WorldWideScience

Sample records for sagittal coronal planes

  1. Evaluation of uterine peristalsis using cine MRI on the coronal plane in comparison with the sagittal plane.

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    Shitano, Fuki; Kido, Aki; Kataoka, Masako; Fujimoto, Koji; Kiguchi, Kayo; Fushimi, Yasutaka; Togashi, Kaori

    2016-01-01

    Uterine peristalsis is supposed to be closely related to the early stages of reproduction. Sperms are preferentially transported from the uterine cervix to the side of the tube with the dominant follicle. However, with respect to magnetic resonance imaging (MRI), uterine peristalsis has only been evaluated at the sagittal plane of cine MRI. To evaluate and compare uterine peristalsis both on sagittal and coronal planes using cine MRI. Internal ethics committee approval was obtained, and subjects provided informed written consent. Thirty-one women underwent MRI scans in the periovulatory phase of the menstrual cycle. Cine MR images obtained by fast advanced spin echo sequence at 3-T field strength magnet (Toshiba Medical Systems) were visually evaluated by two independent radiologists. The frequency and the direction of peristalsis, and the presence of outer myometrium conduction of signal intensities (OMC), were evaluated. The laterality of the dominant follicle was determined on axial images and compared with the peristaltic direction in fundus. The subjects in which peristaltic directions were more clearly recognized were significantly frequent in coronal planes than in sagittal planes (P < 0.05). There was no significant difference in the peristaltic frequency between the sagittal and the coronal plane. However, the OMC was more recognized in the coronal plane than in the sagittal plane (P < 0.05). Peristaltic waves conducted toward the possible ovulation side were observed in only three of the 10 subjects. OMC of uterine peristalsis was better demonstrated in the coronal plane compared to the sagittal plane. © The Foundation Acta Radiologica 2015.

  2. Intrinsic and Extrinsic Contributions to Seated Balance in the Sagittal and Coronal Planes: Implications for Trunk Control After Spinal Cord Injury.

    Science.gov (United States)

    Audu, Musa L; Triolo, Ronald J

    2015-08-01

    The contributions of intrinsic (passive) and extrinsic (active) properties of the human trunk, in terms of the simultaneous actions about the hip and spinal joints, to the control of sagittal and coronal seated balance were examined. Able-bodied (ABD) and spinal-cord-injured (SCI) volunteers sat on a moving platform which underwent small amplitude perturbations in the anterior-posterior (AP) and medial-lateral (ML) directions while changes to trunk orientation were measured. A linear parametric model that related platform movement to trunk angle was fit to the experimental data by identifying model parameters in the time domain. The results showed that spinal cord injury leads to a systematic reduction in the extrinsic characteristics, while most of the intrinsic characteristics were rarely affected. In both SCI and ABD individuals, passive characteristics alone were not enough to maintain seated balance. Passive stiffness in the ML direction was almost 3 times that in the AP direction, making more extrinsic mechanisms necessary for balance in the latter direction. Proportional and derivative terms of the extrinsic model made the largest contribution to the overall output from the active system, implying that a simple proportional plus derivative (PD) controller structure will suffice for restoring seated balance after spinal cord injury.

  3. Morphological segmentation for sagittal plane image analysis.

    Science.gov (United States)

    Bezerra, F N; Paula, I C; Medeiros, F S; Ushizima, D M; Cintra, L S

    2010-01-01

    This paper introduces a morphological image segmentation method by applying watershed transform with markers to scale-space smoothed images and furthermore provides images for clinical monitoring and analysis of patients. The database comprises sagittal plane images taken from a digital camera of patients submitted to Global Postural Reeducation (GPR) physiotherapy treatment. Orthopaedic specialists can use these segmented images to diagnose posture problems, assess physiotherapy treatment evolution and thus reduce diagnostic errors due to subjective analysis.

  4. Sagittal plane deformity: an overview of interpretation and management.

    Science.gov (United States)

    Roussouly, Pierre; Nnadi, Colin

    2010-11-01

    The impact of sagittal plane alignment on the treatment of spinal disorders is of critical importance. A failure to recognise malalignment in this plane can have significant consequences for the patient not only in terms of pain and deformity, but also social interaction due to deficient forward gaze. A good understanding of the principles of sagittal balance is vital to achieve optimum outcomes when treating spinal disorders. Even when addressing problems in the coronal plane, an awareness of sagittal balance is necessary to avoid future complications. The normal spine has lordotic curves in the cephalad and caudal regions with a kyphotic curve in between. Overall, there is a positive correlation between thoracic kyphosis and lumbar lordosis. There are variations on the degree of normal curvature but nevertheless this shape allows equal distribution of forces across the spinal column. It is the disruption of this equilibrium by pathological processes or, as in most cases, ageing that results in deformity. This leads to adaptive changes in the pelvis and lower limbs. The effects of limb alignment on spinal posture are well documented. We now also know that changes in pelvic posture also affect spinal alignment. Sagittal malalignment presents as an exaggeration or deficiency of normal lordosis or kyphosis. Most cases seen in clinical practise are due to kyphotic deformity secondary to inflammatory, degenerative or post-traumatic disorders. They may also be secondary to infection or tumours. There is usually pain and functional disability along with concerns about self-image and social interaction due to inability to maintain a horizontal gaze. The resultant pelvic and lower limb posture is an attempt to restore normal alignment. Addressing this complex problem requires detailed expertise and awareness of the potential pitfalls surrounding its treatment.

  5. Sagittal plane deformity: an overview of interpretation and management

    Science.gov (United States)

    Roussouly, Pierre

    2010-01-01

    The impact of sagittal plane alignment on the treatment of spinal disorders is of critical importance. A failure to recognise malalignment in this plane can have significant consequences for the patient not only in terms of pain and deformity, but also social interaction due to deficient forward gaze. A good understanding of the principles of sagittal balance is vital to achieve optimum outcomes when treating spinal disorders. Even when addressing problems in the coronal plane, an awareness of sagittal balance is necessary to avoid future complications. The normal spine has lordotic curves in the cephalad and caudal regions with a kyphotic curve in between. Overall, there is a positive correlation between thoracic kyphosis and lumbar lordosis. There are variations on the degree of normal curvature but nevertheless this shape allows equal distribution of forces across the spinal column. It is the disruption of this equilibrium by pathological processes or, as in most cases, ageing that results in deformity. This leads to adaptive changes in the pelvis and lower limbs. The effects of limb alignment on spinal posture are well documented. We now also know that changes in pelvic posture also affect spinal alignment. Sagittal malalignment presents as an exaggeration or deficiency of normal lordosis or kyphosis. Most cases seen in clinical practise are due to kyphotic deformity secondary to inflammatory, degenerative or post-traumatic disorders. They may also be secondary to infection or tumours. There is usually pain and functional disability along with concerns about self-image and social interaction due to inability to maintain a horizontal gaze. The resultant pelvic and lower limb posture is an attempt to restore normal alignment. Addressing this complex problem requires detailed expertise and awareness of the potential pitfalls surrounding its treatment. PMID:20567858

  6. Analysis of the relationship between coronal and sagittal deformities in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Hu, Panpan; Yu, Miao; Liu, Xiao; Zhu, Bin; Liu, Xiaoguang; Liu, Zhongjun

    2016-02-01

    To characterize the sagittal alignment of each Lenke type and investigate the relationship between coronal and sagittal deformities in adolescent idiopathic scoliotic (AIS) patients. A cohort of 184 subjects with AIS was retrospectively recruited. Radiographic data were measured and collected, including the Lenke types, Cobb angles of structural curves, and sagittal spino-pelvic parameters. Subjects were grouped according to their genders, Lenke curve types, lumbar modifiers and the amount of coronal structural curves. The sagittal alignment was then compared between the different groups, and correlation analysis was also taken between coronal and sagittal parameters. Besides, each subject's Roussouly type was decided and its distribution was compared among different Lenke types. The cohort included 59 males and 125 females, averagely aged at 15.5 ± 3.3 years old. Most sagittal parameters except thoracic kyphosis (TK) and pelvic tilt (PT) were similar among different Lenke types, while all the sagittal parameters were similar between males and females. The groups with different lumbar modifiers had similar sagittal parameters except TK, which was also true for the groups with different amounts of coronal curves. 42.4 % of the cohort belonged to Roussouly type 3, and the distribution of Roussouly types was comparable among all Lenke types. All sagittal parameters except C7 translation ratio were significantly different among Roussouly types (P < 0.05). Correlation analysis showed that main thoracic (MT) was negatively correlated with lumbar lordosis (LL, r = -0.324), sacral slope (r = -0.321) and spino-sacral angle (r = -0.363). Partial correlation analysis found that thoracolumbar/lumbar was negatively correlated with TK (r = -0.464) and LL (r = -0.422) when MT was controlled. The influence of coronal deformity on sagittal parameters was limited and mainly reflected in the deviation of TK. Most coronal and sagittal parameters were not significantly correlated, and

  7. Sagittal plane biomechanics cannot injure the ACL during sidestep cutting.

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    McLean, Scott G; Huang, Xuemei; Su, Anne; Van Den Bogert, Antonie J

    2004-10-01

    Knee joint sagittal plane forces are a proposed mechanism of anterior cruciate ligament injury during sport movements such as sidestep cutting. Ligament force magnitudes for these movements however, remain unknown. The need to examine injury-causing events suggests elucidation via model-based investigations is possible. Using this approach, the current study determined whether sagittal plane knee loading during sidestep cutting could in isolation injure the anterior cruciate ligament. Experiments were performed on subject-specific forward dynamic musculoskeletal models, generated from data obtained from 10 male and 10 female athletes. Models were optimized to simulate subject-specific cutting movements. Random perturbations (n=5000) were applied to initial contact conditions and quadriceps/hamstrings activation levels to simulate their effect on peak 3D knee loads. Injury via the sagittal plane mechanism was based on the criterion of an anterior drawer force greater than 2000 N. Realistic neuromuscular perturbations produced significant increases in external knee anterior force and valgus and internal rotation moments. Peak anterior drawer force never exceeded 2000 N in any model, and thus failed to cause anterior cruciate ligament injuries. Valgus loads reached values that were high enough to rupture the ligament, occurring more frequently in females than in males. Sagittal plane knee joint forces cannot rupture the anterior cruciate ligament during sidestep cutting. The interaction between muscle and joint mechanics and external ground reaction forces in this plane, places a ceiling on ligament loads. Valgus loading is a more likely injury mechanism, especially in females. Modifying sagittal plane biomechanics will thus unlikely contribute to the prevention of anterior cruciate ligament injuries.

  8. Pictorial essay of ultrasound-reconstructed coronal plane images of the uterus in different uterine pathologies.

    Science.gov (United States)

    Grigore, Mihaela; Grigore, Anamaria; Gafitanu, Dumitru; Furnica, Cristina

    2017-12-11

    Imaging in the major planes (horizontal, coronal, and sagittal) of the uterus is important for determining anatomy and allowing the findings to be standardized, and for evaluating and diagnosing different pathological conditions in clinical practice. Examination of the coronal plane is an important step in identifying uterine pathologies and their relationships to the endometrial canal. Three-dimensional (3D) ultrasound reveals the normal anatomy better and improves the depiction of abnormal anatomy, as the coronal plane of the uterus can easily be obtained using 3D reconstruction techniques. Our pictorial essay demonstrates that adding 3D ultrasound to a routine gynecological workup can be beneficial for clinicians, enabling a precise diagnosis to be made. In addition, the volumes obtained and stored by 3D ultrasound can allow students or residents to become more familiar with normal and abnormal pelvic structures. Clin. Anat, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. Mid-sagittal plane and mid-sagittal surface optimization in brain MRI using a local symmetry measure

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Skoglund, Karl; Ryberg, Charlotte

    2005-01-01

    This paper describes methods for automatic localization of the mid-sagittal plane (MSP) and mid-sagittal surface (MSS). The data used is a subset of the Leukoaraiosis And DISability (LADIS) study consisting of three-dimensional magnetic resonance brain data from 62 elderly subjects (age 66 to 84...... years). Traditionally, the mid-sagittal plane is localized by global measures. However, this approach fails when the partitioning plane between the brain hemispheres does not coincide with the symmetry plane of the head. We instead propose to use a sparse set of profiles in the plane normal direction......, the mid-sagittal plane is not always planar, but a curved surface resulting in poor partitioning of the brain hemispheres. To account for this, this paper also investigates an optimization strategy which fits a thin-plate spline surface to the brain data using a robust least median of squares estimator...

  10. ANALYSIS AND PLANNING OF HINDFOOT DEFORMITY CORRECTION IN SAGITTAL PLANE

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    L. N. Solomin

    2017-01-01

    Full Text Available Background. The disadvantage of the known methods of analysis and planning of hindfoot deformities in the sagittal plaBackground. Long bone deformity planning is well established. However, there are not well described methods of analysis and planning of hindfoot deformities in the sagittal plane. Such planning is made even more difficult with concomitant deformation of the midfoot and/or ankle contracture or malpositioned arthrodesis. The aim of our study was to develop a universal method of analysis and planning of the calcaneus correction, based on the normally derived reference lines and angles.Methods. We analyzed 65 standing lateral foot films in normal adults, 23-54 years old were analyzed. We drew the talus joint line (points “a” and “b” – Line 1. We drew a second line, (Line 2 the calcaneal line, which starts at the back of the calcaneal tuberosity (point “d”, drawn perpendicular to a line from top to bottom of the calcaneal tuberosity. The intersection of the calcaneal line and the talar joint line form point (c anteriorly. We measured lines ab, ac and cd, and their ratios: ac/ab, and cd/ab.Results. Talar joint line (Line 1 and calcaneal line (Line 2 intersect at a point (c, forming an angle 15.2° (±3.4°. The ratio ac/ab = 2.56 (± 1.1. The ratio cd/ab = 4.59 (±1.0. These ratios are constants for calculating the idealized joint lines for deformity planning. For deformity cases, draw Line 1, the talar joint line ab. Extend that line anteriorly to (c, which is a distance ab×2.56 from point (a. From (c, draw an idealized calcaneal line, Line-2, at an angle 15° to Line 1. Place (d on this line, at a distance ab×4.59 from point (c. Next, draw the deformed calcaneal line (Line 3 and point (d1 where it exits the calcaneal tuberosity. Use the same technique and landmarks as for drawing the normal calcaneal line. The intersection of Lines 2 and 3 is the apex of the deformity. Rotate the piece containing Line 3 around this

  11. Extraforaminal stenosis in the lumbosacral spine. Efficacy of MR imaging in the coronal plane

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    Hashimoto, M. [Yamamoto General Hospital, Akita (Japan). Dept. of Radiology; Watanabe, O. [Yamamoto General Hospital, Akita (Japan). Dept. of Radiology; Hirano, H. [Yamamoto General Hospital, Akita (Japan). Dept. of Radiology

    1996-09-01

    Purpose: To review experience with MR images of extraforaminal (EF) stenosis in the lumbosacral spine. Material: MR images from 9 patients with 10 EF stenoses were reviewed. The diagnosis was confirmed in 6 patients at surgery, and in 4 on the basis of findings of nerve root injection combined with nerve block. Results and Conclusion: All patients had congenital lumbosacral anomalies with various degrees of fixation between the last formed level and the pelvis. In all cases, affected roots were compressed between the transverse process of the last lumbar segment and the sacral ala. MR using coronal plane imaging demonstrated the root impingement directly in the far lateral zone in all patients. However, sagittal and axial images were unable to define the EF stenoses in all patients. The results of this study show that a transitional vertebra is a cause of EF stenosis and that MR images using coronal plane are useful in the assessment of EF stenosis. (orig.).

  12. Clinically acceptable agreement between the ViMove wireless motion sensor system and the Vicon motion capture system when measuring lumbar region inclination motion in the sagittal and coronal planes.

    Science.gov (United States)

    Mjøsund, Hanne Leirbekk; Boyle, Eleanor; Kjaer, Per; Mieritz, Rune Mygind; Skallgård, Tue; Kent, Peter

    2017-03-21

    Wireless, wearable, inertial motion sensor technology introduces new possibilities for monitoring spinal motion and pain in people during their daily activities of work, rest and play. There are many types of these wireless devices currently available but the precision in measurement and the magnitude of measurement error from such devices is often unknown. This study investigated the concurrent validity of one inertial motion sensor system (ViMove) for its ability to measure lumbar inclination motion, compared with the Vicon motion capture system. To mimic the variability of movement patterns in a clinical population, a sample of 34 people were included - 18 with low back pain and 16 without low back pain. ViMove sensors were attached to each participant's skin at spinal levels T12 and S2, and Vicon surface markers were attached to the ViMove sensors. Three repetitions of end-range flexion inclination, extension inclination and lateral flexion inclination to both sides while standing were measured by both systems concurrently with short rest periods in between. Measurement agreement through the whole movement range was analysed using a multilevel mixed-effects regression model to calculate the root mean squared errors and the limits of agreement were calculated using the Bland Altman method. We calculated root mean squared errors (standard deviation) of 1.82° (±1.00°) in flexion inclination, 0.71° (±0.34°) in extension inclination, 0.77° (±0.24°) in right lateral flexion inclination and 0.98° (±0.69°) in left lateral flexion inclination. 95% limits of agreement ranged between -3.86° and 4.69° in flexion inclination, -2.15° and 1.91° in extension inclination, -2.37° and 2.05° in right lateral flexion inclination and -3.11° and 2.96° in left lateral flexion inclination. We found a clinically acceptable level of agreement between these two methods for measuring standing lumbar inclination motion in these two cardinal movement planes. Further

  13. [Stature estimation from sagittal and coronal suture lengths for Central European individuals].

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    Kolencherry, Tesseera V; Birngruber, Christoph G; Ramsthaler, Frank; Verhoff, Marcel A; Kölzer, Sarah C

    2016-01-01

    $Human skulls frequently represent the only skeletal remains of an unidentified corpse available for forensic osteological examination. Skulls are very useful in reliably determining sex and also yield fairly good clues to an individual's age and ancestry. To date, however, a sufficiently accurate correlation between skull measurements and stature could not be found. In contrast, the results of a study by Rao et al. (2009) seemed to be promising, by finding a good correlation between the length of the coronal and sagittal sutures and stature in a male Indian population. In an attempt to verify the transferability of their results to a Central European population, the authors measured the length of the sagittal and coronal sutures with a tape measure along with body height in the course of 117 autopsies performed at the Institute of Forensic Medicine at the University of Giessen during 2009 and 2010. The age of the individuals measured ranged from 15 to 96 years (mean value 52.8, median 51 years). Of these individuals, 82 were male and 35 were female. The length of the sagittal suture with respect to body length yielded a correlation coefficient of only r = 0.045 (p = 0.617) in the regression analysis. Similar results were found for the coronal suture: In this case the correlation coefficient was r = 0.015. With an assumed maximum permissible probability of error of α = 0.05, none of the performed regression analyses were found to be statistically significant. As expected, our results suggest that neither the length of the sagittal nor the length of the coronal suture is suitable for a forensic estimation of stature for Central European individuals.

  14. Effect of Coronal Scoliotic Curvature on Sagittal Spinal Shape: Analysis of Parameters in Mature Adolescent Scoliosis Patients.

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    Hong, Jae-Young; Kim, Keon-Woo; Suh, Seung-Woo; Park, Si-Young; Yang, Jae-Hyuk

    2017-05-01

    A radiographic analysis with scoliosis patients. To analyze correlations between sagittal spinal alignment and coronal scoliotic curvature. Sagittal spinal alignment and scoliosis may have a significant relationship, and schematic analysis is needed. The study group was comprised of 163 patients with adolescent idiopathic scoliosis. Subjects underwent anteroposterior and lateral radiographs of the whole spine including hip joints. The radiographic parameters used were magnitude, location and direction of curve, thoracic kyphosis, thoracolumbar kyphosis, lumbar lordosis, sagittal balance, sacral slope, and pelvic angle. Subjects were classified into 4 groups according to the severity of coronal curvature: Cobb angle ≤20 degrees, Cobb angle 21-40 degrees, Cobb angle 41-60 degrees, and Cobb angle >60 degrees. In addition, subjects were divided into 4 subgroups according to Roussouly's classification (types 1-4) of sagittal spinal shape. Schematic analysis was performed to determine the relationship between coronal and sagittal parameters. Analysis of parameters with severity of coronal curvature, thoracic kyphosis, and sacral slope were significantly higher in high-grade scoliosis (PRoussouly groups 3 and 4 showed more severe scoliosis with higher lumbar lordosis and thoracic kyphosis (PRoussouly group 1 demonstrated a significantly higher incidence of low-grade scoliosis, whereas groups 3 and 4 had a higher incidence of high-degree scoliosis by cross-relation analysis (P<0.05). A significant relationship exists between sagittal spinal shape and coronal curvature in scoliosis. Understanding the biplanar shapes of scoliosis may be helpful to the surgeons.

  15. Estimated force and moment of shoulder external rotation muscles: differences between transverse and sagittal planes.

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    de Castro, Marcelo Peduzzi; Ribeiro, Daniel Cury; de Camargo Forte, Felipe; de Toledo, Joelly Mahnic; Costa Krug, Roberto; Fagundes Loss, Jefferson

    2012-12-01

    The aim of this study was to compare shoulder muscle force and moment production during external rotation performed in the transverse and sagittal planes. An optimization model was used for estimating shoulder muscle force production of infraspinatus, teres minor, supraspinatus, anterior deltoid, middle deltoid and posterior deltoid muscles. The model uses as input data the external rotation moment, muscle moment arm magnitude, muscle physiologic cross-sectional area and muscle specific tension. The external rotation moment data were gathered from eight subjects in transverse and six subjects in sagittal plane using an isokinetic dynamometer. In the sagittal plane, all studied muscles presented larger estimated force in comparison with the transverse plane. The infraspinatus, teres minor, supraspinatus and posterior deltoid muscles presented larger moment in sagittal when compared with transverse plane. When prescribing shoulder rehabilitation exercises, therapists should bear in mind the described changes in muscle force production.

  16. Evolution of Sagittal Imbalance Following Corrective Surgery for Sagittal Plane Deformity.

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    McDowell, Michael M; Tempel, Zachary J; Gandhoke, Gurpreet S; Khattar, Nicholas K; Hamilton, D Kojo; Kanter, Adam S; Okonkwo, David O

    2017-07-01

    Sagittal balance in adult spinal deformity is a major predictor of quality of life. A temporary loss of paraspinal muscle force and somatic pain following spine surgery may limit a patient's ability to maintain posture. To assess the evolution of sagittal balance and clinical outcomes during recovery from adult spinal deformity surgery. Retrospective review of a prospective observational database identified a consecutive series of patients with sagittal vertical axis (SVA) > 40 mm undergoing adult deformity surgery. Radiographic parameters and clinical outcomes were measured out to 2 yr after surgery. A total of 113 consecutive patients met inclusion criteria. Mean preoperative SVA was 90.3 mm, increased to 104.6 mm in the first week, then gradually reduced at each follow-up interval to 59.2 mm at 6 wk, 45.0 mm at 3 mo, 38.6 mm at 6 mo, and 34.1 mm at 1 yr (all P sagittal alignment did not fully reflect surgical correction of sagittal balance until 6 mo after adult deformity surgery. Sagittal balance initially worsened then steadily improved at each interval over the first year postoperatively. At 1 yr, all clinical and radiographic measures outcomes were significantly improved.

  17. Impact of coronal and sagittal views on lung gross tumor volume delineation.

    Science.gov (United States)

    Fitton, Isabelle; Duppen, Joop C; Steenbakkers, Roel J H M; Lotz, Heidi; Nowak, Peter J C M; Rasch, Coen R N; van Herk, Marcel

    2016-09-01

    To study the impact of coronal and sagittal views (CSV) on the gross tumor volume (GTV) delineation on CT and matched PET/CT scans in non-small cell lung cancer. GTV delineations were performed by 11 experienced radiation oncologists on CT and PET/CT in 22 patients. Two tumor groups were defined: Group I: Primary tumors surrounded by lung or visceral pleura, without venous invasion, and without large extensions to the chest wall or the mediastinum. Group II: Tumors invading the hilar region, heart, large vessels, pericardium, and the mediastinum and/or associated with atelectasis. Tumor volumes and inter-observers variations (SD) were calculated and compared according to the use of axial view only (AW), axial/coronal/sagittal views (ACSW) and ACSW/PET (ACSWP). CSV were not frequently used (57.4% out of 242 delineations on CT). For group I, ACSW didn't improve significantly mean GTVs. SDs were small on CT and on PET (SD=0.3cm). For group II, ACSW had 27-46% smaller observer variation (mean SD=0.7cm) than AW (mean SD=1.1cm). The smaller observer variation of ACSW users was associated with, on average, a 40% smaller delineated volume (p=0.038). Mean GTV of ACSWP was 21% larger than mean GTV of ACSW on CT. For smaller lung tumors surrounded by healthy lung tissue the effect of multiple axis delineation is limited. However, application of coronal and sagittal windows is highly beneficial for delineation of more complex tumors, with atelectasis and/or pathological lymph nodes even if PET is used. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Biomechanical Comparison of Single- and Double-Leg Jump Landings in the Sagittal and Frontal Plane

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    Taylor, Jeffrey B.; Ford, Kevin R.; Nguyen, Anh-Dung; Shultz, Sandra J.

    2016-01-01

    Background: Double-leg forward or drop-jump landing activities are typically used to screen for high-risk movement strategies and to determine the success of neuromuscular injury prevention programs. However, research suggests that these tasks that occur primarily in the sagittal plane may not adequately represent the lower extremity biomechanics that occur during unilateral foot contact or non?sagittal plane movements that are characteristic of many multidirectional sports. Purpose: To exami...

  19. Global sagittal axis: a step toward full-body assessment of sagittal plane deformity in the human body.

    Science.gov (United States)

    Diebo, Bassel G; Oren, Jonathan H; Challier, Vincent; Lafage, Renaud; Ferrero, Emmanuelle; Liu, Shian; Vira, Shaleen; Spiegel, Matthew Adam; Harris, Bradley Yates; Liabaud, Barthelemy; Henry, Jensen K; Errico, Thomas J; Schwab, Frank J; Lafage, Virginie

    2016-10-01

    body in the sagittal plane. The GSA correlated highly with spinopelvic and lower-extremities sagittal parameters and exhibited remarkable correlations with HRQOL, which exceeded other commonly used parameters.

  20. A systematic review of the angular values obtained by computerized photogrammetry in sagittal plane: a proposal for reference values.

    Science.gov (United States)

    Krawczky, Bruna; Pacheco, Antonio G; Mainenti, Míriam R M

    2014-05-01

    Reference values for postural alignment in the coronal plane, as measured by computerized photogrammetry, have been established but not for the sagittal plane. The objective of this study is to propose reference values for angular measurements used for postural analysis in the sagittal plane for healthy adults. Electronic databases (PubMed, BVS, Cochrane, Scielo, and Science Direct) were searched using the following key words: evaluation, posture, photogrammetry, and software. Articles published between 2006 and 2012 that used the PAS/SAPO (postural assessment software) were selected. Another inclusion criterion was the presentation of, at least, one of the following measurements: head horizontal alignment, pelvic horizontal alignment, hip angle, vertical alignment of the body, thoracic kyphosis, and lumbar lordosis. Angle samples of the selected articles were grouped 2 by 2 in relation to an overall average, which made possible total average, variance, and SD calculations. Six articles were included, and the following average angular values were found: 51.42° ± 4.87° (head horizontal alignment), -12.26° ± 5.81° (pelvic horizontal alignment), -6.40° ± 3.86° (hip angle), and 1.73° ± 0.94° (vertical alignment of the body). None of the articles contained the measurements for thoracic kyphosis and lumbar lordosis. The reference values can be adopted as reference for postural assessment in future researches if the same anatomical points are considered. Copyright © 2014 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  1. Brief communication: age and fractal dimensions of human sagittal and coronal sutures

    DEFF Research Database (Denmark)

    Lynnerup, Niels; Jacobsen, Jens Christian Brings

    2003-01-01

    The fractal dimensions of human sagittal and coronal sutures were calculated on 31 complete skulls from the Terry Collection. The aim was to investigate whether the fractal dimension, relying on the whole sutural length, might yield a better description of age-related changes in sutural morphology...... display an age-related development, but that it is impossible to arrive at any precise age determinations for older adults. It seems that for some individuals, suture obliteration simply does not take place, even at an advanced age, whereas for others, suture obliteration progresses rapidly. Until...... a better understanding of sutural biology is reached, this will render cranial sutures only marginally useful in age determination. This does not mean, however, that investigations should not be made to elucidate more unbiased methods of sutural morphology quantification....

  2. Measurement of lumbar spine intervertebral motion in the sagittal plane using videofluoroscopy.

    Science.gov (United States)

    Harvey, Steven; Hukins, David; Smith, Francis; Wardlaw, Douglas; Kader, Deiary

    2016-08-10

    Static radiographic techniques are unable to capture the wealth of kinematic information available from lumbar spine sagittal plane motion. Demonstration of a viable non-invasive technique for acquiring and quantifying intervertebral motion of the lumbar spine in the sagittal plane. Videofluoroscopic footage of sagittal plane lumbar spine flexion-extension in seven symptomatic volunteers (mean age = 48 yrs) and one asymptomatic volunteer (age = 54 yrs) was recorded. Vertebral bodies were digitised using customised software employing a novel vertebral digitisation scheme that was minimally affected by out-of-plane motion. Measurement errors in intervertebral rotation (± 1°) and intervertebral displacement (± 0.5 mm) compare favourably with the work of others. Some subjects presenting with an identical condition (disc prolapse) exhibited a similar column vertebral flexion-extension relative to S1 (L3: max. 5.9°, min. 5.6°), while in others (degenerative disc disease) there was paradoxically a significant variation in this measurement (L3: max. 28.1°, min. 0.7°). By means of a novel vertebral digitisation scheme and customised digitisation/analysis software, sagittal plane intervertebral motion data of the lumbar spine data has been successfully extracted from videofluoroscopic image sequences. Whilst the intervertebral motion signatures of subjects in this study differed significantly, the available sample size precluded the inference of any clinical trends.

  3. Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella.

    Science.gov (United States)

    Aksahin, Ertugrul; Aktekin, Cem Nuri; Kocadal, Onur; Duran, Semra; Gunay, Cüneyd; Kaya, Defne; Hapa, Onur; Pepe, Murad

    2017-10-01

    The aims of this study were to evaluate sagittal plane alignment in patients with chondromalacia patella via magnetic resonance imaging (MRI), analyse the relationships between the location of the patellar cartilaginous lesions and sagittal alignment and finally investigate the relationships between the sagittal plane malalignment and patellofemoral loadings using by finite element analysis. Fifty-one patients who were diagnosed with isolated modified Outerbridge grade 3-4 patellar chondromalacia based on MRI evaluation and 51 control subjects were evaluated. Chondromalacia patella patients were divided into three subgroups according to the chondral lesion location as superior, middle and inferior. The patella-patellar tendon angle (P-PT) was used for evaluation of sagittal alignment of patellofemoral joint. Each subgroup was compared with control group by using P-PT angle. To investigate the biomechanical effects of sagittal plane malpositioning on patellofemoral joint, bone models were created at 30°, 60° and 90° knee flexion by using mean P-PT angles, which obtained from patients with chondromalacia patellae and control subjects. The total loading and contact area values of the patellofemoral joints were investigated by finite element analysis. The mean age of all participants was 52.9 ± 8.2 years. The mean P-PT angle was significantly lower in chondromalacia group (142.1° ± 3.6°) compared to control group (144.5° ± 5.3°) (p = 0.008). Chondral lesions were located in superior, middle and inferior zones in 16, 20 and 15 patients, respectively. The mean P-PT angles in patients with superior (141.8 ± 2.7) and inferior subgroups (139.2 ± 2.3) were significantly lower than the values in the control group (p chondromalacia than in the control models at the same flexion degrees. There were increased loadings at 30° and 90° flexions in the sagittal patellar tilt models. This study revealed that sagittal plain malpositioning of the

  4. Video raster stereography back shape reconstruction: a reliability study for sagittal, frontal, and transversal plane parameters.

    Science.gov (United States)

    Schroeder, J; Reer, R; Braumann, K M

    2015-02-01

    As reliability of raster stereography was proved only for sagittal plane parameters with repeated measures on the same day, the present study was aiming at investigating variability and reliability of back shape reconstruction for all dimensions (sagittal, frontal, transversal) and for different intervals. For a sample of 20 healthy volunteers, intra-individual variability (SEM and CV%) and reliability (ICC ± 95% CI) were proved for sagittal (thoracic kyphosis, lumbar lordosis, pelvis tilt angle, and trunk inclination), frontal (pelvis torsion, pelvis and trunk imbalance, vertebral side deviation, and scoliosis angle), transversal (vertebral rotation), and functional (hyperextension) spine shape reconstruction parameters for different test-retest intervals (on the same day, between-day, between-week) by means of video raster stereography. Reliability was high for the sagittal plane (pelvis tilt, kyphosis and lordosis angle, and trunk inclination: ICC > 0.90), and good to high for lumbar mobility (0.86 < ICC < 0.97). Apart from sagittal plane spinal alignment, there was a lack of certainty for a high reproducibility indicated by wider ICC confidence intervals. So, reliability was fair to high for vertebral side deviation and the scoliosis angle (0.71 < ICC < 0.95), and poor to good for vertebral rotation values as well as for frontal plane upper body and pelvis position parameters (0.65 < ICC < 0.92). Coefficients for the between-day and between-week interval were a little lower than for repeated measures on the same day. Variability (SEM) was less than 1.5° or 1.5 mm, except for trunk inclination. Relative variability (CV) was greater in global trunk position and pelvis parameters (35-98%) than in scoliosis (14-20%) or sagittal sway parameters (4-8 %). Although we found a lower reproducibility for the frontal plane, raster stereography is considered to be a reliable method for the non-invasive, three-dimensional assessment of spinal alignment in normal non

  5. Damage to superior parietal cortex impairs pointing in the sagittal plane.

    Science.gov (United States)

    Danckert, James; Goldberg, Lana; Broderick, Carol

    2009-05-01

    Neurophysiology and neuroimaging research implicates distinct regions of posterior parietal cortex for reaching versus grasping and for completing these movements in central versus peripheral space. Typically, visuomotor tasks only examine movements made in the frontoparallel plane. We examined a patient with a right superior parietal lesion encompassing the parietal-occipital junction, the intraparietal sulcus and the putative human homologue of V6A on pointing tasks in the sagittal or frontoparallel planes. The patient did not demonstrate a speed-accuracy trade-off, but did show larger times post-peak velocity for all movement directions. Her movements in the sagittal axis were more disordered than movements in the frontoparallel plane. These data indicate a role for superior parietal cortex in fine tuning of visually guided movements and more particularly for movements made back towards the body.

  6. Does Shoe Collar Height Influence Ankle Joint Kinematics and Kinetics in Sagittal Plane Maneuvers?

    Directory of Open Access Journals (Sweden)

    Yang Yang, Ying Fang, Xini Zhang, Junliang He, Weijie Fu

    2017-12-01

    Full Text Available The Objective of the study is to investigate the effects of basketball shoes with different collar heights on ankle kinematics and kinetics and athletic performance in different sagittal plane maneuvers. Twelve participants who wore high-top and low-top basketball shoes (hereafter, HS and LS, respectively performed a weight-bearing dorsiflexion (WB-DF maneuver, drop jumps (DJs, and lay-up jumps (LJs. Their sagittal plane kinematics and ground reaction forces were recorded using the Vicon motion capture system and Kistler force plates simultaneously. Moreover, ankle dorsiflexion and plantarflexion angles, moment, power, stiffness, and jump height were calculated. In the WB-DF test, the peak ankle dorsiflexion angle (p = 0.041 was significantly smaller in HS than in LS. Additionally, the peak ankle plantarflexion moment (p = 0.028 and power (p = 0.022 were significantly lower in HS than in LS during LJs but not during DJs. In both jumping maneuvers, no significant differences were found in the jump height or ankle kinematics between the two shoe types. According to the WB-DF test, increasing shoe collar height can effectively reduce the ankle range of motion in the sagittal plane. Although the HS did not restrict the flexion–extension performance of the ankle joint during two jumping maneuvers, an increased shoe collar height can reduce peak ankle plantarflexion moment and peak power during the push-off phase in LJs. Therefore, a higher shoe collar height should be used to circumvent effects on the partial kinetics of the ankle joint in the sagittal plane.

  7. Does Shoe Collar Height Influence Ankle Joint Kinematics and Kinetics in Sagittal Plane Maneuvers?

    Science.gov (United States)

    Yang, Yang; Fang, Ying; Zhang, Xini; He, Junliang; Fu, Weijie

    2017-12-01

    The Objective of the study is to investigate the effects of basketball shoes with different collar heights on ankle kinematics and kinetics and athletic performance in different sagittal plane maneuvers. Twelve participants who wore high-top and low-top basketball shoes (hereafter, HS and LS, respectively) performed a weight-bearing dorsiflexion (WB-DF) maneuver, drop jumps (DJs), and lay-up jumps (LJs). Their sagittal plane kinematics and ground reaction forces were recorded using the Vicon motion capture system and Kistler force plates simultaneously. Moreover, ankle dorsiflexion and plantarflexion angles, moment, power, stiffness, and jump height were calculated. In the WB-DF test, the peak ankle dorsiflexion angle (p = 0.041) was significantly smaller in HS than in LS. Additionally, the peak ankle plantarflexion moment (p = 0.028) and power (p = 0.022) were significantly lower in HS than in LS during LJs but not during DJs. In both jumping maneuvers, no significant differences were found in the jump height or ankle kinematics between the two shoe types. According to the WB-DF test, increasing shoe collar height can effectively reduce the ankle range of motion in the sagittal plane. Although the HS did not restrict the flexion-extension performance of the ankle joint during two jumping maneuvers, an increased shoe collar height can reduce peak ankle plantarflexion moment and peak power during the push-off phase in LJs. Therefore, a higher shoe collar height should be used to circumvent effects on the partial kinetics of the ankle joint in the sagittal plane.

  8. Sagittal plane spinal mobility is associated with dynamic balance ability of community-dwelling elderly people.

    Science.gov (United States)

    Takeuchi, Yahiko

    2017-01-01

    [Purpose] The purpose of this study was to clarify the correlation between the range of spinal mobility on the sagittal plane and the dynamic balance ability of elderly people living in communities. [Subjects and Methods] The persons studied were 31 healthy elderly people living in the community (16 females and 15 males). The range of mobility of the participants' spines in the sagittal plane was measured by using a spinal mouse(®). Balance ability was evaluated by using Functional reach (FR), Timed up and go (TUG), and Maximum walking speed (MWS). [Results] A significant positive correlation between the flexion range of the lumbar vertebrae and the FR distance was identified, and a significant negative correlation between the extension range of the thoracic vertebrae and the time required for TUG was also identified. In addition, a significant positive correlation between the extension range of the entire spine and MWS, was identified. [Conclusion] The result of this study have clarified that mobility of the spine in the sagittal plane is associated with dynamic balance ability, which is related to falling.

  9. Sagittal Plane Hip, Knee, and Ankle Biomechanics and the Risk of Anterior Cruciate Ligament Injury: A Prospective Study

    National Research Council Canada - National Science Library

    Leppänen, Mari; Pasanen, Kati; Krosshaug, Tron; Kannus, Pekka; Vasankari, Tommi; Kujala, Urho M; Bahr, Roald; Perttunen, Jarmo; Parkkari, Jari

    2017-01-01

    ...: To investigate the relationship between selected sagittal plane hip, knee, and ankle biomechanics and the risk of ACL injury in young female team-sport athletes. Study Design: Case-control study...

  10. Sagittal plane pelvis motion influences transverse plane motion of the femur: Kinematic coupling at the hip joint.

    Science.gov (United States)

    Bagwell, Jennifer J; Fukuda, Thiago Y; Powers, Christopher M

    2016-01-01

    Previous studies have suggested that internal femur rotation can influence sagittal pelvis motion. This indicates that there may be kinematic "coupling" of these two segments. The purpose of the current study was to determine whether there is a consistent and predictable kinematic relationship between the pelvis and the femur. Sixteen healthy subjects (nine females, seven males) performed three trials of maximum anterior and posterior pelvis tilt at four different hip flexion angles (0°, 30°, 60°, and 90°). Ordinary least squares regressions were used to calculate the ratio of transverse femur motion to sagittal pelvis motion using the mean kinematic curves during maximum anterior and posterior pelvis tilting. R(2) values were used to assess the strength of the kinematic relationship between these segments at each hip flexion angle. The ratios of transverse femur motion to sagittal pelvis motion were consistent across all hip flexion angles during anterior and posterior pelvis tilting (range 0.23-0.32; R(2) values greater than 0.97). On average, for every 5° of anterior pelvis tilt there was 1.2-1.6° of internal femur rotation and the converse was true for posterior pelvis tilt and external femur rotation. Our findings suggest that altered pelvis movement in the sagittal plane may influence transverse femur motion. The observed coupling behavior between the pelvis and femur may have implications for musculoskeletal conditions in which excessive internal femur rotation has been deemed contributory to symptoms (i.e. femoroacetabular impingement). Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Multilevel Schwab grade II osteotomies for sagittal plane correction in the management of adult spinal deformity.

    Science.gov (United States)

    Ghobrial, George M; Lebwohl, Nathan H; Green, Barth A; Gjolaj, Joseph P

    2017-11-01

    , CSVL, and TPA, as compared with SVA <10 cm. The LL was the only independent predictor of osteotomy correction per level (LL: β coefficient=-0.108, confidence interval: -0.141 to 0.071, p<.0001). Multilevel SPOs are feasible for restoration of LL as well as sagittal and coronal alignment in the ASD population with or without prior instrumented fusion. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Impact of sagittal spinopelvic alignment on clinical outcomes after decompression surgery for lumbar spinal canal stenosis without coronal imbalance.

    Science.gov (United States)

    Hikata, Tomohiro; Watanabe, Kota; Fujita, Nobuyuki; Iwanami, Akio; Hosogane, Naobumi; Ishii, Ken; Nakamura, Masaya; Toyama, Yoshiaki; Matsumoto, Morio

    2015-10-01

    The object of this study was to investigate correlations between sagittal spinopelvic alignment and improvements in clinical and quality-of-life (QOL) outcomes after lumbar decompression surgery for lumbar spinal canal stenosis (LCS) without coronal imbalance. The authors retrospectively reviewed data from consecutive patients treated for LCS with decompression surgery in the period from 2009 through 2011. They examined correlations between preoperative or postoperative sagittal vertical axis (SVA) and radiological parameters, clinical outcomes, and health-related (HR)QOL scores in patients divided according to SVA. Clinical outcomes were assessed according to Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) scores. Health-related QOL was evaluated using the Roland-Morris Disability Questionnaire (RMDQ) and the JOA Back Pain Evaluation Questionnaire (JOABPEQ). One hundred nine patients were eligible for inclusion in the study. Compared to patients with normal sagittal alignment prior to surgery (Group A: SVA SVA ≥ 50 mm) had significantly smaller lumbar lordosis and thoracic kyphosis angles and larger pelvic tilt. In Group B, there was a significant decrease in postoperative SVA compared with the preoperative SVA (76.3 ± 29.7 mm vs. 54.3 ± 39.8 mm, p = 0.004). The patients in Group B with severe preoperative sagittal imbalance (SVA > 80 mm) had residual sagittal imbalance after surgery (82.8 ± 41.6 mm). There were no significant differences in clinical and HRQOL outcomes between Groups A and B. Compared to patients with normal postoperative SVA (Group C: SVA SVA ≥ 50 mm (Group D) had significantly lower JOABPEQ scores, both preoperative and postoperative, for walking ability (preop: 36.6 ± 26.3 vs. 22.7 ± 26.0, p = 0.038, respectively; postop: 71.1 ± 30.4 vs. 42.5 ± 29.6, p SVA value in patients with preoperative sagittal imbalance; however, the patients with severe preoperative sagittal imbalance (SVA > 80 mm) had residual imbalance

  13. Sagittal and Frontal Plane Evaluation of the Whole Spine and Clinical Outcomes after Vertebral Fractures

    Directory of Open Access Journals (Sweden)

    A. Topalidou

    2015-01-01

    Full Text Available Although it is known that a change in any level of the spine alters biomechanics, there are not many studies to evaluate the spine as a whole in both sagittal and frontal planes. This prospective cohort study evaluates the morphology and mobility of the entire spine in patients with vertebral fractures. The Treatment Group consisted of 43 patients who underwent percutaneous balloon kyphoplasty or percutaneous balloon kyphoplasty plus fixation. The Control Group consisted of 39 healthy subjects. Spinal Mouse was used for the assessment of the curvatures and the mobility of the spine. Clinical outcomes were evaluated by Visual Analogue Scale and Oswestry Disability Index. The measurements were recorded at 15 days and 3, 6, and 12 months postoperatively. Regarding the curvatures and mobility in sagittal plane, a statistically significant increase appeared early at 3 months, for lumbar curve, spinopelvic angulation, and overall trunk inclination. In the frontal plane, most of the improvements were recorded after 6 months. Patients with osteoporotic fracture showed statistically significant lower mean value than patients with traumatic fracture. Pain and disability index showed early improvements. This study provides a comprehensive and complete picture of the functionality of the spine in patients treated with percutaneous balloon kyphoplasty.

  14. Using smartphones in the evaluation of spinal curvatures in a sagittal plane

    Directory of Open Access Journals (Sweden)

    Waś Jakub

    2016-12-01

    Full Text Available Introduction: In physiotherapeutic diagnostic processes, various tools and methods may be used. However, price and availability may limit their daily use in clinical practice. Therefore, the suggestion that smartphones with specific applications may be useful as diagnostic tools can be found in the literature. However, before using them in clinical practice, it is important to verify their reliability. The aim of the study was to evaluate the consistency of measurements of the curvatures in the sagittal plane performed with the Saunders digital inclinometer and a smartphone application.

  15. Estimation and Perturbation of the Mid-Sagittal Plane and its Effects on Corpus Callosum Morphometry

    DEFF Research Database (Denmark)

    Skoglund, Karl; Stegmann, Mikkel Bille; Ryberg, Charlotte

    2005-01-01

    callosum (CC), the white-matter nervous tissue bridging the left and right cerebral hemisphere. A multitude of papers (e.g. [2]) report on measurements performed on the two-dimensional cross-section of the CC defined by the mid-sagittal plane (MSP) which separates the left hemisphere from the right......Brain morphometry is an important tool for detecting and monitoring brain pathologies such as epilepsy, dementia [1,2] and multiple sclerosis [3]. A common method is to delineate some well-defined area of the brain to yield a shape for interor intra-subject studies. One such structure is the corpus...

  16. Undershooting of a neutral reference position by asymptomatic subjects after cervical motion in the sagittal plane.

    Science.gov (United States)

    Hallgren, Richard C; Andary, Michael T

    2008-09-01

    The objective of this study was to determine if blindfolded, asymptomatic subjects undershoot or overshoot a self-selected neutral reference position (NRP) when performing a full-cycle, head repositioning accuracy test in the sagittal plane. An asymptomatic group of subjects, consisting of 7 men and 5 women with no history of head and neck pain, were recruited for the study. Subjects, performing a full-cycle series of head/neck movements in the sagittal plane, attempted to return to a self-selected NRP, defined at the beginning of the movement sequence, without benefit of visual clues. Data were collected for each subject, and repositioning errors were calculated. The sign of the error was used to determine if undershooting or overshooting of the NRP had occurred. Subjects undershot a self-selected NRP at statistically significant levels (P < .01) when performing the head repositioning accuracy test while blindfolded. Subjects undershot the NRP 83% of the time when moving from flexion to the NRP and undershot the NRP 92% of the time when moving from extension to the NRP. A Fisher exact test showed no significant difference between the number of times subjects undershot the NRP when moving from either flexion to the NRP or from extension to the NRP. To our knowledge, neither undershooting nor overshooting of an NRP has previously been reported for asymptomatic subjects at statistically significant levels. Knowing that asymptomatic subjects undershoot an NRP may help to direct treatment and rehabilitation of patients who have experienced whiplash-type injuries and are shown to overshoot the NRP when performing the same test.

  17. Radiographic diagnosis of sagittal plane rotational displacement in pelvic fractures: a cadaveric model and clinical case study.

    Science.gov (United States)

    Shui, Xiaolong; Ying, Xiaozhou; Kong, Jianzhong; Feng, Yongzeng; Hu, Wei; Guo, Xiaoshan; Wang, Gang

    2015-08-01

    Our objective was to measure the sagittal plane rotational (flexion and extension) displacement of hemipelvis radiologically and analyze the ratio of flexion and extension displacement of unstable pelvic fractures. We used 8 cadaveric models to study the radiographic evidence of pelvic fractures in the sagittal plane. We performed pelvic osteotomy on 8 cadavers to simulate anterior and posterior pelvic ring injury. Radiological data were measured in the flexion and extension group under different angles (5°, 10°, 15°, 20°, and 25°). We retrospectively reviewed 164 patients who were diagnosed with a unilateral fracture of the pelvis. Pelvic ring displacement was identified and recorded radiographically in cadaveric models. The flexion and extension displacement of pelvic fractures was measured in terms of the vertical distance of fracture from the top of iliac crest to the pubic tubercle (CD) or from the top of iliac crest to the lowest point of ischial tuberosity (AB). Fifty-seven pelves showed flexion displacement and 15 showed extension displacement. Closed reduction including internal fixation and external fixation was successfully used in 141 cases (86.0 %). The success rates of closed reduction in flexion and extension displacement groups were 77 and 73 %, respectively, which were lower than in unstable pelvic ring fractures. The sagittal plane rotation (flexion and extension) displacement of pelvic fractures could be measured by special points and lines on the radiographs. Minimally invasive reduction should be based on clearly identified differences between the sagittal plane rotation and the vertical displacement of pelvic fractures.

  18. Conjoined bicondylar coronal plane fracture of the distal femur associated with incarcerated patella.

    Science.gov (United States)

    Kishan, Rama; Saibaba, Balaji; Kumar, Vishal; Aggarwal, Sameer

    2016-05-20

    Conjoint bicondylar coronal plane fracture is a rare orthopaedic injury, associated with high-velocity trauma. The proposed mechanism is axially directed shear forces in a flexed knee. To the best of our literature search, only 2 cases of conjoint bicondylar coronal fracture have been published in English literature-1 each in adult and paediatric age group. Conjoint bicondylar coronal plane fracture with incarcerated patella has not yet been reported and hence this is the first report of its kind. We report on the clinical presentation, management and outcome of such a complex injury, along with a comprehensive, up-to-date literature review. Prompt open reduction and internal fixation coupled with early knee mobilisation is the key to achieve good functional outcome. 2016 BMJ Publishing Group Ltd.

  19. The effects of changes in the sagittal plane alignment of running-specific transtibial prostheses on ground reaction forces.

    Science.gov (United States)

    Tominaga, Shuichi; Sakuraba, Keisyoku; Usui, Fumio

    2015-05-01

    [Purpose] To verify the effects of sagittal plane alignment changes in running-specific transtibial prostheses on ground reaction forces (GRFs). [Subjects and Methods] Eight transtibial amputees who used running-specific prostheses during sprinting participated. The sprint movements were recorded using a Vicon-MX system and GRF measuring devices. The experiment levels were set as regularly recommended alignment (REG; the normal alignment for the subjects) and dorsiflexion or plantar flexion from the REG. [Results] The subjects were classified into fast (100-m personal best < 12.50 s) and slow (100-m personal best ≥ 12.50 s) groups. In both groups, there were no significant differences in the center of gravity speed; further, the difference in the stance time was significant in the slow group but not in the fast group. Significant differences were observed in the step length for the fast group, whereas the stance time and step rate significantly differed in the slow group. The GRF impulse showed significant differences in the vertical and braking directions in both groups. [Conclusion] The GRFs are affected by sagittal plane alignment changes in running-specific prostheses. Moreover, our results suggest that the change in GRFs along with the altered sagittal plane alignment influenced the step length and step rate.

  20. Postural stabilization during bilateral and unilateral vibration of ankle muscles in the sagittal and frontal planes.

    Science.gov (United States)

    Duclos, Noémie C; Maynard, Luc; Barthelemy, Joëlle; Mesure, Serge

    2014-09-01

    The purpose was to investigate the postural consequences of proprioceptive perturbation of the Triceps Surae and Peroneus Longus muscles. These muscles are known to control posture respectively in the sagittal and frontal planes during standing. Standard parameters and the time course of center of pressure (CoP) displacements were recorded in 21 young adults, instructed to maintain their balance during tendon vibration. Following 4 s of baseline recording, three types of vibration (80 Hz) were applied for 20 s each on the Peroneus or Achilles tendons, either unilaterally or bilaterally (with eyes shut). The recording continued for a further 24 s after the end of the vibration during the re-stabilization phase. To evaluate the time course of the CoP displacement, each phase of the trial was divided into periods of 4 seconds. Differences between the type of tendon vibration, phases and periods were analyzed using ANOVA. During all tendon vibrations, the speed of the CoP increased and a posterior displacement occurred. These changes were greater during Achilles than during Peroneus vibration for each type of vibration and also during bilateral compared with unilateral vibration. All maximal posterior positions occurred at a similar instant (between 12.7 and 14 s of vibration). Only unilateral Achilles vibration led to a significant medio-lateral displacement compared to the initial state. The effect of the proprioceptive perturbation seems to be influenced by the position of the vibrated muscle according to the planes of the musculoskeletal postural organization. The amplitude of the destabilization may be related to the importance of the muscle for postural control. The medial CoP displacement which occurred during unilateral Achilles vibration is not a general reaction to a single-limb perturbation. Proprioceptive input from the non-perturbed leg was not sufficient for the antero-posterior displacement to be avoided; however, it helped to gain stability over time

  1. Comparative Study between Axial and Coronal Planes of CT Enterography in Evaluation of Disease Activity and Complications of Crohn Disease

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Sung Eun; Park, Seong Jin; Moon, Soung Kyung; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae; Kim, Hyo Jong [Dept. of Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2013-02-15

    To retrospectively compare the accuracy of axial and coronal planes of CT enterography for detection of pathologic findings of Crohn disease. 168 patients who were suspected of having Crohn disease underwent CT enterography. 66 patients who were diagnosed Crohn disease were retrospectively evaluated (endoscopic biopsy of terminal ileum: 12 patients, segmental resection of small bowel: 6 patients, diagnosed based on a combination of clinical, histopathological and imaging findings: 48 patients). 2 radiologists reviewed axial planes of CT enterography and one month later reviewed coronal planes. CT enterography findings of active phase, chronic phase and complications of Crohn disease were evaluated and then compared with axial and coronal planes by using chi-square test. Mucosal hyperenhancement, wall thickening, and mesenteric fat stranding were more detected on axial planes, which were CT findings of active Crohn disease. Pseudosacculation, fibrotic strictures, fistulas, abscesses were more detected on coronal planes, which were CT findings of chronic Crohn disease or complications. In particular, pseudosacculation and fibrotic strictures were significantly more detected on coronal planes. When evaluating CT enterography in Crohn disease, coronal planes provide more useful diagnostic information of pseudosacculation and fibrotic strictures.

  2. Sagittal plane analysis of the spine and pelvis in adult idiopathic scoliosis.

    Science.gov (United States)

    Li, Wei-Shi; Li, Gang; Chen, Zhong-Qiang; Wood, Kirkham B

    2010-11-01

    There has been an increasing recognition of the importance of sagittal spinopelvic alignment in patients with scoliosis as it relates to clinical outcomes. However, the changes seen in sagittal spinopelvic alignment in adult idiopathic scoliosis patients is poorly defined. This study was conducted to evaluate the sagittal alignment of pelvis and spine in adult idiopathic scoliosis patients. The sagittal parameters of the spine and pelvis were analyzed in lateral standing radiographs of 124 patients (mean age 47.4 years) with adult idiopathic scoliosis, including thoracic kyphosis (TK), thoracolumbar junction kyphosis (TLJ), lumbar lordosis (LL), pelvic incidence (PI), sacrum slope (SS), pelvic tilt (PT) and C7 plumb line (C7PL). The patients were divided into three groups according to the age: 20 - 40 years, 41 - 64 years, and ≥ 65 years. The parameters were compared with those in normal adults and adolescent idiopathic scoliosis (AIS) patients. The relationship between all parameters as well as age and sagittal parameters were analyzed. The PI in patients with adult idiopathic scoliosis was 58.1° ± 13.0°, which was significantly higher than that in normal adults. The PT (19.9° ± 10.6°) was also higher than that in both normal adults and AIS patients, while the SS (38.1° ± 12.0°) was similar or smaller. As age increased, C7PL, PT and TJL increased while LL decreased. There was no relationship between age and both PI and TK. PT had the strongest statistical association with the C7PL. PI is higher in adult idiopathic scoliosis than normal subjects. The PT is the most relevant pelvic parameter to the global sagittal alignment of the spine. Age significantly influences sagittal parameters of the spine and pelvis except the PI and TK.

  3. Reliability of a simple fluoroscopic method to study sagittal plane femorotibial contact changes in total knee arthroplasties during flexion.

    Science.gov (United States)

    Lacoste, C; Granizo, J J; Gómez-Barrena, E

    2007-08-01

    Clinical interest in sagittal plane kinematic analysis of the knee undergoing total knee replacement fosters the development of simple, reliable methods to estimate femorotibial contact in a regular clinical setting. In this study, the sagittal femorotibial contact was analysed in lateral X-rays and lateral fluoroscopic views, from extension to knee flexion. Quantitative and categorical data were obtained from these views by two different observers, and compared with data from direct views of the components. Interobserver and intermethod errors for quantitative and categorical data were evaluated based on correlation, kappa coefficient, and Bland-Altman graphs. Interobserver reproducibility of quantitative measurement from fluoroscopic views was r=0.96 while categorical assignment exhibited a kappa coefficient of 0.95. Reproducibility from plain radiographs was not so high, with a kappa coefficient of 0.64. High concordance was also obtained when the method was compared with the direct view of the implant, supporting these measurement techniques. Bland-Altman graphs confirmed the absence of bias in the intermethod comparison. Therefore, with the obvious limitation of rotational assessment, lateral fluoroscopic evaluation enhanced by a simple fitting technique can be used as a valuable tool for clinical evaluation of knee kinematics in the sagittal plane.

  4. Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters.

    Science.gov (United States)

    Lafage, Virginie; Schwab, Frank; Skalli, Wafa; Hawkinson, Nicola; Gagey, Pierre-Marie; Ondra, Stephen; Farcy, Jean-Pierre

    2008-06-15

    Prospective study of 131 patients and volunteers recruited for an analysis of spinal alignment and gravity line (GL) assessment by force plate analysis. To determine relationships between GL, foot position, and spinopelvic landmarks in subjects with varying sagittal alignment. Additionally, the study sought to analyze the role of the pelvis in the maintenance of GL position. Force plate technology permits analysis of foot position and GL in relation to radiographically obtained landmarks. Previous investigation noted fixed GL-heel relationship across a wide age range despite changes in thoracic kyphosis. The pelvis as balance regulator has not been studied in the setting of sagittal spinal deformity. The 131 subjects were grouped by sagittal vertical axis (SVA) offset from the sacrum: sagittal forward (>2.5 cm), neutral (-2.5 cm sagittal backward (SVA <-2.5 cm). Simultaneous spinopelvic radiographs and GL measure were obtained. Offsets between spinopelvic landmarks, heel position, and GL were calculated. Group comparisons were made for all offsets to determine significance. Aside from the offset T9-GL and GL-heels, all other offsets between spinopelvic landmarks and GL revealed significant differences (P < 0.001) across the 3 subject groups. However, with increasing SVA, the GL kept a rather fixed location relative to the feet. A correlation between posterior pelvic shift in relation to the heels with increasing SVA in this study population was confirmed (r = 0.6, P < 0.001). Increasing SVA in standing subjects leads to a posterior pelvic shift in relation to the feet. However, no significant difference in GL-heel offset is noted with increasing SVA. It thus appears that pelvic shift (in relation to the feet) is an important component in maintaining a rather fixed GL-Heels offset even in the setting of variable SVA and trunk inclination.

  5. The severity of basilar invagination and atlantoaxial dislocation correlates with sagittal joint inclination, coronal joint inclination, and craniocervical tilt: a description of new indexes for the craniovertebral junction.

    Science.gov (United States)

    Chandra, P Sarat; Goyal, Nishant; Chauhan, Avnish; Ansari, Abuzer; Sharma, Bhawani Shankar; Garg, Ajay

    2014-12-01

    Joint-distraction and intra-operative manipulation surgeries to correct basilar invagination (BI) and atlantoaxial dislocation (AAD) are becoming standard procedures. However, current data are unable to aid in the understanding of normal and abnormal morphology of the C1/C2 joints. To study various aspects of C1/C2 joint morphology to create normative and patient data on joint abnormalities that could provide the surgeon with objective data for surgical planning and approach. Seventy patients (age, 15-45 years) were compared with an equal number of age- and sex-matched control subjects (age, 21.9±8.2 years) with irreducible BI and AAD from a developmental origin (May 2010-July 2013). Joint anatomy was studied with the use of thin-slice computed tomography scans. The joint parameters studied included sagittal joint inclination, craniocervical tilt, coronal joint inclination, surface area, joint overlap index, and joint reciprocity. The severity of BI and the severity of AAD were compared. Sagittal joint inclination and craniocervical tilt significantly correlated with both BI and AAD (P<.01). Coronal joint inclination correlated with BI (P=.2). The mean sagittal joint inclination value in control subjects was 87.15±5.65° and in patients with BI and AAD was 127.1±22.05°. The mean craniocervical tilt value in controls was 60.2±9.2° and in patients with BI and AAD was 84.0±15.1°. The mean coronal joint inclination value in control subjects was 110.3±4.23° and in patients with BI and AAD was 121.15±14.6°. This study has demonstrated for the first time the important role of joint orientation and its correlation with the severity of BI and AAD and has described new joint indexes.

  6. Effect of Limb Position at the Time of Skin Marker Application on Sagittal Plane Kinematics of the Dog.

    Science.gov (United States)

    Kim, Sun-Young; Torres, Bryan T; Sandberg, Gabriella S; Budsberg, Steven C

    2017-11-01

    Objectives To evaluate the effect of limb position during initial skin marker application on sagittal plane kinematics of the hindlimb. Methods Six healthy dogs (20-30 kg) were evaluated. An established two-dimensional kinematic model of the pelvic limb was utilized to describe sagittal plane motion. Kinematic markers were applied separately for each dog while standing in three different positions: (1) the limb extended cranially, (2) a normal standing limb position and (3) the limb extended caudally. Following marker application at each of the three positions, dynamic gait was recorded at a walk (velocity, 0.9-1.2 m/s; acceleration, 0.5m/s2). Five valid trials were used for comparison. Complete waveform analysis was performed with generalized indicator function analysis (GIFA). Maximum and minimum joint angles and joint range of motion were compared with a one-way repeated measures ANOVA with significance at p < 0.05. Results Significant differences were found between stifle waveforms. No differences were found between the hip or tarsus waveforms. Minimum and maximum joint angles were significantly different for the hip and stifle but not for the tarsus. No differences were found between ranges of motion for any joint evaluated. Clinical Significance Limb position at the time of skin marker application affects gait data and is an important consideration for kinematic analysis of the hindlimb in dogs. Schattauer GmbH Stuttgart.

  7. Glenoid deformity in the coronal plane correlates with humeral head changes in osteoarthritis: a radiographic analysis.

    Science.gov (United States)

    Hawi, Nael; Magosch, Petra; Tauber, Mark; Lichtenberg, Sven; Martetschläger, Frank; Habermeyer, Peter

    2017-02-01

    A variety of measurements can be used to assess radiographic osteoarthritic changes of the shoulder. This study aimed to analyze the correlation between the radiographic humeral-sided Samilson and Prieto classification system and 3 different radiographic classifications describing the changes of the glenoid in the coronal plane. The study material included standardized radiographs of 50 patients with idiopathic osteoarthritis before anatomic shoulder replacement. On the basis of radiographic measurements, the cases were evaluated using the Samilson and Prieto grading system, angle β, inclination type, and critical shoulder angle by 2 independent observers. Classification measurements showed an excellent agreement between observers. Our results showed that the humeral-sided Samilson and Prieto grading system had a statistically significant good correlation with angle β (observer 1, r = 0.74; observer 2, r = 0.77; P  .05). The grade of humeral-sided osteoarthritis according to Samilson and Prieto correlates with the glenoid-sided osteoarthritic changes of the glenoid in the coronal plane described by the angle β and by the inclination type of the glenoid. Higher glenoid-sided inclination is associated with higher grade of osteoarthritis in primary shoulder osteoarthritis. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  8. When is compensation for lumbar spinal stenosis a clinical sagittal plane deformity?

    Science.gov (United States)

    Buckland, Aaron J; Vira, Shaleen; Oren, Jonathan H; Lafage, Renaud; Harris, Bradley Y; Spiegel, Matthew A; Diebo, Bassel G; Liabaud, Barthelemy; Protopsaltis, Themistocles S; Schwab, Frank J; Lafage, Virginie; Errico, Thomas J; Bendo, John A

    2016-08-01

    Degenerative lumbar stenosis (DLS) patients have been reported to lean forward in an attempt to provide neural decompression. Spinal alignment in patients with DLS may resemble that of adult spinal deformity (ASD). No previous studies have compared and contrasted the compensatory mechanisms of DLS and ASD patients. This study aimed to determine the differences in compensatory mechanisms between DLS and ASD patients with increasing severity of sagittal spinopelvic malalignment. Contrasting these compensatory mechanisms may help determine at what severity sagittal malalignment represents a clinical sagittal deformity rather than a compensation for neural compression. This is a retrospective clinical and radiological review. Baseline x-rays in patients without spinal instrumentation, with the clinical radiological and diagnoses of DLS or ASD, were assessed for patterns of spinopelvic compensatory mechanisms. Patients were stratified by sagittal vertical axis (SVA) according to the Scoliosis Research Society-Schwab [SRS-Schwab] classification. Radiographic spinopelvic parameters were measured in the DLS and ASD groups, including SVA, pelvic incidence-lumbar lordosis mismatch (PI-LL), T1 spinopelvic inclination (T1SPi), T1 pelvic angle (TPA), and pelvic tilt (PT). The two diagnosis cohorts were propensity-matched for PI and age. Each group contained 125 patients and was stratified according to the SRS-Schwab classification. Regional spinopelvic,lower limb, and global alignment parameters were assessed to identify differences in compensatory mechanisms between the two groups with differing degrees of deformity. No funding was provided by any third party in relation to carrying out this study or preparing the manuscript. With mild to moderate malalignment (SRS-Schwab groups "0," or "+" for PT, PI-LL, or SVA), DLS patients permit anterior truncal inclination and recruit posterior pelvic shift instead of pelvic tilt to maintain balance, while providing relief of neurologic

  9. Effect of posterior multilevel vertebral osteotomies on coronal and sagittal balance in fused scoliosis deformity caused by previous surgery: preliminary results.

    Science.gov (United States)

    Yang, Jae Hyuk; Suh, Seung Woo; Cho, Won Tae; Hwang, Jin Ho; Hong, Jae Young; Modi, Hitesh N

    2014-10-15

    Prospective case series study. To study the effect of posterior multilevel vertebral osteotomy (posterior crack osteotomy) on coronal and sagittal balance in patients with the fusion mass over the spine caused by previous surgery. Few studies have investigated revisional scoliosis surgery with the fusion mass using osteotomy. Among patients who had a history of prior surgery for scoliosis correction and posterior fusion, those showing progression of the curve postoperatively due to nonunion, implant failure, or adding-on phenomenon were enrolled. All patients were treated using posterior crack osteotomy. For clinical evaluation, the pre- and postoperative Gross Motor Function Classification System score for walking status and the Berg balanced scale were used. For radiological evaluation, pre- and postoperative Cobb angle, and coronal and sagittal balance factors were used. Ten patients (5 males and 5 females) were enrolled. The preoperative diagnosis was neuromuscular scoliosis (3 cases), syndromic scoliosis (1 case), congenital scoliosis (5 cases), and neurofibromatosis (1 case). Osteotomies were performed at 3.3±1.3 levels on average. Pre- and postoperative Cobb angles were 70.8°±30.0° and 28.1°±20.0° (P=0.002 (0.97)), respectively. In pre- and postoperative evaluation of coronal balance, the coronal balance, clavicle angle, and T1-tilt angle were 36.8±27.1 mm and 10.4±8.5 mm, 6.7°±8.0° and 3.3°±1.5°, and 7.8°±19.0° and 4.7°±2.1°, respectively (P=0.002, 0.002, 0.002). In pre- and postoperative evaluation of sagittal balance, the spinal vertical axis, thoracic kyphosis, and lumbar alignments were 25.1±37.8 mm and 14.1±21.8 mm, 33.5°±51.1° and 29.7°±27.4°, and 45.7°±34.8° and 48.9°±23.1° (P=0.002, 0.169, 0.169). The walking and functional statuses did not change (P=0.317, 0.932). Although pulmonary and gastrointestinal complications were noted, the patients were discharged without complications. Posterior crack osteotomy can be

  10. Grizzly bear (Ursus arctos horribilis) locomotion: forelimb joint mechanics across speed in the sagittal and frontal planes.

    Science.gov (United States)

    Shine, Catherine L; Robbins, Charles T; Nelson, O Lynne; McGowan, Craig P

    2017-04-01

    The majority of terrestrial locomotion studies have focused on parasagittal motion and paid less attention to forces or movement in the frontal plane. Our previous research has shown that grizzly bears produce higher medial ground reaction forces (lateral pushing from the animal) than would be expected for an upright mammal, suggesting frontal plane movement may be an important aspect of their locomotion. To examine this, we conducted an inverse dynamics analysis in the sagittal and frontal planes, using ground reaction forces and position data from three high-speed cameras of four adult female grizzly bears. Over the speed range collected, the bears used walks, running walks and canters. The scapulohumeral joint, wrist and the limb overall absorb energy (average total net work of the forelimb joints, -0.97 W kg-1). The scapulohumeral joint, elbow and total net work of the forelimb joints have negative relationships with speed, resulting in more energy absorbed by the forelimb at higher speeds (running walks and canters). The net joint moment and power curves maintain similar patterns across speed as in previously studied species, suggesting grizzly bears maintain similar joint dynamics to other mammalian quadrupeds. There is no significant relationship with net work and speed at any joint in the frontal plane. The total net work of the forelimb joints in the frontal plane was not significantly different from zero, suggesting that, despite the high medial ground reaction forces, the forelimb acts as a strut in that plane. © 2017. Published by The Company of Biologists Ltd.

  11. Transverse forces versus modified ashworth scale for upper limb flexion/extension in para-sagittal plane.

    Science.gov (United States)

    Seth, Nitin; Johnson, Denise; Abdullah, Hussein A

    2017-07-01

    Spasticity is a common impairment following an upper motor neuron lesion in conditions such as stroke and brain injury. A clinical issue is how to best quantify and measure spasticity. Recently, research has been performed to develop new methods of spasticity quantification using various systems. This paper follows up on previous work taking a closer look at the role of transversal forces obtained via rehabilitation robot for motions in the para-sagittal plane. Results from 45 healthy individuals and 40 individuals with acquired brain injury demonstrate that although the passive upper motions are vertical, horizontal forces into and away from the individual's body demonstrate a relationship with the Modified Ashworth Scale. This finding leads the way to new avenues of spasticity quantification and monitoring.

  12. Fast, Accurate and Precise Mid-Sagittal Plane Location in 3D MR Images of the Brain

    Science.gov (United States)

    Bergo, Felipe P. G.; Falcão, Alexandre X.; Yasuda, Clarissa L.; Ruppert, Guilherme C. S.

    Extraction of the mid-sagittal plane (MSP) is a key step for brain image registration and asymmetry analysis. We present a fast MSP extraction method for 3D MR images, based on automatic segmentation of the brain and on heuristic maximization of the cerebro-spinal fluid within the MSP. The method is robust to severe anatomical asymmetries between the hemispheres, caused by surgical procedures and lesions. The method is also accurate with respect to MSP delineations done by a specialist. The method was evaluated on 64 MR images (36 pathological, 20 healthy, 8 synthetic), and it found a precise and accurate approximation of the MSP in all of them with a mean time of 60.0 seconds per image, mean angular variation within a same image (precision) of 1.26o and mean angular difference from specialist delineations (accuracy) of 1.64o.

  13. EMG Analysis and Sagittal Plane Kinematics of the Two-Handed and Single-Handed Kettlebell Swing: A Descriptive Study.

    Science.gov (United States)

    Van Gelder, Leonard H; Hoogenboom, Barbara J; Alonzo, Bryan; Briggs, Dayna; Hatzel, Brian

    2015-11-01

    Kettlebell (KB) swing exercises have been proposed as a possible method to improve hip and spinal motor control as well as improve power, strength, and endurance. To describe electromyographic (EMG) and sagittal plane kinematics during two KB exercises: the two-handed KB swing (THKS) and the single-handed KB swing (SHKS). In addition, the authors sought to investigate whether or not hip flexor length related to the muscular activity or the kinematics of the exercise. Twenty-three healthy college age subjects participated in this study. Demographic information and passive hip flexor length were recorded for each subject. A maximum voluntary isometric contraction (MVIC) of bilateral gluteus maximus (GMAX), gluteus medius (GMED), and biceps femoris (BF) muscles was recorded. EMG activity and sagittal plane video was recorded during both the THKS and SHKS in a randomized order. Normalized muscular activation of the three studied muscles was calculated from EMG data. During both SHKS and THKS, the average percent of peak MVIC for GMAX was 75.02% ± 55.38, GMED 55.47% ± 26.33, and BF 78.95% ± 53.29. Comparisons of the mean time to peak activation (TTP) for each muscle showed that the biceps femoris was the first muscle to activate during the swings. Statistically significant (p < .05), moderately positive correlations (r = .483 and .417) were found between passive hip flexor length and % MVIC for the GMax during the SHKS and THKS, respectively. The THKS and SHKS provide sufficient muscular recruitment for strengthening of all of the muscles explored. This is the first study to show significant correlations between passive hip flexor length and muscular activation of hip extensors, particularly the GMax. Finally, the BF consistently reached peak activity before the GMax and GMed during the SHKS. Level 3.

  14. Sagittal Plane Hip, Knee, and Ankle Biomechanics and the Risk of Anterior Cruciate Ligament Injury: A Prospective Study.

    Science.gov (United States)

    Leppänen, Mari; Pasanen, Kati; Krosshaug, Tron; Kannus, Pekka; Vasankari, Tommi; Kujala, Urho M; Bahr, Roald; Perttunen, Jarmo; Parkkari, Jari

    2017-12-01

    Stiff landings with less knee flexion and high vertical ground-reaction forces have been shown to be associated with an increased risk of anterior cruciate ligament (ACL) injury. The literature on the association between other sagittal plane measures and the risk of ACL injuries with a prospective study design is lacking. To investigate the relationship between selected sagittal plane hip, knee, and ankle biomechanics and the risk of ACL injury in young female team-sport athletes. Case-control study; Level of evidence, 3. A total of 171 female basketball and floorball athletes (age range, 12-21 years) participated in a vertical drop jump test using 3-dimensional motion analysis. All new ACL injuries, as well as match and training exposure data, were recorded for 1 to 3 years. Biomechanical variables, including hip and ankle flexion at initial contact (IC), hip and ankle ranges of motion (ROMs), and peak external knee and hip flexion moments, were selected for analysis. Cox regression models were used to calculate hazard ratios (HRs) with 95% CIs. The combined sensitivity and specificity of significant test variables were assessed using a receiver operating characteristic (ROC) curve analysis. A total of 15 noncontact ACL injuries were recorded during follow-up (0.2 injuries/1000 player-hours). Of the variables investigated, landing with less hip flexion ROM (HR for each 10° increase in hip ROM, 0.61 [95% CI, 0.38-0.99]; P sport players. Studies with larger populations are needed to confirm these findings and to determine the role of ankle flexion ROM as a risk factor for ACL injury. Increasing knee and hip flexion ROMs to produce soft landings might reduce knee loading and risk of ACL injury in young female athletes.

