxes of 370 kW/M{sup 2}, and 610 kW/m{sup 2}. Direct comparisons were made between the demand curve minimum for the unobstructed channel and a channel equipped with a 2.07 mm wide rib that was parallel to the flow and in contact with the heated surface. Data at OFI is presented in the nondimensional terms Of Q{sub ratio} (ratio of heat flux applied to heat flux required to achieve saturated liquid conditions at the exit), and the local Stanton number at the channel exit for each channel arrangement. The Q{sub ratio} and Stanton number values for the unobstructed channel and the rib equipped channel are then compared to produce an estimate of the rib effect.

  13. Innovation on RC Waffle and Ribbed Slab Analysis Models

    Directory of Open Access Journals (Sweden)

    P. Hájek

    2000-01-01

    Full Text Available Waffle and ribbed reinforced concrete slabs are widely used in building constructions in view of the flexibility design and structural efficiency. The wide range of reinforced concrete and composite waffle and ribbed slabs has been theoretically analysed and tested from the point of view of structural behaviour within the research performed in the last years. The results of the experimental investigation, supported by theoretical conclusions, have confirmed significantly better structural properties of the composite waffle slabs (composed from RC and ceramic fillers than the assumptions usually considered in common analysis models. New analysis equivalent models for structural analysis RC and composite waffle and ribbed structures have been developed and compared with the test results. In the paper are presented some generalized conclusions as a basis for the formulation of principles of an optimized design of RC waffle and ribbed slab structures.

  14. Riboflavin synthesis genes ribE, ribB, ribH, ribA reside in the lux operon of Photobacterium leiognathi.

    Science.gov (United States)

    Lin, J W; Chao, Y F; Weng, S F

    2001-06-15

    Nucleotide sequence of the riboflavin synthesis genes ribE, ribB, ribH, ribA (GenBank Accession No. AF364106) resided in the lux operon of Photobacterium leiognathi PL741 has been determined, and the amino acid sequences of riboflavin synthetase (RibE), DHBP synthetase (RibB), lumazine synthetase (RibH), GTP cyclohydrolase II (RibA) encoded by the riboflavin synthesis genes are deduced. Nucleotide sequence reveals that the ribE gene encodes the riboflavin synthetase responsible for converting lumazine to riboflavin, the ribB gene encodes the DHBP synthetase responsible for 3,4-dihydroxyl-2-butanone 4-phosphate synthesis, the ribH gene encodes the lumazine synthetase responsible for lumazine synthesis, and the ribA gene encodes the GTP cyclohydrolase II responsible for lumazine synthesis. Functional analysis illustrates that the specific segments lay behind the ribH and ribA genes might form potential loops Omega(oT) and Omega(TI)--Omega(TII); Omega(oT) is functioned as mRNA stability loop or/and for subregulation by alternative modulation, and Omega(TI)--Omega(TII) could be the transcriptional terminator of the lux operon. The gene order of the ribE, ribB, ribH, ribA genes resided in the lux operon and linked to the lum operon is luxE-luxG-ribE-ribB-ribH-ribA-ter--> (R&R: regulatory region; ter: transcriptional terminator), whereas the R&R is the regulatory region for the lum and the lux operons, and ter and ter* are the transcriptional terminators for the lux and lum operons.

  15. Heat Transfer and Friction Characteristics of the Microfluidic Heat Sink with Variously-Shaped Ribs for Chip Cooling

    Directory of Open Access Journals (Sweden)

    Gui-Lian Wang

    2015-04-01

    Full Text Available This paper experimentally and numerically investigated the heat transfer and friction characteristics of microfluidic heat sinks with variously-shaped micro-ribs, i.e., rectangular, triangular and semicircular ribs. The micro-ribs were fabricated on the sidewalls of microfluidic channels by a surface-micromachining micro-electro-mechanical system (MEMS process and used as turbulators to improve the heat transfer rate of the microfluidic heat sink. The results indicate that the utilizing of micro-ribs provides a better heat transfer rate, but also increases the pressure drop penalty for microchannels. Furthermore, the heat transfer and friction characteristics of the microchannels are strongly affected by the rib shape. In comparison, the triangular ribbed microchannel possesses the highest Nusselt number and friction factor among the three rib types.

  16. Heat transfer and friction characteristics of the microfluidic heat sink with variously-shaped ribs for chip cooling.

    Science.gov (United States)

    Wang, Gui-Lian; Yang, Da-Wei; Wang, Yan; Niu, Di; Zhao, Xiao-Lin; Ding, Gui-Fu

    2015-04-22

    This paper experimentally and numerically investigated the heat transfer and friction characteristics of microfluidic heat sinks with variously-shaped micro-ribs, i.e., rectangular, triangular and semicircular ribs. The micro-ribs were fabricated on the sidewalls of microfluidic channels by a surface-micromachining micro-electro-mechanical system (MEMS) process and used as turbulators to improve the heat transfer rate of the microfluidic heat sink. The results indicate that the utilizing of micro-ribs provides a better heat transfer rate, but also increases the pressure drop penalty for microchannels. Furthermore, the heat transfer and friction characteristics of the microchannels are strongly affected by the rib shape. In comparison, the triangular ribbed microchannel possesses the highest Nusselt number and friction factor among the three rib types.

  17. Bifid ribs observed in the third and the fourth ribs.

    Science.gov (United States)

    Osawa, T; Sasaki, T; Matsumoto, Y; Tsukamoto, A; Onodera, M; Nara, E; Chen, J K; Fujimura, A; Nozaka, Y

    1998-12-01

    Three cases of bifid ribs were found in two cadavers during routine dissections at the Iwate Medical University School of Dentistry. All of the cases were found in the third or the fourth rib. The distal parts of the osseous rib bifurcated with an angle of 60 degrees and both of the branches had their own costal cartilage. The costal cartilage fused again to form the trunk which was connected to the sternum. The space between the two branches was filled with presumably normal intercostal muscles. Blood supply was maintained by a small branch from the interthoracic artery to the upper branches. However, the intercostal nerves did not branch toward the upper branch but only ran along the lower margins of the lower branches of the bifid ribs.

  18. Dirac Coupled Channel Analyses of the high-lying excited states at $^{22}$Ne(p,p$'$)$^{22}$Ne

    CERN Document Server

    Shim, Sugie

    2015-01-01

    Dirac phenomenological coupled channel analyses are performed using an optical potential model for the high-lying excited vibrational states at 800 MeV unpolarized proton inelastic scatterings from $^{22}$Ne nucleus. Lorentz-covariant scalar and time-like vector potentials are used as direct optical potentials and the first-order vibrational collective model is used for the transition optical potentials to describe the high-lying excited vibrational collective states. The complicated Dirac coupled channel equations are solved phenomenologically using a sequential iteration method by varying the optical potential and the deformation parameters. Relativistic Dirac coupled channel calculations are able to describe the high-lying excited states of the vibrational bands in $^{22}$Ne clearly better than the nonrelativistic coupled channel calculations. The channel-coupling effects of the multistep process for the excited states of the vibrational bands are investigated. The deformation parameters obtained from the ...

  19. Poland syndrome with absent ribs

    OpenAIRE

    Rupam Kumar Ta; Kaushik Saha; Arnab Saha; Santanu Ghosh; Mrinmoy Mitra

    2014-01-01

    Poland syndrome is a rare congenital disorder characterized by ipsilateral absence of pectoralis major muscle. This syndrome is associated with various anomalies such as ipsilateral syndactyly, brachidactyly, dextrocardia, herniation of lung, underdevelopment of upper ribs, aplasia or hypoplasia of breast, etc. Only few cases had been reported with absent ribs in Poland syndrome. We report a rare case of Poland syndrome presented to us with mal-development of his right hemithorax and weakness...

  20. Poland syndrome with absent ribs

    Directory of Open Access Journals (Sweden)

    Rupam Kumar Ta

    2014-01-01

    Full Text Available Poland syndrome is a rare congenital disorder characterized by ipsilateral absence of pectoralis major muscle. This syndrome is associated with various anomalies such as ipsilateral syndactyly, brachidactyly, dextrocardia, herniation of lung, underdevelopment of upper ribs, aplasia or hypoplasia of breast, etc. Only few cases had been reported with absent ribs in Poland syndrome. We report a rare case of Poland syndrome presented to us with mal-development of his right hemithorax and weakness of right hand.

  1. A proposed scheme for classifying pediatric rib head fractures using case examples.

    Science.gov (United States)

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

    2015-01-01

    Pediatric rib head fractures are typically described as "posterior" or "costovertebral," terms lacking specificity. To resolve this issue, a scheme was developed to describe the location of rib head fractures observed in a pediatric forensic population. The scheme uses three anatomical landmarks, terminus (tip), tubercle, and costovertebral articular surface to divide the rib head into two subregions, costovertebral and costotransverse. Examples of five cases of infants with rib head fractures are presented using this scheme. Forty-eight rib head fractures were observed in these infants with the following frequencies: 56% (three infants) at the terminus; 21% (three infants) in the costovertebral subregion; 21% (one infant) at the costovertebral articular facet; and 2% (one infant) in the costotransverse subregion. Due to the small number of cases assessed, statistical analyses could not be performed; however, the data demonstrate the variation in distribution of pediatric rib head fractures. © 2014 American Academy of Forensic Sciences.

  2. 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.

  3. Effectiveness of surgical rib fixation on prolonged mechanical ventilation in patients with traumatic rib fractures: A propensity score-matched analysis.

    Science.gov (United States)

    Wada, Tomoki; Yasunaga, Hideo; Inokuchi, Ryota; Matsui, Hiroki; Matsubara, Takehiro; Ueda, Yoshihiro; Gunshin, Masataka; Ishii, Takeshi; Doi, Kent; Kitsuta, Yoichi; Nakajima, Susumu; Fushimi, Kiyohide; Yahagi, Naoki

    2015-12-01

    We investigated whether surgical rib fixation improved outcomes in patients with traumatic rib fractures. This was a retrospective study using a Japanese administrative claim and discharge database. We included patients with traumatic rib fractures admitted to hospitals where surgical rib fixation was available from July 1 2010, to March 31, 2013. We detected patients who underwent surgical rib fixation within 10 days of hospital admission (surgical group) and those who did not (control group). The main outcome was prolonged mechanical ventilation, defined as that performed for 5 or more days, or death within 28 days. One-to-four propensity score matching was performed between the 2 groups with adjustment for possible confounders. Among 4577 eligible patients, 90 (2.0%) underwent the surgical rib fixation. After the matching, we obtained 84 and 336 patients in the surgical and control groups, respectively. Logistic regression analyses showed that the surgical group was significantly less likely to receive prolonged mechanical ventilation or die within 28 days than the control group (22.6% vs 33.3%; odds ratio, 0.59; 95% confidence interval, 0.36-0.96; P=.034). Surgical rib fixation within 10 days of hospital admission may improve outcomes in patients with traumatic rib fractures. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Influence of ribs on train aerodynamic performances

    Institute of Scientific and Technical Information of China (English)

    MIAO Xiu-juan; GAO Guang-jun

    2015-01-01

    The influence of ribs on the train aerodynamic performance was computed using detached eddy simulation (DES), and the transient iteration was solved by the dual-time step lower-upper symmetric Gauss-Seidel (LU-SGS) method. The results show that the ribs installed on the roof have a great effect on the train aerodynamic performance. Compared with trains without ribs, the lift force coefficient of the train with convex ribs changes from negative to positive, while the side force coefficient increases by 110% and 88%, respectively. Due to the combined effect of the lift force and side force, the overturning moment of the train with convex ribs and cutting ribs increases by 140% and 106%, respectively. There is larger negative pressure on the roof of the train without ribs than that with ribs. The ribs on the train would disturb the flow structure and contribute to the air separation, so the separation starts from the roof, while there is no air separation on the roof of the train without ribs. The ribs can also slow down the flow speed above the roof and make the air easily sucked back to the train surface. The vortices at the leeward side of the train without ribs are small and messy compared with those of the train with convex or cutting ribs.

  5. Analysing Gas-Liquid Flow in PEM Electrolyser Micro-Channels (Poster)

    DEFF Research Database (Denmark)

    Lafmejani, Saeed Sadeghi; Olesen, Anders Christian; Kær, Søren Knudsen

    to hot spots. Management of heat and fluid flow through the micro-channels play a great role in the capability of PEM water electrolysis when working at high current densities. Despite, many studies have been done on gas-liquid flows; still there is a lack of research on gas-liquid flows in micro......One means of increasing the hydrogen yield to cost ratio of a PEM water electrolyser, is to increase the operating current density. However, at high current densities (higher than 1 A/cm2), management of heat and mass transfer in the anode current collector and channel becomes crucial and can lead......-sized channels (hydraulic diameter of 1 mm) of PEM water electrolysis. Precisely controlling all the parameters that affect the gas-liquid flow in a PEM water electrolysis cell is quite challenging, hence a simplified setup is constructed consisting of only a transparent channel with a sheet of titanium felt...

  6. Cryptococcal osteomyelitis in the ribs

    Directory of Open Access Journals (Sweden)

    Sethi Somika

    2010-01-01

    Full Text Available Isolated cryptococcal osteomyelitis, in an immunocompetent, is rare and only a few cases have been reported in literature. We present the case of a 30-year-old man presented with pain on the left side of chest with fever and gradually increasing swelling in left lateral lower aspect of chest. Investigation revealed a lytic lesion in the anterior end of left 6 th rib with normal CD4 count. He was tested negative for HIV antigen. Excision of the sixth rib, morphologically revealed cryptococcal osteomyelitis and the patient was given anti-fungal treatment for six months.

  7. Slipping rib syndrome in childhood.

    Science.gov (United States)

    Mooney, D P; Shorter, N A

    1997-07-01

    Slipping rib syndrome is an unusual cause of lower chest and upper abdominal pain in children not mentioned in major pediatric surgical texts. The syndrome occurs when the medial fibrous attachments of the eighth, ninth, or tenth ribs are inadequate or ruptured, allowing their cartilage tip to slip superiorly and impinge on the intervening intercostal nerve. This may cause a variety of somatic and visceral complaints. Although the diagnosis may be made based on history and physical examination, lack of recognition of this disorder frequently leads to extensive diagnostic evaluations before definitive therapy. The authors report on four children who have this disorder.

  8. Structural Analyses of the Ankyrin Repeat Domain of TRPV6 and Related TRPV Ion Channels

    Energy Technology Data Exchange (ETDEWEB)

    Phelps, C.B.; Huang, R.J.; Lishko, P.V.; Wang, R.R.; Gaudet, R. (Harvard)

    2008-06-03

    Transient receptor potential (TRP) proteins are cation channels composed of a transmembrane domain flanked by large N- and C-terminal cytoplasmic domains. All members of the vanilloid family of TRP channels (TRPV) possess an N-terminal ankyrin repeat domain (ARD). The ARD of mammalian TRPV6, an important regulator of calcium uptake and homeostasis, is essential for channel assembly and regulation. The 1.7 A crystal structure of the TRPV6-ARD reveals conserved structural elements unique to the ARDs of TRPV proteins. First, a large twist between the fourth and fifth repeats is induced by residues conserved in all TRPV ARDs. Second, the third finger loop is the most variable region in sequence, length and conformation. In TRPV6, a number of putative regulatory phosphorylation sites map to the base of this third finger. Size exclusion chromatography and crystal packing indicate that the TRPV6-ARD does not assemble as a tetramer and is monomeric in solution. Adenosine triphosphate-agarose and calmodulin-agarose pull-down assays show that the TRPV6-ARD does not interact with either ligand, indicating a different functional role for the TRPV6-ARD than in the paralogous thermosensitive TRPV1 channel. Similar biochemical findings are also presented for the highly homologous mammalian TRPV5-ARD. The implications of the structural and biochemical data on the role of the ankyrin repeats in different TRPV channels are discussed.

  9. Cervical Rib causing Thrombosis of Subclavian Atery

    Directory of Open Access Journals (Sweden)

    P Sharma

    2010-06-01

    Full Text Available We describe here an unusual case of thrombosis of left subclavian artery in a patient with cervical rib. The patient presented with features of ischaemia of left upper limb. X-ray chest revealed bilateral cervical ribs, longer on the left side. Color Doppler studies showed echogenic thrombus within the left subclavian artery. Angiography revealed complete occlusion of left subclavian artery. Embolectomy was done. She was planned for excision of rib. KEYWORDS: cervical rib, thrombosis of subclavian artery.

  10. Analysing Gas-Liquid Flow in PEM Electrolyser Micro-Channels (Poster)

    OpenAIRE

    Lafmejani, Saeed Sadeghi; Olesen, Anders Christian; Kær, Søren Knudsen

    2016-01-01

    One means of increasing the hydrogen yield to cost ratio of a PEM water electrolyser, is to increase the operating current density. However, at high current densities (higher than 1 A/cm2), management of heat and mass transfer in the anode current collector and channel becomes crucial and can lead to hot spots. Management of heat and fluid flow through the micro-channels play a great role in the capability of PEM water electrolysis when working at high current densities. Despite, many studies...

  11. Abdominal mass hiding rib osteomyelitis.

    Science.gov (United States)

    Raffaeli, Genny; Borzani, Irene; Pinzani, Raffaella; Giannitto, Caterina; Principi, Nicola; Esposito, Susanna

    2016-04-12

    Rib osteomyelitis is a rare entity, occurring in approximately 1 % or less of all cases of haematogenous osteomyelitis. Given its rarity and clinical heterogeneity, the diagnosis of rib osteomyelitis can be challenging and requires a high index of suspicion. We present a case of acute osteomyelitis of the rib due to community-acquired methicillin-resistant Staphylococcus aureus (MRSA), which occurred in an otherwise healthy 3-month-old infant and mimicked an epigastric hernia at first. An otherwise healthy 3-month-old female infant was sent by her primary care paediatrician to the paediatric emergency department for possible incarcerated epigastric hernia because for 2 days, she had suffered from mild to moderate fever, irritability, poor feeding, and tender epigastric swelling. Ultrasonographic imaging excluded epigastric hernia, and transthoracic echocardiography ruled out endocarditis. However, clinical assessment combined with laboratory criteria classified the child into the high-risk group for having severe bacterial infection. Consequently, awaiting the definitive diagnosis, she was immediately treated with a broad-spectrum regimen of intravenous antibiotic therapy based on vancomycin (40 mg/kg/die in 3 doses) and meropenem (100 mg/kg/die in 3 doses). Three days after admission, the blood culture result was positive for methicillin-resistant Staphylococcus aureus, and vancomycin remained as antibiotic therapy. On day 3, a second swelling appeared at the level of the seventh left rib, 2 cm-wide, non-erythematous, mildly painful. Ultrasonography of the left chest wall on this occasion showed an image consistent with an acute osteomyelitis of the anterior osteo-chondral region of the 7th rib and associated adjacent periosteal and soft tissue collection and magnetic resonance imaging confirmed the osteomyelitis of the anterior middle-distal part of the 7th left rib, near the costochondral junction. Vancomycin was continued up to a total of 6 weeks of therapy

  12. Sacral rib: an uncommon congenital anomaly.

    Science.gov (United States)

    Miyakoshi, Naohisa; Kobayashi, Akira; Hongo, Michio; Shimada, Yoichi

    2015-06-01

    Sacral rib represents an uncommon pathology in which rib-like structures arise from the sacrum. Supernumerary ribs may occur at any level of the spine, but supernumerary ribs in the sacrococcygeal area are extremely rare. To present the case of a patient with sacral rib and to discuss this entity with reference to the literature. A case report and literature review. A 17-year-old girl presented with low back pain and discomfort in bilateral gluteal regions. Radiographs and computed tomography (CT) of the pelvis showed a smooth-surfaced, rod-like bony structure attaching to the sacrum on the left side. The appearance was consistent with sacral rib. The sacrum was hypoplastic and deviated to the right. Magnetic resonance imaging (MRI) showed insertion of the gluteus maximus (GM) onto the coccyx only on the right side. The sacral rib existed beneath the left GM muscle and received a partial insertion from the left GM muscle. No ligamentous continuation between the sacral rib and coccyx was observed. Conservative treatment relieved symptoms, so no surgical intervention was performed. Sacral rib is a rare congenital anomaly for which surgical intervention is usually unnecessary. However, appropriate workups with CT and/or MRI should be considered for women, because sacral rib may cause complications during childbirth. In the literature, sacral/coccygeal rib is sometimes called "pelvic rib." However, sacral/coccygeal rib should be distinguished from pelvic rib, because pelvic rib originating from the ilium is considered to represent a different entity. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. MULTIPLE BIFID RIBS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Dhana Lakshmi

    2014-04-01

    Full Text Available Ribs are twelve pairs of elastic arches which articulate with vertebral column posteriorly and sternum anteriorly forming much of thoracic skeleton which protects the vital organs. Variations of ribs are being reported and this case report is of multiple bifid ribs observed in a male cadaver. Bifidity occurred in right 2nd, 4th ribs and in left 3rd rib. Dimensions of the foramina were measured and its way of fusion with sternum through costal cartilages were observed. Multiple bifid ribs are a rare anomaly with the incidence of 0.15% to 3.4%. Bifid rib can be a feature of Gorlin - Goltz syndrome. Its clinical importance to physicians, surgeons and radiologists were emphasized.

  14. 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

    2017-05-27

    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

  15. The Direct Numerical Simulation of A Turbulent Channel Flow with Analyses of the Database

    Institute of Scientific and Technical Information of China (English)

    ChunxiaoXU; ZhaoshunZHANG

    1996-01-01

    The database of fully developed turbulent channel flow at low Reynolds number is set up through direct numerical simulations.The budget of dissipation-rate of turbulent kinetic energy is calculated and some existing models for the transport equation of the dissipation rate are evaluated.A new model for the turbulent production and viscous destruction terms is given.It makes a considerable improvement in the near-wall behavior,A new flow structure contributing much to high kurtosis levels in transverse velocity fluctuation in viscous sublayer is found.The common characters they possessed are described.

  16. 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.

  17. Enhanced heat transfer of forced convective fin flow with transverse ribs

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Shyy Woei; Chiou, Shyr Fuu [Thermal Fluids Laboratory, National Kaohsiung Institute of Marine Technology, No. 142, Hai-Chuan Road, Nan-Tzu District, Post code 811, Kaohsiung, Taiwan (China); Su, Lo May [Department of Electrical Engineering, Tung Fang Institute of Technology, Taiwan (China); Yang, Tsun Lirng [Department of Electrical Engineering, Fortune Institute of Technology, Taiwan (China)

    2004-02-01

    This experimental study investigates the heat transfers in three side-opened and bottom-sealed rectangular channels with two opposite walls roughened by 90 staggered ribs, which simulate the enhanced cooling passages in the fin-type heat sinks of electronic chip-sets. The various degrees of interactive effects due to the surface ribs, side-profile leakage flows and stream-wise weakened coolant flow are functionally related with Reynolds number (Re) and channel length-to-gap ratio (L/B), which unravel the considerable impacts on local and spatially averaged heat transfers over the rib-roughened fin surfaces. A selection of detailed heat transfer measurements over the rib-roughened fin surfaces illustrates the manner by which the isolated and interactive influences of Re and L/B-ratio affect the local and spatially averaged heat transfers. Relative to the heat transfer results acquired from the smooth-walled test channels, the augmentations of spatially averaged heat transfers generated by the present surface ribs are in the range of 140-200% of the flat fin reference levels. In conformity with the experimentally revealed heat transfer physics, a regression-type analysis is performed to develop the correlation of spatially-averaged Nusselt number over rib-roughened fin surface, which permits the individual and interactive effect of Re and L/B on heat transfer to be evaluated. A criterion for selecting the optimal length-to-gap ratio of a fin channel, which provides the maximum convective heat flux from the rib-roughened fin surface, is formulated as an engineering tool to assist the design activity for the cooling device of electronic chip-sets. (authors)

  18. Expansion of the Rib Head: A Novel Computed Tomographic Feature of Supernumerary Intrathoracic Ribs.

    Science.gov (United States)

    Kabakus, Ismail Mikdat; Atceken, Zeynep; Ariyurek, Orhan Macit

    2017-02-01

    Intrathoracic ribs are very rare congenital anomalies. Approximately 50 cases have been reported in the literature till date. They are usually present on the right side, between the third and eighth ribs without sex predominance. They may originate from a vertebral body or the proximal or distal part of a rib. In most cases, they are asymptomatic, but they may be associated with developmental abnormalities of ribs and vertebrae. The diagnosis is important to prevent further investigation or intervention. Here we present two rare cases with supernumerary intrathoracic rib and describe a novel sign, namely expansion of the rib head. To the best of our knowledge, this is the shortest supernumerary intrathoracic rib, reported in the literature, on the left side originating from the head of the second rib, which could have been misdiagnosed as osteochondroma due to its atypical features.

  19. The slipping rib syndrome in children.

    Science.gov (United States)

    Saltzman, D A; Schmitz, M L; Smith, S D; Wagner, C W; Jackson, R J; Harp, S

    2001-11-01

    The slipping rib syndrome is an infrequent cause of thoracic and upper abdominal pain and is thought to arise from the inadequacy or rupture of the interchondral fibrous attachments of the anterior ribs. This disruption allows the costal cartilage tips to sublux, impinging on the intercostal nerves. Children with this entity are seldom described in the literature. We present a retrospective review of 12 children and young adults with slipping rib syndrome and a systematic approach for evaluation and treatment.

  20. 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.

  1. 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.

  2. Cavernous Hemangioma of the Rib: A Rare Diagnosis

    Directory of Open Access Journals (Sweden)

    Stavros Gourgiotis

    2010-01-01

    Full Text Available Hemangioma of the rib is an uncommon benign vascular tumour. A case of rib hemangioma in a 29-year-old woman is presented. Chest roentgenogram and computed tomography revealed a mass along the inner surface of the 7th left rib with bone destruction. She underwent resection of the 7th rib. The pathologic diagnosis was cavernous hemangioma. Hemangiomas of the rib are rare tumours but should be kept in mind in the differential diagnosis of rib tumours.

  3. Microarray and quantitative RT-PCR analyses in calcium-channel blockers induced gingival overgrowth tissues of periodontitis patients.

    Science.gov (United States)

    Shimizu, Taro; Kubota, Takehiko; Nakasone, Naohiro; Abe, Daisuke; Morozumi, Toshiya; Yoshie, Hiromasa

    2011-03-01

    The purpose of the present study was to analyse transcriptomes and mRNA expression levels for specific genes in calcium-channel blocker-induced gingival overgrowth (GO) tissues. Eight gingival tissues samples (from both GO negative and positive sites) were harvested from four GO patients for microarray analyses. Twelve candidate genes were selected for further quantitative real time reverse transcription-polymerase chain reaction (qRT-PCR) analyses. Ten GO tissues from periodontitis patients and ten control gingival tissues from healthy subjects were compared by qRT-PCR. Mann-Whitney U-test was used for statistical evaluation. In GO positive tissues, 163-1631 up-regulated and 100-695 down-regulated genes were identified with more than two-fold changes compared with GO negative tissues amongst patients by microarray experiments. No commonly expressed genes amongst the eight sets of microarray data were found. The clustering analysis confirmed that the entire transcriptome patterns showed similarities in individuals, but differences amongst the four patients. The qRT-PCR and statistical analyses for the candidate genes, though, revealed differential gene expressions between GO-positive and negative tissues. We found that matrix metalloproteinase (MMP)-1 and MMP-12 as well as cathepsin-L were significantly up-regulated whilst keratin-10 and transforming growth factor-β1 were significantly down-regulated in GO tissues of periodontitis patients compared with the control gingival tissues of healthy subjects. The microarray analyses revealed that GO pathogenesis was complex and individually varied, though GO-affected gingival tissues were controlled at least by genes related to collagen metabolisms including regulated MMPs, cathepsin-L, growth factors, and keratins to maintain tissue homeostasis in vivo. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. Evolutionary mechanisms of rib loss in anurans: a comparative developmental approach.

    Science.gov (United States)

    Blanco, M J; Sanchiz, B

    2000-04-01

    ABSTRACT The presence of free ribs is presumed to be a primitive morphological character observed only in a few families of Recent anurans, whereas the absence of ribs has been considered to be a derived condition that is widespread within this order. A comparative study of rib development based on representatives of several anuran lineages (Alytes, Bombina, Bufo, Discoglossus, Hyla, Pelobates, Pelodytes, Rana, and Xenopus) reveals a previously undetected diversity of developmental features in the formation and interaction between neural arches and ribs. The absence of free ribs at premetamorphic or later stages is verified in some groups, but we present for the first time evidence of the existence of larval rib rudiments in others, both in the anterior (Rana, Hyla) and posterior (Bufo, Discoglossus, Pelobates) presacral regions. Heterochrony seems to have played a major role in the processes underlying rib reduction. The intracolumnar differences between anterior (V(2)-V(4)) and posterior (V(5)-V(8)) regions are based on perturbations in the timing of early differentiation. Furthermore, a clear shift in the relative timing of ossification among evolutionary lineages was detected. In this respect Xenopus has a highly derived condition. The use of the morphological character of "rib loss" in phylogenetic analyses must be reconsidered due to the different convergent developmental paths described here. The phylogenetic analysis of a "sequence units" matrix of rib development is compared with current anuran phylogenies. Some evolutionary information appears to be clearly present in the ontogenetic data of this "missing morphology," but its value for evolutionary inferences is rather limited.

  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. Large-eddy simulation of turbulent flow and structures in a square duct roughened with perpendicular and V-shaped ribs

    Science.gov (United States)

    Fang, Xingjun; Yang, Zixuan; Wang, Bing-Chen; Tachie, Mark F.; Bergstrom, Donald J.

    2017-06-01

    In this paper, highly disturbed turbulent flows confined within a square duct with uniformly spaced V-shaped ribs mounted on one wall are investigated using large-eddy simulation (LES). Two V-shaped (6 0° and 4 5°) rib cases are studied in comparison with the perpendicular (9 0°) rib case. The LES results are validated against a set of water-channel measurement data newly acquired by the authors. The effects of different shaped ribs on turbulent flow are systematically studied in terms of the mean velocity field, turbulence statistics, and coherent structures. The results show that strong secondary flows in the pattern of a pair of large symmetrical streamwise-elongated vortices exist in all three rib cases. The impacts of rib geometry on turbulent coherent structures are investigated using vortex identifiers, temporal autocorrections, spatial two-point autocorrelations, and velocity spectra.

  7. The Effect of Rib Shape on Stiffness.

    Science.gov (United States)

    Holcombe, Sven A; Wang, Stewart C; Grotberg, James B

    2016-11-01

    This study investigates the isolated effect of rib shape on the mechanical characteristics of ribs subjected to multiple forms of loading. It aims to measure the variation in stiffness due to shape that is seen throughout the population and, in particular, provide a tool for researchers to better understand the influence of shape on resulting stiffness. A previously published six-parameter shape model of the central axis of human ribs was used. It has been shown to accurately model the overall rib path using intrinsic geometric properties such as size, aspect ratio, and skewness, through shapes based on logarithmic spirals with high curvature continuity. In this study the model was fitted to 19,500 ribs from 989 adult female and male CT scans having demographic distributions matching the US adult population. Mechanical loading was simulated through a simplified finite element model aimed at isolating rib shape from other factors influencing mechanical response. Four loading scenarios were used representing idealized free and constrained loading conditions in axial (body-anterior) and lateral directions. Characteristic rib stiffness and maximum stress location were tracked as simulation output measures. Regression models of rib stiffness found that all shape model parameters added information when predicting stiffness under each loading condition, with their linear combination able to account for 95% of the population stiffness variation due to shape in midlevel ribs for free axial loading, and 92%-98% in other conditions. Full regression models including interactive terms explained up to 99% of population variability. Results allow researchers to better evaluate the differences in stiffness results that are obtained from physical testing by providing a framework with which to explain variation due to rib shape.

  8. Optimised mixing and flow resistance during shear flow over a rib roughened boundary

    NARCIS (Netherlands)

    Arfaie, A.; Burns, A. D.; Dorrell, R. M.; Eggenhuisen, J. T.; Ingham, D. B.; McCaffrey, W. D.

    2014-01-01

    A series of numerical investigations has been performed to study the effect of lower boundary roughness on turbulent flow in a two-dimensional channel. The roughness spacing to height ratio, w/k, has been investigated over the range 0.12 to 402 by varying the horizontal rib spacing. The square rough

  9. Design of a rib impactor equipment

    Science.gov (United States)

    Torres, C. R.; García, G.; Aguilar, L. A.; Martínez, L.

    2017-01-01

    The human ribs must be analyzed as long and as curved bones, due to their physiology. For the development of an experimental equipment that simulate the application of loads, over the rib in the moment of a frontal collision in an automobile with seat belt, it was applied a methodology that constituted in the identification of needs and the variables which led the design of 3D model, from this it was used the technique of fused deposition modeling for the development of the equipment pieces. The supports that hold the rib ends were design with two and three degrees of freedom that allows the simulation of rib movement with the spine and the breastbone in the breathing. For the simulation of the seat belt, it was determined to applied two loads over the front part of the rib from the sagittal and lateral plane respectively, for this it was made a displacement through a lineal actuator with a speed of 4mm/s. The outcomes shown a design of an equipment able to obtain the load parameters required to generate fractures in rib specimens. The equipment may be used for the study of specimens with nearby geometries to the rib taken as a reference.

  10. 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.

  11. 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%.

  12. The respective effect of under-rib convection and pressure drop of flow fields on the performance of PEM fuel cells

    Science.gov (United States)

    Wang, Chao; Zhang, Qinglei; Shen, Shuiyun; Yan, Xiaohui; Zhu, Fengjuan; Cheng, Xiaojing; Zhang, Junliang

    2017-03-01

    The flow field configuration plays an important role on the performance of proton exchange membrane fuel cells (PEMFCs). For instance, channel/rib width and total channel cross-sectional area determine the under-rib convection and pressure drop respectively, both of which directly influence the water removal, in turn affecting the oxygen supply and cathodic oxygen reduction reaction. In this study, effects of under-rib convection and pressure drop on cell performance are investigated experimentally and numerically by adjusting the channel/rib width and channel cross-sectional area of flow fields. The results show that the performance differences with various flow field configurations mainly derive from the oxygen transport resistance which is determined by the water accumulation degree, and the cell performance would benefit from the narrower channels and smaller cross sections. It reveals that at low current densities when water starts to accumulate in GDL at under-rib regions, the under-rib convection plays a more important role in water removal than pressure drop does; in contrast, at high current densities when water starts to accumulate in channels, the pressure drop dominates the water removal to facilitate the oxygen transport to the catalyst layer.

  13. The respective effect of under-rib convection and pressure drop of flow fields on the performance of PEM fuel cells

    Science.gov (United States)

    Wang, Chao; Zhang, Qinglei; Shen, Shuiyun; Yan, Xiaohui; Zhu, Fengjuan; Cheng, Xiaojing; Zhang, Junliang

    2017-01-01

    The flow field configuration plays an important role on the performance of proton exchange membrane fuel cells (PEMFCs). For instance, channel/rib width and total channel cross-sectional area determine the under-rib convection and pressure drop respectively, both of which directly influence the water removal, in turn affecting the oxygen supply and cathodic oxygen reduction reaction. In this study, effects of under-rib convection and pressure drop on cell performance are investigated experimentally and numerically by adjusting the channel/rib width and channel cross-sectional area of flow fields. The results show that the performance differences with various flow field configurations mainly derive from the oxygen transport resistance which is determined by the water accumulation degree, and the cell performance would benefit from the narrower channels and smaller cross sections. It reveals that at low current densities when water starts to accumulate in GDL at under-rib regions, the under-rib convection plays a more important role in water removal than pressure drop does; in contrast, at high current densities when water starts to accumulate in channels, the pressure drop dominates the water removal to facilitate the oxygen transport to the catalyst layer. PMID:28251983

  14. Analysis of heat transfer and nanofluid fluid flow in microchannels with trapezoidal, rectangular and triangular shaped ribs

    Science.gov (United States)

    Behnampour, Ali; Akbari, Omid Ali; Safaei, Mohammad Reza; Ghavami, Mohammad; Marzban, Ali; Sheikh Shabani, Gholamreza Ahmadi; zarringhalam, Majid; Mashayekhi, Ramin

    2017-07-01

    In the present study, the effect of triangular, rectangular and trapezoidal ribs on the laminar heat transfer of water-Ag nanofluid in a ribbed triangular channel under a constant heat flux was numerically studied using finite volume method. Height and width of ribs have been assumed to be fixed in order to study the effect of different rib forms. Modeling were performed for laminar flow (Re=1, 50 and 100) and nanofluid volume fractions of 0, 2% and 4%. The results indicated that an increase in volume fraction of solid nanoparticle leads to convectional heat transfer coefficient enhancement of the cooling fluid, whereas increasing the Nusselt number results in a loss of friction coefficient and pressure. Also, along with the fluid velocity increment, there will be an optimal proportion between heat and hydrodynamic transfer behavior which optimizes performance evaluation criteria (PEC) behavior. Among all of the investigated rib forms, the rectangular one made the most changes in the streamlines and the triangular form has the best thermal performance evaluation criteria values. For all studied Reynold numbers, heat transfer values are least for rectangular rib from. Therefore, trapezoidal ribs are recommended in high Reynold numbers.

  15. Ribbed vaults of late Gothic in Sardinia

    Directory of Open Access Journals (Sweden)

    Paola Casu

    2012-06-01

    Full Text Available The late Gothic construction practice, settled in the Spanish Mediterranean area, is based on predetermined geometric rules and is shown in religious buildings with ribbed vaults. The proportion between the sides of the area to cover, tracing plan of the ribs as a succession of corner bisectors, stereotomy problems and volumetric aspects, are just some of the elements that can describe the complex construction of a ribbed vault. The aim of this paper is to analyze the dimensional information of the late gothic ribbed vaults of Sardinia, in order to define the geometric and proportional rules for a correct drawing, establishing a standard procedure for the collection of measures and the construction of the 3D model of vaults.

  16. Supersonic Wing Optimization Using SpaRibs

    Science.gov (United States)

    Locatelli, David; Mulani, Sameer B.; Liu, Qiang; Tamijani, Ali Y.; Kapania, Rakesh K.

    2014-01-01

    This research investigates the advantages of using curvilinear spars and ribs, termed SpaRibs, to design a supersonic aircraft wing-box in comparison to the use of classic design concepts that employ straight spars and ribs. The objective is to achieve a more efficient load-bearing mechanism and to passively control the deformation of the structure under the flight loads. Moreover, the use of SpaRibs broadens the design space and allows for natural frequencies and natural mode shape tailoring. The SpaRibs concept is implemented in a new optimization MATLAB-based framework referred to as EBF3SSWingOpt. This optimization scheme performs both the sizing and the shaping of the internal structural elements, connecting the optimizer with the analysis software. The shape of the SpaRibs is parametrically defined using the so called Linked Shape method. Each set of SpaRibs is placed in a one by one square domain of the natural space. The set of curves is subsequently transformed in the physical space for creating the wing structure geometry layout. The shape of each curve of each set is unique; however, mathematical relations link the curvature in an effort to reduce the number of design variables. The internal structure of a High Speed Commercial Transport aircraft concept developed by Boeing is optimized subjected to stress, subsonic flutter and supersonic flutter constraints. The results show that the use of the SpaRibs allows for the reduction of the aircraft's primary structure weight without violating the constraints. A weight reduction of about 15 percent is observed.

  17. 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.

  18. The effect of age and demographics on rib shape.

    Science.gov (United States)

    Holcombe, Sven A; Wang, Stewart C; Grotberg, James B

    2017-08-01

    Elderly populations have a higher risk of rib fractures and other associated thoracic injuries than younger adults, and the changes in body morphology that occur with age are a potential cause of this increased risk. Rib centroidal path geometry for 20 627 ribs was extracted from computed tomography (CT) scans of 1042 live adult subjects, then fitted to a six-parameter mathematical model that accurately characterizes rib size and shape, and a three-parameter model of rib orientation within the body. Multivariable regression characterized the independent effect of age, height, weight, and sex on the rib shape and orientation across the adult population, and statistically significant effects were seen from all demographic factors (P rib end-to-end separation and rib aspect ratio are seen to increase with age, producing elongated and flatter overall rib shapes in elderly populations, with age alone explaining up to 20% of population variability in the aspect ratio of mid-level ribs. Age was not strongly associated with overall rib arc length, indicating that age effects were related to shape change rather than overall bone length. The rib shape effect was found to be more strongly and directly associated with age than previously documented age-related changes in rib angulation. Other demographic results showed height and sex being most strongly associated with rib size, and weight most strongly associated with rib pump-handle angle. Results from the study provide a statistical model for building rib shapes typical of any given demographic by age, height, weight, and sex, and can be used to help build population-specific computational models of the thoracic rib cage. Furthermore, results also quantify normal population ranges for rib shape parameters which can be used to improve the assessment and treatment of rib skeletal deformity and disease. © 2017 Anatomical Society.

  19. Experimental study of developing turbulent flow and heat transfer in ribbed convergent/divergent rectangular ducts

    Directory of Open Access Journals (Sweden)

    Karthikeyan Sivakumar

    2015-01-01

    Full Text Available The article represents an experimental investigation of friction and heat transfer characteristics of divergent / convergent rectangular ducts with an inclination angle of 1˚ in the y-axis. Measurements were taken for a convergent / divergent rectangular duct of aspect ratio AR at inlet1.25 and outlet in convergent channel 1.35; but in case of divergent duct it can be reversed. The four uniform rib heights, e = 3, 6, 9 and 12 mm the ratio between rib height to hydraulic mean diameter (e/Dm are 34.8, 69.7, 104.6 and 138.7 a constant rib pitch distance, P = 60 mm has been used. The flow rate in terms of average Reynolds number based on the hydraulic mean diameter (Dm is 86 mm of the channel was in a range of 20,000 to 50,000. The two ceramic heating strip of 10 mm thickness is used as a heating element have attached on top and bottom surfaces for the test sections. The heat transfer performance of the divergent / convergent ducts for 3, 6, 9 and 12 mm ribs was conducted under identical mass flow rate based on the Reynolds number. In our experiments has totally 8 different ducts were used. In addition, the acceleration / deceleration caused by the cross section area, the divergent duct generally shows enhanced heat transfer behavior for four different rib sizes, while the convergent duct has an appreciable reduction in heat transfer performance. From result point view divergent duct with 3 mm height ribbed square duct gets maximum heat transfer coefficient with minimum friction loss over the other convergent / divergent ducts.

  20. Analyses of Short Channel Effects of Single-Gate and Double-Gate Graphene Nanoribbon Field Effect Transistors

    Directory of Open Access Journals (Sweden)

    Hojjatollah Sarvari

    2016-01-01

    Full Text Available Short channel effects of single-gate and double-gate graphene nanoribbon field effect transistors (GNRFETs are studied based on the atomistic pz orbital model for the Hamiltonian of graphene nanoribbon using the nonequilibrium Green’s function formalism. A tight-binding Hamiltonian with an atomistic pz orbital basis set is used to describe the atomistic details in the channel of the GNRFETs. We have investigated the vital short channel effect parameters such as Ion and Ioff, the threshold voltage, the subthreshold swing, and the drain induced barrier lowering versus the channel length and oxide thickness of the GNRFETs in detail. The gate capacitance and the transconductance of both devices are also computed in order to calculate the intrinsic cut-off frequency and switching delay of GNRFETs. Furthermore, the effects of doping of the channel on the threshold voltage and the frequency response of the double-gate GNRFET are discussed. We have shown that the single-gate GNRFET suffers more from short channel effects if compared with those of the double-gate structure; however, both devices have nearly the same cut-off frequency in the range of terahertz. This work provides a collection of data comparing different features of short channel effects of the single gate with those of the double gate GNRFETs. The results give a very good insight into the devices and are very useful for their digital applications.

  1. 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.

  2. Archaeal RibL: a new FAD synthetase that is air sensitive.

    Science.gov (United States)

    Mashhadi, Zahra; Xu, Huimin; Grochowski, Laura L; White, Robert H

    2010-10-12

    FAD synthetases catalyze the transfer of the AMP portion of ATP to FMN to produce FAD and pyrophosphate (PP(i)). Monofunctional FAD synthetases exist in eukaryotes, while bacteria have bifunctional enzymes that catalyze both the phosphorylation of riboflavin and adenylation of FMN to produce FAD. Analyses of archaeal genomes did not reveal the presence of genes encoding either group, yet the archaea contain FAD. Our recent identification of a CTP-dependent archaeal riboflavin kinase strongly indicated the presence of a monofunctional FAD synthetase. Here we report the identification and characterization of an archaeal FAD synthetase. Methanocaldococcus jannaschii gene MJ1179 encodes a protein that is classified in the nucleotidyl transferase protein family and was previously annotated as glycerol-3-phosphate cytidylyltransferase (GCT). The MJ1179 gene was cloned and its protein product heterologously expressed in Escherichia coli. The resulting enzyme catalyzes the adenylation of FMN with ATP to produce FAD and PP(i). The MJ1179-derived protein has been designated RibL to indicate that it follows the riboflavin kinase (RibK) step in the archaeal FAD biosynthetic pathway. Aerobically isolated RibL is active only under reducing conditions. RibL was found to require divalent metals for activity, the best activity being observed with Co(2+), where the activity was 4 times greater than that with Mg(2+). Alkylation of the two conserved cysteines in the C-terminus of the protein resulted in complete inactivation. RibL was also found to catalyze cytidylation of FMN with CTP, making the modified FAD, flavin cytidine dinucleotide (FCD). Unlike other FAD synthetases, RibL does not catalyze the reverse reaction to produce FMN and ATP from FAD and PP(i). Also in contrast to other FAD synthetases, PP(i) inhibits the activity of RibL.

  3. Muscle: Bone ratios in beef rib sections.

    Science.gov (United States)

    Dolezal, H G; Murphey, C E; Smith, G C; Carpenter, Z L; McCartor, M

    1982-01-01

    Thirty-eight steers and thirty heifers (14 to 17 months of age, from F(1) Hereford × Brahman cows bred to Angus or Hereford bulls), were either forage-fed for 123 days on millet-bermudagrass pasture or grain-fed for 90 days on a high-concentrate diet and were then commercially slaughtered. Warm carcass weights ranged from 167·8 kg to 324·3 kg. At 24 h post mortem, Texas Agricultural Experiment Station personnel (1) assigned scores or took measurements on each carcass for all factors used in yield grading and quality grading, (2) measured the length of hind leg (HL) and carcass length (CL) and (3) assigned a score for carcass muscling (MS) and, as appropriate, made an adjusted longissimus muscle area (ALA) evaluation. The 9th-10th-11th rib section from one side of each carcass was physically separated into longissimus muscle, fat, 'other soft tissue' and bone and ether extract determinations of the longissimus muscle and 'other soft tissue' components were made and used to adjust the yields of each of these components to a fat-free basis. Muscle to bone ratios ranged from 2·38 to 4·37. With both age and carcass weight held constant, diet, breed and sex explained only 35·8% of the variation in muscle to bone ratio. The best simple correlation with muscle to bone ratio was ALA/CL (r = ·59). Other measures significantly correlated with muscle to bone ratio included ALA (r = 0·55), MS (r = 0·50) and carcass weight (r = 0·49). Multiple regression analyses identified a three-variable subset comprised of ALA, carcass weight and CL which was related (P carcass measures useful for predicting muscle to bone ratio.

