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Sample records for severe non-accidental head

  1. Neuroimaging for non-accidental head injury in childhood: A proposed protocol

    International Nuclear Information System (INIS)

    Jaspan, T.; Griffiths, P.D.; McConachie, N.S.; Punt, J.A.G.

    2003-01-01

    Non-accidental head injury (NAHI) is a major cause of neurological disability and death during infancy. Radiological imaging plays a crucial role in evaluating craniospinal injury, both for guiding medical management and the forensic aspects of abusive trauma. The damage sustained is varied, complex and may be accompanied by an evolving pattern of brain injury secondary to a cascade of metabolic and physiological derangements. Regrettably, many cases are poorly or incompletely evaluated leading to diagnostic errors and difficulties in executing subsequent child care or criminal proceedings. It is evident, from cases referred to the authors, that imaging protocols for NAHI are lacking (or only loosely adhered to, if present) in many centres throughout the U.K. Future research in this field will also be hampered if there is a lack of consistent and reliable radiological data. There is no nationally agreed protocol for imaging NAHI. We propose such a protocol, based upon a wide experience in the medical management of child abuse and extensive involvement in the medicolegal aspects of NAHI. Jaspan, T., et al. (2003). Clinical Radiology58, 44--53

  2. Neuroimaging for non-accidental head injury in childhood: A proposed protocol

    Energy Technology Data Exchange (ETDEWEB)

    Jaspan, T.; Griffiths, P.D.; McConachie, N.S.; Punt, J.A.G

    2003-01-01

    Non-accidental head injury (NAHI) is a major cause of neurological disability and death during infancy. Radiological imaging plays a crucial role in evaluating craniospinal injury, both for guiding medical management and the forensic aspects of abusive trauma. The damage sustained is varied, complex and may be accompanied by an evolving pattern of brain injury secondary to a cascade of metabolic and physiological derangements. Regrettably, many cases are poorly or incompletely evaluated leading to diagnostic errors and difficulties in executing subsequent child care or criminal proceedings. It is evident, from cases referred to the authors, that imaging protocols for NAHI are lacking (or only loosely adhered to, if present) in many centres throughout the U.K. Future research in this field will also be hampered if there is a lack of consistent and reliable radiological data. There is no nationally agreed protocol for imaging NAHI. We propose such a protocol, based upon a wide experience in the medical management of child abuse and extensive involvement in the medicolegal aspects of NAHI. Jaspan, T., et al. (2003). Clinical Radiology58, 44--53.

  3. Current controversies in the interpretation of non-accidental head injury

    International Nuclear Information System (INIS)

    Jaspan, Tim

    The field of non-accidental injury (NAI) has been the subject of a number of theories and hypotheses of variable merit. Concerning injuries that occur within the intracranial compartment, much research has been undertaken to investigate the cause of SDH and parenchymal brain injury. Much, however, remains contentious, particularly regarding the medicolegal aspects of suspected child abuse. Issues that present the greatest challenges will be addressed. (orig.)

  4. Current controversies in the interpretation of non-accidental head injury

    Energy Technology Data Exchange (ETDEWEB)

    Jaspan, Tim [Imaging Centre, University Hospital, Nottingham (United Kingdom)

    2008-06-15

    The field of non-accidental injury (NAI) has been the subject of a number of theories and hypotheses of variable merit. Concerning injuries that occur within the intracranial compartment, much research has been undertaken to investigate the cause of SDH and parenchymal brain injury. Much, however, remains contentious, particularly regarding the medicolegal aspects of suspected child abuse. Issues that present the greatest challenges will be addressed. (orig.)

  5. Performance of computed tomography of the head to evaluate for skull fractures in infants with suspected non-accidental trauma

    Energy Technology Data Exchange (ETDEWEB)

    Culotta, Paige A.; Tran, Quynh-Anh; Donaruma-Kwoh, Marcella [Texas Children' s Hospital, Section of Public Health Pediatrics, Baylor College of Medicine, Houston, TX (United States); Crowe, James E.; Jones, Jeremy Y.; Mehollin-Ray, Amy R.; Tran, H.B.; Dodge, Cristina T. [Texas Children' s Hospital, The Edward B. Singleton, MD, Department of Pediatric Radiology, Baylor College of Medicine, Houston, TX (United States); Camp, Elizabeth A. [Texas Children' s Hospital, Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States); Cruz, Andrea T. [Texas Children' s Hospital, Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States); Texas Children' s Hospital, Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States)

    2017-01-15

    Young children with suspected abusive head trauma often receive skull radiographs to evaluate for fractures as well as computed tomography (CT) of the head to assess for intracranial injury. Using a CT as the primary modality to evaluate both fracture and intracranial injury could reduce exposure to radiation without sacrificing performance. To evaluate the sensitivity of CT head with (3-D) reconstruction compared to skull radiographs to identify skull fractures in children with suspected abusive head trauma. This was a retrospective (2013-2014) cross-sectional study of infants evaluated for abusive head trauma via both skull radiographs and CT with 3-D reconstruction. The reference standard was skull radiography. All studies were read by pediatric radiologists and neuroradiologists, with ten percent read by a second radiologist to evaluate for interobserver reliability. One hundred seventy-seven children (47% female; mean/median age: 5 months) were included. Sixty-two (35%) had skull fractures by radiography. CT with 3-D reconstruction was 97% sensitive (95% confidence interval [CI]: 89-100%) and 94% specific (CI: 87-97%) for skull fracture. There was no significant difference between plain radiographs and 3-D CT scan results (P-value = 0.18). Kappa was 1 (P-value <0.001) between radiologist readings of CTs and 0.77 (P = 0.001) for skull radiographs. CT with 3-D reconstruction is equivalent to skull radiographs in identifying skull fractures. When a head CT is indicated, skull radiographs add little diagnostic value. (orig.)

  6. Non-accidental head injury - the evidence

    Energy Technology Data Exchange (ETDEWEB)

    David, Timothy J. [University of Manchester, Blackley, Department of Child Health, Booth Hall Children' s Hospital, Manchester (United Kingdom)

    2008-06-15

    A postmortem examination and the CT scan documented the above injuries (neuropathology showed acute but with foci of older subdural bleeding) and indicated that in addition there were five recent rib fractures (left ribs 3-5 posteriorly and right ribs 6-7 posteriorly), a large perimacular retinal fold in the left retina, and subscalp bruising in the area of the anterior fontanelle and the occipital area. Family proceedings were commenced in order to protect the 2-year-old girl. Expert forensic, neuro- and eye pathologists instructed on behalf of the girl's father were of the view that the baby's injuries were likely to have resulted from the fall from the bed to the carpet, or alternatively from the step-father's efforts to revive the infant; other possibilities being apnoea and cerebral anoxia and cardiac arrest resulting from gastrooesophageal reflux or overly rough rocking of the baby in a baby rocker by the 2-year-old girl, the scalp bruising allegedly being the result of palpation of the baby's fontanelle by the treating paediatricians. The rib fractures were attributed to cardio-pulmonary resuscitation. This short review looks at the type of evidence that might help one to distinguish between the differing opinions offered as to the cause of this child's injuries. (orig.)

  7. Non-accidental head injury - the evidence

    International Nuclear Information System (INIS)

    David, Timothy J.

    A postmortem examination and the CT scan documented the above injuries (neuropathology showed acute but with foci of older subdural bleeding) and indicated that in addition there were five recent rib fractures (left ribs 3-5 posteriorly and right ribs 6-7 posteriorly), a large perimacular retinal fold in the left retina, and subscalp bruising in the area of the anterior fontanelle and the occipital area. Family proceedings were commenced in order to protect the 2-year-old girl. Expert forensic, neuro- and eye pathologists instructed on behalf of the girl's father were of the view that the baby's injuries were likely to have resulted from the fall from the bed to the carpet, or alternatively from the step-father's efforts to revive the infant; other possibilities being apnoea and cerebral anoxia and cardiac arrest resulting from gastrooesophageal reflux or overly rough rocking of the baby in a baby rocker by the 2-year-old girl, the scalp bruising allegedly being the result of palpation of the baby's fontanelle by the treating paediatricians. The rib fractures were attributed to cardio-pulmonary resuscitation. This short review looks at the type of evidence that might help one to distinguish between the differing opinions offered as to the cause of this child's injuries. (orig.)

  8. Child abuse. Non-accidental head injury

    International Nuclear Information System (INIS)

    Klee, Dirk; Schaper, Joerg

    2011-01-01

    Knowledge of the radiological appearances that are the result of child abuse is an integral part of prevention of further, potentially life-threatening, injury. Radiologists must have un understanding of typical injury patterns of the skeletal system, visceral and intra-cranial structures, which should ideally be ordered chronologically. Necessary radiological investigations follow guidelines with specific criteria that are pointed out in this review. In equivocal cases of abuse, the opinion of a second (paediatric) radiologist should be sought. (orig.)

  9. The importance of surgeon involvement in the evaluation of non-accidental trauma patients.

    Science.gov (United States)

    Larimer, Emily L; Fallon, Sara C; Westfall, Jaimee; Frost, Mary; Wesson, David E; Naik-Mathuria, Bindi J

    2013-06-01

    Non-Accidental Trauma (NAT) is a significant cause of childhood morbidity and mortality, causing 50% of trauma-related deaths at our institution. Our purpose was to evaluate the necessity of primary surgical evaluation and admission to the trauma service for children presenting with NAT. We reviewed all NAT patients from 2007-2011. Injury types, demographic data, and hospitalization information were collected. Comparisons to accidental trauma (AT) patients were made using Wilcoxon rank sum and Student's t tests. We identified 267 NAT patients presenting with 473 acute injuries. Injuries in NAT patients were more severe than in AT patients, and Injury Severity Scores, ICU admission rates, and mortality were all significantly (pinjury were seen in patients with closed head injuries (72%), extremity fractures (51%), rib fractures (82%), and abdominal/thoracic trauma (80%). Despite these complex injury patterns, only 56% received surgical consults, resulting in potential delays in diagnosis, as 24% of abdominal CT scans were obtained >12 hours after hospitalization. Given the high incidence of polytrauma in NAT patients, prompt surgical evaluation is necessary to determine the scope of injury. Admission to the trauma service and a thorough tertiary survey should be considered for all patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Non-accidental injury: a review of the radiology

    International Nuclear Information System (INIS)

    Carty, H.

    1997-01-01

    There have been many descriptions of the radiological features of non-accidental injury since John Caffey introduced the concept of inflicted injury and initially described some of the patterns of injury. Since then, our understanding of the radiologically detectable injuries has increased. This article provides a review of our current understanding of the lesions. (orig.)

  11. Clinical perspectives on osteogenesis imperfecta versus non-accidental injury.

    Science.gov (United States)

    Pereira, Elaine Maria

    2015-12-01

    Although non-accidental injuries (NAI) are more common in cases of unexplained fractures than rare disorders such as osteogenesis imperfecta (OI), ruling out OI and other medical causes of fracture is always indicated. The majority of OI patients can be diagnosed with the help of family history, physical examination, and radiographic findings. In particular, there are a few radiological findings which are seen more commonly in NAI than in OI which may help guide clinician considerations regarding the probability of either of these diagnoses. At the same time, molecular testing still merits careful consideration in cases with unexplained fractures without obvious additional signs of abuse. © 2015 Wiley Periodicals, Inc.

  12. Non-accidental injury in children in Kuala Lumpur: An urban perspective

    Directory of Open Access Journals (Sweden)

    Faridah Mohd Nor

    2016-12-01

    Full Text Available Non-accidental deaths in children in Kuala Lumpur, Malaysia are not uncommon, and they are often reported for identification of injuries. Five case series in children are presented here with typical injuries of differing ages in child abuse. Where history was partially hidden from the real scenario, involvement of family members was inevitable. The injuries were particularly diversified from a single unprecedented injury to multiple severe injuries, which led to the deaths of children less than 3 years of age. The discussion revolved around the autopsy and ancillary investigations in the context of urban perspectives in Kuala Lumpur area.

  13. Menace of childhood non-accidental traumatic brain injuries: A single unit report

    Directory of Open Access Journals (Sweden)

    Musa Ibrahim

    2015-01-01

    Full Text Available Background: Childhood traumatic brain injury (TBI has high rate of mortality and morbidity worldwide. There are dearths of reports from developing countries with large paediatric population on trauma; neurosurgery trauma of nonaccidental origin is not an exemption. This study analysed menace of non-accidental TBI in the paediatric population from our center. Materials and Methods: This is a single unit, retrospective study of the epidemiology of non-accidental TBI in children starting from September, 2008 to March, 2014. The management outcomes of the epidemiology of the non-accidental TBI were analysed. Results: Total of 109 children age range from 0 (intra-natal to 16 years with a mean of 5.8 ± 4.6 years (median, 5 years were enrolled into the study. 34 (31.2% were domestic violence, 26 (23.9% street assaults, 16 (14.7% were due to animal assaults and mishaps, 17 (15.6% fall from heights. Seven (6.4% cases of collapsed buildings were also seen during the period. Four (3.7% industrial accidents and two (1.8% were self-inflicted injuries. There were also three (2.8% cases of iatrogenic TBI out of which two infants (1.8% sustained TBI from cesarean section procedure while one patient (0.9% under general anaesthesia felt from the operation bed resulting to severe TBI. Conclusion: Child abuse, unprotected child labour, parental/care-givers negligence are the main cause of nonaccidental TBI. Human right activists and government agents should be incorporated in curtailing the menace.

  14. Neurosurgery for management of severe head injury

    International Nuclear Information System (INIS)

    Seitz, K.; Richter, H.P.

    1998-01-01

    Neurosurgery as a treatment of severe head injuries is not restricted to invasive surgery but also includes peri-operative intensive care medicine. Thanks to the technological progress and advanced diagnostic tools, especially drug treatments and their efficiency as well as risks can be far better monitored and analysed today. (orig./CB) [de

  15. Postmortem CT of severe head injuries

    International Nuclear Information System (INIS)

    Tamura, Masaru; Tsukahara, Yoshio; Nagaseki, Yoshishige; Horikoshi, Satoru; Yodonawa, Masahiko

    1983-01-01

    CT findings of fatal head injuries were analysed for the cause of death. Postmortem CT examinations were undertaken on 14 cases who died before reaching the hospital or shortly after arrival at the hospital (immediate death group). CT were also examined in non-operative 20 cases who were comatose and who died within 24 hours after severe head injuries (early death group). In the immediate death group, the following findings were demonstrated: a huge amount of free intracranial and intraventricular air in 8 cases; traumatic basal subarachnoid hemorrhage in 3 cases; a mixture of pneumocephalus and subarachnoid hemorrhage in 2 cases, and intracranial hematoma in 1 case. In the early death group: a mixture of pneumocephalus and subarachnoid hemorrhage in 2 cases; traumatic subarachnoid hemorrhage in 5 cases; intracranial hematoma in 11 cases, and brain contusion in 2 cases. The huge amount of intracranial free air due to the severe fracture of the skull base will make the CNS collapse immediately. Basal subarachnoid hemorrhage with signs of brain-stem injuries may result in instantaneous death. Acute subdural hematoma with contusion and edema in elderly patients was the most frequent cause of death in the early death group. (author)

  16. Brain SPECT in severs traumatic head injury

    International Nuclear Information System (INIS)

    Beaulieu, F.; Eder, V.; Pottier, J.M.; Baulieu, J.L.; Fournier, P.; Legros, B.; Chiaroni, P.; Dalonneau, M.

    2000-01-01

    The aim of this work was to compare the results of the early brain scintigraphy in traumatic brain injury to the long term neuropsychological behavior. Twenty four patients had an ECD-Tc99m SPECT, within one month after the trauma; scintigraphic abnormalities were evaluated according to a semi-quantitative analysis. The neuropsychological clinical investigation was interpreted by a synthetic approach to evaluate abnormalities related to residual motor deficit, frontal behavior, memory and language disorders. Fourteen patients (58%) had sequela symptoms. SPECT revealed 80 abnormalities and CT scan only 31. Statistical analysis of uptake values showed significantly lower uptake in left basal ganglia and brain stem in patients with sequela memory disorders. We conclude that the brain perfusion scintigraphy is able to detect more lesions than CT and that it could really help to predict the neuropsychological behavior after severe head injury. Traumatology could become in the future a widely accepted indication of perfusion SPECT. (authors)

  17. A descriptive study of accidental skeletal injuries and non-accidental skeletal injuries of child maltreatment.

    Science.gov (United States)

    Ghanem, Maha A H; Moustafa, Tarek A; Megahed, Haidy M; Salama, Naglaa; Ghitani, Sara A

    2018-02-01

    Lack of awareness and recognition of child maltreatment is the major reason behind underreporting. All victims often interact with the health care system for routine or emergency care. In several research works, non-accidental fractures are the second most common injury in maltreated children and it is represented up to one-third of cases. To determine the incidence of different types of accidental and non-accidental skeletal injuries among children, estimate the severity of injuries according to the modified injury severity score and to determine the degree of fractures either closed or opened (Gustiloe-Anderson open fracture classification). Moreover, identifying fractures resulting from child abuse and neglect. This aimed for early recognition of non-accidental nature of fractures in child maltreatment that can prevent further morbidity and mortality. A descriptive study was carried out on all children (109) with skeletal injuries who were admitted to both Main Alexandria and El-Hadara Orthopedic and Traumatology University Hospitals during six months. History, physical examination and investigations were done for the patients. A detailed questionnaire was taken to diagnose child abuse and neglect. Gustiloe-Anderson open fracture classification was used to estimate the degree of open fractures. Out of 109 children, twelve cases (11%) were categorized as child maltreatment. One case was physical abuse, eight cases (7.3%) were child neglect and three cases (2.8%) were labour exploitation. Road traffic accidents (RTA) was the commonest cause of skeletal injuries followed by falling from height. Regarding falls, they included 4 cases of stair falls in neglected children and another four cases of falling from height (balcony/window). The remaining 36 cases of falls were accidental. The skeletal injuries were in the form of fractures in 99 cases, dislocation in two cases, both fracture and/or dislocation in three cases, and bone deformity from brachial plexus injury

  18. International Olympic Committee consensus statement: harassment and abuse (non-accidental violence) in sport.

    Science.gov (United States)

    Mountjoy, Margo; Brackenridge, Celia; Arrington, Malia; Blauwet, Cheri; Carska-Sheppard, Andrea; Fasting, Kari; Kirby, Sandra; Leahy, Trisha; Marks, Saul; Martin, Kathy; Starr, Katherine; Tiivas, Anne; Budgett, Richard

    2016-09-01

    Despite the well-recognised benefits of sport, there are also negative influences on athlete health, well-being and integrity caused by non-accidental violence through harassment and abuse. All athletes have a right to engage in 'safe sport', defined as an athletic environment that is respectful, equitable and free from all forms of non-accidental violence to athletes. Yet, these issues represent a blind spot for many sport organisations through fear of reputational damage, ignorance, silence or collusion. This consensus statement extends the 2007 IOC Consensus Statement on Sexual Harassment and Abuse in Sport, presenting additional evidence of several other types of harassment and abuse-psychological, physical and neglect. All ages and types of athletes are susceptible to these problems but science confirms that elite, disabled, child and lesbian/gay/bisexual/trans-sexual (LGBT) athletes are at highest risk, that psychological abuse is at the core of all other forms and that athletes can also be perpetrators. Harassment and abuse arise from prejudices expressed through power differences. Perpetrators use a range of interpersonal mechanisms including contact, non-contact/verbal, cyber-based, negligence, bullying and hazing. Attention is paid to the particular risks facing child athletes, athletes with a disability and LGBT athletes. Impacts on the individual athlete and the organisation are discussed. Sport stakeholders are encouraged to consider the wider social parameters of these issues, including cultures of secrecy and deference that too often facilitate abuse, rather than focusing simply on psychopathological causes. The promotion of safe sport is an urgent task and part of the broader international imperative for good governance in sport. A systematic multiagency approach to prevention is most effective, involving athletes, entourage members, sport managers, medical and therapeutic practitioners, educators and criminal justice agencies. Structural and

  19. Targeted treatment of severe head injury

    African Journals Online (AJOL)

    injury is not a homogeneous concept and is poorly classified for the purposes of treatment.1 The separation of patients into 3 categories of severity (mild, moderate and severe) remains a blunt measure used to guide therapy in individual patients. Patients with severe traumatic brain injury (TBI), i.e. a Glasgow Coma Score ...

  20. Non-accidental dettol poisoning in a 3 day old neonate : a rare form ...

    African Journals Online (AJOL)

    2015-02-26

    Feb 26, 2015 ... non-accidental poisoning with dettol® in a neonate. This report presents ... health facility located in Kano city; pregnancy, labour and delivery .... risks undetected as it nearly happened in our index pa- tient. It is equally ... P O, Saliu R O, Adafalu M O. Infanticide in ... hood Non-food poisoning in. Aminu Kano ...

  1. Non-accidental dettol poisoning in a 3 day old neonate : a rare form ...

    African Journals Online (AJOL)

    In Nigeria, Dettol® Antiseptic Solution poisoning is an uncommon occurrence in all age groups. In a registered child specialist clinic in Kano, a three – day old neonate presented with clinical features believed initially to be due to neonatal seizures and sepsis, but which turned out to be due to non-accidental dettol® ...

  2. Measuring the visual salience of alignments by their non-accidentalness.

    Science.gov (United States)

    Blusseau, S; Carboni, A; Maiche, A; Morel, J M; Grompone von Gioi, R

    2016-09-01

    Quantitative approaches are part of the understanding of contour integration and the Gestalt law of good continuation. The present study introduces a new quantitative approach based on the a contrario theory, which formalizes the non-accidentalness principle for good continuation. This model yields an ideal observer algorithm, able to detect non-accidental alignments in Gabor patterns. More precisely, this parameterless algorithm associates with each candidate percept a measure, the Number of False Alarms (NFA), quantifying its degree of masking. To evaluate the approach, we compared this ideal observer with the human attentive performance on three experiments of straight contours detection in arrays of Gabor patches. The experiments showed a strong correlation between the detectability of the target stimuli and their degree of non-accidentalness, as measured by our model. What is more, the algorithm's detection curves were very similar to the ones of human subjects. This fact seems to validate our proposed measurement method as a convenient way to predict the visibility of alignments. This framework could be generalized to other Gestalts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Child abuse. Non-accidental head injury; Kindesmisshandlung. Nicht akzidentelle Kopfverletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Klee, Dirk; Schaper, Joerg [Universitaetsklinik Duesseldorf (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

    2011-12-15

    Knowledge of the radiological appearances that are the result of child abuse is an integral part of prevention of further, potentially life-threatening, injury. Radiologists must have un understanding of typical injury patterns of the skeletal system, visceral and intra-cranial structures, which should ideally be ordered chronologically. Necessary radiological investigations follow guidelines with specific criteria that are pointed out in this review. In equivocal cases of abuse, the opinion of a second (paediatric) radiologist should be sought. (orig.)

  4. Severe head injury in children - a preventable but forgotten epidemic

    African Journals Online (AJOL)

    Severe head injury in a child is a sociological disaster that crosses all sociological ... permanently disabled each year as a result of accidental injury." Over a ..... the daylight when transportation of the patient is more rapid; this results in some ...

  5. Ischemic Retinopathy and Neovascular Proliferation Secondary to Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Muge Coban-Karatas

    2014-01-01

    Full Text Available We report a case with severe head trauma and perforating globe injury in one eye and ischemic retinopathy and neovascular proliferation in the other eye. A 37-year-old male was brought to the emergency department after a motor vehicle accident with severe maxillofacial trauma. Ophthalmic examination revealed hematoma of the left eyelids as well as traumatic rupture and disorganization of the left globe. On the right eye, anterior segment and fundoscopic examination were normal. Primary globe repair was performed. At postoperative one-month visit, the right eye revealed no pathology of the optic disc and macula but severe neovascularization in the temporal peripheral retina. The patient was diagnosed as ischemic retinopathy and neovascular proliferation due to head trauma.

  6. The role of the follow-up chest radiograph in suspected non-accidental injury

    Energy Technology Data Exchange (ETDEWEB)

    Anilkumar, Adikesavalu; Fender, Laura J; Broderick, Nigel J; Somers, John M; Halliday, Katharine E [Nottingham University Hospital NHS Trust, Department of Radiology, Queen' s Medical Centre, Nottingham (United Kingdom)

    2006-03-15

    Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children. (orig.)

  7. The role of the follow-up chest radiograph in suspected non-accidental injury

    International Nuclear Information System (INIS)

    Anilkumar, Adikesavalu; Fender, Laura J.; Broderick, Nigel J.; Somers, John M.; Halliday, Katharine E.

    2006-01-01

    Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children. (orig.)

  8. Patients with severe head trauma who talk and then deteriorate

    Energy Technology Data Exchange (ETDEWEB)

    Isayama, Kazuo; Nakazawa, Shozo; Kobayashi, Shiro; Yokota, Hiroyuki; Ikeda, Yukio; Yajima, Kouzo; Yano, Masami; Otsuka, Toshibumi

    1987-08-01

    Patients with severe head trauma who talk and then deteriorate (or die) are analyzed by means of clinical signs, computerized tomography (CT), and outcome. The twelve severely head-injured patients had an initial verbal score on the Glasgow coma scale (GCS) of 3 or more and a GCS score of 9 or more. There were 8 male and 4 female patients. The ages of these patients ranged from 23 to 85 years (average age 60.9 years); nine of the patients were older than 60 years of age. An initial CT revealed subdural hematoma in 7 cases and traumatic subarachnoid hemorrhage in 8 cases. Serial CT could be used for 9 cases; delayed intracerebral hematoma was found in 5 patients, and acute cerebral swelling, in 3 patients. The elderly tended to have the hematoma, while the young tended to have acute cerebral swelling. Concerning the Glasgow outcome scale of cases of head trauma who talk and then deteriorate three months after trauma, there was moderate disability in 2 cases and a persistent vegetative state in one, while 9 had died.

  9. Double-read of skeletal surveys in suspected non-accidental trauma: what we learned

    International Nuclear Information System (INIS)

    Karmazyn, Boaz; Wanner, Matthew R.; Marine, Megan B.; Miller, Elise M.; Jennings, S.G.; Lay, Sara E.; Massey, James M.; Ouyang, Fangqian; Hibbard, Roberta A.

    2017-01-01

    Missing a fracture in a child on skeletal surveys for suspected non-accidental trauma can have devastating results. Double-read has the potential to improve fracture detection. However the yield of double-read is unknown. To determine the advantage of double-read versus single-read of radiographic skeletal surveys for suspected non-accidental trauma. The study was performed in two phases. In the first phase (April 2013 to September 2013), double-read was performed for all skeletal surveys obtained during weekday working hours. Because we had no new double-read findings in studies initially read as negative, we conducted a second phase (January 2014 to March 2014). In the second phase we limited double-reads to skeletal surveys found positive on the first read. At the end of this period, we retrospectively performed double-read for all initially negative skeletal surveys. We excluded follow-up skeletal surveys. The difference in discrepancy (new fracture or false diagnosis of a fracture) ratio between negative and positive skeletal surveys was evaluated using the Fisher exact test, and change in discrepancy ratio between the first and second study phases was evaluated using the stratified Cochran-Mantel-Haenszel test. Overall in the two phases, 178 skeletal surveys were performed in 178 children (67 girls) with mean age of 9 months (range 3 days to 3.7 years). Double-read found 16 discrepancies in 8/178 (4.5%) skeletal surveys. Seven of these studies showed additional fractures (n=15). In one study, an initial read of a skull fracture was read as a variant on the second read. There was a significant (P=0.01) difference between rate of disagreement in negative skeletal surveys (1/104, 1.0%) and positive skeletal surveys (7/74, 9.5%). No significant change in disagreement rate was demonstrated between the two phases of the study (P=0.59). Double-read of skeletal survey for suspected non-accidental trauma found false-negative fractures in a few cases and rarely found

  10. Double-read of skeletal surveys in suspected non-accidental trauma: what we learned

    Energy Technology Data Exchange (ETDEWEB)

    Karmazyn, Boaz; Wanner, Matthew R.; Marine, Megan B. [Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Riley Hospital for Children, Indianapolis, IN (United States); Miller, Elise M.; Jennings, S.G. [Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN (United States); Lay, Sara E. [Indiana University School of Medicine, Methodist Hospital, Department of Radiology and Imaging Sciences, Indianapolis, IN (United States); Massey, James M. [The Children' s Hospital at TriStar Centennial, Department of Imaging, Nashville, TN (United States); Ouyang, Fangqian [Indiana University School of Medicine, Department of Biostatistics, Indianapolis, IN (United States); Hibbard, Roberta A. [Indiana University School of Medicine, Department of Pediatrics, Section of Child Protection Programs, Riley Hospital for Children, Indianapolis, IN (United States)

    2017-05-15

    Missing a fracture in a child on skeletal surveys for suspected non-accidental trauma can have devastating results. Double-read has the potential to improve fracture detection. However the yield of double-read is unknown. To determine the advantage of double-read versus single-read of radiographic skeletal surveys for suspected non-accidental trauma. The study was performed in two phases. In the first phase (April 2013 to September 2013), double-read was performed for all skeletal surveys obtained during weekday working hours. Because we had no new double-read findings in studies initially read as negative, we conducted a second phase (January 2014 to March 2014). In the second phase we limited double-reads to skeletal surveys found positive on the first read. At the end of this period, we retrospectively performed double-read for all initially negative skeletal surveys. We excluded follow-up skeletal surveys. The difference in discrepancy (new fracture or false diagnosis of a fracture) ratio between negative and positive skeletal surveys was evaluated using the Fisher exact test, and change in discrepancy ratio between the first and second study phases was evaluated using the stratified Cochran-Mantel-Haenszel test. Overall in the two phases, 178 skeletal surveys were performed in 178 children (67 girls) with mean age of 9 months (range 3 days to 3.7 years). Double-read found 16 discrepancies in 8/178 (4.5%) skeletal surveys. Seven of these studies showed additional fractures (n=15). In one study, an initial read of a skull fracture was read as a variant on the second read. There was a significant (P=0.01) difference between rate of disagreement in negative skeletal surveys (1/104, 1.0%) and positive skeletal surveys (7/74, 9.5%). No significant change in disagreement rate was demonstrated between the two phases of the study (P=0.59). Double-read of skeletal survey for suspected non-accidental trauma found false-negative fractures in a few cases and rarely found

  11. Non-accidental injuries found in necropsies of domestic cats: a review of 191 cases.

    Science.gov (United States)

    de Siqueira, Adriana; Cassiano, Fabiana Cecília; de Albuquerque Landi, Marina Frota; Marlet, Elza Fernandes; Maiorka, Paulo César

    2012-10-01

    Animal cruelty is defined as a deliberate action that causes pain and suffering to an animal. In Brazil, legislation known as the Environmental Crimes Law states that cruelty toward all animal species is criminal in nature. From 644 domestic cats necropsied between January 1998 and December 2009, 191 (29.66%) presented lesions highly suggestive of animal cruelty. The main necroscopic finding was exogenous carbamate poisoning (75.39%) followed by blunt-force trauma (21.99%). Cats from 7 months to 2 years of age were the most affected (50.79%). In Brazil, violence is a public health problem and there is a high prevalence of domestic violence. Therefore, even if laws provide for animal welfare and protection, animals are common targets for violent acts. Within a context of social violence, cruelty toward animals is an important parameter to be considered, and the non-accidental lesions that were found are evidence of malicious actions.

  12. Workshop for disabled survivors of severe head injury.

    Science.gov (United States)

    London, P S

    1973-08-18

    Existing services for the disabled do not cater for the needs of lame-brain survivors of severe head injury who may be capable of productive work though they may never become employable. A grant from the Nuffield Provincial Hospitals Trust made it possible to set up in 1967 a special workshop in premises provided by the regional hospital board. The hospital management committee assumed financial responsibility for the centre after three years, and after five years the Department of Health and Social Security purchased adjoining premises, which will double the present accommodation for about 35 persons. Though 45% of the 101 patients attending the workshop have returned to work, no financial support has yet been received from the Department of Employment. A suitably staffed hostel is needed for patients who live too far away to travel daily to and from the workshop. This undertaking has shown a need for special facilities for some of the victims of severe head injury, who differ in many important ways from other disabled persons.

  13. Clinical value of computerized tomography scanning in severe head injury

    International Nuclear Information System (INIS)

    Kobayashi, Shiro; Yano, Masami; Otsuka, Toshibumi; Nakazawa, Shozo

    1982-01-01

    Serial computerized tomography (SCT) was performed on 138 patients suffering from severe head injuries (8 or less on the Glasgow Coma Scale). Standard practice called for scans to be done upon admission (within hours of the injury), and after 1, 3, 7 days and 1 month. Subsequent CT's depended on the patient's condition. Clinical results at the time of discharge were graded according to the Glasgow Outcome Scale. Patients who died, were in a persistent vegetative state, or were severely disabled were considered to have a ''bad outcome''. On the other hand, patients who were somewhat disabled or made good recoveries were considered to have a ''good outcome''. During the serial CT scan, there were new findings (not visualized on the initial CT but appearing on subsequent ones) in 91 of the 138 patients. These new findings were classified as follows; 1) decreased density collection in the subdural space (DDC), 2) ventricular dilation (VD), 3) intracerebral hematoma (ICH), 4) intraventricular hemorrhage (IVH), 5) extracerebral hematoma (ECH), 6) edema (E), 7) infarction (I). We defined ICH, IVH, ECH, E and I as new lesions. Of the 60 patients with new lesions 12 had good outcomes and 48 had poor outcomes. There were 78 patients who did not have any new lesions, 60 with good outcomes and 18 with poor outcomes. A significant correlation was found between good outcomes and the absence of new lesions, and between bad outcomes and the development of new lesions (p 2 = 44.038). We conclude that SCT can help predict the outcome with severe head injury patients and may be very important in their examination and care. (J.P.N.)

  14. The study of lymphocytes glucocorticoid receptor in severe head injury

    International Nuclear Information System (INIS)

    Li Dapei; Wang Haodan; Zhao Qihuang

    1994-01-01

    Glucocorticoid receptors (GCR) of peripheral lymphocytes from 14 patients with severe head injury and 11 normal volunteers are studied by means of single point method of radioligand binding assay. All these patients receive surgical therapy and glucocorticoid of routine dosage. The results show that the GCR level of these patients is lower than that of the normal, while the plasma cortisol level is much higher. These changes correlate closely to the patients' clinical outcome. It is indicated that the GCR level can reflect the degree of stress of these patients and their response to glucocorticoid therapy. Using peripheral lymphocytes instead of the brain biopsy for the measurement of GCR can reflect the GCR changes of brain tissue, it's more convenient to get the sample and more acceptable to the patients

  15. Prognosis of the computerized tomography in the severe head injury

    International Nuclear Information System (INIS)

    Garcia-Nieto, J.J.; Lorenzo Dominguez, M.T.; Martin Sanchez, M.J.; Sanchez Gonzalez, E.

    1991-01-01

    A prospective study is made with sixty five people affected of severe head injury, that is to say, with eight or less points in the Glasgow Coma Scale (GCS), when they get to the hospital. They are studied by computerized tomography at the income, but also, three and seven days after arriving. In this way, we appraise the type of the lesion the intensity and the possible effect-wass, considering in the last case, three features: a) ventricular collapse; b) the mean line structure s shift; c) perimesencefalic cisterns affectation. The findings of this study, are parametized and we were able to introduce them into a computer, getting. The relations between these findings ands the end-results. These last ones appraised throungh the Glasgow Outcome Scale (GOS). We could confirm, that certain findings in the computerized tomography have and unavoidable prognosis, where as others have a better prognosis. (Author)

  16. The influence of severe malnutrition on rehabilitation in patients with severe head injury.

    Science.gov (United States)

    Dénes, Zoltán

    2004-10-07

    The purpose of the study was to evaluate the consequences of severe malnutrition in patients with severe head injury during rehabilitation. The data were collected from medical records of patients admitted to the neurorehabilitation unit over the last 5 years. Twenty of 1850 patients had severe malnutrition, the body mass index (BMI) of these patients were under 15 (10-14) kg/m2. The majority of patients suffered traumatic brain damage (17/20). Thirteen patients arrived with percutaneous endoscopic gastrotomy /PEG, three nasogastric tube in 3 cases we placed PEG. The nutritional strategy included a high-calorie diet, by means of bolus feeding five times during the day, continuous feeding during the night; the daily intake target being more than 2500 kcal. During rehabilitation treatment the majority of patients (13/20) revealed weight gain with a rate of 0.5-2 kg/week. The following complications were treated during the rehabilitation phase: 20 pressure sores, 20 contractures, 11 urinal infections, 6 cases of pneumonia, 2 of purulent bronchitis, 6 of sepsis, 1 penoscrotal abscess, epidydymitis, and 1 case of purulent arthritis. The patients required total assistance at the time of admission. At discharge 10 patients remained completely dependent, 6 patients needed minimal assistance, and 4 patients could perform daily activities independently. The average length of stay in our unit was 78/6-150/days. Patients with head injury suffering from severe malnutrition exhibit serious complications at the time of admission as well as during rehabilitation treatment. The patients were very difficult to mobilize. The length of stay at the rehabilitation unit was 28 days longer when complicated by malnutrition, than head injuries showing normal nutritional status. These findings underline the importance of adequate nutrition in patients with head injury in both the acute ward and in the rehabilitation unit.

  17. Seizure Severity Is Correlated With Severity of Hypoxic-Ischemic Injury in Abusive Head Trauma.

    Science.gov (United States)

    Dingman, Andra L; Stence, Nicholas V; O'Neill, Brent R; Sillau, Stefan H; Chapman, Kevin E

    2017-12-12

    The objective of this study was to characterize hypoxic-ischemic injury and seizures in abusive head trauma. We performed a retrospective study of 58 children with moderate or severe traumatic brain injury due to abusive head trauma. Continuous electroencephalograms and magnetic resonance images were scored. Electrographic seizures (51.2%) and hypoxic-ischemic injury (77.4%) were common in our cohort. Younger age was associated with electrographic seizures (no seizures: median age 13.5 months, interquartile range five to 25 months, versus seizures: 4.5 months, interquartile range 3 to 9.5 months; P = 0.001). Severity of hypoxic-ischemic injury was also associated with seizures (no seizures: median injury score 1.0, interquartile range 0 to 3, versus seizures: 4.5, interquartile range 3 to 8; P = 0.01), but traumatic injury severity was not associated with seizures (no seizures: mean injury score 3.78 ± 1.68 versus seizures: mean injury score 3.83 ± 0.95, P = 0.89). There was a correlation between hypoxic-ischemic injury severity and seizure burden when controlling for patient age (r s =0.61, P interquartile range 0 to 0.23 on magnetic resonance imaging done within two days versus median restricted diffusion ratio 0.13, interquartile range 0.01 to 0.43 on magnetic resonance imaging done after two days, P = 0.03). Electrographic seizures are common in children with moderate to severe traumatic brain injury from abusive head trauma, and therefore children with suspected abusive head trauma should be monitored with continuous electroencephalogram. Severity of hypoxic-ischemic brain injury is correlated with severity of seizures, and evidence of hypoxic-ischemic injury on magnetic resonance imaging may evolve over time. Therefore children with a high seizure burden should be reimaged to evaluate for evolving hypoxic-ischemic injury. Published by Elsevier Inc.

  18. A survey of non-accidental injury imaging in England, Scotland and Wales

    Energy Technology Data Exchange (ETDEWEB)

    James, S L.J.; Halliday, K; Somers, J; Broderick, N

    2003-09-01

    AIM: To identify the potential national variation in non-accidental injury (NAI) imaging in England, Scotland and Wales. MATERIALS AND METHODS: A postal survey was sent to 323 hospitals with both paediatric and radiology departments. These were identified by a search through the Medical Directory. RESULTS: One hundred and thirteen of 323 postal questionnaires were returned within the study period (35%). Sixteen were excluded from the study because either no NAI imaging was performed at that institution or an incorrect address had been used. The total number of completed questionnaires was 97 (30%). Extensive variation was seen in all aspects of NAI imaging including imaging techniques used, total case numbers, follow-up imaging and those who report the NAI imaging. CONCLUSIONS: There is currently no national protocol that incorporates all aspects of NAI imaging in England, Scotland and Wales. Extensive variation in practice has been shown by this survey. Further standardization of NAI imaging practice is required. The draft BSPR skeletal survey guidelines and routine neurological imaging is recommended.

  19. An audit of skeletal surveys for suspected non-accidental injury following publication of the British Society of Paediatric Radiology guidelines

    International Nuclear Information System (INIS)

    Swinson, S.; Tapp, M.; Brindley, R.; Chapman, S.; Offiah, A.; Johnson, K.

    2008-01-01

    Aim: To audit change in the content and standard of skeletal surveys in the UK following the publication of the British Society of Paediatric Radiology (BSPR) guidelines for skeletal surveys in suspected non-accidental injury. Materials and methods: One hundred skeletal surveys, which were performed throughout England and Wales between February 2004 and September 2006 and received for a second opinion at a single children's hospital, were reviewed. The views obtained were compared with the defined reference standard 20 views as recommended by the BSPR. Additionally, each view was assessed for technical quality out of a maximum score of 11. The results were compared with an earlier study published prior to the definitive guideline. Additional information included whether images were film or digital and whether a computed tomography examination of the head was documented. Results: A mean of 16.5 (range 5-20) of the 20 recommended views were covered per survey and 15% of surveys included all 20 recommended views (previously 0%). The mean technical score per film was 9.7/11 (88%). Sixty-two percent of the skeletal surveys were digitally acquired and 59% included a CT examination of the head. Conclusion: There is still considerable variation in skeletal surveys performed in the UK, but progress has been observed in all areas in the light of the BSPR guidelines. There remains room for improvement, and further publicity of the guidelines is recommended

  20. An audit of skeletal surveys for suspected non-accidental injury following publication of the British Society of Paediatric Radiology guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Swinson, S. [Birmingham Children' s Hospital, Birmingham (United Kingdom)], E-mail: sophieswinson@doctors.org.uk; Tapp, M.; Brindley, R.; Chapman, S. [Birmingham Children' s Hospital, Birmingham (United Kingdom); Offiah, A. [Great Ormond Street Hospital, London (United Kingdom); Johnson, K. [Birmingham Children' s Hospital, Birmingham (United Kingdom)

    2008-06-15

    Aim: To audit change in the content and standard of skeletal surveys in the UK following the publication of the British Society of Paediatric Radiology (BSPR) guidelines for skeletal surveys in suspected non-accidental injury. Materials and methods: One hundred skeletal surveys, which were performed throughout England and Wales between February 2004 and September 2006 and received for a second opinion at a single children's hospital, were reviewed. The views obtained were compared with the defined reference standard 20 views as recommended by the BSPR. Additionally, each view was assessed for technical quality out of a maximum score of 11. The results were compared with an earlier study published prior to the definitive guideline. Additional information included whether images were film or digital and whether a computed tomography examination of the head was documented. Results: A mean of 16.5 (range 5-20) of the 20 recommended views were covered per survey and 15% of surveys included all 20 recommended views (previously 0%). The mean technical score per film was 9.7/11 (88%). Sixty-two percent of the skeletal surveys were digitally acquired and 59% included a CT examination of the head. Conclusion: There is still considerable variation in skeletal surveys performed in the UK, but progress has been observed in all areas in the light of the BSPR guidelines. There remains room for improvement, and further publicity of the guidelines is recommended.

  1. Optimisation of the digital radiographic imaging of suspected non-accidental injury

    Science.gov (United States)

    Offiah, Amaka

    Aim: To optimise the digital (radiographic) imaging of children presenting with suspected non-accidental injury (NAI). Objectives: (i) To evaluate existing radiographic quality criteria, and to develop a more suitable system if these are found to be inapplicable to skeletal surveys obtained in suspected NAI. (ii) To document differences in image quality between conventional film-screen and the recently installed Fuji5000R computed radiography (CR) system at Great Ormond Street Hospital for Children, (iii) To document the extent of variability in the standard of skeletal surveys obtained in the UK for suspected NAI. (iv) To determine those radiographic parameters which yield the highest diagnostic accuracy, while still maintaining acceptable radiation dose to the child, (v) To determine how varying degrees of edge-enhancement affect diagnostic accuracy. (vi) To establish the accuracy of soft compared to hard copy interpretation of images in suspected NAI. Materials and Methods: (i) and (ii) Retrospective analysis of 286 paediatric lateral spine radiographs by two observers based on the Commission of European Communities (CEC) quality criteria, (iii) Review of the skeletal surveys of 50 consecutive infants referred from hospitals throughout the United Kingdom (UK) with suspected NAI. (iv) Phantom studies. Leeds TO. 10 and TO. 16 test objects were used to compare the relationship between film density, exposure parameters and visualisation of object details, (iv) Clinical study. Anteroposterior and lateral post mortem skull radiographs of six consecutive infants were obtained at various exposures. Six observers independently scored the images based on visualisation of five criteria, (v) and (vi) A study of diagnostic accuracy in which six observers independently interpreted 50 radiographs from printed copies (with varying degrees of edge-enhancement) and from a monitor. Results: The CEC criteria are useful for optimisation of imaging parameters and allow the detection

  2. Skeletal survey quality in non-accidental injury – A single site evaluation of the effects of imaging checklists

    International Nuclear Information System (INIS)

    Weldon, J.; Price, R.

    2016-01-01

    Aims: Evidence suggests ongoing practice variability in the quality of skeletal survey examinations for non-accidental injury. The purpose of the study was to investigate the effects on examination quality following the implementation of imaging checklists. Method: A retrospective evaluation of skeletal survey examinations was carried out on studies performed between January 2007 and November 2014 at a large District General Hospital Trust. Longitudinal assessment was undertaken over three periods, before and following the introduction of two versions of imaging checklists, following modifications. Examinations were assessed and scored using three measures for completeness and quality employing a modified established scoring system against a professional body national standards document. Results: A total of 121 examinations met the inclusion criteria, all quality assessment measures showed improvements between each period. Examination completeness increased from median of 13 projections, to 20 throughout the three periods. Mann Whitney u Tests showed significant differences between each period. The mean combined anatomy score reduced from 3.11 to 1.10 throughout the three periods. Independent t Tests and Mann Whitney u Tests showed a significant decrease throughout the study period. Total percentage examination quality increased from median 44–83% throughout the three periods. Independent t Tests also showed significant differences between each period. Conclusion: The use of imaging checklists to improve quality and to support the optimal acquisition of the non-accidental injury skeletal survey shows encouraging results. However, further work is needed to optimise content and the use of checklists in practice. - Highlights: • Skeletal survey examinations for non-accidental practices have been shown to vary in content and in quality. • Checklists have demonstrated improvements in compliance to guidelines across health disciplines and in various settings.

  3. CT of the neonatal head

    International Nuclear Information System (INIS)

    Mohan, S.; Rogan, E.A.; Batty, R.; Raghavan, A.; Whitby, E.H.; Hart, A.R.; Connolly, D.J.A.

    2013-01-01

    Computed tomography (CT) is used less often than other techniques on neonatal units. However, in the acute setting, CT can be invaluable in diagnosing or excluding potentially life-threatening conditions and guiding initial management in neonates. Common indications for scanning include trauma, suspected non-accidental injury, infection, or an acute hypoxic or metabolic event. The aim of this review is to provide an overview of the normal neonatal head at CT and compare this to the common pathological abnormalities. Several key features of each condition will be highlighted. It is important to note that some pathological conditions can have overlapping features at CT and, therefore, the clinical history and additional investigations are also of key importance in determining the diagnosis

  4. Suspected alcohol and addictive narcotic use were more at risk to severe head injury

    Directory of Open Access Journals (Sweden)

    Woro Riyadina

    2012-07-01

    Full Text Available Latar belakang: Cedera kepala menyebabkan dampak seperti gangguan kognitif, perilaku dan keterbatasan fisik. Tujuan studi ini untuk menentukan faktor utama yang berkontribusi terhadap keparahan cedera kepala pada pasien yang dirawat inap di rumah sakit. Metode: Studi ini merupakan bagian dari penelitian “Pengembangan Database Registri Trauma sebagai Penunjang Sistem Surveilans Cedera”. Data dikumpulkan dengan cara abstraksi dari rekam medis oleh petugas terlatih dengan formulir registri pada pasien cedera yang dirawat inap di 3 rumah sakit dari bulan Januari – Agustus 2010. Keparahan cedera diklasifikasikan berdasarkan Glasgow Coma Scale (GCS dengan batasan nilai 3-9 mengalami cedera kepala berat, 10-12 cedera kepala sedang dan 13-15 cedera kepala ringan. Hasil: Dari 450 pasien cedera rawat inap terdapat 36 pasien (8% yang mengalami cedera kepala berat. Pasien dengan indikasi mengkonsumsi alkohol/narkotik mempunyai risiko hampir 5 kali mengalami cedera kepala berat [rasio odds suaian (ORa = 4,77; 95% interval kepercayaan (CI=1,04–21,75] dibanding tanpa indikasi. Pasien yang tidak dirujuk mempunyai risiko 5,5 kali  mengalami cedera kepala berat (ORa=5,50; 95% CI=2,28–13,27 dibanding pasien yang dirujuk. Pasien cedera karena kecelakaaan lalu lintas dibanding bukan kecelakaan lalu lintas mempunyai risiko 3 kali mengalami cedera kepala berat (ORa=3,43; 95% CI=1,14–10,32. Kesimpulan: Indikasi mengkonsumsi alkohol/narkotik berkontribusi paling besar terhadap keparahan cedera kepala. Kampanye anti alkohol/narkotik dan perlu dilakukan untuk mencegah cedera kepala berat. (Health Science Indones 2011;2:34-40   Abstract Background: The impact of head injuries were cognitive disorder, behavioral disorder and physical limitation. The objective of this study was to identify a major factor that contributes to head injury severity in hospitalized patients. Methods: This study was part of research "Development of Trauma Registry Databases as a

  5. Intracranial pressure monitoring in severe blunt head trauma: does the type of monitoring device matter?

    Science.gov (United States)

    Aiolfi, Alberto; Khor, Desmond; Cho, Jayun; Benjamin, Elizabeth; Inaba, Kenji; Demetriades, Demetrios

    2018-03-01

    OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma. METHODS This retrospective observational study was based on the American College of Surgeons Trauma Quality Improvement Program database, which was searched for all patients with isolated severe blunt head injury who had an ICP monitor placed in the 2-year period from 2013 to 2014. Extracted variables included demographics, comorbidities, mechanisms of injury, head injury specifics (epidural, subdural, subarachnoid, intracranial hemorrhage, and diffuse axonal injury), Abbreviated Injury Scale (AIS) score for each body area, Injury Severity Score (ISS), vital signs in the emergency department, and craniectomy. Outcomes included 30-day mortality, complications, number of ventilation days, intensive care unit and hospital lengths of stay, and functional independence. RESULTS During the study period, 105,721 patients had isolated severe traumatic brain injury (head AIS score ≥ 3). Overall, an ICP monitoring device was placed in 2562 patients (2.4%): 1358 (53%) had an IVD and 1204 (47%) had an IPD. The severity of the head AIS score did not affect the type of ICP monitoring selected. There was no difference in the median ISS; ISS > 15; head AIS Score 3, 4, or 5; or the need for craniectomy between the 2 device groups. Unadjusted 30-day mortality was significantly higher in the group with IVDs (29% vs 25.5%, p = 0.046); however, stepwise logistic regression analysis showed that the type of ICP monitoring was not an independent risk factor for death

  6. Divided attention years after severe closed head injury : The effect of dependencies between the subtasks

    NARCIS (Netherlands)

    Brouwer, W; Verzendaal, M; van der Naalt, J; Smit, J; van Zomeren, E

    2001-01-01

    Lesions of white matter which connects distant brain areas are characteristic for closed head injury (CHI). It was predicted that this impairs divided attention only if dependent subtasks are used which require communication between corresponding brain processes. Fourteen chronic severe CHI patients

  7. Dysphagia severity following chemoradiation and postoperative radiation for head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Nam P. [Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, VA North Texas Health Care System, Radiation Oncology Service (140), 4500 S, Lancaster Road, Dallas, TX 72516 (United States)]. E-mail: NamPhong.Nguyen@med.va.gov; Moltz, Candace C. [Audiology and Speech Pathology Service (126), VA North Texas Health Care System, Dallas, TX 75216 (United States); Frank, Cheryl [Audiology and Speech Pathology Service (126), VA North Texas Health Care System, Dallas, TX 75216 (United States); Karlsson, Ulf [Department of Radiation Oncology, East Carolina University, Greenville, NC 27858 (United States); Nguyen, Phuc D. [Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, VA North Texas Health Care System, Radiation Oncology Service (140), 4500 S, Lancaster Road, Dallas, TX 72516 (United States); Vos, Paul [Department of Biostatistics, East Carolina University, Greenville, NC 27858 (United States); Smith, Herbert J. [Radiology Service, VA North Texas Health Care System, Dallas, TX 75216 (United States); Dutta, Suresh [Department of Radiation Oncology, University of Southern California, Los Angeles, CA 90033 (United States); Nguyen, Ly M. [Public Health School, University of Michigan, Ann Arbor, MI 48109 (United States); Lemanski, Claire [Department of Radiation Oncology, Val D' Aurelle, Montpellier (France); Chan, Wayne [Radiation Oncology Service, VAMC, Jackson, MS 39216 (United States); Sallah, Sabah [Division of Hematology/Oncology Research, Novo Nordisk, Athens (Greece)

    2006-09-15

    Objective: The purpose of the study is to evaluate dysphagia severity following chemoradiation and postoperative radiation for head and neck cancer, and particularly the aspiration risk because of its potential life-threatening consequence. Materials and methods: We reviewed retrospectively the modified barium swallow (MBS) results in 110 patients who complained of dysphagia following chemoradiation (57) and postoperative radiation (53) of their head and neck cancer. Patients were selected if they were cancer free at the time of the swallowing study. Dysphagia severity was graded on a scale of 1-7. Patients were grouped according to the dysphagia severity: mild (grades 2-3), moderate (grades 4-5), and severe (grades 6-7). Results: Mean and median dysphagia grades were 4.84/5 and 4.12/4 for chemoradiation and postoperative radiation respectively. The mean difference between the two groups is statistically significant (p = 0.02). Mild dysphagia occurred in 13 patients (22%) of the chemoradiation group and 17 (32%) of the postoperative group. Corresponding number for the moderate group was 25 (43%) and 25 (48%), respectively. Severe dysphagia was significant in the chemoradiation group (34%) compared to the postoperative group (19%). However, the difference was not statistically significant (p = 0.29). There was a higher proportion of patients with large tumor (T3-T4) in the chemoradiation group who developed severe dysphagia. Conclusion: Dysphagia remained a significant morbidity of chemoradiation and postoperative radiation for head and neck cancer. Dysphagia may be more severe in the chemoradiation group because of the higher proportion of patients with large tumor, the high radiation dose, and a high number of oropharyngeal tumors. Aspiration occurred in both groups. Diagnostic studies such as MBS should be part of future head and neck cancer prospective studies to assess the prevalence of aspiration, as it may be silent.

  8. Dysphagia severity following chemoradiation and postoperative radiation for head and neck cancer

    International Nuclear Information System (INIS)

    Nguyen, Nam P.; Moltz, Candace C.; Frank, Cheryl; Karlsson, Ulf; Nguyen, Phuc D.; Vos, Paul; Smith, Herbert J.; Dutta, Suresh; Nguyen, Ly M.; Lemanski, Claire; Chan, Wayne; Sallah, Sabah

    2006-01-01

    Objective: The purpose of the study is to evaluate dysphagia severity following chemoradiation and postoperative radiation for head and neck cancer, and particularly the aspiration risk because of its potential life-threatening consequence. Materials and methods: We reviewed retrospectively the modified barium swallow (MBS) results in 110 patients who complained of dysphagia following chemoradiation (57) and postoperative radiation (53) of their head and neck cancer. Patients were selected if they were cancer free at the time of the swallowing study. Dysphagia severity was graded on a scale of 1-7. Patients were grouped according to the dysphagia severity: mild (grades 2-3), moderate (grades 4-5), and severe (grades 6-7). Results: Mean and median dysphagia grades were 4.84/5 and 4.12/4 for chemoradiation and postoperative radiation respectively. The mean difference between the two groups is statistically significant (p = 0.02). Mild dysphagia occurred in 13 patients (22%) of the chemoradiation group and 17 (32%) of the postoperative group. Corresponding number for the moderate group was 25 (43%) and 25 (48%), respectively. Severe dysphagia was significant in the chemoradiation group (34%) compared to the postoperative group (19%). However, the difference was not statistically significant (p = 0.29). There was a higher proportion of patients with large tumor (T3-T4) in the chemoradiation group who developed severe dysphagia. Conclusion: Dysphagia remained a significant morbidity of chemoradiation and postoperative radiation for head and neck cancer. Dysphagia may be more severe in the chemoradiation group because of the higher proportion of patients with large tumor, the high radiation dose, and a high number of oropharyngeal tumors. Aspiration occurred in both groups. Diagnostic studies such as MBS should be part of future head and neck cancer prospective studies to assess the prevalence of aspiration, as it may be silent

  9. Pediatric patients with severe head injury in Japan Neurotrauma Data Bank. Analysis of the prognostic factors

    International Nuclear Information System (INIS)

    Miki, Tamotsu; Haraoka, Jo

    2009-01-01

    The purpose of this study is to evaluate the clinical characteristics of the pediatric patients in the Japan Neurotrauma Data Bank: Project 2004. Project 2004 consisted of severe head injury patients with a Glasgow Coma Scale (GCS) score of 8 or less on admission or during course and patients who were operated for traumatic intracranial lesion between 2004-2006. The subjects were 101 pediatric patients aged 15 years old or less (mean: 7.8 y/o). We retrospectively examined the patients' age, GCS, cause of injury, duration and time of patient transfer, pupillary abnormality, body temperature, serum glucose level, Injury Severity Score (ISS) excluding cranio-cervical score, skull fracture, CT classification of the Traumatic Coma Data Bank (TCDB), main lesion of focal brain injury on CT, and traumatic subarachnoid hemorrhage (SAH) on CT. The mortality rate in children is lower than in adults: 18.8% vs. 39.7%. The factors that correlated to the poor outcome in pediatric patients are lower GCS score on admission, pupillary abnormality, hyperglycemia (more than 200 mg/dl), complications of severe other organ injury, diffuse injury III according to classification of CT, acute subdural hematoma and SAH. Pathophysiologically pediatric patients are not miniatures of adult patients. The data of Project 2004 is extremely significant and indicates the profile of one general view of pediatric patients with severe head injury in Japan. However, further collection of data and careful analysis are necessary for standardizing pediatric head trauma care. (author)

  10. Influence of prayer and prayer habits on outcome in patients with severe head injury.

    Science.gov (United States)

    Vannemreddy, Prasad; Bryan, Kris; Nanda, Anil

    2009-01-01

    The objective of the study is to evaluate the effect of prayers on the recovery of the unconscious patients admitted after traumatic brain injury. A retrospective study of patients with severe head injury was conducted. The Glasgow Coma Scale and Glasgow Outcome Scale scores were examined along with age, gender, smoking, and alcohol intake. There were 13 patients who received prayer and 13 who did not receive prayer during the hospital stay with almost identical mean Glasgow Coma Scale score. The prayer group stayed in the hospital for more days (P = .03). On multivariate analysis, patients' age (P = .01), admission Glasgow Coma Scale score (P = .009), and prayer habits (P = .007) were significant factors. Patients with prayers habits recovered better following severe head injury. The role of intercessory prayer needs further studies in larger groups.