  15. Effect of Acute Alterations in Foot Strike Patterns during Running on Sagittal Plane Lower Limb Kinematics and Kinetics

    Directory of Open Access Journals (Sweden)

    Kevin A. Valenzuela, Scott K. Lynn, Lisa R. Mikelson, Guillermo J. Noffal, Daniel A. Judelson

    2015-03-01

    Full Text Available subjects were identified through slow motion video playback (n = 21, age = 22.8±2.2 years, mass = 73.1±14.5 kg, height 1.75 ± 0.10 m. On day two, subjects performed five overground run trials in both their natural and unnatural strike patterns while motion and force data were collected. Data were collected over two days so that foot strike videos could be analyzed for group placement purposes. Several 2 (Foot Strike Pattern –forefoot strike [FFS], rearfoot strike [RFS] x 2 (Group – PFFG, PRFG mixed model ANOVAs (p < 0.05 were run on speed, active peak vertical ground reaction force (VGRF, peak early stance and mid stance sagittal ankle moments, sagittal plane hip and knee moments, ankle dorsiflexion ROM, and sagittal plane hip and knee ROM. There were no significant interactions or between group differences for any of the measured variables. Within subject effects demonstrated that the RFS condition had significantly lower (VGRF (RFS = 2.58 ± .21 BW, FFS = 2.71 ± 0.23 BW, dorsiflexion moment (RFS = -2.6 1± 0.61 Nm·kg-1, FFS = -3.09 ± 0.32 Nm·kg-1, and dorsiflexion range of motion (RFS = 17.63 ± 3.76°, FFS = 22.10 ± 5.08°. There was also a significantly higher peak plantarflexion moment (RFS = 0.23 ± 0.11 Nm·kg-1, FFS = 0.01 ± 0.01 Nm·kg-1, peak knee moment (RFS = 2.61 ± 0.54 Nm·kg-1, FFS = 2.39 ± 0.61 Nm·kg-1, knee ROM (RFS = 31.72 ± 2.79°, FFS = 29.58 ± 2.97°, and hip ROM (RFS = 42.72 ± 4.03°, FFS = 41.38 ± 3.32° as compared with the FFS condition. This research suggests that acute changes in foot strike patterns during shod running can create alterations in certain lower limb kinematic and kinetic measures that are not dependent on the preferred foot strike pattern of the individual. This research also challenges the contention that the impact transient spike in the vertical ground reaction force curve is only present during a rear foot strike type of running gait.

  16. Sagittal plane mal-alignment in lumbar spinal radiographs in a ...

    African Journals Online (AJOL)

    Background: Plane radiograph of the spine is still the primary or first line investigation in patients with a variety of symptoms including back pain in a resource limited setting like ours. Methods: A crosssectional study of radiographs of patients who were referred to Radiology Department of Jos University Teaching Hospital for ...

  17. Quadriceps Neuromuscular Function and Jump-Landing Sagittal-Plane Knee Biomechanics After Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Ward, Sarah H; Blackburn, Troy; Padua, Darin A; Stanley, Laura E; Harkey, Matthew S; Luc-Harkey, Brittney A; Pietrosimone, Brian G

    2018-01-19

      Aberrant biomechanics may affect force attenuation at the knee during dynamic activities, potentially increasing the risk of sustaining a knee injury or hastening the development of osteoarthritis after anterior cruciate ligament reconstruction (ACLR). Impaired quadriceps neuromuscular function has been hypothesized to influence the development of aberrant biomechanics.   To determine the association between quadriceps neuromuscular function (strength, voluntary activation, and spinal-reflex and corticomotor excitability) and sagittal-plane knee biomechanics during jump landings in individuals with ACLR.   Cross-sectional study.   Research laboratory.   Twenty-eight individuals with unilateral ACLR (7 men, 21 women; age = 22.4 ± 3.7 years, height = 1.69 ± 0.10 m, mass = 69.4 ± 10.1 kg, time postsurgery = 52 ± 42 months).   We quantified quadriceps spinal-reflex excitability via the Hoffmann reflex normalized to maximal muscle response (H : M ratio), corticomotor excitability via active motor threshold, strength as knee-extension maximal voluntary isometric contraction (MVIC), and voluntary activation using the central activation ratio (CAR). In a separate session, sagittal-plane kinetics (peak vertical ground reaction force [vGRF] and peak internal knee-extension moment) and kinematics (knee-flexion angle at initial contact, peak knee-flexion angle, and knee-flexion excursion) were collected during the loading phase of a jump-landing task. Separate bivariate associations were performed between the neuromuscular and biomechanical variables.   In the ACLR limb, greater MVIC was associated with greater peak knee-flexion angle ( r = 0.38, P = .045) and less peak vGRF ( r = -0.41, P = .03). Greater CAR was associated with greater peak internal knee-extension moment (ρ = -0.38, P = .045), and greater H : M ratios were associated with greater peak vGRF ( r = 0.45, P = .02).   Greater quadriceps MVIC and CAR may provide better energy

  18. Viscoelastic properties of the P17 and adult rat brain from indentation in the coronal plane.

    Science.gov (United States)

    Elkin, Benjamin S; Morrison, Barclay

    2013-11-01

    This technical brief serves as an update to our previous work characterizing the region-dependence of viscoelastic mechanical properties of the P17 and adult rat brain in the coronal plane (Elkin et al., 2011, "A Detailed Viscoelastic Characterization of the P17 and Adult Rat Brain," J. Neurotrauma, 28, pp. 2235-2244.). Here, modifications to the microindentation device provided for the reliable measurement of load during the ramp portion of load relaxation microindentation tests. In addition, a correction factor for finite sample thickness was incorporated to more accurately assess the intrinsic mechanical properties of the tissue.The shear relaxation modulus was significantly dependent on the anatomic region and developmental age, with a general increase in stiffness with age and increased stiffness in the hippocampal and cortical regions compared with the white matter and cerebellar regions of the brain. The shear modulus ranged from ∼0.2 kPa to ∼2.6 kPa depending on region, age, and time scale. Best-fit Prony series parameters from least squares fitting to the indentation data from each region are reported, which describe the shear relaxation behavior for each anatomic region within each age group at both short (<10 ms) and long (∼20 s) time scales. These data will be useful for improving the biofidelity of finite element models of rat brain deformation at short time scales, such as models of traumatic brain injury.

  19. The relationships among sagittal-plane lower extremity moments: implications for landing strategy in anterior cruciate ligament injury prevention.

    Science.gov (United States)

    Shimokochi, Yohei; Yong Lee, Sae; Shultz, Sandra J; Schmitz, Randy J

    2009-01-01

    Excessive quadriceps contraction with insufficient hamstrings muscle cocontraction has been shown to be a possible contributing factor for noncontact anterior cruciate ligament (ACL) injuries. Assessing the relationships among lower extremity internal moments may provide some insight into avoiding muscle contraction patterns that increase ACL injury risk. To examine the relationships of knee-extensor moment with ankle plantar-flexor and hip-extensor moments and to examine the relationship between knee moment and center of pressure as a measure of neuromuscular response to center-of-mass position. Cross-sectional study. Applied Neuromechanics Research Laboratory. Eighteen healthy, recreationally active women (age = 22.3 +/- 2.8 years, height = 162.5 +/- 8.1 cm, mass = 57.8 +/- 9.3 kg). Participants performed a single-leg landing from a 45-cm box onto a force plate. Kinetic and kinematic data were collected. Pearson product moment correlation coefficients were calculated among the net peak knee-extensor moment (KEMpk), sagittal-plane ankle (AM) and hip (HM) net internal moments, and anterior-posterior center of pressure relative to foot center of mass at KEMpk (COP). Lower KEMpk related to both greater AM (r = -0.942, P < .001) and HM (r = -0.657, P = .003). We also found that more anterior displacement of COP was related to greater AM (r = -0.750, P < .001) and lower KEMpk (r = 0.618, P = .006). Our results suggest that participants who lean the whole body forward during landing may produce more plantar-flexor moment and less knee-extensor moment, possibly increasing hip-extensor moment and decreasing knee-extensor moment production. These results suggest that leaning forward may be a technique to decrease quadriceps contraction demand while increasing hamstrings cocontraction demand during a single-leg landing.

  20. Weightbearing ankle dorsiflexion range of motion and sagittal plane kinematics during single leg drop jump landing in healthy male athletes.

    Science.gov (United States)

    Dowling, Brittany; McPherson, April L; Paci, James M

    2017-06-21

    Passive ankle dorsiflexion range of motion (DROM) measures have been identified as a risk factor for injury during landings. However, passive measurements might not be indicative of dynamic ankle movement, whereas a weightbearing ROM might be a better tool when evaluating movement. The purpose of this study was to investigate the relationship between weightbearing DROM and sagittal plane landing mechanics in a single leg drop jump task. 73 male athletes (22.1 ± 3.9 years old, height 186.2 ± 11 cm, and weight 100.2 ± 21.8 kg) performed bilateral modified-lunge tasks and bilateral single leg drop jump landings while 3D kinematic data were collected. Hip, knee, and ankle joint angles were calculated at initial contact (IC) maximum knee flexion (MKF), and total excursion (TE) during a single leg drop jump landing. No bilateral differences in DROM and single leg landing mechanics existed. Decreased ankle DROM was correlated to decreased ankle dorsiflexion at MKF (p=0.00) and TE (p=0.00) for both dominant and non-dominant limbs. Decreased ankle DROM was also correlated to decreased knee flexion at IC (p=0.00), MKF(p=0.00), and TE (p=0.1), for both dominant and non-dominant limbs. Ankle DROM correlated to hip flexion at MKF (r=0.25) and TE (r=0.30) in the dominant limb. Restrictions in DROM may contribute to a stiff landing with less flexion at the ankle and knee. These findings may be useful in designing training programs aimed at increasing DROM in order to improve an athlete's landing mechanics and decrease risk of injury.

  1. Reliability of cervical lordosis and global sagittal spinal balance measurements in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Vidal, Christophe; Ilharreborde, Brice; Azoulay, Robin; Sebag, Guy; Mazda, Keyvan

    2013-06-01

    Radiological reproducibility study. To assess intra and interobserver reliability of radiographic measurements for global sagittal balance parameters and sagittal spine curves, including cervical spine. Sagittal spine balance in adolescent idiopathic scoliosis (AIS) is a main issue and many studies have been reported, showing that coronal and sagittal deformities often involve sagittal cervical unbalance. Global sagittal balance aims to obtain a horizontal gaze and gravity line at top of hips when subject is in a static position, involving adjustment of each spine curvature in the sagittal plane. To our knowledge, no study did use a methodologically validated imaging analysis tool able to appreciate sagittal spine contours and distances in AIS and especially in the cervical region. Lateral full-spine low-dose EOS radiographs were performed in 75 patients divided in three groups (control subjects, AIS, operated AIS). Three observers digitally analyzed twice each radiograph and 11 sagittal measures were collected for each image. Reliability was assessed calculating intraobserver Pearson's r correlation coefficient, interobserver intra-class correlation coefficient (ICC) completed with a two-by-two Bland-Altman plot analysis. This measurement method has shown excellent intra and interobserver reliability in all parameters, sagittal curvatures, pelvic parameters and global sagittal balance. This study validated a simple and efficient tool in AIS sagittal contour analysis. It defined new relevant landmarks allowing to characterize cervical segmental curvatures and cervical involvement in global balance.

  2. CHANGES IN THE SAGITTAL BALANCE IN CONGENITAL SCOLIOSIS CORRECTION SURGERY

    Directory of Open Access Journals (Sweden)

    José Antonio Mancuso Filho

    Full Text Available ABSTRACT Objective: This study aimed to determine whether surgery leads to changes in sagittal balance in patients with congenital scoliosis. Methods: We retrospectively reviewed all cases of scoliosis operated in a tertiary hospital between January 2009 and January 2013. In all cases the deformity in the coronal and sagittal planes, kyphosis, and lordosis were measured, using the Cobb method, and spinopelvic parameters: pelvic incidence (PI, sacral slope (SS, and pelvic tilt (PT. Results A hundred and eleven medical records were analyzed, but the sample resulted in 10 patients, six of whom were females (60%. The average age was 13.4 years. In the comparative analysis between pre and postoperative, only the coronal deformity (12.37; CI 95% [7.88-16.86]; p<0.001, the sagittal deformity (12.71; CI 95% [4.21-21.22]; p=0.011, and the lumbar lordosis (9.9; CI 95% [0.38-19.42]; p=0.043 showed significant change. Conclusion: There was no change in the spinopelvic parameters of patients with congenital scoliosis undergoing surgery at IOF-FMUSP between 2009 and 2013; however, it was observed decrease in lumbar lordosis, and deformity angle in the sagittal and coronal planes.

  3. Shoulder motor performance assessment in the sagittal plane in children with hemiplegia during single joint pointing tasks

    Science.gov (United States)

    2014-01-01

    Background Pointing is a motor task extensively used during daily life activities and it requires complex visuo-motor transformation to select the appropriate movement strategy. The study of invariant characteristics of human movements has led to several theories on how the brain solves the redundancy problem, but the application of these theories on children affected by hemiplegia is limited. This study aims at giving a quantitative assessment of the shoulder motor behaviour in children with hemiplegia during pointing tasks. Methods Eight children with hemiplegia were involved in the study and were asked to perform movements on the sagittal plane with both arms, at low and high speed. Subject movements were recorded using an optoelectronic system; a 4-DOF model of children arm has been developed to calculate kinematic and dynamic variables. A set of evaluation indexes has been extracted in order to quantitatively assess whether and how children modify their motor control strategies when perform movements with the more affected or less affected arm. Results In low speed movements, no differences can be seen in terms of movement duration and peak velocity between the More Affected arm (MA) and the Less Affected arm (LA), as well as in the main characteristics of movement kinematics and dynamics. As regards fast movements, remarkable differences in terms of strategies of motor control can be observed: while movements with LA did not show any significant difference in Dimensionless Jerk Index (JI) and Dimensionless Torque-change Cost index (TC) between the elevation and lowering phases, suggesting that motor control optimization is similar for movements performed with or against gravity, movements with MA showed a statistically significant increase of both JI and TC during lowering phase. Conclusions Results suggest the presence of a different control strategy for fast movements in particular during lowering phase. Results suggest that motor control is not able to

  4. The Effects of Frontal- and Sagittal-Plane Plyometrics on Change-of-Direction Speed and Power in Adolescent Female Basketball Players.

    Science.gov (United States)

    McCormick, Brian T; Hannon, James C; Newton, Maria; Shultz, Barry; Detling, Nicole; Young, Warren B

    2016-01-01

    Plyometrics is a popular training modality for basketball players to improve power and change-of-direction speed. Most plyometric training has used sagittal-plane exercises, but improvements in change-of-direction speed have been greater in multi-direction programs. To determine the benefits of a 6-wk frontal-plane plyometric (FPP) training program compared with a 6-wk sagittal-plane plyometric (SPP) training program with regard to power and change-of-direction speed. Fourteen female varsity high school basketball players participated in the study. Multiple 2 × 2 repeated-measures ANOVAs were used to determine differences for the FPP and SPP groups from preintervention to postintervention on 4 tests of power and 2 tests of change-of-direction speed. There was a group main effect for time in all 6 tests. There was a significant group × time interaction effect in 3 of the 6 tests. The SPP improved performance of the countermovement vertical jump more than the FPP, whereas the FPP improved performance of the lateral hop (left) and lateral-shuffle test (left) more than the SPP. The standing long jump, lateral hop (right), and lateral-shuffle test (right) did not show a significant interaction effect. These results suggest that basketball players should incorporate plyometric training in all planes to improve power and change-of-direction speed.

  5. What is the optimal cutoff value of the axis-line-angle technique for evaluating trunk imbalance in coronal plane?

    Science.gov (United States)

    Zhang, Rui-Fang; Fu, Yu-Chuan; Lu, Yi; Zhang, Xiao-Xia; Hu, Yu-Min; Zhou, Yong-Jin; Tian, Nai-Feng; He, Jia-Wei; Yan, Zhi-Han

    2017-02-01

    Accurately evaluating the extent of trunk imbalance in the coronal plane is significant for patients before and after treatment. We preliminarily practiced a new method, axis-line-angle technique (ALAT), for evaluating coronal trunk imbalance with excellent intra-observer and interobserver reliability. Radiologists and surgeons were encouraged to use this method in clinical practice. However, the optimal cutoff value of the ALAT for determination of the extent of coronal trunk imbalance has not been calculated up to now. The purpose of this study was to identify the cutoff value of the ALAT that best predicts a positive measurement point to assess coronal balance or imbalance. A retrospective study at a university affiliated hospital was carried out. A total of 130 patients with C7-central sacral vertical line (CSVL) >0 mm and aged 10-18 years were recruited in this study from September 2013 to December 2014. Data were analyzed to determine the optimal cutoff value of the ALAT measurement. The C7-CSVL and ALAT measurements were conducted respectively twice on plain film within a 2-week interval by two radiologists. The optimal cutoff value of the ALAT was analyzed via receiver operating characteristic (ROC) curve. Comparison variables were performed with chi-square test between the C7-CSVL and ALAT measurements for evaluating trunk imbalance. Kappa agreement coefficient method was used to test the intra-observer and interobserver agreement of C7-CSVL and ALAT. The ROC curve area for the ALAT was 0.82 (95% confidence interval: 0.753-0.894, p.05). Intra-observer agreement values for the C7-CSVL measurements by observers 1 and 2 were 0.79 and 0.91 (pplane with a high level of intra-observer and interobserver agreement, which suggests that the ALAT is suitable for clinical use. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Coronal plane hip muscle activation in football code athletes with chronic adductor groin strain injury during standing hip flexion.

    Science.gov (United States)

    Morrissey, Dylan; Graham, Jennifer; Screen, Hazel; Sinha, Amit; Small, Claire; Twycross-Lewis, Richard; Woledge, Roger

    2012-04-01

    Groin pain arising from adductor muscle injury is common amongst football code athletes and can result in significant time lost from sporting participation. The associated motor control deficits are not well understood. The aim of this study was to better understand the coronal plane muscle activation patterns associated with chronic adductor injury. Measures of muscle activation at various stages of the standing hip flexion manoeuvre were made with surface electromyography and motion capture in 9 male football code subjects with chronic adductor injury, and 9 matched controls. The gluteus medius to adductor longus activation ratio was significantly reduced in subjects with groin pain when the injured leg was either moving (F = 64.3, p muscle activation. No significant differences between the uninjured and injured side of patients was found. Football code athletes with groin pain exhibit significantly altered coronal plane muscle activation with comparison to uninjured subjects. These findings need to be taken into account when planning rehabilitation for these athletes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Comparison of the trunk-pelvis and lower extremities sagittal plane inter-segmental coordination and variability during walking in persons with and without chronic low back pain.

    Science.gov (United States)

    Ebrahimi, Samaneh; Kamali, Fahimeh; Razeghi, Mohsen; Haghpanah, Seyyed Arash

    2017-04-01

    Inter-segmental coordination can be influenced by chronic low back pain (CLBP). The sagittal plane lower extremities inter-segmental coordination pattern and variability, in conjunction with the pelvis and trunk, were assessed in subjects with and without non-specific CLBP during free-speed walking. Kinematic data were collected from 10 non-specific CLBP and 10 non-CLBP control volunteers while the subjects were walking at their preferred speed. Sagittal plane time-normalized segmental angles and velocities were used to calculate continuous relative phase for each data point. Mean absolute relative phase (MARP) and deviation phase (DP) were derived to quantify the trunk-pelvis and bilateral pelvis-thigh, thigh-shank and shank-foot coordination pattern and variability over the stance and swing phases of gait. Mann-Whitney U test was employed to compare the means of DP and MARP values between two groups (same side comparison). Statistical analysis revealed more in-phase/less variable trunk-pelvis coordination in the CLBP group (Ppelvis-thigh coordination pattern (Ppelvis and trunk coordination pattern and variability could be generally affected by CLBP during walking. These changes can be possible compensatory strategies of the motor control system which can be considered in the CLBP subjects. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Correction of coronal plane deformities around the knee using a tension band plate in children younger than 10 years

    Directory of Open Access Journals (Sweden)

    Ruta M Kulkarni

    2015-01-01

    Full Text Available Background: Guided growth through temporary hemiepiphysiodesis has gained acceptance as the preferred primary treatment in treating pediatric lower limb deformities as it is minimally invasive with a lesser morbidity than the traditional osteotomy. The tension band plate is the most recent development in implants used for temporary hemiepiphysiodesis. Our aim was to determine its safety and efficacy in correcting coronal plane deformities around the knee in children younger than 10 years. Materials and Methods: A total of 24 children under the age of 10 were operated for coronal plane deformities around the knee with a single extra periosteal tension band plate and two nonlocking screws. All the children had a pathological deformity for which a detailed preoperative work-up was carried out to ascertain the cause of the deformity and rule out physiological ones. The average age at hemiepiphysiodesis was 5 years 3 months (range: 2 years to 9 years 1 month. Results: The plates were inserted for an average of 15.625 months (range: 7 months to 29 months. All the patients showed improvement in the mechanical axis. Two patients showed partial correction. Two cases of screw loosening were observed. In the genu valgum group, the tibiofemoral angle improved from a preoperative mean of 19.89° valgus (range: 10° valgus to 40° valgus to 5.72° valgus (range: 2° varus to 10° valgus. In patients with genu varum the tibiofemoral angle improved from a mean of 28.27° varus (range: 13° varus to 41° varus to 1.59° valgus (range: 0-8° valgus. Conclusion: Temporary hemiepiphysiodesis through the application of the tension band plate is an effective method to correct coronal plane deformities around the knee with minimal complications. Its ease and accuracy of insertion has extended the indication of temporary hemiepiphysiodesis to patients younger than 10 years and across a wide variety of diagnosis including pathological physis, which were traditionally

  9. Case Presentation of Sagittal Balance.

    Science.gov (United States)

    Kim, Paul K

    2016-04-01

    Sagittal balance is an important concept in spinal coronal and kyphotic deformity correction. Sagittal alignment/lumbar lordosis is increasingly recognized and discussed in terms of surgical outcomes. Positive sagittal balance can lead to development of iatrogenic kyphosis, flatback syndrome, adjacent level degeneration, and junctional kyphosis. This concept is no longer associated only with deformity. Spine surgeons have learned that sagittal alignment/lumbar lordosis is very important even in 1-level or 2-level interbody fusion procedures, and that it can be attained, maintained, or lost during any procedure, resulting in complications.

  10. Sagittal plane gait characteristics in hip osteoarthritis patients with mild to moderate symptoms compared to healthy controls: a cross-sectional study

    Science.gov (United States)

    2012-01-01

    Background Existent biomechanical studies on hip osteoarthritic gait have primarily focused on the end stage of disease. Consequently, there is no clear consensus on which specific gait parameters are of most relevance for hip osteoarthritis patients with mild to moderate symptoms. The purpose of this study was to explore sagittal plane gait characteristics during the stance phase of gait in hip osteoarthritis patients not eligible for hip replacement surgery. First, compared to healthy controls, and second, when categorized into two subgroups of radiographic severity defined from a minimal joint space of ≤/>2 mm. Methods Sagittal plane kinematics and kinetics of the hip, knee and ankle joint were calculated for total joint excursion throughout the stance phase, as well as from the specific events initial contact, midstance, peak hip extension and toe-off following 3D gait analysis. In addition, the Western Ontario and McMaster Universities Osteoarthritis Index, passive hip range of motion, and isokinetic muscle strength of hip and knee flexion and extension were included as secondary outcomes. Data were checked for normality and differences evaluated with the independent Student’s t-test, Welch’s t-test and the independent Mann–Whitney U-test. A binary logistic regression model was used in order to control for velocity in key variables. Results Fourty-eight hip osteoarthritis patients and 22 controls were included in the final material. The patients walked significantly slower than the controls (p=0.002), revealed significantly reduced joint excursions of the hip (phip flexion moment at midstance and peak hip extension (pjoint space ≤/>2 mm suggested that the observed deviations were more pronounced in patients with greater radiographic severity. The biomechanical differences were, however, not reflected in self-reported symptoms or function. Conclusions Reduced gait velocity, reduced sagittal plane joint excursion, and a reduced hip flexion moment in

  11. Sagittal plane gait characteristics in hip osteoarthritis patients with mild to moderate symptoms compared to healthy controls: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Eitzen Ingrid

    2012-12-01

    Full Text Available Abstract Background Existent biomechanical studies on hip osteoarthritic gait have primarily focused on the end stage of disease. Consequently, there is no clear consensus on which specific gait parameters are of most relevance for hip osteoarthritis patients with mild to moderate symptoms. The purpose of this study was to explore sagittal plane gait characteristics during the stance phase of gait in hip osteoarthritis patients not eligible for hip replacement surgery. First, compared to healthy controls, and second, when categorized into two subgroups of radiographic severity defined from a minimal joint space of ≤/>2 mm. Methods Sagittal plane kinematics and kinetics of the hip, knee and ankle joint were calculated for total joint excursion throughout the stance phase, as well as from the specific events initial contact, midstance, peak hip extension and toe-off following 3D gait analysis. In addition, the Western Ontario and McMaster Universities Osteoarthritis Index, passive hip range of motion, and isokinetic muscle strength of hip and knee flexion and extension were included as secondary outcomes. Data were checked for normality and differences evaluated with the independent Student’s t-test, Welch’s t-test and the independent Mann–Whitney U-test. A binary logistic regression model was used in order to control for velocity in key variables. Results Fourty-eight hip osteoarthritis patients and 22 controls were included in the final material. The patients walked significantly slower than the controls (p=0.002, revealed significantly reduced joint excursions of the hip (pp=0.011, and a reduced hip flexion moment at midstance and peak hip extension (p2 mm suggested that the observed deviations were more pronounced in patients with greater radiographic severity. The biomechanical differences were, however, not reflected in self-reported symptoms or function. Conclusions Reduced gait velocity, reduced sagittal plane joint excursion, and

  12. Vertical axis dislocation with coronal fracture of the patella: A previously unreported injury pattern

    Directory of Open Access Journals (Sweden)

    Lynn Murphy

    2015-10-01

    Full Text Available The patella usually dislocates laterally. Less commonly, intra-articular dislocation occurs about either the vertical or horizontal axis. Patellar fractures are generally transverse with varying degrees of comminution, and less frequently vertical in the sagittal plane. We present a 9-year follow-up of a previously undescribed coronal patellar fracture associated with vertical axis dislocation of the patella. The mechanism of this severe injury is described. Keywords: Trauma, Coronal patellar fracture, Vertical axis patellar dislocation, Mechanism of injury

  13. Frontal and sagittal plane analyses of the stair climbing task in healthy adults aged over 40 years: what are the challenges compared to level walking?

    Science.gov (United States)

    Nadeau, S; McFadyen, B J; Malouin, F

    2003-12-01

    This study compared stair climbing and level walking in healthy adults aged over 40 years. Eleven subjects performed at their comfortable speed. The number of parameters studied during stair climbing has been limited, in particular in the frontal plane. Time-distance parameters and three-dimensional kinematic data were obtained using foot-switches and an Optotrak system. Ground reaction forces were collected with a force platform embedded in the second step of the staircase or in the ground for level walking. Relative angles were calculated using a Cardanic rotation matrix and the net moments and the powers at the ankle, knee and hip joints were estimated with an inverse dynamic approach. A significant longer mean cycle duration and a shorter proportion of time in stance was obtained for stair climbing as compared to level walking. Profiles of the frontal plane joint angles, moments and powers indicated a different action of the hip abductors across tasks to control the pelvis in stance. Profiles of the sagittal plane confirmed the dominant role of the knee extensors during stair climbing but revealed also a knee-hip energy generation pattern that allows the avoidance of the intermediate step. Results suggest environment specific adaptations of the neuro-musculo-skeletal system that should be considered in the rehabilitation of stair climbing in patients. This study highlights the challenges of stair climbing compared to level walking in a within subject design. Key features of stair climbing that are important for the rehabilitation of step management are also reported.

  14. Rotation of intramedullary alignment rods affects distal femoral cutting plane in total knee arthroplasty.

    Science.gov (United States)

    Maderbacher, Günther; Matussek, Jan; Keshmiri, Armin; Greimel, Felix; Baier, Clemens; Grifka, Joachim; Maderbacher, Hermann

    2018-02-17

    Intramedullary rods are widely used to align the distal femoral cut in total knee arthroplasty. We hypothesised that both coronal (varus/valgus) and sagittal (extension/flexion) cutting plane are affected by rotational changes of intramedullary femoral alignment guides. Distal femoral cuts using intramedullary alignment rods were simulated by means of a computer-aided engineering software in 4°, 6°, 8°, 10°, and 12° of valgus in relation to the femoral anatomical axis and 4° extension, neutral, as well as 4°, 8°, and 12° of flexion in relation to the femoral mechanical axis. This reflects the different angles between anatomical and mechanical axis in coronal and sagittal planes. To assess the influence of rotation of the alignment guide on the effective distal femoral cutting plane, all combinations were simulated with the rod gradually aligned from 40° of external to 40° of internal rotation. Rotational changes of the distal femoral alignment guides affect both the coronal and sagittal cutting planes. When alignment rods are intruded neutrally with regards to sagittal alignment, external rotation causes flexion, while internal rotation causes extension of the sagittal cutting plane. Simultaneously the coronal effect (valgus) decreases resulting in an increased varus of the cutting plane. However, when alignment rods are intruded in extension or flexion partly contradictory effects are observed. Generally the effect increases with the degree of valgus preset, rotation and flexion. As incorrect rotation of intramedullary alignment guides for distal femoral cuts causes significant cutting errors, exact rotational alignment is crucial. Coronal cutting errors in the distal femoral plane might result in overall leg malalignment, asymmetric extension gaps and subsequent sagittal cutting errors.

  15. Analysis of the sagittal plane after surgical management for Scheuermann's disease: a view on overcorrection and the use of an anterior release.

    NARCIS (Netherlands)

    Hosman, A.J.F.; Langeloo, D.D.; Kleuver, M. de; Anderson, P.G.; Veth, R.P.H.; Slot, G.H.

    2002-01-01

    STUDY DESIGN: A historic cohort study was conducted to investigate surgical correction and sagittal alignment in 33 patients with thoracic Scheuermann's disease. OBJECTIVE: To evaluate kyphosis correction, correction loss, sagittal balance, and the effect of an anterior release. SUMMARY OF

  16. Three-dimensional morphometric analysis of mandibule in coronal plane after bimaxillary rotational surgery.

    Science.gov (United States)

    Lee, Sung-Tak; Choi, Na-Rae; Song, Jae-Min; Shin, Sang-Hun

    2016-12-01

    The aim of this report is to present a new reference for aesthetic mandible surgery using three-dimensional cone-beam computed tomography-based treatment planning for orthognathic surgery which can be implemented in surgical planning and perioperative procedure. To make an objective standard for evaluating aesthetic mandibular outline, we make an aesthetic scoring criteria with consideration of asymmetry, broad mandibular border line, and prominent mandibular angle. Two maxillofacial surgeons and two orthodontists rated their aesthetical evaluation from 1 to 5. Experimental group consisting of 47 female and 38 male patients who had rotational orthognathic two-jaw surgery from 2010 to 2011 were chosen according to aesthetic scoring done by two maxillofacial surgeons and two orthodontists. A high aesthetic score (≥16) means the facial contour is symmetric, with no broad and narrow aesthetic mandible frontal profiles. Control A group consisted of ten female and ten male patients who had no orthognathic surgery experience and low aesthetic score (≤10). Control B group consisted of ten female and ten male patients who had no orthognathic surgery experience and had anaesthetic mandibular frontal profile and a high aesthetic score (≥16). The three-dimensional image of the patient was taken from dental cone-beam CT (DCT) scanning (experimental group and control A group: 6 months DCT after surgery, control B group: 1st visit DCT). Each DCT was reformatted to reorient the 3D image using 3D analyzing program (OnDemand3D, cybermed Inc, CA, USA). After selection of 12 landmarks and the construction of reoriented horizontal, vertical, and coronal reference lines, 15 measurements were taken in 3D analysis of frontal mandibular morphology. Afterwards, horizontal and vertical linear measurements and angular measurements, linear ratio were obtained. Mean Go'Rt-Me'-Go'Lt angular measurement was 100.74 ± 2.14 in female patients and 105.37 ± 3.62 in male patients

  17. How much does the human medial gastrocnemius muscle contribute to ankle torques outside the sagittal plane?☆

    Science.gov (United States)

    Vieira, Taian M.M.; Minetto, Marco A.; Hodson-Tole, Emma F.; Botter, Alberto

    2013-01-01

    Ankle movements in the frontal plane are less prominent though not less relevant than movements in the plantar or dorsal flexion direction. Walking on uneven terrains and standing on narrow stances are examples of circumstances likely imposing marked demands on the ankle medio-lateral stabilization. Following our previous evidence associating lateral bodily sways in quiet standing to activation of the medial gastrocnemius (MG) muscle, in this study we ask: how large is the MG contribution to ankle torque in the frontal plane? By arranging stimulation electrodes in a selective configuration, current pulses were applied primarily to the MG nerve branch of ten subjects. The contribution of populations of MG motor units of progressively smaller recruitment threshold to ankle torque was evaluated by increasing the stimulation amplitude by fixed amounts. From smallest intensities (12–32 mA) leading to the firstly observable MG twitches in force-plate recordings, current pulses reached intensities (56–90 mA) below which twitches in other muscles could not be observed from the skin. Key results showed a substantial MG torque contribution tending to rotate upward the foot medial aspect (ankle inversion). Nerve stimulation further revealed a linear relationship between the peak torque of ankle plantar flexion and inversion, across participants (Pearson R > .81, p torque of ankle inversion amounted to about 13% of plantar flexion peak torque. Physiologically, these results provide experimental evidence that MG activation may contribute to stabilize the body in the frontal plane, especially under situations of challenged stability. PMID:23992638

  18. Validation, repeatability and reproducibility of a noninvasive instrument for measuring thoracic and lumbar curvature of the spine in the sagittal plane.

    Science.gov (United States)

    Chaise, Fabiana O; Candotti, Cláudia T; Torre, Marcelo L; Furlanetto, Tássia S; Pelinson, Patricia P T; Loss, Jefferson F

    2011-01-01

    The need for early identification of postural abnormalities without exposing patients to constant radiation has stimulated the development of instruments aiming to measure the spinal curvatures. To verify the validity, repeatability and reproducibility of angular measures of sagittal curvatures of the spine obtained using an adapted arcometer, by comparing them with Cobb angles of the respective curvatures obtained by using X-rays. 52 participants were submitted to two procedures designed to evaluate the thoracic and lumbar curvatures: (1) X-ray examination from which the Cobb angles (CA) of both curvatures were obtained, and (2) measuring the angles with the arcometer (AA). Two evaluators collected the data using the arcometer, with the rods placed at T1, T12, L1 and L5 spinous processes levels in a way as to permit linear measurements which, with aid of trigonometry, supplied the AA. There was a very strong and significant correlation between AA and CA (r=0.94; p<0.01), with no-significant difference (p=0.32), for the thoracic curvature. There was a strong and significant correlation for the lumbar curvature (r=0.71; p<0.01) between AA and CA, with no-significant difference (p=0.30). There is a very strong correlation between intra-evaluator and inter-evaluator AA. It was possible to quantify reliably the thoracic and lumbar curvatures with the arcometer and it can thus be considered valid and reliable and for use in evaluating spinal curvatures in the sagittal plane.

  19. Reliability of sagittal plane hip, knee, and ankle joint angles from a single frame of video data using the GAITRite camera system.

    Science.gov (United States)

    Ross, Sandy A; Rice, Clinton; Von Behren, Kristyn; Meyer, April; Alexander, Rachel; Murfin, Scott

    2015-01-01

    The purpose of this study was to establish intra-rater, intra-session, and inter-rater, reliability of sagittal plane hip, knee, and ankle angles with and without reflective markers using the GAITRite walkway and single video camera between student physical therapists and an experienced physical therapist. This study included thirty-two healthy participants age 20-59, stratified by age and gender. Participants performed three successful walks with and without markers applied to anatomical landmarks. GAITRite software was used to digitize sagittal hip, knee, and ankle angles at two phases of gait: (1) initial contact; and (2) mid-stance. Intra-rater reliability was more consistent for the experienced physical therapist, regardless of joint or phase of gait. Intra-session reliability was variable, the experienced physical therapist showed moderate to high reliability (intra-class correlation coefficient (ICC) = 0.50-0.89) and the student physical therapist showed very poor to high reliability (ICC = 0.07-0.85). Inter-rater reliability was highest during mid-stance at the knee with markers (ICC = 0.86) and lowest during mid-stance at the hip without markers (ICC = 0.25). Reliability of a single camera system, especially at the knee joint shows promise. Depending on the specific type of reliability, error can be attributed to the testers (e.g. lack of digitization practice and marker placement), participants (e.g. loose fitting clothing) and camera systems (e.g. frame rate and resolution). However, until the camera technology can be upgraded to a higher frame rate and resolution, and the software can be linked to the GAITRite walkway, the clinical utility for pre/post measures is limited.

  20. Posterior Tibial Slope Angle Correlates With Peak Sagittal and Frontal Plane Knee Joint Loading During Robotic Simulations of Athletic Tasks.

    Science.gov (United States)

    Bates, Nathaniel A; Nesbitt, Rebecca J; Shearn, Jason T; Myer, Gregory D; Hewett, Timothy E

    2016-07-01

    Tibial slope angle is a nonmodifiable risk factor for anterior cruciate ligament (ACL) injury. However, the mechanical role of varying tibial slopes during athletic tasks has yet to be clinically quantified. To examine the influence of posterior tibial slope on knee joint loading during controlled, in vitro simulation of the knee joint articulations during athletic tasks. Descriptive laboratory study. A 6 degree of freedom robotic manipulator positionally maneuvered cadaveric knee joints from 12 unique specimens with varying tibial slopes (range, -7.7° to 7.7°) through drop vertical jump and sidestep cutting tasks that were derived from 3-dimensional in vivo motion recordings. Internal knee joint torques and forces were recorded throughout simulation and were linearly correlated with tibial slope. The mean (±SD) posterior tibial slope angle was 2.2° ± 4.3° in the lateral compartment and 2.3° ± 3.3° in the medial compartment. For simulated drop vertical jumps, lateral compartment tibial slope angle expressed moderate, direct correlations with peak internally generated knee adduction (r = 0.60-0.65), flexion (r = 0.64-0.66), lateral (r = 0.57-0.69), and external rotation torques (r = 0.47-0.72) as well as inverse correlations with peak abduction (r = -0.42 to -0.61) and internal rotation torques (r = -0.39 to -0.79). Only frontal plane torques were correlated during sidestep cutting simulations. For simulated drop vertical jumps, medial compartment tibial slope angle expressed moderate, direct correlations with peak internally generated knee flexion torque (r = 0.64-0.69) and lateral knee force (r = 0.55-0.74) as well as inverse correlations with peak external torque (r = -0.34 to -0.67) and medial knee force (r = -0.58 to -0.59). These moderate correlations were also present during simulated sidestep cutting. The investigation supported the theory that increased posterior tibial slope would lead to greater magnitude knee joint moments, specifically

  1. Parameters of dynamic balance in the frontal and sagittal plane and their correlations with poor postures in children aged 10–12 from the Masłów district in Świętokrzyskie province

    Directory of Open Access Journals (Sweden)

    Beata Szczepanowska-Wołowiec

    2013-12-01

    Full Text Available Introduction: Even postural asymmetry may provoke static and balance disorders. Aim of the research: To define the level of dynamic balance among children aged 10–12 and find the correlations between poor postures. Material and methods: This study was conducted among 176 children from Masłów district in Świętokrzyskie province. The Libra platform was used to examine the dynamic balance. Results: Dynamic balance parameters from the sagittal and frontal plane show statistically significant differences between the control group and study groups. Conclusions: The analysis of dynamic balance parameters from the sagittal and frontal plane confirms that the lowest values occur in the control group, higher in children with foot defect, and the highest in children with scoliotic posture.

  2. Pain provocation following sagittal plane repeated movements in people with chronic low back pain: Associations with pain sensitivity and psychological profiles.

    Science.gov (United States)

    Rabey, Martin; Smith, Anne; Beales, Darren; Slater, Helen; O'Sullivan, Peter

    2017-07-01

    Provocative pain responses following standardised protocols of repeated sagittal plane spinal bending have not been reported in people with chronic low back pain (CLBP). Potential differing pain responses to movement likely reflect complex sensorimotor interactions influenced by physical, psychological and neurophysiological factors. To date, it is unknown whether provocative pain responses following repeated bending are associated with different pain sensitivity and psychological profiles. Therefore the first aim of this study was to determine whether data-driven subgroups with different, clinically-important pain responses following repeated movement exist in a large CLBP cohort, specifically using a standardised protocol of repeated sagittal plane spinal bending. The second aim was to determine if the resultant pain responses following repeated movement were associated with pain and disability, pain sensitivity and psychological factors. Clinically-important (≥2-points, 11-point numeric rating scale) changes in pain intensity following repeated forward/backward bending were examined. Participants with different provocative pain responses to forward and backward bending were profiled on age, sex, pain sensitivity, psychological variables, pain characteristics and disability. Three groups with differing provocative pain responses following repeated movements were derived: (i) no clinically-important increased pain in either direction (n=144, 49.0%), (ii) increased pain with repeated bending in one direction only (unidirectional, n=112, 38.1%), (iii) increased pain with repeated bending in both directions (bidirectional, n=38, 12.9%). After adjusting for psychological profile, age and sex, for the group with bidirectional pain provocation responses following repeated spinal bending, higher pressure and thermal pain sensitivity were demonstrated, while for the group with no increase in pain, better cognitive and affective psychological questionnaire scores were

  3. A gait retraining system using augmented-reality to modify footprint parameters: Effects on lower-limb sagittal-plane kinematics.

    Science.gov (United States)

    Bennour, Sami; Ulrich, Baptiste; Legrand, Thomas; Jolles, Brigitte M; Favre, Julien

    2018-01-03

    Improving lower-limb flexion/extension angles during walking is important for the treatment of numerous pathologies. Currently, these gait retraining procedures are mostly qualitative, often based on visual assessment and oral instructions. This study aimed to propose an alternative method combining motion capture and display of target footprints on the floor. The second objectives were to determine the error in footprint modifications and the effects of footprint modifications on lower-limb flexion/extension angles. An augmented-reality system made of an optoelectronic motion capture device and video projectors displaying target footprints on the floor was designed. 10 young healthy subjects performed a series of 27 trials, consisting of increased and decreased amplitudes in stride length, step width and foot progression angle. 11 standard features were used to describe and compare lower-limb flexion/extension angles among footprint modifications. Subjects became accustomed to walk on target footprints in less than 10 min, with mean (± SD) precision of 0.020 ± 0.002 m in stride length, 0.022 ± 0.006 m in step width, and 2.7 ± 0.6° in progression angle. Modifying stride length had significant effects on 3/3 hip, 2/4 knee and 4/4 ankle features. Similarly, step width and progression angle modifications affected 2/3 and 1/3 hip, 2/4 and 1/4 knee as well as 3/4 and 2/4 ankle features, respectively. In conclusion, this study introduced an augmented-reality method allowing healthy subjects to modify their footprint parameters rapidly and precisely. Walking with modified footprints changed lower-limb sagittal-plane kinematics. Further research is needed to design rehabilitation protocols for specific pathologies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Sagittal plane analysis of selective posterior thoracic spinal fusion in adolescent idiopathic scoliosis: a comparison study of all pedicle screw and hybrid instrumentation.

    Science.gov (United States)

    Liu, Tie; Hai, Yong

    2014-07-01

    To compare sagittal profiles of selective posterior thoracic instrumentation with segmental pedicle screws instrumentation and hybrid (hook and pedicle screw). Nowadays, thoracic screws are considered more effective than other constructs in spinal deformity correction and have become the treatment in adolescent idiopathic scoliosis surgery. However, recent research found that this enhanced correction ability may sacrifice sagittal balance. As lumbar lordosis is dependent upon thoracic kyphosis (TK), it has been important to maintain TK magnitude in selective thoracic fusions to keep balance. There is no sagittal measurement analysis between the hybrid and all-screw constructs type in cases of selective thoracic fusion. All adolescent idiopathic scoliosis (Lenke1) patients surgically treated in our department between 2003 and 2008 were reviewed. Radiographs of these patients, whose preoperative, immediately postoperative, and minimum 2-year follow-up after selective thoracic fusion (lower instrumented vertebrae not lower than L1, hybrid group the pedicle screw instrumentation not higher than T10) were evaluated, 21 patients underwent posterior hybrid instrumentation and 21 underwent pedicle screw instrumentation. No significant difference in sagittal profiles was observed between the 2 groups. At final follow-up, the proximal junctional measurement has a minor increase in both the groups. TK (T5-T12) also increased (+2.0 degrees of increase in hybrid group vs. +3.9 degrees of increase in the pedicle screw group). The effect of different instrumentation in changing TK at various time points between 2 groups was statistic different (P=0.004). Lumbar lordosis (L1-L5) was increased in both the groups. No significant changes in distal junctional measurement and thoracolumbar junction were noted. The C7 sagittal plumbline remained negative in both the groups at the final follow-up. There was no statistically significant difference comparing the sagittal alignment

  5. A multi-plane scout sequence using flash imaging.

    Science.gov (United States)

    Wright, S M; Wright, R M

    1988-01-01

    A new pulse sequence is presented for multi-plane imaging which simultaneously acquires images in the axial, coronal, and sagittal planes. Combined with FLASH imaging or other similar techniques, T1- and T2-weighted images in all three planes can be acquired in approximately 12 and 30 seconds, respectively. The sequence is easily implemented by modifying a multi-slice sequence to provide a rotation of gradient assignments between slice excitations. This sequence has been used extensively as a rapid "scout" scan. Several clinical examples are included.

  6. The use of the T1 sagittal angle in predicting overall sagittal balance of the spine.

    Science.gov (United States)

    Knott, Patrick T; Mardjetko, Steven M; Techy, Fernando

    2010-11-01

    A balanced sagittal alignment of the spine has been shown to strongly correlate with less pain, less disability, and greater health status scores. To restore proper sagittal balance, one must assess the position of the occiput relative to the sacrum. The assessment of spinal balance preoperatively can be challenging, whereas predicting postoperative balance is even more difficult. This study was designed to evaluate and quantify multiple factors that influence sagittal balance. Retrospective analysis of existing spinal radiographs. A retrospective review of 52 adult spine patient records was performed. All patients had full-column digital radiographs that showed all the important skeletal landmarks necessary for accurate measurement. The average age of the patient was 53 years. Both genders were equally represented. The radiographs were measured using standard techniques to obtain the following parameters: scoliosis in the coronal plane; lordosis or kyphosis of the cervical, thoracic, and lumbar spine; the T1 sagittal angle (angle between a horizontal line and the superior end plate of T1); the angle of the dens in the sagittal plane; the angle of the dens in relation to the occiput; the sacral slope; the pelvic incidence; the femoral-sacral angle; and finally, the sagittal vertical axis (SVA) measured from both the dens of C2 and from C7. It was found that the SVA when measured from the dens was on average 16 mm farther forward than the SVA measured from C7 (psagittal angle was found to have a moderate positive correlation (r=0.65) with SVA(dens), psagittal T1 tilt can be used as a good predictor of overall sagittal balance. When examining the other variables, it was found that cervical lordosis had a weak correlation (r=0.37) with SVA(dens) that was unexpected, given that cervical lordosis determines head position. Thoracic kyphosis also had a weak correlation (r=0.26) with SVA(C1), which was equally surprising. Lumbar lordosis had a slightly higher correlation

  7. Adult Spinal Deformity: Sagittal Imbalance

    Directory of Open Access Journals (Sweden)

    Cavanilles-Walker JM

    2014-10-01

    Full Text Available Spinal sagittal imbalance, deformity of the spine in the sagittal plane, is nowadays a major cause of pain and disability among patients presenting to the spine clinic in daily practice. Normal sagittal spinal balance is a result of mutual articulation of the pelvis and the spine in the sagittal plane. Sagittal imbalance of the spine could be related to many spinal pathologies interesting primarily the spine or could appear after an instrumentation spinal surgery. Variations in the spine sagittal alignment can be compensated by compensatory mechanisms occurring in the spine, pelvis and lower limb areas. The main objective of these mechanisms is to allow the patient to keep an erect position within the cone of economy in an energy-efficient way. Once a spinal deformity surpasses these compensatory mechanisms surgical intervention is often requested. In this paper the Authors performed comprehensive a critical analysis of the rigidity of the deformity, including the spinal and pelvic parameters. The compensatory mechanisms are paramount in order to be able to offer a tailored solution to these patients. Since conservative measures fail in most patients, successful management of these patients requires achieving fusion of a balanced spine. Appropriate preoperative optimization as well as appropriate surgical preoperative planning are critical in order to avoid potential complications. Selecting the appropriate surgical technique to achieve spinal balance is crucial to success.

  8. Objective classification system for sagittal craniosynostosis based on suture segmentation

    Science.gov (United States)

    Qian, Xiaohua; Tan, Hua; Zhang, Jian; Zhuang, Xiahai; Branch, Leslie; Sanger, Chaire; Thompson, Allison; Zhao, Weiling; Li, King Chuen; David, Lisa; Zhou, Xiaobo

    2015-01-01

    Purpose: Spring-assisted surgery is an effective and minimally invasive treatment for sagittal craniosynostosis (CSO). The principal barrier to the advancement of spring-assisted surgery is the patient-specific spring selection. The selection of spring force depends on the suture involved, subtypes of sagittal CSO, and age of the infant, among other factors. Clinically, physicians manually judge the subtype of sagittal CSO patients based on their CT image data, which may cause bias from different clinicians. An objective system would be helpful to stratify the sagittal CSO patients and make spring choice less subjective. Methods: The authors developed a novel informatics system to automatically segment and characterize sutures and classify sagittal CSO. The proposed system is composed of three phases: preprocessing, sutures segmentation, and classification. First, the three-dimensional (3D) skull was extracted from the CT images and aligned with the symmetry of the cranial vault. Second, a “hemispherical projection” algorithm was developed to transform 3D surface of the skull to a polar two-dimensional plane. Through the transformation, an “effective” projected region can be obtained to enable easy segmentation of sutures. Then, the different types of sutures, such as coronal sutures, lambdoid sutures, sagittal suture, and metopic suture, obtained from the segmented sutures were further identified by a dual-projection technique of the midline of the sutures. Finally, 108 quantified features of sutures were extracted and selected by a proposed multiclass feature scoring system. The sagittal CSO patients were classified into four subtypes: anterior, central, posterior, and complex with the support vector machine approach. Fivefold cross validation (CV) was employed to evaluate the capability of selected features in discriminating the four subtypes in 33 sagittal CSO patients. Receiver operating characteristics (ROC) curves were used to assess the robustness

  9. Redefining Congenital Atlantoaxial Dislocation: Objective Assessment in Each Plane Before and After Operation.

    Science.gov (United States)

    Salunke, Pravin; Sahoo, Sushanta K; Deepak, Arsikere N; Khandelwal, Niranjan K

    2016-11-01

    The C1-C2 joint has multiple degrees of freedom of movement and C1-C2 dislocation (AAD) is often multiplanar. The existing methodology to assess the dislocation is limited to few planes. The object of this study is to redefine and objectively assess congenital AAD in each possible plane, before and after the operation. This study consisted of 95 patients of irreducible congenital AAD operated on with the posterior approach alone. Preoperative and postoperative computed tomography imaging was studied in the axial, coronal, and sagittal planes. The relationship of C1-C2 along with the C1-C2 joint inclination was studied in each plane. The extent and type of dislocation was objectively assessed in each plane (newer indices) and compared with follow-up imaging for correction. The preoperative and postoperative Japenese orthopaedics association scores were compared. The commonest variety (61 patients) was a combination of anteroposterior (AP) and vertical C1-C2 dislocation. Five patients had predominant APnteroposterior, 6 vertical, 4 axial rotational, 9 lateral angular tilt, and 3 had lateral transalational. Seven patients had a combination of dislocation in AP, vertical, and rotational planes. AP dislocation was seen with sagittal inclination of C1-C2 joints and vertical dislocation with coronal inclination. Asymmetry in the joint's sagittal inclination added to a rotational component, whereas asymmetry in the coronal angulation caused lateral angular tilt. Pure rotational or lateral translation dislocation had near-normal C1-C2 orientation. Preoperative Japenese orthopaedics association score was worst in the lateral tilt and the lateral translation. Correction in all planes was achieved in all patients. The objective assessment of C1-C2 dislocation and joints in each plane was to determine its management and help in achieving multiplanar correction. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Rebound Deformity After Growth Modulation in Patients With Coronal Plane Angular Deformities About the Knee: Who Gets It and How Much?

    Science.gov (United States)

    Leveille, Lise A; Razi, Ozan; Johnston, Charles E

    2017-05-18

    With observed success and increased popularity of growth modulation techniques, there has been a trend toward use in progressively younger patients. Younger age at growth modulation increases the likelihood of complete deformity correction and need for implant removal before skeletal maturity introducing the risk of rebound deformity. The purpose of this study was to quantify magnitude and identify risk factors for rebound deformity after growth modulation. We performed a retrospective review of all patients undergoing growth modulation with a tension band plate for coronal plane deformity about the knee with subsequent implant removal. Exclusion criteria included completion epiphysiodesis or osteotomy at implant removal, ongoing growth modulation, and modulation, before implant removal, and at final follow-up. In total, 67 limbs in 45 patients met the inclusion criteria. Mean age at growth modulation was 9.8 years (range, 3.4 to 15.4 y) and mean age at implant removal was 11.4 years (range, 5.3 to 16.4 y). Mean change in HKA after implant removal was 6.9 degrees (range, 0 to 23 degrees). In total, 52% of patients had >5 degrees rebound and 30% had >10 degrees rebound in HKA after implant removal. Females below 10 years and males below 12 years at time of growth modulation had greater mean change in HKA after implant removal compared with older patients (8.4 vs. 4.7 degrees, P=0.012). Patients with initial deformity >20 degrees had an increased frequency of rebound >10 degrees compared with patients with less severe initial deformity (78% vs. 22%, P=0.002). Rebound deformity after growth modulation is common. Growth modulation at a young age and large initial deformity increases risk of rebound. However, rebound does not occur in all at risk patients, therefore, we recommend against routine overcorrection. Level IV-retrospective study.

  11. Adolescent idiopathic scoliosis: sagital plane and low density pedicle screws

    Directory of Open Access Journals (Sweden)

    Rodrigo Augusto do Amaral

    2014-03-01

    Full Text Available OBJECTIVE: To examine the sagittal curves of patients treated with CD instrumentation using exclusively pedicle screws. METHODS: Image analysis of medical records of 27 patients (26 M and 1 F with a minimum follow-up of 6 months, who underwent surgical treatment in our service between January 2005 and December 2010. The curves were evaluated on coronal and sagittal planes, taking into account the potential correction of the technique. RESULTS: In the coronal plan the following curves were evaluated: proximal thoracic (TPx, main thoracic (TPp, and thoracolumbar; lumbar (TL, L, and the average flexibility was 52%, 52%, and 92% and the capacity of correction was 51%, 72%, and 64%, respectively. In the sagittal plane there was a mean increase in thoracic kyphosis (CT of 41% and an average reduction of lumbar lordosis (LL of 17%. Correlation analysis between variables showed Pearson coefficient of correlation of 0.053 and analysis of dispersion of R2 = <0.001. CONCLUSION: The method has shown satisfactory results with maintenance of kyphosis correction in patients with normal and hyper kyphotic deformities.

  12. Importance of sagittal MR imaging in nontraumatic femoral head osteonecrosis in children

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Alice S. [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Wells, Lawrence [Children' s Hospital of Philadelphia, Department of Orthopedic Surgery, Philadelphia, PA (United States); Jaramillo, Diego [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2008-11-15

    In nontraumatic femoral head osteonecrosis, characterization of femoral head collapse is important in staging disease progression and planning treatment. Few prior studies have quantitatively compared the ability of sagittal and coronal MR images to detect femoral head collapse. We hypothesized that sagittal MR images show a greater degree and angular span of femoral head collapse than coronal images. We reviewed 38 hip MRI scans of nontraumatic femoral head osteonecrosis from 34 pediatric patients. In both sagittal and coronal images, the maximal extent and angular location along with the angular span of the femoral head collapse were measured. Differences were evaluated using a paired t-test. The extent of bone and cartilage loss from the femoral head was evaluated. Sagittal MR images showed 29% maximal femoral head radius collapse, whereas coronal images showed 16% collapse (P<0.001). Sagittal images showed a larger angular span of collapse (115 ) than coronal images (55 , P<0.001). Sagittal images showed greater epiphyseal bone loss in the anterior than in the posterior portion (P<0.001), whereas coronal images did not show a significant difference in bone loss between the medial and lateral portion (P=0.32). Sagittal images show greater femoral head collapse than coronal images in nontraumatic femoral head osteonecrosis. (orig.)

  13. The relationships between the center of mass position and the trunk, hip, and knee kinematics in the sagittal plane: a pilot study on field-based video analysis for female soccer players.

    Science.gov (United States)

    Sasaki, Shogo; Nagano, Yasuharu; Kaneko, Satoshi; Imamura, Shoichiro; Koabayshi, Takuma; Fukubayashi, Toru

    2015-03-29

    Athletes with non-contact anterior cruciate ligament tears have common features in the sagittal plane; namely, the body's center of mass (COM) is located posterior to the base of support, the trunk and knee joints are extended, and the hip angle is flexed. However, the relationships among these variables have not been assessed in field-based movements. This study sought to determine relationships between distances from the COM to the base of support and the trunk, hip, and knee positions in women while playing soccer. Sixty events (29 single-leg landing and 31 single-leg stopping events) were analyzed using two-dimensional video analysis. The relationships among the measurement variables were determined using the Pearson's product-moment correlation coefficient, and stepwise multiple linear regression models were used to explore the relationships between the COM position and the kinematic variables. The distance from the COM to the base of support displayed a moderate negative relationship with the trunk angle (r = -0.623, p angle (r = 0.869, p angles were selected in the best regression model (adjusted r(2) = 0.953, p angle and a decreased limb angle at initial contact are associated with a safer COM position. Neuromuscular training may be useful for controlling the trunk and lower limb positions during dynamic activities.

  14. The Relationships Between the Center of Mass Position and the Trunk, Hip, and Knee Kinematics in the Sagittal Plane: A Pilot Study on Field-Based Video Analysis for Female Soccer Players

    Directory of Open Access Journals (Sweden)

    Sasaki Shogo

    2015-03-01

    Full Text Available Athletes with non-contact anterior cruciate ligament tears have common features in the sagittal plane; namely, the body’s center of mass (COM is located posterior to the base of support, the trunk and knee joints are extended, and the hip angle is flexed. However, the relationships among these variables have not been assessed in field-based movements. This study sought to determine relationships between distances from the COM to the base of support and the trunk, hip, and knee positions in women while playing soccer. Sixty events (29 single-leg landing and 31 single-leg stopping events were analyzed using two-dimensional video analysis. The relationships among the measurement variables were determined using the Pearson’s product-moment correlation coefficient, and stepwise multiple linear regression models were used to explore the relationships between the COM position and the kinematic variables. The distance from the COM to the base of support displayed a moderate negative relationship with the trunk angle (r = - 0.623, p < .0001, r2 = 0.388 and a strong positive relationship with the limb angle (r = 0.869, p < .0001, r2 = 0.755. The limb, knee, and trunk angles were selected in the best regression model (adjusted r2 = 0.953, p < .0001, f2 = 20.277. These findings suggest that an increased trunk angle and a decreased limb angle at initial contact are associated with a safer COM position. Neuromuscular training may be useful for controlling the trunk and lower limb positions during dynamic activities.

  15. Sacro-femoral-pubic angle: a coronal parameter to estimate pelvic tilt.

    Science.gov (United States)

    Blondel, Benjamin; Schwab, Frank; Patel, Ashish; Demakakos, Jason; Moal, Bertrand; Farcy, Jean-Pierre; Lafage, Virginie

    2012-04-01

    Pelvic tilt is an established measure of position which has been tied to sagittal plane spinal deformity. Increased tilt is noted in the setting of the aging spine and sagittal malalignment syndromes such as flatback (compensatory mechanism). However, the femoral heads are often poorly visualized on sagittal films of scoliosis series in adults, limiting the ability to determine pelvic incidence and tilt. There is a need to establish a coronal plane (better visualization) pelvic parameter which correlates closely with pelvic tilt. This is a retrospective review of 71 adult patients (47 females and 24 males) with full-length standing spine radiographs. Visualization of all spinal and pelvic landmarks was available coronally and sagittally (including pelvis and acetabuli). Pelvic tilt was calculated through validated digital analysis software (SpineView(®)). A new parameter, the sacro-femoral-pubic angle (midpoint of S1 endplate to centroid of acetabuli to superior border of the pubic symphysis) was analyzed for correlation (and predictive ability) with sagittal pelvic tilt. The sacro-femoral-pubic angle (SFP angle) was highly correlated to PT, and according to this analysis, pelvic tilt could be estimated by the formula: PT = 75 - (SFP angle). A Pearson's correlation coefficient of 0.74 (p < 0.005) and predictive ability of 76% accuracy was obtained (±7.5°). The correlation and predictive ability was greater for males compared to females (male: r = 0.87 and predictive model = 93%; female: r = 0.67 and predictive model = 67%). The pelvic tilt is an essential measure in the context of radiographic evaluation of spinal deformity and malalignment. Given the routinely excellent visibility of coronal films this study established the SFP as a coronal parameter which can reliably estimate pelvic tilt. The high correlation and predictive ability of the SFP angle should prompt further study and clinical application when lateral radiographs do not permit

  16. Valoración de la disposición sagital del raquis en gimnastas especialistas en trampolín. (Assessment of the sagittal plane of the spine in trampoline gymnasts.

    Directory of Open Access Journals (Sweden)

    Pilar Sainz de Baranda

    2009-07-01

    Full Text Available ResumenSe valoró la disposición sagital de la columna vertebral en gimnastas especialistas en la modalidad de trampolín. Se realizó un estudio transversal, en el que participaron 69 gimnastas de trampolín (35 mujeres y 34 varones con una edad media de 14.97 + 4.77 años, y de 6.61+4 años de entrenamiento. La valoración se realizó en tres posiciones: bipedestación relajada, sedentación relajada y flexión máxima del tronco. En todas las posiciones se diferenció la curva dorsal y la lumbar. Para la cuantificación de los grados se utilizó un inclinómetro ISOMED Unilevel-95. En bipedestación la cifosis dorsal media fue 44.96º+8.23º, la lordosis lumbar fue de 36.25º+10.1º. En máxima flexión del tronco desde la bipedestación posición test dedos suelo (FMT-DDS los grados de la curvatura dorsal y lumbar fueron de 51.55º+11º y 29.29º+7.89º. En máxima flexión del tronco desde la sedentación test dedos planta (FMT-DDP los grados de la curvatura dorsal y lumbar fueron de 57.94º+15º y 27.72º+7.51º. En sedentación relajada los grados de la curvatura dorsal y lumbar fueron de 50.28º+10º y 17.48º+9.6º respectivamente. Los valores medios del plano sagital de los gimnastas especialistas en trampolín muestran en bipedestación valores de hipercifosis para la curva dorsal, con una lordosis lumbar normal. En la flexión máxima del tronco se observan valores normales para la cifosis dorsal y valores hipercifóticos para la curva lumbar. En sedentación se observan valores hipercifóticos tanto en la curva dorsal como en la lumbar. Los gimnastas presentan tendencia a una mayor cifosis dorsal en bipedestación y en flexión de tronco. Las gimnastas presentan tendencia a una mayor lordosis en bipedestación y menor cifosis lumbar en flexióny sedentación.Abstract The sagittal plane of the spine was measured in trampoline gymnasts. In this cross-sectional study, 69 club-level trampoline gymnasts (35 females and 34 males

  17. Sagittal Spine Length Measurement: A Novel Technique to Assess Growth of the Spine.

    Science.gov (United States)

    Spurway, Alan J; Chukwunyerenwa, Chukwudi K; Kishta, Waleed E; Hurry, Jennifer K; El-Hawary, Ron

    2016-09-01

    The accuracy and repeatability of a novel sagittal spine length (SSL) radiographic measurement was examined using photographic and radiographic imaging. To validate the new SSL technique for measuring growth in early-onset scoliosis (EOS) patients. Current assessment of patient growth undergoing growth-friendly surgical treatment for EOS is the use of serial vertical spine height measurements (VH) on coronal radiographs. Spine-based distraction implants are able to control the coronal plane deformity of scoliosis, but exhibit a "law of diminishing returns" in the impact of each follow-up lengthening surgery. As these treatments are kyphogenic, we hypothesize that the increase in kyphosis is, in fact, growth out of plane, not captured by standard spine height measurements. Measurement accuracy was assessed using 6 spine model alignments and clinical radiographs of 23 retrospective EOS patients. Inter- and intrarater reliabilities were assessed using interclass coefficient (ICC) analyses. The discrepancy between the VH and SSL was also investigated. The model assessment showed excellent accuracy, with a 1.54 mm (SD: 1.07, range: 0.03-3.14, p = .226) mean error and mean ICCs of 0.999. As the kyphosis increased, a progressive difference between the phantom VH and SSL was observed. Interrater reliability ICCs of the clinical radiographs averaged 0.981 and 0.804, whereas intrarater reliabilities averaged 0.966 and 0.826, for the coronal and sagittal radiographs, respectively. Mean clinical SSLs were 177.5 mm (SD: 28.5, range: 114.3-250.3), whereas the VH averaged 161.6 mm (SD: 31.8, range: 58.5-243.0), resulting in a 16.0-mm (SD: 16.7, range: 0.3-90.3, p < .0001) difference between the two measurements with a progressive difference as the kyphosis increased. The novel SSL measurement is accurate, repeatable, and complements the current growth assessments for EOS treatments. Until sagittal spine lengths are taken into consideration, the "law of diminishing returns" should

  18. Coronal magnetometry

    CERN Document Server

    Zhang, Jie; Bastian, Timothy

    2014-01-01

    This volume is a collection of research articles on the subject of the solar corona, and particularly, coronal magnetism. The book was motivated by the Workshop on Coronal Magnetism: Connecting Models to Data and the Corona to the Earth, which was held 21 - 23 May 2012 in Boulder, Colorado, USA. This workshop was attended by approximately 60 researchers. Articles from this meeting are contained in this topical issue, but the topical issue also contains contributions from researchers not present at the workshop. This volume is aimed at researchers and graduate students active in solar physics. Originally published in Solar Physics, Vol. 288, Issue 2, 2013 and Vol. 289, Issue 8, 2014.

  19. Functional CT imaging of the lung in the axial and coronal plane after single-lung transplantation; Computertomographische Funktionsuntersuchung der Lunge nach einseitiger Lungentransplantation mit axialer und koronarer Akquisition

    Energy Technology Data Exchange (ETDEWEB)

    Kauczor, H.U. [Mainz Univ. (Germany). Klinik fuer Radiologie; Buchenroth, M. [Mainz Univ. (Germany). 3. Medizinische Klinik - Pneumologie; Heussel, C.P. [Mainz Univ. (Germany). Klinik fuer Radiologie; Mayer, E. [Mainz Univ. (Germany). Klinik fuer Herz-, Thorax-, Gefaesschirurgie

    1996-05-01

    After single-lung transplantation in a patient suffering from obstructive emphysema lung function parameters worsened during follow-up. To conplement the routine high-resolution CT (HRCT) scans acquired in inspiration, additional scans were obtained to evaluate regional lung function. The comparison of HRCT scans acquired in inspiration and in expiration revealed different ventilation conditions of both lungs, continuous acquisition in a single slice (dynamic multiscan acquisition) in the axial and coronal plane demonstrated mediastinal shifting and the movement of the diaphragm during the whole breathing cycle. Both modalities can provide important information concerning regional differences of ventilation after single-lung transplantation. Expiratory HRCT should be applied on a regular basis in the follow-up of patients after single-lung transplantation. Expiratory HRCT should be applied on a regular basis in the follow-up of patients after single-lung transplantation. The application of axial and coronal dynamic multiscan acquisitions will be helpful in particular clinical conditions, like increasing hyperinflation, mediastinal shifting or bronchial collapse within the region of the anastomosis. (orig.) [Deutsch] Nach Einzellungentransplantation wegen eines obstruktiven Emphysems wurden bei einem Patienten in der Nachsorge zur Abklaerung einer Verschlechterung der Lungenfunktionsparameter neben einer hochaufloesenden CT (HRCT) in Inspiration zusaetzliche Aufnahmen zur Funktionsbeurteilung durchgefuehrt. Der Vergleich von HRCT-Aufnahmen in In- und Exspiration zeigte die unterschiedlichen Ventilationsverhaeltnisse bei beiden Lungen; kontinuierliche Aufnahmen in einer Schicht (Multirotationsaufnahmen) stellten bei axialer und insbesondere bei direkter koronarer Akquisition die Mediastinal- und Zwerchfellbewegung waehrend des gesamten Atemzyklus dar. Beide Verfahren koennen wichtige Zusatzinformationen ueber regionale Ventilationsdifferenzen nach einseitiger

  20. Clinically acceptable agreement between the ViMove wireless motion sensor system and the Vicon motion capture system when measuring lumbar region inclination motion in the sagittal and coronal planes

    DEFF Research Database (Denmark)

    Mjøsund, Hanne Leirbekk; Boyle, Eleanor; Kjær, Per

    2017-01-01

    BACKGROUND: Wireless, wearable, inertial motion sensor technology introduces new possibilities for monitoring spinal motion and pain in people during their daily activities of work, rest and play. There are many types of these wireless devices currently available but the precision in measurement...

  1. Coronal Holes

    Directory of Open Access Journals (Sweden)

    Steven R. Cranmer

    2009-09-01

    Full Text Available Coronal holes are the darkest and least active regions of the Sun, as observed both on the solar disk and above the solar limb. Coronal holes are associated with rapidly expanding open magnetic fields and the acceleration of the high-speed solar wind. This paper reviews measurements of the plasma properties in coronal holes and how these measurements are used to reveal details about the physical processes that heat the solar corona and accelerate the solar wind. It is still unknown to what extent the solar wind is fed by flux tubes that remain open (and are energized by footpoint-driven wave-like fluctuations, and to what extent much of the mass and energy is input intermittently from closed loops into the open-field regions. Evidence for both paradigms is summarized in this paper. Special emphasis is also given to spectroscopic and coronagraphic measurements that allow the highly dynamic non-equilibrium evolution of the plasma to be followed as the asymptotic conditions in interplanetary space are established in the extended corona. For example, the importance of kinetic plasma physics and turbulence in coronal holes has been affirmed by surprising measurements from the UVCS instrument on SOHO that heavy ions are heated to hundreds of times the temperatures of protons and electrons. These observations point to specific kinds of collisionless Alfvén wave damping (i.e., ion cyclotron resonance, but complete theoretical models do not yet exist. Despite our incomplete knowledge of the complex multi-scale plasma physics, however, much progress has been made toward the goal of understanding the mechanisms ultimately responsible for producing the observed properties of coronal holes.

  2. Sagittal Balance in Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    Xu, Xi-Ming; Wang, Fei; Zhou, Xiao-Yi; Liu, Zi-Xuan; Wei, Xian-Zhao; Bai, Yu-Shu; Li, Ming

    2015-01-01

    Abstract The relationship between spinal sagittal alignment and pelvic parameters is well known in adolescent idiopathic scoliosis. However, few studies have reported the sagittal spinopelvic relationship after selective posterior fusion of thoracolumbar/lumbar (TL/L) curves. We evaluated the relationship between spinal sagittal alignment and the pelvis, and analyzed how the pelvic sagittal state is adjusted in Lenke type 5C patients. We conducted a retrospective study of 36 patients with Lenke type 5C curves who received selective posterior TL/L curve fusion. Coronal and spinopelvic sagittal parameters were pre and postoperatively compared. Pearson coefficients were used to analyze the correlation between all spinopelvic sagittal parameters before and after surgery. We also evaluated 3 pelvic morphologies (anteverted, normal, and retroverted) before and after surgery. Preoperatively, the mean pelvic incidence was 46.0°, with a pelvic tilt and sacral slope (SS) of 8.2° and 37.8°, respectively, and 25% (9/36) of patients had an anteverted pelvis, whereas the other 75% had a normal pelvis. Postoperatively, 42% (15/36) of patients had a retroverted pelvis, 53% (19/36) had a normal pelvis, and 2 patients had an anteverted pelvis. Logistic regression analyses yielded 2 factors that were significantly associated with the risk for a postoperative unrecovered anteverted pelvis, including increased lumbar lordosis (LL) (odds ratio [OR] 4.8, P = 0.029) and increased SS (OR 5.6, P = 0.018). Four factors were significantly associated with the risk of a postoperative newly anteverted pelvis, including LL at the final follow-up (OR 6.9, P = 0.009), increased LL (OR 8.9, P = 0.003), LL below fusion (OR 9.4, P = 0.002), and increased SS (OR 11.5, P = 0.001). The pelvic state may be adjusted after selective posterior TL/L curve fusion in Lenke 5C adolescent idiopathic scoliosis patients. It is difficult to improve an anteverted pelvis in patients who have

  3. Analysis of the cervical spine sagittal alignment in young idiopathic scoliosis: a morphological classification of 120 cases.

    Science.gov (United States)

    Yu, Miao; Silvestre, Clement; Mouton, Tanguy; Rachkidi, Rami; Zeng, Lin; Roussouly, Pierre

    2013-11-01

    To analyze the relationship between the cervical spine and global spinal-pelvic alignment in young patients with idiopathic scoliosis based on a morphological classification, and to postulate the hypothesis that cervical kyphosis is a part of cervico-thoracic kyphosis in them. 120 young patients with idiopathic scoliosis were recruited retrospectively between 2006 and 2011. The following values were measured and calculated: cervical angles (CA), cervico-thoracic angles (CTA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), spinal sacral angle (SSA), hip to C7/hip to sacrum, thoracic kyphosis (TK), lumbar lordosis (LL), Roussouly sagittal classification, Lenke Type Curve and Lumbar Modifier. The cervical curves were classified as lordosis, straight, sigmoid and kyphosis. They were categorized into four groups as cervical non-kyphosis group (CNK Group), cervical kyphosis group (CK Group), cervical-middle-thoracic kyphosis group (CMTK Group), and cervical-lower-thoracic kyphosis group (CLTK Group) according to their morphological characters of sagittal alignments. All parameters were compared and analyzed among groups. The incidence of cervical kyphosis was 40 % (48/120). The CA and the CTA were in significant correlation (r = 0.854, P = 0.00). The cervical spine alignments were revealed to be significantly different among groups (r = 85.04, P = 0.00). Significant differences among groups in CA, CTA and TK were also detected. A strong correlation between the group type and Lenke Lumbar Modifier was still seen (P scoliosis. Despite the deformity in cervical alignment, the global spine could still be well-balanced with spontaneous adjustment. The correlation between our grouping based on the morphological characteristics of the sagittal alignments and Lenke Lumbar Modifier suggests that the coupled motion principle be appropriate to explain the modifications both in coronal and sagittal planes.

  4. Evolution of the postoperative sagittal spinal profile in early-onset scoliosis: is there a difference between rib-based and spine-based growth-friendly instrumentation?

    Science.gov (United States)

    Chen, Zhonghui; Li, Song; Qiu, Yong; Zhu, Zezhang; Chen, Xi; Xu, Liang; Sun, Xu

    2017-12-01

    OBJECTIVE Although the vertical expandable prosthetic titanium rib (VEPTR) and growing rod instrumentation (GRI) encourage spinal growth via regular lengthening, they can create different results because of their different fixation patterns and mechanisms in correcting scoliosis. Previous studies have focused comparisons on coronal plane deformity with minimal attention to the sagittal profile. In this retrospective study, the authors aimed to compare the evolution of the sagittal spinal profile in early-onset scoliosis (EOS) treated with VEPTR versus GRI. METHODS The data for 11 patients with VEPTR and 22 with GRI were reviewed. All patients had more than 2 years' follow-up with more than 2 lengthening procedures. Radiographic measurements were performed before and after the index surgery and at the latest follow-up. The complications in both groups were recorded. RESULTS Patients in both groups had similar diagnoses, age at the index surgery, and number of lengthening procedures. The changes in the major coronal Cobb angle and T1-S1 spinal height were not significantly different between the 2 groups. Compared with the GRI group, the VEPTR group had less correction in thoracic kyphosis (23% ± 12% vs 44% ± 16%, p < 0.001) after the index surgery and experienced a greater correction loss in thoracic kyphosis (46% ± 18% vs 11% ± 8%, p < 0.001) at the latest follow-up. Although the increase in the proximal junctional angle was not significantly different (VEPTR: 7° ± 4° vs GRI: 8° ± 5°, p = 0.569), the incidence of proximal junctional kyphosis was relatively lower in the VEPTR group (VEPTR: 18.2% vs GRI: 22.7%). No significant changes in the spinopelvic parameters were observed, while the sagittal vertical axis showed a tendency toward a neutral position in both groups. The overall complication rate was higher in the VEPTR group than in the GRI group (72.7% vs 54.5%). CONCLUSIONS The VEPTR had coronal correction and spinal growth results similar to those

  5. Cervical sagittal alignment variations in adolescent idiopathic scoliosis patients treated with thoraco-lumbo-sacral orthosis.