  4. Rib for blended wing-body aircraft

    Science.gov (United States)

    Hawley, Arthur V. (Inventor)

    1999-01-01

    Structural ribs for providing structural support for a structure, such as the pressure cabin of a blended-wing body aircraft. In a first embodiment, the ribs are generally Y-shaped, being comprised of a vertical web and a pair of inclined webs attached to the vertical web to extend upwardly and outwardly from the vertical web in different directions, with only the upper edges of the inclined webs being attached to a structural element. In a second embodiment, the ribs are generally trident-shaped, whereby the vertical web extends upwardly beyond the intersection of the inclined webs with the vertical web, with the upper edge of the vertical web as well as the upper edges of the inclined webs being attached to the same structural element.

  5. 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.

  6. Articulations of the ribs: a pictorial review.

    Science.gov (United States)

    Sutro, C J; Sutro, W H

    1981-01-01

    The joints of the ribs are true articulations and may be involved by local or general affections of the skeleton. Scoliosis, kyphosis, infections, arthritis (local or general types) may result in fibrosis, abnormal configuration, or ankylosis of the joints in question. In certain types of fractures of the dorsal vertebrae, disruption of the contiguous rib articulations may result in fibrosis or bony depositions and secondarily aid in local stabilization of the fracture. Narrowing of the intercostal spaces, as noted in kyphosis, scoliosis, and arthritis of the dorsal region, does not seem to be routinely associated with clinical findings of intercostal neuralgia.

  7. 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.

  8. Development of TUF-ELOCA - a software tool for integrated single-channel thermal-hydraulic and fuel element analyses

    Energy Technology Data Exchange (ETDEWEB)

    Popescu, A.I.; Wu, E.; Yousef, W.W.; Pascoe, J. [Nuclear Safety Solutions Ltd., Toronto, Ontario (Canada); Parlatan, Y. [Ontario Power Generation, Toronto, Ontario (Canada); Kwee, M. [Bruce Power, Tiverton, Ontario (Canada)

    2006-07-01

    The TUF-ELOCA tool couples the TUF and ELOCA codes to enable an integrated thermal-hydraulic and fuel element analysis for a single channel during transient conditions. The coupled architecture is based on TUF as the parent process controlling multiple ELOCA executions that simulate the fuel elements behaviour and is scalable to different fuel channel designs. The coupling ensures a proper feedback between the coolant conditions and fuel elements response, eliminates model duplications, and constitutes an improvement from the prediction accuracy point of view. The communication interfaces are based on PVM and allow parallelization of the fuel element simulations. Developmental testing results are presented showing realistic predictions for the fuel channel behaviour during a transient. (author)

  9. Contribution of somitic cells to the avian ribs

    National Research Council Canada - National Science Library

    Evans, Darrell J.R

    2003-01-01

    ... been termed the distal rib. Intercostal spaces lie between adjacent ribs cranially and caudally and are spanned by intercostal muscles, which are involved, in part, in the process of ventilation. The question of where the thoracic ribs originate, embryologically, has been the focus of debate for some time. Controversy has existed since at l...

  10. Mechanical Action of the Intercostal Muscles on the Ribs

    Science.gov (United States)

    de Troyer, Andre; Kelly, Suzanne; Zin, Walter A.

    1983-04-01

    The external and internal interosseous intercostal muscles were separately stimulated at end-expiratory lung volume in anesthetized dogs. These muscles were all found to elevate the ribs into which they insert. By attaching weights to the ribs, it was determined that the nonlinear compliance of the ribs was responsible for this phenomenon.

  11. COSTAL OSTEOCHONDROMA OF RIB: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Chandra Sekharam Naidu

    2015-04-01

    Full Text Available We here with present a case of osteochondroma of the (L 8 th rib, in a child 8 years of, one year duration. He presented with pain and swelling which are gradually increasing. After thorough investigation we have excised the tumor and sent for histopathological examination

  12. Microtia reconstruction: autologous rib and alloplast techniques.

    Science.gov (United States)

    Cabin, Jonathan A; Bassiri-Tehrani, Michael; Sclafani, Anthony P; Romo, Thomas

    2014-11-01

    Microtia represents a spectrum of maldevelopment of the external ear. Reconstructive techniques may utilize an autogenous rib cartilage framework and require 2-4 stages; alternatively, an alloplastic framework can be used and typically requires 1-2 stages. Successful reconstruction of microtia with either technique can provide a significant quality of life improvement, and both techniques are described in this article.

  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. Broadband single-transverse-mode fluorescence sources based on ribs fabricated in pulsed laser deposited Ti: sapphire waveguides

    NARCIS (Netherlands)

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

    2004-01-01

    Active rib waveguides with depths and widths varying from 3 to 5 μm and from 9 to 24 μm, respectively, have been structured by $Ar^{+}$-beam etching in pulsed laser deposited Ti:sapphire layers. Losses in the channel structures were essentially at the same levels as the unstructured planar waveguide

  15. SIMULATION OF TURBULENT FLOW AND HEAT TRANSFER OVER A BACKWARD -FACING STEP WITH RIBS TURBULATORS

    Directory of Open Access Journals (Sweden)

    Khudheyer S Mushatet

    2011-01-01

    Full Text Available Simulation is presented for a backward facing step flow and heat transfer inside a channel with ribs turbulators. The problem was investigated for Reynolds numbers up to 32000. The effect of a step height, the number of ribs and the rib thickness on the flow and thermal field were investigated. The computed results are presented as streamlines counters, velocity vectors and graphs of Nusselt number and turbulent kinetic energy variation. A control volume method employing a staggered grid techniques was imposed to discretize the governing continuity, full Navier Stockes and energy equations. A computer program using a SIMPLE algorithm was developed to handle the considered problem. The effect of turbulence was modeled by using a k-є model with its wall function formulas. The obtained results show that the strength and size of the re-circulation zones behind the step are increased with the increase of contraction ratio(i.e. with the increase of a step height. The size of recirculation regions and the reattachment length after the ribs are decreased with increasing of the contraction ratio. Also the results show that the Reynolds number and contraction ratio have a significant effect on the variation of turbulent kinetic energy and Nusselt number

  16. 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.

  17. Rib fractures in infants due to cardiopulmonary resuscitation efforts.

    Science.gov (United States)

    Dolinak, David

    2007-06-01

    Although it is widely known that adults may sustain fractures of the anterior and/or lateral aspects of the ribs due to cardiopulmonary resuscitation (CPR) efforts, relatively little is written about the generation of CPR-related rib fractures in the infant age range. In a series of 70 consecutive autopsies in infants ranging in age from 2 weeks to 8 months, with no history or indications of injury, the parietal pleura of the thoracic cage was stripped and the ribs carefully examined for fracture. Subtle fractures of the anterolateral aspects of the ribs were discovered in 8 (11%) of the 70 cases. In 7 of the 8 cases, multiple ribs were fractured (ranging up to 10 rib fractures), and in 5 of these cases, the rib fractures were bilateral. All of the rib fractures were subtle, had little if any associated blood extravasation, and would have been easily missed had the parietal pleura not been stripped. These anterolateral rib fractures in infants are the likely correlate of anterolateral rib fractures that are not uncommonly seen in the adult population, resulting from resuscitation efforts. The rib fractures are subtle and may not be identified unless the parietal pleura is stripped.

  18. 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.

  19. 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.

  20. The RIB production target for the SPES project

    Energy Technology Data Exchange (ETDEWEB)

    Monetti, Alberto [viale dell' Universita 2, Laboratori Nazionali di Legnaro, Legnaro (Italy); University of Padua, Department of Industrial Engineering (DII), Padova (Italy); Andrighetto, Alberto; Manzolaro, Mattia; Corradetti, Stefano; Scarpa, Daniele; Rossetto, Francesco; Vasquez, Jesus; Rossignoli, Massimo; Calderolla, Michele; Silingardi, Roberto; Mozzi, Aldo; Vivian, Gianluca; Boratto, Enrico; Ballan, Michele; Prete, Gianfranco [viale dell' Universita 2, Laboratori Nazionali di Legnaro, Legnaro (Italy); Petrovich, Carlo [ENEA, Bologna (Italy); Martinez Dominguez, Fernando [viale dell' Universita 2, Laboratori Nazionali di Legnaro, Legnaro (Italy); ESS Bilbao, Instituto de Fusion Nuclear, Madrid (Spain); Borgna, Francesca [viale dell' Universita 2, Laboratori Nazionali di Legnaro, Legnaro (Italy); University of Padua, Department of Pharmaceutical and Pharmacological Sciences, Padova (Italy); Meneghetti, Giovanni [University of Padua, Department of Industrial Engineering (DII), Padova (Italy)

    2015-10-15

    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. (orig.)

  1. Mach-Zehnder Interferometer Biochemical Sensor Based on Silicon-on-Insulator Rib Waveguide with Large Cross Section.

    Science.gov (United States)

    Yuan, Dengpeng; Dong, Ying; Liu, Yujin; Li, Tianjian

    2015-08-28

    A high-sensitivity Mach-Zehnder interferometer (MZI) biochemical sensing platform based on Silicon-in-insulator (SOI) rib waveguide with large cross section is proposed in this paper. Based on the analyses of the evanescent field intensity, the mode polarization and cross section dimensions of the SOI rib waveguide are optimized through finite difference method (FDM) simulation. To realize high-resolution MZI read-out configuration based on the SOI rib waveguide, medium-filled trenches are employed and their performances are simulated through two-dimensional finite-difference-time domain (2D-FDTD) method. With the fundamental EH-polarized mode of the SOI rib waveguide with a total rib height of 10 μm, an outside rib height of 5 μm and a rib width of 2.5 μm at the operating wavelength of 1550 nm, when the length of the sensitive window in the MZI configuration is 10 mm, a homogeneous sensitivity of 7296.6%/refractive index unit (RIU) is obtained. Supposing the resolutions of the photoelectric detectors connected to the output ports are 0.2%, the MZI sensor can achieve a detection limit of 2.74 × 10(-6) RIU. Due to high coupling efficiency of SOI rib waveguide with large cross section with standard single-mode glass optical fiber, the proposed MZI sensing platform can be conveniently integrated with optical fiber communication systems and (opto-) electronic systems, and therefore has the potential to realize remote sensing, in situ real-time detecting, and possible applications in the internet of things.

  2. RNA-Sequencing Analyses Demonstrate the Involvement of Canonical Transient Receptor Potential Channels in Rat Tooth Germ Development

    Directory of Open Access Journals (Sweden)

    Jun Yang

    2017-06-01

    Full Text Available Tooth development depends on multiple molecular interactions between the dental epithelium and mesenchyme, which are derived from ectodermal and ectomesenchymal cells, respectively. We report on a systematic RNA sequencing analysis of transcriptional expression levels from the bud to hard tissue formation stages of rat tooth germ development. We found that GNAO1, ENO1, EFNB1, CALM1, SIAH2, ATP6V0A1, KDELR2, GTPBP1, POLR2C, SORT1, and members of the canonical transient receptor potential (TRPC channel family are involved in tooth germ development. Furthermore, Cell Counting Kit 8 (CCK8 and Transwell migration assays were performed to explore the effects of these differentially expressed genes (DEGs on the proliferation and migration of dental pulp stem cells. Immunostaining revealed that TRPC channels are expressed at varying levels during odontogenesis. The identified genes represent novel candidates that are likely to be vital for rat tooth germ development. Together, the results provide a valuable resource to elucidate the gene regulatory mechanisms underlying mammalian tooth germ development.

  3. SARAPAN—A Simulated-Annealing-Based Tool to Generate Random Patterned-Channel-Age in CANDU Fuel Management Analyses

    Directory of Open Access Journals (Sweden)

    Doddy Kastanya

    2017-02-01

    Full Text Available In any reactor physics analysis, the instantaneous power distribution in the core can be calculated when the actual bundle-wise burnup distribution is known. Considering the fact that CANDU (Canada Deuterium Uranium utilizes on-power refueling to compensate for the reduction of reactivity due to fuel burnup, in the CANDU fuel management analysis, snapshots of power and burnup distributions can be obtained by simulating and tracking the reactor operation over an extended period using various tools such as the *SIMULATE module of the Reactor Fueling Simulation Program (RFSP code. However, for some studies, such as an evaluation of a conceptual design of a next-generation CANDU reactor, the preferred approach to obtain a snapshot of the power distribution in the core is based on the patterned-channel-age model implemented in the *INSTANTAN module of the RFSP code. The objective of this approach is to obtain a representative snapshot of core conditions quickly. At present, such patterns could be generated by using a program called RANDIS, which is implemented within the *INSTANTAN module. In this work, we present an alternative approach to derive the patterned-channel-age model where a simulated-annealing-based algorithm is used to find such patterns, which produce reasonable power distributions.

  4. The epithelial sodium channel γ-subunit gene and blood pressure: family based association, renal gene expression, and physiological analyses.

    Science.gov (United States)

    Büsst, Cara J; Bloomer, Lisa D S; Scurrah, Katrina J; Ellis, Justine A; Barnes, Timothy A; Charchar, Fadi J; Braund, Peter; Hopkins, Paul N; Samani, Nilesh J; Hunt, Steven C; Tomaszewski, Maciej; Harrap, Stephen B

    2011-12-01

    Variants in the gene encoding the γ-subunit of the epithelial sodium channel (SCNN1G) are associated with both Mendelian and quantitative effects on blood pressure. Here, in 4 cohorts of 1611 white European families composed of a total of 8199 individuals, we undertook staged testing of candidate single-nucleotide polymorphisms for SCNN1G (supplemented with imputation based on data from the 1000 Genomes Project) followed by a meta-analysis in all of the families of the strongest candidate. We also examined relationships between the genotypes and relevant intermediate renal phenotypes, as well as expression of SCNN1G in human kidneys. We found that an intronic single-nucleotide polymorphism of SCNN1G (rs13331086) was significantly associated with age-, sex-, and body mass index-adjusted blood pressure in each of the 4 populations (Ppressure and 0.52-mm Hg increase in diastolic blood pressure (SE=0.33, P=0.002 for systolic blood pressure; SE=0.21, P=0.011 for diastolic blood pressure). The same allele was also associated with higher 12-hour overnight urinary potassium excretion (P=0.04), consistent with increased epithelial sodium channel activity. Renal samples from hypertensive subjects showed a nonsignificant (P=0.07) 1.7-fold higher expression of SCNN1G compared with normotensive controls. These data provide genetic and phenotypic evidence in support of a role for a common genetic variant of SCNN1G in blood pressure determination.

  5. Morphological Analyses and Simulated Flood Elevations in a Watershed with Dredged and Leveed Stream Channels, Wheeling Creek, Eastern Ohio

    Science.gov (United States)

    Sherwood, James M.; Huitger, Carrie A.; Ebner, Andrew D.; Koltun, G.F.

    2008-01-01

    The USGS, in cooperation with the Ohio Emergency Management Agency, conducted a study in the Wheeling Creek Basin to (1) evaluate and contrast land-cover characteristics from 2001 with characteristics from 1979 and 1992; (2) compare current streambed elevation, slope, and geometry with conditions present in the late 1980s; (3) look for evidence of channel filling and over widening in selected undredged reaches; (4) estimate flood elevations for existing conditions in both undredged and previously dredged reaches; (5) evaluate the height of the levees required to contain floods with selected recurrence intervals in previously dredged reaches; and (6) estimate flood elevations for several hypothetical dredging and streambed aggradation scenarios in undredged reaches. The amount of barren land in the Wheeling Creek watershed has decreased from 20 to 1 percent of the basin area based on land-cover characteristics from 1979 and 2001. Barren lands appear to have been converted primarily to pasture, presumably as a result of surface-mine reclamation. Croplands also decreased from 13 to 8 percent of the basin area. The combined decrease in barren lands and croplands is approximately offset by the increase in pasture. Stream-channel surveys conducted in 1987 and again in 2006 at 21 sites in four previously dredged reaches of Wheeling Creek indicate little change in the elevation, slope, and geometry of the channel at most sites. The mean change in width-averaged bed and thalweg elevations for the 21 cross sections was 0.1 feet. Bankfull widths, mean depths, and cross-sectional areas measured at 12 sites in undredged reaches were compared to estimates determined from regional equations. The mean percentage difference between measured and estimated bankfull widths was -0.2 percent, suggesting that bankfull widths in the Wheeling Creek Basin are generally about the same as regional averages for undisturbed basins of identical drainage area. For bankfull mean depth and cross

  6. Chondromyxoid fibroma of the second rib.

    Science.gov (United States)

    Long, Kristin L; Absher, Kimberly J; Draus, John M

    2013-06-01

    Chondromyxoid fibromas are benign tumors which are found most frequently in the metaphyses of long bones. They comprise less than 1% of primary bone neoplasms and display a hypermetabolic appearance on PET imaging. Oftentimes, they are misdiagnosed as chondrosarcomas and are excised due to concern for malignancy. We present a case of a condromyxoid fibroma originating from the second rib of a 15-year-old girl.

  7. 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.

  8. Potassium channels in barley: cloning, functional characterization and expression analyses in relation to leaf growth and development.

    Science.gov (United States)

    Boscari, Alexandre; Clément, Mathilde; Volkov, Vadim; Golldack, Dortje; Hybiak, Jolanta; Miller, Anthony J; Amtmann, Anna; Fricke, Wieland

    2009-12-01

    It is not known how the uptake and retention of the key osmolyte K(+) in cells are mediated in growing leaf tissue. In the present study on the growing leaf 3 of barley, we have cloned the full-length coding sequence of three genes which encode putative K(+) channels (HvAKT1, HvAKT2, HvKCO1/HvTPK1), and of one gene which encodes a putative K(+) transporter (HvHAK4). The functionality of the gene products of HvAKT1 and HvAKT2 was tested through expression in Xenopus laevis oocytes. Both are inward-rectifying K(+) channels which are inhibited by Cs(+). Function of HvAKT1 in oocytes requires co-expression of a calcineurin-interacting protein kinase (AtCIPK23) and a calcineurin B-like protein (AtCBL9) from Arabidopsis, showing cross-species complementation of function. In planta, HvAKT1 is expressed primarily in roots, but is also expressed in leaf tissue. HvAKT2 is expressed particularly in leaf tissue, and HvHAK4 is expressed particularly in growing leaf tissue. Within leaves, HvAKT1 and HvAKT2 are expressed predominantly in mesophyll. Expression of genes changes little in response to low external K(+) or salinity, despite major changes in K(+) concentrations and osmolality of cells. Possible contributions of HvAKT1, HvAKT2, HvKCO1 and HvHAK4 to regulation of K(+) relations of growing barley leaf cells are discussed.

  9. Juvenile first rib fracture caused by morning stretching.

    Science.gov (United States)

    Lee, Seung-Joon; Yie, Kilsoo; Chon, Sung Bin

    2012-08-01

    First rib fractures are very rare, being primarily associated with external blunt trauma. Related conditions, such as sudden contraction of the neck muscle, stress fractures, and fatigue fractures, have been reported sporadically. These fractures are mostly related to repetitive or explosive physical training. However, anatomical relationships and related injury mechanisms may cause first rib fractures without repetitive sports activity. To present a case of juvenile first rib fracture caused by morning stretching without sports activity. CASE  We present a rare case report of juvenile atraumatic first rib fracture. Physicians should be aware that even morning stretching with yawning can cause a first rib fracture in children. Awareness is important for early recognition, and proper management is critical for a pain-free return to normal life. An understanding of the mechanism of atraumatic first rib fracture is important. Copyright © 2012. Published by Elsevier Inc.

  10. 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.

  11. Heat transfer enhancement of Taylor-Couette-Poiseuille flow in an annulus by mounting longitudinal ribs on the rotating inner cylinder

    Energy Technology Data Exchange (ETDEWEB)

    Jeng, Tzer-Ming [Air Force Institute of Technology, Gangshan (Taiwan). Department of Mechanical Engineering; Tzeng, Sheng-Chung; Lin, Chao-Hsien [ChienKuo Technology University, Changhua (Taiwan). Department of Mechanical Engineering

    2007-01-15

    This work experimentally investigates the heat transfer characteristics of Taylor-Couette-Poiseuille flow in an annular channel by mounting longitudinal ribs on the rotating inner cylinder. The ranges of the axial Reynolds number (Re) and the rotational Reynolds number (Re{sub {omega}}) are Re=30-1200 and Re{sub {omega}}=0-2922, respectively. Three modes of the inner cylinder without/with longitudinal ribs are considered. A special entry and exit design for the axial coolant flow reveals some interesting findings. The value of Nusselt number (Nu) is almost minimal at the inlet of the annular channel, and then sharply rises in the axial direction. The average Nusselt number (Nu|) increases with Re. Nu increases rapidly with Re{sub {omega}} at low Re (such as at Re=30 and 60) but that the effect of Re{sub {omega}} decreases as the value increases (such as at Re=300-1200). The ratio Nu|/Nu|{sub 0} increases with Re{sub {omega}} and exceed two at all Re and in the test modes. The heat transfer is typically promoted by mounting longitudinal ribs on the rotating inner cylinder, especially at Re=300 and 600. When Re=300 or 600 and Re{sub {omega}}>2000, the Nu| of the system with ribs reaches around 1.4 times that of Nu|{sub A} (Nu| in mode A). Under a given pumping power constraint (PRe{sup 3}), the Nu| of the system with ribs (modes B and C) generally exceeds that without ribs (mode A), while the difference between the values of Nu| in modes B and A slowly falls as PRe{sup 3} increases. Additionally, mode B (with ribs) is preferred for high heat transfer when PRe{sup 3}<4.5x10{sup 13} but mode C (with cavities on ribs) is optimal for high heat transfer when PRe{sup 3}>4.5x10{sup 13}. (author)

  12. Linear and nonlinear analyses of multi-channel mechanomyographic recordings reveal heterogeneous activation of wrist extensors in presence of delayed onset muscle soreness.

    Science.gov (United States)

    Madeleine, Pascal; Hansen, Ernst A; Samani, Afshin

    2014-12-01

    In this study, we applied multi-channel mechanomyographic (MMG) recordings in combination with linear and nonlinear analyses to investigate muscular and musculotendinous effects of high intensity eccentric exercise. Twelve accelerometers arranged in a 3 × 4 matrix over the dominant elbow muscles were used to detect MMG activity in 12 healthy participants. Delayed onset muscle soreness was induced by repetitive high intensity eccentric contractions of the wrist extensor muscles. Average rectified values (ARV) as well as percentage of recurrence (%REC) and percentage of determinism (%DET) extracted from recurrence quantification analysis were computed from data obtained during static-dynamic contractions performed before exercise, immediately after exercise, and in presence of muscle soreness. A linear mixed model was used for the statistical analysis. The ARV, %REC, and %DET maps revealed heterogeneous MMG activity over the wrist extensor muscles before, immediately after, and in presence of muscle soreness (P<0.01). The ARVs were higher while the %REC and %DET were lower in presence of muscle soreness compared with before exercise (P<0.05). The study provides new key information on linear and nonlinear analyses of multi-channel MMG recordings of the wrist extensor muscles following eccentric exercise that results in muscle soreness. Recurrence quantification analysis can be suggested as a tool for detection of MMG changes in presence of muscle soreness.

  13. The sound transmission of finite ribbed plates using a variational

    DEFF Research Database (Denmark)

    Brunskog, Jonas

    2012-01-01

    Many lightweight structures consist of plates being stiffened by ribs. The rib stiffeners can significantly change the vibration field and the radiation behavior of the structure. These type of structures has thus often been studied in the past. However, there is a lack of simplified expressions...... for the sound transmission of these structures. Therefore, simplified expressions for the sound transmission of finite single leaf ribbed plates are derived, using a variational technique based on integral equations of the fluid loaded plate....

  14. Slipping Rib Syndrome as Persistent Abdominal and Chest Pain.

    Science.gov (United States)

    Bolaños-Vergaray, Juan Javier; de la Gala García, Francisco; Obaya Rebollar, Juan Carlos; Bové Alvarez, Maria

    2015-11-01

    Slipping rib syndrome is an overlooked cause of persistent abdominal or chest pain. The etiology of this syndrome is not well understood, but the characteristic pain is from hypermobility of the false ribs. Although it is a diagnosis of exclusion, misdiagnosis may lead to an excessive workup. A simple clinical examination via the hooking maneuver is the most significant feature of its diagnosis. We describe the case of a 41-year-old woman with slipping rib syndrome.

  15. The experimental set-up of the RIB in-flight facility EXOTIC

    Science.gov (United States)

    Pierroutsakou, D.; Boiano, A.; Boiano, C.; Di Meo, P.; La Commara, M.; Manea, C.; Mazzocco, M.; Nicoletto, M.; Parascandolo, C.; Signorini, C.; Soramel, F.; Strano, E.; Toniolo, N.; Torresi, D.; Tortone, G.; Anastasio, A.; Bettini, M.; Cassese, C.; Castellani, L.; Corti, D.; Costa, L.; De Fazio, B.; Galet, G.; Glodariu, T.; Grebosz, J.; Guglielmetti, A.; Molini, P.; Pontoriere, G.; Rocco, R.; Romoli, M.; Roscilli, L.; Sandoli, M.; Stroe, L.; Tessaro, M.; Zatti, P. G.

    2016-10-01

    We describe the experimental set-up of the Radioactive Ion Beam (RIB) in-flight facility EXOTIC consisting of: (a) two position-sensitive Parallel Plate Avalanche Counters (PPACs), dedicated to the event-by-event tracking of the produced RIBs and to time of flight measurements and (b) the new high-granularity compact telescope array EXPADES (EXotic PArticle DEtection System), designed for nuclear physics and nuclear astrophysics experiments employing low-energy light RIBs. EXPADES consists of eight ΔE -Eres telescopes arranged in a cylindrical configuration around the target. Each telescope is made up of two Double Sided Silicon Strip Detectors (DSSSDs) with a thickness of 40/60 μm and 300 μm for the ΔE and Eres layer, respectively. Additionally, eight ionization chambers were constructed to be used as an alternative ΔE stage or, in conjunction with the entire DSSSD array, to build up more complex triple telescopes. New low-noise multi-channel charge-sensitive preamplifiers and spectroscopy amplifiers, associated with constant fraction discriminators, peak-and-hold and Time to Amplitude Converter circuits were developed for the electronic readout of the ΔE stage. Application Specific Integrated Circuit-based electronics was employed for the treatment of the Eres signals. An 8-channel, 12-bit multi-sampling 50 MHz Analog to Digital Converter, a Trigger Supervisor Board for handling the trigger signals of the whole experimental set-up and an ad hoc data acquisition system were also developed. The performance of the PPACs, EXPADES and of the associated electronics was obtained offline with standard α calibration sources and in-beam by measuring the scattering process for the systems 17O+58Ni and 17O+208Pb at incident energies around their respective Coulomb barriers and, successively, during the first experimental runs with the RIBs of the EXOTIC facility.

  16. Detection and labeling ribs on expiration chest radiographs

    Science.gov (United States)

    Park, Mira; Jin, Jesse S.; Wilson, Laurence S.

    2003-06-01

    Typically, inspiration is preferred when xraying the lungs. The x-ray technologist will ask a patient to be still and to take a deep breath and to hold it. This not only reduces the possibility of a blurred image but also enhances the quality of the image since air-filled lungs are easier to see on x-ray film. However, inspiration causes low density in the inner part of lung field. That means that ribs in the inner part of lung field have lower density than the other parts nearer to the border of the lung field. That is why edge detection algorithms often fail to detect ribs. Therefore to make rib edges clear we try to produce an expiration lung field using a 'hemi-elliptical cavity.' Based on the expiration lung field, we extract the rib edges using canny edge detector and a new connectivity method, called '4 way with 10-neighbors connectivity' to detect clavicle and rib edge candidates. Once the edge candidates are formed, our system selects the best candidates using knowledge-based constraints such as a gradient, length and location. The edges can be paired and labeled as superior rib edge and inferior rib edge. Then the system uses the clavicle, which is obtained in a same method for the rib edge detection, as a landmark to label all detected ribs.

  17. Quantitative Measurement Method for Possible Rib Fractures in Chest Radiographs

    Science.gov (United States)

    Kim, Jaeil; Kim, Sungjun; Kim, Young Jae

    2013-01-01

    Objectives This paper proposes a measurement method to quantify the abnormal characteristics of the broken parts of ribs using local texture and shape features in chest radiographs. Methods Our measurement method comprises two steps: a measurement area assignment and sampling step using a spline curve and sampling lines orthogonal to the spline curve, and a fracture-ness measurement step with three measures, asymmetry and gray-level co-occurrence matrix based measures (contrast and homogeneity). They were designed to quantify the regional shape and texture features of ribs along the centerline. The discriminating ability of our method was evaluated through region of interest (ROI) analysis and rib fracture classification test using support vector machine. Results The statistically significant difference was found between the measured values from fracture and normal ROIs; asymmetry (p rib fracture classifier, trained with the measured values in ROI analysis, detected every rib fracture from chest radiographs used for ROI analysis, but it also classified some unbroken parts of ribs as abnormal parts (8 to 17 line sets; length of each line set, 2.998 ± 2.652 mm; length of centerlines, 131.067 ± 29.460 mm). Conclusions Our measurement method, which includes a flexible measurement technique for the curved shape of ribs and the proposed shape and texture measures, could discriminate the suspicious regions of ribs for possible rib fractures in chest radiographs. PMID:24175118

  18. 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.)

  19. 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.

  20. A Study of the Morbidity Involved in Whole Rib Harvesting and In Situ Splitting Rib Harvesting Surgery.

    Science.gov (United States)

    Zhang, Lu; Sun, Xiao-Ming; Jin, Rong; Shi, Yao-Ming; Sun, Bao-Shan; Zhang, Ying; Zhang, Yu-Guang

    2016-06-01

    Although there have been several reports that detail the in situ rib splitting harvesting surgical procedure, there are limited published studies evaluating this procedure and the traditional whole rib harvesting approach. In this study, the authors conducted a retrospective controlled study on the complications related to the 2 rib harvesting approaches. From March 2012 to May 2014, 24 patients were treated with rib grating, of whom 9 patients received conventional rib harvesting surgery and 15 patients received in situ splitting harvesting surgery. In all patients, a 3-dimensional computed tomography study of the chest was performed 7 days postoperatively. Postoperative complications were assessed and postoperative pain was assessed using a visual analog scale after the first 24, 48, and 72 hours after the surgery. The complication rate for in situ splitting rib harvesting was 6.67% versus 44.44% for patients treated with whole rib grafting surgery. After 48 and 72 hours, the visual analog scale scores in patients treated with in situ splitting rib grafts were significantly lower than the patients treated with traditional surgery. The in situ splitting approach for obtaining a rib results in a clinically significant reduction in complications compared with the traditional approach.

  1. Interchondral subluxation or "clicking rib syndrome".

    Science.gov (United States)

    Abrahams, P

    1976-08-01

    A case history of the interchondral subluxation syndrome is presented, the anatomy as related to the symptoms discussed and the literature of this so-called "clicking-rib syndrome" reviewed. Unfortunately, this syndrome is not widely recognized but it is hoped that this article will bring it to the attention of those most likely to encounter it-the primary-care physician-and so save numerous unnecessary investigations and consultations. Once one is aware of its existence, the condition is easily diagnosed by careful history and examination alone.

  2. Challenges experienced during rehabilitation after traumatic multiple rib fractures: a qualitative study.

    Science.gov (United States)

    Claydon, Jacqueline; Maniatopoulos, Gregory; Robinson, Lisa; Fearon, Paul

    2017-08-02

    People with multiple rib fractures rarely receive rehabilitation aimed specifically at their chest wall injuries. This research explores patient perceptions of rehabilitation and recovery. A qualitative study exploring how a purposive sample of 15 people with traumatic multiple rib fractures at a Major Trauma Centre in the United Kingdom make sense of their recovery. Data collected during one-to-one interviews 4 to 9 months after injury. Transcripts analysed using Interpretative Phenomenological Analysis. Struggling with breathing and pain: Difficulties with breathing and pain were initially so severe ?it takes your breath away? and people felt scared they may not survive. These symptoms gradually improved but feeling "out of puff" often persisted. Life on hold: Healing was considered a natural process which people couldn't influence, creating frustration whilst waiting for injuries to heal. Many believed they would never fully recover and accepted limitations. Lucky to be alive: All participants expressed a sense of feeling lucky to be alive. The seriousness of injury prompted a change in attitude to make the most of life. Rib fractures can be painful, but also frightening. A rehabilitation intervention promoting pain management, normalises trauma and restores physical activity may improve recovery. Implications for Rehabilitation Patients identified challenges with rehabilitation throughout the entire recovery journey, and their rehabilitation needs evolved with time. People find it difficult to regain pre-injury fitness even after their fractures heal and pain subsides. A belief there is nothing that can be done to help rib fractures contributed to people lowering their expectations of achieving a full recovery and developing a sense of "making do". Rehabilitation and patient education after traumatic multiple rib fractures should focus on improving pain management, respiratory fitness and emotional well-being.

  3. 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

  4. 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.

  5. Computed Tomography Measurement of Rib Cage Morphometry in Emphysema

    Science.gov (United States)

    Sverzellati, Nicola; Colombi, Davide; Randi, Giorgia; Pavarani, Antonio; Silva, Mario; Walsh, Simon L.; Pistolesi, Massimo; Alfieri, Veronica; Chetta, Alfredo; Vaccarezza, Mauro; Vitale, Marco; Pastorino, Ugo

    2013-01-01

    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 (R2 = 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 cm2; 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 cm2; 95% CI: 3.0 to 7.8 for an emphysema increase of 5%). Lower rib cage areas decreased as FVC% decreased (5.1 cm2; 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. PMID:23935872

  6. SC Cyclotron and RIB Facilities in Kolkata

    CERN Document Server

    Sinha, Bikash; Chakrabarti, Alok

    2005-01-01

    The superconducting cyclotron under construction at this Centre has bending limit (K-bend) of 520 and focusing limit (K-foc) of 160. It is being constructed, primarily, for nuclear physics experiments with heavy ion beams at intermediate energies. The 100-ton main magnet is currently in the commissioning phase with the main coil already at 4.2K temperature. Magnetic field measurements will be carried out over the next several months. All other systems of the cyclotron are in an advanced stage of fabrication or development. We plan to start assembly of the complete cyclotron around the end of 2005. In the phase-I of the project one beam line has been provided. Construction of three more beam lines and various experimental facilities for nuclear physics as well as irradiation experiments has also been funded and the work is well on its way. An ISOL type Radioactive Ion Beam (RIB) facility is being built with the existing K=130 room temperature cyclotron, VEC, as the primary beam source. In-beam RIB production a...

  7. 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.

  8. 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.

  9. 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)

  10. Effect of rib-cage structure on acoustic chest impedance

    DEFF Research Database (Denmark)

    Zimmermann, Niels Henrik; Møller, Henrik; Hansen, John

    2011-01-01

    even weak sounds originating from e.g. the heart. The acoustic impedance is influenced by the structure of the ribcage; hence the acoustic impedance will change depending on if the coupler has been placed on a top of a rib or between the ribs (the intercostal). The impedance of the chest is measured...

  11. Effect of rib-cage structure on acoustic chest impedance

    DEFF Research Database (Denmark)

    Zimmermann, Niels Henrik; Møller, Henrik; Hansen, John

    2011-01-01

    even weak sounds originating from e.g. the heart. The acoustic impedance is influenced by the structure of the ribcage; hence the acoustic impedance will change depending on if the coupler has been placed on a top of a rib or between the ribs (the intercostal). The impedance of the chest is measured...... in the frequency range from 40 Hz to 5 kHz using an acoustic impedance tube made specifically for the purpose. The measurements are carried out in a grid pattern on the surface of the chest. The grid is aligned according to the ribs; hence the measurements are either on a top of the ribs or between the ribs...

  12. Comparison of postoperative pain relief by intercostal block between pre-rib harvest and post-rib harvest groups.

    Science.gov (United States)

    Bashir, Muhammad Mustehsan; Shahzad, Muhammad Ateeq; Yousaf, Muhammad Nadeem; Khan, Bilal Ahmad; Khan, Farid Ahmad

    2014-01-01

    To compare intercostal nerve block before and after rib harvest in terms of mean postoperative pain score and mean postoperative tramadol usage. Randomized controlled trial. Department of Plastic Surgery, Mayo Hospital, KEMU, Lahore, from January 2011 to July 2012. 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. Mean age was 31.43 ± 10.78 years. The mean pain scores at 6 hours postoperatively were 1.033 ± 0.609 and 2.4667 ± 0.812 in pre-rib harvest and post-rib harvest groups respectively (p Intercostal block administered before rib harvest as preemptive strategy result in decreased postoperative pain scores and narcotic use.

  13. 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.

  14. Single crystalline silicon solar cells with rib structure

    Science.gov (United States)

    Yoshiba, Shuhei; Hirai, Masakazu; Abe, Yusuke; Konagai, Makoto; Ichikawa, Yukimi

    2017-02-01

    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.

  15. 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.

  16. 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.

  17. Evolutionary analyses of KCNQ1 and HERG voltage-gated potassium channel sequences reveal location-specific susceptibility and augmented chemical severities of arrhythmogenic mutations

    Directory of Open Access Journals (Sweden)

    Accili Eric A

    2008-06-01

    Full Text Available Abstract Background Mutations in HERG and KCNQ1 potassium channels have been associated with Long QT syndrome and atrial fibrillation, and more recently with sudden infant death syndrome and sudden unexplained death. In other proteins, disease-associated amino acid mutations have been analyzed according to the chemical severity of the changes and the locations of the altered amino acids according to their conservation over metazoan evolution. Here, we present the first such analysis of arrhythmia-associated mutations (AAMs in the HERG and KCNQ1 potassium channels. Results Using evolutionary analyses, AAMs in HERG and KCNQ1 were preferentially found at evolutionarily conserved sites and unevenly distributed among functionally conserved domains. Non-synonymous single nucleotide polymorphisms (nsSNPs are under-represented at evolutionarily conserved sites in HERG, but distribute randomly in KCNQ1. AAMs are chemically more severe, according to Grantham's Scale, than changes observed in evolution and their severity correlates with the expected chemical severity of the involved codon. Expected chemical severity of a given amino acid also correlates with its relative contribution to arrhythmias. At evolutionarily variable sites, the chemical severity of the changes is also correlated with the expected chemical severity of the involved codon. Conclusion Unlike nsSNPs, AAMs preferentially locate to evolutionarily conserved, and functionally important, sites and regions within HERG and KCNQ1, and are chemically more severe than changes which occur in evolution. Expected chemical severity may contribute to the overrepresentation of certain residues in AAMs, as well as to evolutionary change.

  18. The rib cage stabilizes the human thoracic spine: An in vitro study using stepwise reduction of rib cage structures.

    Science.gov (United States)

    Liebsch, Christian; Graf, Nicolas; Appelt, Konrad; Wilke, Hans-Joachim

    2017-01-01

    The stabilizing effect of the rib cage on the human thoracic spine is still not sufficiently analyzed. For a better understanding of this effect as well as the calibration and validation of numerical models of the thoracic spine, experimental biomechanics data is required. This study aimed to determine (1) the stabilizing effect of the single rib cage structures on the human thoracic spine as well as the effect of the rib cage on (2) the flexibility of the single motion segments and (3) coupled motion behavior of the thoracic spine. Six human thoracic spine specimens including the entire rib cage were loaded quasi-statically with pure moments of ± 2 Nm in flexion/extension (FE), lateral bending (LB), and axial rotation (AR) using a custom-built spine tester. Motion analysis was performed using an optical motion tracking system during load application to determine range of motion (ROM) and neutral zone (NZ). Specimens were tested (1) in intact condition, (2) after removal of the intercostal muscles, (3) after median sternotomy, after removal of (4) the anterior rib cage up to the rib stumps, (5) the right sixth to eighth rib head, and (6) all rib heads. Significant (p rib cage (FE: + 21.1%, LB: + 10.9%, AR: + 72.5%), and all rib heads (AR: + 5.8%) relative to its previous condition. Compared to the intact condition, ROM and NZ increased significantly after removing the anterior part of the rib cage (FE: + 52.2%, + 45.6%; LB: + 42.0%, + 54.0%; AR: + 94.4%, + 187.8%). Median sternotomy (FE: + 11.9%, AR: + 21.9%) and partial costovertebral release (AR: + 11.7%) significantly increased the ROM relative to its previous condition. Removing the entire rib cage increased both monosegmental and coupled motion ROM, but did not alter the qualitative motion behavior. The rib cage has a strong effect on thoracic spine rigidity, especially in axial rotation by a factor of more than two, and should therefore be considered in clinical scenarios, in vitro, and in silico.

  19. Non-diffuseness of vibration fields in ribbed plates

    DEFF Research Database (Denmark)

    Brunskog, Jonas; Chung, Hyuck

    2011-01-01

    This paper presents numerical simulations of structural intensity in a rib-reinforced plate, investigating the diffuseness. Many prediction models of building and structural acoustics, such as statistical energy analysis or energy flow methods, assume the vibrational wave fields to be diffuse....... However, the diffuseness assumption is not always valid. One such example is a rib-reinforced plate typically found in a lightweight floor with wooden joists. Other examples can be found in aircraft and ship structures. The structural intensity of a ribbed plate is computed at low to mid frequencies using...

  20. Nuclear Physics with RIB's: How it all started

    Science.gov (United States)

    Tanihata, Isao

    2016-04-01

    Neutron halos were discovered through measurements of interaction cross sections and fragmentation cross sections of nuclei near the neutron drip line. Such measurements became possible with the use of radioactive ion beams (RIBs) produced though projectile fragmentations of high-energy heavy-ion collisions. RIBs were invented 30 years ago at the Bevalac facility in Berkeley. In this article, I describe how they were invented and how neutron halos were discovered. What happened at that time was a series of small serendipities guiding us to the present prosperous field of RIB science.

  1. Non-censored rib fracture data during frontal PMHS sled tests.

    Science.gov (United States)

    Kemper, Andrew R; Beeman, Stephanie M; Porta, David J; Duma, Stefan M

    2016-09-01

    The purpose of this study was to obtain non-censored rib fracture data due to three-point belt loading during dynamic frontal post-mortem human surrogate (PMHS) sled tests. The PMHS responses were then compared to matched tests performed using the Hybrid-III 50(th) percentile male ATD. Matched dynamic frontal sled tests were performed on two male PMHSs, which were approximately 50(th) percentile height and weight, and the Hybrid-III 50(th) percentile male ATD. The sled pulse was designed to match the vehicle acceleration of a standard sedan during a FMVSS-208 40 kph test. Each subject was restrained with a 4 kN load limiting, driver-side, three-point seatbelt. A 59-channel chestband, aligned at the nipple line, was used to quantify the chest contour, anterior-posterior sternum deflection, and maximum anterior-posterior chest deflection for all test subjects. The internal sternum deflection of the ATD was quantified with the sternum potentiometer. For the PMHS tests, a total of 23 single-axis strain gages were attached to the bony structures of the thorax, including the ribs, sternum, and clavicle. In order to create a non-censored data set, the time history of each strain gage was analyzed to determine the timing of each rib fracture and corresponding timing of each AIS level (AIS = 1, 2, 3, etc.) with respect to chest deflection. Peak sternum deflection for PMHS 1 and PMHS 2 were 48.7 mm (19.0%) and 36.7 mm (12.2%), respectively. The peak sternum deflection for the ATD was 20.8 mm when measured by the chest potentiometer and 34.4 mm (12.0%) when measured by the chestband. Although the measured ATD sternum deflections were found to be well below the current thoracic injury criterion (63 mm) specified for the ATD in FMVSS-208, both PMHSs sustained AIS 3+ thoracic injuries. For all subjects, the maximum chest deflection measured by the chestband occurred to the right of the sternum and was found to be 83.0 mm (36.0%) for PMHS 1, 60.6 mm (23.9%) for PMHS 2

  2. Vascular thoracic outlet syndrome. Longer posterior rib stump causes poor outcome

    NARCIS (Netherlands)

    Geven, Leontien I.; Smit, Andries J.; Ebels, Tjark

    2006-01-01

    Objective: To assess the role of the relative length of the posterior rib stump in outcome after transaxittary first rib resection for thoracic outlet syndrome. Methods: All patients with a transaxittary first rib resection between January 1990 and February 2004 were selected. Relative rib stump len

  3. 20 CFR 225.22 - Employee RIB PIA used in survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Employee RIB PIA used in survivor annuities... Amount of the Residual Lump-Sum Payable § 225.22 Employee RIB PIA used in survivor annuities. The Employee Retirement Insurance Benefit PIA (Employee RIB PIA) is used to compute the employee RIB amount...

  4. QSAR analyses of DDT analogues and their in silico validation using molecular docking study against voltage-gated sodium channel of Anopheles funestus.

    Science.gov (United States)

    Saini, V; Kumar, A

    2014-01-01

    DDT has enjoyed the reputation of a successful pesticide in disease control programme and agricultural practices along with the serious opposition and ban later on due to its biomagnification and toxic action against non-target organisms. The present work was carried out to develop QSAR models for analysing DDT analogues for their pesticidal activity and in silico validation of these models. A 2D-QSAR model was generated using stepwise with multiple regression, and the model with a value of r(2) = 0.7324; q(2) = 0.6215; pred r(2) = 0.7038, containing five descriptors, was selected for further study. The 3D QSAR with CoMFA analysis showed that steric contribution of 21% and electrostatic contribution of about 79% were required for larvicidal activity of DDT analogues. A set of 3430 molecules was generated using the basic DDT skeleton as template, and these were evaluated for their mosquito larvicidal activity using the generated QSAR models and DDT as standard. Eleven molecules were selected for in silico validation of these models. For this, a docking study of the selected molecules against the homology-modelled voltage-gated sodium channel of Anopheles funestus was conducted. The study showed that the activities of these analogues as predicted by 2D-QSAR, 3D-QSAR with CoMFA and dock score were observed to be well correlated.

  5. Accuracy and sampling error of two age estimation techniques using rib histomorphometry on a modern sample.

    Science.gov (United States)

    García-Donas, Julieta G; Dyke, Jeffrey; Paine, Robert R; Nathena, Despoina; Kranioti, Elena F

    2016-02-01

    Most age estimation methods are proven problematic when applied in highly fragmented skeletal remains. Rib histomorphometry is advantageous in such cases; yet it is vital to test and revise existing techniques particularly when used in legal settings (Crowder and Rosella, 2007). This study tested Stout & Paine (1992) and Stout et al. (1994) histological age estimation methods on a Modern Greek sample using different sampling sites. Six left 4th ribs of known age and sex were selected from a modern skeletal collection. Each rib was cut into three equal segments. Two thin sections were acquired from each segment. A total of 36 thin sections were prepared and analysed. Four variables (cortical area, intact and fragmented osteon density and osteon population density) were calculated for each section and age was estimated according to Stout & Paine (1992) and Stout et al. (1994). The results showed that both methods produced a systemic underestimation of the individuals (to a maximum of 43 years) although a general improvement in accuracy levels was observed when applying the Stout et al. (1994) formula. There is an increase of error rates with increasing age with the oldest individual showing extreme differences between real age and estimated age. Comparison of the different sampling sites showed small differences between the estimated ages suggesting that any fragment of the rib could be used without introducing significant error. Yet, a larger sample should be used to confirm these results. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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

    African Journals Online (AJOL)

    Application of the rainfall infiltration breakthrough (RIB) model for groundwater ... Correlation analysis between rainfall and observed WLF data at daily scale and ... data are more realistic than those for daily data, when using long time series.