  11. Quetiapine Induced Acute Dystonia in a patient with History of severe Head Injury

    OpenAIRE

    Robert G. Bota; Joanne W. Witkowski

    2010-01-01

    A patient with a history of severe head injury 10 years ago regained ability to walk after years of being bound to a wheelchair. During the last psychiatric hospitalization, quetiapine was increased to therapeutic dose using a normal titration. As a result the patient developed dystonia of multiple muscle groups requiring 4 days of hospitalization for remittance of symptoms. In this paper, we take a close look at the literature concerning extrapiramidal symptoms (EPS) in this context, and we ...

  12. Long Term Survivorship of a Severely Notched Femoral Stem after Replacing the Fractured Ceramic head with a Cobalt-Chromium Head.

    Science.gov (United States)

    Panagopoulos, Andreas; Tatani, Irini; Megas, Panagiotis

    2016-01-01

    Although ceramic head fracture occurs infrequently today, in the event of a fracture, the resulting revision surgery can prove very challenging, since the ceramic particles lodge into the surrounding soft tissue and can cause rapid implant failure. A case of long term survivorship of a severed notched femoral stem after replacing the fractured femoral head with a cobalt-chromium one is reported in a 40-year old woman with hip dysplasia who underwent an uncomplicated total hip arthroplasty. The incident of ceramic femoral head fracture occurred 14 months postoperatively without reporting any significant trauma. Intraoperative findings at revision were a multifragmented femoral head and a damaged polyethylene insert along with diffuse metallosis and excessive wear of the cone of the stem. Both the stem and the acetabular component were stable. After removal of ceramic fragments, metallotic tissue excision and careful lavage of the joint, the inlay was replaced by a similar one and a cobalt-chromium femoral head was placed to the existing notched taper of the firmly incorporated stem. At the 13 th year follow up examination, the patient had no pain, used no walking aids, and had normal activity with no signs of wearing or loosening in the plain x-rays. Despite current recommendations of using ceramic femoral heads in cases of fracture or to revise the severely damaged stems we were able to provide a long term survivorship up to 13 years postoperatively of a cobalt-chromium femoral head applied to a severe damaged stem.

  13. Quetiapine Induced Acute Dystonia in a patient with History of severe Head Injury

    Directory of Open Access Journals (Sweden)

    Robert G. Bota

    2010-01-01

    Full Text Available A patient with a history of severe head injury 10 years ago regained ability to walk after years of being bound to a wheelchair. During the last psychiatric hospitalization, quetiapine was increased to therapeutic dose using a normal titration. As a result the patient developed dystonia of multiple muscle groups requiring 4 days of hospitalization for remittance of symptoms. In this paper, we take a close look at the literature concerning extrapiramidal symptoms (EPS in this context, and we suggest that in patients with a history of head injury, it is warranted to consider a slower titration of antipsychotic medications, including ones that are considered having a lower risk of EPS such as quetiapine.

  14. Risk factors for severe Dysphagia after concurrent chemoradiotherapy for head and neck cancers

    International Nuclear Information System (INIS)

    Koiwai, Keiichiro; Shikama, Naoto; Sasaki, Shigeru; Shinoda, Atsunori; Kadoya, Masumi

    2009-01-01

    The aim of this study was to investigate the risk factors for dysphagia induced by chemoradiotherapy for head and neck cancers. Forty-seven patients with head and neck cancers who underwent definitive chemoradiotherapy from December 1998 to March 2006 were reviewed retrospectively. Median age was 63 years (range, 16-81). The locations of the primary lesion were as follows: larynx in 18 patients, oropharynx in 11, nasopharynx in 7, hypopharynx in 7 and others in 4. Clinical stages were as follows: Stage II in 20 and Stages III-IV in 27. Almost all patients underwent platinum-based concomitant chemoradiotherapy. The median cumulative dose of cisplatin was 100 mg/m 2 (range, 80-300) and median radiation dose was 70 Gy (range, 50-70). Severe dysphagia (Grade 3-4) was observed in 22 patients (47%) as an acute toxic event. One patient required tube feeding even at 12-month follow-up. In univariate analysis, clinical stage (III-IV) (P=0.017), primary site (oro-hypopharynx) (P=0.041) and radiation portal size (>11 cm) (P<0.001) were found to be associated with severe dysphagia. In multivariate analysis, only radiation portal size was found to have a significant relationship with severe dysphagia (P=0.048). Larger radiation portal field was associated with severe dysphagia induced by chemoradiotherapy. (author)

  15. Severe anemia is associated with poor tumor oxygenation in head and neck squamous cell carcinomas

    International Nuclear Information System (INIS)

    Becker, Axel; Stadler, Peter; Lavey, Robert S.; Haensgen, Gabriele; Kuhnt, Thomas; Lautenschlaeger, Christine; Feldmann, Horst Juergen; Molls, Michael; Dunst, Juergen

    2000-01-01

    Purpose: To investigate the relationship between tumor oxygenation and the blood hemoglobin (Hb) concentration in patients with squamous cell carcinoma of the head and neck (SCCHN). Methods and Materials: A total of 133 patients with SCCHN underwent pretreatment polarographic pO 2 measurements of their tumors. In 66 patients measurements were also made in sternocleidomastoid muscles. The patients were divided into three groups according to their Hb concentration--severe anemia (Hb 2 . Conclusion: Our data suggest that a low Hb concentration and cigarette smoking contribute to inadequate oxygenation of SCCHN and thus for increased radioresistance. Consequently, Hb correction and abstinence from smoking may significantly improve tumor oxygenation

  16. The autopsy-correlation of computed tomography in acute severe head injuries

    International Nuclear Information System (INIS)

    Tomita, Shin; Kim, Hong; Mikabe, Toshio; Karasawa, Hideharu; Watanabe, Saburo

    1981-01-01

    We discuss the importance of Contrast-Enhanced CT (C.E.CT) in establishing the variety of the intracranial pathological process in acute severe head injuries. During a two-and-a-half-year period (June, 1977 - December, 1979) thirty-three patients with acute severe head injuries were autopsied, all of whom had been scanned on admission. Among them, 14 patients had undergone both plain CT and C.E.CT on admission. Brain slices were examined macroscopically in three categories; brain contusion, subarachnoid hemorrhage, and intracerebral hemorrhage. Each category was then compared retrospectively with the plain CT and C.E.CT findings. C.E.CT was found to correspond much better to the autopsy finding than plain CT in the following three points: (1) C.E.CT clearly enhances the contusion areas and reveals occult contusion areas. (2) C.E.CT enhances the areas corresponding to the subarachnoid space due to the breakdown of brain-surface blood vessels. (3) C.E.CT reveals the enlargement and formation of the intracerebral hematoma by the extravasation of the intravenous contrast material from injured arterial vessels. (author)

  17. [Avascular necrosis of the femoral head in a patient with severe aplastic anaemia].

    Science.gov (United States)

    Plichta, Piotr; Pawelec, Katarzyna

    2011-01-01

    Avascular necrosis (AVN) is a pathological condition associated with numerous processes. Most frequent causes of ischaemia of the femoral head include trauma, corticosteroid therapy, radiation therapy, alcoholism, Gaucher's disease, systemic lupus erythematosus, rheumatoid arthritis. Corticosteroid therapy is considered the most frequent risk factor for developing avascular necrosis. In this paper we report a case of a 19-year old female patient who developed avascular necrosis of the right femoral head following treatment of severe aplastic anaemia. Clinical symptoms included groin pain and fever, painful abduction and internal rotation, tenderness over the right hip joint. The plain X-ray was not specific. However magnetic resonance imaging of the hip revealed changes characteristic for avascular necrosis. Conservative treatment was administrated. Two years after the onset of first clinical symptoms the patient is able to walk without pain, although the range of motion of the right hip joint is partially diminished. We evaluated the possible risk factors of AVN, diagnostic methods and prognosis. The onset of avascular necrosis should be considered as one of the relevant complications in patients with severe aplastic anaemia following immunosuppressive treatment.

  18. Severe Dry Eye Syndrome After Radiotherapy for Head-and-Neck Tumors

    International Nuclear Information System (INIS)

    Bhandare, Niranjan; Moiseenko, Vitali; Song, William Y.; Morris, Christopher G.; Bhatti, M. Tariq; Mendenhall, William M.

    2012-01-01

    Purpose: To investigate the incidence of severe dry eye syndrome (DES) after external beam radiotherapy for head-and-neck cancer and its dependence on the parameters relevant to external beam radiotherapy. Methods and Materials: The present retrospective study included 78 patients treated for primary extracranial head-and-neck tumors between 1965 and 2000, whose lacrimal apparatus/entire globe was exposed to fractionated external beam radiotherapy. The dose received by the major lacrimal gland was used for analysis. The end point of the present study was the ophthalmologic diagnosis of severe DES leading to vision compromise. Results: Of the 78 patients, 40 developed severe DES leading to visual compromise. The incidence of DES increased steadily from 6% at 35–39.99 Gy to 50% at 45–49.99 Gy and 90% at 60–64.99 Gy. With a mean of 0.9 years (range, 1 month to 3 years), the latency of DES was observed to be a function of the total dose and the dose per fraction. On univariate and multivariate analysis, the total dose (p < .0001 and p < .0001, respectively) and dose per fraction (p ≤ .0001 and p = .0044, respectively) were significant. However, age, gender, and the use of chemoradiotherapy were not. The actuarial analysis indicated a 5-year probability of freedom from DES of 93% for doses <45 Gy, 29% for 45–59.9 Gy, and 3% doses ≥60 Gy. A logistic normal tissue complication probability model fit to our data obtained a dose of 34 and 38 Gy corresponding to a 5% and 10% incidence of DES. Conclusion: With a dose of 34 Gy corresponding to a 5% incidence of DES, the risk of severe DES increased, and the latency decreased with an increase in the total dose and dose per fraction to the lacrimal gland. The effect of chemoradiotherapy and hyperfractionation on the risk of DES needs additional investigation.

  19. Severe Dry Eye Syndrome After Radiotherapy for Head-and-Neck Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Bhandare, Niranjan, E-mail: bhandn@shands.ufl.edu [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Moiseenko, Vitali [Vancouver Cancer Centre, Vancouver, BC (Canada); Song, William Y. [University of California, San Diego, San Diego, CA (United States); Morris, Christopher G. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Bhatti, M. Tariq [Department of Ophthalmology and Medicine (Division of Neurology), Duke University Medical Center, Durham, NC (United States); Mendenhall, William M. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)

    2012-03-15

    Purpose: To investigate the incidence of severe dry eye syndrome (DES) after external beam radiotherapy for head-and-neck cancer and its dependence on the parameters relevant to external beam radiotherapy. Methods and Materials: The present retrospective study included 78 patients treated for primary extracranial head-and-neck tumors between 1965 and 2000, whose lacrimal apparatus/entire globe was exposed to fractionated external beam radiotherapy. The dose received by the major lacrimal gland was used for analysis. The end point of the present study was the ophthalmologic diagnosis of severe DES leading to vision compromise. Results: Of the 78 patients, 40 developed severe DES leading to visual compromise. The incidence of DES increased steadily from 6% at 35-39.99 Gy to 50% at 45-49.99 Gy and 90% at 60-64.99 Gy. With a mean of 0.9 years (range, 1 month to 3 years), the latency of DES was observed to be a function of the total dose and the dose per fraction. On univariate and multivariate analysis, the total dose (p < .0001 and p < .0001, respectively) and dose per fraction (p {<=} .0001 and p = .0044, respectively) were significant. However, age, gender, and the use of chemoradiotherapy were not. The actuarial analysis indicated a 5-year probability of freedom from DES of 93% for doses <45 Gy, 29% for 45-59.9 Gy, and 3% doses {>=}60 Gy. A logistic normal tissue complication probability model fit to our data obtained a dose of 34 and 38 Gy corresponding to a 5% and 10% incidence of DES. Conclusion: With a dose of 34 Gy corresponding to a 5% incidence of DES, the risk of severe DES increased, and the latency decreased with an increase in the total dose and dose per fraction to the lacrimal gland. The effect of chemoradiotherapy and hyperfractionation on the risk of DES needs additional investigation.

  20. Functional survival after acute care for severe head injury at a designated trauma center in Hong Kong

    Directory of Open Access Journals (Sweden)

    Benedict B.T. Taw

    2012-07-01

    Conclusion: Multidisciplinary neurorehabilitation service is an important component of comprehensive trauma care. Despite significant early mortalities, a proportion of severely head-injured patients who survive acute care may achieve good long-term functional recovery.

  1. Withholding and withdrawing of life support from patients with severe head injury.

    Science.gov (United States)

    O'Callahan, J G; Fink, C; Pitts, L H; Luce, J M

    1995-09-01

    To characterize the withholding or withdrawing of life support from patients with severe head injury. San Francisco General Hospital, a city and county hospital with a Level I trauma center. A standardized questionnaire was used to collect data on demographics and functional outcome of severely head-injured (Glasgow Coma Score of family members. Forty-seven patients who were admitted to a medical-surgical intensive care unit over a 1-yr period. Twenty-four patients had life support withheld or withdrawn, and 23 patients did not. Physician and family separately assessed patient's probable functional outcome, degree of communication between them, reasons important in recommending or deciding on discontinuation of life support, and the result of action taken. Six months later, the families reviewed the process of their decision, how well physician(s) had communicated, and what might have improved communication. Of 24 patients with life support discontinued, 22 died; two were discharged from the hospital. Twenty-three of the 24 patients had a poor prognosis on admission. Of the 23 patients who were continued on life support for the duration of their hospitalization, ten had a poor (p Family's assessment of prognosis agreed with physician's assessment in 22 of the 24 patients from whom life support was discontinued (p families' assessments. Physicians' considerations in recommending limitation of care and families' considerations in making decisions were the same, primarily an inevitably poor prognosis. Neither physician nor families cited cost or availability of care as a deciding factor. Two families disagreed with the recommendation to limit care after initial agreement because the patients' prognosis improved from "likely death" to "vegetative." Care was therefore continued, and both patients remained vegetative 6 months after admission to the hospital and discharge to chronic care facilities. Life support is commonly withheld or withdrawn from patients with severe

  2. Prediction of thermal margin for external cooling of reactor vessel lower head during a severe accident

    International Nuclear Information System (INIS)

    Yoon, Ho Jun; Suh, Kune Y.

    1998-01-01

    In the TMI-2 accident, approximately nineteen (19) tons of molten core material drained into the lower plenum. One of the major findings from the TMI-2 Vessel Investigation Project was that one part of the reactor lower head wall estimated to have attained a temperature of 1100 .deg. C for about 30 minutes has seemingly experienced a comparatively rapid cooldown with no major threat to the vessel integrity. In this regard, recent empirical and analytical studies have shifted interests to such in-vessel retention designs or strategies as reactor cavity flooding, in-vessel flooding and engineered gap cooling of the vessel. Accurate thermohydrodynamic and creep deformation modeling and rupture prediction are the key to the success in developing practically useful in-vessel accident management strategies. As an advanced in-vessel design concept, the COrium Attak Syndrome Immunization Structures (COASIS) are being developed as prospective in-vessel retention devices for a next-generation LWR in concert with existing ex-vessel management measures. Both the engineered gap structures in -vessel (COASISI) and ex-vessel (COASISO) were demonstrated to maintain effective heat transfer geometry during molten core debris attack when applied to the TMI-2 and the Korean Standard Nuclear Power Plant (KSNPP) reactors. The likelihood of lower head creep rupture during a severe accident is found to be significantly suppressed by the COASIS options. In studying the in-vessel severe accident phenomena, one of the main goals is to verify the cooling mechanism in the reactor vessel lower plenum and thereby to prevent the vessel failure from thermal attack by the molten debris. This paper presents the first-principle calculation results for the thermal margin for the case of external cooling of the reactor vessel lower head. Adopting the method presented by F.B. Cheung, et al., we calculated the departure from nucleate boiling ratio (DNBR) for the three cases of pool boiling, flow boiling

  3. Modelling of RPV lower head under core melt severe accident condition using OpenFOAM

    International Nuclear Information System (INIS)

    Madokoro, Hiroshi; Kretzschmar, Frank; Miassoedov, Alexei

    2017-01-01

    Although six years have been passed since the tragic severe accident at Fukushima Daiichi, still large uncertainties exist in modeling of core degradation and reactor pressure vessel (RPV) failure. It is extremely important to obtain a better understanding of complex phenomena in the lower head in order to improve accident management measures. The possible failure mode of reactor pressure vessel and its failure time are especially a matter of importance. Thermal behavior of the molten pool can be simulated by the Phase-change Effective Convectivity Model (PECM), which is a distributed-parameter model developed in the Royal Institute of Technology (KTH), Sweden. The model calculates convective currents not using a pure CFD approach but based on so called “characteristic velocities” that are determined by empirical correlations depending on the geometry and physical properties of the molten pool. At the Karlsruhe Institute of Technology (KIT), the PECM has been implemented in the open-source CFD software OpenFOAM in order to receive detailed predictions of a core melt behavior in the RPV lower head under severe accident conditions. An advantage of using OpenFOAM is that it is very flexible to add and modify models and physical properties. In the current work, the solver is extended to couple PECM with a structure analysis model of the vessel wall. The model considers thermal expansion, plasticity, creep and damage. The model and physical properties are based on those implemented in ANSYS. Although the previous implementation had restriction that the amount of and geometry of the melt cannot be changed, our coupled model allows flexibility of the melt amount and geometry. The extended solver was used to simulate the LIVE-L1 and -L7V experiments and has demonstrated good prediction of the temperature distribution in the molten pool and heat flux distribution through the vessel wall. Regarding the vessel failure the model was applied to one of the FOREVER tests

  4. Critical heat flux for APR1400 lower head vessel during a severe accident

    International Nuclear Information System (INIS)

    Noh, Sang W.; Suh, Kune Y.

    2013-01-01

    Highlights: ► Studied boiling on downward-facing hemispherical vessel with asymmetric thermal insulator. ► Scaled the APR1400 lower head linearly down by 1/10 including ICI tubes and shear keys. ► Performed thermal analysis using ANSYS V11.0 to determine the internal temperature and heat flux. ► Performed tests to obtain the CHF with saturated demineralized water at atmospheric pressure. ► Measured CHF accounting for 3D random flow effect expected in the APR1400 application. -- Abstract: Corium Ablation Stopper Apparatus (CASA) has a downward-facing hemispherical vessel and geometrically asymmetric thermal insulator of the Advanced Power Reactor 1400 MWe (APR1400) scaled linearly down by 1/10, as well as sixty-one in-core instrumentation (ICI) tubes and four shear keys. The heated vessel plays a pivotal role in CASA depending on the configuration of the oxide pool and metal layer to bring about the focusing effect expected of a molten pool in the lower head during a severe accident. The heated vessel was designed through a trial-and-error method and thermal analysis. Thermal analysis was performed using ANSYS V11.0 to investigate the effect of the internal temperature and heat flux on the integral hemispherical copper vessel. The CASA tests were carried out to obtain the critical heat flux (CHF) with saturated and demineralized water at the atmospheric pressure (0.1 MPa). The CHF in the metal layer through the hemispherical channel was found to be lower than that in the ULPU-2400 configuration V data through the streamlined thermal insulator. The experimental CHF was measured and obtained through the CASA hemispherical heated surface accounting for the three-dimensional random flow effect expected in the APR1400 application

  5. A two dimensional approach for temperature distribution in reactor lower head during severe accident

    International Nuclear Information System (INIS)

    Cao, Zhen; Liu, Xiaojing; Cheng, Xu

    2015-01-01

    Highlights: • Two dimensional module is developed to analyze integrity of lower head. • Verification step has been done to evaluate feasibility of new module. • The new module is applied to simulate large-scale advanced PWR. • Importance of 2-D approach is clearly quantified. • Major parameters affecting vessel temperature distribution are identified. - Abstract: In order to evaluate the safety margin during a postulated severe accident, a module named ASAP-2D (Accident Simulation on Pressure vessel-2 Dimensional), which can be implemented into the severe accident simulation codes (such as ATHLET-CD), is developed in Shanghai Jiao Tong University. Based on two-dimensional spherical coordinates, heat conduction equation for transient state is solved implicitly. Together with solid vessel thickness, heat flux distribution and heat transfer coefficient at outer vessel surface are obtained. Heat transfer regime when critical heat flux has been exceeded (POST-CHF regime) could be simulated in the code, and the transition behavior of boiling crisis (from spatial and temporal points of view) can be predicted. The module is verified against a one-dimensional analytical solution with uniform heat flux distribution, and afterwards this module is applied to the benchmark illustrated in NUREG/CR-6849. Benchmark calculation indicates that maximum heat flux at outer surface of RPV could be around 20% lower than that of at inner surface due to two-dimensional heat conduction. Then a preliminary analysis is performed on the integrity of the reactor vessel for which the geometric parameters and boundary conditions are derived from a large scale advanced pressurized water reactor. Results indicate that heat flux remains lower than critical heat flux. Sensitivity analysis indicates that outer heat flux distribution is more sensitive to input heat flux distribution and the transition boiling correlation than mass flow rate in external reactor vessel cooling (ERVC) channel

  6. Translational Research in Enteral and Parenteral Nutrition Support for Patients with Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Fa-liang LIN

    2015-12-01

    Full Text Available Abstract Objective: To explore the key points of the translational research in enteral and pareenteral nutrition support for patients with severe head injury (SHI, and to analyze the influence of different nutritional support routes on the prognosis of SHI patients. Methods: Totally 141 patients with severe craniocerebral injury were selected as study subjects, 47 cases for each group, and were given early enteral nutrition (EEN, delayed enteral nutrition (DEN, and parenteral nutrition (PN, respectively. The effect of different nutritional support routes on SHI patients was observed. Results: After 14 d of treatment, Glasgow coma scale (GCS scores of 3 groups were higher than treatment before (P<0.01, and with statistical differences among groups (P<0.05, or P<0.01. The levels of serum albumin, total serum protein and hemoglobin were higher in EEN group than the other groups (P<0.01. The level of serum albumin was lower in PN group than in DEN group (P<0.05. There were statistical differences in the incidence of complications among three groups (χ2=9.2487, P=0.0098. Conclusion: EEN support is more conductive to the improvement of the nutrition status, reduction of the incidence of complications, and promotion of the prognosis of SHI patients than DEN and PN.

  7. Incidence and severity of head and neck injuries in victims of road traffic crashes: In an economically developed country.

    Science.gov (United States)

    Bener, Abdulbari; Rahman, Yassir S Abdul; Mitra, Biswadev

    2009-01-01

    Head and neck injuries following the road traffic crashes (RTCs) are the most common cause of morbidity and mortality in most developed and developing countries and may also result in temporary or permanent disability. The aim of this study was to determine the incidence pattern of head and neck injuries, investigate its trend and identify the severity of injuries involved with road traffic crashes (RTCs) during the period 2001-2006. This is a retrospective descriptive hospital based study. The patients with head and neck injuries were seen and treated in the Accident and Emergency Department of the Hamad General Hospital and other Trauma Centers of the Hamad Medical Corporation following the road traffic crashes during the period 2001-2006. This study is a retrospective analysis of 6709 patients attended and treated at the Accident and Emergency and Trauma centers for head and neck injuries over a 6 year period. Head and neck injuries were determined according to the ICD 10 criteria. Of these, 3013 drivers, 2502 passengers, 704 pedestrians and 490 two wheel riders (motor bike and cyclists). Details of all the road traffic crash patients were compiled in the database of the Emergency Medical Services (EMS), and the data of patients with head and neck injuries were extracted from this database. A total of 6709 patients with head and neck injuries was reported during the study period. Majority of the victims were non-Qataris (68.7%), men (85.9%) and in the age group 20-44 years (68.5%). There were statistical significant differences in relation to age, nationality, gender, and accident during week ends for head and neck injuries (pQatar from road traffic crashes. The incidence of head and neck injuries is still very high in Qatar, but the severity of injury was mild in most of the victims. The findings of the study highlighted the need for taking urgent steps for safety of people especially drivers and passengers.

  8. CO2 reactivity and brain oxygen pressure monitoring in severe head injury.

    Science.gov (United States)

    Carmona Suazo, J A; Maas, A I; van den Brink, W A; van Santbrink, H; Steyerberg, E W; Avezaat, C J

    2000-09-01

    To investigate the effect of hyperventilation on cerebral oxygenation after severe head injury. A prospective, observational study. Neurointensive care unit at a university hospital. A total of 90 patients with severe head injury (Glasgow Coma Scale score brain tissue oxygen pressure (PbrO2) was performed as a measure of cerebral oxygenation. Arterial PCO2 was decreased each day over a 5-day period for 15 mins by increasing minute volume on the ventilator setting to 20% above baseline. Arterial blood gas analysis was performed before and after changing ventilator settings. Multimodality monitoring, including PbrO2, was performed in all patients. Absolute and relative PbrO2/PaCO2 reactivity was calculated. Outcome at 6 months was evaluated according to the Glasgow Outcome Scale. Effective hyperventilation, defined by a decrease of PaCO2 > or =2 torr (0.27 kPa), was obtained in 218 (84%) of 272 tests performed. Baseline PaCO2 averaged 32.3 +/- 4.5 torr (4.31 +/- 0.60 kPa). Average reduction in PaCO2 was 3.8 +/- 1.7 torr (0.51 +/- 0.23 kPa). PbrO2 decreased by 2.8 +/- 3.7 torr (0.37 +/- 0.49 kPa; p < .001) from a baseline value of 26.5 +/- 11.6 torr (3.53 +/- 1.55 kPa). PbrO2/PaCO2 reactivity was low on day 1 (0.8 +/- 2.3 torr [0.11 +/- 0.31 kPa]), increasing on subsequent days to 6.1 +/- 4.4 torr (0.81 +/- 0.59 kPa) on day 5. PbrO2/PaCO2 reactivity on days 1 and 2 was not related to outcome. In later phases in patients with unfavorable outcome, relative reactivity was increased more markedly, reaching statistical significance on day 5. Increased hyperventilation causes a significant reduction in PbrO2, providing further evidence for possible increased risk of secondary ischemic damage during hyperventilation. The low PbrO2/PaCO2 reactivity on day 1 indicates the decreased responsiveness of cerebral microvascular vessels to PaCO2 changes, caused by generalized vascular narrowing. The increasing PbrO2/PaCO2 reactivity from days 2 to 5 suggests that the risk of

  9. Pressure Heads and Simulated Water Uptake Patterns for a Severely Stressed Bean Crop

    NARCIS (Netherlands)

    Durigon, A.; Santos, dos M.A.; Lier, van Q.D.; Metselaar, K.

    2012-01-01

    In modeling, actual crop transpiration as a function of soil hydraulic conditions is usually estimated from a water content or pressure head dependent reduction function. We compared the performance of the empirical pressure head based reduction function of Feddes (FRF) and a more physically based

  10. Effects of diurnal variations in temperature on non-accidental mortality among the elderly population of Montreal, Québec, 1984-2007.

    Science.gov (United States)

    Vutcovici, Maria; Goldberg, Mark S; Valois, Marie-France

    2014-07-01

    The association between ambient temperature and mortality has been studied extensively. Recent data suggest an independent role of diurnal temperature variations in increasing daily mortality. Elderly adults-a growing subgroup of the population in developed countries-may be more susceptible to the effects of temperature variations. The aim of this study was to determine whether variations in diurnal temperature were associated with daily non-accidental mortality among residents of Montreal, Québec, who were 65 years of age and over during the period between 1984 and 2007. We used distributed lag non-linear Poisson models constrained over a 30-day lag period, adjusted for temporal trends, mean daily temperature, and mean daily concentrations of nitrogen dioxide and ozone to estimate changes in daily mortality with diurnal temperature. We found, over the 30 day lag period, a cumulative increase in daily mortality of 5.12% [95% confidence interval (CI): 0.02-10.49%] for a change from 5.9 °C to 11.1 °C (25th to 75th percentiles) in diurnal temperature, and a 11.27% (95%CI: 2.08-21.29%) increase in mortality associated with an increase of diurnal temperature from 11.1 to 17.5 °C (75th to 99th percentiles). The results were relatively robust to adjustment for daily mean temperature. We found that, in Montreal, diurnal variations in temperature are associated with a small increase in non-accidental mortality among the elderly population. More studies are needed in different geographical locations to confirm this effect.

  11. Intrajejunal Infusion of Levodopa-Carbidopa Gel Can Continuously Reduce the Severity of Dropped Head in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Hiroshi Kataoka

    2017-10-01

    Full Text Available Dropped head can occur in patients with Parkinson’s disease and make their quality of life unpleasant because they cannot obtain a frontal view. The pathophysiologic involvement of dopamine agonist or central or peripheral mechanisms has been proposed. Levodopa therapy with the withdrawal of dopamine agonists was sometimes effective, but the effect in most patients did not persist for the entire day. We describe a patient with Parkinson’s disease whose dropped head responded throughout the day to the continuous intrajejunal infusion of levodopa-carbidopa intestinal gel (LCIG. During off-periods before treatment with LCIG, severe akinesia and freezing of gait were evident, and she could not continuously obtain a frontal view because of the dropped head. About 20 min after the intrajejunal infusion of LCIG, these features remarkably improved, and she could obtain a frontal view. The angle of dropped head was improved from 39.39 to 14.04°. This case suggests that infusion of LCIG can reduce the severity of dropped head for a longer period than oral levodopa.

  12. Traumatic Intraventricular Hemorrhage In Severe Blunt Head Trauma: A One Year Analysis

    Directory of Open Access Journals (Sweden)

    G.R. Bahadorkhan

    2006-05-01

    Full Text Available Background:High resolution CT scan has made early diagnosis of intraventricular hemorrhage (IVH easier. Posttraumatic intraventricular hemorrhage has been reported to a greater extent because of the CT scan. Methods:904 patients were admitted in the NSICU from March 2001 to March 2002 with severe closed head injury, of those only 31 patients with intraventricular hemorrhage (GCS less than 8 are reported herein and the mechanism involved is discussed. Results: Nine cases had intracerebral hemorrhage (contusional group, four cases in the frontal lobe, three cases in the temporal lobe and two cases in the parietal lobe. Nine cases (basal ganglia hemorrhage group had hemorrhage in basal ganglia, six in the caudate nucleus and three in the thalamus, all spreading into the ventricles. In thirteen cases the original site of hemorrhage could not be determined. In this group six cases had accompanying peri-brain stem hemorrhage (peri-brain stem hemorrhage group and different brain stem injury signs. Four cases had IVH less than 5 mL with or without minor intracranial lesions (minor intracranial lesion group. Accompanying major intracranial hemorrhage was found in sixteen cases, six cases had epidural hematoma, four cases had subdural hematoma, and seven had a combination of ASDH, EDH and contusional prarenchymal hemorrhages, all requiring primary surgical evacuation, and seven cases had different degrees of minor abnormalities (i.e. minor epidural hemorrhage, minor subdural hemorrhage,sub-arachnoid hemorrhage, minor cortical contusions or subdural effusions which did not need surgical intervention.Two cases had acute hydrocephalus and needed ventricular external drainage. Conclusion:Acceleration-deceleration impact along the long axis of the skull might be the possible mechanism in shearing injury to perforating vessels of the basal ganglia for early appearance of hemorrhage in the caudate nucleus and thalamus. Hemorrhage in basal ganglia and brain

  13. Characteristics of debris in the lower head of a BWR in different severe accident scenarios

    International Nuclear Information System (INIS)

    Phung, Viet-Anh; Galushin, Sergey; Raub, Sebastian; Goronovski, Andrei; Villanueva, Walter; Kööp, Kaspar; Grishchenko, Dmitry; Kudinov, Pavel

    2016-01-01

    Highlights: • Station blackout scenario with delayed recovery of safety systems in a Nordic BWR is considered. • Genetic algorithm and random sampling methods are used to explore accident scenario domain. • Main groups of scenarios are identified. • Ranges and distributions of characteristics of debris bed in the lower head are determined. - Abstract: Nordic boiling water reactors (BWRs) adopt ex-vessel debris cooling to terminate severe accident progression. Core melt released from the vessel into a deep pool of water is expected to fragment and form a coolable debris bed. Characteristics of corium melt ejection from the vessel determine conditions for molten fuel–coolant interactions (FCI) and debris bed formation. Non-coolable debris bed or steam explosion can threaten containment integrity. Vessel failure and melt ejection mode are determined by the in-vessel accident progression. Characteristics (such as mass, composition, thermal properties, timing of relocation, and decay heat) of the debris bed formed in the process of core relocation into the vessel lower plenum define conditions for the debris reheating, remelting, melt-vessel structure interactions, vessel failure and melt release. Thus core degradation and relocation are important sources of uncertainty for the success of the ex-vessel accident mitigation strategy. The goal of this work is improve understanding how accident scenario parameters, such as timing of failure and recovery of different safety systems can affect characteristics of the debris in the lower plenum. Station blackout scenario with delayed power recovery in a Nordic BWR is considered using MELCOR code. The recovery timing and capacity of safety systems were varied using genetic algorithm (GA) and random sampling methods to identify two main groups of scenarios: with relatively small ( 100 tons) amount of relocated debris. The domains are separated by the transition regions, in which relatively small variations of the input

  14. Characteristics of debris in the lower head of a BWR in different severe accident scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Phung, Viet-Anh, E-mail: vaphung@kth.se; Galushin, Sergey, E-mail: galushin@kth.se; Raub, Sebastian, E-mail: raub@kth.se; Goronovski, Andrei, E-mail: andreig@kth.se; Villanueva, Walter, E-mail: walterv@kth.se; Kööp, Kaspar, E-mail: kaspar@safety.sci.kth.se; Grishchenko, Dmitry, E-mail: dmitry@safety.sci.kth.se; Kudinov, Pavel, E-mail: pavel@safety.sci.kth.se

    2016-08-15

    Highlights: • Station blackout scenario with delayed recovery of safety systems in a Nordic BWR is considered. • Genetic algorithm and random sampling methods are used to explore accident scenario domain. • Main groups of scenarios are identified. • Ranges and distributions of characteristics of debris bed in the lower head are determined. - Abstract: Nordic boiling water reactors (BWRs) adopt ex-vessel debris cooling to terminate severe accident progression. Core melt released from the vessel into a deep pool of water is expected to fragment and form a coolable debris bed. Characteristics of corium melt ejection from the vessel determine conditions for molten fuel–coolant interactions (FCI) and debris bed formation. Non-coolable debris bed or steam explosion can threaten containment integrity. Vessel failure and melt ejection mode are determined by the in-vessel accident progression. Characteristics (such as mass, composition, thermal properties, timing of relocation, and decay heat) of the debris bed formed in the process of core relocation into the vessel lower plenum define conditions for the debris reheating, remelting, melt-vessel structure interactions, vessel failure and melt release. Thus core degradation and relocation are important sources of uncertainty for the success of the ex-vessel accident mitigation strategy. The goal of this work is improve understanding how accident scenario parameters, such as timing of failure and recovery of different safety systems can affect characteristics of the debris in the lower plenum. Station blackout scenario with delayed power recovery in a Nordic BWR is considered using MELCOR code. The recovery timing and capacity of safety systems were varied using genetic algorithm (GA) and random sampling methods to identify two main groups of scenarios: with relatively small (<20 tons) and large (>100 tons) amount of relocated debris. The domains are separated by the transition regions, in which relatively small

  15. Functional survival after acute care for severe head injury at a designated trauma center in Hong Kong.

    Science.gov (United States)

    Taw, Benedict B T; Lam, Alan C S; Ho, Faith L Y; Hung, K N; Lui, W M; Leung, Gilberto K K

    2012-07-01

    Severe head injury is known to be a major cause of early mortalities and morbidities. Patients' long-term outcome after acute care, however, has not been widely studied. We aim to review the outcome of severely head-injured patients after discharge from acute care at a designated trauma center in Hong Kong. This is a retrospective study of prospectively collected data of patients admitted with severe head injuries between 2004 and 2008. Patients' functional status post-discharge was assessed using the Extended Glasgow Outcome Score (GOSE). Of a total of 1565 trauma patients, 116 had severe head injuries and 41 of them survived acute hospital care. Upon the last follow-up, 23 (56.1%) of the acute-care survivors had improvements in their GOSE, six (11.8%) experienced deteriorations, and 12 (23.5%) did not exhibit any change. The greatest improvement was observed in patients with GOSE of 5 and 6 upon discharge, but two of the 16 patients with GOSE 2 or 3 also had a good recovery. On logistic regression analysis, old age and prolonged acute hospital stay were found to be independent predictors of poor functional outcome after a mean follow-up duration of 42 months. Multidisciplinary neurorehabilitation service is an important component of comprehensive trauma care. Despite significant early mortalities, a proportion of severely head-injured patients who survive acute care may achieve good long-term functional recovery. Copyright © 2012, Asian Surgical Association. Published by Elsevier Taiwan LLC. All rights reserved.

  16. Sequential computerized tomography changes and related final outcome in severe head injury patients

    International Nuclear Information System (INIS)

    Lobato, R.D.; Gomez, P.A.; Alday, R.

    1997-01-01

    The authors analyzed the serial computerized tomography (CT) findings in a large series of severely head injured patients in order to assess the variability in gross intracranial pathology through the acute posttraumatic period and determine the most common patterns of CT change. A second aim was to compare the prognostic significance of the different CT diagnostic categories used in the study (Traumatic Coma Data Bank CT pathological classification) when gleaned either from the initial (postadmission) or the control CT scans, and determine the extent to which having a second CT scan provides more prognostic information than only one scan. 92 patients (13.3 % of the total population) died soon after injury. Of the 587 who survived long enough to have at least one control CT scan 23.6 % developed new diffuse brain swelling, and 20.9 % new focal mass lesions most of which had to be evacuated. The relative risk for requiring a delayed operation as related to the diagnostic category established by using the initial CT scans was by decreasing order: diffuse injury IV (30.7 %), diffuse injury III (30.5 %), non evacuated mass (20 %), evacuated mass (20.2 %), diffuse injury II (12.1 %), and diffuse injury I (8.6 %). Overall, 51.2 % of the patients developed significant CT changes (for worse or better) occurring either spontaneously or following surgery, and their final outcomes were more closely related to the control than to the initial CT diagnoses. In fact, the final outcome was more accurately predicted by using the control CT scans (81.2 % of the cases) than by using the initial CT scans (71.5 % of the cases only). Since the majority of relevant CT changes developed within 48 hours after injury a pathological categorization made by using an early control CT scan seems to be most useful for prognostic purposes. Prognosis associated with the CT pathological categories used in the study was similar independently of the moment of the acute posttraumatic period at which

  17. Risk of head-and-neck cancer following a diagnosis of severe cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Svahn, Malene F; Munk, C; Jensen, S M

    2016-01-01

    OBJECTIVE: Women with a history of cervical intraepithelial neoplasia grade 3 including adenocarcinoma in situ (CIN3/AIS) may be more prone to develop cancers of the ano-genital region and head-and-neck cancers. The current literature is, however, limited. METHODS: We established a nationwide...

  18. Investigation of the effect of nitrogen on severity of Fusarium Head Blight in barley

    DEFF Research Database (Denmark)

    Yang, Fen; Jensen, J.D.; Spliid, N.H.

    2010-01-01

    The effect of nitrogen on Fusarium Head Blight (FHB) in a susceptible barley cultivar was investigated using gel-based proteomics. Barley grown with either 15 or 100 kg ha(-1)N fertilizer was inoculated with Fusarium graminearum (Fg). The storage protein fraction did not change significantly...

  19. Development of simplified 1D and 2D models for studying a PWR lower head failure under severe accident conditions

    International Nuclear Information System (INIS)

    Koundy, V.; Dupas, J.; Bonneville, H.; Cormeau, I.

    2005-01-01

    In the study of severe accidents of nuclear pressurized water reactors, the scenarios that describe the relocation of significant quantities of liquid corium at the bottom of the lower head are investigated from the mechanical point of view. In these scenarios, the risk of a breach and the possibility of a large quantity of corium being released from the lower head exist. This may lead to direct heating of the containment or outer vessel steam explosion. These issues are important due to their early containment failure potential. Since the TMI-2 accident, many theoretical and experimental investigations, relating to lower head mechanical behaviour under severe thermo-mechanical loading in the event of a core meltdown accident have been performed. IRSN participated actively in the one-fifth scale USNRC/SNL LHF and OECD LHF (OLHF) programs. Within the framework of these programs, two simplified models were developed by IRSN: the first is a simplified 1D approach based on the theory of pressurized spherical shells and the second is a simplified 2D model based on the theory of shells of revolution under symmetric loading. The mathematical formulation of both models and the creep constitutive equations used are presented in detail in this paper. The corresponding models were used to interpret some of the OLHF program experiments and the calculation results were quite consistent with the experimental data. The two simplified models have been used to simulate the thermo-mechanical behaviour of a 900 MWe pressurized water reactor lower head under severe accident conditions leading to failure. The average transient heat flux produced by the corium relocated at the bottom of the lower head has been determined using the IRSN HARAR code. Two different methods, both taking into account the ablation of the internal surface, are used to determine the temperature profiles across the lower head wall and their effect on the time to failure is discussed. Using these simplified models

  20. Early insulin resistance in severe trauma without head injury as outcome predictor? A prospective, monocentric pilot study

    Directory of Open Access Journals (Sweden)

    Bonizzoli Manuela

    2012-10-01

    Full Text Available Abstract Background Hyperglycemia following major trauma is a well know phenomenon related to stress-induced systemic reaction. Reports on glucose level management in patients with head trauma have been published, but the development of insulin resistance in trauma patients without head injury has not been extensively studied. The aim of this study was therefore to investigate the prognostic role of acute insulin-resistance, assessed by the HOMA model, in patients with severe trauma without head injury. Methods All patients consecutively admitted to the Intensive Care Unit (ICU of a tertiary referral center (Careggi Teaching Hospital, Florence, IT for major trauma without head injury (Jan-Dec 2010 were enrolled. Patients with a previous diagnosis of diabetes mellitus requiring insulin therapy or metabolism alteration were excluded from the analysis. Patients were divided into “insulin resistant” and “non-insulin resistant” based on the Homeostasis Model Assessment index (HOMA IR. Results are expressed as medians. Results Out of 175 trauma patients admitted to the ICU during the study period, a total of 54 patients without head trauma were considered for the study, 37 of whom met the inclusion criteria. In total, 23 patients (62.2% resulted insulin resistant, whereas 14 patients (37.8% were non-insulin resistant. Groups were comparable in demographic, clinical/laboratory characteristics, and severity of injury. Insulin resistant patients had a significantly higher BMI (P=0.0416, C-reactive protein (P=0.0265, and leukocytes count (0.0301, compared to non-insulin resistant patients. Also ICU length of stay was longer in insulin resistant patients (P=0.0381. Conclusions Our data suggest that admission insulin resistance might be used as an early outcome predictor.

  1. Trends of Non-Accidental, Cardiovascular, Stroke and Lung Cancer Mortality in Arkansas Are Associated with Ambient PM2.5 Reductions

    Directory of Open Access Journals (Sweden)

    Marie-Cecile G. Chalbot

    2014-07-01

    Full Text Available The cardiovascular and stroke mortality rates in Arkansas are among the highest in the USA. The annual trends of stroke and cardiovascular mortality are barely correlated to smoking cessation; while the prevalence of risk factors such as obesity; cholesterol and hypertension increased over the 1979–2007 period. The study determined the effect of chronic exposure to PM2.5 on non-accidental; cardiovascular; stroke and lung cancer mortality in Arkansas over the 2000–2010 period using the World Health Organization’s log-linear health impact model. County chronic exposures to PM2.5 were computed by averaging spatially-resolved gridded concentrations using PM2.5 observations. A spatial uniformity was observed for PM2.5 mass levels indicating that chronic exposures were comparable throughout the state. The reduction of PM2.5 mass levels by 3.0 μg/m3 between 2000 and 2010 explained a significant fraction of the declining mortality. The effect was more pronounced in southern and eastern rural Arkansas as compared to the rest of the state. This study provides evidence that the implementation of air pollution regulations has measurable effects on mortality even in regions with high prevalence of major risk factors such as obesity and smoking. These outcomes are noteworthy as efforts to modify the major risk factors require longer realization times.

  2. Optimizing bone surveys performed for suspected non-accidental trauma with attention to maximizing diagnostic yield while minimizing radiation exposure: utility of pelvic and lateral radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Jha, Priyanka; Stein-Wexler, Rebecca; Seibert, Anthony; Wootton-Gorges, Sandra L. [University of California Davis Medical Center, Department of Radiology, Sacramento, CA (United States); Coulter, Kevin [University of California Davis Medical Center, Department of Pediatrics, Sacramento, CA (United States); Li, Chin-Shang [University of California Davis Medical Center, Division of Biostatistics, Department of Public Health Sciences, Sacramento, CA (United States)

    2013-06-15

    Skeletal surveys for non-accidental trauma (NAT) include lateral spinal and pelvic views, which have a significant radiation dose. To determine whether pelvic and lateral spinal radiographs should routinely be performed during initial bone surveys for suspected NAT. The radiology database was queried for the period May 2005 to May 2011 using CPT codes for skeletal surveys for suspected NAT. Studies performed for skeletal dysplasia and follow-up surveys were excluded. Initial skeletal surveys were reviewed to identify fractures present, including those identified only on lateral spinal and/or pelvic radiographs. Clinical information and MR imaging was reviewed for the single patient with vertebral compression deformities. Of the 530 children, 223 (42.1%) had rib and extremity fractures suspicious for NAT. No fractures were identified solely on pelvic radiographs. Only one child (<0.2%) had vertebral compression deformities identified on a lateral spinal radiograph. This infant had rib and extremity fractures and was clinically paraplegic. MR imaging confirmed the vertebral body fractures. Since no fractures were identified solely on pelvic radiographs and on lateral spinal radiographs in children without evidence of NAT, nor in nearly all with evidence of NAT, inclusion of these views in the initial evaluation of children for suspected NAT may not be warranted. (orig.)

  3. Optimizing bone surveys performed for suspected non-accidental trauma with attention to maximizing diagnostic yield while minimizing radiation exposure: utility of pelvic and lateral radiographs

    International Nuclear Information System (INIS)

    Jha, Priyanka; Stein-Wexler, Rebecca; Seibert, Anthony; Wootton-Gorges, Sandra L.; Coulter, Kevin; Li, Chin-Shang

    2013-01-01

    Skeletal surveys for non-accidental trauma (NAT) include lateral spinal and pelvic views, which have a significant radiation dose. To determine whether pelvic and lateral spinal radiographs should routinely be performed during initial bone surveys for suspected NAT. The radiology database was queried for the period May 2005 to May 2011 using CPT codes for skeletal surveys for suspected NAT. Studies performed for skeletal dysplasia and follow-up surveys were excluded. Initial skeletal surveys were reviewed to identify fractures present, including those identified only on lateral spinal and/or pelvic radiographs. Clinical information and MR imaging was reviewed for the single patient with vertebral compression deformities. Of the 530 children, 223 (42.1%) had rib and extremity fractures suspicious for NAT. No fractures were identified solely on pelvic radiographs. Only one child (<0.2%) had vertebral compression deformities identified on a lateral spinal radiograph. This infant had rib and extremity fractures and was clinically paraplegic. MR imaging confirmed the vertebral body fractures. Since no fractures were identified solely on pelvic radiographs and on lateral spinal radiographs in children without evidence of NAT, nor in nearly all with evidence of NAT, inclusion of these views in the initial evaluation of children for suspected NAT may not be warranted. (orig.)

  4. Development of severe accident analysis code - Development of a finite element code for lower head failure analysis

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Hoon; Lee, Choong Ho; Choi, Tae Hoon; Kim, Hyun Sup; Kim, Se Ho; Kang, Woo Jong; Seo, Chong Kwan [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1995-08-01

    The study concerns the development of analysis models and computer codes for lower head failure analysis when a severe accident occurs in a nuclear reactor system. Although the lower head failure modes consists of several failure modes, the study this year was focused on the global rupture with the collapse pressure and mode by limit analysis and elastic deformation. The behavior of molten core causes elevation of temperature in the reactor vessel wall and deterioration of load-carrying capacity of a reactor vessel. The behavior of molten core and the heat transfer modes were, therefore, postulated in several types and the temperature distributions according to the assumed heat flux modes were calculated. The collapse pressure of a nuclear reactor lower head decreases rapidly with elevation of temperature as time passes. The calculation shows the safety of a nuclear reactor is enhanced with the lager collapse pressure when the hot spot is located far from the pole. 42 refs., 2 tabs., 31 figs. (author)

  5. Neuroimaging differential diagnoses to abusive head trauma

    International Nuclear Information System (INIS)

    Girard, Nadine; Brunel, Herve; Dory-Lautrec, Philippe; Chabrol, Brigitte

    2016-01-01

    Trauma is the most common cause of death in childhood, and abusive head trauma is the most common cause of traumatic death and morbidity in infants younger than 1 year. The main differential diagnosis of abusive head trauma is accidental traumatic brain injury, which is usually witnessed. This paper also discusses more uncommon diagnoses such as congenital and acquired disorders of hemostasis, cerebral arteriovenous malformations and metabolic diseases, all of which are extremely rare. Diagnostic imaging including CT and MRI is very important for the distinction of non-accidental from accidental traumatic injury. (orig.)

  6. Neuroimaging differential diagnoses to abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Nadine [AP-HM Timone 2, Department of Neuroradiology, Marseille cedex 05 (France); Aix Marseille University, UMR CNRS 7339, Marseille (France); Brunel, Herve; Dory-Lautrec, Philippe [AP-HM Timone 2, Department of Neuroradiology, Marseille cedex 05 (France); Chabrol, Brigitte [AP-HM Timone, Department of Pediatric Neurology, Marseille (France)

    2016-05-15

    Trauma is the most common cause of death in childhood, and abusive head trauma is the most common cause of traumatic death and morbidity in infants younger than 1 year. The main differential diagnosis of abusive head trauma is accidental traumatic brain injury, which is usually witnessed. This paper also discusses more uncommon diagnoses such as congenital and acquired disorders of hemostasis, cerebral arteriovenous malformations and metabolic diseases, all of which are extremely rare. Diagnostic imaging including CT and MRI is very important for the distinction of non-accidental from accidental traumatic injury. (orig.)

  7. Heading for a fall? Management of head injury in infants.

    LENUS (Irish Health Repository)

    Williamson, M

    2010-09-01

    Head injury is one of the commonest reasons for infants (< 1 year) to attend the Emergency Department (ED). Clinical management varies considerably and concern about non accidental injury results in a high admission rate in some hospitals. Information was obtained on 103 children under one year of age presenting to the ED with head injury in a prospective study. The average age was 6.7 months and 57% of patients were male. Twenty eight babies had skull x rays with 1 skull fracture diagnosed. None required CT brain scan. Ninety eight (94%) were discharged home from the ED. There were no unplanned returns, readmissions or adverse events. The incidence of traumatic brain injury in children under one year of age presenting with head injury is low and the majority can be safely discharged home.

  8. Femoral head retroposition as a potential compensatory mechanism in patients with a severe mismatch between pelvic incidence and lumbar lordosis.

    Science.gov (United States)

    Cheng, Xiaofei; Zhang, Kai; Sun, Xiaojiang; Zhao, Changqing; Li, Hua; Zhao, Jie

    2017-12-01

    Severe mismatch between pelvic incidence (PI) and lumbar lordosis (LL) leads to extra anterior displacement of the gravity line. The objective of this study is to investigate whether femoral head retroposition is a separate compensatory mechanism responsible for the extra anterior displacement. Based on the values of PI and LL, 94 patients were divided into the PI-LL match group (PI-LL ≤ 0°), the mild PI-LL mismatch group (20°> PI-LL >0°), and the severe PI-LL mismatch group (PI-LL ≥ 20°). A series of parameters including PI, LL, PI-LL, thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), knee flexion angle (KFA), tibial obliquity angle (TOA), sagittal vertical axis (SVA), S1 overhang, femoral head shift (FHS), and pelvic shift (PS) were measured and compared among the three groups. The severe PI-LL mismatch group exhibited significantly greater PI, PI-LL, PT, KFA, SVA, PS, and FHS, and less LL and TK, compared with the control and mild PI-LL mismatch group. The mild PI-LL mismatch group had significantly greater PI-LL, PT, KFA, TOA, and S1 overhang, and less LL and SS than the control group. SS, TOA, and S1 overhang in the severe PI-LL mismatch group differed significantly from that in the control group, but did not differ significantly from that in the mild PI-LL mismatch group. Femoral head retroposition is an entirely separate compensatory mechanism and, in this study, participated in the compensation for the anterior displacement of the gravity line induced by extra-sagittal spinal malalignment in patients with severe PI-LL mismatch.

  9. Diagnostic accuracy of fracture detection in suspected non-accidental injury: the effect of edge enhancement and digital display on observer performance

    Energy Technology Data Exchange (ETDEWEB)

    Offiah, A.C. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom) and Institute of Child Health, London (United Kingdom)]. E-mail: amaka.offiah@gosh.nhs.uk; Moon, L. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom); Hall, C.M. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom); Todd-Pokropek, A. [Department of Medical Physics and Bioengineering, University College London, London (United Kingdom)

    2006-02-15

    AIM: To compare the effect of varying degrees of edge enhancement and method of digital image display on fracture detection in suspected non-accidental injury (NAI). MATERIALS AND METHODS: Fifty radiographs from post-mortem skeletal surveys in 13 children with suspected NAI were selected. Images were obtained using a Fuji 5000R computed radiography system. Hard copies were printed with edge enhancement factors 0, 0.5 and 1.2. Images (edge enhancement 0.5) were also displayed on a 1K{sup 2} monitor. Six observers independently evaluated all 200 images for the presence of abnormality. Observers also scored each image for visualization of soft tissues, visualization of trabecular markings and overall image quality. The paired Student's t-test and location receiver operating curve (ROC) analysis were used to compare quality scores and diagnostic accuracy of each display method. Individual and pooled true-positive rates (sensitivity) were determined. For the purposes of ROC analysis, histology was taken as the gold standard. RESULTS: There was no difference in duration of hard and soft-copy reading sessions (p=0.76). After image manipulation soft-copy radiographs scored significantly better for image quality than hard copy (p<0.0001). Pooled observer sensitivity (at a specificity of 90%) was below 50% for all display methods. Diagnostic accuracy varied significantly between observers. Diagnostic accuracy of individual observers was not affected by display method. CONCLUSION: In suspected NAI, diagnostic accuracy of fracture detection is generally low. Diagnostic accuracy appears to be affected more by observer-related factors than by the method of digital image display.

  10. A comparative analysis of reactor lower head debris cooling models employed in the existing severe accident analysis codes

    International Nuclear Information System (INIS)

    Ahn, K.I.; Kim, D.H.; Kim, S.B.; Kim, H.D.

    1998-08-01

    MELCOR and MAAP4 are the representative severe accident analysis codes which have been developed for the integral analysis of the phenomenological reactor lower head corium cooling behavior. Main objectives of the present study is to identify merits and disadvantages of each relevant model through the comparative analysis of the lower plenum corium cooling models employed in these two codes. The final results will be utilized for the development of LILAC phenomenological models and for the continuous improvement of the existing MELCOR reactor lower head models, which are currently being performed at the KAERI. For these purposes, first, nine reference models are selected featuring the lower head corium behavior based on the existing experimental evidences and related models. Then main features of the selected models have been critically analyzed, and finally merits and disadvantages of each corresponding model have been summarized in the view point of realistic corium behavior and reasonable modeling. Being on these evidences, summarized and presented the potential improvements for developing more advanced models. The present study has been focused on the qualitative comparison of each model and so more detailed quantitative analysis is strongly required to obtain the final conclusions for their merits and disadvantages. In addition, in order to compensate the limitations of the current model, required further studies relating closely the detailed mechanistic models with the molten material movement and heat transfer based on phase-change in the porous medium, to the existing simple models. (author). 36 refs

  11. Metabolic crisis in severely head-injured patients: is ischemia just the tip of the iceberg?

    Science.gov (United States)

    Carre, Emilie; Ogier, Michael; Boret, Henry; Montcriol, Ambroise; Bourdon, Lionel; Jean-Jacques, Risso

    2013-10-11

    Ischemia and metabolic crisis are frequent post-traumatic secondary brain insults that negatively influence outcome. Clinicians commonly mix up these two types of insults, mainly because high lactate/pyruvate ratio (LPR) is the common marker for both ischemia and metabolic crisis. However, LPR elevations during ischemia and metabolic crisis reflect two different energetic imbalances: ischemia (Type 1 LPR elevations with low oxygenation) is characterized by a drastic deprivation of energetic substrates, whereas metabolic crisis (Type 2 LPR elevations with normal or high oxygenation) is associated with profound mitochondrial dysfunction but normal supply of energetic substrates. The discrimination between ischemia and metabolic crisis is crucial because conventional recommendations against ischemia may be detrimental for patients with metabolic crisis. Multimodal monitoring, including microdialysis and brain tissue oxygen monitoring, allows such discrimination, but these techniques are not easily accessible to all head-injured patients. Thus, a new "gold standard" and adapted medical education are required to optimize the management of patients with metabolic crisis.

  12. Metabolic crisis in severely head-injured patients: is ischemia just the tip of the iceberg?

    Directory of Open Access Journals (Sweden)

    Emilie eCarre

    2013-10-01

    Full Text Available Ischemia and metabolic crisis are frequent post-traumatic secondary brain insults that negatively influence outcome. Clinicians commonly mix up these two types of insults, mainly because high lactate/pyruvate ratio (LPR is the common marker for both ischemia and metabolic crisis. However, LPR elevations during ischemia and metabolic crisis reflect two different energetic imbalances: ischemia (Type 1 LPR elevations with low oxygenation is characterized by a drastic deprivation of energetic substrates, whereas metabolic crisis (Type 2 LPR elevations with normal or high oxygenation is associated with profound mitochondrial dysfunction but normal supply of energetic substrates. The discrimination between ischemia and metabolic crisis is crucial because conventional recommendations against ischemia may be detrimental for patients with metabolic crisis. Multimodal monitoring, including microdialysis and brain tissue oxygen monitoring, allows such discrimination, but these techniques are not easily accessible to all head-injured patients. Thus, a new gold standard and adapted medical education are required to optimize the management of patients with metabolic crisis.

  13. Severe pain as a possible cause of dropped head syndrome that was attenuated after amputation of an ischemic lower limb.

    Science.gov (United States)

    Maki, Satoshi; Koda, Masao; Furuya, Takeo; Takahashi, Kazuhisa; Yamazaki, Masashi

    2016-03-02

    Dropped head syndrome (DHS) is defined as weakness of the neck extensor muscles causing a correctable chin-on-the-chest deformity. Here we report the case of a patient with severe pain from lower leg ischemia showing DHS whose symptoms were attenuated by pain relief after amputation of the severely ischemic lower leg. To our knowledge this is the first report indicating that severe pain can cause DHS. A 64-year-old Asian woman was referred to our department with a 1-month history of DHS. She also suffered from severe right foot pain because of limb ischemia. She began to complain of DHS as her gangrenous foot pain worsened. She had neck pain and difficulty with forward gaze. We found no clinical or laboratory findings of neuromuscular disorder or isolated neck extensor myopathy. We amputated her leg below the knee because of progressive foot gangrene. Her severe foot pain resolved after the surgery and her DHS was attenuated. Severe pain can cause DHS. If a patient with DHS has severe pain in another part of the body, we recommend considering aggressive pain relief as a treatment option.