    Science.gov (United States)

    Corradin, Marco; Canavese, Federico; Dimeglio, Alain; Dubousset, Jean

    2017-04-01

    Thoraco-lumbo-sacral orthosis (TLSO) is an effective treatment in adolescent idiopathic scoliosis (AIS) patients, but cervical sagittal alignment (CSA) variations after bracing have never been evaluated. The purpose of this study was to assess changes in CSA before, during and after TLSO treatment, and to determine whether patients developed cervical pain. This was a retrospective study in 38 AIS patients (33 females; mean age 10.8 years) treated by TLSO. Patients were Risser 0 (n = 34) or 1 (n = 4). Major curve deformity (MC) in the coronal plane and cervical (CSA), thoracic (TSA) and lumbar (LSA) sagittal alignment were evaluated radiographically at start of treatment (t 0), after 1 month of brace treatment (t 1), and 1 year after end of treatment (t 2). Cervical pain was evaluated at t 2 using a visual analogue scale (VAS). The TLSO was worn for an average of 4.6 years. Mean CSA, TSA and LSA were significantly lower at t 2 than at t 0: 0 ± 2.5° vs. 9.4 ± 2.3°, 24.1 ± 2.6° vs. 29.3 ± 2.4° and 5 ± 1.9° vs. 44.2 ± 2.5°, respectively (p  0.8). VAS score was 0 in all patients. The TLSO can control progression of the deformity in the frontal plane, but it influences CSA, TSA and LSA. In particular, it decreases cervical spine lordosis, with reduction maintained 1 year after the end of treatment. Numerical differences, although statistically significant, were not clinically relevant.

  6. Pediatric sagittal alignment.

    Science.gov (United States)

    Mac-Thiong, Jean-Marc; Labelle, Hubert; Roussouly, Pierre

    2011-09-01

    There is a wide variation in the regional parameters used to describe the spine and sacro-pelvis in children and adolescents. There is a slight tendency for thoracic kyphosis and lumbar lordosis to increase with age. Pelvic incidence and pelvic tilt also tend to increase during growth, while sacral slope remains relatively stable. Strong knowledge of the close relationships between adjacent anatomical regions of the spine and sacro-pelvis is the key when evaluating and interpreting sagittal spino-pelvic alignment. The scheme of correlations between adjacent regional parameters needs to be preserved in order to maintain a balanced posture. The net resultant from these relationships between adjacent anatomical regions is best represented by parameters of sagittal global balance. C7 plumbline tends to move backwards from childhood to adulthood, where it stabilizes or slightly moves forward secondary to degenerative changes. C7 plumbline in front of both hip axis and center of the upper sacral endplate occurs in 29% of subjects aged 3-10 years, 12% of subjects aged between 10 and 18 years, and 14% of subjects aged 18 years or older. Therefore, although most normal subjects stand with a C7 plumbline behind the hip axis, a C7 plumbline in front of both hip axis and sacrum can be seen in normal individuals. However, progressive forward displacement of C7 plumbline should raise a suspicion for the risk of developing spinal pathology.

  7. Quality control of reconstructed sagittal balance for sagittal imbalance.

    Science.gov (United States)

    Chang, Kao-Wha; Leng, Xiangyang; Zhao, Wenhai; Ching-Wei, Cheng; Chen, Tsung-Chein; Chang, Ku-I; Chen, Yin-Yu

    2011-02-01

    Prospective radiographic study. To investigate the feasibility of controlling quality of reconstructed sagittal balance for sagittal imbalance. Patients with sagittal imbalance cannot walk or stand erect without overwork of musculature because of compromised biomechanical advantage. The result is muscle fatigue and activity-related pain. During reconstructive surgery, restoration of optimal sagittal balance is crucial for obtaining satisfactory clinical results. However, there is no way to control quality of reconstructed sagittal balance before or during surgery. A method was developed to determine the lumbosacral curve in a way that theoretically would bring sagittal balance to an ideal state by calculation and simulation for each patient before surgery and then template rods of the curve and a blueprint were made accordingly for operative procedures. Ninety-four consecutive patients with sagittal imbalance due to lumbar kyphosis were treated for intractable pain and then followed up for a mean of 4.3 years. Radiographs were analyzed before surgery, 2 months after surgery, and at most recent follow-up. The mean estimated values of L1-S1 lordosis, sacral inclination angle, sacrofemoral distance, and distribution of L1-S1 lordosis at the closing-opening wedge osteotomy site and L4-S1 segments were 30.8°, 24.6°, 0 mm, 16.1% (-5°), and 62% (-19°), respectively. The mean reconstructed values were 41.1°, 23.3°, 3.9 mm, 41% (-17°), and 46% (-19°), respectively. There were significant differences between estimated and reconstructed values of L1-S1 lordosis and the percentage of distributions; however, there was no significant difference between the estimated and reconstructed magnitude of L4-S1 lordosis, sacral inclination angle, and sacrofemoral distance. A properly oriented pelvis can be brought nearly directly above the hip axis. The mean sagittal global balance, represented by the distance between the vertical line through the hip axis and sacral promontory

  8. Supra-acetabular line is better than supra-iliac line for coronal balance referencing-a study of perioperative whole spine X-rays in degenerative lumbar scoliosis and ankylosing spondylitis patients.

    Science.gov (United States)

    Hey, Hwee Weng Dennis; Kim, Cheung-Kue; Lee, Won-Gyu; Juh, Hyung-Suk; Kim, Ki-Tack

    2017-12-01

    The aim of spinal deformity correction is to restore the spine's functional alignment by balancing it in both the sagittal and coronal planes. Regardless of posture, the ideal coronal profile is straight, and therefore readily assessable. This study compares two radiological methods to determine which better predicts postoperative standing coronal balance. We conducted a single-center, radiographic comparative study between 2011 and 2015. A total of 199 patients with a mean age of 55.1 years were studied. Ninety patients with degenerative lumbar scoliosis (DLS) and 109 ankylosing spondylitis (AS) were treated with posterior surgery during this period. Baseline clinical and radiographic parameters (sagittal and coronal) were recorded. Comparison was performed between the new supra-acetabular line (central sacral vertical line [CSVL1]) and conventional supra-iliac line (CSVL2) perpendicular methods of coronal balance assessment. These methods were also compared with the gold standard standing C7 plumb line. Each patient underwent standardized operative procedures and had perioperative spine X-rays obtained for assessment of spinal balance. Adjusted multivariate analysis was used to determine predictors of coronal balance. Significant differences in baseline characteristics (age, gender, and radiographic parameters) were found between patients with DLS and AS. CSVL1, CSVL2, and C7 plumb line differed in all the perioperative measurements. These three radiological methods showed a mean right coronal imbalance for both diagnoses in all pre-, intra-, and postoperative radiographs. The magnitude of imbalance was the greatest for CSVL2 followed by CSVL1 and subsequently the C7 plumb line. A larger discrepancy between CSVL and C7 plumb line measurements intraoperatively than those postoperatively suggests a postural effect on these parameters, which is greater for CSVL2. Multivariate analysis identified that in DLS, the preoperative C7 plumb line was predictive of its

  9. Patients with proximal junctional kyphosis requiring revision surgery have higher postoperative lumbar lordosis and larger sagittal balance corrections.

    Science.gov (United States)

    Kim, Han Jo; Bridwell, Keith H; Lenke, Lawrence G; Park, Moon Soo; Song, Kwang Sup; Piyaskulkaew, Chaiwat; Chuntarapas, Tapanut

    2014-04-20

    Case control study. To evaluate risk factors in patients in 3 groups: those without proximal junctional kyphosis (PJK) (N), with PJK but not requiring revision (P), and then those with PJK requiring revision surgery (S). It is becoming clear that some patients maintain stable PJK angles, whereas others progress and develop severe PJK necessitating revision surgery. A total of 206 patients at a single institution from 2002 to 2007 with adult scoliosis with 2-year minimum follow-up (average 3.5 yr) were analyzed. Inclusion criteria were age more than 18 years and primary fusions greater than 5 levels from any thoracic upper instrumented vertebra to any lower instrumented vertebrae. Revisions were excluded. Radiographical assessment included Cobb measurements in the coronal/sagittal plane and measurements of the PJK angle at postoperative time points: 1 to 2 months, 2 years, and final follow-up. PJK was defined as an angle greater than 10°. The prevalence of PJK was 34%. The average age in N was 49.9 vs. 51.3 years in P and 60.1 years in S. Sex, body mass index, and smoking status were not significantly different between groups. Fusions extending to the pelvis were 74%, 85%, and 91% of the cases in groups N, P, and S. Instrumentation type was significantly different between groups N and S, with a higher number of upper instrumented vertebra hooks in group N. Radiographical parameters demonstrated a higher postoperative lumbar lordosis and a larger sagittal balance change, with surgery in those with PJK requiring revision surgery. Scoliosis Research Society postoperative pain scores were inferior in group N vs. P and S, and Oswestry Disability Index scores were similar between all groups. Patients with PJK requiring revision were older, had higher postoperative lumbar lordosis, and larger sagittal balance corrections than patients without PJK. Based on these data, it seems as though older patients with large corrections in their lumbar lordosis and sagittal balance

  10. Establishment of reference mandibular plane for anterior alveolar morphology evaluation using cone beam computed tomography*

    Science.gov (United States)

    Wang, Rong-yang; Han, Min; Liu, Hong; Wang, Chun-ling; Xian, Hong-hong; Zhang, Lei; Zhang, Shi-jie; Liu, Dong-xu

    2012-01-01

    To propose a method of establishing the reference mandibular plane (MP), which could be reestablished according to the coordinates of the reference points, and then facilitate the assessment of anterior alveolar morphology using cone beam computed tomography (CBCT), sixty patients with bimaxillary protrusion were randomly selected and CBCT scans were taken. The CBCT scans were transferred to Materialism’s interactive medical image control system 10.01 (MIMICS 10.01), and three dimensional models of the entire jaws were constructed. Reference points determining the reference MP were positioned in the coronal, axial, sagittal windows, and the points were exactly located by recording their coordinates in the interfaces of software. The reference MP provided high intra-observer reliability (Pearson’s r 0.992 to 0.999), and inter-observer reliability (intra-class correlation coefficients (ICCs) 0.996 to 0.999). PMID:23125087

  11. Modeling posture-dependent leg actuation in sagittal plane locomotion

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, J [Department of Mechanical Engineering, Oregon State University, Corvallis, OR 97331 (United States); Clark, J, E-mail: schmitjo@engr.orst.ed [Department of Mechanical Engineering, Florida State University, Tallahassee, FL 32310 (United States)

    2009-12-15

    The spring loaded inverted pendulum template has been shown to accurately model the steady locomotion dynamics of a variety of running animals, and has served as the inspiration for an entire class of dynamic running robots. While the template models the leg dynamics by an energy-conserving spring, insects and animals have structures that dissipate, store and produce energy during a stance phase. Recent investigations into the spring-like properties of limbs, as well as animal response to drop-step perturbations, suggest that animals use their legs to manage energy storage and dissipation, and that this management is important for gait stability. In this paper, we extend our previous analysis of control of the spring loaded inverted pendulum template via changes in the leg touch-down angle to include energy variations during the stance phase. Energy variations are incorporated through leg actuation that varies the force-free leg length during the stance phase, yet maintains qualitatively correct force and velocity profiles. In contrast to the partially asymptotically stable gaits identified in previous analyses, incorporating energy and leg angle variations in this manner produces complete asymptotic stability. Drop-step perturbation simulations reveal that the control strategy is rather robust, with gaits recovering from drops of up to 30% of the nominal hip height.

  12. A lamellar model for the X-ray rocking curves of sagittally bent Laue crystals.

    Science.gov (United States)

    Zhong, Z; Kao, C C; Siddons, D P; Zhong, H; Hastings, J B

    2003-01-01

    The use of sagittally bent asymmetric Laue crystals in horizontally focusing monochromators for high-energy synchrotron X-rays necessitates simulation of the X-ray reflectivity by such crystals. Based on the theory of the lattice distortion in the diffraction plane of sagittally bent Laue crystals, a lamellar model was developed to predict their rocking curves. The model was experimentally verified by rocking-curve measurements from various reflections on silicon crystals of four representative orientations, sagittally bent to various radii, using X-rays of 67 keV energy.

  13. Coronal Fractures of the Scaphoid: A Review.

    Science.gov (United States)

    Slutsky, David J; Herzberg, Guillaume; Shin, Alexander Y; Buijze, Geert A; Ring, David C; Mudgal, Chaitanya S; Leung, Yuen-Fai; Dumontier, Christian

    2016-08-01

    Coronal (or frontal plane) fractures of the scaphoid are distinctly uncommon. There are few published reports of coronal fractures of the scaphoid. This fracture is often missed on the initial X-ray films. A high index of suspicion should exist when there is a double contour of the proximal scaphoid pole on the anteroposterior X-ray view. A computed tomography scan is integral in making the diagnosis. Early recognition is key in salvaging the scaphoid fracture and in preventing articular damage. Level of Evidence IV. Retrospective case series.

  14. Influence of tonsil size on sagittal cephalometric measurements.

    Science.gov (United States)

    Diouf, Joseph Samba; Ngom, Papa Ibrahima; Fadiga, Mohamed Siddick; Badiane, Alpha; Diop-Ba, Khady; Sonko, Ousmane; Diagne, Falou

    2015-06-01

    The role of tonsils in the origin of sagittal skeletodental abnormalities has been widely discussed in the literature but remains controversial. Data on the probable relationship between enlarged tonsils and the presence of these abnormalities were subjective. The aim of this study was to quantify the relationship between the space occupied by the palatine tonsils and sagittal cephalometric measurements. A cross-sectional study was performed on a group of children divided into 5 subgroups according to the standardized tonsillar hypertrophy grading scale. Cephalometric measurements were recorded for each child. Data were analyzed using SPSS 20.0 for Windows. The strength of the association between tonsil grades and quantitative variables was assessed using Spearman's rank correlation coefficient (Rho). The level of significance was fixed at P=0.05. Lengths SN, t2-p3, h-Gn and Xi-pm, and angles I/F, I/SN, i/M, SNB, SNPog and SNGn were significantly and negatively correlated with grades. The ANB angle, the sagittal position of the pogonion and the angle of facial convexity were significantly and positively correlated with grades. Early evaluation of tonsil size can prevent certain skeletodental abnormalities in the sagittal plane caused by upper airway obstruction. Thus, more aggressive late treatments, which are not always as effective as when they are performed during childhood, can be avoided. Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.

  15. Radiological lumbar stenosis severity predicts worsening sagittal malalignment on full-body standing stereoradiographs.

    Science.gov (United States)

    Buckland, Aaron J; Ramchandran, Subaraman; Day, Louis; Bess, Shay; Protopsaltis, Themistocles; Passias, Peter G; Diebo, Bassel G; Lafage, Renaud; Lafage, Virginie; Sure, Akhila; Errico, Thomas J

    2017-05-17

    Patients with degenerative lumbar stenosis (DLS) adopt a forward flexed posture in an attempt to decompress neural elements. The relationship between sagittal alignment and severity of lumbar stenosis has not previously been studied. We hypothesized that patients with increasing radiological severity of lumbar stenosis will exhibit worsening sagittal alignment. This is a cross-sectional study. Our sample consists of patients who have DLS. Standing pelvic, regional, lower extremity and global sagittal alignment, and health-related quality of life (HRQoL) were the outcome measures. Patients with DLS were identified from a retrospective clinical database with corresponding full-body stereoradiographs. Exclusion criteria included coronal malalignment, prior spine surgery, spondylolisthesis>Grade 1, non-degenerative spinal pathology, or skeletal immaturity. Central stenosis severity was graded on axial T2-weighted magnetic resonance imaging (MRI) from L1-S1. Foraminal stenosis and supine lordosis was graded on sagittal T1-weighted images. Standing pelvic, regional, lower extremity, and global sagittal alignment were measured using validated software. The HRQoL measures were also analyzed in relation to severity of stenosis. A total of 125 patients were identified with DLS on appropriate imaging. As central stenosis grade increased, patients displayed significantly increasing standing T1 pelvic angle, pelvic tilt, sagittal vertical axis, and pelvic incidence-lumbar lordosis (pHRQoLs in central or foraminal stenosis. Severity of central lumbar stenosis as graded on MRI correlates with severity of sagittal malalignment. These findings support theories of sagittal malalignment as a compensatory mechanism for central lumbar stenosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Biomechanical comparison of sagittal-parallel versus non-parallel pedicle screw placement.

    Science.gov (United States)

    Farshad, Mazda; Farshad-Amacker, Nadja A; Bachmann, Elias; Snedeker, Jess G; Schmid, Samuel L

    2014-11-01

    While convergent placement of pedicle screws in the axial plane is known to be more advantageous biomechanically, surgeons intuitively aim toward a parallel placement of screws in the sagittal plane. It is however not clear whether parallel placement of screws in the sagittal plane is biomechanically superior to a non-parallel construct. The hypothesis of this study is that sagittal non-parallel pedicle screws do not have an inferior initial pull-out strength compared to parallel placed screws. The established lumbar calf spine model was used for determination of pull-out strength in parallel and non-parallel intersegmental pedicle screw constructs. Each of six lumbar calf spines (L1-L6) was divided into three levels: L1/L2, L3/L4 and L5/L6. Each segment was randomly instrumented with pedicle screws (6/45 mm) with either the standard technique of sagittal parallel or non-parallel screw placement, respectively, under fluoroscopic control. CT was used to verify the intrapedicular positioning of all screws. The maximum pull-out forces and type of failure were registered and compared between the groups. The pull-out forces were 5,394 N (range 4,221 N to 8,342 N) for the sagittal non-parallel screws and 5,263 N (range 3,589 N to 7,554 N) for the sagittal-parallel screws (p = 0.838). Interlevel comparisons also showed no statistically significant differences between the groups with no relevant difference in failure mode. Non-parallel pedicle screws in the sagittal plane have at least equal initial fixation strength compared to parallel pedicle screws in the setting of the here performed cadaveric calf spine experiments.

  17. Developing a System for Efficient Analysis of Lumbosacral Sagittal Balance

    Directory of Open Access Journals (Sweden)

    D. M. Zhuk

    2015-01-01

    Full Text Available Lumbosacral sagittal balance is the neutral vertical alignment in the sagittal plane to provide decreasing stress loading on muscular-ligamentous structures. The achieving sagittal balance is a basis to provide successful surgical treatment and minimize further complications. As of today, there is no standard quantitative evaluation method of sagittal lumbo-sacral balance, which allows conducting its effective analysis and planning surgical treatment taking into consideration the preservation of normal biomechanics of lumbosacral spine. The goal of the study is to develop a diagnostic system for individual correction of lumbo-sacral sagittal balance by the author’s method with automatic counting and optimized matching of data values based on a specified number of terms using medical visualization data. This study has been conducted with RMAPE’s Department of Traumatology and Orthopedic Surgery. To solve the problem, a random searching algorithm has been exploited. The stop condition of the algorithm was to achieve the objective function value in adjusted interval, initial points of which are the calculated (angular values. The interaction of the angular values, used in the proposed method has been investigated, and their proportional change has been proved. Moreover, the mathematical dependence among geometrical and anatomical parameters of lumbosacral spine has been determined. Based on conducted study, a number of algorithms enabling the automation of the individual determination of optimal lumbosacral balance’s parameters at preoperative planning stage for patients with vertebral column diseases have been created. This allows us to raise physician’s efficiency, minimize mid- and long-term risk of postoperative complications, and avoid reoperations, and prognosticate long-term complications already performed surgery.

  18. Pre- and postoperative spinopelvic sagittal balance in adolescent patients with lenke type 5 idiopathic scoliosis.

    Science.gov (United States)

    Yang, Xi; Liu, Limin; Song, Yueming; Zhou, Chunguang; Zhou, Zhongjie; Wang, Lei; Wang, Liang

    2015-01-15

    A retrospective study. To investigate the preoperative spinopelvic sagittal alignment in Lenke 5 patients with adolescent idiopathic scoliosis (AIS), and analyze how it alters after posterior correction. The structural thoracolumbar or lumbar curve may change the local sagittal alignment thereby altering the sagittal balance in Lenke 5 patients with AIS. However, few studies have evaluated the spinopelvic sagittal alignment before and after the surgery in these patients. Forty-eight Lenke 5 patients with AIS who underwent posterior correction and fusion were included in this study. Preoperative and postoperative radiographs were reviewed measuring both the coronal and sagittal parameters. Three pelvic sagittal states (anteverted, normal, or retroverted) were evaluated according to the magnitude relationship of individual pelvic tilt with pelvic incidence (PI). Both the coronal and sagittal parameters between different pelvic sagittal states were compared. The alterations of these parameters by surgery would also be analyzed. The mean follow-up was 1.8 years. Preoperatively, the mean PI was 44.3° with a pelvic tilt of 4.1°. There was 48% patients showing the anteverted pelvis, whereas the remaining 52% showing normal. The patients with anteverted pelvis showed a smaller PI and more distal lower end vertebra than normal pelvis ones. Logistic regression analysis revealed PI (odds ratio [OR] = 0.62, P = 0.024) and lower end vertebra (OR = 2.1, P = 0.037) were significantly associated with the risk of developing anteverted pelvis. The pelvic tilt was significantly increased and 61% of patients with preoperative anteverted pelvis had recovered. Logistic regression analysis revealed PI (OR = 0.7, P = 0.034) and lower instrumented vertebra (OR = 6.5, P = 0.002) were significantly associated with the risk of postoperative uncovered of anteverted pelvis. Anteverted pelvis appears in almost half of Lenke 5 patients with AIS, especially in who have smaller PI or distal lower

  19. Can coronal hole spicules reach coronal temperatures?

    Science.gov (United States)

    Madjarska, M. S.; Vanninathan, K.; Doyle, J. G.

    2011-08-01

    Aims: The present study aims to provide observational evidence of whether coronal hole spicules reach coronal temperatures. Methods: We combine multi-instrument co-observations obtained with the SUMER/SoHO and with the EIS/SOT/XRT/Hinode. Results: The analysed three large spicules were found to be comprised of numerous thin spicules that rise, rotate, and descend simultaneously forming a bush-like feature. Their rotation resembles the untwisting of a large flux rope. They show velocities ranging from 50 to 250 kms-1. We clearly associated the red- and blue-shifted emissions in transition region lines not only with rotating but also with rising and descending plasmas. Our main result is that these spicules although very large and dynamic, are not present in the spectral lines formed at temperatures above 300 000 K. Conclusions: In this paper we present the analysis of three Ca ii H large spicules that are composed of numerous dynamic thin spicules but appear as macrospicules in lower resolution EUV images. We found no coronal counterpart of these and smaller spicules. We believe that the identification of phenomena that have very different origins as macrospicules is due to the interpretation of the transition region emission, and especially the He ii emission, wherein both chromospheric large spicules and coronal X-ray jets are present. We suggest that the recent observation of spicules in the coronal AIA/SDO 171 Å and 211 Å channels probably comes from the existence of transition region emission there. Movie is available in electronic form at http://www.aanda.org

  20. Utility of coronal oblique slices in cervical spine MRI. Improved detection of the neuroforamina; Nutzen der halbkoronaren Schichtung im MRT der Halswirbelsaeule. Verbesserte Erkennbarkeit von Neuroforamina

    Energy Technology Data Exchange (ETDEWEB)

    Freund, W.; Hoepner, G. [Universitaetskliniken Ulm, Klinik fuer Diagnostische und Interventionelle Radiologie, Ulm (Germany); Klessinger, S. [Nova Clinic Biberach, Neurochirurgie, Biberach (Germany); Universitaetskliniken Ulm, Neurochirurgie, Ulm (Germany); Mueller, M. [Universitaetskliniken Ulm, Klinik fuer Diagnostische und Interventionelle Radiologie, Ulm (Germany); Universitaetskliniken Aachen, Diagnostische und Interventionelle Neuroradiologie, Aachen (Germany); Halatsch, M.E. [Universitaetskliniken Ulm, Neurochirurgie, Ulm (Germany); Weber, F. [Bundeswehrkrankenhaus Ulm, Neurologie, Ulm (Germany); Schmitz, B. [Universitaetskliniken Ulm, Neuroradiologie, Ulm (Germany)

    2015-11-15

    Angulated projections are standard in conventional radiography of the cervical spine, but rarely used in magnetic resonance imaging (MRI). As neuroforaminal pathology plays an important role in the etiology of radicular syndromes and may influence an operative approach, the utility of coronal oblique slices in MRI is explored. In a retrospective setting, 25 consecutive patients with neurologically diagnosed cervical monoradiculopathy were identified. T2-weighted sagittal, coronal oblique, and transversal slice orientations were anonymized. Two radiologists and two neurosurgeons independently assessed the cases. Criteria were site, cause, and grading of the neuroforaminal stenosis and the level of confidence on a 100-point visual analog scale (VAS). We computed interrater agreement, sensitivity, and t tests. Using only one slice orientation, the sensitivity in detecting the relevant neuroforamen was 0.40 for transversal, 0.68 for sagittal, and 0.64 for coronal oblique scans. A combination of the different angulations increased sensitivity and in 4 cases only the coronal oblique scans proved diagnostic. The readers felt significantly more confident in attributing the cause of the pathology on coronal oblique planes (a mean of 72 VAS points, p = 0.0003 vs 58 (sagittal) vs 64 (transversal)). Interrater agreement was significantly better for experienced (kappa 0. 48) than for inexperienced readers (0.32, p = 0.02). Adding coronal oblique planes in cervical spine MRI increases sensitivity and confidence in attributing the cause of neuroforaminal pathology. They are regarded as useful by all the readers. (orig.) [German] Im Gegensatz zur Magnetresonanztomographie (MRT) sind in der konventionellen Roentgendiagnostik der Halswirbelsaeule (HWS) Schraegaufnahmen Standard. Da neuroforaminale Pathologien wichtige Ursachen von radikulaeren Syndromen sind und die Operationstechnik moeglicherweise beeinflussen, wird der Nutzen halbkoronarer Schichten in der MRT untersucht. In

  1. [Sagittal balance of the spine].

    Science.gov (United States)

    Mangione, P; Sénégas, J

    1997-01-01

    The authors examined the modifications of sagittal shape and muscular functions in different vertebral diseases in order to investigate their correlations and to specify the role of hip extension in standing posture. We included 57 patients presenting various diseases, among which lumbar kyphosis, spondylosis and spondylolisthesis, backache and lumbar stenosis. We measured joint mobility (hip extension, lumbar flexion), muscular retractions (ilio-psoas, hamstrings, rectus femoris), and muscular strength (spine flexors and extensors, hamstrings, quadriceps femoris). On standing lateral x-rays, measurements were made of various spinal and pelvic parameters, among which the "pelvi-femoral angle", proposed by the authors for hip extension evaluation. There was a significant correlation between pelvi-femoral angle and pelvic backward tilting (r = 0.8037 p tilt-up arise compensating the anterior displacement of the center of gravity, while in spondylolisthesis, anterior displacement is secondary to sacral obliquity. It is very important to evaluate the pelvis position in sagittal spinal diseases, in order to understand postural deterioration mechanisms. Lumbar kyphosis and spondylolisthesis are two examples of failure of upright posture.

  2. Lumbar Lordosis Minus Thoracic Kyphosis: A Novel Regional Predictor for Sagittal Balance in Elderly Populations.

    Science.gov (United States)

    Yang, Changwei; Yang, Mingyuan; Wei, Xianzhao; Shao, Jie; Chen, Yuanyuan; Zhao, Jian; Zhu, Xiaodong; He, Dawei; Li, Ming

    2016-03-01

    A retrospective study. The aim of this study is to introduce a novel regional predictor for sagittal balance in elderly populations and explore its effectiveness of evaluating sagittal balance. Sagittal balance is getting increasing recognition of importance due to its significant association of health-related quality of life. However, no regional parameters could well reflect and predict the whole sagittal balance. Medical records of elderly patients in our outpatient clinic from January 2012 to January 2014 were reviewed with standing full-spine lateral radiograph. Radiological parameters were evaluated, including max thoracic kyphosis (maxTK), max lumbar lordosis (maxLL), LL minus TK(LL-TK), PI minus LL (PI-LL), sacrum slope (SS), pelvic tilt (PT), pelvic incidence (PI), and SVA (sagittal vertical axis). Correlation analysis between SVA, LL-TK, and other radiological spinopelvic parameters and was pursued. Patients were divided into two groups according to whether patients were well-aligned in sagittal plane: Group A (well-aligned, SVA ≤50  mm) and Group B (poorly aligned, SVA >50  mm), and demographic and sagittal parameters were compared. LL-TK ≥0° and PI-LL ≤13° were used as a threshold value to evaluate their effectiveness of prediction for sagittal balance. A total of 129 patients (M: 25 and F: 104) were included in this study. SVA was significantly correlated with NRS (numeric rating scales), age, maxLL, PT, LL-TK, and PI-LL (all, P 13°, 34 patients were poorly aligned (34/39, 87%). LL-TK was a good regional predictor for sagittal balance in elderly population, especially combined with PI-LL. 4.

  3. Coronal Waves and Oscillations

    Directory of Open Access Journals (Sweden)

    Nakariakov Valery M.

    2005-07-01

    Full Text Available Wave and oscillatory activity of the solar corona is confidently observed with modern imaging and spectral instruments in the visible light, EUV, X-ray and radio bands, and interpreted in terms of magnetohydrodynamic (MHD wave theory. The review reflects the current trends in the observational study of coronal waves and oscillations (standing kink, sausage and longitudinal modes, propagating slow waves and fast wave trains, the search for torsional waves, theoretical modelling of interaction of MHD waves with plasma structures, and implementation of the theoretical results for the mode identification. Also the use of MHD waves for remote diagnostics of coronal plasma - MHD coronal seismology - is discussed and the applicability of this method for the estimation of coronal magnetic field, transport coefficients, fine structuring and heating function is demonstrated.

  4. Critérios mecânicos para progressão de exercícios de rotação interna e externa do ombro no plano sagital Mechanical criteria for progression in internal and external rotation exercises of the shoulder in the sagittal plane

    Directory of Open Access Journals (Sweden)

    JM Toledo

    2007-02-01

    progression in internal rotation (IR and external rotation (ER exercises of the shoulder in the sagittal plane. METHOD: Six individuals were assessed using an isokinetic dynamometer and an electrogoniometer. From the data collected, the mean torque, mean resultant force and weighted mean moment arm were calculated using the SAD32 and Matlab® software. RESULTS: The angles at which the peak ER and IR torque occurred were -34° and 6º with values of 43 Nm and 69 Nm, respectively. The peaks for ER and IR muscle force were at 35º and -14º, and the values at these angles were 10227 N and 8464 N, respectively. The weighted mean moment arm for ER presented an increasing pattern over the whole range of motion (ROM and the peak was at the end of the ROM, i.e. at -50º (0.91 cm. The weighted mean moment arm for IR was almost constant with its peak at 50º (0.96 cm. CONCLUSION: The mechanical criteria for progression in internal and external rotation exercises of the shoulder are torque, force and weighted mean moment arm because different overloads on the muscle-tendon structure can be caused according to their patterns over the ROM.

  5. The Relationship between T1 Sagittal Angle and Sagittal Balance: A Retrospective Study of 119 Healthy Volunteers

    OpenAIRE

    Yang, Mingyuan; Yang, Changwei; Ni, Haijian; Zhao, Yuechao; Li, Ming

    2016-01-01

    T1 sagittal angle has been reported to be used as a parameter for assessing sagittal balance and cervical lordosis. However, no study has been performed to explore the relationship between T1 sagittal angle and sagittal balance, and whether T1 sagittal angle could be used for osteotomy guidelines remains unknown. The aim of our study is to explore the relationship between T1 sagittal angle and sagittal balance, determine the predictors for T1 sagittal angle, and determine whether T1 sagittal ...

  6. Puerperal Superior Sagittal Sinus Thrombosis and Pulmonary ...

    African Journals Online (AJOL)

    Superior sagittal sinus thrombosis is a rare and often misdiagnosed disorder. Its occurrence with pulmonary embolism (PE) is much rarer, more so when it occurs in the setting of puerperium. Although cerebral sagittal sinus thrombosis can occur at any time during life, women are particularly vulnerable before delivery and ...

  7. Management of sagittal balance in adult spinal deformity with minimally invasive anterolateral lumbar interbody fusion: a preliminary radiographic study.

    Science.gov (United States)

    Manwaring, Jotham C; Bach, Konrad; Ahmadian, Amir A; Deukmedjian, Armen R; Smith, Donald A; Uribe, Juan S

    2014-05-01

    Minimally invasive (MI) fusion and instrumentation techniques are playing a new role in the treatment of adult spinal deformity. The open pedicle subtraction osteotomy (PSO) and Smith-Petersen osteotomy (SPO) are proven segmental methods for improving regional lordosis and global sagittal parameters. Recently the MI anterior column release (ACR) was introduced as a segmental method for treating sagittal imbalance. There is a paucity of data in the literature evaluating the alternatives to PSO and SPO for sagittal balance correction. Thus, the authors conducted a preliminary retrospective radiographic review of prospectively collected data from 2009 to 2012 at a single institution. The objectives of this study were to: 1) investigate the radiographic effect of MI-ACR on spinopelvic parameters, 2) compare the radiographic effect of MI-ACR with PSO and SPO for treatment of adult spinal deformity, and 3) investigate the radiographic effect of percutaneous posterior spinal instrumentation on spinopelvic parameters when combined with MI transpsoas lateral interbody fusion (LIF) for adult spinal deformity. Patient demographics and radiographic data were collected for 36 patients (9 patients who underwent MI-ACR and 27 patients who did not undergo MI-ACR). Patients included in the study were those who had undergone at least a 2-level MI-LIF procedure; adequate preoperative and postoperative 36-inch radiographs of the scoliotic curvature; a separate second-stage procedure for the placement of posterior spinal instrumentation; and a diagnosis of degenerative scoliosis (coronal Cobb angle > 10° and/or sagittal vertebral axis > 5 cm). Statistical analysis was performed for normality and significance testing. Percutaneous transpedicular spinal instrumentation did not significantly alter any of the spinopelvic parameters in either the ACR group or the non-ACR group. Lateral MI-LIF alone significantly improved coronal Cobb angle by 16°, and the fractional curve significantly

  8. Brain structure in sagittal craniosynostosis

    Science.gov (United States)

    Paniagua, Beatriz; Kim, Sunghyung; Moustapha, Mahmoud; Styner, Martin; Cody-Hazlett, Heather; Gimple-Smith, Rachel; Rumple, Ashley; Piven, Joseph; Gilmore, John; Skolnick, Gary; Patel, Kamlesh

    2017-03-01

    Craniosynostosis, the premature fusion of one or more cranial sutures, leads to grossly abnormal head shapes and pressure elevations within the brain caused by these deformities. To date, accepted treatments for craniosynostosis involve improving surgical skull shape aesthetics. However, the relationship between improved head shape and brain structure after surgery has not been yet established. Typically, clinical standard care involves the collection of diagnostic medical computed tomography (CT) imaging to evaluate the fused sutures and plan the surgical treatment. CT is known to provide very good reconstructions of the hard tissues in the skull but it fails to acquire good soft brain tissue contrast. This study intends to use magnetic resonance imaging to evaluate brain structure in a small dataset of sagittal craniosynostosis patients and thus quantify the effects of surgical intervention in overall brain structure. Very importantly, these effects are to be contrasted with normative shape, volume and brain structure databases. The work presented here wants to address gaps in clinical knowledge in craniosynostosis focusing on understanding the changes in brain volume and shape secondary to surgery, and compare those with normally developing children. This initial pilot study has the potential to add significant quality to the surgical care of a vulnerable patient population in whom we currently have limited understanding of brain developmental outcomes.

  9. Mechanisms of Coronal Heating

    Indian Academy of Sciences (India)

    The Sun is a mysterious star. The high temperature of the chromosphere and corona present one of the most puzzling problems of solar physics. Observations show that the solar coronal heating problem is highly complex with many different facts. It is likely that different heating mechanisms are at work in solar corona.

  10. Effect of mono- or bisegmental lordosizing fusion on short term global and index sagittal balance: a radiographic study.

    Science.gov (United States)

    Tessitore, Enrico; Melloni, Ilaria; Gautschi, Oliver P; Zona, Gianluigi; Schaller, Karl; Berjano, Pedro

    2016-11-17

    Sagittal balance is widely recognized as an important outcome factor in reconstructive spinal surgery for lumbar degenerative conditions. However, its role in short segmental fixation is unknown. The aim of this study is to evaluate the preoperative and short-term postoperative spino-pelvic balance after short (1 or 2 levels) lordosizing lumbar fusion for degenerative disc disease (DDD). Twenty-six consecutive patients (13 males and 13 females) undergoing mono- or bisegmental lordosizing lumbar fusion (XLIF/TLIF) for lumbar DDD were included in the study. Clinical parameters were retrospectively collected from charts. Preoperative and early postoperative (6 weeks and 3 months) full-spine EOS x-rays were evaluated. Spinal parameters evaluating sagittal curvatures, pelvic orientation, global sagittal and coronal alignment, spino-pelvic balance, index level segmental lordosis and disc height were measured and statistically analyzed. A total of n=16 TLIF and n=10 XLIF procedures were performed. N=18 were mono- and n=8 were bisegmental fixations for a total of 34 fused segments. N=7 patients (26.9%) showed a preoperative sagittal imbalance (defined as SVA >50 mm), n=7 patients presented preoperative severe pelvic retroversion (defined as PT>20°) and one patient had both. Disc height, intervertebral angle and segmental lordosis at the operated level significantly increased after surgery (psagittal alignment (SVA, TPA, T1SPi, T9SPi), pelvic orientation (SS, PT), coronal alignment, lumbar and L4-S1 lordosis and thoracic kyphosis has been observed. Mono- and bisegmental lordosizing fusion techniques, as XLIF and TLIF, are able to restore disc height and improve segmental lordosis. However they do not allow restoration of sagittal balance or improvement of compensatory mechanisms. A limited spinal reconstructive surgery on symptomatic levels can be reasonably proposed to patients with hidden or evident sagittal imbalance with any short-term radiographic impact.

  11. Impact of Fatigue on Maintenance of Upright Posture: Dynamic Assessment of Sagittal Spinal Deformity Parameters After Walking 10 Minutes.

    Science.gov (United States)

    Bae, Junseok; Theologis, Alexander A; Jang, Jee-Soo; Lee, Sang-Ho; Deviren, Vedat

    2017-05-15

    Retrospective analysis of prospectively collected data. To assess global and regional spinal sagittal radiographic parameters in adults with loss of lumbar lordosis ("flatback") before and after walking 10 minutes. While routine activities of daily living may exacerbate functional disability of spinal sagittal-plane deformity, there is limited understanding of how sagittal parameters and compensatory mechanisms are affected by activity. Consecutive adults with "flatback" at a single institution who previously had full-length standing spinal radiographs before and after walking 10 minutes were reviewed. Changes in spinal deformity sagittal parameters before and after walking were evaluated for two groups: Compensated Sagittal Deformity ("Compensated": sagittal vertical axis [SVA] ≤4 cm and pelvic tilt [PT] >20°) and Decompensated Sagittal Deformity ("Decompensated": SVA>4 cm and PT>20°). Intra-group radiographic comparisons were performed with paired Student t tests. One hundred fifty-seven patients (143 females, 14 males; average age 67.9 ± 5.9 yr) met inclusion criteria. Initial average SVA was 1.7 ± 1.2 cm for "Compensated" and 11.5 ± 6.4 cm for "Decompensated." After walking 10 minutes, significant deteriorations in average SVA were observed for all "Decompensated" patients and 84.6% of "Compensated" patients. For both groups, this was accompanied by significant decreases in PT and LL and increases in PI-LL (P spinal deformity are less pronounced than when the patient initially presents. This results in significant sagittal decompensation, irrespective of the initial SVA. As we postulate that loss of compensatory mechanisms is due to fatigue on pelvic and spinal extensor muscles, sagittal parameters can be re-evaluated with radiographs obtained after patients walk 10 minutes to unmask a hidden sagittal imbalance in compensated deformities. 3.

  12. Contribution of thin slice (1 mm) oblique coronal proton density-weighted MR images for assessment of anteromedial and posterolateral bundle damage in anterior cruciate ligament injuries

    Energy Technology Data Exchange (ETDEWEB)

    Gokalp, Gokhan, E-mail: drgokhangokalp@yahoo.com [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Demirag, Burak, E-mail: bdemirag@uludag.edu.tr [Department of Orthopedy, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Nas, Omer Fatih, E-mail: omerfatihnas@gmail.com [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Aydemir, Mehmet Fatih, E-mail: fatiha@yahoo.com [Department of Orthopedy, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Yazici, Zeynep, E-mail: zyazici@uludag.edu.tr [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey)

    2012-09-15

    Purpose: To evaluate the diagnostic efficacy of using additional oblique coronal 1 mm proton density-weighted (PDW) MR imaging of the knee for detection and grading anterior cruciate ligament (ACL), anteromedial bundle (AMB) and posterolateral bundle (PLB) injuries. Materials and methods: We prospectively assessed preoperative MR images of 50 patients (36 men, 14 women; age range, 18–62 years). First, we compared the diagnostic performance of routine sagittal (3 mm) and additional oblique coronal images (1 mm) for ACL tears. Then, we compared the tear types (AMB or PLB) and grade presumed from oblique coronal MR imaging with arthroscopy. Results: Arthroscopy revealed ACL tear in 24 (48%) patients. There was significant difference between sagittal images and arthroscopy results for ACL tear recognition (p < 0.001). No significant difference was detected for oblique coronal images when compared with arthroscopy results (p = 0.180). Sensitivity and specificity values for ACL tear diagnosis were 37.04% and 95.65% for sagittal images; 74.07% and 91.30% for oblique coronal images. There was no significant difference between arthroscopy and oblique coronal MR images in grading AMB and PLB injuries (p > 0.05). Conclusion: Addition of thin slice oblique coronal images to conventional sequences could better contribute to better verifying the presence of ACL tear and in determining its grade.

  13. Analysis of sagittal spinopelvic parameters in achondroplasia.

    Science.gov (United States)

    Hong, Jae-Young; Suh, Seung-Woo; Modi, Hitesh N; Park, Jong-Woong; Park, Jung-Ho

    2011-08-15

    Prospective radiological analysis of patients with achondroplasia. To analyze sagittal spinal alignment and pelvic orientation in achondroplasia patients. Knowledge of sagittal spinopelvic parameters is important for the treatment of achondroplasia, because they differ from those of the normal population and can induce pain. The study and control groups were composed of 32 achondroplasia patients and 24 healthy volunteers, respectively. All underwent lateral radiography of the whole spine including hip joints. The radiographic parameters examined were sacral slope (SS), pelvic tilt, pelvic incidence (PI), S1 overhang, thoracic kyphosis, T10-L2 kyphosis, lumbar lordosis (LL1, LL2), and sagittal balance. Statistical analysis was performed to identify significant differences between the two groups. In addition, correlations between parameters and symptoms were sought. Sagittal spinopelvic parameters, namely, pelvic tilt, pelvic incidence, S1 overhang, thoracic kyphosis, T10-L2 kyphosis, lumbar lordosis 1 and sagittal balance were found to be significantly different in the patient and control groups (P achondroplasia patients and normal healthy controls. The present study shows that sagittal spinal and pelvic parameters can assist the treatment of spinal disorders in achondroplasia patients.

  14. Which cardiovascular magnetic resonance planes and sequences provide accurate measurements of branch pulmonary artery size in children with right ventricular outflow tract obstruction?

    Science.gov (United States)

    Vijarnsorn, Chodchanok; Rutledge, Jennifer M; Tham, Edythe B; Coe, James Y; Quinonez, Luis; Patton, David J; Noga, Michelle

    2014-02-01

    Children with right ventricular outflow tract obstructive (RVOTO) lesions require precise quantification of pulmonary artery (PA) size for proper management of branch PA stenosis. We aimed to determine which cardiovascular magnetic resonance (CMR) sequences and planes correlated best with cardiac catheterization and surgical measurements of branch PA size. Fifty-five children with RVOTO lesions and biventricular circulation underwent CMR prior to; either cardiac catheterization (n = 30) or surgery (n = 25) within a 6 month time frame. CMR sequences included axial black blood, axial, coronal oblique and sagittal oblique cine balanced steady-state free precession (bSSFP), and contrast-enhanced magnetic resonance angiography (MRA) with multiplanar reformatting in axial, coronal oblique, sagittal oblique, and cross-sectional planes. Maximal branch PA and stenosis (if present) diameter were measured. Comparisons of PA size on CMR were made to reference methods: (1) catheterization measurements performed in the anteroposterior plane at maximal expansion, and (2) surgical measurement obtained from a maximal diameter sound which could pass through the lumen. The mean differences (Δ) and intra class correlation (ICC) were used to determine agreement between different modalities. CMR branch PA measurements were compared to the corresponding cardiac catheterization measurements in 30 children (7.6 ± 5.6 years). Reformatted MRA showed better agreement for branch PA measurement (ICC > 0.8) than black blood (ICC 0.4-0.6) and cine sequences (ICC 0.6-0.8). Coronal oblique MRA and maximal cross sectional MRA provided the best correlation of right PA (RPA) size with ICC of 0.9 (Δ -0.1 ± 2.1 mm and Δ 0.5 ± 2.1 mm). Maximal cross sectional MRA and sagittal oblique MRA provided the best correlate of left PA (LPA) size (Δ 0.1 ± 2.4 and Δ -0.7 ± 2.4 mm). For stenoses, the best correlations were from coronal oblique MRA of right pulmonary artery (RPA) (Δ -0.2 ± 0.8 mm, ICC 0

  15. Coronal Mass Ejections

    CERN Document Server

    Kunow, H; Linker, J. A; Schwenn, R; Steiger, R

    2006-01-01

    It is well known that the Sun gravitationally controls the orbits of planets and minor bodies. Much less known, however, is the domain of plasma fields and charged particles in which the Sun governs a heliosphere out to a distance of about 15 billion kilometers. What forces activates the Sun to maintain this power? Coronal Mass Ejections (CMEs) and their descendants are the troops serving the Sun during high solar activity periods. This volume offers a comprehensive and integrated overview of our present knowledge and understanding of Coronal Mass Ejections (CMEs) and their descendants, Interplanetary CMEs (ICMEs). It results from a series of workshops held between 2000 and 2004. An international team of about sixty experimenters involved e.g. in the SOHO, ULYSSES, VOYAGER, PIONEER, HELIOS, WIND, IMP, and ACE missions, ground observers, and theoreticians worked jointly on interpreting the observations and developing new models for CME initiations, development, and interplanetary propagation. The book provides...

  16. Normal appearance of the esophagus in sagittal section. Measurement of the anteroposterior diameter with ECG gated MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Nakashima, Aiko; Nakashima, Kenshu; Seto, Hikaru; Kakishita, Masao [Toyama Medical and Pharmaceutical Univ. (Japan). Faculty of Medicine

    1996-03-01

    Sagittal images are valuable for determining the location and local extent of esophageal tumors. However, the normal appearance of the esophagus in sagittal section has not yet been analyzed well, although there have been a few reports on normal esophagus in the axial plane. In this study, the anteroposterior (AP) diameter of normal thoracic esophagus was measured in sagittal images using ECG gated magnetic resonance (MR) imaging, and compared with that of cadavers. In 78 subjects, 222 of 234 portions (95%) were depicted well when the esophagus was divided into three portions (upper thoracic, middle thoracic, and lower thoracic and abdominal). Almost all the AP diameters (96%) were within 15-16 mm. The data correlated well with the measurements in cadavers. The AP diameter of normal thoracic esophagus in sagittal section was considered to be up to 16 mm. These results might be of clinical use to evaluate the location and extent of esophageal tumors. (author)

  17. Additional merit of coronal STIR imaging for MR imaging of lumbar spine

    OpenAIRE

    Ranjana Gupta; Puneet Mittal; Amit Mittal; Kapish Mittal; Sharad Gupta; Ravleen Kaur

    2015-01-01

    Introduction: Back pain is a common clinical problem and is the frequent complaint for referral of lumbar spine magnetic resonance imaging (MRI). Coronal short tau inversion recovery sequence (STIR) can provide diagnostically significant information in small percentage of patients. Materials and Methods: MRI examinations of a total of 350 patients were retrospectively included in the study. MR sequences were evaluated in two settings. One radiologist evaluated sagittal and axial images only, ...

  18. The Relationship between T1 Sagittal Angle and Sagittal Balance: A Retrospective Study of 119 Healthy Volunteers.

    Science.gov (United States)

    Yang, Mingyuan; Yang, Changwei; Ni, Haijian; Zhao, Yuechao; Li, Ming

    2016-01-01

    T1 sagittal angle has been reported to be used as a parameter for assessing sagittal balance and cervical lordosis. However, no study has been performed to explore the relationship between T1 sagittal angle and sagittal balance, and whether T1 sagittal angle could be used for osteotomy guidelines remains unknown. The aim of our study is to explore the relationship between T1 sagittal angle and sagittal balance, determine the predictors for T1 sagittal angle, and determine whether T1 sagittal angle could be used for osteotomy guidelines to restore sagittal balance. Medical records of healthy volunteers in our outpatient clinic from January 2014 to August 2015 were reviewed, and their standing full-spine lateral radiographs were evaluated. Demographic and radiological parameters were collected and analyzed, including age, gender, T1 sagittal angle, maxTK, maxLL, SS, PT, and PI. Correlation coefficients between T1 sagittal angle and other spinopelvic parameters were determined. In addition, multiple regression analysis was performed to establish predictive radiographic parameters for T1 sagittal angle as the primary contributors. A total of 119 healthy volunteers were recruited in our study with a mean age of 34.7 years. It was found that T1 sagittal angle was correlated with maxTK with very good significance (r = 0.697, Psagittal angle could be predicted by using the following regression equation: T1 sagittal angle = 0.6 * maxTK-0.2 * maxLL + 8. In the healthy population, T1 sagittal angle could be considered as a useful parameter for sagittal balance; however, it could not be thoroughly replaced for SVA. maxTK was the primary contributor to T1 sagittal angle. According to this equation, we could restore sagittal balance by surgically changing thoracic kyphosis and lumbar lordosis, which could serve as a guideline for osteotomy.

  19. Magnetic fields and coronal heating

    Science.gov (United States)

    Golub, L.; Maxson, C.; Rosner, R.; Vaiana, G. S.; Serio, S.

    1980-01-01

    General considerations concerning the scaling properties of magnetic-field-related coronal heating mechanisms are used to build a two-parameter model for the heating of closed coronal regions. The model predicts the way in which coronal temperature and electron density are related to photospheric magnetic field strength and the size of the region, using the additional constraint provided by the scaling law of Rosner, Tucker, and Vaiana. The model duplicates the observed scaling of total thermal energy content with total longitudinal flux; it also predicts a relation between the coronal energy density (or pressure) and the longitudinal field strength modified by the region scale size.

  20. Coronal Magnetic Field Models

    Science.gov (United States)

    Wiegelmann, Thomas; Petrie, Gordon J. D.; Riley, Pete

    2017-09-01

    Coronal magnetic field models use photospheric field measurements as boundary condition to model the solar corona. We review in this paper the most common model assumptions, starting from MHD-models, magnetohydrostatics, force-free and finally potential field models. Each model in this list is somewhat less complex than the previous one and makes more restrictive assumptions by neglecting physical effects. The magnetohydrostatic approach neglects time-dependent phenomena and plasma flows, the force-free approach neglects additionally the gradient of the plasma pressure and the gravity force. This leads to the assumption of a vanishing Lorentz force and electric currents are parallel (or anti-parallel) to the magnetic field lines. Finally, the potential field approach neglects also these currents. We outline the main assumptions, benefits and limitations of these models both from a theoretical (how realistic are the models?) and a practical viewpoint (which computer resources to we need?). Finally we address the important problem of noisy and inconsistent photospheric boundary conditions and the possibility of using chromospheric and coronal observations to improve the models.

  1. Puerperal Superior Sagittal Sinus Thrombosis and Pulmonary ...

    African Journals Online (AJOL)

    Superior sagittal sinus thrombosis is a rare and often misdiagnosed disorder. Its occurrence with pulmonary embolism (PE) .... and prolonged immobilization, hence, the possibility that her PE could have resulted from superior ... been forgotten and was alluded to by Diaz etal., as “a syndrome rediscovered in their report.”[20].

  2. Lumbosacral transitional vertebra and S1 radiculopathy: the value of coronal MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bezuidenhout, Abraham Fourie; Lotz, Jan Willem [Stellenbosch University, Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Tygerberg (South Africa)

    2014-06-15

    The association of a lumbosacral transitional vertebra with accelerated degeneration of the disc above has been described. Lumbosacral transitional vertebrae have also been reported as a cause of extraforaminal entrapment of the L5 nerve root between the transverse segment of the transitional vertebra and the sacral ala optimally demonstrated by coronal MRI. The association of the lumbosacral transitional vertebra pseudoarthroses and S1 nerve root entrapment due to degenerative stenosis of the nerve root canal has never been described. We present 12 patients with lumbosacral transitional vertebrae that were referred for symptoms and signs of S1 nerve root radiculopathy in which the sagittal and axial MRI sequences failed to identify a plausible cause for the patients' S1 nerve root symptoms. A coronal T1-weighted imaging (T1WI) MRI sequence was consequently added to the investigation. The coronal T1WI MRI sequence demonstrated hypertrophic degenerative stenosis of the S1 nerve root canal at the level of the lumbosacral transitional vertebra pseudoarthrosis, with entrapment of the respective S1 nerve root in all patients. We emphasize the value of coronal T1WI MRI of the lumbosacral junction and sacrum if the cause for S1 radicular symptoms was not identified on conventional sagittal and axial MRI sequences in patients with lumbosacral transitional vertebrae. (orig.)

  3. Additional merit of coronal STIR imaging for MR imaging of lumbar spine

    Directory of Open Access Journals (Sweden)

    Ranjana Gupta

    2015-01-01

    Full Text Available Introduction: Back pain is a common clinical problem and is the frequent complaint for referral of lumbar spine magnetic resonance imaging (MRI. Coronal short tau inversion recovery sequence (STIR can provide diagnostically significant information in small percentage of patients. Materials and Methods: MRI examinations of a total of 350 patients were retrospectively included in the study. MR sequences were evaluated in two settings. One radiologist evaluated sagittal and axial images only, while another radiologist evaluated all sequences, including coronal STIR sequence. After recording the diagnoses, we compared the MRI findings in two subsets of patients to evaluate additional merit of coronal STIR imaging. Results: With addition of coronal STIR imaging, significant findings were observed in 24 subjects (6.8%. Twenty-one of these subjects were considered to be normal on other sequences and in three subjects diagnosis was changed with the addition of coronal STIR. Additional diagnoses on STIR included sacroiliitis, sacroiliac joint degenerative disease, sacral stress/insufficiency fracture/Looser′s zones, muscular sprain and atypical appendicitis. Conclusion: Coronal STIR imaging can provide additional diagnoses in a small percentage of patients presenting for lumbar spine MRI for back pain. Therefore, it should be included in the routine protocol for MR imaging of lumbar spine.

  4. Additional merit of coronal STIR imaging for MR imaging of lumbar spine.

    Science.gov (United States)

    Gupta, Ranjana; Mittal, Puneet; Mittal, Amit; Mittal, Kapish; Gupta, Sharad; Kaur, Ravleen

    2015-01-01

    Back pain is a common clinical problem and is the frequent complaint for referral of lumbar spine magnetic resonance imaging (MRI). Coronal short tau inversion recovery sequence (STIR) can provide diagnostically significant information in small percentage of patients. MRI examinations of a total of 350 patients were retrospectively included in the study. MR sequences were evaluated in two settings. One radiologist evaluated sagittal and axial images only, while another radiologist evaluated all sequences, including coronal STIR sequence. After recording the diagnoses, we compared the MRI findings in two subsets of patients to evaluate additional merit of coronal STIR imaging. With addition of coronal STIR imaging, significant findings were observed in 24 subjects (6.8%). Twenty-one of these subjects were considered to be normal on other sequences and in three subjects diagnosis was changed with the addition of coronal STIR. Additional diagnoses on STIR included sacroiliitis, sacroiliac joint degenerative disease, sacral stress/insufficiency fracture/Looser's zones, muscular sprain and atypical appendicitis. Coronal STIR imaging can provide additional diagnoses in a small percentage of patients presenting for lumbar spine MRI for back pain. Therefore, it should be included in the routine protocol for MR imaging of lumbar spine.

  5. Coronal Mass Ejections: Observations

    Directory of Open Access Journals (Sweden)

    David F. Webb

    2012-06-01

    Full Text Available Solar eruptive phenomena embrace a variety of eruptions, including flares, solar energetic particles, and radio bursts. Since the vast majority of these are associated with the eruption, development, and evolution of coronal mass ejections (CMEs, we focus on CME observations in this review. CMEs are a key aspect of coronal and interplanetary dynamics. They inject large quantities of mass and magnetic flux into the heliosphere, causing major transient disturbances. CMEs can drive interplanetary shocks, a key source of solar energetic particles and are known to be the major contributor to severe space weather at the Earth. Studies over the past decade using the data sets from (among others the SOHO, TRACE, Wind, ACE, STEREO, and SDO spacecraft, along with ground-based instruments, have improved our knowledge of the origins and development of CMEs at the Sun and how they contribute to space weather at Earth. SOHO, launched in 1995, has provided us with almost continuous coverage of the solar corona over more than a complete solar cycle, and the heliospheric imagers SMEI (2003 – 2011 and the HIs (operating since early 2007 have provided us with the capability to image and track CMEs continually across the inner heliosphere. We review some key coronal properties of CMEs, their source regions and their propagation through the solar wind. The LASCO coronagraphs routinely observe CMEs launched along the Sun-Earth line as halo-like brightenings. STEREO also permits observing Earth-directed CMEs from three different viewpoints of increasing azimuthal separation, thereby enabling the estimation of their three-dimensional properties. These are important not only for space weather prediction purposes, but also for understanding the development and internal structure of CMEs since we view their source regions on the solar disk and can measure their in-situ characteristics along their axes. Included in our discussion of the recent developments in CME

  6. The "clamshell" craniotomy technique in treating sagittal craniosynostosis in older children.

    Science.gov (United States)

    Smyth, Matthew D; Tenenbaum, Marissa J; Kaufman, Christian B; Kane, Alex A

    2006-10-01

    Although most patients with sagittal craniosynostosis are recognized and treated in infancy, some children are not referred to craniofacial centers until later in childhood. In this paper the authors describe a novel operative technique for calvarial reconstruction in older children with previously untreated sagittal craniosynostosis. The authors report a clinical series of eight patients who were treated using novel single-stage calvarial reconstruction, and they assess the complications and outcomes. The patient is placed supine for the procedure, which consists of a coronal incision, bifrontal craniotomy without orbital osteotomy, and multiple interlocking midline parietooccipital osteotomies and recontouring. Fixation is achieved using a bioabsorbable plate system. Cranial indices were calculated from measurements obtained before and after the reconstructive procedures. Preoperative, intraoperative, and postoperative photographs and three-dimensional computed tomography scans are presented for review. Between November 2003 and April 2005, the authors treated seven boys (age range approximately 1-10 years, mean age 4.2 years) with uncorrected sagittal craniosynostosis and one with bicoronal and sagittal synostosis. The mean operating time was 5.13 hours (range 4.3-8 hours), with a mean blood loss of 425 ml (range 200-800 ml). As a percentage of the estimated circulating blood volume, the mean operative blood loss was 33.5% (range 17-57%). The mean hospital stay was 4.9 days. The cranial index significantly improved from a mean of 65.6 to 71.3% (p = 0.001). No acute or delayed complications have been noted. Follow-up examinations performed at an average of 12 months (range 1-17 months) have confirmed early patient and family satisfaction. An approach of aggressive calvarial reconstruction with multiple interleaving osteotomies crossing the midline achieves improvements in biparietal narrowing. Combined with a bifrontal reconstruction, early outcomes are excellent

  7. An overview of coronal seismology.

    Science.gov (United States)

    De Moortel, I

    2005-12-15

    The idea of exploiting observed oscillations as a diagnostic tool for determining the physical conditions of the coronal plasma was first suggested several decades ago (Roberts et al. 1984 Astrophys. J. 279, 857). Until recently, the application of this idea has been very limited by a lack of high-quality observations of coronal oscillations. However, during the last few years, this situation has changed dramatically, especially due to space-based observations by the Solar and Heliospheric Observatory and the Transition Region and Coronal Explorer and waves and oscillations have now been observed in a wide variety of solar structures, such as coronal loops, polar plumes and prominences. This paper will briefly summarize MHD wave theory, which forms the basis for coronal seismology, as well as present an overview of the variety of recently observed waves and oscillations in the solar corona. The present state of coronal seismology will also be discussed. Currently, the uncertainty associated with the obtained parameters is still considerable and, hence, the results require a cautious interpretation. However, these examples do show that coronal seismology is rapidly being transformed from a theoretical possibility to a viable technique.

  8. Ellis-van Creveld Syndrome with Sagittal Craniosynostosis.

    Science.gov (United States)

    Fischer, Andrew S; Weathers, William M; Wolfswinkel, Erik M; Bollo, Robert J; Hollier, Larry H; Buchanan, Edward P

    2015-06-01

    Ellis-van Creveld syndrome (EVC) is a rare disorder (the incidence is estimated at around 7/1,000,000) characterized by the clinical tetrad of chondrodystrophy, polydactyly, ectodermal dysplasia, and cardiac anomalies. Sagittal synostosis is characterized by a dolichocephalic head shape resulting from premature fusion of the sagittal suture. Both are rare disorders, which have never been reported together. We present a case of EVC and sagittal synostosis. We report the clinical features of a Hispanic boy with EVC and sagittal craniosynostosis who underwent cranial vault remodeling. The presentation of this patient is gone over in detail. A never before reported case of EVC and sagittal synostosis is presented in detail.

  9. Influence of mandibular fixation method on stability of the maxillary occlusal plane after occlusal plane alteration.

    Science.gov (United States)

    Yosano, Akira; Katakura, Akira; Takaki, Takashi; Shibahara, Takahiko

    2009-05-01

    In this study, we investigated how method of mandibular fixation influenced longterm postoperative stability of the maxilla in Class III cases. In particular, we investigated change in the maxillary occlusal plane after Occlusal Plane Alteration. Therefore, we focused on change in the palatal plane to evaluate stability of the maxillary occlusal plane, as the position of the palatal plane affects the maxillary occlusal plane. This study included 16 patients diagnosed with mandibular protrusion. Alteration of the occlusal plane was achieved by clockwise rotation of the maxilla by Le Fort I osteotomy and mandibular setback was performed by bilateral sagittal split ramus osteotomy. We analyzed and examined lateral cephalometric radiographs taken at 1 month, 3 months, 6 months, and 1 year after surgery. Stability achieved by two methods of mandibular fixation was compared. In one group of patients (group S) titanium screws were used, and in the other group (group P) titanium-locking mini-plates were used. No significant displacement was recognized in group S, whereas an approximately 0.7mm upward vertical displacement was recognized in the anterior nasal spine in group P. As a result, not only the angle of the palatal plane and S-N plane, but also occlusal plane angle in group P showed a greater decrease than that in group S. The results suggest that fixing the mandible with screws yielded greater stability of the maxilla and maxillary occlusal plane than fixing the mandible with titanium plates.

  10. A comparison of anterior and posterior instrumentation for restoring and retaining sagittal balance in patients with idiopathic adolescent scoliosis.

    Science.gov (United States)

    Tao, Fenghua; Wang, Zhiwei; Li, Ming; Pan, Feng; Shi, Zhicai; Zhang, Ye; Wu, Yungang; Xie, Yang

    2012-08-01

    Retrospective, comparative study. To compare the effects of anterior rod-screw instrumentation and posterior pedicle screw instrumentation on sagittal balance in patients with Lenke type 5 adolescent idiopathic scoliosis (AIS). Lenke type 5 AIS is treated by anterior or posterior spinal fusion surgery. Most studies comparing anterior and posterior fusion surgery have focused on assessing improvement in coronal balance. Studies comparing the effects of anterior and posterior surgery on sagittal balance are lacking. The records of 49 patients diagnosed with Lenke type 5 AIS were examined. A total of 21 patients underwent anterior surgery between 2000 and 2003, while 26 underwent posterior surgery between 2004 and 2006. Preoperative, postoperative, and follow-up thoracic kyphosis (T5-T12 and T2-T12), lumbar lordosis, thoracolumbar junction kyphosis, and spinal vertical axis measurements were made by examining radiographs. Quality of life was assessed using the Scoliosis Research Society-22 questionnaire. All patients were followed up for at least 2 years. There were no significant between group differences in coronal alignment, thoracic kyphosis, or T11-L2 alignment after surgery. Sagittal alignment improvement was significantly more pronounced in the anterior surgery group compared with the posterior surgery group. The fusion segment was also significantly shorter in the anterior surgery compared with the posterior surgery group. Quality of life scores were significantly higher in the anterior surgery group compared with the posterior surgery group. Anterior solid rod-screw instrumentation results in shorter fusion segments, and better sagittal alignment and quality of life than posterior pedicle screw instrumentation in patients with Lenke type 5 AIS.

  11. The Relationship between T1 Sagittal Angle and Sagittal Balance: A Retrospective Study of 119 Healthy Volunteers.

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    Mingyuan Yang

    Full Text Available T1 sagittal angle has been reported to be used as a parameter for assessing sagittal balance and cervical lordosis. However, no study has been performed to explore the relationship between T1 sagittal angle and sagittal balance, and whether T1 sagittal angle could be used for osteotomy guidelines remains unknown. The aim of our study is to explore the relationship between T1 sagittal angle and sagittal balance, determine the predictors for T1 sagittal angle, and determine whether T1 sagittal angle could be used for osteotomy guidelines to restore sagittal balance. Medical records of healthy volunteers in our outpatient clinic from January 2014 to August 2015 were reviewed, and their standing full-spine lateral radiographs were evaluated. Demographic and radiological parameters were collected and analyzed, including age, gender, T1 sagittal angle, maxTK, maxLL, SS, PT, and PI. Correlation coefficients between T1 sagittal angle and other spinopelvic parameters were determined. In addition, multiple regression analysis was performed to establish predictive radiographic parameters for T1 sagittal angle as the primary contributors. A total of 119 healthy volunteers were recruited in our study with a mean age of 34.7 years. It was found that T1 sagittal angle was correlated with maxTK with very good significance (r = 0.697, P<0.001, maxLL with weak significance (r = 0.206, P = 0.024, SS with weak significance (r = 0.237, P = 0.009, PI with very weak significance (r = 0.189, P = 0.039, SVA with moderate significance (r = 0.445, P<0.001, TPA with weak significance (r = 0.207, P = 0.023, and T1SPI with weak significance (r = 0.309, P = 0.001. The result of multiple regression analysis showed that T1 sagittal angle could be predicted by using the following regression equation: T1 sagittal angle = 0.6 * maxTK-0.2 * maxLL + 8. In the healthy population, T1 sagittal angle could be considered as a useful parameter for sagittal balance; however, it could not

  12. Analysis of sagittal balance of ankylosing spondylitis using spinopelvic parameters.

    Science.gov (United States)

    Lee, Jung Sub; Suh, Kuen Tak; Kim, Jeung Il; Goh, Tae Sik

    2014-05-01

    Prospective study. To analyze sagittal spinopelvic parameters in ankylosing spondylitis (AS) patients. There are little data on the relationship between the sagittal spinopelvic parameters and AS. The study and control groups comprised 90 AS patients and 40 controls. Participants were classified into 3 groups: normal (n=40), sagittal balance (n=58), and sagittal imbalance (n=32) groups. All underwent lateral radiograph of the whole spine including hip joints. The radiographic parameters were sacral slope, pelvic tilting, pelvic incidence, overhang of S1, thoracic kyphosis, lumbar lordosis, and C7 plumbline. Statistical analysis was performed to identify significant differences between the 2 groups. Correlations between radiological parameters and symptoms were sought. AS patients and controls were found to be significantly different in terms of sagittal balance, sacral slope, pelvic tilt, pelvic incidence, S1 overhang, and lumbar lordosis. However, no significant difference was observed between these 2 groups for thoracic kyphosis (P>0.05). Of the 90 AS patients, 32 patients (5 women and 27 men) were assigned to the sagittal imbalance group and 58 (12 women and 46 men) to the sagittal balance group. There was a significant difference in all sagittal parameters and visual analogue scale (VAS) score between these 2 groups. Correlation analysis revealed significant relationships between sagittal parameters in AS. However, there was no association between sacral slope and S1 overhang, and between pelvic incidence and VAS score. Stepwise logistic regression analysis revealed that pelvic tilt contributed significantly to sagittal balance. AS patients and normal controls were found to be significantly different in terms of sagittal spinopelvic parameters. Significant relationships were found between sagittal spinopelvic parameters in AS patients. Pelvic tilt was a significant parameter in determination of sagittal balance in AS patient. Furthermore, VAS scores were

  13. Stabbing Planes

    OpenAIRE

    Beame, Paul; Fleming, Noah; Impagliazzo, Russell; Kolokolova, Antonina; Pankratov, Denis; Pitassi, Toniann; Robere, Robert

    2017-01-01

    We introduce and develop a new semi-algebraic proof system, called Stabbing Planes that is in the style of DPLL-based modern SAT solvers. As with DPLL, there is only one rule: the current polytope can be subdivided by branching on an inequality and its "integer negation." That is, we can (nondeterministically choose) a hyperplane a x \\geq b with integer coefficients, which partitions the polytope into three pieces: the points in the polytope satisfying a x \\geq b, the points satisfying a x \\l...

  14. Heating solar coronal holes

    Science.gov (United States)

    Parker, E. N.

    1991-01-01

    It has been shown that the coronal hole, and the associated high-speed stream in the solar wind, are powered by a heat input of the order of 500,000 ergs/sq cm s, with most of the heat injected in the first 1-2 solar radii, and perhaps 100,000 ergs/sq cm s introduced at distances of several solar radii to provide the high speed of the issuing solar wind. The traditional view has been that this energy is obtained from Alfven waves generated in the subphotospheric convection, which dissipate as they propagate outward, converting the wave energy into heat. This paper reviews the generation of waves and the known wave dissipation mechanisms, to show that the necessary Alfven waves are not produced under the conditions presently understood to exist in the sun, nor would such waves dissipate significantly in the first 1-2 solar radii if they existed. Wave dissipation occurs only over distances of the order of 5 solar radii or more.

  15. Solar Coronal Plumes

    Directory of Open Access Journals (Sweden)

    Giannina Poletto

    2015-12-01

    Full Text Available Polar plumes are thin long ray-like structures that project beyond the limb of the Sun polar regions, maintaining their identity over distances of several solar radii. Plumes have been first observed in white-light (WL images of the Sun, but, with the advent of the space era, they have been identified also in X-ray and UV wavelengths (XUV and, possibly, even in in situ data. This review traces the history of plumes, from the time they have been first imaged, to the complex means by which nowadays we attempt to reconstruct their 3-D structure. Spectroscopic techniques allowed us also to infer the physical parameters of plumes and estimate their electron and kinetic temperatures and their densities. However, perhaps the most interesting problem we need to solve is the role they cover in the solar wind origin and acceleration: Does the solar wind emanate from plumes or from the ambient coronal hole wherein they are embedded? Do plumes have a role in solar wind acceleration and mass loading? Answers to these questions are still somewhat ambiguous and theoretical modeling does not provide definite answers either. Recent data, with an unprecedented high spatial and temporal resolution, provide new information on the fine structure of plumes, their temporal evolution and relationship with other transient phenomena that may shed further light on these elusive features.

  16. PARAMETERS FOR THE EVALUATION OF CERVICAL SAGITTAL BALANCE IN IDIOPATHIC SCOLIOSIS

    Directory of Open Access Journals (Sweden)

    MAURICIO COELHO LIMA

    Full Text Available ABSTRACT Objective: There are no values defined as standard in the literature for the parameters of assessment of cervical sagittal balance in patients with idiopathic scoliosis. This study describes the sagittal cervical parameters in patients with idiopathic scoliosis. Methods: Study carried out in a tertiary public hospital in patients with adolescent idiopathic scoliosis, through the evaluation of panoramic radiographs in lateral view. The Cobb method was used to evaluate cervical lordosis from C2 to C7, distance from the center of gravity (COG of the skull to C7, measurement of T1 slope, thoracic inlet angle (TIA, neck tilt, and plumb line from C7 to S1 (SVA C7-S1. A statistical analysis was performed, to demonstrate the relationship between the alignment of the thoracic spine in the sagittal plane and the cervical sagittal balance of patients with scoliosis. Results: Thirty-four patients were female (69.4% and 15 male (30.6%. The mean values for COG-C7 were 0.71 mm (median 0.8 mm/standard deviation [SD]= 0.51 mm. For Cobb C2-C7, the mean was -11.7° (median -10°/SD= 20.4°. The mean slope of T1 was 23.5° (median 25°/SD= 9.5°. The mean cervical version was 58.8° (median 60°/DP= 15.4°. The mean TIA was 81.8° (median 85°/SD= 16.7°. The mean plumb line C7-S1 was -0.28 (-0.3/SD= 1.0. Conclusion: The analysis of the results showed that the mean values for the cervical lordosis are lower than the values described as normal in the literature, suggesting a loss of sagittal cervical balance in these patients.

  17. Validation, repeatability and reproducibility of a noninvasive instrument for measuring thoracic and lumbar curvature of the spine in the sagittal plane Validade, repetibilidade e reprodutibilidade de um instrumento não-invasivo para medição das curvaturas torácica e lombar da coluna vertebral no plano sagital

    Directory of Open Access Journals (Sweden)

    Fabiana O. Chaise

    2011-12-01

    Full Text Available BACKGROUND: The need for early identification of postural abnormalities without exposing patients to constant radiation has stimulated the development of instruments aiming to measure the spinal curvatures. OBJECTIVE: To verify the validity, repeatability and reproducibility of angular measures of sagittal curvatures of the spine obtained using an adapted arcometer, by comparing them with Cobb angles of the respective curvatures obtained by using X-rays. METHODS: 52 participants were submitted to two procedures designed to evaluate the thoracic and lumbar curvatures: (1 X-ray examination from which the Cobb angles (CA of both curvatures were obtained, and (2 measuring the angles with the arcometer (AA. Two evaluators collected the data using the arcometer, with the rods placed at T1, T12, L1 and L5 spinous processes levels in a way as to permit linear measurements which, with aid of trigonometry, supplied the AA. RESULTS: There was a very strong and significant correlation between AA and CA (r=0.94; pCONTEXTUALIZAÇÃO: A necessidade de identificação precoce de alterações posturais, sem expor as pessoas à radiação constante, tem estimulado a construção de instrumentos para medir as curvaturas da coluna vertebral. OBJETIVO: Verificar a validade, repetibilidade e reprodutibilidade dos ângulos das curvaturas sagitais da coluna vertebral, obtidos por meio de um arcômetro adaptado, comparando-os com os ângulos de Cobb (AC das respectivas curvaturas, obtidos por meio de exames radiográficos. MÉTODOS: Cinquenta e dois indivíduos foram submetidos a dois procedimentos destinados a avaliar as curvaturas torácica e lombar: (1 exame de raios-X, a partir do qual os AC de ambas as curvaturas foram obtidos e (2 medição dos ângulos das curvaturas com o arcômetro (AA. Dois avaliadores coletaram os dados usando o arcômetro com as hastes sobre os processos espinhosos T1, T12, L1 e L5, de modo a permitir medidas que, com auxílio de

  18. Determination of craniofacial relation among the subethnic Indian population: A modified approach - (Sagittal relation

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    A Sumathi Felicita

    2012-01-01

    Full Text Available Aim : To measure the linear cephalometric dimensions of anterior and posterior segments of the craniofacial complex sagittally, to establish ratios between different linear dimensions of sagittal segments and check for dimensional balance among the various segments in subjects with normal occlusion, pleasing profile and facial harmony. Setting and Sample Population : Department of Orthodontics, Saveetha University. Lateral cephalograms of 120 subjects of both sexes in the age group of 17-28 years with normal occlusion belonging to Chennai, India Materials and Methods : Linear dimensions of anterior and posterior segments of the craniofacial complex were measured sagittally with the posterior maxillary plane as a key reference plane. Ratios were established between the various parameters in the anterior and posterior region. Results : A ratio of 1:1 was found to exist between the individual and aggregate sagittal segments of the craniofacial complex in both sexes. There was a statistically significant sexual dimorphism in the aggregate lengths(P=0.028,P=0.005.However, the ratio between the anterior cranial floor and effective maxillary length was 2:3 and 5:8 and that between anterior cranial floor to effective mandibular length was 5:8 and 3:5 in females and males respectively. The difference in the above values was not statistically significant. Conclusion : A dimensional balance was found to exist between the maxilla and mandible both at the dentoalveolar and skeletal level with a ratio of 1:1. There was also a dimensional balance between the posterior cranial floor and ramus width. However, there was no architectural balance between the anterior cranial floor and maxilla and mandible.