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

    African Journals Online (AJOL)

    2012-05-23

    May 23, 2012 ... Scenarios using the data from Oudebosch with different rainfall and groundwater abstraction inputs ... A manual entitled 'Preparation of a manual on Quantitative ..... The definition of the symbols used in the RIB programme.

  9. Rib gap anomaly in partial or mosaic trisomy 8

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Collis, J.; Suter, M.; Sillence, D.

    1988-06-01

    Gaps in the first ribs were observed in two children, one with partial and the other with mosaic trisomy for chromosome 8. The sign may be considered in conjunction with other features as a relative indication for chromosomal studies.

  10. 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.

  11. Membranized semiconductor rib waveguides for acousto-optic modulation enhancement

    DEFF Research Database (Denmark)

    Barretto, Elaine Cristina Saraiva; Hvam, Jørn Märcher

    2010-01-01

    Membranized rib waveguides are proposed as an efficient way to increase acousto-optic modulation by up to four orders of magnitude compared to the traditional structures, opening up possibilities of constructing more compact and power-saving devices.......Membranized rib waveguides are proposed as an efficient way to increase acousto-optic modulation by up to four orders of magnitude compared to the traditional structures, opening up possibilities of constructing more compact and power-saving devices....

  12. Solitary plasmacytoma of the rib: A rare case

    Directory of Open Access Journals (Sweden)

    Rikki Singal

    2011-01-01

    Full Text Available Localized solitary plasmacytoma of the bone is a rare disease and is characterized by only one or two isolated bone lesions with no evidence of disease dissemination. We report a case of solitary plasmacytoma of the rib in a 43-year-old female. The patient underwent complete en-bloc resection of the chest wall including rib, muscle, and parietal pleura. Patient is asymptomatic without any recurrence after two and half years of follow up.

  13. 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.

  14. Rib fractures in coronary bypass patients: radionuclide detection.

    Science.gov (United States)

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

    1983-08-01

    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. Post-accelerator LINAC design for the VECC RIB project

    Indian Academy of Sciences (India)

    Arup Bandyopadhyay

    2002-12-01

    Variable Energy Cyclotron Centre (VECC) is presently developing an ISOL post-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 the post-acceleration. The design aspects of these postaccelerator LINAC modules will be discussed in this paper.

  16. Rib Fracture Protocol Advancing the Care of the Elderly Patient.

    Science.gov (United States)

    Leininger, Susan

    This article discusses unique factors associated with rib fractures in the elderly patient population and explains the process used in one facility to develop a revised protocol for the management of elderly patients with a rib fracture. The goals were to eliminate gaps in early trauma care management and employ a care routine that would improve outcomes for this vulnerable group of patients with fracture.

  17. 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.

  18. Occult rib fractures and brachial plexus injury following median sternotomy for open-heart operations.

    Science.gov (United States)

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

    1984-09-01

    The incidence and the sites of rib fractures during open-heart operations through a median sternotomy incision were studied in 36 consecutive patients divided into two groups. In Group 1 (24 patients), a conventional Ankeney retractor was used to expose the heart, and in Group 2 (12 patients), a similar retractor was used but with its uppermost pair of blades removed. Thorough physical examinations and preoperative and postoperative chest roentgenograms were obtained, and postoperative bone scans were done in all patients. No rib fractures were detected on the routine chest roentgenograms in patients in either group. Bone scans, however, showed 44 rib fractures (15 of the first rib, 13 of the second rib, 4 of the third rib, 6 of the fourth rib, 3 of the fifth rib, and 3 of the sixth rib) in 16 patients in Group 1. Six patients in Group 2 had 9 rib fractures (2 of the first rib, 4 of the second rib, and 1 each of the third, fifth, and sixth ribs). None of the patients in Group 2 had brachial plexus injury and neither of the first rib fractures in this group were located posteriorly, whereas 3 patients in Group 1 had both brachial plexus injury and posterior first rib fractures.

  19. Efficient computation of turbulent flow in ribbed passages using a non-overlapping near-wall domain decomposition method

    Science.gov (United States)

    Jones, Adam; Utyuzhnikov, Sergey

    2017-08-01

    Turbulent flow in a ribbed channel is studied using an efficient near-wall domain decomposition (NDD) method. The NDD approach is formulated by splitting the computational domain into an inner and outer region, with an interface boundary between the two. The computational mesh covers the outer region, and the flow in this region is solved using the open-source CFD code Code_Saturne with special boundary conditions on the interface boundary, called interface boundary conditions (IBCs). The IBCs are of Robin type and incorporate the effect of the inner region on the flow in the outer region. IBCs are formulated in terms of the distance from the interface boundary to the wall in the inner region. It is demonstrated that up to 90% of the region between the ribs in the ribbed passage can be removed from the computational mesh with an error on the friction factor within 2.5%. In addition, computations with NDD are faster than computations based on low Reynolds number (LRN) models by a factor of five. Different rib heights can be studied with the same mesh in the outer region without affecting the accuracy of the friction factor. This is tested with six different rib heights in an example of a design optimisation study. It is found that the friction factors computed with NDD are almost identical to the fully-resolved results. When used for inverse problems, NDD is considerably more efficient than LRN computations because only one computation needs to be performed and only one mesh needs to be generated.

  20. Prediction of Heat and Mass Transfer in a Rotating Ribbed Coolant Passage With a 180 Degree Turn

    Science.gov (United States)

    Rigby, David L.

    1999-01-01

    Numerical results are presented for flow in a rotating internal passage with a 180 degree turn and ribbed walls. Reynolds numbers ranging from 5200 to 7900, and Rotation numbers of 0.0 and 0.24 were considered. The straight sections of the channel have a square cross section, with square ribs spaced one hydraulic diameter (D) apart on two opposite sides. The ribs have a height of 0.1D and are not staggered from one side to the other. The full three dimensional Reynolds Averaged Navier-Stokes equations are solved combined with the Wilcox k-omega turbulence model. By solving an additional equation for mass transfer, it is possible to isolate the effect of buoyancy in the presence of rotation. That is, heat transfer induced buoyancy effects can be eliminated as in naphthalene sublimation experiments. Heat transfer, mass transfer and flow field results are presented with favorable agreement with available experimental data. It is shown that numerically predicting the reattachment between ribs is essential to achieving an accurate prediction of heat/mass transfer. For the low Reynolds numbers considered, the standard turbulence model did not produce reattachment between ribs. By modifying the wall boundary condition on omega, the turbulent specific dissipation rate, much better agreement with the flow structure and heat/ mass transfer was achieved. It is beyond the scope of the present work to make a general recommendation on the omega wall boundary condition. However, the present results suggest that the omega boundary condition should take into account the proximity to abrupt changes in geometry.

  1. Delivering multiple independent RIB simultaneously: Technical and operational challenges

    Energy Technology Data Exchange (ETDEWEB)

    Morton, A.C.

    2016-06-01

    ISAC is an ISOL-type facility at which RIB are produced by direct reactions of 480 MeV protons from TRIUMFs main cyclotron on thick targets. Like other ISOL-type facilities, ISAC is limited to the production and delivery of a single RIB at any given time. ARIEL, the Advanced Rare-IsotopE Laboratory, will provide for the production and delivery of, ultimately, two additional RIB, the first produced by photofission on actinide targets using electrons from a new superconducting electron linac and the second by direct and indirect reactions with protons from TRIUMFs main cyclotron. This will allow for the simultaneous delivery of three independent RIB to experimental areas at ARIEL and ISAC. The shift from single-user to multi-user operation will introduce significant technical and operational challenges that RIB facilities have not yet had to address. Almost all aspects of facility operation will become more complex as the first RIB from ARIEL targets become available.

  2. VTT's micron-scale silicon rib+strip waveguide platform

    Science.gov (United States)

    Aalto, Timo; Harjanne, Mikko; Cherchi, Matteo

    2016-05-01

    Silicon rib waveguides enable single-mode (SM) operation even with the combination of multi-micron core dimensions and high refractive index contrast. In such large waveguides the optical mode field is almost completely confined inside the Si core, which leads to small propagation losses and small polarization dependency. The unique SM condition of the rib waveguide also enables the use of an ultra-wide wavelength range, for example from 1.2 to <1.7 μm, without sacrificing either SM operation or low propagation loss. This makes micron-scale Si waveguides particularly well-suited for spectroscopy and extensive wavelength division multiplexing. However, rib waveguides require large bending radii, which lead to large circuit sizes. There are two solutions for this. So-called Euler bends in Si strip waveguides enable low-loss bends down to 1 μm bending radius with less than 0.1 dB/90° loss for both polarizations. Another alternative is a total-internal reflection mirror that can have loss as low as 0.1 dB for both polarizations in either strip or rib waveguides. The excitation of higher order modes in large strip waveguides is avoided by using adiabatic rib-strip converters and low-loss components. With rib and strip waveguides it is possible to reach a unique combination of low loss, extremely small footprint, small polarization dependency, ultra-wide bandwidth and tolerance to high optical powers.

  3. Nasal reconstruction with articulated irradiated rib cartilage

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, C.S.; Cook, T.A.; Guida, R.A. (Univ. of Washington School of Medicine, Seattle (USA))

    1991-03-01

    Nasal structural reconstruction is a formidable task in cases where there is loss of support to both the nasal dorsum and tip. A multitude of surgical approaches and materials have been used for the correction of the saddle-nose deformity with varying degrees of success. Articulated irradiated rib cartilage inserted through an external rhinoplasty approach was used to reconstruct nasal deformities in 18 patients over a 6-year period. Simultaneous use of a midline forehead flap to reconstruct the overlying soft tissue was required in four cases. Follow-up ranged from 1 to 6 years (mean, 2.8 years). Results were rewarding in most cases with marked improvement in nasal support and airway. Revision and/or replacement secondary to trauma or warping of the graft was required in four cases. None of the patients exhibited infection, extrusion, or noticeable resorption. A description of the surgical technique, review of all the cases, and recommendation for continued use of this graft material are discussed.

  4. Ontogeny of 3D rib curvature and its importance for the understanding of human thorax development.

    Science.gov (United States)

    García-Martínez, Daniel; Recheis, Wolfgang; Bastir, Markus

    2016-03-01

    Sagittal and axial rib orientation relative to the spine are two factors that modify rib cage morphology during ontogeny. Some studies suggest that these factors do not operate in the same way at the upper (ribs 1-5) and lower thorax (ribs 6-10) during postnatal growth, but it is unknown if the ontogenetic thoracic changes are produced by morphological changes of the ribs (intrinsic rib factors) or by external factors related to costal joints (extrinsic rib factors). To clarify these questions, we applied 3D geometric morphometrics of landmarks and sliding semilandmarks (N = 20/rib) to 280 individual ribs (1-10) of Homo sapiens comprising the entire human ontogeny and growth simulations were carried out. PCA shows that intrinsic rib factors (rib torsion and axial rib curvature) are ontogenetic factors of variability that contribute to configuring the adult thorax shape. Moreover, growth simulations and regression slopes suggest that the upper thorax unit is comprised by ribs 1-7 and the lower unit at least by ribs 8-10. These results suggest anatomical constraints for ontogenetic rib variation, since ribs 1-7 (true ribs) are directly linked to the sternum. Moreover, these results are supported by functional anatomy because pulmonary kinematics would influence the upper unit and diaphragmatic kinematics would influence the lower one. Our findings are relevant not only to understanding how changes at individual ribs contribute to the adult thorax morphology, but also to the development and evolution of the modern human rib cage. © 2015 Wiley Periodicals, Inc.

  5. 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.

  6. Experimental investigation of impingement heat transfer from a round rib-roughened surface

    Science.gov (United States)

    Isman, Mustafa Kemal; Can, Muhiddin

    2017-04-01

    An experimental investigation on impingement heat transfer from a rib-roughened surface is performed. Single, double, and triple rib configurations are tested. The rib is also located at three different positions for a single rib case. The Reynolds number is varied from 10,000 to 50,000 whereas the dimensionless jet-to-surface distance (z/D) is kept constant as 8. Results show that, the Nusselt number decreases just before a rib. After the rib, however, the Nusselt number decreases by a larger amount. Since ribs cause a reincreasing in the Nusselt number after the stagnation point and since the stagnation point Nusselt number is not affected by ribs, they can be used to enhance heat transfer especially for spot cooling applications. It is also obtained that using ribs is more useful for low speed impinging jets, when heat transfer from the whole surface is considered.

  7. Evaluating Loading Deflection of Distraction Osteogenic Rib in a Rabbit Model.

    Science.gov (United States)

    Shen, Weimin; Tang, Chenlu; Yang, Junyi; Kong, Liangliang; Zhang, Xiaoying

    2016-10-01

    The treatment of patients with partially atrophic rib and rib defects requires an ideal arc of the rib that has adequate bone length and width. To design and assemble a distraction device with a strain gauge, we need to establish an animal model for testing it during rib distraction osteogenesis. Osteotomies were performed at the same position in the fifth rib in 8 rabbits. Customized distraction devices attached to strain gauges were used to distract the ribs. After a month of distraction and consolidation, loading deflection gauges were used, and specimens were examined histologically to record bone formation. Distraction osteogenesis was carried out successfully in all rabbits when the device used to distract the rib up to 4 cm. The device can be used for strain testing during rib distraction osteogenesis performed in a rabbit model. There was no significant difference in the loading deflection gauges of the bone between osteogenic and contralateral ribs. This animal model of costal distraction osteogenesis is successful.

  8. Totally Endoscopic (VATS) First Rib Resection for Thoracic Outlet Syndrome.

    Science.gov (United States)

    George, Robert S; Milton, Richard; Chaudhuri, Nilanjan; Kefaloyannis, Emmanuel; Papagiannopoulos, Kostas

    2017-01-01

    Thoracic outlet syndrome (TOS) causes neurologic symptoms in 95% of cases and vascular symptoms in 5% of cases. Surgical resection is curative. Endoscopic-assisted transaxillary first rib resection has been previously reported. In this study we report a totally endoscopic video-assisted thoracoscopic surgery (VATS) approach using tailored endoscopic instruments. Ten patients (8 women; average age, 32.3 ± 5.6 years) with TOS underwent VATS first rib resection following failure of symptom improvement with physiotherapy. Symptoms were: unilateral neurogenic (n = = 7), bilateral neurogenic (n = = 2), and bilateral arterial compression (n = = 1). Three standard VATS ports were utilized. The parietal pleura and periosteum overlying the first rib were stripped avoiding injury to the neurovascular bundle. The rib was transected with an endoscopic rib cutter and resected completely in a piecemeal fashion using endoscopic bone nibblers. All periosteal remnants were trimmed releasing the neurovascular bundle completely. Patients were discharged within 72 hours following surgery. One patient had the contralateral side treated 18 months later and another patient is awaiting the second surgery. At follow-up, 9 patients had complete resolution of their main symptoms. One patient with neurogenic TOS developed mild functional and sensational loss of the non-dominant hand that improved within 8 months with physiotherapy. VATS first rib resection for TOS provides, unlike the classic approaches, a superior, magnified, and well-illuminated view of the thoracic inlet. It allows good posterior trimming of the first rib, release of brachial plexus, and an aesthetically pleasing result, especially in female patients. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. 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.

  10. 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

  11. The ribbed drapery of the Puerto Princesa Underground River (Palawan, Philippines: morphology and genesis

    Directory of Open Access Journals (Sweden)

    Paolo Forti

    2017-01-01

    Full Text Available During the 2011 speleological expedition to the Puerto Princesa Underground River (Palawan, Philippines a drapery characterized by several close-to-horizontal ribs has been noticed. Even without sampling and analyzing its internal growth layers, a detailed morphological study allowed to present a possible genetic model. The presented model helps to explain its evolution, which is mainly controlled by variation in water flow as a consequence of the Palawan climate. When validated by further analyses, the same genetic mechanism could define also the evolution of the very common but still unexplained complex flowstones, which exhibit several close-to-horizontal steps, widenings and narrowings along their growth axis.

  12. Analysis of the current rib support practices and techniques in U.S. coal mines.

    Science.gov (United States)

    Mohamed, Khaled M; Murphy, Michael M; Lawson, Heather E; Klemetti, Ted

    2016-01-01

    Design of rib support systems in U.S. coal mines is based primarily on local practices and experience. A better understanding of current rib support practices in U.S. coal mines is crucial for developing a sound engineering rib support design tool. The objective of this paper is to analyze the current practices of rib control in U.S. coal mines. Twenty underground coal mines were studied representing various coal basins, coal seams, geology, loading conditions, and rib control strategies. The key findings are: (1) any rib design guideline or tool should take into account external rib support as well as internal bolting; (2) rib bolts on their own cannot contain rib spall, especially in soft ribs subjected to significant load-external rib control devices such as mesh are required in such cases to contain rib sloughing; (3) the majority of the studied mines follow the overburden depth and entry height thresholds recommended by the Program Information Bulletin 11-29 issued by the Mine Safety and Health Administration; (4) potential rib instability occurred when certain geological features prevailed-these include draw slate and/or bone coal near the rib/roof line, claystone partings, and soft coal bench overlain by rock strata; (5) 47% of the studied rib spall was classified as blocky-this could indicate a high potential of rib hazards; and (6) rib injury rates of the studied mines for the last three years emphasize the need for more rib control management for mines operating at overburden depths between 152.4 m and 304.8 m.

  13. Analysis of the current rib support practices and techniques in U.S. coal mines

    Institute of Scientific and Technical Information of China (English)

    Mohamed Khaled M.; Murphy Michael M.; Lawson Heather E.; Klemetti Ted

    2016-01-01

    Design of rib support systems in U.S. coal mines is based primarily on local practices and experience. A better understanding of current rib support practices in U.S. coal mines is crucial for developing a sound engineering rib support design tool. The objective of this paper is to analyze the current practices of rib control in U.S. coal mines. Twenty underground coal mines were studied representing various coal basins, coal seams, geology, loading conditions, and rib control strategies. The key findings are:(1) any rib design guideline or tool should take into account external rib support as well as internal bolting;(2) rib bolts on their own cannot contain rib spall, especially in soft ribs subjected to significant load—external rib control devices such as mesh are required in such cases to contain rib sloughing;(3) the majority of the studied mines follow the overburden depth and entry height thresholds recommended by the Program Information Bulletin 11-29 issued by the Mine Safety and Health Administration;(4) potential rib insta-bility occurred when certain geological features prevailed—these include draw slate and/or bone coal near the rib/roof line, claystone partings, and soft coal bench overlain by rock strata;(5) 47%of the stud-ied rib spall was classified as blocky—this could indicate a high potential of rib hazards;and (6) rib injury rates of the studied mines for the last three years emphasize the need for more rib control management for mines operating at overburden depths between 152.4 m and 304.8 m.

  14. Fabrication of Barrier Ribs for PDP by Capillary Infiltration Process and Their Sintering Behavior

    Institute of Scientific and Technical Information of China (English)

    Tae Jung Tang; Hak Nynu Choi; Chan Hyoung Kang; Yong Seog Kim

    2004-01-01

    Closed-cell type barrier ribs such as meander, honeycomb, SDR, and waffle types were produced using capillary molding process. Sintering of the ribs revealed that the ribs with asymmetric geometry such as meander and SDR type became distorted severely by the sintering process, but the ribs with symmetric geometry such as honeycomb and waffle type maintained their green state morphology. After sintering, the ribs were coated with green phosphor using osmosis coating process and its luminance characteristics were evaluated. The results indicated that the luminance and its efficiency is improved by using closed-cell type ribs with the new phosphor forming technology.

  15. 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.

  16. 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.

  17. 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.

  18. [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.

  19. Botulinum toxin treatment for slipping rib syndrome: a case report.

    Science.gov (United States)

    Pirali, Caterina; Santus, Gianna; Faletti, Sofia; De Grandis, Domenico

    2013-10-01

    Slipping rib syndrome (SRS) is a musculoskeletal cause of severe and recurrent thoracic or abdominal pain. The etiology of SRS is unknown, it seems to arise from costal hypermobility with a tendency of one of the ribs (usually from 8th to 10th but also 11th and 12th have been described) to slip under the superior adjacent rib. Its prevalence is underestimated because SRS is mainly a clinical diagnosis, frequently missed. The critical aspect of the diagnosis is knowledge of the condition itself, which, when lacking, often results in the patient being referred to many different specialists and exposed to unnecessary and costly investigations. The management of the condition includes conservative techniques such as manipulation, localized anesthetic, and steroid or anesthetic nerve block. However, where conservative therapy fails, surgical treatment, with excision of the rib, may be performed. In this paper we describe the case of a patient with persistent and debilitating flank pain who, after many investigations, was diagnosed with SRS. The usual conservative treatment failed, after which we treated the patient with injections of incobotulinumtoxin A into muscles inserting on the inferior side of the rib cage (quadratus lumborum muscle, muscle transversus abdomini, abdominal external oblique muscle, and recto abdomini) achieving a complete relief from pain. To our knowledge botulinum toxin has never been proposed before for the treatment of SRS. We believe that it should be considered as a therapeutic option, especially where other medical treatments have failed or as an intermediate step before surgical intervention.

  20. Tumors of the ribs: experience with 47 cases.

    Science.gov (United States)

    Andrianopoulos, E G; Lautidis, G; Kormas, P; Karameris, A; Lahanis, S; Papachristos, I; Kaselouris, C; Argyropoulos, A

    1999-05-01

    To emphasise the existing difficulties in differentiating benign from malignant rib tumours, and especially the problems that a clinical doctor encounters when dealing with a hyperplastic rib. Forty-seven patients with rib tumour underwent surgery in a period of 12 years (1984-1996). In 40 cases (85%), the lesion was benign and in seven (15%) was malignant. Twenty-one benign tumours originated from cartilage and bone, seven were inflammatory, six originated from the bone marrow, and minor percentages (2.5-5%) had vascular, neurogenous, degenerative or miscellaneous origin. Three of the malignant tumours were primary chondrosarcomas and two were metastatic from kidney. The rest were metastatic from stomach (adeno-Ca), and skin (melanoma). The mean age in the benign group was 25.2 years and in the primary malignant group was 20.7 years. Related symptoms were pain (47%) and swelling (42.5%). One-third (32%) of the patients were asymptomatic and the lesion was accidentally found during routine chest radiography. All patients were treated surgically with wide excision of the tumour and the diagnosis was established histologically. Resection was complete and curative in all cases without recurrence. Since the likelihood of malignancy cannot be excluded, all rib tumours should be considered malignant until proven otherwise. Therefore, prompt intervention is necessary and wide and radical initial excision of the involved rib is advocated.

  1. 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.

  2. Laminar flow in a microchannel with superhydrophobic walls exhibiting transverse ribs

    Science.gov (United States)

    Davies, J.; Maynes, D.; Webb, B. W.; Woolford, B.

    2006-08-01

    One approach recently proposed for reducing the frictional resistance to liquid flow in microchannels is the patterning of microribs and cavities on the channel walls. When treated with a hydrophobic coating, the liquid flowing in the microchannel wets only the surfaces of the ribs, and does not penetrate the cavities, provided the pressure is not too high. The net result is a reduction in the surface contact area between channel walls and the flowing liquid. For microribs and cavities that are aligned normal to the channel axis (principal flow direction), these micropatterns form a repeating, periodic structure. This paper presents results of a study exploring the momentum transport in a parallel-plate microchannel with such microengineered walls. The investigation explored the entire laminar flow Reynolds number range and characterized the influence of the vapor cavity depth on the overall flow field. The liquid-vapor interface (meniscus) in the cavity regions is treated as flat in the numerical analysis and two conditions are explored with regard to the cavity region: (1) The liquid flow at the liquid-vapor interface is treated as shear-free (vanishing viscosity in the vapor region), and (2) the liquid flow in the microchannel core and the vapor flow within the cavity are coupled by matching the velocity and shear stress at the interface. Regions of slip and no-slip behavior exist and the velocity field shows distinct variations from classical laminar flow in a parallel-plate channel. The local streamwise velocity profiles, interfacial velocity distributions, and maximum interfacial velocities are presented for a number of scenarios and provide a sound understanding of the local flow physics. The predictions and accompanying measurements reveal that significant reductions in the frictional pressure drop (enhancement in effective fluid slip at the channel walls) can be achieved relative to the classical smooth-channel Stokes flow. Reductions in the friction

  3. Evaluation of the iPhone with an acrylic sleeve versus the Scoliometer for rib hump measurement in scoliosis

    Directory of Open Access Journals (Sweden)

    Izatt Maree T

    2012-07-01

    Full Text Available Abstract Background Vertebral rotation found in structural scoliosis contributes to trunkal asymmetry which is commonly measured with a simple Scoliometer device on a patient's thorax in the forward flexed position. The new generation of mobile 'smartphones' have an integrated accelerometer, making accurate angle measurement possible, which provides a potentially useful clinical tool for assessing rib hump deformity. This study aimed to compare rib hump angle measurements performed using a Smartphone and traditional Scoliometer on a set of plaster torsos representing the range of torsional deformities seen in clinical practice. Methods Nine observers measured the rib hump found on eight plaster torsos moulded from scoliosis patients with both a Scoliometer and an Apple iPhone on separate occasions. Each observer repeated the measurements at least a week after the original measurements, and were blinded to previous results. Intra-observer reliability and inter-observer reliability were analysed using the method of Bland and Altman and 95% confidence intervals were calculated. The Intra-Class Correlation Coefficients (ICC were calculated for repeated measurements of each of the eight plaster torso moulds by the nine observers. Results Mean absolute difference between pairs of iPhone/Scoliometer measurements was 2.1 degrees, with a small (1 degrees bias toward higher rib hump angles with the iPhone. 95% confidence intervals for intra-observer variability were +/- 1.8 degrees (Scoliometer and +/- 3.2 degrees (iPhone. 95% confidence intervals for inter-observer variability were +/- 4.9 degrees (iPhone and +/- 3.8 degrees (Scoliometer. The measurement errors and confidence intervals found were similar to or better than the range of previously published thoracic rib hump measurement studies. Conclusions The iPhone is a clinically equivalent rib hump measurement tool to the Scoliometer in spinal deformity patients. The novel use of plaster torsos as rib

  4. Incidental imaging findings of congenital rib abnormalities - a case series and review of developmental concepts.

    Science.gov (United States)

    Aignătoaei, Anda Maria; Moldoveanu, Cristina Elena; Căruntu, Irina Draga; Giușcă, Simona Eliza; Partene Vicoleanu, Simona; Nedelcu, Alin Horațiu

    2017-09-04

    Congenital rib abnormalities are found in approximately 2% of the general population. Usually, they occur in isolation, when they are rarely symptomatic, but they can also associate with other malformations. We reviewed imaging examinations performed over a period of two years (2014-2015), enabling us to identify isolated rib abnormalities in six adult patients. The case series consisted in three cases with bilateral cervical ribs and one case each with bifid rib, costal fusion and rib pseudarthrosis. In all patients, the costal anomalies were discovered incidentally. All rib malformations were detected at thoracic radiography, except for the rib pseudarthrosis, which was identified at CT scan. Differential diagnosis was made between cervical ribs and abnormalities of the C7 transverse process and of the first rib, while the other costal malformations were distinguished from tumoral, traumatic or inflammatory lesions of the chest wall, lung and pleura. Considering the existing knowledge on rib development, we suggest a classification of the most common types of rib malformations in three categories: (I) results of homeotic transformation, referring to numerical aberrations; (II) segmentation errors, including costal fusion and bridging; (III) anomalies of resegmentation, resulting in bifid ribs. It is important that radiologists are familiarized with the imaging features of rib abnormalities, since these anomalies can be misinterpreted as lesions with different implications. We aim that the developmental classification proposed in this paper can contribute to a better understanding of this pathology.

  5. Improving the Odds: Intercostal Metal Coils Mark Area to Resect in Rib Lesions.

    Science.gov (United States)

    Riggs, Kyle W; Zeltsman, David; Gu, Bo; Sung, Chris C; Lobko, Igor

    Precise localization of a rib lesion for its resection remains a challenge because of multiple factors including nonpalpable pathology, unfavorable body habitus, inaccurate clinical examination, and unreliable rib count on physical examination, unfavorable lesion location within a rib (its posterior aspect), and resection of sclerotic lesions with grossly intact rib cortex. We describe a novel rib localization technique that eliminates potential mistakes and avoids resection of an inappropriate rib. Our method of rib localization includes placement of metallic coils by interventional radiologists under computed tomography guidance where two coils are deployed within the intercostal spaces, one superior and one inferior to the rib lesion. Intraoperative use of fluoroscopy results in precise localization of rib lesions even in cases where the pathology is not grossly apparent. We implemented this approach in 2014 and have since performed it in five patients for both lytic and sclerotic lesions. Placement of markers superficial to the intercostal spaces resulted in their displacement in one case. Successfully, we removed the correct ribs in each patient without technical difficulties or complications. Our series demonstrates a novel strategy for a highly accurate and relatively easy way to identify the exact portion of the rib for surgical resection. Intercostal space positioning of the coil markers superior and inferior to the lesion prevents their dislodgement during patient transport and positioning on the operating room table, which improves rib identification accuracy and reliability. When combined with intraoperative fluoroscopy, it will greatly eliminate resection of incorrect ribs.

  6. 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...

  7. [Autologous rib cartilage harvesting: operative procedure and postoperative pain reduction].

    Science.gov (United States)

    Rasp, G; Staudenmaier, R; Ledderose, H; Kastenbauer, E

    2000-03-01

    In reconstructive surgery there is a growing demand for cartilage grafts. For small amounts of autologous tissue, cartilage from the nasal septum or ear concha is a sufficient and reliable tissue, but in cases of extensive defects or higher mechanical load autologous rib cartilage is a commonly used transplant. Nevertheless, a serious donor-site morbidity, especially postoperative pain, has to be taken into consideration. We present a modified technique for harvesting rib cartilage with a consecutive local pain therapy. In contrast to the commonly used incision through all layers of tissue the described technique follows the anatomical structures of skin tension-lines, the fascial and muscle fibers and tissue sliding-planes. Starting with a transversal skin incisions 1.5 cm above the costal arch, longitudinal splitting of the rectus abdominis fascia and muscle, the rib cartilage of the ribs 6 to 8 can be exposed. Grafts in the size of at least 3 to 8 cm can be harvested under preservation of the perichondrium. This technique causes a high degree of stability and good function of the abdominal wall. POSTOPERATIVE PAIN THERAPY: After harvesting rib cartilage most patients complain about extensive postoperative pain. For adequate treatment the local application of a long-lasting anesthetic substance close to the intercostal nerves is helpful. The introduction of a peridural catheter opens the feasibility of continuously applying a local anesthetic for 3 to 4 days directly into the donor-site. This procedure reduces the need for general anesthetics dramatically and prevents further complications. This modified technique for harvesting rib cartilage diminishes the donor-site morbidity by reducing the risk of pneumothorax, hernias and functional deficits. Moreover, the local pain therapy assures postoperative wellness and mobility.

  8. Blunt chest trauma: is there a place for rib stabilization?

    Science.gov (United States)

    2017-01-01

    Rib fractures are a common and highly morbid finding in patients with blunt chest trauma. Over the past decade, a renewed interest in (and instrumentation for) rib fixation in this cohort has occurred. Stabilization of the chest wall in this setting, particularly when a flail segment is present, is associated with significant reductions in the rates of respiratory failure, pneumonia, ICU stay, and mortality. Thoracic surgeons should remain actively involved in this evolving area of our specialty to further optimize patient outcomes. PMID:28446987

  9. 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.

  10. Subclavian artery stenosis caused by a prominent first rib

    Directory of Open Access Journals (Sweden)

    Isabelle Claus

    2015-04-01

    Full Text Available Thoracic outlet syndrome is a mechanical space problem in which the brachial plexus and/or subclavian vessels are compressed. Arterial compression is least common and almost always associated with a bony anomaly. We present a case of a 49-year-old woman with a prominent first rib which caused a subclavian artery stenosis. There are many options for subclavian artery repair through open surgery. In high-risk patients, minimal invasive techniques are favorable. To date, few case reports exist on an endovascular artery repair combined with open first rib resection. While long-term follow-up will be necessary, our preliminary results seem promising.

  11. 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.)

  12. Development of analysis and reconstruction tools in Opera and analysis of {tau} {yields} 3 charged hadrons channel; Developpement des outils d'analyse et de reconstruction dans OPERA et analyse du canal {tau} {yields} 3 hadrons charges

    Energy Technology Data Exchange (ETDEWEB)

    Lavy, M

    2004-07-01

    OPERA aims to prove the existence of {nu}{sub {mu}} {yields} {nu}{sub {tau}} oscillation by a direct observation of {nu}{sub {tau}} appearance in a {nu}{sub {mu}} beam. To achieve this goal, a pure {nu}{sub {mu}} beam is produced at CERN and directed towards the Gran Sasso underground laboratory where the OPERA detector is located. The nuclear emulsions composing the detector have a very high degree of accuracy in position ({mu}m) and should allow {tau} lepton detection produced via {nu}{sub {tau}} charged current interaction. The emulsions analysis is thus a key point of the OPERA experiment. The development of simulation and reconstruction software is a part of this thesis work. In an other part of this thesis, it is shown that with a suitable kinematic analysis, the 3 charged hadrons tau decay channel can be used as any tau decay channels in the OPERA data analysis. (author)

  13. 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.

  14. Risk of metastasis among rib abnormalities on bone scans in breast cancer patients

    Science.gov (United States)

    Li, Qin; Chen, Zhiqiang; Zhao, Yansheng; Li, Xiuqing; Pan, Hong; Xia, Tiansong; Chen, Lin; Xu, Zhaoqiang; Zhou, Wenbin; Liu, Xiaoan

    2015-01-01

    Bone scan abnormalities, especially rib lesions, are often confusing for physicians due to a high number of false-positive lesions. This study investigated risk factors that are associated with bone metastasis in 613 breast cancer patients with bone scan abnormalities. Significantly increased rates of bone metastasis were observed in patients with multiple lesions, large tumor sizes, and lymph node involvement. In addition, patients with concurrent lesions of rib and other sites exhibited a significant higher rate of metastatic disease compared to those with other site lesions (P = 0.009). In the subset of 324 patients with rib abnormalities, the rate of metastasis was extremely low in patients with pure rib lesions (1.2%; 95% CI: 0.1%–4.1%). Concurrent lesions of rib and other sites were more likely to be rib metastasis compared to pure rib lesions (P rib lesions and lesions located on bilateral ribs were more likely to be rib metastasis (P rib abnormalities could be recommended for follow-up only. However, if concurrent lesions of rib and other sites were detected on bone scans, additional radiological examinations should be performed to patients. PMID:25939860

  15. 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…

  16. Comparison of Schroedinger and Dirac coupled-channels analyses of the sup 28 Si( p , p prime ) sup 28 Si reaction at 500 MeV

    Energy Technology Data Exchange (ETDEWEB)

    de Swiniarski, R.; Beatty, D.; Donoghue, E.; Fergerson, R.W.; Franey, M.; Gazzaly, M.; Glashausser, C.; Hintz, N.; Jones, K.W.; McClelland, J.B.; Nanda, S.; Plum, M. (Institut des Sciences Nucleaires, 53, avenue des Martyrs, F-38026 Grenoble CEDEX (France) Serin Physics Laboratory, Rutgers University, Piscataway, NJ (USA) School of Physics and Astronomy, University of Minnesota, Minneapolis, MN (USA) Los Alamos Meson Physics Facility, Los Alamos National Laboratory, Los Alamos, NM (USA))

    1990-09-01

    Analyzing powers have been measured for elastic and inelastic scattering of 500-MeV protons from {sup 28}Si. These data for the first 0{sup +}, 2{sup +}, and 4{sup +} states and the corresponding cross-section data have been analyzed with both Schroedinger and Dirac equation phenomenological coupled-channels methods. Good, qualitatively similar, results are achieved with the two methods.

  17. Alkali suppression for pure Radioactive Ion Beam (RIB) production

    CERN Document Server

    E. Bouquerel, R. Catherall, M. Eller, J. Lettry, S. Marzari, T. Stora and the ISOLDE

    The ISOLDE facility at CERN has constantly developed new ion beams with betterpurity and improved yields over the last decades. Chemical selectivity for the productionof pure RIBs can be achieved by condensation of less volatile species in the transferline between the target and the ion source and by selective ionisation schemes such asthat provided by Resonance Ionization Laser Ion Source (RILIS)...

  18. 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.

  19. 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.

  20. MULTIPLE OSSIFIED COSTAL CARTILAGES FOR 1ST RIB

    Directory of Open Access Journals (Sweden)

    Raghavendra D.R.

    2014-12-01

    Full Text Available Costal cartilages are flattened bars of hyaline cartilages. All ribs except the last two, join with the sternum through their respective costal cartilages directly or indirectly. During dissection for 1st MBBS students in the Department of Anatomy, JJMMC, Davangere, variation was found in a male cadaver aged 45 –50 years. Multiple ossified costal cartilages for 1st rib were present on left side. There were 3 costal cartilages connecting 1st rib to manubrium. There were two small intercostal spaces between them. The lower two small costal cartilages fused together to form a common segment which in turn fused with large upper costal cartilage. The large upper costal cartilage forms costochondral joint with 1st rib. All costal cartilages showed features of calcification. The present variation of multiple ossified costal cartilages are due to bifurcation of costal cartilage. It may cause musculoskeletal pain, intercostal nerve entrapment or vascular compression. Awareness of these anomalies are important for radiologists for diagnostic purpose and for surgeons for performing various clinical and surgical procedures.

  1. Embryonic remnants of intercentra and cervical ribs in turtles

    Directory of Open Access Journals (Sweden)

    Ingmar Werneburg

    2013-09-01

    A broad sample of extant turtles possesses a series of paired bones in the neck that are situated between the cervical vertebrae. These paired bones were originally proposed to be cervical rib remnants, but have more recently been interpreted as vestiges of intercentra. Here, we document, for the first time, the neck development of a pleurodire turtle, Emydura subglobosa, and identify blastematous structures, which partially recapitulate the ribs and intercentra of the plesiomorphic tetrapod condition. We identify blastematous “bridges” between intercentra and the corresponding ribs, which we homologize with the vestiges visible in extant turtles and with the remnant parapophyseal articulation processes of the intercentra of some stem taxa. Only the unpaired, median part of the intercentrum of the atlas is retained in adult turtles, but intercentra are recapitulated along the entire vertebral column during development; they are embedded in the cervical myosepta and serve as attachment sites for neck musculature. We also identify two rib rudiments in the occipital region, which may indicate that at least two vertebrae are integrated into the cranium of turtles in particular, and of amniotes in general.

  2. 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.

  3. Nuclear Physics Programs for the Future RIBs Facility in Korea

    Institute of Scientific and Technical Information of China (English)

    Moon Chang-Bum

    2016-01-01

    We present nuclear physics programs based on the planned experiments using rare isotope beams (RIBs) for the future Korean Rare Isotope Beams Accelerator facility(KRIA). This ambitious facility has both an Isotope Separation On Line (ISOL) and fragmentation capability for producing RIBs and accelerating beams of wide range mass of nuclides with energies of a few to hundreds MeV per nucleon. Low energy RIBs at Elab = 5 to 20 MeV per nucleon are for the study of nuclear structure and nuclear astrophysics toward and beyond the drip lines while higher energy RIBs produced by in-flight fragmentation with the reaccelerated ions from the ISOL enable to explore the neutron drip lines in intermediate mass regions. The planned programs have goals for investigating internal structures of the exotic nuclei toward and beyond the nucleon drip lines by addressing the following issues: how the shell structure evolves in areas of extreme proton to neutron imbalance; whether the isospin symmetry maintains in isobaric mirror nuclei at and beyond the drip lines; how two-proton radioactivity affects abundances of the elements;what the role of the continuum states including resonant states above proton-decay threshold in exotic nuclei is in astrophysical nuclear reaction processes, and how the nuclear reaction rates triggered by unbound proton-rich nuclei make an effect on rapid proton capture processes in a very hot stellar plasma.

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

    NARCIS (Netherlands)

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

    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 t

  5. A bond model for ribbed bars based on concrete confinement

    NARCIS (Netherlands)

    Den Uijl, J.A.; Bigaj, A.J.

    1996-01-01

    A new bond model for ribbed bars embedded in concrete has been developed. The model is based on the confining capacity of the concrete surrounding the bar. This confinement capacity is evaluated with the help of a thick-wailed-cylinder model, with which the relation between the radial displacement

  6. 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.

  7. Dirac Coupled-channel Analyses of Polarized Proton Scatterings to the 2$^+$ Gamma Vibrational Band in $^{24}$Mg and $^{26}$Mg

    CERN Document Server

    Shim, Sugie

    2016-01-01

    Dirac coupled channel calculations are performed phenomenologically for the high-lying excited states that belong to the 2$^+$ gamma vibrational band at the 800-MeV polarized proton inelastic scatterings from the s-d shell nuclei, $^{24}$Mg and $^{26}$Mg. Optical potential model is used and scalar and time-like vector potentials are considered as direct potentials. First-order vibrational collective models are used to obtain the transition optical potentials in order to accommodate the high-lying excited vibrational collective states. The complicated Dirac coupled channel equations are solved phenomenologically to reproduce the differential cross section and analyzing power data by varying the optical potential and deformation parameters. It is found that the relativistic Dirac coupled channel calculation could describe the high-lying excited states of the 2$^+$ gamma vibrational band at the 800-MeV polarized proton inelastic scatterings from s-d shell nuclei $^{24}$Mg and $^{26}$Mg reasonably well, showing b...

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

    Science.gov (United States)

    Bemelman, Michael; de Kruijf, M W; van Baal, Mark; Leenen, Luke

    2017-08-01

    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.

  9. 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.

  10. Ribbed bedforms on palaeo-ice stream beds resemble regular patterns of basal shear stress ('traction ribs') inferred from modern ice streams

    Science.gov (United States)

    Stokes, Chris R.; Margold, Martin; Creyts, Timothy

    2017-04-01

    Rapidly-flowing ice streams are an important mechanism through which ice sheets lose mass, and much work has focussed on elucidating the processes that increase or decrease their velocity. Recent work using standard inverse methods has inferred previously-unrecognised regular patterns of high basal shear stress ('sticky spots' >200 kPa) beneath a number of ice streams in Antarctica and Greenland, termed 'traction ribs'. They appear at a scale intermediate between smaller ribbed moraines and much larger mega-ribs observed on palaeo-ice sheet beds, but it is unclear whether they have a topographic expression at the bed. Here, we report observations of rib-like bedforms from Digital Elevation Models (DEMs) along palaeo-ice stream beds in western Canada that resemble both the pattern and dimensions of traction ribs. Their identification suggests that traction ribs may have a topographic expression that lies between, and partly overlaps with, ribbed moraines and much larger mega-ribs. These intermediate-sized bedforms support the notion of a ribbed bedform continuum. Their formation remains conjectural, but our observations from palaeo-ice streams, coupled with those from modern ice masses, suggest they are consistent with wave-like instabilities occurring in the coupled flow of ice and till and modulated by subglacial meltwater drainage. Their form and pattern may also involve glaciotectonism of subglacial sediments.

  11. Mobile radio channels

    CERN Document Server

    Pätzold, Matthias

    2011-01-01

    Providing a comprehensive overview of the modelling, analysis and simulation of mobile radio channels, this book gives a detailed understanding of fundamental issues and examines state-of-the-art techniques in mobile radio channel modelling. It analyses several mobile fading channels, including terrestrial and satellite flat-fading channels, various types of wideband channels and advanced MIMO channels, providing a fundamental understanding of the issues currently being investigated in the field. Important classes of narrowband, wideband, and space-time wireless channels are explored in deta

  12. First rib metamorphosis: its possible utility for human age-at-death estimation.

    Science.gov (United States)

    Kunos, C A; Simpson, S W; Russell, K F; Hershkovitz, I

    1999-11-01

    Human first ribs demonstrate predictable, sequential changes in shape, size, and texture with increasing age, and thus, can be used as an indicator of age at death. Metamorphosis of the first rib's head, tubercle, and costal face was documented in a cross-sectional sample of preadult and adult first ribs of known age at death from the Hamann-Todd skeletal collection (Cleveland Museum of Natural History, Cleveland, Ohio). Blind tests of the usefulness of the first rib as an age indicator were conducted, including tabulation of intraobserver and interobserver inaccuracies and biases. First rib age estimates show inaccuracies and biases by decade comparable to those generated by other aging techniques. Indeed, the first rib method is useful as an isolated age indicator. When used in conjunction with other age indicators, the first rib improves the quality of summary age assessments.

  13. Heat Transfer Augmentation in Developing Flow Through a Ribbed Square Duct

    Institute of Scientific and Technical Information of China (English)

    Khan R K; Ali M.A.T; Akhanda M.A.R

    2006-01-01

    An experimental study is conducted to investigate the heat transfer augmentation in developing turbulent flow through a ribbed square duct. The duct is made of 16mm thick bakelite sheet. The bottom surface of the ribbed wall having rib pitch to height ratio of 10 is heated by passing a c current to the heater placed under it. The uniform heating is controlled using a digital temperature controller and a variac. The results of ribbed duct are compared with the results of a smooth duct under the same experimental conditions. It is observed that the heat transfer augmentation in ribbed duct is better than that of the smooth duct. At Re=5.0 × 104 , the mean temperature of air flowing through the ribbed duct increases by 2.45 percent over the smooth duct, whereas in the ribbed duct Nusselt number increases by 15.14 percent than that of the smooth duct with a 6 percent increase in pressure drop.