  14. A Basic Study on the Failure of Lower Head of Nuclear Reactor Vessel by Molten Core in Severe Accident

    International Nuclear Information System (INIS)

    Cho, Jongrea; Bang, Kwanghyun; Bae, Jihoon; Kim, Changsung; Jeon, Jongwon

    2013-01-01

    This paper is analyzed by transient analysis for eight hours. Thermal conditions were carried out to interpret the data obtained from the existing experiment, and the pressures analyses were conducted considering pressure drop by applying the 1MPa. According to the analysis, a portion of the nozzle and the head is soluble, while nozzles and heads were not separated. This structural analysis has a comparative analysis of strain and displacement due to the existence of creep. Without the creep effect, strain shows 2.7% in 2D model and 4.6 % in 3D model. And, strain shows 2.9% in 2D model and 4.7 % in 3D model, in creep effect condition. Both case is satisfied to allowable strain. When comparing both analyses about creep effect, strain differences are 0.2% in 2D model and 0.1% in 3D model. Thus, it can be seen that in these analyses, the effect that creep has is minor. The purpose of this study is to develop the analysis techniques of the reactor vessel lower head under in-vessel pressure loads and thermal loads in severe accident. First, the temperature distribution in accordance with time using the thermal loads imposed on the lower head inner wall for simplified 2D model and 3D model respectively was analyzed. Second, the pressure applied on the lower head inner wall, was calculated by using the simplified 2D model and 3D model respectively. And The results of the analysis are indicated by equivalent von-mises stress and sum of the displacement, respectively. Third, the creep model and parameters used in the calculation were selected as well as the curve fitting of the experimental creep data. The plastic strain is the major cause of failure of the reactor pressure vessel. However, it can be calculated in this study that creep is not an important factor of failure of the reactor pressure vessel given the above mechanical and thermal loads

  15. Air Versus Ground Transportation in Isolated Severe Head Trauma: A National Trauma Data Bank Study.

    Science.gov (United States)

    Aiolfi, Alberto; Benjamin, Elizabeth; Recinos, Gustavo; De Leon Castro, Alejandro; Inaba, Kenji; Demetriades, Demetrios

    2018-03-01

    The effect of prehospital helicopter emergency medical services (HEMS) on mortality has been analyzed previously in polytrauma patients with discordant results. Our aim was to compare outcomes in patients with isolated severe blunt traumatic brain injuries (TBIs) transported by HEMS or ground emergency medical services (GEMS). We conducted a National Trauma Data Bank study (2007-2014). All adult patients (≥16 years old) who sustained an isolated severe blunt TBI and were transported by HEMS or GEMS were included in the study. There were 145,559 patients who met the inclusion criteria. Overall, 116,391 (80%) patients were transported via GEMS and 29,168 (20%) via HEMS. Median transportation time was longer for HEMS patients (41 vs. 25 min; p transportation was independently associated with improved survival (odds ratio [OR] 0.55; 95% confidence interval [CI] 0.47-0.67; p transport was an independent predictor of survival (AIS 3: OR 0.35; p transport time was not an independent predictor of mortality. Helicopter transport, in adult patients with isolated severe TBI, is associated with improved survival. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Development and management of severe cutaneous side effects in head-and-neck cancer patients during concurrent radiotherapy and cetuximab

    Energy Technology Data Exchange (ETDEWEB)

    Boelke, E.; Mueller-Homey, A.; Pape, H.; Giro, C.; Matuschek, C.; Gripp, S.; Budach, W. [Dept. of Radiation Oncology, Univ. of Duesseldorf (Germany); Gerber, P.A.; Bruch-Gerharz, D.; Homey, B. [Dept. of Dermatology, Univ. of Duesseldorf (Germany); Lammering, G. [Dept. of Radiation Oncology (MAASTRO Clinic), Univ. Hospital Maastricht (Netherlands); Peiper, M. [Dept. of Surgery, Univ. of Duesseldorf (Germany); Hoffmann, T.K. [Dept. of Otorhinolarynogology, Univ. of Duesseldorf (Germany)

    2008-02-15

    Background: the concurrent administration of cetuximab to radiotherapy has recently been shown to improve the clinical outcome of head-and-neck cancer (HNC) patients. An aggravation of the radiation-induced skin toxicity was not described. Here, however, two cases with severe skin toxicity during the combined treatment are reported. Clinical observations: in a small group of five patients with locally advanced HNC treated with irradiation and concurrent cetuximab, two cases of unusually severe radiation dermatitis were observed. Both patients developed confluent moist desquamations confined to the irradiation field at a dose of 40 Gy (CTC - Common Toxicity Criteria, grade 3), which progressed into an ulcerative dermatitis (grade 4) at 58 Gy and 46 Gy, respectively. Histopathology showed a vacuolic degeneration of basal keratinocytes, subepidermal blister formation, and mixed perivascular and interstitial inflammatory infiltrates leading to a complete loss of the epidermis. These cutaneous side effects led to the discontinuation of radiotherapy. Topical corticosteroids and systemic antibiotic treatment resulted in wound healing, which allowed the continuation of radiotherapy. Conclusion: these findings indicate that cetuximab may have the potential to enhance the severity of radiation dermatitis in HNC patients. A systematic monitoring of cutaneous side effects during radiotherapy plus cetuximab is advised in order to reliably estimate the frequency of severe (grade 3/4) radiation dermatitis. (orig.)

  17. Development and management of severe cutaneous side effects in head-and-neck cancer patients during concurrent radiotherapy and cetuximab

    International Nuclear Information System (INIS)

    Boelke, E.; Mueller-Homey, A.; Pape, H.; Giro, C.; Matuschek, C.; Gripp, S.; Budach, W.; Gerber, P.A.; Bruch-Gerharz, D.; Homey, B.; Lammering, G.; Peiper, M.; Hoffmann, T.K.

    2008-01-01

    Background: the concurrent administration of cetuximab to radiotherapy has recently been shown to improve the clinical outcome of head-and-neck cancer (HNC) patients. An aggravation of the radiation-induced skin toxicity was not described. Here, however, two cases with severe skin toxicity during the combined treatment are reported. Clinical observations: in a small group of five patients with locally advanced HNC treated with irradiation and concurrent cetuximab, two cases of unusually severe radiation dermatitis were observed. Both patients developed confluent moist desquamations confined to the irradiation field at a dose of 40 Gy (CTC - Common Toxicity Criteria, grade 3), which progressed into an ulcerative dermatitis (grade 4) at 58 Gy and 46 Gy, respectively. Histopathology showed a vacuolic degeneration of basal keratinocytes, subepidermal blister formation, and mixed perivascular and interstitial inflammatory infiltrates leading to a complete loss of the epidermis. These cutaneous side effects led to the discontinuation of radiotherapy. Topical corticosteroids and systemic antibiotic treatment resulted in wound healing, which allowed the continuation of radiotherapy. Conclusion: these findings indicate that cetuximab may have the potential to enhance the severity of radiation dermatitis in HNC patients. A systematic monitoring of cutaneous side effects during radiotherapy plus cetuximab is advised in order to reliably estimate the frequency of severe (grade 3/4) radiation dermatitis. (orig.)

  18. Oxidative Stress and Antioxidant Therapy in Critically Ill Polytrauma Patients with Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Luca Loredana

    2015-05-01

    Full Text Available Traumatic Brain Injury (TBI is one of the leading causes of death among critically ill patients from the Intensive Care Units (ICU. After primary traumatic injuries, secondary complications occur, which are responsible for the progressive degradation of the clinical status in this type of patients. These include severe inflammation, biochemical and physiological imbalances and disruption of the cellular functionality. The redox cellular potential is determined by the oxidant/antioxidant ratio. Redox potential is disturbed in case of TBI leading to oxidative stress (OS. A series of agression factors that accumulate after primary traumatic injuries lead to secondary lesions represented by brain ischemia and hypoxia, inflammatory and metabolic factors, coagulopathy, microvascular damage, neurotransmitter accumulation, blood-brain barrier disruption, excitotoxic damage, blood-spinal cord barrier damage, and mitochondrial dysfunctions. A cascade of pathophysiological events lead to accelerated production of free radicals (FR that further sustain the OS. To minimize the OS and restore normal oxidant/antioxidant ratio, a series of antioxidant substances is recommended to be administrated (vitamin C, vitamin E, resveratrol, N-acetylcysteine. In this paper we present the biochemical and pathophysiological mechanism of action of FR in patients with TBI and the antioxidant therapy available.

  19. Trauma patient adverse outcomes are independently associated with rib cage fracture burden and severity of lung, head, and abdominal injuries.

    Science.gov (United States)

    Dunham, C Michael; Hileman, Barbara M; Ransom, Kenneth J; Malik, Rema J

    2015-01-01

    We hypothesized that lung injury and rib cage fracture quantification would be associated with adverse outcomes. Consecutive admissions to a trauma center with Injury Severity Score ≥ 9, age 18-75, and blunt trauma. CT scans were reviewed to score rib and sternal fractures and lung infiltrates. Sternum and each anterior, lateral, and posterior rib fracture was scored 1 = non-displaced and 2 = displaced. Rib cage fracture score (RCFS) = total rib fracture score + sternal fracture score + thoracic spine Abbreviated Injury Score (AIS). Four lung regions (right upper/middle, right lower, left upper, and left lower lobes) were each scored for % of infiltrate: 0% = 0; ≤ 20% = 1, ≤ 50% = 2, > 50% = 3; total of 4 scores = lung infiltrate score (LIS). Of 599 patients, 193 (32%) had 854 rib fractures. Rib fracture patients had more abdominal injuries (p fractures (p = 0.0028) and death or need for mechanical ventilation ≥ 3 days (Death/Vdays ≥ 3) (p rib fracture patients, Glasgow Coma Score 3-12 or head AIS ≥ 2 occurred in 43%. A lung infiltrate or hemo/pneumothorax occurred in 55%. Thoracic spine injury occurred in 23%. RCFS was 6.3 ± 4.4 and Death/Vdays ≥ 3 occurred in 31%. Death/Vdays ≥ 3 rates correlated with RCFS values: 19% for 1-3; 24% for 4-6; 42% for 7-12 and 65% for ≥ 13 (p rib fracture score (p = 0.08) or number of fractured ribs (p = 0.80). Rib fracture patients have increased risk for truncal injuries and adverse outcomes. Adverse outcomes are independently associated with rib cage fracture burden. Severity of head, abdominal, and lung injuries also influence rib fracture outcomes.

  20. The Head Injury Retrieval Trial (HIRT): a single-centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics only

    Science.gov (United States)

    Garner, Alan A; Mann, Kristy P; Fearnside, Michael; Poynter, Elwyn; Gebski, Val

    2015-01-01

    Background Advanced prehospital interventions for severe brain injury remains controversial. No previous randomised trial has been conducted to evaluate additional physician intervention compared with paramedic only care. Methods Participants in this prospective, randomised controlled trial were adult patients with blunt trauma with either a scene GCS score <9 (original definition), or GCS<13 and an Abbreviated Injury Scale score for the head region ≥3 (modified definition). Patients were randomised to either standard ground paramedic treatment or standard treatment plus a physician arriving by helicopter. Patients were evaluated by 30-day mortality and 6-month Glasgow Outcome Scale (GOS) scores. Due to high non-compliance rates, both intention-to-treat and as-treated analyses were preplanned. Results 375 patients met the original definition, of which 197 was allocated to physician care. Differences in the 6-month GOS scores were not significant on intention-to-treat analysis (OR 1.11, 95% CI 0.74 to 1.66, p=0.62) nor was the 30-day mortality (OR 0.91, 95% CI 0.60 to 1.38, p=0.66). As-treated analysis showed a 16% reduction in 30-day mortality in those receiving additional physician care; 60/195 (29%) versus 81/180 (45%), p<0.01, Number needed to treat =6. 338 patients met the modified definition, of which 182 were allocated to physician care. The 6-month GOS scores were not significantly different on intention-to-treat analysis (OR 1.14, 95% CI 0.73 to 1.75, p=0.56) nor was the 30-day mortality (OR 1.05, 95% CI 0.66 to 1.66, p=0.84). As-treated analyses were also not significantly different. Conclusions This trial suggests a potential mortality reduction in patients with blunt trauma with GCS<9 receiving additional physician care (original definition only). Confirmatory studies which also address non-compliance issues are needed. Trial registration number NCT00112398. PMID:25795741

  1. Delayed life-threatening subdural hematoma after minor head injury in a patient with severe coagulopathy: a case report

    NARCIS (Netherlands)

    Engelen, Marc; Nederkoorn, Paul J.; Smits, Marion; van de Beek, Diederik

    2009-01-01

    Minor head injury is a frequent cause for neurologic consultation and imaging. Most patients with minor head injury will make an uneventful recovery, but in a very small proportion of these patients life threatening intracranial complications occur. We describe a patient on oral anticoagulation

  2. Delayed life-threatening subdural hematoma after minor head injury in a patient with severe coagulopathy: A case report

    NARCIS (Netherlands)

    M. Engelen (Marc); P.J. Nederkoorn (Paul); M. Smits (Marion); D. van de Beek (Diederik)

    2009-01-01

    textabstractMinor head injury is a frequent cause for neurologic consultation and imaging. Most patients with minor head injury will make an uneventful recovery, but in a very small proportion of these patients life threatening intracranial complications occur. We describe a patient on oral

  3. Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy

    International Nuclear Information System (INIS)

    Dean, Jamie A.; Wong, Kee H.; Gay, Hiram; Welsh, Liam C.; Jones, Ann-Britt; Schick, Ulrike; Oh, Jung Hun; Apte, Aditya; Newbold, Kate L.; Bhide, Shreerang A.; Harrington, Kevin J.; Deasy, Joseph O.; Nutting, Christopher M.; Gulliford, Sarah L.

    2016-01-01

    Purpose: Current normal tissue complication probability modeling using logistic regression suffers from bias and high uncertainty in the presence of highly correlated radiation therapy (RT) dose data. This hinders robust estimates of dose-response associations and, hence, optimal normal tissue–sparing strategies from being elucidated. Using functional data analysis (FDA) to reduce the dimensionality of the dose data could overcome this limitation. Methods and Materials: FDA was applied to modeling of severe acute mucositis and dysphagia resulting from head and neck RT. Functional partial least squares regression (FPLS) and functional principal component analysis were used for dimensionality reduction of the dose-volume histogram data. The reduced dose data were input into functional logistic regression models (functional partial least squares–logistic regression [FPLS-LR] and functional principal component–logistic regression [FPC-LR]) along with clinical data. This approach was compared with penalized logistic regression (PLR) in terms of predictive performance and the significance of treatment covariate–response associations, assessed using bootstrapping. Results: The area under the receiver operating characteristic curve for the PLR, FPC-LR, and FPLS-LR models was 0.65, 0.69, and 0.67, respectively, for mucositis (internal validation) and 0.81, 0.83, and 0.83, respectively, for dysphagia (external validation). The calibration slopes/intercepts for the PLR, FPC-LR, and FPLS-LR models were 1.6/−0.67, 0.45/0.47, and 0.40/0.49, respectively, for mucositis (internal validation) and 2.5/−0.96, 0.79/−0.04, and 0.79/0.00, respectively, for dysphagia (external validation). The bootstrapped odds ratios indicated significant associations between RT dose and severe toxicity in the mucositis and dysphagia FDA models. Cisplatin was significantly associated with severe dysphagia in the FDA models. None of the covariates was significantly associated with severe

  4. Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dean, Jamie A., E-mail: jamie.dean@icr.ac.uk [Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London (United Kingdom); Wong, Kee H. [Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Gay, Hiram [Department of Radiation Oncology, School of Medicine, Washington University in St Louis, St Louis, Missouri (United States); Welsh, Liam C.; Jones, Ann-Britt; Schick, Ulrike [Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Oh, Jung Hun; Apte, Aditya [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Newbold, Kate L.; Bhide, Shreerang A.; Harrington, Kevin J. [Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Division of Radiotherapy and Imaging, The Institute of Cancer Research, London (United Kingdom); Deasy, Joseph O. [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Nutting, Christopher M. [Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Division of Radiotherapy and Imaging, The Institute of Cancer Research, London (United Kingdom); Gulliford, Sarah L. [Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London (United Kingdom)

    2016-11-15

    Purpose: Current normal tissue complication probability modeling using logistic regression suffers from bias and high uncertainty in the presence of highly correlated radiation therapy (RT) dose data. This hinders robust estimates of dose-response associations and, hence, optimal normal tissue–sparing strategies from being elucidated. Using functional data analysis (FDA) to reduce the dimensionality of the dose data could overcome this limitation. Methods and Materials: FDA was applied to modeling of severe acute mucositis and dysphagia resulting from head and neck RT. Functional partial least squares regression (FPLS) and functional principal component analysis were used for dimensionality reduction of the dose-volume histogram data. The reduced dose data were input into functional logistic regression models (functional partial least squares–logistic regression [FPLS-LR] and functional principal component–logistic regression [FPC-LR]) along with clinical data. This approach was compared with penalized logistic regression (PLR) in terms of predictive performance and the significance of treatment covariate–response associations, assessed using bootstrapping. Results: The area under the receiver operating characteristic curve for the PLR, FPC-LR, and FPLS-LR models was 0.65, 0.69, and 0.67, respectively, for mucositis (internal validation) and 0.81, 0.83, and 0.83, respectively, for dysphagia (external validation). The calibration slopes/intercepts for the PLR, FPC-LR, and FPLS-LR models were 1.6/−0.67, 0.45/0.47, and 0.40/0.49, respectively, for mucositis (internal validation) and 2.5/−0.96, 0.79/−0.04, and 0.79/0.00, respectively, for dysphagia (external validation). The bootstrapped odds ratios indicated significant associations between RT dose and severe toxicity in the mucositis and dysphagia FDA models. Cisplatin was significantly associated with severe dysphagia in the FDA models. None of the covariates was significantly associated with severe

  5. Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy.

    Science.gov (United States)

    Dean, Jamie A; Wong, Kee H; Gay, Hiram; Welsh, Liam C; Jones, Ann-Britt; Schick, Ulrike; Oh, Jung Hun; Apte, Aditya; Newbold, Kate L; Bhide, Shreerang A; Harrington, Kevin J; Deasy, Joseph O; Nutting, Christopher M; Gulliford, Sarah L

    2016-11-15

    Current normal tissue complication probability modeling using logistic regression suffers from bias and high uncertainty in the presence of highly correlated radiation therapy (RT) dose data. This hinders robust estimates of dose-response associations and, hence, optimal normal tissue-sparing strategies from being elucidated. Using functional data analysis (FDA) to reduce the dimensionality of the dose data could overcome this limitation. FDA was applied to modeling of severe acute mucositis and dysphagia resulting from head and neck RT. Functional partial least squares regression (FPLS) and functional principal component analysis were used for dimensionality reduction of the dose-volume histogram data. The reduced dose data were input into functional logistic regression models (functional partial least squares-logistic regression [FPLS-LR] and functional principal component-logistic regression [FPC-LR]) along with clinical data. This approach was compared with penalized logistic regression (PLR) in terms of predictive performance and the significance of treatment covariate-response associations, assessed using bootstrapping. The area under the receiver operating characteristic curve for the PLR, FPC-LR, and FPLS-LR models was 0.65, 0.69, and 0.67, respectively, for mucositis (internal validation) and 0.81, 0.83, and 0.83, respectively, for dysphagia (external validation). The calibration slopes/intercepts for the PLR, FPC-LR, and FPLS-LR models were 1.6/-0.67, 0.45/0.47, and 0.40/0.49, respectively, for mucositis (internal validation) and 2.5/-0.96, 0.79/-0.04, and 0.79/0.00, respectively, for dysphagia (external validation). The bootstrapped odds ratios indicated significant associations between RT dose and severe toxicity in the mucositis and dysphagia FDA models. Cisplatin was significantly associated with severe dysphagia in the FDA models. None of the covariates was significantly associated with severe toxicity in the PLR models. Dose levels greater than

  6. Memory for the perceptual and semantic attributes of information in pure amnesic and severe closed-head injured patients.

    Science.gov (United States)

    Carlesimo, Giovanni A; Bonanni, Rita; Caltagirone, Carlo

    2003-05-01

    This study investigated the hypothesis that brain damaged patients with memory disorder are poorer at remembering the semantic than the perceptual attributes of information. Eight patients with memory impairment of different etiology and 24 patients with chronic consequences of severe closed-head injury were compared to similarly sized age- and literacy-matched normal control groups on recognition tests for the physical aspect and the semantic identity of words and pictures lists. In order to avoid interpretative problems deriving from different absolute levels of performance, study conditions were manipulated across subjects to obtain comparable accuracy on the perceptual recognition tests in the memory disordered and control groups. The results of the Picture Recognition test were consistent with the hypothesis. Indeed, having more time for the stimulus encoding, the two memory disordered groups performed at the same level as the normal subjects on the perceptual test but significantly lower on the semantic test. Instead, on the Word Recognition test, following study condition manipulation, patients and controls performed similarly on both the perceptual and the semantic tests. These data only partially support the hypothesis of the study; rather they suggest that in memory disordered patients there is a reduction of the advantage, exhibited by normal controls, of retrieving pictures over words (picture superiority effect).

  7. Subdural Effusions with Hydrocephalus after Severe Head Injury: Successful Treatment with Ventriculoperitoneal Shunt Placement: Report of 3 Adult Cases

    Directory of Open Access Journals (Sweden)

    N. Tzerakis

    2010-01-01

    Full Text Available Background. Subdural collections of cerebrospinal fluid (CSF with associated hydrocephalus have been described by several different and sometimes inaccurate terms. It has been proposed that a subdural effusion with hydrocephalus (SDEH can be treated effectively with a ventriculoperitoneal shunt (V-P shunt. In this study, we present our experience treating patients with SDEH without directly treating the subdural collection. Methods. We treated three patients with subdural effusions and hydrocephalus as a result of a head injury. All the patients were treated with a V-P shunt despite the fact that there was an extra-axial CSF collection with midline shift. Results. In all of the patients, the subdural effusions subsided and the ventricular dilatation improved in the postoperative period. The final clinical outcome remains difficult to predict and depends not only on the successful CSF diversion but also on the primary and secondary brain insult. Conclusion. Subdural effusions with hydrocephalus can be safely and effectively treated with V-P shunting, without directly treating the subdural effusion which subsides along with the treatment of hydrocephalus. However, it is extremely important to make an accurate diagnosis of an SDEH and differentiate this condition from other subdural collections which require different management.

  8. Comparison of intracranial computed tomographic (CT) findings in pediatric abusive and accidental head trauma

    International Nuclear Information System (INIS)

    Hymel, K.P.; Rumack, C.M.; Hay, T.C.; Strain, J.D.; Jenny, C.

    1997-01-01

    Background. Child abuse specialists rely heavily on diagnostic neuroimaging. Objectives. Study objectives were: (1) to compare the frequencies of six specific intracranial CT abnormalities in accidental and non-accidental pediatric head trauma, and (2) to assess interobserver agreement regarding these CT findings. Materials and methods. Three pediatric radiologists blindly and independently reviewed cranial CT scans of pediatric patients who sustained closed head trauma between 1991 and 1994. All patients were less than 4 years of age. Study cases included thirty-nine (50 %) with non-accidental head trauma and thirty-nine (50 %) with accidental head trauma. Each scan was evaluated for the presence or absence of the following six intracranial findings: (1) interhemispheric falx hemorrhage, (2) subdural hemorrhage, (3) large (non-acute) extra-axial fluid, (4) basal ganglia edema, (5) posterior fossa hemorrhage, and (6) frontal-parietal shearing tear(s). Interobserver agreement was calculated as the percentage of total cases in which all reviewers agreed a specific CT finding was present or absent. Diagnosis required independent agreement by all three pediatric radiologists. The frequencies of these six intracranial CT abnormalities were compared between the two study groups by Chi-square analysis and Fisher's exact test. Results. Interobserver agreement between radiologists was greater than 80 % for all lesions evaluated, with the exception of frontal-parietal shearing tear(s). Interhemispheric falx hemorrhage, subdural hemorrhage, large (non-acute) extra-axial fluid, and basal ganglia edema were discovered significantly more frequently in non-accidental trauma (P ≤.05). Conclusion. Although not specific for child abuse, discovery of these intracranial CT abnormalities in young patients should prompt careful evaluation of family and injury circumstances for indicators of non-accidental trauma. (orig.). With 6 figs., 2 tabs

  9. Retrospective evaluation of early and aggressive decompressive craniectomy (DC) for severe head injury. Was that DC necessary?

    International Nuclear Information System (INIS)

    Hagihara, Yasushi; Ueno, Masato; Mizushima, Yasuaki; Matsuoka, Tetsuya

    2011-01-01

    Recently, decompressive craniectomy (DC) for refractory intracranial hypertension (IH) has been widely reevaluated, and many researchers support the advantages of early and aggressive DC in the management of severe head trauma. We too applied DC in the early stages of IH, and confirmed its favorable results compared to those of the standard treatment. In patients with evacuate masses (EM), DC was determined based on the intraoperative condition of the brain parenchyma; in those without EM, intracranial pressure (ICP) ≥30 mmHg was considered the criterion for DC. However, in some cases, the expected brain edema (BE) was absent after DC, and DC seemed unnecessary on retrospection. Here, the effectiveness of DC performed at our hospital and its predictive factors were investigated. Of the 26 DCs performed in the past 3.5 years, 9 were ineffective because the expected BEs were absent on postoperative computed tomography. In those 9 cases, the Glasgow coma scale (GCS) scores and D-dimer of fibrinogen degradation product (FDP-DD) were significantly higher and lower, respectively, than those of the control group. Patients with EM showed similar trends regarding the GCS score and FDP-DD, both of which are probable indicators of BE. In patients without EM, the GCS score and FDP-DD were normal, but their base excess at admission was significantly low with increased ICP, requiring DC. GCS score and FDP-DD may represent the extent of mechanically damaged brain, and this may explain their relation with DC effectiveness in patients with EM. In patients without EM and with mild brain damage, base excess that reflects the respiratory or circulatory disorder should be the predictor for BE. (author)

  10. Mental fatigue after very severe closed head injury: Sustained performance, mental effort, and distress at two levels of workload in a driving simulator

    NARCIS (Netherlands)

    Riese, H.; Hoedemaeker, M.; Brouwer, W.H.; Mulder, L.J.M.; Cremer, R.; Veldman, J.B.P.

    1999-01-01

    In patients with very severe closed head injury (CHI), returning to work is often problematic. The present study focuses on a persistent complaint of these patients, viz. mental fatigue. To study this, the effect of sustained workload is assessed in a continuous dynamic divided attention task. Three

  11. Mental fatigue after very severe closed head injury : Sustained performance, mental effort, and distress at two levels of workload in a driving simulator

    NARCIS (Netherlands)

    Riese, H; Hoedemaeker, M; Brouwer, WH; Mulder, LJM; Veldman, JBP

    In patients with very severe closed head injury (CHI), returning to work is often problematic. The present study focuses on a persistent complaint of these patients, viz. mental fatigue. To study this, the effect of sustained workload is assessed in a continuous dynamic divided attention task. Three

  12. Head Injuries

    Science.gov (United States)

    ... a severe blow to the head can still knock the brain into the side of the skull ... following certain precautions and taking a break from sports and other activities that make symptoms worse. Playing ...

  13. The M. D. Anderson Symptom Inventory-Head and Neck Module, a Patient-Reported Outcome Instrument, Accurately Predicts the Severity of Radiation-Induced Mucositis

    International Nuclear Information System (INIS)

    Rosenthal, David I.; Mendoza, Tito R.; Chambers, Mark; Burkett, V. Shannon; Garden, Adam S.; Hessell, Amy C.; Lewin, Jan S.; Ang, K. Kian; Kies, Merrill S.; Gning, Ibrahima; Wang, Xin S.; Cleeland, Charles S.

    2008-01-01

    Purpose: To compare the M. D. Anderson Symptom Inventory-Head and Neck (MDASI-HN) module, a symptom burden instrument, with the Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN) module, a quality-of-life instrument, for the assessment of mucositis in patients with head-and-neck cancer treated with radiotherapy and to identify the most distressing symptoms from the patient's perspective. Methods and Materials: Consecutive patients with head-and-neck cancer (n = 134) completed the MDASI-HN and FACT-HN before radiotherapy (time 1) and after 6 weeks of radiotherapy or chemoradiotherapy (time 2). The mean global and subscale scores for each instrument were compared with the objective mucositis scores determined from the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0. Results: The global and subscale scores for each instrument showed highly significant changes from time 1 to time 2 and a significant correlation with the objective mucositis scores at time 2. Only the MDASI scores, however, were significant predictors of objective Common Terminology Criteria for Adverse Events mucositis scores on multivariate regression analysis (standardized regression coefficient, 0.355 for the global score and 0.310 for the head-and-neck cancer-specific score). Most of the moderate and severe symptoms associated with mucositis as identified on the MDASI-HN are not present on the FACT-HN. Conclusion: Both the MDASI-HN and FACT-HN modules can predict the mucositis scores. However, the MDASI-HN, a symptom burden instrument, was more closely associated with the severity of radiation-induced mucositis than the FACT-HN on multivariate regression analysis. This greater association was most likely related to the inclusion of a greater number of face-valid mucositis-related items in the MDASI-HN compared with the FACT-HN

  14. Risk of Severe Toxicity According to Site of Recurrence in Patients Treated With Stereotactic Body Radiation Therapy for Recurrent Head and Neck Cancer

    International Nuclear Information System (INIS)

    Ling, Diane C.; Vargo, John A.; Ferris, Robert L.; Ohr, James; Clump, David A.; Yau, Wai-Ying Wendy; Duvvuri, Umamaheswar; Kim, Seungwon; Johnson, Jonas T.; Bauman, Julie E.; Branstetter, Barton F.; Heron, Dwight E.

    2016-01-01

    Purpose: To report a 10-year update of our institutional experience with stereotactic body radiation therapy (SBRT) for reirradiation of locally recurrent head and neck cancer, focusing on predictors of toxicity. Methods and Materials: A retrospective review was performed on 291 patients treated with SBRT for recurrent, previously irradiated head and neck cancer between April 2002 and March 2013. Logistic regression analysis was performed to identify predictors of severe acute and late toxicity. Patients with <3 months of follow-up (n=43) or who died within 3 months of treatment (n=21) were excluded from late toxicity analysis. Results: Median time to death or last clinical follow-up was 9.8 months among the entire cohort and 53.1 months among surviving patients. Overall, 33 patients (11.3%) experienced grade ≥3 acute toxicity and 43 (18.9%) experienced grade ≥3 late toxicity. Compared with larynx/hypopharynx, treatment of nodal recurrence was associated with a lower risk of severe acute toxicity (P=.03), with no significant differences in severe acute toxicity among other sites. Patients treated for a recurrence in the larynx/hypopharynx experienced significantly more severe late toxicity compared with those with oropharyngeal, oral cavity, base of skull/paranasal sinus, salivary gland, or nodal site of recurrence (P<.05 for all). Sixteen patients (50%) with laryngeal/hypopharyngeal recurrence experienced severe late toxicity, compared with 6-20% for other sites. Conclusions: Salvage SBRT is a safe and effective option for most patients with previously irradiated head and neck cancer. However, patients treated to the larynx or hypopharynx experience significantly more late toxicity compared with others and should be carefully selected for treatment, with consideration given to patient performance status, pre-existing organ dysfunction, and goals of care. Treatment toxicity in these patients may be mitigated with more conformal plans to allow for increased

  15. Risk of Severe Toxicity According to Site of Recurrence in Patients Treated With Stereotactic Body Radiation Therapy for Recurrent Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ling, Diane C.; Vargo, John A. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Ferris, Robert L. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Ohr, James [Division of Medical Oncology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Clump, David A.; Yau, Wai-Ying Wendy [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Duvvuri, Umamaheswar; Kim, Seungwon; Johnson, Jonas T. [Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Bauman, Julie E. [Division of Medical Oncology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Branstetter, Barton F. [Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Heron, Dwight E., E-mail: herond2@umpc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States)

    2016-07-01

    Purpose: To report a 10-year update of our institutional experience with stereotactic body radiation therapy (SBRT) for reirradiation of locally recurrent head and neck cancer, focusing on predictors of toxicity. Methods and Materials: A retrospective review was performed on 291 patients treated with SBRT for recurrent, previously irradiated head and neck cancer between April 2002 and March 2013. Logistic regression analysis was performed to identify predictors of severe acute and late toxicity. Patients with <3 months of follow-up (n=43) or who died within 3 months of treatment (n=21) were excluded from late toxicity analysis. Results: Median time to death or last clinical follow-up was 9.8 months among the entire cohort and 53.1 months among surviving patients. Overall, 33 patients (11.3%) experienced grade ≥3 acute toxicity and 43 (18.9%) experienced grade ≥3 late toxicity. Compared with larynx/hypopharynx, treatment of nodal recurrence was associated with a lower risk of severe acute toxicity (P=.03), with no significant differences in severe acute toxicity among other sites. Patients treated for a recurrence in the larynx/hypopharynx experienced significantly more severe late toxicity compared with those with oropharyngeal, oral cavity, base of skull/paranasal sinus, salivary gland, or nodal site of recurrence (P<.05 for all). Sixteen patients (50%) with laryngeal/hypopharyngeal recurrence experienced severe late toxicity, compared with 6-20% for other sites. Conclusions: Salvage SBRT is a safe and effective option for most patients with previously irradiated head and neck cancer. However, patients treated to the larynx or hypopharynx experience significantly more late toxicity compared with others and should be carefully selected for treatment, with consideration given to patient performance status, pre-existing organ dysfunction, and goals of care. Treatment toxicity in these patients may be mitigated with more conformal plans to allow for increased

  16. The Head Injury Retrieval Trial (HIRT): a single-centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics only.

    Science.gov (United States)

    Garner, Alan A; Mann, Kristy P; Fearnside, Michael; Poynter, Elwyn; Gebski, Val

    2015-11-01

    Advanced prehospital interventions for severe brain injury remains controversial. No previous randomised trial has been conducted to evaluate additional physician intervention compared with paramedic only care. Participants in this prospective, randomised controlled trial were adult patients with blunt trauma with either a scene GCS score definition), or GCSdefinition). Patients were randomised to either standard ground paramedic treatment or standard treatment plus a physician arriving by helicopter. Patients were evaluated by 30-day mortality and 6-month Glasgow Outcome Scale (GOS) scores. Due to high non-compliance rates, both intention-to-treat and as-treated analyses were preplanned. 375 patients met the original definition, of which 197 was allocated to physician care. Differences in the 6-month GOS scores were not significant on intention-to-treat analysis (OR 1.11, 95% CI 0.74 to 1.66, p=0.62) nor was the 30-day mortality (OR 0.91, 95% CI 0.60 to 1.38, p=0.66). As-treated analysis showed a 16% reduction in 30-day mortality in those receiving additional physician care; 60/195 (29%) versus 81/180 (45%), pdefinition, of which 182 were allocated to physician care. The 6-month GOS scores were not significantly different on intention-to-treat analysis (OR 1.14, 95% CI 0.73 to 1.75, p=0.56) nor was the 30-day mortality (OR 1.05, 95% CI 0.66 to 1.66, p=0.84). As-treated analyses were also not significantly different. This trial suggests a potential mortality reduction in patients with blunt trauma with GCSdefinition only). Confirmatory studies which also address non-compliance issues are needed. NCT00112398. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Variations of the blood gas levels and thermodilutional parameters during ICP monitoring after severe head trauma in children.

    Science.gov (United States)

    Lubrano, Riccardo; Elli, Marco; Stoppa, Francesca; Di Traglia, Mario; Di Nardo, Matteo; Perrotta, Daniela; David, Piero; Paoli, Sara; Cecchetti, Corrado

    2015-08-01

    The purpose of this study was to define, in children following head trauma and GSC ≤ 8, at which level of intracranial pressure (ICP), the thermodilutional, and gas analytic parameters implicated in secondary cerebral insults shows initial changes. We enrolled in the study 56 patients: 30 males and 26 females, mean age 71 ± 52 months. In all children, volumetric hemodynamic and blood gas parameters were monitored following initial resuscitation and every 4 h thereafter or whenever a hemodynamic deterioration was suspected. During the cumulative hospital stay, a total of 1050 sets of measurements were done. All parameters were stratified in seven groups according to ICP (group A1 = 0-5 mmHg, group A2 = 6-10 mmHg, group A3 = 11-15 mmHg, group A4 16-20 mmHg, group A5 21-25 mmHg, group A6 26-30 mmHg, group A7 >31 mmHg). Mean values of jugular oxygen saturation (SJO2), jugular oxygen partial pressure (PJO2), extravascular lung water (EVLWi), pulmonary vascular permeability (PVPi), fluid overload (FO), and cerebral extraction of oxygen (CEO2) vary significantly from A3 (11-15 mmHg) to A4 (16-20 mmHg). They relate to ICP in a four-parameter sigmoidal function (4PS function with: r(2) = 0.90), inflection point of 15 mmHg of ICP, and a maximum curvature point on the left horizontal asymptote at 13 mmHg of ICP. Mean values of SJO2, PJO2, EVLWi, PVPi, FO, and CEO2 become pathologic at 15 mmHg of ICP; however, the curve turns steeper at 13 mmHg, possibly a warning level in children for the development of post head trauma secondary insult.

  18. A Study on the Coupled FEM-Analysis for Reactor Vessel Lower Head of APR1400 under the Severe Accident Scenario

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyonam; Namgung, Ihn [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2014-10-15

    For the stabilization of the RPV the in-vessel retention strategy with external reactor vessel cooling (IVR-ERVC) is adopted in APR1400. Under this severe accident condition, a good understanding of the mechanical behavior of the reactor vessel lower head (RVLH) is necessary both for verification of structural integrity and for improving the design applying appropriate accident mitigation strategies. The purpose of this study is to develop the analysis method of the RVLH with thermo-mechanical analysis using FEM tool (ANSYS v.15) in case of core-melting severe accident condition, and then analyze the RVLH of APR1400 including creep behavior. The plastic strain can be the major cause of lower head failure on the reactor vessel, and the creep cannot be not negligible factor of the failure under the severe accident condition. In the study, we applied constant convection coefficient at assumed temperature on the outside wall of RPV and substitute creep data of SA-508. In addition, it was found that the steel ablation at the interface between corium and vessel steel is not only a thermal phenomenon in the METCOR experiments. Corrosion processes and the formation of eutectics lead to the erosion of the vessel steel at temperatures that are significantly lower than the melting temperature of steel. It called thermo-chemical attack of the corium (corrosion). Reduced wall thickness because of the thermo-chemical effect by corium increase the equivalent plastic strain, and decrease the minimum time to reach 20% creep strain.

  19. Present status of severe head injured patients with an admission glasgow coma scale score of 3 based on the Japan neurotrauma data bank

    International Nuclear Information System (INIS)

    Uzura, Masahiko

    2011-01-01

    Severe head injured patients presenting with Glasgow Coma Scale (GCS) score of 3 have been hesitated to treat aggressively. We analyzed present status of patients with GCS score of 3 from the Project 2004 in the Japan Neurotrauma Data Bank. Among 1,101 cases registered, 805 cases with GCS score of 8 or less on admission. Of those, 215 cases with GCS score of 3 were classified the survival group (51 cases) and the dead group (164 cases) and compared each group. These results showed that the characteristics associated with favorable outcome including absence of cardiopulmonary arrest, no abnormality of pupil findings, stable condition of respiration and circulation, serum glucose level (less than 184 mg/dl), absence of initial CT findings including skull base fracture, pneumocephalus and subarachnoid hemorrhage, no serious extracranial injures including Injury Severity Scale score of less than 25, critic al care including intracranial pressure monitoring and temperature management. We suggest that it is important to treat brain and systemic problems aggressively in severe head injured patients with GCS score of 3. (author)

  20. Cerebral vasoreactivity in response to a head-of-bed position change is altered in patients with moderate and severe obstructive sleep apnea.

    Science.gov (United States)

    Gregori-Pla, Clara; Cotta, Gianluca; Blanco, Igor; Zirak, Peyman; Giovannella, Martina; Mola, Anna; Fortuna, Ana; Durduran, Turgut; Mayos, Mercedes

    2018-01-01

    Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA. Furthermore, we have monitored the effect of two years of continuous positive airway pressure (CPAP) treatment on the cerebral vasoreactivity. CBF was measured at different head-of-bed position changes (supine to 30° to supine) in sixty-eight patients with OSA grouped according to severity (forty moderate to severe, twenty-eight mild) and in fourteen control subjects without OSA. A subgroup (n = 13) with severe OSA was measured again after two years of CPAP treatment. All patients and controls showed a similar CBF response after changing position from supine to 30° (p = 0.819), with a median (confidence interval) change of -17.5 (-10.3, -22.9)%. However, when being tilted back to the supine position, while the control group (p = 0.091) and the mild patients with OSA (p = 0.227) recovered to the initial baseline, patients with moderate and severe OSA did not recover to the baseline (9.8 (0.8, 12.9)%, p < 0.001) suggesting altered cerebral vasoreactivity. This alteration was correlated with OSA severity defined by the apnea-hypopnea index, and with mean nocturnal arterial oxygen saturation. The CBF response was normalized after two years of CPAP treatment upon follow-up measurements. In conclusion, microvascular CBF response to a head-of-bed challenge measured by diffuse correlation spectroscopy suggests that moderate and severe patients with OSA have altered cerebral vasoreactivity related to OSA severity. This may normalize after two years of CPAP

  1. The use of stable xenon-enhanced computed tomographic studies of cerebral blood flow to define changes in cerebral carbon dioxide vasoresponsivity caused by a severe head injury.

    Science.gov (United States)

    Marion, D W; Bouma, G J

    1991-12-01

    Previous studies using the xenon-133 cerebral blood flow (CBF) method have documented the impairment of CO2 vasoresponsivity after a severe head injury, but only global values can be obtained reliably with this technique. We studied CO2 vasoresponsivity using the stable xenon-enhanced computed tomographic CBF method, which provided information about well-defined cortical regions and deep brain structures not available with the xenon-133 method. In 17 patients with admission Glasgow Coma Scale scores of 8 or less, hemispheric CO2 vasoresponsivity ranged from 1.3 to 8.5% per mm Hg change in partial CO2 pressure. Lobar, cerebellar, basal ganglia, and brain stem CO2 vasoresponsivity frequently varied from the mean global value by more than 25%. In all but one patient, local CO2 vasoresponsivity in one or more of these areas differed from the mean global value by more than 50%. The greatest variability occurred in patients with acute subdural hematomas and diffuse (bihemispheric) injuries. This variability in CO2 vasoresponsivity has important implications for the effective and safe management of intracranial hypertension that frequently accompanies severe head injury.

  2. Thermal Load Analysis of Multilayered Corium in the Lower Head of Reactor Pressure Vessel during Severe Accident

    Energy Technology Data Exchange (ETDEWEB)

    Whang, Seok Won; Park, Hyun Sun [POSTECH, Pohang (Korea, Republic of); Hwang, Tae Suk [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2014-05-15

    In-Vessel Retention (IVR) is one of the severe accident management strategies to terminate or mitigate the severe accident which is also called 'core-melt accident'. The reactor vessel would be cooled by flooding the cavity with water. The molten core mixture is divided into two or three layers due to the density difference. Light metal layer which contains Fe and Zr is on the oxide layer which is consist of UO{sub 2} and ZrO{sub 2}. Heavy metal layer which contains U, Fe and Zr is located under the oxide layer. In oxide layer, the crust which is solidified material is formed along the boundary. The assessment of IVR for nuclear power plant has been conducted with lumped parameter method by Theofanous, Rempe and Esmaili. In this paper, the numerical analysis was performed and verified with the Esmaili's work to analyze thermal load of multilayered corium in pressurized reactor vessel and also to examine the condition of in-vessel corium characteristic before the vessel failure that lead to ex-vessel severe accident progression for example, ex-vessel debris bed cooling. The in-vessel coolability analysis for several scenarios is conducted for the plant which has higher power than AP1000. Two sensitivity analyses are conducted, the first is emissivity of light metal layer and the second is the heat transfer coefficient correlations of oxide layer. The effect of three layered system also investigated. In this paper, the numerical analysis was performed and verified with Esmaili's model to analyze thermal load of multilayered corium in pressurized reactor vessel. For two layered system, thermal load was analyzed according to the severe accident scenarios, emissivity of the light metal layer and heat transfer correlations of the.

  3. Does 'black' brain mean doom? - computed tomography in the prediction of outcome in children with severe head injuries: 'benign' vs 'malignant' brain swelling

    International Nuclear Information System (INIS)

    Whyte, K.M.; Pascoe, M.

    1989-01-01

    A retrospective review of initial and subsequent Computed Tomography (CT) scans of 179 children who had suffered severe head injury requiring admission to intensive care was performed. The aim was to define the CT appearance which was always associated with a poor outcome. The children whose brain showed poor definition of basal ganglia and grey-white differentiation overall, together with sufficient swelling to obliterate the ambient cistern and third ventricle always died or remained in a vegetative state. Over half of these had reduced brain density, and several had small focal high densities consistent with contusions or petechial haemorrhages. A typical appearance showed homogeneous scans at the levels of the ambient cistern and thalami with no normal internal brain detail. Conversely obliteration of the ambient cistern associated with a large surface collection was compatible with complete recovery if grey-white definition remained normal and treatment was prompt

  4. Head injury - first aid

    Science.gov (United States)

    ... medlineplus.gov/ency/article/000028.htm Head injury - first aid To use the sharing features on this page, ... a concussion can range from mild to severe. First Aid Learning to recognize a serious head injury and ...

  5. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... the head uses special x-ray equipment to help assess head injuries, severe headaches, dizziness, and other ... aneurysm, bleeding, stroke and brain tumors. It also helps your doctor to evaluate your face, sinuses, and ...

  6. Long-term follow up MRI in children with severe head injury; Kernspintomographische Verlaufskontrolle bei Kindern nach Schaedel-Hirn-Trauma

    Energy Technology Data Exchange (ETDEWEB)

    Dinter, D.; Schmidt, B.; Neff, K.W.; Georgi, M. [Heidelberg Univ., Mannheim (Germany). Fakultaet fuer Klinische Medizin; Koelfen, W. [Elisabeth-Krankenhaus, Rheydt (Germany). Paediatrische Klinik; Freund, M.C. [Universitaetsklinik fuer Radiodiagnostik, Innsbruck (Austria)

    1999-10-01

    Purpose: A prospective study was initiated for the correlation of the findings in the initial cranial CT with the long-term follow-up MRI in children with severe head injury. Another aim was the evaluation of frequency and location of lesions, found only in MRI. Methods: 70 children with severe head injury and initially performed pathological CCT were followed up (mean time 3 years) by MRI. Results: 71% of the children had a pathological MRI. In 43% of the children with subdural bleeding could be found parenchymal lesions in the underlying cortex. All 15 children with epidural bleeding had unsuspicious findings at the former hematoma. All of the contusions were found as parenchymal residual lesions. 44% of the children had evidence of parenchymal lesions in the follow-up MRI initially and retrospectively not revealable. 16 lesions in the corpus callosum were only revealed by MRI. Conclusion: This study shows the higher sensitivity of magnetic resonance imaging in non-hemorrhagic parenchymal lesions and in 'diffuse axonal injury'. A MRI-examination is recommended in children with severe head injury, especially in patients with normal CCT and posttraumatic neurological deficits. (orig.) [German] Fragestellung: Im Rahmen einer prospektiven Studie wurden die Befunde initial durchgefuehrter Computertomographien bei Kindern mit schwerem SHT mit den Ergebnissen einer MR-Nachuntersuchung korreliert und zusaetzlich eine Evaluation der Haeufigkeit und Lokalisation ausschliesslich kernspintomographisch nachweisbarer Laesionen durchgefuehrt. Methodik: 70 Kinder mit initial nach SHT durchgefuehrtem und pathologischem CT wurden im Rahmen eines Follow-up im zeitlichen Abstand von durchschnittlich 3 Jahren kernspintomographisch nachuntersucht. Ergebnisse: Bei 71% der nachuntersuchten Kinder konnten pathologische MRT-Befunde erhoben werden. 43% der Kinder mit einer subduralen Blutung wiesen kortikal, der ehemaligen Blutung anliegende, Parenchymlaesionen auf, dagegen

  7. Prognosis of the computerized tomography in the severe head injury. Valor pronostico de la tomografia axial computada (TC) en los traumatismos craneoencefalicos severos

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Nieto, J.J.; Lorenzo Dominguez, M.T.; Martin Sanchez, M.J.; Sanchez Gonzalez, E.

    1991-01-01

    A prospective study is made with sixty five people affected of severe head injury, that is to say, with eight or less points in the Glasgow Coma Scale (GCS), when they get to the hospital. They are studied by computerized tomography at admission, and three and seven days after arrival. In this way, we appraise the type of the lesion, its intensity and the possible prognosis, considering in the last case three features: a) ventricular collapse; b) the mean line structure s shift; and c) effects on perimesencephalic cistern. The findings were parametized and we were able to introduce into the computer program relationships between these findings and the end results. These last ones were appraised through the Glasgow Outcome Scale (GOS). We could show that certain findings in computerized tomography scans have an unavoidable prognosis while as others have a more favorable prognosis. (Author)

  8. Cranial MR imaging and cerebral 99mTc HM-PAO-SPECT in patients with subacute or chronic severe closed head injury and normal CT examinations

    International Nuclear Information System (INIS)

    Prayer, L.; Wimberger, D.; Oder, W.; Kramer, J.; Schindler, E.; Podreka, I.; Imhof, H.

    1993-01-01

    Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and 99m Tc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOX) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS = III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction. (au) (18 refs.)

  9. Cranial MR imaging and cerebral 99mTc HM-PAO-SPECT in patients with subacute or chronic severe closed head injury and normal CT examinations

    International Nuclear Information System (INIS)

    Prayer, L.; Wimberger, D.; Oder, W.; Kramer, J.; Schindler, E.; Podreka, I.; Imhof, H.

    1993-01-01

    Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and 99m Tc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOS) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS=III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction. (orig.)

  10. Cranial MR imaging and cerebral [sup 99m]Tc HM-PAO-SPECT in patients with subacute or chronic severe closed head injury and normal CT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, L.; Wimberger, D.; Oder, W.; Kramer, J.; Schindler, E.; Podreka, I.; Imhof, H.

    1993-11-01

    Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and [sup 99m]Tc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOX) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS = III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction. (au) (18 refs.).

  11. Fatores que influenciaram a evolução de 206 pacientes com traumatismo craniencefálico grave Relevant factors in 206 patients with severe head injury

    Directory of Open Access Journals (Sweden)

    Venâncio Pereira Dantas Filho

    2004-06-01

    Full Text Available A busca de fatores prognósticos para o traumatismo craniencefálico (TCE tem sido alvo de muitos estudos nas últimas décadas. A identificação de indicadores consistentes da evolução destes pacientes tem representado um grande desafio e sua utilidade considerada evidente tanto para orientar o tratamento, quanto para a estimativa do resultado final. Baseados numa casuística de 206 pacientes com TCE grave (8 pontos ou menos pela Escala de Coma de Glasgow - ECG, estudamos a influência de vários fatores sobre a evolução dos pacientes. A gravidade inicial medida pela ECG, a presença de hipertensão intracraniana (níveis acima de 20 mmHg, o tipo de lesão intracraniana e a presença de hipoxia, hipotensão arterial e a associação de hipóxia e hipotensão arterial tiveram influência significativa sobre a evolução dos pacientes. A presença de politraumatismo (pelo menos dois sítios de lesão além do TCE e a idade (acima e abaixo de 40 anos não influenciaram significativamente a evolução dos pacientes desta casuística.The search for head injury prognostic factors has been intense in the last decades. The importance of identification of these factors has been also recognised to treatment orientation and results estimatives. Based on 206 severe head injuried patients series, we analized the influence of factors over the outcome. The initial severity by Glasgow coma scale, the presence of intracranial hypertension (over 20 mmHg, the type of intracranial lesion and the presence of hypoxia, systemic hypotension or both, significantly influenced the results. The presence of multiple traumas (at least two sites of lesion over head injury, as age, did not influence the final results in this series.

  12. Cytokines levels, Severity of acute mucositis and the need of PEG tube installation during chemo-radiation for head and neck cancer - a prospective pilot study

    International Nuclear Information System (INIS)

    Meirovitz, Amichay; Kuten, Michal; Billan, Salem; Abdah-Bortnyak, Roxolyana; Sharon, Anat; Peretz, Tamar; Sela, Mordechai; Schaffer, Moshe; Barak, Vivian

    2010-01-01

    The purpose of this pilot study was to detect a correlation between serum cytokine levels and severity of mucositis, necessitating installation of a percutaneous endoscopic gastrostomy tube (PEG) in head and neck (H&N) cancer patients receiving combined chemo-radiation therapy. Fifteen patients with H&N epithelial cancer were recruited to this study. All patients received radiotherapy to the H&N region, with doses ranging from 50-70 Gy. Chemotherapy with cisplatin, carboplatin, 5-fluorouracil and taxanes was given to high-risk patients, using standard chemotherapy protocols. Patients were evaluated for mucositis according to WHO common toxicity criteria, and blood samples were drawn for inflammatory (IL-1, IL-6, IL-8, TNF-α) and anti-inflammatory (IL-10) cytokine levels before and during treatment. A positive correlation was found between IL-6 serum levels and severity of mucositis and dysphagia; specifically, high IL-6 levels at week 2 were correlated with a need for PEG tube installation. A seemingly contradictory correlation was found between low IL-8 serum levels and a need for a PEG tube. These preliminary results, indicating a correlation between IL-6 and IL-8 serum levels and severity of mucositis and a need for a PEG tube installation, justify a large scale study

  13. Effect of midazolam versus propofol sedation on markers of neurological injury and outcome after isolated severe head injury: a pilot study.

    LENUS (Irish Health Repository)

    Ghori, Kamran A

    2012-02-03

    BACKGROUND: Midazolam and propofol are sedative agents commonly administered to patients with brain injury. We compared plasma concentrations of glial cell S100beta protein and nitric oxide (NO) between patients who received midazolam and those who received propofol sedation after severe brain injury, and investigated the association between S100beta and NO concentrations and neurological outcome. DESIGN: 28 patients with severe head injury (Glasgow Coma Score <9) who required sedation and ventilation were randomly assigned to receive midazolam (n =15) or propofol (n = 13) based sedation. Blood samples were drawn daily for 5 days for estimation of S100beta and NO concentrations. Neurological outcome was assessed 3 months later as good (Glasgow Outcome Score [GOS], 4-5) or poor (GOS, 1-3). RESULTS: A good neurological outcome was observed in 8\\/15 patients (53%) in the midazolam group and 7\\/13 patients (54%) in the propofol group. Patients with a poor outcome had higher serum S100beta concentrations on ICU admission and on Days 1-4 in the ICU than those with a good outcome (mean [SD] on Day 1, 0.99 [0.81] v 0.41 [0.4] microg\\/L; Day 2, 0.80 [0.81] v 0.41 [0.24] microg\\/L; Day 3, 0.52 [0.55] v 0.24 [0.25] microg\\/L; and Day 4, 0.54 [0.43] v 0.24 [0.35] microg\\/L; P<0.05). There was no significant difference on Day 5. Plasma NO concentrations were not associated with outcome. In subgroup analysis, there was no difference in S100beta and NO concentrations between patients with a good outcome versus those with a poor outcome in either the midazolam or propofol group. CONCLUSIONS: Plasma concentrations of markers of neurological injury in patients with severe head injury were similar in those who received midazolam sedation and those who received propofol. Patients who had a poor neurological outcome at 3 months had consistently higher serum S100beta concentrations during the initial 4 days after injury than patients who had a good outcome.

  14. Effects of neurosurgical treatment and severity of head injury on cognitive functioning, general health and incidence of mental disorders in patients with traumatic brain injury.

    Science.gov (United States)

    Rezaei, Sajjad; Asgari, Karim; Yousefzadeh, Shahrokh; Moosavi, Heshmat-Allah; Kazemnejad, Ehsan

    2012-01-01

    Neurosurgical treatment and the severity of head injury (HI) can have remarkable effect on patients' neuropsychiatric outcomes. This research aimed to study the effect of these factors on cognitive functioning, general health and incidence of mental disorders in patients with a traumatic brain injury (TBI). In this descriptive, longitudinal study, 206 TBI patients entered the study by consecutive sampling; they were then compared according to neurosurgery status and severity of their HI. Both groups underwent neurosurgical and psychological examinations. The mini mental state examination (MMSE) and general health questionnaire-28 items (GHQ-28) were administered to the study participants. At follow-up, four months later, the groups underwent a structured clinical interview by a psychiatrist based on the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) diagnostic criteria regarding the presence of mental disorders. Analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) were performed and adjusted for the effect of confounding variables (age, gender, Glasgow outcome scale (GOS) , and level of education). The severity of HI had the most significant effect for the following variables; cognitive functioning and physical symptoms (P < 0.05). The effect of the neurosurgical treatment factor was not significant; however, the interaction effect of the two variables on social dysfunction, and total score of the GHQ-28 questionnaire appeared to be significant (P < 0.05). Fisher's exact test indicated that after a four month follow-up period, no significant differences were seen between the two groups (with or without neurosurgery) in the incidence of mental disorders, while χ(2) Test showed that having a more severe HI is significantly correlated with the incidence of mental disorders (P < 0.01). The implications of this study should be discussed with an emphasis on negative, effective factors on the cognitive

  15. Prevalence and impact of diffuse axonal injury in patients with moderate and severe head injury: a cohort study of early magnetic resonance imaging findings and 1-year outcome.

    Science.gov (United States)

    Skandsen, Toril; Kvistad, Kjell Arne; Solheim, Ole; Strand, Ingrid Haavde; Folvik, Mari; Vik, Anne

    2010-09-01

    In this prospective cohort study the authors examined patients with moderate to severe head injuries using MR imaging in the early phase. The objective was to explore the occurrence of diffuse axonal injury (DAI) and determine whether DAI was related to level of consciousness and patient outcome. One hundred and fifty-nine patients (age range 5-65 years) with traumatic brain injury, who survived the acute phase, and who had a Glasgow Coma Scale (GCS) score of 3-13 were admitted between October 2004 and August 2008. Of these 159 patients, 106 were examined using MR imaging within 4 weeks postinjury. Patients were classified into 1 of 3 stages of DAI: Stage 1, in which lesions were confined to the lobar white matter; Stage 2, in which there were callosal lesions; and Stage 3, in which lesions occurred in the dorsolateral brainstem. The outcome measure used 12 months postinjury was the Glasgow Outcome Scale-Extended (GOSE). Diffuse axonal injury was detected in 72% of the patients and a combination of DAI and contusions or hematomas was found in 50%. The GCS score was significantly lower in patients with "pure DAI" (median GCS Score 9) than in patients without DAI (median GCS Score 12; p GOSE score of 7, and patients without DAI had a median GOSE score of 8 (p = 0.10). Outcome was better in patients with DAI Stage 1 (median GOSE Score 8) and DAI Stage 2 (median GOSE Score 7.5) than in patients with DAI Stage 3 (median GOSE Score 4; p < 0.001). Thus, in patients without any brainstem injury, there was no difference in good recovery between patients with DAI (67%) and patients without DAI (66%). Diffuse axonal injury was found in almost three-quarters of the patients with moderate and severe head injury who survived the acute phase. Diffuse axonal injury influenced the level of consciousness, and only in patients with DAI was GCS score related to outcome. Finally, DAI was a negative prognostic sign only when located in the brainstem.