  19. The Sagittal Pelvic Thickness: A Determining Parameter for the Regulation of the Sagittal Spinopelvic Balance

    OpenAIRE

    Jean, Legaye

    2013-01-01

    Objective. To propose and validate a dimensional parameter, the sagittal pelvic thickness (SPT) (distance between the middle point of the upper sacral plate and the femoral heads axis, expressed as a ratio with the length of the upper plate of S1: (SPT/S1) for the analysis of the sagittal balance of the pelvispinal unit. Methods. The parameters were analysed on standing radiographic imaging and compared for normal, low back pain, children, and spondylolysis cases. Results. Values of SPT/S1 we...

  20. The Coronal Monsoon: Thermal Nonequilibrium Revealed by Periodic Coronal Rain

    Science.gov (United States)

    Auchère, Frédéric; Froment, Clara; Soubrié, Elie; Antolin, Patrick; Oliver, Ramon; Pelouze, Gabriel

    2018-02-01

    We report on the discovery of periodic coronal rain in an off-limb sequence of Solar Dynamics Observatory/Atmospheric Imaging Assembly images. The showers are co-spatial and in phase with periodic (6.6 hr) intensity pulsations of coronal loops of the sort described by Auchère et al. and Froment et al. These new observations make possible a unified description of both phenomena. Coronal rain and periodic intensity pulsations of loops are two manifestations of the same physical process: evaporation/condensation cycles resulting from a state of thermal nonequilibrium. The fluctuations around coronal temperatures produce the intensity pulsations of loops, and rain falls along their legs if thermal runaway cools the periodic condensations down and below transition-region temperatures. This scenario is in line with the predictions of numerical models of quasi-steadily and footpoint heated loops. The presence of coronal rain—albeit non-periodic—in several other structures within the studied field of view implies that this type of heating is at play on a large scale.

  1. Influence of intentional femoral component flexion in navigated TKA on gap balance and sagittal anatomy.

    Science.gov (United States)

    Roßkopf, J; Singh, P K; Wolf, P; Strauch, M; Graichen, H

    2014-03-01

    Navigation has proven its ability to accurately restore coronal leg axis; however, for a good clinical outcome, other factors such as sagittal anatomy and balanced gaps are at least as important. In a gap-balanced technique, the size of the flexion gap is equalled to that of the extension gap. Flexion of the femoral component has been described as a theoretical possibility to balance flexion and extension gap. Aim of this study was to assess whether intentional femoral component flexion is helpful in balancing TKA gaps and in restoring sagittal anatomy. One hundred and thirty-one patients with TKA were included in this study. Implantation was performed in a navigated, gap-balanced, tibia-first technique. The femoral component flexion needed to equal flexion to extension gap was calculated based upon the navigation data. The sagittal diameter, the anterior and posterior offset were measured pre- and postoperatively based on the lateral radiographs. Medial and lateral gaps in extension and flexion as well as flexion/extension gap differences pre- and postoperatively were analysed. Additionally range of motion (ROM) and patient satisfaction (SF 12) were obtained. To achieve equal flexion and extension gap, the femoral component was flexed in 120 out of 131 patients showing mean flexion of 2.9° (SD 2.2°; navigation data) and 3.1° (SD 2.0°; radiological analysis), respectively. Based on this technique, it was possible to balance the extension gap (sagittal diameter was restored in 114 out of 131 cases (87%); however, anterior offset was significantly reduced by 1.3 mm (SD 3.9°), and posterior offset was significantly increased by 1.6 mm (SD 3.3°). No correlation between any navigation and radiological parameter was found with ROM and SF 12. The navigation-based, gap-balanced technique allows intentional flexion of the femoral component in order to balance gaps in more than 90% of primary TKA cases. Simultaneously, the sagittal diameter is restored in 87% of

  2. Value of sagittal color Doppler ultrasonography as a supplementary tool in the differential diagnosis of fetal cleft lip and palate

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myoung Seok [Dept. of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Cho, Jeong Yeon; Kim, Sang Youn; Kim, Seung Hyup [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Park, Joong Shin; Jun, Jong Kwan [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    2017-01-15

    The purpose of this study was to evaluate the feasibility and usefulness of sagittal color Doppler ultrasonography (CDUS) for the diagnosis of fetal cleft lip (CL) and cleft palate (CP). We performed targeted ultrasonography on 25 fetuses with CL and CP, taking coronal and axial images of the upper lip and maxillary alveolar arch in each case. The existence of defects in and malalignment of the alveolus on the axial image, hard palate defects on the midsagittal image, and flow-through defects on CDUS taken during fetal breathing or swallowing were assessed. We compared the ultrasonography findings with postnatal findings in all fetuses. Alveolar defects were detected in 16 out of 17 cases with CP and four out of eight cases with CL. Alveolar malalignment and hard palate defects were detected in 11 out of 17 cases and 14 out of 17 cases with CP, respectively, but not detected in any cases with CL. Communicating flow through the palate defect was detected in 11 out of 17 cases of CL with CP. The accuracy of detection in axial scans of an alveolar defect and malalignment was 80% and 76%, respectively. Accuracy of detection of in mid-sagittal images of hard palate defect and flow was 80% and 86%, respectively. The overall diagnostic accuracy of combined axial and sagittal images with sagittal CDUS was 92%. Sagittal CDUS of the fetal hard palate is a feasible method to directly reveal hard palate bony defects and flow through defects, which may have additional value in the differential diagnosis of fetal CL and CP.

  3. Intra- and inter-observer reliability of determining radiographic sagittal parameters of the spine and pelvis using a manual and a computer-assisted methods.

    Science.gov (United States)

    Dimar, John R; Carreon, Leah Y; Labelle, Hubert; Djurasovic, Mladen; Weidenbaum, Mark; Brown, Courtney; Roussouly, Pierre

    2008-10-01

    Sagittal imbalance is a significant factor in determining clinical treatment outcomes in patients with deformity. Measurement of sagittal alignment using the traditional Cobb technique is frequently hampered by difficulty in visualizing landmarks. This report compares traditional manual measurement techniques to a computer-assisted sagittal plane measurement program which uses a radius arc methodology. The intra and inter-observer reliability of the computer program has been shown to be 0.92-0.99. Twenty-nine lateral 90 cm radiographs were measured by a computer program for an array of sagittal plane measurements. Ten experienced orthopedic spine surgeons manually measured the same parameters twice, at least 48 h apart, using a digital caliper and a standardized radiographic manual. Intraclass correlations were used to determine intra- and interobserver reliability between different manual measures and between manual measures and computer assisted-measures. The inter-observer reliability between manual measures was poor, ranging from -0.02 to 0.64 for the different sagittal measures. The intra-observer reliability in manual measures was better ranging from 0.40 to 0.93. Comparing manual to computer-assisted measures, the ICC ranged from 0.07 to 0.75. Surgeons agreed more often with each other than with the machine when measuring the lumbar curve, the thoracic curve, and the spino-sacral angle. The reliability of the computer program is significantly higher for all measures except for lumbar lordosis. A computer-assisted program produces a reliable measurement of the sagittal profile of the spine by eliminating the need for distinctly visible endplates. The use of a radial arc methodology allows for infinite data points to be used along the spine to determine sagittal measurements. The integration of this technique with digital radiography's ability to adjust image contrast and brightness will enable the superior identification of key anatomical parameters normally

  4. Key aspects of coronal heating

    Science.gov (United States)

    Klimchuk, James A.

    2015-01-01

    We highlight 10 key aspects of coronal heating that must be understood before we can consider the problem to be solved. (1) All coronal heating is impulsive. (2) The details of coronal heating matter. (3) The corona is filled with elemental magnetic stands. (4) The corona is densely populated with current sheets. (5) The strands must reconnect to prevent an infinite build-up of stress. (6) Nanoflares repeat with different frequencies. (7) What is the characteristic magnitude of energy release? (8) What causes the collective behaviour responsible for loops? (9) What are the onset conditions for energy release? (10) Chromospheric nanoflares are not a primary source of coronal plasma. Significant progress in solving the coronal heating problem will require coordination of approaches: observational studies, field-aligned hydrodynamic simulations, large-scale and localized three-dimensional magnetohydrodynamic simulations, and possibly also kinetic simulations. There is a unique value to each of these approaches, and the community must strive to coordinate better. PMID:25897094

  5. Olecranon fractures with sagittal splits treated with dual fixation.

    Science.gov (United States)

    Morwood, Michael P; Ruch, David S; Leversedge, Fraser J; Mithani, Suhail K; Kamal, Robin N; Richard, Marc J

    2015-04-01

    To assess the results of olecranon fractures with an intra-articular sagittal plane fracture managed by orthogonal fixation constructs. A retrospective chart review was performed and 14 proximal ulna fractures with intra-articular comminution resulting in separate medial and lateral fragments were identified. All fractures were classified according to the Schatzker, Mayo, and AO classification systems. Postoperative functional assessment, Disabilities of the Arm, Shoulder, and Hand (DASH) score, time to union, and complications were recorded. Eleven patients were treated with both dorsal and lateral plates. Three patients were managed with a single dorsal plate and cerclage wires. All fractures healed. Mean length of follow-up was 15 months (range, 4-72 mo). Mean range of motion at final follow-up was a flexion-extension arc of 24° to 129° with 89° and 79° of pronation and supination, respectively. The most common complication was symptomatic hardware, leading to removal of hardware in 5 of 14 (36%) patients. Average postoperative Disabilities of the Arm, Shoulder, and Hand score was 7. Two patients developed heterotopic ossification and 1 patient required a local pedicled flap for soft-tissue coverage. Identification of this subset of fractures is critical to successful management. A supplemental lateral plate or cerclage wires can successfully manage these difficult fractures and achieve good outcomes. Therapeutic IV. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  6. Observational Analysis of Coronal Fans

    Science.gov (United States)

    Talpeanu, D.-C.; Rachmeler, L; Mierla, Marilena

    2017-01-01

    Coronal fans (see Figure 1) are bright observational structures that extend to large distances above the solar surface and can easily be seen in EUV (174 angstrom) above the limb. They have a very long lifetime and can live up to several Carrington rotations (CR), remaining relatively stationary for many months. Note that they are not off-limb manifestation of similarly-named active region fans. The solar conditions required to create coronal fans are not well understood. The goal of this research was to find as many associations as possible of coronal fans with other solar features and to gain a better understanding of these structures. Therefore, we analyzed many fans and created an overview of their properties. We present the results of this statistical analysis and also a case study on the longest living fan.

  7. Coronal Mass Ejections An Introduction

    CERN Document Server

    Howard, Timothy

    2011-01-01

    In times of growing technological sophistication and of our dependence on electronic technology, we are all affected by space weather. In its most extreme form, space weather can disrupt communications, damage and destroy spacecraft and power stations, and increase radiation exposure to astronauts and airline passengers. Major space weather events, called geomagnetic storms, are large disruptions in the Earth’s magnetic field brought about by the arrival of enormous magnetized plasma clouds from the Sun. Coronal mass ejections (CMEs) contain billions of tons of plasma and hurtle through space at speeds of several million miles per hour. Understanding coronal mass ejections and their impact on the Earth is of great interest to both the scientific and technological communities. This book provides an introduction to coronal mass ejections, including a history of their observation and scientific revelations, instruments and theory behind their detection and measurement, and the status quo of theories describing...

  8. Working group 3: Coronal streamers

    Science.gov (United States)

    Kopp, Roger A.

    1994-10-01

    The working group on coronal streamers convened on the first day of the 2nd SOHO Workshop, which took place in Marciana Marina, Isola d'Elba, 27 September 1 October 1993. Recent progress in streamer observational techniques and theoretical modeling was reported. The contribution of streamers to the mass and energy supply for the solar wind was discussed. Moreover, the importance of thin electric current sheets for determining both the gross dynamical properties of streamers and the fine-scale filamentary structure within streamers, was strongly emphasized. Potential advances to our understanding of these areas of coronal physics that could be made by the contingent of instruments aboard SOHO were pointed out.

  9. Working group 1: Coronal streamers

    Science.gov (United States)

    Kopp, R. A.

    1994-02-01

    The working group on coronal streamers convened on the first day of the 2nd SOHO Workshop, which took place in Marciana Marina, Isola d'Elba, 27 September--1 October 1993. Recent progress in streamer observational techniques and theoretical modeling was reported. The contribution of streamers to the mass and energy supply for the solar wind was discussed. Moreover, the importance of thin electric current sheets for determining both the gross dynamical properties of streamers and the fine-scale filamentary structure within streamers, was strongly emphasized. Potential advances to our understanding of these areas of coronal physics that could be made by the contingent of instruments aboard SOHO were shown.

  10. Craniosynostosis of coronal suture in Twist1+/- mice occurs through endochondral ossification recapitulating the physiological closure of posterior frontal suture

    Directory of Open Access Journals (Sweden)

    Bjorn eBehr

    2011-07-01

    Full Text Available Craniosynostosis, the premature closure of cranial suture, is a pathologic condition that affects 1/2000 live births. Saethre-Chotzen syndrome is a genetic condition characterized by craniosynostosis. The Saethre-Chotzen syndrome, which is defined by loss-of-function mutations in the TWIST gene, is the second most prevalent craniosynostosis. Although much of the genetics and phenotypes in craniosynostosis syndromes is understood, less is known about the underlying ossification mechanism during suture closure. We have previously demonstrated that physiological closure of the posterior frontal (PF suture occurs through endochondral ossification. Moreover, we revealed that antagonizing canonical Wnt signaling in the sagittal suture leads to endochondral ossification of the suture mesenchyme and sagittal synostosis, presumably by inhibiting Twist1. Classic Saethre-Chotzen syndrome is characterized by coronal synostosis, and the haploinsufficient Twist1+/- mice represents a suitable model for studying this syndrome. Thus, we seeked to understand the underlying ossification process in coronal craniosynostosis in Twist1+/- mice. Our data indicate that coronal suture closure in Twist1+/- mice occurs between postnatal day 9 to 13 by endochondral ossification, as shown by histology, gene expression analysis and immunohistochemistry. In conclusion, this study reveals that coronal craniosynostosis in Twist1+/- mice occurs through endochondral ossification. Moreover, it suggests that haploinsufficency of Twist1 gene, a target of canonical Wnt-signaling, and inhibitor of chondrogenesis, mimics conditions of inactive canonical Wnt-signaling leading to craniosynostosis.

  11. Finite element analysis of sagittal balance in different morphotype: Forces and resulting strain in pelvis and spine.

    Science.gov (United States)

    Filardi, Vincenzo; Simona, Portaro; Cacciola, Giorgio; Bertino, Salvatore; Soliera, Luigi; Barbanera, Andrea; Pisani, Alessandro; Milardi, Demetrio; Alessia, Bramanti

    2017-06-01

    In humans, vertical posture acquisition caused several changes in bones and muscles which can be assumed as verticalization. Pelvis, femur, and vertebral column gain an extension position which decreases muscular work by paravertebral muscles in the latter. It's widely known that six different morphological categories exist; each category differs from the others by pelvic parameters and vertebral column curvatures. Both values depend on the Pelvic Incidence, calculated as the angle between the axes passing through the rotation centre of the two femur heads and the vertical axis passing through the superior plate of the sacrum. The aim of this study is to evaluate the distribution of stress and the resulting strain along the axial skeleton using finite element analysis. The use of this computational method allows performing different analyses investigating how different bony geometries and skeletal structures can behavior under specific loading conditions. A computerized tomography (CT) of artificial bones, carried on at 1.5 mm of distance along sagittal, coronal and axial planes with the knee at 0° flexion (accuracy 0.5 mm), was used to obtain geometrical data of the model developed. Lines were imported into a commercial code (Hypermesh by Altair(®)) in order to interpolate main surfaces and create the solid version of the model. In particular six different models were created according Roussoly's classification, by arranging geometrical position of the skeletal components. Loading conditions were obtained by applying muscular forces components to T1 till to L5, according to a reference model (Daniel M. 2011), and a fixed constrain was imposed on the lower part of the femurs. Materials were assumed as elastic with an Elastic modulus of 15 GPa, a Shear Modulus of 7 GPa for bony parts, and an Elastic modulus of 6 MPa, a Shear Modulus of 3 MPa for cartilaginous parts. Six different simulations have been carried out in order to evaluate the mechanical behavior

  12. Exploring Coronal Structures with SOHO

    Indian Academy of Sciences (India)

    We applied advanced image enhancement techniques to explore in detail the characteristics of the small-scale structures and/or the low contrast structures in several Coronal Mass Ejections (CMEs) observed by SOHO. We highlight here the results from our studies of the morphology and dynamical evolution of CME ...

  13. Ellis–van Creveld Syndrome with Sagittal Craniosynostosis

    Science.gov (United States)

    Fischer, Andrew S.; Weathers, William M.; Wolfswinkel, Erik M.; Bollo, Robert J.; Hollier, Larry H.; Buchanan, Edward P.

    2014-01-01

    Ellis–van Creveld syndrome (EVC) is a rare disorder (the incidence is estimated at around 7/1,000,000) characterized by the clinical tetrad of chondrodystrophy, polydactyly, ectodermal dysplasia, and cardiac anomalies. Sagittal synostosis is characterized by a dolichocephalic head shape resulting from premature fusion of the sagittal suture. Both are rare disorders, which have never been reported together. We present a case of EVC and sagittal synostosis. We report the clinical features of a Hispanic boy with EVC and sagittal craniosynostosis who underwent cranial vault remodeling. The presentation of this patient is gone over in detail. A never before reported case of EVC and sagittal synostosis is presented in detail. PMID:26000085

  14. Craniotomy of the Fused Sagittal Suture Over the Superior Sagittal Sinus Is a Safe Procedure.

    Science.gov (United States)

    Kölby, David; Fischer, Sara; Arab, Khalid; Maltese, Giovanni; Olsson, Robert; Paganini, Anna; Tarnow, Peter; Kölby, Lars

    2017-05-01

    Spring-assisted cranioplasty to correct sagittal synostosis is based on midline craniotomy through the closed sagittal suture, over the superior sagittal sinus (SSS). The aim of the present study was to evaluate the perioperative safety of this technique. This is a retrospective study of all patients operated with median craniotomy and springs from 1998 to the end of 2015. For comparison, all Pi-plasties performed during the same time interval were also evaluated. The safety measures were evaluated based on incidence of damage to SSS, incidence of dural tears, perioperative blood loss, operative time, and hospital stay. In the group that had undergone midline craniotomy combined with springs (n = 225), 4 perioperative damages to SSS and 1 dural tear were seen. The perioperative blood loss was 62.8 ± 65.3 mL (mean ± standard deviation). The operative time was 67.9 ± 21.5 minutes and the hospital stay was 4.8 ± 1.1 days. In the group that had undergone pi-plasty (n = 105), no damages to SSS but 3 dural tears were seen. The perioperative blood loss was 352.8 ± 174.4 mL. The operative time was 126.0 ± 31.7 minutes and the hospital stay was 7.1 ± 1.4 days. Craniotomy SSS in sagittal synostosis is a safe procedure with low morbidity in terms of damage to the SSS. Midline craniotomy combined with springs has significantly lower preoperative blood loss, operative time, and hospital stay (P < 0.001 for all) compared to pi-plasty.

  15. A variability study of computerized sagittal spinopelvic radiologic measurements of trunk balance.

    Science.gov (United States)

    Berthonnaud, E; Labelle, H; Roussouly, P; Grimard, G; Vaz, G; Dimnet, J

    2005-02-01

    The accurate measurement of spinal and pelvic alignment in the sagittal plane is of prime importance for various disorders. Pelvic incidence (PI) is a fundamental anatomic parameter that is specific and constant for each adult individual and is related to pelvic orientation as well as to the size of lumbar lordosis (LL). It is the summation of the sacral slope (SS) and pelvic tilt (PT), two position-dependent variables that determine pelvic orientation in the sagittal plane. The authors have proposed a computer software designed to measure PI, SS, PT, LL, and thoracic kyphosis (TK) on standardized standing lateral digitized x-rays of the spine and pelvis. The purpose of this study was to evaluate the inter- and intraobserver variability of measurements using this software, to determine if it can be used reliably in a clinical environment. The standing lateral x-rays of 30 subjects were randomly selected from the database of two medical institutions. The normal population had standard radiographs on which the various pertinent landmarks were marked by one operator prior to digitization, whereas the scoliotic population had digital radiographs that obviated the need for prior marking of landmarks. Four individuals measured all variables on the 30 x-rays on two occasions, with a 15-day interval between the two sessions. Statistical analysis was done with intraclass correlation coefficients (ICCs). The ICC measured within observers was between 0.93 and 0.99, whereas the ICC between observers varied between 0.92 and 0.99. The variations observed were similar for normal and scoliotic subjects, and prior marking of the x-rays had no significant influence. We conclude that the variability of measurements with this method is lower than with similar radiologic measures done manually and that the use of this software can be recommended for future clinical and research studies of spinopelvic sagittal balance.

  16. Video analysis of sagittal spinal posture in healthy young and older adults.

    Science.gov (United States)

    Kuo, Yi-Liang; Tully, Elizabeth A; Galea, Mary P

    2009-01-01

    Changes in posture are of concern because of their association with pain or impaired physical function. Previous studies that have used computer-aided video motion analysis systems to measure posture have been compromised by the use of problematic models of skin marker placement. This study aimed to quantify and compare sagittal spinal posture in standing and sitting between young and older adults using a two-dimensional PEAK Motus system and a revised skin marker model. Twenty-four healthy young adults and 22 healthy older adults volunteered for this study. The angles of the upper and lower cervical spine, thoracic spine, lumbar spine as well as the orientations of the head, neck, and pelvic plane with respect to an external reference were measured in the standing and sitting positions. Compared to young adults, healthy older adults demonstrated a forward head posture, with increased lower cervical spine flexion and increased upper cervical extension in both positions. Older adults also sat with significantly increased thoracic kyphosis and decreased lumbar spine flexion. The angular relationship between adjacent spinal regions in the sagittal plane can be objectively quantified using image-based analysis. The concept that the anteroposterior tilt of the pelvis in standing dictates the lumbar and thoracic curves was supported by the correlations between these adjacent regions in both age groups. The model of skin marker placement used in this study can have a broader application as a clinical tool for image-based postural assessment.

  17. Grading Anterior Cruciate Ligament Graft Injury after Ligament Reconstruction Surgery: Diagnostic Efficacy of Oblique Coronal MR Imaging of the Knee

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Gyu; Hong, Sung Hwan; Choi, Ja Young; Jun, Woo Sun; Choi, Jung Ah; Park, Eun Ah; Kang, Heung Sik; Kwon, Jong Won [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2008-04-15

    Objective : The purpose of this study was to evaluate the diagnostic efficacy of using additional oblique coronal MRI of the knee for grading anterior cruciate ligament (ACL) graft injury after ligament reconstruction surgery. Materials and Methods : We retrospectively reviewed 51 consecutive MR knee examinations of 48 patients who underwent both ACL reconstruction and follow-up arthroscopy. The MR examinations included the orthogonal axial, sagittal, coronal images and the oblique coronal T2-weighted images, which were oriented in parallel with the course of the femoral intercondylar roof. Two radiologists independently evaluated the status of the ACL grafts with using the routine knee MRI and then with adding the oblique coronal imaging. The severity of ACL graft injury was graded using a 3-point system from MR images as intact, partial tear or complete tear, and the results were compared with the arthroscopic results. Weighted kappa statistics were used to analyze the diagnostic accuracies of the knee MRI with and without the additional oblique coronal imaging. For each evaluation, the observers reported a confidence level for grading the ACL graft injuries in the two imaging groups. Result : The weighted kappa values according to the routine knee MRI were 0.555 (reader 1) and 0.515 (reader 2). The inclusion of additional oblique coronal imaging increased the weighted kappa values to 0.666 (reader 1) and 0.611 (reader 2). The mean confidence levels by each reader were significantly higher (p < 0.01, paired t-test) with the additional oblique coronal imaging than by using the routine knee MRI alone. Conclusion : The additional use of oblique coronal MRI of the knee improves both the diagnostic accuracy and confidence for grading ACL graft injury.

  18. VLA Measurements of Faraday Rotation through Coronal Mass Ejections

    OpenAIRE

    Kooi, Jason E.; Fischer, Patrick D.; Buffo, Jacob J.; Spangler, Steven R.

    2016-01-01

    Coronal mass ejections (CMEs) are large-scale eruptions of plasma from the Sun that play an important role in space weather. Faraday rotation (FR) is the rotation of the plane of polarization that results when a linearly polarized signal passes through a magnetized plasma such as a CME. FR observations of a source near the Sun can provide information on the plasma structure of a CME shortly after launch. We report on simultaneous white-light and radio observations made of three CMEs in August...

  19. The influence of preoperative spinal sagittal balance on clinical outcomes after microendoscopic laminotomy in patients with lumbar spinal canal stenosis.

    Science.gov (United States)

    Dohzono, Sho; Toyoda, Hiromitsu; Matsumoto, Tomiya; Suzuki, Akinobu; Terai, Hidetomi; Nakamura, Hiroaki

    2015-07-01

    More information about the association between preoperative anterior translation of the C-7 plumb line and clinical outcomes after decompression surgery in patients with lumbar spinal canal stenosis (LSS) would help resolve problems for patients with sagittal imbalance. The authors evaluated whether preoperative sagittal alignment of the spine affects low-back pain and clinical outcomes after microendoscopic laminotomy. This study was a retrospective review of prospectively collected surgical data. The study comprised 88 patients with LSS (47 men and 41 women) who ranged in age from 39 to 86 years (mean age 68.7 years). All patients had undergone microendoscopic laminotomy at Osaka City University Graduate School of Medicine from May 2008 through October 2012. The minimum duration of clinical and radiological follow-up was 6 months. All patients were evaluated by Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) scores for low-back pain, leg pain, and leg numbness before and after surgery. The distance between the C-7 plumb line and the posterior corner of the sacrum (sagittal vertical axis [SVA]) was measured on lateral standing radiographs of the entire spine obtained before surgery. Radiological factors and clinical outcomes were compared between patients with a preoperative SVA ≥ 50 mm (forward-bending trunk [F] group) and patients with a preoperative SVA sagittal plane did not affect JOA scores after microendoscopic laminotomy in patients with LSS. However, low-back pain was worse for patients with preoperative anterior translation of the C-7 plumb line than for those without.

  20. Brace treatment of thoracolumbar kyphosis in spondylometaphyseal dysplasia with restoration of vertebral morphology and sagittal profile: a case report.

    Science.gov (United States)

    Ibrahim, Sameh; Labelle, Hubert; Mac-Thiong, Jean-Marc

    2015-06-01

    The Kozlowski type of spondylometaphyseal dysplasia (SMD-K) is characterized by vertebral and metaphyseal abnormalities. The longitudinal evolution of thoracolumbar kyphosis associated with vertebral anomalies in SMD-K is unclear. To document the longitudinal changes in sagittal alignment and vertebral morphology in a patient with SMD-K treated nonoperatively with a Milwaukee brace. Case report. Patient with SMD-K having multiple vertebral anomalies and a thoracolumbar kyphosis. A girl with SMD-K seen initially at 21 months old was followed for 14 years. She presented with thoracolumbar kyphosis associated with multiple vertebral anomalies consisting primarily of hypoplasia at L1, beaking at L2, and ovoid shape of adjacent vertebrae. The patient was treated with a Milwaukee brace and followed until she was 16 years old. After initiation of brace treatment, the thoracolumbar kyphosis gradually resolved and she had a normal sagittal alignment at last follow-up. Normal vertebral morphology was also completely restored in the sagittal plane. The patient developed a main thoracic scoliosis that did not require additional treatment. Nonoperative treatment with bracing can be attempted in patients with SMD-K affected by thoracolumbar kyphosis and multiple vertebral anomalies, because full restoration of normal sagittal alignment and vertebral morphology is possible. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. FUNCTIONAL DISABILITY, SAGITTAL ALIGNMENT AND PELVIC BALANCE IN LUMBAR SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Luis Muñiz Luna

    2016-03-01

    Full Text Available ABSTRACT Objectives: To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360o circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation. Method: Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius. Results: Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases. Conclusion: The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.

  2. The usefulness of sagittal reformation for diagnosis of sternal fracture

    Energy Technology Data Exchange (ETDEWEB)

    Im, Dong Jin; Hahn, Seok; Kim, Young Ju [Dept. of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2014-01-15

    The purpose of our study was to evaluate the usefulness of sagittal reformation of chest computed tomography for the diagnosis of sternal fracture after trauma. We retrospectively reviewed medical records and chest computer tomography (CT) of 716 patients in the emergency department after trauma between January and December 2010. Two radiologists investigated chest CT images. We investigated numbers and locations of sternal fractures on axial images only and on both axial and sagittal images for each radiologist. First, radiologist found sternal fractures in 58 patients (70.7%) on only axial images, and 80 (97.5%) on both axial and sagittal images. Second, radiologist found fractures in 67 patients (81.7%) on axial image only and 81 (98.7%) on both axial and sagittal images. The sensitivity increased after adding sagittal reformation images for each radiologist (p < 0.05, respectively). On the axial images, the interobserver agreement was low (k 0.596) between the two radiologists. However, on both axial and sagittal images, the interobserver agreement increased (k = 0.872). Sagittal reformation of chest CT increases the chance of diagnosis for sternal fracture and leads to early diagnosis resulting in appropriate treatment.

  3. Sagittal Balance Correction in Lateral Interbody Fusion for Degenerative Scoliosis.

    Science.gov (United States)

    Blizzard, Daniel J; Gallizzi, Michael A; Sheets, Charles; Smith, Benjamin T; Isaacs, Robert E; Eure, Megan; Brown, Christopher R

    2016-01-01

    Sagittal balance restoration has been shown to be an important determinant of outcomes in corrective surgery for degenerative scoliosis. Lateral interbody fusion (LIF) is a less-invasive technique which permits the placement of a high lordosis interbody cage without risks associated with traditional anterior or transforaminal interbody techniques. Studies have shown improvement in lumbar lordosis following LIF, but only one other study has assessed sagittal balance in this population. The objective of this study is to evaluate the ability of LIF to restore sagittal balance in degenerative lumbar scoliosis. Thirty-five patients who underwent LIF for degenerative thoracolumbar scoliosis from July 2013 to March 2014 by a single surgeon were included. Outcome measures included sagittal balance, lumbar lordosis, Cobb Angle, and segmental lordosis. Measures were evaluated pre-operative, immediately post-operatively, and at their last clinical follow-up. Repeated measures ANOVAs were used to assess the differences between pre-operative, first postoperative, and a follow-up visit. The average sagittal balance correction was not significantly different: 1.06cm from 5.79cm to 4.74cm forward. The average Cobb angle correction was 14.1 degrees from 21.6 to 5.5 degrees. The average change in global lumbar lordosis was found to be significantly different: 6.3 degrees from 28.9 to 35.2 degrees. This study demonstrates that LIF reliably restores lordosis, but does not significantly improve sagittal balance. Despite this, patients had reliable improvement in pain and functionality suggesting that sagittal balance correction may not be as critical in scoliosis correction as previous studies have indicated. LIF does not significantly change sagittal balance; however, clinical improvement does not seem to be contingent upon sagittal balance correction in the degenerative scoliosis population. The DUHS IRB has determined this study meets criteria for an IRB waiver.

  4. A new dimension to cephalometry: DW plane

    Directory of Open Access Journals (Sweden)

    Shruti K Hatewar

    2015-01-01

    Full Text Available Context: An accurate jaw relationship is critically important in orthodontic diagnosis and treatment planning. Various angular and linear measurements that have been proposed can be erroneous because they depend on various factors. Aim: The purpose of this study is to establish a new cephalometric measurement to assess the skeletal jaw discrepancy using Walker's point. Settings and Design: Lateral cephalogram of 100 Indian subjects with age range (8–11, 12–18, 19-27 were obtained. Inclusion criteria were – clinically Class I occlusion; normal overjet and overbite; orthoganthic profile; competent lips and cephalometrically normal ANB; Wits appraisal; Rakosi Jarabak's angle of inclination and mandibular plane angle. Materials and Methods: Four skeletal landmarks: Point A, Point B, Walker's point (W and Wing point (w were used to indicate the severity and type of skeletal dysplasia. Double W (DW was constructed joining the Walker's and Wing point. Statistical Analysis Used: Analysis of variance test and Student's t-test was applied which showed significant results. Results: The difference between Walker's perpendicular to A Point and Walker's perpendicular to B Point gave the sagittal jaw discrepancy and was found to be 8.2 ± 0.9 mm. This measurement remained relatively constant throughout life. Conclusions: DW plane is an effective way to accurately establish the skeletal jaw relationship. It analyses the variance between linear measurements to determine the sagittal jaw relationship, linear measurements for vertical maxillary height and angular measurements to determine rotational jaw changes.

  5. Sagittal Abdominal Diameter: Application in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Thaís Da Silva-Ferreira

    2014-05-01

    Full Text Available Excess visceral fat is associated with cardiovascular risk factors. Sagittal abdominal diameter (SAD has recently been highlighted as an indicator of abdominal obesity, and also may be useful in predicting cardiovascular risk. The purpose of the present study was to review the scientific literature on the use of SAD in adult nutritional assessment. A search was conducted for scientific articles in the following electronic databases: SciELO , MEDLINE (PubMed and Virtual Health Library. SAD is more associated with abdominal fat (especially visceral, and with different cardiovascular risk factors, such as, insulin resistance, blood pressure, and serum lipoproteins than the traditional methods of estimating adiposity, such as body mass index and waist-to-hip ratio. SAD can also be used in association with other anthropometric measures. There are still no cut-off limits established to classify SAD as yet. SAD can be an alternative measure to estimate visceral adiposity. However, the few studies on this diameter, and the lack of consensus on the anatomical site to measure SAD, are obstacles to establish cut-off limits to classify it.

  6. Experimental Evaluation of Balance Prediction Models for Sit-to-Stand Movement in the Sagittal Plane

    Directory of Open Access Journals (Sweden)

    Oscar David Pena Cabra

    2013-01-01

    Full Text Available Evaluation of balance control ability would become important in the rehabilitation training. In this paper, in order to make clear usefulness and limitation of a traditional simple inverted pendulum model in balance prediction in sit-to-stand movements, the traditional simple model was compared to an inertia (rotational radius variable inverted pendulum model including multiple-joint influence in the balance predictions. The predictions were tested upon experimentation with six healthy subjects. The evaluation showed that the multiple-joint influence model is more accurate in predicting balance under demanding sit-to-stand conditions. On the other hand, the evaluation also showed that the traditionally used simple inverted pendulum model is still reliable in predicting balance during sit-to-stand movement under non-demanding (normal condition. Especially, the simple model was shown to be effective for sit-to-stand movements with low center of mass velocity at the seat-off. Moreover, almost all trajectories under the normal condition seemed to follow the same control strategy, in which the subjects used extra energy than the minimum one necessary for standing up. This suggests that the safety considerations come first than the energy efficiency considerations during a sit to stand, since the most energy efficient trajectory is close to the backward fall boundary.

  7. Markerless motion capture can provide reliable 3D gait kinematics in the sagittal and frontal plane.

    Science.gov (United States)

    Sandau, Martin; Koblauch, Henrik; Moeslund, Thomas B; Aanæs, Henrik; Alkjær, Tine; Simonsen, Erik B

    2014-09-01

    Estimating 3D joint rotations in the lower extremities accurately and reliably remains unresolved in markerless motion capture, despite extensive studies in the past decades. The main problems have been ascribed to the limited accuracy of the 3D reconstructions. Accordingly, the purpose of the present study was to develop a new approach based on highly detailed 3D reconstructions in combination with a translational and rotational unconstrained articulated model. The highly detailed 3D reconstructions were synthesized from an eight camera setup using a stereo vision approach. The subject specific articulated model was generated with three rotational and three translational degrees of freedom for each limb segment and without any constraints to the range of motion. This approach was tested on 3D gait analysis and compared to a marker based method. The experiment included ten healthy subjects in whom hip, knee and ankle joint were analysed. Flexion/extension angles as well as hip abduction/adduction closely resembled those obtained from the marker based system. However, the internal/external rotations, knee abduction/adduction and ankle inversion/eversion were less reliable. Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.

  8. Sagittal plane kinematics of passive dorsiflexion of the foot in adolescent athletes.

    Science.gov (United States)

    Gatt, Alfred; Chockalingam, Nachiappan; Falzon, Owen

    2013-01-01

    Although assessment of passive maximum foot dorsiflexion angle is performed routinely, there is a paucity of information regarding adolescents' foot and foot segment motion during this procedure. There are currently no trials investigating the kinematics of the adolescent foot during passive foot dorsiflexion. A six-camera optoelectronic motion capture system was used to collect kinematic data using the Oxford Foot Model. Eight female amateur gymnasts 11 to 16 years old (mean age, 13.2 years; mean height, 1.5 m) participated in the study. A dorsiflexing force was applied to the forefoot until reaching maximum resistance with the foot placed in the neutral, pronated, and supinated positions in random order. The maximum foot dorsiflexion angle and the range of movement of the forefoot to hindfoot, tibia to forefoot, and tibia to hindfoot angles were computed. Mean ± SD maximum foot dorsiflexion angles were 36.3° ± 7.2° for pronated, 36.9° ± 4.0° for neutral, and 33.0° ± 4.9° for supinated postures. One-way repeated-measures analysis of variance results were nonsignificant among the 3 groups (P = .70), as were the forefoot to tibia angle and hindfoot to tibia angle variations (P = .091 and P = .188, respectively). Forefoot to hindfoot angle increased with the application of force, indicating that in adolescents, the forefoot does not lock at any particular posture as portrayed by the traditional Rootian paradigm. Participants had very flexible foot dorsiflexion, unlike those in another study assessing adolescent athletes. This finding, together with nonsignificant statistical results, implies that foot dorsiflexion measurement may be performed at any foot posture without notably affecting results.

  9. Markerless motion capture can provide reliable 3D gait kinematics in the sagittal and frontal plane

    DEFF Research Database (Denmark)

    Sandau, Martin; Koblauch, Henrik; Moeslund, Thomas B.

    2014-01-01

    Estimating 3D joint rotations in the lower extremities accurately and reliably remains unresolved in markerless motion capture, despite extensive studies in the past decades. The main problems have been ascribed to the limited accuracy of the 3D reconstructions. Accordingly, the purpose of the pr...

  10. Knee and hip sagittal and transverse plane changes after two fatigue protocols.

    Science.gov (United States)

    Lucci, Shawn; Cortes, Nelson; Van Lunen, Bonnie; Ringleb, Stacie; Onate, James

    2011-09-01

    Fatigue has been shown to alter the biomechanics of lower extremity during landing tasks. To date, no study has examined the effects of two types of fatigue on kinetics and kinematics. This study was conducted to assess biomechanical differences between two fatigue protocols [Slow Linear Oxidative Fatigue Protocol (SLO-FP) and Functional Agility Short-Term Fatigue Protocol (FAST-FP)]. Single-group repeated measures design. Fifteen female collegiate soccer players had to perform five successful trials of unanticipated sidestep cutting (SS) pre- and post-fatigue protocols. The SLO-FP consisted of an initial VO(2peak) test followed by 5-min rest, and a 30-min interval run. The FAST-FP consisted of 4 sets of a functional circuit. Biomechanical measures of the hip and knee were obtained at different instants while performing SS pre- and post-fatigue. Repeated 2 × 2 ANOVAs were conducted to examine task and fatigue differences. Alpha level set a priori at 0.05. During the FAST-FP, participants had increased knee internal rotation at initial contact (IC) (12.5 ± 5.9°) when compared to the SLO-FP (7.9 ± 5.4°, pangles (36.4 ± 8.4°) compared to post-fatigue (30.4 ± 9.3°, p=0.003), also greater knee flexion during pre-fatigue (25.6 ± 6.8°) than post-fatigue (22.4 ± 8.4°, p=0.022). The results of this study showed that hip and knee mechanics were substantially altered during both fatigue conditions. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  11. Comparison of parameters of spinal curves in the sagittal plane measured by photogrammetry and inclinometry.

    Science.gov (United States)

    Walicka-Cupryś, Katarzyna; Drzał-Grabiec, Justyna; Mrozkowiak, Mirosław

    2013-10-31

    BACKGROUND. The photogrammetric method and inclinometer-based measurements are commonly employed to assess the anteroposterior curvatures of the spine. These methods are used both in clinical trials and for screening purposes. The aim of the study was to compare the parameters used to characterise the anteroposterior spinal curvatures as measured by photogrammetry and inclinometry. MATERIAL AND METHODS. The study enrolled 341 subjects: 169 girls and 172 boys, aged 4 to 9 years, from kindergartens and primary schools in Rzeszów. The anteroposterior spinal curvatures were examined by photogrammetry and with a mechanical inclinometer. RESULTS. There were significant differences in the α angle between the inclinometric and photogrammetric assessment in the Student t test (p=0.017) and the Fisher Snedecor test (p=0.0001), with similar differences in the β angle (Student's t p=0.0001, Fisher Snedecor p=0.007). For the γ angle, significant differences were revealed with Student's t test (p=0.0001), but not with the Fisher Snedecor test (p = 0.22). CONCLUSIONS. 1. Measurements of inclination of particular segments of the spine obtained with the photogrammetric method and the inclinometric method in the same study group revealed statistically significant differences. 2. The results of measurements obtained by photogrammetry and inclinometry are not comparable. 3. Further research on agreement between measurements of the anteroposterior spinal curvatures obtained using the available measurement equipment is recommended.

  12. The effect of thoracic kyphosis and sagittal plane alignment on vertebral compressive loading

    Science.gov (United States)

    Bruno, Alexander G.; Anderson, Dennis E.; D’Agostino, John; Bouxsein, Mary L.

    2012-01-01

    To better understand the biomechanical mechanisms underlying the association between hyperkyphosis of the thoracic spine and risk of vertebral fracture and other degenerative spinal pathology, we used a previously validated musculoskeletal model of the spine to determine how thoracic kyphosis angle and spinal posture affect vertebral compressive loading. We simulated an age-related increase in thoracic kyphosis (T1-T12 Cobb angle 50° to 75°) during two different activities (relaxed standing and standing with 5 kg weights in the hands) and three different posture conditions: 1) an increase in thoracic kyphosis with no postural adjustment (uncompensated posture), 2) an increase in thoracic kyphosis with a concomitant increase in pelvic tilt that maintains a stable center of mass and horizontal eye gaze (compensated posture), and 3) an increase in thoracic kyphosis with a concomitant increase in lumbar lordosis that also maintains a stable center of mass and horizontal eye gaze (congruent posture). For all posture conditions, compressive loading increased with increasing thoracic kyphosis, with loading increasing more in the thoracolumbar and lumbar regions than in the mid-thoracic region. Loading increased the most for the uncompensated posture, followed by the compensated posture, with the congruent posture almost completely mitigating any increases in loading with increased thoracic kyphosis. These findings indicate that thoracic kyphosis and spinal posture both influence vertebral loading during daily activities, implying that thoracic kyphosis measurements alone are not sufficient to characterize the impact of spinal curvature on vertebral loading. PMID:22589006

  13. Walking sagittal balance correction by pedicle subtraction osteotomy in adults with fixed sagittal imbalance.

    Science.gov (United States)

    Yagi, Mitsuru; Kaneko, Shinjiro; Yato, Yoshiyuki; Asazuma, Takashi; Machida, Masafumi

    2016-08-01

    Pedicle subtraction osteotomy (PSO) is widely used to treat severe fixed sagittal imbalance. However, the effect of PSO on balance has not been fully documented. The aim of this study was to assess dynamic walking balance after PSO to treat fixed sagittal imbalance. Gait and balance were assessed in 15 consecutive adult female patients who had been treated by PSO for a fixed sagittal imbalance and compare patients' preop and postop dynamic walking balance with that of 15 age- and gender-matched healthy volunteers (HV). Each patient's chart, X-rays, pre and postop SRS22 outcome scores, and ODI were reviewed. Means were compared by Mann-Whitney U test and Chi-square test. The mean age was 66.3 years (51-74 years). The mean follow-up was 2.7 years (2-3.5 years). The C7PL and GL, measured on the force platform, were both improved from 24.2 ± 7.3 cm and 27.6 ± 9.4 to 5.4 ± 2.6 cm and 7.2 ± 3.4 cm, respectively. The baseline hip ROM was significantly smaller in patients compared to HV, whereas no significant difference was observed in the knee or ankle ROM. The pelvic tilt (preop -0.4° ± 1.4°, postop 8.9° ± 1.0°), and maximum hip-extension angle (preop -1.2° ± 14.2°, postop -11.2° ± 7.2°) were also improved after surgery. Cadence (116 s/min), stance-swing ratio (stance 63.2 % vs. swing 36.8 %), and stride (98.0 cm) were all increased after surgery. On the other hand, gait velocity was significantly slower in the PSO group at both pre and postop than in HV (PSO 53.3 m/min at preop and 58.8 m/min at postop vs. HV 71.1 m/min, p = 0.04). Despite a mild residual spinal-pelvic malalignment, PSO restored sagittal alignment and balance satisfactorily and has improved the gait pattern.

  14. Small differences between anatomical and mechanical sagittal femur axes: a radiological and navigated study of 50 patients.

    Science.gov (United States)

    Jenny, Jean-Yves; Barbe, Bruno

    2012-07-01

    The purposes of the study were to define the orientation of the anatomical and mechanical axes of the femur on the lateral plane on long leg X-rays including the femoral head, and to compare these results to the intra-operative measurement of the mechanical axis by a nonimage-based navigation system. Fifty cases of patients operated on for total knee replacement were included. All patients had digital pre- and post-operative long leg lateral X-rays including the femoral head. All prostheses were implanted with a nonimage-based navigation system. Five sagittal femur axes were measured on pre- and post-operative X-rays. The sagittal orientation of the distal femoral resection was measured by the navigation system and on the post-operative X-rays. Significant, but small differences were observed in the orientation of the different axes on the pre- and post-operative X-rays. The correlation and the agreement between all axes were good. There was no significant modification on the post-operative X-rays. There were significant, but small differences between the navigated and radiological orientation of the distal femur resection, but the correlation and the agreement were good. The differences observed are small and have probably little clinical relevance. The distal cortical axis may be the best compromise. The navigation system allows measuring accurately the orientation of the distal femoral resection in the sagittal plane.

  15. Differentiation of a Femoral Hernia from an Inguinal Hernia on Isotropic Multidetector-Row CT (MDCT): the Benefit of Inguinal Ligament Coronal-Oblique Images

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ju Hyun; Jang, Kyung Mi; Kim, Min Jeong; Ko, Ji Young; Koh, Sung Hye; Yie, Mi Yeon; Min, Kwang Seon; Kim, In Gyu [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Choi, Dong Il; Park, Yul Ri [Samsung Medical Center, Seoul (Korea, Republic of)

    2009-04-15

    This study was designed to evaluate the diagnostic value of the use of inguinal ligament coronal-oblique CT images in the differentiation of femoral hernias from inguinal hernias. A total of 32 patients (with 11 femoral hernias and 21 inguinal hernias) underwent CT imaging. All of the examinations were performed with a 16- multidetector row CT (MDCT) scanner with contrast enhancement, and transverse sections, coronal sections and coronal-oblique CT images were reformed along an imaginary inguinal ligament plane. Two independent observers retrospectively evaluated the CT scans. Image analysis was first performed with only transverse and coronal images. A second analysis was then performed with transverse, coronal and coronal- oblique images. The mean angle difference between coronal and coronal-oblique CT images was 8.0 degrees (range, 0-22 degrees). A radiologist correctly diagnosed the presence of a femoral hernia in nine (82%) of 11 patients and a radiology fellow correctly diagnosed the presence of a femoral hernia in seven (64%) of 11 patients in the first session. Both of the reviewers made the correct diagnosis in all patients in the second session. For inguinal hernias, both reviewers correctly diagnosed all patients during both sessions. The coronal-oblique CT images were the most valuable images for the evaluation of the relationship between hernias of the neck and inguinal ligament. Inguinal ligament coronal-oblique CT images can provide additional diagnostic value in the evaluation of groin hernias.

  16. Outcome of primary posterior sagittal anorectoplasty of high ...

    African Journals Online (AJOL)

    2013-01-29

    Jan 29, 2013 ... Background: Conventional posterior sagittal anorectoplasty (PSARP) for high anorectal malformation (ARM) involves initial colostomy creation with ... associated multiple congenital anomalies and high risk of overwhelming sepsis .... muscle complex, and mark the position for the neoanus. Inclusion criteria.

  17. Posterior sagittal rectopexy in the treatment of recurrent rectal ...

    African Journals Online (AJOL)

    Pediatric Surgery. Annals of Pediatric Surgery 2011, 7:101–104. Keywords: children, complications, posterior sagittal rectopexy, rectal prolapse, recurrent. Department of ... Correspondence to Amel Abd Eltwab Hashish, Department of Pediatric Surgery,. Faculty of ... without constipation, prolonged diarrhea, malnutrition,.

  18. Evaluation of Global Sagittal Balance in Koreans Adults.

    Science.gov (United States)

    Cho, Yongjae

    2017-09-01

    The global sagittal postural patterns as characterized by Roussouly classification have been previously described in various ethnicities, there were no studies investigated in Koreans. To analyze the distribution of the global sagittal postural patterns in Korean adults using Roussouly classification, the author prospectively studied. 252 asymptomatic Korean adults was recruited. Data was obtained by reviewing the films for each subject. Spinopelvic parameters were measured and sagittal postural patterns were then determined according to Roussouly classification. We compared the data across different ethnicities from our study and a previous study to further characterize Korean sagittal postures. The subject included 151 males and 101 females, with mean age of 33.2±8.2 years. The average descriptive results were as below: thoracic kyphosis 28.6±7.7°, lumbar lordosis 48.3±10.2°, sacral slope 37.8±5.8°, pelvic incidence 45.1±7.5°, pelvic tilt 9.4±6.7°, spinosacral angle 130.1±5.4°, and sagittal vertical axis 16.25±22.5 mm. 125 subjects among 252 (49.6%) belonged to Roussouly type 3 (namely neutral). There were also 58 (23%), 33 (13.1%), and 36 (14.3) subjects in type 1, 2, and 4 (namely non-neutral), respectively. Enrolling 252 asymptomatic Korean adults, this prospective study found that 49.6% of asymptomatic Korean adults possessed a sagittal posture of Roussouly type 3. All radiologic parameters follows general concept of spinal sagittal balance pattern. Overall, this study might be a basis for further investigation of spinal sagittal balance.

  19. Noninvasive diagnosis of superior sagittal sinus thrombosis in a neonate.

    Science.gov (United States)

    Govaert, P; Voet, D; Achten, E; Vanhaesebrouck, P; van Rostenberghe, H; van Gysel, D; Afschrift, M

    1992-05-01

    A newborn boy presented within the first day of life with moaning, anemia, and thrombocytopenia. The clinical syndrome resulted from thrombosis of the posterior part of the superior sagittal sinus due to impression at birth of the tip of the occipital squama. Both computed tomography and ultrasound scans were valuable noninvasive tools for documentation of the thrombus itself and the cerebral sequelae. Color Doppler ultrasound scan confirmed the absence and reappearance of flow in the superior sagittal sinus.

  20. How is sagittal balance acquired during bipedal gait acquisition? Comparison of neonatal and adult pelves in three dimensions. Evolutionary implications.

    Science.gov (United States)

    Tardieu, Christine; Bonneau, Noémie; Hecquet, Jérôme; Boulay, Christophe; Marty, Catherine; Legaye, Jean; Duval-Beaupère, Geneviève

    2013-08-01

    We compare adult and intact neonatal pelves, using a pelvic sagittal variable, the angle of sacral incidence, which presents significant correlations with vertebral curvature in adults and plays an important role in sagittal balance of the trunk on the lower limbs. Since the lumbar curvature develops in the child in association with gait acquisition, we expect a change in this angle during growth which could contribute to the acquisition of sagittal balance. To understand the mechanisms underlying the sagittal balance in the evolution of human bipedalism, we also measure the angle of incidence of hominid fossils. Fourty-seven landmarks were digitized on 50 adult and 19 intact neonatal pelves. We used a three-dimensional model of the pelvis (DE-VISU program) which calculates the angle of sacral incidence and related functional variables. Cross-sectional data from newborns and adults show that the angle of sacral incidence increases and becomes negatively correlated with the sacro-acetabular distance. During ontogeny the sacrum becomes curved, tends to sink down between the iliac blades as a wedge and moves backward in the sagittal plane relative to the acetabula, thus contributing to the backwards displacement of the center of gravity of the trunk. A chain of correlations links the degree of the sacral slope and of the angle of incidence, which is tightly linked with the lumbar lordosis. We sketch a model showing the coordinated changes occurring in the pelvis and vertebral column during the acquisition of bipedalism in infancy. In the australopithecine pelves, Sts 14 and AL 288-1, and in the Homo erectus Gona pelvis the angle of sacral incidence reaches the mean values of humans. Discussing the incomplete pelves of Ardipithecus ramidus, Australopithecus sediba and the Nariokotome Boy, we suggest how the functional linkage between pelvis and spine, observed in humans, could have emerged during hominid evolution. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Comparison of the Sagittal Spine Lordosis by Supine Computed Tomography and Upright Conventional Radiographs in Patients with Spinal Trauma

    Directory of Open Access Journals (Sweden)

    Samy Bouaicha

    2014-01-01

    Full Text Available Study Design. Retrospective data analysis. Objective. To compare the sagittal lordosis of the lumbar spine by supine computed tomography (CT and upright conventional radiographs. Summary of Background Data. There is sparse data about position and modality dependent changes of radiographic measurements in the sagittal lumbar spine. Methods. The anatomical and functional Cobb angles of the thoracolumbar spine in 153 patients with spinal injury were measured by conventional upright sagittal radiographs and supine CT scans. Patients were assigned either to group A (n=101, with radiologically confirmed vertebral fractures, or to group B (n=52, without any osseous lesions. The interchangeability of the two imaging modalities was calculated using a ±3° and 5° range of acceptance. Results. Group A showed a mean intraindividual difference of −3.8° for both the anatomical and the functional Cobb angle. Only 25.7% and 27.7% of the 101 patients showed a difference within the tolerated ±3° margin. Using the ±5° limits, only 46 and 47 individuals fell within the acceptable range, respectively. In the patients in group B, the mean intraindividual difference was −2.1° for the anatomical and −1.5° for the functional Cobb angle. Of the 52 patients, only 14 and 13 patients, respectively demonstrated an intraindividual difference within ±3°. With regard to a threshold of ±5°, both the functional and anatomical values were within the defined margins in only 25 (48% patients. Conclusion. The use of supine CT measurements as a baseline assessment of the sagittal lordosis of the injured thoracolumbar spine does not appear to be appropriate when upright conventional sagittal plane radiographs are used for follow-up measurements.

  2. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters.

    Science.gov (United States)

    Berthonnaud, Eric; Dimnet, Joannès; Roussouly, Pierre; Labelle, Hubert

    2005-02-01

    The purpose of this study is to introduce a method to analyze and characterize the global sagittal balance of the human trunk using indexes derived from the shape and orientation of the pelvis and cervical, thoracic, and lumbar spine. Standing lateral x-rays of a cohort of 160 asymptomatic young adult volunteers were obtained. On each radiograph, a simplified model of the spine and pelvis was created using a dedicated computer software, and the following shape and orientation variables were calculated at each anatomic level: pelvic incidence, pelvic tilt, sacral slope, cervical curvature and tilt, thoracic curvature and tilt, and lumbar curvature and tilt. Significant linear correlations were found between each single adjacent shape parameter as well as between each single adjacent orientation parameter at all anatomic levels. Significant correlations were also found between some shape and orientation parameters at the same anatomic level as well as between adjacent anatomic areas. In general, the linear correlations were stronger between shape and orientation variables at the pelvic, lumbar, and cervical areas and weaker at the thoracic level and between the thoracic and lumbar areas. These results confirm that the pelvis and spine in the sagittal plane can be considered as a linear chain linking the head to the pelvis where the shape and orientation of each anatomic segment are closely related and influence the adjacent segment to maintain a stable posture with a minimum of energy expenditure. Changes in shape or orientation at one level will have a direct influence on the adjacent segment. Knowledge of these normal relationships is of prime importance for the comprehension of sagittal balance in normal and pathologic conditions of the spine and pelvis.

  3. Is the sagittal postural alignment different in normal and dysphonic adult speakers?

    Science.gov (United States)

    Franco, Débora; Martins, Fernando; Andrea, Mário; Fragoso, Isabel; Carrão, Luís; Teles, Júlia

    2014-07-01

    Clinical research in the field of voice disorders, in particular functional dysphonia, has suggested abnormal laryngeal posture due to muscle adaptive changes, although specific evidence regarding body posture has been lacking. The aim of our study was to verify if there were significant differences in sagittal spine alignment between normal (41 subjects) and dysphonic speakers (33 subjects). Cross-sectional study. Seventy-four adults, 35 males and 39 females, were submitted to sagittal plane photographs so that spine alignment could be analyzed through the Digimizer-MedCalc Software Ltd program. Perceptual and acoustic evaluation and nasoendoscopy were used for dysphonic judgments: normal and dysphonic speakers. For thoracic length curvature (TL) and for the kyphosis index (KI), a significant effect of dysphonia was observed with mean TL and KI significantly higher for the dysphonic speakers than for the normal speakers. Concerning the TL variable, a significant effect of sex was found, in which the mean of the TL was higher for males than females. The interaction between dysphonia and sex did not have a significant effect on TL and KI variables. For the lumbar length curvature variable, a significant main effect of sex was demonstrated; there was no significant main effect of dysphonia or significant sex×dysphonia interaction. Findings indicated significant differences in some sagittal spine posture measures between normal and dysphonic speakers. Postural measures can add useful information to voice assessment protocols and should be taken into account when considering particular treatment strategies. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  4. A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis

    Directory of Open Access Journals (Sweden)

    Paulo Alvim Borges

    Full Text Available OBJECTIVES: Spinopelvic alignment has been associated with improved quality of life in patients with vertebral deformities, and it helps to compensate for imbalances in gait. Although surgical treatment of scoliosis in patients with neuromuscular spinal deformities promotes correction of coronal scoliotic deformities, it remains poorly established whether this results in large changes in sagittal balance parameters in this specific population. The objective of this study is to compare these parameters before and after the current procedure under the hypothesis is that there is no significant modification. METHODS: Sampling included all records of patients with neuromuscular scoliosis with adequate radiographic records treated at Institute of Orthopedics and Traumatology of Clinics Hospital of University of São Paulo (IOT-HCFMUSP from January 2009 to December 2013. Parameters analyzed were incidence, sacral inclination, pelvic tilt, lumbar lordosis, thoracic kyphosis, spinosacral angle, spinal inclination and spinopelvic inclination obtained using the iSite-Philips digital display system with Surgimap and a validated method for digital measurements of scoliosis radiographs. Comparison between the pre- and post-operative conditions involved means and standard deviations and the t-test. RESULTS: Based on 101 medical records only, 16 patients met the inclusion criteria for this study, including 7 males and 9 females, with an age range of 9-20 and a mean age of 12.9±3.06; 14 were diagnosed with cerebral palsy. No significant differences were found between pre and postoperative parameters. CONCLUSIONS: Despite correction of coronal scoliotic deformity in patients with neuromuscular deformities, there were no changes in spinopelvic alignment parameters in the group studied.

  5. Lower extremity energy absorption and biomechanics during landing, part II: frontal-plane energy analyses and interplanar relationships.

    Science.gov (United States)

    Norcross, Marc F; Lewek, Michael D; Padua, Darin A; Shultz, Sandra J; Weinhold, Paul S; Blackburn, J Troy

    2013-01-01

    Greater sagittal-plane energy absorption (EA) during the initial impact phase (INI) of landing is consistent with sagittal-plane biomechanics that likely increase anterior cruciate ligament (ACL) loading, but it does not appear to influence frontal-plane biomechanics. We do not know whether frontal-plane INI EA is related to high-risk frontal-plane biomechanics. To compare biomechanics among INI EA groups, determine if women are represented more in the high group, and evaluate interplanar INI EA relationships. Descriptive laboratory study. Research laboratory. Participants included 82 (41 men, 41 women; age = 21.0 ± 2.4 years, height = 1.74 ± 0.10 m, mass = 70.3 ± 16.1 kg) healthy, physically active volunteers. We assessed landing biomechanics with an electromagnetic motion-capture system and force plate. We calculated frontal- and sagittal-plane total, hip, knee, and ankle INI EA. Total frontal-plane INI EA was used to create high, moderate, and low tertiles. Frontal-plane knee and hip kinematics, peak vertical and posterior ground reaction forces, and peak internal knee-varus moment (pKVM) were identified and compared across groups using 1-way analyses of variance. We used a χ (2) analysis to evaluate male and female allocation to INI EA groups. We used simple, bivariate Pearson product moment correlations to assess interplanar INI EA relationships. The high-INI EA group exhibited greater knee valgus at ground contact, hip adduction at pKVM, and peak hip adduction than the low-INI EA group (P .05). Greater frontal-plane INI EA was associated with less favorable frontal-plane biomechanics that likely result in greater ACL loading. Women were more likely than men to use greater frontal-plane INI EA. The magnitudes of sagittal- and frontal-plane INI EA were largely independent.

  6. Cervical spine alignment, sagittal deformity, and clinical implications: a review.

    Science.gov (United States)

    Scheer, Justin K; Tang, Jessica A; Smith, Justin S; Acosta, Frank L; Protopsaltis, Themistocles S; Blondel, Benjamin; Bess, Shay; Shaffrey, Christopher I; Deviren, Vedat; Lafage, Virginie; Schwab, Frank; Ames, Christopher P

    2013-08-01

    This paper is a narrative review of normal cervical alignment, methods for quantifying alignment, and how alignment is associated with cervical deformity, myelopathy, and adjacent-segment disease (ASD), with discussions of health-related quality of life (HRQOL). Popular methods currently used to quantify cervical alignment are discussed including cervical lordosis, sagittal vertical axis, and horizontal gaze with the chin-brow to vertical angle. Cervical deformity is examined in detail as deformities localized to the cervical spine affect, and are affected by, other parameters of the spine in preserving global sagittal alignment. An evolving trend is defining cervical sagittal alignment. Evidence from a few recent studies suggests correlations between radiographic parameters in the cervical spine and HRQOL. Analysis of the cervical regional alignment with respect to overall spinal pelvic alignment is critical. The article details mechanisms by which cervical kyphotic deformity potentially leads to ASD and discusses previous studies that suggest how postoperative sagittal malalignment may promote ASD. Further clinical studies are needed to explore the relationship of cervical malalignment and the development of ASD. Sagittal alignment of the cervical spine may play a substantial role in the development of cervical myelopathy as cervical deformity can lead to spinal cord compression and cord tension. Surgical correction of cervical myelopathy should always take into consideration cervical sagittal alignment, as decompression alone may not decrease cord tension induced by kyphosis. Awareness of the development of postlaminectomy kyphosis is critical as it relates to cervical myelopathy. The future direction of cervical deformity correction should include a comprehensive approach in assessing global cervicalpelvic relationships. Just as understanding pelvic incidence as it relates to lumbar lordosis was crucial in building our knowledge of thoracolumbar deformities, T

  7. Sagittal spino-pelvic alignment in chronic low back pain.

    Science.gov (United States)

    Chaléat-Valayer, Emmanuelle; Mac-Thiong, Jean-Marc; Paquet, Jérôme; Berthonnaud, Eric; Siani, Fabienne; Roussouly, Pierre

    2011-09-01

    The differences in sagittal spino-pelvic alignment between adults with chronic low back pain (LBP) and the normal population are still poorly understood. In particular, it is still unknown if particular patterns of sagittal spino-pelvic alignment are more prevalent in chronic LBP. The current study helps to better understand the relationship between sagittal alignment and low back pain. To compare the sagittal spino-pelvic alignment of patients with chronic LBP with a cohort of asymptomatic adults. Sagittal spino-pelvic alignment was evaluated in prospective cohorts of 198 patients with chronic LBP and 709 normal subjects. The two cohorts were compared with respect to the sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), lumbar lordosis (LL), lumbar tilt (LT), lordotic levels, thoracic kyphosis (TK), thoracic tilt (TT), kyphotic levels, and lumbosacral joint angle (LSA). Correlations between parameters were also assessed. Sagittal spino-pelvic alignment is significantly different in chronic LBP with respect to SS, PI, LT, lordotic levels, TK, TT and LSA, but not PT, LL, and kyphotic levels. Correlations between parameters were similar for the two cohorts. As compared to normal adults, a greater proportion of patients with LBP presented low SS and LL associated with a small PI, while a greater proportion of normal subjects presented normal or high SS associated with normal or high PI. Sagittal spino-pelvic alignment was different between patients with chronic LBP and controls. In particular, there was a greater proportion of chronic LBP patients with low SS, low LL and small PI, suggesting the relationship between this specific pattern and the presence of chronic LBP.

  8. Direct coronal computed tomography of the pelvis and the retroperitoneal space

    Energy Technology Data Exchange (ETDEWEB)

    Umeyama, Tomokazu; Nemoto, Ryosuke; Nemoto, Shinichi (Tsukuba Univ., Sakura, Ibaraki (Japan))

    1983-05-01

    In comparison with ultrasonography, the disadvantage of the technique of computed tomography (CT) has been the relative lack of flexibility afforded by the single transverse plane of section. Therefore we developed direct coronal CT imaging of the pelvis and the retroperitoneal space by changing the position of the patient in the gantry. In comparison with transverse CT images we got some advantages in this method. In the case of bladder cancer, it was easy to detect the locality and stage of the tumors which arose from the posteriol wall or neck of the bladder. In the case of prostate cancer, it offered substantial information concerning the invasion of the tumor into the seminal vesicle and pelvic floor. In the case of retroperitoneal tumor we could evaluate the extension of the tumor more exactly. We emphasized the advantages of direct coronal CT, i.e., improved image quality, improved definition of coronal anatomy and shorter examination time.

  9. Evolving Coronal Holes and Interplanetary Erupting Stream ...

    Indian Academy of Sciences (India)

    The newborn coronal hole emerges on the Sun, owing to the changes in magnetic field configuration leading to the opening of closed magnetic structure into the corona. The fundamental activity for the onset of an erupting stream seems to be a transient opening of pre-existing closed magnetic structures into a new coronal ...

  10. Microwave Enhancement in Coronal Holes: Statistical Properties

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Astrophysics and Astronomy; Volume 21; Issue 3-4. Microwave Enhancement in Coronal Holes: Statistical Properties. Ν. Gopalswamy Κ. Shibasaki Μ. Salem. Session X – Cycle Variation in the Quiet Corona & Coronal Holes Volume 21 Issue 3-4 September-December 2000 pp 413-417 ...

  11. Super-resolution reconstruction in frequency, image, and wavelet domains to reduce through-plane partial voluming in MRI

    Energy Technology Data Exchange (ETDEWEB)

    Gholipour, Ali, E-mail: ali.gholipour@childrens.harvard.edu; Afacan, Onur; Scherrer, Benoit; Prabhu, Sanjay P.; Warfield, Simon K. [Department of Radiology, Boston Children’s Hospital, Boston, Massachusetts 02115 and Harvard Medical School, Boston, Massachusetts 02115 (United States); Aganj, Iman [Radiology Department, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts 02129 and Harvard Medical School, Boston, Massachusetts 02115 (United States); Sahin, Mustafa [Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts 02115 and Harvard Medical School, Boston, Massachusetts 02115 (United States)

    2015-12-15

    Purpose: To compare and evaluate the use of super-resolution reconstruction (SRR), in frequency, image, and wavelet domains, to reduce through-plane partial voluming effects in magnetic resonance imaging. Methods: The reconstruction of an isotropic high-resolution image from multiple thick-slice scans has been investigated through techniques in frequency, image, and wavelet domains. Experiments were carried out with thick-slice T2-weighted fast spin echo sequence on the Academic College of Radiology MRI phantom, where the reconstructed images were compared to a reference high-resolution scan using peak signal-to-noise ratio (PSNR), structural similarity image metric (SSIM), mutual information (MI), and the mean absolute error (MAE) of image intensity profiles. The application of super-resolution reconstruction was then examined in retrospective processing of clinical neuroimages of ten pediatric patients with tuberous sclerosis complex (TSC) to reduce through-plane partial voluming for improved 3D delineation and visualization of thin radial bands of white matter abnormalities. Results: Quantitative evaluation results show improvements in all evaluation metrics through super-resolution reconstruction in the frequency, image, and wavelet domains, with the highest values obtained from SRR in the image domain. The metric values for image-domain SRR versus the original axial, coronal, and sagittal images were PSNR = 32.26 vs 32.22, 32.16, 30.65; SSIM = 0.931 vs 0.922, 0.924, 0.918; MI = 0.871 vs 0.842, 0.844, 0.831; and MAE = 5.38 vs 7.34, 7.06, 6.19. All similarity metrics showed high correlations with expert ranking of image resolution with MI showing the highest correlation at 0.943. Qualitative assessment of the neuroimages of ten TSC patients through in-plane and out-of-plane visualization of structures showed the extent of partial voluming effect in a real clinical scenario and its reduction using SRR. Blinded expert evaluation of image resolution in

  12. Position of mandibular canal and ramus morphology before and after sagittal split ramus osteotomy.

    Science.gov (United States)

    Ueki, Koichiro; Okabe, Katsuhiko; Miyazaki, Mao; Mukozawa, Aya; Marukawa, Kohei; Nakagawa, Kiyomasa; Yamamoto, Etsuhide

    2010-08-01

    The purpose of this study was to evaluate changes in the mandibular canal and ramus morphology before and after a sagittal split ramus osteotomy. The subjects were 30 patients (60 sides) with mandibular prognathism who had undergone bilateral sagittal split ramus osteotomy setback surgery. The mandibular canal position and ramus morphology were measured at the 3 horizontal planes under the mandibular foramen level (level A), 1 cm lower than level A (level B), and 2 cm lower than level A (level C) preoperatively and 1 year postoperatively by computed tomography. Postoperative ramus width, lateral distance, lateral marrow distance, and canal length were significantly larger than the preoperative values at the foramen, 1 cm lower, and 2 cm lower. The mandibular canal completely contacted the lateral cortex without lateral bone marrow in 6 sides (10%) in levels A and B and 4 sides (6.7%) in level C preoperatively and 6 sides (10%) in level C postoperatively. This study suggested that postoperative mandibular canal position was located more posteriorly and the postoperative lateral bone marrow became thicker compared with the preoperative state. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Analysis of Global Sagittal Postural Patterns in Asymptomatic Chinese Adults.

    Science.gov (United States)

    Hu, Panpan; Yu, Miao; Sun, Zhuoran; Li, Weishi; Jiang, Liang; Wei, Feng; Liu, Xiaoguang; Chen, Zhongqiang; Liu, Zhongjun

    2016-04-01

    A prospective imaging study. To characterize the distribution of the global sagittal postural patterns in asymptomatic Chinese adults using Roussouly classification. The norms of sagittal parameters in asymptomatic Chinese population have been previously described, but no report described their global sagittal postural patterns as characterized by Roussouly classification. A cohort of 272 asymptomatic Chinese adults was recruited. Data was assimilated by reviewing the films for each subject. Sagittal parameters were measured and sagittal postural patterns were then determined according to Roussouly classification. The pattern distributions were compared across genders within the study cohort. We also compared the data across different ethnicities from our study and a previous study to further characterize Chinese sagittal postures. The cohort included 161 males and 111 females, with mean age of 23.2±4.4 years. The average descriptive results were as below: pelvic incidence (PI) 46.4°±9.6°, thoracic kyphosis (TK) 24.2°±9.0°, lumbar lordosis (LL) 50.6°±10.6°, sacral slope (SS) 37.2°±7.6°, pelvic tilt (PT) 9.4°±6.8°, spinosacral angle (SSA) 131.1°±7.5° and sagittal vertical axis (SVA) 17.24±32.36 mm. Despite a significant difference between two genders in LL, PI, SSA, and SVA, no difference was found in the distribution of Roussouly types among them. 47.8% of our cohort belonged to Roussouly type 3, while type 1, 2 and 4 comprised 23.2%, 14.0% and 15.1% of the subjects, respectively. Roussouly classification was capable of categorizing sagittal parameters except for the PT. This study also found that 4.4% of the recruited subjects belonged to the C7-anterior subgroup. From a characterization of the sagittal postural patterns of asymptomatic Chinese adults using Roussouly classification, the distribution was similar between Chinese males and females; however, from a cross-study comparison, it was different between asymptomatic Chinese and Caucasian

  14. Coronal 2D MR cholangiography overestimates the length of the right hepatic duct in liver transplantation donors

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bohyun [University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul (Korea, Republic of); Ajou University School of Medicine, Department of Radiology, Ajou University Medical Center, Suwon (Korea, Republic of); Kim, Kyoung Won; Kim, So Yeon; Park, So Hyun [University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul (Korea, Republic of); Lee, Jeongjin [Soongsil University, School of Computer Science and Engineering, Seoul (Korea, Republic of); Song, Gi Won; Jung, Dong-Hwan; Ha, Tae-Yong; Lee, Sung Gyu [University of Ulsan College of Medicine, Department of Surgery, Division of Hepatobiliary and Liver Transplantation Surgery, Asan Medical Center, Seoul (Korea, Republic of)

    2017-05-15

    To compare the length of the right hepatic duct (RHD) measured on rotatory coronal 2D MR cholangiography (MRC), rotatory axial 2D MRC, and reconstructed 3D MRC. Sixty-seven donors underwent coronal and axial 2D projection MRC and 3D MRC. RHD length was measured and categorized as ultrashort (≤1 mm), short (>1-14 mm), and long (>14 mm). The measured length, frequency of overestimation, and the degree of underestimation between two 2D MRC sets were compared to 3D MRC. The length of the RHD from 3D MRC, coronal 2D MRC, and axial 2D MRC showed significant difference (p < 0.05). RHD was frequently overestimated on the coronal than on axial 2D MRC (61.2 % vs. 9 %; p <.0001). On coronal 2D MRC, four (6 %) with short RHD and one (1.5 %) with ultrashort RHD were over-categorized as long RHD. On axial 2D MRC, overestimation was mostly <1 mm (83.3 %), none exceeding 3 mm or over-categorized. The degree of underestimation between the two projection planes was comparable. Coronal 2D MRC overestimates the RHD in liver donors. We suggest adding axial 2D MRC to conventional coronal 2D MRC in the preoperative workup protocol for living liver donors to avoid unexpected confrontation with multiple ductal openings when harvesting the graft. (orig.)

  15. Change in sagittal balance with placement of an interspinous spacer.

    Science.gov (United States)

    Schulte, Leah M; O'Brien, Joseph R; Matteini, Lauren E; Yu, Warren D

    2011-09-15

    A prospective case series. To determine the effect of X-STOP implantation on sagittal spinal balance using 36-inch films. Interspinous process spacers have been shown as an effective treatment of neurogenic claudication. The devices block the last few degrees of extension at the stenotic level, thus preventing compression of the nerve roots. These devices have been criticized because they may push the patient's spine into a kyphotic position. However, opening the stenotic level may allow a patient to stand more upright, thereby improving sagittal balance. Institutional review board's approval was obtained. A prospective study of 20 patients who were undergoing an X-STOP insertion was utilized. Their spines were x-rayed preoperatively and postoperatively with 36-inch films. Preoperative and postoperative sagittal balance was measured with a C7 body plum line on both films and the difference was measured. Lumbar lordosis was also compared using Cobb angles. Measurements taken from lateral full-length spine radio-graphs showed an average improvement in sagittal balance of 2.0 cm (range -3.7 to 6.1 cm). The average change in lordosis was -1.1°. Although previous studies of interspinous process distraction have examined segmental lordosis, disc angles, and other parameters, this study is the first to examine overall spinal balance on full-length films. Interspinous distraction does not seem to be detrimental to sagittal balance, and may improve it.

  16. Dentoalveolar Heights in Vertical and Sagittal Facial Patterns.

    Science.gov (United States)

    Islam, Zafar Ul; Shaikh, Attiya Jawaid; Fida, Mubassar

    2016-09-01

    To determine and compare the mean dentoalveolar heights (mm) in different vertical and sagittal facial patterns. Cross-sectional study. Orthodontics Clinic, The Aga Khan University Hospital, Karachi, from September to November 2013. Subjects, aged 15 - 20 years, having fully erupted first permanent molars and central incisors were included in the study from orthodontic records. The pretreatment cephalographs of subjects were traced manually over an illuminator. The various parameters like angles and dentoalveolar heights were measured and recorded on data collection form. Mean value ± SD for the variables were generated. ANOVAwas used to compare the means of dentoalveolar heights among the vertical and sagittal facial patterns. Post Hoc Bonferroni test was applied to show difference among the three vertical and three sagittal facial patterns. P-value equal to or less than 0.05 was taken as statistically significant. The mean age of subjects was 15.8 ±3.2 years in vertical group and 16.3 ±2.9 years in sagittal group. There was statistically significant difference (p=0.008) for the upper anterior dentoalveolar height (UADH) among vertical groups, with statistically significant difference for UADH between hyperdivergent and normodivergent (p=0.04) and hyperdivergent and hypodivergent (p=0.01) facial patterns. The UADH were significantly greater in the hyperdivergent group as compared to both the normodivergent and hypodivergent groups. The sagittal groups showed no statistically significant difference for dentoalveolar heights.