  14. Crystallization and preliminary X-ray diffraction analyses of pseudechetoxin and pseudecin, two snake-venom cysteine-rich secretory proteins that target cyclic nucleotide-gated ion channels

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Nobuhiro [Institute of Applied Biochemistry, University of Tsukuba, Tsukuba, Ibaraki 305-8572 (Japan); Department of Biochemistry, National Institute of Agrobiological Sciences, Tsukuba, Ibaraki 305-8602 (Japan); Yamazaki, Yasuo [Department of Biochemistry, Meiji Pharmaceutical University, Kiyose, Tokyo 204-8588 (Japan); Fujimoto, Zui [Department of Biochemistry, National Institute of Agrobiological Sciences, Tsukuba, Ibaraki 305-8602 (Japan); Morita, Takashi [Department of Biochemistry, Meiji Pharmaceutical University, Kiyose, Tokyo 204-8588 (Japan); Mizuno, Hiroshi, E-mail: mizuno-hiroshi@aist.go.jp [Department of Biochemistry, National Institute of Agrobiological Sciences, Tsukuba, Ibaraki 305-8602 (Japan); VALWAY Technology Center, NEC Soft Ltd, Koto-ku, Tokyo 136-8627 (Japan); Institute for Biological Resources and Functions, National Institute of Advanced Industrial Science and Technology, Central 6, Tsukuba, Ibaraki 305-8566 (Japan); Institute of Applied Biochemistry, University of Tsukuba, Tsukuba, Ibaraki 305-8572 (Japan)

    2005-08-01

    Crystals of pseudechetoxin and pseudecin, potent peptidic inhibitors of cyclic nucleotide-gated ion channels, have been prepared and X-ray diffraction data have been collected to 2.25 and 1.90 Å resolution, respectively. Cyclic nucleotide-gated (CNG) ion channels play pivotal roles in sensory transduction of retinal and olfactory neurons. The elapid snake toxins pseudechetoxin (PsTx) and pseudecin (Pdc) are the only known protein blockers of CNG channels. These toxins are structurally classified as cysteine-rich secretory proteins and exhibit structural features that are quite distinct from those of other known small peptidic channel blockers. This article describes the crystallization and preliminary X-ray diffraction analyses of these toxins. Crystals of PsTx belonged to space group P2{sub 1}2{sub 1}2{sub 1}, with unit-cell parameters a = 60.30, b = 61.59, c = 251.69 Å, and diffraction data were collected to 2.25 Å resolution. Crystals of Pdc also belonged to space group P2{sub 1}2{sub 1}2{sub 1}, with similar unit-cell parameters a = 60.71, b = 61.67, c = 251.22 Å, and diffraction data were collected to 1.90 Å resolution.

  15. Operative fixation of rib fractures after blunt trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma.

    Science.gov (United States)

    Kasotakis, George; Hasenboehler, Erik A; Streib, Erik W; Patel, Nimitt; Patel, Mayur B; Alarcon, Louis; Bosarge, Patrick L; Love, Joseph; Haut, Elliott R; Como, John J

    2017-03-01

    Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the past few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. Population, intervention, comparison, and outcome (PICO) questions were formulated for patients with and without flail chest. Outcomes of interest included mortality, duration of mechanical ventilation (DMV), hospital and intensive care unit (ICU) length of stay (LOS), incidence of pneumonia, need for tracheostomy, and pain control. A systematic review and meta-analysis of currently available evidence was performed per the Grading of Recommendations Assessment, Development, and Evaluation methodology. Twenty-two studies were identified and analyzed. These included 986 patients with flail chest, of whom 334 underwent rib ORIF. Rib ORIF afforded lower mortality; shorter DMV, hospital LOS, and ICU LOS; and lower incidence of pneumonia and need for tracheostomy. The data quality was deemed very low, with only three prospective randomized trials available. Analyses for pain in patients with flail chest and all outcomes in patients with nonflail chest were not feasible due to inadequate data. In adult patients with flail chest, we conditionally recommend rib ORIF to decrease mortality; shorten DMV, hospital LOS, and ICU LOS; and decrease incidence of pneumonia and need for tracheostomy. We cannot offer a recommendation for pain control, or any of the outcomes in patients with nonflail chest with currently available data. Systematic review/meta-analysis, level III.

  16. 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

    2017-05-30

    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

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

    Science.gov (United States)

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

    2016-06-01

    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. Between March 2005 and December 2013, consecutive patients with blunt thoracic trauma, who were admitted to the Department of Thoracic Surgery at Tungs' Taichung Metro Harbor Hospital (Taichung, Taiwan), were reviewed in this retrospective cohort study with the approval of the Institutional Review Board. The duration of hospital stay, ventilator support, injury severity score (ISS), type of injury, associated injuries, treatments, and mortality were analyzed statistically. A total of 1621 thoracic trauma patients were included in this study, with a male majority and an age range of 18-95 years (mean age, 51.2 years). Approximately 11.7% of these patients had an ISS ≥ 16 and a mortality rate of 6.9%. Among them, 78.5% had rib fractures; 31.8%, traumatic hemothorax; 15.6%, pneumothorax; 9.6%, hemopneumothorax; and 4.6%, lung contusion. The most common associated injury was extremity fracture, followed by head injury and clavicle fracture. Surgery on the extremities (20.6% of patients) and chest tube placement (22.7% of patients) were the most common treatments. The number of rib fractures was associated with prolonged hospital and intensive care unit (ICU) stays (≥7 days), an ISS ≥ 16, and pulmonary complications of hemothorax, pneumothorax, and hemopneumothorax, but not with mechanical ventilator use. Furthermore, old age was significantly associated with rib fractures in patients with thoracic trauma. 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

  18. 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

  19. 13 ribs as a predictor of long gap esophageal atresia: myth or reality? Analysis of associated findings of esophageal atresia and abnormal rib count.

    Science.gov (United States)

    Durell, Jonathan; Dagash, Haitham; Eradi, Bala; Rajimwale, Ashok; Nour, Shawqui; Patwardhan, Nitin

    2017-08-01

    The presence of 13 pairs of ribs on pre-operative chest x-ray has been postulated to be an indicator for long gap esophageal atresia (EA). This study sought to determine the validity of this theory and identify associated pathological conditions in patients with EA and abnormal rib count. Babies with EA from January 2005 - December 2012 were retrospectively analyzed. Information was gathered from neonatal health records and operation notes. Chest x-rays were reviewed to determine rib count. Long gap EA was defined as failure to achieve primary esophageal anastomosis. Statistical analysis performed with Fisher's exact test. Seventy-six patients were identified. Eight patients had long gap EA, with none of these patients having 13 pairs of ribs. Paradoxically, 10 patients with esophageal atresia +/- trachea-esophageal atresia (EA +/- TEF) and supernumerary ribs underwent primary repair. Nine patients had 11 pairs of ribs, of which 2 had pure EA and a long gap. Using Fisher's exact test to compare the groups of supernumary ribs and non-supernumary ribs there is a p value of 0.587. VACTERL association was identified in 40% of those with supernumerary ribs. Various associated syndromes and concomitant abnormalities were identified. We found no association between 13 pairs of ribs and long gap in esophageal atresia. Those with 13 pairs of ribs were more likely to have associated anomalies, although this was not statistically significant. Our cohort of patients was found to have a range of pathology related to genetic syndromes, further atresias, and malformations, which is well known to be associated with children born with EA +/- TEF. Prognosis study - level IV. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. The evolutionary origin of the turtle shell and its dependence on the axial arrest of the embryonic rib cage.

    Science.gov (United States)

    Hirasawa, Tatsuya; Pascual-Anaya, Juan; Kamezaki, Naoki; Taniguchi, Mari; Mine, Kanako; Kuratani, Shigeru

    2015-05-01

    Turtles are characterized by their possession of a shell with dorsal and ventral moieties: the carapace and the plastron, respectively. In this review, we try to provide answers to the question of the evolutionary origin of the carapace, by revising morphological, developmental, and paleontological comparative analyses. The turtle carapace is formed through modification of the thoracic ribs and vertebrae, which undergo extensive ossification to form a solid bony structure. Except for peripheral dermal elements, there are no signs of exoskeletal components ontogenetically added to the costal and neural bones, and thus the carapace is predominantly of endoskeletal nature. Due to the axial arrest of turtle rib growth, the axial part of the embryo expands laterally and the shoulder girdle becomes encapsulated in the rib cage, together with the inward folding of the lateral body wall in the late phase of embryogenesis. Along the line of this folding develops a ridge called the carapacial ridge (CR), a turtle-specific embryonic structure. The CR functions in the marginal growth of the carapacial primordium, in which Wnt signaling pathway might play a crucial role. Both paleontological and genomic evidence suggest that the axial arrest is the first step toward acquisition of the turtle body plan, which is estimated to have taken place after the divergence of a clade including turtles from archosaurs. The developmental relationship between the CR and the axial arrest remains a central issue to be solved in future. © 2014 Wiley Periodicals, Inc.

  1. 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.

  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. Cytokeratin - positive rib osteosarcoma metastasizing to the small intestine

    Directory of Open Access Journals (Sweden)

    Hiroko Kuwabara

    2014-01-01

    Full Text Available Osteosarcoma (OS is a malignant tumor in which osteoid or bone is produced directly by tumor cells. Some OS cells are positive for cytokeratin (CK and epithelial membrane antigen by immunohistochemistry (IHC and this may lead to a misdiagnosis of metastatic carcinoma, particularly when the tumor location is unusual. On the other hand, gastrointestinal metastasis of OS is rare. We present the case of a 67-year-old Japanese man with a small intestinal intussusception due to metastasis of a CK-positive rib OS. The tumor cells were positive for CK, osteopontin and osteonectin by IHC and a diagnosis of a CK-positive chest wall OS metastasizing to the small intestine was considered. Osteoid or bone formation was histologically absent and therefore chest wall OS had to be differentially diagnosed from metastatic carcinoma of unknown origin. A postmortem histological analysis confirmed a rib OS. Awareness of CK-positive OS is important for making a correct diagnosis and for disease management and an immunohistochemical analysis of the tumor for expression of osteopontin and osteonectin may be used to support the diagnosis. In addition, this case shows that rib OS can metastasize to the gastrointestinal tract, albeit rarely, which may induce an intestinal intussusception.

  4. Respiratory pattern changes produced by intercostal muscle/rib vibration.

    Science.gov (United States)

    Bolser, D C; Lindsey, B G; Shannon, R

    1988-06-01

    Large-amplitude vibration of the intercostal muscles/ribs has an inhibitory effect on inspiratory motor output. This effect has been attributed, in part, to the stimulation of intercostal muscle tendon organs. Intercostal muscle/rib vibration can also produce a decrease or increase in respiratory frequency. Studies were conducted 1) to determine whether, in addition to intercostal tendon organs, costovertebral joint mechanoreceptors (CVJR's) contribute to the inspiratory inhibitory effect of intercostal muscle/rib vibration (IMV) and 2) to explain the different respiratory frequency responses to IMV previously reported. Phrenic (C5) activity was monitored in paralyzed thoracotomized, artificially ventilated cats. Vibration (125 Hz) at amplitudes greater than 1,200 micron of one T6 intercostal space in decerebrated vagotomized rats reduced phrenic activity. This response was still present but weaker in some animals after denervation of the T6 intercostal muscles. Subsequent denervation of the T6 CVJR's by dorsal root sections eliminated this effect. Respiratory frequency decreased during simultaneous vibration (greater than 1,200 micron) of the T5 and T7 intercostal spaces in vagotomized cats. Respiratory frequency increased during IMV of two intercostal spaces (greater than 1,300 micron) in vagal intact cats. The use of different anesthetics (pentobarbital, allobarbital) did not alter these results. We conclude that CVJR's may contribute to the inhibitory effect of IMV on medullary inspiratory activity. The presence or absence of pulmonary vagal afferents can account for the different respiratory frequency responses to IMV, and different anesthetics did not influence these results.

  5. DiGeorge syndrome with vertebral and rib dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Puno-Cocuzza, C.; David, K.; Kogekar, N. [Brooklyn Hospital Center, NY (United States)

    1994-09-01

    DiGeorge syndrome results from defect in the development of the third and fourth pharyngeal pouches, and is characterized by conotruncal heart defects, aplasia or hypoplasia of thymus and parathyroid glands resulting in immune deficiency and hypocalcemia. Other associated abnormalities include renal, thyroid and diaphragmatic defects, oral clefting, etc. Etiologically, it is heterogeneous, with a microdeletion of 22q11 present in over 80% of cases. Our patient was born following a pregnancy complicated by insulin dependent gestational diabetes. There was truncus arteriosus type 2, absense of thymic shadow on CXR with severe deficiency of T cell function, and persistent hypocalcemia with low parathormone. Right kidney was absent. Dysplastic ribs including fused and bifid ribs were noted. Hypoplastic vertebrae and hemivertebrae were present through thoracic and lumbar regions. Chromosome analysis was normal, and metaphase FISH analysis with probe N25 representing locus D22S75 did not show any deletion of 22q11.2. The skeletal findings similar to these have not been previously reported in association with DiGeorge syndrome to our knowledge. Vertebral and rib abnormalities are known to occur with pregestational maternal diabetes. Maternal diabetes has also been suggested to be a possible etiology in a very small proportion of DiGeorge syndrome cases. It is possible that these findings occured together on account of gestational maternal diabetes in our case.

  6. LDA - Measurements of Transitional Flows Induced by a Square Rib

    Energy Technology Data Exchange (ETDEWEB)

    Becker, S.; Durst, F.; Stoots, Carl Marcel; Condie, Keith Glenn; McEligot, Donald Marinus

    2002-03-01

    New fundamental measurements are presented for the transition process in flat plate boundary layers downstream of two-dimensional square ribs. By use of laser Doppler anemometry (LDA) and a large Matched-Index-of-Refraction (MIR) flow system, data for wall-normal fluctuations and Reynolds stresses were obtained in the near wall region to y+<0.1 in addition to the usual mean streamwise velocity component and its fluctuation. By varying velocity and rib height, the experiment investigated the following range of conditions: k+ = 5.5 to 21, 0.3rib. For "large" elements, evolution of turbulent statistics of the viscous layer for a turbulent boundary layer (y+<~30) was rapid even in flows where the mean velocity profile still showed laminar behavior.

  7. Hybrid channel flow-type mechanisms in the Greater Himalayan Sequence (West Nepal): new constraints from vorticity of flow and quartz petrofabric analyses.

    Science.gov (United States)

    Frassi, Chiara

    2016-04-01

    Three main tectono-metamorphic units are classically recognized along the Himalayan belt: the Lesser Himalayan (LH), the Greater Himalayan sequence (GHS) and the Tibetan Sedimentary sequence (TSS). The GHS may be interpreted as a low-viscosity tabular body of mid-crustal rocks extruded southward in Miocene times beneath the Tibetan plateau between two parallel and opposite-sense crustal-scale shear zones: the Main Central thrust at the base, and the South Tibetan Detachment system at the top. The pre-/syn-shearing mineral assemblage documented within these crustal-scale shear zones indicates that the metamorphic grade increases toward the core of the GHS producing an inverted and a normal thermal gradient respectively on the top and on the bottom of the slab. In addition, thermal profiles estimated using both petrology- and microstructures/fabrics-based thermometers indicate that the metamorphic isograds are condensed. Although horizontal extension and vorticity estimates collected across the GHS could be strongly biased by the criteria used to define the map position of the MCT, published vorticity data document general shear flow (1>Wk>0) within the slab with a pure-shear component of flow slightly predominant within the core of the GHS whereas the simple-shear component seems to dominate at the top of the slab. The lower boundary of the GHS records a general shear flow with a comparable contribution of simple and pure shearing. The associated crustal extrusion is compatible with Couette - Poiseuille velocity flow profile as assumed in crustal-scale channel flow-type models In this study, the quartz c-axis petrofabrics, vorticity and deformation-temperature studies are integrated with microstructures and metamorphic studies to individuate the location of the MCT and to document the spatial distribution of ductile deformation patterns across the lower portion of the GHS exposed in the Chaudabise river valley in western Nepal. My results indicate that the Main

  8. Clustered ribbed-nanoneedle structured copper surfaces with high-efficiency dropwise condensation heat transfer performance.

    Science.gov (United States)

    Zhu, Jie; Luo, Yuting; Tian, Jian; Li, Juan; Gao, Xuefeng

    2015-05-27

    We report that the dropwise condensation heat transfer (DCHT) effectiveness of copper surfaces can be dramatically enhanced by in situ grown clustered ribbed-nanoneedles. Combined experiments and theoretical analyses reveal that, due to the microscopically rugged and low-adhesive nature of building blocks, the nanosamples can not only realize high-density nucleation but constrain growing condensates into suspended microdrops via the self-transport and/or self-expansion mode for subsequently self-propelled jumping, powered by coalescence-released excess surface energy. Consequently, our nanosample exhibits over 125% enhancement in DCHT coefficient. This work helps develop advanced heat-transfer materials and devices for efficient thermal management and energy utilization.

  9. Determining the critical size of a rabbit rib segmental bone defect model.

    Science.gov (United States)

    Liu, Fengzhen; Chen, Kun; Hou, Lei; Li, Keyi; Wang, Dawei; Zhang, Bin; Wang, Xiumei

    2016-10-01

    In order to establish and standardize the rabbit rib segmental bone defect model, it is of vital importance to determine rabbit rib critical size defect (CSD). According to the general time needed for spontaneous long-bone regeneration, three-month observation period was set to determine the CSD. The rabbit rib segmental bone defects with different sizes from 1 to 5 cm with or without periosteum were performed in the eighth rib of 4-month-old male New Zealand rabbits and underwent X-ray examinations at the 4th, 8th and 12th weeks postoperatively. The gross and histological examinations at postoperative week 12 were evaluated, which showed that the critical sizes in the rabbit rib models with and without periosteum were 5 and 2 cm, respectively. This study provides prerequisite data for establishing rabbit rib CSD model and evaluating bone materials using this model.

  10. [Hydatid disease of the first rib treated surgically by the Roos approach].

    Science.gov (United States)

    Marghli, A; Smati, B; Abdelmalek, M; Attia, S; Djilani, H; Kilani, T

    2008-12-01

    Hydatid disease is a parasitic infection due to Echinococcus granulosus. Since involvement of the ribs and in particular the first rib is rare, diagnosis and treatment in these locations can pose special problems. The purpose of this report is to describe the case of a 27-year-old man in whom an apical left opacity was discovered by chance. Clinical examination was normal. Thoracic ultrasound demonstrated multilocular cyst in the left apical region of the thorax. Thoracic computed tomography (CT) demonstrated a hydatid cyst originating from the first rib. The patient was operated using the technique known as the Roos approach. The procedure consisted of cystectomy with resection of the first rib. The multiloculated appearance of the lesion and erosion at the first rib was consistent with hydatid cyst. The Roos approach is the technique of choice for the treatment of the first rib.

  11. An inversion procedure for coupled-channel scattering: determining the deuteron-nucleus tensor interaction 21.30.-x; 13.75.Cs; 25.10.+s; Inverse scattering; Deuteron scattering; Nuclear tensor interaction; Tensor analysing power; Coupled channel inversion

    CERN Document Server

    Cooper, S G; MacKintosh, R S; Pomerantsev, V N

    2000-01-01

    A practical S-matrix to potential inversion procedure which applies to coupled-channel scattering is presented. The inversion technique is described in the context of the problem of determining a tensor interaction T sub R which exactly reproduces non-diagonal S sup J sub l sub l sub ' for spin one projectiles. It also applies to spin-((1)/(2)) plus spin-((1)/(2)) scattering. The method is a generalization of the iterative-perturbative, IP, method. In this paper, spin-1 IP inversion is tested and evaluated and the variation of the potential is investigated for cases where there is insufficient information to define the potential uniquely. Since T sub P interactions must be presumed to be present in many applications, we examine the potentials which result when the S-matrix is generated from a T sub P interaction. The spin-1 IP algorithm can be incorporated within a direct observable-to-potential inversion procedure to provide an efficient alternative to standard phenomenology. We evaluate its application to f...

  12. Phylogenetic analyses of the homologous transmembrane channel-forming proteins of the F0F1-ATPases of bacteria, chloroplasts and mitochondria.

    Science.gov (United States)

    Blair, A; Ngo, L; Park, J; Paulsen, I T; Saier, M H

    1996-01-01

    Sequences of the three integral membrane subunits (subunits a, b and c) of the F0 sector of the proton-translocating F-type (F0F1-) ATPases of bacteria, chloroplasts and mitochondria have been analysed. All homologous-sequenced proteins of these subunits, comprising three distinct families, have been identified by database searches, and the homologous protein sequences have been aligned and analysed for phylogenetic relatedness. The results serve to define the relationships of the members of each of these three families of proteins, to identify regions of relative conservation, and to define relative rates of evolutionary divergence. Of these three subunits, c-subunits exhibited the slowest rate of evolutionary divergence, b-subunits exhibited the most rapid rate of evolutionary divergence, and a-subunits exhibited an intermediate rate of evolutionary divergence. The results allow definition of the relative times of occurrence of specific events during evolutionary history, such as the intragenic duplication event that gave rise to large c-subunits in eukaryotic vacuolar-type ATPases after eukaryotes diverged from archaea, and the extragenic duplication of F-type ATPase b-subunits that occurred in blue-green bacteria before the advent of chloroplasts. The results generally show that the three F0 subunits evolved as a unit from a primordial set of genes without appreciable horizontal transmission of the encoding genetic information although a few possible exceptions were noted.

  13. 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 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.

  14. 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.

  15. 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.

  16. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Vawter, Gregory A. (Albuquerque, NM); Smith, Robert E. (Albuquerque, NM)

    1998-01-01

    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.

  18. 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.

  19. Quantitative geometric analysis of rib, costal cartilage and sternum from childhood to teenagehood.

    Science.gov (United States)

    Sandoz, Baptiste; Badina, Alina; Laporte, Sébastien; Lambot, Karene; Mitton, David; Skalli, Wafa

    2013-09-01

    Better understanding of the effects of growth on children's bones and cartilage is necessary for clinical and biomechanical purposes. The aim of this study is to define the 3D geometry of children's rib cages: including sternum, ribs and costal cartilage. Three-dimensional reconstructions of 960 ribs, 518 costal cartilages and 113 sternebrae were performed on thoracic CT scans of 48 children, aged 4 months to 15 years. The geometry of the sternum was detailed and nine parameters were used to describe the ribs and rib cages. A "costal index" was defined as the ratio between cartilage length and whole rib length to evaluate the cartilage ratio for each rib level. For all children, the costal index decreased from rib level 1 to 3 and increased from level 3 to 7. For all levels, the cartilage accounted for 45-60 % of the rib length, and was longer for the first years of life. The mean costal index decreased by 21 % for subjects over 3-year old compared to those under three (p < 10(-4)). The volume of the sternebrae was found to be highly age dependent. Such data could be useful to define the standard geometry of the pediatric thorax and help to detect clinical abnormalities.

  20. Plasmacytoma presenting as missing rib on chest film: a case report and review of the literature.

    Science.gov (United States)

    Caffery, Terrell; Foy, Matthew

    2014-01-01

    A 33-year-old man presented to the emergency department (ED) with chief complaint of chest pain, persisting for approximately one year. Chest X-ray revealed he was missing the right posterior fifth rib. Physical examination showed no surgical scars, and he reported no history of chest trauma. A CT of his chest demonstrated a mass involving the posterior aspect of the right fifth rib, and subsequent biopsy revealed plasma cells. Laboratory results indicated the tumor was a solitary plasmacytoma of the rib. He was referred to oncology and treated with radiation therapy. This case report illustrates an unusual presentation of a solitary plasmacytoma of the rib.

  1. 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 brain injuries (P = .003), hemothorax/pneumothorax (P = .006), spleen, and liver injury (P 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.

  2. 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.)

  3. Clinical Analysis for the Correlation of Intra-abdominal Organ Injury in the Patients with Rib Fracture

    Science.gov (United States)

    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 patients that had visited the hospital emergency room from January 2007 to December 2009, a retrospective study was conducted on 453 patients suffering from rib fracture due to blunt trauma. Rib fracture was classified according to location (left, right, and bilateral), and according to level (upper rib fracture [1-2nd rib], middle rib fracture [3-8th rib], and lower rib fracture [9-12th rib]). The researched data was statistically compared and analyzed to investigate the correlation between the location, level, and number of rib fracture and intra-abdominal organ injury. Results Motor vehicle injury was found to be the most common mechanism of injury with 208 cases (46%). Associated injuries accompanied with rib fracture were generated in 276 cases (61%). Intra-abdominal organ injury was discovered in 97 cases (21%). Liver injury was the most common intra-abdominal injury associated with rib fracture with 39 cases (40%), followed by spleen injury, with 23 cases (23%). Intra-abdominal injury according to level of rib fracture was presented as upper rib fracture in 11 cases (11%), middle rib fracture in 31 cases (32%), and lower rib fracture in 55 cases (57%), thus verifying that intra-abdominal injuries were commonly accompanied in lower rib fractures (p=0.03). In particular, significant increase of intra-abdominal injury was presented in fractures below the 8th rib (p=0.03). The number of intra-abdominal injuries requiring emergency operations was significantly higher in patients

  4. 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

  5. Primary lymphoma of bone originating in a rib.

    Science.gov (United States)

    Nishiyama, N; Nakatani, S; Inoue, K; Katoh, T; Kinoshita, H

    2000-03-01

    Malignant lymphoma originating in the bone is rare and is now recognized as being an independent clinicopathologic entity known as primary lymphoma of bone. A 60-year-old man complaining of right chest and back pain consulted our hospital for further examination. Chest X-ray and computed tomogram revealed osteolysis and a surrounding soft tissue mass in the sixth right rib. An ultrasonically-guided needle biopsy of the tumor was performed, and histologic examination indicated the dense proliferation of similar-sized atypical cells with nucleoli and an irregular nuclear border. A diagnosis of diffuse, medium-sized non-Hodgkin's lymphoma, B-cell type was made. En block resection of the tumor and chest wall was performed. Macroscopically, the tumor measured 7.5 x 4.8 x 3.0 cm in diameter, and the histologic findings were similar to those of the preoperative needle biopsy. Unfortunately, postoperative treatment with radiation therapy and chemotherapy was ultimately unsuccessful, and a local recurrence and metastatic lesions appeared in the stomach and para-aortic abdominal lymph nodes 7 months after the first symptom appeared. The patient died 3 months later. Surgery was chosen as the initial therapy as it was considered that a rib resection would not result in serious respiratory compromise and the complete resection of the tumor would be superior to radiation therapy for local control. Some authors have reported that the surgical resection of a primary lymphoma of the bone originating in a rib can yield a good prognosis. However, it is a systemic disease and a more effective therapeutic strategy should be developed.

  6. 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.

  7. 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.

  8. Rib Cartilage Assessment Relative to the Healthy Ear in Young Children with Microtia Guiding Operative Timing.

    Science.gov (United States)

    Kang, Shen-Song; Guo, Ying; Zhang, Dong-Yi; Jiang, Du-Yin

    2015-08-20

    The optimal age at which to initiate for auricular reconstruction is controversial. Rib cartilage growth is closely related to age and determines the feasibility and outcomes of auricular reconstruction. We developed a method to guide the timing of auricular reconstruction in children with microtia ranging in age from 5 to 10 years. Rib cartilage and the healthy ear were assessed using low-dose multi-slice computed tomography. The lengths of the eighth rib cartilage and the helix of the healthy ear (from the helical crus to the joint of the helix and the earlobe) were measured. Surgery was performed when the two lengths were approximately equal. The preoperative eighth rib measurements significantly correlated with the intraoperative measurements (P rib growth was not linear. In 76 (62.8%) of 121 patients, the eighth rib length was approximately equal to the helix length in the healthy ear; satisfactory outcomes were achieved in these patients. In 18 (14.9%) patients, the eighth rib was slightly shorter than the helix, helix fabrication was accomplished by adjusting the length of the helical crus of stent, and satisfactory outcomes were also achieved. Acceptable outcomes were achieved in 17 (14.0%) patients in whom helix fabrication was accomplished by cartilage splicing. In 9 (7.4%) patients with insufficient rib cartilage length, the operation was delayed. In one (0.8%) patient with insufficient rib cartilage length, which left no cartilage for helix splicing, the result was unsatisfactory. Eighth rib cartilage growth is variable. Rib cartilage assessment relative to the healthy ear can guide auricular reconstruction and personalize treatment in young patients with microtia.

  9. Rib Cartilage Assessment Relative to the Healthy Ear in Young Children with Microtia Guiding Operative Timing

    Institute of Scientific and Technical Information of China (English)

    Shen-Song Kang; Ying Guo; Dong-Yi Zhang; Du-Yin Jiang

    2015-01-01

    Background:The optimal age at which to initiate for auricular reconstruction is controversial.Rib cartilage growth is closely related to age and determines the feasibility and outcomes of auricular reconstruction.We developed a method to guide the timing of auricular reconstruction in children with microtia ranging in age from 5 to 10 years.Methods:Rib cartilage and the healthy ear were assessed using low-dose multi-slice computed tomography.The lengths of the eighth rib cartilage and the helix of the healthy ear (from the helical crus to the joint of the helix and the earlobe) were measured.Surgery was performed when the two lengths were approximately equal.Results:The preoperative eighth rib measurements significantly correlated with the intraoperative measurements (P < 0.05).From 5 to 10 years of age,eighth rib growth was not linear.In 76 (62.8%) of 121 patients,the eighth rib length was approximately equal to the helix length in the healthy ear;satisfactory outcomes were achieved in these patients.In 18 (14.9%) patients,the eighth rib was slightly shorter than the helix,helix fabrication was accomplished by adjusting the length of the helical crus of stent,and satisfactory outcomes were also achieved.Acceptable outcomes were achieved in 17 (14.0%) patients in whom helix fabrication was accomplished by cartilage splicing.In 9 (7.4%) patients with insufficient rib cartilage length,the operation was delayed.In one (0.8%) patient with insufficient rib cartilage length,which left no cartilage for helix splicing,the result was unsatisfactory.Conclusions:Eighth rib cartilage growth is variable.Rib cartilage assessment relative to the healthy ear can guide auricular reconstruction and personalize treatment in young patients with microtia.

  10. Efficacy and safety of VEPTR instrumentation for progressive spine deformities in young children without rib fusions.

    Science.gov (United States)

    Hasler, Carol-Claudius; Mehrkens, Arne; Hefti, Fritz

    2010-03-01

    This retrospective study analyses 23 children treated with vertical expandable prosthetic titanium rib (VEPTR) for correction of non-congenital early onset spine deformities. After the index procedure (IP), the device was lengthened at 6-month intervals. The average (av) age at the time of IP was 6.5 years (1.11-10.5). The av follow-up time was 3.6 years (2-5.8). Diagnosis included 1 early onset idiopathic scoliosis, 11 neuromuscular, 2 post-thoracotomy scoliosis, 1 Sprengel deformity, 2 hyperkyphosis, 1 myopathy and 5 syndromic. Surgeries (187) included 23 IPs, av 6.5 (4-10) device expansions per patient (149) and 15 unplanned surgeries. 23 complications (0.13 per surgery) included 10 skin sloughs, 5 implant dislocations, 2 rod breakages and 6 infections. Coronal Cobb angle was av 68 degrees (11 degrees -111 degrees ), at follow-up av 54 degrees (0 degrees -105 degrees). Pelvic obliquity was av 33 degrees (13 degrees -60 degrees ), at follow-up av 16 degrees (0 degrees -42 degrees ). T1 tilt was av 29 degrees (5 degrees -84 degrees ), two remained unchanged, the remainder improved 10 degrees -68 degrees. Sagittal plane: All but two had stable profiles, two hyperkyphosis of 110 degrees /124 degrees improved to 56 degrees /86 degrees. Space available for lung ratio was less than 90% in ten before the IP, improved in nine and deteriorated in one. Originally designed for thoracic insufficiency syndromes related to rib and vertebral anomalies, VEPTR proved to be a valuable alternative to dual growing rods for non-congenital early onset spine deformities. The complication rate was lower, the control of the sagittal plane and the pelvic obliquity was as good, but the correction of the coronal plane deformity was less than growing rods. However, VEPTR's spine-sparing approach might provoke less spontaneous spinal fusion and ease the final correction at maturity.

  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...

  12. 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.

  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. Sternum Length and Rib Cage Dimensions Compared with Bodily Proportions in Adults with Cystic Fibrosis

    Directory of Open Access Journals (Sweden)

    Louis-Philippe Laurin

    2012-01-01

    Full Text Available BACKGROUND: A greater structural expansion of the rib cage in females compared with males has been described in cystic fibrosis (CF patients; however, conflicting data exist as to whether an elongation of the bony ribs and sternum contributes to this expansion.

  15. The use of nylon cable ties to repair rib fractures in neonatal foals.

    Science.gov (United States)

    Downs, Chris; Rodgerson, Dwayne

    2011-03-01

    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.

  16. Synostosis of first and second thoracic ribs: Anatomical and radiological assessment

    Directory of Open Access Journals (Sweden)

    Gupta V

    2009-10-01

    Full Text Available An unusual specimen showing synostosis of left sided first and second ribs was encountered during scanning of bones in anatomy department. The ribs were partially fused in the region of their neck and tubercles, and displayed an osseous tunnel. The tunnel measured 1.2 cm in length and was directed anterolaterally. The shaft of first rib imperceptibly blended with that of the second and resulted in obliteration of first intercostal space. The maximum width of this conjoint shaft was 3.6 cm. Superior surface of the rib specimen was marked by a large muscular impression for scalenus medius muscle. The groove for subclavian artery on the superior surface of first rib was prominent. The anterior end of the second rib and a portion of its shaft were separated from the anterior end of first rib by a V-shaped notch. The radiograph of the specimen confirmed the presence of a tunnel between the fused portions of neck and tubercle. Such skeletal abnormalities may be associated with segmentation defects of bony tissues and variations in the disposition of neurovascular structures, thus rendering them vulnerable to compression at the thoracic outlet. The fused ribs affect the chest wall expansion and may result in respiratory complications. Precise knowledge and awareness of such anomalies is important for clinicians, especially for thoracic surgeons and radiologists.

  17. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Science.gov (United States)

    Seng, Piseth; Alliez, Antoine; Honnorat, Estelle; Menard, Amelie; Casanova, Dominique; Stein, Andreas

    2014-01-01

    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. PMID:26793446

  18. 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.

  19. 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

  20. Late-onset chest wall abscess due to a biodegradable rib pin infection after lung transplantation.

    Science.gov (United States)

    Goda, Yasufumi; Chen-Yoshikawa, Toyofumi F; Kusunose, Masaaki; Hamaji, Masatsugu; Motoyama, Hideki; Hijiya, Kyoko; Aoyama, Akihiro; Date, Hiroshi

    2017-03-17

    A 55-year-old man with end-stage emphysema underwent a right single-lung transplantation through a posterolateral thoracotomy. The fifth rib was divided and fused back using a biodegradable pin made of polylactide acid and hydroxyapatite. Two weeks postoperatively, he suffered from central vein catheter-related sepsis due to methicillin-sensitive Staphylococcus aureus. After being successfully treated for sepsis, he was discharged. However, 3 months later, computed tomography revealed multiple loculated abscesses in the chest wall and the right pleural space. Reoperative thoracotomy revealed abscesses mainly located around the fifth rib, where the pin was inserted. Both cultures of the abscess and the fifth rib were positive for methicillin-sensitive S. aureus, which suggested that the rib pin was the cause of the secondary infection. This case suggests the rib pins, even if they are biodegradable, could have a risk of infections side effect especially for the immunosuppressed patients.

  1. Control of Separating Flow Behind a Step by Means of Slotted Ribs

    Science.gov (United States)

    D'yachenko, A. Yu.; Zhdanov, V. L.; Smul'skii, Ya. I.; Terekhov, V. I.

    2017-05-01

    One of the promising and simplest methods of passively controlling separating flow behind a backward-facing step with the aid of slotted ribs is considered. The size and number of slots were varied in wide ranges in experiments so that the relative area of the slots amounted to R = Fs/Fr = 0-1. The influence of the longitudinal vortices induced by the teeth in a rib on the distribution of pressure and heat transfer rate in the recirculation region in the case of varying the sizes of slots in a rib, the spacing between them, and the position of the rib relative to the backwardfacing step has been studied. The effectiveness of using slotted ribs for reducing the length and intensity of the region of reverse flow behind the step is shown.

  2. Lateral Thoracic Osteoplastic Rib-Sparing Technique Used for Lateral Spine Surgery: Technical Note.

    Science.gov (United States)

    Moisi, Marc; Fisahn, Christian; Tubbs, R Shane; Page, Jeni; Rice, Richard; Paulson, David; Kazemi, Noojan; Hanscom, David; Oskouian, Rod J

    2016-07-05

    Of patients who have undergone lateral approaches to the thoracic spine, surgical site postoperative pain appears to be greater among those who have undergone transection and removal of a rib segment than those who have not. Therefore, techniques that conserve anatomical position and minimize tissue disruption would theoretically result in less pain and a quicker recovery. Herein, we describe a rib-sparing osteoplastic technique used when rib segments need to be displaced in order to create an unobscured corridor to the operative target. Our approach minimizes soft tissue disruption and restores the anatomical function of the rib. Based on our experience, these patients report less pain, mobilize earlier, and are discharged sooner than those who have had rib segments sacrificed as part of a lateral approach to the spine.

  3. Recognition of a rare intrathoracic rib with computed tomography: a case report.

    Science.gov (United States)

    Abdollahifar, Mohammad-Amin; Abdi, Shabnam; Bayat, Mohammad; Masteri Farahani, Reza; Abbaszadeh, Hojjat-Allah

    2017-03-01

    One of the uncommon congenital variations is intrathoracic rib which a normal, a bifid, or an accessory rib lies within the thoracic cavity that is founded accidentally. Clinically, in most cases they are without symptoms; however, it may cause intrathoracic problems therefore it is important for radiologists and physicians to identify to prevent of excessive intervention and treatment during imaging diagnostic techniques of thoracic problems. In this report, we provide the case of a rare presentation of an intrathoracic rib in a 3-year-old boy arising from the inferior portion of a second rib based on findings from computed tomography. To our knowledge, this is only the second reported case of this type of intrathoracic rib that demonstrated with computed tomography.

  4. 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.

  5. [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.

  6. Lateral Thoracic Osteoplastic Rib-Sparing Technique Used for Lateral Spine Surgery: Technical Note

    Science.gov (United States)

    Fisahn, Christian; Tubbs, R. Shane; Page, Jeni; Rice, Richard; Paulson, David; Kazemi, Noojan; Hanscom, David; Oskouian, Rod J

    2016-01-01

    Of patients who have undergone lateral approaches to the thoracic spine, surgical site postoperative pain appears to be greater among those who have undergone transection and removal of a rib segment than those who have not. Therefore, techniques that conserve anatomical position and minimize tissue disruption would theoretically result in less pain and a quicker recovery. Herein, we describe a rib-sparing osteoplastic technique used when rib segments need to be displaced in order to create an unobscured corridor to the operative target. Our approach minimizes soft tissue disruption and restores the anatomical function of the rib. Based on our experience, these patients report less pain, mobilize earlier, and are discharged sooner than those who have had rib segments sacrificed as part of a lateral approach to the spine. PMID:27551648

  7. Modification of the rib operon derived from Bacillus subtilis and its expression in Escherichia coli

    Institute of Scientific and Technical Information of China (English)

    Zhang Huitu; Meng Kun; Wang Yaru; Luo Huiying; Yuan Tiezheng; Yang Peilong; Bai Yingguo; Yao Bin; Fan Yunliu

    2007-01-01

    A riboflavin operon(rib operon)derived from Bacillus subtilis 368 was modified on structure and the resulting operons were expressed in various strains of Escherichia coli. The results showed that the optimization of the rib operon and the host strain used for expression are two main factors affecting the riboflavin production. Replacing the promoter l and rfn box of the rib operon with a strong constructive promoter spo l drastically increased the expression of the rib genes. When E. Coli JMl09 was used as the host strain, the highest riboflavin production reached 95.3μg/mL(about eight times higher than that 0f the unmodified rib operon). In addition, when tetracycline(20 μg/mL)was used as the selective pressure, compared with the ampicillin resistant transformants, a higher riboflavin yield Was obtained in tetracycline resistant host strain.

  8. 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

  9. 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.

  10. 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.

  11. The biomechanics of human ribs: material and structural properties from dynamic tension and bending tests.

    Science.gov (United States)

    Kemper, Andrew R; McNally, Craig; Pullins, Clayton A; Freeman, Laura J; Duma, Stefan M; Rouhana, Stephen M

    2007-10-01

    The purpose of this study was to quantify both the tensile material properties and structural response of human ribs in order to determine which variables contribute to regional variation in the strength of human ribs. This was done by performing 94 matched tests on human rib specimens; 46 tension coupon tests, 48 three-point bending tests. Contralateral matched specimens were dissected from anterior and lateral regions of ribs 4 through 7 of six male fresh frozen post mortem human subjects ranging from 42 to 81 years of age. Tension coupons were taken from one side of the thorax, while three-point bending specimens were taken from the opposite side as the tension coupons at corresponding anatomical locations. The results of the tension coupon testing showed that there were no significant differences with respect to region or rib level: ultimate stress (p=0.90; p=0.53), ultimate strain (p=0.49; p=0.86), or modulus (p=0.72; p=0.81). In contrast, lateral three-point bending specimens were found to have a significantly higher peak bending moment (pbending specimens also had a significantly larger area moment of inertia (pradius of gyration (pradius of gyration (p=0.04) were found to be significantly different with respect to rib level. For lateral specimens, the area moment of inertia (pradius of gyration (p=0.03) were found to be significantly different with respect to rib level. These results clearly illustrate that there is variation in the structural response of human ribs with respect to anatomical region and rib level and this variation is due to changes in local geometry of each rib while the material properties remain constant.

  12. 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.

  13. Comparison of Numerical and Experimental Studies for Flow-Field Optimization Based on Under-Rib Convection in Polymer Electrolyte Membrane Fuel Cells

    Directory of Open Access Journals (Sweden)

    Nguyen Duy Vinh

    2016-10-01

    Full Text Available The flow-field design based on under-rib convection plays an important role in enhancing the performance of polymer electrolyte membrane fuel cells (PEMFCs because it ensures the uniform distribution of the reacting gas and the facilitation of water. This research focused on developing suitable configurations of the anode and cathode bipolar plates to enhance the fuel cell performance based on under-rib convection. The work here evaluated the effects of flow-field designs, including a serpentine flow field with sub channel and by pass and a conventional serpentine flow-field on single-cell performance. Both the experiment and computer simulation indicated that the serpentine flow field with sub channel and by pass (SFFSB configuration enables more effective utilization of the electrocatalysts since it improves reactant transformation rate from the channel to the catalyst layer, thereby dramatically improving the fuel cell performance. The simulation and experimental results indicated that the power densities are increased by up to 16.74% and 18.21%, respectively, when applying suitable flow-field configurations to the anode and cathode bipolar plates. The findings in this are the foundation for enhancing efficient PEMFCs based on flow field design.

  14. Natural merodiploidy of the lux-rib operon of Photobacterium leiognathi from coastal waters of Honshu, Japan.

    Science.gov (United States)

    Ast, Jennifer C; Urbanczyk, Henryk; Dunlap, Paul V

    2007-09-01

    Sequence analysis of the bacterial luminescence (lux) genes has proven effective in helping resolve evolutionary relationships among luminous bacteria. Phylogenetic analysis using lux genes, however, is based on the assumptions that the lux genes are present as single copies on the bacterial chromosome and are vertically inherited. We report here that certain strains of Photobacterium leiognathi carry multiple phylogenetically distinct copies of the entire operon that codes for luminescence and riboflavin synthesis genes, luxCDABEG-ribEBHA. Merodiploid lux-rib strains of P. leiognathi were detected during sequence analysis of luxA. To define the gene content, organization, and sequence of each lux-rib operon, we constructed a fosmid library of genomic DNA from a representative merodiploid strain, lnuch.13.1. Sequence analysis of fosmid clones and genomic analysis of lnuch.13.1 defined two complete, physically separate, and apparently functional operons, designated lux-rib1 and lux-rib2. P. leiognathi strains lelon.2.1 and lnuch.21.1 were also found to carry lux-rib1 and lux-rib2, whereas ATCC 25521T apparently carries only lux-rib1. In lnuch.13.1, lelon.2.1, lnuch.21.1, and ATCC 25521T, lux-rib1 is flanked upstream by lumQ and putA and downstream by a gene for a hypothetical multidrug efflux pump. In contrast, transposase genes flank lux-rib2 of lnuch.13.1, and the chromosomal location of lux-rib2 apparently differs in lnuch.13.1, lelon.2.1, and lnuch.21.1. Phylogenetic analysis demonstrated that lux-rib1 and lux-rib2 are more closely related to each other than either one is to the lux and rib genes of other bacterial species, which rules out interspecies lateral gene transfer as the origin of lux-rib2 in P. leiognathi; lux-rib2 apparently arose within a previously unsampled or extinct P. leiognathi lineage. Analysis of 170 additional strains of P. leiognathi, for a total of 174 strains examined from coastal waters of Japan, Taiwan, the Philippine Islands, and

  15. Natural Merodiploidy of the lux-rib Operon of Photobacterium leiognathi from Coastal Waters of Honshu, Japan▿ †

    Science.gov (United States)

    Ast, Jennifer C.; Urbanczyk, Henryk; Dunlap, Paul V.

    2007-01-01

    Sequence analysis of the bacterial luminescence (lux) genes has proven effective in helping resolve evolutionary relationships among luminous bacteria. Phylogenetic analysis using lux genes, however, is based on the assumptions that the lux genes are present as single copies on the bacterial chromosome and are vertically inherited. We report here that certain strains of Photobacterium leiognathi carry multiple phylogenetically distinct copies of the entire operon that codes for luminescence and riboflavin synthesis genes, luxCDABEG-ribEBHA. Merodiploid lux-rib strains of P. leiognathi were detected during sequence analysis of luxA. To define the gene content, organization, and sequence of each lux-rib operon, we constructed a fosmid library of genomic DNA from a representative merodiploid strain, lnuch.13.1. Sequence analysis of fosmid clones and genomic analysis of lnuch.13.1 defined two complete, physically separate, and apparently functional operons, designated lux-rib1 and lux-rib2. P. leiognathi strains lelon.2.1 and lnuch.21.1 were also found to carry lux-rib1 and lux-rib2, whereas ATCC 25521T apparently carries only lux-rib1. In lnuch.13.1, lelon.2.1, lnuch.21.1, and ATCC 25521T, lux-rib1 is flanked upstream by lumQ and putA and downstream by a gene for a hypothetical multidrug efflux pump. In contrast, transposase genes flank lux-rib2 of lnuch.13.1, and the chromosomal location of lux-rib2 apparently differs in lnuch.13.1, lelon.2.1, and lnuch.21.1. Phylogenetic analysis demonstrated that lux-rib1 and lux-rib2 are more closely related to each other than either one is to the lux and rib genes of other bacterial species, which rules out interspecies lateral gene transfer as the origin of lux-rib2 in P. leiognathi; lux-rib2 apparently arose within a previously unsampled or extinct P. leiognathi lineage. Analysis of 170 additional strains of P. leiognathi, for a total of 174 strains examined from coastal waters of Japan, Taiwan, the Philippine Islands, and

  16. External rib structure can be predicted using mathematical models: An anatomical study with application to understanding fractures and intercostal muscle function.