  16. Heads Up

    Science.gov (United States)

    ... Connect with Us HEADS UP Apps Reshaping the Culture Around Concussion in Sports Get HEADS UP on Your Web Site Concussion ... HEADS UP on your web site! Create a culture of safety for young athletes Officials, learn how you can ... UP to Providers HEADS UP to Youth Sports HEADS UP to School Sports HEADS UP to ...

  17. Grading Dysphagia as a Toxicity of Head and Neck Cancer: Differences in Severity Classification Based on MBS DIGEST and Clinical CTCAE Grades.

    Science.gov (United States)

    Goepfert, Ryan P; Lewin, Jan S; Barrow, Martha P; Warneke, Carla L; Fuller, Clifton D; Lai, Stephen Y; Weber, Randal S; Hutcheson, Katherine A

    2018-04-01

    Clinician-reported toxicity grading through common terminology criteria for adverse events (CTCAE) stages dysphagia based on symptoms, diet, and tube dependence. The new dynamic imaging grade of swallowing toxicity (DIGEST) tool offers a similarly scaled five-point ordinal summary grade of pharyngeal swallowing as determined through results of a modified barium swallow (MBS) study. This study aims to inform clinicians on the similarities and differences between dysphagia severity according to clinical CTCAE and MBS-derived DIGEST grading. A cross-sectional sample of 95 MBS studies was randomly selected from a prospectively-acquired MBS database among patients treated with organ preservation strategies for head and neck cancer. MBS DIGEST and clinical CTCAE dysphagia grades were compared. DIGEST and CTCAE dysphagia grades had "fair" agreement per weighted κ of 0.358 (95% CI .231-.485). Using a threshold of DIGEST ≥ 3 as reference, CTCAE had an overall sensitivity of 0.50, specificity of 0.84, and area under the curve (AUC) of 0.67 to identify severe MBS-detected dysphagia. At less than 6 months, sensitivity was 0.72, specificity was 0.76, and AUC was 0.75 while at greater than 6 months, sensitivity was 0.22, specificity was 0.90, and AUC was 0.56 for CTCAE to detect dysphagia as determined by DIGEST. Classification of pharyngeal dysphagia on MBS using DIGEST augments our understanding of dysphagia severity according to the clinically-derived CTCAE while maintaining the simplicity of an ordinal scale. DIGEST likely complements CTCAE toxicity grading through improved specificity for physiologic dysphagia in the acute phase and improved sensitivity for dysphagia in the late-phase.

  18. Varus femoral osteotomy improves sphericity of the femoral head in older children with severe form of Legg-Calvé-Perthes disease.

    Science.gov (United States)

    Terjesen, Terje; Wiig, Ola; Svenningsen, Svein

    2012-09-01

    In the Norwegian prospective study on Legg-Calvé-Perthes disease (LCPD), we found varus femoral osteotomy gave better femoral head sphericity at a mean of 5 years postoperative than physiotherapy in children older than 6.0 years at diagnosis with femoral head necrosis of more than 50%. That study did not include separate analyses for hips with 100% necrosis and those with a percentage of necrosis between 50% and 100%. We asked whether (1) femoral osteotomy improves femoral head sphericity at followup in all patients with more than 50% femoral head necrosis or in selected groups only and (2) there is a critical age between 6.0 and 10.0 years over which femoral osteotomy does not improve the prognosis. We treated 70 patients with unilateral LCPD, age at diagnosis of more than 6.0 years, and femoral head necrosis of more than 50% with varus femoral osteotomy between 1996 and 2000. We classified necrosis using the Catterall classification. We established a control group of 51 similar children who received physiotherapy. At the 5-year followup visit, the hips were graded according to femoral head shape: spherical, ovoid, or flat. At 5-year followup, there was no difference between the treatment groups in radiographic outcome in Catterall Group 3 hips. In Catterall Group 4 hips, femoral head sphericity was better in the osteotomy group, with flat femoral heads in 14% compared to 75% after physiotherapy. The same trend toward better head sphericity occurred when the lateral pillar classification was used. In children aged 6.0 to 10.0 years, in whom the whole femoral head is affected, femoral head sphericity 5 years after femoral osteotomy was better than that after physiotherapy.

  19. Correlation Between the Severity of Cetuximab-Induced Skin Rash and Clinical Outcome for Head and Neck Cancer Patients: The RTOG Experience

    Energy Technology Data Exchange (ETDEWEB)

    Bar-Ad, Voichita, E-mail: voichita.bar-ad@jefferson.edu [Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Zhang, Qiang [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Harari, Paul M. [University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Axelrod, Rita [Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Rosenthal, David I. [University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Trotti, Andy [H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Jones, Christopher U. [Radiological Associates of Sacramento, Sacramento, California (United States); Garden, Adam S. [University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Song, Guobin [Virginia Mason Medical Center, Seattle, Washington (United States); Foote, Robert L. [Mayo Clinic, Rochester, Minnesota (United States); Raben, David [University of Colorado Comprehensive Cancer Center, Denver, Colorado (United States); Shenouda, George [McGill University, Montreal, Quebec (Canada); Spencer, Sharon A. [University of Alabama at Birmingham, Birmingham, Alabama (United States); Harris, Jonathan [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Le, Quynh-Thu [Stanford University Medical Center, Stanford, California (United States)

    2016-08-01

    Purpose: To evaluate the severity of cetuximab-induced skin rash and its correlation with clinical outcome and late skin toxicity in patients with head and neck squamous cell carcinoma treated with chemoradiation therapy and cetuximab. Methods and Materials: Analysis included patients who received loading dose and ≥1 cetuximab dose concurrent with definitive chemoradiation therapy (70 Gy + cisplatin) or postoperative chemoradiation therapy (60-66 Gy + docetaxel or cisplatin). Results: Six hundred two patients were analyzed; 383 (63.6%) developed grade 2 to 4 cetuximab rash. Patients manifesting grade 2 to 4 rash had younger age (P<.001), fewer pack-years smoking history (P<.001), were more likely to be males (P=.04), and had p16-negative (P=.04) oropharyngeal tumors (P=.003). In univariate analysis, grade 2 to 4 rash was associated with better overall survival (hazard ratio [HR] 0.58, P<.001) and progression-free survival (HR 0.75, P=.02), and reduced distant metastasis rate (HR 0.61, P=.03), but not local-regional failure (HR 0.79, P=.16) relative to grade 0 to 1 rash. In multivariable analysis, HRs for overall survival, progression-free survival, distant metastasis, and local-regional failure were, respectively, 0.68 (P=.008), 0.85 (P=.21), 0.64 (P=.06), and 0.89 (P=.48). Grade ≥2 rash was associated with improved survival in p16-negative patients (HR 0.28 [95% confidence interval 0.11-0.74]) but not in p16-positive patients (HR 1.10 [0.42-2.89]) (P=.05 for interaction). Twenty-five percent of patients with grade 2 to 4 acute in-field radiation dermatitis experienced grade 2 to 4 late skin fibrosis, versus 14% of patients with grade 0 to 1 acute in-field radiation dermatitis (P=.002). Conclusion: Grade 2 to 4 cetuximab rash was associated with better survival, possibly due to reduction of distant metastasis. This observation was noted mainly in p16-negative patients. Grade 2 to 4 acute in-field radiation dermatitis was associated with higher rate of

  20. WE-AB-207B-08: Exploring and Refining the QUANTEC Guideline to Reduce Severe Hyposalivation Following IMRT for Head and Neck Cancer

    International Nuclear Information System (INIS)

    Thor, M; Oh, J; Deasy, J; Owosho, A; Rosenburg, H; Yom, S; Huryn, J; Estilo, C; Riaz, N; Tsai, J; Lee, N

    2016-01-01

    Purpose: The aim of this study was to investigate the usefulness of the QUANTEC guideline to prevent xerostomia after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC) with respect to follow-up time. In addition, we explored alternative guidelines to further reduce xerostomia. Methods: The QUANTEC guideline suggests a mean dose to the contralateral (Dmeancontra) parotid<20 Gy, or Dmeancontra and Dmean to the ipsilateral parotid (Dmeanipsi)<25 Gy. Stimulated whole mouth saliva flow measurements (WMSFM) were conducted at a median of 11 (3–24) months for 63 patients treated with IMRT for HNC to a median dose of 70 Gy in 2006–2015. Severe hyposalivation/xerostomia was defined as WMSFM ≤25% post- relative to pre-RT. Patients were stratified into a <6m (xerostomia: 27% (n=15)), and a 6–24m (xerostomia: 19% (n=10)) follow-up group. Dose-response modeling was performed using logistic regression including Dmeancontra, or Dmeancontra and Dmeanipsi. The area under the receiver-operating characteristics curve (AUC) was used to assess discriminative ability, and the agreement between the estimated and observed rate of xerostomia was given by Spearman’s rank correlation coefficient (Rs), and related p-values. Results: Of the non-xerostomia patients, 65% (<6m) and 56% (6–24m) fulfilled Dmeancontra<20 Gy. The estimated and observed rate of xerostomia agreed at <6m (AUC=0.78; Rs=0.46; p=0.001), and was 28% at Dmeancontra=20 Gy. A smaller number of non-xerostomia patients fulfilled the two-gland guideline (33% (<6m) and 26% (6–24m)), but the AUC was higher than using Dmeancontra only (<6m: AUC=0.90; Rs=0.63; p<0.0001; 6–24m: AUC=0.84; Rs=0.25; p=0.08), and the following amendment of the two-gland guideline was suggested: (0.17*Dmeancontra+0.11*Dmeanipsi-8.13)<-1.60 (<6m), and (0.05*Dmeancontra+0.02*Dmeanipsi-3.10)<-1.60 (6–24m). Conclusion: The QUANTEC guideline is effective to prevent xerostomia <6m post-RT, but its usefulness is reduced at

  1. WE-AB-207B-08: Exploring and Refining the QUANTEC Guideline to Reduce Severe Hyposalivation Following IMRT for Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Thor, M; Oh, J; Deasy, J [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, Nyc, NY (United States); Owosho, A; Rosenburg, H; Yom, S; Huryn, J; Estilo, C [Department of Surgery, Memorial Sloan Kettering Cancer Center, Nyc, NY (United States); Riaz, N; Tsai, J; Lee, N [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, NYC, NY (United States)

    2016-06-15

    Purpose: The aim of this study was to investigate the usefulness of the QUANTEC guideline to prevent xerostomia after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC) with respect to follow-up time. In addition, we explored alternative guidelines to further reduce xerostomia. Methods: The QUANTEC guideline suggests a mean dose to the contralateral (Dmeancontra) parotid<20 Gy, or Dmeancontra and Dmean to the ipsilateral parotid (Dmeanipsi)<25 Gy. Stimulated whole mouth saliva flow measurements (WMSFM) were conducted at a median of 11 (3–24) months for 63 patients treated with IMRT for HNC to a median dose of 70 Gy in 2006–2015. Severe hyposalivation/xerostomia was defined as WMSFM ≤25% post- relative to pre-RT. Patients were stratified into a <6m (xerostomia: 27% (n=15)), and a 6–24m (xerostomia: 19% (n=10)) follow-up group. Dose-response modeling was performed using logistic regression including Dmeancontra, or Dmeancontra and Dmeanipsi. The area under the receiver-operating characteristics curve (AUC) was used to assess discriminative ability, and the agreement between the estimated and observed rate of xerostomia was given by Spearman’s rank correlation coefficient (Rs), and related p-values. Results: Of the non-xerostomia patients, 65% (<6m) and 56% (6–24m) fulfilled Dmeancontra<20 Gy. The estimated and observed rate of xerostomia agreed at <6m (AUC=0.78; Rs=0.46; p=0.001), and was 28% at Dmeancontra=20 Gy. A smaller number of non-xerostomia patients fulfilled the two-gland guideline (33% (<6m) and 26% (6–24m)), but the AUC was higher than using Dmeancontra only (<6m: AUC=0.90; Rs=0.63; p<0.0001; 6–24m: AUC=0.84; Rs=0.25; p=0.08), and the following amendment of the two-gland guideline was suggested: (0.17*Dmeancontra+0.11*Dmeanipsi-8.13)<-1.60 (<6m), and (0.05*Dmeancontra+0.02*Dmeanipsi-3.10)<-1.60 (6–24m). Conclusion: The QUANTEC guideline is effective to prevent xerostomia <6m post-RT, but its usefulness is reduced at

  2. Correlation between the severity of cetuximab-induced skin rash and clinical outcome for head and neck cancer patients: The XXXX experience

    Science.gov (United States)

    Bar-Ad, Voichita; Zhang, Qiang (Ed); Harari, Paul M.; Axelrod, Rita; Rosenthal, David I.; Trotti, Andy; Jones, Christopher U.; Garden, Adam S.; Song, Guobin; Foote, Robert L.; Raben, David; Shenouda, George; Spencer, Sharon A.; Harris, Jonathan; Le, Quynh-Thu

    2016-01-01

    Purpose The purpose of the present study was to evaluate severity of cetuximab-induced skin rash and its correlation with clinical outcome and late skin toxicity in patients with head and neck squamous cell carcinoma treated with chemoradiotherapy and cetuximab. Materials & Methods Analysis included patients who received loading dose and ≥ 1cetuximab dose concurrent with definitive chemoradiotherapy (70Gy + cisplatin) or postoperative chemoradiotherapy (60–66Gy + docetaxel or cisplatin). Results Six hundred two patients were analyzed; 383 (63.6%) developed Grade 2–4 cetuximab rash. Patients manifesting Grade 2–4 rash had younger age (p<0.001), fewer pack-years smoking history (p<0.001), were more likely to be males (p=0.04), and had p16-negative (p=0.04) oropharyngeal tumors (p=0.003). In univariate analysis, Grade 2–4 rash was associated with better overall survival (OS) (hazard ratio [HR] 0.58, p<0.001) and progression-free survival (PFS) (HR 0.75, p=0.02), and reduced distant metastasis (DM) rate (HR 0.61, p=0.03), but not local-regional failure (LRF) (HR 0.79, p=0.16) relative to Grade 0–1 rash. In multivariable analysis, HRs for OS, PFS, DM, and LRF were 0.68 (p=0.008), 0.85 (p=0.21), 0.64 (p=0.06), and 0.89 (p=0.48). Grade ≥2 rash was associated with improved survival in p16 negative patients (HR 0.28 (0.11–0.74)) but not in p16 positive patients (HR 1.10 (0.42–2.89)) (p=0.05 for interaction). Twenty-five percent of patients with Grade 2–4 acute in-field radiation dermatitis experienced Grade 2–4 late skin fibrosis vs. 14% of patients with Grade 0–1 acute in-field radiation dermatitis (p=0.002). Conclusion Grade 2–4 cetuximab rash was associated with better survival possibly due to reduction of distant metastasis. This observation was noted mainly in p16 negative patients. Grade 2–4 acute in-field radiation dermatitis was associated with higher rate of late Grade 2–4 skin fibrosis. PMID:27212198

  3. Post Traumatic Cerebral Oedema in Severe Head Injury is Related to Intracranial Pressure and Cerebral Perfusion Pressure but not to Cerebral Compliance

    Directory of Open Access Journals (Sweden)

    U Nujaimin

    2009-07-01

    thus assisting in the acute post operative management of severely head injured patients. Hence post operative CT brain scans may be done to verify the ICP and CPP readings postoperatively. Subsequently, withdrawal of sedation for neurological assessment after surgery could be done if the CT brain scan showed an opened basal cistern and Marshall I and II coupled with ICP of less than 20 mmHg.

  4. Slow information processing after very severe closed head injury : impaired access to declarative knowledge and intact application and acquisition of procedural knowledge

    NARCIS (Netherlands)

    Timmerman, ME; Brouwer, WH

    As an explanation of the pattern of slow information processing after closed head injury (CHI), hypotheses of impaired access to declarative memory and intact application and acquisition of procedural memory after CHI are presented. These two hypotheses were tested by means of four cognitive

  5. High rate of severe radiation dermatitis during radiation therapy with concurrent cetuximab in head and neck cancer : Results of a survey in EORTC institutes

    NARCIS (Netherlands)

    Giro, Christian; Berger, Bernhard; Boelke, Edwin; Ciernik, I. Frank; Duprez, Frederic; Locati, Laura; Maillard, Sophie; Ozsahin, Mahmut; Pfeffer, Raphael; Robertson, A. Gerry; Langendijk, Johannes A.; Budach, Wilfried

    Objective: Examination of the rate of grade III or grade IV radiation dermatitis during treatment of head and neck cancer (HNC) with radiotherapy (RT) and concurrent cetuximab in EORTC centres. Materials and method: A questionnaire was sent to all members of the EORTC Radiation Oncology Group and

  6. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Computed tomography (CT) of the head uses special x-ray equipment to help assess head injuries, severe headaches, ... is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside ...

  7. High rate of severe radiation dermatitis during radiation therapy with concurrent cetuximab in head and neck cancer: Results of a survey in EORTC institutes

    International Nuclear Information System (INIS)

    Giro, Christian; Berger, Bernhard; Boelke, Edwin; Ciernik, I. Frank; Duprez, Frederic; Locati, Laura; Maillard, Sophie; Ozsahin, Mahmut; Pfeffer, Raphael; Robertson, A. Gerry; Langendijk, Johannes A.; Budach, Wilfried

    2009-01-01

    Objective: Examination of the rate of grade III or grade IV radiation dermatitis during treatment of head and neck cancer (HNC) with radiotherapy (RT) and concurrent cetuximab in EORTC centres. Materials and method: A questionnaire was sent to all members of the EORTC Radiation Oncology Group and Head and Neck Group (111 institutions) to evaluate the widespread use of cetuximab and radiotherapy in HNC and to estimate the frequency of grades III and IV skin reactions in the radiation portals associated with this protocol. Co-morbidities, RT schedules and co-medications were also recorded. Results: We received responses from 28 institutions in 11 countries. A total of 125 HNC patients from 15 institutions were treated with cetuximab and concurrent RT. Information about the skin reactions was available from 71 patients. Of these 36 had no grade III/IV adverse effects in the RT field, 15 had a grade III and 20 had grade IV radiation dermatitis. No detectable relation of grades III and IV radiation dermatitis with co-morbidities such as liver insufficiency or renal dysfunction was found. Conclusion: According to the results of the questionnaire, grade III/IV radiation dermatitis is observed in 49% of HNC patients treated with cetuximab and concurrent RT. A systematic clinical monitoring of cutaneous side effects during RT plus cetuximab is advised to ensure the safety of this protocol

  8. Recent trends of severe head injury in Japan Neurotrauma Data Bank with special reference to road traffic accident. Comparison of clinical features and outcome between Project 1998 and Project 2004

    International Nuclear Information System (INIS)

    Ono, Junichi; Sakamoto, Tetsuya; Kawamata, Tatsuro; Tokutomi, Takashi; Ogawa, Takeki; Shigemori, Minoru; Yamaura, Akira; Nakamura, Norio

    2009-01-01

    This study was conducted to clarify the recent trends of severe head injury in the Japan Neurotrauma Data Bank (JNTDB) with special reference to traffic accident. In the JNTDB, the number of severely head-injured patients (Glasgow Coma Scale (GCS) score of 8 or less) were 832 in Project 1998 and 797 in Project 2004. Those were divided into 2 groups: traffic accident (TA) group, and non-TA (nTA) group. In addition, the former group was classified into 4 groups: 4 wheel vehicle (4WV) group, motorcycle (MC) group, bicycle (BC) group, and pedestrian (P) group. Analyzed here were cause of injury, age distribution, incidence of alcohol intake, means of transportation, clinical severity (GCS and injury severity score), initial CT findings (Traumatic Coma Data Bank), and outcome at discharge (Glasgow Outcome Scale). In the Project 2004; Traffic accident was less common as the cause of injury. The proportion of younger patients was lower in the TA group, especially in the 4WV and MC groups. Incidence of alcohol intake was lower in the TA group, particularly in the MC groups. Patient transfer by helicopter was more common in both the TA and nTA groups. The proportion of GCS of 3 to 5 was lower in the TA group, especially in the MC group. In the initial CT findings, type 3 of diffuse injury and evacuated mass were less frequent in both groups, and in the 4WV, BC, and P groups. Outcome at discharge: Mortality rate was lower in both groups, and in the 4WV, MC and P groups, but the percentage of good outcomes was unchanged. These results indicated the recent trends of severely head-injured patients who were injured by traffic accident. But there were some problems, such as study protocol and meaningless results, so that further verification is indispensable in the JNTDB study. (author)

  9. Risk of head-and-neck cancer following a diagnosis of severe cervical intraepithelial neoplasia: a nationwide population-based cohort study in Denmark.

    Science.gov (United States)

    Svahn, M F; Munk, C; Jensen, S M; von Buchwald, C; Frederiksen, K; Kjaer, S K

    2016-07-01

    Women with a history of cervical intraepithelial neoplasia grade 3 including adenocarcinoma in situ (CIN3/AIS) may be more prone to develop cancers of the ano-genital region and head-and-neck cancers. The current literature is, however, limited. We established a nationwide cohort of approximately 2,500,000 Danish women born in 1918-1990. By linking the cohort to population-based health registries, we obtained information on CIN3/AIS, cancer, migration, death, education, and smoking. Cox proportional hazards models were used to estimate hazard ratios (HRs) and confidence intervals (CIs) for the association between CIN3/AIS and risk of head-and-neck squamous cell carcinoma (HNSCC). HRs were presented for any HNSCC and for four subgroups categorized by their anticipated degree of association with human papillomavirus (HPV). A history of CIN3/AIS was significantly associated with an increased overall relative risk of HNSCC after adjustment for year of birth, attained age, and length of education. The risk was especially high for sites anticipated to be strongly associated with HPV (e.g. base of tongue, tonsils) (HR, 2.49; 95% CI, 1.84-3.36). Lower risks were found for sites anticipated to be not or weakly associated with HPV (e.g. nasal cavity, middle ear, sinuses) (HR, 1.29; 95% CI, 0.61-2.76). Women with a history of CIN3/AIS have a significantly higher risk of HNSCC than women without such a history. The increased relative risk persisted for at least 20years after the CIN3/AIS diagnosis. Women with CIN3/AIS may be more susceptible to the consequences of HPV and/or may have higher risk behavior, such as smoking. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Predictors of severe late radiotherapy-related toxicity after hyperfractionated radiotherapy with or without concomitant cisplatin in locally advanced head and neck cancer. Secondary retrospective analysis of a randomized phase III trial (SAKK 10/94)

    International Nuclear Information System (INIS)

    Ghadjar, Pirus; Simcock, Mathew; Zimmermann, Frank; Betz, Michael; Bodis, Stephan; Bernier, Jacques; Studer, Gabriela; Aebersold, Daniel M.

    2012-01-01

    Background and purpose: This secondary analysis was performed to identify predictive factors for severe late radiotherapy (RT)-related toxicity after treatment with hyperfractionated RT +/− concomitant cisplatin in locally advanced head and neck cancer. Materials and methods: Patients were retrospectively analyzed from the previously reported randomized phase III trial: SAKK 10/94. Severe late RT-related toxicity was defined as late RTOG ⩾ grade 3 toxicity starting 3 months after end of RT and/or potential treatment-related death within 3 years of randomization. Results: Two hundred and thirteen randomized patients were analyzed; 84 (39%) experienced severe late RT-related toxicity. With median follow-up of 9.7 years (range, 0.4–15.4 years), median time to severe late RT-related toxicity was 9.6 years. In the univariate Cox proportional hazards model the following variables were associated with severe late RT-related toxicity: advanced N-classification (p < 0.001); technically unresectable disease (p = 0.04); weight loss ratio (p = 0.003); supportive measures (p = 0.009) and severe acute dysphagia (p = 0.001). In the subsequent multivariate analysis all variables except use of supportive measures remained statistically significant. Conclusions: Chemotherapy did not appear to affect severe late RT-related toxicity, but advanced N-classification, technically unresectable disease, weight loss ratio, and severe acute dysphagia were independent predictive factors for severe late RT-related toxicity.

  11. Efficacy and safety of granulocyte macrophage-colony stimulating factor (GM-CSF) on the frequency and severity of radiation mucositis in patients with head and neck carcinoma

    International Nuclear Information System (INIS)

    Kannan, V.; Bapsy, Poonamallee P.; Anantha, Naranappa; Doval, Dinesh Chandra; Vaithianathan, Hema; Banumathy, G.; Reddy, Krishnamurthy B.; Kumaraswamy, Saklaspur Veerappaiah; Shenoy, Ashok Mohan

    1997-01-01

    Purpose: Based on the clinical evidence of mucosal protection by GM-CSF during cytotoxic chemotherapy, a pilot study was undertaken to determine the safety and mucosal reaction of patients receiving GM-CSF while undergoing definitive conventional fractionated radiotherapy in head and neck carcinoma. Methods and Materials: Patients were considered eligible if buccal mucosa and oropharynx were included in the teleradiation field. Ten adult patients with squamous cell carcinoma of head and neck (buccal mucosa--8 and posterior (1(3)) tongue--2) were entered into the trial. Radiation therapy was delivered with telecobalt machine at conventional 2 Gy fraction and 5 fractions/week. The radiation portals consisted of two parallel opposing lateral fields. GM-CSF was given subcutaneously at a dose of 1 μg/kg body weight, daily, after 20 Gy until the completion of radiation therapy. Patients were evaluated daily for mucosal reaction, pain, and functional impairment. Results: The median radiation dose was 66 Gy. Eight patients received ≥60 Gy. The tolerance to GM-CSF was good. All 10 patients completed the planned daily dose of GM-CSF without interruption. Mucosal toxicity was Grade I in four patients till the completion of radiotherapy (dose range 50-66 Gy). Six patients developed Grade II reaction, fibrinous mucosal lesions of maximum size 1.0-1.5 cm, during radiotherapy. None developed Grade III mucositis. The maximum mucosal pain was Grade I during GM-CSF therapy. In two patients after starting GM-CSF the pain reduced in intensity. Functional impairment was mild to moderate. All patients were able to maintain adequate oral intake during the treatment period. Total regression of mucosal reaction occurred within 8 days following completion of radiotherapy. Conclusions: GM-CSF administration concurrently with conventional fractionated radiotherapy was feasible without significant toxicity. The acute side effects of radiotherapy namely mucositis, pain, and functional

  12. Head Lice

    Science.gov (United States)

    ... nits. You should also use hot water to wash any bed linens, towels, and clothing recently worn by the person who had head lice. Vacuum anything that can’t be washed, such as the couch, carpets, your child’s car seat, and any stuffed animals. Because head lice ...

  13. The relationship between observer-based toxicity scoring and patient assessed symptom severity after treatment for head and neck cancer. A correlative cross sectional study of the DAHANCA toxicity scoring system and the EORTC quality of life questionnaires

    International Nuclear Information System (INIS)

    Jensen, Kenneth; Bonde Jensen, Anders; Grau, Cai

    2006-01-01

    Background and purpose: Morbidity is an important issue in cancer research. The observer-based toxicity scoring system used by DAHANCA (the Danish head and neck cancer study group) has proved itself sensitive to differences in toxicity in a large randomised study, but like other toxicity scoring systems it has not been formally validated. Conversely, the EORTC quality of life questionnaire (QLQ) has been validated as a tool for collecting information about the consequences of disease and treatment on the well being of cancer patients. The purpose of this study was to examine the relationship between the two methods of side effect recording. Patients and methods: One hundred and sixteen recurrence free patients with laryngeal (n=44), pharyngeal (n=34) and oral cavity (n=38) cancer attending follow-up after radiotherapy (n=83) or surgery (n=33) completed EORTC C30, the core questionnaire concerning general symptoms and function and EORTC H and N35 the head and neck specific questionnaire. The attending physicians in the follow-up clinic evaluated and recorded DAHANCA toxicity scores on the same patients. Results: The DAHANCA toxicity scoring system and the EORTC QLQ correlated with several clinical endpoints. The conceptually similar endpoints of the two methods correlated significantly. The objective endpoints of the DAHANCA scoring system were only correlated with quality of life endpoints to a very low degree. The DAHANCA toxicity scores had a low sensitivity (0.48-0.74) in detecting equivalent subjective complaints from the questionnaires and the observer-based scoring system severely underestimated patient complaints. A specific patient group where the DAHANCA score had a higher tendency to fail could not be detected. Conclusion: The DAHANCA toxicity score is an effective instrument in assessing objective treatment induced toxicity in head and neck cancer patients but insensitive and non-specific with regard to patient assessed subjective endpoints. This

  14. Fatal Tension Pneumoperitoneum Due to Non-Accidental Trauma

    OpenAIRE

    Thornton, Stephen L.; Hunter, Jeremy; Scott, Mark

    2015-01-01

    A previously healthy two-year-old boy presented to the emergency department with vomiting. He was cyanotic with mottling of both lower extremities. He was in respiratory distress with retractions and diminished breath sounds. His abdomen was distended and rigid. He had a pulse of 170 beats per minute, blood pressure of 144/69mmHg and respiratory rate of 42 breaths per minute. He was endotracheally intubated. Chest and abdominal radiographs demonstrated a tension pneumo...

  15. Fatal Tension Pneumoperitoneum Due to Non-Accidental Trauma

    Directory of Open Access Journals (Sweden)

    Stephen L. Thornton

    2015-10-01

    Full Text Available A previously healthy two-year-old boy presented to the emergency department with vomiting. He was cyanotic with mottling of both lower extremities. He was in respiratory distress with retractions and diminished breath sounds. His abdomen was distended and rigid. He had a pulse of 170 beats per minute, blood pressure of 144/69mmHg and respiratory rate of 42 breaths per minute. He was endotracheally intubated. Chest and abdominal radiographs demonstrated a tension pneumoperitoneum.

  16. Skeletal imaging of child abuse (non-accidental injury)

    International Nuclear Information System (INIS)

    Offiah, Amaka; Rijn, Rick R. van; Perez-Rossello, Jeanette Mercedes; Kleinman, Paul K.

    2009-01-01

    In recent years there has been a worldwide increased awareness that children are physically abused by their carers. Radiologists play a vital role in the detection of inflicted injuries. This article reviews the skeletal imaging findings seen in child abuse. (orig.)

  17. Skeletal imaging of child abuse (non-accidental injury)

    NARCIS (Netherlands)

    Offiah, A.; van Rijn, R.R.; Perez-Rossello, J.M.; Kleinman, P.K.

    2009-01-01

    In recent years there has been a worldwide increased awareness that children are physically abused by their carers. Radiologists play a vital role in the detection of inflicted injuries. This article reviews the skeletal imaging findings seen in child abuse

  18. Skeletal imaging of child abuse (non-accidental injury)

    Energy Technology Data Exchange (ETDEWEB)

    Offiah, Amaka [Great Ormond Street Hospital, Radiology Department, London (United Kingdom); Rijn, Rick R. van [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam Zuid-Oost (Netherlands); Perez-Rossello, Jeanette Mercedes; Kleinman, Paul K. [Children' s Hospital Boston, Radiology Department, Boston, MA (United States)

    2009-05-15

    In recent years there has been a worldwide increased awareness that children are physically abused by their carers. Radiologists play a vital role in the detection of inflicted injuries. This article reviews the skeletal imaging findings seen in child abuse. (orig.)

  19. Head Start.

    Science.gov (United States)

    Greenman, Geri

    2000-01-01

    Discusses an art project in which students created drawings of mop heads. Explains that the approach of drawing was more important than the subject. States that the students used the chiaroscuro technique, used by Rembrandt and Caravaggio, in which light appears out of the darkness. (CMK)

  20. The relationship between observer-based toxicity scoring and patient assessed symptom severity after treatment for head and neck cancer. A correlative cross sectional study of the DAHANCA toxicity scoring system and the EORTC quality of life questionnaires

    DEFF Research Database (Denmark)

    Jensen, Kenneth; Bonde Jensen, Anders; Grau, Cai

    2006-01-01

          toxicity scoring systems it has not been formally validated. Conversely,       the EORTC quality of life questionnaire (QLQ) has been validated as a tool       for collecting information about the consequences of disease and treatment       on the well being of cancer patients. The purpose of this study......) completed       EORTC C30, the core questionnaire concerning general symptoms and function       and EORTC H&N35 the head and neck specific questionnaire. The attending       physicians in the follow-up clinic evaluated and recorded DAHANCA toxicity       scores on the same patients. RESULTS: The DAHANCA...... low degree. The       DAHANCA toxicity scores had a low sensitivity (0.48-0.74) in detecting       equivalent subjective complaints from the questionnaires and the       observer-based scoring system severely underestimated patient complaints.       A specific patient group where the DAHANCA score had...

  1. Sharing a Host Plant (Wheat [Triticum aestivum]) Increases the Fitness of Fusarium graminearum and the Severity of Fusarium Head Blight but Reduces the Fitness of Grain Aphids (Sitobion avenae)

    Science.gov (United States)

    Drakulic, Jassy; Caulfield, John; Woodcock, Christine; Jones, Stephen P. T.; Linforth, Robert; Bruce, Toby J. A.

    2015-01-01

    We hypothesized that interactions between fusarium head blight-causing pathogens and herbivores are likely to occur because they share wheat as a host plant. Our aim was to investigate the interactions between the grain aphid, Sitobion avenae, and Fusarium graminearum on wheat ears and the role that host volatile chemicals play in mediating interactions. Wheat ears were treated with aphids and F. graminearum inoculum, together or separately, and disease progress was monitored by visual assessment and by quantification of pathogen DNA and mycotoxins. Plants exposed to both aphids and F. graminearum inoculum showed accelerated disease progression, with a 2-fold increase in disease severity and 5-fold increase in mycotoxin accumulation over those of plants treated only with F. graminearum. Furthermore, the longer the period of aphid colonization of the host prior to inoculation with F. graminearum, the greater the amount of pathogen DNA that accumulated. Headspace samples of plant volatiles were collected for use in aphid olfactometer assays and were analyzed by gas chromatography-mass spectrometry (GC-MS) and GC-coupled electroantennography. Disease-induced plant volatiles were repellent to aphids, and 2-pentadecanone was the key semiochemical underpinning the repellent effect. We measured aphid survival and fecundity on infected wheat ears and found that both were markedly reduced on infected ears. Thus, interactions between F. graminearum and grain aphids on wheat ears benefit the pathogen at the expense of the pest. Our findings have important consequences for disease epidemiology, because we show increased spread and development of host disease, together with greater disease severity and greater accumulation of pathogen DNA and mycotoxin, when aphids are present. PMID:25769834

  2. Flued head replacement alternatives

    International Nuclear Information System (INIS)

    Smetters, J.L.

    1987-01-01

    This paper discusses flued head replacement options. Section 2 discusses complete flued head replacement with a design that eliminates the inaccessible welds. Section 3 discusses alternate flued head support designs that can drastically reduce flued head installation costs. Section 4 describes partial flued head replacement designs. Finally, Section 5 discusses flued head analysis methods. (orig./GL)

  3. Goniometer head

    International Nuclear Information System (INIS)

    Dzhazairov-Kakhramanov, V.; Berger, V.D.; Kadyrzhanov, K.K.; Zarifov, R.A.

    1994-01-01

    The goniometer head is an electromechanical instrument that performs the independent transfer of a testing sample on three coordinate axes (X, Y, Z) within limits of ±8 mm and independent rotation relative of these directions. The instrument comprises a sample holder, bellows component and three electrometer drives. The sample holder rotates around the axes X and Y, and is installed on the central arm which rotates around axis Z. One characteristic of this instrument is its independence which allows its use in any camera for researches in the field of radiation physics. 2 figs

  4. The role of parotid gland irradiation in the development of severe hyposalivation (xerostomia) after intensity-modulated radiation therapy for head and neck cancer: Temporal patterns, risk factors, and testing the QUANTEC guidelines.

    Science.gov (United States)

    Owosho, Adepitan A; Thor, Maria; Oh, Jung Hun; Riaz, Nadeem; Tsai, C Jillian; Rosenberg, Haley; Varthis, Spyridon; Yom, Sae Hee K; Huryn, Joseph M; Lee, Nancy Y; Deasy, Joseph O; Estilo, Cherry L

    2017-04-01

    The aims of this study were to investigate temporal patterns and potential risk factors for severe hyposalivation (xerostomia) after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC), and to test the two QUANTEC (Quantitative Analysis of Normal Tissue Effects in the Clinic) guidelines. Sixty-three patients treated at the Memorial Sloan Kettering Cancer Center between 2006 and 2015, who had a minimum of three stimulated whole mouth saliva flow measurements (WMSFM) at a median follow-up time of 11 (range: 3-24) months were included. Xerostomia was defined as WMSFM ≤25% compared to relative pre-radiotherapy. Patients were stratified into three follow-up groups: 1: xerostomia was 27%, 14% and 17% at follow-up time points 1, 2 and 3, respectively. At xerostomia (Dmean contra : 25 Gy vs. 15 Gy; Dmean ipsi : 44 Gy vs. 25 Gy). Patients with xerostomia had higher pre-RT WMSFM (3.5 g vs. 2.4 g), and had been treated more frequently with additional chemotherapy (93% vs. 63%; all 4 variables: p xerostomia was higher compared to patients without (26 Gy vs. 20 Gy). The RR as specified by the one- and two-gland QUANTEC guideline was 2.3 and 1.4 for patients with Xerostomia following IMRT peaks within six months post-radiotherapy and fades with time. Limiting the mean dose to both parotid glands (ipsilateral xerostomia. Both QUANTEC guidelines are effective in preventing xerostomia. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  5. Is HEADS in our heads?

    DEFF Research Database (Denmark)

    Boisen, Kirsten A; Hertz, Pernille Grarup; Blix, Charlotte

    2016-01-01

    contraception], Safety, Self-harm) interview is a feasible way of exploring health risk behaviors and resilience. OBJECTIVE: The purpose of this study was to evaluate how often HEADS topics were addressed according to young patients and staff in pediatric and adult outpatient clinics. METHODS: We conducted...... care professionals participated. We found only small reported differences between staff and young patients regarding whether home, education, and activity were addressed. However, staff reported twice the rate of addressing smoking, alcohol, illegal drugs, sexuality, and contraception compared to young...... patients. Young patients reported that smoking, alcohol, illegal drugs, sexuality, and contraception were addressed significantly more at adult clinics in comparison to pediatric clinics. After controlling for age, gender and duration of illness, according to young patients, adjusted odds ratios...

  6. Head Impact Laboratory (HIL)

    Data.gov (United States)

    Federal Laboratory Consortium — The HIL uses testing devices to evaluate vehicle interior energy attenuating (EA) technologies for mitigating head injuries resulting from head impacts during mine/...

  7. Heading and head injuries in soccer.

    Science.gov (United States)

    Kirkendall, D T; Jordan, S E; Garrett, W E

    2001-01-01

    In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill obviously places the player at risk of head injury and the game does carry some risk. Head injury can be a result of contact of the head with another head (or other body parts), ground, goal post, other unknown objects or even the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions or even, in rare cases, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected soccer players have some degree of cognitive dysfunction. It is important to determine the reasons behind such deficits. Purposeful heading has been blamed, but a closer look at the studies that focus on heading has revealed methodological concerns that question the validity of blaming purposeful heading of the ball. The player's history and age (did they play when the ball was leather and could absorb significant amounts of water), alcohol intake, drug intake, learning disabilities, concussion definition and control group use/composition are all factors that cloud the ability to blame purposeful heading. What does seem clear is that a player's history of concussive episodes is a more likely explanation for cognitive deficits. While it is likely that the subconcussive impact of purposeful heading is a doubtful factor in the noted deficits, it is unknown whether multiple subconcussive impacts might have some lingering effects. In addition, it is unknown whether the noted deficits have any affect on daily life. Proper instruction in the technique is critical because if the ball contacts an unprepared head (as in accidental head-ball contacts), the potential for serious injury is possible. To further our understanding of the relationship of heading, head injury and cognitive deficits, we need to: learn more about the actual impact of a ball on the

  8. Head first C#

    CERN Document Server

    Stellman, Andrew

    2010-01-01

    You want to learn C# programming, but you're not sure you want to suffer through another tedious technical book. You're in luck: Head First C# introduces this language in a fun, visual way. You'll quickly learn everything from creating your first program to learning sophisticated coding skills with C# 4.0, Visual Studio 2010 and .NET 4, while avoiding common errors that frustrate many students. The second edition offers several hands-on labs along the way to help you build and test programs using skills you've learned up to that point. In the final lab, you'll put everything together. From o

  9. Tridimensional pose estimation of a person head

    International Nuclear Information System (INIS)

    Perez Berenguer, Elisa; Soria, Carlos; Nasisi, Oscar; Mut, Vicente

    2007-01-01

    In this work, we present a method for estimating 3-D motion parameters; this method provides an alternative way for 3D head pose estimation from image sequence in the current computer vision literature. This method is robust over extended sequences and large head motions and accurately extracts the orientation angles of head from a single view. Experimental results show that this tracking system works well for development a human-computer interface for people that possess severe motor incapacity

  10. Remediation of attention deficits in head injury.

    OpenAIRE

    Nag S; Rao S

    1999-01-01

    Head injury is associated with psychological sequelae which impair the patient′s psychosocial functioning. Information processing, attention and memory deficits are seen in head injuries of all severity. We attempted to improve deficits of focused, sustained and divided attention. The principle of overlapping sources of attention resource pools was utilised in devising the remediation programme. Tasks used simple inexpensive materials. Four head injured young adult males with post conc...

  11. Head Trauma: First Aid

    Science.gov (United States)

    First aid Head trauma: First aid Head trauma: First aid By Mayo Clinic Staff Most head trauma involves injuries that are minor and don't require ... 21, 2015 Original article: http://www.mayoclinic.org/first-aid/first-aid-head-trauma/basics/ART-20056626 . Mayo ...

  12. Head and neck cancer

    International Nuclear Information System (INIS)

    Vogl, S.E.

    1988-01-01

    This book contains 10 chapters. Some of the titles are: Combined Surgical Resection and Irradiation for Head and Neck Cancers; Analysis of Radiation Therapy Oncology Group Head and Neck Database: Identification of Prognostic Factors and the Re-evaluation of American Joint Committee Stages; Combined Modality Approach to Head and Neck Cancer; Induction Combination Chemotherapy of Regionally Advanced Head and Neck Cancer; and Outcome after Complete Remission to Induction Chemotherapy in Head and Neck Cancer

  13. OCULAR MANIFESTATIONS OF HEAD INJURIES

    Directory of Open Access Journals (Sweden)

    Kanukollu Venkata Madusudana Rao

    2016-12-01

    Full Text Available BACKGROUND This prospective study aimed to evaluate the incidence of ocular manifestations in head injury and their correlation with the intracranial lesions. MATERIALS AND METHODS A total of 108 consecutive cases of closed head injury admitted in the neurosurgical ward of a tertiary teaching hospital underwent a thorough ophthalmic assessment. Clinical examination, radiological imaging and Glasgow Coma Scale (GCS were applied to grade the severity of injury. RESULTS Total number of 108 patients of head injury were examined of which 38 patients had ocular manifestations (35.18%. Of these, 85.18% were males, 84% of injuries were due to road traffic accidents and 16% were due to fall from a height. The ocular manifestations were as follows- Orbital complications were seen in 6 patients (15.8%. Anterior segment manifestations included black eyes seen in 10 patients (26.3%, subconjunctival haemorrhage in 10.5% of patients (4 patients, corneal involvement in 21% of patients (8 patients and pupillary involvement in 50% of patients (19 patients. Posterior segment manifestations were seen in 26.3% of patients (10 patients and were as follows- Purtscher’s retinopathy in 2 patients and optic atrophy in 5 patients. Cranial nerve palsies were seen in 15 patients (39.47% and supranuclear movement disorders were seen in 3 patients (8%. CONCLUSION Even though, neurosurgeons perform comprehensive clinical examination including eye examination, the main purpose is limited to aid topical diagnosis of neurological lesions. This study emphasises the importance of a detailed eye examination by an ophthalmologist to prevent irreversible visual loss in addition to aiding in the neurological diagnosis. Pupillary involvement, papilloedema and ocular motor paresis pointed to a more severe head injury. This observational prospective study helped us to correlate the severity of head injuries in association with ocular findings in patients admitted in neurosurgical ward

  14. Ulnar nerve entrapment complicating radial head excision

    Directory of Open Access Journals (Sweden)

    Kevin Parfait Bienvenu Bouhelo-Pam

    Full Text Available Introduction: Several mechanisms are involved in ischemia or mechanical compression of ulnar nerve at the elbow. Presentation of case: We hereby present the case of a road accident victim, who received a radial head excision for an isolated fracture of the radial head and complicated by onset of cubital tunnel syndrome. This outcome could be the consequence of an iatrogenic valgus of the elbow due to excision of the radial head. Hitherto the surgical treatment of choice it is gradually been abandoned due to development of radial head implant arthroplasty. However, this management option is still being performed in some rural centers with low resources. Discussion: The radial head plays an important role in the stability of the elbow and his iatrogenic deformity can be complicated by cubital tunnel syndrome. Conclusion: An ulnar nerve release was performed with favorable outcome. Keywords: Cubital tunnel syndrome, Peripheral nerve palsy, Radial head excision, Elbow valgus

  15. Ophthalmic manifestations of head injury.

    Science.gov (United States)

    Kowal, L

    1992-02-01

    Head injuries are frequently associated with ophthalmic problems. The commonest problems seen in this series of 161 patients with head injury were problems with poor accommodation (16% of patients; 58% of these persisted), convergence (14% of patients; 35% of these persisted), pseudomyopia (19%; 55% persisted) and optic atrophy (26% of the patients; 78% of these were mild and easily missed on routine testing, and 22% were severe). Motility disorders were common, especially cranial nerve palsies. Other less frequent motility disturbances included apparent inferior oblique palsy, comitant esotropia, and exotropia which was often of the convergence insufficiency type.

  16. Wheelchair control by head motion

    Directory of Open Access Journals (Sweden)

    Pajkanović Aleksandar

    2013-01-01

    Full Text Available Electric wheelchairs are designed to aid paraplegics. Unfortunately, these can not be used by persons with higher degree of impairment, such as quadriplegics, i.e. persons that, due to age or illness, can not move any of the body parts, except of the head. Medical devices designed to help them are very complicated, rare and expensive. In this paper a microcontroller system that enables standard electric wheelchair control by head motion is presented. The system comprises electronic and mechanic components. A novel head motion recognition technique based on accelerometer data processing is designed. The wheelchair joystick is controlled by the system’s mechanical actuator. The system can be used with several different types of standard electric wheelchairs. It is tested and verified through an experiment performed within this paper.

  17. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... for Brain Tumors Radiation Therapy for Head and Neck Cancer Others American Stroke Association National Stroke Association ... Computer Tomography (CT) Safety During Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine ...

  18. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... When the image slices are reassembled by computer software, the result is a very detailed multidimensional view ... Safety Images related to Computed Tomography (CT) - Head Videos related to Computed Tomography (CT) - Head Sponsored by ...

  19. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... the limitations of CT Scanning of the Head? What is CT Scanning of the Head? Computed tomography, ... than regular radiographs (x-rays). top of page What are some common uses of the procedure? CT ...

  20. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head Computed tomography (CT) of the head uses special x-ray ... What is CT Scanning of the Head? Computed tomography, more commonly known as a CT or CAT ...

  1. Head trauma and CT

    International Nuclear Information System (INIS)

    Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitoshi

    1979-01-01

    In our cases of acute and subacute subdural hematoma, the use of CT was evaluated. In our department of surgery, acute subdural hematoma was found in 46 of 388 patients of head trauma who underwent CT. Acute subdural hematoma, like epidural hematoma was usually visualized as a high-density area along the cranial inner table, and this was easily differenciated from epidural hematoma because of difference in shape from the other. The picture of acute subdural hematoma was occasionally confused with that of intracerebral hematoma or cerebral contusion. Single use of CT does not differenciate subacute subdural hematoma from chronic subdural hematoma. However, CT usually visualized acute hematoma as a high-density area, showing the extent of hematoma. Comparison of the thickness of hematoma with the axis deviation of the median part such as the 3rd cerebral ventricle suggested severity of cerebral edema. CT also revealed bilateral or multiple lesions of cerebral contusion or intracerebral hematoma. (Ueda, J.)

  2. Computerised tomographic patterns in patients with head injury at ...

    African Journals Online (AJOL)

    2011-04-15

    Apr 15, 2011 ... The clinical severity of head injury is classified based on ... head injury include road traffic accidents (RTA), assaults, ... information in the management of patients with head ... Materials and Methods ... The right cerebral hemisphere was involved in 13 cases .... Nerve palsies – 3rd, 5th, 6th cranial nerves. 3.

  3. Lower head failure analysis

    International Nuclear Information System (INIS)

    Rempe, J.L.; Thinnes, G.L.; Allison, C.M.; Cronenberg, A.W.

    1991-01-01

    The US Nuclear Regulatory Commission is sponsoring a lower vessel head research program to investigate plausible modes of reactor vessel failure in order to determine (a) which modes have the greatest likelihood of occurrence during a severe accident and (b) the range of core debris and accident conditions that lead to these failures. This paper presents the methodology and preliminary results of an investigation of reactor designs and thermodynamic conditions using analytic closed-form approximations to assess the important governing parameters in non-dimensional form. Preliminary results illustrate the importance of vessel and tube geometrical parameters, material properties, and external boundary conditions on predicting vessel failure. Thermal analyses indicate that steady-state temperature distributions will occur in the vessel within several hours, although the exact time is dependent upon vessel thickness. In-vessel tube failure is governed by the tube-to-debris mass ratio within the lower head, where most penetrations are predicted to fail if surrounded by molten debris. Melt penetration distance is dependent upon the effective flow diameter of the tube. Molten debris is predicted to penetrate through tubes with a larger effective flow diameter, such as a boiling water reactor (BWR) drain nozzle. Ex-vessel tube failure for depressurized reactor vessels is predicted to be more likely for a BWR drain nozzle penetration because of its larger effective diameter. At high pressures (between ∼0.1 MPa and ∼12 MPa) ex-vessel tube rupture becomes a dominant failure mechanism, although tube ejection dominates control rod guide tube failure at lower temperatures. However, tube ejection and tube rupture predictions are sensitive to the vessel and tube radial gap size and material coefficients of thermal expansion

  4. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

  5. Bottom head failure program plan

    International Nuclear Information System (INIS)

    Meyer, R.O.

    1989-01-01

    Earlier this year the NRC staff presented a Revised Severe Accident Research Program Plan (SECY-89-123) to the Commission and initiated work on that plan. Two of the near-term issues in that plan involve failure of the bottom head of the reactor pressure vessel. These two issues are (1) depressurization and DCH and (2) BWR Mark I Containment Shell Meltthrough. ORNL has developed models for several competing failure mechanisms for BWRs. INEL has performed analytical and experimental work directly related to bottom head failure in connection with several programs. SNL has conducted a number of analyses and experimental activities to examine the failure of LWR vessels. In addition to the government-sponsored work mentioned above, EPRI and FAI performed studies on vessel failure for the Industry Degraded Core Rulemaking Program (IDCOR). EPRI examined the failure of a PWR vessel bottom head without penetrations, as found in some Combustion Engineering reactors. To give more attention to this subject as called for by the revised Severe Accident Research Plan, two things are being done. First, work previously done is being reviewed carefully to develop an overall picture and to determine the reliability of assumptions used in those studies. Second, new work is being planned for FY90 to try to complete a reasonable understanding of the failure process. The review and planning are being done in close cooperation with the ACRS. Results of this exercise will be presented in this paper

  6. Head impact in a snowboarding accident.

    Science.gov (United States)

    Bailly, N; Llari, M; Donnadieu, T; Masson, C; Arnoux, P J

    2017-09-01

    To effectively prevent sport traumatic brain injury (TBI), means of protection need to be designed and tested in relation to the reality of head impact. This study quantifies head impacts during a typical snowboarding accident to evaluate helmet standards. A snowboarder numerical model was proposed, validated against experimental data, and used to quantify the influence of accident conditions (speed, snow stiffness, morphology, and position) on head impacts (locations, velocities, and accelerations) and injury risk during snowboarding backward falls. Three hundred twenty-four scenarios were simulated: 70% presented a high risk of mild TBI (head peak acceleration >80 g) and 15% presented a high risk of severe TBI (head injury criterion >1000). Snow stiffness, speed, and snowboarder morphology were the main factors influencing head impact metrics. Mean normal head impact speed (28 ± 6 km/h) was higher than equivalent impact speed used in American standard helmet test (ASTM F2040), and mean tangential impact speed, not included in standard tests, was 13.8 (±7 km/h). In 97% of simulated impacts, the peak head acceleration was below 300 g, which is the pass/fail criteria used in standard tests. Results suggest that initial speed, impacted surface, and pass/fail criteria used in helmet standard performance tests do not fully reflect magnitude and variability of snowboarding backward-fall impacts. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Unilateral otolith centrifugation by head tilt.

    Science.gov (United States)

    Winters, Stephanie M; Bos, Jelte E; Klis, Sjaak F L

    2014-01-01

    To test for otolith asymmetries, several studies described horizontal translation of the body and head en bloc during fast vertical axis rotation. This stimulus causes one otolithic organ to rotate on-axis, and the other to experience centripetal acceleration. To test a new, more simple method of unilateral stimulation with head tilt and the body remaining on axis. During stationary and during 360 deg/s rotation, 12 healthy blindfolded subjects had their heads tilted 30 degrees sideways, positioning one otolithic organ on the axis of rotation after the other. The haptic subjective vertical (SV) was recorded several times by means of a manually adjustable rod. It was found that during stationary the SV tilted about 4 degrees on average in the direction of the head. During rotation, the SV tilted about 9 degrees on average. We therefore estimate the effect of eccentric otolith rotation to be 5 degrees on average. Tilt of the subjective vertical induced by head tilt during on-axis body rotation can provide a relatively uncomplicated alternative to test unilateral otolithic function as compared to body and head translation during rotation. Moreover, unlike eccentric rotation of the entire body, somatosensory cues are minimized by keeping the body fixed on axis and by subtracting the effect of head tilt per se.

  8. Head CT scan

    Science.gov (United States)

    ... scan - orbits; CT scan - sinuses; Computed tomography - cranial; CAT scan - brain ... head size in children Changes in thinking or behavior Fainting Headache, when you have certain other signs ...

  9. Bottom head assembly

    International Nuclear Information System (INIS)

    Fife, A.B.

    1998-01-01

    A bottom head dome assembly is described which includes, in one embodiment, a bottom head dome and a liner configured to be positioned proximate the bottom head dome. The bottom head dome has a plurality of openings extending there through. The liner also has a plurality of openings extending there through, and each liner opening aligns with a respective bottom head dome opening. A seal is formed, such as by welding, between the liner and the bottom head dome to resist entry of water between the liner and the bottom head dome at the edge of the liner. In the one embodiment, a plurality of stub tubes are secured to the liner. Each stub tube has a bore extending there through, and each stub tube bore is coaxially aligned with a respective liner opening. A seat portion is formed by each liner opening for receiving a portion of the respective stub tube. The assembly also includes a plurality of support shims positioned between the bottom head dome and the liner for supporting the liner. In one embodiment, each support shim includes a support stub having a bore there through, and each support stub bore aligns with a respective bottom head dome opening. 2 figs

  10. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head Computed tomography (CT) of the head uses special x-ray equipment ... story here Images × Image Gallery Patient undergoing computed tomography (CT) scan. View full size with caption Pediatric Content ...

  11. Reactor head shielding apparatus

    International Nuclear Information System (INIS)

    Schukei, G.E.; Roebelen, G.J.

    1992-01-01

    This patent describes a nuclear reactor head shielding apparatus for mounting on spaced reactor head lifting members radially inwardly of the head bolts. It comprises a frame of sections for mounting on the lifting members and extending around the top central area of the head, mounting means for so mounting the frame sections, including downwardly projecting members on the frame sections and complementary upwardly open recessed members for fastening to the lifting members for receiving the downwardly projecting members when the frame sections are lowered thereto with lead shielding supported thereby on means for hanging lead shielding on the frame to minimize radiation exposure or personnel working with the head bolts or in the vicinity thereof

  12. Head flexion angle while using a smartphone.

    Science.gov (United States)

    Lee, Sojeong; Kang, Hwayeong; Shin, Gwanseob

    2015-01-01

    Repetitive or prolonged head flexion posture while using a smartphone is known as one of risk factors for pain symptoms in the neck. To quantitatively assess the amount and range of head flexion of smartphone users, head forward flexion angle was measured from 18 participants when they were conducing three common smartphone tasks (text messaging, web browsing, video watching) while sitting and standing in a laboratory setting. It was found that participants maintained head flexion of 33-45° (50th percentile angle) from vertical when using the smartphone. The head flexion angle was significantly larger (p smartphone, could be a main contributing factor to the occurrence of neck pain of heavy smartphone users. Practitioner Summary: In this laboratory study, the severity of head flexion of smartphone users was quantitatively evaluated when conducting text messaging, web browsing and video watching while sitting and standing. Study results indicate that text messaging while sitting caused the largest head flexion than that of other task conditions.

  13. Antipredatory function of head shape for vipers and their mimics.

    Directory of Open Access Journals (Sweden)

    Janne K Valkonen

    Full Text Available Most research into the adaptive significance of warning signals has focused on the colouration and patterns of prey animals. However, behaviour, odour and body shape can also have signal functions and thereby reduce predators' willingness to attack defended prey. European vipers all have a distinctive triangular head shape; and they are all venomous. Several non-venomous snakes, including the subfamily Natricinae, commonly flatten their heads (also known as head triangulation when disturbed. The adaptive significance of this potential behavioural mimicry has never been investigated.We experimentally tested if the triangular head shape typical of vipers offers protection against predation. We compared the predation pressure of free-ranging predators on artificial snakes with triangular-shaped heads against the pressure on replicas with narrow heads. Snakes of both head types had either zigzag patterned bodies, typical of European vipers, or plain (patternless bodies. Plain snakes with narrower Colubrid-like heads suffered significantly higher predation by raptors than snakes with triangular-shaped heads. Head shape did not, however, have an additive effect on survival in zigzag-patterned snakes, suggesting that species which differ from vipers in colouration and pattern would benefit most from behavioural mimicry. Our results demonstrate that the triangular head shape typical of vipers can act as a warning signal to predators. We suggest that head-shape mimicry may be a more common phenomenon among more diverse taxa than is currently recognised.