  17. Mid-callosal plane determination using preferred directions from diffusion tensor images

    Science.gov (United States)

    Costa, André L.; Rittner, Letícia; Lotufo, Roberto A.; Appenzeller, Simone

    2015-03-01

    The corpus callosum is the major brain structure responsible for inter{hemispheric communication between neurons. Many studies seek to relate corpus callosum attributes to patient characteristics, cerebral diseases and psychological disorders. Most of those studies rely on 2D analysis of the corpus callosum in the mid-sagittal plane. However, it is common to find conflicting results among studies, once many ignore methodological issues and define the mid-sagittal plane based on precary or invalid criteria with respect to the corpus callosum. In this work we propose a novel method to determine the mid-callosal plane using the corpus callosum internal preferred diffusion directions obtained from diffusion tensor images. This plane is analogous to the mid-sagittal plane, but intended to serve exclusively as the corpus callosum reference. Our method elucidates the great potential the directional information of the corpus callosum fibers have to indicate its own referential. Results from experiments with five image pairs from distinct subjects, obtained under the same conditions, demonstrate the method effectiveness to find the corpus callosum symmetric axis relative to the axial plane.

  18. Sagittal Fresh Blood Imaging with Interleaved Acquisition of Systolic and Diastolic Data for Improved Robustness to Motion

    Science.gov (United States)

    Atanasova, Iliyana P.; Kim, Daniel; Storey, Pippa; Rosenkrantz, Andrew B; Lim, Ruth P.; Lee, Vivian S.

    2012-01-01

    Purpose To improve robustness to patient motion of ‘fresh blood imaging’ (FBI) for lower extremity non-contrast MRA. Methods In FBI, two sets of 3D fast spin echo images are acquired at different cardiac phases and subtracted to generate bright-blood angiograms. Routinely performed with a single coronal slab and sequential acquisition of systolic and diastolic data, FBI is prone to subtraction errors due to patient motion. In this preliminary feasibility study, FBI was implemented with two sagittal imaging slabs, and the systolic and diastolic acquisitions were interleaved to minimize sensitivity to motion. The proposed technique was evaluated in volunteers and patients. Results In ten volunteers, imaged while performing controlled movements, interleaved FBI demonstrated better tolerance to subject motion than sequential FBI. In one patient with peripheral arterial disease, interleaved FBI offered better depiction of collateral flow by reducing sensitivity to inadvertent motion. Conclusions FBI with interleaved acquisition of diastolic and systolic data in two sagittal imaging slabs offers improved tolerance to patient motion. PMID:23300129

  19. Coronal Mass Ejections travel time

    Science.gov (United States)

    Braga, Carlos Roberto; Souza de Mendonça, Rafael Rodrigues; Dal Lago, Alisson; Echer, Ezequiel

    2017-10-01

    Coronal mass ejections (CMEs) are the main source of intense geomagnetic storms when they are earthward directed. Studying their travel time is a key-point to understand when the disturbance will be observed at Earth. In this work, we study the CME that originated the interplanetary disturbance observed on 2013/10/02. According to the observations, the CME that caused the interplanetary disturbance was ejected on 2013/09/29. We obtained the CME speed and estimate of the time of arrival at the Lagrangian Point L1 using the concept of expansion speed. We found that observed and estimated times of arrival of the shock differ between 2 and 23 hours depending on method used to estimate the radial speed.

  20. Image-based reconstruction of the Newtonian dynamics of solar coronal ejecta

    Science.gov (United States)

    Uritsky, Vadim M.; Thompson, Barbara J.

    2016-10-01

    We present a new methodology for analyzing rising and falling dynamics of unstable coronal material as represented by high-cadence SDO AIA images. The technique involves an adaptive spatiotemporal tracking of propagating intensity gradients and their characterization in terms of time-evolving areas swept out by the position vector originated from the Sun disk center. The measured values of the areal velocity and acceleration are used to obtain quantitative information on the angular momentum and acceleration along the paths of the rising and falling coronal plasma. In the absence of other forces, solar gravitation results in purely ballistic motions consistent with the Kepler's second law; non-central forces such as the Lorentz force introduce non-zero torques resulting in more complex motions. The developed algorithms enable direct evaluation of the line-of-sight component of the net torque applied to a unit mass of the ejected coronal material which is proportional to the image-plane projection of the observed areal acceleration. The current implementation of the method cannot reliably distinguish torque modulations caused by the coronal force field from those imposed by abrupt changes of plasma mass density and nontrivial projection effects. However, it can provide valid observational constraints on the evolution of large-scale unstable magnetic topologies driving major solar-coronal eruptions as demonstrated in the related talk by B. Thompson et al.

  1. Sagittal alignment of cervical spine in adult idiopathic scoliosis.

    Science.gov (United States)

    Aykac, Bilal; Ayhan, Selim; Yuksel, Selcen; Guler, Umit Ozgur; Pellise, Ferran; Alanay, Ahmet; Perez-Grueso, Francisco Javier Sanchez; Acaroglu, Emre

    2015-06-01

    Alignment of the cervical spine (CS) in adolescent idiopathic scoliosis (IS) as well as in asymptomatic adult populations has recently been studied and described as being less lordotic in the adolescent IS population. However, few studies have examined the sagittal alignment of the CS in adult IS or its association with other radiological variables and clinical relevance. The aim of this study is to analyse the sagittal alignment of CS in adult IS and its association with age, alignment of the thoracic, lumbar and global spinal column as well as health-related quality of life (HRQOL) parameters. A retrospective review of prospectively collected data from a multicenter database was performed. Of 468 consecutive adult IS patients, 213 were included in the study; the remainder were excluded due to poor quality X-rays where the CS was not properly visible, or previous surgery. X-rays were measured for the following CS parameters: [Cranial base-C2 (C0-C2) lordosis, C2-C7 lordosis, thoracic (T1) slope, thoracic inlet angle (TIA) and odontoid (Od)-T1 offset using a measurement software]. These measurements were then evaluated for possible associations with patient age and with pre-existing alignment parameters and HRQOL scores using Pearson correlation tests. The average and standard deviations for CS alignment parameters were 32.3° ± 10.2° for C0-C2; 5.7° ± 14.1° for C2-C7; 23.9° ± 11.3° for T1 slope, 70.5° ± 14.7° for TIA and 20.8° ± 16.5° for Od-T1 offset. CS alignment showed a significant (p < 0.05) correlation with age, T kyphosis and several other sagittal alignment parameters such as sagittal vertical axis (SVA), global tilt and T1 sagittal tilt, but not with the HRQOL parameters. The sagittal alignment of the CS in adult IS is less lordotic than the normal average while less kyphotic than that of IS of a younger age. It correlates with age, thoracic kyphosis and some global sagittal alignment parameters. These findings suggest that CS alignment is

  2. Sagittal synostosis: I. Preoperative morphology of the skull

    DEFF Research Database (Denmark)

    Guimaraes-Ferreira, J.; Gewalli, F.; David, L.

    2006-01-01

    The aim of this study was to characterise the preoperative morphology of the skull in sagittal synostosis in an objective and quantified way. The shapes of the skulls of 105 patients with isolated premature synostosis of the sagittal suture ( SS group) were studied and compared with those...... of a control group of 72 children with unilateral incomplete cleft lip (UICL). A standardised radiocephalometric technique was used to obtain the images. A modification of a method developed by Kreiborg was used to analyse the radiocephalograms, which included the digitisation of 88 landmarks in the calvaria...

  3. Observational features of equatorial coronal hole jets

    Directory of Open Access Journals (Sweden)

    G. Nisticò

    2010-03-01

    Full Text Available Collimated ejections of plasma called "coronal hole jets" are commonly observed in polar coronal holes. However, such coronal jets are not only a specific features of polar coronal holes but they can also be found in coronal holes appearing at lower heliographic latitudes. In this paper we present some observations of "equatorial coronal hole jets" made up with data provided by the STEREO/SECCHI instruments during a period comprising March 2007 and December 2007. The jet events are selected by requiring at least some visibility in both COR1 and EUVI instruments. We report 15 jet events, and we discuss their main features. For one event, the uplift velocity has been determined as about 200 km s−1, while the deceleration rate appears to be about 0.11 km s−2, less than solar gravity. The average jet visibility time is about 30 min, consistent with jet observed in polar regions. On the basis of the present dataset, we provisionally conclude that there are not substantial physical differences between polar and equatorial coronal hole jets.

  4. Observational features of equatorial coronal hole jets

    Directory of Open Access Journals (Sweden)

    G. Zimbardo

    2010-03-01

    Full Text Available Collimated ejections of plasma called "coronal hole jets" are commonly observed in polar coronal holes. However, such coronal jets are not only a specific features of polar coronal holes but they can also be found in coronal holes appearing at lower heliographic latitudes. In this paper we present some observations of "equatorial coronal hole jets" made up with data provided by the STEREO/SECCHI instruments during a period comprising March 2007 and December 2007. The jet events are selected by requiring at least some visibility in both COR1 and EUVI instruments. We report 15 jet events, and we discuss their main features. For one event, the uplift velocity has been determined as about 200 km s−1, while the deceleration rate appears to be about 0.11 km s−2, less than solar gravity. The average jet visibility time is about 30 min, consistent with jet observed in polar regions. On the basis of the present dataset, we provisionally conclude that there are not substantial physical differences between polar and equatorial coronal hole jets.

  5. FORWARD: A toolset for multiwavelength coronal magnetometry

    Directory of Open Access Journals (Sweden)

    Sarah eGibson

    2016-03-01

    Full Text Available Determining the 3D coronal magnetic field is a critical, but extremely difficult problem to solve. Since different types of multiwavelength coronal data probe different aspects of the coronal magnetic field, ideally these data should be used together to validate and constrain specifications of that field. Such a task requires the ability to create observable quantities at a range of wavelengths from a distribution of magnetic field and associated plasma -- i.e., to perform forward calculations. In this paper we describe the capabilities of the FORWARD SolarSoft IDL package, a uniquely comprehensive toolset for coronal magnetometry. FORWARD is a community resource that may be used both to synthesize a broad range of coronal observables, and to access and compare synthetic observables to existing data. It enables forward fitting of specific observations, and helps to build intuition into how the physical properties of coronal magnetic structures translate to observable properties. FORWARD can also be used to generate synthetic test beds from MHD simulations in order to facilitate the development of coronal magnetometric inversion methods, and to prepare for the analysis of future large solar telescope data.

  6. Comparison of coronal and axial computed tomography measurements of mediastinal nodes before primary surgery for non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Guinet, Claude [Department of Radiology, Hôtel Dieu Hospital, AP-HP, 1, Place du Parvis Notre-Dame, 75181 Paris Cedex (France); Rousset, Pascal, E-mail: roussetpascal@gmail.com [Department of Radiology, Hôtel Dieu Hospital, AP-HP, 1, Place du Parvis Notre-Dame, 75181 Paris Cedex (France); Bobbio, Antonio; Alifano, Marco [Department of Thoracic Surgery, Hôtel Dieu Hospital, AP-HP, 1, Place du Parvis Notre-Dame, 75181 Paris Cedex (France); Damotte, Diane [Department of Pathology, Hôtel Dieu Hospital, AP-HP, 1, Place du Parvis Notre-Dame, 75181 Paris Cedex (France); Régnard, Jean-François [Department of Thoracic Surgery, Hôtel Dieu Hospital, AP-HP, 1, Place du Parvis Notre-Dame, 75181 Paris Cedex (France); Buy, Jean-Noël [Department of Radiology, Hôtel Dieu Hospital, AP-HP, 1, Place du Parvis Notre-Dame, 75181 Paris Cedex (France)

    2012-09-15

    Objective: To assess computed tomography (CT) evaluation of mediastinal nodes in non-small cell lung cancer to predict metastatic involvement by measurement of their axis and surface area in the coronal plane, as compared to standard short-axis measures in the axial plane. Methods: Evaluation of mediastinal nodes was retrospectively performed on CT scans of 100 patients before thoracotomy. In all patients, mediastinal dissection was performed in the appropriate stations (n = 264) according to the side (59 right, 41 left) of the tumor. Measurements of short axis and surface area of the largest node in each dissected station were performed on axial and coronal planes. Results: By using the standard threshold of axial short axis ≥10 mm, sensitivity and specificity were 25% and 98%, respectively. Areas under receiver operating characteristic curves were 0.828 and 0.821 for axial short axis and axial surface area data. For comparison, areas under receiver operating characteristic curves were 0.843 and 0.845 for coronal short axis and coronal surface area data, respectively. So, for a specificity of 98%, sensitivity was 29% for coronal short axis ≥11 mm and 33% for coronal surface area ≥123 mm{sup 2}. When using axial short axis ≥10 mm or coronal surface area ≥120 mm{sup 2}, sensitivity was 45%, whereas specificity remained at 96%. Conclusion: Coronal measurements of mediastinal nodes give a slightly albeit non-significant improvement of diagnostic accuracy over axial ones. If both axial short axis and coronal surface area are taken into account, accuracy is improved.

  7. Comparison of coronal and axial computed tomography measurements of mediastinal nodes before primary surgery for non-small cell lung cancer.

    Science.gov (United States)

    Guinet, Claude; Rousset, Pascal; Bobbio, Antonio; Alifano, Marco; Damotte, Diane; Régnard, Jean-François; Buy, Jean-Noël

    2012-09-01

    To assess computed tomography (CT) evaluation of mediastinal nodes in non-small cell lung cancer to predict metastatic involvement by measurement of their axis and surface area in the coronal plane, as compared to standard short-axis measures in the axial plane. Evaluation of mediastinal nodes was retrospectively performed on CT scans of 100 patients before thoracotomy. In all patients, mediastinal dissection was performed in the appropriate stations (n=264) according to the side (59 right, 41 left) of the tumor. Measurements of short axis and surface area of the largest node in each dissected station were performed on axial and coronal planes. By using the standard threshold of axial short axis ≥10 mm, sensitivity and specificity were 25% and 98%, respectively. Areas under receiver operating characteristic curves were 0.828 and 0.821 for axial short axis and axial surface area data. For comparison, areas under receiver operating characteristic curves were 0.843 and 0.845 for coronal short axis and coronal surface area data, respectively. So, for a specificity of 98%, sensitivity was 29% for coronal short axis ≥11 mm and 33% for coronal surface area ≥123 mm(2). When using axial short axis ≥10 mm or coronal surface area ≥120 mm(2), sensitivity was 45%, whereas specificity remained at 96%. Coronal measurements of mediastinal nodes give a slightly albeit non-significant improvement of diagnostic accuracy over axial ones. If both axial short axis and coronal surface area are taken into account, accuracy is improved. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. Space weather and coronal mass ejections

    CERN Document Server

    Howard, Tim

    2013-01-01

    Space weather has attracted a lot of attention in recent times. Severe space weather can disrupt spacecraft, and on Earth can be the cause of power outages and power station failure. It also presents a radiation hazard for airline passengers and astronauts. These ""magnetic storms"" are most commonly caused by coronal mass ejections, or CMES, which are large eruptions of plasma and magnetic field from the Sun that can reach speeds of several thousand km/s. In this SpringerBrief, Space Weather and Coronal Mass Ejections, author Timothy Howard briefly introduces the coronal mass ejection, its sc

  9. Sagittal parameters of global cervical balance using EOS imaging: normative values from a prospective cohort of asymptomatic volunteers.

    Science.gov (United States)

    Le Huec, J C; Demezon, H; Aunoble, S

    2015-01-01

    To define reference parameters for analyzing sagittal balance of the cervical spine in asymptomatic volunteers. Prospective study after Bioethics Committee approval. Imaging performed using a low-dose radiographic system (EOS Imaging, Paris, France). The absence of pain was assessed using the Oswestry Questionnaire and VAS. 106 subjects were included of whom 55.66 % were men. The parameters measured were: pelvic incidence, pelvic tilt, sacral slope, thoracic and lumbar curvature, C7 plumb line position and the spino-sacral angle. The C7 slope and new parameters were measured: cranial incidence, defined in relation to the McGregor line and the sella turcica allowing to define cranial slope and tilt, and the spino-cranial angle (SCA). This study demonstrated a close correlation between the C7 slope and the cranio-cervical system. Economic sagittal balance in the asymptomatic population was defined by a constant SCA angle of 83° ± 9°. To maintain this balance, a spine with a marked C7 slope will present lordosis and vice versa. Cranial incidence is an anatomical parameter characteristic of the cranio-cervical system which makes it possible to analyze the spatial positioning of the head and to predict the desired value of cervical lordosis which is closely correlated to cranial slope. The C7 slope has a predictive value of the shape of the cervical spine in the sagittal plane. One-third of the asymptomatic population had cervical kyphosis. Our results could be used to study sagittal balance before and after arthrodesis, or cervical prosthesis.

  10. Posterior coronal plating for tibial fractures: technique and advantages

    Directory of Open Access Journals (Sweden)

    Montu Jain

    2014-04-01

    Full Text Available Objective:Tibial shaft fractures are straightforward to treat but when associated with soft tissue injury particularly at the nail entry/plate insertion site or there is significant comminution proximally or a large butterfly fragment/a second split component in the posterior coronal plane, it is a challenge to the treating surgeon. The aim of the present report is to describe the technique of posterior coronal plating in such a scenario and its advantages. Methods:Between July 2008 and June 2011, 12 patients were pro spectively treated by this approach using 4.5 mm broad dynamic compression plates. Results:The time of bony consolidation and full weight bearing averaged 21.7 weeks (range, 16-26 weeks. Patients were followed up for at least 24 months (range, 24-48 months. At 1 year postoper atively, no loss in reduction or alignment was observed. Mean Hospital for Lower Extremity Measurement Functional Score was 72.8 (range, 64-78. All patients were satisfied with their treatment outcomes. Conclusion:Direct posterior approach and fixation using prone position helps to visualise the fracture fragments and provide rigid fixation. The approach is simple and extensile easily, apart from advantages of less soft tissue and hardware problems compared to standard medial or lateral plating. Key words: Tibial fractures; Bone plates; Orthopedic procedures

  11. The Parker Problem and the Theory of Coronal Heating

    Science.gov (United States)

    Craig, I. J. D.; Sneyd, A. D.

    2005-11-01

    To illustrate his theory of coronal heating, Parker initially considers the problem of disturbing a homogeneous vertical magnetic field that is line-tied across two infinite horizontal surfaces. It is argued that, in the absence of resistive effects, any perturbed equilibrium must be independent of z. As a result random footpoint perturbations give rise to magnetic singularities, which generate strong Ohmic heating in the case of resistive plasmas. More recently these ideas have been formalized in terms of a magneto-static theorem but no formal proof has been provided. In this paper we investigate the Parker hypothesis by formulating the problem in terms of the fluid displacement. We find that, contrary to Parker's assertion, well-defined solutions for arbitrary compressibility can be constructed which possess non-trivial z-dependence. In particular, an analytic treatment shows that small-amplitude Fourier disturbances violate the symmetry ∂z = 0 for both compact and non-compact regions of the (x, y) plane. Magnetic relaxation experiments at various levels of gas pressure confirm the existence and stability of the Fourier mode solutions. More general footpoint displacements that include appreciable shear and twist are also shown to relax to well-defined non-singular equilibria. The implications for Parker's theory of coronal heating are discussed.

  12. Bilateral sagittal split osteotomy versus distraction osteogenesis for mandibular advancements

    NARCIS (Netherlands)

    Baas, E.M.

    2015-01-01

    The aim of this thesis was to compare the treatment modality of distraction osteogenesis (DO) with the gold standard for mandibular advancement surgery. In fact we compare distraction osteogenesis with the standard of care, which is a conventional bilateral sagittal split osteotomy as described by

  13. Lenke 1 and 5: changes in sagittal balance

    Directory of Open Access Journals (Sweden)

    Delson Valdemir Pessin

    2014-09-01

    Full Text Available OBJECTIVE: To assess in a cross-sectional study whether there are changes in sagittal balance in patients with adolescent idiopathic scoliosis Lenke types 1 and 5 compared with patients without pathology of the spine and compare the values of the parameters of normal subjects with the parameters found in the literature. METHODS: We measured the values of the parameters of sagittal balance of 21 patients with scoliosis and 14 patients without scoliosis in panoramic radiographs or simply collected data previously measured from the medical records. We compared the mean values of normal subjects, the mean values found in the literature, and the means between normal subjects and patients with scoliosis. For this, we used the Student t test. RESULTS: Using a confidence interval of 5% (p < 0.05 and the Student t test we obtained statistical significance in the comparison of two parameters of sagittal balance between normal subjects and patients with scoliosis. We observed similarities in the measurements of the average parameters of normal subjects with regard to the work already published. CONCLUSIONS: The adolescent idiopathic scoliosis causes changes in two parameters of sagittal balance with statistical significance but suggests changes in all other parameters. As for comparison with previously published work, the results were similar.

  14. Intra-operative complications in sagittal and vertical ramus osteotomies

    NARCIS (Netherlands)

    van Merkesteyn, J. P.; Groot, R. H.; van Leeuwaarden, R.; Kroon, F. H.

    1987-01-01

    In orthognatic surgery of the mandibular ramus, intra-operative complications as a lesion of the inferior alveolar nerve, fractures of the osteotomised segments, incomplete sectioning, malpositioning of segments and haemorrhage may occur. In this report, intra-operative complications in 124 sagittal

  15. Interplanetary Coronal Mass Ejections observed by MESSENGER and Venus Express

    CERN Document Server

    Good, S W

    2015-01-01

    Interplanetary coronal mass ejections (ICMEs) observed by the MESSENGER (MES) and Venus Express (VEX) spacecraft have been catalogued and analysed. The ICMEs were identified by a relatively smooth rotation of the magnetic field direction consistent with a flux rope structure, coinciding with a relatively enhanced magnetic field strength. A total of 35 ICMEs were found in the surveyed MES data (primarily from March 2007 to April 2012), and 84 ICMEs in the surveyed VEX data (from May 2006 to December 2013). The ICME flux rope configurations have been determined. Ropes with northward leading edges were about four times more common than ropes with southward leading edges, in agreement with a previously established solar cycle dependence. Ropes with low inclinations to the solar equatorial plane were about four times more common than ropes with high inclinations, possibly an observational effect. Left and right-handed ropes were observed in almost equal numbers. In addition, data from MES, VEX, STEREO-A, STEREO-B ...

  16. Energy conversion in the coronal plasma

    Science.gov (United States)

    Martens, P. C. H.

    1986-01-01

    Solar and stellar X-ray emission are the observed waste products of the interplay between magnetic fields and the motion of stellar plasma. Theoretical understanding of the process of coronal heating is of utmost importance, since the high temperature is what defines the corona in the first place. Most of the research described deals with the aspects of the several rivalling theories for coronal heating. The rest of the papers deal with processes of energy conversion related to flares.

  17. Compensatory mechanisms contributing to keep the sagittal balance of the spine

    National Research Council Canada - National Science Library

    Barrey, Cédric; Roussouly, Pierre; Le Huec, Jean-Charles; D’Acunzi, Gennaro; Perrin, Gilles

    2013-01-01

    .... For the two last stages, the compensatory mechanisms permit to limit the consequences of loss of lumbar lordosis on global sagittal alignment and therefore contribute to keep the sagittal balance...

  18. Which oblique plane is more helpful in diagnosing an anterior cruciate ligament tear?

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, J.W. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Yoon, Y.C. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of)], E-mail: ycyoon@skku.edu; Kim, Y.N. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Ahn, J.H. [Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Choe, B.K. [Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2009-03-15

    Aim: To evaluate the diagnostic role of additional oblique coronal and oblique sagittal magnetic resonance imaging (MRI) for an anterior cruciate ligament (ACL) tear. Materials and methods: A total of 101 patients who had undergone preoperative knee MRI examinations with orthogonal and two sets of oblique images were enrolled in the study. Two radiologists evaluated the MRI images by the use of four methods: orthogonal images only (method A); orthogonal and additional oblique coronal images (method B); orthogonal and oblique sagittal images (method C); and orthogonal images with oblique coronal and sagittal images (method D). The status of the ACL (normal or tear) was determined by consensus. The sensitivity, specificity, and accuracy for an ACL tear with the use of each method were calculated in comparison with arthroscopy as the reference standard, and values were statistically analysed using the McNemar test. The diagnostic accuracies were compared using receiver operating characteristic (ROC) analysis. Results: Arthroscopy identified 10 partial ACL tears and 30 complete ACL tears. The specificities and accuracies for methods B, C, and D were significantly higher than the specificities and accuracies for method A (p < 0.05). There was no significant difference in the sensitivity, specificity, and accuracy for methods B, C, and D. Diagnostic ability was not significantly different for each method, as determined by ROC analysis (p > 0.05). Conclusions: Additional oblique imaging for an ACL tear improved the specificity. Either of the oblique imaging methods is sufficient, and no further improvement in the diagnostic efficacy was achieved by simultaneous use.

  19. Composition of Coronal Mass Ejections

    Science.gov (United States)

    Zurbuchen, T. H.; Weberg, M.; von Steiger, R.; Mewaldt, R. A.; Lepri, S. T.; Antiochos, S. K.

    2016-01-01

    We analyze the physical origin of plasmas that are ejected from the solar corona. To address this issue, we perform a comprehensive analysis of the elemental composition of interplanetary coronal mass ejections (ICMEs) using recently released elemental composition data for Fe, Mg, Si, S, C, N, Ne, and He as compared to O and H. We find that ICMEs exhibit a systematic abundance increase of elements with first ionization potential (FIP) less than 10 electronvolts, as well as a significant increase of Ne as compared to quasi-stationary solar wind. ICME plasmas have a stronger FIP effect than slow wind, which indicates either that an FIP process is active during the ICME ejection or that a different type of solar plasma is injected into ICMEs. The observed FIP fractionation is largest during times when the Fe ionic charge states are elevated above Q (sub Fe) is greater than 12.0. For ICMEs with elevated charge states, the FIP effect is enhanced by 70 percent over that of the slow wind. We argue that the compositionally hot parts of ICMEs are active region loops that do not normally have access to the heliosphere through the processes that give rise to solar wind. We also discuss the implications of this result for solar energetic particles accelerated during solar eruptions and for the origin of the slow wind itself.

  20. MULTIDIMENSIONAL MODELING OF CORONAL RAIN DYNAMICS

    Energy Technology Data Exchange (ETDEWEB)

    Fang, X.; Xia, C.; Keppens, R. [Centre for mathematical Plasma Astrophysics, Department of Mathematics, KU Leuven, B-3001 Leuven (Belgium)

    2013-07-10

    We present the first multidimensional, magnetohydrodynamic simulations that capture the initial formation and long-term sustainment of the enigmatic coronal rain phenomenon. We demonstrate how thermal instability can induce a spectacular display of in situ forming blob-like condensations which then start their intimate ballet on top of initially linear force-free arcades. Our magnetic arcades host a chromospheric, transition region, and coronal plasma. Following coronal rain dynamics for over 80 minutes of physical time, we collect enough statistics to quantify blob widths, lengths, velocity distributions, and other characteristics which directly match modern observational knowledge. Our virtual coronal rain displays the deformation of blobs into V-shaped features, interactions of blobs due to mostly pressure-mediated levitations, and gives the first views of blobs that evaporate in situ or are siphoned over the apex of the background arcade. Our simulations pave the way for systematic surveys of coronal rain showers in true multidimensional settings to connect parameterized heating prescriptions with rain statistics, ultimately allowing us to quantify the coronal heating input.

  1. Coronal rain in magnetic bipolar weak fields

    Science.gov (United States)

    Xia, C.; Keppens, R.; Fang, X.

    2017-07-01

    Aims: We intend to investigate the underlying physics for the coronal rain phenomenon in a representative bipolar magnetic field, including the formation and the dynamics of coronal rain blobs. Methods: With the MPI-AMRVAC code, we performed three dimensional radiative magnetohydrodynamic (MHD) simulation with strong heating localized on footpoints of magnetic loops after a relaxation to quiet solar atmosphere. Results: Progressive cooling and in-situ condensation starts at the loop top due to radiative thermal instability. The first large-scale condensation on the loop top suffers Rayleigh-Taylor instability and becomes fragmented into smaller blobs. The blobs fall vertically dragging magnetic loops until they reach low-β regions and start to fall along the loops from loop top to loop footpoints. A statistic study of the coronal rain blobs finds that small blobs with masses of less than 1010 g dominate the population. When blobs fall to lower regions along the magnetic loops, they are stretched and develop a non-uniform velocity pattern with an anti-parallel shearing pattern seen to develop along the central axis of the blobs. Synthetic images of simulated coronal rain with Solar Dynamics Observatory Atmospheric Imaging Assembly well resemble real observations presenting dark falling clumps in hot channels and bright rain blobs in a cool channel. We also find density inhomogeneities during a coronal rain "shower", which reflects the observed multi-stranded nature of coronal rain. Movies associated to Figs. 3 and 7 are available at http://www.aanda.org

  2. Morphological changes in the temporomandibular joint before and after sagittal splitting ramus osteotomy of the mandible for skeletal mandibular protrusion.

    Science.gov (United States)

    Enami, Koji; Yamada, Kazuhiro; Kageyama, Toru; Taguchi, Akira

    2013-04-01

    Changes of temporomandibular joint (TMJ) morphology were analyzed in 21 patients with mandibular protrusion corrected using bilateral sagittal split ramus osteotomy (SSRO) and mini-plate fixation with TMJ cephalometric laminographs. The condylar pass angle, eminence to the FH plane angle, and total height of fossa and lower height of fossa in both left and right sides, significantly decreased after surgery. The width of the condyle, in both left and right sides, significantly increased after treatment. However, in the joint spaces, there were no significant differences before and after treatment. The amount of change in the eminence to the FH plane angle, total height of fossa and lower height of fossa, before and after surgery, showed significant positive correlations with that of SNB, before and after surgery. These results suggest that adaptive bone remodeling of the TMJ might occur due to the correction of occlusion and craniofacial morphology by SSRO in patients with mandibular protrusion.

  3. Microstrip Resonator for High Field MRI with Capacitor-Segmented Strip and Ground Plane

    DEFF Research Database (Denmark)

    Zhurbenko, Vitaliy; Boer, Vincent; Petersen, Esben Thade

    2017-01-01

    ) segmenting stripe and ground plane of the resonator with series capacitors. The design equations for capacitors providing symmetric current distribution are derived. The performance of two types of segmented resonators are investigated experimentally. To authors’ knowledge, a microstrip resonator, where both......High field MRI coils are often based on transmission line resonators. Due to relatively short wavelength of RF fields, such coils produce uneven field patterns. Here we show, that it is possible to manipulate magnetic field patterns of microstrip resonators in both planes (sagittal and transverse......, strip and ground plane are capacitor-segmented, is shown here for the first time....

  4. Sex Differences in Frontal and Transverse Plane Hip and Knee Kinematics During the Modified Star Excursion Balance Test

    Directory of Open Access Journals (Sweden)

    Willis Brad W.

    2017-09-01

    Full Text Available Purpose. The modified Star Excursion Balance Test (mSEBT assesses dynamic neuromuscular control, with predictive ability regarding lower extremity injury risk. Previous kinematic mSEBT analyses are limited to sex differences between injured or fatigued populations or non-fatigued groups in the sagittal plane only. We hypothesize that sex differences exist in the frontal and transverse plane kinematics of the hip and knee in healthy, non-fatigued subjects during the mSEBT. Methods. The descriptive laboratory study involved 38 healthy subjects: 20 males (aged 24.8 ± 2.7 years and 18 females (24.1 ± 3.7 years. Peak kinematics, obtained by a VICONTM motion system, of the hip and knee in the sagittal, frontal, and transverse plane were compared during the anterior, posteromedial, and posterolateral reach of the mSEBT. Wilcoxon rank test with significant differences at p < 0.05 was used. Results. Kinematic differences existed between the groups in the frontal and transverse plane of the hip and knee in all reach directions (p < 0.05. No differences were found in the sagittal plane of the hip or knee between the groups. Conclusions. Sex differences exist in frontal and transverse plane kinematics of the hip and knee during the mSEBT. The mSEBT may be enhanced as an injury prediction tool, if frontal and transverse plane kinematics were included during risk assessment screening.

  5. Spectropolarimetric forward modelling of the lines of the Lyman-series using a self-consistent, global, solar coronal model

    Science.gov (United States)

    Khan, A.; Belluzzi, L.; Landi Degl'Innocenti, E.; Fineschi, S.; Romoli, M.

    2011-05-01

    Context. The presence and importance of the coronal magnetic field is illustrated by a wide range of phenomena, such as the abnormally high temperatures of the coronal plasma, the existence of a slow and fast solar wind, the triggering of explosive events such as flares and CMEs. Aims: We investigate the possibility of using the Hanle effect to diagnose the coronal magnetic field by analysing its influence on the linear polarisation, i.e. the rotation of the plane of polarisation and depolarisation. Methods: We analyse the polarisation characteristics of the first three lines of the hydrogen Lyman-series using an axisymmetric, self-consistent, minimum-corona MHD model with relatively low values of the magnetic field (a few Gauss). Results: We find that the Hanle effect in the above-mentioned lines indeed seems to be a valuable tool for analysing the coronal magnetic field. However, great care must be taken when analysing the spectropolarimetry of the Lα line, given that a non-radial solar wind and active regions on the solar disk can mimic the effects of the magnetic field, and, in some cases, even mask them. Similar drawbacks are not found for the Lβ and Lγ lines because they are more sensitive to the magnetic field. We also briefly consider the instrumental requirements needed to perform polarimetric observations for diagnosing the coronal magnetic fields. Conclusions: The combined analysis of the three aforementioned lines could provide an important step towards better constrainting the value of solar coronal magnetic fields.

  6. The Search for Stellar Coronal Mass Ejections

    Science.gov (United States)

    Villadsen, Jacqueline Rose

    2017-05-01

    Coronal mass ejections (CMEs) may dramatically impact habitability and atmospheric composition of planets around magnetically active stars, including young solar analogs and many M dwarfs. Theoretical predictions of such effects are limited by the lack of observations of stellar CMEs. This thesis addresses this gap through a search for the spectral and spatial radio signatures of CMEs on active M dwarfs. Solar CMEs produce radio bursts with a distinctive spectral signature, narrow-band plasma emission that drifts to lower frequency as a CME expands outward. To search for analogous events on nearby stars, I worked on system design, software, and commissioning for the Starburst project, a wideband single-baseline radio interferometry backend dedicated to stellar observations. In addition, I led a survey of nearby active M dwarfs with the Karl G. Jansky Very Large Array (VLA), detecting coherent radio bursts in 13 out of 23 epochs, over a total of 58 hours. This survey's ultra-wide bandwidth (0.23-6.0 GHz) dynamic spectroscopy, unprecedented for stellar observations, revealed diverse behavior in the time-frequency plane. Flare star UV Ceti produced complex, luminous events reminiscent of brown dwarf aurorae; AD Leo sustained long-duration, intense, narrow-band "storms"; and YZ CMi emitted a burst with substructure with rapid frequency drift, resembling solar Type III bursts, which are attributed to electrons moving at speeds of order 10% of the speed of light. To search for the spatial signature of CMEs, I led 8.5-GHz observations with the Very Long Baseline Array simultaneous to 24 hours of the VLA survey. This program detected non-thermal continuum emission from the stars in all epochs, as well as continuum flares on AD Leo and coherent bursts on UV Ceti, enabling measurement of the spatial offset between flaring and quiescent emission. These observations demonstrate the diversity of stellar transients that can be expected in time-domain radio surveys, especially

  7. Unitals in Projective Planes

    CERN Document Server

    Barwick, Susan

    2008-01-01

    Unitals are key structures in projective planes, and have connections with other structures in algebra. This book presents a monograph on unitals embedded in finite projective planes. It offers a survey of the research literature on embedded unitals. It is suitable for graduate students and researchers who want to learn about this topic

  8. Sagittal Balance in Adolescent Idiopathic Scoliosis: A Radiographic Study of Spinopelvic Compensation After Selective Posterior Fusion of Thoracolumbar/Lumbar (Lenke 5C) Curves.

    Science.gov (United States)

    Xu, Xi-Ming; Wang, Fei; Zhou, Xiao-Yi; Liu, Zi-Xuan; Wei, Xian-Zhao; Bai, Yu-Shu; Li, Ming

    2015-11-01

    The relationship between spinal sagittal alignment and pelvic parameters is well known in adolescent idiopathic scoliosis. However, few studies have reported the sagittal spinopelvic relationship after selective posterior fusion of thoracolumbar/lumbar (TL/L) curves. We evaluated the relationship between spinal sagittal alignment and the pelvis, and analyzed how the pelvic sagittal state is adjusted in Lenke type 5C patients. We conducted a retrospective study of 36 patients with Lenke type 5C curves who received selective posterior TL/L curve fusion. Coronal and spinopelvic sagittal parameters were pre and postoperatively compared. Pearson coefficients were used to analyze the correlation between all spinopelvic sagittal parameters before and after surgery. We also evaluated 3 pelvic morphologies (anteverted, normal, and retroverted) before and after surgery. Preoperatively, the mean pelvic incidence was 46.0°, with a pelvic tilt and sacral slope (SS) of 8.2° and 37.8°, respectively, and 25% (9/36) of patients had an anteverted pelvis, whereas the other 75% had a normal pelvis. Postoperatively, 42% (15/36) of patients had a retroverted pelvis, 53% (19/36) had a normal pelvis, and 2 patients had an anteverted pelvis. Logistic regression analyses yielded 2 factors that were significantly associated with the risk for a postoperative unrecovered anteverted pelvis, including increased lumbar lordosis (LL) (odds ratio [OR] 4.8, P = 0.029) and increased SS (OR 5.6, P = 0.018). Four factors were significantly associated with the risk of a postoperative newly anteverted pelvis, including LL at the final follow-up (OR 6.9, P = 0.009), increased LL (OR 8.9, P = 0.003), LL below fusion (OR 9.4, P = 0.002), and increased SS (OR 11.5, P = 0.001). The pelvic state may be adjusted after selective posterior TL/L curve fusion in Lenke 5C adolescent idiopathic scoliosis patients. It is difficult to improve an anteverted pelvis in patients who have an LL

  9. Spine evaluation: Determination of the relationship between thoracic spinal deformity and sagittal curves by a noninvasive method DOI: 10.5007/1980-0037.2010v12n4p282

    Directory of Open Access Journals (Sweden)

    Dalva Minonroze Albuquerque Ferreira

    2010-01-01

    Full Text Available The objectives of this study were to compare sagittal plane alignment between subjects with spinal deformities and a group presenting no changes; to test the reliability of the tool used, and to determine the existence of correlations between spinal deformity and sagittal curvature measures. Forty young subjects were divided into two groups: a control group (n=20 presenting no changes or spinal deformity less than 0.5 cm in the dorsal curvature and 0.7 cm in the lumbar curvature, and an experimental group (n=20 with spinal deformities greater than those described for the control group. Spinal deformity and sagittal plane curvatures were measured using a water level-based tool and by the Adams test. Data were collected from the two groups on two distinct occasions. The Mann-Whitney test showed no difference between sampling times. A significant difference between the two groups was only observed in terms of cervical curvature. Spearman’s test revealed a linear correlation between dorsal curvature and dorsal spinal deformity in the control group, between dorsal and lumbar curves in the two groups, and between dorsal spinal deformity and lumbar and sacral curves and between sacral curvature and dorsal and lumbar curves in the experimental group. In conclusion, spinal deformity measurement is associated with sagittal plane curvatures. The method proposed here is reliable, simple and accessible and can be reproduced without high costs and damage to the patient’s health.

  10. Coroners and death certification law reform: the Coroners and Justice Act 2009 and its aftermath.

    Science.gov (United States)

    Luce, Tom

    2010-10-01

    After considering various different options for half a decade, the last Government legislated in 2009 to reform the England and Wales coroner and death certification systems. The Coroners and Justice Act 2009 provides for the creation of a new Chief Coroner post to lead the jurisdiction and for local medical examiners to oversee a new death certification scheme applicable equally to burial and cremation cases. In October 2010 the new Government announced that it judges the main coroner reform to be unaffordable, will not proceed with it and plans to repeal the provisions. It intends to implement the new death certification arrangements, which is welcome. The decision to abort the main coroner reform in spite of longstanding and widespread recognition of the need for major change is deplorable though in line with other failures over the last century to properly modernise this neglected service.

  11. Maxillomandibular Advancement in Obstructive Sleep Apnea Syndrome Patients: a Restrospective Study on the Sagittal Cephalometric Variables

    Directory of Open Access Journals (Sweden)

    Paolo Ronchi

    2013-06-01

    Full Text Available Objectives: The present retrospective study analyzes sagittal cephalometric changes in patients affected by obstructive sleep apnea syndrome submitted to maxillomandubular advancement. Material and Methods: 15 adult sleep apnea syndrome (OSAS patients diagnosed by polysomnography (PSG and treated with maxillomandubular advancement (MMA were included in this study. Pre- (T1 and postsurgical (T2 PSG studies assessing the apnea/hypopnea index (AHI and the lowest oxygen saturation (LSAT level were compared. Lateral cephalometric radiographs at T1 and T2 measuring sagittal cephalometric variables (SNA, SNB, and ANB were analyzed, as were the amount of maxillary and mandibular advancement (Co-A and Co-Pog, the distance from the mandibular plane to the most anterior point of the hyoid bone (Mp-H, and the posterior airway space (PAS.Results: Postoperatively, the overall mean AHI dropped from 58.7 ± 16 to 8.1 ± 7.8 events per hour (P < 0.001. The mean preoperative LSAT increased from 71% preoperatively to 90% after surgery (P < 0.001. All the patients in our study were successfully treated (AHI < 20 or reduced by 50%. Cephalometric analysis performed after surgery showed a statistically significant correlation between the mean SNA variation and the decrease in the AHI (P = 0.01. The overall mean SNA increase was 6°.Conclusions: Our findings suggest that the improvement observed in the respiratory symptoms, namely the apnea/hypopnea episodes, is correlated with the SNA increase after surgery. This finding may help maxillofacial surgeons to establish selective criteria for the surgical approach to sleep apnea syndrome patients.

  12. Temporomandibular joint computed tomography: development of a direct sagittal technique

    Energy Technology Data Exchange (ETDEWEB)

    van der Kuijl, B.; Vencken, L.M.; de Bont, L.G.; Boering, G. (Univ. of Groningen, (Netherlands))

    1990-12-01

    Radiology plays an important role in the diagnosis of temporomandibular disorders. Different techniques are used with computed tomography offering simultaneous imaging of bone and soft tissues. It is therefore suited for visualization of the articular disk and may be used in patients with suspected internal derangements and other disorders of the temporomandibular joint. Previous research suggests advantages to direct sagittal scanning, which requires special positioning of the patient and a sophisticated scanning technique. This study describes the development of a new technique of direct sagittal computed tomographic imaging of the temporomandibular joint using a specially designed patient table and internal light visor positioning. No structures other than the patient's head are involved in the imaging process, and misleading artifacts from the arm or the shoulder are eliminated. The use of the scanogram allows precise correction of the condylar axis and selection of exact slice level.

  13. Coronal ultra-thick multiplanar CT reconstructions (MPR) of the pelvis in the multiple trauma patient: an alternative for the initial conventional radiograph

    Energy Technology Data Exchange (ETDEWEB)

    Leschka, S.; Alkadhi, H.; Boehm, T.; Marincek, B.; Wildermuth, S. [Inst. fuer Diagnostische Radiologie, UniversitaetsSpital Zuerich (Switzerland)

    2005-10-01

    Purpose: multiple trauma patients with clinically suspected pelvic fractures often directly undergo a CT scan. However, the initial portable pelvis film (PPF) for further follow-up is then not available. This study examines whether coronal ultra-thick multiplanar reconstructions from CT data are similar when compared with the initial PPF, thus having the potential to serve as an alternative baseline image. Materials and methods: initial PPF and coronal ultra-thick multiplanar CT reconstructions of 33 multiple trauma patients with pelvic fractures were retrospectively analyzed by two independent radiologists with regard to image quality, visualization of anatomical landmarks, and diagnostic accuracy. The primary diagnosis of pelvic fractures was made by using thin axial CT images and thin slice coronal and sagittal reconstructions and served as the standard of reference. Results: coronal ultra-thick multiplanar CT reconstructions were superior to PPF regarding image adjustment (p < 0.02), absence of overlaying structures (p < 0.05), and overall image quality (p < 0.01). Visualization of most anatomical landmarks was similar with both modalities, except of the iliosacral joint and acetabular lines which were more accurately depicted on ultrathick multiplanar CT reconstructions (p < 0.05). Diagnostic accuracy of coronal ultra-thick CT reconstructions was similar to PPF regarding most fracture types, except of a higher accuracy of coronal ultra-thick CT reconstructions for iliosacral joint and acetabular column fractures (p < 0.05). Conclusion: coronal ultrathick multiplanar CT reconstructions of the pelvis provide similar image quality and diagnostic accuracy compared to PPF and are therefore suited as alternative baseline image in multiple trauma patients who directly undergo CT. (orig.)

  14. Coronal tissue loss in endodontically treated teeth.

    Science.gov (United States)

    Sulaiman, A O; Shaba, O P; Dosumu, O O; Ajayi, D M

    2012-12-01

    To categorize the endodontically treated teeth according to the extent of coronal tissue loss in order to determine the appropriate restoration required. A two year descriptive study was done at the Conservative Clinic of the Department of Restorative Dentistry, Dental Centre, University College Hospital, Ibadan. Successful endodontically treated teeth were assessed and categorized according to the extent of tissue loss based on standard criteria proposed by Smith and Schuman. Two hundred and ninety endodontically treated teeth were assessed for success both clinically and radiographically. Eighty (27.6%) were anterior teeth, 78 (26.9%) were premolars while 132 (45.5%) were molars. Dental caries was found to be the most common (61.4%) indication for endodontic treatment and caused more coronal tissue damage (moderate and significant) when compared with other indications for endodontic treatment. Two hundred and twenty seven (78.3%) endodontically treated teeth had moderate coronal tissue loss, 41 (14.1%) had minimal damage while 22 (7.6%) had significant tissue damage. Dental caries was the most common indication for endodontic treatment of the posterior teeth while trauma was the most common indication for the anterior teeth. Majority of the endodontically treated teeth that were evaluated for tissue loss had moderate coronal tissue damage. It is therefore recommended that proper and prompt evaluation of the remaining coronal tooth tissue following successful endodontic treatment be carried out in order to determine the appropriate definitive restoration required that will be easy for the clinician and less expensive to the patients.

  15. Changes in frontal morphology after single-stage open posterior-middle vault expansion for sagittal craniosynostosis.

    Science.gov (United States)

    Khechoyan, David; Schook, Carolyn; Birgfeld, Craig B; Khosla, Rohit K; Saltzman, Babette; Teng, Chia Chi; Ettinger, Russell; Gruss, Joseph S; Ellenbogen, Richard; Hopper, Richard A

    2012-02-01

    There is controversy regarding whether the frontal bossing associated with sagittal synostosis requires direct surgical correction or spontaneously remodels after isolated posterior cranial expansion. The authors retrospectively measured changes in frontal bone morphology in patients with isolated sagittal synostosis 2 years after open posterior and midvault cranial expansion and compared these changes with those occurring in age-comparable healthy control groups. Forty-three patients age 1 year or younger (mean, 6 months) with sagittal synostosis underwent computed tomography scan digital analysis immediately after and 2 years after posterior-middle cranial vault expansion. Quantitative angular and linear measures were taken along the midsagittal and axial planes to capture both aspects of frontal bossing. The change in values over the 2 years were compared with healthy controls with normal computed tomography scans taken to rule out head trauma. All measures indicative of frontal bossing decreased significantly from the time of posterior-middle vault expansion to 2 years postoperatively. Whereas the majority of patients at time of the operation had frontal bossing measures greater than two standard deviations outside the age-comparable control mean, almost all patients were within two standard deviations of the norm 2 years later. Lateral forehead bossing and anterior cranial growth was greater the older the patient was at the time of the operation, suggesting that the more time that passed before the operation, the more compensatory anterior fossa growth occurred. Central forehead position relative to the anterior cranial base was greatest in the younger patients at the time of operation, suggesting that a central forehead bulge was an early compensatory response to premature sagittal fusion. As a group, patients with sagittal synostosis start to normalize their forehead morphology within 2 years if an isolated posterior operation is performed at 1 year of age

  16. Sagittal spinopelvic balance in normal children and adolescents.

    Science.gov (United States)

    Mac-Thiong, Jean-Marc; Labelle, Hubert; Berthonnaud, Eric; Betz, Randal R; Roussouly, Pierre

    2007-02-01

    The sagittal spinopelvic balance is poorly documented in normal pediatric subjects. The purpose of this study is to characterize the sagittal spinopelvic balance in the pediatric population and to evaluate the correlations between spinopelvic parameters. Seven parameters were evaluated from the lateral standing radiographs of 341 normal subjects aged 3-18 years old: thoracic kyphosis (TK), thoracic tilt (TT), lumbar lordosis (LL), lumbar tilt (LT), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI). The mean values for the pelvic parameters were 49.1+/-11.0, 7.7+/-8.0 and 41.4+/-8.2 degrees for PI, PT and SS, respectively. The mean values for the spinal parameters were 48.0+/-11.7, 44.0+/-10.9, -7.3+/-5.2 and -3.1+/-5.2 degrees for LL, TK, LT and TT, respectively. The spinopelvic parameters were different from those reported in normal adults, but the correlations between the parameters were similar. PI was significantly related to SS and PT. Significant correlations were found between the parameters of adjacent anatomical regions. Pelvic morphology (PI) regulates sagittal sacro-pelvic orientation (SS and PT). Sacral orientation (SS) is correlated with the shape (LL) and orientation (LT) of the lumbar spine. Adjacent anatomical regions of the spine and pelvis are interdependent, and their relationships result in a stable and compensated posture, presumably to minimize energy expenditure. Results from this study could be used as an aid for the planning of surgery in pediatric patients with spinal deformity in order to restore a relatively normal sagittal spinopelvic balance.

  17. Classification of normal sagittal spine alignment: refounding the Roussouly classification.

    Science.gov (United States)

    Laouissat, Féthi; Sebaaly, Amer; Gehrchen, Martin; Roussouly, Pierre

    2017-04-28

    Although the Roussouly classification of common variants in spinal sagittal alignment is well accepted, no studies have implemented it in an asymptomatic adult population. In addition, no study investigated the radiographic features of asymptomatic patients with an anteverted pelvis. The aim of this prospective radiographic study of 296 asymptomatic adults without spinal pathology was to investigate how the Roussouly classification could include the anteverted pelvis concept. Pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), and the lumbar parameters lumbar lordosis (Global LL), lordosis tilt angle (LTA), total number of lordotic vertebra (LL verteb), and C7 plumbline/sacrofemoral distance ratio (C7PL ratio) were evaluated in 296 healthy volunteers (126 males, 170 females; mean age, 27 years; range 18-48 years). Comparison between the five types of the Roussouly classification used Student, ANOVA, and Tukey tests for quantitative variables and χ (2), Fischer, and Holm tests for qualitative variables. Mean PI and PT were, respectively, (39°, 10°) for type 1, (41°, 10°) for type 2, (53°, 13°) for type 3, and (62°, 12°) for type 4 (p  35°. PT was low or negative (mean 4° ± 3°). C7PL ratio was >1 (in front of the hip axis) in 13% of all cases, and between 0 and 1 (between sacrum and hip axis) in 49%. Although asymptomatic adults stood with stable global balance, the sagittal spinal alignment of healthy subjects, newly divided in 5 sagittal types, varied significantly. Type 3 AP appears as a new and unusual sagittal shape with low-grade PI, very low or negative PT, and hyperlordosis. Whereas most asymptomatic adults stood with C7PL behind the hip axis, a sizeable portion had C7 in front of the hip axis. This could be a new controversial aspect of ideal spinal balance.

  18. Variability in Minimally Invasive Surgery for Sagittal Craniosynostosis.

    Science.gov (United States)

    Garland, Catharine B; Camison, Liliana; Dong, Shirley M; Mai, Rick S; Losee, Joseph E; Goldstein, Jesse A

    2018-01-01

    Minimally invasive approaches to the surgical correction of sagittal craniosynostosis are gaining favor as an alternative to open cranial vault remodeling. In this systematic review, the reviewers evaluate the variability in described surgical techniques for minimally invasive correction of sagittal craniosynostosis. Articles were selected based on predetermined inclusion and exclusion criteria from an online literature search through PubMed, EMBASE, and the Cochrane library. Extracted data included the incisions, method of dissection, osteotomies performed, and type of force therapy utilized.A total of 28 articles from 15 author groups were included in the final analysis. Of the 28 articles, 17 distinct techniques were identified. Significant variation existed in both the technique and the terminology used to describe it. Access to the cranium varied between a standard bicoronal incision (n = 2), a "lazy S" incision (n = 2), and multiple short incisions along the fused sagittal suture (n = 13). Additional variations were found in the size and design of the osteotomy, the usage (and duration, if applicable) of force therapy, and the age of the patient at the time of surgical intervention.This systematic review demonstrates that minimally invasive approaches to sagittal craniosynostosis vary widely in technique with respect to the incisions, osteotomies, and force therapy used. Additionally, the terminology employed in describing minimally invasive approaches is inconsistent across centers. This discrepancy between technique and terminology presents challenges for reporting and interpreting the increasing body of literature on this subject. We recommend standard terminology be used for future publications on minimally invasive techniques.

  19. Coronal reconstruction of unenhanced abdominal CT for correct ureteral stone size classification

    Energy Technology Data Exchange (ETDEWEB)

    Berkovitz, Nadav; Simanovsky, Natalia; Hiller, Nurith [Hadassah Mount Scopus - Hebrew University Medical Center, Department of Radiology, Jerusalem (Israel); Katz, Ran [Hadassah Mount Scopus - Hebrew University Medical Center, Department of Urology, Jerusalem (Israel); Salama, Shaden [Hadassah Mount Scopus - Hebrew University Medical Center, Department of Emergency Medicine, Jerusalem (Israel)

    2010-05-15

    To determine whether size measurement of a urinary calculus in coronal reconstruction of computed tomography (CT) differs from stone size measured in the axial plane, and whether the difference alters clinical decision making. We retrospectively reviewed unenhanced CT examinations of 150 patients admitted to the emergency room (ER) with acute renal colic. Maximal ureteral calculus size was measured on axial slices and coronal reconstructions. Clinical significance was defined as an upgrading or downgrading of stone size according to accepted thresholds of treatment: {<=}5 mm, 6-9 mm and {>=}10 mm. There were 151 stones in 150 patients (male:female 115:34, mean age 41 years). Transverse stone diameters ranged from 1 to 11 mm (mean 4 mm). On coronal images, 56 (37%) stones were upgraded in severity; 46 (30%) from below 5 mm to 6 mm or more, and ten (7%) from 6-9 mm to 10 mm or more. Transverse measurement on the axial slices enabled correct categorization of 95 stones (63%). Transverse calculus measurement on axial slices often underestimates stone size and provides incorrect clinical classification of the true maximal stone diameter. Coronal reconstruction provides additional information in patients with renal colic that may alter treatment strategy. (orig.)

  20. Osseous healing after sagittal splitting ramus osteotomy in mandibular prognathism. Three-dimensional CT measurement

    Energy Technology Data Exchange (ETDEWEB)

    Nemoto, Toshiyuki; Akizuki, Hiromichi; Michi, Ken-ichi [Showa Univ., Tokyo (Japan). School of Dentistry

    2001-07-01

    The purpose of the present study was to clarify the relationship between the cleavage and fixation of bone fragments and the osseous healing after sagittal splitting ramus osteotomy. Subjects consisted of 12 patients with mandibular prognathism, on which we performed sagittal splitting ramus osteotomy on both sides. Thus, we performed this osteotomy on 24 rami. These rami were studied immediately after, and 1 year after, surgery by Three-dimensional CT. With regard to the morphology of the anterior and posterior borders of the mandibular ramus, the majority (70.8%) showed the smooth type (smooth type: proximal and distal bone fragments are not discernible, and there is a smooth transition between them) in the lower plane. In the upper plane, the smooth type was less frequent (39.6%), and the stairway type (stairway type: either the proximal bone fragment or the distal bone fragment is protruded, thus showing a stairway form) was more frequent (43.8%). The concave type (concave type: there is a gap, i.e. an opened bone fragment, between two bone fragments, thus showing a concave form) was more frequently observed at the anterior border than at the posterior border, in both planes. With regard to the relationship between the morphology of the posterior border of the mandibular ramus and the cleavage of proximal and distal fragments, the stairway type was more frequent if both fragments were completely split through the posterior border, but the smooth type was more frequent if the cleavage spared the posterior border. With regard to the relationship between the morphology of the anterior and posterior borders of the mandibular ramus and the distance between proximal and distal bone fragments, the distance was greatest in the concave type, followed by the stairway type and the smooth type, in this order. The concave type was observed in cases in which the mean distance was more than 6.1 mm. As for the relationship between the posterior protrusion of the distal bone

  1. Isolated sagittal craniosynostosis: definition, classification, and surgical indications.

    Science.gov (United States)

    Massimi, Luca; Caldarelli, Massimo; Tamburrini, Gianpiero; Paternoster, Giovanna; Di Rocco, Concezio

    2012-09-01

    Sagittal craniosynostosis (SC) remains the most common type of synostosis, accounting for about a half of all forms. It would result from a mesenchymal disorder involving the intramembranous ossification of the sagittal suture and leading to its early fusion. No specific data on the etiologic factors are currently available. The premature ossification of the sagittal suture can result in three main types of SC, according to the different segment prevalently involved: anterior, posterior, and complete SC. The diagnosis is easily obtained by clinical examination. However, a radiological work up (3D CT scan) may be necessary to rule out hidden venous or cranial anomalies possibly associated with most severe cases, or for the surgical planning. The most common indication for surgery is the improvement of the cosmetic appearance of the skull, since a cranial deformation may have a significant psychological impact on affected subjects. To relieve from raised intracranial pressure is a further indication to surgery. Although an increased intracranial pressure can be demonstrated in a minority of affected children at diagnosis, indeed, it can present later (usually after the second/third year of life) with chronic symptoms. The role of surgery in the preservation of cognitive functions in scaphocephalic patients does not seem to be relevant, since minor anomalies of the cerebral development associated with SC would occur independently from the cranial shape. On the other hand, the surgical correction may show a protective effect on some visual skills, like the ability to fix and follow, and the fixation shift.

  2. Density and Morphology of Coronal Prominence Cavities

    Science.gov (United States)

    Gibson, Sarah; Fuller, J.

    2009-05-01

    Coronal prominence cavities are fundamental parts of prominences. They hold clues to the magnetic structure of pre-CME equilibria, and better represent the coronal source of the expanding volume in CMEs and magnetic clouds than a prominence does alone. However, prominence cavities have not been nearly as comprehensively observed and studied as prominences. This is in part due to projection effects which can complicate interpretation of observations, and in part because spectroscopic diagnostic studies require targeted observations, which have only recently been attempted. I will present recent work using white-light observations of cavities to model the morphological and density properties of polar crown filament cavities, with projection effects taken into account. I will also comment on recent attempts to obtain spectral diagnostics of coronal prominence cavities, and will discuss the implications of all of these observations for cavity stability and thermal and magnetic properties.

  3. Free Magnetic Energy and Coronal Heating

    Science.gov (United States)

    Winebarger, Amy; Moore, Ron; Falconer, David

    2012-01-01

    Previous work has shown that the coronal X-ray luminosity of an active region increases roughly in direct proportion to the total photospheric flux of the active region's magnetic field (Fisher et al. 1998). It is also observed, however, that the coronal luminosity of active regions of nearly the same flux content can differ by an order of magnitude. In this presentation, we analyze 10 active regions with roughly the same total magnetic flux. We first determine several coronal properties, such as X-ray luminosity (calculated using Hinode XRT), peak temperature (calculated using Hinode EIS), and total Fe XVIII emission (calculated using SDO AIA). We present the dependence of these properties on a proxy of the free magnetic energy of the active region

  4. Effect of Preoperative Sagittal Balance on Cervical Laminoplasty Outcomes.

    Science.gov (United States)

    Oshima, Yasushi; Takeshita, Katsushi; Taniguchi, Yuki; Matsubayashi, Yoshitaka; Doi, Toru; Ohya, Junichi; Soma, Kazuhito; Kato, So; Oka, Hiroyuki; Chikuda, Hirotaka; Tanaka, Sakae

    2016-11-01

    Retrospective case series. To clarify how preoperative global sagittal imbalance influences outcomes in patients with cervical compression myelopathy undergoing cervical laminoplasty. The influence of sagittal balance on outcomes of cervical laminoplasty remains uncertain. The authors retrospectively reviewed data of 106 patients who underwent double-door cervical laminoplasty between 2004 and 2011 and investigated the influence of the C7 sagittal vertical axis (SVA) on outcome scores. Primary outcomes used were Japanese Orthopedic Association (JOA) scores, Numerical Rating Scale for neck or arm pain, the Short Form 36 Health Survey (physical and mental component summary scores ), and the Neck Disability Index (NDI). Ninety-two patients with complete data were eligible for inclusion. The preoperative C7 SVA was ≤5 cm in 64 patients (69.6%) and > 5 cm in 28 (30.4%). We compared each parameter by the magnitude of spinal sagittal balance (preoperative C7 SVA > 5 cm vs. C7 SVA ≤ 5 cm) after adjusting for age via the least square mean analysis because the average age was significantly higher in patients with C7 SVA > 5 cm. As for the radiographic parameters, both C2-7 SVA and C7 SVA were larger in patients when the C7 SVA was > 5 cm. Numerical Rating Scale for postoperative arm pain, postoperative JOA scores, and both pre- and postoperative physical component summary and NDI were worse in patients with C7 SVA > 5 cm; however, the JOA score recovery rate and changes in physical component summary and NDI were not significantly different. Postoperative functional outcome scores were significantly lower in patients with C7 SVA > 5 cm, although the improvement after cervical laminoplasty was not greatly affected. The involvement of global sagittal balance and cervical regional alignment should be considered in evaluating surgical outcomes for patients undergoing cervical laminoplasty. 4.

  5. DIRECT OBSERVATION OF SOLAR CORONAL MAGNETIC FIELDS BY VECTOR TOMOGRAPHY OF THE CORONAL EMISSION LINE POLARIZATIONS

    Energy Technology Data Exchange (ETDEWEB)

    Kramar, M. [Physics Department, The Catholic University of America, 620 Michigan Avenue NE, Washington, DC 20064 (United States); Lin, H. [Institute for Astronomy, University of Hawaii at Manoa, 34 Ohia Ku Street, Pukalani, Maui, HI 96768 (United States); Tomczyk, S., E-mail: kramar@cua.edu, E-mail: lin@ifa.hawaii.edu, E-mail: tomczyk@ucar.edu [High Altitude Observatory, 3080 Center Green Drive, Boulder, CO 80301 (United States)

    2016-03-10

    We present the first direct “observation” of the global-scale, 3D coronal magnetic fields of Carrington Rotation (CR) Cycle 2112 using vector tomographic inversion techniques. The vector tomographic inversion uses measurements of the Fe xiii 10747 Å Hanle effect polarization signals by the Coronal Multichannel Polarimeter (CoMP) and 3D coronal density and temperature derived from scalar tomographic inversion of Solar Terrestrial Relations Observatory (STEREO)/Extreme Ultraviolet Imager (EUVI) coronal emission lines (CELs) intensity images as inputs to derive a coronal magnetic field model that best reproduces the observed polarization signals. While independent verifications of the vector tomography results cannot be performed, we compared the tomography inverted coronal magnetic fields with those constructed by magnetohydrodynamic (MHD) simulations based on observed photospheric magnetic fields of CR 2112 and 2113. We found that the MHD model for CR 2112 is qualitatively consistent with the tomography inverted result for most of the reconstruction domain except for several regions. Particularly, for one of the most noticeable regions, we found that the MHD simulation for CR 2113 predicted a model that more closely resembles the vector tomography inverted magnetic fields. In another case, our tomographic reconstruction predicted an open magnetic field at a region where a coronal hole can be seen directly from a STEREO-B/EUVI image. We discuss the utilities and limitations of the tomographic inversion technique, and present ideas for future developments.

  6. Magnetohydrodynamic waves in coronal polar plumes.

    Science.gov (United States)

    Nakariakov, Valery M

    2006-02-15

    Polar plumes are cool, dense, linear, magnetically open structures that arise from predominantly unipolar magnetic footpoints in the solar polar coronal holes. As the Alfvén speed is decreased in plumes in comparison with the surrounding medium, these structures are natural waveguides for fast and slow magnetoacoustic waves. The simplicity of the geometry of polar plumes makes them an ideal test ground for the study of magnetohydrodynamic (MHD) wave interaction with solar coronal structures. The review covers recent observational findings of compressible and incompressible waves in polar plumes with imaging and spectral instruments, and interpretation of the waves in terms of MHD theory.

  7. Preventing Distal Junctional Kyphosis by Applying the Stable Sagittal Vertebra Concept to Selective Thoracic Fusion in Adolescent Idiopathic Scoliosis.

    Science.gov (United States)

    Yang, Joshua; Andras, Lindsay M; Broom, Alexander M; Gonsalves, Nicholas R; Barrett, Kody K; Georgiadis, Andrew G; Flynn, John M; Tolo, Vernon T; Skaggs, David L

    2018-01-01

    Multicenter retrospective review. To assess the effectiveness of using the stable sagittal vertebra (SSV) for selecting the lowest instrumented vertebrae (LIV) to prevent distal junctional kyphosis (DJK) in selective thoracic fusions. Cho et al. reported that including the SSV in a fusion decreased the rate of DJK in thoracic hyperkyphosis. A retrospective review was performed of patients from two pediatric hospitals with adolescent idiopathic scoliosis who underwent selective posterior thoracic fusion with the LIV at L2 or above from 2000 to 2012. Patients with less than 2 years' follow-up were excluded. The primary outcome measure was DJK, defined radiographically as ≥10° between the superior end plate of the LIV and the inferior end plate of the vertebra below on a standing lateral radiograph. We investigated the SSV, which was defined as the vertebral level at which 50% of the vertebral body was in front of the posterior sacral vertical line (PSVL) on a standing lateral radiograph. This particular definition was referred to as SSV. A total of 113 patients met the inclusion criteria. Mean age was 14.4 years. Mean Cobb angle was 58°. The overall rate of DJK was 7% (8/113). When the LIV was superior to SSV, the rate of DJK was 17% (8/46) versus 0% (0/67) when the LIV was at or inferior to SSV (p=.01). The rates of DJK for patients with the LIV one, two, and three levels above SSV were 17% (4/24), 7% (1/14), and 43% (3/7), respectively. There was no significant association between preoperative or postoperative maximum kyphosis, thoracic kyphosis, thoracolumbar kyphosis, pelvic incidence, sagittal balance or coronal balance, and development of DJK. Although LIV selection is complex, choosing the LIV at or below the SSV is a simple rule that minimizes the risk of DJK. Level IV. Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

  8. Lumbar Facet Joint Arthritis Is Associated with More Coronal Orientation of the Facet Joints at the Upper Lumbar Spine

    Directory of Open Access Journals (Sweden)

    Thorsten Jentzsch

    2013-01-01

    Full Text Available We retrospectively analyzed CT scans of 620 individuals, who presented to our traumatology department between 2008 and 2010. Facet joint (FJ arthritis was present in 308 (49.7% individuals with a mean grade of 1. It was seen in 27% of individuals ≤40 years and in 75% of individuals ≥41 years ( as well as in 52% of females and 49% of males (. Mean FJ orientation was 30.4° at L2/3, 38.7° at L3/4, 47° at L4/5, and 47.3° at L5/S1. FJ arthritis was significantly associated with more coronal (increased degree FJ orientation at L2/3 ( with a cutoff point at ≥32°. FJs were more coronally oriented (48.8° in individuals ≤40 years and more sagittally oriented (45.6° in individuals ≥41 years at L5/S1 (. Mean FJ asymmetry was 4.89° at L2/3, 6.01° at L3/4, 6.67° at L4/5, and 7.27° at L5/S1, without a significant difference for FJ arthritis. FJ arthritis is common, increases with age, and affects both genders equally. More coronally oriented FJs (≥32° in the upper lumbar spine may be an individual risk factor for development of FJ arthritis.

  9. 3D-MRCP for evaluation of intra- and extrahepatic bile ducts: comparison of different acquisition and reconstruction planes.

    Science.gov (United States)

    Ringe, Kristina Imeen; Hartung, Dagmar; von Falck, Christian; Wacker, Frank; Raatschen, Hans-Jürgen

    2014-05-19

    Magnetic resonance cholangiopancreatography (MRCP) is an established technique for the evaluation of intra- and extrahepatic bile ducts in patients with known or suspected hepatobiliary disease. However, the ideal acquisition and reconstruction plane for optimal bile duct evaluation with 3D technique has not been evaluated. The purpose of our study was to compare different acquisition and reconstruction planes of 3D-MRCP for bile duct assessment. 34 patients (17f/17 m, mean age 41y) referred for MRCP were included in this prospective IRB-approved study. Respiratory-triggered 3D-T2w-MRCP sequences were acquired in coronal and axial plane. Coronal and axial MIP were reconstructed based on each dataset (resulting in two coronal and two axial MIP, respectively). Three readers in two sessions independently assessed the MIP, regarding visualization of bile ducts and image quality. Results were compared (Wilcoxon test). Intra- and interobserver variability were calculated (kappa-statistic). In case of coronal data acquisition, visualization of bile duct segments was significantly better on coronal reconstructed MIP images as compared to axial reconstructed MIP (p 0.05). Image quality of coronal and axial datasets did not differ significantly. Intra- and interobserver agreement regarding bile duct visualization were moderate to excellent (κ-range 0.55-1.00 and 0.42-0.85, respectively). The results of our study suggest that for visualization and evaluation of intra- and extrahepatic bile duct segments reconstructed images in coronal orientation are preferable. The orientation of the primary dataset (coronal or axial) is negligible.

  10. Three-Dimensional Morphology of a Coronal Prominence Cavity

    Science.gov (United States)

    Gibson, S. E.; Kucera, T. A.; Rastawicki, D.; Dove, J.; deToma, G.; Hao, J.; Hill, S.; Hudson, H. S.; Marque, C.; McIntosh, P. S.; hide

    2010-01-01

    We present a three-dimensional density model of coronal prominence cavities, and a morphological fit that has been tightly constrained by a uniquely well-observed cavity. Observations were obtained as part of an International Heliophysical Year campaign by instruments from a variety of space- and ground-based observatories, spanning wavelengths from radio to soft-X-ray to integrated white light. From these data it is clear that the prominence cavity is the limb manifestation of a longitudinally-extended polar-crown filament channel, and that the cavity is a region of low density relative to the surrounding corona. As a first step towards quantifying density and temperature from campaign spectroscopic data, we establish the three-dimensional morphology of the cavity. This is critical for taking line-of-sight projection effects into account, since cavities are not localized in the plane of the sky and the corona is optically thin. We have augmented a global coronal streamer model to include a tunnel-like cavity with elliptical cross-section and a Gaussian variation of height along the tunnel length. We have developed a semi-automated routine that fits ellipses to cross-sections of the cavity as it rotates past the solar limb, and have applied it to Extreme Ultraviolet Imager (EUVI) observations from the two Solar Terrestrial Relations Observatory (STEREO) spacecraft. This defines the morphological parameters of our model, from which we reproduce forward-modeled cavity observables. We find that cavity morphology and orientation, in combination with the viewpoints of the observing spacecraft, explains the observed variation in cavity visibility for the east vs. west limbs

  11. Standing sagittal alignment of the whole axial skeleton with reference to the gravity line in humans.

    Science.gov (United States)

    Hasegawa, Kazuhiro; Okamoto, Masashi; Hatsushikano, Shun; Shimoda, Haruka; Ono, Masatoshi; Homma, Takao; Watanabe, Kei

    2017-05-01

    between offset of C7 vertebra from the sagittal vertical axis (a vertical line drawn through the posterior superior corner of the sacrum in the sagittal plane) and age, but no correlation was detected between the centre of the acoustic meati-GL offset and age. Cervical lordosis (CL), pelvic tilt (PT), pelvic incidence, hip extension, knee flexion and ankle dorsiflexion increased significantly with age. Our results revealed that aging induces trunk stooping, but the global alignment is compensated for by an increase in the CL, PT and knee flexion, with the main function of CL and PT to maintain a horizontal gaze in a healthy population. © 2017 The Authors Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.

  12. Cervical sagittal alignment in adult hyperkyphosis treated by posterior instrumentation and in situ bending.

    Science.gov (United States)

    Paternostre, F; Charles, Y P; Sauleau, E A; Steib, J-P

    2017-02-01

    cervical alignment or proximal instrumentation level. Two cervical alignment types, lordotic or kyphotic, were observed thoracic hyperkyphosis patients. This alignment was mainly triggered by the amount of thoracic kyphosis and lumbar lordosis, linked to pelvic incidence. Moreover, the inclination of the C7-T1 junctional area plays a key role in the amount of cervical lordosis. The correction of T4-T12 kyphosis induced compensatory modifications at adjacent segments: T1-T4 kyphosis increase (PJK) and L1-S1 lordosis decrease. Global spino-pelvic alignment and head position did not change in the sagittal plane. The cervical spine tented to keep in its preoperative position in most patients. Level IV. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Skeletal Stability after Large Mandibular Advancement (> 10 mm with Bilateral Sagittal Split Osteotomy and Skeletal Elastic Intermaxillary Fixation

    Directory of Open Access Journals (Sweden)

    Kristoffer Schwartz

    2016-06-01

    Full Text Available Objectives: The aim of the present study was to assess the skeletal stability after large mandibular advancement (> 10 mm with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation and to correlate the skeletal stability with the vertical facial type. Material and Methods: A total of 33 consecutive patients underwent bimaxillary surgery to correct skeletal Class II malocclusion with a mandibular advancement (> 10 mm measured at B-point and postoperative skeletal elastic intermaxillary fixation for 16 weeks. Skeletal stability was evaluated using lateral cephalometric radiographs obtained preoperative (T1, 8 weeks postoperatively (T2, and 18 month postoperatively (T3. B-point and pogonion (Pog was used to measure the skeletal relapse and the mandibular plane angle (MP-angle was used to determine the vertical facial type. Results: The mean advancement from T1 to T2 were 11.6 mm and 13.5 mm at B-point and Pog, respectively. The mean skeletal relapse from T2 to T3 was -1.3 mm at B-point and -1.6 mm at Pog. The nineteen patients characterized as long facial types, showed the highest amount of skeletal relapse (-1.5 mm at B-point and -1.9 mm at Pog. Conclusions: The present study showed a limited amount of skeletal relapse in large mandibular advancement (> 10 mm with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation. Bilateral sagittal split osteotomy in combination with skeletal intermaxillary fixation can therefore be an alternative to distraction osteogenesis in large mandibular advancements.

  14. Solar Wind Associated with Near Equatorial Coronal Hole M ...

    Indian Academy of Sciences (India)

    2015-05-25

    May 25, 2015 ... coronal hole and solar wind. For both the wavelength bands, we also com- pute coronal hole radiative energy near the earth and it is found to be of similar order as that of solar wind energy. However, for the wavelength. 193 Å, owing to almost similar magnitudes of energy emitted by coronal hole and ...

  15. Exercising 'Race' Through the Coronation Physical Training ...

    African Journals Online (AJOL)

    ... through their concern with race. The Coronation Physical Training Competition fitted into this agenda. Despite betrayal by the English during the post South African War negotiations, Black political movements and individuals continued seeking means to prove themselves loyal subjects of the King. Black schools therefore ...

  16. Frontoorbital advancement in coronal suture craniosynostosis: a ...

    African Journals Online (AJOL)

    Background Surgical therapy of coronal craniosynostosis in the modern era has evolved with the adoption of frontoorbital advancement and forehead reshaping to correct the supraorbital rim recession and the abnormal form of the cranium. The aim of this study was to evaluate the efficiency of quantitative preoperative ...

  17. Frontoorbital advancement in coronal suture craniosynostosis: a ...

    African Journals Online (AJOL)

    The frontal bone was then removed as indicated. The most lateral aspect of the coronal suture was radically removed with rongeurs, including a part of the greater and lesser wings of the sphenoid bone. The frontal and temporal lobes of the brain were gently repositioned to allow for safe upper orbital osteotomies through ...

  18. Magnetic Topology of Coronal Hole Linkages

    Science.gov (United States)

    Titov, V. S.; Mikic, Z.; Linker, J. A.; Lionello, R.; Antiochos, S. K.