    Science.gov (United States)

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

    2015-05-01

    As ribs adapt to stress like all bones, and the chest behaves as a pressure vessel, the effect of stress on the ribs can be determined by measuring rib height and thickness. Rib height and thickness (depth) were measured using CT scans of seven rib cages from anonymized cadavers. A Finite Element Analysis (FEA) model of a rib cage was constructed using a validated approach and used to calculate intramuscular forces as the vectors of both circumferential and axial chest wall forces at right angles to the ribs. Nonlinear quadratic models were used to relate rib height and rib thickness to rib level, and intercostal muscle force to vector stress. Intercostal muscle force was also related to vector stress using Pearson correlation. For comparison, rib height and thickness were measured on CT scans of children. Rib height increased with rib level, increasing by 13% between the 3rd and 7th rib levels, where the 7th/8th rib was the widest part or "equator" of the rib cage, P Intercostal muscle force was significantly related to vector stress, Pearson correlation r = 0.944, P = 0.005. The three nonlinear quadratic models developed all had statistically significant parameter estimates with P intercostal muscle force, showing that environmental factors affect external rib morphology. © 2015 Wiley Periodicals, Inc.

  17. [Desmoplastic fibroma of the rib: two case reports].

    Science.gov (United States)

    Ayadi-Kaddour, Aïda; Ben Slama, Sana; Braham, Emna; Abid, Leila; Ismail, Olfa; Smati, Belhassen; Djilani, Habiba; El Mezni, Faouzi

    2005-10-01

    Desmoplastic fibroma is a very rare primary tumor of bone, closely related to aggressive fibromatosis of soft tissue. Although considered a benign lesion, it can be very aggressive locally and has a high rate of local recurrence after incomplete surgical excision. Radiologically, the lesion shows no distinctive features, often simulating osteosarcoma, fibrous dysplasia, or fibrosarcoma. Rib involvement by desmoplastic fibroma is extremely rare. We present two cases of desmoplastic fibroma involving this unusual location with lytic costal lesion and chest wall extension. Histological examination after surgical resection revealed that the tumor consisted of spindle cells with small, elongated nuclei in a background of numerous collagen fibers and infiltrating lamellar bone. There was no evidence of nuclear atypia, mitotic activity, or necrosis. We also discuss histological differential diagnosis as well as clinical features and the radiological and pathologic findings of this rare disease. Recognition of this entity is important to ensure proper surgical treatment.

  18. 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.)

  19. Structure optimization of polymeric Mach-Zehnder rib waveguide

    Institute of Scientific and Technical Information of China (English)

    LU Rong-guo; LiU Yong-zhi; LIAO Jin-kun; LIAO Yi-tao; HAN Wen-jie

    2007-01-01

    A systematic analysis of the polymeric Mach-Zehnder rib waveguide is presented based on the calculation and optimization. The simulation is carried out with the Effective Index Method (EIM) and two-dimensional (2-D)Finite Difference Beam Propagation Method (FD-BPM). The large refractive index step between the consecutive polymer layers is reduced by using EIM and thus the precision of the calculation is ensured. The important parameters of the waveguide such as Y-junction angle and the separation gap are discussed and their relationships with the optical power propagation and the loss characteristics are investigated in this paper. The total loss of the optimized structure is 0.258 dB.

  20. Structural efficiency study of composite wing rib structures

    Science.gov (United States)

    Swanson, Gary D.; Gurdal, Zafer; Starnes, James H., Jr.

    1988-01-01

    A series of short stiffened panel designs which may be applied to a preliminary design assessment of an aircraft wing rib is presented. The computer program PASCO is used as the primary design and analysis tool to assess the structural efficiency and geometry of a tailored corrugated panel, a corrugated panel with a continuous laminate, a hat stiffened panel, a blade stiffened panel, and an unstiffened flat plate. To correct some of the shortcomings in the PASCO analysis when shear is present, a two step iterative process using the computer program VICON is used. The loadings considered include combinations of axial compression, shear, and lateral pressure. The loading ranges considered are broad enough such that the designs presented may be applied to other stiffened panel applications. An assessment is made of laminate variations, increased spacing, and nonoptimum geometric variations, including a beaded panel, on the design of the panels.

  1. Interactive Simulation of Diaphragm Motion Through Muscle and Rib Kinematics

    Science.gov (United States)

    Villard, Pierre-Frédéric; Bourne, Wesley; Bello, Fernando

    Modeling of diaphragm behaviour is of relevance to a number of clinical procedures such as lung cancer radiotherapy and liver access interventions. The heterogeneity in tissue composition of the diaphragm, as well as the various physiological phenomena influencing its behaviour, requires a complex model in order to accurately capture its motion. In this chapter we present a novel methodology based on a heterogenous model composed of mass-spring and tensegrity elements. The physiological boundary conditions have been carefully taken into account and applied to our model. Thus, it incorporates the influence of the rib kinematics, the muscle natural contraction/relaxation and the motion of the sternum. Initial validation results show that the behaviour of the model closely follows that of a real diaphragm.

  2. Posterior Correction Without Rib-head Resection for Patients With Neurofibromatosis Type 1, Dystrophic Scoliosis, and Rib-head Protrusion Into the Spinal Canal.

    Science.gov (United States)

    Cai, Siyi; Zhang, Jianguo; Shen, Jianxiong; Zhao, Hong; Weng, Xisheng; Qiu, Guixing

    2017-02-01

    A retrospective study. The objective of this study is to report the result of patients with neurofibromatosis type 1(NF-1), dystrophic scoliosis, and rib-head protrusion into the spinal canal who received posterior scoliosis correction surgery without rib-head resection. A total of 124 patients with NF-1 and dystrophic scoliosis were treated at our institution during the study period. Eight patients with a median age of 12 years had rib-head protrusion into the spinal canal and received surgery and were included in the analysis. All 8 patients (6 male, 2 female) were treated from 2003 to 2013 and received posterior correction with a pedicle screw-rod 3-dimensional correction system or screw-hook hybrid system. Scoliosis correction rate and percentage of spinal canal occupied by the rib head were analyzed. The median patient age, number of segments fused, and follow-up duration were 12 years, 10.5, and 22.5 months, respectively. There were no surgery-related complications, and symptoms in all patients improved after surgery. The median postoperative and 1-year follow-up sagittal kyphotic angles were significantly smaller as compared with the preoperative value (28.5 and 31 vs. 62.5 degrees, P=0.012). The median postoperative coronal Cobb angle of the main thoracic curve was significantly smaller compared with the preoperative value (29 vs. 64.5 degrees, P=0.012). The median percentage of the spinal canal occupied by the intraspinal rib was significantly lower at 1-year follow-up compared with the preoperative value (23.1% vs. 28.6%, P=0.018). Posterior correction without rib-head excision can provide good outcomes for patients with NF-1 and dystrophic scoliosis and rib-head protrusion into the spinal canal.

  3. [Intrapleural catheter analgesia in patients with multiple rib fractures].

    Science.gov (United States)

    Wulf, H; Jeckström, W; Maier, C; Winckler, K

    1991-01-01

    Patients with multiple rib fractures often suffer from severe pain that impairs their respiratory performance. The effect of interpleural administration of bupivacaine (20 ml 0.25% every 4 h) for pain management was evaluated in ten patients. The initial interpleural injection resulted in significant pain relief and improvement of arterial oxygen tension. Two patients needed additional i.v. injections of opioids (piritramide 15-22.5 mg/24 h). In one patient a small asymptomatic pneumothorax was observed following placement of the catheter, which resolved spontaneously. No other complications were reported. In an intraindividual comparison, bupivacaine alone and bupivacaine plus epinephrine 1:200,000 were compared with regard to pharmacokinetics of bupivacaine, analgesic effect, side effects, and respiratory performance. The addition of epinephrine yielded only minor advantages from a pharmacokinetic point of view (median peak concentration of bupivacaine 1.8 micrograms/ml vs 2.0 micrograms/ml for bupivacaine alone). The quality and duration of analgesia and the effects on respiration were not influenced by epinephrine. The heart rate was significantly higher and the blood pressure significantly lower when epinephrine was added to the solution. Nevertheless, these differences were too small to be of clinical importance. Even though maximum total plasma concentrations of bupivacaine above 2 micrograms/ml were found in some patients, there were no signs of CNS toxicity, most probably because of the increased protein binding of bupivacaine following trauma. Accordingly, the maximum free plasma concentrations in all patients were below the threshold level of 0.24 micron/ml. We therefore conclude tht interpleural administration of bupivacaine could be a valuable means of pain relief in patients with multiple rib fractures, providing no severe pulmonary contusions or concomitant injuries are present.

  4. Physical mechanisms of active control of sound transmission through rib stiffened double-panel structure

    Science.gov (United States)

    Ma, Xiyue; Chen, Kean; Ding, Shaohu; Yu, Haoxin

    2016-06-01

    This paper presents an analytical investigation on physical mechanisms of actively controlling sound transmission through a rib stiffened double-panel structure using point source in the cavity. The combined modal expansion and vibro-acoustic coupling methods are applied to establish the theoretical model of such active structure. Under the condition of minimizing radiated power of the radiating ribbed plate, the physical mechanisms are interpreted in detail from the point of view of modal couplings similar as that used in existed literatures. Results obtained demonstrate that the rule of sound energy transmission and the physical mechanisms for the rib stiffened double-panel structure are all changed, and affected by the coupling effects of the rib when compared with the analytical results obtained for unribbed double-panel case. By taking the coupling effects of the rib into considerations, the cavity modal suppression and rearrangement mechanisms obtained in existed investigations are modified and supplemented for the ribbed plate case, which gives a clear interpretation for the physical nature involved in the active rib stiffened double-panel structure.

  5. Fundamentally excited flow past a surface-mounted rib. Part I: Turbulent structure characterisation

    Indian Academy of Sciences (India)

    P K Panigrahi

    2001-10-01

    Different data analysis techniques for characterisation of the turbulent flow past a surface-mounted rib are reviewed. Deficiencies of the existing techniques are explained and modified techniques for determination of coherent structure magnitude and phase jitter are suggested. The effect of fundamental excitation on the flow is studied by using these turbulent signal analysis techniques. The appropriate length scale for characterizing the large-scale structures present in the reattaching shear layer of the surface-mounted rib is found to be the momentum thickness at the downstream edge of the rib, and the corresponding Strouhal number is 0.013. This is in contrast to a rib in the free stream, where the rib height is the correct scaling parameter. The post reattachment region is observed to be dominated by large-scale structures contrary to the traditional belief that large eddies break into small scales at the reattachment location. Low magnitude of phase jitter in the near field region is observed, indicating coherence of the flow structures. Phase decorrelation begins to occur beyond three rib heights from the downstream edge of the rib. From the quadrant analysis results, the outer edge of the shear layer is observed to be dominated by large-scale ejection motions.

  6. FIRST RIB STRESS FRACTURE IN A SIDEARM BASEBALL PITCHER: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Takeshi Sakata

    2005-06-01

    Full Text Available Stress fractures of the first rib in athletes are rare. A 14-year-old male, a baseball pitcher who changed from an overhand to a sidearm style, with a stress fracture of the first rib, was reported. Most Stress fractures in the first rib occur at the subclavian groove, between the attachments of the scalenus anterior and scalenus medius muscles, which is the thinnest and weakest portion of the rib. However, in this case the stress fracture occurred at the uncommon region, posterior to the insertion of the scalenus medius muscle, in the first rib. The motion analysis of the pitching in this case demonstrated that the sidearm style induced much more horizontal abduction in the shoulder at the top position than did the overhand style. The findings of electromyography in the serratus anterior muscle, one of the muscles which insert on the first rib, through the pitching motion did not demonstrate any significant differences between the two styles. In this case, the repetition of horizontal over-abduction of the shoulder when sidearm pitching appears to have been the cause of the unusual stress fracture of the first rib at this site

  7. Rib Composite Flap With Intercostal Nerve and Internal Thoracic Vessels for Mandibular Reconstruction.

    Science.gov (United States)

    Zhang, Bin; Li, Ke-Yi; Jiang, Li-Cheng; Meng, Zhen; Wang, Xiu-Mei; Cui, Fu-Zhai; Zhu, Ying-Nan; Wu, Ya-Ping

    2016-10-01

    The purpose of this study was to present the outcome and discuss the feasibility of rib composite flap with intercostal nerve and internal thoracic vessels for reconstructing mandibular defect. Rib composite flaps have been used in 82 patients for reconstructing benign tumor-caused large mandibular defects: 66 of the 82 patients were reconstructed using rib composite flap with intercostal nerve and internal thoracic vessels, whereas the other 16 patients were reconstructed using rib composite flap with internal thoracic vessels, without intercostal nerve. After operation, clinical observation, imageological examination, and sensory detection were used to evaluate the effect of reconstruction. All rib composite flaps with intercostal nerve and internal thoracic vessels were successfully harvested and transplanted. Both immediate and long-term examination showed good appearance reconstruction. All followed-up patients conveyed good satisfaction degree with function and appearance reconstruction. Postoperative panoramic x-ray examination showed new bone formation between the transplanted rib and mandibular stump. Good recoveries of mandibular nerve sensory were observed when followed up after reconstruction surgery. Rib composite flap with intercostal nerve and internal thoracic vessels could be a promising method for reconstruction of mandibular defects.

  8. The effects of longitudinal ribs on entropy generation for laminar forced convection in a microchannel

    Directory of Open Access Journals (Sweden)

    Pourmahmoud Nader

    2016-01-01

    Full Text Available This paper deals with fluid flow, heat transfer and entropy generation in an internally ribbed microchannel. Mass, momentum and energy equations for constant heat flux boundary condition are solved using the finite volume method. Average Nusselt number and Fanning friction factor are reported as a function of rib height at different Reynolds numbers. The effects of non-dimensional rib height, wall heat flux and the Reynolds number on the entropy generation attributed to friction, heat transfer and total entropy generation are explored. The first law indicates that rib height has the great effect on the flow filed and heat transfer. The second law analysis reveals that for any values of Reynolds number and wall heat flux, as rib height grows; the frictional irreversibility increases while, there is a rib height which provides the minimum heat transfer irreversibility. It is found that the optimum rib height with the minimum total entropy generation rate depends on Reynolds number and wall heat flux.

  9. Heat transfer and pressure drop in an annular channel with downflow

    Science.gov (United States)

    Dolan, F. X.; Crowley, C. J.; Qureshi, Z. H.

    The onset of a flow instability (OFI) determines the minimum flow rate for cooling in the flow channels of a nuclear fuel assembly. A test facility was constructed with full-scale models (length and diameter) of annular flow channels incorporating many instruments to measure heat transfer and pressure drop with downflow in the annulus. Tests were performed both with and without axial centering ribs at prototypical values of pressure, flow rate and uniform wall heat flux. The axial ribs have the effect of subdividing the annulus into quadrants, so the problem becomes one of parallel channel flow, unlike previous experiments in tubes (upflow and downflow). Other tests were performed to determine the effects if any of asymmetric and non-uniform circumferential wall heating, operating pressure level and dissolved gas concentration. Data from the tests are compared with models for channel heat transfer and pressure drop profiles in several regimes of wall heating from single-phase forced convection through partially and fully developed nucleate boiling. Minimum stable flow rates were experimentally determined as a function of wall heat flux and heat distribution and compared with the model for the transition to fully developed boiling which is a key criterion in determining the OFI condition in the channel. The heat transfer results in the channel without ribs are in excellent agreement with predictions from a computer model of the flow in the annulus and with empirical correlations developed from similar tests. The test results with centering ribs show that geometrical variations between the channels can lead to differences in subchannel behavior which can make the effect of the ribs and the geometry an important factor when assessing the power level at which the fuel assembly (and the reactor) can be operated to prevent overheating in the event of a loss-of-coolant-accident (LOCA).

  10. 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.

  11. 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.

  12. The Matrix Rib Plating System: improving aesthetic outcomes in microvascular breast reconstruction.

    Science.gov (United States)

    Ahdoot, Michael A; Echo, Anthony; Otake, Leo R; Son, Ji; Zeidler, Kamakshi R; Saadian, Isaac; Lee, Gordon K

    2013-04-01

    During microvascular breast reconstruction, exposure of internal mammary vessels (IMVs) is facilitated by the removal of a portion of the rib resulting in occasional chest contour deformity (CCD). The use of rib plating may reduce CCD and reduce postoperative pain. All patients underwent microvascular breast reconstruction using IMVs. In the retrospective arm, photographs were assessed by a blinded reviewer for CCDs. In the prospective cohort, patients were randomized to rib plating with the Synthes Matrix Rib Plating System or no rib plating. Postoperatively, patients were assessed for CCD and pain. In the retrospective arm, 11 of 98 (11.2%) patients representing 12 of 130 (9.2%) breast reconstructions had a noticeable contour deformity. The average body mass index (BMI) of patients with CCDs was 26.6 kg/m. In the prospective arm, there was 16% (3 of 19) rate of visible and palpable CCDs among controls, compared to 0% rate of palpable and visible contour deformity in the rib plating group. Pain was decreased in the rib plating group on all postoperative days. The pain reduction was statistically significant at rest by postoperative day 30. The majority of patients (9 of 11) with compromised aesthetic outcomes had a BMI less than 30 kg/m, suggesting a paucity of overlying soft tissue contributed to visibility of these bony defects. Rib plating prevented chest contour deformity, reduced postoperative pain, and added limited additional morbidity. We believe that rib plating is a safe, useful adjunct to microvascular breast reconstruction using IMVs, as it may improve aesthetic outcomes and reduce postoperative pain.

  13. Rib overgrowth may be a contributing factor for pectus excavatum: Evaluation of prepubertal patients younger than 10years old.

    Science.gov (United States)

    Park, Chul Hwan; Kim, Tae Hoon; Haam, Seok Jin; Lee, Sungsoo

    2015-11-01

    We compared the costal cartilage and rib length between prepubertal patients with symmetric pectus excavatum and age- and sex-matched controls without anterior chest wall depression to evaluate if rib overgrowth is a contributing factor for pectus excavatum The sample included 18 prepubertal patients ribs and costal cartilage were measured using three-dimensional volume-rendered computed tomography and curved multiplanar reformatting techniques. The rib and costal cartilage lengths, total combined rib and costal cartilage length, and costal index ([length of cartilage/length of rib]×100 [%]) at the fourth to sixth levels were compared between the groups. The rib lengths in the patient group were significantly longer than in the control group for the 6th right rib and 4th, 5th, and 6th left ribs. The costal cartilage lengths and costal indices were not different between two groups. In patients with symmetric pectus excavatum aged ribs were longer than those of controls, suggesting that abnormal rib overgrowth may be a contributing factor responsible for pectus excavatum rather than cartilage overgrowth. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Langerhans Cell Histiocytosis of the Rib in an Adult: A Case Report

    Directory of Open Access Journals (Sweden)

    Sung Hyun Kim

    2016-01-01

    Full Text Available Single-site, single-system Langerhans cell histiocytosis (LCH of the rib is one of the rarest causes of bone tumor in adults. Herein, we report a case of a healthy 35-year-old male who presented with upper back pain that was attributed to a solitary osteolytic lesion at the posterolateral aspect of his sixth rib. For diagnostic confirmation and treatment, partial resection of the sixth rib was performed and pathologic finding was consistent with LCH. At the final follow-up after 2 years, no local recurrence or metastasis was observed.

  15. 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.

  16. Langerhans Cell Histiocytosis of the Rib in an Adult: A Case Report

    Science.gov (United States)

    Kim, Sung Hyun; Choi, Moon Young

    2016-01-01

    Single-site, single-system Langerhans cell histiocytosis (LCH) of the rib is one of the rarest causes of bone tumor in adults. Herein, we report a case of a healthy 35-year-old male who presented with upper back pain that was attributed to a solitary osteolytic lesion at the posterolateral aspect of his sixth rib. For diagnostic confirmation and treatment, partial resection of the sixth rib was performed and pathologic finding was consistent with LCH. At the final follow-up after 2 years, no local recurrence or metastasis was observed. PMID:26933424

  17. Solar swimming pool heating plants self-constructed with ribbed pipes

    Energy Technology Data Exchange (ETDEWEB)

    Pfenning, R.

    The solar absorber suitable for self-construction consists of ribbed pipes which can be joined together to units of any size with the help of simple plug connections. By using especially developed ribbed pipes for absorbing the insolation an increased surface and, moreover, a greater stability can be achieved. The material used for the ribbed pipes is a special polypropylene which is UV stable and resistant against all chemicals occurring in swimming pool water. The same is valid for the rubber parts of the plug connections which are made of EPDM.

  18. 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.)

  19. 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.)

  20. Evaluating the point of separation, during carcass fabrication, between the beef wholesale rib and the beef wholesale chuck.

    Science.gov (United States)

    Reuter, B J; Wulf, D M; Shanks, B C; Maddock, R J

    2002-01-01

    This study determined whether there is a logical point of value change, related to either tenderness or consumer acceptance, at which to separate the beef carcass within the rib/chuck region. Rib/chuck rolls (RCR); (n = 30) consisting of the ribeye roll and chuck eye roll subprimals (2nd through 12th rib locations) were cut into 22 steaks each (two steaks per rib location), and Warner-Bratzler shear force and consumer purchase preference were evaluated for steaks at each rib location. Steaks from different locations of the RCR were composed of differing proportions of several muscles: longissimus muscle (LM), spinalis dorsi and multifidus dorsi (SM), and complexus (CO). The LM (4th to 12th rib) contained three tenderness regions: 7th through 12th rib, 5th and 6th ribs, and 4th rib regions (lowest, intermediate, and highest shear force values, respectively; P consumers. Steaks (n = 330) were offered for sale at a retail supermarket and case time was monitored on each steak to determine consumer purchase preference. Steaks from the 2nd through 4th rib locations required more time to sell (P < 0.01) than steaks from the 5th through 12th rib locations. Two alternative locations for the rib/chuck separation point could be between the 6th and 7th ribs, yielding a ribeye subprimal useful in marketing a "premium quality" product, or between the 4th and 5th ribs, which would yield four more 2.5-cm ribeye steaks per carcass.

  1. Multislice computed tomography of the first rib: a useful technique for bone age assessment.

    Science.gov (United States)

    Moskovitch, Guillaume; Dedouit, Fabrice; Braga, José; Rougé, Daniel; Rousseau, Hervé; Telmon, Norbert

    2010-07-01

    Macroscopic study of the first rib has been described by Kunos et al. as an efficient method of age estimation. We retrospectively reviewed a test sample of 160 first right ribs obtained from multislice computed tomography (MSCT) clinical investigations of living individuals aged 15-30 years old. Based on the descriptions of Kunos et al., we analyzed the morphological appearance of the sternal end of the first rib on two- and three-dimensional MSCT reconstructions and defined changes in appearance in stages (from 2 to 5). We also studied the calcification and ossification of the costal cartilage as an independent feature. By statistical analysis (ANOVA), we determined for each gender the correlation between the estimated stage of the costal face, the appearance of the costal cartilage, and the documented age of the subjects. We demonstrated that MSCT of the first rib appears to be an efficient noninvasive modality for bone age estimation.

  2. 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

    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...... 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...... density may be a potential risk factor for the development of exercise-induced rib stress fractures in elite rowers....

  3. Modal density and modal distribution of bending wave vibration fields in ribbed plates

    DEFF Research Database (Denmark)

    Dickow, Kristoffer Ahrens; Brunskog, Jonas; Ohlrich, Mogens

    2013-01-01

    Plates reinforced by ribs or joists are common elements in lightweight building structures, as well as in other engineering structures such as vehicles, ships, and aircraft. These structures, however, are often not well suited for simple structural acoustic prediction models such as statistical...... energy analysis. One reason is that the modal density is not uniformly distributed due to the spatial periodicity introduced by the ribs. This phenomenon is investigated in the present paper, using a modal model of a ribbed plate. The modal model uses the Fourier sine modes, and the coupling between...... the plate and ribs is incorporated using Hamilton's principle. This model is then used to investigate the modal density of the considered spatially periodic structure, and a grouping of the modes in different dominating directions is proposed. Suggestions are also given regarding how to proceed towards...

  4. 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.

  5. Rib metastases from a non-tonsillar squamous cell carcinoma in a dog.

    Science.gov (United States)

    Clarke, B S; Mannion, P A; White, R A S

    2011-03-01

    Metastatic spread to the ribs in a 15-year-old, male, neutered, Irish setter is reported occurring secondary to an oral squamous cell carcinoma (SCC). The dog presented with a history of a rapidly growing SCC of the right upper incisive region, which was confirmed by histopathology as a SCC. Thoracic radiographs showed bony lesions associated with the body of the right third rib, and the fifth and seventh costal cartilages. A rostral partial maxillectomy was performed as palliative treatment for the oral mass and a core biopsy of the lesion on the third rib was performed. The rib lesion was identified histopathologically as a metastatic SCC. A review of the literature of oropharyngeal SCC and the metastatic potential of non-tonsillar SCC is presented, in particular metastatic bone disease. This case report suggests possible implications of metastatic bone disease for treatment and prognosis for future cases of non-tonsillar SCC.

  6. Natural replacement of vertically inherited lux-rib genes of Photobacterium aquimaris by horizontally acquired homologues.

    Science.gov (United States)

    Urbanczyk, Henryk; Furukawa, Takashi; Yamamoto, Yuki; Dunlap, Paul V

    2012-08-01

    We report here the first instance of a complete replacement of vertically inherited luminescence genes by horizontally acquired homologues. Different strains of Photobacterium aquimaris contain homologues of the lux-rib genes that have a different evolutionary history. Strain BS1 from the Black Sea contains a vertically inherited lux-rib operon, which presumably arose in the ancestor of this species, whereas the type strain NBRC 104633(T) , from Sagami Bay, lacks the vertically inherited lux-rib operon and instead carries a complete and functional lux-rib operon acquired horizontally from a bacterium related to Photobacterium mandapamensis. The results indicate that the horizontal acquisition of the lux genes expanded the pan-genome of P. aquimaris, but it did not influence the phylogenetic divergence of this species.

  7. 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.

  8. 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

  9. Numerical and experimental investigation of enhancement of heat transfer in dimpled rib heat exchanger tube

    Science.gov (United States)

    Kumar, Anil; Maithani, Rajesh; Suri, Amar Raj Singh

    2017-06-01

    In this study, numerical and experimental investigation has been carried out for a range of system and operating parameters in order to analyse the effect of dimpled rib on heat and fluid flow behaviours in heat exchanger tube. Tube has, stream wise spacing (x/d d ) range of 15-35, span wise spacing (y/d d ) range of 15-35, ratio of dimpled depth to print diameter (e/d d ) of 1.0 and Reynolds number (Re n ) ranges from 4000 to 28,000. Simulations were carried out to obtain heat and fluid flow behaviour of smooth and rough tube, using commercial CFD software, ANSYS 16.0 (Fluent). Renormalization k - ɛ model was employed to assess the influence of dimpled on turbulent flow and velocity field. Simulation results show that, the enhancement of 3.18 times in heat transfer and 2.87 times enhancement in thermal hydraulic performance as a function of stream wise direction (x/d d ) of 15 and span wise direction (y/d d ) of 15 respectively. Comparison between numerical and experimental simulation results showed that good agreement as the data fell within ±10% error band.

  10. Design of the IXO optics based on thin glass plates connected by reinforcing ribs

    Science.gov (United States)

    Parodi, G.; Martelli, F.; Basso, S.; Citterio, O.; Civitani, M.; Conconi, P.; Ghigo, M.; Pareschi, G.; Zambra, A.

    2011-09-01

    Effective area requirements for the large X-ray mirror of the International X-ray Observatory (IXO) are about 3 m2 at 1keV, 0.65 m2 at 6 keV and 150 cm2 at 30 keV. Because of its large dimension, the telescope cannot be realized as a monolithic structure but rather it requires the integration and assembly in the telescope optical bench of a number of basic module units, called X-ray Optical Unit (XOU). We are currently studying a method for the production of these basic units that is based on the slumping technology for the production of thin glass segmented mirrors. It foresees the implementation of a stacking integration concept based on the use of reinforcing ribs connecting the glass segments in order to create very stiff structures. This paper reports on the last design of the single optical module and describe the results of FEM analyses that show how it is possible to use an innovative approach to the integration of the slumped glass foils.

  11. Multi-Modal Treatment Approach to Painful Rib Syndrome: Case Series and Review of the Literature.

    Science.gov (United States)

    Germanovich, Andrew; Ferrante, Francis Michael

    2016-03-01

    Mechanical chest wall pain is a common presenting complaint in the primary care office, emergency room, and specialty clinic. Diagnostic testing is often expensive due to similar presenting symptoms that may involve the heart or lungs. Since the chest wall biomechanics are poorly understood by many clinicians, few effective treatments are offered to patients with rib-related acute pain, which may lead to chronic pain. This case series and literature review illustrates biomechanics involved in the pathogenesis of rib-related chest wall pain and suggests an effective multi-modal treatment plan using interventional techniques with emphasis on manual manipulative techniques. Case series and literature review. Pain clinic in an academic medical center. This is a case series of 3 patients diagnosed with painful rib syndrome using osteopathic palpatory physical examination techniques. Ultrasound-guided intercostal nerve blocks were followed by manual manipulation of mechanically displaced ribs as a part of our multi-modal treatment plan. A review of the literature was undertaken to clarify nomenclature used in the description of rib-related pain, to describe the biomechanics involved in the pathogenesis of mechanical rib pain, and to illustrate the use of effective manual manipulation techniques. This review is introductory and not a complete review of all manual or interventional pain management techniques applicable to the treatment of mechanical rib-related pain. Manual diagnostic and therapeutic skills can be learned by physicians to treat biomechanically complex rib-related chest wall pain in combination with interventional image-guided techniques. Pain physicians should learn certain basic manual manipulation skills both for diagnostic and therapeutic purposes.

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

    Science.gov (United States)

    Oldenborg, Sabine; Valk, Christel; van Os, Rob; Oei, Bing; Venselaar, Jack; Vörding, Paul Zum Vörde Sive; van Randen, Adriënne; Crezee, Hans; van Tienhoven, Geertjan; Rasch, Coen

    2016-04-01

    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.

  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

    2016-10-04

    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. 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 or younger. 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. Data for 1396 children 48 months or younger with rib fractures were abstracted from 10 articles. Among infants younger than 12 months, abuse prevalence ranged from 67% to 82%, whereas children 12 to 23 and 24 to 35 months old had study-specific abuse prevalences of 29% and 28%, respectively. Age younger than 12 months was the only characteristic significantly associated with increased likelihood of abuse across multiple studies. 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. Abuse is the most common cause of rib fractures in infants younger than 12 months. Prospective studies with standardized methods are needed to improve accuracy in determining abuse prevalence among children with rib fractures and characteristics associated with abusive rib fractures.

  14. Modified Interscalene Approach for Resection of Symptomatic Cervical Rib: Anatomic Review and Clinical Study.

    Science.gov (United States)

    Abdel Ghany, Walid; Nada, Mohamed A; Toubar, Ahmed F; Desoky, Ahmed E; Ibrahim, Hesham; Nassef, Marwa A; Mahran, Mostafa G

    2017-02-01

    Cervical ribs have been reported to be present in about 0.5% of the general population, 10% of patients with cervical rib who are symptomatic usually have neurogenic symptoms, but some have arterial symptoms. In 1861, Coote was the first to excise a cervical rib through a supraclavicular approach and relieved the symptoms of thoracic outlet syndrome. In this study, we address the efficacy and safety of a modification to the supraclavicular approach for resection of symptomatic cervical ribs. The surgical team in collaboration with an anatomist performed cadaveric dissections of the posterior triangle of the neck in the Department of Anatomy, Ain Shams University. A prospective study was performed of 25 patients with moderate to severe neck or upper limb pain; this pain was resistant to medical treatment for at least 6 months. Preoperative cervical radiography showed cervical ribs. Pain was assessed by using the visual analog scale. Electrophysiologic tests were performed to confirm the diagnosis. In this study, we performed a modified supraclavicular interscalene approach with resection of the symptomatic rib and without resecting either of the scalene muscles or the first thoracic rib. A total of 25 patients were included in this study; the mean age was 36 years (± 12 standard deviation), and the mean follow-up period was 12.3 months. All patients had moderate (28%) to severe (72%) preoperative pain. Motor deficits were present in 6 cases (24%); Sensory manifestations were present in 80%. All patients had a relief of severe pain at the first postoperative visit in the first week. There were improvements in the motor power in 5 of the 6 patients who had preoperative motor deficit. A modified supraclavicular interscalene approach for resection of symptomatic cervical ribs has been shown to be effective in the treatment of neuralgic pain. Compared with other approaches, it proved to be less invasive, with small transverse incision and without resection of scalenus

  15. 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.)

  16. The Prediction of Mass Loaded Natural Frequencies and Forced Response of Complex, Rib-Stiffened Structures.

    Science.gov (United States)

    1979-12-01

    NLS LX-2 Power Supply AFFDL/FBG + 15V DC Strobe Strobex 121 A Force Gauge Piezotronics 480 A Power Unit Low Frequency Electrodyne N 300 Oscillator i 9...UNLOADED (b) RIB STI FENED PANEL MODE SHAPE UNLOADED Fig. C-3 (a) View 1 M ode 3; (b) View 2 M ode 3 (191.22 Rz) 133 (a) RIB ST I FrEND PFOCL "IDE SHAPE

  17. 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.

  18. 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. PMID:23393600

  19. "Occult" rib fractures diagnosed on computed tomography scan only are still a risk factor for solid organ injury.

    Science.gov (United States)

    Bhattacharya, Bishwajit; Fieber, Jennifer; Schuster, Kevin; Davis, Kimberly; Maung, Adrian

    2015-01-01

    Prior to the widespread use of computed tomography (CT) scan imaging, lower rib fractures diagnosed on chest X-rays (CXRs) were considered a risk factor for abdominal solid organ injury (ASOI). However, CXRs miss about 50% of the rib fractures that are detected on CT scans. We hypothesized that these "occult" rib fractures would not be predictive for ASOI. Retrospective review of a level I trauma center's database identified all adult blunt trauma patients (n = 11,170) over a 5-year period. Data were abstracted for demographics, injury severity score, presence of ASOI, extremity, pelvic and spine fractures as well as presence and location of rib fractures. Rib fractures correlated with the presence of ASOI, regardless of whether they were diagnosed by CXR or CT scan alone (P rib fractures, especially, correlated with the presence of ipsilateral ASOI (P rib fractures than CXR, rib fractures remain a marker for increased likelihood of ASOI regardless of the modality by which they are diagnosed. Patients with rib fractures also have a greater incidence of spine and pelvic fractures. As the trauma community debates moving away from routine whole-body CT imaging towards a more selective approach, these results suggest that any clinical suspicion of rib fractures, despite a negative CXR, may warrant further investigation.

  20. DNS Study of the Turbulent Taylor-Vortex Flow on a Ribbed Inner Cylinder

    Directory of Open Access Journals (Sweden)

    Takahiro Tsukahara

    2013-01-01

    Full Text Available Turbulent Taylor-vortex flows over regularly spaced square ribs mounted on a rotating inner cylinder surface were investigated using direct numerical simulations (DNSs for a Reynolds number of 3200 (based on the inner-wall velocity and the gap width between two cylinders in an apparatus with an inner-to-outer radius ratio of 0.617, while varying the streamwise interval of the ribs. We examined the flow and pressure fields around each rib, focusing on the recirculation zone, the frictional drag coefficient, and the pressure (form drag. Our results for the Taylor-Couette flows were compared to DNS for plane Poiseuille flows over ribbed surfaces performed by Leonardi et al. (2003. We determined the qualitative consistency between them with respect to the roughness effect, which depends significantly on the rib interval, but the rate of increase in the flow resistance was remarkably dampened by roughness in the present flows. Taylor vortices remaining over roughened cylinder surfaces were found to induce quick pressure recovery behind each rib, leading to less pressure drag and an enhanced backflow in the recirculation zone.

  1. Correlating first- and second-rib fractures noted on spine computed tomography with major vessel injury.

    Science.gov (United States)

    Khosla, Ankaj; Ocel, Joseph; Rad, Arash Ehteshami; Kallmes, David F

    2010-11-01

    First- and second-rib fractures diagnosed on plain radiographs have been associated with traumatic aortic injury. We examined whether such fractures diagnosed on computed tomography (CT), which is of greater sensitivity than plain radiograms for rib fractures, are associated with traumatic vascular injury. We identified 1,894 patients who had undergone a chest CT angiogram with indication of trauma between 2005 and 2008. Among these, 185 patients were selected at random. The main mechanism of injury was motor vehicle accident or a fall. The patients were divided into two groups: patients with first- and/or second-rib fractures and those without. Proportions of patients with major vessel injury noted on CT angiography were compared between groups. Information regarding displacement of the fracture, location of the fracture, detection upon plain film, and gender of the patients was also evaluated and correlated with incidence of major vessel injury. Fisher's test and χ2 analysis were used to determine significance of the data. Incidence of major vessel injury was similar between patients with and without first- and/or second-rib fractures (7% vs. 9%, respectively; p = 0.59). No subset of type of rib fracture was associated with greater incidence of aortic injury. First- and second-fractures are not associated with greater incidence of aortic injury. Thus, the previous axiom that first- and second-rib fractures should result in increased examination for aortic injury may not hold true.

  2. Regional effects of ovariectomy and cadmium on bone mineral in ribs from aged female beagles

    Energy Technology Data Exchange (ETDEWEB)

    Hurst, D.R. (Miami Univ., Oxford, OH (USA). Dept. of Zoology)

    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 {sup 45}Ca labeled skeletons were divided into four groups: sham controls (SO{minus}); ovariectomized (OV{minus}); 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{sub 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 {sup 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{minus} and OV+ mid-rib regions had significantly lower dry and ash weights than SO{minus}. Total Ca contents of these same regions were also decreased in the OV{minus} and OV+. The only significant change in Ca/dry and Ca/ash was observed when comparing OV+ to SO{minus}. 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.

  3. Rib head protrusion into the central canal in type 1 neurofibromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Ton, Jimmy; Yen, Philip [University of California, Davis Medical Center and U.C. Davis Children' s Hospital, Department of Radiology, Sacramento, CA (United States); Stein-Wexler, Rebecca [University of California, Davis Medical Center and U.C. Davis Children' s Hospital, Department of Radiology, Sacramento, CA (United States); Shriners Hospital of Northern California, Department of Radiology, Sacramento, CA (United States); Gupta, Munish [University of California, Davis Medical Center and U.C. Davis Children' s Hospital, Department of Orthopedic Surgery, Sacramento, CA (United States); Shriners Hospital of Northern California, Department of Orthopedic Surgery, Sacramento, CA (United States)

    2010-12-15

    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.)

  4. Characterizing the dynamics of a flexible rod wrapped by transverse repeated ribs subjected to axial flow

    Energy Technology Data Exchange (ETDEWEB)

    Perets, Y., E-mail: yaronprts@gmail.com [Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva (Israel); Sher, E. [Faculty of Aerospace Engineering, Technion – Israel Institute of Technology, Haifa (Israel); Harari, R. [Nuclear Research Center – Negev (NRCN), Beer-Sheva (Israel)

    2014-04-01

    Highlights: • The dynamic instability of a repeated ribs cylindrical rod in annular axial flow geometry was studied. • The results indicate a strong dependency between rod instability and rib roughness. • The rod dynamics become stabilized when the pitch-to-height ratio of the ribs increases. • Increase of the rib width-to-height ratio destabilizes the rod. • The nonlinear model confirms the existence of post critical instability and the reliability of the linear results. - Abstract: This study focuses on the dynamics of a flexible cylindrical structure wrapped by repeated transverse rectangular ribs, in an annular flow geometry, under two boundary conditions: simply supported ends and clamped ends. The dynamics is predicted by linear and nonlinear theories. Based on the linear equation a straightforward nonlinear equation can be derived. A parametric investigation of the effect of the ribs’ dimensionless geometry characterized by the pitch-to-height and width-to-height ratios, on the fluid-elastic instability characteristics is considered. The results of the present study indicate a strong dependency between rod instability and rib roughness. The nonlinear model confirms the existence of post critical instability and the reliability of the linear results.

  5. Atlas-based rib-bone detection in chest X-rays.

    Science.gov (United States)

    Candemir, Sema; Jaeger, Stefan; Antani, Sameer; Bagci, Ulas; Folio, Les R; Xu, Ziyue; Thoma, George

    2016-07-01

    This paper investigates using rib-bone atlases for automatic detection of rib-bones in chest X-rays (CXRs). We built a system that takes patient X-ray and model atlases as input and automatically computes the posterior rib borders with high accuracy and efficiency. In addition to conventional atlas, we propose two alternative atlases: (i) automatically computed rib bone models using Computed Tomography (CT) scans, and (ii) dual energy CXRs. We test the proposed approach with each model on 25 CXRs from the Japanese Society of Radiological Technology (JSRT) dataset and another 25 CXRs from the National Library of Medicine CXR dataset. We achieve an area under the ROC curve (AUC) of about 95% for Montgomery and 91% for JSRT datasets. Using the optimal operating point of the ROC curve, we achieve a segmentation accuracy of 88.91±1.8% for Montgomery and 85.48±3.3% for JSRT datasets. Our method produces comparable results with the state-of-the-art algorithms. The performance of our method is also excellent on challenging X-rays as it successfully addressed the rib-shape variance between patients and number of visible rib-bones due to patient respiration.

  6. The post-natal fate of supernumerary ribs in rat teratogenicity studies.

    Science.gov (United States)

    Wickramaratne, G A

    1988-04-01

    A common occurrence in rat teratology studies, supernumerary ribs, have been considered to be indicative of teratogenicity by some authors but not to be so indicative by others. As a teratogenic event is, by definition a permanent change, a study to follow the fate of supernumerary ribs in the development of adulthood of the rat was undertaken. An established teratogen in the rat, aspirin, was used to increase the frequency of supernumerary ribs. Even though aspirin treatment of the dams doubled the initial frequency of supernumerary ribs the results show that over the first 60 days post-partum their frequency in both control and treated groups decline to essentially zero. This decline in frequency of supernumerary ribs is complemented by an increase in the proportion of foetuses with a fully developed transverse process on the first lumbar vertebra. The proposal that supernumerary ribs in the rat are a result of developmental delays in a labile region of the axial skeleton and not a manifestation of a teratogenic event is presented.

  7. 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 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.

  8. 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.

  9. 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.

  10. A special dish from traditional Turkish Cuisine: Stuffed lamb ribs

    Directory of Open Access Journals (Sweden)

    Emel Memis Kocaman

    2015-11-01

    Full Text Available Turkish people, who have a long historical background, have a rich culture in terms of cuisine. “Dolma” (meal made by stuffing/wrapping is one of the most important dishes of the Turkish Cuisine. Turks produced very different types of meals made by stuffing or wrapping and by combining herbals, meat and offals products. Stuffed Lamb Ribs (in Turkish; Kaburga Dolması or Sura is a special dish that is known in many regions of Turkey. Since it is a dish whose preparation is hard and requires virtuosity, it is generally cooked as a feast meal on religious holidays, and commonly cooked on the Feast of Sacrifice for Muslims. This study aims to present how “Stuffed Lamb Ribs” are prepared, which is one of the traditional dishes of Turkish Cuisine and is one stuffed dish that has started to become forgotten. In this study, the data was collected by personal interviews with source people who are over 60 years old, live in different provinces of Turkey, and traditionally cook this dish. This study ensures the promotion of a very special taste, which has begun to be forgotten and is not known widely even in Turkey, at an international level.

  11. Kvalitative analyser ..

    DEFF Research Database (Denmark)

    Boolsen, Merete Watt

    bogen forklarer de fundamentale trin i forskningsprocessen og applikerer dem på udvalgte kvalitative analyser: indholdsanalyse, Grounded Theory, argumentationsanalyse og diskursanalyse......bogen forklarer de fundamentale trin i forskningsprocessen og applikerer dem på udvalgte kvalitative analyser: indholdsanalyse, Grounded Theory, argumentationsanalyse og diskursanalyse...

  12. Evidence for a myotomal Hox/Myf cascade governing nonautonomous control of rib specification within global vertebral domains.

    Science.gov (United States)

    Vinagre, Tânia; Moncaut, Natalia; Carapuço, Marta; Nóvoa, Ana; Bom, Joana; Mallo, Moisés

    2010-04-20

    Hox genes are essential for the patterning of the axial skeleton. Hox group 10 has been shown to specify the lumbar domain by setting a rib-inhibiting program in the presomitic mesoderm (PSM). We have now produced mice with ribs in every vertebra by ectopically expressing Hox group 6 in the PSM, indicating that Hox genes are also able to specify the thoracic domain. We show that the information provided by Hox genes to specify rib-containing and rib-less areas is first interpreted in the myotome through the regional-specific control of Myf5 and Myf6 expression. This information is then transmitted to the sclerotome by a system that includes FGF and PDGF signaling to produce vertebrae with or without ribs at different axial levels. Our findings offer a new perspective of how Hox genes produce global patterns in the axial skeleton and support a redundant nonmyogenic role of Myf5 and Myf6 in rib formation.

  13. The ribB FMN riboswitch from Escherichia coli operates at the transcriptional and translational level and regulates riboflavin biosynthesis.

    Science.gov (United States)

    Pedrolli, Danielle; Langer, Simone; Hobl, Birgit; Schwarz, Julia; Hashimoto, Masayuki; Mack, Matthias

    2015-08-01

    FMN riboswitches are genetic elements that, in many bacteria, control genes responsible for biosynthesis and/or transport of riboflavin (vitamin B2 ). We report that the Escherichia coli ribB FMN riboswitch controls expression of the essential gene ribB coding for the riboflavin biosynthetic enzyme 3,4-dihydroxy-2-butanone-4-phosphate synthase (RibB; EC 4.1.99.12). Our data show that the E. coli ribB FMN riboswitch is unusual because it operates at the transcriptional and also at the translational level. Expression of ribB is negatively affected by FMN and by the FMN analog roseoflavin mononucleotide, which is synthesized enzymatically from roseoflavin and ATP. Consequently, in addition to flavoenzymes, the E. coli ribB FMN riboswitch constitutes a target for the antibiotic roseoflavin produced by Streptomyces davawensis.

  14. 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

  15. Rib approximation without intercostal nerve compression reduces post-thoracotomy pain: a prospective randomized study.

    Science.gov (United States)

    Bayram, Ahmet Sami; Ozcan, Metin; Kaya, Fatma Nur; Gebitekin, Cengiz

    2011-04-01

    One of the most important considerations in the care of thoracic surgery patients is the control of pain, which leads to increased morbidity and relevant mortality. Between February and May 2009, 60 patients undergoing full muscle-sparing posterior minithoracotomy were prospectively randomized into two groups, according to the thoracotomy closure techniques. In the first group (group A), two holes were drilled into the sixth rib using a hand perforator, and sutures were passed through the holes in the sixth rib and were circled from the upper edge of the fifth rib, thereby compressing the intercostal nerve underneath the fifth rib. In the second group (group B), the intercostal muscle underneath the fifth rib was partially dissected along with the intercostal nerve, corresponding to the holes on the sixth rib. Two 1/0 polyglactin (Vicyrl) sutures were passed through the holes in the sixth rib and above the intercostal nerve. There were 30 patients in each group. The visual analog score, observer verbal ranking scale (OVRS) scores for pain, and Ramsay sedation scores were used to follow-up on postoperative analgesia and sedation. The von Frey hair test was used to evaluate hyperalgesia of the patients. The patients in group B had lower visual analog scores at rest and during coughing. The patients in group B had lower OVRS scores than group A patients. The groups were not statistically different in terms of the Ramsay sedation scores and von Frey hair tests. Thoracotomy closure by a technique that avoids intercostal nerve compression significantly decreases post-thoracotomy pain. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  16. Rib-sparing internal mammary vessel harvest for microvascular breast reconstruction in 100 consecutive cases.