  14. Heading Frequency Is More Strongly Related to Cognitive Performance Than Unintentional Head Impacts in Amateur Soccer Players

    Directory of Open Access Journals (Sweden)

    Walter F. Stewart

    2018-04-01

    Full Text Available ObjectiveCompared to heading, unintentional head impacts (e.g., elbow to head, head to head, head to goalpost in soccer are more strongly related to risk of moderate to very severe Central Nervous System (CNS symptoms. But, most head impacts associated with CNS symptoms that occur in soccer are mild and are more strongly related to heading. We tested for a differential relation of heading and unintentional head impacts with neuropsychological (NP test performance.MethodActive adult amateur soccer players were recruited in New York City and the surrounding areas for this repeated measures longitudinal study of individuals who were enrolled if they had 5+ years of soccer play and were active playing soccer 6+ months/year. All participants completed a baseline validated questionnaire (“HeadCount-2w”, reporting 2-week recall of soccer activity, heading and unintentional head impacts. In addition, participants also completed NP tests of verbal learning, verbal memory, psychomotor speed, attention, and working memory. Most participants also completed one or more identical follow-up protocols (i.e., HeadCount-2w and NP tests at 3- to 6-month intervals over a 2-year period. Repeated measures General Estimating Equations (GEE linear models were used to determine if variation in NP tests at each visit was related to variation in either heading or unintentional head impacts in the 2-week period before testing.Results308 players (78% male completed 741 HeadCount-2w. Mean (median heading/2-weeks was 50 (17 for men and 26 (7 for women. Heading was significantly associated with poorer performance on psychomotor speed (p < 0.001 and attention (p = 0.02 tasks and was borderline significant with poorer performance on the working memory (p = 0.06 task. Unintentional head impacts were not significantly associated with any NP test. Results did not differ after excluding 22 HeadCount-2w with reported concussive or borderline concussive symptoms

  15. Tauopathy PET and amyloid PET in the diagnosis of chronic traumatic encephalopathies: studies of a retired NFL player and of a man with FTD and a severe head injury.

    Science.gov (United States)

    Mitsis, E M; Riggio, S; Kostakoglu, L; Dickstein, D L; Machac, J; Delman, B; Goldstein, M; Jennings, D; D'Antonio, E; Martin, J; Naidich, T P; Aloysi, A; Fernandez, C; Seibyl, J; DeKosky, S T; Elder, G A; Marek, K; Gordon, W; Hof, P R; Sano, M; Gandy, S

    2014-09-16

    Single, severe traumatic brain injury (TBI) which elevates CNS amyloid, increases the risk of Alzheimer's disease (AD); while repetitive concussive and subconcussive events as observed in athletes and military personnel, may increase the risk of chronic traumatic encephalopathy (CTE). We describe two clinical cases, one with a history of multiple concussions during a career in the National Football League (NFL) and the second with frontotemporal dementia and a single, severe TBI. Both patients presented with cognitive decline and underwent [(18)F]-Florbetapir positron emission tomography (PET) imaging for amyloid plaques; the retired NFL player also underwent [(18)F]-T807 PET imaging, a new ligand binding to tau, the main constituent of neurofibrillary tangles (NFT). Case 1, the former NFL player, was 71 years old when he presented with memory impairment and a clinical profile highly similar to AD. [(18)F]-Florbetapir PET imaging was negative, essentially excluding AD as a diagnosis. CTE was suspected clinically, and [(18)F]-T807 PET imaging revealed striatal and nigral [(18)F]-T807 retention consistent with the presence of tauopathy. Case 2 was a 56-year-old man with personality changes and cognitive decline who had sustained a fall complicated by a subdural hematoma. At 1 year post injury, [(18)F]-Florbetapir PET imaging was negative for an AD pattern of amyloid accumulation in this subject. Focal [(18)F]-Florbetapir retention was noted at the site of impact. In case 1, amyloid imaging provided improved diagnostic accuracy where standard clinical and laboratory criteria were inadequate. In that same case, tau imaging with [(18)F]-T807 revealed a subcortical tauopathy that we interpret as a novel form of CTE with a distribution of tauopathy that mimics, to some extent, that of progressive supranuclear palsy (PSP), despite a clinical presentation of amnesia without any movement disorder complaints or signs. A key distinguishing feature is that our patient presented

  16. Femoral head avascular necrosis

    International Nuclear Information System (INIS)

    Chrysikopoulos, H.; Sartoris, D.J.; Resnick, D.L.; Ashburn, W.; Pretorius, T.

    1988-01-01

    MR imaging has been shown to be more sensitive and specific than planar scintigraphy for avascular necrosis (AVN) of the femoral head. However, experience with single photon emission CT (SPECT) is limited. The authors retrospectively compared 1.5-T MR imaging with SPECT in 14 patients with suspected femoral head AVN. Agreement between MR imaging and SPECT was present in 24 femurs, 14 normal and ten with AVN. MR imaging showed changes of AVN in the remaining four femoral heads. Of these, one was normal and the other three inconclusive for AVN by SPECT. The authors conclude that MR imaging is superior to SPECT for the evaluation of AVN of the hip

  17. Protective head of sensors

    International Nuclear Information System (INIS)

    Liska, K.; Anton, P.

    1987-01-01

    The discovery concerns the protective heads of diagnostic assemblies of nuclear power plants for conductors of the sensors from the fuel and control parts of the said assemblies. A detailed description is presented of the design of the protective head which, as compared with the previous design, allows quick and simple assembly with reduced risk of damaging the sensors. The protective head may be used for diagnostic assemblies both in power and in research reactors and it will be used for WWER reactor assemblies. (A.K.). 3 figs

  18. Heading Frequency Is More Strongly Related to Cognitive Performance Than Unintentional Head Impacts in Amateur Soccer Players.

    Science.gov (United States)

    Stewart, Walter F; Kim, Namhee; Ifrah, Chloe; Sliwinski, Martin; Zimmerman, Molly E; Kim, Mimi; Lipton, Richard B; Lipton, Michael L

    2018-01-01

    Compared to heading, unintentional head impacts (e.g., elbow to head, head to head, head to goalpost) in soccer are more strongly related to risk of moderate to very severe Central Nervous System (CNS) symptoms. But, most head impacts associated with CNS symptoms that occur in soccer are mild and are more strongly related to heading. We tested for a differential relation of heading and unintentional head impacts with neuropsychological (NP) test performance. Active adult amateur soccer players were recruited in New York City and the surrounding areas for this repeated measures longitudinal study of individuals who were enrolled if they had 5+ years of soccer play and were active playing soccer 6+ months/year. All participants completed a baseline validated questionnaire ("HeadCount-2w"), reporting 2-week recall of soccer activity, heading and unintentional head impacts. In addition, participants also completed NP tests of verbal learning, verbal memory, psychomotor speed, attention, and working memory. Most participants also completed one or more identical follow-up protocols (i.e., HeadCount-2w and NP tests) at 3- to 6-month intervals over a 2-year period. Repeated measures General Estimating Equations (GEE) linear models were used to determine if variation in NP tests at each visit was related to variation in either heading or unintentional head impacts in the 2-week period before testing. 308 players (78% male) completed 741 HeadCount-2w. Mean (median) heading/2-weeks was 50 (17) for men and 26 (7) for women. Heading was significantly associated with poorer performance on psychomotor speed ( p  impacts were not significantly associated with any NP test. Results did not differ after excluding 22 HeadCount-2w with reported concussive or borderline concussive symptoms. Poorer NP test performance was consistently related to frequent heading during soccer practice and competition in the 2 weeks before testing. In contrast, unintentional head impacts incurred

  19. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... you! Do you have a personal story about radiology? Share your patient story here Images × Image Gallery ... Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to ...

  20. Exploding head syndrome.

    Science.gov (United States)

    Sharpless, Brian A

    2014-12-01

    Exploding head syndrome is characterized by the perception of abrupt, loud noises when going to sleep or waking up. They are usually painless, but associated with fear and distress. In spite of the fact that its characteristic symptomatology was first described approximately 150 y ago, exploding head syndrome has received relatively little empirical and clinical attention. Therefore, a comprehensive review of the scientific literature using Medline, PsycINFO, Google Scholar, and PubMed was undertaken. After first discussing the history, prevalence, and associated features, the available polysomnography data and five main etiological theories for exploding head syndrome are summarized. None of these theories has yet reached dominance in the field. Next, the various methods used to assess and treat exploding head syndrome are discussed, as well as the limited outcome data. Finally, recommendations for future measure construction, treatment options, and differential diagnosis are provided. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... medically necessary because of potential risk to the baby. This risk is, however, minimal with head CT ... intravenous contrast indicate mothers should not breastfeed their babies for 24-48 hours after contrast medium is ...

  2. Early Head Start Evaluation

    Data.gov (United States)

    U.S. Department of Health & Human Services — Longitudinal information from an evaluation where children were randomly assigned to Early Head Start or community services as usual;direct assessments and...

  3. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... top of page Additional Information and Resources RTAnswers.org Radiation Therapy for Brain Tumors Radiation Therapy for ... Tomography (CT) - Head Sponsored by Please note RadiologyInfo.org is not a medical facility. Please contact your ...

  4. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... of the Head? Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic ... white on the x-ray; soft tissue, such as organs like the heart or liver, shows up ...

  5. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much ... head CT scanning. Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 ...

  6. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... rays). top of page What are some common uses of the procedure? CT scanning of the head ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

  7. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... rays). top of page What are some common uses of the procedure? CT scanning of the head ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  8. Head Start Impact Study

    Data.gov (United States)

    U.S. Department of Health & Human Services — Nationally representative, longitudinal information from an evaluation where children were randomly assigned to Head Start or community services as usual;direct...

  9. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Stroke Brain Tumors Computer Tomography (CT) Safety During Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Computed Tomography (CT) - ...

  10. TCGA head Neck

    Science.gov (United States)

    Investigators with The Cancer Genome Atlas (TCGA) Research Network have discovered genomic differences – with potentially important clinical implications – in head and neck cancers caused by infection with the human papillomavirus (HPV).

  11. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... your doctor to evaluate your face, sinuses, and skull or to plan radiation therapy for brain cancer. ... typically used to detect: bleeding, brain injury and skull fractures in patients with head injuries. bleeding caused ...

  12. The exploding head syndrome.

    Science.gov (United States)

    Green, M W

    2001-06-01

    This article reviews the features of an uncommon malady termed "the exploding head syndrome." Sufferers describe terrorizing attacks of a painless explosion within their head. Attacks tend to occur at the onset of sleep. The etiology of attacks is unknown, although they are considered to be benign. Treatment with clomipramine has been suggested, although most sufferers require only reassurance that the spells are benign in nature.

  13. Rotational Acceleration during Head Impact Resulting from Different Judo Throwing Techniques

    OpenAIRE

    MURAYAMA, Haruo; HITOSUGI, Masahito; MOTOZAWA, Yasuki; OGINO, Masahiro; KOYAMA, Katsuhiro

    2014-01-01

    Most severe head injuries in judo are reported as acute subdural hematoma. It is thus necessary to examine the rotational acceleration of the head to clarify the mechanism of head injuries. We determined the rotational acceleration of the head when the subject is thrown by judo techniques. One Japanese male judo expert threw an anthropomorphic test device using two throwing techniques, Osoto-gari and Ouchigari. Rotational and translational head accelerations were measured with and without an ...

  14. GPK heading machine

    Energy Technology Data Exchange (ETDEWEB)

    Krmasek, J.; Novosad, K.

    1981-01-01

    This article evaluates performance tests of the Soviet made GPK heading machine carried out in 4 coal mines in Czechoslovakia (Ostrava-Karvina region and Kladno mines). GPK works in coal seams and rocks with compression strength of 40 to 50 MPa. Dimensions of the tunnel are height 1.8 to 3.8 m and width 2.6 to 4.7 m, tunnel gradient plus to minus 10 degrees. GPK weighs 16 t, its conical shaped cutting head equipped with RKS-1 cutting tools is driven by an electric motor with 55 kW capacity. Undercarriage of the GPK, gathering-arm loader, hydraulic system, electric system and dust supression system (water spraying or pneumatic section) are characterized. Specifications of GPK heading machines are compared with PK-3r and F8 heading machines. Reliability, number of failures, dust level, noise, productivity depending on compression strength of rocks, heading rate in coal and in rocks, energy consumption, performance in inclined tunnels, and cutting tool wear are evaluated. Tests show that GPK can be used to drive tunnels in coal with rock constituting up to 50% of the tunnel crosscut, as long as rock compression strength does not exceed 50 MPa. In rocks characterized by higher compression strength cutting tool wear sharply increases. GPK is characterized by higher productivity than that of the PK-3r heading machine. Among the weak points of the GPK are: unsatisfactory reliability and excessive wear of its elements. (4 refs.) (In Czech)

  15. WASA-BOSS. Development and application of Severe Accident Codes. Evaluation and optimization of accident management measures. Subproject E. Improvement of the lower head model in MELCOR and calculations in connection with the FUKUSHIMA accident. Final report; WASA-BOSS. Weiterentwicklung und Anwendung von Severe Accident Codes. Bewertung und Optimierung von Stoerfallmassnahmen. Teilprojekt E. Verbesserung des Lower Head-Modelles fuer MELCOR und MELCOR-Rechnungen zu Fukushima. Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Kretzschmar, Frank; Dietrich, Philipp; Gabriel, Stephan; Miassoedov, Alexei

    2016-12-15

    The knowledge of the key phenomena, which govern the chronological sequence of a core melt accident, is a crucial precondition for the development of SAMGs (Severe Management Guides) to avoid and mitigate the radiological consequences for the population and the environment. In the frame of a dissertation a new model has been coupled with MELCOR, which describes the thermal interaction of a core melt with the RPV (reactor pressure vessel) wall in the lower plenum. This model allows a better description of this phenomenon. The method to couple extern programs with MELCOR had been already developed and used in a former dissertation at KIT-IKET. The model has been validated recalculating according experiments in the LIVE facility. Afterwards a defined accident scenario has been calculated for a German generic KONVOI power plant. 12 months after the start of the project a MELCOR input has been developed using data delivered by the Ruhr university of Bochum (subproject ''Simulation des Unfalls in Fukushima-Daichi zur Bewertung des Stoerfall-Analysecodes ATHLET-CD''). The results of this simulation have made a contribution to review the current understanding of the FUKUSHIMA sequence. HZDR and KIT-IKET have agreed in the course of the project, that KIT-IKET will develop a MELCOR input of a german generic KONVOI power plant following an ATHLET-CDinput of HZDR. Using this MELCOR input, a comparative analysis has been performed.

  16. Magnetic Resonance Imaging (MRI) -- Head

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful ... the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

  17. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful ... the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

  18. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

  19. Head, Neck, and Oral Cancer

    Science.gov (United States)

    ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

  20. Magnitude of Severe Head Injury and Its Associated Factors among ...

    African Journals Online (AJOL)

    2018-05-01

    May 1, 2018 ... that is the main cause of morbidity and mortality in all age groups of the world's populations including Ethiopia. In view of this, ..... Projections of mortality and burden of disease from 2002 to 2030 (Deaths by. Income Group) ...

  1. Unilateral otolith centrifugation by head tilt

    NARCIS (Netherlands)

    Winters, S.M.; Bos, J.E.; Klis, S.F.L.

    2014-01-01

    BACKGROUND: To test for otolith asymmetries, several studies described horizontal translation of the body and head en bloc during fast vertical axis rotation. This stimulus causes one otolithic organ to rotate on-axis, and the other to experience centripetal acceleration. OBJECTIVE: To test a new,

  2. Driving with head-slaved camera system

    NARCIS (Netherlands)

    Oving, A.B.; Erp, J.B.F. van

    2001-01-01

    In a field experiment, we tested the effectiveness of a head-slaved camera system for driving an armoured vehicle under armour. This system consists of a helmet-mounted display (HMD), a headtracker, and a motion platform with two cameras. Subjects performed several driving tasks on paved and in

  3. Head first Ajax

    CERN Document Server

    Riordan, Rebecca M

    2008-01-01

    Ajax is no longer an experimental approach to website development, but the key to building browser-based applications that form the cornerstone of Web 2.0. Head First Ajax gives you an up-to-date perspective that lets you see exactly what you can do -- and has been done -- with Ajax. With it, you get a highly practical, in-depth, and mature view of what is now a mature development approach. Using the unique and highly effective visual format that has turned Head First titles into runaway bestsellers, this book offers a big picture overview to introduce Ajax, and then explores the use of ind

  4. Head First Statistics

    CERN Document Server

    Griffiths, Dawn

    2009-01-01

    Wouldn't it be great if there were a statistics book that made histograms, probability distributions, and chi square analysis more enjoyable than going to the dentist? Head First Statistics brings this typically dry subject to life, teaching you everything you want and need to know about statistics through engaging, interactive, and thought-provoking material, full of puzzles, stories, quizzes, visual aids, and real-world examples. Whether you're a student, a professional, or just curious about statistical analysis, Head First's brain-friendly formula helps you get a firm grasp of statistics

  5. Ghost Head Nebula

    Science.gov (United States)

    1999-01-01

    Looking like a colorful holiday card, a new image from NASA's Hubble Space Telescope reveals a vibrant green and red nebula far from Earth. The image of NGC 2080, taken by Hubble's Wide Field and Planetary Camera 2, designed and built by NASA's Jet Propulsion Laboratory, Pasadena, Calif., is available online at http://www.jpl.nasa.gov/images/wfpc . Images like this help astronomers investigate star formation in nebulas. NGC 2080, nicknamed 'The Ghost Head Nebula,' is one of a chain of star-forming regions lying south of the 30 Doradus nebula in the Large Magellanic Cloud. 30 Doradus is the largest star-forming complex in the local group of galaxies. This 'enhanced color' picture is composed of three narrow-band-filter images obtained by Hubble on March 28, 2000. The red and blue light come from regions of hydrogen gas heated by nearby stars. The green light on the left comes from glowing oxygen. The energy to illuminate the green light is supplied by a powerful stellar wind, a stream of high-speed particles coming from a massive star just outside the image. The central white region is a combination of all three emissions and indicates a core of hot, massive stars in this star-formation region. Intense emission from these stars has carved a bowl-shaped cavity in surrounding gas. In the white region, the two bright areas (the 'eyes of the ghost') - named A1 (left) and A2 (right) -- are very hot, glowing 'blobs' of hydrogen and oxygen. The bubble in A1 is produced by the hot, intense radiation and powerful stellar wind from one massive star. A2 contains more dust and several hidden, massive stars. The massive stars in A1 and A2 must have formed within the last 10,000 years, since their natal gas shrouds are not yet disrupted by the powerful radiation of the newborn stars. The Space Telescope Science Institute is operated by the Association of Universities for Research in Astronomy, Inc., for NASA, under contract with the Goddard Space Flight Center, Greenbelt, Md. The

  6. [Abnormal head turn in a patient with Brown's syndrome].

    Science.gov (United States)

    van Waveren, M; Krzizok, T; Besch, D

    2008-08-01

    We report on an eight-year-old boy, who was presented in our clinic because of head turn. The cause of the tortecollis (ocular or general) in this case was and still cannot be explained. Only by applying extensive prism adaptation tests it was possible to prove the ocular character of the head turn. An eight-year-old boy with Brown's syndrome was referred to us because of a head tilt to the left side. Six months previously surgery on the M. obl. superior of the right eye was performed in another clinic. No improvement of the head tilt could be observed after the operation. In addition, an exotropia became decompensated. Under a 3-day occlusion of one eye, no change of the head turn and the squint could be measured. No other cause of the head turn could be found by an orthopaedist and a paediatrist. Under a prism of 20 cm/m basis in and 10 cm/m basis against the positive vertical deviation, the head tilt decreased, so that we decided to do a second surgery. The head tilting had not resumed at one year after the surgery. Although the initial diagnostic findings ruled out an ocular cause, it was possible to lessen the head tilting with the aid of the prism adaptation test. This case study emphasises the usefulness of a prism adaptation test of several days duration in order to validate an ocular cause of head turn and to determine an adequate indication for surgery.

  7. Silva as the Head

    DEFF Research Database (Denmark)

    Svabo, Connie

    2015-01-01

    The head of the performance design programme is substituted by a sister's academy delegate. this performance situation formed part of a week of semesterstart where the students and professors visited Sister's Academy, Malmø. I participated in the Sister's Academy as visiting researcher and here i...

  8. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head ...

  9. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... are present in the paranasal sinuses. plan radiation therapy for cancer of the brain or other tissues. guide the ... RTAnswers.org Radiation Therapy for Brain Tumors Radiation Therapy for Head and Neck Cancer Others American Stroke Association National Stroke Association top ...

  10. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Radiation Dose in X-Ray and CT Exams Blood Clots CT Perfusion of the Head CT Angiography ( ...

  11. The Twente humanoid head

    NARCIS (Netherlands)

    Reilink, Rob; Visser, L.C.; Bennik, J.; Carloni, Raffaella; Brouwer, Dannis Michel; Stramigioli, Stefano

    2009-01-01

    This video shows the results of the project on the mechatronic development of the Twente humanoid head. The mechanical structure consists of a neck with four degrees of freedom (DOFs) and two eyes (a stereo pair system) which tilt on a common axis and rotate sideways freely providing a three more

  12. Head injury in children

    International Nuclear Information System (INIS)

    Sugiura, Makoto; Mori, Nobuhiko; Yokosuka, Reiko; Yamamoto, Masaaki; Imanaga, Hirohisa

    1981-01-01

    Findings of computerized tomography (CT) in 183 cases of head injury in children were investigated with special reference to CT findings of mild head injury. As was expected, CT findings of mild head injury fell within the normal range, in almost all cases. However, abnormal findings were noticed in 4 out of 34 cases (12%) in acute stage and 7 out of 76 cases (9%) in chronic stage. They were 3 cases of localized low density area in acute stage and 6 cases of mild cerebral atrophy in chronic stage, etc. There were some cases of mild head injury in which CT findings were normal while EEG examination revealed abnormality. Also in some cases, x-ray study demonstrated linear skull fracture which CT failed to show. These conventional techniques could be still remained as useful adjunct aid in diagnosis of head injury. CT findings of cases of cerebral contusion in their acute stage were divided as follows; normal, low density, small ventricle and ventricular and/or cisternal hemorrhage, frequency of incidence being 38, 17, 22, 11% respectively. These findings were invariably converted to cerebral atrophy from 10 days to 2 months after the impacts. In the cases with intracranial hematoma revealed by CT, only 32% of them showed clinical signs of Araki's type IV in their acute stage and 63% of them showed no neurological defects, that is Araki's type I and II. A case of extreme diffuse cerebral atrophy which followed acute subdural hematoma caused by tear of bridging veins without cortical contusion was presented. (author)

  13. Intention tremor after head injury

    International Nuclear Information System (INIS)

    Iwadate, Yasuo; Saeki, Naokatsu; Namba, Hiroki; Odaki, Masaru; Oka, Nobuo.

    1989-01-01

    Eight cases of intention tremor as a late complication of head injury were investigated. The patients ranged in age from 3 to 24 years. All received severe head injuries and lapsed into coma immediately afterward (Glasgow Coma Scale scores ≤8). Six patients exhibited decerebration or decortication. Hemiparesis was present in six cases and oculomotor nerve palsy in four. In the chronic stage, all patients displayed some degree of impairment of higher cortical function and five had dysarthria and/or ataxia. Initial computed tomography (CT) scans within 3 hours after the injury were obtained in five cases, of which four showed a hemorrhagic lesion in the midbrain or its surroundings. Other CT findings were diffuse cerebral swelling (four cases), intraventricular hemorrhage (three), and multiple hemorrhagic lesions (two). In the chronic stage, generalized cortical atrophy or ventricular enlargement was noted in five cases. These clinical features and CT findings indicate diffuse brain damage as well as midbrain damage and may reflect shearing injury. (author)

  14. Abusive Head Trauma in Children: A Literature Review

    Directory of Open Access Journals (Sweden)

    Nahara R.L. Lopes

    2013-09-01

    Conclusions: : Considering the severity of abusive head trauma in children, it is critical that prevention strategies be implemented and evaluated in the Brazilian context. It is suggested that its incidence indicators be assessed at the national level.

  15. Head and Neck Cancer Treatment

    Science.gov (United States)

    ... Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer overview What are my ... and neck cancer. For updated information on new cancer treatments that are available, you should discuss these issues ...

  16. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... for Brain Tumors Radiation Therapy for Head and Neck Cancer Others : American Stroke Association National Stroke Association ... MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging ( ...

  17. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... are the limitations of MRI of the Head? What is MRI of the Head? Magnetic resonance imaging ( ... brain) in routine clinical practice. top of page What are some common uses of the procedure? MR ...

  18. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with ... and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with ...

  19. Head Lice: Prevention and Control

    Science.gov (United States)

    ... and General Public. Contact Us Parasites Home Prevention & Control Language: English (US) Español (Spanish) Recommend on Facebook ... that can be taken to help prevent and control the spread of head lice: Avoid head-to- ...

  20. MRI in head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jin Kyo [Shin Wha Hospital, Seoul (Korea, Republic of)

    1986-02-15

    In the diagnosis of head injury, Magnetic Resonance Imaging (MRI), like CT, is an effective method of distinguishing between intracerebral and extracerebral lesions. In our experience of MRI, early hematomas are almost isointense by Saturation Recovery (SR) method, so these must be performed with Spin Echo (SE) method for better visualization of hematomas. Isodense subdural hematomas, which is a diagnostic dilemma on CT images, are clearly seen on MRI. Delayed hematomas or residual parenchymal lesions are better demonstrated on MRI than on CT. Direct cornal, sagittal images and multiplanar facility of MRI provides excellent visualization of the the location and shape of extracerebral collection of hematoma. For the screening of head traumas, SE method is a technique of choice because of its excellent sensitivity within limited time.

  1. Where is Russia heading?

    Directory of Open Access Journals (Sweden)

    Natalija Pliskevič

    1999-10-01

    Full Text Available The author examines the proceedings from the collection Where is Russia Heading? (= Куда идёт Россия?, published between 1994 and 1998 in connection with the international symposium held under this name each year in Moscow. The symposia and their proceeding, involving leading Russian and foreign experts, were significant in that they encompassed a wide range of themes – social, economic, political, legislative, cultural and other transformations that have been occurring in Russia during the past decades. The author, however, limits her review to contributions dealing with ethno-political and socio-cultural transformations in Russia. She concludes that the question – “Where is Russia heading?” – still remains open to answers.

  2. MRI in head trauma

    International Nuclear Information System (INIS)

    Hong, Jin Kyo

    1986-01-01

    In the diagnosis of head injury, Magnetic Resonance Imaging (MRI), like CT, is an effective method of distinguishing between intracerebral and extracerebral lesions. In our experience of MRI, early hematomas are almost isointense by Saturation Recovery (SR) method, so these must be performed with Spin Echo (SE) method for better visualization of hematomas. Isodense subdural hematomas, which is a diagnostic dilemma on CT images, are clearly seen on MRI. Delayed hematomas or residual parenchymal lesions are better demonstrated on MRI than on CT. Direct cornal, sagittal images and multiplanar facility of MRI provides excellent visualization of the the location and shape of extracerebral collection of hematoma. For the screening of head traumas, SE method is a technique of choice because of its excellent sensitivity within limited time.

  3. "Head versus heart"

    Directory of Open Access Journals (Sweden)

    Paul Rozin

    2007-08-01

    Full Text Available Most American respondents give ``irrational,'' magical responses in a variety of situations that exemplify the sympathetic magical laws of similarity and contagion. In most of these cases, respondents are aware that their responses (usually rejections, as of fudge crafted to look like dog feces, or a food touched by a sterilized, dead cockroach are not ``scientifically'' justified, but they are willing to avow them. We interpret this, in some sense, as ``heart over head.'' We report in this study that American adults and undergraduates are substantially less likely to acknowledge magical effects when the judgments involve money (amount willing to pay to avoid an ``unpleasant'' magical contact than they are when using preference or rating measures. We conclude that in ``head-heart'' conflicts of this type, money tips the balance towards the former, or, in other words, that money makes the mind less magical.

  4. Renewing Head Start's Promise: Invest in What Works for Disadvantaged Preschoolers

    Science.gov (United States)

    Mead, Sara

    2014-01-01

    Since Head Start's last reauthorization in 2007, the Department of Health and Human Services, which oversees Head Start, has implemented significant reforms that are improving the program. In "Renewing Head Start's Promise: Invest in What Works for Disadvantaged Preschoolers," Sara Mead offers several recommendations to enable…

  5. [The exploding head syndrome].

    Science.gov (United States)

    Bongers, K M; ter Bruggen, J P; Franke, C L

    1991-04-06

    The case is reported of a 47-year old female suffering from the exploding head syndrome. This syndrome consists of a sudden awakening due to a loud noise shortly after falling asleep, sometimes accompanied by a flash of light. The patient is anxious and experiences palpitations and excessive sweating. Most patients are more than fifty years of age. Further investigations do not reveal any abnormality. The pathogenesis is unknown, and no therapy other than reassurance is necessary.

  6. Where are we heading

    International Nuclear Information System (INIS)

    Noto, L.A.

    1996-01-01

    The present paper deals with different aspects connected to the global petroleum industry by discussing the way of heading. The aspects cover themes like new frontiers, new relationships, sanctions, global climate change, new alliances and new technology. New frontiers and relationships concern domestic policy affecting the industry, and sanctions are discussed in connection with trade. The author discusses the industry's participation in the global environmental policy and new alliances to provide greater opportunity for developing new technology

  7. "Head versus heart"

    OpenAIRE

    Paul Rozin; Heidi Grant; Stephanie Weinberg; Scott Parker

    2007-01-01

    Most American respondents give ``irrational,'' magical responses in a variety of situations that exemplify the sympathetic magical laws of similarity and contagion. In most of these cases, respondents are aware that their responses (usually rejections, as of fudge crafted to look like dog feces, or a food touched by a sterilized, dead cockroach) are not ``scientifically'' justified, but they are willing to avow them. We interpret this, in some sense, as ``heart over head.'' We report in this ...

  8. Head segmentation in vertebrates

    OpenAIRE

    Kuratani, Shigeru; Schilling, Thomas

    2008-01-01

    Classic theories of vertebrate head segmentation clearly exemplify the idealistic nature of comparative embryology prior to the 20th century. Comparative embryology aimed at recognizing the basic, primary structure that is shared by all vertebrates, either as an archetype or an ancestral developmental pattern. Modern evolutionary developmental (Evo-Devo) studies are also based on comparison, and therefore have a tendency to reduce complex embryonic anatomy into overly simplified patterns. Her...

  9. Retrospective evaluation and dating of non-accidental rib fractures in infants

    International Nuclear Information System (INIS)

    Sanchez, T.R.; Nguyen, H.; Palacios, W.; Doherty, M.; Coulter, K.

    2013-01-01

    Aim: To describe the sequential appearance of healing rib fractures on initial and follow-up radiographs using published guidelines in approximating the age of rib fractures in infants with the aim of establishing a more objective method of dating rib fractures by measuring the thickness of the callous formation. Materials and methods: This was a retrospective analysis of initial and follow-up digital skeletal surveys of infants less than 12 months of age performed between January 2008 and January 2012 at the University of California Davis Children's Hospital. Six radiological features of rib fractures evaluating the appearance of the callous formation (C stage) and fracture line (F stage) were assessed. Patients with osteogenesis imperfecta, known vitamin D deficiency, and skeletal or metabolic dysplasia were not included in the study. Thereafter, callous thickness was measured and recorded for each stage. Results: Sixteen infants (age range 1–11 months, seven males and nine females) with 23 rib fractures were analysed. The thickness of the callous formation follows a predictable pattern advancing one stage after a 2-week follow-up with progressive callous thickening starting from stage 2, peaks at around stage 4, and then tapers and remodels until it almost disappears when the fracture is healed at stage 6. Conclusion: It appears that rib fractures in infants follow a predictable pattern of healing. Measuring the thickness of the callous formation is a more objective way of guiding the radiologist in estimating the age of the fracture

  10. Patterns and mechanisms of injury in non-accidental injury in ...

    African Journals Online (AJOL)

    Correspondence: Prof Nazeema Ebrahim, e-mail: nebrahim@medunsa.ac.za ... among healthcare workers about the possibility of child abuse is of utmost ... It is for this reason that a rag doll was used ... Children may present with bizarre marks ... adult. Caffey's observations. “The modern medical concept of child abuse has ...

  11. Non-accidental injury: a retrospective analysis of a large cohort

    International Nuclear Information System (INIS)

    Carty, Helen; Pierce, Agnes

    2002-01-01

    The radiology literature describing the injuries of child abuse is very extensive. Articles on the distribution of injuries and the way in which a diagnosis was reached are less frequent. This article represents the detailed analysis of a cohort of patients, suspected of being victims of abuse, referred to the authors. It necessarily reflects personal experience and is not a population study. The distribution of the injuries in a cohort of 467 patients is reviewed. (orig.)

  12. Non-accidental injury: a retrospective analysis of a large cohort

    Energy Technology Data Exchange (ETDEWEB)

    Carty, Helen; Pierce, Agnes [RLC NHS Trust-Alder Hey, Liverpool L12 2 AP (United Kingdom)

    2002-12-01

    The radiology literature describing the injuries of child abuse is very extensive. Articles on the distribution of injuries and the way in which a diagnosis was reached are less frequent. This article represents the detailed analysis of a cohort of patients, suspected of being victims of abuse, referred to the authors. It necessarily reflects personal experience and is not a population study. The distribution of the injuries in a cohort of 467 patients is reviewed. (orig.)

  13. How to explore and report children with suspected non-accidental trauma

    International Nuclear Information System (INIS)

    Adamsbaum, Catherine; Mejean, Nathalie; Merzoug, Valerie; Rey-Salmon, Caroline

    2010-01-01

    Child abuse is a controversial problem of special concern. Recent reports have focused on the broad variability of reporting to child protection services. Radiologists play a key role in the early diagnosis and imaging of suspected inflicted injury. Imaging must be performed and then interpreted with rigour. The aims of this review are: To review the recent recommended guidelines for imaging in cases of suspicion of abuse. These include a highly detailed complete skeletal survey with centered views, whilst brain CT and/or MRI are mandatory in children younger than 2 years. The use of abdominal imaging is debatable if the child has no symptoms. All siblings younger than 2 years should be assessed in the same way while the diagnosis of abuse is investigated. Body MRI is an interesting modality that remains a ''work-in-progress''. To highlight that dating of both brain and skeletal injuries is imprecise. The main point is, however, to determine if the pattern is of ''age-different'' lesions. This not only provides a strong argument for the diagnosis of abuse, but also indicates repetitive violence with a high risk for further injury and death. To remember that the medical perspective is to protect the child. Thus, radiologists must communicate clearly the suspicion of abuse and the degree of certainty to clinicians to aid reporting or hospitalization. (orig.)

  14. How to explore and report children with suspected non-accidental trauma

    Energy Technology Data Exchange (ETDEWEB)

    Adamsbaum, Catherine [Paris Descartes University, St Vincent de Paul Hospital, Radiology Department, Pediatric Imaging, Paris Cedex 14 (France); Mejean, Nathalie; Merzoug, Valerie [St Vincent de Paul Hospital, Radiology Department, Pediatric Imaging, Paris Cedex 14 (France); Rey-Salmon, Caroline [Hotel Dieu Hospital, AP-HP, Medico-Judicial Unit, Paris (France)

    2010-06-15

    Child abuse is a controversial problem of special concern. Recent reports have focused on the broad variability of reporting to child protection services. Radiologists play a key role in the early diagnosis and imaging of suspected inflicted injury. Imaging must be performed and then interpreted with rigour. The aims of this review are: To review the recent recommended guidelines for imaging in cases of suspicion of abuse. These include a highly detailed complete skeletal survey with centered views, whilst brain CT and/or MRI are mandatory in children younger than 2 years. The use of abdominal imaging is debatable if the child has no symptoms. All siblings younger than 2 years should be assessed in the same way while the diagnosis of abuse is investigated. Body MRI is an interesting modality that remains a ''work-in-progress''. To highlight that dating of both brain and skeletal injuries is imprecise. The main point is, however, to determine if the pattern is of ''age-different'' lesions. This not only provides a strong argument for the diagnosis of abuse, but also indicates repetitive violence with a high risk for further injury and death. To remember that the medical perspective is to protect the child. Thus, radiologists must communicate clearly the suspicion of abuse and the degree of certainty to clinicians to aid reporting or hospitalization. (orig.)

  15. "Stuttering" after minor head trauma.

    Science.gov (United States)

    Strasberg, Stephen; Johnson, Elizabeth J; Parry, Thomas

    2016-03-01

    Traumatic brain injury (TBI) is defined as impairment in brain function as a result of mechanical force. It is classified based on clinical findings using the Glasgow Coma Scale (GCS). Mild TBI is defined as GCS 14-15; moderate, 9-13; and severe, 3-8. Patients with the same TBI classification may have very different underlying pathology. In moderate to severe TBI, the primary pathology may include contusions, hemorrhage, diffuse axonal injury, direct cellular damage, "tearing and shearing of the tissues, loss of the blood-brain barrier, disruption of the neurochemical homeostasis and loss of the electrochemical function". Although the primary pathology associated with mild TBI may be milder versions of the same pathology associated with moderate and severe TBI, it is generally a metabolic injury. However, it is reported that 15% of patients with mild TBI and a GCS score of 14 or 15 will have an intracranial lesion; less than 1% of these require neurosurgical intervention. Although patients with mild TBI may have intracranial lesions, it is rare that the presenting and only physical examination finding is an isolated neurologic finding. Here we present a case of isolated head trauma with a single physical examination finding--expressive aphasia.

  16. Head movements and postures as pain behavior

    Science.gov (United States)

    Al-Hamadi, Ayoub; Limbrecht-Ecklundt, Kerstin; Walter, Steffen; Traue, Harald C.

    2018-01-01

    Pain assessment can benefit from observation of pain behaviors, such as guarding or facial expression, and observational pain scales are widely used in clinical practice with nonverbal patients. However, little is known about head movements and postures in the context of pain. In this regard, we analyze videos of three publically available datasets. The BioVid dataset was recorded with healthy participants subjected to painful heat stimuli. In the BP4D dataset, healthy participants performed a cold-pressor test and several other tasks (meant to elicit emotion). The UNBC dataset videos show shoulder pain patients during range-of-motion tests to their affected and unaffected limbs. In all videos, participants were sitting in an upright position. We studied head movements and postures that occurred during the painful and control trials by measuring head orientation from video over time, followed by analyzing posture and movement summary statistics and occurrence frequencies of typical postures and movements. We found significant differences between pain and control trials with analyses of variance and binomial tests. In BioVid and BP4D, pain was accompanied by head movements and postures that tend to be oriented downwards or towards the pain site. We also found differences in movement range and speed in all three datasets. The results suggest that head movements and postures should be considered for pain assessment and research. As additional pain indicators, they possibly might improve pain management whenever behavior is assessed, especially in nonverbal individuals such as infants or patients with dementia. However, in advance more research is needed to identify specific head movements and postures in pain patients. PMID:29444153

  17. Lower head integrity under steam explosion loads

    Energy Technology Data Exchange (ETDEWEB)

    Theofanous, T.G.; Yuen, W.W.; Angelini, S.; Freeman, K.; Chen, X.; Salmassi, T. [Center for Risk Studies and Safety, Univ. of California, Santa Barbara, CA (United States); Sienicki, J.J.

    1998-01-01

    Lower head integrity under steam explosion loads in an AP600-like reactor design is considered. The assessment is the second part of an evaluation of the in-vessel retention idea as a severe accident management concept, the first part (DOE/ID-10460) dealing with thermal loads. The assessment is conducted in terms of the Risk Oriented Accident Analysis Methodology (ROAAM), and includes the comprehensive evaluation of all relevant severe accident scenarios, melt conditions and timing of release from the core region, fully 3D mixing and explosion wave dynamics, and lower head fragility under local, dynamic loading. All of these factors and brought together in a ROAAM Probabilistic Framework to evaluate failure likelihood. The conclusion is that failure is `physically unreasonable`. (author)

  18. Aspectos técnicos da monitorização da pressão intracraniana pelo método subaracnóideo no traumatismo craniencefálico grave Technical aspects of intracranial pressure monitoring by subarachnoid method in severe head injury

    Directory of Open Access Journals (Sweden)

    Venâncio Pereira Dantas Filho

    2001-12-01

    Full Text Available Foram analisados prospectivamente 206 pacientes com traumatismo craniencefálico (TCE grave (8 pontos ou menos na Escala de Coma de Glasgow, internados na Unidade de Terapia Intensiva do Hospital das Clínicas da Universidade Estadual de Campinas. Após avaliação por tomografia computadorizada de crânio (TC, 72 pacientes necessitaram de tratamento neurocirúrgico. Todos os pacientes foram submetidos à monitorização contínua da pressão intracraniana (PIC pelo método subaracnóideo (11 com parafuso metálico e 195 com cateter plástico. Os níveis de PIC foram registrados continuamente na tela do monitor, sendo os seus valores de final de hora anotados em ficha padronizada. Todos os pacientes foram tratados segundo um protocolo orientado pelos níveis da PIC. Não foram observadas complicações hemorrágicas ou hematomas intracranianos relacionados ao método de monitorização em TC de controle. Para controle de infecções intracranianas, foram colhidas amostras de líquido cefalorraquidiano através de punção lateral C1-C2 em 66 pacientes com PIC abaixo de 20 mm Hg, sendo positivas as culturas para Acinetobacter sp em 2 pacientes. O resultado final na alta hospitalar mostrou 75 (36,40% óbitos e 131 (63,6% sobreviventes. Os níveis de PIC influenciaram significativamente o resultado final (pTwo hundred and six patients with severe head injury (Glasgow Coma Scale of 8 points or less after nonsurgical resuscitation on admission, managed at Intensive Care Unit-Hospital das Clínicas - Universidade Estadual de Campinas were prospectively analysed. All patients were assessed by CT scan and 72 required neurosurgical intervention. All patients were continuously monitored to evaluate intracranial pressure (ICP levels by a subarachnoid device (11 with subarachnoid metallic bolts and 195 with subarachnoid polyvinyl catheters. The ICP levels were continuously observed in the bedside pressure monitor display and their end-hour values were

  19. Kinematics of the AM-50 heading machine cutting head

    Energy Technology Data Exchange (ETDEWEB)

    Sikora, W; Bak, K; Klich, R [Politechnika Slaska, Gliwice (Poland). Instytut Mechanizacji Gornictwa

    1987-01-01

    Analyzes motion of the cutter head of the AM-50 heading machine. Two types of head motion are comparatively evaluated: planar motion and spatial motion. The spatial motion consists of the head rotational motion and horizontal or vertical feed motion, while planar motion consists of rotational motion and vertical feed motion. Equations that describe head motion under conditions of cutter vertical or horizontal feed motion are derived. The angle between the cutting speed direction and working speed direction is defined. On the basis of these formulae variations of cutting speed depending on the cutting tool position on a cutter head are calculated. Calculations made for 2 extreme cutting tools show that the cutting speed ranges from 1,205 m/s to 3,512 m/s. 4 refs.

  20. Head First Web Design

    CERN Document Server

    Watrall, Ethan

    2008-01-01

    Want to know how to make your pages look beautiful, communicate your message effectively, guide visitors through your website with ease, and get everything approved by the accessibility and usability police at the same time? Head First Web Design is your ticket to mastering all of these complex topics, and understanding what's really going on in the world of web design. Whether you're building a personal blog or a corporate website, there's a lot more to web design than div's and CSS selectors, but what do you really need to know? With this book, you'll learn the secrets of designing effecti

  1. Head first C#

    CERN Document Server

    Stellman, Andrew

    2008-01-01

    Head First C# is a complete learning experience for object-oriented programming, C#, and the Visual Studio IDE. Built for your brain, this book covers C# 3.0 and Visual Studio 2008, and teaches everything from language fundamentals to advanced topics including garbage collection, extension methods, and double-buffered animation. You'll also master C#'s hottest and newest syntax, LINQ, for querying SQL databases, .NET collections, and XML documents. By the time you're through, you'll be a proficient C# programmer, designing and coding large-scale applications. Every few chapters you will come

  2. Head First Python

    CERN Document Server

    Barry, Paul

    2010-01-01

    Ever wished you could learn Python from a book? Head First Python is a complete learning experience for Python that helps you learn the language through a unique method that goes beyond syntax and how-to manuals, helping you understand how to be a great Python programmer. You'll quickly learn the language's fundamentals, then move onto persistence, exception handling, web development, SQLite, data wrangling, and Google App Engine. You'll also learn how to write mobile apps for Android, all thanks to the power that Python gives you. We think your time is too valuable to waste struggling with

  3. Head First Mobile Web

    CERN Document Server

    Gardner, Lyza; Grigsby, Jason

    2011-01-01

    Despite the huge number of mobile devices and apps in use today, your business still needs a website. You just need it to be mobile. Head First Mobile Web walks you through the process of making a conventional website work on a variety smartphones and tablets. Put your JavaScript, CSS media query, and HTML5 skills to work-then optimize your site to perform its best in the demanding mobile market. Along the way, you'll discover how to adapt your business strategy to target specific devices. Navigate the increasingly complex mobile landscapeTake both technical and strategic approaches to mobile

  4. Reactor vessel head permanent shield

    International Nuclear Information System (INIS)

    Hankinson, M.F.; Leduc, R.J.; Richard, J.W.; Malandra, L.J.

    1989-01-01

    A nuclear reactor is described comprising: a nuclear reactor pressure vessel closure head; control rod drive mechanisms (CRDMs) disposed within the closure head so as to project vertically above the closure head; cooling air baffle means surrounding the control rod drive mechanisms for defining cooling air paths relative to the control rod drive mechanisms; means defined within the periphery of the closure head for accommodating fastening means for securing the closure head to its associated pressure vessel; lifting lugs fixedly secured to the closure head for facilitating lifting and lowering movements of the closure head relative to the pressure vessel; lift rods respectively operatively associated with the plurality of lifting lugs for transmitting load forces, developed during the lifting and lowering movements of the closure head, to the lifting lugs; upstanding radiation shield means interposed between the cooling air baffle means and the periphery of the enclosure head of shielding maintenance personnel operatively working upon the closure head fastening means from the effects of radiation which may emanate from the control rod drive mechanisms and the cooling air baffle means; and connecting systems respectively associated with each one of the lifting lugs and each one of the lifting rods for connecting each one of the lifting rods to a respective one of each one of the lifting lugs, and for simultaneously connecting a lower end portion of the upstanding radiation shield means to each one of the respective lifting lugs

  5. [Avascular necrosis of the femoral head].

    Science.gov (United States)

    Porubský, Peter; Trč, Tomáš; Havlas, Vojtěch; Smetana, Pavel

    Avascular necrosis of the femoral head in adults is not common, but not too rare diseases. In orthopedic practice, it is one of the diseases that are causing implantation of hip replacement at a relatively early age. In the early detection and initiation of therapy can delay the implantation of prosthesis for several years, which is certainly more convenient for the patient and beneficial. This article is intended to acquaint the reader with the basic diagnostic procedures and therapy.

  6. Adaptive algorithm of magnetic heading detection

    Science.gov (United States)

    Liu, Gong-Xu; Shi, Ling-Feng

    2017-11-01

    Magnetic data obtained from a magnetic sensor usually fluctuate in a certain range, which makes it difficult to estimate the magnetic heading accurately. In fact, magnetic heading information is usually submerged in noise because of all kinds of electromagnetic interference and the diversity of the pedestrian’s motion states. In order to solve this problem, a new adaptive algorithm based on the (typically) right-angled corridors of a building or residential buildings is put forward to process heading information. First, a 3D indoor localization platform is set up based on MPU9250. Then, several groups of data are measured by changing the experimental environment and pedestrian’s motion pace. The raw data from the attached inertial measurement unit are calibrated and arranged into a time-stamped array and written to a data file. Later, the data file is imported into MATLAB for processing and analysis using the proposed adaptive algorithm. Finally, the algorithm is verified by comparison with the existing algorithm. The experimental results show that the algorithm has strong robustness and good fault tolerance, which can detect the heading information accurately and in real-time.

  7. Evaluation of head movement periodicity and irregularity during locomotion of Caenorhabditis elegans

    Directory of Open Access Journals (Sweden)

    Ryuzo eShingai

    2013-03-01

    Full Text Available Caenorhabditis elegans is suitable for studying the nervous system, which controls behavior. C. elegans shows sinusoidal locomotion on an agar plate. The head moves not only sinusoidally but also more complexly, which reflects regulation of the head muscles by the nervous system. The head movement becomes more irregular with senescence. To date, the head movement complexity has not been quantitatively analyzed. We propose two simple methods for evaluation of the head movement regularity on an agar plate using image analysis. The methods calculate metrics that are a measure of how the head end movement is correlated with body movement. In the first method, the length along the trace of the head end on the agar plate between adjacent intersecting points of the head trace and the quasi-midline of the head trace, which was made by sliding an averaging window of 1/2 the body wavelength, was obtained. Histograms of the lengths showed periodic movement of the head and deviation from it. In the second method, the intersections between the trace of the head end and the trace of the 5 (near the pharynx or 50% (the mid-body point from the head end in the centerline length of the worm image were marked. The length of the head trace between adjacent intersections was measured, and a histogram of the lengths was produced. The histogram for the 5% point showed deviation of the head end movement from the movement near the pharynx. The histogram for the 50% point showed deviation of the head movement from the sinusoidal movement of the body center. Application of these methods to wild type and several mutant strains enabled evaluation of their head movement periodicity and irregularity, and revealed a difference in the age-dependence of head movement irregularity between the strains. A set of five parameters obtained from the histograms reliably identifies differences in head movement between strains.

  8. The study and development of magnetic recording heads. A thin film integrated magnetic head

    International Nuclear Information System (INIS)

    Lazzari, Jean-Pierre

    1970-01-01

    A new integrated magnetic head is described. The head was made by vacuum deposition using a mask. A magnetically coupled multilayer construction led to high performance. The results obtained indicate that the device functions equally well, for reading and writing. A set of calculations was developed which could simulate and optimize the behavior of the recording head. The results obtained with the writing were in good agreement with those obtained from experiments and quite different from results which have been several times previously published. In addition a new method was developed for measuring high fields in confined spaces; a 1000 A diameter probe was used in conjunction with a low angle diffraction procedure. The measurements give results which are very different from those obtained by current theories based on the magnetic potentials at the surface. (author) [fr

  9. Surgical Management of Severe Epistaxis.

    Science.gov (United States)

    Lin, Giant; Bleier, Benjamin

    2016-06-01

    Many patients with severe epistaxis benefit from endoscopic intervention for control of bleeding. Critical maneuvers to improve endoscopic visualization during surgery include head-of-bed elevation, application of topical vasoconstrictors, and local injection of vasonstrictors. Controlled, hypotensive anesthesia may also decrease intraoperative blood loss and improve visualization during surgery. Intractable posterior epistaxis can be controlled with high rates of success with endoscopic sphenopalatine artery ligation. Although less common, intractable anterior epistaxis may be controlled by anterior ethmoid artery ligation once this artery is identified as the primary source. Less common sources of severe epistaxis are also discussed in this article. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Representation of heading direction in far and near head space

    NARCIS (Netherlands)

    Poljac, E.; Berg, A.V. van den

    2003-01-01

    Manipulation of objects around the head requires an accurate and stable internal representation of their locations in space, also during movements such as that of the eye or head. For far space, the representation of visual stimuli for goal-directed arm movements relies on retinal updating, if eye

  11. Chryse 'Alien Head'

    Science.gov (United States)

    2005-01-01

    26 January 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows an impact crater in Chryse Planitia, not too far from the Viking 1 lander site, that to seems to resemble a bug-eyed head. The two odd depressions at the north end of the crater (the 'eyes') may have formed by wind or water erosion. This region has been modified by both processes, with water action occurring in the distant past via floods that poured across western Chryse Planitia from Maja Valles, and wind action common occurrence in more recent history. This crater is located near 22.5oN, 47.9oW. The 150 meter scale bar is about 164 yards long. Sunlight illuminates the scene from the left/lower left.

  12. The head-mounted microscope.

    Science.gov (United States)

    Chen, Ting; Dailey, Seth H; Naze, Sawyer A; Jiang, Jack J

    2012-04-01

    Microsurgical equipment has greatly advanced since the inception of the microscope into the operating room. These advancements have allowed for superior surgical precision and better post-operative results. This study focuses on the use of the Leica HM500 head-mounted microscope for the operating phonosurgeon. The head-mounted microscope has an optical zoom from 2× to 9× and provides a working distance from 300 mm to 700 mm. The headpiece, with its articulated eyepieces, adjusts easily to head shape and circumference, and offers a focus function, which is either automatic or manually controlled. We performed five microlaryngoscopic operations utilizing the head-mounted microscope with successful results. By creating a more ergonomically favorable operating posture, a surgeon may be able to obtain greater precision and success in phonomicrosurgery. Phonomicrosurgery requires the precise manipulation of long-handled cantilevered instruments through the narrow bore of a laryngoscope. The head-mounted microscope shortens the working distance compared with a stand microscope, thereby increasing arm stability, which may improve surgical precision. Also, the head-mounted design permits flexibility in head position, enabling operator comfort, and delaying musculoskeletal fatigue. A head-mounted microscope decreases the working distance and provides better ergonomics in laryngoscopic microsurgery. These advances provide the potential to promote precision in phonomicrosurgery. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  13. Right thalamic infarction after closed head injury

    International Nuclear Information System (INIS)

    Nagaya, Takashi; Doi, Terushige; Katsumata, Tsuguo; Kuwayama, Naoto

    1986-01-01

    We reported a case of right thalamic infarction after a closed head injury. A 12-year-old boy was hit by an autotruck. He was semi-comatose, with left temporal scalp swelling and excoriation in the left lower limb. Three days after the accident, he exhibited left hemiparesis. CT scans on the day of the accident showed no abnormality, but on the following day, right thalamic infarction appeared. Right carotid angiography showed only an irregular vascular shadow in the cisternal segment of the right internal carotid artery. Vascular obstruction after closed head injury is rare, especially in the intracranial vessels, and several pathogeneses may be postulated. The right thalamic infarction in this case was supposed to be due to the damage of the perforators from the right posterior communicating artery and the right posterior cerebral artery, which were struck as a contre-coup by the force from the left side. (author)

  14. Modular reactor head shielding system

    International Nuclear Information System (INIS)

    Jacobson, E. B.

    1985-01-01

    An improved modular reactor head shielding system is provided that includes a frame which is removably assembled on a reactor head such that no structural or mechanical alteration of the head is required. The shielding system also includes hanging assemblies to mount flexible shielding pads on trolleys which can be moved along the frame. The assemblies allow individual pivoting movement of the pads. The pivoting movement along with the movement allowed by the trolleys provides ease of access to any point on the reactor head. The assemblies also facilitate safe and efficient mounting of the pads directly to and from storage containers such that workers have additional shielding throughout virtually the entire installation and removal process. The flexible shielding pads are designed to interleave with one another when assembled around the reactor head for substantially improved containment of radiation leakage

  15. Review of adult head injury admissions into the intensive care unit of ...

    African Journals Online (AJOL)

    The most common mode of injury was road traffic accident. All the patients admitted to ICU had either moderate or severe head injury, with 73.7% having severe head injury. About 26.3% of the patients had associated cervical spine injuries and 50% had various musculoskeletal and soft tissue injuries. Cranial computed ...

  16. Effects of Sex and Event Type on Head Impact in Collegiate Soccer

    Science.gov (United States)

    Reynolds, Bryson B.; Patrie, James; Henry, Erich J.; Goodkin, Howard P.; Broshek, Donna K.; Wintermark, Max; Druzgal, T. Jason

    2017-01-01

    Background: The effects of head impact in sports are of growing interest for clinicians, scientists, and athletes. Soccer is the most popular sport worldwide, but the burden of head impact in collegiate soccer is still unknown. Purpose: To quantify head impact associated with practicing and playing collegiate soccer using wearable accelerometers. Study Design: Descriptive epidemiological study. Methods: Mastoid patch accelerometers were used to quantify head impact in soccer, examining differences in head impact as a function of sex and event type (practice vs game). Seven female and 14 male collegiate soccer players wore mastoid patch accelerometers that measured head impacts during team events. Data were summarized for each athletic exposure, and statistical analyses evaluated the mean number of impacts, mean peak linear acceleration, mean peak rotational acceleration, and cumulative linear and rotational acceleration, each grouped by sex and event type. Results: There were no differences in the frequency or severity of head impacts between men’s and women’s soccer practices. For men’s soccer, games resulted in 285% more head impacts than practices, but there were no event-type differences in mean impact severity. Men’s soccer games resulted in more head impacts than practices across nearly all measured impact severities, which also resulted in men’s soccer games producing a greater cumulative impact burden. Conclusion: Similar to other sports, men’s soccer games have a greater impact burden when compared with practices, and this effect is driven by the quantity rather than severity of head impacts. In contrast, there were no differences in the quantity or severity of head impacts in men’s and women’s soccer practices. These data could prompt discussions of practical concern to collegiate soccer, such as understanding sex differences in head impact and whether games disproportionately contribute to an athlete’s head impact burden. PMID:28491885

  17. Stereotactic Body Radiotherapy for Head and Neck Tumors

    Science.gov (United States)

    2016-04-18

    Squamous Cell Carcinoma of the Head and Neck; Nasopharyngeal Carcinoma; Salivary Gland Cancer; Head and Neck Sarcoma; Paraganglioma of Head and Neck; Chordoma of Head and Neck; Chondrosarcoma of Head and Neck; Angiofibroma of Head and Neck

  18. Turbidity Current Head Mixing

    Science.gov (United States)

    Hernandez, David; Sanchez, Miguel Angel; Medina, Pablo

    2010-05-01

    A laboratory experimental set - up for studying the behaviour of sediment in presence of a turbulent field with zero mean flow is compared with the behaviour of turbidity currents [1] . Particular interest is shown on the initiation of sediment motion and in the sediment lift - off. The behaviour of the turbidity current in a flat ground is compared with the zero mean flow oscilating grid generated turbulence as when wave flow lifts off suspended sediments [2,3]. Some examples of the results obtained with this set-up relating the height of the head of the turbidity current to the equilibrium level of stirred lutoclines are shown. A turbulent velocity u' lower than that estimated by the Shield diagram is required to start sediment motion. The minimum u' required to start sediment lift - off, is a function of sediment size, cohesivity and resting time. The lutocline height depends on u', and the vorticity at the lutocline seems constant for a fixed sediment size [1,3]. Combining grid stirring and turbidty current head shapes analyzed by means of advanced image analysis, sediment vertical fluxes and settling speeds can be measured [4,5]. [1] D. Hernandez Turbulent structure of turbidity currents and sediment transport Ms Thesis ETSECCPB, UPC. Barcelona 2009. [2] A. Sánchez-Arcilla; A. Rodríguez; J.C. Santás; J.M. Redondo; V. Gracia; R. K'Osyan; S. Kuznetsov; C. Mösso. Delta'96 Surf-zone and nearshore measurements at the Ebro Delta. A: International Conference on Coastal Research through large Scale Experiments (Coastal Dynamics '97). University of Plymouth, 1997, p. 186-187. [3] P. Medina, M. A. Sánchez and J. M. Redondo. Grid stirred turbulence: applications to the initiation of sediment motion and lift-off studies Physics and Chemistry of the Earth, Part B: Hydrology, Oceans and Atmosphere. 26, Issue 4, 2001, Pages 299-304 [4] M.O. Bezerra, M. Diez, C. Medeiros, A. Rodriguez, E. Bahia., A. Sanchez-Arcilla and J.M. Redondo. Study on the influence of waves on

  19. Live Speech Driven Head-and-Eye Motion Generators.

    Science.gov (United States)

    Le, Binh H; Ma, Xiaohan; Deng, Zhigang

    2012-11-01

    This paper describes a fully automated framework to generate realistic head motion, eye gaze, and eyelid motion simultaneously based on live (or recorded) speech input. Its central idea is to learn separate yet interrelated statistical models for each component (head motion, gaze, or eyelid motion) from a prerecorded facial motion data set: 1) Gaussian Mixture Models and gradient descent optimization algorithm are employed to generate head motion from speech features; 2) Nonlinear Dynamic Canonical Correlation Analysis model is used to synthesize eye gaze from head motion and speech features, and 3) nonnegative linear regression is used to model voluntary eye lid motion and log-normal distribution is used to describe involuntary eye blinks. Several user studies are conducted to evaluate the effectiveness of the proposed speech-driven head and eye motion generator using the well-established paired comparison methodology. Our evaluation results clearly show that this approach can significantly outperform the state-of-the-art head and eye motion generation algorithms. In addition, a novel mocap+video hybrid data acquisition technique is introduced to record high-fidelity head movement, eye gaze, and eyelid motion simultaneously.