    2010-01-01

    In recent work, Antiochos and coworkers argued that the boundary between the open and closed field regions on the Sun can be extremely complex with narrow corridors of open ux connecting seemingly disconnected coronal holes from the main polar holes, and that these corridors may be the sources of the slow solar wind. We examine, in detail, the topology of such magnetic configurations using an analytical source surface model that allows for analysis of the eld with arbitrary resolution. Our analysis reveals three important new results: First, a coronal hole boundary can join stably to the separatrix boundary of a parasitic polarity region. Second, a single parasitic polarity region can produce multiple null points in the corona and, more important, separator lines connecting these points. Such topologies are extremely favorable for magnetic reconnection, because it can now occur over the entire length of the separators rather than being con ned to a small region around the nulls. Finally, the coronal holes are not connected by an open- eld corridor of finite width, but instead are linked by a singular line that coincides with the separatrix footprint of the parasitic polarity. We investigate how the topological features described above evolve in response to motion of the parasitic polarity region. The implications of our results for the sources of the slow solar wind and for coronal and heliospheric observations are discussed.

  19. Coronal bright points associated with minifilament eruptions

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Junchao; Jiang, Yunchun; Yang, Jiayan; Bi, Yi; Li, Haidong [Yunnan Observatories, Chinese Academy of Sciences, Kunming 650011 (China); Yang, Bo; Yang, Dan, E-mail: hjcsolar@ynao.ac.cn [Also at Graduate School of Chinese Academy of Sciences, Beijing, China. (China)

    2014-12-01

    Coronal bright points (CBPs) are small-scale, long-lived coronal brightenings that always correspond to photospheric network magnetic features of opposite polarity. In this paper, we subjectively adopt 30 CBPs in a coronal hole to study their eruptive behavior using data from the Atmospheric Imaging Assembly (AIA) and the Helioseismic and Magnetic Imager (HMI) on board the Solar Dynamics Observatory. About one-quarter to one-third of the CBPs in the coronal hole go through one or more minifilament eruption(s) (MFE(s)) throughout their lifetimes. The MFEs occur in temporal association with the brightness maxima of CBPs and possibly result from the convergence and cancellation of underlying magnetic dipoles. Two examples of CBPs with MFEs are analyzed in detail, where minifilaments appear as dark features of a cool channel that divide the CBPs along the neutral lines of the dipoles beneath. The MFEs show the typical rising movements of filaments and mass ejections with brightenings at CBPs, similar to large-scale filament eruptions. Via differential emission measure analysis, it is found that CBPs are heated dramatically by their MFEs and the ejected plasmas in the MFEs have average temperatures close to the pre-eruption BP plasmas and electron densities typically near 10{sup 9} cm{sup –3}. These new observational results indicate that CBPs are more complex in dynamical evolution and magnetic structure than previously thought.

  20. Microflares as Possible Sources for Coronal Heating

    Indian Academy of Sciences (India)

    We present a preliminary study of 27 microflares observed by Solar X-ray Spectrometer (SOXS) mission during July 2003 to August 2006. We found that all 27 microflares show the Fe-line feature peaking around 6.7 keV, which is an indicator of the presence of coronal plasma temperature ≥ 9 MK. On the other hand, the ...

  1. Mechanisms of Coronal Heating S. R. Verma

    Indian Academy of Sciences (India)

    Abstract. The Sun is a mysterious star. The high temperature of the chromosphere and corona present one of the most puzzling problems of solar physics. Observations show that the solar coronal heating problem is highly complex with many different facts. It is likely that different heating mechanisms are at work in solar ...

  2. Large-scale Globally Propagating Coronal Waves

    Directory of Open Access Journals (Sweden)

    Alexander Warmuth

    2015-09-01

    Full Text Available Large-scale, globally propagating wave-like disturbances have been observed in the solar chromosphere and by inference in the corona since the 1960s. However, detailed analysis of these phenomena has only been conducted since the late 1990s. This was prompted by the availability of high-cadence coronal imaging data from numerous spaced-based instruments, which routinely show spectacular globally propagating bright fronts. Coronal waves, as these perturbations are usually referred to, have now been observed in a wide range of spectral channels, yielding a wealth of information. Many findings have supported the “classical” interpretation of the disturbances: fast-mode MHD waves or shocks that are propagating in the solar corona. However, observations that seemed inconsistent with this picture have stimulated the development of alternative models in which “pseudo waves” are generated by magnetic reconfiguration in the framework of an expanding coronal mass ejection. This has resulted in a vigorous debate on the physical nature of these disturbances. This review focuses on demonstrating how the numerous observational findings of the last one and a half decades can be used to constrain our models of large-scale coronal waves, and how a coherent physical understanding of these disturbances is finally emerging.

  3. Linking Stealthy Signatures of Coronal Mass Ejections at the Sun to 1 AU

    Science.gov (United States)

    Mulligan, T.; Nitta, N.

    2015-12-01

    One of the underlying problems in the investigation of CME genesis and evolution is relating remote- sensing observations of coronal mass ejections (CMEs) to in-situ observations of interplanetary CMEs (ICMEs). Typically, remote-sensing observations of an eruption are first observed in the low corona, followed by coronagraph observations of the global structure of the CME projected onto the plane of the sky, and then finally local, highly-quantitative measurements of an ICME are made in situ along a spacecraft trajectory. However, the dramatic change in solar activity in recent years has raised awareness of "stealth" CMEs, which are CMEs observed in coronagraph data but not in coronal images, especially in disk view. Largely identified during the deep minimum of cycle 23/24, stealth CMEs appear to be on the rise. Since solar cycle 25 brings with it the possibility of yet another low activity cycle, it is very likely that the number of stealth CMEs will remain a significant fraction of ejecta. We investigate the properties of stealth CMEs during the rise of solar cycle 24 and through the current solar maximum, paying special attention to their proximity to coronal holes. We investigate the existence of mismatched polarity reversals in the magnetic field and electron strahl measured in situ within ICMEs associated with stealth CMEs. We discuss the plausibility of interaction with solar wind emanating from coronal holes as a key element of stealth CME eruption as evidenced by expanding coronal hole boundaries during eruption and the presence of interchange reconnection within ICMEs.

  4. Fast Plane Wave Imaging

    DEFF Research Database (Denmark)

    Jensen, Jonas

    This PhD project investigates and further develops methods for ultrasound plane wave imaging and blood flow estimation with the objective of overcoming some of the major limitations in conventional ultrasound systems, which are related to low frame rates and only estimation of velocities along...... the ultrasound beam. The first part of the contribution investigates the compromise between frame rate and plane wave image quality including the influence of grating lobes from a λ-pitch transducer. A method for optimizing the image quality is suggested, and it is shown that the frame rate can be increased...... healthy volunteers. Complex flow patterns were measured in an anthropomorphic flow phantom and showed good agreement with the velocity field simulated using computational fluid dynamics. The last part of the contribution investigates two clinical applications. Plane wave imaging was used for slow velocity...

  5. Transformational plane geometry

    CERN Document Server

    Umble, Ronald N

    2014-01-01

    Axioms of Euclidean Plane Geometry The Existence and Incidence Postulates The Distance and Ruler Postulates The Plane Separation Postulate The Protractor Postulate The Side-Angle-Side Postulate and the Euclidean Parallel Postulate Theorems of Euclidean Plane Geometry The Exterior Angle Theorem Triangle Congruence Theorems The Alternate Interior Angles Theorem and the Angle Sum Theorem Similar Triangles Introduction to Transformations, Isometries, and Similarities Transformations Isometries and SimilaritiesAppendix: Proof of Surjectivity Translations, Rotations, and Reflections Translations Rotations Reflections Appendix: Geometer's Sketchpad Commands Required by Exploratory Activities Compositions of Translations, Rotations, and Reflections The Three Points Theorem Rotations as Compositions of Two Reflections Translations as Compositions of Two Halfturns or Two Reflections The Angle Addition Theorem Glide Reflections Classification of Isometries The Fundamental Theorem and Congruence Classification of Isometr...

  6. Comparative assessment of sagittal skeletal discrepancy: a cephalometric study.

    Science.gov (United States)

    Aparna, P; Kumar, Dilip N; Prasad, Mandav; Shamnur, Naveen; G, Arun Kumar; K R, Sridhar; B R, Gopal Krishna; Gupta, Neeraj

    2015-04-01

    Evaluating the sagittal apical base relationship during orthodontic diagnosis and treatment planning is an important step. This study was aimed at comparison of Beta angle, ANB angle and Wit's appraisal for assessment of sagittal skeletal discrepancy. Eighty six young adults (43 female and 43 male) were selected from the patient's reporting to Department of Orthodontics, College of Dental Sciences, Davangere, India. Family lineage was studied to know the nativity of Davangere. The standardized pre-treatment lateral cephalogram of the chosen sample was traced. The sample was divided into three skeletal pattern groups: Class I, Class II and Class III, based on the ANB angle and profile, Beta angle was assessed in each group. The data was subjected to statistical analysis student's t-test, ANOVA test and correlation and regression analysis, using the software namely SPSS Software version 13. Microsoft word and Excel were used to generate graphs and tables. In the local Davangere population, Class I skeletal pattern group exhibited Beta angle between 26°-34°, Beta angle less than 27° was found in Class II skeletal pattern, and Beta angle greater than 32° was seen Class III skeletal pattern. The coefficient of variation of Beta angle in all the three groups was significantly homogenous compared to ANB angle and Wits appraisal. The correlation and regression analysis of the total sample indicated a highly significant correlation between Beta angle and ANB angle (pskeletal patterns. The Correlation and regression analysis for the total sample suggests a highly significant relation between Beta angle and ANB angle and, between Beta angle and Wits appraisal. It can be more reliably used to assess sagittal jaw discrepancies than ANB angle and Wits appraisal.

  7. Sagittal balance analysis after pedicle subtraction osteotomy in ankylosing spondylitis.

    Science.gov (United States)

    Debarge, Romain; Demey, Guillaume; Roussouly, Pierre

    2011-09-01

    This is a radiographic study of ankylosing spondylitis patients with severe fixed kyphotic deformity who underwent pedicle subtraction osteotomy. Our goal was to measure and validate new angle to assess global kyphosis and to evaluate the sagittal balance after surgery. This is the first report which describes new angle to assess global kyphosis (T1-S1). Pre and postoperative controls were compared according to the Pelvic Incidence. The sagittal parameters ankylosing spondylitis patients were compared with 154 asymptomatic patients. In addition to the pelvic parameters and the C7 tilt, we used the spino-sacral angle. Pelvic incidence in ankylosing spondylitis patients was higher than asymptomatic population (61° vs. 51°). For a same tilt of C7 for both groups, the low pelvic incidence group had a lower sacral slope and pelvic tilt and a higher global kyphosis (spino-sacral angle = 90°) than the high pelvic incidence group (spino-sacral angle = 98°). In the adult volunteers, the C7 tilt and spino-sacral angle measured, respectively, 95° and 135°. The preoperative C7 tilt measured 73° and increased to 83° (p = 0.0025). The preoperative spino-sacral angle measured 96° and increased to 113.3° (p = 0.003). A low pelvic incidence pelvis has a lower sacral slope than in high pelvic incidence and can support a bigger kyphosis. All the parameters were improved by the pedicle subtraction osteotomy, but the average spinosacral angle remained lower than the control group. When C7 tilt was useful to assess the improvement of the sagittal balance, SSA allowed a better evaluation of the correction of kyphosis itself.

  8. Sagittal morphology and equilibrium of pelvis and spine.

    Science.gov (United States)

    Vaz, G; Roussouly, P; Berthonnaud, E; Dimnet, J

    2002-02-01

    A prospective analysis of the sagittal profile of 100 healthy young adult volunteers was carried out in order to evaluate the relationship between the shape of the pelvis and lumbar lordosis and to create a databank of the morphologic and positional parameters of the pelvis and spine in a normal healthy population. Inclusion criteria were as follows: no previous spinal surgery, no low back pain, no lower limb length inequality, no scoliotic deviation. For each subject, a 30 x 90-cm sagittal radiograph including spine, pelvis and proximal femurs in standing position on a force plate was performed. The global axis of gravity was determined with the force plate. Each radiograph was digitized using dedicated software. The spinal parameters registered were values for thoracic kyphosis and lumbar lordosis. The pelvic angles measured were: pelvic incidence, sacral slope and pelvic tilt. The global axis of gravity was on average 9 mm anterior of the center of the femoral heads. The anatomic parameter of pelvic incidence angle varied from 33 degrees to 85 degrees (mean: 51.7 degrees, SD: 11 degrees). The average lumbar lordosis was 46.5 degrees. The average thoracic kyphosis was 47 degrees. We found a statistical correlation between incidence angle and lumbar lordosis (r=0.69, P<0.001) and between sacral slope angle and lumbar lordosis (r=0.75, P<0.001). Spine and pelvis balance around the hip axis in order to position the gravity line over the femoral heads. We propose a scheme of sagittal balance of the standing human body.

  9. SAGITTAL SPINAL MORPHOLOGY IN HIGHLY TRAINED ADOLESCENT TENNIS PLAYERS

    Directory of Open Access Journals (Sweden)

    José M. Muyor

    2013-09-01

    Full Text Available Sports with a predominance of forward-bending and extension postures have been associated with alterations in the sagittal spinal curvatures and greater risk of spinal injury. Because, the tennis players adopt these postures, the aims of this study were: 1 to describe spinal curvatures and pelvic tilt in male and female highly trained adolescent tennis players during relaxed standing posture and with thoracic spine corrected (in prone lying on the floor; and 2 to determine the frequency of thoracic hyperkyphosis and lumbar hypo/hyper lordosis in these postures. Forty adolescent tennis players (24 male and 16 female aged 13-18 years, participated voluntarily in this study. The Spinal Mouse system was used to measure sagittal spinal curvatures and pelvic tilt. The mean values in the relaxed standing posture were 43.83° ± 7.87° (thoracic kyphosis, - 27.58° ± 7.01° (lumbar lordosis, and 13.38° ± 5.57° (pelvic tilt for male tennis players, respectively; and 36.13° ± 6.69° (thoracic kyphosis, - 32.69° ± 5.06° (lumbar lordosis, 20.94° ± 5.36° (pelvic tilt for female tennis players (p < 0.05 between genders in all spinal parameters. The male and female tennis players showed a frequency of 62.5% and 93.8% (p = 0.032 for neutral thoracic kyphosis, and 83.3% and 93.8% (p = 0.062 in neutral lumbar lordosis, respectively. In conclusion, due to the high percentage of neutral spinal curvatures in both male and female tennis players, to practice tennis in these levels does not alter sagittal spinal morphology in the relaxed standing posture in adolescent highly trained tennis players

  10. Management of distal humeral coronal shear fractures

    Science.gov (United States)

    Yari, Shahram S; Bowers, Nathan L; Craig, Miguel A; Reichel, Lee M

    2015-01-01

    Coronal shear fractures of the distal humerus are rare, complex fractures that can be technically challenging to manage. They usually result from a low-energy fall and direct compression of the distal humerus by the radial head in a hyper-extended or semi-flexed elbow or from spontaneous reduction of a posterolateral subluxation or dislocation. Due to the small number of soft tissue attachments at this site, almost all of these fractures are displaced. The incidence of distal humeral coronal shear fractures is higher among women because of the higher rate of osteoporosis in women and the difference in carrying angle between men and women. Distal humeral coronal shear fractures may occur in isolation, may be part of a complex elbow injury, or may be associated with injuries proximal or distal to the elbow. An associated lateral collateral ligament injury is seen in up to 40% and an associated radial head fracture is seen in up to 30% of these fractures. Given the complex nature of distal humeral coronal shear fractures, there is preference for operative management. Operative fixation leads to stable anatomic reduction, restores articular congruity, and allows initiation of early range-of-motion movements in the majority of cases. Several surgical exposure and fixation techniques are available to reconstruct the articular surface following distal humeral coronal shear fractures. The lateral extensile approach and fixation with countersunk headless compression screws placed in an anterior-to-posterior fashion are commonly used. We have found a two-incision approach (direct anterior and lateral) that results in less soft tissue dissection and better outcomes than the lateral extensile approach in our experience. Stiffness, pain, articular incongruity, arthritis, and ulnohumeral instability may result if reduction is non-anatomic or if fixation fails. PMID:25984515

  11. Genesis Solar Wind Interstream, Coronal Hole and Coronal Mass Ejection Samples: Update on Availability and Condition

    Science.gov (United States)

    Allton, J. H.; Gonzalez, C. P.; Allums, K. K.

    2017-01-01

    Recent refinement of analysis of ACE/SWICS data (Advanced Composition Explorer/Solar Wind Ion Composition Spectrometer) and of onboard data for Genesis Discovery Mission of 3 regimes of solar wind at Earth-Sun L1 make it an appropriate time to update the availability and condition of Genesis samples specifically collected in these three regimes and currently curated at Johnson Space Center. ACE/SWICS spacecraft data indicate that solar wind flow types emanating from the interstream regions, from coronal holes and from coronal mass ejections are elementally and isotopically fractionated in different ways from the solar photosphere, and that correction of solar wind values to photosphere values is non-trivial. Returned Genesis solar wind samples captured very different kinds of information about these three regimes than spacecraft data. Samples were collected from 11/30/2001 to 4/1/2004 on the declining phase of solar cycle 23. Meshik, et al is an example of precision attainable. Earlier high precision laboratory analyses of noble gases collected in the interstream, coronal hole and coronal mass ejection regimes speak to degree of fractionation in solar wind formation and models that laboratory data support. The current availability and condition of samples captured on collector plates during interstream slow solar wind, coronal hole high speed solar wind and coronal mass ejections are de-scribed here for potential users of these samples.

  12. [Sagittal balance of the spine: a therapeutic revolution].

    Science.gov (United States)

    Faundez, A; Roussouly, P; Le Huec, J C

    2011-12-21

    In humans, the erect position and bipedal walk is possible because of a balance between pelvic and spinal parameters. The most important pelvic parameter is the pelvic incidence which represents the base on which the spine lies. With aging, thoracic kyphosis increases, lumbar lordosis decreases, compromising the spino-pelvic balance. Compensatory phenomenons are possible, but rely mostly on the amplitude of pelvic incidence. Analysis of spino-pelvic parameters and detection of a compensated or uncompensated sagittal imbalance are mandatory before any therapeutic action is undertaken for a degenerative pathology of the spine.

  13. SNAP focal plane

    Energy Technology Data Exchange (ETDEWEB)

    Lampton, Michael L.; Kim, A.; Akerlof, C.W.; Aldering, G.; Amanullah, R.; Astier, P.; Barrelet, E.; Bebek, C.; Bergstrom, L.; Berkovitz, J.; Bernstein, G.; Bester, M.; Bonissent, A.; Bower, C.; Carithers Jr., W.C.; Commins, E.D.; Day, C.; Deustua, S.E.; DiGennaro,R.; Ealet, A.; Ellis, R.S.; Eriksson, M.; Fruchter, A.; Genat, J.-F.; Goldhaber, G.; Goobar, A.; Groom, D.; Harris, S.E.; Harvey, P.R.; Heetderks, H.D.; Holland, S.E.; Huterer, D.; Karcher, A.; Kolbe, W.; Krieger, B.; Lafever, R.; Lamoureux, J.; Levi, M.E.; Levin, D.S.; Linder,E.V.; Loken, S.C.; Malina, R.; Massey, R.; McKay, T.; McKee, S.P.; Miquel, R.; Mortsell, E.; Mostek, N.; Mufson, S.; Musser, J.; Nugent, P.; Oluseyi, H.; Pain, R.; Palaio, N.; Pankow, D.; Perlmutter, S.; Pratt, R.; Prieto, E.; Refregier, A.; Rhodes, J.; Robinson, K.; Roe, N.; Sholl, M.; Schubnell, M.; Smadja, G.; Smoot, G.; Spadafora, A.; Tarle, G.; Tomasch,A.; von der Lippe, H.; Vincent, R.; Walder, J.-P.; Wang, G.

    2002-07-29

    The proposed SuperNova/Acceleration Probe (SNAP) mission will have a two-meter class telescope delivering diffraction-limited images to an instrumented 0.7 square-degree field sensitive in the visible and near-infrared wavelength regime. We describe the requirements for the instrument suite and the evolution of the focal plane design to the present concept in which all the instrumentation--visible and near-infrared imagers, spectrograph, and star guiders--share one common focal plane.

  14. The role of minimally invasive lateral lumbar interbody fusion in sagittal balance correction and spinal deformity.

    Science.gov (United States)

    Costanzo, Giuseppe; Zoccali, Carmine; Maykowski, Philip; Walter, Christina M; Skoch, Jesse; Baaj, Ali A

    2014-10-01

    The recent proliferation of minimally invasive lateral lumbar interbody fusion (LLIF) techniques has drawn attention to potential for these techniques to control or correct sagittal misalignment in adult spinal deformity. We systemically reviewed published studies related to LLIF use in adult spinal deformity treatment with emphasis on radiographic assessment of sagittal balance. A literature review was conducted to examine studies focusing on sagittal balance restoration in adult degenerative scoliosis with the LLIF approach. Fourteen publications, 12 retrospective and 2 prospective, reported data regarding lumbar lordosis correction (1,266 levels in 476 patients) but only two measured global sagittal alignment. LLIF appears to be especially effective when the lumbar lordosis and sagittal balance correction goals are less than 10° and 5 cm, respectively. However, the review demonstrated a lack of consistent reporting on sagittal balance restoration with the MIS LLIF techniques.

  15. [Sagittal Balance of the Spine--Clinical Importance and Radiographic Assessment].

    Science.gov (United States)

    Decker, S; Müller, C W; Omar, M; Krettek, C; Schwab, F; Trobisch, P D

    2016-04-01

    Sagittal deformities of the spine frequently result in back pain, as patients have to expend much energy in compensation. The sagittal alignment of the spine is defined by its curvatures (lordosis and kyphosis) relative to the position of the pelvis. Diagnostic assessment is based on full spine a. p. and lateral X-rays. The sagittal balance is primarily described by different angles that can be measured, e.g. lumbar lordosis, pelvic incidence, pelvic tilt and thoracic kyphosis. The quality of life can best be estimated by subtracting lumbar lordosis from the pelvic incidence. However, initial evaluation of the sagittal balance can also be based on the sagittal vertical axis. The severity of imbalance can be described by the sagittal vertical axis and the pelvic tilt, but surgical therapy necessitates a more profound analysis, which can be based on the SRS-Schwab classification. Georg Thieme Verlag KG Stuttgart · New York.

  16. Sagittal Subtalar and Talocrural Joint Assessment During Ambulation With Controlled Ankle Movement (CAM) Boots.

    Science.gov (United States)

    McHenry, Benjamin D; Exten, Emily L; Cross, Janelle A; Kruger, Karen M; Law, Brian; Fritz, Jessica M; Harris, Gerald

    2017-11-01

    The purpose of the current study was to determine sagittal plane talocrural and subtalar kinematic differences between barefoot and controlled ankle movement (CAM) boot walking. This study used fluoroscopic images to determine talar motion relative to tibia and calcaneal motion relative to talus. Fourteen male subjects (mean age 24.1 ± 3.5 years) screened for normal gait were tested. A fluoroscopy unit was used to collect images at 200 Hz during stance. Sagittal motion of the talocrural and subtalar joints were analyzed barefoot and within short and tall CAM boots. Barefoot talocrural mean maximum plantar and dorsiflexion were 9.2 ± 5.4 degrees and -7.5 ± 7.4 degrees, respectively; short CAM boot mean maximum plantar and dorsiflexion were 3.2 ± 4.0 degrees and -4.8 ± 10.2 degrees, respectively; and tall CAM boot mean maximum plantar and dorsiflexion were -0.2 ± 3.5 degrees and -2.4 ± 5.1 degrees, respectively. Talocrural mean range of motion (ROM) decreased from barefoot (16.7 ± 5.1 degrees) to short CAM boot (8.0 ± 4.9 degrees) to tall CAM boot (2.2 ± 2.5 degrees). Subtalar mean maximum plantarflexion angles were 5.3 ± 5.6 degrees for barefoot walking, 4.1 ± 5.9 degrees for short CAM boot walking, and 3.0 ± 4.7 degrees for tall CAM boot walking. Mean minimum subtalar plantarflexion angles were 0.7 ± 3.2 degrees for barefoot walking, 0.7 ± 2.9 degrees for short CAM boot walking, and 0.1 ± 4.8 degrees for tall CAM boot walking. Subtalar mean ROM decreased from barefoot (4.6 ± 3.9 degrees) to short CAM boot (3.4 ± 3.8 degrees) to tall CAM boot (2.9 ± 2.6 degrees). Tall and short CAM boot intervention was shown to limit both talocrural and subtalar motion in the sagittal plane during ambulation. The greatest reductions were seen with the tall CAM boot, which limited talocrural motion by 86.8% and subtalar motion by 37.0% compared to barefoot. Short CAM boot intervention reduced talocrural motion by 52.1% and subtalar motion by 26.1% compared to

  17. Limited hip and knee flexion during landing is associated with increased frontal plane knee motion and moments.

    Science.gov (United States)

    Pollard, Christine D; Sigward, Susan M; Powers, Christopher M

    2010-02-01

    It has been proposed that female athletes who limit knee and hip flexion during athletic tasks rely more on the passive restraints in the frontal plane to deceleration their body center of mass. This biomechanical pattern is thought to increase the risk for anterior cruciate ligament injury. To date, the relationship between sagittal plane kinematics and frontal plane knee motion and moments has not been explored. Subjects consisted of 58 female club soccer players (age range: 11-20 years) with no history of knee injury. Kinematics, ground reaction forces, and surface electromyography were collected while each subject performed a drop landing task. Subjects were divided into two groups based on combined sagittal plane knee and hip flexion angles during the deceleration phase of landing (high flexion and low flexion). Subjects in the low flexion group demonstrated increased knee valgus angles (P=0.02, effect size 0.27), increased knee adductor moments (P=0.03, effect size 0.24), decreased energy absorption at the knee and hip (P=0.02, effect size 0.25; and P<0.001, effect size 0.59), and increased vastus lateralis EMG when compared to subjects in the high flexion group (P=0.005, effect size 0.35). Female athletes with limited sagittal plane motion during landing exhibit a biomechanical profile that may put these individuals at greater risk for anterior cruciate ligament injury. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  18. Computed tomographic analysis of the position and course of the mandibular canal: relevance to the sagittal split ramus osteotomy.

    Science.gov (United States)

    Tsuji, Y; Muto, T; Kawakami, J; Takeda, S

    2005-05-01

    The aim of this study was to investigate the position and course of the mandibular canal through the mandibular ramus using computed tomographic (CT) imaging and to relate the findings to performing sagittal split ramus osteotomies. The mandibles of 35 patients with skeletal Class III prognathism with symmetry (12 males and 23 females) were observed on transaxial computed tomograms acquired with a slice thickness of 2 mm. The position and course of the mandibular canal from the mandibular foramen to the mandibular body at the level of the second molar were measured at four specific locations in the same plane. Among the 70 rami examined, lack of a bone marrow space on the buccal side, including a fusion type anatomy with no buccal side cortical bone of the mandibular canal, were observed at the CT location between the mandibular foramen and mandibular angle. Our results suggest that special care must be taken when sagittal splitting is performed, and the safest location for the buccal corticotomy is anterior to the mandibular angle.

  19. Prediction of sagittal balance in patients with osteoporosis using spinopelvic parameters.

    Science.gov (United States)

    Lee, Jung Sub; Lee, Hong Seok; Shin, Jong Ki; Goh, Tae Sik; Son, Seung Min

    2013-05-01

    Little data is available on the relationships between sagittal balance and spinopelvic parameters in osteoporosis. We analyzed sagittal spinopelvic parameters in osteoporotic patients. In this prospective study, the patient and control groups comprised 124 osteoporotic patients and 40 controls. Average age was 72.4 ± 6.8 in the osteoporosis group and 42.7 ± 12.5 in the control group, which was significantly different (P sagittal vertical axis, namely, a sagittal balance group (n = 56) and a sagittal imbalance group (n = 68). All 164 study subjects underwent whole spine lateral radiography, which included hip joints. The radiographic parameters investigated were sacral slope, pelvic tilt, pelvic incidence, thoracic kyphosis, lumbar lordosis, and sagittal vertical axis. Statistical analysis was performed to identify significant differences between the two groups. Osteoporotic patients and controls were found to be significantly different in terms of sagittal vertical axis, sacral slope, pelvic tilt, lumbar lordosis, and thoracic kyphosis. However, no significant difference was observed between patients and controls in terms of pelvic incidence (P > 0.05). Significant differences were found between the balance and imbalance groups in terms of age, lumbar spine bone mineral density (LSBMD), femoral neck BMD (FNBMD), visual analogue scale (VAS) score, sacral slope, and pelvic incidence. Correlation analysis revealed significant relationships between sagittal parameters and osteoporosis. Stepwise logistic regression analysis revealed that FNBMD and pelvic incidence contributed significantly to sagittal balance. Sagittal spinopelvic parameters were found to be significantly different in patients and normal controls. Significant relationships were found between sagittal spinopelvic parameters in osteoporotic patients. In particular, low FNBMD and high pelvic incidence were significant parameters in determination of sagittal balance in osteoporotic patients.

  20. Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis

    National Research Council Canada - National Science Library

    Harroud, Adil; Labelle, Hubert; Joncas, Julie; Mac-Thiong, Jean-Marc

    2013-01-01

    Global sagittal alignment is considered as an important aspect in the management of spinal disorders, but the evidence establishing its clinical impact in lumbosacral spondylolisthesis is still poor...

  1. Distribution of sagittal occlusal relationships in different stages of dentition

    Directory of Open Access Journals (Sweden)

    Emine KAYGISIZ

    2015-01-01

    Full Text Available The aim of this study was to assess the distribution of sagittal occlusal relationships in different dentition periods in a Turkish sample group. In total, 1,110 patients (561 females, 549 males aged 4.6-23 years were randomly chosen after intraoral clinical examination. The subjects were classified according to their sagittal occlusal relationships and four dentition stages –deciduous, early mixed, late mixed, and permanent dentition. The statistical significance of the occurrence of malocclusion types in dentition stages was evaluated by Chi-square and Fischer’s exact tests. Class I malocclusion was observed at the highest rate in all dentition stages. Class III malocclusion was observed at the highest rate in the permanent dentition, whereas Class II malocclusion was observed at the highest rate in the late mixed dentition. The rates of Class I, II, and III malocclusions were similar in males and females. Our study reveals that the prevalence of malocclusion and need for orthodontic treatment has increased in the population towards the permanent dentition.

  2. Analysis of sagittal condyl inclination in subjects with temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Dodić Slobodan

    2010-01-01

    Full Text Available Bacground/Aim. Disturbances of mandibular border movements is considered to be one of the major signs of temporomandibular disorders (TMD. The purpose of this study was to evaluate the possible association between disturbances of mandibular border movements and the presence of symptoms of TMD in the young. Methods. This study included two groups of volunteers between 18 and 26 years of age. The study group included 30 examineers with signs (symptoms of TMD, and the control group also included 30 persons without any signs (symptoms of TMD. The presence of TMD was confirmed according to the craniomandibular index (Helkimo. The functional analysis of mandibular movements was performed in each subject using the computer pantograph. Results. The results of this study did not confirm any significant differences between the values of the condylar variables/sagittal condylar inclination, length of the sagital condylar guidance, in the control and in the study group. Conclusion. The study did not confirm significant differences in the length and inclination of the protrusive condylar guidance, as well as in the values of the sagittal condylar inclination between the subjects with the signs and symptoms of TMD and the normal asymptomatic subjects.

  3. Corona performance of conductor-to-plane gaps as influenced by underneath grounded and negatively stressed metallic grids

    Energy Technology Data Exchange (ETDEWEB)

    Abdel-Salam, M [Department of Electrical Engineering, Assiut University, Assiut (Egypt); Hashem, A [Department of Physics, Faculty of Science, Assiut University, Assiut (Egypt); Turky, A [Department of Physics, Faculty of Science, Assiut University, Assiut (Egypt); Aziz, A Abdel [Department of Physics, Faculty of Science, Assiut University, Assiut (Egypt)

    2007-03-21

    This paper is aimed at investigating how the positive dc corona performance of conductor-to-plane gaps is influenced by grounded and negatively stressed metallic grids located underneath the coronating conductor. A systematic experimental study is made to investigate the corona current-voltage characteristics and the current density distribution at the ground plane with and without grid. The wire-to-wire spacing, number, lateral distribution and height of grid wires as well as the conductor diameter are varied. The current density distribution at the ground plane is correlated with Warburg law that was proposed for point-plane coronas.

  4. Interceptive orthopedics for the correction of maxillary transverse and sagittal deficiency in the early mixed dentition period

    Directory of Open Access Journals (Sweden)

    Ashok Kumar Talapaneni

    2011-01-01

    Full Text Available Dentofacial Orthopedics directed to a hypoplastic maxilla in the prepubertal period redirects growth of the maxilla in the vertical, transverse and sagittal planes of space. The orthopedic correction of maxillary hypoplasia in the early mixed dentition period thus intercepts the establishment of permanent structural asymmetry in the mandible and helps in the achievement of optimal dentofacial esthetics. This paper presents the growth redirection in a hypoplastic maxilla of an 8-year-old girl with simultaneous rapid maxillary expansion and protraction headgear therapy for a period of 11 months which corrected the posterior unilateral cross-bite, the positional asymmetry of the mandible and established an orthognathic profile in the individual.

  5. Sagittal craniofacial growth evaluated on children dry skulls using V2 and V3 canal openings as references.

    Science.gov (United States)

    Harnet, J-Cl; Lombardi, T; Lutz, J-Ch; Meyer, P; Kahn, J-L

    2007-10-01

    The purpose of this study was to investigate the relationship between standard cephalometric landmarks and lines and those using ovale, rotundum, greater palatine and infra-orbital foramina as references. Thirty-four children dry skulls, 19 males and 15 females aged 0-6 years, were examined by computed tomography scanning. The classical cephalometric dimensions of skull base were measured from middle sagittal plane crossing over basion, nasion and sella turcica. Those of hard palate (maxilla and palatine bone) were measured from axial plane intersecting posterior nasal spine and anterior nasal spine. The dimensions between ovale and rotundum foramina, rotundum and infra-orbital foramina, greater palatine and infra-orbital foramina were determined by using constructed tomographic planes enclosing these different foramina. Biostatistical analysis using partial correlations showed that the linear variables with nerve canal openings as references are strongly related to length of both the skull base and of the hard palate. The results highlight the importance of the nerve canal openings of skull base and bone facial components in normal or pathologic craniofacial growth investigations.

  6. Dynamic, regional mechanical properties of the porcine brain: indentation in the coronal plane.

    Science.gov (United States)

    Elkin, Benjamin S; Ilankova, Ashok; Morrison, Barclay

    2011-07-01

    Stress relaxation tests using a custom designed microindentation device were performed on ten anatomic regions of fresh porcine brain (postmortem time Prony series representation was used to describe the shear relaxation modulus for each anatomic region tested. Prony series parameters fit to load data from indentations performed to ∼10% strain differed significantly by anatomic region. The gray and white matter of the cerebellum along with corpus callosum and brainstem were the softest regions measured. The cortex and hippocampal CA1/CA3 were found to be the stiffest. To examine the large strain behavior of the tissue, multistep indentations were performed in the corona radiata to strains of 10%, 20%, and 30%. Reduced relaxation functions were not significantly different for each step, suggesting that quasi-linear viscoelastic theory may be appropriate for representing the nonlinear behavior of this anatomic region of porcine brain tissue. These data, for the first time, describe the dynamic and short time scale behavior of multiple anatomic regions of the porcine brain which will be useful for understanding porcine brain injury biomechanics at a finer spatial resolution than previously possible.

  7. Femoral bowing plane adaptation to femoral anteversion

    Directory of Open Access Journals (Sweden)

    Alp Akman

    2017-01-01

    Full Text Available Background: Femoral bowing plane (FBP is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21-84 years. Results: The anteversion values were found as the angle between a distal condylar axis (DCA and femoral neck anteversion axis (FNAA along an imaginary longitudinal femoral axis (LFA in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78-102°. On the other hand, FBP does not lie close to the sagittal femoral plane (SFP; instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P0 < 0.001; r = 0.680 and r = −0.682, respectively. Combined correlation is perfect (R[2] = 1 as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component

  8. Solar Coronal Jets: Observations, Theory, and Modeling

    Science.gov (United States)

    Raouafi, N. E.; Patsourakos, S.; Pariat, E.; Young, P. R.; Sterling, A.; Savcheva, A.; Shimojo, M.; Moreno-Insertis, F.; Devore, C. R.; Archontis, V.; hide

    2016-01-01

    Chromospheric and coronal jets represent important manifestations of ubiquitous solar transients, which may be the source of signicant mass and energy input to the upper solar atmosphere and the solar wind. While the energy involved in a jet-like event is smaller than that of nominal solar ares and Coronal Mass Ejections (CMEs), jets share many common properties with these major phenomena, in particular, the explosive magnetically driven dynamics. Studies of jets could, therefore, provide critical insight for understanding the larger, more complex drivers of the solar activity. On the other side of the size-spectrum, the study of jets could also supply important clues on the physics of transients closeor at the limit of the current spatial resolution such as spicules. Furthermore, jet phenomena may hint to basic process for heating the corona and accelerating the solar wind; consequently their study gives us the opportunity to attack a broadrange of solar-heliospheric problems.

  9. A Survey of Coronal Cavity Density Profiles

    Science.gov (United States)

    Fuller, J.; Gibson, S. E.

    2009-08-01

    Coronal cavities are common features of the solar corona that appear as darkened regions at the base of coronal helmet streamers in coronagraph images. Their darkened appearance indicates that they are regions of lowered density embedded within the comparatively higher density helmet streamer. Despite interfering projection effects of the surrounding helmet streamer (which we refer to as the cavity rim), Fuller et al. have shown that under certain conditions it is possible to use a Van de Hulst inversion of white-light polarized brightness (pB) data to calculate the electron density of both the cavity and cavity rim plasma. In this article, we apply minor modifications to the methods of Fuller et al. in order to improve the accuracy and versatility of the inversion process, and use the new methods to calculate density profiles for both the cavity and cavity rim in 24 cavity systems. We also examine trends in cavity morphology and how departures from the model geometry affect our density calculations. The density calculations reveal that in all 24 cases the cavity plasma has a flatter density profile than the plasma of the cavity rim, meaning that the cavity has a larger density depletion at low altitudes than it does at high altitudes. We find that the mean cavity density is over four times greater than that of a coronal hole at an altitude of 1.2 R sun and that every cavity in the sample is over twice as dense as a coronal hole at this altitude. Furthermore, we find that different cavity systems near solar maximum span a greater range in density at 1.2 R sun than do cavity systems near solar minimum, with a slight trend toward higher densities for systems nearer to solar maximum. Finally, we found no significant correlation of cavity density properties with cavity height—indeed, cavities show remarkably similar density depletions—except for the two smallest cavities that show significantly greater depletion.

  10. Reliability and Validity Measurement of Sagittal Lumbosacral Quiet Standing Posture with a Smartphone Application in a Mixed Population of 183 College Students and Personnel

    Directory of Open Access Journals (Sweden)

    George A. Koumantakis

    2016-01-01

    Full Text Available Accurate recording of spinal posture with simple and accessible measurement devices in clinical practice may lead to spinal loading optimization in occupations related to prolonged sitting and standing postures. Therefore, the purpose of this study was to establish the level of reliability of sagittal lumbosacral posture in quiet standing and the validity of the method in differentiating between male and female subjects, establishing in parallel a normative database. 183 participants (83 males and 100 females, with no current low back or pelvic pain, were assessed using the “iHandy Level” smartphone application. Intrarater reliability (3 same-day sequential measurements was high for both the lumbar curve (ICC2,1: 0.96, SEM: 2.13°, and MDC95%: 5.9° and the sacral slope (ICC2,1: 0.97, SEM: 1.61°, and MDC95%: 4.46° sagittal alignment. Data analysis for each gender separately confirmed equally high reliability for both male and female participants. Correlation between lumbar curve and sacral slope was high (Pearson’s r=0.86, p<0.001. Between-gender comparisons confirmed the validity of the method to differentiate between male and female lumbar curve and sacral slope angles, with females generally demonstrating greater lumbosacral values (p<0.001. The “iHandy Level” application is a reliable and valid tool in the measurement of lumbosacral quiet standing spinal posture in the sagittal plane.

  11. Coronal Heating Observed with Hi-C

    Science.gov (United States)

    Winebarger, Amy R.

    2013-01-01

    The recent launch of the High-Resolution Coronal Imager (Hi-C) as a sounding rocket has offered a new, different view of the Sun. With approx 0.3" resolution and 5 second cadence, Hi-C reveals dynamic, small-scale structure within a complicated active region, including coronal braiding, reconnection regions, Alfven waves, and flows along active region fans. By combining the Hi-C data with other available data, we have compiled a rich data set that can be used to address many outstanding questions in solar physics. Though the Hi-C rocket flight was short (only 5 minutes), the added insight of the small-scale structure gained from the Hi-C data allows us to look at this active region and other active regions with new understanding. In this talk, I will review the first results from the Hi-C sounding rocket and discuss the impact of these results on the coronal heating problem.

  12. Observing the Unobservable? Modeling Coronal Cavity Densities

    Science.gov (United States)

    Fuller, J.; Gibson, S. E.; de Toma, G.; Fan, Y.

    2008-05-01

    Prominence cavities in coronal helmet streamers are readily detectable in white-light coronagraph images, yet their interpretation may be complicated by projection effects. In order to determine a cavity's density structure, it is essential to quantify the contribution of noncavity features along the line of sight. We model the coronal cavity as an axisymmetric torus that encircles the Sun at constant latitude and fit it to observations of a white-light cavity observed by the Mauna Loa Solar Observatory (MLSO) MK4 coronagraph from 2006 January 25 to 30. We demonstrate that spurious noncavity contributions (including departures from axisymmetry) are minimal enough to be incorporated in a density analysis as conservatively estimated uncertainties in the data. We calculate a radial density profile for cavity material and for the surrounding helmet streamer (which we refer to as the "cavity rim") and find that the cavity density is depleted by a maximum of 40% compared to the surrounding helmet streamer at low altitudes (1.18 R⊙) but is consistently higher (double or more) than in coronal holes. We also find that the relative density depletion between cavity and surrounding helmet decreases as a function of height. We show that both increased temperature in the cavity relative to the surrounding helmet streamer and a magnetic flux rope configuration might lead to such a flattened density profile. Finally, our model provides general observational guidelines that can be used to determine when a cavity is sufficiently unobstructed to be a good candidate for plasma diagnostics.

  13. BKP plane partitions

    Energy Technology Data Exchange (ETDEWEB)

    Foda, Omar; Wheeler, Michael [Department of Mathematics and Statistics, University of Melbourne, Parkville, Victoria 3010 (Australia)

    2007-01-15

    Using BKP neutral fermions, we derive a product expression for the generating function of volume-weighted plane partitions that satisfy two conditions. If we call a set of adjacent equal height-h columns, h > 0, an h-path, then 1. Every h-path can assume one of two possible colours. 2. There is a unique way to move along an h-path from any column to another.

  14. WAVE LEAKAGE AND RESONANT ABSORPTION IN A LOOP EMBEDDED IN A CORONAL ARCADE

    Energy Technology Data Exchange (ETDEWEB)

    Rial, S.; Terradas, J.; Oliver, R.; Ballester, J. L. [Departament de Fisica, Universitat de les Illes Balears, E-07122, Palma de Mallorca (Spain); Arregui, I., E-mail: samuel.rial@uib.es, E-mail: jaume.terradas@uib.es, E-mail: ramon.oliver@uib.es, E-mail: joseluis.ballester@uib.es, E-mail: iarregui@iac.es [Instituto de Astrofisica de Canarias, E-38205 La Laguna, Tenerife (Spain)

    2013-01-20

    We investigate the temporal evolution of impulsively generated perturbations in a potential coronal arcade with an embedded loop. For the initial configuration we consider a coronal loop, represented by a density enhancement, which is unbounded in the ignorable direction of the arcade. The linearized time-dependent magnetohydrodynamic equations have been numerically solved in field-aligned coordinates and the time evolution of the initial perturbations has been studied in the zero-{beta} approximation. For propagation constrained to the plane of the arcade, the considered initial perturbations do not excite trapped modes of the system. This weakness of the model is overcome by the inclusion of wave propagation in the ignorable direction. Perpendicular propagation produces two main results. First, damping by wave leakage is less efficient because the loop is able to act as a better wave trap of vertical oscillations. Second, the consideration of an inhomogeneous corona enables the resonant damping of vertical oscillations and the energy transfer from the interior of the loop to the external coronal medium.

  15. Automatic Determination of the Conic Coronal Mass Ejection Model Parameters

    Science.gov (United States)

    Pulkkinen, A.; Oates, T.; Taktakishvili, A.

    2009-01-01

    Characterization of the three-dimensional structure of solar transients using incomplete plane of sky data is a difficult problem whose solutions have potential for societal benefit in terms of space weather applications. In this paper transients are characterized in three dimensions by means of conic coronal mass ejection (CME) approximation. A novel method for the automatic determination of cone model parameters from observed halo CMEs is introduced. The method uses both standard image processing techniques to extract the CME mass from white-light coronagraph images and a novel inversion routine providing the final cone parameters. A bootstrap technique is used to provide model parameter distributions. When combined with heliospheric modeling, the cone model parameter distributions will provide direct means for ensemble predictions of transient propagation in the heliosphere. An initial validation of the automatic method is carried by comparison to manually determined cone model parameters. It is shown using 14 halo CME events that there is reasonable agreement, especially between the heliocentric locations of the cones derived with the two methods. It is argued that both the heliocentric locations and the opening half-angles of the automatically determined cones may be more realistic than those obtained from the manual analysis

  16. Rehabilitation after ACL Injury: A Fluoroscopic Study on the Effects of Type of Exercise on the Knee Sagittal Plane Arthrokinematics

    Directory of Open Access Journals (Sweden)

    Sadegh Norouzi

    2013-01-01

    Full Text Available A safe rehabilitation exercise for anterior cruciate ligament (ACL injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (. During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (. It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise.

  17. Shoulder motor performance assessment in the sagittal plane in children with hemiplegia during single joint pointing tasks

    National Research Council Canada - National Science Library

    Formica, Domenico; Petrarca, Maurizio; Rossi, Stefano; Zollo, Loredana; Guglielmelli, Eugenio; Cappa, Paolo

    2014-01-01

    .... The study of invariant characteristics of human movements has led to several theories on how the brain solves the redundancy problem, but the application of these theories on children affected by hemiplegia is limited...

  18. Relevance of the hyperelastic behavior of cruciate ligaments in the modeling of the human knee joint in sagittal plane

    Directory of Open Access Journals (Sweden)

    Daniel Alejandro Ponce-Saldias

    2015-01-01

    Full Text Available La ruptura del ligamento cruzado anterior (LCA es la lesión más comúnde la rodilla humana. Cuando se requiere cirugía, es de mucha ayuda para los cirujanosdefi nir científi camente el mejor punto de inserción del injerto, para que pueda tener unafuncionalidad similar a la de un LCA intacto. Para esto, es crucial la estimación de la fuerzaque actúa en el ligamento (o injerto en respuesta a una carga externa aplicada sobre larodilla. Esta fuerza es llamada fuerza in-situ. El objetivo de esta investigación es evidenciarla relevancia del comportamiento hiperelástico de los ligamentos cruzados en el modelajebidimensional de la rodilla. Para ello, se propone una metodología secuencial de modelajebasándose en teoría de mecanismos y el método de Davies. En una primera aproximación,los ligamentos cruzados son considerados como cuerpos rígidos; en una segundaaproximación, como cuerpos con comportamiento hiperelástico. Esas dos aproximacionesson comparadas. El modelo proporciona informaciones que permiten asistir el planeamiento pre-operatorio, mediante la simulación de las posiciones y la fuerzas in-situ del LCA. Lametodología propuesta consiste en cuatro pasos y considera un procedimiento experimentalrealizado mediante un manipulador robótico que obtiene las fuerzas in-situ. Las fuerzasin-situ experimentales son usadas para validar el modelo propuesto. Además de apoyaral planeamiento pre-operatorio, el modelo permite verificar dos hipótesis biomecánicasrelevantes: 1. Para la simulación de la fuerza in-situ del LCA, el modelaje de los ligamentoscruzados como barras rígidas, presenta resultados semejantes a los del modelaje queconsidera el comportamiento hiperelástico (más elaborado. 2. Las fuerzas in-situ delLCA pueden ser aproximadas satisfactoriamente, cuando la rodilla es modelada como unmecanismo bidimensional de 4-barras. Con base en los resultados puede concluirse que lasfuerzas obtenidas por simulaciones que consideran el comportamiento hiperelástico de losligamentos cruzados, son muy próximas a aquellas fuerzas obtenidas en simulaciones queconsideran los ligamentos cruzados como cuerpos rígidos. También se puede observar quelos resultados simulados son bastante similares a los resultados experimentales, lo que esrelevante considerando que el modelaje propuesto es simplificado.

  19. Rehabilitation after ACL Injury: A Fluoroscopic Study on the Effects of Type of Exercise on the Knee Sagittal Plane Arthrokinematics

    Science.gov (United States)

    Norouzi, Sadegh; Esfandiarpour, Fateme; Shakourirad, Ali; Salehi, Reza; Akbar, Mohammad; Farahmand, Farzam

    2013-01-01

    A safe rehabilitation exercise for anterior cruciate ligament (ACL) injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT) of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (P < 0.05). During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (P = 0.002) and 15° (P = 0.012). It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise. PMID:24066288

  20. Gender Differences among Sagittal Plane Knee Kinematic and Ground Reaction Force Characteristics during a Rapid Sprint and Cut Maneuver

    Science.gov (United States)

    James, C. Roger; Sizer, Phillip S.; Starch, David W.; Lockhart, Thurmon E.; Slauterbeck, James

    2004-01-01

    Women are more prone to anterior cruciate ligament (ACL) injury during cutting sports than men. The purpose of this study was to examine knee kinematic and ground reaction forces (GRF) differences between genders during cutting. Male and female athletes performed cutting trials while force platform and video data were recorded (180 Hz).…

  1. Joint Loading in the Sagittal Plane During Gait Is Associated With Hip Joint Abnormalities in Patients With Femoroacetabular Impingement.

    Science.gov (United States)

    Samaan, Michael A; Schwaiger, Benedikt J; Gallo, Matthew C; Sada, Kiyoshi; Link, Thomas M; Zhang, Alan L; Majumdar, Sharmila; Souza, Richard B

    2017-03-01

    Femoroacetabular impingement (FAI) is a morphological abnormality of the hip joint that results in functional impairments during various activities of daily living (ADL) such as walking. Purpose/Hypothesis: The purpose of this study was to determine if lower extremity joint loading differed between patients with FAI and controls and to determine whether these altered biomechanical parameters were associated with intra-articular abnormalities. It was hypothesized that patients with FAI would exhibit altered lower extremity joint loading during walking when compared with healthy controls and that these altered joint loading patterns would be associated with intra-articular abnormalities. Controlled laboratory study. Lower extremity kinetics was assessed during walking at a self-selected speed in 15 presurgical patients with FAI and 34 healthy controls matched for age and body mass index. All participants underwent unilateral hip magnetic resonance imaging (MRI) to assess hip joint abnormalities. Hip joint abnormalities were assessed using a semiquantitative MRI-based scoring system. Self-reported outcomes of pain and function were obtained using the Hip disability and Osteoarthritis Outcome Score (HOOS), and physical performance was measured using the 6-minute walk test (6MWT). Group differences were assessed using an independent t test and analysis of variance. In the patients with FAI, associations of joint kinetics with HOOS subscores and intra-articular abnormalities were assessed using the Pearson ( r) and Spearman (ρ) correlation coefficients, respectively. Compared with the control group, the FAI group exhibited a significantly increased severity of acetabular (FAI: 1.87 ± 1.55; control: 0.47 ± 0.79; P FAI: 3.27 ± 2.79; control: 1.21 ± 1.55; P = .002) cartilage abnormalities, increased levels of pain (FAI: 65.0 ± 18.8; control: 98.2 ± 3.4; P = .001), and reduced function (FAI: 67.2 ± 21.5; control: 98.9 ± 3.4; P FAI: 1.55 ± 0.19 m/s; control: 1.63 ± 0.22 m/s; P = .20) and 6MWT performance (FAI: 628.0 ± 91.2 m; control: 667.2 ± 73.4 m; P = .13). The FAI group demonstrated increased hip flexion moment impulses (FAI: 0.14 ± 0.04 N·m·s/kg; control: 0.11 ± 0.03 N·m·s/kg; P = .03), peak ankle dorsiflexion moments (FAI: 1.64 ± 0.16 N·m/kg; control: 1.46 ± 0.31 N·m/kg; P = .04), and ankle dorsiflexion moment impulses (FAI: 0.39 ± 0.07 N·m·s/kg; control: 0.31 ± 0.07 N·m·s/kg; P = .01) compared with the control group. Within the FAI group, an increased hip flexion moment impulse during walking was significantly correlated with increased pain ( r = -0.60, P = .03), decreased ADL ( r = -0.57, P = .04), and increased severity of acetabular cartilage abnormalities (ρ = 0.82, P FAI exhibited altered hip and ankle joint loading patterns during walking. These data suggest that patients with FAI demonstrate both local and distal joint alterations during walking and that hip joint loading is directly related to hip joint abnormalities. The results of this study suggest that the hip flexion moment impulse may be an important biomechanical parameter to understand FAI, as the hip flexion moment impulse during walking was shown to be directly related to hip joint abnormalities on MRI.

  2. Spine Shape in Sagittal and Frontal Planes in Short- and Tall-Statured Children Aged 13 Years

    Science.gov (United States)

    Lichota, Malgorzata

    2008-01-01

    Study aim: To assess spine curvatures, postural categories and scolioses in short and tall children aged 13 years. Material and methods: Short-statured (below Percentile 10) and tall-statured (above Percentile 90) boys (n = 13 and 18, respectively) and girls (n = 10 and 11, respectively) aged 13 years were studied. The following angles of spine…

  3. Review of rehabilitation and orthopedic conservative approach to sagittal plane diseases during growth: hyperkyphosis, junctional kyphosis, and Scheuermann disease.

    Science.gov (United States)

    Zaina, F; Atanasio, S; Ferraro, C; Fusco, C; Negrini, A; Romano, M; Negrini, S

    2009-12-01

    An increase of the physiological kyphosis during growth is defined hyperkyphosis (HK) and, according to the level where the apex of the curve can be retrieved, we can distinguish a thoracic HK and a thoraco-lumbar one, also called junctional kyphosis. Since these conditions can cause pain and esthetics impairments, lead in adulthood to an higher incidence of spinal and shoulder pain, and evolve during growth, it is important to manage this deformity. The aim of this paper was to present the state of the art about HK and its treatment. Scheuermann Disease (SCHK) is the better known cause of HK; other causes can be idiopathic or postural, trunk extensor muscles weakness or neurological problems. Despite etiology a specific treatment can be required during growth to prevent evolution and reach a better spinal alignment in adulthood. It is at the base of treatment and allow monitoring. There are some validated methods that can be used in a comprehensive rehabilitation approach. Evidence in this field is scanty, even if there is quite a consensus on possible treatments. They aim at improving posture and esthetics, and abolishing pain; they include: exercises, used mainly in mobile postural/idiopathic HK, and in SCHK without HK; braces (plus exercises, in this case aimed at reducing brace impairments), that in rigid HK and in most of SCHK patients also allow a better vertebral growth; surgery could be used in worst cases, even if it should be carefully considered, because it requires fusion and loss of spinal function.

  4. Subtotal cranial vault remodelling in anterior sagittal suture closure: impact of age on surgical outcome

    NARCIS (Netherlands)

    Engel, M.; Hoffmann, J.; Muhling, J.; Castrillon-Oberndorfer, G.; Seeberger, R.; Freudlsperger, C.

    2012-01-01

    Isolated fusion of the sagittal suture is usually treated before 1 year of age, but some patients present at a later age. The aim of this study was to evaluate the impact of children's age on the surgical outcome. The authors investigated 46 patients with isolated nonsyndromic sagittal

  5. Extensor Tendon Instability Due to Sagittal Band Injury in a Martial Arts Athlete: A Case Report.

    Science.gov (United States)

    Kochevar, Andrew; Rayan, Ghazi

    2017-03-01

    A Taekwondo participant sustained a hand injury from punching an opponent that resulted in painful instability of the ring finger extensor digitorum communis tendon due to sagittal band damage. His symptoms resolved after reconstructive surgery on the sagittal band (SB) with stabilization of the extensor tendon over the metacarpophalangeal joint.

  6. Superior Sagittal Sinus Thrombosis Complicating Typhoid Fever in a Teenager

    Directory of Open Access Journals (Sweden)

    P. O. Okunola

    2012-01-01

    Full Text Available Cerebral venous sinus (sinovenous thrombosis (CSVT is a rare life-threatening disorder in childhood that is often misdiagnosed. CSVT encompasses cavernous sinus thrombosis, lateral sinus thrombosis, and superior sagittal sinus thrombosis (SSST. We present an adolescent girl who was well until two weeks earlier when she had a throbbing frontal headache and fever with chills; she later had dyspnoea, jaundice, melena stool, multiple seizures, nuchal rigidity, and monoparesis of the right lower limb a day before admission. Urine test for Salmonella typhi Vi antigen was positive, and Widal reaction was significant. Serial cranial computerized tomography scans revealed an expanding hypodense lesion in the parafalcine region consistent with SSST or a parasagittal abscess. Inadvertent left parietal limited craniectomy confirmed SSST. She recovered completely with subsequent conservative management. Beyond neuropsychiatric complications of Typhoid fever, CSVT should be highly considered when focal neurologic deficits are present.

  7. Mandibular nerve schwannoma resection using sagittal split ramus osteotomy.

    Science.gov (United States)

    Mahmood, Laith; Demian, Nagi; Weinstock, Yitzchak E; Weissferdt, Annikka

    2013-11-01

    A case is presented of a unique presentation and treatment of a mandibular nerve schwannoma. Its uniqueness stems from the fact that it consisted of 2 distinct tumors along the same nerve: one within the body of the mandible and the other within the ipsilateral pterygomandibular space. Rather than the standard approach of lip split and hemimandibulectomy, a unique approach of a sagittal split ramus osteotomy was used that allowed access to the 2 lesions and avoided the added morbidity of the former approach. The 2 portions of the lesion were successfully removed and the patient was satisfied with the result. Recurrence has not been detected after 6 months. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Degenerative retrolisthesis: is it a compensatory mechanism for sagittal imbalance?

    Science.gov (United States)

    Jeon, C-H; Park, J-U; Chung, N-S; Son, K-H; Lee, Y-S; Kim, J-J

    2013-09-01

    We investigated the spinopelvic morphology and global sagittal balance of patients with a degenerative retrolisthesis or anterolisthesis. A total of 269 consecutive patients with a degenerative spondylolisthesis were included in this study. There were 95 men and 174 women with a mean age of 64.3 years (sd 10.5; 40 to 88). A total of 106 patients had a pure retrolisthesis (R group), 130 had a pure anterolisthesis (A group), and 33 had both (R+A group). A backward slip was found in the upper lumbar levels (mostly L2 or L3) with an almost equal gender distribution in both the R and R+A groups. The pelvic incidence and sacral slope of the R group were significantly lower than those of the A (both p anterolisthesis and high pelvic incidence.

  9. Sagittal spinopelvic parameters in 2-level lumbar degenerative spondylolisthesis

    Science.gov (United States)

    Wang, Tao; Wang, Hui; Liu, Huan; Ma, Lei; Liu, Feng-Yu; Ding, Wen-Yuan

    2016-01-01

    Abstract The purpose of our study is to evaluate sagittal parameters in 2-level lumbar degenerative spondylolisthesis (DS) (TLDS). A total of 15 patients with TLDS, 40 patients with single-level DS (SLDS), and 30 normal volunteers as control were included in our study. All subjects performed on full spine X-ray. Two categorized data were analyzed: patient characteristics—age, sex, body mass index, radiographic parameters-pelvic incidence (PI), pelvic tilt (PT), lumbar lordosis (LL), sacral slope (SS), PI–LL, Cobb between the fifth thoracic vertebral and 12th thoracic vertebral (T5–T12), sagittal vertical axis (SVA) Cobb angle of spondylolisthesis level (CSL), ratio of PT to SS (PT/SS), CSL/LL, variation trend of SS over PI, and LL over PI. The PI (73.1° vs 52.9°), SS (50.8° vs 32.2°), LL (53.1° vs 46.9°), SVA (66.1 vs 22.0 mm), PI–LL (20.0° vs 6.0°), and CSL (23.6° vs 20.0°) in TLDS were significantly larger than these in SLDS. The PI (73.1° vs 40.6°), PT (22.3° vs 17.1°), SS (50.8° vs 23.5°), LL (53.1° vs 32.5°), PI–LL (20.0° vs 8.1°), and SVA (66.1 vs 17.0 mm) in TLDS were significantly larger than those in the normal group (NG). The PI (52.9° vs 40.6°), PT (21.0° vs 17.1°), SS (32.2° vs 23.5°), LL (46.9° vs 32.5°), and SVA (22.0 vs 17.0 mm) in SLDS were significantly higher than those in NG. However, PT/SS (44.0%), LL over PI (y = 0.39x + 24.25), SS over PI (y = 10.79 + 0.55x) were lower in TLDS than these in SLDS (63.8%, y = 0.41x + 25, y = 0.65x − 2.09, respectively), and the similar tend between SLDS and NG (74.0%, y = 0.49x + 13.09, y = 0.67x − 3.9, respectively). Our results showed that 2-level lumbar DS, which was caused by multiple-factors, has a severe sagittal imbalance, but single-level has not any. When we plan for surgical selection for 2-level lumbar DS, global sagittal balance must be considered. PMID:27977581

  10. Assessment of spring cranioplasty biomechanics in sagittal craniosynostosis patients.

    Science.gov (United States)

    Borghi, Alessandro; Schievano, Silvia; Rodriguez Florez, Naiara; McNicholas, Roisin; Rodgers, Will; Ponniah, Allan; James, Greg; Hayward, Richard; Dunaway, David; Jeelani, N U Owase

    2017-11-01

    OBJECTIVE Scaphocephaly secondary to sagittal craniosynostosis has been treated in recent years with spring-assisted cranioplasty, an innovative approach that leverages the use of metallic spring distractors to reshape the patient skull. In this study, a population of patients who had undergone spring cranioplasty for the correction of scaphocephaly at the Great Ormond Street Hospital for Children was retrospectively analyzed to systematically assess spring biomechanical performance and kinematics in relation to spring model, patient age, and outcomes over time. METHODS Data from 60 patients (49 males, mean age at surgery 5.2 ± 0.9 months) who had received 2 springs for the treatment of isolated sagittal craniosynostosis were analyzed. The opening distance of the springs at the time of insertion and removal was retrieved from the surgical notes and, during the implantation period, from planar radiographs obtained at 1 day postoperatively and at the 3-week follow-up. The force exerted by the spring to the patient skull at each time point was derived after mechanical testing of each spring model-3 devices with the same geometry but different wire thicknesses. Changes in the cephalic index between preoperatively and the 3-week follow-up were recorded. RESULTS Stiffer springs were implanted in older patients (p springs were used (p spring models, however, the devices all plateaued. Indeed, regardless of patient age or spring model, after 10 days from insertion, all the devices were open. CONCLUSIONS Results in this study provide biomechanical insights into spring-assisted cranioplasty and could help to improve spring design and follow-up strategy in the future.

  11. Changes in Habitual and Active Sagittal Posture in Children and Adolescents with and without Visual Input – Implications for Diagnostic Analysis of Posture

    Science.gov (United States)

    Mazet, Carola; Mazet, Dirk; Hammes, Annette; Schmitt, Eduard

    2016-01-01

    Introduction Poor posture in children and adolescents has a prevalence of 22-65% and is suggested to be responsible for back pain. To assess posture, photometric imaging of sagittal posture is widely used, but usually only habitual posture positions (resting position with minimal muscle activity) are analysed. Aim The objective of this study was 1) to investigate possible changes in posture-describing parameters in the sagittal plane, when the subjects changed from a habitual passive posture to an actively corrected posture, and 2) to investigate the changes in posture parameters when an actively corrected posture was to be maintained with closed eyes. Materials and Methods In a group of 216 male children and adolescents (average 12.4 ± 2.5 years, range 7.0 – 17.6 years), six sagittal posture parameters (body tilt BT, trunk incline TI, posture index PI, horizontal distances between ear, shoulder and hip and the perpendicular to the ankle joint) were determined by means of photometric imaging in an habitual passive posture position, in an actively erect posture with eyes open, and in active stance with eyes closed. The change in these parameters during the transition between the posture positions was analysed statistically (dependent t-Test or Wilcoxon-Test) after Bonferroni correction (pposture BT, TI, PI, dEar, dShoulder, and dHip decreased significantly(pposture positions. Conclusion Changes in sagittal posture parameters that occur when a habitual passive posture switches into an active posture or when an active posture is to be maintained while the eyes are closed can be used for diagnostic purposes regarding poor posture and posture regulation. PMID:27042547

  12. C7 sagittal vertical axis is the determinant of the C5-C7 angle in cervical sagittal alignment.

    Science.gov (United States)

    Matsubayashi, Yoshitaka; Chikuda, Hirotaka; Oshima, Yasushi; Taniguchi, Yuki; Fujimoto, Yoh; Shimizu, Takachika; Tanaka, Sakae

    2017-05-01

    Previous studies have indicated that the T1 slope correlates with cervical lordosis. In contrast, the specific impact of the C7 sagittal vertical axis (C7SVA) on cervical lordosis remains unknown. This study aimed to investigate the specific role of C7SVA in cervical lordosis. This was a retrospective radiographic study. Forty-eight consecutive patients who underwent lateral standing radiography of the entire spine were retrospectively reviewed. Radiographic parameters included occipito (Oc)-C7, Oc-C2, C2-C7, C2-C4, and C5-C7 angles; T1 slope; C7SVA; T1 pelvic angle (TPA); pelvic incidence; pelvic tilt; and sacral slope. The radiographs of 96 consecutive patients who underwent lateral standing radiography of the entire spine in June 2015 in our hospital were retrospectively reviewed. Patients having cervical deformities, having undergone cervical fusion, and under 18 years of age were excluded. A total of 48 Asian patients (14 men and 34 women; mean age, 54.6 years) were eligible. Pathologies included scoliosis, myelopathy, thoracolumbar deformity, and spondylosis. Spearman rank correlation coefficients were used to examine correlations between the parameters. The relationship between C5-C7 lordosis and the radiographic parameters was calculated using the forward stepwise multivariate regression analysis. The authors do not have financial associations relevant to this article. C7SVA correlated with the Oc-C7 (r=0.42) and C2-C7 (r=0.50) angles. However, the correlation coefficient was smaller than that between the T1 slope and Oc-C7 (r=0.83) or C2-C7 (r=0.76) angles. When the C2-C7 angle was divided into C2-C4 and C5-C7 angles, C7SVA correlated with the C5-C7 (r=0.63) angle but not with the C2-C4 angle. The correlation coefficient between the C5-C7 angle and C7SVA was higher than that between the C5-C7 angle and T1 slope (r=0.53) or the C5-C7 angle and TPA (r=0.60). Using radiographic parameters and age, multiple regression analysis revealed that only C7SVA affected

  13. Transequatorial Coronal Cloud Prominences Versus Transequatorial Channel Prominence

    Science.gov (United States)

    Martin, S. F.; Daga, K.

    2016-12-01

    Seven transequatorial channel prominences were identified in the McCauley et al. catalog of erupting prominences from June 2010 - Sep 2014 (2015 Solar Phys. 290, 1703). A comparable number of transequatorial coronal cloud prominences were identified in the Martin et al. study of coronal cloud prominences from May 2010 - April 2012 (IAU Symposium 320, 2016, p. 276). The similar locations of these two subsets of two primary prominence classifications make them nearly ideal candidates for comparison of their properties. Coronal rain is an integral dynamic in coronal cloud prominences whereas counterstreaming motion is characteristic of channel prominences. The two subsets are representative of the the differing magnetic structure, mass origin, evolution, and environmental properties of coronal cloud prominences and channel prominences in general. These samples illustrate how coronal cloud prominences require different models than channel prominences. However, both types of prominences appear to be dependent upon pre-existing environments that largely control their structure and dynamics.

  14. The OBS control plane

    DEFF Research Database (Denmark)

    Manolova, Anna Vasileva; Ruepp, Sarah Renée

    2010-01-01

    Optical Burst Switching and Generalized Multi-Protocol Label Switching have been around for more than a decade now. The topic of their integration received a fair amount of research interest. This article reviews the main proposed architectures so far and outlines their advantages and drawbacks....... The applicability analysis carried out here focuses on the actual feasibility of the integration and the potential trade-offs which appear when two contradicting principles are combined. Taking advantage of the flexibility of the GMPLS control plane does not seem to be as easy and as straightforward as expected...

  15. Mosaic Focal Plane Development

    Science.gov (United States)

    Mason, D.; Horner, S.; Aamodt, E.

    Advances in manufacturing and applied sciences have enabled the development of large ground and spaced based astronomical instruments having a Field of View (FOV) large enough to capture a large portion of the universe in a single image. A large FOV can be accomplished using light weighted optics, improved structures, and the development of mosaic Focal Plane Assemblies (mFPAs). A mFPA comprises multiple Charged Coupled Devices (CCD) mounted onto a single baseplate integrated at the focus plane of the instrument. Examples of current, or proposed, missions utilizing mFPA technology include FAME, GEST, Kepler, GAIA, LSST, and SNAP. The development of a mFPA mandates tight control on the design trades of component development, CCD definition and characterization, component integration, and performance verification testing. This paper addresses the results of the Lockheed Martin Space Systems Company (LMSSC), Advanced Technology Center (ATC) developed mFPA. The design trades and performance characterization are services provided by the LMSSC ATC but not detailed in this paper.

  16. Effect of trunk sagittal attitude on shoulder, thorax and pelvis three-dimensional kinematics in able-bodied subjects during gait.

    Directory of Open Access Journals (Sweden)

    Alberto Leardini

    Full Text Available It has been shown that an original attitude in forward or backward inclination of the trunk is maintained at gait initiation and during locomotion, and that this affects lower limb loading patterns. However, no studies have shown the extent to which shoulder, thorax and pelvis three-dimensional kinematics are modified during gait due to this sagittal inclination attitude. Thirty young healthy volunteers were analyzed during level walking with video-based motion analysis. Reflecting markers were mounted on anatomical landmarks to form a two-marker shoulder line segment, and a four-marker thorax and pelvis segments. Absolute and relative spatial rotations were calculated, for a total of 11 degrees of freedom. The subjects were divided into two groups of 15 according to the median of mean thorax inclination angle over the gait cycle. Preliminary MANOVA analysis assessed whether gender was an independent variable. Then two-factor nested ANOVA was used to test the possible effect of thorax inclination on body segments, planes of motion and gait periods, separately. There was no significant difference in all anthropometric and spatio-temporal parameters between the two groups, except for subject mass. The three-dimensional kinematics of the thorax and pelvis were not affected by gender. Nested ANOVA revealed group effect in all segment rotations apart those at the pelvis, in the sagittal and frontal planes, and at the push-off. Attitudes in sagittal thorax inclination altered trunk segments kinematics during gait. Subjects with a backward thorax showed less thorax-to-pelvis motion, but more shoulder-to-thorax and thorax-to-laboratory motion, less motion in flexion/extension and in lateral bending, and also less motion during push-off. This contributes to the understanding of forward propulsion and sideways load transfer mechanisms, fundamental for the maintenance of balance and the risk of falling.

  17. Effect of trunk sagittal attitude on shoulder, thorax and pelvis three-dimensional kinematics in able-bodied subjects during gait.

    Science.gov (United States)

    Leardini, Alberto; Berti, Lisa; Begon, Mickaël; Allard, Paul

    2013-01-01

    It has been shown that an original attitude in forward or backward inclination of the trunk is maintained at gait initiation and during locomotion, and that this affects lower limb loading patterns. However, no studies have shown the extent to which shoulder, thorax and pelvis three-dimensional kinematics are modified during gait due to this sagittal inclination attitude. Thirty young healthy volunteers were analyzed during level walking with video-based motion analysis. Reflecting markers were mounted on anatomical landmarks to form a two-marker shoulder line segment, and a four-marker thorax and pelvis segments. Absolute and relative spatial rotations were calculated, for a total of 11 degrees of freedom. The subjects were divided into two groups of 15 according to the median of mean thorax inclination angle over the gait cycle. Preliminary MANOVA analysis assessed whether gender was an independent variable. Then two-factor nested ANOVA was used to test the possible effect of thorax inclination on body segments, planes of motion and gait periods, separately. There was no significant difference in all anthropometric and spatio-temporal parameters between the two groups, except for subject mass. The three-dimensional kinematics of the thorax and pelvis were not affected by gender. Nested ANOVA revealed group effect in all segment rotations apart those at the pelvis, in the sagittal and frontal planes, and at the push-off. Attitudes in sagittal thorax inclination altered trunk segments kinematics during gait. Subjects with a backward thorax showed less thorax-to-pelvis motion, but more shoulder-to-thorax and thorax-to-laboratory motion, less motion in flexion/extension and in lateral bending, and also less motion during push-off. This contributes to the understanding of forward propulsion and sideways load transfer mechanisms, fundamental for the maintenance of balance and the risk of falling.

  18. Analysis of risk factors for sagittal translation after pedicle subtraction osteotomy in ankylosing spondylitis patients.

    Science.gov (United States)

    Park, Jin-Sung; Kim, Jaedong; Joo, Il-Han; Sim, Kyu-Dong; Park, Ye-Soo

    2018-01-02

    Sagittal translation, a potential complication of pedicle subtraction osteotomy (PSO), can results in neurologic damage. However, few studies have been conducted on sagittal translation and its risk factors after PSO in patients with ankylosing spondylitis (AS). To report cases of sagittal translation that developed after PSO in patients with AS with kyphotic deformity and to analyze risk factors for sagittal translation. A retrospective case-control study PATIENT SAMPLE: This study included 53 patients (58 cases) with AS who underwent PSO to correct their kyphotic deformity. The modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) was measured before the surgery. Radiologic pelvic and sagittal parameters were also measured before and after surgery. Developments of sagittal translation were confirmed with intraoperative radiograph. The subjects were grouped according to the presence (ST group) and absence (non-ST group) of sagittal translation. The demographic and radiologic parameters were compared between two groups. Through multivariate logistic regression analysis, the correlations between sagittal translation and relevant parameters were analyzed for risk factor evaluation. Sagittal translation developed in 16 patients (30.2%) [16 cases (27.6%)]. The mean lumbar lordosis angle and sagittal vertical axis of both ST group and non-ST group were successfully corrected. In a comparison of two groups, the ST group (58.2 ± 13.3) showed a significantly higher mSASSS than the non-ST group (33.9 ± 11.9) (p<0.001). The ST group (50.4°± 7.8°, 16.9° ± 6.8°) also showed a significantly higher preoperative pelvic incidence and sacral slope than the non-ST group (45.3° ± 7.2°, 11.0°± 7.7°) (p=0.026, p=0.011). No significant differences were observed between the two groups for the rest of radiologic parameters. In multivariate analysis, only mSASSS was positively correlated with sagittal translation (odds ratio 1.16, p=0.001). The incidence of sagittal

  19. Magnetic topological analysis of coronal bright points

    Science.gov (United States)

    Galsgaard, K.; Madjarska, M. S.; Moreno-Insertis, F.; Huang, Z.; Wiegelmann, T.

    2017-10-01

    Context. We report on the first of a series of studies on coronal bright points which investigate the physical mechanism that generates these phenomena. Aims: The aim of this paper is to understand the magnetic-field structure that hosts the bright points. Methods: We use longitudinal magnetograms taken by the Solar Optical Telescope with the Narrowband Filter Imager. For a single case, magnetograms from the Helioseismic and Magnetic Imager were added to the analysis. The longitudinal magnetic field component is used to derive the potential magnetic fields of the large regions around the bright points. A magneto-static field extrapolation method is tested to verify the accuracy of the potential field modelling. The three dimensional magnetic fields are investigated for the presence of magnetic null points and their influence on the local magnetic domain. Results: In nine out of ten cases the bright point resides in areas where the coronal magnetic field contains an opposite polarity intrusion defining a magnetic null point above it. We find that X-ray bright points reside, in these nine cases, in a limited part of the projected fan-dome area, either fully inside the dome or expanding over a limited area below which typically a dominant flux concentration resides. The tenth bright point is located in a bipolar loop system without an overlying null point. Conclusions: All bright points in coronal holes and two out of three bright points in quiet Sun regions are seen to reside in regions containing a magnetic null point. An as yet unidentified process(es) generates the brigh points in specific regions of the fan-dome structure. The movies are available at http://www.aanda.org

  20. Coronal Loops: Evolving Beyond the Isothermal Approximation

    Science.gov (United States)

    Schmelz, J. T.; Cirtain, J. W.; Allen, J. D.