    Science.gov (United States)

    Sacks, Justin M; Chang, David W

    2009-05-01

    Using the internal mammary vessels as recipient vessels in free-flap autologous breast reconstruction has become a common practice. However, these vessels are typically accessed by removing a costochondral segment. The purpose of this study was to describe the authors' rib-sparing technique for accessing the internal mammary vessels that is efficient and reliable and limits chest wall morbidity. The authors analyzed 100 consecutive free-tissue transfers for breast reconstruction in which the internal mammary vessels were accessed using a rib-sparing technique. The data were obtained from a prospectively maintained database and medical records. Of the 100 free-flap reconstructions, 47 used deep inferior epigastric perforator flaps, 45 used muscle-sparing transverse rectus abdominis myocutaneous flaps, six used superficial inferior epigastric artery flaps, and two used superior gluteal artery perforator flaps. No rib cartilage was removed in 66, but a segment of rib cartilage was removed in 34 procedures to optimize the exposure and facilitate anastomosis. After the initial learning curve, however, the internal mammary vessels were used in approximately 90 percent of cases without removal of any rib cartilage. The third intercostal space was used to access the internal mammary vessels two-thirds of the time, and the second intercostal space was used one-third of the time. There were no incidences of complications or morbidity associated with the rib-sparing approach to internal mammary vessel harvest. For most patients, the rib-sparing technique is an efficient and safe approach for exposing the internal mammary vasculature for microvascular breast reconstruction while minimizing chest wall morbidity.

  17. 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

    2016-02-01

    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.

  18. SpaRibs Geometry Parameterization for Wings with Multiple Sections using Single Design

    Science.gov (United States)

    De, Shuvodeep; Jrad, Mohamed; Locatelli, Davide; Kapania, Rakesh K.; Baker, Myles; Pak, Chan-Gi

    2017-01-01

    The SpaRibs topology of an aircraft wing has a significant effect on its structural behavior and stability as well as the flutter performance. The development of additive manufacturing techniques like Electron Beam Free Form Fabrication (EBF3) has made it feasible to manufacture aircraft wings with curvilinear spars, ribs (SpaRibs) and stiffeners. In this article a new global-local optimization framework for wing with multiple sections using curvilinear SpaRibs is described. A single design space is used to parameterize the SpaRibs geometry. This method has been implemented using MSC-PATRAN to create a broad range of SpaRibs topologies using limited number of parameters. It ensures C0 and C1 continuities in SpaRibs geometry at the junction of two wing sections with airfoil thickness gradient discontinuity as well as mesh continuity between all structural components. This method is advantageous in complex multi-disciplinary optimization due to its potential to reduce the number of design variables. For the global-local optimization the local panels are generated by an algorithm which is totally based on a set algebra on the connectivity matrix data. The great advantage of this method is that it is completely independent of the coordinates of the nodes of the finite element model. It is also independent of the order in which the elements are distributed in the FEM. The code is verified by optimizing of the CRM Baseline model at trim condition at Mach number equal to 0.85 for five different angle of attack (-2deg, 0deg,2deg,4deg and 6deg). The final weight of the wing is 19,090.61 lb. This value is comparable to that obtained by Qiang et al. 6 (19,269 lb).

  19. 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

  20. The Effect of Concomitant Rib Deformity in Congenital Scoliosis on Spinal Curve Correction After Segmental Pedicle Screw Instrumentation.

    Science.gov (United States)

    Ameri, Ebrahim; Fouladi, Daniel F; Safari, Mir Bahram; Tari, Hossein Vahid; Ghandhari, Hassan

    2017-05-01

    A single-center, prospective study. To investigate the effect of rib anomaly on surgical curve correction outcome in congenital scoliosis. The presence of rib anomalies may complicate surgical correction of congenital scoliosis. The outcome of surgical correction, however, has not been documented in scoliotic patients with and without rib deformity. Percent Cobb angle decrease (CAD) after operation was calculated in 94 patients with congenital scoliosis. Posterior segmental pedicle screw instrumentation (posterior approach) with or without previous anterior spinal release and fusion (anterior approach) was the method of correction. The impact of vertebral anomaly and rib deformity on CAD was examined. Although the type of vertebral anomaly had no significant effect on the mean CAD, it was significantly lower in 56 patients with rib deformity compared with that in the remaining patients without rib deformity (35.14%±15.83% vs. 51.54%±17.82%, Prib abnormalities, and in those with same-level vertebral and rib deformities. Patients' sex and age at the time of operation, rib number abnormality, and the type of operation (ie, posterior-only approach vs. anterior and posterior approach) did not contribute significantly to Cobb angle change after operation. Concomitant rib deformities, particularly of complex and unilateral types, significantly compromise operative curve correction outcome in congenital scoliosis.

  1. Chest wall pain and rib fracture after stereotactic radiotherapy for peripheral non-small cell lung cancer.

    Science.gov (United States)

    Voroney, Jon-Paul J; Hope, Andrew; Dahele, Max R; Purdie, Thomas G; Purdy, Thomas; Franks, Kevin N; Pearson, Shannon; Cho, John B C; Sun, Alex; Payne, David G; Bissonnette, Jean-Pierre; Bezjak, Andrea; Brade, Anthony M

    2009-08-01

    Stereotactic body radiotherapy is an emerging treatment option for peripheral non-small cell lung cancer in medically inoperable patients. With high dose per fraction radiotherapy, late side effects are of possible concern. In our initial cohort of 42 patients treated with 54 to 60 Gy in three fractions, nine patients have rib fracture. The median dose to rib fracture sites was 46 to 50 Gy, depending on the method of dose calculation. We describe a typical case of poststereotactic radiotherapy rib fracture and present dosimetric analysis of patients with rib fracture.

  2. Effect of analgesia on the changes in respiratory parameters in blunt chest injury with multiple rib fractures

    National Research Council Canada - National Science Library

    Eyo Ekpe; Catherine Eyo

    2017-01-01

    Background: Blunt chest injury with multiple rib fractures can result in such complications as pneumonia, atelectasis, bronchiectasis, empyema thoracis, acute respiratory distress syndrome, and prolonged...

  3. An experimental investigation of heat transfer and fluid flow in a rectangular duct with inclined discrete ribs

    Directory of Open Access Journals (Sweden)

    K. R. Aharwal, B. K. Gandhi, J. S. Saini

    2010-11-01

    Full Text Available Artificial roughness in the form of repeated ribs is generally used for enhancement of heat transfer heated surface to the working fluid. In the present work experimental investigations has been carried out to study the effect of a gap in the inclined rib on the heat transfer and fluid flow characteristics of heated surface. A rectangular duct of aspect ratio of 5.83 has been used to conduct experiments on one rib roughened surface. Experimental data have been collected to determine Nusselt number (heat transfer coefficient as a function of roughness and flow parameters in the form of repeated ribs. In order to understand the mechanism of heat transfer through a roughened duct having inclined rib with and without gap, the detailed analysis of the fluid flow structure is required. Therefore the detailed velocity structures of fluid flow inside a similar roughened duct as used for the heat transfer analysis were obtained by 2-Dimensional Particle Image Velocimetry (PIV system and the heat transfer results were correlated with the flow structure. It was found that inclined rib with a gap (inclined discrete rib had better heat transfer performance compared to the continuous inclined rib arrangement. Further the inclined discrete rib with relative gap width (g/e of 1.0 gives the higher heat transfer performance compared to the other relative gap width.

  4. Percutaneous radiofrequency ablation for lung tumors beneath the rib under CT fluoroscopic guidance with gantry tilt

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Takanobu; Yamagami, Takuji; Tanaka, Osamu; Yoshimatsu, Rika; Miura, Hiroshi; Nishimura, Tsunehiko (Dept. of Radiology, Graduate School of Medical Science, Kyoto Prefectural Univ. of Medicine, Kamigyo, Kyoto (Japan)), e-mail: yamagami@koto.kpu-m.ac.jp

    2010-05-15

    Background: Radiofrequency (RF) ablation of lung tumors has become a treatment of choice, especially for unresectable cases. However, RF ablation of small lung lesions located just beneath the rib is difficult. Purpose: To evaluate the efficacy and safety of gantry tilting for the performance of RF ablation of peripheral lesions located beneath the rib. Material and Methods: Our study was based on 18 of 293 lesions in the lung for which RF ablation was performed under CT scan fluoroscopic guidance at our institution between October 2004 and March 2009. For these 18 lesions, RF ablation was performed with gantry tilting because a rib blocked visualization of the RF ablation route even after other attempts had been made to change the relationship between the target and the rib. Results: All RF needles, with only one exception, were successfully advanced to hit the tumor. The commonest complication was a pneumothorax, which occurred in seven procedures. No serious complications occurred. The progression-free rates were 82.4% at 6 months, 62.5% at 12 months, and 30% at 24 months. Mean local progression-free duration was 17.6+-11.6 months (range 4-36 months). Conclusion: RF ablation under CT scan fluoroscopic guidance with gantry tilt is a useful and safe technique for RF ablation of lung nodules located beneath the rib

  5. 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.

  6. 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.

  7. Renal Cell Carcinoma Presenting as Radiating Rib Pain: A 65-Year-Old Woman.

    Science.gov (United States)

    Cofano, Gregory; Meyers, Meredith; Sergent, Adam; LaCourt, Shawn

    2016-03-01

    The purpose of this case report is to describe chiropractic management and referral of a patient with rib pain who was subsequently diagnosed with renal cell carcinoma. A 65-year-old woman presented with radiating rib pain to a chiropractic clinic. She was treated with a 2-week course of conservative care. On follow-up evaluation, she reported a deep ache over her lower ribs, wrapping around to her abdomen. Palpation under the anterior rib cage reproduced her pain, and she also had a positive Murphy Sign. She was referred for an abdominal ultrasonography. Ultrasonography showed a 12-cm solid vascular mass of the right kidney. Further imaging studies using computerized tomography and magnetic resonance imaging confirmed the ultrasonography findings. She was referred to a cancer center for staging of the cancer and subsequent surgical treatment. The involved tissue, as well as the kidney and part of the inferior vena cava, was removed, and the pathology report determined that the mass was clear cell carcinoma. This case describes an unusual presentation of a patient with rib pain that had previously undiagnosed renal cancer. Referral by her doctor of chiropractic resulted in detection of the tumor and treatment.

  8. 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.)

  9. Effect of ribs in HIFU beam path on formation of coagulative necrosis in goat liver

    Science.gov (United States)

    Li, Faqi; Gong, Xiaobo; Hu, Kai; Li, Chongyan; Wang, Zhibiao

    2006-05-01

    The motives of the work are to explore the effect of ribs in HIFU beam path on HIFU ablation goat liver. A model-JC Focused Ultrasound Tumor Therapeutic System was used. A 0.75 MHz focused transducer with 150mm aperture and 120mm focal length was used in all experiment. Acoustical power can be adjusted. 30 goats were divided into control group (HIFU beam through rib cage, HIFU alone), experiment group 1(HIFU beam through rib cage, HIFU combined with microbubble) and experiment group 2(Ribs in HIFU beam path were surgically removed, HIFU alone). 20 targeted regions at 5cm away from skin surface were applied for creating necrosis with linear scanning of 15mm length using HIFU in 3 groups. All animals were sacrificed two days later and exposed organs were dissected. After obtaining the maximal section, the volumes of the necrotic regions were measured, then to calculate Energy Efficiency Factor (EEF). Researched results showed that Ribs in HIFU beam path affected the formation of coagulative necrosis and enhanced EEF in control group. HIFU combined with microbubble could enhance the formation of coagulative necrosis and decrease EEF.

  10. 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.

  11. Optimization of the Interconnect Ribs for a Cathode-Supported Solid Oxide Fuel Cell

    Directory of Open Access Journals (Sweden)

    Wei Kong

    2014-01-01

    Full Text Available A comprehensive mathematical model of the performance of the cathode-supported solid oxide fuel cell (SOFC with syngas fuel is presented. The model couples the intricate interdependency between the ionic conduction, electronic conduction, gas transport, the electrochemical reaction processes in the functional layers and on the electrode/electrolyte interfaces, methane steam reforming (MSR and the water gas shift reaction (WGSR. The validity of the mathematical model is demonstrated by the excellent agreement between the numerical and experimental I-V curves. The effect of anode rib width and cathode rib width on gas diffusion and cell performance is examined. The results show conclusively that the cell performance is strongly influenced by the rib width. Furthermore, the anode optimal rib width is smaller than that for cathode, which is contrary to anode-supported SOFC. Finally, the formulae for the anode and cathode optimal rib width are given, which provide an easy to use guidance for the broad SOFC engineering community.

  12. 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.

  13. Holographic interferometry as a method to detect welding failures on ribbed iron structures

    Science.gov (United States)

    Vincitorio, F. M.; Budini, N.; Mulone, C.; Freyre, C.; Spector, M.; López Díaz, A. J.; Ramil Rego, A.; Yañez Casal, A.

    2013-11-01

    Metallic structures made of ribbed iron bars (ADN-420) are of common use in sheds and supporting structures. Usually, trusses are constructed with many pieces of ribbed iron bars, combined together through a welding process. Although ribbed iron manufacturers do not recommend this type of structure it is still frequently used. The main weakness of these trusses is the welding point because ribbed iron is not a material suitable for welding. This work presents results obtained from an analysis of welding points between ribbed iron bars extracted from a collapsed truss, by means of conventional (optical) and digital holographic interferometry (HI and DHI, respectively). The experiments were divided in two different series of studies. The first series were performed by HI on metallographic samples while the second series were done by DHI on different welding points. These results were complemented by metallographic analysis made in an external laboratory. DHI indicated that the bars did not have important failures but evidenced defects in one of the welding points under analysis. This information together with metallographic results allowed inferring that the collapse was probably due to an error in the design of the structure, since the iron bars were out of standard compliance.

  14. Effects of unilateral airway occlusion on rib motion and inspiratory intercostal activity in dogs.

    Science.gov (United States)

    Leduc, Dimitri; Marechal, Sarah; Taton, Olivier; Blairon, Bernard; Legrand, Alexandre

    2017-04-01

    Unilateral bronchial occlusion, a complication of many lung diseases, causes dyspnea but the mechanism of this symptom is uncertain. In this study, electromyographic (EMG) activity in the parasternal and external intercostal muscles in the third intercostal space and inspiratory motion of the third rib on both sides of the thorax were assessed during occlusion of a main bronchus for a single breath in anesthetized dogs. Occlusion produced a 65% increase in external intercostal EMG activity in both hemithoraces without altering parasternal EMG activity. Concomitantly, the inspiratory cranial rib motion showed a 50% decrease on both sides of the thorax. These changes were unaffected by bilateral vagotomy. However, when an external, caudally oriented force was applied to the third rib on the right or left side so that its inspiratory cranial displacement was abolished, activity in the adjacent external intercostals showed a twofold increase, but rib motion and external activity in the contralateral hemithorax remained unchanged. It is concluded that during occlusion of a main bronchus, the increase in external intercostal activity is induced by the decrease in inspiratory cranial rib displacement in both hemithoraces, and that this decrease is determined by the increase in pleural pressure swings on both sides of the mediastinum. This mechanism, combined with the decrease in PaO2, induces similar alterations when unilateral bronchial occlusion is maintained for a series of consecutive breaths. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  15. High incidence of cervical ribs indicates vulnerable condition in Late Pleistocene woolly rhinoceroses

    Directory of Open Access Journals (Sweden)

    Alexandra A.E. van der Geer

    2017-08-01

    Full Text Available Mammals as a rule have seven cervical vertebrae, a number that remains remarkably constant. Changes of this number are associated with major congenital abnormalities (pleiotropic effects that are, at least in humans, strongly selected against. Recently, it was found that Late Pleistocene mammoths (Mammuthus primigenius from the North Sea have an unusually high incidence of abnormal cervical vertebral numbers, approximately ten times higher than that of extant elephants. Abnormal numbers were due to the presence of large cervical ribs on the seventh vertebra, indicating a homeotic change from a cervical rib-less vertebra into a thoracic rib-bearing vertebra. The high incidence of cervical ribs indicates a vulnerable condition and is thought to be due to inbreeding and adverse conditions that may have impacted early pregnancies in declining populations. In this study we investigated the incidence of cervical ribs in another extinct Late Pleistocene megaherbivore from the North Sea and the Netherlands, the woolly rhinoceros (Coelodonta antiquitatis. We show that the incidence of abnormal cervical vertebral numbers in the woolly rhinoceros is unusually high for mammals (15,6%, n = 32 and much higher than in extant Rhinoceratidae (0%, n = 56. This indicates that woolly rhinoceros lived under vulnerable conditions, just like woolly mammoths. The vulnerable condition may well have contributed to their eventual extinction.

  16. Manufacturing and assembly of IWS support rib and lower bracket for ITER vacuum vessel

    Science.gov (United States)

    Laad, R.; Sarvaiya, Y.; Pathak, H. A.; Raval, J. R.; Choi, C. H.

    2017-04-01

    ITER Vacuum Vessel (VV) is made of double walls connected by ribs structure and flexible housings. Space between these walls is filled up with In Wall Shielding (IWS) blocks to (1) shield neutrons streaming out of plasma and (2) reduce toroidal magnetic field ripple. These blocks will be connected to the VV through a supporting structure of Support Rib (SR) and Lower Bracket (LB) assembly. SR and LB are two independent components manufactured from SS 316L(N)-IG, Total 1584 support ribs and 3168 lower bracket of different sizes and shapes will be manufactured for the IWS. Two lower brackets will be welded with one support rib to make an assembly. The welding between SR and LB is a full penetration welding. Total 1584 assemblies of different sizes and shapes will be manufactured. Sufficient experience gained from manufacturing and testing of mock ups, final manufacturing of IWS support rib and lower bracket has been started at the site of IWS manufacturer M/s. Avasarala Technologies Limited (ATL). This paper will describe, optimization of water jet cutting speed on IWS material, selection criteria for K type weld joint, unique features of fixture of assembly, manufacturing of Mock ups, and welding processes with NDTs.

  17. IGRT/ART phantom with programmable independent rib cage and tumor motion

    Energy Technology Data Exchange (ETDEWEB)

    Haas, Olivier C. L., E-mail: o.haas@coventry.ac.uk [Control Theory and Applications Centre, Coventry University, Coventry CV1 2TL (United Kingdom); Mills, John A.; Land, Imke; Mulholl, Pete; Menary, Paul; Crichton, Robert; Wilson, Adrian; Sage, John [Department of Clinical Physics and Bioengineering, University Hospital, Coventry CV2 2DX (United Kingdom); Anna, Morenc [University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester, LE1 5WW (United Kingdom); Depuydt, Tom [Radiotherapy, Medical Physics Group, University Hospital UZ Brussel, Laarbeeklaan 101 - 1090 Brussels (Belgium)

    2014-02-15

    Purpose: This paper describes the design and experimental evaluation of the Methods and Advanced Equipment for Simulation and Treatment in Radiation Oncology (MAESTRO) thorax phantom, a new anthropomorphic moving ribcage combined with a 3D tumor positioning system to move target inserts within static lungs. Methods: The new rib cage design is described and its motion is evaluated using Vicon Nexus, a commercial 3D motion tracking system. CT studies at inhale and exhale position are used to study the effect of rib motion and tissue equivalence. Results: The 3D target positioning system and the rib cage have millimetre accuracy. Each axis of motion can reproduce given trajectories from files or individually programmed sinusoidal motion in terms of amplitude, period, and phase shift. The maximum rib motion ranges from 7 to 20 mm SI and from 0.3 to 3.7 mm AP with LR motion less than 1 mm. The repeatability between cycles is within 0.16 mm root mean square error. The agreement between CT electron and mass density for skin, ribcage, spine hard and inner bone as well as cartilage is within 3%. Conclusions: The MAESTRO phantom is a useful research tool that produces programmable 3D rib motions which can be synchronized with 3D internal target motion. The easily accessible static lungs enable the use of a wide range of inserts or can be filled with lung tissue equivalent and deformed using the target motion system.

  18. First rib fractures: not always a hallmark of severe trauma-a report of three cases

    Institute of Scientific and Technical Information of China (English)

    Atin Jaiswal; Yashwant S Tanwar; Masood Habib; Vijay Jain

    2013-01-01

    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.

  19. Generation of Turbulent Inflow Conditions for Pipe Flow via an Annular Ribbed Turbulator

    Science.gov (United States)

    Moallemi, Nima; Brinkerhoff, Joshua

    2016-11-01

    The generation of turbulent inflow conditions adds significant computational expense to direct numerical simulations (DNS) of turbulent pipe flows. Typical approaches involve introducing boxes of isotropic turbulence to the velocity field at the inlet of the pipe. In the present study, an alternative method is proposed that incurs a lower computational cost and allows the anisotropy observed in pipe turbulence to be physically captured. The method is based on a periodic DNS of a ribbed turbulator upstream of the inlet boundary of the pipe. The Reynolds number based on the bulk velocity and pipe diameter is 5300 and the blockage ratio (BR) is 0.06 based on the rib height and pipe diameter. The pitch ratio is defined as the ratio of rib streamwise spacing to rib height and is varied between 1.7 and 5.0. The generation of turbulent flow structures downstream of the ribbed turbulator are identified and discussed. Suitability of this method for accurate representation of turbulent inflow conditions is assessed through comparison of the turbulent mean properties, fluctuations, Reynolds stress profiles, and spectra with published pipe flow DNS studies. The DNS results achieve excellent agreement with the numerical and experimental data available in the literature.

  20. Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study

    Science.gov (United States)

    Nielson, Carrie M; Orwoll, Eric; Bauer, Douglas C; Cauley, Jane A

    2010-01-01

    Objective To study the causes and consequences of radiologically confirmed rib fractures (seldom considered in the context of osteoporosis) in community dwelling older men. Design Prospective cohort study (Osteoporotic Fractures in Men (MrOS) Study). Setting and participants 5995 men aged 65 or over recruited in 2000-2 from six US sites; 99% answered mailed questionnaires about falls and fractures every four months for a mean 6.2 (SD 1.3) year follow-up. Main outcome measures New fractures validated by radiology reports; multivariate Cox proportional hazard ratios were used to evaluate factors independently associated with time to incident rib fracture; associations between baseline rib fracture and incident hip and wrist fracture were also evaluated. Results The incidence of rib fracture was 3.5/1000 person years, and 24% (126/522) of all incident non-spine fractures were rib fractures. Nearly half of new rib fractures (48%; n=61) followed falling from standing height or lower. Independent risk factors for an incident rib fracture were age 80 or above, low bone density, difficulty with instrumental activities of daily living, and a baseline history of rib/chest fracture. Men with a history of rib/chest fracture had at least a twofold increased risk of an incident rib fracture (adjusted hazard ratio 2.71, 95% confidence interval 1.86 to 3.95), hip fracture (2.05, 1.33 to 3.15), and wrist fracture (2.06, 1.14 to 3.70). Only 14/82 of men reported being treated with bone specific drugs after their incident rib fracture. Conclusions Rib fracture, the most common incident clinical fracture in men, was associated with classic risk markers for osteoporosis, including old age, low hip bone mineral density, and history of fracture. A history of rib fracture predicted a more than twofold increased risk of future fracture of the rib, hip, or wrist, independent of bone density and other covariates. Rib fractures should be considered to be osteoporotic fractures in the

  1. Osteoblastic lesion screening with an advanced post-processing package enabling in-plane rib reading in CT-images.

    Science.gov (United States)

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

    2016-05-20

    To evaluate screening and diagnostic accuracy for the detection of osteoblastic rib lesions using an advanced post-processing package enabling in-plane rib reading in CT-images. We retrospectively assessed the CT-data of 60 consecutive prostate cancer patients by applying dedicated software enabling in-plane rib reading. Reading the conventional multiplanar reconstructions was considered to be the reference standard. To simulate clinical practice, the reader was given 10 s to screen for sclerotic rib lesions in each patient applying both approaches. Afterwards, every rib was evaluated individually with both approaches without a time limit. Sensitivities, specificities, positive/negative predictive values and the time needed for detection were calculated depending on the lesion's size (largest diameter  10 mm). In 53 of 60 patients, all ribs were properly displayed in plane, in five patients ribs were partially displayed correctly, and in two patients none of the ribs were displayed correctly. During the 10-s screening approach all patients with sclerotic rib lesions were correctly identified reading the in-plane images (including the patients without a correct rib segmentation), whereas 14 of 23 patients were correctly identified reading conventional multiplanar images. Overall screening sensitivity, specificity, and positive/negative predictive values were 100/27.0/46.0/100 %, respectively, for in-plane reading and 60.9/100/100/80.4 %, respectively, for multiplanar reading. Overall diagnostic (no time limit) sensitivity, specificity, and positive/negative predictive values of in-plane reading were 97.8/92.8/74.6/99.5 %, respectively. False positive results predominantly occurred for lesions ribs allows reliable detection of osteoblastic lesions for screening purposes. The limited specificity results from false positives predominantly occurring for small lesions.

  2. Osteoblastoma of the rib with CT and MR imaging: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Ye Jing

    2012-03-01

    Full Text Available Abstract Osteoblastoma is a rare bone tumor which is mostly found in the vertebral column and long bone. We describe a 59-year-old woman with osteoblastoma in the right fifth posterior segment of the rib, whose presenting symptoms were right back pain for two years and awakened at night. Chest computer tomography (CT and thoracic spine magnetic resonance (MR imaging findings included an expansile lesion of the right fifth rib and an ossified matrix. Surgical resection of the lesion confirmed a benign osteoblastoma. 12 months follow-up revealed disappearance of right back pain. Rib osteoblastoma in plain film has been described previously; however, to our knowledge this is the only case report emphasized in CT and MR imaging.

  3. Multi-pass spinning of thin-walled tubular part with longitudinal inner ribs

    Institute of Scientific and Technical Information of China (English)

    JIANG Shu-yong; ZHENG Yu-feng; REN Zheng-yi; LI Chun-feng

    2009-01-01

    Based on the process experiments, micrography analysis was dedicated to advancing the understanding of plastic flow of the metal in backward ball spinning of thin-walled tubular part with longitudinal inner ribs. Micrography analysis reveals that severe plastic deformation leads to grain refinement, grain orientation and grain flow line of the spun part. Based on rigid-plastic finite element method, DEFORME3D finite element code was used to simulate and analyze multi-pass backward ball spinning of thin-walled tubular part with longitudinal inner ribs. Finite element simulation results involve the distributions of the strain, the shape variation of the inner ribs as well as the prediction of the spinning loading.

  4. The forced sound transmission of finite ribbed plates, investigating the influence of point connections and periodicity

    DEFF Research Database (Denmark)

    Brunskog, Jonas

    2015-01-01

    Many engineering structures consist of plates being stiffened by ribs. The ribs can be connected to the plate in a line connection (welded or glued) or in point connections (screwed). It is well known that the rib stiffeners can significantly change the vibration field and the radiation behavior...... been derived, using a variational technique based on integral-differential equations of the fluid loaded plate. In this way an optimal solution is derived, using a very simple initial guess of the vibration field. The finite plate is assumed being mounted in a rigid baffle. The approach is based...... the model. The influence of point versus line connections, as well as periodicity effects, is investigated....

  5. Glued Joint Behavior of Ribs for Wood-Based Composite Plates

    Science.gov (United States)

    Frolovs, G.; Rocens, K.; Sliseris, J.

    2015-11-01

    This article presents experimental investigations of composite sandwich plywood plates with cell type core and their connections between skin layers of birch plywood and a core of straight and curved plywood honeycomb-type ribs. This shape of core ribs provides several improvements for these plates in the manufacturing process as well as improves the mechanical properties of plywood plates. This specific form of ribs allows simplifying the manufacturing of these plates although it should be detailed and improved. The most typical cases (series of specimens) were compared to the results obtained from FEM (ANSYS) simulations. All thicknesses of elements are chosen according to plywood supplier assortment. Standard birch plywood (Riga Ply) plates were used - three layer plywood was chosen for skin elements (Surfaces) and three or five layer plywood was chosen for edge elements. Different bond pressures were taken to compare their influence on joint strength and stiffness.

  6. Aesthetic auricular reconstruction with autologous rib cartilage grafts in adult microtia patients.

    Science.gov (United States)

    Han, So-Eun; Lim, So-Young; Pyon, Jai-Kyung; Bang, Sa-ik; Mun, Goo-Hyun; Oh, Kap Sung

    2015-08-01

    Cartilage calcification is an important factor in aesthetic auricular reconstruction using autologous rib cartilage grafts in adults, a technique that involves difficult manipulation and unexpected absorption. As a result, artificial implants or prosthetics are considered for auricular reconstruction in adult patients despite the limitations of artificial material. In this article, we present our experience with auricular reconstruction using autologous rib cartilage grafts in adult microtia patients with reliable aesthetic results and minimal complications. A retrospective chart review was performed for 84 microtia patients ranging in age from 21 to 56 (average: 29.9) years who underwent auricular reconstruction using autologous rib cartilage grafts from March 2001 to March 2013. To validate our acceptable reconstructive results, two independent observers performed postoperative photographic evaluation of two groups (adults and children) using non-inferiority tests in addition to patient questionnaires. The mean operation time for rib cartilage grafts was 3 h and 53 min, and the follow-up time for all patients ranged from 6 months to 8 years. Surgery-related complications occurred in only three cases. On objective photographic evaluation, the adult group was not inferior to the child group in auricular shape, location, or symmetry. The subjective patient satisfaction evaluation reported a high satisfaction rate. As this study shows, aesthetic auricular reconstruction using rib cartilage grafts in adult microtia patients is possible even in cases with advanced cartilage calcification. Modification of the fabricating framework, well-preserved flap vascularity, and complete understanding of physiological aspects of rib cartilage are essential for aesthetic auricular reconstruction. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Pain as an indication for rib fixation: a bi-institutional pilot study.

    Science.gov (United States)

    de Moya, Marc; Bramos, Thanos; Agarwal, Suresh; Fikry, Karim; Janjua, Sumbal; King, David R; Alam, Hasan B; Velmahos, George C; Burke, Peter; Tobler, William

    2011-12-01

    In trauma patients, open reduction and internal fixation of rib fractures remain controversial. We hypothesized that patients who have open reduction and internal fixation of rib fractures would experience less pain compared with controls and thus require fewer opiates. Further, we hypothesized that improved pain control would result in fewer pulmonary complications and decreased length of stay. This is a retrospective bi-institutional matched case-control study. Cases were matched 1:2 by age, injury severity Score, chest abbreviated injury severity score, head abbreviated injury severity score, pulmonary contusion score, and number of fractured ribs. The daily total doses of analgesic drugs were converted to equianalgesic intravenous morphine doses, and the primary outcome was inpatient narcotic administration. Sixteen patients between July 2005 and June 2009 underwent rib fixation in 5 ± 3 days after injury using an average of 3 (1-5) metallic plates. Morphine requirements decreased from 110 mg ± 98 mg preoperatively to 63 ± 57 mg postoperatively (p = 0.01). There were no significant differences between cases and controls in the mean morphine dose (79 ± 63 vs. 76 ± 55 mg, p = 0.65), hospital stay (18 ± 12 vs. 16 ± 11 days, p = 0.67), intensive care unit stay (9 ± 8 vs. 7 ± 10 days, p = 0.75), ventilation days (7 ± 8 vs. 6 ± 10, p = 0.44), and pneumonia rates (31% vs. 38%, p = 0.76). The need for analgesia was significantly reduced after rib fixation in patients with multiple rib fractures. However, no difference in outcomes was observed when these patients were compared with matched controls in this pilot study. Further study is required to investigate these preliminary findings.

  8. AUGMENTATION OF RIBS TURBULATORS HEIGHT ON THE HYDROTHERMAL PERFORMANCE OF DOUBLE PIPE HEAT EXCHANGER

    Directory of Open Access Journals (Sweden)

    HUSSAIN H. AL-KAYIEM

    2017-02-01

    Full Text Available Thermal performance of double pipe heat exchanger can be enhanced by imposed turbulence in the annular flow using artificial roughening. This paper presents experimental results on enhancing the heat transfer by artificial roughening using energy promoters installed on the inner surface of the cold flow annulus. An experimental test rig was fabricated having 2.0 m long annular flow test section with 76.2 mm and 34.2 mm outside and inside diameters, respectively. The energy promoters have ribs shape with rectangular cross section. Two cases of rib’s pitch to height ratios, equal to 10 and 15 and three height to hydraulic diameter, equal to 0.0595, 0.083, and 0.107 have been studied. The investigations were carried out at various flow rates within Reynolds number range of 2900 to 21000 in the cold annulus. For each roughening case, the thermal and hydraulic performances wereevaluated by determining Stanton number and the associated pressure drop, respectively. The experimental results showed that enhancement in the heat transfer was combined with a penalty in the pressure drop due to the increase in the friction factor values. The combined hydrothermal enhancement results of the DPHE, in terms of the performance index, indicate that the small height ribs to hydraulic diameter of 0.0595, augmented higher than the large height ribs to hydraulic diameter of 0.107. Hence, it is recommended to use ribs installed on the inner surface of the annulus ribs to hydraulic diameter in the range of 0.06 ± 0.005. Also, it is recommended to investigate further parameters to explore further on the influencing of the ribs on the hydrothermal performance of the DPHE.

  9. 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.

  10. Optimization in modeling the ribs-bounded contour from computer tomography scan

    Science.gov (United States)

    Bilinskas, M. J.; Dzemyda, G.

    2016-10-01

    In this paper a method for analyzing transversal plane images from computer tomography scans is presented. A mathematical model that describes the ribs-bounded contour was created and the problem of approximation is solved by finding out the optimal parameters of the model in the least-squares sense. Such model would be useful in registration of images independently on the patient position on the bed and on the radio-contrast agent injection. We consider the slices, where ribs are visible, because many important internal organs are located here: liver, heart, stomach, pancreas, lung, etc.

  11. High-Q silicon-on-insulator optical rib waveguide racetrack resonators

    Science.gov (United States)

    Kiyat, Isa; Aydinli, Atilla; Dagli, Nadir

    2005-03-01

    In this work, detailed design and realization of high quality factor (Q) racetrack resonators based on silicon-on-insulator rib waveguides are presented. Aiming to achieve critical coupling, suitable waveguide geometry is determined after extensive numerical studies of bending loss. The final design is obtained after coupling factor calculations and estimation of propagation loss. Resonators with quality factors (Q) as high as 119000 has been achieved, the highest Q value for resonators based on silicon-on-insulator rib waveguides to date with extinction ratios as large as 12 dB.

  12. 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.

  13. Mechanism of the rib spalling and the controlling in the very soft coal seam

    Energy Technology Data Exchange (ETDEWEB)

    Wang Jia-chen [China University of Mining and Technology, Beijing (China). Laboratory of Coal Resources and Mine Safety Technology

    2007-08-15

    The mechanism of rib spalling was studied and a way of controlling it was proposed by decreasing coal wall pressure and increasing the shear strength of the coal wall. Using the top coal caving technique and increasing the resistance of the support can reduce the pressure on the coal wall. The cohesion and shear strength of the coal wall may be increased by means of water infusion through the coal wall. These are effective ways of preventing rib spalling. The quick advance of the coal wall and having the correct low wall height are also advantageous to wall stability. 2 refs., 11 figs.

  14. High-Q silicon-on-insulator optical rib waveguide racetrack resonators.

    Science.gov (United States)

    Kiyat, Isa; Aydinli, Atilla; Dagli, Nadir

    2005-03-21

    In this work, detailed design and realization of high quality factor (Q) racetrack resonators based on silicon-on-insulator rib waveguides are presented. Aiming to achieve critical coupling, suitable waveguide geometry is determined after extensive numerical studies of bending loss. The final design is obtained after coupling factor calculations and estimation of propagation loss. Resonators with quality factors (Q) as high as 119000 has been achieved, the highest Q value for resonators based on silicon-on-insulator rib waveguides to date with extinction ratios as large as 12 dB.

  15. Performance of Ar+-milled Ti:Sapphire rib waveguides as single transverse-mode broadband fluorescence sources

    NARCIS (Netherlands)

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

    2003-01-01

    Rib waveguides have been fabricated in pulsed-laser-deposited Ti:sapphire layers using photolithographic patterning and subsequent Ar+-beam milling. Fluorescence output powers up to 300 W have been observed from the ribs following excitation by a 3-W multiline argon laser. Mode intensity profiles sh

  16. A statistical human rib cage geometry model accounting for variations by age, sex, stature and body mass index.

    Science.gov (United States)

    Shi, Xiangnan; Cao, Libo; Reed, Matthew P; Rupp, Jonathan D; Hoff, Carrie N; Hu, Jingwen

    2014-07-18

    In this study, we developed a statistical rib cage geometry model accounting for variations by age, sex, stature and body mass index (BMI). Thorax CT scans were obtained from 89 subjects approximately evenly distributed among 8 age groups and both sexes. Threshold-based CT image segmentation was performed to extract the rib geometries, and a total of 464 landmarks on the left side of each subject׳s ribcage were collected to describe the size and shape of the rib cage as well as the cross-sectional geometry of each rib. Principal component analysis and multivariate regression analysis were conducted to predict rib cage geometry as a function of age, sex, stature, and BMI, all of which showed strong effects on rib cage geometry. Except for BMI, all parameters also showed significant effects on rib cross-sectional area using a linear mixed model. This statistical rib cage geometry model can serve as a geometric basis for developing a parametric human thorax finite element model for quantifying effects from different human attributes on thoracic injury risks.

  17. Application of the rainfall infiltration breakthrough (RIB) model for groundwater recharge estimation in west coastal South Africa

    CSIR Research Space (South Africa)

    Sun, X

    2013-04-01

    Full Text Available level fluctuations (WLF) on a monthly basis was proposed in the rainfall infiltration breakthrough (RIB) model for the purpose of groundwater recharge estimation. In this paper, the physical meaning of parameters in the CRD and previous RIB models...

  18. Comparing and determining the causes of ribbed mussel nitrogen isotope signatures in three New England sub-watersheds

    Science.gov (United States)

    Geukensia demissa, the ribbed mussel, is a useful indicator of sources of nitrogen input into coastal watersheds as it possesses a slow tissue turnover rate and is a common salt marsh species. During the summer of 2016, we sampled ribbed mussels from three New England sub-watersh...

  19. Microbiological safety of commercial prime rib preparation methods: thermal inactivation of Salmonella spp. in mechanically tenderized beef roasts

    Science.gov (United States)

    A survey of food service operations in a medium-size Midwestern city was conducted to evaluate the microbiological safety of prime rib preparation methods relative to survival of Salmonella spp. in both intact and tenderized (non-intact) product. All six restaurants visited seared rib eye roasts (ai...

  20. Performance of Ar+-milled Ti:Sapphire rib waveguides as single transverse mode broadband fluorescence sources

    NARCIS (Netherlands)

    Grivas, C.; Shepherd, D.P.; May-Smith, T.C.; Eason, R.W.; Pollnau, M.; Crunteanu, A.; Jelinek, M.

    2003-01-01

    Rib waveguides have been fabricated in pulsed-laser-deposited Ti:sapphire layers using photolithographic patterning and subsequent Ar+-beam milling. Fluorescence output powers up to 300 W have been observed from the ribs following excitation by a 3-W multiline argon laser. Mode intensity profiles sh

  1. The riboflavin transporter RibU in Lactococcus lactis : Molecular characterization of gene expression and the transport mechanism

    NARCIS (Netherlands)

    Burgess, CM; Slotboom, DJ; Geertsma, ER; Duurkens, Hinderika; Poolman, B; van Sinderen, D

    2006-01-01

    This study describes the characterization of the riboflavin transport protein RibU in the lactic acid bacterium Lactococcus lactis subsp. cremoris NZ9000. RibU is predicted to contain five membrane-spanning segments and is a member of a novel transport protein family, not described in the Transport

  2. Statistical-mechanical analysis of multiuser channel capacity with imperfect channel state information

    Institute of Scientific and Technical Information of China (English)

    Wang Hui-Song; Zeng Gui-Hua

    2008-01-01

    In this paper,the effect of imperfect channel state information at the receiver, which is caused by noise and other interference, on the multi-access channel capacity is analysed through a statistical-mechanical approach. Replica analyses focus on analytically studying how the minimum mean square error (MMSE) channel estimation error appears in a multiuser channel capacity formula. And the relevant mathematical expressions are derived. At the same time,numerical simulation results are demonstrated to validate the Replica analyses. The simulation results show how the system parameters, such as channel estimation error, system load and signal-to-noise ratio, affect the channel capacity.

  3. 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

  4. 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.

  5. 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.

  6. Torsion and bending in the neck and tail of sauropod dinosaurs and the function of cervical ribs: insights from functional morphology and biomechanics.

    Directory of Open Access Journals (Sweden)

    Holger Preuschoft

    Full Text Available The long necks of sauropods have been subject to many studies regarding their posture and flexibility. Length of the neck varies among groups. Here, we investigate neck posture and morphology in several clades from a mechanical viewpoint. Emphasis is put on comparing sauropod necks and tails with structures in living archosaurs and mammals. Differences in the use made of necks and tails lead to clear-cut differences in the mechanical loads occurring in the same models. Ways of sustaining loads are identified by theoretical considerations. If the observed skeletal structures are suited to resist the estimated loading in a particular posture, this concordance is taken as an argument that this posture or movement was of importance during the life of the individual. Apart from the often-discussed bending in side view, we analyze the often overlooked torsion. Because torsional stresses in a homogenous element concentrate near the periphery, a cylindrical cross section gives greatest strength, and the direction of forces is oblique. In a vertebrate neck, during e.g. shaking the head and twisting the neck, oblique muscles, like the mm. scaleni, if activated unilaterally initiate movement, counterbalance the torsional moments and keep the joints between neck vertebrae in equilibrium. If activated bilaterally, these muscles keep the neck balanced in an energy-saving upright posture. The tendons of the mm. scaleni may have ossified as cervical ribs The long cervical ribs in brachiosaurids and mamenchisaurids seem to have limited flexibility, whereas the shorter cervical ribs in Diplodocidae allowed free movement. The tails of sauropods do not show pronounced adaptation to torsion, and seem to have been carried more or less in a horizontal, extended posture. In this respect, sauropod tails resemble the necks of herbivorous cursorial mammals. These analyses provide an improved understanding of neck use that will be extended to other sauropods in subsequent

  7. Torsion and bending in the neck and tail of sauropod dinosaurs and the function of cervical ribs: insights from functional morphology and biomechanics.

    Science.gov (United States)

    Preuschoft, Holger; Klein, Nicole

    2013-01-01

    The long necks of sauropods have been subject to many studies regarding their posture and flexibility. Length of the neck varies among groups. Here, we investigate neck posture and morphology in several clades from a mechanical viewpoint. Emphasis is put on comparing sauropod necks and tails with structures in living archosaurs and mammals. Differences in the use made of necks and tails lead to clear-cut differences in the mechanical loads occurring in the same models. Ways of sustaining loads are identified by theoretical considerations. If the observed skeletal structures are suited to resist the estimated loading in a particular posture, this concordance is taken as an argument that this posture or movement was of importance during the life of the individual. Apart from the often-discussed bending in side view, we analyze the often overlooked torsion. Because torsional stresses in a homogenous element concentrate near the periphery, a cylindrical cross section gives greatest strength, and the direction of forces is oblique. In a vertebrate neck, during e.g. shaking the head and twisting the neck, oblique muscles, like the mm. scaleni, if activated unilaterally initiate movement, counterbalance the torsional moments and keep the joints between neck vertebrae in equilibrium. If activated bilaterally, these muscles keep the neck balanced in an energy-saving upright posture. The tendons of the mm. scaleni may have ossified as cervical ribs The long cervical ribs in brachiosaurids and mamenchisaurids seem to have limited flexibility, whereas the shorter cervical ribs in Diplodocidae allowed free movement. The tails of sauropods do not show pronounced adaptation to torsion, and seem to have been carried more or less in a horizontal, extended posture. In this respect, sauropod tails resemble the necks of herbivorous cursorial mammals. These analyses provide an improved understanding of neck use that will be extended to other sauropods in subsequent studies.

  8. Torsion and Bending in the Neck and Tail of Sauropod Dinosaurs and the Function of Cervical Ribs: Insights from Functional Morphology and Biomechanics

    Science.gov (United States)

    Preuschoft, Holger; Klein, Nicole

    2013-01-01

    The long necks of sauropods have been subject to many studies regarding their posture and flexibility. Length of the neck varies among groups. Here, we investigate neck posture and morphology in several clades from a mechanical viewpoint. Emphasis is put on comparing sauropod necks and tails with structures in living archosaurs and mammals. Differences in the use made of necks and tails lead to clear-cut differences in the mechanical loads occurring in the same models. Ways of sustaining loads are identified by theoretical considerations. If the observed skeletal structures are suited to resist the estimated loading in a particular posture, this concordance is taken as an argument that this posture or movement was of importance during the life of the individual. Apart from the often-discussed bending in side view, we analyze the often overlooked torsion. Because torsional stresses in a homogenous element concentrate near the periphery, a cylindrical cross section gives greatest strength, and the direction of forces is oblique. In a vertebrate neck, during e.g. shaking the head and twisting the neck, oblique muscles, like the mm. scaleni, if activated unilaterally initiate movement, counterbalance the torsional moments and keep the joints between neck vertebrae in equilibrium. If activated bilaterally, these muscles keep the neck balanced in an energy-saving upright posture. The tendons of the mm. scaleni may have ossified as cervical ribs The long cervical ribs in brachiosaurids and mamenchisaurids seem to have limited flexibility, whereas the shorter cervical ribs in Diplodocidae allowed free movement. The tails of sauropods do not show pronounced adaptation to torsion, and seem to have been carried more or less in a horizontal, extended posture. In this respect, sauropod tails resemble the necks of herbivorous cursorial mammals. These analyses provide an improved understanding of neck use that will be extended to other sauropods in subsequent studies. PMID

  9. Partitioning of the contributions of rib cage and abdomen to ventilation in ankylosing spondylitis

    Science.gov (United States)

    Grimby, Gunnar; Fugl-Meyer, Axel R.; Blomstrand, Ann

    1974-01-01

    Grimby, G., Fugl-Meyer, A. R., and Blomstrand, A. (1974).Thorax,29, 179-184. Partitioning of the contributions of rib cage and abdomen to ventilation in ankylosing spondylitis. The relative contributions of the rib cage and abdomen to ventilation were studied in the sitting position in patients with ankylosing spondylitis, using measurements of changes in the anteroposterior diameters. The functional impairment of the spine and adjacent joints was also evaluated. In most patients vital capacity and total lung capacity were reduced, but functional residual capacity was normal. The relative contribution of the rib cage to ventilation was reduced at rest compared to normal subjects, and decreased further during hyperventilation induced by rebreathing. The end-expiratory level of the abdomen decreased more markedly during hyperventilation than in normal subjects and even the end-inspiratory level of the abdomen increased somewhat. The findings are consistent with a reduced mobility of the ribs and a greater than normal excursion of the diaphragm during breathing. PMID:4831523

  10. Novel rib structures in Yb-doped KY(WO4)2 for laser applications

    NARCIS (Netherlands)

    Gardillou, F.; Borca, C.N.; Romanyuk, Y.E.; Hibert, C.; Salathé, R.P.; Pollnau, Markus

    2006-01-01

    We report for the first time, on the fabrication of flexible refractive-index-contrast rib waveguides based on Yb-doped $KY(WO_4)_2$ epilayers. These results pave the way for integrated optical circuits in this promising material.