  20. Investigating the correspondence between driver head position and glance location

    Directory of Open Access Journals (Sweden)

    Joonbum Lee

    2018-02-01

    Full Text Available The relationship between a driver’s glance orientation and corresponding head rotation is highly complex due to its nonlinear dependence on the individual, task, and driving context. This paper presents expanded analytic detail and findings from an effort that explored the ability of head pose to serve as an estimator for driver gaze by connecting head rotation data with manually coded gaze region data using both a statistical analysis approach and a predictive (i.e., machine learning approach. For the latter, classification accuracy increased as visual angles between two glance locations increased. In other words, the greater the shift in gaze, the higher the accuracy of classification. This is an intuitive but important concept that we make explicit through our analysis. The highest accuracy achieved was 83% using the method of Hidden Markov Models (HMM for the binary gaze classification problem of (a glances to the forward roadway versus (b glances to the center stack. Results suggest that although there are individual differences in head-glance correspondence while driving, classifier models based on head-rotation data may be robust to these differences and therefore can serve as reasonable estimators for glance location. The results suggest that driver head pose can be used as a surrogate for eye gaze in several key conditions including the identification of high-eccentricity glances. Inexpensive driver head pose tracking may be a key element in detection systems developed to mitigate driver distraction and inattention.

  1. CTOD-based acceptance criteria for heat exchanger head staybolts

    International Nuclear Information System (INIS)

    Lam, P.S.; Sindelar, R.L.; Barnes, D.M.; Awadalla, N.G.

    1992-01-01

    The primary coolant piping system of the Savannah River Site (SRS) reactors contains twelve heat exchangers to remove the waste heat from the nuclear materials production. A large break at the inlet or outlet heads of the heat exchangers would occur if the restraint members of the heads become inactive. The heat exchanger head is attached to the tubesheet by 84 staybolts. The structural integrity of the heads is demonstrated by showing the redundant capacity of the staybolts to restrain the head at design conditions and under seismic loadings. The beat exchanger head is analyzed with a three- dimensional finite element model. The restraint provided by the staybolts is evaluated for several postulated cases of inactive or missing staybolts, that is, bolts that have a flaw exceeding the ultrasonic testing (UT) threshold depth of 25% of the bolt diameter. A limit of 6 inactive staybolts is reached with a fracture criterion based on the maximum allowable local displacement at the active staybolts which corresponds to the crack tip opening displacement (CTOD) of 0.032 inches. An acceptance criteria methodology has been developed to disposition flaws reported in the staybolt inspections while ensuring adequate restraint capacity of the staybolts to maintain integrity of the heat exchanger heads against collapse. The methodology includes an approach for the baseline and periodic inspections of the staybolts. A total of up to 6 staybolts, reported as containing flaws with depths at or exceeding 25% would be acceptable in the heat exchanger

  2. Development and field performance of indy race car head impact padding.

    Science.gov (United States)

    Melvin, J W; Bock, H; Anderson, K; Gideon, T

    2001-11-01

    The close-fitting cockpit of the modern Indy car single seat race car has the potential to provide a high level of head and neck impact protection in rear and side impacts. Crash investigation has shown that a wide variety of materials have been used as the padding for these cockpits and, as a result, produced varying outcomes in crashes. Additionally, these pads have not always been positioned for optimal performance. The purpose of this study was to investigate the head impact performance of a variety of energy-absorbing padding materials under impact conditions typical of Indy car rear impacts and to identify superior materials and methods of improving their performance as race car head pads. An extensive series of tests with the helmeted Hybrid III test dummy head and neck on an impact mini-sled was conducted to explore head padding concepts. Following this, a performance specification for a simplified impact test using a rigid headform that simulates the helmeted head was developed and recommendations for performance levels of head padding based on biomechanical data on helmeted head impacts were made. In 1997, during the time that the head pad research was being performed, the Indy Racing League introduced a new chassis specification for their cars. There were a number of rear- and side-impact crashes during that season that resulted in seven severe head injuries. Examples of the head padding in those cars were included in the experimental study. The results of the head pad research were used to specify new padding materials that met the new biomechanical criteria. The placement of the head pads was also changed for better location of the padding. These changes instituted in 1998 have reduced the number of head injuries in crashes similar to or more severe than those of 1997 and have resulted in only occasional moderate head injuries (concussions) in the 1998 and 1999 seasons.

  3. Femoral head necrosis; Hueftkopfnekrose

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, J.; Scheurecker, G.; Scheurecker, A.; Stoeger, A.; Huber, A. [Roentgeninstitut am Schillerpark, Linz (Austria); Hofmann, S. [Orthopaedisches Landeskrankenhaus Stolzalpe (Austria)

    2009-05-15

    The epidemiology and pathohistogenesis of avascular femoral head necrosis has still not been clarified in detail. Because the course of the disease runs in stages and over a long time period nearly always culminates in the necessity for a total hip prosthesis, an exact radiological evaluation is of paramount importance for the treatment. There is a need for a common staging system to enable comparison of different therapy concepts and especially their long-term results. In this article the ARCO staging system is described in full detail, which includes all radiological modalities as well as histopathological alterations. (orig.) [German] Bei der avaskulaeren Femurkopfnekrose handelt es sich um ein Krankheitsbild, dessen Ursachen noch immer nicht vollstaendig geklaert sind. Da die Erkrankung stadienhaft verlaeuft und ueber einen laengeren Zeitraum betrachtet nahezu immer in einem prothetischen Hueftersatz muendet, ist eine genaue radiologische Abklaerung fuer die Behandlung von enormer Bedeutung. Um Langzeiterfolge verschiedener Therapiekonzepte vergleichen zu koennen, sind eine exakte Beschreibung und darauf basierend die Verwendung einer einheitlichen Stadieneinteilung wuenschenswert. In der vorliegenden Arbeit wird die ARCO-Stadieneinteilung im Detail beschrieben, die alle bildgebenden Methoden beruecksichtigt und histopathologische Veraenderungen mit einbezieht. (orig.)

  4. Head trauma and CT

    International Nuclear Information System (INIS)

    Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitoshi

    1979-01-01

    It has been said that chronic subdural hematoma cannot be diagnosed by CT. In our cases, CT was used, and the results were described. According to the density of the picture, CT findings of chronic subdural hematoma could be classified into 3 types, those of higher density than that of the cerebral paranchyma, those of isodensity, and those of lower density than that of the cerebral parenchyma. The difference among them appeared to be due to variation in the fluid in hematoma, especially that in hemoglobin concentration. Chronic subdural hematoma was found in 27 of 388 cases of head trauma in which CT was undertaken in our department of surgery for last 2 years. It is difficult to differenciate this disease from subdural edema or subarachnoideal retention of the cerebrospinal fluid. In many cases, use of contrast medium added no change to the CT picture. Cerebral angiography is necessary for definite diagnosis of the disease. Chronic subdural hematoma gives more varieties of findings than other intracranial hematomas. However, if the film is very carefully read, CT is still useful for diagnosing this disease in spite of initially remarked difficulties. (Ueda, J.)

  5. Risk factors for mortality in children with abusive head trauma.

    Science.gov (United States)

    Shein, Steven L; Bell, Michael J; Kochanek, Patrick M; Tyler-Kabara, Elizabeth C; Wisniewski, Stephen R; Feldman, Kenneth; Makoroff, Kathi; Scribano, Philip V; Berger, Rachel P

    2012-10-01

    We sought to identify risk factors for mortality in a large clinical cohort of children with abusive head trauma. Bivariate analysis and multivariable logistic regression models identified demographic, physical examination, and radiologic findings associated with in-hospital mortality of children with abusive head trauma at 4 pediatric centers. An initial Glasgow Coma Scale (GCS) ≤ 8 defined severe abusive head trauma. Data are shown as OR (95% CI). Analysis included 386 children with abusive head trauma. Multivariable analysis showed children with initial GCS either 3 or 4-5 had increased mortality vs children with GCS 12-15 (OR = 57.8; 95% CI, 12.1-277.6 and OR = 15.6; 95% CI, 2.6-95.1, respectively, P < .001). Additionally, retinal hemorrhage (RH), intraparenchymal hemorrhage, and cerebral edema were independently associated with mortality. In the subgroup with severe abusive head trauma and RH (n = 117), cerebral edema and initial GCS of 3 or 4-5 were independently associated with mortality. Chronic subdural hematoma was independently associated with survival. Low initial GCS score, RH, intraparenchymal hemorrhage, and cerebral edema are independently associated with mortality in abusive head trauma. Knowledge of these risk factors may enable researchers and clinicians to improve the care of these vulnerable children. Copyright © 2012 Mosby, Inc. All rights reserved.

  6. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... severe headaches, dizziness, and other symptoms of aneurysm, bleeding, stroke and brain tumors. It also helps your ... emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. Tell your ...

  7. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Radiology (ACR) and the Radiological Society of North America (RSNA), comprising physicians with expertise in several radiologic ... Site Map Copyright © 2018 Radiological Society of North America, Inc. (RSNA). To help ensure current and accurate ...

  8. Dkk1 and noggin cooperate in mammalian head induction

    Science.gov (United States)

    del Barco Barrantes, Ivan; Davidson, Gary; Gröne, Hermann-Josef; Westphal, Heiner; Niehrs, Christof

    2003-01-01

    Growth factor antagonists play important roles in mediating the inductive effects of the Spemann organizer in amphibian embryos and its equivalents in other vertebrates. Dual inhibition of Wnt and BMP signals has been proposed to confer head organizer activity. We tested the requirement of this coinhibition in Xenopus and mice. In Xenopus, simultaneous reduction of the BMP antagonists chordin and noggin, and the Wnt antagonist dickkopf1 (dkk1) leads to anterior truncations. In mice, compound mutants for dkk1 and noggin display severe head defects, with deletion of all head structures anterior to the mid-hindbrain boundary. These defects arise as a result of a failure in anterior specification at the gastrula stage. The results provide genetic evidence for the dual inhibition model and indicate that dkk1 and noggin functionally cooperate in the head organizer. PMID:12952897

  9. Anaphylaxis Due to Head Injury

    Directory of Open Access Journals (Sweden)

    Bruner, Heather C.

    2015-05-01

    Full Text Available Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury. [West J Emerg Med. 2015;16(3:435–437.

  10. Anaphylaxis due to head injury.

    Science.gov (United States)

    Bruner, Heather C; Bruner, David I

    2015-05-01

    Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury.

  11. Boxing-related head injuries.

    Science.gov (United States)

    Jayarao, Mayur; Chin, Lawrence S; Cantu, Robert C

    2010-10-01

    Fatalities in boxing are most often due to traumatic brain injury that occurs in the ring. In the past 30 years, significant improvements in ringside and medical equipment, safety, and regulations have resulted in a dramatic reduction in the fatality rate. Nonetheless, the rate of boxing-related head injuries, particularly concussions, remains unknown, due in large part to its variability in clinical presentation. Furthermore, the significance of repeat concussions sustained when boxing is just now being understood. In this article, we identify the clinical manifestations, pathophysiology, and management of boxing-related head injuries, and discuss preventive strategies to reduce head injuries sustained by boxers.

  12. Head-positioning scintillation camera and head holder therefor

    International Nuclear Information System (INIS)

    Kay, T.D.

    1976-01-01

    A holder for immobilizing the head of a patient undergoing a vertex brain scan by a Gamma Scintillation Camera is described. The holder has a uniquely designed shape capable of comfortably supporting the head. In addition, this holder can be both adjustably and removably utilized in combination with the scintillation camera so as to enable the brain scan operation to take place while the patient is in the seated position

  13. Head and Neck Cancers in Developing Countries

    Directory of Open Access Journals (Sweden)

    Poonam Joshi

    2014-04-01

    Full Text Available Head and neck cancers are the most common cancers in developing countries, especially in Southeast Asia. Head and neck cancers are more common in males compared to females. This is mainly attributed to tobacco, areca nut, alcohol, etc. Oral cancers are most common amongst all head and neck squamous cell cancers (HNSCC. HNSCC in the developing world differ from those in the Western world in terms of age, site of disease, etiology, and molecular biology. Poverty, illiteracy, advanced stage at presentation, lack of access to health care, and poor treatment infrastructure pose a major challenge in management of these cancers. The annual GDP (gross domestic product spent on health care is very low in developing countries compared to the developed countries. Cancer treatment leads to a significant financial burden on the cancer patients and their families. Several health programs have been implemented to curb this rising burden of disease. The main aims of these health programs are to increase awareness among people regarding tobacco and to improve access to health care facilities, early diagnosis, treatment, and palliative care.

  14. Head and Neck Cancer

    International Nuclear Information System (INIS)

    Tomita, Toshiki; Imanishi, Yorihisa

    2008-01-01

    The limitation of concurrent chemo-radiotherapy (CCRT) in head and neck cancer (HNC) as the primary treatment is described based on recent findings. Limits in the application/indication involve factors of age, performance status (PS) and renal function. The first is that, as deaths in >71 years old patients are derived from other causes (41%) than HNC, CCRT is only useful for younger population; the second, patients with PS 0-1 or Karnofsky performance score >60-70 can be indicated; and third, contraindicated are those with creatinine clearance (CCr) <60 mL/min as the key drug cisplatin in CCRT has a high renal toxicity. It should be recognized that completion rates of chemotherapy and RT are as low as 66-85% and 84-92%, respectively, in CCRT. CCRT has such limiting adverse events as mucitis, dry mouth, dysohagia, weight loss, neutropenia, sepsis, etc., which are most important in CCRT application. CCRT is recommended for the primary cancers of larynx and hypopharynx because they are significantly better conserved than middle pharyngeal, oral and upper jaw cancers. Evidence of CCRT is poor for cancers in paranasal sinuses. Planned neck dissection (PND) is for the cervical metastatic lymph nodes and conducted 6-12 weeks after CCRT regardless to its outcome. In fluorodeoxyglucose-positron emission tomography (FDG-PET) negative cases, PND can be omitted. Necessity of PND is possibly inversely proportional to CCRT intensity performed. For control of remote metastasis, CCRT has obvious limits and inductive chemotherapy before it is currently considered. Salvage surgery post CCRT does not always yield a relief because of complication. Patients with advanced laryngeal cancer can be selected either to surgery or CCRT depending on results of the inductive chemotherapy. To predict the sensitivity to CCRT, some biomarkers like HPV, EGFR and VEGF have been suggested to be useful by retrospective studies. Understanding the limitation is as important as knowing the usefulness in

  15. Supportive care for head and neck cancer patients receiving radiotherapy

    International Nuclear Information System (INIS)

    Zenda, Sadamoto

    2015-01-01

    Recently (chemo-)radiotherapy has been widely used in head and neck cancer with definite evidence. As long survivor has increased, social problems associated with late toxicity have become more. Late toxicities induced by radiotherapy for head and neck lesion are often severe. Xerostomia is one of the severe late toxicities conventionally and dysphagia after chemoradiotherapy is a new topic. Some industrial development (ex. Intensity Modulated Radiotherapy: IMRT) play a great role in toxicity management. Multidisciplinary approach (cooperation between not only physicians but also nurses and dentists) is necessary to control toxicities. The research of supportive care will be needed same as definitive treatment in the future. (author)

  16. Sports-related Head Injury

    Science.gov (United States)

    ... and head gear come in many sizes and styles for many sports and must properly fit to ... to play or practice." The "Concussion Diagnosis and Management" section details circumstances in which an athlete should ...

  17. Heater head for stirling engine

    Science.gov (United States)

    Corey, John A.

    1985-07-09

    A monolithic heater head assembly which augments cast fins with ceramic inserts which narrow the flow of combustion gas and obtains high thermal effectiveness with the assembly including an improved flange design which gives greater durability and reduced conduction loss.

  18. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should ... a digital cloud server. Currently, MRI is the most sensitive imaging test of the head (particularly the ...

  19. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... and may add approximately 15 minutes to the total exam time. top of page What will I ... the limitations of MRI of the Head? High-quality images are assured only if you are able ...

  20. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... the head (particularly the brain) in routine clinical practice. top of page What are some common uses ... gadolinium contrast material except when absolutely necessary for medical treatment. See the MRI Safety page for more ...

  1. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no ... Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose medical conditions. ...

  2. Head, Neck, and Oral Cancer

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    Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

  3. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... top of page Additional Information and Resources RTAnswers.org : Radiation Therapy for Brain Tumors Radiation Therapy for ... Imaging (MRI) - Head Sponsored by Please note RadiologyInfo.org is not a medical facility. Please contact your ...

  4. Head, Neck, and Oral Cancer

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    Full Text Available ... It can also invite bacteria that lead to gum disease. Click here to find out more. Who We ... It can also invite bacteria that lead to gum disease. Click here to find out more. Oral, Head ...

  5. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... the head (particularly the brain) in routine clinical practice. top of page What are some common uses ... may follow your regular daily routine and take food and medications as usual. Some MRI examinations may ...

  6. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... practice. top of page What are some common uses of the procedure? MR imaging of the head ... gadolinium contrast, it may still be possible to use it after appropriate pre-medication. Patient consent will ...

  7. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... or headphones during the exam. MRI scanners are air-conditioned and well-lit. Music may be played ... the limitations of MRI of the Head? High-quality images are assured only if you are able ...

  8. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... practice. top of page What are some common uses of the procedure? MR imaging of the head ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

  9. American Head and Neck Society

    Science.gov (United States)

    ... research and insights. Comments This field is for validation purposes and should be left unchanged. This iframe ... and Announcements Copyright ©2016 · American Head and Neck Society · Privacy and Return Policy Managed by BSC Management, ...

  10. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... practice. top of page What are some common uses of the procedure? MR imaging of the head ... for immediate assistance. Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 ...

  11. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... MRI) of the head uses a powerful magnetic field, radio waves and a computer to produce detailed ... there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some ...

  12. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... by the interpreting radiologist. Frequently, the differentiation of abnormal (diseased) tissue from normal tissues is better with ... Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to Magnetic ...

  13. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... medically necessary. MRI may not always distinguish between cancer tissue and fluid, known as edema . MRI typically ... Brain Tumors Radiation Therapy for Head and Neck Cancer Others : American Stroke Association National Stroke Association top ...

  14. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... a computer to produce detailed pictures of the brain and other cranial structures that are clearer and ... sensitive imaging test of the head (particularly the brain) in routine clinical practice. top of page What ...

  15. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... practice. top of page What are some common uses of the procedure? MR imaging of the head ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  16. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... page Additional Information and Resources RTAnswers.org : Radiation Therapy for Brain Tumors Radiation Therapy for Head and ...

  17. Head, Neck, and Oral Cancer

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    Full Text Available ... teeth or become infected. It can also invite bacteria that lead to gum disease. Click here to find out ... and surgically treating cancer of the head, neck and mouth. The Oral Cancer Foundation estimates that close to ...

  18. Eye-based head gestures

    DEFF Research Database (Denmark)

    Mardanbegi, Diako; Witzner Hansen, Dan; Pederson, Thomas

    2012-01-01

    A novel method for video-based head gesture recognition using eye information by an eye tracker has been proposed. The method uses a combination of gaze and eye movement to infer head gestures. Compared to other gesture-based methods a major advantage of the method is that the user keeps the gaze...... mobile phone screens. The user study shows that the method detects a set of defined gestures reliably.......A novel method for video-based head gesture recognition using eye information by an eye tracker has been proposed. The method uses a combination of gaze and eye movement to infer head gestures. Compared to other gesture-based methods a major advantage of the method is that the user keeps the gaze...

  19. Topiramate Responsive Exploding Head Syndrome

    OpenAIRE

    Palikh, Gaurang M.; Vaughn, Bradley V.

    2010-01-01

    Exploding head syndrome is a rare phenomenon but can be a significant disruption to quality of life. We describe a 39-year-old female with symptoms of a loud bang and buzz at sleep onset for 3 years. EEG monitoring confirmed these events occurred in transition from stage 1 sleep. This patient reported improvement in intensity of events with topiramate medication. Based on these results, topiramate may be an alternative method to reduce the intensity of events in exploding head syndrome.

  20. Topiramate responsive exploding head syndrome.

    Science.gov (United States)

    Palikh, Gaurang M; Vaughn, Bradley V

    2010-08-15

    Exploding head syndrome is a rare phenomenon but can be a significant disruption to quality of life. We describe a 39-year-old female with symptoms of a loud bang and buzz at sleep onset for 3 years. EEG monitoring confirmed these events occurred in transition from stage 1 sleep. This patient reported improvement in intensity of events with topiramate medication. Based on these results, topiramate may be an alternative method to reduce the intensity of events in exploding head syndrome.

  1. Severe Traumatic Brain Injury

    Science.gov (United States)

    ... TBI Online Concussion Training Press Room Guide to Writing about TBI in News and Social Media Living with TBI HEADS UP to Brain Injury Awareness Get Email Updates To receive email updates about this topic, ...

  2. Mummified trophy heads from Peru: diagnostic features and medicolegal significance.

    Science.gov (United States)

    Verano, John W

    2003-05-01

    Several forms of mummified human trophy heads were produced by prehistoric and historic native groups in South America. This paper describes the diagnostic features of trophy heads produced by the Nasca culture of ancient Peru. A growing interest in these mummified heads among collectors of Pre-Columbian art and antiquities has led to their illegal exportation from Peru, in violation of national and international antiquities laws. Requests from the Peruvian government to protect its cultural patrimony led the United States in 1997 to declare these heads as items subject to U.S. import restriction, along with six other categories of human remains. Despite such restrictions, Nasca trophy heads continue to reach private collectors outside of Peru and thus may be encountered by local, state, or federal law enforcement officials unfamiliar with their characteristic features and origin. The objective of this paper is to describe the features that allow Nasca trophy heads to be identified and distinguished from other archaeological and forensic specimens that may be submitted to a forensic anthropologist for identification.

  3. Analysis of real-time head accelerations in collegiate football players.

    Science.gov (United States)

    Duma, Stefan M; Manoogian, Sarah J; Bussone, William R; Brolinson, P Gunnar; Goforth, Mike W; Donnenwerth, Jesse J; Greenwald, Richard M; Chu, Jeffrey J; Crisco, Joseph J

    2005-01-01

    To measure and analyze head accelerations during American collegiate football practices and games. A newly developed in-helmet 6-accelerometer system that transmits data via radio frequency to a sideline receiver and laptop computer system was implemented. From the data transfer of these accelerometer traces, the sideline staff has real-time data including the head acceleration, the head injury criteria value, the severity index value, and the impact location. Data are presented for instrumented players for the entire 2003 football season, including practices and games. American collegiate football. Thirty-eight players from Virginia Tech's varsity football team. Accelerations and pathomechanics of head impacts. : A total of 3312 impacts were recorded over 35 practices and 10 games for 38 players. The average peak head acceleration, Gadd Severity Index, and Head Injury Criteria were 32 g +/- 25 g, 36 g +/- 91 g, and 26 g +/- 64 g, respectively. One concussive event was observed with a peak acceleration of 81 g, a 267 Gadd Severity Index, and 200 Head Injury Criteria. Because the concussion was not reported until the day after of the event, a retrospective diagnosis based on his history and clinical evaluation suggested a mild concussion. The primary finding of this study is that the helmet-mounted accelerometer system proved effective at collecting thousands of head impact events and providing contemporaneous head impact parameters that can be integrated with existing clinical evaluation techniques.

  4. Mild head injury and attention deficit hyperactivity disorder in children.

    Science.gov (United States)

    Chasle, Veronique; Riffaud, Laurent; Longuet, Romain; Martineau-Curt, Marie; Collet, Yann; Le Fournier, Luc; Pladys, Patrick

    2016-12-01

    Post-concussion syndrome is a well-described complication following moderate and severe head trauma but whether it occurs after mild head injury in children remains unclear. The aim of this study was to evaluate whether exposure to mild head injury with potential additional risk factors (non-surgical lesion on computed tomographic, high kinetic trauma, or Glasgow Coma Scale <15) is associated with attention deficit hyperactivity disorder (ADHD) after the head trauma. This study was performed in an emergency department on children admitted between 2009 and 2013. It compared victims of mild head injury aged 6-16 years with matched children presenting isolated non-surgical forearm fracture (ratio1/2). ADHD was assessed using Conners' Global Index-Parent short version 3-40 months after the trauma. The patients were compared using chi-square test or Fisher's exact test, t test or u-test as appropriate with a p value set at 0.05. During the study period, 676 patients were admitted for mild head injury. Among them, 34 (5 %) fulfilled the inclusion criteria and were compared with 64 matched patients admitted for a forearm fracture. The groups were comparable. ADHD was observed in both groups (18 % in the mild head injury group, 11 % in the control group) with no significant differences between groups. The prevalence was high when compared to an expected frequency of 3.5-5.6 % in children aged 6-12 years in the general population. These results suggest that pre-existing ADHD may have contributed to injury proneness in both groups and does not argue for a specific risk of ADHD induced by mild head injury. The diagnosis of ADHD should be evoked at admission of children aged 6-16 years presenting with a trauma.

  5. Absorbed dose estimates to structures of the brain and head using a high-resolution voxel-based head phantom

    International Nuclear Information System (INIS)

    Evans, Jeffrey F.; Blue, Thomas E.; Gupta, Nilendu

    2001-01-01

    The purpose of this article is to demonstrate the viability of using a high-resolution 3-D head phantom in Monte Carlo N-Particle (MCNP) for boron neutron capture therapy (BNCT) structure dosimetry. This work describes a high-resolution voxel-based model of a human head and its use for calculating absorbed doses to the structures of the brain. The Zubal head phantom is a 3-D model of a human head that can be displayed and manipulated on a computer. Several changes were made to the original head phantom which now contains over 29 critical structures of the brain and head. The modified phantom is a 85x109x120 lattice of voxels, where each voxel is 2.2x2.2x1.4 mm 3 . This model was translated into MCNP lattice format. As a proof of principle study, two MCNP absorbed dose calculations were made (left and right lateral irradiations) using a uniformly distributed neutron disk source with an 1/E energy spectrum. Additionally, the results of these two calculations were combined to estimate the absorbed doses from a bilateral irradiation. Radiobiologically equivalent (RBE) doses were calculated for all structures and were normalized to 12.8 Gy-Eq. For a left lateral irradiation, the left motor cortex receives the limiting RBE dose. For a bilateral irradiation, the insula cortices receive the limiting dose. Among the nonencephalic structures, the parotid glands receive RBE doses that were within 15% of the limiting dose

  6. Practice type effects on head impact in collegiate football.

    Science.gov (United States)

    Reynolds, Bryson B; Patrie, James; Henry, Erich J; Goodkin, Howard P; Broshek, Donna K; Wintermark, Max; Druzgal, T Jason

    2016-02-01

    OBJECT IVE: This study directly compares the number and severity of subconcussive head impacts sustained during helmet-only practices, shell practices, full-pad practices, and competitive games in a National Collegiate Athletic Association (NCAA) Division I-A football team. The goal of the study was to determine whether subconcussive head impact in collegiate athletes varies with practice type, which is currently unregulated by the NCAA. Over an entire season, a cohort of 20 collegiate football players wore impact-sensing mastoid patches that measured the linear and rotational acceleration of all head impacts during a total of 890 athletic exposures. Data were analyzed to compare the number of head impacts, head impact burden, and average impact severity during helmet-only, shell, and full-pad practices, and games. Helmet-only, shell, and full-pad practices and games all significantly differed from each other (p ≤ 0.05) in the mean number of impacts for each event, with the number of impacts being greatest for games, then full-pad practices, then shell practices, and then helmet-only practices. The cumulative distributions for both linear and rotational acceleration differed between all event types (p football players.

  7. Computed Tomography: Ocular Manifestations In Acute Head Injury

    African Journals Online (AJOL)

    Administrator

    Methods: We reviewed 98 brain computed tomographic results retrospectively. ... was also performed to compare the difference of the ocular findings and sexes. ... Ocular findings were more in males and the severity of the ocular findings was .... Male. Female. Indications. Acute mild closed head injury. 12(15.0). 1(5.6).

  8. Using Priors to Compensate Geometrical Problems in Head-Mounted Eye Trackers

    DEFF Research Database (Denmark)

    Batista Narcizo, Fabricio; Ahmed, Zaheer; Hansen, Dan Witzner

    The use of additional information (a.k.a. priors) to help the eye tracking process is presented as an alternative to compensate classical geometrical problems in head-mounted eye trackers. Priors can be obtained from several distinct sources, such as: sensors to collect information related...... estimation specially for uncalibrated head-mounted setups....

  9. Time pressure management as a compensatory strategy training after closed head injury

    NARCIS (Netherlands)

    Fasotti, L; Kovacs, F; Eling, PATM; Brouwer, WH

    Following severe closed head injury, deficits in speed of information processing are common. As a result, many head-injured patients experience a feeling of "information overload" in daily tasks that once were relatively easy. Many remedial programmes have been designed that treat different aspects

  10. Head First 2D Geometry

    CERN Document Server

    Fallow), Stray

    2009-01-01

    Having trouble with geometry? Do Pi, The Pythagorean Theorem, and angle calculations just make your head spin? Relax. With Head First 2D Geometry, you'll master everything from triangles, quads and polygons to the time-saving secrets of similar and congruent angles -- and it'll be quick, painless, and fun. Through entertaining stories and practical examples from the world around you, this book takes you beyond boring problems. You'll actually use what you learn to make real-life decisions, like using angles and parallel lines to crack a mysterious CSI case. Put geometry to work for you, and

  11. Spinal cord injury and its association with blunt head trauma

    OpenAIRE

    Paiva, Wellingson S; Oliveira, Arthur MP; Andrade, Almir F; Amorim, Robson LO; Lourenço, Leonardo JO; Teixeira, Manoel J

    2011-01-01

    Wellingson S Paiva, Arthur MP Oliveira, Almir F Andrade, Robson LO Amorim, Leonardo JO Lourenço, Manoel J TeixeiraDivision of Neurosurgery, University of São Paulo, BrazilBackground: Severe and moderate head injury can cause misdiagnosis of a spinal cord injury, leading to devastating long-term consequences. The objective of this study is to identify risk factors involving spine trauma and moderate-to-severe brain injury.Methods: A prospective study involving 1617 patien...

  12. Heat Transfer Analysis of a Diesel Engine Head

    Directory of Open Access Journals (Sweden)

    M. Diviš

    2003-01-01

    Full Text Available This paper documents the research carried out at the Josef Božek Research Center of Engine and Automotive Engineering dealing with extended numerical stress/deformation analyses of engines parts loaded by heat and mechanical forces. It contains a detailed description of a C/28 series diesel engine head FE model and a discussion of heat transfer analysis tunning and results. The head model consisting of several parts allows a description of contact interaction in both thermal and mechanical analysis.

  13. Averaging hydraulic head, pressure head, and gravitational head in subsurface hydrology, and implications for averaged fluxes, and hydraulic conductivity

    Directory of Open Access Journals (Sweden)

    G. H. de Rooij

    2009-07-01

    Full Text Available Current theories for water flow in porous media are valid for scales much smaller than those at which problem of public interest manifest themselves. This provides a drive for upscaled flow equations with their associated upscaled parameters. Upscaling is often achieved through volume averaging, but the solution to the resulting closure problem imposes severe restrictions to the flow conditions that limit the practical applicability. Here, the derivation of a closed expression of the effective hydraulic conductivity is forfeited to circumvent the closure problem. Thus, more limited but practical results can be derived. At the Representative Elementary Volume scale and larger scales, the gravitational potential and fluid pressure are treated as additive potentials. The necessary requirement that the superposition be maintained across scales is combined with conservation of energy during volume integration to establish consistent upscaling equations for the various heads. The power of these upscaling equations is demonstrated by the derivation of upscaled water content-matric head relationships and the resolution of an apparent paradox reported in the literature that is shown to have arisen from a violation of the superposition principle. Applying the upscaling procedure to Darcy's Law leads to the general definition of an upscaled hydraulic conductivity. By examining this definition in detail for porous media with different degrees of heterogeneity, a series of criteria is derived that must be satisfied for Darcy's Law to remain valid at a larger scale.

  14. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... examination poses almost no risk to the average patient when appropriate safety guidelines are followed. If sedation is used, there ... have a personal story about radiology? Share your patient story here Images ... Disease Head Injury Brain Tumors Images related ...

  15. Womanhood in Bessie Head's fiction

    African Journals Online (AJOL)

    Rain Cloud~· Gather ( 1969), Maru ( 1972) and A Question of Power ( 1974 ),. Head addresses and ... Yet as is the case in most literature by black women from Africa and the. Caribbean .... womanhood comes into play in the principal's decision to get rid of her: "she ... which tl}e principal intends to use to his advantage.

  16. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... cancer of the head, neck and mouth. The Oral Cancer Foundation estimates that close to 42,000 Americans ... diagnosed with oral or pharyngeal cancer this year. Oral cancer’s mortality is particularly high, not because it is ...

  17. Blunt Head Trauma and Headache

    Directory of Open Access Journals (Sweden)

    Ana B Chelse

    2015-04-01

    Full Text Available Investigators from New York Presbyterian Morgan Stanley Children’s Hospital examined whether having an isolated headache following minor blunt head trauma was suggestive of traumatic brain injury (TBI among a large cohort of children 2-18 years of age.

  18. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... very early stage by mapping the motion of water molecules in the tissue. This water motion, known as diffusion, is impaired by most ... the limitations of MRI of the Head? High-quality images are assured only if you are able ...

  19. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... structures of the brain and can also provide functional information (fMRI) in selected cases. MR images of ... Articles and Media MR Angiography (MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain ...

  20. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... of which shows a thin slice of the body. The images can then be studied from different angles by ... information please consult the ACR Manual on Contrast Media and its references. top of page What are the limitations of MRI of the Head? High-quality images are assured only if you are able to ...

  1. Return of the talking heads

    DEFF Research Database (Denmark)

    Reinecke Hansen, Kenneth; Bro, Peter; Andersson, Ralf

    2016-01-01

    . In order to analyze the latest development entering the third wave, we propose a theoretically based dramaturgical model for the television news item. The analysis concludes that, with the current ‘return’ of the talking heads format, the pre-produced and pre-packaged bulletin program about past events...

  2. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ... more. TMJ and Facial Pain TMJ and Facial ... Teeth Management Wisdom Teeth Management An impacted wisdom tooth can ...

  3. Head Start Center Design Guide.

    Science.gov (United States)

    Administration for Children, Youth, and Families (DHHS), Washington, DC. Head Start Bureau.

    This guide contains suggested criteria for planning, designing, and renovating Head Start centers so that they are safe, child-oriented, developmentally appropriate, beautiful, environmentally sensitive, and functional. The content is based on the U.S. General Services Administration's Child Care Center Design Guide, PBS-P140, which was intended…

  4. Analytical modelling of soccer heading

    Indian Academy of Sciences (India)

    ... game is that the players are permitted to use their head to direct the ball during ... method in assessing the cognitive functions that can be applied not only to ... It is attached to a spring (stiffness, k1) and a dashpot (damping coefficient, c1).

  5. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... the head uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the brain and other cranial structures that are clearer and more detailed than other imaging methods. This exam does not use ionizing radiation and may require an injection of a ...

  6. Large subgaleal hematoma producing turban head in 10 year boy with cerebral palsy: rare case report with review of literature

    Directory of Open Access Journals (Sweden)

    Tripathi Praveen Kumar

    2016-12-01

    Full Text Available Subgaleal hematomas (SGHs are not uncommon. Because the subgaleal space has no anatomical boundaries, SGHs usually involve a large space and are typically limited to the parietal region. Cases of SGHs involving whole of head are relatively rare. In this study we report a rare case of massive enlargement of head after SGH causing severe pain and giving an appearance of turban. A 10 year old, male patient with cerebral palsy presented with progressive enlargement of head attaining a size of turban due to habitual head banging and self-punching overhead. SGH drainage and hematoma aspiration were performed and the patient’s head size was restored.

  7. Player and Game Characteristics and Head Impacts in Female Youth Ice Hockey Players.

    Science.gov (United States)

    Reed, Nick; Taha, Tim; Greenwald, Richard; Keightley, Michelle

    2017-08-01

      Despite the growing popularity of ice hockey among female youth and interest in the biomechanics of head impacts in sport, the head impacts sustained by this population have yet to be characterized.   To describe the number of, biomechanical characteristics of, and exposure to head impacts of female youth ice hockey players during competition and to investigate the influences of player and game characteristics on head impacts.   Cohort study.   Twenty-seven female youth ice hockey players (mean age = 12.5 ± 0.52 years) wore instrumented ice hockey helmets during 66 ice hockey games over a 3-year period. Data specific to player, game, and biomechanical head impact characteristics were recorded. A multiple regression analysis identified factors most associated with head impacts of greater frequency and severity.   A total of 436 total head impacts were sustained during 6924 minutes of active ice hockey participation (0.9 ± 0.6 impacts per player per game; range, 0-2.1). A higher body mass index (BMI) significantly predicted a higher number of head impacts sustained per game (P = .008). Linear acceleration of head impacts was greater in older players and those who played the forward position, had a greater BMI, and spent more time on the ice (P = .008), whereas greater rotational acceleration was present in older players who had a greater BMI and played the forward position (P = .008). During tournament games, increased ice time predicted increased severity of head impacts (P = .03).   This study reveals for the first time that head impacts are occurring in female youth ice hockey players, albeit at a lower rate and severity than in male youth ice hockey players, despite the lack of intentional body checking.

  8. Experimental investigation of creep behavior of reactor vessel lower head

    International Nuclear Information System (INIS)

    Chu, T.Y.; Pilch, M.; Bentz, J.H.; Behbahani, A.

    1998-03-01

    The objective of the USNRC supported Lower Head Failure (LHF) Experiment Program at Sandia National Laboratories is to experimentally investigate and characterize the failure of the reactor pressure vessel (RPV) lower head due to the thermal and pressure loads of a severe accident. The experimental program is complemented by a modeling program focused on the development of a constitutive formulation for use in standard finite element structure mechanics codes. The problem is of importance because: lower head failure defines the initial conditions of all ex-vessel events; the inability of state-of-the-art models to simulate the result of the TMI-II accident (Stickler, et al. 1993); and TMI-II results suggest the possibility of in-vessel cooling, and creep deformation may be a precursor to water ingression leading to in-vessel cooling

  9. The coolability limits of a reactor pressure vessel lower head

    Energy Technology Data Exchange (ETDEWEB)

    Theofanous, T.G.; Syri, S. [Univ. of California, Santa Barbara, CA (United States)

    1995-09-01

    Configuration II of the ULPU experimental facility is described, and from a comprehensive set of experiments are provided. The facility affords full-scale simulations of the boiling crisis phenomenon on the hemispherical lower head of a reactor pressure vessel submerged in water, and heated internally. Whereas Configuration I experiments (published previously) established the lower limits of coolability under low submergence, pool-boiling conditions, with Configuration II we investigate coolability under conditions more appropriate to practical interest in severe accident management; that is, heat flux shapes (as functions of angular position) representative of a core melt contained by the lower head, full submergence of the reactor pressure vessel, and natural circulation. Critical heat fluxes as a function of the angular position on the lower head are reported and related the observed two-phase flow regimes.

  10. Henry Head and the Theatre of Reverie

    Directory of Open Access Journals (Sweden)

    Tiffany Watt-Smith

    2011-04-01

    Full Text Available In 1903, the neurologist Henry Head (1861-1940 embarked on a painful self-experiment, in which he severed the radial nerve of his left arm, and then charted the gradual and faltering return of sensitivity to the limb over the next four and a half years. To directly experience his own sensations, Head entered into a trance-like state of distraction or reverie he called a ‘negative attitude of attention’. This article explores Head’s peculiar technique for looking within, and argues that while introspection was an established strategy in psychological laboratories, Head’s reverie also resonated with techniques associated with actors and theatrical audiences during this period. Viewing psychological self-experimentation through the lens of theatre, this article makes visible aspects of Head’s embodied, affective laboratory encounters, often obscured in accounts of his experiment. At the same time, it proposes that the broader historical and cultural significance of Head’s experiment lies in his attempt to observe himself by producing states of inattention and reverie at will, mental ‘attitudes’ that were themselves the subject of a rapidly evolving debate in scientific and aesthetic circles at the turn of the twentieth century.

  11. Significance of head CT in neuro-ophthalmology

    International Nuclear Information System (INIS)

    Nishimoto, Yuichiro; Masuyama, Yoshimasa; Nakamura, Yasuko; Fujimoto, Toshiro.

    1979-01-01

    It is important to perform CT purposefully in patients with some neuro-ophthalmological disorders. Using Hitachi CT-H250 with the finer matrix of 256 x 256 and a section thickness of 5 mm and 10 mm, we performed head CT in 98 patients with various kinds of neuro-ophthalmological disorders in these 30 months. Neuro-ophthalmological findings in these patients were visual disturbance, visual field defects (hemianopsia, quandrantanopsia, enlargement of the blind spot, central scotoma), papilledema, optic nerve atrophy, difficulties in ocular movements, and others. In 44 (44.9%) of these 98 patients, abnormal findings were displayed in the head CT, characterizing intracranial tumors, intracranial infarction, aneurysms in intracranial vessels, arterio-venous malformation, enlargement of the ventricle or the cistern. In some cases the head CT was the decisive procedure in ensuring a correct diagnosis. We presented findings in the head CT in several interesting cases. We recognized the necessity of the head CT in patients with neuro-ophthalmological disorders. (author)

  12. Preschool Facilities - MDC_HeadStart

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — A label (point) feature class of Head Start / Early Head Start/ Delegate Agencies/ Child Care Partnership & Family Day Care Homes Programs location in Miami-Dade...

  13. Heads Up to High School Sports

    Science.gov (United States)

    ... submit" value="Submit" /> HEADS UP to School Sports Recommend on Facebook Tweet Share Compartir To help ... organizations, developed the HEADS UP: Concussion in School Sports initiative and materials. Specific Concussion Information for... Coaches ...

  14. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... with HEADS UP & CDC's Injury Center HEADS UP Resources File Formats Help: How do I view different ... 6348 Email CDC-INFO U.S. Department of Health & Human Services HHS/Open USA.gov Top

  15. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... Submit Button Connect with HEADS UP & CDC's Injury Center HEADS UP Resources File Formats Help: How do ... Page last updated: April 24, 2017 Content source: Centers for Disease Control and Prevention , National Center for ...

  16. Head and Neck Cancer—Patient Version

    Science.gov (United States)

    Head and neck cancers include cancers in the larynx (voice box), throat, lips, mouth, nose, and salivary glands. Start here to find information on head and neck cancer treatment in adults and children, causes and prevention, screening, research, and statistics.

  17. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... Training course: This page has moved Recommend on Facebook Tweet Share Compartir This training course has been ... with HEADS UP & CDC's Injury Center HEADS UP Resources ... HHS/Open USA.gov Top

  18. Head stabilization in whooping cranes

    Science.gov (United States)

    Kinloch, M.R.; Cronin, T.W.; Olsen, Glenn H.; Chavez-Ramirez, Felipe

    2005-01-01

    The whooping crane (Grus americana) is the tallest bird in North America, yet not much is known about its visual ecology. How these birds overcome their unusual height to identify, locate, track, and capture prey items is not well understood. There have been many studies on head and eye stabilization in large wading birds (herons and egrets), but the pattern of head movement and stabilization during foraging is unclear. Patterns of head movement and stabilization during walking were examined in whooping cranes at Patuxent Wildlife Research Center, Laurel, Maryland USA. Four whooping cranes (1 male and 3 females) were videotaped for this study. All birds were already acclimated to the presence of people and to food rewards. Whooping cranes were videotaped using both digital and Hi-8 Sony video cameras (Sony Corporation, 7-35 Kitashinagawa, 6-Chome, Shinagawa-ku, Tokyo, Japan), placed on a tripod and set at bird height in the cranes' home pens. The cranes were videotaped repeatedly, at different locations in the pens and while walking (or running) at different speeds. Rewards (meal worms, smelt, crickets and corn) were used to entice the cranes to walk across the camera's view plane. The resulting videotape was analyzed at the University of Maryland at Baltimore County. Briefly, we used a computerized reduced graphic model of a crane superimposed over each frame of analyzed tape segments by means of a custom written program (T. W. Cronin, using C++) with the ability to combine video and computer graphic input. The speed of the birds in analyzed segments ranged from 0.30 m/s to 2.64 m/s, and the proportion of time the head was stabilized ranged from 79% to 0%, respectively. The speed at which the proportion reached 0% was 1.83 m/s. The analyses suggest that the proportion of time the head is stable decreases as speed of the bird increases. In all cases, birds were able to reach their target prey with little difficulty. Thus when cranes are walking searching for food

  19. 29 CFR 1918.103 - Head protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Head protection. 1918.103 Section 1918.103 Labor... must ensure that head protection complies with any of the following consensus standards: (i) ANSI Z89.1... as head protection devices that are constructed in accordance with one of the above consensus...

  20. 29 CFR 1915.155 - Head protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Head protection. 1915.155 Section 1915.155 Labor... helmets. (1) Head protection must comply with any of the following consensus standards: (i) ANSI Z89.1... as head protection devices that are constructed in accordance with one of the above consensus...

  1. 29 CFR 1910.135 - Head protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 5 2010-07-01 2010-07-01 false Head protection. 1910.135 Section 1910.135 Labor... head protection. (1) Head protection must comply with any of the following consensus standards: (i... consensus standards will be deemed to be in compliance with the requirements of this section. [59 FR 16362...

  2. Small head size after atomic irradiation

    International Nuclear Information System (INIS)

    Miller, R.W.; Mulvihill, J.J.

    1975-01-01

    A study of children exposed to nuclear explosions in Hiroshima and Nagasaki showed small head size and mental retardation when exposure occurred less than 18 weeks of gestational age. Increased frequency of small head size occurred when maternal exposure was 10 to 19 rad. Tables and graphs are presented to show relationships between dose, gestational age, and frequency of small head size

  3. Health Coordination Manual. Head Start Health Services.

    Science.gov (United States)

    Administration for Children, Youth, and Families (DHHS), Washington, DC. Head Start Bureau.

    Part 1 of this manual on coordinating health care services for Head Start children provides an overview of what Head Start health staff should do to meet the medical, mental health, nutritional, and/or dental needs of Head Start children, staff, and family members. Offering examples, lists, action steps, and charts for clarification, part 2…

  4. 21 CFR 868.1930 - Stethoscope head.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Stethoscope head. 868.1930 Section 868.1930 Food... DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1930 Stethoscope head. (a) Identification. A stethoscope head is a weighted chest piece used during anesthesia to listen to a patient's heart, breath, and...

  5. 29 CFR 1926.100 - Head protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Head protection. 1926.100 Section 1926.100 Labor... § 1926.100 Head protection. (a) Employees working in areas where there is a possible danger of head... protected by protective helmets. (b) Helmets for the protection of employees against impact and penetration...

  6. Effect of ice surface size on collision rates and head impacts at the World Junior Hockey Championships, 2002 to 2004.

    Science.gov (United States)

    Wennberg, Richard

    2005-03-01

    To determine if collision rates and head impacts in elite junior hockey differed between games played on the small North American ice surface (85 ft wide), an intermediate-size Finnish ice surface (94 ft wide), and the large standard international ice surface (100 ft wide). Videotape analysis of all games involving Team Canada from the 2002 (large ice, Czech Republic), 2003 (small ice, Canada), and 2004 (intermediate ice, Finland) World Junior Championships. All collisions were counted and separated into various categories (volitional player/player bodychecks, into boards or open ice, plus accidental/incidental player/boards, player/ice, head/stick, head/puck). Further subdivisions included collisions involving the head directly or indirectly and notably severe head impacts. Small, intermediate, and large ice surface mean collisions/game, respectively, were 295, 258, 222, total collisions; 251, 220, 181, volitional bodychecks; 126, 115, 88, into boards; 125, 106, 93, open ice; 71, 52, 44, total head; 44, 36, 30, indirect head; 26, 16, 13, direct head; and 1.3, 0.5, 0.3, severe head (P < 0.05 for small-intermediate ice and intermediate-large ice differences in total collisions; P < 0.005 for small-large ice difference; P < 0.05 for small-intermediate ice differences in head impacts; P < 0.01 for small-large ice differences in total and severe head impacts). There is a significant inverse correlation between ice size and collision rates in elite hockey, including direct, indirect, and severe head impacts. These findings suggest that uniform usage of the larger international rinks could reduce the risk of injury, and specifically, concussions in elite hockey by decreasing the occurrence of collisions and head impacts.

  7. Light water reactor lower head failure analysis

    International Nuclear Information System (INIS)

    Rempe, J.L.; Chavez, S.A.; Thinnes, G.L.

    1993-10-01

    This document presents the results from a US Nuclear Regulatory Commission-sponsored research program to investigate the mode and timing of vessel lower head failure. Major objectives of the analysis were to identify plausible failure mechanisms and to develop a method for determining which failure mode would occur first in different light water reactor designs and accident conditions. Failure mechanisms, such as tube ejection, tube rupture, global vessel failure, and localized vessel creep rupture, were studied. Newly developed models and existing models were applied to predict which failure mechanism would occur first in various severe accident scenarios. So that a broader range of conditions could be considered simultaneously, calculations relied heavily on models with closed-form or simplified numerical solution techniques. Finite element techniques-were employed for analytical model verification and examining more detailed phenomena. High-temperature creep and tensile data were obtained for predicting vessel and penetration structural response

  8. Light water reactor lower head failure analysis

    Energy Technology Data Exchange (ETDEWEB)

    Rempe, J.L.; Chavez, S.A.; Thinnes, G.L. [EG and G Idaho, Inc., Idaho Falls, ID (United States)] [and others

    1993-10-01

    This document presents the results from a US Nuclear Regulatory Commission-sponsored research program to investigate the mode and timing of vessel lower head failure. Major objectives of the analysis were to identify plausible failure mechanisms and to develop a method for determining which failure mode would occur first in different light water reactor designs and accident conditions. Failure mechanisms, such as tube ejection, tube rupture, global vessel failure, and localized vessel creep rupture, were studied. Newly developed models and existing models were applied to predict which failure mechanism would occur first in various severe accident scenarios. So that a broader range of conditions could be considered simultaneously, calculations relied heavily on models with closed-form or simplified numerical solution techniques. Finite element techniques-were employed for analytical model verification and examining more detailed phenomena. High-temperature creep and tensile data were obtained for predicting vessel and penetration structural response.

  9. Fuel rod pellet loading head

    International Nuclear Information System (INIS)

    Howell, T.E.

    1975-01-01

    An assembly for loading nuclear fuel pellets into a fuel rod comprising a loading head for feeding pellets into the open end of the rod is described. The pellets rest in a perforated substantially V-shaped seat through which air may be drawn for removal of chips and dust. The rod is held in place in an adjustable notched locator which permits alignment with the pellets

  10. Very Low Head Turbine Deployment in Canada

    International Nuclear Information System (INIS)

    Kemp, P; Williams, C; Sasseville, Remi; Anderson, N

    2014-01-01

    The Very Low Head (VLH) turbine is a recent turbine technology developed in Europe for low head sites in the 1.4 - 4.2 m range. The VLH turbine is primarily targeted for installation at existing hydraulic structures to provide a low impact, low cost, yet highly efficient solution. Over 35 VLH turbines have been successfully installed in Europe and the first VLH deployment for North America is underway at Wasdell Falls in Ontario, Canada. Deployment opportunities abound in Canada with an estimated 80,000 existing structures within North America for possible low-head hydro development. There are several new considerations and challenges for the deployment of the VLH turbine technology in Canada in adapting to the hydraulic, environmental, electrical and social requirements. Several studies were completed to determine suitable approaches and design modifications to mitigate risk and confirm turbine performance. Diverse types of existing weirs and spillways pose certain hydraulic design challenges. Physical and numerical modelling of the VLH deployment alternatives provided for performance optimization. For this application, studies characterizing the influence of upstream obstacles using water tunnel model testing as well as full-scale prototype flow dynamics testing were completed. A Cold Climate Adaptation Package (CCA) was developed to allow year-round turbine operation in ice covered rivers. The CCA package facilitates turbine extraction and accommodates ice forces, frazil ice, ad-freezing and cold temperatures that are not present at the European sites. The Permanent Magnet Generator (PMG) presents some unique challenges in meeting Canadian utility interconnection requirements. Specific attention to the frequency driver control and protection requirements resulted in a driver design with greater over-voltage capability for the PMG as well as other key attributes. Environmental studies in Europe included fish friendliness testing comprised of multiple in

  11. Very Low Head Turbine Deployment in Canada

    Science.gov (United States)

    Kemp, P.; Williams, C.; Sasseville, Remi; Anderson, N.

    2014-03-01

    The Very Low Head (VLH) turbine is a recent turbine technology developed in Europe for low head sites in the 1.4 - 4.2 m range. The VLH turbine is primarily targeted for installation at existing hydraulic structures to provide a low impact, low cost, yet highly efficient solution. Over 35 VLH turbines have been successfully installed in Europe and the first VLH deployment for North America is underway at Wasdell Falls in Ontario, Canada. Deployment opportunities abound in Canada with an estimated 80,000 existing structures within North America for possible low-head hydro development. There are several new considerations and challenges for the deployment of the VLH turbine technology in Canada in adapting to the hydraulic, environmental, electrical and social requirements. Several studies were completed to determine suitable approaches and design modifications to mitigate risk and confirm turbine performance. Diverse types of existing weirs and spillways pose certain hydraulic design challenges. Physical and numerical modelling of the VLH deployment alternatives provided for performance optimization. For this application, studies characterizing the influence of upstream obstacles using water tunnel model testing as well as full-scale prototype flow dynamics testing were completed. A Cold Climate Adaptation Package (CCA) was developed to allow year-round turbine operation in ice covered rivers. The CCA package facilitates turbine extraction and accommodates ice forces, frazil ice, ad-freezing and cold temperatures that are not present at the European sites. The Permanent Magnet Generator (PMG) presents some unique challenges in meeting Canadian utility interconnection requirements. Specific attention to the frequency driver control and protection requirements resulted in a driver design with greater over-voltage capability for the PMG as well as other key attributes. Environmental studies in Europe included fish friendliness testing comprised of multiple in

  12. Fractionation schedules for cancers of the head and neck

    International Nuclear Information System (INIS)

    Harari, Paul M.

    1995-01-01

    Purpose/Objective: This refresher course reviews current research activity and treatment results in the field of radiation therapy fractionation. The presentation emphasizes worldwide studies of altered fractionation, highlighting head and neck cancer as the primary teaching model. Basic radiobiological principles guiding the development of altered fractionation regimens, and advancing the understanding of fractionation effects on normal and tumor tissue are reviewed. A 'standard' prescription of 2 Gy x 35 fractions = 70 Gy may not provide the optimal balance between primary tumor control and late normal tissue effects for all patients with squamous cell carcinoma of the head and neck. The last decade has witnessed the treatment of thousands of head and neck cancer patients with curative radiotherapy using altered fractination schedules designed to improve overall treatment results. Although the number of different fractionation regimens currently being investigated continues to increase, the common guiding principles behind their design are relatively simple. Common fractionation terminology (i.e., accelerated hyperfractionation) will be reviewed, as well as a brief summary of radiobiological concepts pertaining to tumor potential doubling time, tumor proliferation kinetics, overall treatment time and fraction size-dependence of acute and late tissue effects. Several well known head and neck fractionation schedules from around the world (Manchester Christie Hospital-United Kingdom, Princess Margaret Hospital-Canada, Massachusetts General Hospital-USA, MD Anderson Hospital-USA, University of Florida-USA, Mount Vernon Hospital CHART-United Kingdom, RTOG and EORTC trials-USA and Europe) will be summarized with regard to design-rationale, treatment technique and results. The design of several current cooperative group trials investigating altered head and neck fractionation will be presented, as well as concepts prompting the pilot evaluation of several brand new

  13. Environmental and Physiological Factors Affect Football Head Impact Biomechanics.

    Science.gov (United States)

    Mihalik, Jason P; Sumrall, Adam Z; Yeargin, Susan W; Guskiewicz, Kevin M; King, Kevin B; Trulock, Scott C; Shields, Edgar W

    2017-10-01

    Recent anecdotal trends suggest a disproportionate number of head injuries in collegiate football players occur during preseason football camp. In warmer climates, this season also represents the highest risk for heat-related illness among collegiate football players. Because concussion and heat illnesses share many common symptoms, we need 1) to understand if environmental conditions, body temperature, and hydration status affect head impact biomechanics; and 2) to determine if an in-helmet thermistor could provide a valid measure of gastrointestinal temperature. A prospective cohort of 18 Division I college football players (age, 21.1 ± 1.4 yr; height, 187.7 ± 6.6 cm; mass, 114.5 ± 23.4 kg). Data were collected during one control and three experimental sessions. During each session, the Head Impact Telemetry System recorded head impact biomechanics (linear acceleration, rotational acceleration, and severity profile) and in-helmet temperature. A wet bulb globe device recorded environmental conditions, and CorTemp™ Ingestible Core Body Temperature Sensors recorded gastrointestinal temperature. Our findings suggest that linear acceleration (P = 0.57), rotational acceleration (P = 0.16), and Head Impact Technology severity profile (P = 0.33) are not influenced by environmental or physiological conditions. We did not find any single or combination of predictors for impact severity. Rotational acceleration was approaching significance between our early experimental sessions when compared with our control session. More research should be conducted to better understand if rotational accelerations are a component of impact magnitudes that are affected due to changes in environmental conditions, body temperature, and hydration status.