    2002-05-01

    Are coronal loops isothermal? A controversy over this question has arisen recently because different investigators using different techniques have obtained very different answers. Analysis of SOHO-EIT and TRACE data using narrowband filter ratios to obtain temperature maps has produced several key publications that suggest that coronal loops may be isothermal. We have constructed a multi-thermal distribution for several pixels along a relatively isolated coronal loop on the southwest limb of the solar disk using spectral line data from SOHO-CDS taken on 1998 Apr 20. These distributions are clearly inconsistent with isothermal plasma along either the line of sight or the length of the loop, and suggested rather that the temperature increases from the footpoints to the loop top. We speculated originally that these differences could be attributed to pixel size -- CDS pixels are larger, and more `contaminating' material would be expected along the line of sight. To test this idea, we used CDS iron line ratios from our data set to mimic the isothermal results from the narrowband filter instruments. These ratios indicated that the temperature gradient along the loop was flat, despite the fact that a more complete analysis of the same data showed this result to be false! The CDS pixel size was not the cause of the discrepancy; rather, the problem lies with the isothermal approximation used in EIT and TRACE analysis. These results should serve as a strong warning to anyone using this simplistic method to obtain temperature. This warning is echoed on the EIT web page: ``Danger! Enter at your own risk!'' In other words, values for temperature may be found, but they may have nothing to do with physical reality. Solar physics research at the University of Memphis is supported by NASA grant NAG5-9783. This research was funded in part by the NASA/TRACE MODA grant for Montana State University.

  1. A multi-channel coronal spectrophotometer.

    Science.gov (United States)

    Landman, D. A.; Orrall, F. Q.; Zane, R.

    1973-01-01

    We describe a new multi-channel coronal spectrophotometer system, presently being installed at Mees Solar Observatory, Mount Haleakala, Maui. The apparatus is designed to record and interpret intensities from many sections of the visible and near-visible spectral regions simultaneously, with relatively high spatial and temporal resolution. The detector, a thermoelectrically cooled silicon vidicon camera tube, has its central target area divided into a rectangular array of about 100,000 pixels and is read out in a slow-scan (about 2 sec/frame) mode. Instrument functioning is entirely under PDP 11/45 computer control, and interfacing is via the CAMAC system.

  2. Assessment and comparison of proximal segment changes following mandibular set-back through bilateral sagittal split ramus osteotomy and intraoral verticosagittal ramus osteotomy

    Directory of Open Access Journals (Sweden)

    Mahmood Hashemi H.

    2008-04-01

    Full Text Available Background and Aim: Proximal segment movements following different methods of ramus osteotomy is one of the undesired consequences of orthognathic surgery. Theoretically, it seems that intraoral verticosagittal ramus osteotomy can minimize the movement of proximal segment. In this study, changes in intergonial distance and ramus flaring angles were evaluated and compared in transverse plane after mandibular set back by two osteotomy techniques.Materials and Methods: In this randomized clinical trial 20 patients with mandibular prognathism without any asymmetry were selected and divided into two groups of 10 each.One group was treated by bilateral sagittal split ramus osteotomy and the other by intraoral verticosagittal ramus osteotomy technique. Intergonial width and inner ramal angle in transverse plane were measured on radiographs before and 1 and 12 weeks post surgery . Data were analyzed using covariance test with P<0.05 as the level of significance.Results: Changes of intergonial distance and interramal angle in each group were significant after 1 and 12 weeks after surgery. No statistically significant difference was observed between the two studied groups.Conclusion: According to the results of this study, there is no difference between bilateral sagittal split and intraoral verticosagittal ramus osteotomy techniques regarding mandibular width and ramus flaring changes.

  3. Relationship of EUV Irradiance Coronal Dimming Slope and Depth to Coronal Mass Ejection Speed and Mass

    Science.gov (United States)

    Mason, James Paul; Woods, Thomas N.; Webb, David F.; Thompson, Barbara J.; Colaninno, Robin C.; Vourlidas, Angelos

    2016-01-01

    Extreme ultraviolet (EUV) coronal dimmings are often observed in response to solar eruptive events. These phenomena can be generated via several different physical processes. For space weather, the most important of these is the temporary void left behind by a coronal mass ejection (CME). Massive, fast CMEs tend to leave behind a darker void that also usually corresponds to minimum irradiance for the cooler coronal emissions. If the dimming is associated with a solar are, as is often the case, the are component of the irradiance light curve in the cooler coronal emission can be isolated and removed using simultaneous measurements of warmer coronal lines. We apply this technique to 37dimming events identified during two separate two-week periods in 2011, plus an event on 2010 August 7 analyzed in a previous paper, to parameterize dimming in terms of depth and slope. We provide statistics on which combination of wavelengths worked best for the flare-removal method, describe the fitting methods applied to the dimming light curves, and compare the dimming parameters with corresponding CME parameters of mass and speed. The best linear relationships found are nu(sub CME) [km/s] approx. equals 2.36 x 10 6 [km/%] x s(sub dim) [%/s] m(sub CME) [g] approx. equals 2.59 x 10(exp.15 [g/%] x the square root of d(sub dim) [%].These relationships could be used for space weather operations of estimating CME mass and speed using near-real-time irradiance dimming measurements.

  4. Sagittal whole-spine magnetic resonance imaging in 750 consecutive outpatients: accurate determination of the number of lumbar vertebral bodies.

    Science.gov (United States)

    Hanson, Eric H; Mishra, Rahul K; Chang, David S; Perkins, Thomas G; Bonifield, Daniel R; Tandy, Richard D; Cartwright, Peter E; Peoples, Randal R; Orrison, William W

    2010-01-01

    When the number of lumbar and sacral vertebrae is being assessed, variations from typical lumbosacral anatomy may confuse the practitioner, potentially leading to significant clinical errors. In this study, the authors describe the statistical variation in lumbar spine anatomy in an outpatient imaging setting, evaluate the potential implications for clinical practice based on the variation in the number of lumbar-type vertebrae identified, and recommend a method for rapidly determining the number of lumbar spine vertebral bodies (VBs) in outpatients referred for lumbar spine MR imaging. A total of 762 patients (male and female) who presented with low back-related medical conditions underwent whole-spine MR imaging in an outpatient setting. The high-speed whole-spine evaluation was successful for determining the number of lumbar-type VBs in 750 (98%) of 762 consecutive patients. The sagittal whole-spine 3-T MR imaging system images obtained between the beginning of January 2005 and the end of February 2007 were reviewed. The VBs were counted successively from the level of C-2 inferiorly to the intervertebral disc below the most inferior lumbar-type VB. Numbers of disc herniations were also evaluated in the context of the number of VBs. One in 5 of these outpatients did not have 5 lumbar-type vertebrae: 14.5% had 6; 5.3% had 4; and 1 (0.13%) had the rare finding of 3 lumbar-type vertebrae. Two-thirds of the individuals with 6 lumbar-type vertebrae were male and two-thirds of the individuals with 4 lumbar-type vertebrae were female. Sagittal whole-spine MR imaging can be performed rapidly and efficiently in the majority of patients (98%), and provides improved accuracy for the determination of the number of lumbar-type VBs. A supplementary coronal MR, Ferguson view radiograph or intraoperative fluoroscopic determination for the presence of lumbosacral transitional vertebrae may add additional information when indicated for clinical treatment or surgical planning.

  5. Laser beam measurement of abdominal sagittal diameter in obese children: a validation study.

    Science.gov (United States)

    Flodmark, C E; Shen, W; Punyanitya, M; Leander, P; Lanke, J; Pietrobelli, A

    2013-04-01

    Sagittal diameter (SAD) has been reported to correlate to visceral fat and cardiovascular risk factors. SAD is measured with the individual lying down, halfway between the lower rib margin and the iliac crest; it represents the mid-height of the abdomen. The aim of this study was to validate SAD measured using a recently-developed laser beam device (SAD(LDB) ) against SAD measured using MRI (SAD(MRI)). Of 48 obese children (25 boys, 23 girls) aged 9-11 years on the waiting list for obesity treatment, 34 agreed to a baseline measurement, which was followed by repeated measurements 6 and 12 months later in 31 and 22 children respectively. MRI was used to examine SAD(MRI) at 5 cm above (SAD(MRI,cra) ) and below (SAD(MRI,cau)) the mid plane of the L4-5 intervertebral disc. Each of the differences SAD(LBD) - SAD(MRI, cau) and SAD(LBD) - SAD(MRI,cra) was subjected to a repeated-measurements ANOVA; the visit did not have a statistically significant effect in either case (p = 0.19 and p = 0.72, respectively). The difference SAD(LBD) - SAD(MRI, cau) was 1.50 on average (p SAD(LBD) -SAD(MRI, cra) was 1.26 (p SAD(MRI) from SAD(LDB) can be performed in different ways: by means of linear regression or by means of an additive correction. Thus, this laser device can be used instead of MRI to estimate SAD by using a simple correction. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

  6. MRI T2 mapping of the asymptomatic supraspinatus tendon by age and imaging plane using clinically relevant subregions

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    Anz, Adam W., E-mail: anz.adam.w@gmail.com [The Steadman Clinic, Vail, CO (United States); Lucas, Erin P., E-mail: erin.lucas14@gmail.com [Steadman Philippon Research Institute, Vail, CO (United States); Fitzcharles, Eric K., E-mail: ericfitzcharles@gmail.com [Steadman Philippon Research Institute, Vail, CO (United States); Surowiec, Rachel K., E-mail: Rachel.surowiec@sprivail.org [Steadman Philippon Research Institute, Vail, CO (United States); Millett, Peter J., E-mail: drmillett@thesteadmanclinic.com [The Steadman Clinic, Vail, CO (United States); Ho, Charles P., E-mail: Charles.ho@sprivail.org [Steadman Philippon Research Institute, Vail, CO (United States)

    2014-05-15

    Purpose: Diagnosis of partial rotator cuff tears and tendonopathy using conventional MRI has proven variable. Quantitative T2 mapping may have application for assessing rotator cuff health. In order to evaluate the usefulness of T2 mapping for the rotator cuff, methods must be refined for mapping the supraspinatus tendon, and normative T2 values must first be acquired. Materials and methods: This study was IRB approved. Thirty asymptomatic volunteers (age: 18–62) were evaluated with sagittal and coronal T2 mapping sequences. Manual segmentation of tendon and muscle as a unit and tendon alone was performed twice by two independent raters. Segmentations were divided into medial, middle and lateral subregions and mean T2 values calculated. Results: Anatomic comparison of mean T2 values illustrated highest values in the medial region, lowest values in the lateral region, and intermediate values for the middle region upon coronal segmentation (p < 0.001). In sagittal segmentations, there were higher values in the medial region and no significant differences between the lateral and middle subregions. No significant differences were found with comparison across age groups. Inter and intra-rater segmentation repeatability was excellent, with coefficients ranging from 0.85 to 0.99. Conclusion: T2 mapping illustrated anatomic variation along the supraspinatus muscle-tendon unit with low standard deviations and excellent repeatability, suggesting that changes in structure due to degeneration or changes associated with healing after repair may be detectable.

  7. Reproducibility of thoracic kyphosis measurements in patients with adolescent idiopathic scoliosis

    DEFF Research Database (Denmark)

    Ohrt-Nissen, Søren; Cheung, Jason Pui Yin; Hallager, Dennis Winge

    2017-01-01

    BACKGROUND: Current surgical treatment for adolescent idiopathic scoliosis (AIS) involves correction in both the coronal and sagittal plane, and thorough assessment of these parameters is essential for evaluation of surgical results. However, various definitions of thoracic kyphosis (TK) have been...

  8. Age-related variations in global spinal alignment and sagittal balance in asymptomatic Japanese adults.

    Science.gov (United States)

    Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Kawabata, Shinji; Kuroiwa, Toshihiko

    2017-05-01

    The global spinal sagittal alignment varies widely among healthy individuals as it is affected by not only race, but also aging. We investigated age-related changes in the spinal alignment in asymptomatic Japanese individuals. The subjects comprised 220 individuals without any spine-related neurological symptoms or treatment history thereof who visited our outpatient clinic. Lateral radiographs of the whole spine were taken for all subjects in the standing position. Based on the images obtained, spino-pelvic parameters were calculated using Jackson's method so as to analyze any correlations with age. TIA, TK, and C2-C7A were found to markedly increase with age from late middle age (P sagittal balance (P > 0.05). However, there were 22 subjects (10%) with C7SVA > 50 mm, with those aged 70 years or older accounting for half of this subpopulation. Sagittal balance tended to be retained even in elderly subjects if lumbosacral lordosis was large enough to compensate for thoracic kyphosis. A very strong correlation was found between the L1 slope and whole-spine sagittal balance (P sagittal balance. The whole-spine sagittal balance can deteriorate if the compensatory changes in the lumbosacral spine are insufficient. The L1 slope is a central parameter that defines the whole-spine sagittal balance. PI; pelvic incidence; SS; sacral slope; PT; pelvic tilt; LL; lumbar lordosis; C7SVA; C7 sagittal vertical axis; SSA; spinosacral angle; TK; thoracic kyphosis; C2-C7SVA; C2-C7 sagittal vertical axis; C2-C7A; C2-C7 Angle; TIA; thoracic inlet angle; NT; neck tilt.

  9. Analytical investigations on the Coronation Gospels manuscript

    Science.gov (United States)

    Aceto, Maurizio; Agostino, Angelo; Fenoglio, Gaia; Idone, Ambra; Crivello, Fabrizio; Griesser, Martina; Kirchweger, Franz; Uhlir, Katharina; Puyo, Patricia Roger

    2017-01-01

    The Coronation Gospels or Krönungsevangeliar is a manuscript kept in Vienna at the Kunsthistorisches Museum Wien, datable to the end of VIII century A.D. and produced at Charlemagne court. It is an example of a purple codex, i.e. its parchment is coloured in purple. It has to be considered as one of the most important medieval codices, according to its use to take oath in the coronation ceremony of kings and emperors of the Holy Roman Empire up to 1792. In order to gather information of the manufacture of the manuscript and its present conservation state, a diagnostic investigation campaign has been carried out in situ with totally non-invasive techniques. X-ray Fluorescence Spectrometry (XRF), UV-visible diffuse reflectance spectrophotometry with optical fibres (FORS), spectrofluorimetry, optical microscopy and multispectral analysis have been applied in order to identify the colourants used in the decoration of the manuscript, with the main concern to the dye used to impart the purple hue to the parchment. The information collected was useful in order to address some of the questions raised by art historians concerning its history.

  10. Closed coronal structures. II - Generalized hydrostatic model

    Science.gov (United States)

    Serio, S.; Peres, G.; Vaiana, G. S.; Golub, L.; Rosner, R.

    1981-01-01

    Numerical computations of stationary solar coronal loop atmospheres are used to extend earlier analytical work. Two classes of loops are examined, namely symmetric loops with a temperature maximum at the top but now having a length greater than the pressure scale height and loops which have a local temperature minimum at the top. For the first class, new scaling laws are found which relate the base pressure and loop length to the base heating, the heating deposition scale height, and the pressure scale height. It is found that loops for which the length is greater than about two to three times the pressure scale height do not have stable solutions unless they have a temperature minimum at the top. Computed models with a temperature inversion at the top are permitted in a wider range of heating deposition scale height values than are loops with a temperature maximum at the top. These results are discussed in relation to observations showing a dependence of prominence formation and stability on the state of evolution of magnetic structures, and a general scenario is suggested for the understanding of loop evolution from emergence in active regions through the large-scale structure phase to opening in coronal holes.

  11. Featured Image: Waves in a Coronal Fan

    Science.gov (United States)

    Kohler, Susanna

    2017-09-01

    The inset in this Solar Dynamics Observatory image shows a close-up view of a stunning coronal fan extending above the Suns atmosphere. These sweeping loops were observed on 7 March 2012 by a number of observatories, revealing the first known evidence of standing slow magnetoacoustic waves in cool coronal fan loops. The oscillations of the loops, studied in a recent article led by Vaibhav Pant (Indian Institute of Astrophysics), were triggered by blast waves that were generated by X-class flares from the distant active region AR 11429 (marked withthe yellow box at left). The overplotted X-ray curve in the top right corner of the image (click for the full view) shows the evolution of the flares that perturbed the footpoints of the loops. You can check out the video of the action below, and follow the link to the original article to read more about what these oscillations tell us about the Suns activity. CitationV. Pant et al 2017 ApJL 847 L5. doi:10.3847/2041-8213/aa880f

  12. Importance of sagittal kick symmetry for underwater dolphin kick performance.

    Science.gov (United States)

    Atkison, Ryan R; Dickey, James P; Dragunas, Andrew; Nolte, Volker

    2014-02-01

    The purpose of this study was to determine how sagittal kick symmetry in the underwater dolphin kick (UDK) between the downkick and upkick phases is related to UDK performance. Fifteen adult male competitive swimmers ranging from provincial to international level were filmed performing three trials each of maximum effort UDK over 15m using an underwater video camera. Video frames were manually digitized and each subjects' single fastest trial was evaluated for between-subject comparisons. Kinematic variables were calculated for each individual and Pearson product-moment correlations between the average horizontal centre of mass velocity (Vx) and all kinematic variables were calculated. Horizontal velocity during the downkick, horizontal velocity during the upkick, relative time spent in each phase, maximum chest flexion angle, maximum knee and ankle extension angles, the ratio of flexion/extension for chest, knee and ankle angles, and maximum vertical toe velocity during the upkick phase correlated significantly with Vx (pimportance of kick symmetry for UDK performance, and indicate that performing the upkick phase well appears to be most important for UDK performance. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Sagittal venous sinus thrombosis after cesarean section: a case report

    Directory of Open Access Journals (Sweden)

    Farideh Keypour

    2013-07-01

    Full Text Available Background: Cerebral venous thrombosis (CVT is uncommon after cesarean section. Although it can be a leading cause of maternal mortality. CVT may occur during pregnancy because of hypercoagulable states such as preeclampsia, thrombophilias, antiphospholipid antibody syndrome and sepsis.Case presentation: A 31 years old woman G2 Ab1 at 37 weeks gestational age with  premature rupture of membrane underwent cesarean section because breech presentation and preeclampsia. Spinal anesthesia was done for emergent cesarean section. On the second day after cesarean section, she developed headache, vomiting, focal neurologic deficits, paresthesia, blurred vision. Brain magnetic resonance imaging (MRI showed thrombosis in anterior half of superior sagittal sinus. Treatment consisted of anticoagulation.  Conclusion: Thrombophilias, pregnancy-related hypertension and cesarean section are the predisposing factors for thromboembolism. Unfractionated heparin and low molecular weight heparin (LMWs are effective drugs for thromboprophylaxis. It is vital to prevent venous thrombosis to reduce mortality during both intrapartum and postpartum periods. Consideration of cerebral venous thrombosis in similar cases is recommended.

  14. Magnetism Matters: Coronal Magnetometry Using Multi-Wavelength Polarimetry

    Science.gov (United States)

    Gibson, Sarah E.

    2015-08-01

    The solar coronal magnetic field is key both to solving fundamental problems in solar physics such as coronal heating and solar wind acceleration, and to predicting the internal magnetic structure and thus space-weather impact of coronal mass ejections. I will describe the current state of the art in coronal magnetometry, and present results from the Coronal Multichannel Polarimeter (CoMP) at Mauna Loa Solar Observatory (MLSO), which since 2011 has taken polarimetric observations of the solar corona in the near-infrared on a near-daily basis. I will discuss work in progress that utilizes forward modeling to synthesize polarimetric data at multiple heights and vantage points, and at wavelengths from radio to infrared to visible to ultraviolet. The goal is to use such synthetic testbeds to determine the ideal set of observations for constraining the coronal magnetic field, and to establish a Data-Optimized Coronal Field Model (DOC-FM) that efficiently incorporates these data into global magnetic models. This work will provide essential tools and motivation for the planning and implementation of future coronal polarimetric projects and missions spanning a broad range of wavelengths.

  15. Magnetic Field in the Gravitationally Stratified Coronal Loops

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... We study the effect of gravitational stratification on the estimation of magnetic fields in the coronal loops. By using the method of MHD seismology of kink waves for the estimation of magnetic field of coronal loops, we derive a new formula for the magnetic field considering the effect of gravitational ...

  16. Solar Cycle Variation of Interplanetary Coronal Mass Ejection ...

    Indian Academy of Sciences (India)

    2010-08-25

    Aug 25, 2010 ... Spörer's sunspot law at low latitudes (thus, no 'butterfly diagram'); how- ever, at high latitudes, there may be a poleward motion and an equator- ward motion from the rise to the maximum to the declining phases. Key words. Sun: activity, coronal mass ejections (CMEs). 1. Introduction. Interplanetary coronal ...

  17. Solar Wind Associated with Near Equatorial Coronal Hole

    Indian Academy of Sciences (India)

    We find a strong association between different parameters of coronal hole and solar wind. For both the wavelength bands, we also compute coronal hole radiative energy near the earth and it is found to be of similar order as that of solar wind energy. However, for the wavelength 193 Å, owing to almost similar magnitudes of ...

  18. Seismology of Transversely Oscillating Coronal Loops with Siphon Flows

    Science.gov (United States)

    Terradas, J.; Arregui, I.; Verth, G.; Goossens, M.

    2011-03-01

    There are ubiquitous flows observed in the solar atmosphere of sub-Alfvénic speeds; however, after flaring and coronal mass ejection events flows can become Alfvénic. In this Letter, we derive an expression for the standing kink mode frequency due to siphon flow in coronal loops, valid for both low and high speed regimes. It is found that siphon flow introduces a linear, spatially dependent phase shift along coronal loops and asymmetric eigenfunctions. We demonstrate how this theory can be used to determine the kink and flow speed of oscillating coronal loops with reference to an observational case study. It is shown that the presence of siphon flow can cause the underestimation of magnetic field strength in coronal loops using the traditional seismological methods.

  19. The addition of a sagittal image fusion improves the prostate cancer detection in a sensor-based MRI /ultrasound fusion guided targeted biopsy.

    Science.gov (United States)

    Günzel, Karsten; Cash, Hannes; Buckendahl, John; Königbauer, Maximilian; Asbach, Patrick; Haas, Matthias; Neymeyer, Jörg; Hinz, Stefan; Miller, Kurt; Kempkensteffen, Carsten

    2017-01-13

    To explore the diagnostic benefit of an additional image fusion of the sagittal plane in addition to the standard axial image fusion, using a sensor-based MRI/US fusion platform. During July 2013 and September 2015, 251 patients with at least one suspicious lesion on mpMRI (rated by PI-RADS) were included into the analysis. All patients underwent MRI/US targeted biopsy (TB) in combination with a 10 core systematic prostate biopsy (SB). All biopsies were performed on a sensor-based fusion system. Group A included 162 men who received TB by an axial MRI/US image fusion. Group B comprised 89 men in whom the TB was performed with an additional sagittal image fusion. The median age in group A was 67 years (IQR 61-72) and in group B 68 years (IQR 60-71). The median PSA level in group A was 8.10 ng/ml (IQR 6.05-14) and in group B 8.59 ng/ml (IQR 5.65-12.32). In group A the proportion of patients with a suspicious digital rectal examination (DRE) (14 vs. 29%, p = 0.007) and the proportion of primary biopsies (33 vs 46%, p = 0.046) were significantly lower. The rate of PI-RADS 3 lesions were overrepresented in group A compared to group B (19 vs. 9%; p = 0.044). Classified according to PI-RADS 3, 4 and 5, the detection rates of TB were 42, 48, 75% in group A and 25, 74, 90% in group B. The rate of PCa with a Gleason score ≥7 missed by TB was 33% (18 cases) in group A and 9% (5 cases) in group B; p-value 0.072. An explorative multivariate binary logistic regression analysis revealed that PI-RADS, a suspicious DRE and performing an additional sagittal image fusion were significant predictors for PCa detection in TB. 9 PCa were only detected by TB with sagittal fusion (sTB) and sTB identified 10 additional clinically significant PCa (Gleason ≥7). Performing an additional sagittal image fusion besides the standard axial fusion appears to improve the accuracy of the sensor-based MRI/US fusion platform.

  20. The vertical projection of the sum of the ground reactive forces of a standing patient is not the same as the C7 plumb line: a radiographic study of the sagittal alignment of 153 asymptomatic volunteers.

    Science.gov (United States)

    Roussouly, Pierre; Gollogly, Sohrab; Noseda, Olivier; Berthonnaud, Eric; Dimnet, Johanes

    2006-05-15

    A radiographic study of 153 normal volunteers. 1) To test the hypothesis that the vertical projection of the sum of the ground reactive forces of a standing patient is located in the same place in the sagittal plane as the C7 plumb line; 2) to determine if there are consistent geometric relationships between the location of the top of the spine and the pelvis in the sagittal plane that occur in individuals without symptoms of back pain or radiographic evidence of deformity. Defining the optimal state of spinal balance is difficult. A full understanding of the compensatory relationships between the spine, pelvis, and lower limbs remains elusive. A total of 153 normal volunteers were subjected to radiographic examination using a digital force plate, a stabilized standing position, a standardized radiographic technique, and the computerized measurement of sagittal alignment. 1) The C7 plumb line and the gravity line in a stabilized standing position are not located in the same place; 2) the association between the center of T1 and the sacral endplate may be an anatomic constant and a marker of spinal balance in individuals without symptoms of back pain or radiographic evidence of deformity, and is determined by the formula 99 degrees - 0.1 degrees (sacral slope). We speculate that this information will be very helpful in evaluating symptomatic spinal disease in the context of the overall alignment of the spine and pelvis.

  1. Assessment of Coronal Radiographic Parameters of the Spine in the Treatment of Adolescent Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Mohsen Karami

    2016-10-01

    Preoperative coronal balance is very important to make a balanced spine after surgery. Other parameters like Lenke classification or main thoracic overcorrection did not affect postoperative coronal decompensation.

  2. Evaluation of failing hemodialysis fistulas with multidetector CT angiography: Comparison of different 3D planes

    Energy Technology Data Exchange (ETDEWEB)

    Karadeli, E. [Department of Radiology, Baskent University, Faculty of Medicine, Ankara (Turkey); Tarhan, N.C. [Department of Radiology, Baskent University, Faculty of Medicine, Ankara (Turkey)], E-mail: caglat@baskent-ank.edu.tr; Ulu, E.M. Kayahan; Tutar, N.U. [Department of Radiology, Baskent University, Faculty of Medicine, Ankara (Turkey); Basaran, O. [Department of General Surgery, Baskent University, Faculty of Medicine, Ankara (Turkey); Coskun, M.; Niron, E.A. [Department of Radiology, Baskent University, Faculty of Medicine, Ankara (Turkey)

    2009-01-15

    Purpose: To evaluate failing hemodialysis fistula complications using 16-detector MDCTA, and to assess the accuracies of different 3D planes. Materials and methods: Thirty patients (16 men, 14 women, aged 27-79 years) were referred for hemodialysis access dysfunction. Thirty-one MDCTA exams were done prior to fistulography. For MDCTA, contrast was administered (2 mL/kg at 5 mL/s) via a peripheral vein in the contralateral arm. Axial MIP, coronal MIP, and VRT images were constructed. Venous complications were evaluated on axial source images, on each 3D plane, and on all-planes together. Results were analyzed using McNemar test. Results: Axial MIP, VRT and all-planes evaluations were most sensitive for fistula site detection (93%). Coronal MIP had the highest sensitivity, specificity and accuracy (35%, 96%, and 85%, respectively) for detecting venous stenosis. VRT and all-planes had the highest sensitivity and accuracy for detecting aneurysms (100%). All-planes and axial MIP were most sensitive for detecting venous occlusion (61% and 54%). Comparisons of detection frequencies for each venous pathology between the five categories of MDCTA revealed no significant differences (P > 0.05). MDCTA additionally showed 3 partially thrombosed aneurysms, 4 anastomosis site stenosis and 12 arterial complications. Conclusion: MDCTA overall gives low sensitivity for detection of central vein stenosis and moderate sensitivity for occlusion. For most pathology, all-planes evaluation of MDCTA gives highest sensitivity and accuracy rates when compared to other planes. For venous stenosis and occlusion, MDCTA should be considered when ultrasonography and fistulography are inconclusive. MDCTA is helpful in identifying aneurysms, collaterals, partial venous thromboses and additional arterial, anastomosis site pathologies.

  3. Criteria to restore the sagittal balance in deformity and degenerative spondylolisthesis.

    Science.gov (United States)

    Lamartina, Claudio; Berjano, Pedro; Petruzzi, Mary; Sinigaglia, Aldo; Casero, Giovanni; Cecchinato, Riccardo; Damilano, Marco; Bassani, Roberto

    2012-05-01

    To present in a single source the relevant information needed to assess spinopelvic balance and alignment, and to estimate the amount of correction needed in a patient during surgical treatment. Narrative literature review Sagittal balance can be evaluated by global balance estimates (sagittal vertical axis and T1 tilt). Other important parameters are the relationship between pelvic incidence and lumbar lordosis (spinopelvic harmony), between pelvic incidence and difference of thoracic kyphosis and lumbar lordosis (spinopelvic balance), excess of pelvic tilt, knee flexion and thoracic compensatory hypokyphosis. Different methods to calculate the amount of surgical correction needed in patients with sagittal imbalance have been based on combinations of these parameters. Relevant parameters of sagittal imbalance have been identified and correlated with clinical outcomes. Methods for calculation of surgical correction of imbalance have been proposed, but not validated in patients with mid-term follow-up.

  4. Multidirectional Cranial Distraction Osteogenesis with Simplified Modifications for Treating Sagittal Synostosis

    Directory of Open Access Journals (Sweden)

    Ataru Sunaga, MD

    2017-10-01

    Conclusions:. Simplified MCDO has a number of advantages over conventional distraction procedures such as discretionary reshaping/expansion of cranium and predictable osteogenesis and is a valid treatment option for patients with sagittal synostosis.

  5. A previously unreported variant of the synostotic sagittal suture: Case report and review of salient literature

    Directory of Open Access Journals (Sweden)

    Madison Budinich

    2016-12-01

    Conclusion: To our knowledge, a synostotic sagittal suture has not been reported that extended posteriorly it involve the occipital bone. Those who interpret imaging or operate on this part of the skull should consider such a variation.

  6. Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis.

    Science.gov (United States)

    Harroud, Adil; Labelle, Hubert; Joncas, Julie; Mac-Thiong, Jean-Marc

    2013-04-01

    Global sagittal alignment is considered as an important aspect in the management of spinal disorders, but the evidence establishing its clinical impact in lumbosacral spondylolisthesis is still poor. This study evaluated the impact of global sagittal alignment on the health-related quality of life (HRQOL) of patients with spondylolisthesis. A retrospective study of 149 consecutive unoperated children and adolescents presenting with lumbosacral spondylolisthesis (117 low-grade and 32 high-grade) was performed. Two global sagittal alignment parameters were measured on standing lateral radiographs: spinal tilt (ST) and C7 plumbline deviation (C7P deviation). All patients completed the SRS-22 questionnaire to assess HRQOL. Pearson's correlations were calculated between parameters of global sagittal alignment and HRQOL. Multiple regression analyses were also undertaken to account for slip percentage and lumbosacral kyphosis (LSK). Both global sagittal alignment parameters were correlated with the SRS-22 total score. When analyzed separately, the correlation was absent in patients with a low-grade slip but remained significant for patients with a high-grade slip (r = 0.35 for ST; r = -0.35 for C7P deviation). The relation was strengthened in high-grade spondylolisthesis when considering only patients with a C7P in front of the posterior corner of upper sacral endplate (r = 0.48 for ST; r = -0.48 for C7P deviation) and was also positive for the SRS-22 pain and appearance domains. For these last patients, the relationship with global sagittal alignment remained significant in the multiple regression analysis. HRQOL was particularly worse for high-grade patients with a C7P in front of the hip axis. In high-grade spondylolisthesis, an increasing positive sagittal alignment was related to a poorer SRS-22 total score, especially when the C7P is in front of the hip axis. Global sagittal alignment should particularly be assessed in patients with high-grade spondylolisthesis.

  7. Superior sagittal sinus thrombosis: a rare complication in a child with nephrotic syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Pirogovsky, A.; Adi, M.; Barzilai, N. [Dept. of Radiology, Kaplan Medical Center, Rehovot (Israel); Dagan, A.; Sinai, L.; Sthoeger, D. [Div. of Paediatrics, Kaplan Medical Center, Rehovot (Israel); Tabachnik, E. [Div. of Paediatrics, Kaplan Medical Center, Rehovot (Israel); Paediatric ICU, Kaplan Hospital, Rehovot (Israel)

    2001-10-01

    A 2-year-old boy with new-onset nephrotic syndrome developed recurrent vomiting, apathy and papilloedema. Superior sagittal sinus thrombosis was diagnosed on cranial CT and MRI. He gradually recovered after treatment with heparin, fresh frozen plasma and warfarin with complete resolution of the thrombosis after 1 month. Superior sagittal sinus thrombosis is an extremely rare complication of nephrotic syndrome in children. Early diagnosis is essential for institution of anticoagulation therapy and a successful outcome. (orig.)

  8. Comparison of Sagittal Spinopelvic Alignment in Patients With Ankylosing Spondylitis and Thoracolumbar Fracture

    Science.gov (United States)

    Pan, Tao; Qian, Bang-Ping; Qiu, Yong

    2016-01-01

    Abstract This article is a comparative study. The aim of the study is to investigate the difference of sagittal alignment of the pelvis and spine between patients with thoracolumbar kyphosis secondary to ankylosing spondylitis (AS) and thoracolumbar fracture, and to evaluate the role of sacropelvic component in AS patients’ adaption to the changes in sagittal alignment. Advanced stages of AS are often associated with thoracolumbar kyphosis, resulting in an abnormal spinopelvic balance and pelvic morphology, whereas thoracolumbar fractures may lead to major kyphosis with a potential compromise of the spinal canal, which can cause an abnormal spinopelvic balance. Until now, the comparison of that sagittal alignment between AS and thoracolumbar fracture is not found in the literature. This study included 30 cases of AS and 30 cases of thoracolumbar fracture. Sagittal spinal and pelvic parameters were measured from the standing lateral radiograph, and the following 11 radiological parameters were measured, including global kyphosis (GK), thoracic kyphosis (TK), C7 tilt (C7T), sagittal vertical axis (SVA), spino-pelvic angle (SSA), lumbar lordosis (LL), upper arc of lumbar lordosis (ULL), lower arc of lumbar lordosis (LLL), pelvic incidence (PI), sacrum slope (SS), pelvic tilt (PT), and T9 tilt (T9T). Analysis of variance was used in the comparison of each dependent variable between the 2 cohorts. The relationship between sagittal spinal alignment and pelvic morphology of AS patients was determined via Pearson correlation coefficient (r). Compared with the thoracolumbar fracture group, AS patients had significantly lower C7T, SSA, LL, LLL and SS (78.3° ± 9.3° vs 88.0° ± 2.7°, P sagittal alignment of the pelvis and spine between patients with AS and thoracolumbar fracture, and changes in pelvic morphology compensated more in AS patients for a thoracolumbar kyphosis. These findings may be helpful for better understanding of sagittal alignment in patients

  9. Postoperative changes in pelvic parameters and sagittal balance in adult isthmic spondylolisthesis.

    Science.gov (United States)

    Park, Se Jun; Lee, Chong Suh; Chung, Sung Soo; Kang, Kyung Chung; Shin, Seong Kee

    2011-06-01

    Correction of deformity in adult isthmic spondylolisthesis can affect the pelvic parameters and sagittal balance. To evaluate the correlation with the amount of deformity correction and the subsequent change in pelvic parameters after surgical correction of adult isthmic spondylolisthesis and to determine which deformity parameter most affects the postoperative restoration of spinopelvic sagittal alignment. Fifty-eight patients with 1-level isthmic spondylolisthesis were included. Their average age was 55 years (range, 24-76 years). All patients underwent operation by posterior lumbar interbody fusion and posterior instrumentation. The pre- and postoperative sacral slope, pelvic tilt, lumbar lordosis (LL), and sagittal balance were measured, and then the correlation between these parameters and deformity parameters such as slip degree, slip angle, and height of the intervertebral disc (HOD) was evaluated. The slip degree, slip angle, and HOD were significantly recovered after surgery. Pelvic parameters and sagittal balance changed subsequently. Sacral slope was increased by 4.4 degrees, and pelvic tilt was decreased by 4.4 degrees. LL was increased by 5.2 degrees and sagittal balance was displaced 5.6 mm posteriorly. Only the restoration of the HOD showed a significant correlation with the change in LL (r = 0.305, P = .02) and sagittal balance (r = 0.377, P = .004). Surgical correction of adult isthmic spondylolisthesis with posterior lumbar interbody fusion and posterior instrumentation resulted in improvement of sacral slope, pelvic tilt, LL, and sagittal balance. Only restoration of the HOD was significantly correlated with improvement of LL and sagittal balance. Therefore we presume it is important to restore the HOD in surgical correction of adult isthmic spondylolisthesis.

  10. The effect of Core Stability Exercises (CSE) on trunk sagittal acceleration

    OpenAIRE

    Aluko, Augustine

    2012-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. Aims: The aim of this study was to investigate Core Stability Exercise (CSE) induced changes in trunk sagittal acceleration as a measure of performance in participants following an acute onset of non-specific low back pain (LBP). Methodology: A Lumbar Motion Monitor (LMM) was used to measure trunk sagittal acceleration. The LMM was demonstrated to be reliable [Intra-Class Correlation (ICC)...

  11. The Role of Proprioception in the Sagittal Setting of Anticipatory Postural Adjustments During Gait Initiation

    OpenAIRE

    Pereira Marcelo P.; Pelicioni Paulo H. Silva; Gobbi Lilian T.B.

    2015-01-01

    Purpose. Previous studies have studied the role of proprioception on the setting of anticipatory postural adjustments (APA) during gait initiation. However, these studies did not investigate the role of proprioception in the sagittal APA setting. We aimed to investigate the role of proprioception manipulation to induce APA sagittal adaptations on gait initiation. Methods. Fourteen healthy adults performed gait initiation without, and with, vibration applied before movement onset, and during m...

  12. Flux Accretion and Coronal Mass Ejection Dynamics

    Science.gov (United States)

    Welsch, Brian

    2017-08-01

    Coronal mass ejections (CMEs) are the primary drivers of severe space weather disturbances in the heliosphere. The equations of ideal magnetohydrodynamics (MHD) have been used to model the onset and, in some cases, the subsequent acceleration of ejections. Both observations and numerical modeling, however, suggest that magnetic reconnection likely plays a major role in most, if not all, fast CMEs. Here, we theoretically investigate the dynamical effects of accretion of magnetic flux onto a rising ejection by reconnection involving the ejection's background field. This reconnection alters the magnetic structure of the ejection and its environment, thereby modifying forces acting during the eruption, generically leading to faster acceleration of the CME. Our ultimate aim is to characterize changes in CME acceleration in terms of observable properties of magnetic reconnection, such as the amount of reconnected flux, deduced from observations of flare ribbons and photospheric magnetic fields.

  13. Turbulent resistive heating of solar coronal arches

    Science.gov (United States)

    Benford, G.

    1983-01-01

    The possibility that coronal heating occurs by means of anomalous Joule heating by electrostatic ion cyclotron waves is examined, with consideration given to currents running from foot of a loop to the other. It is assumed that self-fields generated by the currents are absent and currents follow the direction of the magnetic field, allowing the plasma cylinder to expand radially. Ion and electron heating rates are defined within the cylinder, together with longitudinal conduction and convection, radiation and cross-field transport, all in terms of Coulomb and turbulent effects. The dominant force is identified as electrostatic ion cyclotron instability, while ion acoustic modes remain stable. Rapid heating from an initial temperature of 10 eV to 100-1000 eV levels is calculated, with plasma reaching and maintaining a temperature in the 100 eV range. Strong heating is also possible according to the turbulent Ohm's law and by resistive heating.

  14. Error Analysis on Plane-to-Plane Linear Approximate Coordinate ...

    Indian Academy of Sciences (India)

    c Indian Academy of Sciences. Error Analysis on Plane-to-Plane Linear Approximate Coordinate. Transformation. Q. F. Zhang1,∗, Q. Y. Peng1 & J. H. Fan2. 1Department of Computer Science, Jinan University, Guangzhou 510632, China. ... This work is partially supported by the National Natural Science Foundation.

  15. A comparison of standard definitions and sagittal abdominal ...

    Science.gov (United States)

    Introduction: Metabolic syndrome (MeTS) is the cluster of several clinical symptoms that together represent the strongest risk factor for cardiovascular disease. The prevalence of MeTS in adolescents is difficult to estimate given that there are several, but no agreed upon definition of MeTS for this age group. It is important to estimate MeTS and identify at-risk adolescents early in order to provide effective interventions prior to the development of diabetes and coronary heart disease. Objective: Study objectives are to: (1) estimate the prevalence of MeTS in U.S. adolescents using three widely adopted definitions and (2) compare changes in prevalence of MeTS when utilizing sagittal abdominal diameter (SAD) as a component of MeTS. Methods: Data from U.S. adolescents ages 12–19 years (N=970) in the NHANES (2011–2014) were analyzed. MeTS standard definitions developed by Cook et al. (2003), deFerranti et al. (2007), and the International Disease Federation (IDF, 2007) were applied to estimate the sex-stratified, weighted prevalence of MeTS and its individual components (i.e., high waist circumference (WC), hypertension, blood lipid abnormalities, and high fasting blood glucose (FBG)). The definitions were modified by substituting SAD for WC, and weighted MeTS prevalence was re-estimated. Results: Regardless of gender and definition, abnormal blood lipids and high WC were the most prevalent MeTS components. For both sexes, estimated prevalence of componen

  16. Spontaneous improvement of cervical alignment after correction of global sagittal balance following pedicle subtraction osteotomy.

    Science.gov (United States)

    Smith, Justin S; Shaffrey, Christopher I; Lafage, Virginie; Blondel, Benjamin; Schwab, Frank; Hostin, Richard; Hart, Robert; O'Shaughnessy, Brian; Bess, Shay; Hu, Serena S; Deviren, Vedat; Ames, Christopher P

    2012-10-01

    Sagittal spinopelvic malalignment is a significant cause of pain and disability in patients with adult spinal deformity. Surgical correction of spinopelvic malalignment can result in compensatory changes in spinal alignment outside of the fused spinal segments. These compensatory changes, termed reciprocal changes, have been defined for thoracic and lumbar regions but not for the cervical spine. The object of this study was to evaluate postoperative reciprocal changes within the cervical spine following lumbar pedicle subtraction osteotomy (PSO). This was a multicenter retrospective radiographic analysis of patients from International Spine Study Group centers. Inclusion criteria were as follows: adults (>18 years old) with spinal deformity treated using lumbar PSO, a preoperative C7-S1 plumb line greater than 5 cm, and availability of pre- and postoperative full-length standing radiographs. Seventy-five patients (60 women, mean age 59 years) were included. The lumbar PSO significantly improved sagittal alignment, including the C7-S1 plumb line, C7-T12 inclination, and pelvic tilt (p sagittal malalignment (postoperative sagittal vertical alignment sagittal spinopelvic malalignment compensate with abnormally increased cervical lordosis in an effort to maintain horizontal gaze. Surgical correction of sagittal malalignment results in improvement of the abnormal cervical hyperlordosis through reciprocal changes.

  17. Influence of age and sagittal balance of the spine on the value of the pelvic incidence.

    Science.gov (United States)

    Jean, Legaye

    2014-07-01

    The pelvic incidence (PI) was recognized as the key factor of the sagittal balance of the spine. Its value was described own for each individual and unchanged during adulthood. To bring out the effect of the age and of a sagittal imbalance in the variability of the value of PI. 200 subjects with chronic low back pain due to sagittal imbalance were compared to 89 normal subjects. For each groups, the cases were divided according to the age (19-40, 6-40 years, over 60 years). The PI and the sagittal positional parameters were measured on large radiographs in standardized standing position. The correlation between age and PI was observed significant only for the >60 years cases. The mean values of PI were significantly greater for these cases. An increase of the value of PI was attributable to a twisting mobilization within the sacroiliac joint. It results from a forward projection of the gravity due to a sagittal disturbance and a pelvic compensatory backward rotation. This twisting into the sacroiliac joint was incriminated in the origin of chronic low back pain. The sagittal pelvi-spinal imbalance may be incriminated in the increasing of the value of PI by a painful destabilization sacro-iliac, with leads to an increasing of the value of PI.

  18. Does thoracoscopic anterior release of rigid idiopathic scolioses associated with correction by posterior instrumentation result in better long-term frontal and sagittal balance?

    Science.gov (United States)

    Longis, P-M; Odri, G; Passuti, N; Brossard, D; Delécrin, J

    2011-11-01

    The aim of treatment of scolioses is to reduce deformities and restore balance in the spine. In rigid forms of scoliosis, associating anterior release could provide greater frontal and/or sagittal plane correction and improve balance in the spine. This study compared correction and long-term balance on two planes between two homogeneous groups of idiopathic rigid scolioses treated with and without thoracoscopic release. The study included rigid scolioses with less than 35% reducibility and a Cobb angle of more than 60°, who all underwent posterior correction using a rod rotation technique. There were 29 patients, 14 who underwent a one-step procedure (group A) and 15 a two-step procedure (group B), with the subgroups of kyphoscolioses and lordoscolioses determined in each group. Frontal balance, Cobb angle, thoracic kyphosis and the Jackson plumbline were measured on pre- and postoperative X-rays and at the final follow-up. The mean long-term final follow-up was 144 months for group A and 54 months for group B. Frontal plane correction was identical in groups A and B. Frontal balance was preserved in all cases at the final follow-up. Sagittal balance was not modified with or without anterior release. The thoracoscopic release step resulted in an additional correction of 15.5° (23%) of thoracic hyperkyphosis in patients with kyphoscoliosis (P=0.003). Thoracoscopy did not improve short term results in the Cobb angle or frontal or saggital balance. Nevertheless, enhanced correction of thoracic hyperkyphosis was obtained with this procedure. In this study, the association of thoracoscopic anterior release with posterior correction by rod rotation to treat rigid scolioses did not appear to improve results, except for the correction of thoracic hyperkyphosis. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  19. Sagittal spinal profile and spinopelvic balance in parents of scoliotic children.

    Science.gov (United States)

    Janssen, Michiel M A; Vincken, Koen L; van Raak, Sjoerd M; Vrtovec, Tomaž; Kemp, Bastiaan; Viergever, Max A; Bartels, Lambertus W; Castelein, René M

    2013-12-01

    It is well known that spinal biomechanics and familial predisposition play an important role in the onset and evolution of idiopathic scoliosis. The relationship between the sagittal profile of the spine and spinal biomechanics has also been established in a number of studies. It has been suggested previously that a certain sagittal spinal configuration with implications for spinal rotational stiffness is inherited, thus providing a possible explanation for the well-known hereditary component in adolescent idiopathic scoliosis (AIS). To test the hypothesis that the familial trend in AIS may be partially explained by the inheritance of a sagittal spinal profile, which has been shown to make the spine less resistant to rotatory decompensation. A prospective case controlled radiographic analysis of the sagittal profile of the spine and spinopelvic alignment. One hundred two parents of scoliotic children, compared with 102 age-matched controls (parents of nonscoliotic children). Physiologic measures: sagittal profile of the spine and spinopelvic alignment. Freestanding lateral radiographs of 51 parent couples of girls with severe (Cobb angle >30°) progressive AIS (AIS group) and 102 age-matched controls (control group) were taken. Parents with manifest spinal deformities or spinal pathology of any kind were excluded based on history or spinal X-ray to avoid distorted sagittal images with unreliable measurements. Values were calculated for thoracic kyphosis (T4-T12), lumbar lordosis (L1-L5), spinal balance (sagittal plumb line of C7 and T4, T1-L5 sagittal spinal inclination, T9 sagittal offset), curvature parameters (expressed in the area under the curve [AUC]), and pelvic parameters (pelvic tilt, pelvic incidence, and sacral slope). In addition, the height, offset, and length of the posteriorly inclined spinal segment, inclination of each vertebra, and normalized sagittal spinal profile were calculated. Differences in spinopelvic alignment between fathers and mothers

  20. Seismology of transversely oscillating coronal loops with siphon flows

    OpenAIRE

    Terradas, J.; Arregui, I.; Verth, G.; Goossens, M.

    2011-01-01

    There are ubiquitous flows observed in the solar atmosphere of sub-Alfv\\'{e}nic speeds, however after flaring and coronal mass ejection events flows can become Alfv\\'{e}nic. In this Letter, we derive an expression for the standing kink mode frequency due to siphon flow in coronal loops, valid for both low and high speed regimes. It is found that siphon flow introduces a linear spatially dependent phase shift along coronal loops and asymmetric eigenfunctions. We demonstrate how this theory can...

  1. Case report: pre-eruptive intra-coronal radiolucencies revisited.

    LENUS (Irish Health Repository)

    Counihan, K P

    2012-08-01

    Pre-eruptive intra-coronal radiolucency (PEIR) describes a radiolucent lesion located in the coronal dentine, just beneath the enamel-dentine junction of unerupted teeth. The prevalence of this lesion varies depending on the type and quality of radiographic exposure and age of patients used for assessment. The aetiology of pre-eruptive intra-coronal radiolucent lesions is not fully understood, but published clinical and histological evidence suggest that these lesions are resorptive in nature. Issues around the diagnosis, treatment planning and clinical management of this lesion are explored using previously unreported cases.

  2. Magnetohydrodynamic waves and coronal seismology: an overview of recent results.

    Science.gov (United States)

    De Moortel, Ineke; Nakariakov, Valery M

    2012-07-13

    Recent observations have revealed that magnetohydrodynamic (MHD) waves and oscillations are ubiquitous in the solar atmosphere, with a wide range of periods. We give a brief review of some aspects of MHD waves and coronal seismology that have recently been the focus of intense debate or are newly emerging. In particular, we focus on four topics: (i) the current controversy surrounding propagating intensity perturbations along coronal loops, (ii) the interpretation of propagating transverse loop oscillations, (iii) the ongoing search for coronal (torsional) Alfvén waves, and (iv) the rapidly developing topic of quasi-periodic pulsations in solar flares.

  3. Heating of solar coronal holes by reflected Alfven waves

    Science.gov (United States)

    Moore, R. L.; Musielak, Z. E.; Suess, S. T.; An, C.-H.

    1992-01-01

    As a continuation of the work of Moore et al. (1991), who found evidence that coronal holes are heated by Alfven waves that are reflected back down within the coronal holes, this paper shows that to demonstrate this evidence, it is only necessary to consider a subset of the Moore et al. models, namely, those having radial magnetic field. Using these models, it is shown that the Alfven velocity is not constant in the atmosphere of coronal holes, but changes with height (or radius), causing downward reflection of all upward Alfven waves of sufficiently long wavelength (or period).

  4. Impact of the growing use of narrative verdicts by coroners on geographic variations in suicide: analysis of coroners' inquest data.

    Science.gov (United States)

    Carroll, R; Hawton, K; Kapur, N; Bennewith, O; Gunnell, D

    2012-08-01

    Coroners' death certificates form the basis of suicide statistics in England and Wales. Recent increases in coroners' use of narrative verdicts may affect the reliability of local and national suicide rates. We used Ministry of Justice data on inquests held between 2008 and 2009 and Local Authority suicide data (2001-02 and 2008-09) to investigate variations between coroners in their use of narrative verdicts and the impact of these on suicide rates, using 'other' verdicts (79% of which are narratives) as a proxy for narrative verdicts. There was wide geographic variation in Coroners' use of 'other' (mainly narrative) verdicts--they comprised between 0 and 50% (median = 9%) of verdicts given by individual coroners in 2008-09. Coroners who gave more 'other' verdicts gave fewer suicide verdicts (r = - 0.41; P narratives the least. Variation in Coroners' use of narrative verdicts influences the validity of reported regional suicide rates. Small-area suicide rates, and changes in these rates over time in the last decade, should be interpreted with caution.

  5. Reproduction of superior sagittal sinus animal model by bypass transplantation of biomaterial graft

    Directory of Open Access Journals (Sweden)

    Qing-yong LUO

    2011-03-01

    Full Text Available Objective To establish the beagles model of superior sagittal sinus bypass graft,and explore the feasibility of reconstruction of superior sagittal sinus with biomaterials using this model.Methods Eight adult male beagles(weight: 12.5-22.0kg were involved in the present study.The superior sagittal sinus was exposed and blocked via bone window,and then anastomosed side-to-end to the biomaterial graft under the dedicated microscope of neurosurgery surgery,expectant treatment such as anti-inflammatory was given for the animals.The digital subtraction venography(DSV and color Doppler flow imaging(CDFI of superior sagittal sinus were performed in 1,2,4 and 8 weeks after the operation.Eight weeks after the operation,all the animals were sacrificed and the material graft was examined histologically.Results The DSV and CDFI of superior sagittal sinus showed that the stomas of 2 beagles were with slight stenosis and high flow velocity,of 1 beagle with small leakage and low flow velocity,while of other 5 beagles were normal.The histological examination showed endothelial cells were growing on the graft and superior sagittal sinus,and crawling toward the lumen of graft 8 weeks after the operation.Conclusion The beagles model of superior sagittal sinus bypass graft was established successfully.The short-term effect of the model was satisfactory,while further work should be performed to determine the long-term effects.

  6. Sagittal alignment of the spine-pelvis-lower extremity axis in patients with severe knee osteoarthritis

    Science.gov (United States)

    Wang, W. J.; Liu, F.; Zhu, Y.W.; Sun, M.H.; Qiu, Y.

    2016-01-01

    Objectives Normal sagittal spine-pelvis-lower extremity alignment is crucial in humans for maintaining an ergonomic upright standing posture, and pathogenesis in any segment leads to poor balance. The present study aimed to investigate how this sagittal alignment can be affected by severe knee osteoarthritis (KOA), and whether associated changes corresponded with symptoms of lower back pain (LBP) in this patient population. Methods Lateral radiograph films in an upright standing position were obtained from 59 patients with severe KOA and 58 asymptomatic controls free from KOA. Sagittal alignment of the spine, pelvis, hip and proximal femur was quantified by measuring several radiographic parameters. Global balance was accessed according to the relative position of the C7 plumb line to the sacrum and femoral heads. The presence of chronic LBP was documented. Comparisons between the two groups were carried by independent samples t-tests or chi-squared test. Results Patients with severe KOA showed significant backward femoral inclination (FI), hip flexion, forward spinal inclination, and higher prevalence of global imbalance (27.1% versus 3.4%, p 10° (n = 36) presented with significant pelvic anteversion and hip flexion. A total of 39 patients with KOA (66.1%) suffered from LBP. There was no significant difference in sagittal alignment between KOA patients with and without LBP. Conclusions The sagittal alignment of spine-pelvis-lower extremity axis was significantly influenced by severe KOA. The lumbar spine served as the primary source of compensation, while hip flexion and pelvic anteversion increased for further compensation. Changes in sagittal alignment may not be involved in the pathogenesis of LBP in this patient population. Cite this article: W. J. Wang, F. Liu, Y.W. Zhu, M.H. Sun, Y. Qiu, W. J. Weng. Sagittal alignment of the spine-pelvis-lower extremity axis in patients with severe knee osteoarthritis: A radiographic study. Bone Joint Res 2016;5:198–205

  7. Sagittal balance of the spine in patients with osteoporotic vertebral fractures.

    Science.gov (United States)

    Fechtenbaum, J; Etcheto, A; Kolta, S; Feydy, A; Roux, C; Briot, K

    2016-02-01

    This study aims to compare the sagittal global spinal balance of patients consulting for osteoporosis, aged above 50 years with and without osteoporotic vertebral fractures (VFs). Global spinal balance is abnormal even in subjects without VFs. VFs and age are determinants of sagittal global balance; however, pelvic parameters play a role in compensatory mechanisms. This study aims to compare the spine curvatures, pelvic parameters, and the sagittal global spinal balance of patients aged above 50 years with and without osteoporotic vertebral fractures. Two hundred patients (95 % women) aged 68.3 ± 9.5 years underwent full skeleton radiographs in the standing position, by EOS®, a low dose biplane X-ray imaging system. VFs were evaluated according to Genant's classification. Spinal (thoracic and lumbar Cobb's indices, thoracic and lumbar tilts) and pelvic (pelvic tilt, sacral slope, and pelvic incidence) parameters were measured. Sagittal spinal balance was measured using the C7 plumb line and the spinosacral angle (SSA). We compared these parameters in patients with and without vertebral fracture and assessed the determinants of abnormal sagittal spinal balance. Sixty-nine patients had at least one VF. The sagittal spinal balance was significantly altered in patients with at least one VF, and there was an effect of the number and severity of VFs on parameters. Discriminative value for identification of patients with at least one VF, assessed by Area Under the Curves (AUCs) was 0.652 and 0.706 for C7 plumbline and SSA, respectively. Using multivariate analysis, parameters significantly associated with abnormal spinal balance (SSA) were the presence of at least one VF (OR = 4.96, P balance is abnormal in subjects consulting for osteoporosis, even in subjects without VFs. VFs and age are determinants of abnormal sagittal global balance; however, pelvic parameters play a role in compensatory mechanisms.

  8. Coronal Dynamics at Recent Total Solar Eclipses

    Science.gov (United States)

    Pasachoff, J. M.; Lu, M.; Davis, A. B.; Demianski, M.; Rusin, V.; Saniga, M.; Seaton, D. B.; Lucas, R.; Babcock, B. A.; Dantowitz, R.; Gaintatzis, P.; Seeger, C. H.; Malamut, C.; Steele, A.

    2014-12-01

    Our composite images of the solar corona based on extensive imaging at the total solar eclipses of 2010 (Easter Island), 2012 (Australia), and 2013 (Gabon) reveal several coronal mass ejections and other changes in coronal streamers and in polar plumes. Our resultant spatial resolution is finer than that available in imaging from spacecraft, including that from SOHO/LASCO or STEREO. We trace the eruptions back to their footpoints on the sun using imaging from SDO and SWAP, and follow them upwards through the corona, measuring velocities. The high-resolution computer compositing by Miloslav Druckmüller and Hana Druckmüllerová (2010 and 2013) and Pavlos Gaintatzis (2012) allows comparison of our images with those taken at intervals of minutes or hours along the totality path. Williams College's 2013 eclipse expedition was supported in part by grant 9327-13 from National Geographic Society/Committee for Research and Exploration. Our work on the 2012 eclipse is supported in part by grant AGS-1047726 from Solar Terrestrial Research/NSF AGS. V.R. and M.S. were partially supported by the VEGA grant agency project 2/0098/10 and 2/0003/13 (Slovak Academy of Sciences) and Grant 0139-12 from NG/CRE, and Hana Druckmüllerová by grant 205/09/1469 of the Czech Science Foundation. M.L. was supported by Sigma Xi. C.M. was a Keck Northeast Astronomy Consortium Summer Fellow, supported at Williams College by REU/NSF grant AST-1005024. Partial support was provided by U.S. Department of Defense's ASSURE program. J.M.P. thanks Caltech's Planetary Sciences Department for hospitality. Support for D.B.S. and SWAP came from PRODEX grant C90345 managed by ESA in collaboration with the Belgian Federal Science Policy Office (BELSPO) in support of the PROBA2/SWAP mission, and from the EC's Seventh Framework Programme (FP7/2007-2013) under grant 218816 (SOTERIA project, www.soteria-space.eu). SWAP is a project of the Centre Spatial de Liège and the Royal Observatory of Belgium funded by

  9. First Imaging Observation of Standing Slow Wave in Coronal Fan Loops

    Energy Technology Data Exchange (ETDEWEB)

    Pant, V.; Tiwari, A.; Banerjee, D. [Indian Institute of Astrophysics, Bangalore 560 034 (India); Yuan, D. [Institute of Space Science and Applied Technology, Harbin Institute of Technology, Shenzhen 518000 (China)

    2017-09-20

    We observe intensity oscillations along coronal fan loops associated with the active region AR 11428. The intensity oscillations were triggered by blast waves that were generated due to X-class flares in the distant active region AR 11429. To characterize the nature of oscillations, we created time–distance maps along the fan loops and noted that the intensity oscillations at two ends of the loops were out of phase. As we move along the fan loop, the amplitude of the oscillations first decreased and then increased. The out-of-phase nature together with the amplitude variation along the loop implies that these oscillations are very likely to be standing waves. The period of the oscillations is estimated to be ∼27 minutes, damping time to be ∼45 minutes, and phase velocity projected in the plane of sky to be ∼65–83 km s{sup −1}. The projected phase speeds were in the range of the acoustic speed of coronal plasma at about 0.6 MK, which further indicates that these are slow waves. To the best of our knowledge, this is the first report on the existence of the standing slow waves in non-flaring fan loops.

  10. Study of the early phase of a Coronal Mass Ejection driven shock in EUV images

    Science.gov (United States)

    Frassati, Federica; Susino, Roberto; Mancuso, Salvatore; Bemporad, Alessandro

    2017-10-01

    The November 1st, 2014 prominence eruption (associated with a C2.7 class flare) resulted in a fast, partial-halo Coronal Mass Ejection (CME). During its early propagation, the CME produced a type II radio burst (seen by the Bruny Island Radio Spectrometer) starting around 04:57 UT when the front entered into the LASCO/C2 field of view (FOV) and the top of the CME front was at the heliocentric distance of about 2.5 R_{⊙}. In order to identify the source of the type II radio burst, we studied the kinematic of the eruption with EUV images acquired by SDO/AIA. Profiles of the observed EUV front speed have been compared with the Alfvén speed profiles derived by combining the plasma electron densities obtained from Emission Measure analysis and model magnetic fields extrapolated on the plane of the sky. Our results show that the northern half of the front became super-Alfvénic at approximately the same time when the type-II radio burst started. A comparison between the starting frequency of the type II emission and the frequencies corresponding to the coronal densities of the locations where the EUV front became super-Alfvénic suggests that the radio sources should be located in the northern flank of the front.

  11. Photospheric magnetic field of an eroded-by-solar-wind coronal mass ejection

    Science.gov (United States)

    Palacios, J.; Cid, C.; Saiz, E.; Guerrero, A.

    2017-10-01

    We have investigated the case of a coronal mass ejection that was eroded by the fast wind of a coronal hole in the interplanetary medium. When a solar ejection takes place close to a coronal hole, the flux rope magnetic topology of the coronal mass ejection (CME) may become misshapen at 1 AU as a result of the interaction. Detailed analysis of this event reveals erosion of the interplanetary coronal mass ejection (ICME) magnetic field. In this communication, we study the photospheric magnetic roots of the coronal hole and the coronal mass ejection area with HMI/SDO magnetograms to define their magnetic characteristics.

  12. Cyclical Variation of the Quiet Corona and Coronal Holes

    Indian Academy of Sciences (India)

    Recent advances in the understanding of the quiet corona and coronal holes are reviewed. The review is based on long-term accumulation of data from eclipse observations, coronagraph observations, helium 10830 Å spectroheliograms, and X-ray observations.

  13. Initiation and Propagation of Coronal Mass Ejections P. F. Chen

    Indian Academy of Sciences (India)

    , which is generated at the tachocline layer, emerges throughout the convection zone and the lower atmosphere into the tenuous corona. The coronal field keeps adjusting to a more and more complex magnetic structure in a quasi-steady way.

  14. [A study on the experiences of nurse coroners].

    Science.gov (United States)

    Han, Jin Sook; Park, In Sook

    2008-04-01

    The purpose of this study was to describe the essential structure of the postmortem- examination experiences of nurse career coroners (forensic investigators), to have a profound understanding of their experiences, and ultimately to lay the foundation for nurses' entry into the field of forensic nursing. The subjects in this study were six coroners. After an in-depth interview from January to June 2007, the collected data were analyzed by Colaizzi as qualitative research. Four categories emerged from seven theme clusters. The four categories were: attracted by being dubbed a stabilized public official, a sense of achievement due to having clarified false death, self-confidence after distinguishing the victim and the wrongdoer, eternal developmental potential is seen. It is expected that this study will provide useful information for nurses who are interested in becoming coroners. It will be helpful for career nurses to extend their nursing science into emerging fields like coroners and select a follow-up career.

  15. Production planning and coronal stop deletion in spontaneous speech

    National Research Council Canada - National Science Library

    James Tanner; Morgan Sonderegger; Michael Wagner

    2017-01-01

    .... We examine coronal stop deletion (CSD), a variable process conditioned by preceding and upcoming phonological context, in a corpus of spontaneous British English speech, as a means of investigating a number of variables associated with planning...

  16. Deviation of landmarks in accordance with methods of establishing reference planes in three-dimensional facial CT evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Kaeng Won; Yoon, Suk Ja; Kang, Byung Cheol; Kook, Min Suk; Lee, Jae Seo [School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju (Korea, Republic of); Kim, Young Hee [Dept. of Oral and Maxillofacial Radiology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Palomo, Juan Martin [Dept. of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland (Korea, Republic of)

    2014-09-15

    This study aimed to investigate the deviation of landmarks from horizontal or midsagittal reference planes according to the methods of establishing reference planes. Computed tomography (CT) scans of 18 patients who received orthodontic and orthognathic surgical treatment were reviewed. Each CT scan was reconstructed by three methods for establishing three orthogonal reference planes (namely, the horizontal, midsagittal, and coronal reference planes). The horizontal (bilateral porions and bilateral orbitales) and midsagittal (crista galli, nasion, prechiasmatic point, opisthion, and anterior nasal spine) landmarks were identified on each CT scan. Vertical deviation of the horizontal landmarks and horizontal deviation of the midsagittal landmarks were measured. The porion and orbitale, which were not involved in establishing the horizontal reference plane, were found to deviate vertically from the horizontal reference plane in the three methods. The midsagittal landmarks, which were not used for the midsagittal reference plane, deviated horizontally from the midsagittal reference plane in the three methods. In a three-dimensional facial analysis, the vertical and horizontal deviations of the landmarks from the horizontal and midsagittal reference planes could vary depending on the methods of establishing reference planes.

  17. Coroner consistency - The 10-jurisdiction, 10-year, postcode lottery?

    Science.gov (United States)

    Mclean, Maxwell

    2015-04-01

    The investigation and classification of deaths in England and Wales relies upon the application by medical practitioners of diverse reporting standards set locally by coroners and thereafter upon the effectively unconstrained decision process of those same coroners. The author has conducted extensive comparative analysis of Ministry of Justice data on reports to the coroner and their inquest and verdict returns alongside Office of National Statistics data pertaining to the numbers of registered deaths in equivalent local jurisdictions. Here, he analyses 10 jurisdictions characterised by almost identical inquest return numbers in 2011. Substantial variation was found in reporting rates to the coroner and in the profile of inquest verdicts. The range of deaths reported varied from 34% to 62% of all registered deaths. Likewise only 2 of the 10 jurisdictions shared the same ranking of proportions in which the six common verdicts were reached. Individual jurisdictions tended to be consistent over time in their use of verdicts. In all cases, proportionately more male deaths were reported to the coroner. Coroners generally seemed prima facie to be 'gendered' in their approach to verdicts; that is, they were consistently more likely to favour a particular verdict when dealing with a death, according to the sex of the deceased. The extent to which coroners seemed gendered varied widely. While similar services such as the criminal courts or the Crown Prosecution Service are subject to extensive national guidance in an attempt to constrain idiosyncratic decision making, there seems no reason why this should apply less to the process of death investigation and classification. Further analysis of coroners' local practices and their determinants seems necessary. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Effect of one- or two-level posterior lumbar interbody fusion on global sagittal balance.

    Science.gov (United States)

    Cho, Jae Hwan; Joo, Youn-Suk; Lim, Cheongsu; Hwang, Chang Ju; Lee, Dong-Ho; Lee, Choon Sung

    2017-06-02

    Sagittal imbalance is associated with poor clinical outcomes in patients with degenerative lumbar disease. However, there is no consensus on the impact of posterior lumbar interbody fusion (PLIF) on local and global sagittal balance. To reveal the effect of one- or two-level PLIF on global sagittal balance. A retrospective case-control study. This study included 88 patients who underwent a one- or two-level PLIF for spinal stenosis with spondylolisthesis. Clinical and radiological parameters were measured pre- and postoperatively. All patients were followed up for >2 years. Clinical outcomes included a visual analog scale, Oswestry Disability Index, and EuroQol 5-dimension questionnaire (EQ-5D). Radiological parameters were measured using whole-spine standing lateral radiographs. Fusion, loosening, subsidence rates, and adverse events were also evaluated. Patients were divided into two groups according to their preoperative C7-S1 sagittal vertical axis (SVA): Group N: SVA≤5 cm vs Group I: SVA>5 cm; they were also divided according to postoperative changes in C7-S1 SVA. Clinical and radiological outcomes were compared between the groups. All clinical outcomes and radiological parameters improved postoperatively. C7-S1 SVA improved (-1.6 cm) after L3-L5 fusion, but it was compromised (+3.6 cm) after L4-S1 fusion (p=.001). Preoperative demographic and clinical data showed no difference except in the anxiety or depression domain of EQ-5D. No differences were found in postoperative clinical outcomes. Lumbar lordosis, pelvic tilt, and thoracic kyphosis slightly improved in Group N, whereas C7-S1 SVA decreased from 9.5 cm to 3.8 cm (pSVA, we found that the decreasing trend in the postoperative C7-S1 SVA was related to a larger preoperative C7-S1 SVA (p=.030) and a more proximal level fusion (L3-L5 vs L4-S1, p=.033). Global sagittal balance improved after short-level lumbar fusion surgery in patients having spinal stenosis with spondylolisthesis who showed

  19. Hunting for Stellar Coronal Mass Ejections

    Science.gov (United States)

    Korhonen, Heidi; Vida, Krisztián; Leitzinger, Martin; Odert, Petra; Kovács, Orsolya Eszter

    2017-10-01

    Coronal mass ejections (CMEs) are explosive events that occur basically daily on the Sun. It is thought that these events play a crucial role in the angular momentum and mass loss of late-type stars, and also shape the environment in which planets form and live. Stellar CMEs can be detected in optical spectra in the Balmer lines, especially in Hα, as blue-shifted extra emission/absorption. To increase the detection probability one can monitor young open clusters, in which the stars are due to their youth still rapid rotators, and thus magnetically active and likely to exhibit a large number of CMEs. Using ESO facilities and the Nordic Optical Telescope we have obtained time series of multi-object spectroscopic observations of late-type stars in six open clusters with ages ranging from 15 Myrs to 300 Myrs. Additionally, we have studied archival data of numerous active stars. These observations will allow us to obtain information on the occurrence rate of CMEs in late-type stars with different ages and spectral types. Here we report on the preliminary outcome of our studies.

  20. Guided flows in coronal magnetic flux tubes

    Science.gov (United States)

    Petralia, A.; Reale, F.; Testa, P.

    2018-01-01

    Context. There is evidence that coronal plasma flows break down into fragments and become laminar. Aims: We investigate this effect by modelling flows confined along magnetic channels. Methods: We consider a full magnetohydrodynamic (MHD) model of a solar atmosphere box with a dipole magnetic field. We compare the propagation of a cylindrical flow perfectly aligned with the field to that of another flow with a slight misalignment. We assume a flow speed of 200 km s-1 and an ambient magnetic field of 30 G. Results: We find that although the aligned flow maintains its cylindrical symmetry while it travels along the magnetic tube, the misaligned one is rapidly squashed on one side, becoming laminar and eventually fragmented because of the interaction and back-reaction of the magnetic field. This model could explain an observation made by the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory of erupted fragments that fall back onto the solar surface as thin and elongated strands and end up in a hedge-like configuration. Conclusions: The initial alignment of plasma flow plays an important role in determining the possible laminar structure and fragmentation of flows while they travel along magnetic channels. Movies are available in electronic form at http://www.aanda.org

  1. Coronal microleakage assessed by polymicrobial markers.

    Science.gov (United States)

    Britto, Leandro Rodrigues; Grimaudo, Nicholas J; Vertucci, Frank J

    2003-08-15

    Studies have shown significant bacterial leakage following exposure of sealed root canals to artificial and natural saliva. The objective of this study was to determine contamination via bacterial migration in artificial saliva in endodontically treated teeth using different obturation techniques and sealers. A total of 144 extracted, human mandibular anterior teeth were cleaned and shaped to a #40 master apical file using hand and rotary instrumentation. One hundred and twenty teeth were divided into two experimental groups. The teeth in Group 1 were obturated with gutta-percha using lateral compaction and five different sealers, and the teeth in Group 2 were obturated with gutta-percha using thermomechanical compaction and five different sealers. The remaining 24 teeth were prepared as positive and negative controls. All specimens, except the negative controls, were inoculated every five days with Anaerobic streptococci (NCTC 9891) related to Peptostreptococcus micros and Prevotella intermedia (ATCC 25611). The contamination onset time was continuously recorded and turbid broths cultured for bacteria identification. The controls behaved as expected. Regardless of the combination between obturation techniques and different sealers, all broths became turbid during this experiment. The correlation between the obturation techniques and the sealers revealed statistical significance using ANOVA (psealer allowed a slower rate of coronal-apical bacterial migration.

  2. Guided flows in coronal magnetic flux tubes

    Science.gov (United States)

    Petralia, A.; Reale, F.; Testa, P.

    2017-12-01

    Context. There is evidence that coronal plasma flows break down into fragments and become laminar. Aims: We investigate this effect by modelling flows confined along magnetic channels. Methods: We consider a full magnetohydrodynamic (MHD) model of a solar atmosphere box with a dipole magnetic field. We compare the propagation of a cylindrical flow perfectly aligned with the field to that of another flow with a slight misalignment. We assume a flow speed of 200 km s-1 and an ambient magnetic field of 30 G. Results: We find that although the aligned flow maintains its cylindrical symmetry while it travels along the magnetic tube, the misaligned one is rapidly squashed on one side, becoming laminar and eventually fragmented because of the interaction and back-reaction of the magnetic field. This model could explain an observation made by the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory of erupted fragments that fall back onto the solar surface as thin and elongated strands and end up in a hedge-like configuration. Conclusions: The initial alignment of plasma flow plays an important role in determining the possible laminar structure and fragmentation of flows while they travel along magnetic channels. Movies are available in electronic form at http://www.aanda.org

  3. Are chromospheric nanoflares a primary source of coronal plasma?

    Energy Technology Data Exchange (ETDEWEB)

    Klimchuk, J. A. [NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States); Bradshaw, S. J., E-mail: James.A.Klimchuk@nasa.gov, E-mail: stephen.bradshaw@rice.edu [Department of Physics and Astronomy, Rice University, Houston, TX 77005 (United States)

    2014-08-10

    It has been suggested that the hot plasma of the solar corona comes primarily from impulsive heating events, or nanoflares, that occur in the lower atmosphere, either in the upper part of the ordinary chromosphere or at the tips of type II spicules. We test this idea with a series of hydrodynamic simulations. We find that synthetic Fe XII (195) and Fe XIV (274) line profiles generated from the simulations disagree dramatically with actual observations. The integrated line intensities are much too faint; the blueshifts are much too fast; the blue-red asymmetries are much too large; and the emission is confined to low altitudes. We conclude that chromospheric nanoflares are not a primary source of hot coronal plasma. Such events may play an important role in producing the chromosphere and powering its intense radiation, but they do not, in general, raise the temperature of the plasma to coronal values. Those cases where coronal temperatures are reached must be relatively uncommon. The observed profiles of Fe XII and Fe XIV come primarily from plasma that is heated in the corona itself, either by coronal nanoflares or a quasi-steady coronal heating process. Chromospheric nanoflares might play a role in generating waves that provide this coronal heating.

  4. New Evidence that Magnetoconvection Drives Solar–Stellar Coronal Heating

    Energy Technology Data Exchange (ETDEWEB)

    Tiwari, Sanjiv K.; Panesar, Navdeep K.; Moore, Ronald L.; Winebarger, Amy R. [NASA Marshall Space Flight Center, Mail Code ST 13, Huntsville, AL 35812 (United States); Thalmann, Julia K., E-mail: sanjivtiwari80@gmail.com [Institute of Physics/IGAM, University of Graz, Universittsplatz 5/II, A-8010 Graz (Austria)

    2017-07-10

    How magnetic energy is injected and released in the solar corona, keeping it heated to several million degrees, remains elusive. Coronal heating generally increases with increasing magnetic field strength. From a comparison of a nonlinear force-free model of the three-dimensional active region coronal field to observed extreme-ultraviolet loops, we find that (1) umbra-to-umbra coronal loops, despite being rooted in the strongest magnetic flux, are invisible, and (2) the brightest loops have one foot in an umbra or penumbra and the other foot in another sunspot’s penumbra or in unipolar or mixed-polarity plage. The invisibility of umbra-to-umbra loops is new evidence that magnetoconvection drives solar-stellar coronal heating: evidently, the strong umbral field at both ends quenches the magnetoconvection and hence the heating. Broadly, our results indicate that depending on the field strength in both feet, the photospheric feet of a coronal loop on any convective star can either engender or quench coronal heating in the loop’s body.