  11. The role of a video-assisted thoracic approach for rib fixation.

    Science.gov (United States)

    Fraser, S F; Tan, C; Kuppusamy, M K; Gukop, P; Hunt, I J

    2017-04-01

    Rib fixation remains a contentious issue in the current practice of orthopaedic, trauma and thoracic surgeons. Whilst rib fractures are undoubtedly associated with high levels of morbidity and mortality, the optimal surgical approach has not yet been fully elucidated in prospective trials and the volume of procedures performed remains low. We evaluated 21 consecutive patients who underwent surgical rib fixation either via a standard thoracotomy approach or following the introduction of a video-assisted technique with minimal thoracic incisions. The average age of patients undergoing rib fixation was 47 and the median length of post-operative stay was 4 days. More than 70 % of patients were found to have concurrent haemothoraces, and 19 % had significant injuries to underlying intra-thoracic structures requiring repair. One patient returned to theatre for persistent blood loss; however, there were no other immediate complications or mortalities. We discuss the involvement of thoracic surgeons, early assessment of the thoracic cavity with video assistance and optimal peri-operative management with particular reference to cases which demonstrate recent changes in our practice.

  12. Rib Torque Does Not Assist Resting Tidal Expiration or Most Conversational Speech Expiration

    Science.gov (United States)

    Hixon, Thomas J.

    2006-01-01

    Purpose: This research note discusses a common misconception in speech science and speech-language pathology textbooks that rib torque (i.e., "rotational stress") assists resting tidal expiration and conversational speech production. Method: The nature of this misconception is considered. Conclusion: An alternate conceptualization is offered that…

  13. Construction of kidney phantom model with acoustic shadow by rib bones and respiratory organ motion

    Science.gov (United States)

    Lee, Dongjun; Koizumi, Norihiro; Tsukihara, Hiroyuki; Azuma, Takashi; Nomiya, Akira; Yoshinaka, Kiyoshi; Sugita, Naohiko; Homma, Yukio; Matsumoto, Yoichiro; Mitsuishi, Mamoru

    2017-03-01

    We have been studying the Non-Invasive Ultrasound Theragnostic System (NIUTS), which tracks and follows the affected area while irradiating High Intensity Focused Ultrasound (HIFU). In this report, we propose a phantom model that includes rib bones and respiratory motion.

  14. Historic overview of treatment techniques for rib fractures and flail chest

    NARCIS (Netherlands)

    Bemelman, M.; Poeze, M.; Blokhuis, T. J.; LEENEN, LPH

    2010-01-01

    Introduction From the beginning of the twentieth century till the current time, an overview is presented of the surgical treatment for rib fractures and flail chest. Methods Many techniques have been used to stabilize the thorax wall. There has been no follow-up for the most described techniques and

  15. 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.

  16. Fibrous dysplasia of the rib presenting as a huge chest wall tumor: report of a case.

    Science.gov (United States)

    Chang, B S; Lee, S C; Harn, H J

    1994-07-01

    Fibrous dysplasia of the rib is not uncommon, but is rarely demonstrated as a huge chest wall mass with severe clinical symptoms. A 59-year-old patient, presenting with a huge, rapidly expanding chest wall tumor compressing the lung, liver and heart accompanied by chest pain and dyspnea, is reported. The tumor was success-fully excised by local radical resection.

  17. Biphasic pulmonary blastoma: An unusual presentation with chest wall, rib, and pleural involvement

    National Research Council Canada - National Science Library

    Dixit, Ramakant; Joshi, Nalin; Dave, Lokendra

    2014-01-01

    ... such as cough, hemoptysis, dyspnea, and chest pain. About 40% of cases are asymptomatic and found coincidentally. The usual radiological appearance consists of a well-circumscribed mass measuring 2.5-25 cm in diameter. [3] Pleural effusion occurs very occasionally and chest wall with rib involvement in adult BPB is probably not reported...

  18. Process factors influencing spinning deformation of thin-walled tubular part with longitudinal inner ribs

    Institute of Scientific and Technical Information of China (English)

    江树勇; 薛克敏; 宗影影; 喻林

    2004-01-01

    As a successively and locally plastic deformation process, ball backward spinning is applied for the purpose of producing thin-walled tubular parts with longitudinal inner ribs. By simplifying ball backward spinning as forward extrusion mechanics model, slab method is used in order to solve spinning force. Based on plastic mechanics, the influence of the process parameters involved on formability of inner ribs as well as the quality defects of spun parts is analyzed so as to present an approach to acquire the desired parts. The quality of inner ribs is one of the critical tasks in obtaining the desired spun workpieces and the height of inner rib depends greatly on spinning material,ball diameter, feed ratio, and wall thickness of tubular blank. The knowledge of the influence of process variables such as ball diameter, feed ratio, and wall thickness of tubular blank on the spinning process is essential to prevent the quality defects of the spun parts and obtain the desired spun parts.

  19. Fully automatic lung segmentation and rib suppression methods to improve nodule detection in chest radiographs.

    Science.gov (United States)

    Soleymanpour, Elaheh; Pourreza, Hamid Reza; Ansaripour, Emad; Yazdi, Mehri Sadooghi

    2011-07-01

    Computer-aided Diagnosis (CAD) systems can assist radiologists in several diagnostic tasks. Lung segmentation is one of the mandatory steps for initial detection of lung cancer in Posterior-Anterior chest radiographs. On the other hand, many CAD schemes in projection chest radiography may benefit from the suppression of the bony structures that overlay the lung fields, e.g. ribs. The original images are enhanced by an adaptive contrast equalization and non-linear filtering. Then an initial estimation of lung area is obtained based on morphological operations and then it is improved by growing this region to find the accurate final contour, then for rib suppression, we use oriented spatial Gabor filter. The proposed method was tested on a publicly available database of 247 chest radiographs. Results show that this method outperformed greatly with accuracy of 96.25% for lung segmentation, also we will show improving the conspicuity of lung nodules by rib suppression with local nodule contrast measures. Because there is no additional radiation exposure or specialized equipment required, it could also be applied to bedside portable chest x-rays. In addition to simplicity of these fully automatic methods, lung segmentation and rib suppression algorithms are performed accurately with low computation time and robustness to noise because of the suitable enhancement procedure.

  20. 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.

  1. Fractured Ribs and the CT Funky Fat Sign of Diaphragmatic Rupture

    Directory of Open Access Journals (Sweden)

    Iclal Ocak

    2016-01-01

    Full Text Available Traumatic diaphragmatic rupture remains a diagnostic challenge for both radiologists and surgeons. In recent years, multidetector CT has markedly improved the diagnosis of diaphragmatic injury in polytrauma patients. Herein, we describe two cases of subacute presentation of traumatic diaphragmatic rupture from a penetrating rib fracture and subsequent intrathoracic herniation of omental fat, representing the CT “funky fat” sign.

  2. Reconstruction of ulnar defect with vascularized rib graft: A case report.

    Science.gov (United States)

    Spiker, Andrea M; Humbyrd, Casey J; Osgood, Greg M; Yang, Stephen C; Deune, E Gene

    2017-02-01

    This case report describes the reconstruction of a segmental ulnar defect using a vascularized rib graft. A 27-year-old man was injured during military service by an improvised explosive device, resulting in bilateral through-the-knee amputations, left hand deformity, and a segmental left ulnar defect. After unsuccessful ulnar reconstruction with nonvascularized autologous bone and allograft bone substitutes, he presented to our institution. We removed the residual allograft fragments from the ulnar defect, harvested a vascularized left sixth rib with the intercostal artery and vein, secured the construct with internal hardware, and performed microanastomoses of the intercostal artery and vein to the posterior interosseous artery and vein. Postoperatively, he had a hematoma at the vascularized graft recipient site caused by anticoagulation therapy for his chronic deep vein thrombosis. Despite this, the rib graft successfully incorporated on the basis of radiographic and clinical examinations at 27 months. He had no pain and good function of the arm. The results of this case suggest that a vascularized rib graft for forearm reconstruction may be a viable option with minimal donor site morbidity. © 2015 Wiley Periodicals, Inc. Microsurgery 37:160-164, 2017.

  3. Spinning Deformation Criteria of Thin-walled Tubular Part with Longitudinal Inner Ribs

    Institute of Scientific and Technical Information of China (English)

    JIANG Shuyong; XUE Kemin; LI Chunfeng; REN Zhengyi

    2006-01-01

    As a successive and local plastic delormation process, backward ball spinning was applied for the purpose of producing thin-walled tubular parts with longitudinal inner ribs. According to the local plastic deformation theory, the application of yield criterion to the spinning process and the influence of the radial spinning force component on the formability of inner ribs were analyzed. Based on yield criterion and plastic mechanics, the stable flow rude of metal material and forming criteria of the inner ribs were obtained and conformed to the experimental results so as to contribute greatly to improving the ball spinning process and optimizing the process variables, such as the diameter of ball, the reduction in a pass and the wall thickness of tubular blank, which have a significant influence on the formability of the inner ribs. The knowledge of the influence of the process variables such as the diameter of ball, the reduction in a pass and the wall thickness of tubular blank on the spinning process is essential to preventing the quality defects of the spun parts and obtaining the desired spun parts.

  4. Ovariectomy-induced changes in aged beagles: Histomorphometry and mineral content of the rib

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, A.K.; Bhattacharyya, M.H.; Hurst, D. [Argonne National Lab., IL (United States). Center for Mechanistic Biology and Biotechnology; Miller, S. [Univ. of Utah, Salt Lake City, UT (United States). Radiobiology Div.; Sacco-Gibson, N. [Proctor and Gamble Pharmaceuticals, Cincinnati, OH (United States)

    1997-08-01

    The effects of ovariectomy on the aged beagle skeleton were studied by histomorphometric analysis of the cortical bone in sequential rib biopsies. Biopsies were taken from each ovariectomized (OV) or sham-operated (SO) dog at the time of surgery and at 1, 4, and 8.5 months after surgery. Tetracycline, calcein, and xylenol orange, respectively, were administered by a fluorochrome labeling procedure (2d-10d-2d) just prior to each postoperative biopsy to provide markers of bone formation. Analysis of sequential biopsies provided a means to follow the response to ovariectomy over time and compare each animal against its own baseline. Examination of sequential biopsies indicated that cortical porosity increased by the fourth month after ovariectomy and remained high at 8.5 months. Ovariectomy did not influence histomorphometric indices at one month after surgery, but substantial differences were observed at later times. Ovariectomy stimulated a transient increase in bone formation and was increased six-fold over that of SO dogs at four months. Ribs were also analyzed for mineral content at necropsy. The rib was heterogeneous along its length for calcium content and concentration. In the midrib where biopsies for histomorphometric analysis were taken, ovariectomy induced a decrease in mass and mineral content; total calcium was decreased by approximately 31%. These data demonstrate that the rib cortical bone is a responsive site for the effects of ovariectomy in female dogs.

  5. Role of joint receptors in modulation of inspiratory intercostal activity by rib motion in dogs.

    Science.gov (United States)

    De Troyer, A

    1997-09-01

    1. Inspiratory activity in the canine external intercostal muscles is exquisitely sensitive to the direction and amplitude of the inspiratory displacement of the ribs. This study was designed to investigate the role of muscle receptors, in particular the muscle spindles, in mediating this phenomenon. 2. External intercostal inspiratory activity showed a reflex increase when the normal cranial motion of the ribs and the normal shortening of the muscles was reduced, and showed a reflex decrease when the cranial motion of the ribs and the shortening of the muscles was augmented. However, clamping the two ribs making up the interspace and maintaining muscle length constant only moderately attenuated these responses. 3. These persistent responses remained unchanged after section of the levator costae muscles. 4. The responses were attenuated but still present after section of the external intercostals in the contiguous segments and denervation of the internal intercostals. 5. These reflex responses are therefore mediated in part by non-muscular receptors, which most likely lie within the costovertebral joints. These joint receptors might be a primary determinant of the load-compensating reflex.

  6. Design for beam splitting components employing silicon-on-insulator rib waveguide structures.

    Science.gov (United States)

    Hsiao, C S; Wang, Likarn

    2005-12-01

    We present a new design for beam splitting components employing a silicon-on-insulator rib waveguide structures. In the new design, a high-index thin-film layer is deposited in the rib section to reduce the wave field dispersive tails in the slab section and accordingly render the mode field a confined spot. This in turn improves the beam splitting performance of some conventional waveguide components such as y branches and multimode interference couplers (MMICs), in terms of the excess loss, fiber coupling loss, and compactness of these components. For a 1 x 2 y-branch beam splitter, the excess loss can be as small as 0.43 dB in the new design, which is much lower than that for a conventional rib waveguide structure (which is 1.28 dB). For a 1 x 2 MMIC in our example, the new rib waveguide structure presents an excess loss of 0.064 dB for the TE mode and 0.046 dB for the TM mode, with negligible nonuniformity in dimensions of 30 microm x 1040 microm, whereas its counterpart (i.e., the one with the same dimensions but without a thin-film layer) presents an excess loss of approximately 0.86 dB for both modes. A conventional MMIC must have dimensions larger than 70 microm x 5650 microm to maintain almost the same low excess loss.

  7. Treatment of congenital thoracic scoliosis with associated rib fusions using VEPTR expansion thoracostomy: a surgical technique.

    Science.gov (United States)

    Dayer, Romain; Ceroni, Dimitri; Lascombes, Pierre

    2014-07-01

    Untreated growing patients with congenital scoliosis and fused ribs will develop finally thoracic insufficiency syndrome. The technique of expansion thoracoplasty with implantation of a vertical expandable prosthetic titanium rib (VEPTR) was introduced initially to treat these children. This article attempts to provide an overview of the surgical technique of opening-wedge thoracostomy and VEPTR instrumentation in children with congenital thoracic scoliosis and fused ribs. Our modification of the surgical approach using a posterior midline incision rather than the modified thoracotomy incision initially described could potentially help to diminish wound dehiscence and secondary infection, while preserving a more acceptable esthetic appearance of the back. Vertical expandable prosthetic titanium rib-based treatments should be undertaken only with a good knowledge of its numerous specific complications. Every aspect of the treatment should be oriented to minimize these complications. At the same time it should be kept in mind that the ultimate step of this long-term fusionless treatment strategy will be a technically demanding spine fusion.

  8. 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

    2017-05-25

    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 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.

  9. Numerical investigation of mist/air impingement cooling on ribbed blade leading-edge surface.

    Science.gov (United States)

    Bian, Qingfei; Wang, Jin; Chen, Yi-Tung; Wang, Qiuwang; Zeng, Min

    2017-05-23

    The working gas turbine blades are exposed to the environment of high temperature, especially in the leading-edge region. The mist/air two-phase impingement cooling has been adopted to enhance the heat transfer on blade surfaces and investigate the leading-edge cooling effectiveness. An Euler-Lagrange particle tracking method is used to simulate the two-phase impingement cooling on the blade leading-edge. The mesh dependency test has been carried out and the numerical method is validated based on the available experimental data of mist/air cooling with jet impingement on a concave surface. The cooling effectiveness on three target surfaces is investigated, including the smooth and the ribbed surface with convex/concave columnar ribs. The results show that the cooling effectiveness of the mist/air two-phase flow is better than that of the single-phase flow. When the ribbed surfaces are used, the heat transfer enhancement is significant, the surface cooling effectiveness becomes higher and the convex ribbed surface presents a better performance. With the enhancement of the surface heat transfer, the pressure drop in the impingement zone increases, but the incremental factor of the flow friction is smaller than that of the heat transfer enhancement. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Minimization of Defective Products in The Department of Press Bridge & Rib Through Six Sigma DMAIC Phases

    Science.gov (United States)

    Rochman, YA; Agustin, A.

    2017-06-01

    This study proposes the DMAIC Six Sigma approach of Define, Measure, Analyze, Improve/Implement and Control (DMAIC) to minimizing the number of defective products in the bridge & rib department. There are 5 types of defects were the most dominant are broken rib, broken sound board, strained rib, rib sliding and sound board minori. The imperative objective is to improve the quality through the DMAIC phases. In the define phase, the critical to quality (CTQ) parameters was identified minimization of product defects through the pareto chart and FMEA. In this phase, to identify waste based on the current value stream mapping. In the measure phase, the specified control limits product used to maintain the variations of the product, the calculation of the value of DPMO (Defect Per Million Opportunities) and the calculation of the value of sigma level. In analyze phase, determine the type of defect of the most dominant and identify the causes of defective products. In the improve phase, the existing design was modified through various alternative solutions by conducting brainstorming sessions. In this phase, the solution was identified based on the results of FMEA. Improvements were made to the seven priority causes of disability based on the highest RPN value. In the control phase, focusing on improvements to be made. Proposed improvements include making and define standard operating procedures, improving the quality and eliminate waste defective products.

  11. 30 CFR 57.3460 - Maintenance between machinery or equipment and ribs.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Maintenance between machinery or equipment and... NONMETAL MINES Ground Control Precautions-Underground Only § 57.3460 Maintenance between machinery or equipment and ribs. Persons shall not perform maintenance work between machinery or equipment and...

  12. Clinical significance of conventional rib series in patients with minor thoracic trauma

    Energy Technology Data Exchange (ETDEWEB)

    Hoffstetter, P.; Dornia, C. [Asklepios Medical Center, Bad Abbach (Germany). Radiology; University Medical Center Regensburg (Germany). Radiology; Wagner, M.; Niessen, C.; Dendl, L.M.; Stroszczynski, C.; Schreyer, A.G. [University Medical Center Regensburg (Germany). Radiology; Al Suwaidi, M.H. [Asklepios Medical Center, Bad Abbach (Germany). Rheumatology/Clinical Immmunology

    2014-09-15

    Background: Conventional rib series (RS) represent a dedicated radiographic technique to visualize the bony parts of the chest wall. The method is commonly used to evaluate minor thoracic trauma, frequently in combination with chest radiographs (CRs). The aim of this study is to asses the clinical relevance of rib fractures diagnosed by RS in minor thoracic trauma. Methods: Retrospective study of 669 patients who received RS for the evaluation of minor thoracic trauma. 405 of the 669 patients received an additional CR. Radiological reports were classified into fracture versus no fracture. Patients were divided into four groups depending on the clinical follow-up. The findings of RS and CR were analyzed using the McNemar test. The statistical significance between the results of the radiographic examinations and the clinical follow-up was analyzed by the Chi-Square test and the Kruskal-Wallis test. Results: We included 669 patients (61.4% men, 38.6% women, median age: 51 years, range: 13-92 years). Analyzing the reports of 669 patients who received RS, 157 (23.5%) patients were diagnosed with at least one fractured rib while no fracture was found in 512 (76.5%) patients. Considering the 157 patients with fractured ribs, 73 (46.8%) had a single fracture, 38 (24.4%) and two fractures and 45 (28.8%) had more than two fractures. When assessing the 405 CRs, we detected 69 (17%) fractures while the corresponding RS of the same patients revealed 87 (21.5%) fractures (p < 0.05). Concerning all patients with rib fractures, 63.1% received medical therapy, while 64.5% of those patients without a radiologically documented fracture also received therapy (p = 0.25). Conclusion: Our results suggest a limited clinical value of detected rib fractures based on RS. Despite being superior compared to CR in diagnosing rib fractures, the results from RS seem to have no significant influence on further clinical management and therapeutic measures. Minor thoracic trauma should be evaluated

  13. [Clinical analysis on characteristics of rib cartilage calcification in congenital microtia patients].

    Science.gov (United States)

    Fengfeng, Guo; Xiaobo, Yu; Bo, Pan; Lin, Lin; Haiyue, Jiang

    2015-09-01

    To explore the incidence, degree, and pattern of rib cartilage calcification in congenital microtia patients, in order to provide reference for harvesting the rib cartilage, sculpturing cartilage framework. From Jun. 2013 to Nov. 2014, 383 patients (age range, 6-45 years) underwent CT scans of the chest. 11 patients with bony diseases or traumatic history were excluded. The remaining 372 patients were divided by age into four groups as 6-15, 16-25, 26-35, 36-45 years old. Twenty patients (10 male and 10 female) were selected by the order of patient identification number in each age group, thus selecting a total of 80 patients (40 male and 40 female). Retrospective study of CT scans of the chest in 80 patients and the incidence, degree, and pattern of cartilage calcification of the sixth to eighth ribs were noted. A chi-square test is conducted to test whether there are significant difference between the variables through the SPSS 19.0 software. Overall, 40.4% (194/480) cartilage was calcified; female patients (47.50%, 114/240) showed higher frequency of calcification than male patients (33.33%, 80/240, P = 0. 025). Calcification rates of all age groups are 1.7% (2/120), 46.7% (56/ 120), 49.2% (59/120), 64.2% (77/120). Calcification rate of 6-15 years group is lowest in all groups (P 0.05). Calcification rates of the sixth and sevent rib cartilage were higher than those of the eighth rib cartilage in all age groups except 6-15 years group, who had a similar rate of all three ribs. Calcification rate of all three rib cartilage was significantly increased with age. Calcification rates of the amle's rib cartilage and the female's in all age groups are 3.3% (2/60) and 0.0% (0/60) (6-15 years): 33.3% (20/60) and 60.0% (36/60) (16-25 years): 40.0% (24/60) and 58.3% (35/60) (26-35 years), 56.7% (34/60) and 71.2% (43/60) (36-45 years). In 6-15 years group calcification rates of male and female had a similar rate, while female's rates were higher than male's rates in other

  14. Resonances in the rotational constants of 0_{g}^{-}(6s_{1/2}+6p_{1/2}) Cs2 levels analysed by an improved-Bv-formula associated to a 2-channel model

    Science.gov (United States)

    Jelassi, Haikel; Pruvost, Laurence

    2016-08-01

    Spin-orbit coupling in 0g-(6s1/2+6p1/2) long-range molecular levels of Cs2 assigned to resonances in the rotational constant (Bv) spectrum (Lignier L. et al., Phys. Chem. Chem. Phys., 13 (2011) 18910; Pichler M. et al., J. Chem. Phys., 121 (2004) 1796) has been analyzed with a model which associates an improved-B v -formula (established here) and a 2-channel model. The approach explains the Lorentzian shape of the observed resonances superimposing a non-horizontal background and the fit of the B v -spectrum allows us to deduce the spin-orbit coupling parameters. We compare this approach with an analysis of the binding energies using the vibrational quantum defect (VQD). The good agreement between the methods lets one conclude that the improved-B v -formula associated with a 2-channel model provides a pertinent approach for analyzing coupled molecular series.

  15. Video-assisted thoracoscopic surgery for intrathoracic first rib resection in thoracic outlet syndrome

    Science.gov (United States)

    Hwang, Jinwook; Min, Byung-Ju; Jo, Won-Min

    2017-01-01

    Background First rib resection is a surgical treatment for decompressing the neurovascular structures in thoracic outlet syndrome (TOS). Historically, extrathoracic approaches have used a posterior, supraclavicular, or transaxillary incision to remove the first rib. In this report, we demonstrate video-assisted thoracoscopic surgery for intrathoracic first rib resection (VATS-IFRR). Methods Between 2009 and 2014, eight patients underwent VATS-IFRR for TOS. Surgery was performed through two 5-mm ports and one 10-mm port. Endoscopic graspers, a hook-type electrocautery probe, a long peapod intervertebral disc rongeur, and Kerrison punches were used. The types of disease, operative times, chest tube indwelling days, lengths of hospital stay after operation, perioperative complications, postoperative pain scale ratings, and postoperative symptom recurrence rates at provocation tests were reviewed. The surgical outcomes were compared to published outcomes of extrathoracic approaches and other VATS approaches. Results The eight patients (3 right ribs, 5 left ribs) exhibited neurogenic (1 patient), combined type (2 patients), arterial (4 patients), and venous type (1 patient) TOS. The mean operative time was 190 (range 155-310) minutes. No mortalities or major complications occurred. The mean chest tube indwelling duration was 6 (range 3–10) days, and the mean postoperative hospital stay was 9 (range 4–21) days. The mean immediate postoperative pain numeric rating scale (NRS) score was 2.7/10 (range 2–4). No recurrence was observed during follow-up (median 25.5 months, range 10–64 months) in any patient. Conclusions VATS-IFRR was safe and had several advantages. Thus, VATS-IFRR is a minimally invasive surgical option suitable for treating selective cases of TOS. PMID:28840002

  16. Increasing heat transfer of non-Newtonian nanofluid in rectangular microchannel with triangular ribs

    Science.gov (United States)

    Shamsi, Mohammad Reza; Akbari, Omid Ali; Marzban, Ali; Toghraie, Davood; Mashayekhi, Ramin

    2017-09-01

    In this study, computational fluid dynamics and the laminar flow of the non-Newtonian fluid have been numerically studied. The cooling fluid includes water and 0.5 wt% Carboxy methyl cellulose (CMC) making the non-Newtonian fluid. In order to make the best of non-Newtonian nanofluid in this simulation, solid nanoparticles of Aluminum Oxide have been added to the non-Newtonian fluid in volume fractions of 0-2% with diameters of 25, 45 and 100 nm. The supposed microchannel is rectangular and two-dimensional in Cartesian coordination. The power law has been used to speculate the dynamic viscosity of the cooling nanofluid. The field of numerical solution is simulated in the Reynolds number range of 5 ribs with angle of attacks of 30°, 45° and 60° is studied on flow parameters and heat transfer due to the fluid flow. The results show that an increase in the volume fraction of nanoparticles as well as the use for nanoparticles with smaller diameters lead to greater heat transfer. Among all the studied forms, the triangular rib from with an angle of attack 30° has the biggest Nusselt number and the smallest pressure drop along the microchannel. Also, an increase in the angle of attack and as a result of a sudden contact between the fluid and the ribs and also a reduction in the coflowing length (length of the rib) cause a cut in heat transfer by the fluid in farther parts from the solid wall (tip of the rib).

  17. The effectiveness of transdermal opioid in the management multiple rib fractures: randomized clinical trial.

    Science.gov (United States)

    Solak, Okan; Oz, Gürhan; Kokulu, Serdar; Solak, Ozlem; Doğan, Gökçen; Esme, Hıdır; Ocalan, Kubilay; Baki, Elif Doğan

    2013-09-01

    The most commonly observed pathology in chest traumas is rib fracture, and the most important clinical symptom is severe pain. To investigate the effectiveness of intramuscular opioid (IMO), intravenous patient-controlled analgesia (IVPCA) and the Fentanyl transdermal therapeutic system (TTS) in the management of rib fracture pain. Prospective randomized clinical trial. In our prospective and randomised study, we included 45 patients with a diagnosis of multiple rib fractures. There were three groups and intercostal nerve blockage (ICB) in the first day and oral paracetamol for five days was administered to each group as standard. In Group IMO (n=15), 4×40 mg pethidine HCl was administered to the patients, while in Group IVPCA (n=15) this was 5 μg/mL continuous intravenous fentanyl and was 50 μg fentanyl TTS in Group TTS (n=15). The demographics, injury data and vital signs of the patients were recorded. Pain was scored using Visual Analogue Scale (VAS). The pain during lying down (VASl) and mobilisation (VASm) was detected. There were no differences between the three groups regarding age, sex, the trauma pattern, the number and distribution of costal fracture localisations, the presence of additional pathology, complications, thoracal catheter and the duration of thoracal catheter. No significant difference between the groups regarding systolic and diastolic arterial tension, number of breaths and beats in a minute was observed (p>0.05). We observed an improvement in the mean VAS score after treatment in all three groups. The mean VASl score significantly decreased after treatment in each group (p0.05). In the analgesia of patients with multiple rib fractures, TTS administration with ICB showed similar effectiveness with IVPCA administration with ICB. In the management of pain due to multiple rib fractures, TTS administration is a safe, non-invasive and effective procedure.

  18. Chronic pain and its impact on quality of life following a traumatic rib fracture.

    Science.gov (United States)

    Shelat, V G; Eileen, S; John, L; Teo, L T; Vijayan, A; Chiu, M T

    2012-08-01

    Traumatic rib fractures account for 7-40 % of trauma admissions and most of them heal spontaneously and do not contribute to disability. The prevalence of chronic pain and its impact on quality of life following a traumatic rib fracture has not been studied adequately. A retrospective review of electronic medical records of all the traumatic rib fracture admissions from January 2007 to December 2008 was conducted. This was followed up with a brief telephonic survey of the following questions: (1) Do you have pain following the trauma? (2) If YES, how severe is your pain from a score of zero to ten? (3) Does the pain affect your life style? (4) Does the pain affect your work? (5) Do you need to take regular pain medications? One hundred and two patients responded to the survey and 23 patients (22.5 %) complained of chronic persistent pain. In patients with pain, six patients (26 %) had chronic pain that required regular use of analgesics, eight patients (35 %) complained of impairment of work life, and three patients (13 %) complained of impairment of personal quality of life. Chronic pain was not related to age, number of ribs fractured, flail chest, hemothorax and/or pneumothorax, chest tube insertion, or Injury Severity Score (ISS). This study confirms the high incidence of chronic pain after a traumatic rib fracture. While the majority of the patients can manage this pain without interference of their quality of life, a few do suffer from life style/work interference and may have to resort to regular analgesic usage.

  19. Expiratory rib cage compression in mechanically ventilated adults: systematic review with meta-analysis

    Science.gov (United States)

    Borges, Lúcia Faria; Saraiva, Mateus Sasso; Saraiva, Marcos Ariel Sasso; Macagnan, Fabrício Edler; Kessler, Adriana

    2017-01-01

    Objective To review the literature on the effects of expiratory rib cage compression on ventilatory mechanics, airway clearance, and oxygen and hemodynamic indices in mechanically ventilated adults. Methods Systematic review with meta-analysis of randomized clinical trials in the databases MEDLINE (via PubMed), EMBASE, Cochrane CENTRAL, PEDro, and LILACS. Studies on adult patients hospitalized in intensive care units and under mechanical ventilation that analyzed the effects of expiratory rib cage compression with respect to a control group (without expiratory rib cage compression) and evaluated the outcomes static and dynamic compliance, sputum volume, systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, peripheral oxygen saturation, and ratio of arterial oxygen partial pressure to fraction of inspired oxygen were included. Experimental studies with animals and those with incomplete data were excluded. Results The search strategy produced 5,816 studies, of which only three randomized crossover trials were included, totaling 93 patients. With respect to the outcome of heart rate, values were reduced in the expiratory rib cage compression group compared with the control group [-2.81 bpm (95% confidence interval [95%CI]: -4.73 to 0.89; I2: 0%)]. Regarding dynamic compliance, there was no significant difference between groups [-0.58mL/cmH2O (95%CI: -2.98 to 1.82; I2: 1%)]. Regarding the variables systolic blood pressure and diastolic blood pressure, significant differences were found after descriptive evaluation. However, there was no difference between groups regarding the variables secretion volume, static compliance, ratio of arterial oxygen partial pressure to fraction of inspired oxygen, and peripheral oxygen saturation. Conclusion There is a lack of evidence to support the use of expiratory rib cage compression in routine care, given that the literature on this topic offers low methodological quality and is inconclusive. PMID

  20. Modelling of the acoustic field of a multi-element HIFU array scattered by human ribs

    Energy Technology Data Exchange (ETDEWEB)

    Gelat, Pierre [National Physical Laboratory, Hampton Road, Teddington TW11 0LW (United Kingdom); Ter Haar, Gail [Therapeutic Ultrasound Group, Physics Department, Institute of Cancer Research, Sutton SM2 5NG (United Kingdom); Saffari, Nader, E-mail: Pierre.Gelat@npl.co.uk [Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom)

    2011-09-07

    The efficacy of high-intensity focused ultrasound (HIFU) for the treatment of a range of different cancers, including those of the liver, prostate and breast, has been demonstrated. As a non-invasive focused therapy, HIFU offers considerable advantages over techniques such as chemotherapy and surgical resection in terms of reduced risk of harmful side effects. Despite this, there are a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the rib cage to induce tissue necrosis in the required volume whilst minimizing the formation of side lobes. Multi-element random-phased arrays are currently showing great promise in overcoming the limitations of single-element transducers. Nevertheless, successful treatment of a patient with liver tumours requires a thorough understanding of the way in which the ultrasonic pressure field from a HIFU array is scattered by the rib cage. In order to address this, a boundary element approach based on a generalized minimal residual (GMRES) implementation of the Burton-Miller formulation was used in conjunction with phase conjugation techniques to focus the field of a 256-element random HIFU array behind human ribs at locations requiring intercostal and transcostal treatment. Simulations were carried out on a 3D mesh of quadratic pressure patches generated using CT scan anatomical data for adult ribs 9-12 on the right side. The methodology was validated on spherical and cylindrical scatterers. Field calculations were also carried out for idealized ribs, consisting of arrays of strip-like scatterers, demonstrating effects of splitting at the focus. This method has the advantage of fully accounting for the effect of scattering and diffraction in 3D under continuous wave excitation.

  1. Guideline-Driven Care Improves Outcomes in Patients with Traumatic Rib Fractures.

    Science.gov (United States)

    Flarity, Kathleen; Rhodes, Whitney C; Berson, Andrew J; Leininger, Brian E; Reckard, Paul E; Riley, Keyan D; Shahan, Charles P; Schroeppel, Thomas J

    2017-09-01

    There is no established national standard for rib fracture management. A clinical practice guideline (CPG) for rib fractures, including monitoring of pulmonary function, early initiation of aggressive loco-regional analgesia, and early identification of deteriorating respiratory function, was implemented in 2013. The objective of the study was to evaluate the effect of the CPG on hospital length of stay. Hospital length of stay (LOS) was compared for adult patients admitted to the hospital with rib fracture(s) two years before and two years after CPG implementation. A separate analysis was done for the patients admitted to the intensive care unit (ICU). Over the 48-month study period, 571 patients met inclusion criteria for the study. Pre-CPG and CPG study groups were well matched with few differences. Multivariable regression did not demonstrate a difference in LOS (B = -0.838; P = 0.095) in the total study cohort. In the ICU cohort (n = 274), patients in the CPG group were older (57 vs 52 years; P = 0.023) and had more rib fractures (4 vs 3; P = 0.003). Multivariable regression identified a significant decrease in LOS for those patients admitted in the CPG period (B = -2.29; P = 0.019). Despite being significantly older with more rib fractures in the ICU cohort, patients admitted after implementation of the CPG had a significantly reduced LOS on multivariable analysis, reducing LOS by over two days. This structured intervention can limit narcotic usage, improve pulmonary function, and decrease LOS in the most injured patients with chest trauma.

  2. COORDINATION BETWEEN RIBS MOTION AND THORACOABDOMINAL VOLUMES IN SWIMMERS DURING RESPIRATORY MANEUVERS

    Directory of Open Access Journals (Sweden)

    Karine J. Sarro

    2008-06-01

    Full Text Available This work aimed to verify if swimmers present better chest wall coordination during breathing than healthy non-athletes analyzing the correlation between ribs motion and the variation of thoracoabdominal volumes. The results of two up-to-date methods based on videogrammetry were correlated in this study. The first one measured the volumes of 4 separate compartments of the chest wall (superior thorax, inferior thorax, superior abdomen and inferior abdomen as a function of time. The second calculated the rotation angle of the 2nd to the 10th ribs around the quasi-transversal axis also in function of time. The chest wall was represented by 53 markers, attached to the ribs, vertebrae, thorax and abdomen of 15 male swimmers and of 15 non- athletes. A kinematical analysis system equipped with 6 digital video cameras (60Hz was used to obtain the 3D coordinates of the markers. Correlating the curves of ribs rotation angles with the curves of the separate volumes, swimmers presented higher values than non-athletes when the superior and inferior abdomen were considered and the highest correlation values were found in swimmers for the inferior thorax. These results suggest a better coordination between ribs motion and thoracoabdominal volumes in swimmers, indicating the prevalent and coordinated action of the diaphragm and abdominal muscles to inflate and deflate the chest wall. The results further suggest that swimming practice leads to the formation of an optimized breathing pattern and can partially explain the higher lung volumes found in these athletes reported in literature.

  3. The surgical stabilization of multiple rib fractures using titanium elastic nail in blunt chest trauma with acute respiratory failure.

    Science.gov (United States)

    Tarng, Yih-Wen; Liu, Yuan-Yuarn; Huang, Fong-Dee; Lin, Hsing-Lin; Wu, Tzu-Chin; Chou, Yi-Pin

    2016-01-01

    Blunt chest injuries are usually combined with multiple rib fractures and severe lung contusions. This can occasionally induce acute respiratory failure and prolong ventilations. In order to reduce the periods of ventilator dependency, we propose a less invasive method of fixing multiple rib fractures. Since October 2009, we have developed a new method to fix fractured ribs caused by blunt trauma. Rib fixations were performed using 2.0- or 2.5-mm intramedullary titanium elastic nails (TEN), with the help of video-assisted thoracoscopic surgery (VATS) and minimal thoracic incisions. All the patients' demographics and postoperative data were collected. From January 2010 to December 2012, a total of 65 patients presenting with multiple rib fractures resulting in acute respiratory failure were included in the study. Twelve patients received the new surgical fixation. Rib fixations were performed at an average of 4 days after trauma. Patients were successfully weaned off ventilators after an average of 3 days. The average length of stay in the hospital and the intensive care unit (ICU) was shorter for the patients with fixation than for nonsurgical patients. All twelve patients returned to normal daily activities and work. In the reconstruction of an injured chest wall, the VATS with TENs fixation in multiple rib fractures is feasible. This method is also effective in decreasing the length of the surgical wound. Because the structure of the chest cage is protected, the period of mechanical ventilation is shortened and the length of stay in the hospital and the ICU can be reduced.

  4. Multiple Rib Exostoses in a Boy: A Rare CaseResulting in Surgery Secondary to Cosmetic Concerns

    Directory of Open Access Journals (Sweden)

    Seyed Hosein Fattahi Masoum

    2014-09-01

    Full Text Available A seven year-old boy with several painless masses on the ribs and shoulder was referred to our hospital. The masses were so prominent that they prevented the child’s sleep. Since the patient had been ridiculed by his friends due to the rib prominences, he had refused to attend school. After clinical and radiological evaluations, the masses were diagnosed as hereditary multiple exostoses of the shoulder and ribs. He underwent surgery for cosmetic reasons resulting in the patient’s return to a normal life.

  5. Mechanosensitive Channels

    Science.gov (United States)

    Martinac, Boris

    Living cells are exposed to a variety of mechanical stimuli acting throughout the biosphere. The range of the stimuli extends from thermal molecular agitation to potentially destructive cell swelling caused by osmotic pressure gradients. Cellular membranes present a major target for these stimuli. To detect mechanical forces acting upon them cell membranes are equipped with mechanosensitive (MS) ion channels. Functioning as molecular mechanoelectrical transducers of mechanical forces into electrical and/or chemical intracellular signals these channels play a critical role in the physiology of mechanotransduction. Studies of prokaryotic MS channels and recent work on MS channels of eukaryotes have significantly increased our understanding of their gating mechanism, physiological functions, and evolutionary origins as well as their role in the pathology of disease.

  6. Effect of channel geometrical configuration on the pressure distribution and stress failure in a running PEM fuel cell

    Directory of Open Access Journals (Sweden)

    Maher A.R. Sadiq Al-Baghdadi

    2017-01-01

    Full Text Available Proton Exchange membrane (PEM fuel cells are still undergoing intense development, and the combination of new and optimized materials, improved product development, novel architectures, more efficient transport processes, and design optimization and integration are expected to lead to major gains in performance, efficiency, durability, reliability, manufacturability and cost-effectiveness. PEM fuel cell assembly pressure is known to cause large strains in the cell components. All components compression occurs during the assembly process of the cell, but also during fuel cell operation due to membrane swelling when absorbs water and cell materials expansion due to heat generating in catalyst layers. Additionally, the repetitive channel-rib pattern of the bipolar plates results in a highly inhomogeneous compressive load, so that while large strains are produced under the rib, the region under the channels remains approximately at its initial uncompressed state. This leads to significant spatial variations in GDL thickness and porosity distributions, as well as in electrical and thermal bulk conductivities and contact resistances (both at the ribe-GDL and membrane-GDL interfaces. These changes affect the rates of mass, charge, and heat transport through the GDL, thus impacting fuel cell performance and lifetime. In this study, computational fluid dynamics (CFD model of a PEM fuel cell has been developed to simulate the pressure distribution inside the cell, which are occurring during fuel cell assembly (bolt assembling, and membrane swelling and cell materials expansion during fuel cell running due to the changes of temperature and relative humidity. The PEM fuel cell model simulated includes the following components; two bi-polar plates, two GDLs, and, an MEA (membrane plus two CLs. This model is used to study and analyse the effect of channel geometrical configuration on the mechanical behaviour of the PEM fuel cell components. The analysis

  7. Real-World Rib Fracture Patterns in Frontal Crashes in Different Restraint Conditions.

    Science.gov (United States)

    Lee, Ellen L; Craig, Matthew; Scarboro, Mark

    2015-01-01

    The purpose of this study was to use the detailed medical injury information in the Crash Injury Research and Engineering Network (CIREN) to evaluate patterns of rib fractures in real-world crash occupants in both belted and unbelted restraint conditions. Fracture patterns binned into rib regional levels were examined to determine normative trends associated with belt use and other possible contributing factors. Front row adult occupants with Abbreviated Injury Scale (AIS) 3+ rib fractures, in frontal crashes with a deployed frontal airbag, were selected from the CIREN database. The circumferential location of each rib fracture (with respect to the sternum) was documented using a previously published method (Ritchie et al. 2006) and digital computed tomography scans. Fracture patterns for different crash and occupant parameters (restraint use, involved physical component, occupant kinematics, crash principal direction of force, and occupant age) were compared qualitatively and quantitatively. There were 158 belted and 44 unbelted occupants included in this study. For belted occupants, fractures were mainly located near the path of the shoulder belt, with the majority of fractures occurring on the inboard (with respect to the vehicle) side of the thorax. For unbelted occupants, fractures were approximately symmetric and distributed across both sides of the thorax. There were negligible differences in fracture patterns between occupants with frontal (0°) and near side (330° to 350° for drivers; 10° to 30° for passengers) crash principal directions of force but substantial differences between groups when occupant kinematics (and contacts within the vehicle) were considered. Age also affected fracture pattern, with fractures tending to occur more anteriorly in older occupants and more laterally in younger occupants (both belted and unbelted). Results of this study confirmed with real-world data that rib fracture patterns in unbelted occupants were more distributed

  8. 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.)

  9. Chondral Rib Fractures in Professional American Football: Two Cases and Current Practice Patterns Among NFL Team Physicians

    National Research Council Canada - National Science Library

    McAdams, Timothy R; Deimel, Jay F; Ferguson, Jeff; Beamer, Brandon S; Beaulieu, Christopher F

    2016-01-01

    ...: To present 2 cases of chondral rib injuries in the National Football League (NFL) and discuss the current practice patterns for management of these injuries among the NFL team physicians. Study Design: Case series...

  10. Chest Wall Pain and Rib Fracture after Stereotactic Radiotherapy for Peripheral Non-small Cell Lung Cancer

    National Research Council Canada - National Science Library

    Voroney, Jon-Paul J; Hope, Andrew; Dahele, Max R; Purdy, Thomas; Franks, Kevin N; Pearson, Shannon; Cho, John B. C; Sun, Alex; Payne, David G; Bissonnette, Jean-Pierre; Bezjak, Andrea; Brade, Anthony M

    2009-01-01

    .... With high dose per fraction radiotherapy, late side effects are of possible concern. In our initial cohort of 42 patients treated with 54 to 60 Gy in three fractions, nine patients have rib fracture...

  11. Additional circular intercostal space created by bifurcation of the left 3rd rib and its costal cartilage: a case report.

    Science.gov (United States)

    Kumar, Naveen; Guru, Anitha; Patil, Jyothsna; Ravindra, Swamy; Badagabettu, Satheesha Nayak

    2013-01-08

    In the thorax there are normally 11 pairs of intercostal spaces: the spaces between adjacent ribs. The intercostal spaces contain intercostal muscles, intercostal nerves and vessels. During a routine dissection for undergraduate medical students, we observed a variation involving the left 3rd rib and 3rd costal cartilage in the cadaver of a man of Indian ethnicity aged about 65 years. The left 3rd rib and its costal cartilage were bifurcated at their costochondral junction enclosing a small circular additional intercostal space. Muscle tissue covered by deep fascia was present in this circular intercostal space. The muscle in the circular intercostal space received its nerve supply from a branch of the 2nd intercostal nerve. Knowledge of such variations is helpful to surgeons operating on the anterior thoracic wall involving ribs and intercostal spaces. Knowing the possibility of the presence of an additional space between normal intercostal spaces can guide a surgeon through to a successful surgery.

  12. Semi-analytical model of Raman generation in silicon-on-insulator rib waveguide with DBR/F-P resonator

    National Research Council Canada - National Science Library

    Tyszka-Zawadzka, A; Szczepański, P; Mossakowska-Wyszyńska, A; Karpierz, M; Bugaj, M

    2013-01-01

    An approximate method of modelling of Raman generation in silicon-on-insulator (SOI) rib waveguide with DBR/F-P resonator including spatial field distribution and nonlinear effects such as Raman amplification and two photon absorption...

  13. Is there an association between fractures of the cervical spine and first- and second-rib fractures?

    Energy Technology Data Exchange (ETDEWEB)

    Logan, P.M. [Dalhouse Univ., Dept. of Radiology, Halifax, Nova Scotia (Canada); Queen Elizabeth II Health Science Centre, Victoria General Site, Halifax, Nova Scotia (Canada)

    1999-02-01

    Objective: To investigate a potential association between cervical spine injury and first- and second-rib fractures. Methods: Retrospective review of the radiologic and medical records of 28 consecutive patients admitted to an acute spinal injury unit. Results: A total of 10 (36%) of the patients with cervical spine trauma also had fractures of either the first or second ribs. Eight of these 10 patients had a fracture or fracture-subluxation of the seventh cervical vertebra or the C6/7 segment. Conclusion: Almost one-third of patients with traumatic cervical spine injury have an associated upper-rib fracture. The strongest association is between injury at the C7 level and first-rib fracture. (author)

  14. Technical note: Prediction of chemical rib section composition by dual energy X-ray absorptiometry in Zebu beef cattle.