  14. Is Heading in Youth Soccer Dangerous Play?

    Science.gov (United States)

    O'Kane, John W

    2016-01-01

    Soccer is among the most popular youth sports with over 3 million youth players registered in the U.S. Soccer is unique in that players intentionally use their head to strike the ball, leading to concerns that heading could cause acute or chronic brain injury, especially in the immature brains of children. Pub Med search without date restriction was conducted in November 2014 and August 2015 using the terms soccer and concussion, heading and concussion, and youth soccer and concussion. 310 articles were identified and reviewed for applicable content specifically relating to youth athletes, heading, and/or acute or chronic brain injury from soccer. Soccer is a low-risk sport for catastrophic head injury, but concussions are relatively common and heading often plays a role. At all levels of play, concussions are more likely to occur in the act of heading than with other facets of the game. While concussion from heading the ball without other contact to the head appears rare in adult players, some data suggests children are more susceptible to concussion from heading primarily in game situations. Contributing factors include biomechanical forces, less developed technique, and the immature brain's susceptibility to injury. There is no evidence that heading in youth soccer causes any permanent brain injury and there is limited evidence that heading in youth soccer can cause concussion. A reasonable approach based on U.S. Youth Soccer recommendations is to teach heading after age 10 in controlled settings, and heading in games should be delayed until skill acquisition and physical maturity allow the youth player to head correctly with confidence.

  15. Assessment of forward head posture in females: observational and photogrammetry methods.

    Science.gov (United States)

    Salahzadeh, Zahra; Maroufi, Nader; Ahmadi, Amir; Behtash, Hamid; Razmjoo, Arash; Gohari, Mahmoud; Parnianpour, Mohamad

    2014-01-01

    There are different methods to assess forward head posture (FHP) but the accuracy and discrimination ability of these methods are not clear. Here, we want to compare three postural angles for FHP assessment and also study the discrimination accuracy of three photogrammetric methods to differentiate groups categorized based on observational method. All Seventy-eight healthy female participants (23 ± 2.63 years), were classified into three groups: moderate-severe FHP, slight FHP and non FHP based on observational postural assessment rules. Applying three photogrammetric methods - craniovertebral angle, head title angle and head position angle - to measure FHP objectively. One - way ANOVA test showed a significant difference in three categorized group's craniovertebral angle (P< 0.05, F=83.07). There was no dramatic difference in head tilt angle and head position angle methods in three groups. According to Linear Discriminate Analysis (LDA) results, the canonical discriminant function (Wilks'Lambda) was 0.311 for craniovertebral angle with 79.5% of cross-validated grouped cases correctly classified. Our results showed that, craniovertebral angle method may discriminate the females with moderate-severe and non FHP more accurate than head position angle and head tilt angle. The photogrammetric method had excellent inter and intra rater reliability to assess the head and cervical posture.

  16. Head injury predictors in sports trauma--a state-of-the-art review.

    Science.gov (United States)

    Fernandes, Fábio A O; de Sousa, Ricardo J Alves

    2015-08-01

    Head injuries occur in a great variety of sports. Many of these have been associated with neurological injuries, affecting the central nervous system. Some examples are motorsports, cycling, skiing, horse riding, mountaineering and most contact sports such as football, ice and field hockey, soccer, lacrosse, etc. The outcome of head impacts in these sports can be very severe. The worst-case scenarios of permanent disability or even death are possibilities. Over recent decades, many In recent decades, a great number of head injury criteria and respective thresholds have been proposed. However, the available information is much dispersed and a consensus has still not been achieved regarding the best injury criteria or even their thresholds. This review paper gives a thorough overview of the work carried out by the scientific community in the field of impact biomechanics about head injuries sustained during sports activity. The main goal is to review the head injury criteria, as well as their thresholds. Several are reviewed, from the predictors based on kinematics to the ones based on human tissue thresholds. In this work, we start to briefly introduce the head injuries and their mechanisms commonly seen as a result of head trauma in sports. Then, we present and summarize the head injury criteria and their respective thresholds. © IMechE 2015.

  17. Comparative analyses of bicyclists and motorcyclists in vehicle collisions focusing on head impact responses.

    Science.gov (United States)

    Wang, Xinghua; Peng, Yong; Yi, Shengen

    2017-11-01

    To investigate the differences of the head impact responses between bicyclists and motorcyclists in vehicle collisions. A series of vehicle-bicycle and vehicle-motorcycle lateral impact simulations on four vehicle types at seven vehicle speeds (30, 35, 40, 45, 50, 55 and 60 km/h) and three two-wheeler moving speeds (5, 7.5 and 10 km/h for bicycle, 10, 12.5 and 15 km/h for motorcycle) were established based on PC-Crash software. To further comprehensively explore the differences, additional impact scenes with other initial conditions, such as impact angle (0, π/3, 2π/3 and π) and impact position (left, middle and right part of vehicle front-end), also were supplemented. And then, extensive comparisons were accomplished with regard to average head peak linear acceleration, average head impact speed, average head peak angular acceleration, average head peak angular speed and head injury severity. The results showed there were prominent differences of kinematics and body postures for bicyclists and motorcyclists even under same impact conditions. The variations of bicyclist head impact responses with the changing of impact conditions were a far cry from that of motorcyclists. The average head peak linear acceleration, average head impact speed and average head peak angular acceleration values were higher for motorcyclists than for bicyclists in most cases, while the bicyclists received greater average head peak angular speed values. And the head injuries of motorcyclists worsened faster with increased vehicle speed. The results may provide even deeper understanding of two-wheeler safety and contribute to improve the public health affected by road traffic accidents.

  18. First Class Call Stacks: Exploring Head Reduction

    Directory of Open Access Journals (Sweden)

    Philip Johnson-Freyd

    2016-06-01

    Full Text Available Weak-head normalization is inconsistent with functional extensionality in the call-by-name λ-calculus. We explore this problem from a new angle via the conflict between extensionality and effects. Leveraging ideas from work on the λ-calculus with control, we derive and justify alternative operational semantics and a sequence of abstract machines for performing head reduction. Head reduction avoids the problems with weak-head reduction and extensionality, while our operational semantics and associated abstract machines show us how to retain weak-head reduction's ease of implementation.

  19. Porcine head response to blast.

    Science.gov (United States)

    Shridharani, Jay K; Wood, Garrett W; Panzer, Matthew B; Capehart, Bruce P; Nyein, Michelle K; Radovitzky, Raul A; Bass, Cameron R 'dale'

    2012-01-01

    Recent studies have shown an increase in the frequency of traumatic brain injuries related to blast exposure. However, the mechanisms that cause blast neurotrauma are unknown. Blast neurotrauma research using computational models has been one method to elucidate that response of the brain in blast, and to identify possible mechanical correlates of injury. However, model validation against experimental data is required to ensure that the model output is representative of in vivo biomechanical response. This study exposes porcine subjects to primary blast overpressures generated using a compressed-gas shock tube. Shock tube blasts were directed to the unprotected head of each animal while the lungs and thorax were protected using ballistic protective vests similar to those employed in theater. The test conditions ranged from 110 to 740 kPa peak incident overpressure with scaled durations from 1.3 to 6.9 ms and correspond approximately with a 50% injury risk for brain bleeding and apnea in a ferret model scaled to porcine exposure. Instrumentation was placed on the porcine head to measure bulk acceleration, pressure at the surface of the head, and pressure inside the cranial cavity. Immediately after the blast, 5 of the 20 animals tested were apneic. Three subjects recovered without intervention within 30 s and the remaining two recovered within 8 min following respiratory assistance and administration of the respiratory stimulant doxapram. Gross examination of the brain revealed no indication of bleeding. Intracranial pressures ranged from 80 to 390 kPa as a result of the blast and were notably lower than the shock tube reflected pressures of 300-2830 kPa, indicating pressure attenuation by the skull up to a factor of 8.4. Peak head accelerations were measured from 385 to 3845 G's and were well correlated with peak incident overpressure (R(2) = 0.90). One SD corridors for the surface pressure, intracranial pressure (ICP), and head acceleration are

  20. Spinal cord injury and its association with blunt head trauma

    Directory of Open Access Journals (Sweden)

    Paiva WS

    2011-09-01

    Full Text Available Wellingson S Paiva, Arthur MP Oliveira, Almir F Andrade, Robson LO Amorim, Leonardo JO Lourenço, Manoel J TeixeiraDivision of Neurosurgery, University of São Paulo, BrazilBackground: Severe and moderate head injury can cause misdiagnosis of a spinal cord injury, leading to devastating long-term consequences. The objective of this study is to identify risk factors involving spine trauma and moderate-to-severe brain injury.Methods: A prospective study involving 1617 patients admitted in the emergency unit was carried out. Of these patients, 180 with moderate or severe head injury were enrolled. All patients were submitted to three-view spine series X-ray and thin cut axial CT scans for spine trauma investigations.Results: 112 male patients and 78 female patients, whose ages ranged from 11 to 76 years (mean age, 34 years. The most common causes of brain trauma were pedestrians struck by motor vehicles (31.1%, car crashes (27.7%, and falls (25%. Systemic lesions were present in 80 (44.4% patients and the most common were fractures, and lung and spleen injuries. 52.8% had severe and 47.2% moderate head trauma. Fourteen patients (7.8% suffered spinal cord injury (12 in cervical spine, one in lumbar, and one thoracic spine. In elderly patients, the presence of associated lesions and Glasgow Coma Scale (GCS < 9 were statistically significant as risk factors (P < 0.05 for spine injury.Conclusion: Spinal cord injury related to moderate and severe brain trauma usually affects the cervical spine. The incidence of spinal lesions and GCS < 9 points were related to greater incidence of spinal cord injury.Keywords: head injury, spine trauma, risk factors

  1. Off with your heads: isolated organs in early Soviet science and fiction

    Science.gov (United States)

    Krementsov, Nikolai

    2009-01-01

    In the summer of 1925, a debutant writer, Aleksandr Beliaev, published a ‘scientific-fantastic story’, which depicted the travails of a severed human head living in a laboratory, supported by special machinery. Just a few months later, a young medical researcher, Sergei Briukhonenko, succeeded in reviving the severed head of a dog, using a special apparatus he had devised to keep the head alive. This paper examines the relationship between the literary and the scientific experiments with severed heads in post-revolutionary Russia, which reflected the anxieties about death, revival, and survival in the aftermath of the 1914–1923 ‘reign of death’ in that country. It contrasts the anguished ethical questions raised by the story with the public fascination for ‘science that conquers death’. PMID:19442924

  2. Clinical Risk Factors for Head Impact During Falls in Older Adults: A Prospective Cohort Study in Long-Term Care.

    Science.gov (United States)

    Yang, Yijian; Mackey, Dawn C; Liu-Ambrose, Teresa; Leung, Pet-Ming; Feldman, Fabio; Robinovitch, Stephen N

    To examine risk factors associated with head impact during falls in older adults in long-term care (LTC). Two LTC facilities in British Columbia, Canada. 160 LTC residents. Prospective cohort study. Between 2007 and 2014, we video captured 520 falls experienced by participants. Each fall video was analyzed to determine whether impact occurred to the head. Using generalized estimating equation models, we examined how head impact was associated with other fall characteristics and health status prior to the fall. Head impact occurred in 33% of falls. Individuals with mild cognitive impairment were at higher risk for head impact (odds ratio = 2.8; 95% confidence interval, 1.5-5.0) than those with more severe cognitive impairment. Impaired vision was associated with 2.0-fold (1.3-3.0) higher odds of head impact. Women were 2.2 times (1.4-3.3) more likely than men to impact their head during a fall. Head impact is common during falls in LTC, with less cognitively impaired, female residents who suffered from visual impairment, being most likely to impact their head. Future research should focus on improving our ability to detect neural consequences of head impact and evaluating the effect of interventions for reducing the risk for fall-related head injuries in LTC.

  3. Peer Effects on Head Start Children’s Preschool Competency

    Science.gov (United States)

    DeLay, Dawn; Hanish, Laura D.; Martin, Carol Lynn; Fabes, Richard A.

    2015-01-01

    The goals of the present study were to investigate whether young children attending Head Start (N=292; Mage=4.3 years) selected peers based on their preschool competency and whether children’s levels of preschool competency were influenced by their peers’ levels of preschool competency. Children’s peer interaction partners were intensively observed several times a week over one academic year. Social network analyses revealed that children selected peer interaction partners with similar levels of preschool competency and were influenced over time by their partners’ levels of preschool competency. These effects held even after controlling for several child (e.g., sex and language) and family factors (e.g., financial strain and parent education). Implications for promoting preschool competency among Head Start children are discussed. PMID:26479545

  4. Oral complications of radiotherapy in the head and neck

    International Nuclear Information System (INIS)

    Jham, Bruno Correi; Freire, Addah Regina da Silva

    2006-01-01

    Radiotherapy is a treatment modality largely used for head and neck malignancies. However, high doses of radiation in large areas, including the oral cavity, maxilla, mandible and salivary glands may result in several undesired reactions. Mucositis, candidosis, disgeusia, radiation caries, osteoradionecrosis, soft tissue necrosis and xerostomia are some of radiotherapy's complications.Aim: The aim of this study is to briefly review the side effects that may be seen in the oral cavity during or after radiotherapy treatment in the head and neck region.Basic Method Used: Review of relevant literature.Study Design: Literature review.Results: Radiotherapy is still associated with several side effects, significantly affecting patients quality of life.Conclusions: A multidisciplinary treatment, including physicians, dentists, speech therapists, nutritionists, and psychologists, is the best alternative to minimize, or even prevent such reactions. (author)

  5. The Science of Racing against Opponents: Affordance Competition and the Regulation of Exercise Intensity in Head-to-Head Competition.

    Science.gov (United States)

    Hettinga, Florentina J; Konings, Marco J; Pepping, Gert-Jan

    2017-01-01

    Athlete-environment interactions are crucial factors in understanding the regulation of exercise intensity in head-to-head competitions. Previously, we have proposed a framework based on the interdependence of perception and action, which allows us to explore athletic behavior in the more complex pacing situations occurring when athletes need to respond to actions of their opponents. In the present perspective we will further explore whether opponents, crucial external factors in competitive sports, could indeed be perceived as social invitations for action. Decisions regarding how to expend energy over the race are based on internal factors such as the physiological/biomechanical capacity of the athlete in relation to external factors such as those presented by opponents. For example: Is the athlete able to overtake competitors, or not? We present several experimental studies that demonstrate that athletes regulate their exercise intensity differently in head-to-head competition compared to time-trial exercises: Relational athlete-environment aspects seem to outweigh benefits of the individual optimal energy distribution. Also, the behavior of the opponents has been shown to influence pacing strategies of competing athletes, again demonstrating the importance of relational athlete-environment aspects in addition to strictly internal factors. An ecological perspective is presented in which opponents are proposed to present social affordances, and decision-making is conceptualized as a resultant of affordance-competition. This approach will provide novel insights in tactical decision-making and pacing behavior in head-to-head competitions. Future research should not only focus on the athlete's internal state, but also try to understand opponents in the context of the social affordances they provide.

  6. Assessment of head injury of children due to golf ball impact.

    Science.gov (United States)

    Lee, Heow Pueh; Wang, Fang

    2010-10-01

    Head trauma injury due to impact by a flying golf ball is one of the most severe possible injury accidents on the golf course. Numerical simulations based on the finite element method are presented to investigate head injury in children due to impact by a flying golf ball. The stress and energy flow patterns in a head model during the golf ball impact are computed for various combinations of striking speed, falling angle of the golf ball before impact, and impact location. It is found that a child is more prone to head injury due to golf ball impact on the frontal and side/temporal areas. The simulated results are found to conform to the clinical reports on children's head injuries from flying golf balls.

  7. Trunk- and head-centred spatial coordinates do not affect free-viewing perceptual asymmetries.

    Science.gov (United States)

    Nicholls, Michael E R; Mattingley, Jason B; Bradshaw, John L; Krins, Phillip W

    2003-11-01

    Turning the trunk or head to the left can reduce the severity of leftward neglect. This study sought to determine whether turning the trunk or head to the right would reduce pseudoneglect: A phenomenon where normal participants underestimate the rightward features of a stimulus. Participants made luminance judgements of two mirror-reversed greyscales stimuli. A preference for selecting the stimulus dark on the left was found. The effect of trunk-centred coordinates was examined in Expt. 1 by facing the head toward the display and turning the trunk to the left, right or toward the display. Head-centred coordinates were examined in Expt. 2 by directing the eyes toward the display and then turning the head and trunk. No effect of rotation was observed. It was concluded that the leftward bias for the greyscales task could be based on an object-centred attentional bias or left-to-right eye scanning habits.

  8. Head position modulates optokinetic nystagmus.

    Science.gov (United States)

    Pettorossi, V E; Ferraresi, A; Botti, F M; Panichi, R; Barmack, N H

    2011-08-01

    Orientation and movement relies on both visual and vestibular information mapped in separate coordinate systems. Here, we examine how coordinate systems interact to guide eye movements of rabbits. We exposed rabbits to continuous horizontal optokinetic stimulation (HOKS) at 5°/s to evoke horizontal eye movements, while they were statically or dynamically roll-tilted about the longitudinal axis. During monocular or binocular HOKS, when the rabbit was roll-tilted 30° onto the side of the eye stimulated in the posterior → anterior (P → A) direction, slow phase eye velocity (SPEV) increased by 3.5-5°/s. When the rabbit was roll-tilted 30° onto the side of the eye stimulated in the A → P direction, SPEV decreased to ~2.5°/s. We also tested the effect of roll-tilt after prolonged optokinetic stimulation had induced a negative optokinetic afternystagmus (OKAN II). In this condition, the SPEV occurred in the dark, "open loop." Modulation of SPEV of OKAN II depended on the direction of the nystagmus and was consistent with that observed during "closed loop" HOKS. Dynamic roll-tilt influenced SPEV evoked by HOKS in a similar way. The amplitude and the phase of SPEV depended on the frequency of vestibular oscillation and on HOKS velocity. We conclude that the change in the linear acceleration of the gravity vector with respect to the head during roll-tilt modulates the gain of SPEV depending on its direction. This modulation improves gaze stability at different image retinal slip velocities caused by head roll-tilt during centric or eccentric head movement.

  9. Severe Aplastic Anemia (SAA)

    Science.gov (United States)

    ... page Print this page My Cart Severe aplastic anemia (SAA) Severe aplastic anemia (SAA) is a disease ... leukemia (ALL) Other diseases What is severe aplastic anemia (SAA)? SAA is a bone marrow disease. The ...

  10. Essential radiology for head injury

    International Nuclear Information System (INIS)

    Mok, D.W.H.; Kreel, L.

    1988-01-01

    The book covers the guidelines established by the Royal College of Radiologists for the radiographic evaluation of head injuries. It presents a chapter reviewing the normal radiologic anatomy of the skull in six different projections. The advantages and limitations of each projection are addressed. The third chapter, contains 43 radiographs dedicated to the calcified pineal gland and other intracranial calcifications. The book reports on specific types of fractures: linear fractures of the vault, depressed fractures of the vault, fractures in children, fractures of the base of the skull, and fractures of the facial bones

  11. Head First jQuery

    CERN Document Server

    Benedetti, Ryan

    2011-01-01

    Want to add more interactivity and polish to your websites? Discover how jQuery can help you build complex scripting functionality in just a few lines of code. With Head First jQuery, you'll quickly get up to speed on this amazing JavaScript library by learning how to navigate HTML documents while handling events, effects, callbacks, and animations. By the time you've completed the book, you'll be incorporating Ajax apps, working seamlessly with HTML and CSS, and handling data with PHP, MySQL and JSON. If you want to learn-and understand-how to create interactive web pages, unobtrusive scrip

  12. HEAD MOVEMENT DURING WALKING IN THE CAT

    Science.gov (United States)

    ZUBAIR, HUMZA N.; BELOOZEROVA, IRINA N.; SUN, HAI; MARLINSKI, VLADIMIR

    2016-01-01

    Knowledge of how the head moves during locomotion is essential for understanding how locomotion is controlled by sensory systems of the head. We have analyzed head movements of the cat walking along a straight flat pathway in the darkness and light. We found that cats' head left-right translations, and roll and yaw rotations oscillated once per stride, while fore-aft and vertical translations, and pitch rotations oscillated twice. The head reached its highest vertical positions during second half of each forelimb swing, following maxima of the shoulder/trunk by 20–90°. Nose-up rotation followed head upward translation by another 40–90° delay. The peak-to-peak amplitude of vertical translation was ~1.5 cm and amplitude of pitch rotation was ~3°. Amplitudes of lateral translation and roll rotation were ~1 cm and 1.5–3°, respectively. Overall, cats' heads were neutral in roll and 10–30° nose-down, maintaining horizontal semicircular canals and utriculi within 10° of the earth horizontal. The head longitudinal velocity was 0.5–1 m/s, maximal upward and downward linear velocities were ~0.05 and ~0.1 m/s, respectively, and maximal lateral velocity was ~0.05 m/s. Maximal velocities of head pitch rotation were 20–50 °/s. During walking in light, cats stood 0.3–0.5 cm taller and held their head 0.5–2 cm higher than in darkness. Forward acceleration was 25–100% higher and peak-to-peak amplitude of head pitch oscillations was ~20 °/s larger. We concluded that, during walking, the head of the cat is held actively. Reflexes appear to play only a partial role in determining head movement, and vision might further diminish their role. PMID:27339731

  13. 45 CFR 1308.21 - Parent participation and transition of children into Head Start and from Head Start to public...

    Science.gov (United States)

    2010-10-01

    ... into Head Start and from Head Start to public school. 1308.21 Section 1308.21 Public Welfare... AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD START... Standards § 1308.21 Parent participation and transition of children into Head Start and from Head Start to...

  14. Accident or maltreatment? Radiographic X-ray patterns in non-accidental trauma. The concept of sentinel injuries

    International Nuclear Information System (INIS)

    Hirsch, F.W.; Sorge, I.; Roth, C.; Gosemann, J.H.

    2016-01-01

    The focus of this review article is on child abuse and the radiographic pattern of X-ray findings. The radiologist should be able to recognize typical injuries resulting from child abuse. In some cases the findings are highly specific for abuse and these include metaphyseal corner fractures of the long bones in children aged up to 24 months. In other cases the fractures are not specific but highly indicative of child abuse: rib fractures, for example can be associated with child abuse in more than 50 % of the cases; however, maltreatment is difficult to diagnose without taking the entire pattern of skeletal findings into consideration so that a radiological screening of the entire skeleton is often necessary. The concept of sentinel injuries might be helpful for deciding in which cases a complete skeletal screening should be performed. In the age group up to 24 months old a complete skeletal status (with some exceptions) is recommended if one of the three sentinel injuries of rib fractures, intracranial bleeding and abdominal trauma is present. (orig.) [de

  15. Not a NICE CT protocol for the acutely head injured child

    International Nuclear Information System (INIS)

    Willis, A.P.; Latif, S.A.A.; Chandratre, S.; Stanhope, B.; Johnson, K.

    2008-01-01

    Aim: To assess the impact of the introduction of the Birmingham Children's Hospital (BCH) head injury computed tomography (CT) guidelines, when compared with the National Institute of Health and Clinical Excellence (NICE) guidelines, on the number of children with head injuries referred from the Emergency Department (ED) undergoing a CT examination of the head. Material and methods: All children attending BCH ED over a 6-month period with any severity of head injury were included in the study. ED case notes were reviewed and data were collected on a specifically designed proforma. Indications for a CT examination according to both NICE and BCH head injury guidelines and whether or not CT examinations were performed were recorded. Results: A total of 1428 children attended the BCH ED following a head injury in the 6-month period. The median age was 4 years (range 6 days to 15 years) and 65% were boys. Four percent of children were referred for a CT using BCH guidelines and were appropriately examined. If the NICE guidelines had been strictly adhered to a further 8% of children would have undergone a CT examination of the head. All of these children were discharged without complication. The remaining 88% had no indication for CT examination by either BCH or NICE and appropriately did not undergo CT. Conclusions: Adherence to the NICE head injury guidelines would have resulted in a three-fold increase in the total number of CT examinations of the head. The BCH head injury guidelines are both safe and appropriate in the setting of a large children's hospital experienced in the management of children with head injuries

  16. Overexpression of EMMPRIN isoform 2 is associated with head and neck cancer metastasis.

    Directory of Open Access Journals (Sweden)

    Zhiquan Huang

    Full Text Available Extracellular matrix metalloproteinase inducer (EMMPRIN, a plasma membrane protein of the immunoglobulin (Ig superfamily, has been reported to promote cancer cell invasion and metastasis in several human malignancies. However, the roles of the different EMMPRIN isoforms and their associated mechanisms in head and neck cancer progression remain unknown. Using quantitative real-time PCR, we found that EMMPRIN isoform 2 (EMMPRIN-2 was the only isoform that was overexpressed in both head and neck cancer tissues and cell lines and that it was associated with head and neck cancer metastasis. To determine the effects of EMMPRIN-2 on head and neck cancer progression, we transfected head and neck cancer cells with an EMMPRIN-2 expression vector and EMMPRIN-2 siRNA to exogenously modulate EMMPRIN-2 expression and examined the functional importance of EMMPRIN-2 in head and neck cancer invasion and metastasis. We found that EMMPRIN-2 promoted head and neck cancer cell invasion, migration, and adhesion in vitro and increased lung metastasis in vivo. Mechanistic studies revealed that EMMPRIN-2 overexpression promoted the secretion of extracellular signaling molecules, including matrix metalloproteinases-2(MMP-2, urokinase-type plasminogen activator(uPA and Cathepsin B, in head and neck cancer cells. While MMP-2 and uPA have been demonstrated to be important mediators of EMMPRIN signaling, the role of Cathepsin B in EMMPRIN-mediated molecular cascades and tumorigenesis has not been established. We found that EMMPRIN-2 overexpression and Cathepsin B down-regulation significantly inhibited the invasion, migration and adhesion of Tca8133 cells, suggesting that Cathepsin B is required for EMMPRIN-2 enhanced cell migration and invasion in head and neck cancer. The results of our study demonstrate the important role of EMMPRIN-2 in head and neck cancer progression for the first time and reveal that increased extracellular secretion of Cathepsin B may be a novel

  17. Overexpression of EMMPRIN isoform 2 is associated with head and neck cancer metastasis.

    Science.gov (United States)

    Huang, Zhiquan; Tan, Ning; Guo, Weijie; Wang, Lili; Li, Haigang; Zhang, Tianyu; Liu, Xiaojia; Xu, Qin; Li, Jinsong; Guo, Zhongmin

    2014-01-01

    Extracellular matrix metalloproteinase inducer (EMMPRIN), a plasma membrane protein of the immunoglobulin (Ig) superfamily, has been reported to promote cancer cell invasion and metastasis in several human malignancies. However, the roles of the different EMMPRIN isoforms and their associated mechanisms in head and neck cancer progression remain unknown. Using quantitative real-time PCR, we found that EMMPRIN isoform 2 (EMMPRIN-2) was the only isoform that was overexpressed in both head and neck cancer tissues and cell lines and that it was associated with head and neck cancer metastasis. To determine the effects of EMMPRIN-2 on head and neck cancer progression, we transfected head and neck cancer cells with an EMMPRIN-2 expression vector and EMMPRIN-2 siRNA to exogenously modulate EMMPRIN-2 expression and examined the functional importance of EMMPRIN-2 in head and neck cancer invasion and metastasis. We found that EMMPRIN-2 promoted head and neck cancer cell invasion, migration, and adhesion in vitro and increased lung metastasis in vivo. Mechanistic studies revealed that EMMPRIN-2 overexpression promoted the secretion of extracellular signaling molecules, including matrix metalloproteinases-2(MMP-2), urokinase-type plasminogen activator(uPA) and Cathepsin B, in head and neck cancer cells. While MMP-2 and uPA have been demonstrated to be important mediators of EMMPRIN signaling, the role of Cathepsin B in EMMPRIN-mediated molecular cascades and tumorigenesis has not been established. We found that EMMPRIN-2 overexpression and Cathepsin B down-regulation significantly inhibited the invasion, migration and adhesion of Tca8133 cells, suggesting that Cathepsin B is required for EMMPRIN-2 enhanced cell migration and invasion in head and neck cancer. The results of our study demonstrate the important role of EMMPRIN-2 in head and neck cancer progression for the first time and reveal that increased extracellular secretion of Cathepsin B may be a novel mechanism

  18. Genetic alterations in head and neck squamous cell carcinomas

    Directory of Open Access Journals (Sweden)

    Nagai M.A.

    1999-01-01

    Full Text Available The genetic alterations observed in head and neck cancer are mainly due to oncogene activation (gain of function mutations and tumor suppressor gene inactivation (loss of function mutations, leading to deregulation of cell proliferation and death. These genetic alterations include gene amplification and overexpression of oncogenes such as myc, erbB-2, EGFR and cyclinD1 and mutations, deletions and hypermethylation leading to p16 and TP53 tumor suppressor gene inactivation. In addition, loss of heterozygosity in several chromosomal regions is frequently observed, suggesting that other tumor suppressor genes not yet identified could be involved in the tumorigenic process of head and neck cancers. The exact temporal sequence of the genetic alterations during head and neck squamous cell carcinoma (HNSCC development and progression has not yet been defined and their diagnostic or prognostic significance is controversial. Advances in the understanding of the molecular basis of head and neck cancer should help in the identification of new markers that could be used for the diagnosis, prognosis and treatment of the disease.

  19. A pre-Hispanic head.

    Directory of Open Access Journals (Sweden)

    Raffaella Bianucci

    Full Text Available This report on a male head revealed biologic rhythms, as gleaned from hydrogen isotope ratios in hair, consistent with a South-American origin and Atomic Mass Spectrometry radiocarbon dating (AMS compatible with the last pre-Hispanic period (1418-1491 AD, 95.4% probability. Biopsies showed exceptionally well-preserved tissues. The hair contained high levels of toxic elements (lead, arsenic and mercury incompatible with life. There was no evidence for lead deposition in bone consistent with post-mortem accumulation of this toxic element in the hair. We propose that the high content of metals in hair was the result of metabolic activity of bacteria leading to metal complexation in extra cellular polymeric substances (EPS. This is a recognized protective mechanism for bacteria that thrive in toxic environments. This mechanism may account for the tissues preservation and gives a hint at soil composition where the head was presumably buried. Our results have implications for forensic toxicology which has, hitherto, relied on hair analyses as one means to reconstruct pre-mortem metabolism and for detecting toxic elements accumulated during life. Our finding also has implications for other archaeological specimens where similar circumstances may distort the results of toxicological studies.

  20. A pre-Hispanic head.

    Science.gov (United States)

    Bianucci, Raffaella; Jeziorska, Maria; Lallo, Rudy; Mattutino, Grazia; Massimelli, Massimo; Phillips, Genevieve; Appenzeller, Otto

    2008-04-30

    This report on a male head revealed biologic rhythms, as gleaned from hydrogen isotope ratios in hair, consistent with a South-American origin and Atomic Mass Spectrometry radiocarbon dating (AMS) compatible with the last pre-Hispanic period (1418-1491 AD, 95.4% probability). Biopsies showed exceptionally well-preserved tissues. The hair contained high levels of toxic elements (lead, arsenic and mercury) incompatible with life. There was no evidence for lead deposition in bone consistent with post-mortem accumulation of this toxic element in the hair. We propose that the high content of metals in hair was the result of metabolic activity of bacteria leading to metal complexation in extra cellular polymeric substances (EPS). This is a recognized protective mechanism for bacteria that thrive in toxic environments. This mechanism may account for the tissues preservation and gives a hint at soil composition where the head was presumably buried. Our results have implications for forensic toxicology which has, hitherto, relied on hair analyses as one means to reconstruct pre-mortem metabolism and for detecting toxic elements accumulated during life. Our finding also has implications for other archaeological specimens where similar circumstances may distort the results of toxicological studies.

  1. Anatomy of the infant head

    International Nuclear Information System (INIS)

    Bosma, J.F.

    1986-01-01

    This text is mainly an atlas of illustration representing the dissection of the head and upper neck of the infant. It was prepared by the author over a 20-year period. The commentary compares the anatomy of the near-term infant with that of a younger fetus, child, and adult. As the author indicates, the dearth of anatomic information about postnatal anatomic changes represents a considerable handicap to those imaging infants. In part 1 of the book, anatomy is related to physiologic performance involving the pharynx, larynx, and mouth. Sequential topics involve the regional anatomy of the head (excluding the brain), the skeleton of the cranium, the nose, orbit, mouth, larynx, pharynx, and ear. To facilitate use of this text as a reference, the illustrations and text on individual organs are considered separately (i.e., the nose, the orbit, the eye, the mouth, the larynx, the pharynx, and the ear). Each part concerned with a separate organ includes materials from the regional illustrations contained in part 2 and from the skeleton, which is treated in part 3. Also included in a summary of the embryologic and fetal development of the organ

  2. Computing camera heading: A study

    Science.gov (United States)

    Zhang, John Jiaxiang

    2000-08-01

    An accurate estimate of the motion of a camera is a crucial first step for the 3D reconstruction of sites, objects, and buildings from video. Solutions to the camera heading problem can be readily applied to many areas, such as robotic navigation, surgical operation, video special effects, multimedia, and lately even in internet commerce. From image sequences of a real world scene, the problem is to calculate the directions of the camera translations. The presence of rotations makes this problem very hard. This is because rotations and translations can have similar effects on the images, and are thus hard to tell apart. However, the visual angles between the projection rays of point pairs are unaffected by rotations, and their changes over time contain sufficient information to determine the direction of camera translation. We developed a new formulation of the visual angle disparity approach, first introduced by Tomasi, to the camera heading problem. Our new derivation makes theoretical analysis possible. Most notably, a theorem is obtained that locates all possible singularities of the residual function for the underlying optimization problem. This allows identifying all computation trouble spots beforehand, and to design reliable and accurate computational optimization methods. A bootstrap-jackknife resampling method simultaneously reduces complexity and tolerates outliers well. Experiments with image sequences show accurate results when compared with the true camera motion as measured with mechanical devices.

  3. Head impact exposure measured in a single youth football team during practice drills.

    Science.gov (United States)

    Kelley, Mireille E; Kane, Joeline M; Espeland, Mark A; Miller, Logan E; Powers, Alexander K; Stitzel, Joel D; Urban, Jillian E

    2017-11-01

    OBJECTIVE This study evaluated the frequency, magnitude, and location of head impacts in practice drills within a youth football team to determine how head impact exposure varies among different types of drills. METHODS On-field head impact data were collected from athletes participating in a youth football team for a single season. Each athlete wore a helmet instrumented with a Head Impact Telemetry (HIT) System head acceleration measurement device during all preseason, regular season, and playoff practices. Video was recorded for all practices, and video analysis was performed to verify head impacts and assign each head impact to a specific drill. Eleven drills were identified: dummy/sled tackling, install, special teams, Oklahoma, one-on-one, open-field tackling, passing, position skill work, multiplayer tackle, scrimmage, and tackling drill stations. Generalized linear models were fitted to log-transformed data, and Wald tests were used to assess differences in head accelerations and impact rates. RESULTS A total of 2125 impacts were measured during 30 contact practices in 9 athletes (mean age 11.1 ± 0.6 years, mean mass 44.9 ± 4.1 kg). Open-field tackling had the highest median and 95th percentile linear accelerations (24.7 g and 97.8 g, respectively) and resulted in significantly higher mean head accelerations than several other drills. The multiplayer tackle drill resulted in the highest head impact frequency, with an average of 0.59 impacts per minute per athlete, but the lowest 95th percentile linear accelerations of all drills. The front of the head was the most common impact location for all drills except dummy/sled tackling. CONCLUSIONS Head impact exposure varies significantly in youth football practice drills, with several drills exposing athletes to high-magnitude and/or high-frequency head impacts. These data suggest that further study of practice drills is an important step in developing evidence-based recommendations for modifying or eliminating

  4. Head and neck position sense.

    Science.gov (United States)

    Armstrong, Bridget; McNair, Peter; Taylor, Denise

    2008-01-01

    Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or

  5. Ideal femoral head size in total hip arthroplasty balances stability and volumetric wear.

    Science.gov (United States)

    Cross, Michael B; Nam, Denis; Mayman, David J

    2012-10-01

    Over the last several years, a trend towards increasing femoral head size in total hip arthroplasty to improve stability and impingement free range of motion has been observed. The specific questions we sought to answer in our review were: (1) What are the potential advantages and disadvantages of metal-on-metal, ceramic-on-ceramic, and metal-on-polyethylene bearings? (2) What is effect that femoral head size has on joint kinematics? (3) What is the effect that large femoral heads have on bearing surface wear? A PubMed search and a review of 2012 Orthopaedic Research Society abstracts was performed and articles were chosen that directly answered components of the specific aims and that reported outcomes with contemporary implant designs or materials. A review of the literature suggests that increasing femoral head size decreases the risk of postoperative dislocation and improves impingement free range of motion; however, volumetric wear increases with large femoral heads on polyethylene and increases corrosion of the stem in large metal-on-metal modular total hip arthroplasty (THA); however, the risk of potentially developing osteolysis or adverse reactions to metal debris respectively is still unknown. Further, the effect of large femoral heads with ceramic-on-ceramic THA is unclear, due to limited availability and published data. Surgeons must balance the benefits of larger head size with the increased risk of volumetric wear when determining the appropriate head size for a given patient.

  6. Analysis of right anterolateral impacts: the effect of head rotation on the cervical muscle whiplash response

    Directory of Open Access Journals (Sweden)

    Narayan Yogesh

    2005-05-01

    Full Text Available Abstract Background The cervical muscles are considered a potential site of whiplash injury, and there are many impact scenarios for whiplash injury. There is a need to understand the cervical muscle response under non-conventional whiplash impact scenarios, including variable head position and impact direction. Methods Twenty healthy volunteers underwent right anterolateral impacts of 4.0, 7.6, 10.7, and 13.0 m/s2 peak acceleration, each with the head rotated to the left, then the head rotated to the right in a random order of impact severities. Bilateral electromyograms of the sternocleidomastoids, trapezii, and splenii capitis following impact were measured. Results At a peak acceleration of 13.0 m/s2, with the head rotated to the right, the right trapezius generated 61% of its maximal voluntary contraction electromyogram (MVC EMG, while all other muscles generated 31% or less of this variable (31% for the left trapezius, 13% for the right spleinus. capitis, and 16% for the left splenius capitis. The sternocleidomastoids muscles also tended to show an asymmetric EMG response, with the left sternocleidomastoid (the one responsible for head rotation to the right generating a higher percentage (26% of its MVC EMG than the left sternocleidomastoid (4% (p Conclusion The EMG response to a right anterolateral impact is highly dependent on the head position. The sternocleidomastoid responsible for the direction of head rotation and the trapezius ipsilateral to the direction of head rotation generate the most EMG activity.

  7. A customized head and neck support system

    International Nuclear Information System (INIS)

    Bentel, Gunilla C.; Marks, Lawrence B.; Sherouse, George W.; Spencer, David P.

    1995-01-01

    Purpose: To describe a customized head and neck immobilization system for patients receiving radiotherapy including a head support that conforms to the posterior contour of the head and neck. Methods: The system includes a customized headrest to support the posterior head and neck. This is fixed to a thermoplastic face mask that molds to the anterior head/face contours. The shape of these customized head and neck supports were compared to 'standard' supports. Results: This system is comfortable for the patients and appears to be effective in reproducing the setup of the treatment. Conclusions: The variability in the size and shape of the customized posterior supports exceeded that of 'standard' headrests. It is our clinical impression that the customized supports improve reproducibility and are now a standard part of our immobilization system. The quantitative analysis of the customized headrests and some commonly used 'standard' headrests suggests that the customized supports are better able to address variabilities in patient shape

  8. AHP 47: YELLOW-HEAD HORSE

    Directory of Open Access Journals (Sweden)

    Sangs rgyas bkra shis སངས་རྒྱས་བཀྲ་ཤིས།

    2017-04-01

    Full Text Available My family had a stallion we called Rta mgo ser 'Yellow-Head Horse'. Father and two of his brothers occasionally rode it. Father said that Yellow-Head was very wild when it was taken to join local horseraces. I didn't believe that because Yellow-Head was very gentle when Mother rode it to the local monastery and also when I rode it.

  9. Craniofacial growth in a whole rat head transplant: how does a non-functional head grow?

    Science.gov (United States)

    Sugawara, Y; Hirabayashi, S; Harii, K

    1999-01-01

    To evaluate factors intrinsic to the regulation of craniofacial bone growth, we have developed a new experimental model in which the whole head of an infant rat is transplanted to the body of an isohistogenic rat by means of microvascular anastomosis. In our model, the transplanted head has neither scars nor any moving soft tissue that could modify growth around facial bones. Using this model, we evaluated the growth pattern of the craniofacial complex by means of serial roentgenographic cephalometrics. Ten transplantations were performed using 10-day-old rats as donors and 8-week-old rats as recipients. Cephalograms were taken from the lateral direction at 10, 20, 30, and 40 days after transplantation. Several reference points were selected to analyze the growth pattern. In the present study, we conclude that the size and form of the bony complex are mainly determined genetically. There is craniofacial skeletal growth in the absence of muscle function and brain growth. Further, both the nasal cartilage and the sutures appear to be autonomous growth centers having intrinsic growth potential. Genetic or epigenetic information plays an important role at the skeletal level, but it also affects the muscles through the medium of the muscular tonus responsible for posture and other related phenomena.

  10. Posture of the head and pharyngeal swallowing

    International Nuclear Information System (INIS)

    Ekberg, O.

    1986-01-01

    Closure of the laryngeal vestibule during swallowing is important for protection of the airways. The present investigation included 53 patients with dysphagia examined cineradiographically with the head held in resting posture, flexion and extension. The ability to protect the airways by the downward movement of the epiglottis and by obliteration of the laryngeal vestibule was studied in different postures of the head. Of 35 patients with normal laryngeal obliteration with the head in resting position 10 showed a defective closure at swallowing in extension. In 18 patients with defective closure of the laryngeal vestibule in resting position 9 were improved on flexion and two on extension of the head. In one patient with defectie closure of the laryngeal vestibule in resting position swallowing in flexion showed an aggravated dysfunction. In our other patients the defective closure became more marked on extension. Four patients had less effective downward movement of the epiglottis with the head in extension. Of 10 patients with defective epiglottic movement with the head in resting position two were improved on tilting the head forwards. The results show that the position of the head influences the closure of the airways during swallowing. Patients with defective protection of the laryngeal vestibule should be instructed to swallow with the head tilted forwards. (orig.)

  11. Multi-head Watson-Crick automata

    OpenAIRE

    Chatterjee, Kingshuk; Ray, Kumar Sankar

    2015-01-01

    Inspired by multi-head finite automata and Watson-Crick automata in this paper, we introduce new structure namely multi-head Watson-Crick automata where we replace the single tape of multi-head finite automaton by a DNA double strand. The content of the second tape is determined using a complementarity relation similar to Watson-Crick complementarity relation. We establish the superiority of our model over multi-head finite automata and also show that both the deterministic and non-determinis...

  12. [Severe rhabdomyolysis secondary to severe hypernatraemic dehydration].

    Science.gov (United States)

    Mastro-Martínez, Ignacio; Montes-Arjona, Ana María; Escudero-Lirio, Margarita; Hernández-García, Bárbara; Fernández-Cantalejo Padial, José

    2015-01-01

    Rhabdomyolysis is a rare paediatric condition. The case is presented of a patient in whom this developed secondary to severe hypernatraemic dehydration following acute diarrhoea. Infant 11 months of age who presented with vomiting, fever, diarrhoea and anuria for 15 hours. Parents reported adequate preparation of artificial formula and oral rehydration solution. He was admitted with malaise, severe dehydration signs and symptoms, cyanosis, and low reactivity. The laboratory tests highlighted severe metabolic acidosis, hypernatraemia and pre-renal kidney failure (Sodium [Na] plasma 181 mEq/L, urine density> 1030). He was managed in Intensive Care Unit with gradual clinical and renal function improvement. On the third day, slight axial hypotonia and elevated cell lysis enzymes (creatine phosphokinase 75,076 IU/L) were observed, interpreted as rhabdomyolysis. He was treated with intravenous rehydration up to 1.5 times the basal requirements, and he showed a good clinical and biochemical response, being discharged 12 days after admission without motor sequelae. Severe hypernatraemia is described as a rare cause of rhabdomyolysis and renal failure. In critically ill patients, it is important to have a high index of suspicion for rhabdomyolysis and performing serial determinations of creatine phosphokinase for early detection and treatment. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Capabilities of Helmets for Preventing Head Injuries Induced by Ballistic Impacts

    Directory of Open Access Journals (Sweden)

    D.V. Balandin

    2004-01-01

    Full Text Available The limiting performance of ballistically loaded helmets designed to reduce head injuries is studied analytically. The projectile does not penetrate the helmet. This analysis evaluates the absolute minimum of the peak displacement of the helmet shell relative to the head, provided that criteria measuring the severity of head injuries lie within prescribed limits. Rather than optimize a specific design configuration, e.g. a viscoelastic foam liner, characteristics of a time-dependent force representing the helmet liner are calculated. The formulation reduces the limiting performance analysis to an optimal control problem.

  14. The Effect of Head Positioning and Head Tilting on the Incidence of Intraventricular Hemorrhage in Very Preterm Infants: A Systematic Review.

    Science.gov (United States)

    de Bijl-Marcus, Karen A; Brouwer, Annemieke J; de Vries, Linda S; van Wezel-Meijler, Gerda

    2017-01-01

    Despite advances in neonatal intensive care, germinal matrix-intraventricular hemorrhage (GMH-IVH) remains a frequent, serious complication of premature birth. Neutral head position and head tilting have been suggested to reduce the risk of GMH-IVH in preterm infants during the first 72 h of life. The aim of this study was to provide a systematic review of the effect of neutral head positioning and head tilting on the incidence of GMH-IVH in very preterm infants (gestational age ≤30 weeks). In addition, we reviewed their effect on cerebral hemodynamics and oxygenation. Literature was searched (June 2016) in the following electronic databases: CINAHL, Embase, Medline, SCOPUS, and several trial registers. One underpowered trial studied the effect of head positioning on the incidence of GMH-IVH. This randomized controlled trial enrolled 48 preterm infants and found no effect on the occurrence of GMH-IVH. Three observational studies investigated the effect of head rotation and/or tilting on cerebral oxygenation in 68 preterm infants in total. Their results suggest that cerebral oxygenation is not significantly affected by changes in head positioning. The effect of head positioning and/or tilting on cerebral hemodynamics was described in 2 observational studies of 28 preterm infants and found no significant effect. There is insufficient evidence regarding the effect of head positioning and tilting on the incidence of GMH-IVH and cerebral hemodynamics and oxygenation in preterm infants. We recommend further research in this field, especially in extremely preterm and clinically unstable infants during the first postnatal days. © 2016 S. Karger AG, Basel.

  15. Radial head button holing: a cause of irreducible anterior radial head dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su-Mi; Chai, Jee Won; You, Ja Yeon; Park, Jina [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Bae, Kee Jeong [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Orthopedic Surgery, Seoul (Korea, Republic of)

    2016-10-15

    ''Buttonholing'' of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign. Magnetic resonance imaging (MRI) clearly demonstrated anterior dislocation of the fractured radial head through the torn annular ligament. The anterior joint capsule and proximal portion of the annular ligament were interposed between the radial head and capitellum, preventing closed reduction of the radial head. Familiarity with this condition and imaging findings will aid clinicians to make a proper diagnosis and fast decision to perform an open reduction. (orig.)

  16. Deficit in figure-ground segmentation following closed head injury.

    Science.gov (United States)

    Baylis, G C; Baylis, L L

    1997-08-01

    Patient CB showed a severe impairment in figure-ground segmentation following a closed head injury. Unlike normal subjects, CB was unable to parse smaller and brighter parts of stimuli as figure. Moreover, she did not show the normal effect that symmetrical regions are seen as figure, although she was able to make overt judgments of symmetry. Since she was able to attend normally to isolated objects, CB demonstrates a dissociation between figure ground segmentation and subsequent processes of attention. Despite her severe impairment in figure-ground segmentation, CB showed normal 'parallel' single feature visual search. This suggests that figure-ground segmentation is dissociable from 'preattentive' processes such as visual search.

  17. Total retinal detachment occurring after minor head trauma.

    Science.gov (United States)

    Mircea, Pienaru; Ramona, Serban; Mircea, Filip; Andrei, Filip

    2015-01-01

    The objective of this article is to present the case of a patient with a severe decrease of visual acuity that occurred after an apparently minor head injury. Following the investigations, the patient was diagnosed with rhegmatogenous retinal detachment that was triggered by a fall from the same level and which occurred on a background of lattice degeneration. In this case, a minor trauma caused a severe complication because the patient had a contributing factor for the complication. The patient was operated and the end result was satisfactory.

  18. Head movement during CT brain perfusion acquisition of patients with suspected acute ischemic stroke

    International Nuclear Information System (INIS)

    Fahmi, F.; Beenen, L.F.M.; Streekstra, G.J.; Janssen, N.Y.; Jong, H.W. de; Riordan, A.; Roos, Y.B.; Majoie, C.B.; Bavel, E. van; Marquering, H.A.

    2013-01-01

    Objective: Computed Tomography Perfusion (CTP) is a promising tool to support treatment decision for acute ischemic stroke patients. However, head movement during acquisition may limit its applicability. Information of the extent of head motion is currently lacking. Our purpose is to qualitatively and quantitatively assess the extent of head movement during acquisition. Methods: From 103 consecutive patients admitted with suspicion of acute ischemic stroke, head movement in 220 CTP datasets was qualitatively categorized by experts as none, minimal, moderate, or severe. The movement was quantified using 3D registration of CTP volume data with non-contrast CT of the same patient; yielding 6 movement parameters for each time frame. The movement categorization was correlated with National Institutes of Health Stroke Scale (NIHSS) score and baseline characteristic using multinomial logistic regression and student's t-test respectively. Results: Moderate and severe head movement occurred in almost 25% (25/103) of all patients with acute ischemic stroke. The registration technique quantified head movement with mean rotation angle up to 3.6° and 14°, and mean translation up to 9.1 mm and 22.6 mm for datasets classified as moderate and severe respectively. The rotation was predominantly in the axial plane (yaw) and the main translation was in the scan direction. There was no statistically significant association between movement classification and NIHSS score and baseline characteristics. Conclusions: Moderate or severe head movement during CTP acquisition of acute stroke patients is quite common. The presented registration technique can be used to automatically quantify the movement during acquisition, which can assist identification of CTP datasets with excessive head movement

  19. Overexpression of EMMPRIN Isoform 2 Is Associated with Head and Neck Cancer Metastasis

    OpenAIRE

    Huang, Zhiquan; Tan, Ning; Guo, Weijie; Wang, Lili; Li, Haigang; Zhang, Tianyu; Liu, Xiaojia; Xu, Qin; Li, Jinsong; Guo, Zhongmin

    2014-01-01

    Extracellular matrix metalloproteinase inducer (EMMPRIN), a plasma membrane protein of the immunoglobulin (Ig) superfamily, has been reported to promote cancer cell invasion and metastasis in several human malignancies. However, the roles of the different EMMPRIN isoforms and their associated mechanisms in head and neck cancer progression remain unknown. Using quantitative real-time PCR, we found that EMMPRIN isoform 2 (EMMPRIN-2) was the only isoform that was overexpressed in both head and n...

  20. Head movement during CT brain perfusion acquisition of patients with suspected acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Fahmi, F., E-mail: f.fahmi@amc.uva.nl [Department of Biomedical Engineering and Physics, AMC, Amsterdam (Netherlands); Beenen, L.F.M., E-mail: l.f.beenen@amc.uva.nl [Department of Radiology, AMC, Amsterdam (Netherlands); Streekstra, G.J., E-mail: g.j.streekstra@amc.uva.nl [Department of Biomedical Engineering and Physics, AMC, Amsterdam (Netherlands); Janssen, N.Y., E-mail: n.n.janssen@amc.uva.nl [Department of Biomedical Engineering and Physics, AMC, Amsterdam (Netherlands); Jong, H.W. de, E-mail: H.W.A.M.deJong@umcutrecht.nl [Department of Radiology, UMC Utrecht, 3584CX, Utrecht (Netherlands); Riordan, A., E-mail: alan.riordan@gmail.com [Department of Radiology, UMC Utrecht, 3584CX, Utrecht (Netherlands); Roos, Y.B., E-mail: y.b.roos@amc.uva.nl [Department of Neurology, AMC, Amsterdam (Netherlands); Majoie, C.B., E-mail: c.b.majoie@amc.uva.nl [Department of Radiology, AMC, Amsterdam (Netherlands); Bavel, E. van, E-mail: e.vanbavel@amc.uva.nl [Department of Biomedical Engineering and Physics, AMC, Amsterdam (Netherlands); Marquering, H.A., E-mail: h.a.marquering@amc.uva.nl [Department of Biomedical Engineering and Physics, AMC, Amsterdam (Netherlands); Department of Radiology, AMC, Amsterdam (Netherlands)

    2013-12-01

    Objective: Computed Tomography Perfusion (CTP) is a promising tool to support treatment decision for acute ischemic stroke patients. However, head movement during acquisition may limit its applicability. Information of the extent of head motion is currently lacking. Our purpose is to qualitatively and quantitatively assess the extent of head movement during acquisition. Methods: From 103 consecutive patients admitted with suspicion of acute ischemic stroke, head movement in 220 CTP datasets was qualitatively categorized by experts as none, minimal, moderate, or severe. The movement was quantified using 3D registration of CTP volume data with non-contrast CT of the same patient; yielding 6 movement parameters for each time frame. The movement categorization was correlated with National Institutes of Health Stroke Scale (NIHSS) score and baseline characteristic using multinomial logistic regression and student's t-test respectively. Results: Moderate and severe head movement occurred in almost 25% (25/103) of all patients with acute ischemic stroke. The registration technique quantified head movement with mean rotation angle up to 3.6° and 14°, and mean translation up to 9.1 mm and 22.6 mm for datasets classified as moderate and severe respectively. The rotation was predominantly in the axial plane (yaw) and the main translation was in the scan direction. There was no statistically significant association between movement classification and NIHSS score and baseline characteristics. Conclusions: Moderate or severe head movement during CTP acquisition of acute stroke patients is quite common. The presented registration technique can be used to automatically quantify the movement during acquisition, which can assist identification of CTP datasets with excessive head movement.

  1. Eyewear Computing – Augmenting the Human with Head-mounted Wearable Assistants (Dagstuhl Seminar 16042)

    OpenAIRE

    Bulling, Andreas; Cakmakci, Ozan; Kunze, Kai; Rehg, James M.

    2016-01-01

    The seminar was composed of workshops and tutorials on head-mounted eye tracking, egocentric vision, optics, and head-mounted displays. The seminar welcomed 30 academic and industry researchers from Europe, the US, and Asia with a diverse background, including wearable and ubiquitous computing, computer vision, developmental psychology, optics, and human-computer interaction. In contrast to several previous Dagstuhl seminars, we used an ignite talk format to reduce the time of talks to...

  2. Head First WordPress

    CERN Document Server

    Siarto, Jeff

    2010-01-01

    Whether you're promoting your business or writing about your travel adventures, Head First WordPress will teach you not only how to make your blog look unique and attention-grabbing, but also how to dig into the more complex features of WordPress 3.0 to make your website work well, too. You'll learn how to move beyond the standard WordPress look and feel by customizing your blog with your own URL, templates, plugin functionality, and more. As you learn, you'll be working with real WordPress files: The book's website provides pre-fab WordPress themes to download and work with as you follow al

  3. Low-head hydro power

    Science.gov (United States)

    Lemer, E. J.

    1980-11-01

    With a view toward increasing the U.S. electric output, the Army Corps of Engineers has estimated that 55 GW can be obtained immediately from new capacity at existing dams and 40 GW more over the long term. Given the long lead times needed to build new dams, most interest has centered on the existing dams. The Corps of Engineers has established that 21 GW can be obtained from hydroelectric and 34 GW from nonpower dams. Existing hydroelectric sites are being expanded by the utilities, but exploitation of the nonpower dams will require governmental encouragement, because the vast majority are low-head sites (dams less than 40 m high). In the present paper, the question of economics and national policy is examined. The advantages which would accrue from substituting axial turbines for the Kaplan turbine are noted.

  4. Natural head position: An overview.

    Science.gov (United States)

    Meiyappan, N; Tamizharasi, S; Senthilkumar, K P; Janardhanan, K

    2015-08-01

    Cephalometrics has given us a different perspective of interpreting various skeletal problems in the dentofacial complex. Natural head position (NHP) is a reproducible, physiologically determined aspect of function. To determine NHP, a horizontal or vertical reference line outside the crania was used, but preference was given generally to the horizontal. Various intra and extracranial cephalometric horizontal reference planes have been used to formulate diagnosis and plan individualized treatment for an integrated correction of the malocclusion cephalometrics is constantly undergoing refinements in its techniques and analyses to improve the clinical applications. Even though various methods for establishing NHP have been proposed, still it remains a challenge to the clinicians to implement the concept of NHP thoroughly in all the stages of treatment because of practical difficulties in the clinical scenario.

  5. Person-Independent Head Pose Estimation Using Biased Manifold Embedding

    Directory of Open Access Journals (Sweden)

    Sethuraman Panchanathan

    2008-02-01

    Full Text Available Head pose estimation has been an integral problem in the study of face recognition systems and human-computer interfaces, as part of biometric applications. A fine estimate of the head pose angle is necessary and useful for several face analysis applications. To determine the head pose, face images with varying pose angles can be considered to be lying on a smooth low-dimensional manifold in high-dimensional image feature space. However, when there are face images of multiple individuals with varying pose angles, manifold learning techniques often do not give accurate results. In this work, we propose a framework for a supervised form of manifold learning called Biased Manifold Embedding to obtain improved performance in head pose angle estimation. This framework goes beyond pose estimation, and can be applied to all regression applications. This framework, although formulated for a regression scenario, unifies other supervised approaches to manifold learning that have been proposed so far. Detailed studies of the proposed method are carried out on the FacePix database, which contains 181 face images each of 30 individuals with pose angle variations at a granularity of 1∘. Since biometric applications in the real world may not contain this level of granularity in training data, an analysis of the methodology is performed on sparsely sampled data to validate its effectiveness. We obtained up to 2∘ average pose angle estimation error in the results from our experiments, which matched the best results obtained for head pose estimation using related approaches.

  6. Hip Dislocation Increases Roughness of Oxidized Zirconium Femoral Heads in Total Hip Arthroplasty: An Analysis of 59 Retrievals

    Science.gov (United States)

    Moussa, Mohamed E.; Esposito, Christina I.; Elpers, Marcella E.; Wright, Timothy M.; Padgett, Douglas E.

    2014-01-01

    The aims of this study were to assess damage on the surface of retrieved oxidized zirconium metal (OxZr) femoral heads, to measure surface roughness of scratches, and to evaluate the extent of surface effacement using scanning electron microscopy (SEM). Ceramic zirconia-toughened alumina (ZTA) heads were analyzed for comparison. OxZr femoral heads explanted for recurrent dislocation had the most severe damage (p<0.001). The median surface roughness of damaged OxZr femoral heads was 1.49μm, compared to 0.084μm for damaged ZTA heads and 0.052μm for undamaged OxZr (p<0.001). This may be of clinical concern because increased surface roughness has the potential to increase the wear of polyethylene liners articulating against these OxZr heads in THA. PMID:25443362

  7. Head trauma and CT with special reference to diagnosis of complications of head trauma

    International Nuclear Information System (INIS)

    Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitose

    1979-01-01

    Cases in which CT was useful for the diagnosis of complications of head trauma were reported. First, complications of head trauma were given an outline, and then, cases of protrusion of the brain, traumatic pneumocephalus, and cerebro-vascular disorders caused by head trauma were mentioned. (Tsunoda, M.)