  5. Correlates of bone mineral density and sagittal spinal balance in the aged.

    Science.gov (United States)

    Cho, Yung; Lee, Gangpyo; Aguinaldo, Jhoan; Lee, Kun-Jai; Kim, Keewon

    2015-02-01

    To investigate the relationship between bone mineral density (BMD) and sagittal spinal balance in the Korean elderly population. The retrospective study included subjects aged 60 years and above, who had whole-spine lateral radiography and dual-energy X-ray absorptiometry (DEXA) within a year's gap between each other. Sagittal vertical axis (SVA) for evaluation of sagittal spinal balance and five spinopelvic parameters were measured through radiography. The presence of compression fracture was identified. Correlations of BMD T-scores with SVA and with the spinopelvic parameters were assessed using Pearson correlation coefficient (PCC). Linear regression analyses were performed between SVA and the clinical and radiologic variables. One hundred twenty-two subjects (42 males and 80 females; mean age, 69.93±5.5 years) were included in the study. BMD, femur or spine, was not correlated with SVA or any spinopelvic parameters in both genders (PCCsagittal spinal balance in the aged. Sagittal spinal balance was explained partly by lumbar lordosis and compression fracture. Further study is warranted to understand progression of sagittal imbalance with age.

  6. Influence of transforaminal lumbar interbody fusion procedures on spinal and pelvic parameters of sagittal balance.

    Science.gov (United States)

    Ould-Slimane, Mourad; Lenoir, Thibaut; Dauzac, Cyril; Rillardon, Ludovic; Hoffmann, Etienne; Guigui, Pierre; Ilharreborde, Brice

    2012-06-01

    Restitution of sagittal balance is important after lumbar fusion, because it improves fusion rate and may reduce the rate of adjacent segment disease. The purpose of the present study was to describe the impact of transforaminal lumbar interbody fusion (TLIF) procedures on pelvic and spinal parameters and sagittal balance. Forty-five patients who had single-level TLIF were included in this study. Pelvic and spinal radiological parameters of sagittal balance were measured preoperatively, postoperatively and at latest follow-up. Age at surgery averaged 58.4 (±9.6) years. Mean follow-up was 35.1 months (±4.1). Twenty-nine percent of the patients exhibited anterior imbalance preoperatively, with high pelvic tilt (17.6° ± 7.9°). Of the 32 (71%) patients well balanced before the procedure, 22 (70%) had a large pelvic tilt (>20°), due to retroversion of the pelvis as an adaptive response to the loss of lordosis. Three dural tears (7%) were reported intraoperatively. Interbody cages were more posterior than intended in 27% of the cases. Disc height and lumbar lordosis at fusion level significantly increased postoperatively (p sagittal balance was not significantly modified (p = 0.07). Single-level circumferential fusion helps patients reducing their pelvic compensation, but the amount of correction does not allow for complete correction of sagittal imbalance.

  7. Sagittal balance and pelvic parameters--a paradigm shift in spinal surgery.

    Science.gov (United States)

    Johnson, R D; Valore, A; Villaminar, A; Comisso, M; Balsano, M

    2013-02-01

    It has become evident in recent years that global assessment of spinal sagittal balance is necessary for optimal management of the degenerate spine. Pelvic parameters have been developed which appear to correlate well with the natural history of degenerative spine disorders and outcomes from surgery. Although these parameters have a limited evidence base, they are now in widespread use by spinal surgeons and, in particular, spinal deformity surgeons. It is necessary for all surgeons treating spinal pathology to have a working knowledge of the principles of spinal sagittal balance, to be able to recognise sagittal imbalance and its compensatory mechanisms. In this article we outline the main concepts of spinal sagittal balance and pelvic parameters and how these concepts are leading to a paradigm shift in the surgical management of spinal disorders. We propose that analysis of pelvic parameters of sagittal balance will form an essential part of the evaluation of new surgical techniques for spinal conditions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Treatment of Sagittal Fracture of the Zygomatic Arch Root Assisted by Surgical Navigation Technology.

    Science.gov (United States)

    Dai, Jin-Hong; Xu, Dong-Dong; Yang, Chang-Yuan; Li, Zu-Bing; Li, Zhi

    2018-01-29

    Sagittal fracture at the temporal root of the zygomatic arch often occurs as a part of zygomaticomaxillary fractures. The authors described the application of computer-assisted navigation in the lag screw insertion for the fixation of sagittal fracture at the temporal root of zygomatic arch. Using the presurgical planning of the computer-assisted navigation system, the trajectory of lag screw insertion was designed, and the insertion depth was calculated. In the presurgical planning, the trajectory of screw insertion was placed with an anterior inclination of 10° to 15° (mean: 12.24°), and the screw insertion depth was 9.0 to 12.0 mm (mean: 10.65 mm). In the operation, the screw insertion in the fixation of the sagittal fracture was performed under the guidance of navigation system according to the presurgical planning. The postoperative CT scan showed exact reduction and fixation of the sagittal fracture in all cases. Computer-assisted navigation is a useful tool for the lag screw insertion in the precise fixation of sagittal fracture at the temporal root of the zygomatic arch in complex zygomaticomaxillary fractures.

  9. Evidence showing the relationship between sagittal balance and clinical outcomes in surgical treatment of degenerative spinal diseases: a literature review

    National Research Council Canada - National Science Library

    Le Huec, Jean-Charles; Faundez, Antonio; Dominguez, Dennis; Hoffmeyer, Pierre; Aunoble, Stéphane

    2015-01-01

    The measure of radiographic pelvic and spinal parameters for sagittal balance analysis has gained importance in reconstructive surgery of the spine and particularly in degenerative spinal diseases (DSD...

  10. ON THE RELATIONSHIP BETWEEN THE CORONAL MAGNETIC DECAY INDEX AND CORONAL MASS EJECTION SPEED

    Energy Technology Data Exchange (ETDEWEB)

    Xu Yan; Liu Chang; Jing Ju; Wang Haimin, E-mail: yx2@njit.edu [Space Weather Research Lab, Center for Solar-Terrestrial Research, New Jersey Institute of Technology, 323 Martin Luther King Boulevard, Newark, NJ 07102-1982 (United States)

    2012-12-10

    Numerical simulations suggest that kink and torus instabilities are two potential contributors to the initiation and prorogation of eruptive events. A magnetic parameter called the decay index (i.e., the coronal magnetic gradient of the overlying fields above the eruptive flux ropes) could play an important role in controlling the kinematics of eruptions. Previous studies have identified a threshold range of the decay index that distinguishes between eruptive and confined configurations. Here we advance the study by investigating if there is a clear correlation between the decay index and coronal mass ejection (CME) speed. Thirty-eight CMEs associated with filament eruptions and/or two-ribbon flares are selected using the H{alpha} data from the Global H{alpha} Network. The filaments and flare ribbons observed in H{alpha} associated with the CMEs help to locate the magnetic polarity inversion line, along which the decay index is calculated based on the potential field extrapolation using Michelson Doppler Imager magnetograms as boundary conditions. The speeds of CMEs are obtained from the LASCO C2 CME catalog available online. We find that the mean decay index increases with CME speed for those CMEs with a speed below 1000 km s{sup -1} and stays flat around 2.2 for the CMEs with higher speeds. In addition, we present a case study of a partial filament eruption, in which the decay indices show different values above the erupted/non-erupted part.

  11. VLA Measurements of Faraday Rotation through Coronal Mass Ejections

    Science.gov (United States)

    Kooi, Jason E.; Fischer, Patrick D.; Buffo, Jacob J.; Spangler, Steven R.

    2017-04-01

    Coronal mass ejections (CMEs) are large-scale eruptions of plasma from the Sun, which play an important role in space weather. Faraday rotation is the rotation of the plane of polarization that results when a linearly polarized signal passes through a magnetized plasma such as a CME. Faraday rotation is proportional to the path integral through the plasma of the electron density and the line-of-sight component of the magnetic field. Faraday-rotation observations of a source near the Sun can provide information on the plasma structure of a CME shortly after launch. We report on simultaneous white-light and radio observations made of three CMEs in August 2012. We made sensitive Very Large Array (VLA) full-polarization observations using 1 - 2 GHz frequencies of a constellation of radio sources through the solar corona at heliocentric distances that ranged from 6 - 15 R_{⊙}. Two sources (0842+1835 and 0900+1832) were occulted by a single CME, and one source (0843+1547) was occulted by two CMEs. In addition to our radioastronomical observations, which represent one of the first active hunts for CME Faraday rotation since Bird et al. ( Solar Phys., 98, 341, 1985) and the first active hunt using the VLA, we obtained white-light coronagraph images from the Large Angle and Spectrometric Coronagraph (LASCO) C3 instrument to determine the Thomson-scattering brightness [BT], providing a means to independently estimate the plasma density and determine its contribution to the observed Faraday rotation. A constant-density force-free flux rope embedded in the background corona was used to model the effects of the CMEs on BT and Faraday rotation. The plasma densities (6 - 22×103 cm^{-3}) and axial magnetic-field strengths (2 - 12 mG) inferred from our models are consistent with the modeling work of Liu et al. ( Astrophys. J., 665, 1439, 2007) and Jensen and Russell ( Geophys. Res. Lett., 35, L02103, 2008), as well as previous CME Faraday-rotation observations by Bird et al

  12. Compensatory mechanisms contributing to keep the sagittal balance of the spine.

    Science.gov (United States)

    Barrey, Cédric; Roussouly, Pierre; Le Huec, Jean-Charles; D'Acunzi, Gennaro; Perrin, Gilles

    2013-11-01

    Aging spine is characterized by facet joints arthritis, degenerative disc disease, bone remodeling and atrophy of extensor muscles resulting in a progressive kyphosis of the lumbar spine. The aim of this paper is to describe the different compensatory mechanisms for patients with severe degenerative lumbar spine. According to the severity of the imbalance, three stages are observed: balanced, balanced with compensatory mechanisms and imbalanced. For the two last stages, the compensatory mechanisms permit to limit the consequences of loss of lumbar lordosis on global sagittal alignment and therefore contribute to keep the sagittal balance of the spine. The basic concept is to extend adjacent segments of the kyphotic spine allowing for compensation of the sagittal unbalance but potentially inducing adverse effects. Finally, we propose a three-step algorithm to analyze the global balance status and take into consideration the presence of the compensatory mechanisms in the spinal, pelvic and lower limb areas.

  13. Influence of implant rod curvature on sagittal correction of scoliosis deformity

    DEFF Research Database (Denmark)

    Salmingo, Remel A.; Tadano, Shigeru; Abe, Yuichiro

    2014-01-01

    BACKGROUND CONTEXT: Deformation of in vivo–implanted rods could alter the scoliosis sagittal correction. To our knowledge, no previous authors have investigated the influence of implanted-rod deformation on the sagittal deformity correction during scoliosis surgery. PURPOSE: To analyze the changes...... of the implant rod’s angle of curvature during surgery and establish its influence on sagittal correction of scoliosis deformity. STUDY DESIGN: A retrospective analysis of the preoperative and postoperative implant rod geometry and angle of curvature was conducted. PATIENT SAMPLE: Twenty adolescent idiopathic...... scoliosis patients underwent surgery. Average age at the time of operation was 14 years. OUTCOME MEASURES: The preoperative and postoperative implant rod angle of curvature expressed in degrees was obtained for each patient. METHODS: Two implant rods were attached to the concave and convex side...

  14. Roussouly's sagittal spino-pelvic morphotypes as determinants of gait in asymptomatic adult subjects.

    Science.gov (United States)

    Bakouny, Ziad; Assi, Ayman; Massaad, Abir; Saghbini, Elie; Lafage, Virginie; Skalli, Wafa; Ghanem, Ismat; Kreichati, Gaby

    2017-05-01

    Sagittal alignment is known to greatly vary between asymptomatic adult subjects; however, there are no studies on the possible effect of these differences on gait. The aim of this study is to investigate whether asymptomatic adults with different Roussouly sagittal alignment morphotypes walk differently. Ninety-one asymptomatic young adults (46M & 45W), aged 21.6±2.2years underwent 3D gait analysis and full body biplanar X-rays with three-dimensional (3D) reconstructions of their spines and pelvises and generation of sagittal alignment parameters. Subjects were divided according to Roussouly's sagittal alignment classification. Sagittal alignment and kinematic parameters were compared between Roussouly types. 17 subjects were classified as type 2, 47 as type 3, 26 as type 4 but only 1 as type 1. Type 2 subjects had significantly more mean pelvic retroversion (less mean pelvic tilt) during gait compared to type 3 and 4 subjects (type 2: 8.2°; type 3:11.2°, type 4: 11.3°) and significantly larger ROM pelvic obliquity compared to type 4 subjects (type 2: 11.0°; type 4: 9.1°). Type 2 subjects also had significantly larger maximal hip extension during stance compared to subjects of types 3 and 4 (type 2: -11.9°; type 3: -8.8°; type 4: -7.9°) and a larger ROM of ankle plantar/dorsiflexion compared to type 4 subjects (type 2: 31.1°; type 4: 27.9°). Subjects with type 2 sagittal alignment were shown to have a gait pattern involving both increased hip extension and pelvic retroversion which could predispose to posterior femoroacetabular impingement and consequently osteoarthritis. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. [SPINO-PELVIC SAGITTAL ALIGNMENT IN PATIENTS WITH HIGH-GRADE L5 ISTHMIC SPONDYLOLISTHESIS].

    Science.gov (United States)

    Yang, Xi; Kong, Qingquan; Song, Yueming; Liu, Limin; Li, Tao; Gong, Quan; Zeng, Jiancheng; Liu, Hao

    2016-01-01

    To observe the character of spino-pelvic sagittal alignment in patients with high-grade L5 isthmic spondylolisthesis, and to analyze the sagittal alignment alteration after operation. Between January 2009 and June 2014, 25 patients with high-grade L5 isthmic spondylolisthesis underwent posterior surgery, and the clinical data were retrospectively analyzed as study group. There were 14 males and 11 females with a mean age of 42.5 years (range, 20-65 years). The mean disease duration was 6 months (range, 3-12 months). According to the Meyerding evaluating system, 15 cases were rated as degree III, and 10 cases as degree IV. Eighty healthy adult volunteers were recruited simultaneously as control group. The lumbar sacral angle (LSA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), and sagittal vertical axis (SVA) were measured on preoperative and last follow-up standing full length lateral X-ray films. And these parameters were compared between study group (preoperative parameters) and control group. Then the patients in study group were divided into 2 subgroups according to Hresko's method: the balanced pelvis subgroup (n = 14) and unbalanced pelvis subgroup (n = 11). The sagittal parameters were compared between 2 subgroups, and the alteration of sagittal parameters before surgery and at last follow-up was analyzed in each subgroup respectively. All patients in study group were followed up 18 months on average (range, 6-48 months). After surgery, spondylolisthesis was reduced from degree III to degree 0 in 12 cases and to degree I in 3 cases, and from degree IV to degree 0 in 6 cases and to degree I in 4 cases. Bone fusion was obtained in all patients at last follow-up. The preoperative PI, SS, PT, and SVA of study group were significantly greater than those of control group (P spondylolisthesis have greater PI, abnormal lumbosacral kyphosis, and sagittal imbalance.

  16. Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlation study

    Science.gov (United States)

    Ilharreborde, Brice; Dauzac, Cyril; Lenoir, Thibault; Rillardon, Ludovic; Guigui, Pierre

    2007-01-01

    Recent studies suggested a predominant role of spinopelvic parameters to explain lumbosacral spondylolisthesis pathogeny. We compare the pelvic incidence and other parameters of sagittal spinopelvic balance in adolescents and young adults with developmental spondylolisthesis to those parameters in a control group of healthy volunteers. We compared the angular parameters of the sagittal balance of the spine in a cohort of 244 patients with a developmental L5–S1 spondylolisthesis with those of a control cohort of 300 healthy volunteers. A descriptive and correlation study was performed. The L5 anterior slipping and lumbosacral kyphosis in spondylolisthesis patients was described using multiple regression analysis study. Our study demonstrates that the related measures of sagittal spinopelvic alignment are disturbed in adolescents and young adults with developmental spondylolisthesis. These subjects stand with an increased sacral slope, pelvic tilt and lumbar lordosis but with a decreased thoracic kyphosis. Pelvic incidence was significantly higher in spondylolisthesis patients as compared with controls but was not clearly correlated with the grade of slipping. We showed the same “sagittal balance strategy” in spondylolisthesis patients as in the control group regarding correlations between pelvic incidence, sacral slope, pelvic tilt and lumbar lordosis. We believe that the lumbosacral kyphosis is a stronger factor than pelvic incidence which need to be taken into account as a predominant factor in theories of pathogenesis of lumbosacral spondylolithesis. We thus believe that increased lumbar lordosis associated with L5–S1 spondylolisthesis is secondary to the high pelvic incidence and is an important factor causing high shear stresses at the L5–S1 pars interarticularis. However, the “local” sagittal imbalance of the lumbosacral junction is compensated by adjacent mobile segments in the upper lumbar spine, the pelvis orientation and the thoracic spine

  17. Postural model of sagittal spino-pelvic alignment and its relevance for lumbosacral developmental spondylolisthesis.

    Science.gov (United States)

    Mac-Thiong, Jean-Marc; Wang, Zhi; de Guise, Jacques A; Labelle, Hubert

    2008-10-01

    Comparative study of sagittal spino-pelvic alignment in children and adolescents with developmental lumbosacral spondylolisthesis compared with asymptomatic subjects. To develop a global postural model of sagittal spino-pelvic alignment. The relationships between parameters of sagittal spino-pelvic alignment in developmental spondylolisthesis are still unclear. Radiographs of 120 control subjects and 131 subjects with developmental spondylolisthesis (91 low-grade, 40 high-grade) were reviewed. Subjects with high-grade spondylolisthesis were divided according to their sacro-pelvic alignment: balanced versus retroverted sacro-pelvis. Parameters of the sacro-pelvis (pelvic incidence, pelvic tilt, sacral slope), lumbosacral region (lumbosacral angle, slip percentage), lumbar spine (lumbar lordosis, lumbar tilt), thoracic spine (thoracic kyphosis, thoracic tilt), and global balance (spinal tilt, sagittal offset between C7 and femoral heads) were assessed. Parameters were compared between all groups and a correlation study was performed between all parameters. A postural model that includes the measured parameters was used to analyze the obtained correlations. Significant differences in all parameters are found between all groups, except for sagittal offset. The pattern and strength of correlations is similar between normal and low-grade subjects, showing interdependence between sacro-pelvic, lumbosacral, lumbar, and thoracic regions. The pattern of relationships was altered in high-grade spondylolisthesis, especially for subjects with a retroverted sacro-pelvis for which correlations between pelvic incidence and pelvic tilt, and between the sacro-pelvic unit and lumbar spine geometry are lost. Children and adolescents stand with a relatively constant global sagittal spino-pelvic alignment, regardless of the local lumbosacral deformity. A normal posture is maintained in low-grade spondylolisthesis and in high-grade spondylolisthesis with a balanced sacro-pelvis. Posture

  18. Nanodust dynamics during a coronal mass ejection

    Directory of Open Access Journals (Sweden)

    A. Czechowski

    2017-09-01

    Full Text Available The dynamics of nanometer-sized grains (nanodust is strongly affected by electromagnetic forces. High-velocity nanodust was proposed as an explanation for the voltage bursts observed by STEREO. A study of nanodust dynamics based on a simple time-stationary model has shown that in the vicinity of the Sun the nanodust is trapped or, outside the trapped region, accelerated to high velocities. We investigate the nanodust dynamics for a time-dependent solar wind and magnetic field configuration in order to find out what happens to nanodust during a coronal mass ejection (CME. The plasma flow and the magnetic field during a CME are obtained by numerical simulations using a 3-D magnetohydrodynamic (MHD code. The equations of motion for the nanodust particles are solved numerically, assuming that the particles are produced from larger bodies moving in near-circular Keplerian orbits within the circumsolar dust cloud. The charge-to-mass ratios for the nanodust particles are taken to be constant in time. The simulation is restricted to the region within 0.14 AU from the Sun. We find that about 35 % of nanodust particles escape from the computational domain during the CME, reaching very high speeds (up to 1000 km s−1. After the end of the CME the escape continues, but the particle velocities do not exceed 300 km s−1. About 30 % of all particles are trapped in bound non-Keplerian orbits with time-dependent perihelium and aphelium distances. Trapped particles are affected by plasma ion drag, which causes contraction of their orbits.

  19. Nanodust dynamics during a coronal mass ejection

    Science.gov (United States)

    Czechowski, Andrzej; Kleimann, Jens

    2017-09-01

    The dynamics of nanometer-sized grains (nanodust) is strongly affected by electromagnetic forces. High-velocity nanodust was proposed as an explanation for the voltage bursts observed by STEREO. A study of nanodust dynamics based on a simple time-stationary model has shown that in the vicinity of the Sun the nanodust is trapped or, outside the trapped region, accelerated to high velocities. We investigate the nanodust dynamics for a time-dependent solar wind and magnetic field configuration in order to find out what happens to nanodust during a coronal mass ejection (CME). The plasma flow and the magnetic field during a CME are obtained by numerical simulations using a 3-D magnetohydrodynamic (MHD) code. The equations of motion for the nanodust particles are solved numerically, assuming that the particles are produced from larger bodies moving in near-circular Keplerian orbits within the circumsolar dust cloud. The charge-to-mass ratios for the nanodust particles are taken to be constant in time. The simulation is restricted to the region within 0.14 AU from the Sun. We find that about 35 % of nanodust particles escape from the computational domain during the CME, reaching very high speeds (up to 1000 km s-1). After the end of the CME the escape continues, but the particle velocities do not exceed 300 km s-1. About 30 % of all particles are trapped in bound non-Keplerian orbits with time-dependent perihelium and aphelium distances. Trapped particles are affected by plasma ion drag, which causes contraction of their orbits.

  20. Forecasting Coronal Mass Ejections from Vector Magnetograms

    Science.gov (United States)

    Falconer, D. A.; Moore, R. L.; Gary, G. A.; Six, N. Frank (Technical Monitor)

    2002-01-01

    In a 17 vector magnetogram study of 12 bipolar active regions (Falconer, Moore, & Gary, 2002, ApJ in press), we correlated four quantitative global magnetic measures with the Coronal Mass Ejections (CME) productivity of the active region. The global measures included a measure of active region size, the total magnetic flux phi and three measures of an active region global nonpotentiality 1) the net current (I (sub N)), 2) the length of the strong-shear, strong-field main neutral line (L(sub SS)) and 3) and the normalized twist (alpha = muIN/PHI). The CME productivity was determined from YOHKOH/SXT observations, Geostationary Operational Environmental Satellite (GOES), and when possible Solar and Heliospheric Observatory/Large Angle and Spectrometric Coronagraph Experiment (SOHO/LASCO) observations within 12 days of the day of the magnetogram. We found that the three measures of global nonpotentiality (I(sub N), L(sub SS), alpha) were all well correlated (greater than 99% confidence level) with an active region's CME productivity. The sample size was to small to confirm if there was a statistical significant correlation of the globally nonscientist measures with future CME activity (i.e. from the date of the magnetogram forward). We are doubling our sample, and will report on the statistical significance of global nonpotentiality as a predictor of future CME productivity. The new active regions are all from the first year of the upgraded MSFC vector magnetograms. This work, is funded by NSF through the Space Weather Program, by NASA through the Living with the Star, Targeted Research and Technology, and by NASA Solar Physics Supporting Research and Technology Program. The upgrade to the MSFC vector magnetograph was supported by the High Energy Solar Spectroscopic Imager (HESSI) mission.

  1. Alphabet Soup: Sagittal Balance Correction Osteotomies of the Spine-What Radiologists Should Know.

    Science.gov (United States)

    Takahashi, T; Kainth, D; Marette, S; Polly, D

    2017-11-30

    Global sagittal malalignment has been demonstrated to have correlation with clinical symptoms and is a key component to be restored in adult spinal deformity. In this article, various types of sagittal balance-correction osteotomies are reviewed primarily on the basis of the 3 most commonly used procedures: Smith-Petersen osteotomy, pedicle subtraction osteotomy, and vertebral column resection. Familiarity with the expected imaging appearance and commonly encountered complications seen on postoperative imaging studies following correction osteotomies is crucial for accurate image interpretation. © 2018 by American Journal of Neuroradiology.

  2. Sagittal synostosis: II. Cranial morphology and growth after the modified pi-plasty

    DEFF Research Database (Denmark)

    Guimaraes-Ferreira, J.; Gewalli, F.; David, L.

    2006-01-01

    The aim of this study was to characterise the postoperative cranial growth and morphology after a modified pi-plasty for sagittal synostosis. The shape of the skull of 82 patients with isolated premature synostosis of the sagittal suture ( SS group) operated on with a modified pi-plasty was studied...... selected landmarks, and angles defined by groups of three landmarks). Paired and unpaired t tests were used to assess the differences between the variables studied. These were accepted as significant for values of p...

  3. Importance of Sagittal Alignment of the Cervical Spine in the Management of Degenerative Cervical Myelopathy.

    Science.gov (United States)

    Buell, Thomas J; Buchholz, Avery L; Quinn, John C; Shaffrey, Christopher I; Smith, Justin S

    2018-01-01

    Cervical spine sagittal malalignment correlates with worse symptoms and outcomes in patients with degenerative cervical myelopathy (DCM), and should influence surgical management. An anterior versus posterior surgical approach may not significantly change outcomes in patients with preoperative lordosis; however, most studies suggest improved neurologic recovery among kyphotic patients after adequate correction of local sagittal alignment through an anterior or combined anterior-posterior approach. There are no comprehensive guidelines for DCM management in the setting of cervical malalignment; therefore, surgical management should be tailored to individual patients and decisions made at the discretion of treating surgeons with attention to basic principles. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Analysis of Factors Associated With Sagittal Balance in Normal Asymptomatic Individuals: A Retrospective Study in a Population of East China.

    Science.gov (United States)

    Yang, Mingyuan; Yang, Changwei; Zhai, Xiao; Zhao, Jian; Zhu, Xiaodong; Li, Ming

    2017-02-15

    A retrospective study. To determine primary contributors to sagittal balance and establish a predictive equation of sagittal balance in normal asymptomatic subjects. Sagittal balance has been verified to be associated with health-related quality of life. Although many studies have been performed to explore factors contributing to sagittal balance in various disease states, no study has been conducted in normal asymptomatic subjects in East China. Medical records of 340 asymptomatic healthy volunteers were reviewed from January 2014 to August 2015, including 311 for exploring the risk factors and predictive equation, and 29 for validation. Demographic and radiological parameters were evaluated. Correlation analysis between spinopelvic parameters was pursued. Regression analyses were performed to establish predictive radiographic parameters for sagittal balance. Paired t test was conducted to test the regression equation. There was a very good correlation between T1 sagittal angle and maxTK, maxLL and SS, SS and PI, and PT and PI; a moderate correlation between maxTK and maxLL, and maxLL and PI; a weak correlation between T1 sagittal angle and age, age and maxTK, age and SS, age and PT, age and SVA, T1 sagittal angel and SVA, SVA and PT, and SVA and PI; and very weak correlation between T1 sagittal angle and maxLL, maxLL and PT, SVA and LL, and PT and SS. Age, T1 sagittal angle, maxLL, PT, and PI were primary contributors to sagittal balance, which could be predicted by the regression equation: SVA = 0.294 × age + 0.367 × T1 sagittal angle - 1.149 × maxLL-0.704 × PT + 1.378 × PI - 34.164. No significant difference was found between actual SVA and predicted SVA using our equation (P = 0.307). Age, T1 sagittal angle, maxLL, PT, and PI were primary contributors to maintaining sagittal balance in normal asymptomatic subjects, and sagittal balance could be predicted by calculation using the equation derived in this study. 2.

  5. Planar magnetic structures in coronal mass ejection-driven sheath regions

    Directory of Open Access Journals (Sweden)

    E. Palmerio

    2016-02-01

    Full Text Available Planar magnetic structures (PMSs are periods in the solar wind during which interplanetary magnetic field vectors are nearly parallel to a single plane. One of the specific regions where PMSs have been reported are coronal mass ejection (CME-driven sheaths. We use here an automated method to identify PMSs in 95 CME sheath regions observed in situ by the Wind and ACE spacecraft between 1997 and 2015. The occurrence and location of the PMSs are related to various shock, sheath, and CME properties. We find that PMSs are ubiquitous in CME sheaths; 85 % of the studied sheath regions had PMSs with the mean duration of 6 h. In about one-third of the cases the magnetic field vectors followed a single PMS plane that covered a significant part (at least 67 % of the sheath region. Our analysis gives strong support for two suggested PMS formation mechanisms: the amplification and alignment of solar wind discontinuities near the CME-driven shock and the draping of the magnetic field lines around the CME ejecta. For example, we found that the shock and PMS plane normals generally coincided for the events where the PMSs occurred near the shock (68 % of the PMS plane normals near the shock were separated by less than 20° from the shock normal, while deviations were clearly larger when PMSs occurred close to the ejecta leading edge. In addition, PMSs near the shock were generally associated with lower upstream plasma beta than the cases where PMSs occurred near the leading edge of the CME. We also demonstrate that the planar parts of the sheath contain a higher amount of strong southward magnetic field than the non-planar parts, suggesting that planar sheaths are more likely to drive magnetospheric activity.

  6. Semicircular canal plane head impulses detect absent function of individual semicircular canals.

    Science.gov (United States)

    Cremer, P D; Halmagyi, G M; Aw, S T; Curthoys, I S; McGarvie, L A; Todd, M J; Black, R A; Hannigan, I P

    1998-04-01

    We studied the human vestibulo-ocular reflex (VOR) in response to head 'impulses': brief, unpredictable, passive, high-acceleration (up to 4000 degrees/s2), low-amplitude (20-30 degrees) head rotations. We delivered the head impulses approximately in the plane of the semicircular canal (SCC) being tested. To test the anterior and posterior SCCs, the head impulses were delivered in a diagonal plane, midway between the frontal (roll) and sagittal (pitch) planes. We recorded head and eye position in three dimensions with scleral search coils in nine normal subjects, seven patients following unilateral surgical vestibular neurectomy and three patients following unilateral posterior SCC occlusion. In the post-surgical patients we demonstrated a severe, permanent VOR gain deficit (0.2-0.3) for head impulses directed toward any single non-functioning SCC. The sensitivity of the test depends on the physiological properties of primary vestibular afferents, and its specificity depends on the anatomical orientation of the SCCs. The diagonal head impulse is the first test of individual vertical SCC function in humans, and together with the horizontal head impulse, forms a comprehensive battery of SCC-plane tests. These canal-plane impulses could be useful in evaluating patients with vertigo or other vestibular disorders.

  7. Plane waves as tractor beams

    Science.gov (United States)

    Forgács, Péter; Lukács, Árpád; Romańczukiewicz, Tomasz

    2013-12-01

    It is shown that in a large class of systems, plane waves act as tractor beams: i.e., an incident plane wave can exert a pulling force on the scatterer. The underlying physical mechanism for the pulling force is due to the sufficiently strong scattering of the incoming wave into another mode carrying more momentum, in which case excess momentum is created behind the scatterer. This tractor beam or negative radiation pressure (NRP) effect, is found to be generic in systems with multiple scattering channels. In a birefringent medium, electromagnetic plane waves incident on a thin plate exert NRP of the same order of magnitude as optical radiation pressure, while in artificial dielectrics (metamaterials), the magnitude of NRP can even be macroscopic. In two dimensions, we study various scattering situations on vortices, and NRP is shown to occur by the scattering of heavy baryons into light leptons off cosmic strings, and by neutron scattering off vortices in the XY model.

  8. Coronal and apical sealing ability of a new endodontic cement

    Science.gov (United States)

    Zafar, Morvarid; Iravani, Maryam; Eghbal, Mohammad Jafar; Asgary, Saeed

    2009-01-01

    INTRODUCTION: This in vitro study aims to evaluate the coronal and apical sealing ability of gutta-percha (GP) root filling used with either mineral trioxide aggregate (MTA), new endodontic cement (NEC) or AH26 as filler/sealers. MATERIALS AND METHODS: Forty eight single-rooted extracted teeth were selected, decoronated and then instrumented. Samples were randomly divided into three experimental (n=12) and two control groups (n=6). In group 1, root canals were filled using lateral condensation technique (L); while single cone technique (S) was used for groups 2 and 3. AH26, MTA and NEC were the root canal sealer/fillers in groups 1, 2 and 3, respectively. Samples were immersed in 1% methylene-blue dye and then independently centrifuged apically and coronally. The roots were split longitudinally and linear extent of dye penetration was measured with a stereomicroscope from apical and coronal directions. Data were analyzed using One-way ANOVA and T-test. RESULTS: No statistical differences in mean apical dye penetration between groups LGP/AH26, SGP/MTA and SGP/NEC were found; SGP/NEC group showed significantly less coronal dye penetration (P<0.001). CONCLUSION: Considering the limitations of this in vitro study, it was concluded that the simple single cone technique with NEC can provide favorable coronal and apical seal. PMID:23864871

  9. Surgical outcome after using a modified technique of the pi-procedure for posterior sagittal suture closure

    NARCIS (Netherlands)

    Engel, M.; Freudlsperger, C.; Hoffmann, J.; Muhling, J.; Castrillon-Oberndorfer, G.; Seeberger, R.

    2012-01-01

    Fusion of the sagittal suture is the most prevalent form of craniosynostosis. Due to the variety of deformities of scaphocephaly depending on the location of the fused sagittal suture, the surgical procedure has to be adjusted to the individual case. In this study, 38 patients with a predominantly

  10. Comparative Study of Skeletal Stability between Postoperative Skeletal Intermaxillary Fixation and No Skeletal Fixation after Bilateral Sagittal Split Ramus Osteotomy

    DEFF Research Database (Denmark)

    Hartlev, Jens; Godtfredsen, Erik; Andersen, Niels Trolle

    2014-01-01

    OBJECTIVES: The purpose of the present study was to evaluate skeletal stability after mandibular advancement with bilateral sagittal split osteotomy. MATERIAL AND METHODS: Twenty-six patients underwent single-jaw bilateral sagittal split osteotomy (BSSO) to correct skeletal Class II malocclusion....

  11. The additional value of an oblique image plane for MRI of the anterior and posterior distal tibiofibular syndesmosis

    Energy Technology Data Exchange (ETDEWEB)

    Hermans, John J.; Ginai, Abida Z.; Wentink, Noortje [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Hop, Wim C.J. [Erasmus University Medical Center, Department of Epidemiology and Biostatistics, Rotterdam (Netherlands); Beumer, Annechien [Amphia Ziekenhuis, Department of Orthopaedics, Upper Limb Unit, Breda (Netherlands)

    2011-01-15

    The optimal MRI scan planes of collateral ligaments of the ankle have been described extensively, with the exception of the syndesmotic ligaments. We assessed the optimal scan plane for depicting the distal tibiofibular syndesmosis. In order to determine the optimal oblique caudal-cranial and lateral-medial MRI scan plane, two fresh frozen cadaveric ankles were used. The angle of the scan plane that demonstrated the anterior and posterior distal tibiofibular ligament uninterrupted in their full length was determined. In a prospective study this oblique scan plane was then used in addition to the axial and coronal planes, for MRI scans of both ankles in 21 healthy volunteers. Two observers independently evaluated the anterior tibiofibular ligament (ATIFL) and posterior tibiofibular ligament (PTIFL) regarding the continuity of the individual fascicles, thickness and wavy contour of the ligaments in both the axial and the oblique plane. Kappa was calculated to determine the interobserver agreement. McNemar's test was used to statistically quantify the significance of the two scan planes. In the axial plane the ATIFL was in 31% (13/42) partly and in 69% (29/42) completely discontinuous; in the oblique plane the ATIFL was continuous in 88% (37/42) and partly discontinuous in 12% (5/42). Compared with the axial plane, the oblique plane demonstrated significantly less discontinuity (p < 0.001), but not significantly less thickening (p = 1.00) or less wavy contour (p = 0.06) of the ATIFL. In the axial scan plane the PTIFL was continuous in 76% (32/42), partially discontinuous in 19% (8/42) and completely discontinuous in 5% (2/42); in the oblique plane the PTIFL was continuous in 100% (42/42). Compared with the axial plane, the oblique plane demonstrated significantly less discontinuity (p = 0.002), but not significantly less thickening (p = 1.00) or less wavy contour (p = 0.50) of the PTIFL. The interobserver agreement score and kappa ({kappa}) regarding the

  12. Plane waves in noncommutative fluids

    Energy Technology Data Exchange (ETDEWEB)

    Abdalla, M.C.B., E-mail: mabdalla@ift.unesp.br [Instituto de Física Teórica, UNESP, Universidade Estadual Paulista, Rua Dr. Bento Teobaldo Ferraz 271, Bloco 2, Barra-Funda, Caixa Postal 70532-2, 01156-970, São Paulo, SP (Brazil); Holender, L., E-mail: holender@ufrrj.br [Grupo de Física Teórica e Matemática Física, Departamento de Física, Universidade Federal Rural do Rio de Janeiro (UFRRJ), Cx. Postal 23851, BR 465 Km 7, 23890-000 Seropédica, RJ (Brazil); Santos, M.A., E-mail: masantos@cce.ufes.br [Departamento de Física e Química, Universidade Federal do Espírito Santo (UFES), Avenida Fernando Ferarri S/N, Goiabeiras, 29060-900 Vitória, ES (Brazil); Vancea, I.V., E-mail: ionvancea@ufrrj.br [Grupo de Física Teórica e Matemática Física, Departamento de Física, Universidade Federal Rural do Rio de Janeiro (UFRRJ), Cx. Postal 23851, BR 465 Km 7, 23890-000 Seropédica, RJ (Brazil)

    2013-08-01

    We study the dynamics of the noncommutative fluid in the Snyder space perturbatively at the first order in powers of the noncommutative parameter. The linearized noncommutative fluid dynamics is described by a system of coupled linear partial differential equations in which the variables are the fluid density and the fluid potentials. We show that these equations admit a set of solutions that are monochromatic plane waves for the fluid density and two of the potentials and a linear function for the third potential. The energy–momentum tensor of the plane waves is calculated.

  13. Sagittal range of motion after a spinal fracture : does ROM correlate with functional outcome?

    NARCIS (Netherlands)

    Post, RB; Leferink, VJM

    2004-01-01

    Literature regarding the effect of a spinal fracture and its treatment in terms of resulting spinal range of motion (ROM) is scarce. However, there is need for data regarding sagittal spinal ROM, since many patients who sustain a spinal fracture are concerned about the back mobility they will have

  14. Postoperative change in sagittal balance after Kyphoplasty for the treatment of osteoporotic vertebral compression fracture.

    Science.gov (United States)

    Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Kawabata, Shinji; Kuroiwa, Toshihiko

    2015-04-01

    The influence of vertebral cement augmentation on spinal sagittal balance is unknown. The present study aimed to analyze the changes in total spinal alignment after Kyphoplasty in VCF patients. The study involved 21 VCF patients who underwent Kyphoplasty. In all patients, lateral radiographs of the entire spine were taken preoperatively and 1 month after surgery, to measure the pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), sagittal vertical axis (SVA), and spinosacral angle (SSA). These parameters were compared between VCF patients and 30 healthy volunteers. In VCF patients, the parameters were compared before and after Kyphoplasty. In VCF patients, preoperative SVA was 7.00 ± 3.9 cm, showing a significant shift to anterior sagittal balance as compared to the healthy group (1.45 ± 2.7 cm) (P Kyphoplasty, SVA decreased to 5.02 ± 2.91 (P = 0.0007) and LL and SSA increased (LL P = 0.028; SSA P = 0.0031). Postoperative decrease of SVA was correlated with the kyphotic change of treated vertebra (r = 0.792, P Kyphoplasty to 2.38 ± 2.3 postoperatively (P Kyphoplasty plays a role not only in reducing pain associated with fractures but also in improving sagittal imbalance in the treatment of painful vertebral compression fracture.

  15. Comparison of radiological spino-pelvic sagittal parameters in skiers and non-athletes.

    Science.gov (United States)

    Todd, Carl; Kovac, Peter; Swärd, Anna; Agnvall, Cecilia; Swärd, Leif; Karlsson, Jon; Baranto, Adad

    2015-10-17

    The purpose of the present study is to compare the radiological parameters of the spino-pelvic sagittal alignment in young elite skiers and non-athletes of a similar age. The sample group (n = 102) consisted of elite Alpine and Mogul skiers (n = 75) and a non-athletic population (n = 27), mean age for both groups was 17.7 (±1.4) years (skiers mean age 18.3 SD 1.1 and controls 16.4 SD 0.6). Radiological measurements of the spino-pelvic sagittal alignment were examined from plain radiographs taken in the long-standing position. There were no significant differences reported in the pelvic parameters between both groups. A difference was reported in the sagittal vertebral axis between skiers (8.0 cm SD 46.0) and the control group (-2.0 cm SD 39.0), which may be of clinical significance, in spite of being statistically non-significant. Type I spinal curves according to Roussouly were shown to be more prevalent in the skiers (18.2%) compared with the control group (0.0%) and were statistically significant (p = 0.03). Elite young skiers are shown to have a more prevalent type I spine and a different spino-pelvic sagittal alignment compared to a healthy non-sporting population of a similar age.

  16. INFLUENCE OF THE SAGITTAL BALANCE ON THE CLINICAL OUTCOME IN SPINAL FUSION

    Directory of Open Access Journals (Sweden)

    Marcela Almeida Campos Coutinho

    2016-03-01

    Full Text Available ABSTRACT Objective: Evaluates which radiographic parameters of the sagittal and spinopelvic balance influence the clinical and functional outcomes of a sample of patients undergoing spinal fusion. Methods: We studied 32 patients who underwent spinal fusion. Radiographs of the total spine were obtained from all patients. The clinical and functional parameters studied were analysis of pain by visual analogic scale (VAS and Oswestry and SRS-30 questionnaires. We analyzed the correlation between the clinical and functional parameters and radiographic parameters of the sagittal and spinopelvic balance. Results: There was no significant correlation between parameters pelvic incidence (PI, pelvic tilt (PT, lumbar lordosis (LL and difference between PI and LL (PI-LL and clinical parameters (p > 0.05 and r <0.2. Significant correlation were identified only between Sagittal Vertical Axis (SVA and Satisfaction with Treatment domain of SRS-30 (r = 0.402 e p = 0.023 and between thoracic kyphosis (TK and the total SRS-30 (r = 0.419 and p = 0.017. Conclusions: According to the study results, it was not possible to precisely characterize the role of the parameters of the sagittal and spinopelvic balance in the post-operative analysis of the clinical outcome of spinal fusion. There was a significant correlation only between SVA and the Satisfaction with Treatment domain of SRS-30 and between TK and total SRS-30.

  17. Effect of Cervical Sagittal Balance on Laminoplasty in Patients With Cervical Myelopathy.

    Science.gov (United States)

    Kato, Minori; Namikawa, Takashi; Matsumura, Akira; Konishi, Sadahiko; Nakamura, Hiroaki

    2017-04-01

    Retrospective clinical study. We evaluated the relationship between cervical sagittal alignment parameters and clinical status in patients with cervical myelopathy and analyzed the effect of cervical sagittal balance on cervical laminoplasty. Patients with cervical myelopathy (n = 110) who underwent laminoplasty were included in this study. The relationship between cervical sagittal alignment parameters and clinical status was evaluated. The changes in radiographic cervical sagittal parameters and clinical status 2 years after surgery were compared between patients with preoperative C2-7 SVA ≥35 mm (group A) and those with preoperative C2-7 SVA SVA had no correlation with defined health-related quality of life evaluation scores. At 2-year follow-up, the improvement in SF-36 physical component summary was significantly lower in group A than in group B. The postoperative change of C2-7 SVA did not significantly differ in 2 groups. Patients in group A maintained cervical regional balance after laminoplasty but experienced extensive postoperative neck pain. Our patients with a C2-7 SVA of ≥35 mm maintained cervical regional balance after laminoplasty and their improvement in myelopathy was equivalent to that in patients with a C2-7 SVA of SVA of ≥35 mm experienced severe postoperative neck pain. C2-7 SVA is a parameter worth considering because it can lead to poor QOL and axial neck pain after laminoplasty.

  18. Comparison of Sagittal Spinopelvic Alignment between Lumbar Degenerative Spondylolisthesis and Degenerative Spinal Stenosis.

    Science.gov (United States)

    Lim, Jae Kwan; Kim, Sung Min

    2014-06-01

    The purpose of this study was to evaluate the differences in sagittal spinopelvic alignment between lumbar degenerative spondylolisthesis (DSPL) and degenerative spinal stenosis (DSS). Seventy patients with DSPL and 72 patients with DSS who were treated with lumbar interbody fusion surgery were included in this study. The following spinopelvic parameters were measured on whole spine lateral radiographs in a standing position : pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis angle (LL), L4-S1 segmental lumbar angle (SLL), thoracic kyphosis (TK), and sagittal vertical axis from the C7 plumb line (SVA). Two groups were subdivided by SVA value, respectively. Normal SVA subgroup and positive SVA subgroup were divided as SVA value (SVA of DSPL was significantly greater than that of DSS (p=0.001). In sub-group analysis between the positive (34.3%) and normal SVA (65.7%), there were significant differences in LL/PI and SLL/PI (pSVA (87.5%), there were significant differences in PT/PI, SS/PI, LL/PI and SLL/PI ratios (p<0.05) in the DSS group. Patients with lumbar degenerative spondylolisthesis have the propensity for sagittal imbalance and higher pelvic incidence compared with those with degenerative spinal stenosis. Sagittal imbalance in patients with DSPL is significantly correlated with the loss of lumbar lordosis, especially loss of segmental lumbar lordosis.

  19. [Progressive Intracranial Hypertension due to Superior Sagittal Sinus Thrombosis Following Mild Head Trauma: A Case Report].

    Science.gov (United States)

    Suto, Yuta; Maruya, Jun; Watanabe, Jun; Nishimaki, Keiichi

    2015-07-01

    Cerebral venous sinus thrombosis after mild head trauma without skull fracture or intracranial hematoma is exceptionally rare. We describe an unusual case of progressive intracranial hypertension due to superior sagittal sinus thrombosis following mild head trauma. A 17-year-old boy presented with nape pain a day after a head blow during a gymnastics competition (backward double somersault). On admission, he showed no neurological deficit. CT scans revealed no skull fractures, and there were no abnormalities in the brain parenchyma. However, his headache worsened day-by-day and he had begun to vomit. Lumbar puncture was performed on Day 6, and the opening pressure was 40 cm of water. After tapping 20 mL, he felt better and the headache diminished for a few hours. MR venography performed on Day 8 revealed severe flow disturbance in the posterior third of the superior sagittal sinus with multiple venous collaterals. Because of the beneficial effects of lumbar puncture, we decided to manage his symptoms of intracranial hypertension conservatively with repeated lumbar puncture and administration of glycerol. After 7 days of conservative treatment, his symptoms resolved completely, and he was discharged from the hospital. Follow-up MR venography performed on Day 55 showed complete recanalization of the superior sagittal sinus. The exact mechanism of sinus thrombosis in this case is not clear, but we speculate that endothelial damage caused by shearing stress because of strong rotational acceleration or direct impact to the superior sagittal sinus wall may have initiated thrombus formation.

  20. Cost, operation and hospitalization times in distraction osteogenesis versus sagittal split osteotomy

    NARCIS (Netherlands)

    van Strijen, P. J.; Breuning, K. H.; Becking, A. G.; Perdijk, F. B. T.; Tuinzing, D. B.

    2003-01-01

    Distraction osteogenesis in 'common' surgical orthodontics is mentioned as an alternative for conventional sagittal split osteotomy. After a 'learning curve' in the surgical skills of distraction, the two techniques can be compared concerning time and cost aspects. Forty-seven patients (male n=28,

  1. Soft tissue profile changes after bilateral sagittal split osteotomy for mandibular setback: a systematic review.

    NARCIS (Netherlands)

    Joss, C.U.; Joss-Vassalli, I.M.; Berge, S.J.; Kuijpers-Jagtman, A.M.

    2010-01-01

    PURPOSE: To evaluate the ratio of soft tissue to hard tissue in bilateral sagittal split setback osteotomy with rigid internal fixation or wire fixation. MATERIALS AND METHODS: A literature search was performed using PubMed, Medline, CINAHL, Web of Science, the Cochrane Library, and Google Scholar

  2. Long term stability of mandibular advancement procedures : bilateral sagittal split osteotomy versus distraction osteogenesis

    NARCIS (Netherlands)

    Baas, E. M.; Pijpe, J.; de Lange, J.

    The aim of this study was to compare the postoperative stability of the mandible after a bilateral lengthening procedure, either by bilateral sagittal split osteotomy (BSSO) or distraction osteogenesis (DO). All patients who underwent mandibular advancement surgery between March 2001 and June 2004

  3. Stability of mandibular advancement procedures: bilateral sagittal split osteotomy versus distraction osteogenesis

    NARCIS (Netherlands)

    Vos, M.D.; Baas, E.M.; de Lange, J.; Bierenbroodspot, F.

    2009-01-01

    The aim of this study was to compare the postoperative stability of the mandible after a bilateral lengthening procedure, either by bilateral sagittal split osteotomy (BSSO) or distraction osteogenesis (DOG). All patients who underwent mandibular advancement surgery between March 2001 and June 2004

  4. Assessment of masticatory function in patients with non-sagittal occlusal discrepancies.

    Science.gov (United States)

    Choi, T-H; Kim, B-I; Chung, C J; Kim, H-J; Baik, H-S; Park, Y-C; Lee, K-J

    2015-01-01

    Non-sagittal occlusal discrepancies such as posterior cross-bite and anterior openbite are common types of malocclusion, but studies on masticatory function related to those malocclusions have been scarce. The aim of this study was to quantify the masticatory performance in patients with non-sagittal discrepancies compared to those with normal occlusion, using both objective and subjective measures. Maximum bite force and contact area using Dental Prescale(®) system as a static objective assessment, Mixing Ability Index (MAI) as a dynamic objective evaluation and food intake ability (FIA) as a subjective assessment were analysed from 21 people in normal occlusion (Group N) and 64 patients with posterior cross-bite (Group C), anterior openbite (Group O) or both (Group B). The differences of the maximum bite force, the contact area, the MAI and the FIA were compared, and their correlations were figured out. The non-sagittal malocclusion groups showed lower values in the maximum bite force, the contact area, the MAI and the FIA compared to those in the normal group (P masticatory function in patients with non-sagittal discrepancies is significantly reduced both objectively and subjectively. © 2014 John Wiley & Sons Ltd.

  5. Comparison of Asymmetric and Ice-cream Cone Models for Halo Coronal Mass Ejections

    Science.gov (United States)

    Na, H.; Moon, Y.

    2011-12-01

    Halo coronal mass ejections (HCMEs) are major cause of the geomagnetic storms. To minimize the projection effect by coronagraph observation, several cone models have been suggested: an ice-cream cone model, an asymmetric cone model etc. These models allow us to determine the three dimensional parameters of HCMEs such as radial speed, angular width, and the angle between sky plane and central axis of the cone. In this study, we compare these parameters obtained from different models using 48 well-observed HCMEs from 2001 to 2002. And we obtain the root mean square error (RMS error) between measured projection speeds and calculated projection speeds for both cone models. As a result, we find that the radial speeds obtained from the models are well correlated with each other (R = 0.86), and the correlation coefficient of angular width is 0.6. The correlation coefficient of the angle between sky plane and central axis of the cone is 0.31, which is much smaller than expected. The reason may be due to the fact that the source locations of the asymmetric cone model are distributed near the center, while those of the ice-cream cone model are located in a wide range. The average RMS error of the asymmetric cone model (85.6km/s) is slightly smaller than that of the ice-cream cone model (87.8km/s).

  6. Extreme-ultraviolet observations of global coronal wave rotation

    Energy Technology Data Exchange (ETDEWEB)

    Attrill, G. D. R. [Defence Science and Technology Laboratory, Dstl Porton Down, Salisbury, Wiltshire SP4 0JQ (United Kingdom); Long, D. M.; Green, L. M.; Harra, L. K.; Van Driel-Gesztelyi, L., E-mail: gdrattrill@dstl.gov.uk [University College London, Mullard Space Science Laboratory, Holmbury St. Mary, Dorking, Surrey RH5 6NT (United Kingdom)

    2014-11-20

    We present evidence of global coronal wave rotation in EUV data from SOHO/EIT, STEREO/EUVI, and SDO/AIA. The sense of rotation is found to be consistent with the helicity of the source region (clockwise for positive helicity, anticlockwise for negative helicity), with the source regions hosting sigmoidal structures. We also study two coronal wave events observed by SDO/AIA where no clear rotation (or sigmoid) is observed. The selected events show supporting evidence that they all originate with flux rope eruptions. We make comparisons across this set of observations (both with and without clear sigmoidal structures). On examining the magnetic configuration of the source regions, we find that the nonrotation events possess a quadrupolar magnetic configuration. The coronal waves that do show a rotation originate from bipolar source regions.

  7. Solar transition region and coronal response to heating rate perturbations

    Science.gov (United States)

    Mariska, John T.

    1987-01-01

    Observations of Doppler shifts in UV emission lines formed in the solar transition region show continual plasma downflows and impulsive plasma upflows. Using numerical simulations, the authors examine the conjecture that areas of downflowing plasma are the base regions of coronal loops in which the heating is gradually decreasing and that areas of upflowing plasma are the base regions of coronal loops in which the heating rate is gradually increasing. Beginning with a coronal loop in equilibrium, the heating rate is reduced on time scales of 100, 1000, and 2000 s to 10 percent and 1 percent of the initial value, and the loop is allowed to evolve to a new equilibrium. The heating rate for the cooled models is then increased back to the initial value on the same time scales. While significant mass motions do develop in the simulations, both the emission measure and the velocity at 100,000 K do not show the characteristics present in UV observations.

  8. Coronal Loop Evolution Observed with AIA and Hi-C

    Science.gov (United States)

    Mulu-Moore, Fana; Winebarger, A.; Cirtain, J.; Kobayashi, K.; Korreck, K.; Golub, L.; Kuzin. S.; Walsh, R.; DeForest, C.; DePontieu, B.; hide

    2012-01-01

    Despite much progress toward understanding the dynamics of the solar corona, the physical properties of coronal loops are not yet fully understood. Recent investigations and observations from different instruments have yielded contradictory results about the true physical properties of coronal loops. In the past, the evolution of loops has been used to infer the loop substructure. With the recent launch of High Resolution Coronal Imager (Hi-C), this inference can be validated. In this poster we discuss the first results of loop analysis comparing AIA and Hi-C data. We find signatures of cooling in a pixel selected along a loop structure in the AIA multi-filter observations. However, unlike previous studies, we find that the cooling time is much longer than the draining time. This is inconsistent with previous cooling models.

  9. Multiplanar sinus CT: a systematic approach to imaging before functional endoscopic sinus surgery.

    Science.gov (United States)

    Hoang, Jenny K; Eastwood, James D; Tebbit, Christopher L; Glastonbury, Christine M

    2010-06-01

    The purpose of this essay is to present a systematic approach to the use of coronal, axial, and sagittal images for CT evaluation of the sinuses before functional endoscopic sinus surgery (FESS). We present a systematic approach to the use of coronal, axial, and sagittal images in CT evaluation before FESS. Each imaging plane is valuable for displaying anatomic variants, which can predispose a patient to recurrent disease and affect the surgical approach, and critical variants, which can make surgery hazardous.

  10. Radiologic features of dropped head syndrome in the overall sagittal alignment of the spine.

    Science.gov (United States)

    Hashimoto, Kazuki; Miyamoto, Hiroshi; Ikeda, Terumasa; Akagi, Masao

    2017-06-10

    Dropped head syndrome (DHS) is a rare clinical entity which is defined as a chin-on-chest deformity in the standing or sitting position, resulting from sagittal imbalance of the cervical region. The purpose of the present study was to clarify the radiologic features of DHS in the overall sagittal alignment of the spine. We also investigated the changes in sagittal alignment after correction surgery for DHS. Twenty DHS patients [1 male and 19 female, with an average age of 78.9 years (range 59-88)] with a main complaint of horizontal gaze disorder were enrolled in this study. Spino-pelvic lateral radiographs in the free-standing clavicle position were taken of all patients. Parameters such as sagittal vertical axis (SVA), C2-7 angle, clivo-axial angle (CAA), C2-7 SVA, T1 slope, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured, and the radiologic features of DHS in the overall sagittal alignment of the spino-pelvis were investigated. Eight patients underwent correction surgery, and the parameter changes between pre- and post-operative radiographs were also examined. DHS appeared to have two distinct types: SVA+ and SVA-. Seven of 20 cases were SVA+, and 13 were SVA-. The radiologic parameters in which we found statistically significant differences between the groups were: 80.2 ± 68 and -44.5 ± 40 (SVA), 42.1 ± 16.8 and 18.4 ± 11.4 (T1 slope), and 21.1 ± 19.2 and 44.2 ± 19.8 (LL) in SVA+ and SVA-, respectively. After surgical intervention, T1 slope and LL appeared to approach normal in the SVA- group, because compensation at downward spine was no longer necessary. In SVA+ group, although the patients gained horizontal gaze after surgery, abnormality of the sagittal alignment in the whole spine remained, because compensation in the thoracic and lumbar spine was still insufficient. The present study has indicated that radiologic feature of DHS in the sagittal alignment of the

  11. A review of methods for evaluating the quantitative parameters of sagittal pelvic alignment.

    Science.gov (United States)

    Vrtovec, Tomaž; Janssen, Michiel M A; Likar, Boštjan; Castelein, René M; Viergever, Max A; Pernuš, Franjo

    2012-05-01

    The sagittal alignment of the pelvis represents the basic mechanism for maintaining postural equilibrium, and a number of methods were developed to assess normal and pathologic pelvic alignments from two-dimensional sagittal radiographs in terms of positional and anatomic parameters. To provide a complete overview of the existing methods for quantitative evaluation of sagittal pelvic alignment and summarize the relevant publications. Review article. An Internet search for terms related to sagittal pelvic alignment was performed to obtain relevant publications, which were further supplemented by selected publications found in their lists of references. By summarizing the obtained publications, the positional and anatomic parameters of sagittal pelvic alignment were described, and their values and relationships to other parameters and features were reported. Positional pelvic parameters relate to the position and orientation of the observed subject and are represented by the sacral slope, pelvic tilt, pelvic overhang, sacral inclination, sacrofemoral angle, sacrofemoral distance, pelvic femoral angle, pelvic angle, and sacropelvic translation. Anatomic pelvic parameters relate to the anatomy of the observed subject and are represented by the pelvisacral angle (PSA), pelvic incidence (PI), pelvic thickness (PTH), sacropelvic angle (PRS1), pelvic radius (PR), femorosacral posterior angle (FSPA), sacral table angle (STA), and sacral anatomic orientation (SAO). The review was mainly focused on the evaluation of anatomic pelvic parameters, as they can be compared among subjects and therefore among different studies. However, ambiguous results were yielded for normal and pathologic subjects, as the reported values show a relatively high variability in terms of standard deviation for every anatomic parameter, which amounts to around 10 mm for PTH and PR; 10° for PSA, PI, and SAO; 9° for PRS1 and FSPA; and 5° for STA in the case of normal subjects and is usually even

  12. Force Lines in Plane Stress

    DEFF Research Database (Denmark)

    Rathkjen, Arne

    A state of plane stress is illustrated by means of two families of curves, each family representing constant values of a derivative of Airy's stress function. The two families of curves form a map giving in the first place an overall picture of regions of high and low stress, and in the second pl...

  13. Plane and parabolic solar panels

    OpenAIRE

    Sales, J. H. O.; Suzuki, A. T.

    2009-01-01

    We present a plane and parabolic collector that absorbs radiant energy and transforms it in heat. Therefore we have a panel to heat water. We study how to increment this capture of solar beams onto the panel in order to increase its efficiency in heating water.

  14. Algebraic Methods in Plane Geometry

    Indian Academy of Sciences (India)

    Srimath

    group, taxicab number, Carmi- chael number. Algebraic Methods in Plane Geometry. 2. Cubic Curves. Shailesh A Shirali. Shailesh Shirali heads a. Community Mathematics. Center at Rishi Valley. School (KFI). He has a ..... Ian Stewart and David Tall, Algebraic Number Theory and Fermat's Last. Theorem, A K Peters, 2002.

  15. Normal variation in sagittal spinal alignment parameters in adult patients: an EOS study using serial imaging.

    Science.gov (United States)

    Hey, Hwee Weng Dennis; Tan, Kian Loong Melvin; Moorthy, Vikaesh; Lau, Eugene Tze-Chun; Lau, Leok-Lim; Liu, Gabriel; Wong, Hee-Kit

    2018-01-13

    To describe normal variations in sagittal spinal radiographic parameters over an interval period and establish physiological norms and guidelines for which these images should be interpreted. Data were prospectively collected from a continuous series of adult patients with first-episode mild low back pain presenting to a single institution. The sagittal parameters of two serial radiographic images taken 6-months apart were obtained with the EOS® slot scanner. Measured parameters include CL, TK, TL, LL, PI, PT, SS, and end and apical vertebrae. Chi-squared test and Wilcoxon Signed Rank test were used to compare categorical and continuous variables, respectively. Sixty patients with a total of 120 whole-body sagittal X-rays were analysed. Mean age was 52.1 years (SD 21.2). Mean interval between the first and second X-rays was 126.2 days (SD 47.2). Small variations (< 1°) occur for all except PT (1.2°), CL (1.2°), and SVA (2.9 cm). Pelvic tilt showed significant difference between two images (p = 0.035). Subgroup analysis based on the time interval between X-rays, and between the first and second X-rays, did not show significant differences. Consistent findings were found for end and apical vertebrae of the thoracic and lumbar spine between the first and second X-rays for sagittal curve shapes. Radiographic sagittal parameters vary between serial images and reflect dynamism in spinal balancing. SVA and PT are predisposed to the widest variation. SVA has the largest variation between individuals of low pelvic tilt. Therefore, interpretation of these parameters should be patient specific and relies on trends rather than a one-time assessment.

  16. Postoperative cervical sagittal imbalance negatively affects outcomes following surgery for cervical spondylotic myelopathy

    Science.gov (United States)

    Roguski, Marie; Benzel, Edward C.; Curran, Jill N.; Magge, Subu N.; Bisson, Erica F.; Krishnaney, Ajit A.; Steinmetz, Michael P.; Butler, William E.; Heary, Robert F.; Ghogawala, Zoher

    2014-01-01

    Study Design Prospective observational cohort study Objective To determine if postoperative cervical sagittal balance is an independent predictor of HR-QOL outcome following surgery for CSM. Summary of Background Data Both ventral and dorsal fusion procedures for cervical spondylotic myelopathy (CSM) are effective at reducing the symptoms of myelopathy. The importance of cervical sagittal balance in predicting overall HR-QOL outcome following ventral versus dorsal surgery for CSM has not been previously explored. Methods A prospective, nonrandomized cohort of 49 patients undergoing dorsal and ventral fusion surgery for CSM was examined. Preoperative and postoperative C2-C7 sagittal vertical axis (SVA) was measured on standing lateral cervical spine radiographs. Outcome was assessed with two disease-specific measures – the mJOA scale and the Oswestry NDI- and two generalized outcome measures – the SF-36 PCS and EQ-5D. Assessments were performed preoperatively, and at 3 months, 6 months, and 1 year postoperatively. Statistical analyses were performed using SAS v.9.3 (Cary, NC). Results Most patients experienced improvement in all outcome measures regardless of approach. Both preoperative and postoperative C2-C7 SVA measurements were independent predictors of clinically significant improvement in SF-36 PCS scores (p=0.03 and p=0.02). The majority of patients with C2-C7 SVA values greater than 40mm did not improve from an overall HR-QOL perspective (SF-36 PCS) despite improvement in myelopathy. The postoperative sagittal balance value was inversely correlated with a clinically significant improvement of SF-36 PCS scores in patients undergoing dorsal surgery but not ventral surgery (p=0.03 vs. p=0.93). Conclusions Preoperative and postoperative sagittal balance measurements independently predict clinical outcomes following surgery for CSM. PMID:25419682

  17. Discrepancy Between Standing Posture and Sagittal Balance During Walking in Adult Spinal Deformity Patients.

    Science.gov (United States)

    Arima, Hideyuki; Yamato, Yu; Hasegawa, Tomohiko; Togawa, Daisuke; Kobayashi, Sho; Yasuda, Tatsuya; Banno, Tomohiro; Oe, Shin; Matsuyama, Yukihiro

    2017-01-01

    Retrospective case series. The present study aimed to determine the characteristics of patients with adult spinal deformity (ASD) with a discrepancy between standing and walking postures. Standing radiographic parameters are typically used to evaluate patients with ASD. Patients with ASD with relatively good sagittal alignment on standing radiography have, however, been reported to walk with a forward trunk tilt. Patients with ASD (n = 93; 13 men, 80 women; mean age, 65.0 yr) who underwent corrective surgery and preoperative gait analysis at our hospital between 2011 and 2013 were included. Spine radiographs and gait analysis data were acquired preoperatively. Standing-trunk tilt angle (STA) on lateral standing x-ray, gait-trunk tilt angle (GTA) from lateral gait images, and radiographic parameters of the spine and pelvis (lumbar lordosis [LL], pelvic tilt, and sagittal vertical axis) were measured. We calculated the increasing trunk tilt angle (ITA), by subtracting the STA from the GTA, for use as an index of discrepancy between standing posture and sagittal balance during walking. We examined the relation between radiographic parameters and ITA. The mean preoperative STA and GTA were 3.5° and 11.1°, respectively. The mean preoperative ITA, which represents the degree of discrepancy between standing posture and sagittal balance during walking, was 7.6°. The mean preoperative sagittal vertical axis, LL, pelvic incidence (PI), pelvic tilt, and PI minus LL were 102.6 mm, 20.3°, 52.9°, 32.1°, and 32.6°, respectively. The PI minus LL mismatch was positively correlated with the ITA (R = 0.237, P = 0.023). In particular, patients with ASD with a PI minus LL mismatch of more than 40° had a significantly greater ITA. Gait analysis revealed that a preoperative standing-walking discrepancy is associated with severe PI - LL mismatch. 4.

  18. The Influence of Natural Head Position on the Cervical Sagittal Alignment

    Science.gov (United States)

    Wang, Kuan; Deng,, Zhen; Li, Zhengyan; Wang, Huihao; Zhan, Hongsheng

    2017-01-01

    This study investigated the relationship between the parameters related to the natural head position and cervical segmental angles and alignment of patients with neck pain. The lateral radiographs of the cervical spine were collected from 103 patients and were used to retrospectively analyze the correlation between the natural head position, cervical local sagittal angles, and alignment. Sagittal measurements were as follows: cervical curvature classification, slope of McGregor's line (McGS), local sagittal angles (C0–C2 angle, C2–C5 angle, C5–C7 angle, and C2–C7 angle), T1 slope, center of gravity of the head to sagittal vertical axis (CG–C7 SVA), and local sagittal alignment (C0–C2 SVA and C2–C7 SVA). McGS was significantly correlated to C0–C2 angle (r = 0.57), C0–C2 SVA (r = −0.53), C2–C7 SVA (r = −0.28), and CG–C7 SVA (r = −0.47). CG–C7 SVA was also significantly correlated to curvature type (r = 0.27), C5–C7 angle (r = −0.37), and C2–C7 angle (r = −0.39). A backward shift with an extended head position may accompany a relatively normal curvature of the cervical spine. The effect of posture control in relieving abnormal mechanical state of the cervical spine needs to be further confirmed by biomechanical analysis. 2017 Kuan Wang et al.

  19. Sagittal spinopelvic malalignment in Parkinson disease: prevalence and associations with disease severity.

    Science.gov (United States)

    Oh, Jae Keun; Smith, Justin S; Shaffrey, Christopher I; Lafage, Virginie; Schwab, Frank; Ames, Christopher P; Matsumoto, Morio; Baik, Jong Sam; Ha, Yoon

    2014-06-15

    Prospective study. Our objectives were to evaluate the prevalence of sagittal spinopelvic malalignment in a consecutive series of patients with Parkinson disease (PD) and to identify factors associated with sagittal spinopelvic deformity in this population. PD is a degenerative neurological condition characterized by tremor, rigidity, bradykinesia, and loss of postural reflexes. The prevalence of spinal deformity in PD is higher than that of age-matched adults without PD. This study was a prospective assessment of consecutive patients with PD presenting to a neurology clinic during 12 months. Inclusion criteria included age more than 21 years and diagnosis of PD. Age- and sex-matched control group was selected from patients with cervical spondylosis. Clinical and demographic factors were collected including Unified Parkinson Disease Rating Scale score and Hoehn and Yahr stage. Full-length standing spine radiographs were assessed. Patients were grouped into either low C7 sagittal vertical axis (SVA) (SVA (≥5 cm) and into matched (≤10°) or mismatched (>10°) pelvic incidence (PI)-lumbar lordosis. Eighty-nine patients met criteria (41 males/48 females), including 52 with low C7 SVA and 37 with high C7 SVA. Significantly higher prevalence of high C7 SVA was found in PD (41.6 vs. 16.8%; P SVA group was significantly older (72.4 vs. 65.1 yr; P SVA (r = 0.474). Compared with the matched (≤10°) PI-lumbar lordosis group, the mismatch PI-lumbar lordosis group had higher C7 SVA, higher PI, higher pelvic tilt, lower lumbar lordosis, and lower thoracic kyphosis (P ≤ 0.003). Patients with PD have a high prevalence of sagittal spinopelvic malalignment than control group patients. Greater severity of PD is associated with sagittal spinopelvic malalignment. 3.

  20. A Preliminary Algorithm Using Spine Measurement Software to Predict Sagittal Alignment Following Pedicle Subtraction Osteotomy

    Science.gov (United States)

    Merrill, Robert K.; Kim, Jun S.; Leven, Dante M.; Meaike, Joshua J.; Kim, Joung Heon

    2017-01-01

    Study Design: Retrospective case series. Objective: To evaluate if spine measurement software can simulate sagittal alignment following pedicle subtraction osteotomy (PSO). Methods: We retrospectively reviewed consecutive adult spinal deformity patients who underwent lumbar PSO. Sagittal measurements were performed on preoperative lateral, standing radiographs. Sagittal measurements after simulated PSO were compared to actual postoperative measurements. A regression equation was developed using cases 1-7 to determine the amount of manual rotation required of each film to match the simulated sagittal vertical axis (SVA) to the actual postoperative SVA. The equation was then applied to cases 8-13. Results: For all 13 cases, the spine software accurately simulated lumbar lordosis, pelvic incidence lumbar lordosis mismatch, and T1 pelvic angle, with no significant differences between actual and simulated measurements. The pelvic tilt (PT), sacral slope (SS), thoracolumbar alignment (TL), thoracic kyphosis (TK), T9 spino-pelvic inclination (T9SPi), T1 spino-pelvic inclination (T1SPi), and SVA were inaccurately simulated. The PT, SS, T9SPi, T1SPi, and SVA all change with manual rotation of the film, and by using the regression equation developed with cases 1-7, we were able to improve the accuracy and decrease the variability of the simulated PT, SS, T9SPi, T1SPi, and SVA for cases 8-13. Conclusions: Dedicated spine measurement software can accurately simulate certain sagittal measurements, such as LL, PI-LL, and TPA, following PSO. A number of measurements, including PT, SS, TL, TK, T9SPi, T1SPi, and SVA were inaccurately simulated. Our preliminary algorithm improved the accuracy and decreased the variability of certain measurements, but requires future prospective studies for further validation. PMID:28894684

  1. Sagittal synostosis in X-linked hypophosphatemic rickets and related diseases

    Energy Technology Data Exchange (ETDEWEB)

    Currarino, Guido [Texas Scottish Rite Hospital, Department of Radiology, Dallas, TX (United States)

    2007-08-15

    The recent observations of two new cases of X-linked hypophosphatemic rickets associated with premature closure of the sagittal suture prompted a review of similar cases seen in this institution. To review the clinical records and skull radiographs of 28 children with hypophosphatemic rickets in order to investigate the frequency and type of craniosynostosis and other cranial vault changes seen in these conditions and to review the literature for relevant findings. Clinical and imaging records were reviewed on 28 patients with hypophosphatemic rickets, all younger than 18 years. Most patients had X-linked hypophosphatemic rickets and a few had autosomal-dominant hypophosphatemic rickets or were non-familial cases. Of the 28 patients, 13 had sagittal synostosis. Dolichocephaly was present in ten patients. The configuration of the cranial vault in some of these ten patients with dolichocephaly varied somewhat from that seen in nonsyndromic sagittal synostosis. In one patient, a Chiari I malformation was demonstrated by MRI. In another patient with increased intracranial pressure the sagittal suture closure was associated with lambdoidal synostosis. Dolichocephaly was not present in three patients, suggesting that the synostosis started later than in the other patients, probably in the second year of life, a period of slower brain growth than in the first year. The two patients in this group of three showed thickening and sclerosis of the cranial vault of uncertain etiology. There is an increased risk of sagittal synostosis in hypophosphatemic rickets and related diseases in children. The appearance of the cranial vault in this type of synostosis can vary from that seen in nonsyndromic synostosis. In this setting, careful clinical and imaging follow-up is warranted. (orig.)

  2. The Influence of Natural Head Position on the Cervical Sagittal Alignment

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    Kuan Wang

    2017-01-01

    Full Text Available Introduction. This study investigated the relationship between the parameters related to the natural head position and cervical segmental angles and alignment of patients with neck pain. Material and Methods. The lateral radiographs of the cervical spine were collected from 103 patients and were used to retrospectively analyze the correlation between the natural head position, cervical local sagittal angles, and alignment. Sagittal measurements were as follows: cervical curvature classification, slope of McGregor’s line (McGS, local sagittal angles (C0–C2 angle, C2–C5 angle, C5–C7 angle, and C2–C7 angle, T1 slope, center of gravity of the head to sagittal vertical axis (CG–C7 SVA, and local sagittal alignment (C0–C2 SVA and C2–C7 SVA. Results. McGS was significantly correlated to C0–C2 angle (r=0.57, C0–C2 SVA (r=−0.53, C2–C7 SVA (r=−0.28, and CG–C7 SVA (r=−0.47. CG–C7 SVA was also significantly correlated to curvature type (r=0.27, C5–C7 angle (r=−0.37, and C2–C7 angle (r=−0.39. Conclusions. A backward shift with an extended head position may accompany a relatively normal curvature of the cervical spine. The effect of posture control in relieving abnormal mechanical state of the cervical spine needs to be further confirmed by biomechanical analysis.

  3. [CHANGE AND CLINICAL SIGNIFICANCE OF CERVICAL SPINE SAGITTAL ALIGNMENT OF ADOLESCENT IDIOPATHIC SCOLIOSIS].

    Science.gov (United States)

    Ye, Feng; Shi, Jianxiong; Hu, Jianxin; Huang, Bo; Qiu, Hao; Chu, Tongwei

    2016-03-01

    To investigate the changes and relationship of cervical spine sagittal alignment and other spinal-pelvic sagittal parameters in adolescent idiopathic scoliosis. Between July 2011 and July 2014, 35 patients with idiopathic scoliosis who met the inclusion criteria underwent posterior pedicle screw instrumentation and fusion. There were 12 males and 23 females with a mean age of 16.2 years (range, 13-20 years), including 16 cases of Lenke type 1, 7 cases of Lenke type 2, 4 cases of Lenke type 3, 3 cases of Lenke type 4, 4 cases of Lenke type 5, and 1 case of Lenke type 6. The average follow-up time was 10.9 months (range, 5-36 months). The pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), cervical lordosis (CL), T1 slope, C2 slope, C7 sagittal vertical axis (C7 SVA), C2.7 plumbline (cSVA) were measured on pre- and post-operative standing lateral X-ray film. Based on preoperative CL, the patients were divided into kyphosis group (CL > 0 degress) and lordosis group (CL 0.05). There were 17 patients in lordosis group and 18 in kyphosis group before operation. Intra-group comparisons showed significant changes in PT, PI, SS, C2 slope, and C7 SVA in lordosis group, and in PT, PI, SS, LL, CL, TK, T1 slope, and C2 slope in kyphosis group (P spine and pelvis. The change of cervical sagittal alignment has a certain correlation with the change of thoracic kyphosis. Attention to properly maintaining or restoring cervical sagittal lordosis alignment should be considered in preoperative evaluation of adolescent indiopathic scoliosis.

  4. Thermal instabilities in magnetically confined plasmas - Solar coronal loops