    Science.gov (United States)

    Prados, L F; Zanetti, D; Amaral, P M; Mariz, L D S; Sathler, D F T; Filho, S C Valadares; Silva, F F; Silva, B C; Pacheco, M C; Alhadas, H M; Chizzotti, M L

    2016-06-01

    It is expensive and laborious to evaluate carcass composition in beef cattle. The objective of this study was to evaluate a method to predict the 9th to 11th rib section (rib) composition through empirical equations using dual energy X-ray absorptiometry (DXA). Dual energy X-ray absorptiometry is a validated method used to describe tissue composition in humans and other animals, but few studies have evaluated this technique in beef cattle, and especially in the Zebu genotype. A total of 116 rib were used to evaluate published prediction equations for rib composition and to develop new regression models using a cross-validation procedure. For the proposed models, 93 ribs were randomly selected to calculate the new regression equations, and 23 different ribs were randomly selected to validate the regressions. The rib from left carcasses were taken from Nellore and Nellore × Angus bulls from 3 different studies and scanned using DXA equipment (GE Healthcare, Madison, WI) in the Health Division at Universidade Federal de Viçosa (Viçosa, Brazil). The outputs of the DXA report were DXA lean (g), DXA fat free mass (g), DXA fat mass (g), and DXA bone mineral content (BMC; g). After being scanned, the rib were dissected, ground, and chemically analyzed for total ether extract (EE), CP, water, and ash content. The predictions of rib fat and protein from previous published equations were different ( g) = 37.082 + 0.907× DXA lean ( = 0.95); fat free mass (g) = 103.224 + 0.869 × DXA fat free mass ( = 0.93); EE mass (g) = 122.404 + 1.119 × DXA fat mass ( = 0.86); and ash mass (g) = 18.722 + 1.016 × DXA BMC ( = 0.39). The equations were validated using Mayer's test, the concordance correlation coefficient, and the mean square error of prediction for decomposition. For both equations, Mayer's test indicated that if the intercept and the slope were equal to 0 and 1 ( > 0.05), respectively, then the equation correctly estimated the rib composition. Comparing observed and

  15. Recent results from the TwinSol low-energy RIB facility

    Energy Technology Data Exchange (ETDEWEB)

    Becchetti, F.D. [U. Michigan, Ann Arbor, MI 48109 (United States); Kolata, J.J. [U. Notre Dame, Notre Dame, IN 46556 (United States)

    2016-06-01

    We report on some of the recent developments and experimental work done at the twin-solenoid low-energy radioactive-ion-beam (RIB) facility TwinSol installed at the U Notre Dame 10 MV FN tandem accelerator. The TwinSol facility is a joint project of the University of Michigan (UM) and the University of Notre Dame (UND), and includes several U.S. and foreign collaborators. A number of significant experiments including RIB-induced transfer reactions, elastic scattering, resonant scattering, and fusion at energies near and well below the Coulomb barrier have been performed with this facility. Several of these as well as future work and upgrades planned will be described.

  16. 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

  17. Intraosseous Schwannoma of Rib With Severe Back Pain and Characteristic Pathological Findings.

    Science.gov (United States)

    Yao, Takahide; Otsuka, Hajime; Koezuka, Satoshi; Makino, Takashi; Hata, Yoshinobu; Ishiwatari, Takao; Shibuya, Kazutoshi; Iyoda, Akira

    2016-08-01

    A 44-year-old man was admitted to our hospital with severe back pain continuing for 12 years. Computed tomography of the chest revealed a 14 mm diameter tumor with calcification located in the right seventh rib. We performed right seventh rib and sixth to seventh intercostal muscle partial resection. Microscopically, the tumor showed typical features of a schwannoma composed of Antoni A and Antoni B tissues. The tumor had positive immunohistochemical staining for S-100 protein. The pathological diagnosis was intraosseous schwannoma. The patient's severe back pain disappeared and there was no recurrence or metastasis of the tumor during a 1-year follow up. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Effectiveness of intercostal nerve block for management of pain in rib fracture patients.

    Science.gov (United States)

    Hwang, Eun Gu; Lee, Yunjung

    2014-08-01

    Controlling pain in patients with fractured ribs is essential for preventing secondary complications. Conventional medications that are administered orally or by using injections are sufficient for the treatment of most patients. However, additional aggressive pain control measures are needed for patients whose pain cannot be controlled effectively as well as for those in whom complications or a transition to chronic pain needs to be prevented. In this study, we retrospectively analyzed the medical records of patients in our hospital to identify the efficacy and characteristics of intercostal nerve block (ICNB), as a pain control method for rib fractures. Although ICNB, compared to conventional methods, showed dramatic pain reduction immediately after the procedure, the pain control effects decreased over time. These findings suggest that the use of additional pain control methods (e.g. intravenous patient-controlled analgesia and/or a fentanyl patch) is recommended for patients in who the pain level increases as the ICNB efficacy decreases.

  19. Mechanics analysis on the conditions of rock burst occurrence in the coal mass of roadway rib

    Institute of Scientific and Technical Information of China (English)

    CHEN Xue-hua; DENG Xiao-lin; LI Zhong-hua

    2008-01-01

    According to the rock burst features occurred in the coal mass of roadway rib in one mine, the mechanics model of coal mass and roof structure system along the edge of goaf was founded to analyze the stress of roof rock layer, so the subside curve of roof rock layer was deduced. Furthermore, the stability of coal and rock system were analyzed, the critical load and critical resistance zone were used to judge the danger degree of rock burst occurrence. The influence of coal mass strength, brittleness degree, coal seam thickness, roof thickness, suspending length, equivalent shear module on the critical load,critical resistance zone was confirmed. So the rock burst occurrence conditions of coal mass in roadway rib mainly depend on mining depth, coal seam thickness and hard roof and floor, which are decided by the above studies, and successfully applied in prediction and prevention of rock burst in this mine.

  20. Nose and Midface Augmentation by Rib Cartilage Grafts: Methods and Outcome in 32 Cases

    Directory of Open Access Journals (Sweden)

    Adham Farouk

    2015-01-01

    Full Text Available Recession of the midface is a relatively common condition that can have a negative impact on facial and nasal aesthetic appearance, and it poses a challenge to plastic surgeons. In cases with generalized maxillary retrusion and/or malocclusion, bone advancement surgery is required, but in localized cases, mostly seen in cleft lip patients, the quest is for an ideal material and a proper technique that would be used to augment the receding area. Throughout a period of seven years, thirty-two patients with nose and midface retrusion were managed by a construct of rib cartilage grafts designed to compensate the deficiency at the maxillary, piriform, and premaxillary areas. Results were satisfactory for most patients in terms of improved fullness of malar area, improved nasal tip projection and rotation, and improvement of upper lip. The presented technique of rib cartilage grafting is a safe and effective method for nose and midface augmentation.

  1. Performance estimation of artificially roughened solar air heater duct provided with continuous ribs

    Directory of Open Access Journals (Sweden)

    Mridul Sharma, Varun

    2010-09-01

    Full Text Available The use of an artificial roughness on a surface is an effective technique to enhance the rate of heat transfer to fluid flow in the duct of a solar air heater. This paper presents a comparison of exergetic performance of solar air heaters having different types of geometry of roughness elements (continuous ribs on the absorber plate. The exergy efficiency has been computed by using the correlations for heat transfer and friction factor developed by various investigators within the investigated range of operating and system parameters. The exergy efficiency based criterion shows the better results at lower value of Re. There is not a single roughness geometry which gives best exergetic performance for whole range of Reynolds number. Solar air heater having rib-grooved and arc shaped wire as artificial roughness is found to have better exergy efficiency in the lower range of Reynolds number. However, smooth duct is found suitable in the higher range of Reynolds number.

  2. High-definition video-assisted transaxillary first rib resection for thoracic outlet syndrome.

    Science.gov (United States)

    Chan, Yiu Che; Gelabert, Hugh A

    2013-04-01

    Transaxillary first rib resection is a well-established effective surgical treatment for patients with symptomatic thoracic outlet syndrome, but surgical access may be limited and visualization is constrained. The use of high-definition video-assisted imaging overcomes these limitations. The use of high-definition video-assisted visualization of the anatomy enhances the surgeon's tactile feedback of the rib from the small open wound and is effective in providing better surgical access and allows clear identification of vital structures for the operating surgical team. This technique enhances the appreciation of anatomic detail, situational awareness of the team, and allows for more efficient assistance to the surgeon. Improved visualization also facilitates effective education of nurses, residents, and students.

  3. External Pressure Forming and Buckling Analysis of Tubular Parts with Ribs

    Institute of Scientific and Technical Information of China (English)

    Gang LIU; Xuelian YIN; Shijian YUAN

    2006-01-01

    Buckling and forming processes of tubes with varying slenderness ratio(ratio of length to diameter)under external hydraulic pressure were analyzed with three-dimensional finite element method(FEM)for studying tube external pressure forming(EPF). Buckling pressures for different tube blanks without mandrel were predicted, and an EPF of a carbon steel tube onto a mandrel with six ribs was simulated. Both thickness distribution and buckling pressure from the simulations were found to be in agreement with those from experiments. Buckling pressures are shown to be a function of the slenderness ratio. The tubular part with six ribs produced by EPF has a uniform thickness distribution, whose maximum thinning rate is only 5.9%.

  4. Reconstruction of large iliac crest defects after graft harvest using autogenous rib graft: a prospective controlled study.

    Science.gov (United States)

    Bapat, Mihir R; Chaudhary, Kshitij; Garg, Hitesh; Laheri, Vinod

    2008-11-01

    Prospective controlled study analyzing the donor site morbidity after reconstruction of full thickness iliac crest defects, using autologous rib grafts. To compare the pain and cosmetic outcomes of patients with iliac crest reconstruction with those who have had no reconstruction of the iliac crest. Chronic donor site pain and poor cosmesis have been the major deterrents in using iliac crest for long-segment spinal reconstructions. Iliac crest reconstruction with rib has been reported but most studies are uncontrolled and retrospective. Patients with iliac defects rib graft harvested during the anterolateral approach to spine. Rib graft of the appropriate contour was impacted into the notches created in the iliac crest defect. The control group comprised 16 patients without reconstruction of the iliac crest. The pain, cosmesis, and functional disability were assessed on the basis of visual analog scores and a predesigned questionnaire. Judet iliac views were used to assess the incorporation of the rib graft. Evaluation was performed at 1.5, 3, 6, and 12 months, respectively. Intensity and incidence of pain was significantly lower in the reconstructed group. Cosmetic outcome was also significantly better in this group. Patients in control group had significant complications related to the tenting of skin over the defect such as bursitis and skin necrosis. Radiologic incorporation was documented in 95% of patients with 1 patient having resorption of the rib graft. Rib graft reconstruction provides a cheap and effective alternative for iliac crest reconstruction. Patients undergoing thoracotomy or thoraco-phrenico-lumbotomy for spinal reconstruction, the unutilized rib graft should be used to reconstruct the iliac defect. Reduced donor site morbidity and better cosmesis are the major benefits of reconstruction.

  5. Case report: ultrasound-guided continuous thoracic paravertebral block for outpatient acute pain management of multilevel unilateral rib fractures.

    Science.gov (United States)

    Murata, Hiroaki; Salviz, Emine Aysu; Chen, Stephanie; Vandepitte, Catherine; Hadzic, Admir

    2013-01-01

    A 61-year-old man with multiple unilateral rib fractures (T3-T8) gained the ability to breathe deeply and to ambulate after ultrasound-guided continuous thoracic paravertebral block and was discharged home after being observed for 15 hours after the block. The ultrasound guidance was helpful in determining the site of rib fractures and the optimal level for catheter placement. This report also discusses the management of analgesia using continuous paravertebral block in an outpatient with trauma.

  6. Number of Ribs Resected is Associated with Respiratory Complications Following Lobectomy with en bloc Chest Wall Resection.

    Science.gov (United States)

    Geissen, Nicole M; Medairos, Robert; Davila, Edgar; Basu, Sanjib; Warren, William H; Chmielewski, Gary W; Liptay, Michael J; Arndt, Andrew T; Seder, Christopher W

    2016-08-01

    Pulmonary lobectomy with en bloc chest wall resection is a common strategy for treating lung cancers invading the chest wall. We hypothesized a direct relationship exists between number of ribs resected and postoperative respiratory complications. An institutional database was queried for patients with non-small cell lung cancer that underwent lobectomy with en bloc chest wall resection between 2003 and 2014. Propensity matching was used to identify a cohort of patients who underwent lobectomy via thoracotomy without chest wall resection. Patients were propensity matched on age, gender, smoking history, FEV1, and DLCO. The relationship between number of ribs resected and postoperative respiratory complications (bronchoscopy, re-intubation, pneumonia, or tracheostomy) was examined. Sixty-eight patients (34 chest wall resections; 34 without chest wall resection) were divided into 3 cohorts: cohort A = 0 ribs resected (n = 34), cohort B = 1-3 ribs resected (n = 24), and cohort C = 4-6 ribs resected (n = 10). Patient demographics were similar between cohorts. The 90-day mortality rate was 2.9 % (2/68) and did not vary between cohorts. On multivariate analysis, having 1-3 ribs resected (OR 19.29, 95 % CI (1.33, 280.72); p = 0.03), 4-6 ribs resected [OR 26.66, (1.48, 481.86); p = 0.03), and a lower DLCO (OR 0.91, (0.84, 0.99); p = 0.02) were associated with postoperative respiratory complications. In patients undergoing lobectomy with en bloc chest wall resection for non-small cell lung cancer, the number of ribs resected is directly associated with incidence of postoperative respiratory complications.

  7. Mechanical analysis of the human cadaveric thoracic spine with intact rib cage.

    Science.gov (United States)

    Mannen, Erin M; Anderson, John T; Arnold, Paul M; Friis, Elizabeth A

    2015-07-16

    The goal of this study was to characterize the overall in-plane and basic coupled motion of a cadaveric human thoracic spine with intact true ribs. Researchers are becoming increasingly interested in the thoracic spine due to both the high prevalence of injury and pain in the region and also innovative surgical techniques that utilize the rib cage. Computational models can be useful tools to predict loading patterns and understand effects of surgical procedures or medical devices, but they are often limited by insufficient cadaveric input data. In this study, pure moments to ±5 Nm were applied in flexion-extension, lateral bending, and axial rotation to seven human cadaveric thoracic spine specimens (T1-T12) with intact true ribs to determine symmetry of in-plane motion, differences in neutral and elastic zone motion and stiffness, and significance of out-of-plane rotations and translations. Results showed that lateral bending and axial rotation exhibited symmetric motion, neutral and elastic zone motion and stiffness values were significantly different for all modes of bending (p<0.05), and out-of-plane rotations and translations were greater than zero for most rotations and translations. Overall in-plane rotations were 7.7±3.4° in flexion, 9.6±3.7° in extension, 23.3±8.4° in lateral bending, and 26.3±12.2° in axial rotation. Results of this study could provide inputs or validation comparisons for computational models. Future studies should characterize coupled motion patterns and local and regional level biomechanics of cadaveric human thoracic spines with intact true ribs.

  8. Improving detector spatial resolution using pixelated scintillators with a barrier rib structure

    Science.gov (United States)

    Liu, Langechuan; Lu, Minghui; Cao, Wanqing; Peng, Luke; Chen, Arthur

    2016-03-01

    Indirect conversion flat panel detectors (FPDs) based on amorphous silicon (a-Si) technology are widely used in digital X-ray imaging. In such FPDs a scintillator layer is used for converting X-rays into visible light photons. However, the lateral spread of these photons inside the scintillator layer reduces spatial resolution of the FPD. In this study, FPDs incorporating pixelated scintillators with a barrier rib structure were developed to limit lateral spread of light photons thereby improving spatial resolution. For the pixelated scintillator, a two-dimensional barrier rib structure was first manufactured on a substrate layer, coated with reflective materials, and filled to the rim with the scintillating material of gadolinium oxysulfide (GOS). Several scintillator samples were fabricated, with pitch size varying from 160 to 280 μm and rib height from 200 to 280 μm. The samples were directly coupled to an a-Si flat panel photodiode array with a pitch of 200 μm to convert optical photons to electronic signals. With the pixelated scintillator, the detector modulation transfer function was shown to improve significantly (by 94% at 2 cycle/mm) compared to a detector using an unstructured GOS layer. However, the prototype does show lower sensitivity due to the decrease in scintillator fill factor. The preliminary results demonstrated the feasibility of using the barrier-rib structure to improve the spatial resolution of FPDs. Such an improvement would greatly benefit nondestructive testing applications where the spatial resolution is the most important parameter. Further investigation will focus on improving the detector sensitivity and exploring its medical applications.

  9. The chemical heritage of Aspergillus flavus in A. oryzae RIB 40

    DEFF Research Database (Denmark)

    Rank, Christian; Klejnstrup, Marie Louise; Petersen, Lene Maj

    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...... with indications to specific genetic changes. Several new metabolites and changes in biosynthetic routes have been found in A. oryzae, indicating subtle changes in the genomic heritage from A. flavus....

  10. Analgesic Choice in Management of Rib Fractures: Paravertebral Block or Epidural Analgesia?

    Science.gov (United States)

    Malekpour, Mahdi; Hashmi, Ammar; Dove, James; Torres, Denise; Wild, Jeffrey

    2017-06-01

    Rib fractures are commonly encountered in the setting of trauma. The aim of this study was to assess the association between the clinical outcome of rib fracture and epidural analgesia (EA) versus paravertebral block (PVB) using the National Trauma Data Bank (NTDB). Using the 2011 and 2012 versions of the NTDB, we retrieved completed records for all patients above 18 years of age who were admitted with rib fractures. Primary outcome was in-hospital mortality. Secondary outcomes were length of stay (LOS), intensive care unit (ICU) admission, ICU LOS, mechanical ventilation, duration of mechanical ventilation, development of pneumonia, and development of any other complication. Clinical outcomes were first compared between propensity score-matched EA and PVB patients. Then, EA and PVB patients were combined into the procedure group and the outcomes were compared with propensity score-matched patients that received neither intervention (no-procedure group). A total of 194,766 patients were included in the study with 1073 patients having EA, 1110 patients having PVB, and 192,583 patients having neither procedure. After propensity score matching, comparison of primary and secondary outcomes between EA and PVB patients showed no difference. Comparison of propensity score-matched procedure and no-procedure patients showed prolonged LOS and more frequent ICU admissions in patients receiving a procedure (both P rib fractures. There was an association between use of a block and improved outcome, but this could be explained by selection of healthier patients to receive a block. Prospective study of this association is recommended.

  11. Randomized, double-blind, placebo-controlled trial using lidocaine patch 5% in traumatic rib fractures.

    Science.gov (United States)

    Ingalls, Nichole K; Horton, Zachary A; Bettendorf, Matthew; Frye, Ira; Rodriguez, Carlos

    2010-02-01

    The lidocaine patch 5% was developed to treat postherpetic neuralgia. Anecdotal experience at our institution suggests the lidocaine patch 5% decreases narcotic usage in patients with traumatic rib fractures. This trial was developed to define the patch's efficacy. Patients with rib fractures admitted to the trauma service at our Level I trauma center were enrolled and randomized in a 1 to 1 double-blind manner to receive a lidocaine patch 5% or placebo patch. Fifty-eight patients who met the inclusion criteria were enrolled from January 2007 to August 2008. Demographic and clinical information were recorded. The primary outcomes variable was total narcotic use, analyzed using the 1-tailed Mann-Whitney test. The secondary outcomes variables included non-narcotic pain medication, average pain score, pulmonary complications, and length of stay. Significance was defined based on a 1-sided test for the primary outcome and 2-sided tests for other comparisons, at p rib fractures, gender, trauma mechanism, preinjury lung disease, smoking history, percent of current smokers, and need for placement of chest tube between the lidocaine patch 5% and placebo groups. There was no difference between the lidocaine patch 5% and placebo groups, respectively, with regard to total IV narcotic usage: median, 0.23 units versus 0.26 units; total oral narcotics: median, 4 units versus 7 units; pain score: 5.6 +/- 0.4 versus 6.0 +/- 0.3 (mean +/- SEM); length of stay: 7.8 +/- 1.1 versus 6.2 +/- 0.7; or percentage of patients with pulmonary complications: 72.7% versus 72.0%. The lidocaine patch 5% does not significantly improve pain control in polytrauma patients with traumatic rib fractures.

  12. Bone images from dual-energy subtraction chest radiography in the detection of rib fractures

    Energy Technology Data Exchange (ETDEWEB)

    Szucs-Farkas, Zsolt, E-mail: zsolt.szuecs@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Lautenschlager, Katrin, E-mail: katrin@students.unibe.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Flach, Patricia M., E-mail: patricia.flach@irm.unibe.ch [Institute of Forensic Medicine, University of Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Ott, Daniel, E-mail: daniel.ott@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Strautz, Tamara, E-mail: tamara.strautz@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Vock, Peter, E-mail: peter.vock@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Ruder, Thomas D., E-mail: thomas.ruder@irm.unibe.ch [Institute of Forensic Medicine, University of Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland)

    2011-08-15

    Objective: To assess the sensitivity and image quality of chest radiography (CXR) with or without dual-energy subtracted (ES) bone images in the detection of rib fractures. Materials and methods: In this retrospective study, 39 patients with 204 rib fractures and 24 subjects with no fractures were examined with a single exposure dual-energy subtraction digital radiography system. Three blinded readers first evaluated the non-subtracted posteroanterior and lateral chest radiographs alone, and 3 months later they evaluated the non-subtracted images together with the subtracted posteroanterior bone images. The locations of rib fractures were registered with confidence levels on a 3-grade scale. Image quality was rated on a 5-point scale. Marks by readers were compared with fracture localizations in CT as a standard of reference. Results: The sensivity for fracture detection using both methods was very similar (34.3% with standard CXR and 33.5% with ES-CXR, p = 0.92). At the patient level, both sensitivity (71.8%) and specificity (92.9%) with or without ES were identical. Diagnostic confidence was not significantly different (2.61 with CXR and 2.75 with ES-CXR, p = 0.063). Image quality with ES was rated higher than that on standard CXR (4.08 vs. 3.74, p < 0.001). Conclusions: Despite a better image quality, adding ES bone images to standard radiographs of the chest does not provide better sensitivity or improved diagnostic confidence in the detection of rib fractures.

  13. COORDINATION BETWEEN RIBS MOTION AND THORACOABDOMINAL VOLUMES IN SWIMMERS DURING RESPIRATORY MANEUVERS

    OpenAIRE

    Karine J. Sarro; Barros, Ricardo M.L.; Silvatti, Amanda P.

    2008-01-01

    This work aimed to verify if swimmers present better chest wall coordination during breathing than healthy non-athletes analyzing the correlation between ribs motion and the variation of thoracoabdominal volumes. The results of two up-to-date methods based on videogrammetry were correlated in this study. The first one measured the volumes of 4 separate compartments of the chest wall (superior thorax, inferior thorax, superior abdomen and inferior abdomen) as a function of time. The second cal...

  14. 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.

  15. 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

  16. 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.

  17. Detection of rib fractures in minor chest injuries: a comparison between ultrasonography and radiography performed on the same day

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Yong Soo; Back, Chang Hee; Lee, Kyung Rae; Shin, Yun Hack; Whang, Yeong Seop; Jeong, Ku Young [Yeosu Baek Hospital, Yeosu (Korea, Republic of); Chung, Soo Hyun [NamWon Medical Center, NamWon (Korea, Republic of); Whang, Cheol Mog [Konyang University Hospital, Daejeon (Korea, Republic of)

    2007-04-15

    We wished to compare the ability of ultrasonography and radiography performed on the same day to detect rib fractures in minor chest injuries. Two hundred and fifteen patients with minor chest injuries were selected. Radiography and ultrasonography were performed on the same day with these patients. Chest wall pain was the only presenting symptom. Two radiologists performed ultrasonography. Fractures were identified by a disruption of the anterior margin of the rib and costal cartilage. The incidence and location of fractures and complications revealed by radiography and ultrasonography were compared. Radiographs revealed the presence of 70 rib fractures in 50 (23%) of 215 patients and ultrasonography revealed the presence of 203 rib fractures in 133 (62%) of 215 patients. Ultrasonography uniquely identified 133 rib fractures in 83 patients. Ultrasonography identified a 2.9 fold increase in the number of fractures in a 2.6 fold number of subjects as compared to radiography. Of the 203 sonographically detected fractures, 201 were located in the rib, one was located at the costochondral junction, and one in the costal cartilage. There were no complications seen by either radiography or ultrasonography. Ultrasonography reveals more fractures than those that may be overlooked on radiography for minor chest injuries.

  18. Study of the temperature rise induced by a focusing transducer with a wide aperture angle on biological tissue containing ribs

    Science.gov (United States)

    Xin, Wang; Jiexing, Lin; Xiaozhou, Liu; Jiehui, Liu; Xiufen, Gong

    2016-04-01

    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. Project supported by the National Basic Research Program of China (Grant Nos. 2012CB921504 and 2011CB707902), the National Natural Science Foundation of China (Grant No. 11274166), the Fundamental Research Funds for the Central Universities, China (Grant No. 020414380001), the Fund from State Key Laboratory of Acoustics, Chinese Academy of Sciences (Grant No. SKLA201401), China Postdoctoral Science Foundation (Grant No. 2013M531313), and the Priority Academic Program Development of Jiangsu Higher Education Institutions and SRF for ROCS, SEM.

  19. Characteristics of entropy generation and heat transfer in a microchannel with fan-shaped reentrant cavities and internal ribs

    Institute of Scientific and Technical Information of China (English)

    XIA; GuoDong; ZHAI; YuLing; CUI; ZhenZhen

    2013-01-01

    Three-dimensional laminar fluid flow and heat transfer in a micro heat sink with cavities and internal ribs are investigated us-ing numerical methods. Moreover, according to the second law of thermodynamics, the model of entropy generation is also established for variable cross section of the microchannel. The simulation encompasses Reynolds number of 198-600, relative cavity height e1/Dhvalues of 0-0.65, relative rib height e2/Dhrange of 0-0.2167. The results show that the effect of relative rib height on entropy generation is significant, while the relative cavity height has little effect on it. The combined effect of cavities and ribs in the microchannel has better performance of heat transfer than the smooth microchannel under similar conditions. Extensive simulations are conducted to collect data on the characteristics of heat transfer and fluid flow in a micro heat sink with cavities and internal ribs. Using these data, correlations for Nusselt number and friction factor in terms of Reynolds number and the geometry of cavity and rib have been developed.

  20. The red-eared slider turtle carapace under fatigue loading: The effect of rib-suture arrangement.

    Science.gov (United States)

    Achrai, Ben; Daniel Wagner, H

    2015-08-01

    Biological structures consisting of strong boney elements interconnected by compliant but tough collagenous sutures are abundantly found in skulls and shells of, among others, armadillos, alligators, turtles and more. In the turtle shell, a unique arrangement of alternating rigid (rib) and flexible (suture) elements gives rise to superior mechanical performance when subjected to low and high strain-rate loadings. However, the resistance to repeated load cycling - fatigue - of the turtle shell has yet to be examined. Such repeated loading could approximately simulate the consecutive high-stress bending loads exerted during (a predator) biting or clawing. In the present study flexural high-stress cyclic loads were applied to rib and suture specimens, taken from the top dorsal part of the red-eared slider turtle shell, termed carapace. Subsequently, to obtain a more complete and integrated fatigue behavior of the carapace, specimens containing a complex alternating rib-suture-rib-suture-rib configuration were tested as well. Although the sutures were found to be the least resistant to repeated loads, a synergistic effect was observed for the complex specimens, displaying improved fatigue durability compared to the individual (suture or even rib) constituents. This study may assist in the design of future high-stress fatigue-resistant materials incorporating complex assemblies of rigid and flexible elements. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Poland Syndrome: Use of Vertical Expandable Prosthetic Titanium Rib System before Walking Age-A Case Report.

    Science.gov (United States)

    Drebov, Rosen S; Katsarov, Atanas

    2016-07-01

    Aim  To present a new therapy for Poland syndrome (PS) using a novel surgical approach: the vertical expandable prosthetic titanium rib (VEPTR) system. Methods  The VEPTR system rib-to-rib variant was used to enhance the chest wall and vertebral column support in a young patient before walking age. Case Report  We present a 12-month-old infant diagnosed with left-sided PS at the age of 6 months associated with missing ribs, scoliosis, and absence of the left pectoral muscles. Because of four missing ribs, paradoxical breathing was present. In addition, the left scapula was protruding into the chest due to the missing rib support. Scoliosis was caused by a left-sided nonsegmented bar of the thoracic spine. Results  We decided to use the VEPTR system before the patient reached walking age to prevent progression of column deformation and future pulmonary problems. To improve the spinal deformity, to stabilize the thorax, and to improve thoracic function, we performed the operation at 1 year of age. At 10-month follow-up, the patient was reevaluated. The construction was still stable and scoliosis had not deteriorated. Conclusion  The VEPTR system is a choice of treatment in young patients with PS to prevent late complications after a child reaches walking age.

  2. Long-term patient outcomes after surgical stabilization of rib fractures.

    Science.gov (United States)

    Majercik, Sarah; Cannon, Quinn; Granger, Steven R; VanBoerum, Don H; White, Thomas W

    2014-07-01

    Rib fractures are common, and can be disabling. Recently, there has been increased interest in surgical stabilization of rib fractures (SSRF). It is difficult to define long-term benefits of the procedure. This is a descriptive study of patient outcomes after SSRF. SSRF patients between April 2010 and August 2012 at a Level I trauma center were identified. Data were collected from the medical records. A telephone survey asking about pain, satisfaction, and employment was administered to patients after hospital discharge. One hundred-one patients met inclusion criteria. Fifty (50%) patients completed the survey. Indications for SSRF included flail chest, displaced fractures, pain, and inability to wean from mechanical ventilation. Pain was gone at 5.4 ± 1.1 weeks post discharge. Satisfaction with SSRF on a scale of 1 to 10 was 9.2 ± .2. Ninety percent of employed patients returned to the same work at 8.5 ± 1.2 weeks. SSRF patients are satisfied and are able to return to normal activity with few limitations. A prospective study using modern rib fixation technology is needed to further define benefits. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Prospective clinical trial of surgical intervention for painful rib fracture nonunion.

    Science.gov (United States)

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

    2014-06-01

    We performed a prospective clinical trial of resection with or without plate fixation for symptomatic rib fracture nonunion three or more months postinjury with 6-month postoperative followup. The McGill Pain Questionnaire (MPQ) and RAND 36 Health Survey were administered and activity level (sedentary, ambulatory, moderately active, vigorous), functional status (disabled, nonphysical labor, physical labor), and work status (employed, unemployed, retired, student) were queried pre- and postoperatively. Twenty-four patients 4 to 197 months (median, 16 months) postinjury underwent surgical intervention for one to four rib fracture nonunions (median, two nonunions). Evidence of intercostal nerve entrapment was present in nine patients (38%). MPQ Present Pain Intensity and Pain Rating Index and RAND 36 Physical Functioning, Role Physical, Social Functioning, Role Social, Bodily Pain, Vitality, Mental Health, and General Health were significantly improved at six months compared with study entry (P rib fracture nonunion may improve chronic pain and disability but without change in functional or work status. Resection of adjacent nonunions with significant gaps may lead to chest wall hernia.

  4. Desmoplastic fibroma of the rib with cystic change: a case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Okubo, Taketo [Juntendo University, Department of Orthopaedic Surgery, School of Medicine, Tokyo (Japan); Juntendo University, Department of Human Pathology, School of Medicine, Bunkyo-ku, Tokyo (Japan); Saito, Tsuyoshi [Juntendo University, Department of Human Pathology, School of Medicine, Bunkyo-ku, Tokyo (Japan); Takagi, Tatsuya; Suehara, Yoshiyuki; Kaneko, Kazuo [Juntendo University, Department of Orthopaedic Surgery, School of Medicine, Tokyo (Japan)

    2014-05-15

    Desmoplastic fibroma (DF) is a rare, locally aggressive, solitary tumor microscopically composed of well-differentiated myofibroblasts with abundant dense collagen deposition. The most common sites are the long tubular bones and mandible. To our knowledge, only five cases of DF in the ribs have been reported. Here, we report a case of DF in this rare location with unusual radiological findings. A 40-year-old man presented with a 4-year history of swelling of the right chest wall. Radiographs revealed a mass at the right 9th rib, and computed tomography demonstrated a mass of 14 x 12 x 8 cm at the right 9th rib with expanded cystic change and marked calcification that appeared to have arisen from the bone. Open biopsy suggested DF. Total excision was performed, and the chest wall was reconstructed. The surgical specimen was a yellowish tumor with multilocular cystic change containing a viscous liquid. The tumor was composed of a proliferation of less-atypical spindle-shaped cells in a collagenous background. The cystic change was observed in the extra-osseous lesion. No β-catenin cytoplasmic/nuclear accumulation was detected, and no β-catenin or GNAS genetic mutations were detected. A final diagnosis of DF was made on the basis of the pathological and radiological findings. The patient was successfully treated with total excision of the tumor with no evidence of recurrence 6 months after surgery. (orig.)

  5. Value of postmortem thoracic CT over radiography in imaging of pediatric rib fractures

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Terence S.; Babyn, Paul S. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Reyes, Jeanette A.; Chiasson, David A. [The Hospital for Sick Children, Department of Paediatric Laboratory Medicine, Toronto (Canada); Moineddin, Rahim [University of Toronto, Department of Family and Community Medicine, Toronto (Canada); Berdon, Walter E. [Columbia Presbyterian Medical Center, Babies Hospital, Department of Radiology, New York, NY (United States)

    2011-06-15

    Studies have reported that thoracic CT may provide greater sensitivity compared with radiography in detection of pediatric rib fractures and fracture healing. The additional sensitivity afforded by thoracic CT may have medicolegal implications where abuse is suspected. To determine the additional value of postmortem thoracic CT compared with radiography in detecting pediatric rib fractures, and fracture healing, using autopsy findings as a gold standard. We retrospectively reviewed 56 coroner's cases with postmortem radiography and CT thoracic survey. All studies underwent primary interpretation by one or two radiologists. The study radiologist independently reviewed all images from 13 patients with positive findings on radiography, CT or autopsy. Sensitivity and specificity between observers and imaging modalities were compared. Primary interpretation: Fractures were recognized on radiography in 5/12 patients who had fractures found at autopsy, and on CT in 8/12 patients. In total, 29% (24/83) of fractures were reported on radiography, and 51% (52/101) of fractures were reported on CT. Study radiologist: Fractures were recognized on radiography in 7/12 patients who had fractures found at autopsy, and on CT in 11/12 patients. In total, 46% (38/83) of fractures were reported on radiography, and 85% (86/101) of fractures were reported on CT. Postmortem thoracic CT provides greater sensitivity than radiography in detecting pediatric rib fractures, most notably in anterior and posterior fractures. However, the degree of improvement in sensitivity provided by CT might depend on observer experience. (orig.)

  6. Ovariectomy-induced changes in aged beagles : histomorphometry of rib cortical bone.

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, A. K.; Bhattacharyya, M. H.; Miller, S.; Sacco-Gibson, N.; Center for Mechanistic Biology and Biotechnology; Univ. of Utah; Procter & Gamble Pharmaceuticals

    1998-03-01

    Bone loss associated with estrogen depletion is well documented in cancellous bone but less well characterized in cortical bone. The effects of ovariectomy on the aged beagle skeleton were studied by histomorphometric analysis of the cortical bone in sequential rib biopsies. Biopsies were taken from each ovariectomized or sham-operated dog at the time of surgery and at 1, 4, and 8.5 months after surgery. Just prior to each postoperative biopsy, tetracycline, calcein, and xylenol orange, respectively, were administered by a fluorochrome labeling procedure (2d-10d-2d) to provide markers of bone formation. Analysis of sequential rib biopsies provided a means to follow the ovariectomy response over time and to compare each animal against its own baseline. Though ovariectomy did not influence histomorphometric indices at 1 month after surgery, a transient increase in cortical bone formation occurred thereafter, with a sixfold increase over that of sham-operated dogs at 4 months (P < 0.001) and a return to near control levels at 8.5 months. Cortical porosity increased by the fourth month after ovariectomy and remained high at 8.5 months. These data demonstrate for the first time that rib cortical bone is a responsive site for the effects of ovariectomy in aged female dogs.

  7. Extraordinary incidence of cervical ribs indicates vulnerable condition in Late Pleistocene mammoths

    Directory of Open Access Journals (Sweden)

    Jelle W.F. Reumer

    2014-03-01

    Full Text Available The number of cervical vertebrae in mammals is highly conserved at seven. We have shown that changes of this number are selected against due to a coupling with major congenital abnormalities (pleiotropic effects. Here we show that the incidence of abnormal cervical vertebral numbers in Late Pleistocene mammoths from the North Sea is high (33.3% and approximately 10 times higher than that of extant elephants (3.6%. Abnormal numbers were due to the presence of large cervical ribs on the seventh vertebra, which we deduced from the presence of rib articulation facets on sixth (posterior side and seventh (anterior side cervical vertebrae. The incidence of abnormal cervical vertebral numbers in mammoths appears to be much higher than in other mammalian species, apart from exceptional sloths, manatees and dugongs and indicates a vulnerable condition. We argue that the increased incidence of cervical ribs in mammoths is probably caused by inbreeding and adverse conditions that impact early pregnancies in declining populations close to extinction in the Late Pleistocene.

  8. PREPARATION AND APPLICATION OF PHOTOSENSITIVE COPOLYMERS FOR PDP BARRIER RIBS FORMED BY PHOTOLITHOGRAPHY

    Institute of Scientific and Technical Information of China (English)

    Tao Zhang; Qian-wen Dong; Wei Zhang; Jie Wei

    2013-01-01

    In this work,the photosensitive paste was prepared.It was comprised of inorganic particles and a photosensitive organic component.The inorganic particles included glass,ceramics,and metals.The organic component should contain at least the following photosensitive materials:photosensitive monomers,photoreactive copolymer and photopolymerization initiators.The photoreactive copolymer played a role of an adhesive in the photosensitive paste.Meanwhile in the development stage,the carboxyl groups of the copolymer reacted with the alkalescent developer.Following this,the unexposed part must be removed and an excellent pattern can be formed.A series of three-component acrylic copolymers (MAA/St/MMA) were designed,and then synthesized via free radical polymerization.Subsequently glycidyl methacrylate (GMA) was employed to modify the prepared copolymers through ring-opening reactions between the carboxyl groups and the epoxide groups.Eventually the photosensitive copolymers were obtained and used to form the barrier ribs of PDPs.The chemical structure,glass transition temperature,acid value and molecular weight of photosensitive copolymers had different effects on the structure and pattern of PDP barrier ribs.Through analyzing effects of different polymer performance parameters on the patterns of barrier ribs,the optimal photosensitive copolymer was acquired.

  9. Vibroacoustic Optimization of Stiffening Ribs and Damping Material Distribution on Sheet Metal Parts

    Directory of Open Access Journals (Sweden)

    M. Carfagni

    2004-01-01

    Full Text Available Vehicle noise and vibration levels are basic parameters in passenger comfort. Both static and dynamic stiffness of sheet metal parts is commonly increased by means of stiffening ribs. Vibrations are also reduced by adding a layer of damping material on the floor, the roof, the firewall and other parts of the vehicle. In common practice the panels to be treated are ribbed according to criteria based on the designer’s experience, rather than on well defined design procedures and are uniformly covered by a layer of damping material. However, these are not efficient design solutions, especially with regard to the effectiveness of vibration reduction and to weight containment. In this paper a novel approach to achieve an optimal distribution of stiffening ribs and damping material will be presented. The proposed method is based on a Genetic Algorithm (G.A. procedure which takes into account both the vibroacoustic performance and the weight and cost reduction. A simple case study will be illustrated to demonstrate the capabilities of the developed procedure.

  10. 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.

  11. Experimental investigation of active rib stitch knitted architecture for flow control applications

    Science.gov (United States)

    Abel, Julianna M.; Mane, Poorna; Pascoe, Benjamin; Luntz, Jonathan; Brei, Diann

    2010-04-01

    Actively manipulating flow characteristics around the wing can enhance the high-lift capability and reduce drag; thereby, increasing fuel economy, improving maneuverability and operation over diverse flight conditions which enables longer, more varied missions. Active knits, a novel class of cellular structural smart material actuator architectures created by continuous, interlocked loops of stranded active material, produce distributed actuation that can actively manipulate the local surface of the aircraft wing to improve flow characteristics. Rib stitch active knits actuate normal to the surface, producing span-wise discrete periodic arrays that can withstand aerodynamic forces while supplying the necessary displacement for flow control. This paper presents a preliminary experimental investigation of the pressuredisplacement actuation performance capabilities of a rib stitch active knit based upon shape memory alloy (SMA) wire. SMA rib stitch prototypes in both individual form and in stacked and nestled architectures were experimentally tested for their quasi-static load-displacement characteristics, verifying the parallel and series relationships of the architectural configurations. The various configurations tested demonstrated the potential of active knits to generate the required level of distributed surface displacements while under aerodynamic level loads for various forms of flow control.

  12. Forced heat convection in a reciprocating duct fitted with 45 degree ribs

    Energy Technology Data Exchange (ETDEWEB)

    Shyy Woei, Chang [National Kaohsiung Institute of Marine Technology, Dept. of Marine Engineering, Taiwan (China)

    2002-03-01

    This experimental study investigated heat-transfer physics of forced convection in a reciprocating square duct fitted with 45 deg C crossed ribs on two opposite walls. The parametric conditions involved several Reynolds, pulsating and buoyancy numbers, respectively, in the ranges of 600-10 000, 0-10, and 0-0.14 with five different reciprocating frequencies tested, namely, 0.67, 1, 1.33, 1.67 and 2 Hz. The rib-induced flows in the static duct produced an augmentation of heat transfer in the range of 260-300% compared to the smooth-walled situation. The reciprocating heat-transfer data reconfirmed the appearance of large-scale wavy-like axial heat transfer distribution that differed significantly from the stationary results. The manner in which the pulsating force and convective inertia, with and without buoyancy interaction, interactively affected the local heat transfer along the rib-roughened surface was illustrated using a number of experimentally based observations and extrapolations. The buoyancy interaction in the reciprocating duct reduced heat transfer, which effect was enhanced by increasing the pulsating number, but appeared to be a weak function of Reynolds number. When the Reynolds and pulsating numbers were relatively low, a range of heat transfer impediments, that could lead the spatial-time averaged heat-transfer to levels about 71 % of non-reciprocating values, was observed. A further increase of pulsating number resulted in a subsequent heat-transfer recovery, which tendency could lead to heat-transfer improvement from the non-reciprocating level. An empirical correlation to evaluate the spatial-time averaged heat transfer over the reciprocating ribbed duct was developed to assist the design activity. The possibility to further enhance heat-transfer via the use of angled ribs in a reciprocating duct is confirmed, but it is important to ensure that the range of reciprocating flow parameters produced does not create heat-transfer impediment in order

  13. Epidural analgesia for traumatic rib fractures is associated with worse outcomes: a matched analysis.

    Science.gov (United States)

    McKendy, Katherine M; Lee, Lawrence F; Boulva, Kerianne; Deckelbaum, Dan L; Mulder, David S; Razek, Tarek S; Grushka, Jeremy R

    2017-06-15

    The optimal method of pain control for patients with traumatic rib fractures is unknown. The aim of this study was to determine the effect of epidural analgesia on respiratory complications and in-hospital mortality in patients with rib fractures. Adult patients at a level I trauma center with ≥1 rib fracture from blunt trauma were included (2004-2013). Those with a blunt-penetrating mechanism, traumatic brain injury, or underwent a laparotomy or thoracotomy were excluded. Patients who were treated with epidural analgesia (EPI) were compared with those were not treated with epidural analgesia (NEPI) using coarsened exact matching. Primary outcomes were respiratory complications (pneumonia, deep vein thrombosis/pulmonary embolus, and respiratory failure) and 30-d in-hospital mortality. Secondary outcomes were total hospital and intensive care unit length of stay, and duration of ventilator support. About 1360 patients (EPI: 329 and NEPI: 1031) met inclusion criteria (mean age: 54.2 y; standard deviation [SD]: 19.7; 68% male). The mean number of rib fractures was 4.8 (SD: 3.3; 21% bilateral) with a high total burden of injury (mean Injury Severity Score: 19.9 [SD: 8.9]). The overall incidence of respiratory complications was 13% and mortality was 4%. After matching, 204 EPI patients were compared with 204 NEPI patients, with no differences in baseline characteristics. EPI patients experienced more respiratory complications (19% versus 10%, P = 0.009), but no differences in 30-d mortality (5% versus 2%, P = 0.159), duration of mechanical ventilation (EPI: 148 h [SD: 167] versus NEPI: 117 h [SD: 187], P = 0.434), or duration of intensive care unit length of stay (6.5 d [SD: 7.6] versus 5.8 d [SD: 9.1], P = 0.626). Hospital stay was higher in the EPI group (16.6 d [SD: 19.6] vs 12.7 d [SD: 15.2], P = 0.026). Epidural analgesia is associated with increased respiratory complications without providing mortality benefit after traumatic rib fractures

  14. Cross-Cultural Consumer Acceptability and Purchase Intent of Forage-Finished Rib-Eye Steaks.

    Science.gov (United States)

    Torrico, Damir Dennis; Wardy, Wisdom; Pujols, Kairy Dharali; Carabante, Kennet Mariano; Jirangrat, Wannita; Scaglia, Guillermo; Janes, Marlene E; Prinyawiwatkul, Witoon

    2015-10-01

    Rib-eye steaks, from 3 forage-finished systems (S1, S2, and S3) and 1 commercial steak (C), either cooked by 1-sided-grilling or 2-sided-grilling, were evaluated for sensory acceptability [overall appearance (ORA) and overall appearance of fat (OAF) for raw steaks; overall appearance (OCA), overall beef aroma (OBA), overall beef flavor (OBF), juiciness, tenderness and overall liking (OL) for cooked steaks] and purchase intent by Hispanic, Asian and U.S. consumers. They also indicated preferred degree of doneness and cooking methods. Cross-cultural differences in preferences and consumer acceptability of rib-eye steaks were observed. Grilling was the most preferred cooking method. Hispanics and Asians preferred medium and/or medium well, while U.S. consumers preferred medium and/or medium rare. For cooked steaks, the population effect was significant for all sensory attributes; Asians generally scored lower than did Hispanics and U.S. consumers. C and S3 generally had higher scores for all sensory attributes across 3 populations. Purchase intent for all forage-finished steaks was higher for Hispanics and U.S. consumers compared to Asians (50.0% to 77.8% compared with 43.2% to 65.9%). Attributes influencing purchase intent of forage-finished steaks differed among populations: tenderness (odds ratio = 1.4) for Hispanics, OCA (odds ratio = 1.5) for Asians, and OBF (odds rat