  8. Palmer Drought Severity Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — PDSI from the Dai dataset. The Palmer Drought Severity Index (PDSI) is devised by Palmer (1965) to represent the severity of dry and wet spells over the U.S. based...

  9. Posture, head stability, and orientation recovery during vestibular regeneration in pigeons.

    Science.gov (United States)

    Dickman, J David; Lim, Insook

    2004-09-01

    Compensatory behavior such as oculomotor, gaze, and postural responses that occur during movement largely depend upon a functioning vestibular system. In the present study, the initial loss and subsequent recovery of postural and head stability in pigeons undergoing vestibular regeneration were examined. Adult pigeons were trained to manipulate a straight run chamber to peck an illuminated key for fluid reward. Six behavioral measures assessing performance, posture, and head stability were quantified. These included run latency, steps (walking), path negotiation (lane changes), gaze saccades, head bobs, and head shakes. Once normative values were obtained for four birds, complete lesion of all receptor cells and denervation of the epithelia in the vestibular endorgans were produced using a single intralabyrinthine application of streptomycin sulfate. Each bird was then tested at specific times during regeneration and the same behavioral measures examined. At 7 days post-streptomycin treatment (PST), all birds exhibited severe postural and head instability, with tremors, head shakes, staggering, and circling predominating. No normal trial runs, walking, gaze saccades, or head bobs were present. Many of these dysfunctions persisted through 3-4 weeks PST. Gradually, tremor and head shakes diminished and were replaced with an increasing number of normal head bobs during steps and gaze saccades. Beginning at 4 weeks PST, but largely inaccurate, was the observed initiation of directed steps, less staggering, and some successful path negotiation. As regeneration progressed, spatial orientation and navigation ability increased and, by 49 days PST, most trials were successful. By 70 days PST, all birds had recovered to pretreatment levels. Thus, it was observed that ataxia must subside, coincident with normalized head and postural stability prior to the recovery of spatial orientation and path navigation recovery. Parallels in recovery were drawn to hair cell regeneration

  10. Internal fixation of severely displaced mandibular condylar neck fracture with the aid of ramus osteotomy. A revised technique

    DEFF Research Database (Denmark)

    Hillerup, S

    1997-01-01

    A technique is described whereby the mandibular condyle can be located, replaced and fixed in case of a severely displaced fracture with exarticulation of the condylar head.......A technique is described whereby the mandibular condyle can be located, replaced and fixed in case of a severely displaced fracture with exarticulation of the condylar head....

  11. 49 CFR 214.113 - Head protection.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Head protection. 214.113 Section 214.113 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... conform to the national consensus standards for industrial head protection (American National Standards...

  12. Systematic biases in human heading estimation.

    Directory of Open Access Journals (Sweden)

    Luigi F Cuturi

    Full Text Available Heading estimation is vital to everyday navigation and locomotion. Despite extensive behavioral and physiological research on both visual and vestibular heading estimation over more than two decades, the accuracy of heading estimation has not yet been systematically evaluated. Therefore human visual and vestibular heading estimation was assessed in the horizontal plane using a motion platform and stereo visual display. Heading angle was overestimated during forward movements and underestimated during backward movements in response to both visual and vestibular stimuli, indicating an overall multimodal bias toward lateral directions. Lateral biases are consistent with the overrepresentation of lateral preferred directions observed in neural populations that carry visual and vestibular heading information, including MSTd and otolith afferent populations. Due to this overrepresentation, population vector decoding yields patterns of bias remarkably similar to those observed behaviorally. Lateral biases are inconsistent with standard bayesian accounts which predict that estimates should be biased toward the most common straight forward heading direction. Nevertheless, lateral biases may be functionally relevant. They effectively constitute a perceptual scale expansion around straight ahead which could allow for more precise estimation and provide a high gain feedback signal to facilitate maintenance of straight-forward heading during everyday navigation and locomotion.

  13. Clinical features of the exploding head syndrome.

    Science.gov (United States)

    Pearce, J M

    1989-07-01

    Fifty patients suffering from the "exploding head syndrome" are described. This hitherto unreported syndrome is characterised by a sense of an explosive noise in the head usually in the twilight stage of sleep. The associated symptoms are varied, but the benign nature of the condition is emphasised and neither extensive investigation nor treatment are indicated.

  14. Clinical features of the exploding head syndrome.

    OpenAIRE

    Pearce, J M

    1989-01-01

    Fifty patients suffering from the "exploding head syndrome" are described. This hitherto unreported syndrome is characterised by a sense of an explosive noise in the head usually in the twilight stage of sleep. The associated symptoms are varied, but the benign nature of the condition is emphasised and neither extensive investigation nor treatment are indicated.

  15. The Role of the Primary School Head.

    Science.gov (United States)

    Davies, Lester

    1987-01-01

    This study uses Henry Mintzberg's structural observation method to examine British primary school head teachers' work patterns and determine the nature of their role. Head teachers' days were characterized by brevity, variety, and fragmentation similar to those discussed in findings of other empirical managerial studies. Leadership roles stressed…

  16. Elastic plastic buckling of elliptical vessel heads

    International Nuclear Information System (INIS)

    Alix, M.; Roche, R.L.

    1981-08-01

    The risks of buckling of dished vessel head increase when the vessel is thin walled. This paper gives the last results on experimental tests of 3 elliptical heads and compares all the results with some empirical formula dealing with elastic and plastic buckling

  17. Head Start Impact Study. Technical Report

    Science.gov (United States)

    Puma, Michael; Bell, Stephen; Cook, Ronna; Heid, Camilla; Shapiro, Gary; Broene, Pam; Jenkins, Frank; Fletcher, Philip; Quinn, Liz; Friedman, Janet; Ciarico, Janet; Rohacek, Monica; Adams, Gina; Spier, Elizabeth

    2010-01-01

    This Technical Report is designed to provide technical detail to support the analysis and findings presented in the "Head Start Impact Study Final Report" (U.S. Department of Health and Human Services, January 2010). Chapter 1 provides an overview of the Head Start Impact Study and its findings. Chapter 2 provides technical information on the…

  18. Humeral head size in shoulder arthroplasty

    DEFF Research Database (Denmark)

    Vaesel, M T; Olsen, Bo Sanderhoff; Søjbjerg, Jens Ole

    1998-01-01

    Changes in kinematics after hemiarthroplasty of the glenohumeral joint were investigated in nine cadaveric specimens. During experiments the influence of the humeral head size on glenohumeral kinematics was evaluated. A modular prosthesis with five different head sizes and press-fit stems was use...

  19. Motion control of the Twente humanoid head

    NARCIS (Netherlands)

    Visser, L.C.; Carloni, Raffaella; Stramigioli, Stefano

    2009-01-01

    In this work, we present the design and the realization of the motion control algorithm implemented in the Twente hu- manoid head, a seven degrees of freedom (dof) robotic sys- tem. The aim of the project is to have a humanoid head that can serve as a research platform for human-machine interac-

  20. 76 FR 70009 - Head Start Program

    Science.gov (United States)

    2011-11-09

    ... importance of the early years of a child's growth and development. On December 12, 2007, the Improving Head... education, serving nearly one million of our nation's most vulnerable young children and their families. It... Administration for Children and Families 45 CFR Part 1307 Head Start Program; Final Rule #0;#0;Federal Register...

  1. Moving Toward Bioadjuvant Approaches to Head and Neck Cancer Prevention

    International Nuclear Information System (INIS)

    Saba, Nabil F.; Hammond, Anthea; Shin, Dong M.; Khuri, Fadlo R.

    2007-01-01

    Head and neck squamous cell carcinoma affects >45,000 Americans annually. Patients who are successfully treated for their primary tumor are at high risk of developing a second primary tumor, making effective preventive strategies highly desirable for this disease. Although a landmark study in 1990 suggested some benefit of high-dose retinoids in head and neck cancer prevention, subsequent trials using more tolerable doses have shown limited clinical success. Newer preventive strategies have included bioadjuvant therapy combining retinoids with interferon and α-tocopherol, combinations of molecularly targeted agents, and oncolytic viruses. Furthermore, considerable evidence has supported a cancer protective role for several nutrients, including green tea and curcumin analogs. Natural compounds such as these with favorable long-term safety profiles might be particularly suited to the cancer prevention setting, in which patients will usually tolerate only moderate risk and toxicity

  2. Targeting ADAM12 in human disease: head, body or tail?

    DEFF Research Database (Denmark)

    Jacobsen, J; Wewer, U M

    2009-01-01

    ) and insulin-like growth factor receptor signaling. The body of the protein (consisting of the disintegrin, cysteine-rich, and EGF-like domains) is involved in contacts with the extracellular matrix and other cells through interactions with integrins and syndecans. Finally, the tail of the protein (consisting......ADAM12/meltrin alpha is a type I transmembrane multidomain protein involved in tumor progression and other severe diseases, including osteoarthritis, and as such could be considered as a potential drug target. In addition to protease activity, ADAM12 possesses cell binding and cell signaling...... properties. This functional trinity is reflected in the structure of ADAM12, which can be divided into head, body, and tail. The head of the protein (consisting of the pro and catalytic domains) mediates processing of growth factors and cytokines and has been implicated in epidermal growth factor (EGF...

  3. Visual perception of axes of head rotation

    Science.gov (United States)

    Arnoldussen, D. M.; Goossens, J.; van den Berg, A. V.

    2013-01-01

    Registration of ego-motion is important to accurately navigate through space. Movements of the head and eye relative to space are registered through the vestibular system and optical flow, respectively. Here, we address three questions concerning the visual registration of self-rotation. (1) Eye-in-head movements provide a link between the motion signals received by sensors in the moving eye and sensors in the moving head. How are these signals combined into an ego-rotation percept? We combined optic flow of simulated forward and rotational motion of the eye with different levels of eye-in-head rotation for a stationary head. We dissociated simulated gaze rotation and head rotation by different levels of eye-in-head pursuit. We found that perceived rotation matches simulated head- not gaze-rotation. This rejects a model for perceived self-rotation that relies on the rotation of the gaze line. Rather, eye-in-head signals serve to transform the optic flow's rotation information, that specifies rotation of the scene relative to the eye, into a rotation relative to the head. This suggests that transformed visual self-rotation signals may combine with vestibular signals. (2) Do transformed visual self-rotation signals reflect the arrangement of the semi-circular canals (SCC)? Previously, we found sub-regions within MST and V6+ that respond to the speed of the simulated head rotation. Here, we re-analyzed those Blood oxygenated level-dependent (BOLD) signals for the presence of a spatial dissociation related to the axes of visually simulated head rotation, such as have been found in sub-cortical regions of various animals. Contrary, we found a rather uniform BOLD response to simulated rotation along the three SCC axes. (3) We investigated if subject's sensitivity to the direction of the head rotation axis shows SCC axes specifcity. We found that sensitivity to head rotation is rather uniformly distributed, suggesting that in human cortex, visuo-vestibular integration is

  4. Visual perception of axes of head rotation

    Directory of Open Access Journals (Sweden)

    David Mattijs Arnoldussen

    2013-02-01

    Full Text Available Registration of ego-motion is important to accurately navigate through space. Movements of the head and eye relative to space are registered through the vestibular system and optical flow, respectively. Here, we address three questions concerning the visual registration of self-rotation. 1. Eye-in-head movements provide a link between the motion signals received by sensors in the moving eye and sensors in the moving head. How are these signals combined into an ego-rotation percept? We combined optic flow of simulated forward and rotational motion of the eye with different levels of eye-in-head rotation for a stationary head. We dissociated simulated gaze rotation and head rotation by different levels of eye-in-head pursuit.We found that perceived rotation matches simulated head- not gaze-rotation. This rejects a model for perceived self-rotation that relies on the rotation of the gaze line. Rather, eye-in-head signals serve to transform the optic flow’s rotation information, that specifies rotation of the scene relative to the eye, into a rotation relative to the head. This suggests that transformed visual self-rotation signals may combine with vestibular signals.2. Do transformed visual self-rotation signals reflect the arrangement of the semicircular canals (SCC? Previously, we found sub-regions within MST and V6+ that respond to the speed of the simulated head rotation. Here, we re-analyzed those BOLD signals for the presence of a spatial dissociation related to the axes of visually simulated head rotation, such as have been found in sub-cortical regions of various animals. Contrary, we found a rather uniform BOLD response to simulated rotation along the three SCC axes.3. We investigated if subject’s sensitivity to the direction of the head rotation axis shows SCC axes specifcity. We found that sensitivity to head rotation is rather uniformly distributed, suggesting that in human cortex, visuo-vestibular integration is not arranged into

  5. Public knowledge of head and neck cancer.

    LENUS (Irish Health Repository)

    O'Connor, T E

    2010-04-01

    Studies show 60% of patients with newly diagnosed Head & Neck Squamous Cell Cancer in Ireland, present with advanced disease. A poor level of knowledge and awareness among the public of Head & Neck Cancer, is an important consideration in the often delayed presentation for medical attention in many of these cases. Our study surveyed 200 members of the public to assess their knowledge and awareness of Head & Neck Cancer. One hundred and forty (70%) of respondents had never encountered the term "Head & Neck Cancer". One hundred and forty six (73%) failed to identify excessive alcohol consumption as a risk factor. Less than 100 (50%) would have concern about persisting hoarseness or a prolonged oral ulcer. An urgent need exists to raise awareness of Head & Neck Cancer among the public in Ireland.

  6. Head orientation prediction: delta quaternions versus quaternions.

    Science.gov (United States)

    Himberg, Henry; Motai, Yuichi

    2009-12-01

    Display lag in simulation environments with helmet-mounted displays causes a loss of immersion that degrades the value of virtual/augmented reality training simulators. Simulators use predictive tracking to compensate for display lag, preparing display updates based on the anticipated head motion. This paper proposes a new method for predicting head orientation using a delta quaternion (DQ)-based extended Kalman filter (EKF) and compares the performance to a quaternion EKF. The proposed framework operates on the change in quaternion between consecutive data frames (the DQ), which avoids the heavy computational burden of the quaternion motion equation. Head velocity is estimated from the DQ by an EKF and then used to predict future head orientation. We have tested the new framework with captured head motion data and compared it with the computationally expensive quaternion filter. Experimental results indicate that the proposed DQ method provides the accuracy of the quaternion method without the heavy computational burden.

  7. Assessment of outcome after severe brain damage.

    Science.gov (United States)

    Jennett, B; Bond, M

    1975-03-01

    Persisting disability after brain damage usually comprises both mental and physical handicap. The mental component is often the more important in contributing to overall social disability. Lack of an objective scale leads to vague and over-optimistic estimates of outcome, which obscure the ultimate results of early management. A five-point scale is described--death, persistent vegetative state, severe disability, moderate disability, and good recovery. Duration as well as intensity of disability should be included in an index of ill-health; this applies particularly after head injury, because many disabled survivors are young.

  8. Femoral head allograft disinfection system using moderate heat

    International Nuclear Information System (INIS)

    Knaepler, H.; Von Garrel, T.

    1999-01-01

    The employment of a reliable thermal viral inactivation process, which minimally manipulates tissues, for surgically retrieved femoral head allografts addresses the increased concerns with virus transmissibility while minimizing the loss of biological properties. The newest European and German surgical bone banking guidelines have incorporated the use of independently validated then-nal viral inactivation methods in place of repeat serological testing of donor. Our investigations have shown that heat treatment at 80 degree C for a minimum of 10 minutes provides safe, good quality cancellous bone allografts and increases the cost-effectiveness and simplicity of managing a hospital frozen femoral head bone bank. Human femoral head centers were contaminated with different vegetative bacterial and viral suspensions. A core temperature of 80 degree C for 10 minutes was sufficient to fully inactivate 3 x 106 ml Staphylococcus aureus and Streptococcus faecalis, and >5 loglo steps of cytomeglia (herpes group), polio (enterovirus), and yellow fever (arbovirus) viruses. A one hour treatment in a water bath set at 80 degree sufficient to fully inactivate E. coli, proteus vulgaris, and Pseudomonas aerog. vegetative suspensions; 20 minutes was sufficient to fully inactivate the D antigen (rhesus factor) but had no effect on A or B antigens. Several biomechanical and biological properties of bone following a one hour treatment in a water bath set at 80 degree C were investigated. Employing compression and tension tests, 80 degree C treated human and porcine cancellous bone blocks showed reductions in properties ranging from 8-19% compared to untreated control groups. Osteointegration at 3 months following treatment of explanted and then reimplanted autograft rat diaphyseal segment was 15% less than untreated controls. Subsequently, a thermal disinfection system for femoral heads from living donors (Lobator Marburg Bone Bank System, Telos GmbH, Hungen, Germany) was developed. A

  9. Radiation-related small head sizes among prenatally exposed atomic bomb survivors

    International Nuclear Information System (INIS)

    Otaki, Masanori; Schull, William J.

    2004-01-01

    The population prenatally exposed to the atomic bombings of Hiroshima and Nagasaki, referred to as the In Utero Clinical Sample, on whom Dosimetry System 1986 doses are available consists of 1566 individuals (1242 in Hiroshima and 324 in Nagasaki). Of these study subjects, 1473 had the circumference of their heads measured at least once between ages 9 to 19. Among these 1473 individuals, 62 had small heads - the circumference of the head was two standard deviations or more below the observed specific age-at-measurement mean. Twenty-six of the 30 cases with severe mental retardation described elsewhere are included among these subjects. Of these 26 severely mentally retarded cases, 15 (58%) had small heads. Most (86%) of the individuals with small heads were exposed in the first or second trimester of pregnancy - 55% in the former period and 31% in the latter. Various dose-response relationships, with and without a threshold, have been fitted to the data grouped by the trimester or postovulatory age (weeks after ovulation) at which exposure occurred. A significant effect of radiation on the frequency of individuals with atypically small heads is observed only in the first and second trimesters and for the intervals postovulation of 0-7 weeks and 8-15 weeks. Although the risk of a small head at 0-7 weeks postovulation increases significantly with increasing dose, no increase in risk for severe mental retardation is noted in this period. No excess risk of a small head was seen in the third trimester or among individuals exposed at ≥ 16 weeks postovulation. The estimated threshold, based either on a linear or a linear-quadratic dose-response relationship, is zero or thereabouts. This apparent absence of a threshold and the somewhat different periods of vulnerability suggest an embryological difference in the development of both a small head and mental retardation. Mean IQ (using the Koga test) and its standard deviation are 63.8 and 8.5, respectively, for the

  10. Vessel head penetrations: French approach for maintenance in the PLIM program

    International Nuclear Information System (INIS)

    Champigny, F.

    2002-01-01

    Full text: In 1991, in the Bugey nuclear power plant, for the first time a leak occurred at the level of a vessel head penetration made with base nickel alloy (Inconel 600). This leak was caused by a primary stress corrosion cracking coming from inside the penetration tube. The crack was trough wall extent and primary fluid went out from the top of the vessel head. Immediately, Electricite de France launched important research programs and expertise in order to understand the root causes and propose solutions to this problem. The root causes confirmed PWSCC, and in the same time solutions for repair were studied and an inspection program was established to check the base metal of other vessel head penetrations. After several tests, repair solutions were abandoned because of their high costs (financial and dosimetry). EDF decided to replace all the vessel heads with Inconel 600 penetrations. Non destructive developments leaded to use eddy currents for detection and characterization but also televisual techniques to confirm. In a second step, in order to inspect without removing the inside thermal sleeve, eddy current and ultrasonic sword probes were achieved and used to inspect all vessel heads penetrations. Up to now, 75% of the vessel head have been replaced on the 900 MW and 1300 MW fleets but to replace wisely the last vessel heads EDF continues to perform NDE of the penetrations on the basis of safety criteria. This paper describes the different steps of the applied policy in France, NDE methods, criteria and the results obtained. (author)

  11. Assessment of a head support system to prevent pediatric out-of-position: an observational study.

    Science.gov (United States)

    Lopez-Valdes, Francisco J; Forman, Jason L; Ash, Joseph H; Kent, Richard; Alba, Juan J; Segui-Gomez, Maria

    Head injuries are the most common severe injuries sustained by pediatric occupants in road traffic crashes. Preventing children from adopting positions that can result in an increased injury risk due to unfavorable interactions with the restraints is fundamental. The objective of this paper was to assess the effect of a head support system (SS) on the lateral position of the head, the vertical position of the sternum and the shoulder belt fit. Thirty pediatric rear-seat passengers were exposed to two 75-minute trials. Volunteers were restrained by a three-point belt and, if needed, used the appropriate child restraint system for their anthropometry (high-back booster, low-back booster, no booster). A case crossover study was designed in which the volunteers used the head support system (SS) during one of the trials, acting as their own controls (No SS) in the other. Compared to the control group, the head support reduced significantly the 90(th) percentile value of the absolute value of the relative lateral motion of the head, regardless of the restraint used. The system also reduced the maximum downward position of the sternal notch within the low-back booster group. As for the belt fit, the use of the head support improved significantly the position of the shoulder belt on the occupant in the low-back booster and in the no booster groups.

  12. Making the most of the imaging we have: using head MRI to estimate body composition

    International Nuclear Information System (INIS)

    Lack, C.M.; Lesser, G.J.; Umesi, U.N.; Bowns, J.; Chen, M.Y.; Case, D.; Hightower, R.C.; Johnson, A.J.

    2016-01-01

    Aim: To investigate the use of clinical head magnetic resonance imaging (MRI) in determining body composition and to evaluate how well it correlates with established measures based on abdominal computed tomography (CT). Materials and methods: Ninety-nine consecutive patients were identified who had undergone both brain MRI and abdominal CT within a 2-week span. Volumes of fat and muscle in the extracranial head were measured utilising several techniques by both abdominal CT and head MRI. Results: MRI-based total fat volumes in the head correlated with CT-based measurements of fat in the abdomen using both single-section (r=0.64, p<0.01) and multisection (r=0.60, p<0.01) techniques. No significant correlation was found between muscle volumes in the abdomen and head. Conclusion: Based on the present results, head MRI-based measures may provide a useful surrogate for CT measurements of abdominal fat, particularly in patients with neurological cancers, as head MRI (and not abdominal CT) is routinely and repeatedly obtained for the purpose of clinical care for these patients. - Highlights: • We compared body composition using brain MRI with previously proven abdominal CT. • Fat and muscle volumes of the extracranial compartment can be measured by MRI. • Muscle volume in the face does not correlate with abdominal muscle volume. • Fat volume in the face can be used as a surrogate for abdominal fat volume.

  13. Resting position of the head and malocclusion in a group of patients with cerebral palsy

    Science.gov (United States)

    Martinez-Mihi, Victoria; Orellana, Lorena M.; Silvestre-Rangil, Javier

    2014-01-01

    Cerebral palsy are found as a result of these disorders, along with associated neuromuscular functional alterations that affect the resting position of the head. In this context, the resting position of the head could be responsible for several skeletal and dental occlusal disorders among patients with cerebral palsy. Objective: To assess the presence of malocclusions in patients with cerebral palsy, define the most frequent types of malocclusions, and evaluate how the resting position of the head may be implicated in the development of such malocclusions. Study design: Forty-four patients aged between 12-55 years (18 males and 26 females) were studied. Occlusal conditions, the Dental Aesthetic Index (DAI), changes in the resting position of the head, and breathing and swallowing functions were assessed. Results: Orthodontic treatment was required by 70.8% of the patients, the most frequent malocclusions being molar class II, open bite and high overjet. These individuals showed altered breathing and swallowing functions, as well as habit and postural disorders. The resting position of the head, especially the hyperextended presentation, was significantly correlated to high DAI scores. Conclusions: The results obtained suggest that patients with cerebral palsy are more susceptible to present malocclusions, particularly molar class II malocclusion, increased open bite, and high overjet. Such alterations in turn are more common in patients with a hyperextended position of the head. Key words:Cerebral palsy, malocclusion, head position, disabled patients. PMID:24596627

  14. Gender differences in head-neck segment dynamic stabilization during head acceleration.

    Science.gov (United States)

    Tierney, Ryan T; Sitler, Michael R; Swanik, C Buz; Swanik, Kathleen A; Higgins, Michael; Torg, Joseph

    2005-02-01

    Recent epidemiological research has revealed that gender differences exist in concussion incidence but no study has investigated why females may be at greater risk of concussion. Our purpose was to determine whether gender differences existed in head-neck segment kinematic and neuromuscular control variables responses to an external force application with and without neck muscle preactivation. Forty (20 females and 20 males) physically active volunteers participated in the study. The independent variables were gender, force application (known vs unknown), and force direction (forced flexion vs forced extension). The dependent variables were kinematic and EMG variables, head-neck segment stiffness, and head-neck segment flexor and extensor isometric strength. Statistical analyses consisted of multiple multivariate and univariate analyses of variance, follow-up univariate analyses of variance, and t-tests (P Gender differences existed in head-neck segment dynamic stabilization during head angular acceleration. Females exhibited significantly greater head-neck segment peak angular acceleration (50%) and displacement (39%) than males despite initiating muscle activity significantly earlier (SCM only) and using a greater percentage of their maximum head-neck segment muscle activity (79% peak activity and 117% muscle activity area). The head-neck segment angular acceleration differences may be because females exhibited significantly less isometric strength (49%), neck girth (30%), and head mass (43%), resulting in lower levels of head-neck segment stiffness (29%). For our subject demographic, the results revealed gender differences in head-neck segment dynamic stabilization during head acceleration in response to an external force application. Females exhibited significantly greater head-neck segment peak angular acceleration and displacement than males despite initiating muscle activity earlier (SCM only) and using a greater percentage of their maximum head-neck segment

  15. Traumatic injuries: imaging of head injuries

    Energy Technology Data Exchange (ETDEWEB)

    Besenski, N. [Croatian Institute for Brain Research, Zagreb (Croatia)

    2002-06-01

    Due to the forces of acceleration, linear translation, as well as rotational and angular acceleration, the brain undergoes deformation and distortion depending on the site of impact of traumatizing force direction, severity of the traumatizing force, and tissue resistance of the brain. Linear translation of accereration in a closed-head injury can run along the shorter diameter of the skull in latero-lateral direction causing mostly extra-axial lesions (subdural hematoma,epidural hematoma, subarachnoidal hemorrhage) or quite pronounced coup and countercoup contusions. Contusions are considerably less frequently present in medial or paramedial centroaxial blows (fronto-occipital or occipito-frontal). The centroaxial blows produce a different pattern of lesions mostly in the deep structures, causing in some cases a special category of the brain injury, the diffuse axonal injury (DAI). The brain stem can also be damaged, but it is damaged more often in patients who have suffered centroaxial traumatic force direction. Computed tomography and MRI are the most common techniques in patients who have suffered brain injury. Computed tomography is currently the first imaging technique to be used after head injury, in those settings where CT is available. Using CT, scalp, bone, extra-axial hematomas, and parenchymal injury can be demonstrated. Computed tomography is rapid and easily performed also in monitored patients. It is the most relevant imaging procedure for surgical lesions. Computed tomography is a suitable method to follow the dynamics of lesion development giving an insight into the corresponding pathological development of the brain injury. Magnetic resonance imaging is more sensitive for all posttraumatic lesions except skull fractures and subarachnoidal hemorrhage, but scanning time is longer, and the problem with the monitoring of patients outside the MRI field is present. If CT does not demonstrate pathology as can adequately be explained to account for

  16. Traumatic injuries: imaging of head injuries

    International Nuclear Information System (INIS)

    Besenski, N.

    2002-01-01

    Due to the forces of acceleration, linear translation, as well as rotational and angular acceleration, the brain undergoes deformation and distortion depending on the site of impact of traumatizing force direction, severity of the traumatizing force, and tissue resistance of the brain. Linear translation of accereration in a closed-head injury can run along the shorter diameter of the skull in latero-lateral direction causing mostly extra-axial lesions (subdural hematoma,epidural hematoma, subarachnoidal hemorrhage) or quite pronounced coup and countercoup contusions. Contusions are considerably less frequently present in medial or paramedial centroaxial blows (fronto-occipital or occipito-frontal). The centroaxial blows produce a different pattern of lesions mostly in the deep structures, causing in some cases a special category of the brain injury, the diffuse axonal injury (DAI). The brain stem can also be damaged, but it is damaged more often in patients who have suffered centroaxial traumatic force direction. Computed tomography and MRI are the most common techniques in patients who have suffered brain injury. Computed tomography is currently the first imaging technique to be used after head injury, in those settings where CT is available. Using CT, scalp, bone, extra-axial hematomas, and parenchymal injury can be demonstrated. Computed tomography is rapid and easily performed also in monitored patients. It is the most relevant imaging procedure for surgical lesions. Computed tomography is a suitable method to follow the dynamics of lesion development giving an insight into the corresponding pathological development of the brain injury. Magnetic resonance imaging is more sensitive for all posttraumatic lesions except skull fractures and subarachnoidal hemorrhage, but scanning time is longer, and the problem with the monitoring of patients outside the MRI field is present. If CT does not demonstrate pathology as can adequately be explained to account for

  17. Severe accident phenomena

    International Nuclear Information System (INIS)

    Jokiniemi, J.; Kilpi, K.; Lindholm, I.; Maekynen, J.; Pekkarinen, E.; Sairanen, R.; Silde, A.

    1995-02-01

    Severe accidents are nuclear reactor accidents in which the reactor core is substantially damaged. The report describes severe reactor accident phenomena and their significance for the safety of nuclear power plants. A comprehensive set of phenomena ranging from accident initiation to containment behaviour and containment integrity questions are covered. The report is based on expertise gained in the severe accident assessment projects conducted at the Technical Research Centre of Finland (VTT). (49 refs., 32 figs., 12 tabs.)

  18. [Case of exploding head syndrome].

    Science.gov (United States)

    Okura, Mutsumi; Taniguchi, Mitsutaka; Muraki, Hisae; Sugita, Hideko; Ohi, Motoharu

    2010-01-01

    Exploding head syndrome (EHS) attacks are characterized by the sensation of sudden loud banging noises, and are occasionally accompanied by the sensation of a flash light. Although these attacks in themselves are usually not painful, it is reported that EHS attacks may precede migraines and may be perceived as auras. A 53-year-old woman, with a 40-year history of fulgurating migraines, experienced 2 different types of EHS attacks. During most of the attacks, which were not painful, she heard sounds like someone yelling or cars passing by. Only 1 episode was accompanied with the sensation of a flash light and of sounds similar to those of an electrical short circuit. On the video-polysomnography, video-polysomnography showed 11 EHS attacks occurred during stage N1 and stage N2; these attacks were preceded by soft snoring. She also had moderate obstructive sleep apnea syndrome (Apnea Hypopnea Index: 16.7) for which an oral appliance was prescribed; the EHS attacks did not recur after this treatment. The pathophysiology of EHS is still unclear. A detailed analysis of PSG data may help in understanding the pathophysiology of this syndrome and also in the selection of therapeutic strategies.

  19. [Head and neck adaptive radiotherapy].

    Science.gov (United States)

    Graff, P; Huger, S; Kirby, N; Pouliot, J

    2013-10-01

    Onboard volumetric imaging systems can provide accurate data of the patient's anatomy during a course of head and neck radiotherapy making it possible to assess the actual delivered dose and to evaluate the dosimetric impact of complex daily positioning variations and gradual anatomic changes such as geometric variations of tumors and normal tissues or shrinkage of external contours. Adaptive radiotherapy is defined as the correction of a patient's treatment planning to adapt for individual variations observed during treatment. Strategies are developed to selectively identify patients that require replanning because of an intolerable dosimetric drift. Automated tools are designed to limit time consumption. Deformable image registration algorithms are the cornerstones of these strategies, but a better understanding of their limits of validity is required before adaptive radiotherapy can be safely introduced to daily practice. Moreover, strict evaluation of the clinical benefits is yet to be proven. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  20. Head circumference in Iranian infants

    Directory of Open Access Journals (Sweden)

    Mohammad Esmaeili

    2015-03-01

    Full Text Available Introduction: Head circumference (HC measurement is one of the important parameter for diagnosis of neurological, developmental disorders and dysmorphic syndromes. Recognition of different disorders requires an understanding of normal variation for HC size, in particular, in infancy period with most rapid growth of the brain. Because of international and interracial standard chart differences about anthropometric indices, some differences from local to local, generation to generation and changes in ethnic mix of population and socioeconomic factors, periodic revolution of HC size is suggested. The aims of our study were presenting local HC standard for an Iranian infant population and comparison with the American national center of health statistics (NCHS charts accepted by WHO. Methods: 1003 subjects aged from birth to 24 months apparently healthy normal children enrolled randomly in this cross sectional study. HC size were measured and recorded. Tables and graphs were depicted by Excel Microsoft Office 2007. We use two tailed t-student test for statistical analysis. Results: The mean of HC size in boys was larger than girls. The curves were followed a similar pattern to NCHS based on a visual comparison. Overall our subjects in both sexes at birth time had smaller HC size than NCHS. In other ages our children had larger HC size than those of NCHS. Conclusion: Because of international and interracial difference of HC size. We recommend in each area of the world, local anthropometric indices are constructed and used clinically. In addition more extensive and longitudinally design comprehensive studies is suggested.

  1. Optimised intake stroke analysis for flat and dome head pistons ...

    African Journals Online (AJOL)

    Optimised intake stroke analysis for flat and dome head pistons. ... in understanding the performance characteristics optioned between flat head and dome head pistons in engine design. ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  2. Vestibular ablation and a semicircular canal prosthesis affect postural stability during head turns

    Science.gov (United States)

    Thompson, Lara A.; Haburcakova, Csilla; Lewis, Richard F.

    2016-01-01

    In our study, we examined postural stability during head turns for two rhesus monkeys: one, single animal study contrasted normal and mild bilateral vestibular ablation and a second animal study contrasted severe bilateral vestibular ablation with and without prosthetic stimulation. The monkeys freely stood, unrestrained on a balance platform and made voluntary head turns between visual targets. To quantify each animals’ posture, motions of the head and trunk, as well as torque about the body’s center-of-mass, were measured. In the mildly ablated animal, we observed less foretrunk sway in comparison to the normal state. When the canal prosthesis provided electric stimulation to the severely ablated animal, it showed a decrease in trunk sway during head turns. Because the rhesus monkey with severe bilateral vestibular loss exhibited a decrease in trunk sway when receiving vestibular prosthetic stimulation, we propose that the prosthetic electrical stimulation partially restored head velocity information. Our results provide an indication that a semicircular canal prosthesis may be an effective way to improve postural stability in patients with severe peripheral vestibular dysfunction. PMID:27405997

  3. Multi-headed comparatives in Portuguese

    Directory of Open Access Journals (Sweden)

    Rui Marques

    2005-06-01

    Full Text Available This paper aims at offering a global picture of the subtype of comparative constructions known as ‘multi-headed comparatives’ (from the fact that they exhibit more than one comparative operator in semantic interdependence. As a prerequisite to the fulfilment of his goal, an attempt will be made to clarify the scope of the notion ‘comparative construction’ and to draw a general typology of such constructions. The boundaries of the notion ‘comparative construction’ are defined by contrasting a “genuine” class of comparative constructions with others that hold some syntactic or semantic resemblance to them. Different typologies will be taken into consideration. As for multi-headed comparatives, even though different examples of these constructions have been identified in the scarce literature on the matter, the discussion on their syntactic patterns and meaning is still embryonic. This paper suggests that the expressive power of these comparatives, which seem to provide a particular strategy of information compression, is higher than has been assumed. Four sub-kinds of multi-headed comparatives are identified, based on meaning differences, namely: multi-headed comparatives with a distributive reading, multi-headed comparatives with a cumulative reading, multi-headed comparatives with a comparison of ‘ratios’ reading, and multi-headed comparatives with a comparison of differences reading. While resorting to some classic English examples, the object language will predominantly be Portuguese.

  4. Subchondral insufficiency fractures of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Davies, M.; Cassar-Pullicino, V.N. [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom); Darby, A.J. [Department of Pathology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom)

    2004-02-01

    The aim of this study was to increase awareness of, and to show the variable clinical and radiological features of, subchondral insufficiency fractures of the femoral head. The clinical and radiological findings in 7 patients with subchondral insufficiency fractures of the femoral head were reviewed retrospectively. The diagnosis was confirmed histologically in 4 patients. Radiographs were performed in all patients, MRI in 5 and scintigraphy in 4 patients. Radiographs showed varying degrees of femoral head collapse in 4 patients. In the remaining 3 patients radiographs showed a normal femoral head, regional osteoporosis and focal sclerosis, respectively. Magnetic resonance imaging showed a low-signal band on T1- and T2-weighted images in the subchondral bone adjacent or parallel to the articular surface associated with bone marrow oedema. Scintigraphy showed increased uptake in the femoral head. Insufficiency fractures of the femoral head are easily overlooked or confused with avascular necrosis and, when there is significant joint destruction, osteoarthritis. Unsuspected insufficiency fracture of the femoral head can lead to significant and rapid loss of bone stock in osteoporotic patients waiting for arthroplasty for osteoarthritis. Increased awareness of this condition will hopefully lead to earlier diagnosis and a successful outcome of conservative treatment. (orig.)

  5. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... from the contrast material, including nausea, headache and pain at the site of injection. Similarly, patients are ... If you are anxious, confused or in severe pain, you may find it difficult to lie still ...

  6. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... any recent surgeries. Some conditions, such as severe kidney disease, may prevent you from being given gadolinium contrast ... an MRI. If you have a history of kidney disease or liver transplant, it will be necessary to ...

  7. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you ... problems, or if you have had any recent surgeries. Some conditions, such as severe kidney disease, may ...

  8. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... be present in your body due to prior accidents. Foreign bodies near and especially lodged in the ... recorded. If you are anxious, confused or in severe pain, you may find it difficult to lie ...

  9. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... data suggest that it is safe to continue breastfeeding after receiving intravenous contrast. For further information please ... If you are anxious, confused or in severe pain, you may find it difficult to lie still ...

  10. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... will be removed. MRI exams generally include multiple runs (sequences), some of which may last several minutes. ... top of page Who interprets the results and how do I get them? A radiologist, a physician ...

  11. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... Most MRI exams are painless. However, some patients find it uncomfortable to remain still during MR imaging. ... anxious, confused or in severe pain, you may find it difficult to lie still during imaging. A ...

  12. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... MRI exam, a physician, nurse or technologist will insert an intravenous (IV) catheter, also known as an ... physicians with expertise in several radiologic areas. Outside links: For the convenience of our users, RadiologyInfo .org ...

  13. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... of many conditions, including tumors. MRI enables the discovery of abnormalities that might be obscured by bone ... Radiology (ACR) and the Radiological Society of North America (RSNA), comprising physicians with expertise in several radiologic ...

  14. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... any recent surgeries. Some conditions, such as severe kidney disease, may prevent you from being given gadolinium ... an MRI. If you have a history of kidney disease or liver transplant, it will be necessary ...

  15. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... Radiology (ACR) and the Radiological Society of North America (RSNA), comprising physicians with expertise in several radiologic ... Site Map Copyright © 2018 Radiological Society of North America, Inc. (RSNA). To help ensure current and accurate ...

  16. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... as severe kidney disease, may prevent you from being given gadolinium contrast for an MRI. If you ... of time after placement (usually six weeks) before being safe for MRI examinations. Examples include but are ...

  17. Less head motion during MRI under task than resting-state conditions.

    Science.gov (United States)

    Huijbers, Willem; Van Dijk, Koene R A; Boenniger, Meta M; Stirnberg, Rüdiger; Breteler, Monique M B

    2017-02-15

    Head motion reduces data quality of neuroimaging data. In three functional magnetic resonance imaging (MRI) experiments we demonstrate that people make less head movements under task than resting-state conditions. In Experiment 1, we observed less head motion during a memory encoding task than during the resting-state condition. In Experiment 2, using publicly shared data from the UCLA Consortium for Neuropsychiatric Phenomics LA5c Study, we again found less head motion during several active task conditions than during a resting-state condition, although some task conditions also showed comparable motion. In the healthy controls, we found more head motion in men than in women and more motion with increasing age. When comparing clinical groups, we found that patients with a clinical diagnosis of bipolar disorder, or schizophrenia, move more compared to healthy controls or patients with ADHD. Both these experiments had a fixed acquisition order across participants, and we could not rule out that a first or last scan during a session might be particularly prone to more head motion. Therefore, we conducted Experiment 3, in which we collected several task and resting-state fMRI runs with an acquisition order counter-balanced. The results of Experiment 3 show again less head motion during several task conditions than during rest. Together these experiments demonstrate that small head motions occur during MRI even with careful instruction to remain still and fixation with foam pillows, but that head motion is lower when participants are engaged in a cognitive task. These finding may inform the choice of functional runs when studying difficult-to-scan populations, such as children or certain patient populations. Our findings also indicate that differences in head motion complicate direct comparisons of measures of functional neuronal networks between task and resting-state fMRI because of potential differences in data quality. In practice, a task to reduce head motion

  18. De-severing distance

    DEFF Research Database (Denmark)

    Jensen, Hanne Louise; de Neergaard, Maja

    2016-01-01

    De-severing Distance This paper draws on the growing body of mobility literature that shows how mobility can be viewed as meaningful everyday practices (Freudendal –Pedersen 2007, Cresswell 2006) this paper examines how Heidegger’s term de-severing can help us understand the everyday coping with ...

  19. Severe Bleeding: First Aid

    Science.gov (United States)

    ... 12, 2017. Jevon P, et al. Part 5 — First-aid treatment for severe bleeding. Nursing Times. 2008;104:26. Oct. 19, 2017 Original article: http://www.mayoclinic.org/first-aid/first-aid-severe-bleeding/basics/ART-20056661 . Mayo ...

  20. Allergy in severe asthma

    NARCIS (Netherlands)

    Del Giacco, Stefano R.; Bakirtas, A.; Bel, E.; Custovic, A.; Diamant, Z.; Hamelmann, E.; Heffler, E.; Kalayci, O.; Saglani, S.; Sergejeva, S.; Seys, S.; Simpson, A.; Bjermer, Leif

    It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term 'Severe Asthma' encompasses a highly heterogeneous group of patients who require treatment on steps

  1. Magnetic force microscopy study on wide adjacent track erasure in perpendicular magnetic write heads

    Science.gov (United States)

    Ruksasakchai, P.; Saengkaew, K.; Cheowanish, I.; Damrongsak, B.

    2017-09-01

    We used a phase-contrast magnetic force microscopy (MFM) to observe and analyze the failure of magnetic write heads due to the WATEr problem, which limits the off-track performance. During MFM imaging, the magnetic write head was energized by a DC current. The induced out-of-plane magnetic field was then detected by scanning a MFM probe across the surface of the magnetic write head. MFM images were then mapped with WATEr measured results from a spin stand method. Results showed that WATEr effect can be generated by several factors, i.e. the structure of magnetic domains and walls from material discontinuities and the magnetic field leakage at different locations on magnetic write heads. Understanding WATEr mechanisms is useful for design and process development engineers.

  2. Currency flaw severity. [Banknotes

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, C.; Burnett, M.; Goodman, C.; Sherrod, R.; Schmoyer, R.; Harrison, C.; Uppuluri, R.

    1986-01-01

    A survey of currency flaw severity was carried out using 300 banknotes and 37 judges. Each judge assigned each note to one of five flaw severity categories. These categories correspond to severity grades of 1 to 5 with 1 equivalent to ''always accepted'' and 5 ''never accepted.'' An average flaw severity grade for each note was obtained by taking the mean of the severity grades assigned to that note by the 37 judges. Thus, each note has a single numerical real-number flaw grade between 1 and 5. Mathematical modeling of the currency flaw survey results is continuing with some very promising initial results. Our present model handles common excess ink and missing ink flaw types quite well. We plan to extend the model to ink level, mash, setoff and blanket impression flaw types.

  3. [Natural head position's reproducibility on photographs].

    Science.gov (United States)

    Eddo, Marie-Line; El Hayeck, Émilie; Hoyeck, Maha; Khoury, Élie; Ghoubril, Joseph

    2017-12-01

    The purpose of this study is to evaluate the reproducibility of natural head position with time on profile photographs. Our sample is composed of 96 students (20-30 years old) at the department of dentistry of Saint Joseph University in Beirut. Two profile photographs were taken in natural head position about a week apart. No significant differences were found between T0 and T1 (E = 1.065°). Many studies confirmed this reproducibility with time. Natural head position can be adopted as an orientation for profile photographs in orthodontics. © EDP Sciences, SFODF, 2017.

  4. Experimental test of spatial updating models for monkey eye-head gaze shifts.

    Directory of Open Access Journals (Sweden)

    Tom J Van Grootel

    Full Text Available How the brain maintains an accurate and stable representation of visual target locations despite the occurrence of saccadic gaze shifts is a classical problem in oculomotor research. Here we test and dissociate the predictions of different conceptual models for head-unrestrained gaze-localization behavior of macaque monkeys. We adopted the double-step paradigm with rapid eye-head gaze shifts to measure localization accuracy in response to flashed visual stimuli in darkness. We presented the second target flash either before (static, or during (dynamic the first gaze displacement. In the dynamic case the brief visual flash induced a small retinal streak of up to about 20 deg at an unpredictable moment and retinal location during the eye-head gaze shift, which provides serious challenges for the gaze-control system. However, for both stimulus conditions, monkeys localized the flashed targets with accurate gaze shifts, which rules out several models of visuomotor control. First, these findings exclude the possibility that gaze-shift programming relies on retinal inputs only. Instead, they support the notion that accurate eye-head motor feedback updates the gaze-saccade coordinates. Second, in dynamic trials the visuomotor system cannot rely on the coordinates of the planned first eye-head saccade either, which rules out remapping on the basis of a predictive corollary gaze-displacement signal. Finally, because gaze-related head movements were also goal-directed, requiring continuous access to eye-in-head position, we propose that our results best support a dynamic feedback scheme for spatial updating in which visuomotor control incorporates accurate signals about instantaneous eye- and head positions rather than relative eye- and head displacements.

  5. Meta-analytic evaluation of the association between head injury and risk of amyotrophic lateral sclerosis.

    Science.gov (United States)

    Watanabe, Yukari; Watanabe, Takamitsu

    2017-10-01

    Head injury is considered as a potential risk factor for amyotrophic lateral sclerosis (ALS). However, several recent studies have suggested that head injury is not a cause, but a consequence of latent ALS. We aimed to evaluate such a possibility of reverse causation with meta-analyses considering time lags between the incidence of head injuries and the occurrence of ALS. We searched Medline and Web of Science for case-control, cross-sectional, or cohort studies that quantitatively investigated the head-injury-related risk of ALS and were published until 1 December 2016. After selecting appropriate publications based on PRISMA statement, we performed random-effects meta-analyses to calculate odds ratios (ORs) and 95% confidence intervals (CI). Sixteen of 825 studies fulfilled the eligibility criteria. The association between head injuries and ALS was statistically significant when the meta-analysis included all the 16 studies (OR 1.45, 95% CI 1.21-1.74). However, in the meta-analyses considering the time lags between the experience of head injuries and diagnosis of ALS, the association was weaker (OR 1.21, 95% CI 1.01-1.46, time lag ≥ 1 year) or not significant (e.g. OR 1.16, 95% CI 0.84-1.59, time lag ≥ 3 years). Although it did not deny associations between head injuries and ALS, the current study suggests a possibility that such a head-injury-oriented risk of ALS has been somewhat overestimated. For more accurate evaluation, it would be necessary to conduct more epidemiological studies that consider the time lags between the occurrence of head injuries and the diagnosis of ALS.

  6. Rotational acceleration during head impact resulting from different judo throwing techniques.

    Science.gov (United States)

    Murayama, Haruo; Hitosugi, Masahito; Motozawa, Yasuki; Ogino, Masahiro; Koyama, Katsuhiro

    2014-01-01

    Most severe head injuries in judo are reported as acute subdural hematoma. It is thus necessary to examine the rotational acceleration of the head to clarify the mechanism of head injuries. We determined the rotational acceleration of the head when the subject is thrown by judo techniques. One Japanese male judo expert threw an anthropomorphic test device using two throwing techniques, Osoto-gari and Ouchi-gari. Rotational and translational head accelerations were measured with and without an under-mat. For Osoto-gari, peak resultant rotational acceleration ranged from 4,284.2 rad/s(2) to 5,525.9 rad/s(2) and peak resultant translational acceleration ranged from 64.3 g to 87.2 g; for Ouchi-gari, the accelerations respectively ranged from 1,708.0 rad/s(2) to 2,104.1 rad/s(2) and from 120.2 g to 149.4 g. The resultant rotational acceleration did not decrease with installation of an under-mat for both Ouchi-gari and Osoto-gari. We found that head contact with the tatami could result in the peak values of translational and rotational accelerations, respectively. In general, because kinematics of the body strongly affects translational and rotational accelerations of the head, both accelerations should be measured to analyze the underlying mechanism of head injury. As a primary preventative measure, throwing techniques should be restricted to participants demonstrating ability in ukemi techniques to avoid head contact with the tatami.

  7. Sperm head's birefringence: a new criterion for sperm selection.

    Science.gov (United States)

    Gianaroli, Luca; Magli, M Cristina; Collodel, Giulia; Moretti, Elena; Ferraretti, Anna P; Baccetti, Baccio

    2008-07-01

    To investigate the characteristics of birefringence in human sperm heads and apply polarization microscopy for sperm selection at intracytoplasmic sperm injection (ICSI). Prospective randomized study. Reproductive Medicine Unit, Società Italiana Studi Medicina della Riproduzione, Bologna, Italy. A total of 112 male patients had birefringent sperm selected for ICSI (study group). The clinical outcome was compared with that obtained in 119 couples who underwent a conventional ICSI cycle (control group). The proportion of birefringent spermatozoa was evaluated before and after treatment in relation to the sperm sample quality. Embryo development and clinical outcome in the study group were compared with those in the controls. Proportion of birefringent sperm heads, rates of fertilization, cleavage, pregnancy, implantation, and ongoing implantation. The proportion of birefringent spermatozoa was significantly higher in normospermic samples when compared with oligoasthenoteratospermic samples with no progressive motility and testicular sperm extraction samples. Although fertilization and cleavage rates did not differ between the study and control groups, in the most severe male factor condition (oligoasthenoteratospermic with no progressive motility and testicular sperm extraction), the rates of clinical pregnancy, ongoing pregnancy, and implantation were significantly higher in the study group versus the controls. The analysis of birefringence in the sperm head could represent both a diagnostic tool and a novel method for sperm selection.

  8. A prospective study of fetal head growth, autistic traits and autism spectrum disorder

    Science.gov (United States)

    Blanken, Laura M. E.; Dass, Alena; Alvares, Gail; van der Ende, Jan; Schoemaker, Nikita K.; El Marroun, Hanan; Hickey, Martha; Pennell, Craig; White, Scott; Maybery, Murray T.; Dissanayake, Cheryl; Jaddoe, Vincent W. V.; Verhulst, Frank C.; Tiemeier, Henning; McIntosh, Will; Whitehouse, Andrew

    2018-01-01

    Altered trajectories of brain growth are often reported in Autism Spectrum Disorder (ASD), particularly during the first year of life. However, less is known about prenatal head growth trajectories, and no study has examined the relation with postnatal autistic symptom severity. The current study prospectively examined the association between fetal head growth and the spectrum of autistic symptom severity in two large population‐based cohorts, including a sample of individuals with clinically diagnosed ASD. This study included 3,820 children from two longitudinal prenatal cohorts in The Netherlands and Australia, comprising 60 individuals with a confirmed diagnosis of ASD. Latent growth curve models were used to examine the relationship between fetal head circumference measured at three different time points and autistic traits measured in postnatal life using either the Social Responsiveness Scale or the Autism‐Spectrum Quotient. While lower initial prenatal HC was weakly associated with increasing autistic traits in the Dutch cohort, this relationship was not observed in the Australian cohort, nor when the two cohorts were analysed together. No differences in prenatal head growth were found between individuals with ASD and controls. This large population‐based study identified no consistent association across two cohorts between prenatal head growth and postnatal autistic traits. Our mixed findings suggest that further research in this area is needed. Autism Res 2018, 11: 602–612. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Lay Summary It is not known whether different patterns of postnatal brain growth in Autism Spectrum Disorder (ASD) also occurs prenatally. We examined fetal head growth and autistic symptoms in two large groups from The Netherlands and Australia. Lower initial prenatal head circumference was associated with autistic traits in the Dutch, but not the Australian

  9. Post-heading heat stress and yield impact in winter wheat of China.

    Science.gov (United States)

    Liu, Bing; Liu, Leilei; Tian, Liying; Cao, Weixing; Zhu, Yan; Asseng, Senthold

    2014-02-01

    Wheat is sensitive to high temperatures, but the spatial and temporal variability of high temperature and its impact on yield are often not known. An analysis of historical climate and yield data was undertaken to characterize the spatial and temporal variability of heat stress between heading and maturity and its impact on wheat grain yield in China. Several heat stress indices were developed to quantify heat intensity, frequency, and duration between heading and maturity based on measured maximum temperature records of the last 50 years from 166 stations in the main wheat-growing region of China. Surprisingly, heat stress between heading and maturity was more severe in the generally cooler northern wheat-growing regions than the generally warmer southern regions of China, because of the delayed time of heading with low temperatures during the earlier growing season and the exposure of the post-heading phase into the warmer part of the year. Heat stress between heading and maturity has increased in the last decades in most of the main winter wheat production areas of China, but the rate was higher in the south than in the north. The correlation between measured grain yields and post-heading heat stress and average temperature were statistically significant in the entire wheat-producing region, and explained about 29% of the observed spatial and temporal yield variability. A heat stress index considering the duration and intensity of heat between heading and maturity was required to describe the correlation of heat stress and yield variability. Because heat stress is a major cause of yield loss and the number of heat events is projected to increase in the future, quantifying the future impact of heat stress on wheat production and developing appropriate adaptation and mitigation strategies are critical for developing food security policies in China and elsewhere. © 2013 John Wiley & Sons Ltd.

  10. Severe childhood malnutrition

    DEFF Research Database (Denmark)

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J

    2017-01-01

    The main forms of childhood malnutrition occur predominantly in children malnutrition. Here, we use...... the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal...... nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide...

  11. TMI-2 reactor vessel head removal

    International Nuclear Information System (INIS)

    Bengel, P.R.; Smith, M.D.; Estabrook, G.A.

    1984-12-01

    This report describes the safe removal and storage of the Three Mile Island Unit 2 reactor vessel head. The head was removed in July 1984 to permit the removal of the plenum and the reactor core, which were damaged during the 1979 accident. From July 1982, plans and preparations were made using a standard head removal procedure modified by the necessary precautions and changes to account for conditions caused by the accident. After data acquisition, equipment and structure modifications, and training the head was safely removed and stored and the internals indexing fixture and a work platform were installed on top of the vessel. Dose rates during and after the operation were lower than expected; lessons were learned from the operation which will be applied to the continuing fuel removal operations activities

  12. Engineering science and mechanics department head named

    OpenAIRE

    Nystrom, Lynn A.

    2004-01-01

    Ishwar K. Puri, professor of mechanical engineering and executive associate dean of engineering at the University of Illinois at Chicago, will become the head of Virginia Tech•À_ó»s Department of Engineering Science and Mechanics Aug. 1.

  13. "Head õhtut ja õnn kaasa" / Triin Thalheim

    Index Scriptorium Estoniae

    Thalheim, Triin, 1982-

    2006-01-01

    George Clooney mängufilm "Head õhtut ja õnn kaasa" ("Good Night, and Good Luck") teleajakirjanik Edward R. Murrow võitlusest senaator Joseph McCarthy vastu. Lisatud "Filmi ajaloolised võtmetegelased"

  14. Head Lice: Malathion Frequently Asked Questions

    Science.gov (United States)

    ... be checked for signs of infestation. Does malathion kill head lice eggs? Yes. The malathion lotion (Ovide*) ... Privacy FOIA No Fear Act OIG 1600 Clifton Road Atlanta , GA 30329-4027 USA 800-CDC-INFO ( ...

  15. Drugs Approved for Head and Neck Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for head and neck cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  16. Heidbreder to head Office of Legal Counsel

    OpenAIRE

    Hincker, Lawrence

    2006-01-01

    Kay Heidbreder of Blacksburg, has been appointed University Counsel by the Virginia Attorney General and will head the university's legal office. Heidbreder, who holds the position of assistant attorney general, has been associate general counsel at Virginia Tech since 1985.

  17. TMI-2 reactor vessel head removal

    International Nuclear Information System (INIS)

    Bengel, P.R.; Smith, M.D.; Estabrook, G.A.

    1985-09-01

    This report describes the safe removal and storage of the Three Mile Island Unit 2 (TMI-2) reactor vessel head. The head was removed in July 1984 to permit the removal of the plenum and the reactor core, which were damaged during the 1979 accident. From July 1982, plans and preparations were made using a standard head removal procedure modified by the necessary precautions and changes to account for conditions caused by the accident. After data acquisition, equipment and structure modifications, and training, the head was safely removed and stored; and the internals indexing fixture and a work platform were installed on top of the vessel. Dose rates during and after the operation were lower than expected; lessons were learned from the operation which will be applied to the continuing fuel removal operations activities

  18. Achieving Consensus Through Professionalized Head Nods

    DEFF Research Database (Denmark)

    Oshima, Sae

    2014-01-01

    of nodding in a particular professional-client setting, namely, hair salon interactions. My interest specifically lies in the frequent occurrence of synchronized head nods during the “service-assessment sequence,” where both service provider and customer inspect and determine whether the completed work...... is adequate. I pursue mechanisms of synchronized head nods by revealing exactly how participants collaborate in producing a nod, and how their verbal actions may at times be designed accordingly. In doing so, the study provides insight into what consensus may look like at service encounters in Japan......While the interactional functions of head nodding in everyday Japanese conversation have been frequently studied, a discourse on head nodding as a professional communicative practice has yet to be explored. With the method of multimodal conversation analysis, the current study examines the role...

  19. Transfer Pricing; Charging of head office costs

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, Joergen

    1998-07-01

    The key issues discussed in this presentation are (1) What are head office costs?, (2) Why is the charging an area of concern for international companies?, (3) Which part of head office costs should be charged?, (4) OECD guidelines on charging. Head office costs are classified as Shareholder costs, Stewardship costs, Costs related to a specific subsidiary or group of subsidiaries (on call), and Costs related to operational activities in the parent company. The OECD reports of 1984 and 1996 are discussed. In Norsk Hydro's experience, the practising of the OECD guidelines by national authorities are confusing and not consistent over time or across borders. To get a better understanding of how charging of corporate head office costs are dealt with on an international level, Norsk Hydro asked Deloitte and Touche in London to carry out a study on international companies' behaviour. Their conclusions are included.

  20. Unusual Cancers of the Head and Neck

    Science.gov (United States)

    ... more information). Unusual Cancers of the Head and Neck Nasopharyngeal Cancer See the PDQ summary on Childhood ... of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ ...